medicine through time Flashcards
what were the believed causes of illness and disease in c1250 - 1500?
humours astrology god ( sinning ) jews miasma
what were popular treatments of disease over time?
1250 - 1500 humoural treatments ( theory of opposites) herbal remedies charity hospitals physicians care at home
1500 - 1700 "transference herbal remedies iatrochemistry humoural treatments "
1700 - 1900
improvements in surgical treatment
more ingredients from the ‘new world’ + overseas trading so more advanced herbal treatments
chemical treatments
1900 + “antibiotics
magic bullet
nhs”
what were popular ways of preventing disease over time?
1250 - 1500 praying good smells amulants " " 1500 - 1700 regimen sanitatis pilgrimage good diet no sinning everything in moderation cleaning streets for dead animals etc" 1700 - 1900 "jenner and his vaccines inoculation antiseptic surgery improvement of hospitals " 1900 + "healthy lifestyle campaigns compulsory vaccinations clean air acts "
what was care like over time?
1250 - 1500 "charity hospitals care at home physicians apothecaries barber surgeons wise woman " 1500 - 1700 "pest houses hospitals began to treat patients dissolution of the monasteries decreased the number of hospitals a lot of care at home 1700 - 1900 " improvement of hospitals 1900 + "national insurance act for workers NHS ( 1948 ) over 2500 hospitals "
compare how people acted towards the plague in 1348 and later in 1665?
similarities
- thought it was caused by god as a punishment
- it was also blamed on astrology and miasma
- wore amulets and surrounded themselves with nice smells as a prevention
- people tried to purify the air by holding herbs to smell or burning fires/ tar barrels
differences
- quarantined a lot stricter in 1665 and marked the doors with crosses
- the government intervened to stop the spread, large funerals, public meetings, fairs and theatres were closed
what were the four stages of the chain of evacuation ( in order )?
regimental aid post
Advanced dressings station
Casualty clearing station
base hospital s
when and what was significant about the battle in ypres
1914
first use of mines dig under Germans to blow them up
when and what was significant about the second battle of Ypres?
1915
first use of chlorine gas by Germans and the British used cotton pads and urine for protection
when and what was significant about the battle of the Somme
1916
first tanks and creeping barrage
most losses
when and what was significant about the battle was of arras?
1917
British built tunnels for bases and areas underground hospital with 700 beds
when and what was significant about the battle of cambrai?
1917
first tank battle 450 used
what were symptoms of shell shock?
tiredness, nightmares, loss of speech, uncontrollable shaking and comple the mental breakdown
how many suffered from shell shock
80,000
what were the symptoms of trench fever?
flu like symptoms with a high temperature and headache and aching muscles
how many suffered from trench fever?
500,000
how was trench fever eventually prevented?
delousing stations
what was the cause of trench foot?
standing in water logged trenches with no change is boots or socks
how was trench foot prevented?
soldiers carried three pairs of socks and changed twice a day they were also told to rub whale oil on their feet
what were symptoms of trench foot?
feet would swell and go numb
what was the role of base hospitals?
near ports in france/Belgium. Large hospitals with all equipment and some specialist ones of gas and head injuries count treat 2500
what was the significance of the arras hospital
it was underground , so safe from shelling had 700 beds and an operating theatre
who invented x-rays?
wilhelm roentgen
what was the enlightenment?
a movement I. Europe during the 18th century that promoted the rides that people could thea m did themselves and that traditional authorities like the nobility and the church should not be able to control everyday life
what are the main factors that affect understanding of the causes of illness and disease?
science technology attitudes in society Individuals institutions
when was Florence nightingale born?
1820
what changes did nightingale implement in hospitals?
she split the patients into different wards depending on their requirements
she improved training for nurses by establishing a school in Iondon
she wrote notes on nursing in 1859
and made nursing a more respectable job
why was nightingale credible enough to implement change?
nightingale made a huge difference in the Crimean war ( 1854)
she decreased the mortality rate by 38%
by ensuring that there was clean bedding and good meals; scrubbing brushes to clean wounds and
what were the three main problems with surgery?
bleeding
pain
infection
when was the smallpox vaccine developed?
1796
what were the oppositions’ arguments to the vaccine?
the inoculators disapproved because the vaccine would have ruined their business and lost them money
the church disapproved because Jenner used animals in trials which the church disagreed with
the royal society saw no scientific proof so they wouldn’t support the vaccine
why did the government support jenner’s vaccine?
because it was safer and more reliable to inoculations and cheaper because the recipients didn’t need to quarantine unlike the inoculators who were contagious
what was the opposition to developments in anaesthetics and antiseptics?
