Medicine Flashcards
1
Q
How did the church control ideas in the Middle Ages?
A
- It ran universities where physicians were trained
- Priests could read and write unlike most people, this meant monasteries had lots of influence so what was written and read
- Proved traditional, rational explanations for disease, they particularly liked Galen as his ideas fitted Christian beliefs
- They taught that people should follow Jesus example and care for the sick, hospitals were often in monasteries
2
Q
Who was Galen?
A
- Roman doctor
- Created the theory of opposites
- Drew detailed diagrams of human anatomy after operating on wounded gladiators
3
Q
Who was Hippocrates?
A
- Ancient Greek doctor
- Most treatments were based on diet, exercise, rest and for humours
- Wrote the Hippocratic oath - doctors would respect life and prevent harm
- Wrote the hippocratic collection, included symptoms and treatments
4
Q
What was the theory of Miasma?
A
- ‘Bad air’
- It related to God because bad smells indicated sin
5
Q
What were the religious and supernatural methods to prevent illness in the Middle Ages?
A
- Living a Christian life
- Carrying lucky charms or amulets
- Chanting incantations
- Self punishment, flagellation
6
Q
What were the rational methods to prevent illness in the Middle Ages?
A
- Trying to keep streets clean
- Bathing and washing
- Exercising
- Not over eating
- Bleeding and purging
- Purifying the air
7
Q
What were barber surgeons?
A
- No medical training
- Carried out bloodletting, pulling teeth and lancing boils
- Did basic surgery such as amputating limbs, very low success rate
- Cost less than a physician 
8
Q
What were apothecaries?
A
- Received training but no medical qualifications
- Mixed medicines and ointments based on their own knowledge or directions of a physician
- Cost money, but less than a physician
9
Q
What were physicians?
A
- Medically trained at university
- Diagnosed illnesses and gave treatments or send patients to an apothecary or barber surgeon
- Urine charts, astrology used
- Expensive, mostly used by wealthy
- Very few of them
10
Q
What gave care in the home?
A
- Most people were treated at home by female family member
- The village ‘wisewoman’, would also tend to people in their homes for free
11
Q
How did physicians treat patients?
A
- Observe the patient’s symptoms and check their pulse, skin colour, urine
- Consulted urine charts in their vademecum
- Consultant Zodiac charts
- Then either treated patients themselves or sent them to an apothecary or barber surgeon
12
Q
What were the features of hospitals in the Middle Ages?
A
- Many were places where travellers and pilgrims stayed on their journeys
- Patients and surroundings were kept very clean
- They were places of recuperation rather than where patients were treated for disease
- Patients were given fresh food and plenty of rest
- Usually people with infectious diseases were not admitted
- Some were built for specific infectious diseases
- Many were run by the church
13
Q
How did people think the black death was caused?
A
- Religion – God sent the plague as punishment for people sins
- Astrology – the position of Mars, Jupiter and Saturn was unusual at this time
- Miasma – bad air or smells caused by decaying rubbish
- Volcanoes – poisonous gases from European volcanoes and earthquakes carried in the air
- Four humours – most physicians is believed that disease is caused by an imbalance in four humours
- Outsiders – strangers or witches had caused the disease
14
Q
How did people try to avoid catching the Black Death?
A
- Praying and fasting – people believed God caused the disease, so tried to show god they were sorry by punishing themselves
- Clearing up rubbish in the streets
- Smelling toilets or other bad smells, believed it would overcome the plague
- Lighting a fire in the room, ringing bells, having birds fly around the room for air circulation
- Carrying herbs and spices to avoid breathing bad air
- Not letting unknown people enter the town
15
Q
What were the symptoms of the Black Death?
A
- Swelling of the lymph glands into large lumps filled with pus (buboes)
- Fever and chills
- Headache
- Vomiting, diarrhoea, abdominal pain
16
Q
What were the treatments for the Black Death?
A
- Praying and holding lucky charms
- Cutting open buboes to drain the pus
- Holding bread against the buboes then burying it in the ground
- Eating cool things and taking cold baths
17
Q
How did the work of physicians change in the renaissance?
