Medicine Through Time, c1250-Present Flashcards
1
Q
What is an illness or disease?
A
A series of effects or symptoms caused by a type of pathogen.
2
Q
How do we become ill?
A
When a harmful pathogen enters the body and damages the cells.
3
Q
Who was Hippocrates?
A
A Greek doctor who looked for obvious rational ideas as to why people suffered with disease.
4
Q
What did Hippocrates do?
A
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.
5
Q
What were the four different humours?
A
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.
6
Q
How was an imbalance of the humours treated?
A
Bringing the humours back into balance by purging.
7
Q
How were Hippocrates ideas’ received?
A
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.
8
Q
Who was Claudius Galen?
A
A Greek doctor who worked and lived in Ancient Rome, 500 years after Hippocrates.
9
Q
What did Galen do?
A
The studied the work of Hippocrates and built on his ideas of the four humours.
10
Q
What did Galen believe?
A
That each humour could be balanced by doing the opposite - the Theory of Opposites.
11
Q
Other than studying illness, what else did Galen do?
A
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.
12
Q
How did Galen’s work survive?
A
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.
13
Q
Why were Galen’s ideas accepted?
A
As he believed in one God.
14
Q
What were medical ideas predominantly linked to in the Middle Ages?
A
Religion or superstition. However, there were some rational explanations.
15
Q
What was the most common rational idea?
A
The miasmas caused disease - that fifth poisoned the air.
16
Q
In the Middle Ages, what did some doctors use to try to diagnose disease?
A
Urine colour, they did not believe it caused disease though.
17
Q
What supernatural beliefs did any belief affected a persons health and body?
A
The positions of the stars and the planets.
18
Q
Other than urine charts, how else did doctors try to diagnose disease?
A
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.
19
Q
In the Middle Ages, who was believed to have supernatural powers?
A
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.
20
Q
What was King Edward famous for?
A
He would touch over 200 scrofula and tb suffers a year during his reign (1272-1307).
21
Q
What would people wear to try to treat illness?
A
Lucky charms or amulets.
22
Q
How important was religion in medieval England?
A
Middle ages Britain was densely Christian and the church held great power and influence over all aspects of life.
23
Q
Who did some people believe send disease?
A
God as a punishment for sinful behaviour.
24
Q
How did people try to prevent God sending disease?
A
Lighting candles in church as an offering to God, praying, fasting, going on pilgrimage or punishing themselves (flagellants).
25
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.
26
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.
27
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.
28
What disease in particular could the king's touch cure?
Scrofula - 2,000 were touched a year.
29
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.
30
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.
31
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.
32
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.
33
What could people be given to try to cure disease?
Herbal remedies were also used to cure people.
34
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.
35
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.
36
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.
37
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
38
What sort of advice would be on a regimen sanitatis?
Getting enough sleep, not overeating and maintaining good hygiene practises such as bathing.
39
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.
40
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.
41
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.
42
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.
43
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.
44
Who would apothecaries typically treat?
Lots of people would see an apothecary as an alternative to a doctor as they were comparitively cheap.
45
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.
46
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.
47
Who would barber surgeons treat?
They would treat the patients seen by physicians and were a lot cheaper.
48
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.
49
Where/how did family/women train?
It would be passed down through families and from wise women. Often they worked as apprentices.
50
Who would family/women treat?
Pregnant women, poor people who could not afford surgeons and the vast majority of sick people.
51
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.
52
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.
53
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.
54
Who was not treated in hospitals?
Insane and pregnant patients. Infectious and terminal patients.
55
Who cared for the sick at home?
Women cared for their relatives and dependents when needed.
56
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.
57
When did the Black Death occur?
1348
58
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.
59
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.
60
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.
61
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.
62
How much of the population was killed by the Black Death?
Almost half.
63
What creature carried the plague bacteria in its guts?
Fleas
64
How did the black rats get to England?
In cargo on ships.
65
Where did the plague first break out into the world?
Central Asia
66
How many days did it take for plague victims to die?
6 days
67
How quickly did the plague victims die if the infection spread to the lingo?
A couple of days.
68
How did coughing spread the Black Death?
Inhaling droplets of mucus.
