Medicine Flashcards
How and why did the church run hospitals
Many priests and monks were doctors
The church taught that it was part of peoples religious duty to take care of the sick and poor
Therefore almost wall of the hospitals in Europe were run by the church
They were mainly designed for caring rather than curing
What treatments used in the medieval time period are still being used in the renaissance time period
Not much changed from medieval time period
Herbal remedies( new plants brought to England from the new world e.g bark from the cinchona tree treated malaria)
Treatments based on Hippocrates T4H and Galens theory of opposites e.g blood letting and purging
Opium treated pain
What did doctors in the renaissance say caused disease
What treatments did they use
Still didn’t what caused disease and therefore couldn’t treat disease effectively
Therefore they had lots of different cures to choose from none particularly effective
Didn’t have one proven method of curing disease
Many treatments had no scientific basis
How did the church continue to promote more natural explanations of disease
The church was the only organisation that tried to keep alive the medical ideas of Ancient Greece and Rome
Monasteries preserved many of the manuscripts of Galen and often wrote about herbs and medicines
The church opened medical schools and taught the ideas of Galen
How else did the church influence medicine in the medieval time period
Promoted cures such as pilgrimages to places like Canterbury where saints were believed to perform miracles
Flogging the mentally I’ll to drive out demons
Explain the discoveries made by pare
Gun shot wound old method- cauterised with a red hot iron or boiling oil
Pare’s method-mixed his own ointment of rose oil, turpentine and egg yolk
Stop bleeding old method- pressed a red hot iron called a cautery against the stump which sealed the blood vessels and stop patients bleeding to death but was agonising
Pare’s method- tie silk thread around each blood vessel to close them up- this is called ligatures
Explain how the factor of war influenced surgery in the 20th century
- blood loss
During ww1 Karl Landsteiner divided blood into groups, the problem of bleeding was solved. Some of these blood groups could not be mixed
Clotting on contact with air was solved in ww1 by using sodium citrate
Explain how the factor of war influenced surgery in the 20th century
- plastic surgery
The development of new weapons in the 20th century meant that the number and type of facial and skin wounds increased. In Britain, Harold Giles set up a unit in 1917 to treat horrific wounds inflicted by war. Gillies and his colleagues treated over 5000 servicemen
What supernatural causes and treatments of disease did the church promote
Very influential in explaining why people got ill and how to treat the sick e.g supernatural explanations of disease were common.
God and saints were thought to have intervened in daily life, having the true power to make people sick or care for them.
The church also taught that Gods sent disease and misfortune as a punishment or as a test of faith
And mental illness was where people were possessed by the devil
What was quackery
What were their treatments
What disease their treatment cured
How they promoted their treatments
Quacker- travelling salesmen selling cure all’s
Sold as a preventative cure
Most famous was Daffy’s elixir supposed to cure all store of disease such as constipation, fits, worms, gout, kidney stones.
All it did was cure constipation as it was a perfect laxative
Sellers tended to be charming and charismatic played on people’s fear of getting disease like the plague
Fancy packing, a famous client and newspaper would help sell the cure
Who’s did Alexander Fleming influence with his work and what did these people do as a result
Flemings work influenced the work of Florey and Chain to experiment and extract penicillin from the mould.
Ince they secured funding they mass produced the drug which enabled them to start clinical trials to see how it worked on patients with bacterial infections
How did Louis Pasteur use scientific methods to discover that germs caused disease
In a series of careful experiments he proved that the microbes that caused things to go bad floated around in the air
He used a microscope to see the bacteria in alcohol that was making beer go bad
Used a swan neck flask to prevent germs getting into the liquid so it didn’t turn sour
Who did Louis Pasteur influence with his work and what did this person discover as a result
Pasteur was not a doctor so he couldn’t prove that germs caused disease in humans
Published his results in 1864 and Robert Koch, a German doctor was able to experiment with isolating germs using chemical dyes to enable him to link specific germs such as tuberculosis and typhoid.
Paul Ehrlich was able to produce a magical bullet to kill germs that caused the disease syphillis
How did Christianity affect mediaeval medicine?
The Christian church believed in following example of Jesus who healed the sick. Therefore Christians believed it was good to look after the sick.
God sent illness as a punishment, e.g. mental illness, or a test of faith so curing an illness would challenge gods will
Monks preserved and copied by hand, ancient, medical text
Prayers were the most important treatment rather than drugs
Christians believed in caring for the sick and started many hospitals ; over 700 per set up in England between 1000 and 1500
The church believed in miraculous healing, and the sick were encouraged to visit, shrines a pilgrimage with the relics of a holy person, and prayed to saints to cure the illness
What was a natural cause of disease?