A
- As fewer people believed astrology caused disease, physicians stopped using astrology charts
- Due to improved knowledge of digestion, physicians realised that urine was not a good indicator of disease and stopped using urine chats
- They carried out more direct observations rather than relying on the patient explaining their symptoms
18
Q
Who was Thomas Sydenham?
A
- He worked as a doctor during the 1660s and 70s
- In 1676 he wrote his book, Observationes Medicae
- Nicknamed ‘English Hippocrates’
- He didn’t rely on medical books when diagnosing, instead he recorded symptoms
- Believed disease wasn’t related to the nature of the person who had it
19
Q
How did the printing press promote change?
A
- Invented in 1440 by Gutenberg
- By the start of the Renaissance, there were hundreds of printing presses across Europe
- It meant that many exact copies could be produced in a short amount of time
- The ideas and discoveries of scientists and doctors could be shared more effectively and much faster
- It reduced the churches control of ideas, it couldn’t prevent the publication of ideas it didn’t approve of
20
Q
What was the Royal Society?
A
- They met for the first time in 1660
- It recorded the results of experiments and sponsored scientists to enable them to carry out research
- In 1662 it received a royal charter from Charles II, this gave them credibility and raised their profile
- In 1665 they published a journal called Philosophical Transactions, it meant that scientists could build on each other’s work
- It encouraged members to write reports in English instead of Latin, and in straightforward language to make it accessible for everyone
21
Q
How did hospitals change in the Renaissance?
A
- Used less for travellers and more for sick people
- Many had their own apothecary and physicians frequently visited
- In 1536, the dissolution of the monasteries caused most hospitals to close
- It wasn’t until well into the 1700s that the number of hospitals returned to pre-dissolution levels
- More pest houses appeared, where people with contagious disease went for care
- When hospitals did reappear, they were run by physicians who focused on treating the sick rather than religion
22
Q
What were some changes in prevention and treatment in the Renaissance?
A
- More emphasis on removing miasma, by removing sewage and rubbish
- People regularly change the clothes to keep clean instead of just bathing
- Herbal remedies from newly discovered countries appeared in England, and some were effective
- The theory of transference led people to rub objects on themselves to try and transfer the disease to the object
- Alchemy caused chemical cures using metals or minerals to become popular
23
Q
In what ways did the training for apothecaries and surgeons stay the same in the renaissance?
A
- They were still not giving university training
- They were still seen as inferior to physicians and they were cheaper
24
Q
In what ways did the training for physicians stay the same in the renaissance?
A
- They were still trained at universities and the training lasted for many years
- Training was still based on learning from textbooks rather than practical experience
25
In what ways did the training for apothecaries and surgeons change in the Renaissance?
- Both were better trained through being in guild systems, where they were apprentices > journeyman > masters
- A license was now needed, these were only issued after complete training
26
In what ways did the training for physicians change in the Renaissance?
- There was a wider variety of medical books and detailed drawings due to the printing press
- New ideas about anatomy inspired some physicians to become more practical and experimental
- Dissection was legalised but took time to become commonplace
27
Who was Andreas Vesalius?
- He carried out a large number of dissections of human bodies
- He published his book, ‘On the fabric of the human body’, in 1543
28
What was the importance of Vesalius?
- Made study of anatomy fashionable, it became central to study of medicine
- Proved some of Galen’s work incorrect, this encouraged others to question Galen’s theories
- He encouraged others to carry out dissections
- His work was widely published in England, his illustrations of the human body were copied into other medical textbooks
29
When was the Great Plague?
1665
30
How did people’s ideas about what caused the plague change during the great plague?
- Miasma, this was the most common belief
- Fewer people believed it was caused by an imbalance in the four humours
- People knew that disease could be passed from person to person
31
How did people try and treat the Great Plague?
- Herbal remedies, either mixed in the home bye-bye apothecaries and ‘quack’ doctors
- The theory of transference meant people tried to transfer the disease to other objects, especially birds
- People believed you could sweat the disease out, so sufferers were wrapped up and put by a fire
32
How did the government try to prevent the Great Plague from spreading?
- Theatres were closed and large gatherings were banned
- Dogs and cats were killed
- Barrels of tar were burned in the streets
- Every day, carts collected the dead then buried them in deep mass graves
- Household was boarded into its home for 40 days, or taken to a pest house
- Days of fasting and public prayers were ordered
33
Who was William Harvey?
