Medicine Through Time, c1250-Present Flashcards
What is an illness or disease?
A series of effects or symptoms caused by a type of pathogen.
How do we become ill?
When a harmful pathogen enters the body and damages the cells.
Who was Hippocrates?
A Greek doctor who looked for obvious rational ideas as to why people suffered with disease.
What did Hippocrates do?
He carefully observed his patients and noticed that humans contained 4 different humours. He believed when a person’s humours were imbalances they become ill.
What were the four different humours?
Blood, yellow bile, black bile and phlegm. They were linked to weather seasons as often a sick person would have symptoms that linked to one of these.
How was an imbalance of the humours treated?
Bringing the humours back into balance by purging.
How were Hippocrates ideas’ received?
His ideas spread quickly and was widely accepted. He always encouraged doctors to observe the patient first, this is called clinical observation. As a result today doctors can still take the Hippocratic Oath to observe and care for their patients. His works were widely used and read.
Who was Claudius Galen?
A Greek doctor who worked and lived in Ancient Rome, 500 years after Hippocrates.
What did Galen do?
The studied the work of Hippocrates and built on his ideas of the four humours.
What did Galen believe?
That each humour could be balanced by doing the opposite - the Theory of Opposites.
Other than studying illness, what else did Galen do?
He was a gladiator doctor and was experienced in basic surgery and took a keen interest in studying the anatomy. Although due to religious beliefs about the soul he had to use animals which created lots of errors.
How did Galen’s work survive?
He passed his knowledge into the future generation and wrote over 250 books on medicine and the anatomy which still would have been used in medical schools until the 1500s.
Why were Galen’s ideas accepted?
As he believed in one God.
What were medical ideas predominantly linked to in the Middle Ages?
Religion or superstition. However, there were some rational explanations.
What was the most common rational idea?
The miasmas caused disease - that fifth poisoned the air.
In the Middle Ages, what did some doctors use to try to diagnose disease?
Urine colour, they did not believe it caused disease though.
What supernatural beliefs did any belief affected a persons health and body?
The positions of the stars and the planets.
Other than urine charts, how else did doctors try to diagnose disease?
Physicians studied the stars (astrology) and used Zodiac charts that link specific parts of the body to different star signs and planets to diagnose and treat the patient.
In the Middle Ages, who was believed to have supernatural powers?
Other believed that the King had special powers to heal the sick. The king would rub holy oil on his hands which would allow him to cure illness.
What was King Edward famous for?
He would touch over 200 scrofula and tb suffers a year during his reign (1272-1307).
What would people wear to try to treat illness?
Lucky charms or amulets.
How important was religion in medieval England?
Middle ages Britain was densely Christian and the church held great power and influence over all aspects of life.
Who did some people believe send disease?
God as a punishment for sinful behaviour.
How did people try to prevent God sending disease?
Lighting candles in church as an offering to God, praying, fasting, going on pilgrimage or punishing themselves (flagellants).
In response to the plague, what religious thing did the King order?
Acts of national prayer to fasting to try to cure or prevent the plague.
What 6 different religious treatments were used during the plague?
Healing prayers and incantations; paying for a special mass to be said; fasting; pilgrimages to the tombs of people noted for their healing powers; touting holy relics; presenting an offering at a shrine; and lighting a candle proportionally as tall as what you wanted to heal.
Who did some people believe could cure disease?
People believed that the kings touch had the power to heal certain illnesses as during his coronation his hands would be rubbed with special holy oil - giving him supernatural powers.
What disease in particular could the king’s touch cure?
Scrofula - 2,000 were touched a year.
What other supernatural treatment did people believe could cause disease?
Astrology played a role in treatments offered bu physicians as they consulted star charts when diagnosing illness. Treatments varied according to the horoscope of the patient, also the alignment of the planets was checked at every stage of the treatment.
What was the most common treatment for an imbalance of the four humours?
Phlebotomy was the most common treatment for an imbalance in the humours - bad humours could be removed. It was so common that they didn’t carry out the procedure themselves - monks were forbidden from bleeding their patients. Sometimes it was done by barber surgeons and wise women.
How could a patient be bled?
By cutting a vein (this was the most straightforward way), leeches (usually used for people whose age or condition made traditional bleeding too dangerous) and cupping (the skin would be pierced with a knife or a pin until to bled and a cup placed over to draw blood out of the skin.
Other than phlebotomy, how was an imbalance of the four humours treated?
Purging was also used by physicians because it was believed that the humours were created from the foods eaten so the digestive system to remove any leftover food by giving them an emetic, laxative or enema.