Christian church, approves of the knowledge of the ancient, Greeks and Romans ; Galen, although he lived in Roman times, believed in one God, this is fitted with Christian ideas
Doctors use clinical observations, chicken for pulse and urine, the four humours
Super natural cause of disease
Many diseases that Hippocratic in Galenic medicines cannot cure for these diseases, supernatural ideas, influence doctors treatments
Doctors checked potions of the stars, recommended charms and prayers
What did doctors base the natural cures on?
Mediaeval doctors base, their natural cures on ancient Greek theory of illness which involve the equal balance of the body of four humours -blood phlegm, black bile and yellow bile.
They believed that a person became ill when they were out of balance, and the doctor’s job was to restore this balance
The influence of Islamic ideas about medicine on mediaeval medicine
The Islamic religion encourage the medical learning and discoveries. The Prophet Mohammed said.” for every disease Allah has given a cure. So doctors are inspired to find them.
Muslim scientists were encouraged, discover queues, a new drugs such as Senna
In the Islamic empire, people with mental illnesses were treated with compassion
Islamic medicine valued Hippocratic in Galenic medicine and preserved and learned from the books of the ancient world
Muslim hospitals were meant for treating patients, not simply caring for them, as was the case in the Christian world
What was the theory of the four humours?
It was influenced by Greek ideas about balance. The Greeks believe that the world is made up of four elements.
When one of the humours was out of balance of the person would become ill
Gallens own ideas
He disagreed with some of the treatments recommended by Hippocrates
He use the theory of opposites to treat his patience. For example, if a woman had a cold, he might prescribe pepper.
He was a great believer in the power of bloodletting
His ideas lasted so long as he was excepted by the church, as he often spoke about the creator in his writing
What was a mediaeval surgeon?
These were sometimes educated and wealthy. They were trained in the great medical schools, but some formally trained doctors regarded surgery as manual work and we have nothing to do with it.
What is a barber surgeon?
Barber surgeons were less educated and less wealthy. They performed surgery for the poor, but we’re not usually formally trained
They combined haircutting with simple surgery, such as bloodletting and tooth pulling
What is mediaeval anatomy?
By about 1300 public by section of a limited number of human corpses were permitted in the medical schools, however, mediaeval anatomists failed to get the real benefit from this as all the lecturer did, was sit on his chair, reading from an anatomy book
Based on fragments of Galen work
Work that I section was done by demonstrator their job to find and show the features pointed out by the book as the master read the text aloud
If what he found out, not fit the theory, it was thought that the demonstrator had made a mistake, or the body was wrong rather than the actual book
Who was Guy de Chauliac
Most famous 14th century surgeon
He wanted to show that he was just as educated as the university doctors
He quoted Galen no fewer than 890 times
Problems in surgery- medieval
Main problems were pain and infection
Wine was used to clean wounds- we now know that wine acted as an antiseptic
There were also several attempts to deal with pain
One way was by drugging the patient before an operation, e.g giving the patient opium based drugs
Mediaeval operations were minor an external
Operations for cataracts are common, as were those for dealing with broken or dislocated bones
What were problems with Islamic medicine?
Islam did not encourage new developments as it forbade a section of the body
The Qur’an was regarded as containing all the important knowledge needed and therefore there was no point in trying to make new discoveries
Unwilling to criticise other ancient books e.g Galen
Many Arabic doctors believed that theory was more important than practice
What are monasteries like?
Monasteries had a higher standard of hygiene with some having toilets
Had their own drainage and water supplies, either from away a river or via a complicated water system had a purity settlement tank
The dirty water left over would be used to clear the toilets
The toilet would be in a separate building, and there would be a monk in charge of a laver a place, where hands and face as well washed
There will also be a monk in charge of issuing clean sheets for the monks bed
People bathed in kept clean
Mediaeval towns
No clean water to wash and cook with
Sewage running down the streets or into the river shared cesspits which leaked overflowed, or they went over a stream
Peasant shared houses with their animals
No fresh water to clean with, and some women boiled meat fat to make soap
Rarely wash themselves or their clothes
They were open, sewers, rubbish, and excrement thrown from the windows
Pigs, dogs and rats roam, the streets
What did people think caused the Black Death?
Breathing bad air (miasma)- mediaeval towns were very smelly, and the smell was supposed to contain disease
Annoying gods, the plague was his punishment
Looking at a victim, the disease was spread by eye 👁️ contact
Drinking from poisoned Wells . Germans believe the Jews are poison in drinking water to kill of non-Jews.