69
Why did the Black Death spread quickly in the cities of Britain?
Tightly packed streets were good for disease.
70
Which type of people suffered the most from the plague?
The youngest, oldest and poorest.
71
In which English city did 15 of the 52 town councillors die for the Plague?
Bristol
72
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.
73
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.
74
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.
75
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.
76
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.
77
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.
78
What diseases did people suffer from in the Renaissance period?
Small pox, the Great Pox (syphillis) and sweating sickness.
79
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.
80
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.
81
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.
82
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.
83
What did Girolamo Fracastoro do?
In 1546, a new text called On Contagion theorised that disease was caused by seeds spread in the air.
84
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.
85
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.
86
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.
87
What did Thomas Sydenham do?
In 1676, the medical textbook Observations Medical was published which theorised that illness was caused by external factors opposed to the Theory of the Four Humours.
88
What did Anthony Von Leeuwenhoek do?
By 1638, more powerful microscopes had been developed to allow for the observation of tiny animalcules or little animals in plaque scraped from between teeth. The first recorded observation of bacteria.
89
What was the nickname of Thomas Sydenham?
The English Hippocrates
90
What was Thomas Sydenham's occupation?
Doctor in the 1660s and 1670s.
91
What was the main idea about illness that existed during his life time?
The Theory of the Four Humours
92
When studying a sick patient Thomas Sydenham refused to rely on what?
Medical books.
93
Thomas Sydenham made a point of...
closely observing the symptoms and treating the disease causing them. Instead of seeking them all as side effects of one cause.
94
Thomas Sydenham published works:
A book called Observations Medical in 1676 with his theories about disease and observations of various epidemics.
95
One of Sydenham's most controversial ideas was that...
disease were like plants and animals because they could be organised into different groups.
96
What medical theory did Thomas Sydenham disagree with?
The Theory of the Four Humours because it said treatments varied from person to person whereas he encouraged observation and disagreed with the nature of the person affecting the disease.
97
What did Sydenham encourage his students, and all doctors, to do?
To observe their patients, note down their symptoms in detailed descriptions and look for remedies to tackle the disease.
98
What two diseases did Sydenham successfully identify as being different?
Measles and scarlet fever.
99
What new medical treatments did Sydenham develop for smallpox and malaria?
To treat smallpox he prescribed airy bedrooms, light blankets and cold drinks. To treat malaria he popularised a treatment from Peru which is still used today.
100
Who created the world's first printing press?
Johannes Gutenberg, a German goldsmith in 1440.
101
How many presses were in operation by 1500?
Hundred in Europe.
102
Why was the printing press faster than the original way of copying books?
Text no longer had to be copied by hand.
103
Who used to control the copying of books?
It was in the hands of the church.
104
Why were books criticising Galen now being published?
The Church could no longer only publish works they agreed with.
105
Why was the Royal Society set up in 1660?
So that they could share and discuss new ideas and discoveries.
106
What was the aim of the Royal Society?
To promote and carry out experiments to further the understanding of science.
107
What did the Royal Society receive in 1662?
Its royal charter from Charles II, who had a keen interest in science. This gave the society credibility. It meant that they were doing something right.
108
What did the Royal Society begin to publish in 1665?
The Society began publishing their scientific journal, called Philosophical Transactions. It was the world's first scientific journal which continues to be published today.
109
Why did the Royal Society encourage scientists to publish in English?
So that their ideas could be easily understood by more people.
110
Where would the ideas published be kept?
In a library for anyone to study.
111
What did the Royal Society make possible for doctors?
To be able to study each others' research. It was therefore very important in the development of new medical ideas.
112
Before the renaissance period, what were hopsitals used for?
Travellers, pilgrims, the elderly and a few sick people would have attended hospitals for food, shelter and prayer.
113
In the 16th century, what could a patient expect at a hospital?
- A good diet: food was still important because people did not have access to food which was good for them.
- A visit from a physician: they visit up to twice a day to prescribe treatments and observe symptoms.
- Medication - many hospitals had their own pharmacy and apothecary.
114
What impact did the dissolution of monasteries have on health?