- anaesthetics allowed deeper and more dangerous surgeries to take place which resulted in deaths ( infection and bleeding ) so the anaesthetics were wrongfully.blamed
the victorians believed that pain relief was interfering with gods plan
some doctors believed that patients were more likely to die if they were unconscious rather than awake and screaming
when was the germ theory widely accepted?
1890’s
what were Koch’s influences in Britain?
he developed a dye which made it easier to studying microbes
he encouraged doctors to study the diseases not the symptoms
kochs new methods of growing microbes made it easier for other scientists fists to study specific diseases
what were the aims of the second public health act in …..?
1875
providing clean water to stop diseases that were spread in dirty water
disposing of sewage to prevent drinking and washing water from becoming polluted
employing a public officer of health to monitor outbreaks of disease
ensuring new house were of better quality to stop damp and overcrowding
when did snow present his findings on cholera?
1855
why was the impact of medical discoveries in 1500-1700 so small?
Lack of quality medical instruments
the general public believed in the theory of the four humours
There were still huge gaps in knowledge
when was the dissolution of the monasteries?
1536
how did vesalius encourage change?
he made the study of anatomy more acceptable and fashionable
he inspired others to challenge old views like he did with galen and do their own dissections and make detailed drawings
how were attitudes towards the four humours changing in 1500-1700
physicians started to reject the fours humours but could find nothing to replace it with so treatments stayed the same
and people the general public did still believe in the four humours
what comments can I make when the nature of the source is a diary?
- first hand account. (Primary source) so accurate
- personal account so little risk of exaggeration ( little risk of dramatisation for effect )
- could be affected by emotion of tiredness
- might not describe the average western front if written during a battle
-
what comments can I say when the purpose of the source is journalism?
- could be downplayed to prevent concern
- propaganda
- second hand so less accurate and reliable
what can I say when the nature of a source is a photo?
- primary source so accurate and reliable
- depending on purpose could be propaganda
- lack of precise details could hinder the utility
what were the names and roles of the four trenches?
communication trench
support trench - 80m behind the frontline and the troops would retreat here if the frontline trench came under attack
frontline trench - this was where attacks would be made from
the reserve trench - 100m behind the support trench and was where reserve troops could be mobilised for a counter attack if the frontline trench was captured by the enemy
describe two features of blood transfusion
• Initially transfusions on the Western Front were carried out using a syringe and tube, with the donor
present (1). This stopped the patient going into shock from blood loss (1).
• Ways to store blood were discovered by Lewisohn, Weil, Rous and Turner (1). Greater amounts of
blood could be available for operations in field hospitals (1).
• A blood depot was set up before the Battle of Cambrai (1). The army developed ways of dealing with
large numbers of casualties on the Western Front (1)
describe two features of base hospitals
they were located near the coast so that it would be easy to transport men back to Britain for treatment of more serious wounds
they had operating theatres to perform surgery on wounds that were serious but not so much that the men couldn’t go back to the fighting after treatment.
they began to experiment with new surgeries
what were the believed causes of disease and illness in 1500 - 1700?
some began to disagree with humour theory
miasma
seeds in the air
problems with bodily chemicals
what were the believed causes of disease and illness in 1700 - 1900?
spontaneous generation ( rotting matter produced microbes which were spread by miasma ) germ theory (microbes cause decay ) "
what were the believed causes of disease and illness in 1900+?
genetics
lifestyle
what actions were taken to prevent disease in c1250 - 1500?
praying
good smells
ambulants
what actions were taken to prevent disease in c1500 - 1700?
regimen sanitatis pilgrimage good diet no sinning everything in moderation cleaning streets for dead animals etc
what actions were taken to prevent disease in 1700 - 1900?
jenner and his vaccines
inoculation
antiseptic surgery
improvement of hospitals
what actions were taken to prevent disease in 1900+?
healthy lifestyle campaigns
compulsory vaccinations
clean air acts
what treatments were popular in c1250 - 1500?
"charity hospitals care at home physicians humoural treatments herbal remedies praying fasting"
what treatments were popular in 1500 - 1700?
“transference
herbal remedies
iatrochemistry
humoural treatments “
what treatments were popular in 1700 - 1900?
improvements in surgical treatment
what treatments were popular in 1900+?
antibiotics
magic bullet
nhs
why was there change between the medieval period and the renaissance?
printing press, more wars - more injuries to cure, dissolution of the monasteries, less religion hold so more dissection and experimentation could happen vesalius the royal society sydenham
Church: Decline of Church’s power in Reformation, allowed
new ideas such as dissection; improved knowledge but many people still highly religious and resistant.
Technology: Printing Press allowed spread of ideas to challenge the Church, took printing out of Church hands. Royal Society allowed the printing of Vesalius’ books. Microscope and water pump influences Harvey. Government:
Charles II supported scientific revolution and Royal Society; government action during the Great Plague, but was still only a reaction to the problem.
