medicine through time Flashcards

1
Q

what were the believed causes of illness and disease in c1250 - 1500?

A
humours 
astrology 
god ( sinning ) 
jews
miasma
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2
Q

what were popular treatments of disease over time?

A
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”

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3
Q

what were popular ways of preventing disease over time?

A
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  "
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4
Q

what was care like over time?

A
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 
"
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5
Q

compare how people acted towards the plague in 1348 and later in 1665?

A

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
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6
Q

what were the four stages of the chain of evacuation ( in order )?

A

regimental aid post

Advanced dressings station

Casualty clearing station

base hospital s

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7
Q

when and what was significant about the battle in ypres

A

1914

first use of mines dig under Germans to blow them up

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8
Q

when and what was significant about the second battle of Ypres?

A

1915

first use of chlorine gas by Germans and the British used cotton pads and urine for protection

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9
Q

when and what was significant about the battle of the Somme

A

1916
first tanks and creeping barrage
most losses

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10
Q

when and what was significant about the battle was of arras?

A

1917

British built tunnels for bases and areas underground hospital with 700 beds

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11
Q

when and what was significant about the battle of cambrai?

A

1917

first tank battle 450 used

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12
Q

what were symptoms of shell shock?

A

tiredness, nightmares, loss of speech, uncontrollable shaking and comple the mental breakdown

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13
Q

how many suffered from shell shock

A

80,000

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14
Q

what were the symptoms of trench fever?

A

flu like symptoms with a high temperature and headache and aching muscles

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15
Q

how many suffered from trench fever?

A

500,000

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16
Q

how was trench fever eventually prevented?

A

delousing stations

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17
Q

what was the cause of trench foot?

A

standing in water logged trenches with no change is boots or socks

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18
Q

how was trench foot prevented?

A

soldiers carried three pairs of socks and changed twice a day they were also told to rub whale oil on their feet

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19
Q

what were symptoms of trench foot?

A

feet would swell and go numb

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20
Q

what was the role of base hospitals?

A

near ports in france/Belgium. Large hospitals with all equipment and some specialist ones of gas and head injuries count treat 2500

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21
Q

what was the significance of the arras hospital

A

it was underground , so safe from shelling had 700 beds and an operating theatre

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22
Q

who invented x-rays?

A

wilhelm roentgen

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23
Q

what was the enlightenment?

A

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

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24
Q

what are the main factors that affect understanding of the causes of illness and disease?

A
science 
technology 
attitudes in society 
Individuals 
institutions
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25
Q

when was Florence nightingale born?

A

1820

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26
Q

what changes did nightingale implement in hospitals?

A

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

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27
Q

why was nightingale credible enough to implement change?

A

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

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28
Q

what were the three main problems with surgery?

A

bleeding
pain
infection

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29
Q

when was the smallpox vaccine developed?

A

1796

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30
Q

what were the oppositions’ arguments to the vaccine?

A

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

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31
Q

why did the government support jenner’s vaccine?

A

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

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32
Q

what was the opposition to developments in anaesthetics and antiseptics?

A
  • 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

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33
Q

when was the germ theory widely accepted?

A

1890’s

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34
Q

what were Koch’s influences in Britain?

A

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

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35
Q

what were the aims of the second public health act in …..?

A

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

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36
Q

when did snow present his findings on cholera?

A

1855

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37
Q

why was the impact of medical discoveries in 1500-1700 so small?

A

Lack of quality medical instruments

the general public believed in the theory of the four humours

There were still huge gaps in knowledge

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38
Q

when was the dissolution of the monasteries?

A

1536

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39
Q

how did vesalius encourage change?

A

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

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40
Q

how were attitudes towards the four humours changing in 1500-1700

A

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

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41
Q

what comments can I make when the nature of the source is a diary?

A
  • 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

-

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42
Q

what comments can I say when the purpose of the source is journalism?

A
  • could be downplayed to prevent concern
  • propaganda
  • second hand so less accurate and reliable
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43
Q

what can I say when the nature of a source is a photo?

A
  • primary source so accurate and reliable
  • depending on purpose could be propaganda
  • lack of precise details could hinder the utility
44
Q

what were the names and roles of the four trenches?

A

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

45
Q

describe two features of blood transfusion

A

• 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)

46
Q

describe two features of base hospitals

A

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

47
Q

what were the believed causes of disease and illness in 1500 - 1700?

A

some began to disagree with humour theory
miasma
seeds in the air
problems with bodily chemicals

48
Q

what were the believed causes of disease and illness in 1700 - 1900?

A
spontaneous generation ( rotting matter produced microbes which were spread by miasma ) 
germ theory (microbes cause decay ) "
49
Q

what were the believed causes of disease and illness in 1900+?

A

genetics

lifestyle

50
Q

what actions were taken to prevent disease in c1250 - 1500?

A

praying
good smells
ambulants

51
Q

what actions were taken to prevent disease in c1500 - 1700?