From 1536 onwards, the dissolution of monasteries in England dramatically changed the availability of health care. Some smaller hospitals and St Bartholemew's remained open because Henry VIII rebounded it in 1546 or were founded by charities. Although some were opened without religious sponsors.
115
What were lazar houses?
Places that treated people suffering from leprosy.
116
What did people realise by 1500?
People slowly began to realise that disease could be transmitted from person to person, even though they did not understand why.
117
After discovering that disease can be transmitted from person to person, what happened?
New types of hospitals began to appear that catered only for people suffering from plague or pox. These were known as pest houses or pox houses, they provided a much needed service because previously they had to go elsewhere or risk infecting their families.
118
Doing the renaissance period, where were most people care for?
At home.
119
Who provided care at home?
Women - this included rich, well-born ladies (like Lady Grace Mildmay) and poor women working in big cities to support their families.
120
What remained the same in the way people were cared from the middle ages to the renaissance?
1. They continued to be mostly cared for at home.
| 2. People still received food when they visited hospitals.
121
What had changed in the way people were cared for from the middle ages to the renaissance?
1. People with infectious diseases were now treated in pest houses.
2. Doctors actually visited the hospitals to treat the sick. They would view their symptoms.
122
How did treatment change from the middle ages to the renaissance?
- Transference: illnesses or a disease could be transferred to something else.
- By the 1660s iatrochemistry or medical chemistry had become popular this was because of the impact that alchemy had on medicine. Metals such as antimony and mercury were used to treat illness.
- New herbs from the New World were used as medicines such as sarsaparilla, ipecac, cinchona, coffee, nutmeg and tobacco.
- Colours of remedies were more often chosen to match the illness.
123
How did treatment stay the same from the middle ages to the renaissance?
- Herbal remedies continued to be popular.
- Bleeding, purging and sweating were all used as treatments because the belief that illness was caused by an imbalance in the Four Humours was strong.
- Metals such as antimony and mercury were used to treat illnesses as they caused the patient to swear or vomit.
124
How did prevention change from the middle ages to the renaissance?
- Towns and cities were better run so now people were fined for leaving waste outside their houses.
- Local authorities punished minor criminals by making them clean the streets. Some set up rotes to drain swamps.
- Henry VIII closed London's stews to stop the spread of syphilis as it was thought to be caused by bathing.
- Bathing was less popular: people kept clean by rubbing themselves down with fresh linen and changing their clothes.
- New instruments like barometers and thermometers were used to measure atmosphere to test the idea that disease was spread by certain weather conditions.
125
How did prevention stay the same from the middle ages to the renaissance?
- Cleanliness was considered important. The body, home and streets should be clean to be free of miasma - bad smells.
- People still believed that the season you were born in effected your bodies strength or constitution.
- As treatments offered no certainty that people would recover, prevention (avoiding disease) was still believed to be the best medicine.
- People tried to avoid disease by following a regimen sanitatis and not eating rich and fatty foods or drinking too much alcohol.
126
What were apothecaries and surgeons like in the renaissance?
Apothecaries continued to mix remedies and surgeons continued to carry out simple operations. But education for both types of medical profession increased considerably between 1500-1700. New wounds on the battlefield meant that more surgery was necessary, while the introduction of iatrochemistry introduced new ingredients into the stores of apothecaries.
127
What were physicians like in the renaissance?
Physicians continued to be trained at universities. Training courses changed very little. Although new subjects were introduced like iatrochemistry and anatomy. Most learning was still from books and not form practical experience.
128
Why was dissection still unpopular?
Although the decline of the church meant that dissection was legalised, it was still very difficult to get a supply of fresh corpses to dissect. Very few universities had an anatomy theatre because most of them did not think it necessary to train a physician in anatomy.
129
What did many artists begin to do in the renaissance period?
Illustrate medical texts because protestantism rejected highly-decorated churches, so many artists found themselves with hours to spend and in need of work, so they were able to create detailed drawings for medical textbooks.
130
Where did Vesalius train?
Vesalius trained to become a doctor in Paris in 1533 - it was a centre for the new humanist ideas about medicine. From there, he went to Padua, which had a very famous university, where he become a lecturer in surgery.