Individuals: Sydenham, Vesalius, Harvey and Royal Society all played key roles in improving knowledge.
why was there change between the renaissance period and the industrial period?
people began to openly challenge the ideas of the church; instead people used observation and reason
urbanisation; now more people lived in dirty and filthy cities demands for solution s were great
the government began to help communities and introduce public health acts and compulsory vaccinations because now working men could vote it was essential to keep them content
communication vastly improved so now doctors and scientists could attend conferences and learn from each other
science and technology: microscopes and vaccines
no influence from the church
why was there change between the industrial period and the modern?
huge advancements in science and technology
government: NHS, mass production of penicillin
the wars
why was there continuity between the medieval period and the renaissance?
wars
the church and tradition
lack of new technology
government only reacted
lack of quality medical instruments,
more knowledge of anatomy but no help for living patients
no money ( obvs none from church and gov probs needed it for war )
closing of hospitals
tradition
Closing of churches impacted hospital care.
Government: Charles II supported scientific revolution and Royal Society; government action during the Great Plague, but was still only a reaction to the problem.
Tradition: Majority of population still respected tradition, especially during the Great Plague.
describe two features of the RAMC
founded in 1898
it was responsible for the treatment of the soldiers on the western front and its numbers grew from 3,000 to 13,000 during the war
describe two features of the regimental aid post
located within 200m of the frontline
in order to give immediate first aid so the men could return to fighting ( it could not deal with serious injuries )
men often arrived by foot or were carried in by other soldiers
composed of regimental medical officers and stretcher bearers with first aid knowledge
in communication trenches or deserted frontline
describe two features of the dressing stations
about 400m from the frontline
in order to be safe from shelling but close enough for easy access
located in abandoned buildings, dug outs or bunkers in order to be safe from shelling
each station would be maned with 10 medical officers and medical orderlies and stretcher bearers of the RAMC from 1915 there were also some nurses
men often arrived by door or were carried in by other soldiers
could treat 700 men but couldn’t perform surgery and often got overwhelmed
describe two features of the casualty clearing stations
several miles from the frontline for safety but close enough to be accessible for horse ambulances
often located in buildings such as factories or schools and near a railway line to transport soldiers to the base hospitals if necessary
used a triage system to help officers make decisions about treatment
could treat 1000 men and could perform surgery and treat critical wounds
describe two features of the field ambulance
could treat 150 men in theory but could treat more in major battles
did not have the facilities to tend to wounded men for more than a week and men who had been treated would either e returned to their units or moved on to the next phase bu a horse or motor ambulances
what were the advantages and disadvantages of horse drawn ambulances?
couldn’t cope with large number of casualties
the men transported were often shaken about which just worsened their injuries
but horse drawn ambulances were good for transport in muddy terrain but now six horses were used per wagon, instead of two
who was responsible for the development of plastic surgery?
harold gillies
who developed new methods of brain surgery?
Harvey cushing
describe two features of the thomas splint
the splint was designed to stop the leg moving in cases of a gunshot or shrapnel would to the leg
it increased the survival rate from 20% to 82%
when the leg was not still the man would have lost a lot of blood and probably would be in shock and developed gas gangrene - this heavily decreased the chances of surviving an operation on the wound so most people who did survive only did because of an amputation
describe two features of the trench system
trenches were dug in a zig zag pattern
so the enemy couldn’t fire straight down and kill soldiers
holes were dug into the side of the trenches where men could take protective cover when need ( dug outs )
how do we know that cushing was successful?
he had a survival rate of 71% compared to the normal 50% of other surgeons
describe two features of gas attacks
they caused great panic and fear because they suffocated and their skin burned
however, were not a major cause of death with only about 6,000 British soldiers dying
the british originally used cottons pads and urine to protect themselves
describe two features of plastic surgery
men were returned to england for facial reconstructive surgery and the key hospital that provided this surgery was the queen’s hospital in kent by the end of the war around 12,000 operations had been performed
what is aseptic surgery and how was it achieved?
surgery where everything was made clean before the surgery to prevent germs causing infection
the surgeons wore washed their arms hands and face and wore gowns
surgical instruments were sterilised and the air was sterilised by being pumped through a heating system
what were the initial disadvantages of x-rays?
People didn’t fully understand the risks of radiation. Patients could suffer burns or hair loss because of the high levels of radiation.
Roentgen developed a table-top machine, but the glass tube used was fragile and easily broken.
An x-ray of a hand on the table-top machine took about 90 minutes!
Larger x-ray machines were difficult to move around
when was the first human blood transfusion?
1818
who discovered the blood groups and why was it important?
karl landsteiner because it meant that the recipient wouldn’t refuse the donor’s blood
what was the cause of gangrene?
open wounds infected by bacteria in soil
what were the symptoms of gangrene?