- Was a lecturer of anatomy at a College of physicians
- Carried out public dissections
- Taught the importance of observing symptoms, rather than relying on textbooks for diagnosis
- Published, ‘an anatomical account of the motion of the heart and blood in animals’, in 1628, it contained detailed drawings

34
What did William Harvey discover about the circulation of blood?
- He researched Vesalius’ theory that blood flow towards the heart, he proved this right by using a dissected body and pumps to show blood only flowed one way
- He then proved that blood could not be produced by the liver and absorbed into the body, as Galen had thought
- He was influenced by new technology, such as mechanical water pumps, which made him think the way human bodies work in a similar way
- He discovered the arteries and veins were part of one system and that blood was pumped around the body by the heart
35
What was the importance of William Harvey?
- He proves some of Galen’s theories wrong, making people question his other theories
- By 1700 his work was being taught in medical schools
- As a royal physician, Harvey’s work gained publicity and credibility
- His scientific methods of observation and use of dissection had brought results, so were copied by others
- His discoveries left many unanswered questions which encouraged further experiments
36
What was the theory of spontaneous generation?
Germs were produced by decaying matter
37
How did microscopes change medicine in the 18th and 19th century?
- By 1700, Max games have developed cloudy images of bacteria or germs
- By 1850, microscopes had further improved so that tiny images could be seen clearly
38
What was the germ theory?
- In 1861, Louis Pasteur (a French chemist) published his germ theory
- This proved spontaneous generation was incorrect
- He proved that microbes in the air cause decay, he discovered this when investigating why liquids turned sour in the the brewing industry
- He also theorised that germs cause disease but was unable to prove this
39
What role did Robert Koch have in developing the germ theory?
- Koch (a German doctor and scientist) read Pasteur’s work and proved him right
- He identified the specific microbes that caused TB in 1882, and cholera in 1883
- He developed an easier way of growing bacteria on agar jelly
- He also discovered that chemical dyes stained bacteria, making them easier to see under a microscope
- Other scientists then used these methods to identify the microbes that caused other diseases
40
Who was Florence Nightingale and how did she improve hospital care?
- Little training for female nurses
- Attended the first nurses training school in Germany
- Was asked to lead a team at a military hospital during the Crimean war
- Believed in Miasma so promoted hygiene, fresh air and good supplies for nurses
- She published books on nursing and set up a training school for nurses
41
What were the changes in hospital care during the 18th and 19th century?
- The first cottage hospital (nurses gave care and GPs prescribed home treatments) opened in 1859
- Hospital cleanliness and organisation improved, due to Nightingale and Pasteur
- Specialist hospitals, like asylums for mentally ill and fever houses for infectious diseases
- Public pressure led to infirmaries being set up for the poorest in society
42
What different substances were used for anaesthetics during the 18th and 19th century?
- Before 1800, alcohol and opium had little success easing pain in operations
- In 1844 laughing gas was used in dentistry, but failed to ease pain and patients remained conscious
- From 1846 ether It made patient totally unconscious and lasted a while, however it made them cough during and sick afterwards
- From 1847 chloroform (discovered by James Simpson) was very effective with few side-effects, however it was hard to get the dose right and could kill people because of the effect on the heart
- In 1884 cocaine was used as the first local anaesthetic, in 1905 a less addictive version (novocaine) was used
43
How did Joseph Lister develop antiseptics?
- In 1861 half the patients in surgery die from post-operative infections, Lister starts work as a surgeon
- In 1864 Lister reads Pasteur’s germ theory and learns that carbolic acid kills parasites in sewage
- In 1865 Lister soaks bandages in carbolic acid to avoid infected wounds
- In 1866 Lister uses carbolic acid to clean wounds and equipment and invents a spray to kill germs in the air
- In 1867 Lister states that his wards have been infection-free for nine months, he publishes his ideas
44
What opposition was there to anaesthetics?
- People are worried about the long-term effects
- They thought being unconscious made patients more likely to die
- The Victorians were very religious and thought God inflicted pain for a reason, so it was wrong to interfere with this pain
45
What role did Louis Pasteur have in vaccinations?