131
What was Vesalius' first publication?
In 1536, he published Six Anatomical Tables - showing the different parts of the human body. It was labelled in Latin, Greek, Hebrew and Arabic. Three of the six drawings showed a human skeleton, which Vesalius himself had assembled. He used it in his lectures and were very popular with his students and colleagues.
132
What did Vesalius publish in 1543?
De Humani Corporis Fabrica or On the Fabric of the Human Body - the work he is most famous for.
133
What were the 5 major error Vesalius highlighted in the work of Galen?
- The human lower jaw was in one part, not two.
- The vena cava did not lead to the liver.
- Men did not have one fewer pair of ribs than women.
- The human liver did not have five separate lobes.
- The human breastbone was in three parts, not seven.
134
What did Vesalius encourage other doctors to do?
Base their work on dissection rather than believing old books. He wrote that is was vital the anatomy professors carry out dissections for themselves, and claimed that this was really important if further advances in medical knowledge were to be made.
135
How were Vesalius' texts different to medical texts?
Because his books were illustrated with incredibly detailed drawings of the human body in various stages of dissection.
136
In what 5 ways did Vesalius impact medical training and knowledge?
- Made the study of anatomy not only acceptable by fashionable.
- He caused great controversy.
- His work was heavily copied and even plagiarised.
- Inspired other anatomists, some of whom went on to correct his own mistakes.
- He was a trail blazer.
137
What did Galen say out blood and why did people continue to believe it?
That is was created in the liver and was used up in the body. Although doctors increasingly challenged the ideas, most ordinary people continued to accept this idea into the 1600s due to a lack of science and technology.
138
When was William Harvey born?
1578
139
Where did Harvey study?
Harvey studied medicine at Cambridge and then studied at the famous medical school in Padua.
140
What was Harvey's occupation?
In 1615 he became a lecturer of anatomy at the College of Physicians and by 1618 he was one of the royal doctors for King James I.
141
What two things did Harvey have keen interests in?
1. Dissection
| 2. Observing the human body.
142
What did Harvey teach his students?
Part of Harvey's job was to carry out public dissections and he taught his students that it was important to observe the body and believe what they saw, rather than reading classical texts.
143
How was Harvey influenced by Vesalius?
Harvey studied the work of Vesalius whilst he was at Padua medical school, learning that Vesalius believed that the veins of the body contained valves, which was proof that the blood in those veins flowed towards the heart.
144
How did Harvey have evidence for his theory?
He dissected bodies and saw evidence to prove this theory.
145
How did Harvey prove his theory?
When Harvey tried to pump liquids through the veins the other way, it did not work. This proved that the blood only flowed towards the heart, contradicting what Galen had taught about the blood.
146
What was Harvey challenging?
Harvey was challenging the old traditional ideas of Galen. Galen believed that blood was created in the liver. Harvey worked out that is blood really was created in the liver then it would have to make 1,800 litres of blood a day! This convinced Harvey that blood must circulate around the body.
147
Why did William Harvey experiment on cold blooded animals?
They had a much slower heartbeat, to observe the movement of their blood while they were still alive. In order to study the circulation of the blood?
148
What did Harvey prove through his research into the circulation of the blood?
That arteries and veins were linked together in one system.
149
How did Harvey test his theory about the circulation of the blood?
Tying a tight cord around somebody's arm and cutting off the blood flow in the artery leading into the arm. Because the artery in the arm is deeper than in the veins, loosening the cord a little bit allowed blood into the arm but stopped it from flowing out and the veins swelled with blood. This also proved the existence of arteries.
150
What two other ideas of Galen's did Harvey challenge?
Galen suggested that blood flowed from one side of the heart to the other through invisible pores in the walls of the ventricles. He also said that veins carried both blood and pneuma. Harvey criticised both of these, showing that veins carried only blood. He proved that the heart acted as a pump just as the new mechanical fire pumps did.
151
What five factors made Harvey's research possible?
- Individuals: Harvey's own abilities and others such as Vesalius had previously proved parts of the work of Galen wrong, which made it easier for other scientists.
- Scientific breakthroughs: such as dissections becoming more commonplace.
