Medicine

Question 1

Hippocrates

Answer 1

460BC - 370BC
Ancient Greek doctor famous for using natural explanations of disease and the four humours.
He was significant because his ideas continued to be the basis for the beliefs about the causes of disease and the treatments of illness.
He wrote over 60 books.

Question 2

Galen

Answer 2

130 AD - 210 AD
He dissected animals for anatomical discovery.
The church supported his ideas, therefore he was rarely challenged.

Question 3

Rhazes

Answer 3

865 - 925
Encouraged careful observation and wrote over 150 books.
Wrote a book called Doubts on Galen
Distinguished measles from smallpox for the first time.

Question 4

Avicenna

Answer 4

980 - 1037
His book was used as the standard European textbook
Wrote the Canon of medicine
Listed the medical properties of 760 different drugs
He discussed anorexia and obesity.

Question 5

John of Arderne

Answer 5

1307 - 1392
Set up the Guild of Surgeons in 1368
Surgical manual Practica (1376) based on his experience in the hundred years war. Showed illustrations of operations and instruments to help other surgeons.
Specialised in operations for anal abscess.

Question 6

Vesalius

Answer 6

1514 - 1564
The Fabric of the Human Body (1543)
A very accurate textbook based on dissections of the human body. He corrected Galen’s mistakes as he dissected animals. Provided proof of Galen’s mistakes - breastbone in human has three parts, not seven as in an ape.
Basis for better treatments in the future. His illustrations were copied into a manual for barber-surgeons called Compendiosa.

Question 7

Pare

Answer 7

1510 - 90
1537 - improvised a cream of rose oil, egg white and turpentine in a battle.
He wrote a book on treating wounds in 1545
Pare tied blood vessels with ligatures to stop bleeding.
Designed false limbs for wounded soldiers - included drawings of false limbs in his books.
Translated Vesalius’s works.
Elizabeth’s surgeon William Clowes made Pare’s work well known - described Pare as a famous surgeon master. Copied Pare’s burn treatments and agreed that gunshots were not poisonous.

Question 8

Harvey

Answer 8

1578 - 1657
Challenged Galen by saying blood circulated around the body.
He dissected and studied human hearts.
Found that blood could only travel one way by pumping a liquid the wrong way through valves in the vein.
Published De Motu Cordis in 1628 - about the blood
Criticism of going against Galen and challenging the idea of bloodletting to balance the humours.
Significant later for transfusions in 1901 and testing blood allows doctors to quickly diagnose illness.

Question 9

Thomas Sydenham

Answer 9

1624 - 89
stressed the observation of symptoms and was critical of quack medicine.
Noted symptoms of scarlet fever and used iron for treating anaemia.
Ignored Harvey’s discoveries because they did not help in treating patients.
Still used bleeding
His book Medical Observations (1676) became a standard textbook

Question 10

Hunter

Answer 10

1728 - 93
Books based on his observations, dissection skill and experience in the army.
The natural history of teeth (1771)
On Venereal disease (1786)
Blood inflammation and gunshot wounds (1794)
He recommended not enlarging gunshot wounds when treating them
Demanded careful observation in surgery
Tried radical surgery - 1785 saved a man’s leg with a throbbing lump instead of amputation.
Experimented pumping wax into blood vessels to study circulation.

Question 11

Jenner

Answer 11

1749 - 1823
Country doctor in Gloucestershire
1796 - gave cowpox to 8 year old boy then gave him a smallpox inoculation.
No disease followed
First vaccination

Question 12

Simpson

Answer 12

1811 - 70
Discovered chloroform in 1847
Nitrous oxide and ether posed problems
Hannah Greener was the first person to die from chloroform

Question 13

Pasteur

Answer 13

1822 - 95
Proved that germs caused decay, not the other way round.
In 1884 - Pasteur produced a vaccine for rabies
1881 - vaccine for anthrax
1879 - an accidental use of weakened chicken cholera germs created the first chicken cholera vaccine.

Question 14

Lister

Answer 14

1827 - 1912
Thought germ theory might explain surgical infection.
Sprayed carbolic acid on surgeons hands and operating area
Soaked bandages and instruments in carbolic acid.

Question 15

Koch

Answer 15

1843 - 1910
Identified microbes responsible for anthrax (1876), cholera germs (1884) and TB (1882)
He dyed specific microbes
Proved specific microbes caused specific diseases.

