Medicine & Surgery Flashcards
What is the current average life expectancy?
80
What was the average life expectancy in 1350?
Around 30 years, although the rich would have often lived longer
What are the four humors?
Four different liquids , ‘humours’: blood, phlegm, yellow bile, black bile.
What were the Greek’s opinions on the four humours?
That every person had their own individual mix of the four humours and an imbalance of them caused illness. They also thought that the humours were linked to the four seasons and the idea of four elements (earth, air, fire and water)
With the Greek’s belief in the four humours, how did they treat illnesses?
By trying to restore the balance of the four humours, for example letting out excess blood
What did Hippocrates, the leading Greek doctor suggest?
That most treatment should be based on rest, changes in diet and leaving the body to heal itself
Which doctor in the 2nd century believed in bloodletting as a treatment for nearly all illnesses?
Galen
What was Galen’s Theory Of Opposites?
That if you had too much phlegm, which was ‘linked to’ water and cold, you should eat hot peppers to warm you up, and if you had a temperature you should eat cucumber which would cool you down
What about Galen made many people think that there was no point in further medical research other than his?
He produced over 350 texts about medicine and surgery summarising medical knowledge at the time, explaining his new ideas and linking them with existing theories, making them into one. His confidence in his ideas made people believe him.
When and where was the first European medical school established?
In Salerno in the 10th century
In the first European medical school, what was the teaching based on?
Galen’s ideas and texts, rather than students having any practical experience.
As learning increased in the 12th century, how was astrology thought to be linked to medicine?
Scholars linked star signs to the Greek idea of the four elements. For an example, doctors believed that an operation on the head should be avoided when the moon is in the sign of Aries.
Physicians often used a handbook called ‘vade mecum’ (which is latin for ‘Go with me’). What did these manuals include?
Urine charts where the physician could compare the colour of the patients urine with the chart to help diagnose the illness, and/or a zodiac chart which would help the physician to know when to avoid certain treatments.
What occurred in 1348?
The Black Death
Describe the ‘Black Death’, also known as the ‘bubonic plague’
The bubonic plague was contracted from fleas that were carried by rats. If a person was bitten by a flea, the disease would enter their bloodstream. As their body attempted to fight the disease, their lymph glands swelled into buboes, and 2/3 people who caught it would die.
Why did people whip themselves due to the bubonic plague?
Because they believed that it was a punishment/test from God, and so walked in procession to churches, whipping themselves to show God that they were sorry in hope that he would show mercy.
Name two ideas as to the cause of the bubonic plague other than a punishment/test from God.
An unusual positioning of Mars, Jupiter and Saturn, poisonous fumes from volcanoes and earthquakes, bad air (miasma) from decay (spread through movements in the air), an imbalance in the four humours, or the activities of groups of outsiders such as strangers or witches
Name three treatments tried for the bubonic plague
Holding a piece of bread against the buboes and then burying it in the ground, fasting and praying, eating cool things, carrying herbs and spices to smell, walking in procession to a church, saying prayers, whipping each other, cutting open the buboes and draining the pus, tidying the rubbish from the streets, lighting a fire in the room, keeping the air moving by ringing bells or keeping birds flying around the room, and stopping people from entering or leaving the town/village.
What were the six main options for treatment in the middle ages?
A trained physician, The apothecary, The barber-surgeon, The hospital, The housewife-physician, or prayer and pilgrimage.
What was important about Andreas Vesalius?
`He published an important book called ‘The Fabric Of The Human Body’, which showed drawings of muscles, nerves, and a skeleton of the human body. Carrying out human dissections meant that he discovered flaws in Galen’s teachings. He disproved the theory that the heart was divided by a septum which has holes in it for blood to pass through, the theory that the liver supposedly had lobes, the theory that teh human jaw has two bones, as it has one, and that the sternum had seven parts, of which it only had 3.
What was important about William Harvey?
He came after Vesalius, and also found errors in Galen’s ideas. He published an explanation of his ideas which was supported by details of his studies in a book in 1628 called ‘An Anatomical Account of the Motion of the Heart and Blood in Animals’. He disproved Galen’s idea that veins carry a mixture of blood and air, showing that they only carry blood, and showed that the idea of Galen’s that blood is constantly manufactured by the liver and used up as it travels around the body, showing that it circulates repeatedly around the body with the heart acting as the pump.
Why was printing important for the development of medicine?
It meant that printed copies of books such as those by Vesalius and Harvey could be produced quickly and cheaply, meaning that even if physicians didn’t carry out dissections themselves, they still had the opportunity to learn a lot from Vesalius’ illustrations of human anatomy. Also, they could copy Harvey’s experiments for themselves.
