Medicine Flashcards by Charlie O'Mara

Medieval England (1250-1500)
Causes of disease

The four humours - blood , phlegm , yellow bile , black bile

Punishment from god

Miasma - bad air

Astrology - alignment of planets and stars

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Medieval England (1250-1500)
Galen

Greek doctor

Used bloodletting or purging to prevent and treat illness

Developed Hippocrates ideas
Theory of opposites - balancing humours

Carried dissections of dead animals

Drew diagrams of human anatomy

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Medieval England (1250-1500)
Hippocrates

Greek doctor
Wrote Hippocratic oath which is still said today
Theory of four humours

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Medieval England (1250-1500)
Treatments

Rational methods
- Bloodletting for an imbalance of humours. This was done by cutting a vein , leeches or by cupping. This was done by barber surgeons
- Purging to re - balance humours. Making a patient vomit or go to the toilet. Emetics and laxatives were mixed by apothecaries , wise women or at the patient home.

Purifying air , keeping streets clean , bathing and washing , exercising, not overeating

Herbal remedies and ointments were applied to the skin.

Religious - praying , fasting , pilgrimage or paying for a special mass to be said

Supernatural - specific ideas e.g hanging a magpies beak around your neck to cure a toothache

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Medieval England (1250-1500)
Preventions

Chanting incantations
Self punishment - flagellation
Carrying lucky charms or amulets
Living a good Christian life

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Medieval England (1250-1500)
Hospitals

Increasing in number - 1200
Rest
Very clean
Run by the church
Infected people would not be accepted
Care not cure

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Medieval England (1250-1500)
Physicians

Observed symptoms - pulse , skin colour , urine
Consulted urine charts
Consulted zodiac signs

Trained at university for 7 years. Diagnosed or treated patients. Expensive.

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Medieval England (1250-1500)
Treaters for the sick

Barber surgeons - no training , bloodletting , pulling teeth. Basic surgery with very low success rate. Cheap

Apothecaries - training but no qualifications. Mixed medicine and ointments. Cost money but cheaper than physician.

Care in the home - treated by female family member. Wise women of village Woudl tend to people for free.

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Medieval England (1250-1500)
Black Death

1348-49
Causes - religion , astrology ( position of mars , Jupiter and Saturn ) , miasma , four humours

Prevention - praying and fasting , cleaning streets , smelling bad smells to overcome plague , carrying herbs and spices

Treatments - cutting open buboes , eating cool things , praying , lucky charms

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The renaissance
1500-1700
Causes of disease

Change but continuity
- miasma continued, four humours continued

Fewer believed in old ideas , people challenged the church

Physicians carried out more direct observations on their patients

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The renaissance
1500-1700
Transmission of ideas

Printing press 1440 by Gutenberg

Royal Society set up by Charles 11 , from 1665 they published a journal called Philosophical Transactions as they aimed to further scientific understanding

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The renaissance
1500-1700
Continuity in prevention , treatment and care

Hospitals
Most had own apothecary
1536 Henry VIII dissolution of monasteries caused many to close
Pest houses - contagious diseases
Hospitals run by physicians when they reappeared

Community care - home by female relative , physicians too expensive , members of Community helped

Treatments and preventions
Herbal remedies , bleeding and purging , cleanliness, prayer , healthy living

More emphasis on miasma

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The renaissance
1500-1700
Vesalius

On the fabric of the human body 1543
Proved 300 of Galens theories incorrect eg jaw is one bone not two
Dissections
Work was published in Europe

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The renaissance
1500-1700
Great plague 1665

Causes
Miasma
People knew it could be spread person to person
Four humours

Treatments
Strapping chickens to infected areas
Sweat the disease - put in thick blankets by a fire
Herbal remedies

Preventions
- quarantine
- pray
- nice smelling objects

Government action
- large gatherings banned
- streets cleaned
- fasting and public prayers
- Homes bordered for 40 days or pest house if catches plague
- burned cats and dogs
200,000 and 40,000 ordered by Charles 11

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The renaissance
1500-1700
William Harvey

Public dissections
Used observation
Circulation - influenced by mechanical water pumps he discovered that blood flowed one way proving Vesalius right. Arteries and veins a part of that system.

An anatomical account of the motion of the heart and blood - 1628

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18th and 19th century
1700-1900
Causes of disease

Spontaneous generation - germs
Miasma

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18th and 19th century
1700-1900
Koch and Pasteur

Louis Pasteurs germ theory disproved spontaneous generation

Robert Koch - used Pasteurs work to study microbes under a microscope. Proved Pasteur right. Identified specific microbes that cause TB in 1882 and cholera in 1883. Also developed a new way of growing bacteria on agar jelly.