Yeah, an imbalance of the body is four humours Galen can’t be wrong
The position of the planet, the relationship of the planets in the movement of the Sun affected health
Touching a victim
How to prevent the Black death
Strap alive, chicken shaved to the plague sore
Eat arsenic powder
Run for the hills
Kill all the dogs and cats in town
Drink 10-year-old treacle
Go from town to town, flogging yourself with a whip
Put herbs on the fire to make the air smells sweet
Eat crushed emeralds
Let the blood out of the patient
Sit in the sewer, the bad of plague will be driven away by the worst of drains
Why were the conditions in monasteries better than the towns?
Wealth-money to spend on cleaner facilities
many people gave money, valuables and land in return for prayers to be said for them when they died . Monks made lots of money from producing wool and used large areas of land to keep the sheep.
Knowledge - monks could read and understand books in the library’s. They learn the basic idea of separating clean water from the waste water that came from the toilet and wash places.
Location- isolation, help protect monks from epidemics. Christian ministries in Abbys were near to rivers. Water was an important resources, supply Milly’s kitchen bakeries and breweries.
Why did the black death spread so quickly
Street cleaning was poor
Dirty streets, encouraged, rats to breed
Unhygienic habits, for example, throwing out rubbish were common
Animal dug up quickly, buried victims bodies
Laws about clinginess were difficult to enforce
Quarantine was not effective on infected villages
Ignorance of germs, and cause a disease was widespread
Major impact on society due to the Black death
Social impact-whole village is wiped out
Political impact -demands for higher wages contributed to the peasants revolt(1381) and the weakening of the feudal system
Religious impact -damage to Catholic church because experienced priest died. Others had run away.
Economic impact -created food shortages, so the price of food went up, creating more hardship for the poor.
Land owners switched to sheep farming as this needed fewer workers
Farm workers demand higher wages and we are less willing to be tied to the land and work for the feudal landlord 
Vesalius
He was in autonomist, who wrote the fabric of the human body
Criticised Galen
Dissected bodies to prove Galen was not right and made mistakes about the anatomy of the body. E.g. humans do not have two jaw bones.
Harvey
Discovered the heart was a pump, recirculating the blood around the body
Criticised, Galen heart was not porous, no holes in the septum
Used scientific method to prove his theory is e.g. experimentation and observations
Dissections
He observed the slow, beating hearts of cold blooded animals to understand how the muscles worked
He read widely what the Italian of commonest at Padua (Vesalius )do I discovered in built upon their work
Experimented pumping liquid the wrong way through valves in veins, proving that blood could only go around one way
The great plague 1665
Ideas about the causes and treatments used to are generally the same as in 1348 eg. God, bad air, and the theory of four humours
Going to church /praying, replacing the bad are using sweet flowers or herbs ect
The main change was in public health, where the Mayor of London introduced Plague orders to try to combat the disease e.g rakers, searchers and examiners
They wear starting to make a link between dirt and disease
Hunter
Famous surgeon anatomist
Dissected bodies and kept a collection of specimens
Train surgeon members of the company of surgeons
Wrote books in surgery and on anatomy
use careful, observations and scientific methods 
Jenner and the smallpox vaccination
Cowpox is a milder version of smallpox usually affect cows. Jenna was a country doctor in Gloucestershire. Jenna may have heard stories of people catching. I’ll put your protected against smallpox and the size of tests theory in 1796 by giving cowpox to an eight-year-old boy as an experiment.
Six weeks later, he gave the boys smallpox inoculation, and no disease followed
Why Jenner’s vaccination had opposition?
He cannot explain how vaccination worked
Many doctors are profiting from smallpox inoculation
Attempts to repeat his experiment failed for example in South London smallpox hospital. William Woodville and George Pearson test cowpox their experiments. It was contaminated and a patient died.
Jenna was not a fashionable city doctor, so there was snobbery against him
Why Jenner’s vaccination was accepted
Jenna had proven the effectiveness of the vaccination by scientific experiment
Vaccination was less dangerous than inoculation
Members of the royal family were vaccinated, which influenced opinion
Parliament acknowledge Jenner’s research play £10,000 grant in 1802
In 1853, the British government made smallpox vaccinations compulsory
Louis Pasteur?
Before pasta people had thought that germs made you sick, but could never prove it
Pasteur prove the spontaneous generation theory wrong
Germs didn’t come out of decaying matter, but caused matter to decay
Pasteur developed a method of proven germs cause decay, but did not prove that they caused illness in humans, because he couldn’t identify the germs that made people sick, as he was a chemist and not a doctor 
Robert Koch
Robert Koch used his knowledge of chemical dies to develop a way to prove that germs made you ill
He was able to build on this to create vaccines for mage illnesses, such tuberculosis, but was not able to develop a way of curing illness
Paul Erlich
Studied antibiotics(magic bullets) and was convinced a chemical could be found to do the job of the antibodies
He was looking for a magic bullet to kill syphilis and experiment to with a variety of chemical compounds
He tried 605 variations, but had no success
To his surprise at number 606 Salvarsan 606 worked
Florence Nightingale
Before Nightingale, nursing was considered to be a job for drunks, and was not respected
Through homework in the Crimea Nightingale improve the conditions in hospitals and reduced number of deaths
She set up a school for nursing and made it respected profession
James Simpson and anaesthetics 
James Simpson developed chloroform. This was the first effective anaesthetic.