A
regimen sanitatis
pilgrimage
good diet
no sinning
everything in moderation 
cleaning streets for dead animals etc
52
Q

what actions were taken to prevent disease in 1700 - 1900?

A

jenner and his vaccines
inoculation
antiseptic surgery
improvement of hospitals

53
Q

what actions were taken to prevent disease in 1900+?

A

healthy lifestyle campaigns
compulsory vaccinations
clean air acts

54
Q

what treatments were popular in c1250 - 1500?

A
"charity hospitals 
care at home 
physicians
humoural treatments 
herbal remedies 
praying 
fasting"
55
Q

what treatments were popular in 1500 - 1700?

A

“transference
herbal remedies
iatrochemistry
humoural treatments “

56
Q

what treatments were popular in 1700 - 1900?

A

improvements in surgical treatment

57
Q

what treatments were popular in 1900+?

A

antibiotics
magic bullet
nhs

58
Q

why was there change between the medieval period and the renaissance?

A
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.

59
Q

why was there change between the renaissance period and the industrial period?

A

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

60
Q

why was there change between the industrial period and the modern?

A

huge advancements in science and technology
government: NHS, mass production of penicillin
the wars

61
Q

why was there continuity between the medieval period and the renaissance?

A

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.

62
Q

describe two features of the RAMC

A

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

63
Q

describe two features of the regimental aid post

A

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

64
Q

describe two features of the dressing stations

A

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

65
Q

describe two features of the casualty clearing stations

A

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

66
Q

describe two features of the field ambulance

A

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

67
Q

what were the advantages and disadvantages of horse drawn ambulances?

A

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

68
Q

who was responsible for the development of plastic surgery?

A

harold gillies

69
Q

who developed new methods of brain surgery?

A

Harvey cushing

70
Q

describe two features of the thomas splint

A

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

71
Q

describe two features of the trench system

A

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 )

72
Q

how do we know that cushing was successful?

A

he had a survival rate of 71% compared to the normal 50% of other surgeons

73
Q

describe two features of gas attacks

A

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

74
Q

describe two features of plastic surgery

A

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

75
Q

what is aseptic surgery and how was it achieved?

A

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

76
Q

what were the initial disadvantages of x-rays?

A

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

77
Q

when was the first human blood transfusion?

A

1818

78
Q

who discovered the blood groups and why was it important?

A

karl landsteiner because it meant that the recipient wouldn’t refuse the donor’s blood

79
Q

what was the cause of gangrene?

A

open wounds infected by bacteria in soil

80
Q

what were the symptoms of gangrene?

A

Dead tissue. The bacteria caused gas to build up in the wound

81
Q

what was the solution to dealing with gangrene, gas and other injuries that were infected?

A

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.

82
Q

how did sydenham implement change?

A

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

83
Q

how did the royal society encourage change? also when was it founded?

A

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

84
Q

how did the printing press encourage change? and when was in invented?

A

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

85
Q

how did medical education improve in the renaissance?

A

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

86
Q

how did medical education stay the same in the renaissance?

A

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

87
Q

compare one way in which treatment of disease was similar in the medieval period and the renaissance

A

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

88
Q

how did Harvey encourage change? and when was he around?

A

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

89
Q

define spontaneous generation

A

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

90
Q

what was, and who theorised the germ theory?

A

louis pasteur

he thought that micro - organisms caused decay

91
Q

did pasteur’s work have an influence is britain, why/why not?

A

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

92
Q

which well-respected doctor made encourage the germ theory?

A

henry bastian

93
Q

when did pasteur present the germ theory and when was it widely believed?

A

1861

1890’s

94
Q

what was chloroform a solution for?

A

pain in surgeries

95
Q

what were the impacts of anaesthetics in surgery?

A

anaesthetics allowed lengthier and more complex surgeries to take place

but now that deeper surgeries were occurring infection and bleeding were even bigger problems

96
Q

who invented chloroform and when?

A

james Simpson

1847

97
Q

why was infection a huge problem in surgery?

A

because doctors rarely cleaned their surroundings or themselves and wearing a stained doctors coat showed how much experience you had

98
Q

who first used carbolic acid and when?

A

joseph lister in 1865

99
Q

why did carbolic acid not catch on?

A

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

100
Q

although carbolic acid did little for change in the short term, what did it do in the long term?

A

it altered doctors’ attitudes and they began to steam clean instruments and wear rubber gloves, face masks and surgical gowns

101
Q

what government action was taken during the great plague and when was it?

A

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’

102
Q

why did the government not like the germ theory?

A

because it had no practical solutions

103
Q

when was the public health act and what did it do?

A

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

104
Q

what were the believed causes of cholera and how did snow discredit them?

A

people thought cholera spread through miasma but snow said that because cholera affected the guts not the lungs this could not be the case

105
Q

why did the government build new sewers?

A

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