18th and 19th century
1700-1900
Hospital care

Florence nightingale
- Scutari hospital in Crimean war (1854-56)
- Trained nurses and midwives
- Improved conditions
- Pavilion Plan
- reduced death rate at hospitals from 42% to 2%

New hospitals + specialist hospitals
Nurses given a more central role in care and cure
Improved training , organisation and cleanliness

18th and 19th century
1700-1900
Anaesthetics and antiseptics

Joseph Lister - Carbolic acid to kill bacteria and avoid infection (1865)
Aseptic technique - sterilised equipment and clothing

James Simpson - chloroform (1847) as an anaesthetic

John snow developed an inhaler for chloroform which helped queen Victoria safely deliver her baby

Surgery was pain free , death rate to shock reduced , infection decreased

18th and 19th century
1700-1900
Prevention

Vaccination against anthrax and chicken chorea for animals and rabies for humans

Public health acts 1848/1875
Following Chadwick’s 1842 report on bad conditions

Government had a laissez faire attitude

1875 compulsory to clean water , sewer , public toilets , street lights , parks and inspect for cleanliness

18th and 19th century
1700-1900
Jenner and Vaccination

Noticed the milkmaids who had been treated for cowpox never got smallpox. He injected a boy who had smallpox with cowpox and he survived

By 1800 100000 people had been vaccinated worldwide

1802 Royal Jennerian society set up and by 1804 12000 British people had been vaccinated

1852 vaccinations were compulsory

18th and 19th century
1700-1900
Cholera in London , 1854

John snow discovered cholera was spread by contaminated water not miasma
Removed the broad street pump in 1854

This caused a new London sewer system and lead to the public health act of 1875

1900-present
Modern Britain
Genetics and lifestyle

James Watson and Francis crick worked on DNA. Worked out double helix structure and led to the human genome project of 1990

Lifestyle
Smoking , alcohol , diet

1900-present
Modern Britain
Diagnosis

Labs to test skin or blood
X-rays to see inside body
Monitors to see what is going on over time

Technology advances
Incubators , X-rays , microscopes , Pacemakers , dialysis machines etc

1900-present Modern Britain Care and treatment

Magic bullets - a chemcial compound that Woudl attack and kill the microbe causing a specific disease Dr hata and Erlich joined team in 1909 and the 606th compound of Salvarsan cured syphilis Antibiotics Keyhole surgery (tiny cameras) - improves precision and reduces patients recovery time Robotic surgery - more precision

1900-present Modern Britain Prevention

NHS 1948 - improves access to care Compulsory vaccinations Government - more funding and laws to reduce spread Lifestyle campaigns - smoking ban 2006 - smoking amongst men has fallen from 68% to 20% from 1948 - 2010

1900-present Modern Britain Penicillin

1928 - Alexander Fleming accidentally discovers bacteria in a Petri dish being killed by penicillin mould. This was an excellent antibiotic Florey and chain developed on Flemings ideas Florey got the US government to produce penicillin during the war to show its effectiveness. Mass production began in 1942 and in Britain in 1943

The western front Blood transfusions

Sodium citrate to blood to stop clotting Refrigerated Citrate glucose - 4 weeks stored Blood bank at Cambrai was a blood depot 1917 a routine process at CCS

The western front Weapons and wounded

Shells and shrapnel 58% of wounds Bullets 31% Dirty shrapnel caused gas gangrene and infections Brodie helmet developed reduced head wounds by 80% Gas masks given in 1915

The western front Pre war discoveries

X-ray Blood transfusions Aseptic surgery

The western front Plastic surgery + brain surgery

Face surgery - Harold gillies Cut skin from donor area and put on face. Queens hospital Kent more than 5000 patients. Brain surgery - Harvey Cushing used magnets to remove shrapnel from head. The death rate for his surgery was 29% compared to 50% at other surgeons

The western front Thomas splint

Stopped joints from moving so reduced blood loss Increased survival rate to 82%

The western front Treatment of wounds and infections

Carrel Dakin method - tubes of antiseptic sterlllised slag solute in wounds Debridement - cutting away dead or damaged and infection tissue Amputation - prevents spreading

The western front Hospitals

Thompsons Cave 800m of tunnels Close to front line 700 places for stretchers Operating theatre Electricity and piped water Waiting rooms

The western front Chain of evacuation Advanced dressing stations

Stage 2 of COE Maximum stay of 1 week 400m from RAP Abandoned building , dug outs or tents Staffed by 10 medical officers , stretcher bearers + nurses Walked or stretchered in

The western front Chain of evacuation Casualty Clearing Station

3rd stage of COE Safety back from frontline Survey occurred Wounded were triaged Accessible by ambulances In factories or schools near railway lines 24 CCS at Ypres

The western front Chain of evacuation Regimental Aid posts

Stage 1 of COE Immediate first aid 200m from frontline Men walked or carried in (Stretcher bearers 6-8 men per stretcher ) Staffed by RA officer or stretcher bearers

The western front Base hospitals

Last stage of COE Operating theatres , X-ray , specialist centres Critical wounds Miles from frontline Men walked Large converted buildings Ambulance or train there

The renaissance 1500-1700 Sydenham

Used direct observation to identify symptoms A more rational method Discovered scarlet fever was different to measles His book was called ‘observations medicate’ 1676

Western front trench diseases

Shell shock - PTSD symptoms Trench foot - caused by mud and wet. Used whale oil + changed socks or amputated limbs. 75000 deaths from British soldiers Trench fever - caused by fleas , cramped and lice. Delousing stations where clothes were cleaned.

Western front all battles with one fact

Ypres 1 - 50,000 brits killed , first mine explosion underground (1914) Ypres 2 - 1st chlorine gas used (1915) Somme - worst battle , 57000 brits dead in one day , 300000 killed overall (1916) Arras - base hospital underground and flooded (1917) Ypres 3 - very muddy (1917)