Operations could be before me to painlessly
This did not make surgery say for many people would still die from infection as a result of the surgery. This was pre-germ theory.
Joseph, Lister and antiseptic
Lister introduced the antiseptic(germ, killing) carbolic acid, which helped more people survive operations
He recommended soaking bandages, washing instruments and hands in carbolic acid, as well as spraying the patient with it
His ideas were not accepted by everyone as not everyone excepted Pasteur’s germ theory
Industrial medicine, the general population
The population is growing and shifting, causing large amount of people to live in densely population areas
This meant conditions were poor and disease, easily spread
People did not want to be forced to keep clean (laisser faire attitude) and the ratepayers were not prepared to pay to clean up these areas
A lack of knowledge of what cause disease meant they didn’t understand the need to clean
Edwin Chadwick
Edwin Chadwick did a survey on the living conditions in towns and villages
He found people living in town to the lower life expectancy
He recommended that the government should be responsible for improving living conditions
Many people opposed his recommended as they had a laisser faire attitude(leave alone)
This information led to creation of the first public health act in 1848, but it was not compulsory
Cholera and Jon Snow
Caused by drinking contaminated water and the symptoms were diarrhoea, vomiting, cramps, fever, and death
People living at the time, didn’t understand what caused it
They thought it was touch, bad, smells in a punishment from God and could be avoided if people had good habits
They also didn’t, therefore know how to cure /preventive barrels of tower burns in the streets to quarantine, people and doctors advised of water should be boiled
Jon Snow discover that people who drink water from a pump in Broad Street, got cholera because a cesspit had leaked into the water supply
He took of the pump handle and annoy people died of cholera in the area
However, he didn’t know, germs cause disease, and that a germ was causing cholera
public health act
As a result of Edwin Chadwick support, the government introduced the 1848, public health act to improve the situation
the actor little impact as it was not compulsory for towns to follow answer the government cannot force them to improve conditions
Due to the failure of the first public health act, the great stink in London in 1858, and another cholera outbreak in 1875 the introduced another act
This was compulsory
1875 public-health acted every area was to have a medical officer of health and sanitary inspector or houses to have proper sewers or streets to be clean EST
The impact of war and technology on surgery in health
During WW, one blood transfusions were carried out for the first time, mixing it with sodium citrate to stop it clotting
Karl Landsteiner discover the blood groups
Harold Giles is plastic surgery to repair soldiers faces during WW1
X-rays were used for the first time optical fibres were invented to allow keyhole surgery and surgery. Using lasers was first used in an eye operation in 1987.
The first heart transplant carried out by Christian Barnard in 1967
Penicillin
At the start of the 20th century, they still didn’t have an effective way of killing bacteria want to go inside the body
Alexander Fleming by chance discovered that penicillin could kill bacteria, he wrote an essay in this but went back to researching sulphonamides
Howard Florey and Ernst Chain read Flemings work and this led to them developing antibiotics
They experimented on mice, then humans and secured $80 million of funding from the USA after they joined in 1941 to treat wounded soldiers
Drugs and treatment since 1945
Killer disease of previous time periods have been eliminated due to antibiotics and vaccines
New illness/disease e.g eczema,asthma,malaria,diabetes
Biggest killers of the modern world- cancer and heart disease due to increase life expectancy and change in lifestyle
In 1946 the world Health Organisation was set up to help all people to reach the highest possible level of health - physical, mental and social well-being.
Funded a mass vaccination programme which emanated small pox
Watson and Crick discovered DNA- conditions can be passed on from parent to child through their genes
Modern public health
Liberal government influenced by the work of Rowntree and Booth passed reforms to benefit the sick, old and children in society.
These reforms were: national insurance old aged pensions, free school meals and the labour exchange
Private insurance companies and doctors didn’t like these reforms
In 1948 the NHS was introduced by the labour government. That aimed to give people welfare from the cradle to the grave
The setting up of the NHS was influenced by the work of Bevan and Beveridge
The services it provided were: maternity, dentists, ambulance, GPS, surgeries, health clinics, district nurses
But by the 1950 it was costing too much and charges were introduced for dentistry, glasses and prescriptions