What could people be given to try to cure disease?
Herbal remedies were also used to cure people.
What could herbal remedies contain?
They could contain up to 70 ingredients - making it very expensive. Common ingredients included: mint, aloe vera, camomile, rose oils, tamarind, almonds, saffron, butter, absinth, turpentine and corals.
What was a common herbal remedy?
Theriaca which was spice based and contains 70 ingredients such as ginger, cardanom, pepper, saffron, viper flesh and opium.
How did religion play a role in preventing illness?
The Church offered tithes to the church to ensure minor sins were forgiven regularly as it was believed the best way to avoid sin was by leading a life free from sin.
What was the regimen sanitatis?
A loose set of instructions provided by physicians to help a patient maintained good health. Sometimes, a physician would provide one written for their patient, because of this it was only available for the very rich
What sort of advice would be on a regimen sanitatis?
Getting enough sleep, not overeating and maintaining good hygiene practises such as bathing.
How did people prevent illness caused by miasma?
Purifying the air from miasmata involved spreading sweet herbs such as lavender and cleaning the streets by removing dead animals lying around and cleaning up smelly public toilets. Sometimes the herbs could be placed in a locket called a pommander.
Where/how did physicians train?
Between 7 to 10 years to get a degreee at a University such as Oxford, Cambridge, Paris, Bologna and Montpilier by reading books.
Who would physicians typically treat?
They mainly diagnosed illness and recommend a course of treatment - they rarely treated people themselves. They treated royalty and the very wealthy full-time.
What treatments would physicians give?
- Look at a sample of the patient’s urine, faeces and blood.
- Consult the astrological charts under which the patients was born and the time they fell sick.
- Create a course of treatments based on the patient.
- They rarely got involved in treating the patients themselves.
How did apothecaries train?
They did not need to go to university, so they learned from other apothecaries and studied herbal manuals such as Material Medica, from their own experience and passed down knowledge from families.
Who would apothecaries typically treat?
Lots of people would see an apothecary as an alternative to a doctor as they were comparitively cheap.
What treatments would apothecaries give?
- Created remedies and prescribe potions.
- Providing amulets and charms.
- The most common remedies were made from herbs, minerals and animal parts.
- Some cures combined prayer, magic and folklore.
- They mixed ingredient to make ointments and medicines for physicians.
Where/how did barber surgeons train?
They did not go to university buy trained as apprentices through observing others. They improved their skills through practise and reading books on surgery.
Who would barber surgeons treat?
They would treat the patients seen by physicians and were a lot cheaper.
What treatments would barber surgeons give?
They did basic surgery such as bleeding, removing surface tumours, sewing up wounds and making splints for broken bones. Occasionally they had to amputate a limp or remove painful bladder stones. A skilled surgeon could set broken limb, remove an arrow or even remove cataracts from the eyes.
Where/how did family/women train?
It would be passed down through families and from wise women. Often they worked as apprentices.
Who would family/women treat?
Pregnant women, poor people who could not afford surgeons and the vast majority of sick people.
What treatments could family/women treat?
They teated most illnesses and knew a wide range of remedies. They would grow various plants known for their healing properties keeping the patient clean, warm and well-fed. Carried out minor surgeries and bleedings.
Who controlled/operated hospitals?
Staffed by monks and nuns. The nuns would do the routine nursing, while the priests and monks saw to the spiritual warfare of the patients.
What treatments were offered at hospitals?
Caring for the sick, rather than curing disease. They were good places to rest and recover. Physicians were not employed because religious men were forbidden from cutting the body so treatment was very limited.
Who was not treated in hospitals?
Insane and pregnant patients. Infectious and terminal patients.
Who cared for the sick at home?
Women cared for their relatives and dependents when needed.
What treatments were offered in the home?
Making the patient comfortable, preparing restorative foods, mixing herbal remedies and growing various plants for these herbal remedies such as marigold and clover. Many people were happier at home than at a hospital.
When did the Black Death occur?
1348
What were the symptoms of the Black Death?
- Chest pains and breathing troubles.
- Fever
- Boils and black buboes appearing in the groin and armpits.
- Sneezing and coughing up blood.
What did people believe caused the Black Death?
- Imbalance of the Four Humours.
- Impure air causing corruption to the body’s humous from poisonous fumes released from an earthquake.
- The result of God deserting mankind as a punishment for the sin in the world.
- In 1345 there was an unusual positioning go the planets Mars, Jupiter and Saturn.
- People wrongly believed Jews caused the Black Death despite being expelled from Britain in the 13th century.