Question 16

Ehrlich

Answer 16

1854 - 1915
Created the first magic bullet
Found a chemical cure for syphilis in 1909
Allowed other doctors to discover magic bullets: meningitis, pneumonia and scarlet fever.
German doctor - worked with Koch

Question 17

Chadwick

Answer 17

1800 - 90
English social reformer
In charge of an inquiry into living conditions after cholera outbreaks of 1837 and 38
Report published in 1842 - 20,000 copies sold

Question 18

Snow

Answer 18

1813 - 58
Discovered that cholera was waterborne
Cholera outbreak of 1854 - 20,000 people died
Found that people who died lived near the same water pump in Broad Street.
Removed pump handle and the outbreak stopped.
Snow found that a street toilet was leaking into the pump’s water source.

Question 19

Bazalgette

Answer 19

1819 - 91
Parliament gave him enough money to build a new sewer system for London. By 1866, he had built an 83-mile sewer system system that removed which removed 420 millions gallons of sewage a day.

Question 20

Fleming

Answer 20

Fleming wanted to find a way to treat infected wounds.
1928 - Fleming went on holiday and left several plates of Staphylococcus germs on a bench in his lab
When he came home he noticed penicillin mould had grown on the plate and killed the germs around it.
A spore from this mould had floated up the stairs into his lab
He mistakenly concluded penicillin was a natural antiseptic
He eventually lost interest in it

Question 21

Florey and Chain

Answer 21

In the 1930’s - noticed penicillin’s ability to kill germs
Successfully tested it on 8 mice
Treated a person with a bad infection - infection cleared up but patient died when penicillin ran out
June 1941 - Florey met with US government who agreed to pay chemical companies to make millions of gallons of it.
By end of war, 250,000 soldiers were treated with it and 15% would have died without it

Question 22

Rowntree and Booth

Answer 22

Booth’s report - Found that 30% of Londoners were so poor that they didn’t have enough money to eat properly, despite having full time jobs. Found there was a link between poverty and high death rate.
Rowntree’s report - Found that 28% of New York population did not have the minimum amount of money to live on at some point in their life.

Question 23

Beveridge

Answer 23

1942 - report about the state of Britain sold over 100,000 copies in its first month of publication.
People had the right to be free of the five giants that could ruin their lives:
Disease
Want
Ignorance
Idleness
Squalor
Said that the government should ‘take charge of social security from the cradle to the grave’

Question 24

Bevan

Answer 24

Introduced the NHS in 1948
Overcame opposition from doctors who did not want to be controlled by the government and lose income.
He promised them a salary and allowed them to treat patients as well
2015 - 16, the NHS budget was £116 billion
People still have to pay for prescriptions and dental treatment

Question 25

How did Christianity affect medieval medicine?

Answer 25

Monks preserved and copied ancient medical texts 700 hospitals were set up between 1000 and 1500 Hospitals were funded by the church or a wealthy patron St Leonard's hospital was payed for by Norman King Stephen Church arrested Roger Bacon for suggesting doctors not rely on old books

Question 26

What was the Islam effect on medicine?

Answer 26

805 - Al - Rashid set up a major new hospital in Baghdad with a medical school and a library. Islamic monks preserved hundreds old medical books by Hippocrates and Galen They actually treated patients Medical ideas reached England through trade

Question 27

What were the limitations of Medieval surgery?

Answer 27

Operated without effective painkillers Had no idea that dirt carried disease Could not help patients with deep wounds to the body Sometimes thought pus in the wound was good

Question 28

Why were conditions in monasteries better?

Answer 28

Money that was donated was spent on cleaner facilities Isolated location helped them survive epidemics - they were also near to rivers Monks could read and understand medical books They separated clean water and waste water Monks had routines of cleanliness

Question 29

Black death?

Answer 29

1348 Causes believed - position of stars and planets, bad air, wells poisoned by Jews, punishment from God Disease spread because of unhygienic conditions Remedies - prayer, strapping chicken to buboes, moving away, local councils tried to quarantine 1.5 million died between 1348 and 1350 Demands for higher wages contributed to peasants revolt

Question 30

Great plague?

Answer 30

1665, 100,000 people died in London Treatments - bleeding with leeches, smoking, sniffing a sponge soaked in vinegar, using snakes and scorpions to draw out the poison Moving to the countryside

Question 31

What were hospitals like in the 18th century?