- Pasteur’s team of scientists discovered that a weakened version of a disease-causing microbe could be used to create immunity from that disease
- Pasteur developed vaccines against anthrax and chicken cholera for animals, and against rabies for humans
46
What were the reasons for the public health act 1875?
- The government had a laissez-faire approach to public health
- During the 19th century several academics (especially cholera) caused the government’s attitude to change
- Also the increasing number of men who could vote influenced politicians
- By 1875 people recognised that it was the government’s responsibility to improve living conditions in cities
47
What did the public health act 1875 state?
City authorities must provide:
- Clean water
- Sewers
- Public toilets
- Street lighting
- Public parks
Also:
- Inspect lodging houses for cleanliness
- Monitor the building of new houses to prevent damp and overcrowding
- Check the quality of food sold in shops
- Employ a public health officer to monitor disease
48
How did Edward Jenner discover a vaccine for smallpox?
- Since the 1720s doctors had been inoculating people against smallpox with a mild version of disease
- Jenner regularly treated people for the mild disease, cowpox, and noticed that these people never caught smallpox
- In the 1790s he tested his theory by infecting local people with cowpox then infecting with smallpox, none caught smallpox
49
What effects did Jenner’s discovery have on society?
- In 1798 the Royal Society refused to publish his ideas ideas, so he paid to print his findings which included instructions so others could follow
- By 1800 around 100,000 people worldwide had been vaccinated, but it took time to be popular in Britain
- In 1802 the Royal Jennerian society was set up to promote the vaccination
- In 1840 vaccinations were provided for free to the poor
- In 1853 vaccinations were made compulsory
- By 1979 smallpox had been wiped out
50
Why was there opposition to Jenner?
- People thought it was wrong to give people and animals disease
- It interfered with God’s plan
- Doctors lost money when the government offered free vaccination
- Some doctors didn’t vaccinate properly so it didn’t work
51
What was cholera?
- Mostly affected the poorest slum areas of cities
- Causes severe diarrhoea and vomiting, leading to dehydration
- In the early 19th century there was no treatment and most people who caught it died
52
What did John Snow do?
- He observed the cholera epidemic of 1848-49 and began his theory that cholera was spread through contaminated drinking water
- When cholera broke out again in 1854 in Soho he mapped all the deaths and found a strong link to one water pump on Broad Street
- He removed the handle from the pump so people couldn’t collect water and the number of deaths fell dramatically
- It was later discovered that a cesspit close by was leaking water into the water
53
What was the significance of Jon Snow’s work?
- Many cholera deaths in Soho were prevented
- As the Germ theory hadn’t yet emerged, the government didn’t act on Snow’s recommendation to build a new sewer system
- Snow‘s work later, combined with other evidence, meant a new London sewer system was completed in 1875
- This link between between dirty water and disease led to the public health act in 1875 when authorities were finally forced to provide clean water
54
How did the understanding of genetics change in modern Britain?
- Mendel showed how characteristics are passed between generations
- New technology (electron microscopes, x-rays) let scientists discover that every cell in the body contains DNA
- James Watson and Francis Crick worked together on how genetic codes of DNA fitted together
- They analysed x-ray crystallography by Marice Wilkins and Rosalind Franklin at Kings College Hospital
- In 1953 they worked out the double helix structure
- In 1990 James Watson led the Human Genome project and started mapping out every gene in human DNA

55
What were the effects of understanding genetics better?
- A better understanding of some genetic conditions, such as Down’s syndrome
- Predicting whether individuals are at higher risk of cancer
- The discovery that stem cells can be grown into different cells
56
What are some examples of technology used in modern Britain medicine?
- Microscopes
- Incubators
- X-rays
- Prosthetic limbs
- MRI, CT, ultrasound scans
- Endoscopes
- Pacemakers
- Dialysis machine
- Insulin pumps
- Blood sugar and blood pressure monitors
- Hypodermic needles
57
How were magic bullets discovered?
- Paul Ehrlich and his team, helped by German government, tested many compounds of Salvarson (arsenic) to find one to cure syphilis
- In 1909 Dr Hata joined the team and discovered they had rejected a compound that worked, the 606th
58
Who discovered blood groups? What year? Importance?
- Karl Landsteiner
- 1901
- In 1902 his colleagues found a fourth group
- Made transfusions successful
59
What were some ways that enabled diagnosis to improve in modern Britain?