Describe the impact of Renaissance discoveries with technology on medicine.
Things such as mechanisms in pumps and clocks helped people to better accept the idea of the body functioning as a machine.
The Medical Renaissance saw many old ideas about anatomy and physiology challenged, with the printing press spreading those ideas faster and more cheaply than before. But, were there many new developments in the understanding of disease itself?
No. There was resistance to change, and there weren’t many new developments in the understanding of disease itself.
Why did the work of Harvey not seem very relevant to the work of physicians and the problems of disease?
Because his work was on physiology, which is how the body’s organs function, rather than on the cause/ treatment of illness.
Why is the role of women in medieval medicine a difficult topic to research?
Because our evidence is so limited due to most people in the period c1350-c1750 not having the ability to read or write. The education for girls was based around running the home, meaning that there are little sources provided by women to describe their lives in that period. Men didn’t feel that accounts of daily life were important, so there is a limited amount of resources about family life and daily activities.
Describe people’s general knowledge of disease and what medical treatment was like in the medieval and Renaissance periods.
People had no real knowledge of what caused disease to spread, and medical treatment was based on theories such as the four humours and miasma (poor air). During the Reformation in the 16th century, the influence of the church on medical training began to decline, while a better understanding of the body began to develop, based on a more scientific approach to knowledge and understanding.
What is the idea of miasma?
That disease is caused by poisonous vapours in the air.
What happened as a result of the use of machinery in agriculture?
There was less work to be done in the countryside, and so many people moved to the rapidly growing towns such as Manchester and Leeds to work in the new factories there. In those towns, the standard of workers’ health was most often extremely poor and so disease spread quickly.
Describe the standard of factory worker’s health in the mid 18th century.
The conditions in the factories led to ill health, for example, poor ventilation created breathing problems. There were often accidents with machinery in the factories. The housing was poor quality, with damp and poorly ventilated rooms, and there were often more than one family inhabiting one home. Sewers often ran into rivers where people sourced drinking water, and there was also less access to fresh food than in rural areas.
Describe what happened to Britain in terms of Cholera in 1831.
It first arrived in 1831, having been in India for many centuries before. It was a frightening disease because people could die within a single day and it spread so fast that thousands could die within a few weeks. A picture from that year, 1831, called ‘The Silent Highwayman’ depicted Death rowing along the River Thames with the caption ‘Your money or your life’. It meant that people needed to spend money improving the water quality of the Thames or it’d kill them.
How is Cholera spread, and what are its effects?
It is spread through bacteria which is passed on through food and water that has been contaminated by an infected person. It causes sickness and severe diarrhoea and the sufferer dies from dehydration, often within 24 hours.
How is Diphtheria spread, and what are its effects?
It spreads through tiny droplets when coughing/sneezing, or through contact with the soiled clothes of an infected person. It causes bleeding and sometimes paralysis, and suffocation from a blocked throat normally caused death.
How did a growing interest in science c1750-c1900 affect people’s ideas about disease?
They grew less likely to blame disease on the supernatural or unbalanced humours.
What were the two ideas that the search for a scientific explanation for disease c1750-c1900 caused?
Miasma: disease is caused by poisonous vapours in the air, and Spontaneous Generation: disease was caused by germs that were produced by flesh and/or vegetables as they rotted.
What was the initial process used to treat smallpox, and how was it carried out?
Inoculation, which was developed in China and spread through Asia. A small amount of pus would be taken from a smallpox sufferer’s blister and then spread into a small cut made between the thumb and forefinger of the person being inoculated. That caused a mild version of smallpox to develop, making the person then immune to further attacks.
Why did inoculation not completely solve the problem of smallpox?
Because not everyone could afford to have it done, and it was not always effective and/or safe.
What was Edward Jenner’s discovery?
He found out that people who had already had cowpox would not contract smallpox. He tested this on an 8yr old boy by inserting cowpox matter from a sufferer of the illness into cuts on his arm, and found it to be true. To make sure of his findings, he vaccinated another 23 people in the same way, and received the same results.
Why was the smallpox vaccine so effectively spread?
Jenner didn’t mind other people using his ideas as he wanted many people to benefit from his work. In 1802, the Jennerian Society was set up in London to promote vaccination, and within two years of that 12,000 people had been vaccinated. In 1852, the government made it compulsory to be vaccinated.
Why did many doctors oppose Jenner’s work?
Because when the government provided a grant to have people vaccinated for free, they lost money because people no longer paid them for inoculations.
What was the significance of the germ theory, and what was it?