Answer 31

Many new hospitals were built - 1720 - 50 saw five new general hospitals built in London More patients - 20,000 patients by the year 1800 Specialist wards for different types of disease Treatment based on the four humours Christians now thought it was better to now treat the sick Now thought illness could be dealt with a more scientific approach Some hospitals added pharmacies - Edinburgh in 1776 Specialist hospitals: Lock hospital for venereal disease ( 1746) British hospital for mothers and babies (1749)

Question 32

Reasons for opposition for vaccination?

Answer 32

Jenner could not explain how vaccination worked Many doctors were profiting from smallpox inoculation Attempts to repeat his experiment failed because much of the equipment were contaminated Jenner was not a fashionable city doctor

Question 33

Why was vaccination accepted?

Answer 33

Jenner proved the effectiveness of vaccination by scientific experiment Vaccination was less dangerous than inoculation Members of the royal family were vaccinated Parliament gave Jenner £10,000 in 1802 1853 - smallpox vaccination became compulsory

Question 34

Reasons for opposition to anaesthetics?

Answer 34

Surgeons were used to operating quickly on a conscious patient Some surgeons during the Crimean war thought soldiers should put up with the pain Some patients died because of incorrect dosage because of chloroform Religious objections as pain in childbirth was thought to be God's will.

Question 35

Reasons for opposition to antiseptic surgery?

Answer 35

Doctors did not accept germ theory. Carbolic acid dried skin and irritated lungs Lister changed his techniques - people thought this was due to ineffectiveness He still operated in street clothes

Question 36

What were cities like in the 19th century?

Answer 36

Rows of back to back houses Four or five people living in one small room Few houses had toilets - most were outside and shared with other families Pumps were fed by rivers that also took away sewage No rubbish collections or fresh running water.

Question 37

What was the government action to the Chadwick report?

Answer 37

Laissez-faire attitude - government did not want to interfere MP's who rented out slum houses did not want the expense of tearing them down. 1848 public health act after cholera outbreak Central Board of Health set up to improve public health Any town could set up Local Board of Health Local councils empowered to spend money cleaning up the streets 1853 - only 103 towns set up Local Board of Health 1854 - Central Board of Health closed down due to resentment of government interference

Question 38

1875 public health act?

Answer 38

``` 1867 - working class men given the vote 1875 - local councils had to appoint medical officers. councils ordered to build sewers, supply fresh water and collect rubbish ```

Question 39

Body and disease after 1945?

Answer 39

1953 - stem cells discovered and in 2013, first human liver grown from stem cells 1953 - scientists at Cambridge university map out the DNA structure - leads to developments in gene therapy, genetic screening and genetic engineering. 1973 - CAT scan invented 1975 - endoscope probes allowed doctors to see inside the body 1987 - MRI invented

Question 40

Surgery after 1945?

Answer 40

1950 - first open heart surgery | 1968 - first heart transplant

Question 41

Treatment after 1945?

Answer 41

1957 - thalidomide used to treat mourning sickness but causes birth defects. 1978 - IVF treatment

Question 42

X-rays?

Answer 42

Discovered in 1895 Marie Curie developed mobile X-ray machines. Allowed surgeons to discover exactly where bullets and shrapnel were in injured soldiers.

Question 43

Blood transfusions?

Answer 43

1900 - Landsteiner discovered blood groups 1914 - Hustin discovered that sodium citrate stopped blood from clotting 1938 - British national blood transfusion service opened Large blood banks opened during WW2

Question 44

Plastic surgery?

Answer 44

WW1 - Gillies set up a special unit to graft skin and treat severe facial wounds Queen's Hospital in Kent provided over 1000 beds for soldiers with severe facial wounds by 1921

Question 45

Transplant surgery?

Answer 45

1952 - first ever transplant (kidney) 1967 - first heart transplant in South Africa 1970 - Cyclosporine developed which stops body rejecting transplanted organs 1986 - Davina Thompson because the first heart, lung and liver transplant 2006 - First partial face transplant is carried out 2008 - First full face transplant

Question 46

Liberal reforms?

Answer 46

1906 - Free school meals provided to poor children 1907 - School medical service set up - free medical inspections 1908 - Children's and Young Person's act introduced; parents are breaking the law if they neglect their children 1908 - Old age pensions introduced 1909 - first job centres are built 1911 - unemployment benefit, free medical treatment and sickness pay.