- Blood tests – tested for many conditions without invasive diagnosis methods, 1930s
- Blood sugar monitoring – so diabetes sufferers can manage their condition, 1960s
- Blood pressure monitor – to diagnose high and low bread pressure, 1880s
- Endoscopes – to investigate digestive symptoms and assist treatment by carrying surgical instruments into the body, 1900s
- Electrocardiograms – use electrical impulses to track heart activity, 1900s
60
What were some developments in scanning techniques in modern Britain?
- X-rays – to see inside human body without cutting into it, diagnosed broken bones etc, 1890s
- MRI scans - use radio waves and magnets to identify soft tissue damage in the brain and heart, 1970s
- CT - combines X-rays to identify tumours, 1970s
- Ultrasound – use sound waves to build a picture, can diagnose kidney stones, 1940s
61
What did the first magic bullet lead to?
- In 1932, Gerhard Domagk developed the second magic bullet, Prontosil, which cured some types of blood poisoning
- Other scientists found that sulphonamide in Protosil also cured pneumonia, scarlet fever, and meningitis
62
What caused the NHS to be set up?
The 1942 Beveridge Report recommended it
63
How was the NHS funded and set up?
- Paid for by national insurance contributions, taking from wages
- Took over existing hospitals and medical services
- The government was now responsible for 1143 voluntary hospitals and 1545 city Hospitals
64
What problems did the NHS face?
- Post-war Britain didn’t have a lot of money to spend on medical care
- Many hospitals were built in the 19th century so needed updating
- Many GPs needed modernisation
65
When was the diphtheria vaccination campaign? (give more details)
- 1942
- Children immunised in WW2
- First national vaccination campaign
- 3000 children died a year
66
When was the Polio vaccination? (give more details)
- 1956
- 8000 cases reported each year in Britain
- Successful - last person to get it in Britain was in 1984
67
When were the clean air acts? Why were they put in place?
- 1956 and 1968
- To prevent the spread of smog in London
68
When was the Health Act that banned smoking in public places?
- 2006
- But didn’t come into effect until 2007
69
What were the stages of the discovery of penicillin?
- In 1928 Alexander Fleming noticed bacteria in a petri dish was killed by penicillin mould
- In 1929 and published his findings but he didn’t believe it would work on living people as it was ineffective when mixed with blood
- In 1939 Florey and Chain continued his research
- In 1940 they tested penicillin on infected mice and it was successful
- In 1941 it was first tested on a human with blood poisoning , it proved effective but they ran out of penicillin so he died anyway
70
What were the stages of mass-producing penicillin?
- Florey asked UK drug companies but they were busy producing chemicals for WW2
- In July 1941 Florey asked US drug companies, they agreed but on a small scale
- After US joined WW2 the government funded 21 drug companies to mass-produce it in 1942
- In 1943 UK drug companies also started to mass-produce it
- By D-Day in June 1944 there was enough penicillin to treat all Allied casualties (2.3 million doses)
- In 1945, Hodgkin identified the chemical structure of penicillin, leading to synthetic versions being produced
71
How many people are diagnosed with lung cancer each year?
Over 40,000
72
How is technology used to diagnose lung cancer?
- In the past x-rays were used but they weren’t detailed enough for accurate diagnosis 
- Today CT scans are used which create a more detailed picture
73
How is the science and technology used to treat lungs cancer?
- Radiotherapy, to shrink or prevent growth of a tumour
- Chemotherapy, used since 1970s, injected with many different drugs to shrink the tumour before surgery
- Transplants, cancerous lungs can be replaced with lungs from an organ donor
- Genetic research, some chemotherapy drugs work better for tumours with a certain genetic mutation
74
What are the problems with diagnosing lung cancer?
- Often not detected until it is very advanced so can’t be treated
- No national screening program, people are not routinely tested as tests are not accurate enough to outweigh the negative effects
75
How has the UK government tried to prevent lung cancer?
- TV advertising for cigarettes banned in 1965
- Tax on tobacco products is regularly increased
- In 2007 smoking was banned in public places and the legal age for buying raised from 16-18
- In 2012 all cigarette products in shops are covered
- In 2015 smoking ban in cars carrying children under 18