- Attitudes in society: the 'Medical Renaissance'. There was more interest in science and in solving some of the puzzles of the human body. People had begun to search for rational explanations for things.
- Institutions: such as the government or King Charles I which gave him credibility.
- Technology: such as mechanical firefighter pumps. Newly popular technologies, like the pump used when fighting fires, inspired Harvey to look again at how the heart worked.
152
What was the impact of Harvey?
- His book, An Anatomical Account of the Motion of the Heart is considered to be the beginning of modern physiology.
- The most immediate impact that Harvey's theory has was to encourage other scientists to experiment on actual bodies.
153
Did Harvey's work on the circulation of blood have much practical impact on medicine in the 17th century?
The impact of Harvey's discoveries on treatment was quite limited. He may have paved the way for a modern understanding of anatomy and how the human body functions, but a lot of doctors at the time ignored him. Some even openly criticised him. Nobody liked to be told that they had been doing their job wrong. They also reasoned that nobody recovered from disease by simply knowing that blood flowed to the heart. To many, it had not practical application. English medical textbooks continued to give Galen's account until 1651; Harvey's ideas only began to appear in universities from 1673.
154
What was the year of the Great Plague?
1665
155
How long did the Great Plague last?
June until November - 5 months.
156
How many Londoners were killed by the Great Plague?
100,000 (one in five people).
157
What was the record number of people killed in a week during the Great Plague?
7,000 in September.
158
What was the Great Plague spread by?
Fleas carried on rats.
159
What were the ideas about the causes of the Great Plague?
- Fewer people belied it, but many still believed that the Theory of the Four Humours could be a cause of the plague.
- Punishment from God: many believed that the plague was sent by God to mankind in order to clean up his kingdom.
- Astrology: there had been an unusual alignment between the planets, people believed that this was a sign that there was trouble ahead.
- Miamsa: this was the most popular theory about the cause of the Plague. People believed that is was caused by a miasma.
- By 1665, many people believed that disease could be spread from person to person.
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What action did the government take during the Great Plague?
King Charles II ordered that people should fast regularly and made a list of actions to be carried out. Public meetings, fairs and large funerals were banned. Theatres were closed. Streets and alleyways were ordered to be cleaned. Barrels of tar were burnt in the street (sometimes with herbs) to clear away the miasma. Around 40,000 dogs and 200,000 cats were killed. Searchers were employed to monitor the homes of the sick. People were quarantined for 28 days and carts would collect the dead everyday to be buried.
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What were the treatments for the Great Plague?
- Recipies for herbal remedies continued to be extremely popular. These took the form of medicines or rubs.
- Quack doctors took advantage of the general panic and mixed remedies and advertised them as fabulous cures.
- Physicians advised that patients be wrapped in thick wooden cloth and laid by a fire to sweat it out or scraping a live pigeon to a bubo or lancing it with a feather.
- People did not still understand the cause so mostly tried to avoid it.
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How did people try to prevent the Great Plague?
- Plague doctors wore special costumes to avoid catching the disease.
- The College of Physicians recommended a variety of preventative measures: prayer and repentance; quarantine anybody who had the plague; carrying a commander; various diets such as fasting or eating butter and garlic.
- Most people turned to local haters for help. Plague water was popular treatment. Also native and exotic herbs. Even catching syphilis.
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What happened for 1700?
Nationwide epidemics swept Britain. There were 11 outbreaks in London, the worst killed 3548 people.
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What was innoculation?
In order to inoculate themselves against smallpox they caught a mild dose of the disease so they would avoid catching a more severe form of it.
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Who was Edward Jenner?
In 1796 he was a country doctor in Gloucestershire.
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How did Edward Jenner train?
He trained as an apprentice to a surgeon apothecary.
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Where did Edward Jenner first work?
As a doctor at St George's Hospital in London.
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Who did Jenner treat?
A lot of dairy farms / milk maids.
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What did Jenner discover?
The smallpox vaccine.
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How did Jenner show the scientific method?
- Observation: he noted that lots of dairymaids did not catch smallpox, after catching cowpox.
- Theory/hypothesis: he decided the two must be somehow connected.