The germ theory was that there are microbes in the air which cause decay. It was an important breakthrough in scientific understanding, and disproved the theory of spontaneous generation. It lead Koch to identify the specific microbes that caused some individual diseases.
Describe the development of Pasteur’s germ theory.
Pasteur investigated the problem of liquids turning sour in the brewing and vinegar industries. As more powerful microscopes had recently become available, he could observe the growth of unwanted small organisms in the liquids. He discovered that heating the liquid killed the bacteria and so stopped it going sour. In 1861, he published his germ theory, showing that there were microbes in the air and that they caused decay. His work disproved the theory of spontaneous generation because no decay occurred if matter was sealed in a container. That showed that the microbes weren’t produced by the matter itself, but were in the air surrounding it.
Describe the work of Robert Koch
In 1875, Koch, who had read Pasteur’s work, decided to investigate whether bacteria were linked to disease. Working with a team of scientists and funded by the German government, Koch identified the specific microbes that caused anthrax in sheep. In 1882, he identified the specific microbes that caused tuberculosis, and in 1883, the specific microbes that caused cholera. He found out that chemical dyes could be used to stain specific bacteria so they could be studied more easily under the microscope.
Why did Pasteur’s germ theory have limited impact on medicine at the time?
Because each disease had to be researched individually, so progress was slow.
Describe the training of doctors at the start of the 18th century: the ‘industrial period’.
The training was still mainly theoretical, but a mall number of criminals’ bodies were allowed to be used for dissection in medical schools and hospitals.
Why did medical training begin to improve in 1815?
Because the Society of Apothecaries and the Royal College of Surgeons introduced examinations before they awarded a certificate.
What was the purpose of body snatchers in the 18th and early 19th century?
They seized the bodies of hanged criminals, or dug up newly buried criminals in order to provide dissection specimens for students.
Explain the significance of John Hunter.
His lectures on anatomy helped develop a more professional approach to medical training, and he emphasised the importance of observation and experiment. His students included Edward Jenner, who followed Hunter’s methods when investigating cowpox. He employed a secretary to write up his notes, and paid an artist to draw the discoveries he made through dissection, and published several important works, including one about the changes that occurred in pregnancy. Hunter was incredibly skilled in dissection techniques, and studied many aspects of anatomy, using specimens to show the human body’s structure and physiology and the progressive stages of a disease. He carried out various experiments on the sexually transmitted infections of syphilis and gonorrhoea.
Why did women’s role in midwifery decline after the invention of forceps in the 17th century?
Because the midwife needed training to use them successfully.
When could women first qualify as doctors at a British university, and what adversity did they still face?
In 1877, and they still faced opposition from males who thought they were too emotional for dissections, not intelligent enough for the training and that patients would not take them seriously.
Where were people treated in the 19th century?
The middle/upper classes would usually be treated at home, some doctors set up ‘sick clubs’, where people could pay a small amount into a fund weekly to cover any costs of treatment from the doctor, the working classes may attend the dispensary or out-patients department of a hospital, and many old, sick and disabled people had to enter the local workhouses.
Why did Pasteur’s work on germs have an impact on hospitals?
Because it lead to most hospitals accepting the need for antiseptic conditions and equipment in the wards.
What did the government do to help with the care of the poor in the 19th century?
In 1867, it was ordered that Poor Law Unions should join together to build infirmaries that were separate from the workhouses and that had a full time doctor appointed to them. New asylums for people with mental health issues were established, and fever houses for those with infectious diseases were built.
Describe what apothecaries were selling during the early 19th century.
‘Preparations’, which were advertised as being a cure for practically anything.They were potions, ointments and pills, made from things such as coloured liquids, lard, ginger, alcohol, turpentine and wax. The ingredients for pills were made into a paste and then shaped by lands.76666
How did the role of the newspaper and the development of photographs help to catalyse change?
People became more aware of problems, and public pressure sometimes forced change.
What four questions must be applied to all sources when analysing them?
Who produced it, why did they produce it, where did they source their information, and can it be assumed that any information and conclusions based on the source can be applied to other areas in the country?
Describe the significance of Emil Von Behring.
He developed Koch’s work too isolate the antitoxins used by the body to fight diphtheria, then found a way to inject them to cure the disease.
Describe the significance of Paul Ehrlich, a member of Koch’s team in connection with Dr Sahachiro Hata.
He set up a research team to build on Behring and Koch’s work, and tried to combine a dye with other chemicals to find a cure for syphilis. He researched for several years, only able to due to government funding. Hata joined the research and reviewed some previous experiment, discovering that the 606th compound they had tested and then dismissed was actually effective. The use of chemical drugs to target and cure illness was an important breakthrough.