How did people treat the Black Death?
- Confess your sins and ask God for forgiveness through prayer. But if it is God’s will there is no cure.
- Lack of knowledge so were impossible to know how to cure.
- Bleeding and purging, however it made people die more quickly. Also, strong smelling herbs which were believed to have strong cleansing properties.
- Burst buboes.
- Flagellants, during themselves.
- People bought remedies and herbs from apothecaries. But they had uncertain affects. It become clear that no one was capable of curing the disease.
How did people try to prevent catching the Black Death?
- Pray to God and fast, go on a pilgrimage and make offerings to Hod and show God how sorry you are by self-flagellation.
- Quarantine laws to stop people moving around too much.
- They started cleaning the streets to get rid of the foul stench of rubbish and rotting.
- Physicians did not visit patients homes.
- Doing joyful things and avoiding anything sad.
- Escaping the foul air. Carrying a posy of flows to your nose to combat the ‘miasmas’.
- Avoid bathing to stop corrupting pores.
How much of the population was killed by the Black Death?
Almost half.
What creature carried the plague bacteria in its guts?
Fleas
How did the black rats get to England?
In cargo on ships.
Where did the plague first break out into the world?
Central Asia
How many days did it take for plague victims to die?
6 days
How quickly did the plague victims die if the infection spread to the lingo?
A couple of days.
How did coughing spread the Black Death?
Inhaling droplets of mucus.
Why did the Black Death spread quickly in the cities of Britain?
Tightly packed streets were good for disease.
Which type of people suffered the most from the plague?
The youngest, oldest and poorest.
In which English city did 15 of the 52 town councillors die for the Plague?
Bristol
What is renaissance?
A French word that means rebirth. Traditional ideas were slowly breaking down for new ideas. In 1500-1750 medicine was heavily influenced, although it was more about laying the foundations for changes in medicine to come. Society’s attitude changes.
Why was progress improving in the renaissance period?
- Science and technology: development of printing led to ideas and knowledge being spread further and faster.
- Science: dissections of humans become commonplace and so knowledge of the human anatomy improved.
- Individuals: the church began to lose its power and influence over society, and this gave individuals the opportunity to experiment and look into other, rather than religious causes of disease.
What ideas changed a lot?
- The Theory of the Four Humours: very few physicians believed this by the end of the 17th century, though it was still used when diagnosing disease, because patients understood it.
- The human body: there was a much better understanding of the anatomy.
- Diagnosing using urine: Physicians now understood that urine was not directly related to a person’s health.
What ideas changed a little?
- The use of medical books: Physicians carried out more observations of their patients. However, they still relied on texts for looking up symptoms.
- The influence of the Church: most people not recognised that God did not send disease. However, in times of epidemics, such as during the Great Plague, religious causes were still considered.
- Supernatural: Although astrology was much less popular from 1500, in times of epidemics people still wore charms to ward off disease.
What ideas stayed the same?
- Miasmata: the idea that disease was spread by bad smells and evil fumes was constant throughout this period and even become more widespread during epidemics.
Why was the impact of medical discoveries in c1500-1700 so small?
- There was still huge gaps in knowledge.
- The general public believed in the Theory of the Four Humours.
- The lack of quality medical instruments.
What diseases did people suffer from in the Renaissance period?
Small pox, the Great Pox (syphillis) and sweating sickness.
What did some people begin to argue about the four humours?
The Four Humours could not easily explain certain disease and did not cure them.
How was society changing in the Renaissance period?
Across Europe new forms of Christianity and a more secular society was developing: and understanding of the surrounding world was increasing with scientific discoveries.
What did some people continue to believe caused illness and disease?
There was still a widespread belief in miasmata as a cause of humour imbalance and disease.
What did Paracelus do?
In the 16th century, the Theory of the Four Humours was rejected by some radical physicians because disease was seen an something separate from the body and needed to be attacked. So new treatments were formed, influenced by alchemy.
What did Girolamo Fracastoro do?
In 1546, a new text called On Contagion theorised that disease was caused by seeds spread in the air.
What did William Harvey do?
In 1628, a new theory was published in Britain, which suggested that blood circulated around the body instead of being made in the liver, as taught by Galen.
What did Jan Baptiste Van Helmot do?
A better understanding the the digestive system developed, meaning that people gradually stopped believing disease was caused by eating the wrong things. Urine was no longer seen as a good way to diagnose illness.
What did Robert Hooke do?
New microscopes were being developed, which allowed for much clearer magnification. A new book, Micrographia, published in 1665, showed many detailed images, including a close-up drawing of a flea.