- Text/experiment: in 1796 he infected a local boy with cowpox, James Phipps. Six weeks later he attempted to infect James again and then again.
- Write up findings: in 1798, he wrote up his findings.
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How did Jenner ensure other doctors could use the same technique?
He wrote instructions.
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Who opposed the smallpox vaccine?
- Church: using animal infection in human medical trials is against God's will.
- Innoculators: it is destroying their businesses.
- Royal Society: they refuse to publish it because there is lots of opposition in the scientific community due to a lack of understanding of how it worked.
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Why did the government back vaccination?
- It was safer and a more reliable alternative.
| - It was cheaper, people did not need to be put into quarantine.
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What were the three factors in the successful development of smallpox vaccine?
- Edward Jenner: trained as a doctor who worked as a surgeon in an apothecary and hospital. He used careful scientific methods to test and prove his vaccination.
- Government: provided funding and set up a society to promote vaccination. Passed laws that made it compulsory.
- Observation: Jenner observed the pattern of cowpox in dairy maids. He planned it carefully and repeated it. Several times.
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What three key laws led to the fall in smallpox cases?
- 1840: the government makes inoculation a crime.
- 1852: it makes smallpox vaccination compulsory.
- 1872: begin to enforce compulsory vaccination.
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What was the short-term impact of the smallpox vaccination?
Many lives were saved. By 1800, 100,000 people were vaccinated. In two years after the founding of the Royal Jennerian Society in 1803, 12,000 British people were vaccinated.
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What was the long-term impact of the smallpox vaccination?
Vaccination became normal. After 1872 the number of cases fell dramatically. Jenner's work shared other scientists like Pasteur and Koch to search for other vaccines.
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What is the downside to the smallpox vaccination?
It was a one off. It would be another 80 years before another vaccine was developed because the true cause of disease was still not known.
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What was the enlightenment?
A movement in the 18th century that looks for scientific explanations for every part of life including medicine. The scientific revolution replaced old explanations with new ones.
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How did the growth of cities at this time affect health and medicine?
The new cities were not well-planned and quickly became dirty and disease-ridden. Diseases like tuberculosis, typhus and smallpox were a big threat. It was overcrowded and there was a lack of sewage removal and clean water supplies.
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What replaced the Theory of the Four Humours in the 18th century?
In the 18th century, the theory of spontaneous generation replaced the theory of the theory of the four humours. it said that germs were present on decaying matter. Most people perceived microbes were the produce of decay, rather than the cause of it.
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What happened in 1796?
Edward Jenner discovered the smallpox vaccine.
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What happened in 1860?
The French Academy of Science challenges scientists to prove or disprove the theory of spontaneous generation.
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What happened in 1861?
Louis Pasteur uses microscopes to prove that is is microbes that causes decay when working on how wine and vinegar spoil. He calls this Germ Theory.
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What happened in 1878?
While working on chicken cholera Pasteur discover how a weaker strain of diseases can be used to make a vaccine to prevent disease.
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What are the four principles of Germ Theory?
1. The air contains living microorganisms.
2. Microbes can be killed by heating them.
3. Microbes in the air cause decay.
4. Microbes are not evenly distributed in the air.
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What did Pasteur's work prove?
It proved that germs caused disease. It also worked out how to make vaccines.
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What do they call Robert Koch?
The father of bacteriology.
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What did Robert Koch's work prove?
That different germs cause different diseases.
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What did Robert Koch make easier to do?
To study germs by growing them in petri dishes on agar jelly and make it easier to see them with microscopes by staining them with industrial dyes.
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How did scientists and doctors use Koch's work?
To identify the germs that caused diphtheria, pneuma, meningitis, tetanus and the plague.
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Why was Robert's work important?
As once the germ was identified they could make a vaccine to prevent it.
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Why was the impact of germ theory in Britain minimal?
- Pasteur was not a doctor and he worked on food not disease.
- Important doctors in Britain continued to promote spontaneous generation.
- The role of germs in causing disease was doubted because even healthy people were covered in them.
- Progress in preventing disease remained limited until it was proven that different germs caused different diseases.
- Even in 1884 the British government preferred to believe that cholera was caused by soil not germs.