Dead tissue. The bacteria caused gas to build up in the wound
what was the solution to dealing with gangrene, gas and other injuries that were infected?
Amputation of infected areas
wound excision or debridement: This was cutting away the dead, damaged and infected tissue from around the wound to reduce infection risk
The Carrel-Dakin Method: Sterilised salt solution pumped into the wound through a tube. Only lasted 6 hours, not enough of it had to be ready made. But by 1917 was the most effective method.
how did sydenham implement change?
encouraged scientists to study all symptoms at once not individually
he thought disease could be categorised
he developed new ways to treat disease e.g instead of sweating as a treatment of smallpox he prescribed airy bedrooms, light blankets and cold drinks
how did the royal society encourage change? also when was it founded?
1660
its aim was to promote and carry out experiments to further the understanding of science
it allowed scientists to discuss and share new ideas
it was also made credible because it had the support of charles I
how did the printing press encourage change? and when was in invented?
1440
it allowed ideas to be more widespread and allowed access to drawings
it enable knowledge to be spread more quickly and accurately now that text didn’t have to be copied boy hand
the church couldn’t censor what was published so now books condemning galen and other scientific books could be published
how did medical education improve in the renaissance?
trainee doctors had much better access to medical textbooks and there were a wider variety of these books due to the printing press
Protestantism rejected the highly decorated churches so some artists began to draw medical sketches for textbooks and even those who couldn’t afford textbooks could obtain individual copies called fugitive sheets
how did medical education stay the same in the renaissance?
new ideas were slow to take effect in schools
most learning was from books not practical education
although dissection was legal, very few universities had an a anatomy theatre or a trained physician
compare one way in which treatment of disease was similar in the medieval period and the renaissance
both periods used herbal remedies often concocted at home by wise women or from apothecaries to cure disease,
in the medieval period herbs like mint camomile and rose oils were used
but in the renaissance many more exotic herbs were available due to britain’s travels to the ‘new world’ so herbs like cinchona and sarsaparilla were used
how did Harvey encourage change? and when was he around?
late 1500’s
he disproved galen’s theories by using observation and experimentation ( proved that blood only flows one way and that blood wasn’t produced in the liver )
charles 1 employed his as a personal physician which helped give him credibility
define spontaneous generation
living organisms were produced from non living organisms
so microbes were a product of decay NOT a cause
( microbes could be seen because of the increased quality of microscopes
what was, and who theorised the germ theory?
louis pasteur
he thought that micro - organisms caused decay
did pasteur’s work have an influence is britain, why/why not?
nope
ATTITUDES AMONG DOCTORS
because his work specialised on food decay not disease
his idea went against spontaneous generation which was heavily believed as famous doctors like Henry Bastian supported it
and microbes were seen everywhere even in healthy people so people could not believe that these same thing could cause disease
which well-respected doctor made encourage the germ theory?
henry bastian
when did pasteur present the germ theory and when was it widely believed?
1861
1890’s
what was chloroform a solution for?
pain in surgeries
what were the impacts of anaesthetics in surgery?
anaesthetics allowed lengthier and more complex surgeries to take place
but now that deeper surgeries were occurring infection and bleeding were even bigger problems
who invented chloroform and when?
james Simpson
1847
why was infection a huge problem in surgery?
because doctors rarely cleaned their surroundings or themselves and wearing a stained doctors coat showed how much experience you had
who first used carbolic acid and when?
joseph lister in 1865
why did carbolic acid not catch on?
because lister had no scientific proof and very few believed in the germ theory
carbolic spray died out the skin and left behind an odd smell so surgeons didn’t trust it
although carbolic acid did little for change in the short term, what did it do in the long term?
it altered doctors’ attitudes and they began to steam clean instruments and wear rubber gloves, face masks and surgical gowns
what government action was taken during the great plague and when was it?
1665
public meetings, fairs and even large funerals were banned
theatres were closed
cats, dogs and pigeons were killed if seen on the street
infected people had to quarantine and the house’s were painted with a red cross saying ‘lord have mercy on us’
why did the government not like the germ theory?
because it had no practical solutions
when was the public health act and what did it do?
1875
provided clean water to stop diseases spread through water
disposed of sewage to prevent drinking and washing water
ensured new houses were of better quality
employed a public officer of health to monitor outbreaks of disease
what were the believed causes of cholera and how did snow discredit them?
people thought cholera spread through miasma but snow said that because cholera affected the guts not the lungs this could not be the case
why did the government build new sewers?
because they listened to snow when he said that cholera was spread by waste from cesspits contaminating drinking water and because of the summer of 1858
‘the great stink’ the stench of the sewage heated by the unusually warm sun nudged the government into action