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What was the positive impact of germ theory?
- A Scottish surgeon Joseph Lister read Pasteur's work and linked germs to infection in patients recovering from operations.
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How did cholera spread?
Through person to person contact or water contaminated with the faeces of a sufferer.
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When did cholera first break out in Britain?
1831
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What was the worst outbreak of cholera in Britain?
In 1848-49 which killed 53,293 people.
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What was the last epidemic of cholera occur in Britain?
In 1956-66 which killed 14,378 people.
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Why did the first attempts to deal with cholera unsuccessful?
Because they believed miasmata and rotting material caused disease and so tried to tackle that.
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Who was John Snow?
A surgeon who had moved to Soho in 1836 and had become London's leading anaethetist.
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What did John Snow discover?
After witnessing the 1848-49 epidemic Snow inferred that cholera could not be transmitted by a miasma because it affected the guts not the lungs and that drinking water was being contaminated by the cholera-ridden faeces being disposed of in the cities drains.
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In Soho in 1854, how many people died of cholera?
93
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What did Snow discover during the 1854 epidemic?
That cholera was responsible for those deaths by creating a spot map to show where the deaths occurred and noticed a pattern around the water pump.
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What pattern did Snow notice?
Only 5 people died in the workhouse out of 535.
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How did Snow prove his theory?
By removing the handle from the water pump, after which the number of cases of cholera dropped dramatically. Also, he inspected the well which had been contaminated by a nearby cesspit.
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What did John Snow do in 1855?
He presented his findings to a house of commons committee and showed his evidence that cholera was transmitted by dirty water.
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How did the government react at first to John Snow's findings?
The government didn't support Snow's findings because accepting it meant that they would have to take action so still supported miasma.
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Why did the government's opinion later change on John Snow's work?
In 1860, after the Great Stink of 1858, the government eventually accepted Snow's recommendations and it was completed in 1875 by Joseph Bazalgette.
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What factors affected change in ideas about the cause of disease?
- Individuals: Pasteur discovered germ theory and vaccines. Koch discovers different germs caused different diseases. Lister made the link between germs and disease.
- The British Government: only began to get involved in everyday life when more people had the right to vote. At first germ theory did not offer any practical solutions so they did not promote it.
- Science/communication: focus on finding answers to the big questions of science/improved communication enabled scientists to share their work with each other and draw their own conclusions and theories.
- Attitudes: the enlightenment led to interest in rational explanations for diseases. Growing cities lead to dangerous outbreaks of disease. Germ theory wasn't widely accepted until the 1880s because it took a long time to show that specific microbes were always present.
- Technology: better microscopes meant the study of germs possible. Koch improved ways of observing germs by developing the petri dish and dyes to help scientists to better observe bacteria.
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What is laissez faire?
French phrase that means 'let them be.'
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Why was there some continuity in the way sick people were treated and cared for between 1700-1900?
Because it took a while for medical science to catch up with new ideas about illness and disease. As medical treatments and ideas about disease began to progress so did hospitals and the care they provided.
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What were hospitals like in the 18th century?
By 1700 there were only 5 hospitals in England and all were in London. Throughout the 18th century new hospitals began to appear founded using donations from wealthy members of the public and doctors began to visit hospitals weekly, sometimes even for free. Increasingly all hospitals were visited by doctors and they had a surgeon and an apothecary on site. There was also a small staff of untrained nurses to care for the patients.
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What were hospitals like from 1800-1850s?
Although hospitals grew, the rich still preferred to be treated at home. Hospitals were still particular about who they treat, but increasingly they accepted the deserving poor who could not afford to pay their medical bills. Unfortunately though as more people attend hospitals they become less sanitary. Although hospitals had separate wards, doctors still went from patient to patient and ward to ward without washing their hands or changing their clothes, as they did not understand that germs caused disease, so they did not take steps to avoid germs.
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When was Florence Nightingale born?
1820
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How did Nightingale train?
As a nurse in Germany.
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What was Nightingale's job in 1853?
Superintendent of nurses at King's College Hospital.
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What happened in 1854?
Britain went to war with Russia in the Crimea. Persuaded the giver
