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MEDIC
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- 1Medieval: Black Death – 1348;-Arrived in Britain in 1348.
-Spread by coughs sneezes, black rat flea bites (rates carried overseas by ships).
-Causes and treatments.
Poisoned water~ blamed Jews
God - prayed, flagellants.
-4 Humours~ opposites, purging, vomiting, blood letting.
-Symptoms
Breathing difficulties.
High temperature.
Swellings.
Exhaustion. - 2Renaissance: Background;-Began with lose study of classic texts + being critical of old translations.
-Return of classical texts renewed faith in 4 Humours + Opposites theory.
-'Rebirth'.
-Greater interest on how human body worked (observation + dissection) - 3Renaissance: Public health;-Many wars which took up resources.
-Increasing urban population~ strain on clean water supplies + sewage systems. - 4Renaissance: Factors;-Printing Press~ ideas spread
-Weakening power of Church~ no religious beliefs on causes of disease~ looked for natural causes + could dissect.
-Artists drawing from life~ medical drawings drawn + shared.
-Renewed interest in Ancient learning~ people wanted to learn how to read, challenged old medical ideas. - 5Renaissance: Vesalius – Anatomy;-Studied anatomy, became professor of surgery and anatomy. Did dissections + wrote books based on his observations using accurate diagrams. 1543~ wrote 'On The Fabric of the Human Body.'
-Pointed out Galen's mistakes by proving...
Jaw bone one bone, not two.
No holes in septum of heart. - 6Renaissance: Paré~ Surgery;-Disproves Galen by proving the bezoar stone isn't a treatment for poison.
-Battlefield surgeon, in battle he ran out of boiling oil (used to treat gunshot wounds) so made an ointment of roses, turpentine + egg yolk.
-Develops ligatures to seal wounds. - 7Renaissance: Harvey~ circulation of blood;-Identifies difference between arteries + veins.
-Disproves Galen by discovering circulation of blood. - 8Renaissance: Black Death 1665;-Worst appearance. Death toll = 100 000.
-To control spread households locked in + red crosses painted on doors.
-Carts organised by police roamed city collecting corpses for mass burial.
-People realised disease was contagious, but not that germs caused it. - 91750- 1900: Smallpox + Edward Jenner;-Inoculation
In 18c, small pox was a big killer. People immunised against smallpox using pus from sores of a sufferer. But sometimes led to death.
-Edward Jenner
Country doctors, heard that milkmaids didn't get smallpox, instead milder cowpox. Discovered that people who had cowpox didn't get small pox. 1796 - inoculated small boy with pus from sores of cowpox sufferer. Then injected James with smallpox, James didn't catch the disease!
-Opposition to smallpox vaccine.
Jenner couldn't scientifically explain who it worked. Inoculators afraid of losing money. Worried about side effects (e.g. cowpox). Church believed vaccination wasn't natural. - 101750- 1900: Why did they stop reading Galen in the 19th century?;-New understanding of body and Galen's descriptions were incomplete/wrong.
-Doctors did dissections + used microscopes. Galen's books not important.
-4 Humours not accepted. People initially thought miasma caused disease. - 111750- 1900: Developments in nursing;-Mary Seacole~ poor Jamaican background. Volunteers to be nurse in Crimean war, is rejected but does anyway self-financing journey. Nursed soldiers on battlefields and built 'British Hotel.' Goes bankrupt when returns to UK~ receives support due to press interest in story + write autobiography.
-Florence Nightingale~ Brought discipline + professionalism to a job with bad reputation. Wealthy background, became nurse despite family opposing. Went to Crimean War to sort out nursing care in English camp. Improved death rates, due to improvements in ward hygiene. Returned home + wrote book 'Notes on Nursing' + sets up hospital in London. - 121750- 1900: How did scientists discover the causes of disease?;-Robert Koch~ German scientist. Linked diseases to the specific microbe. Developed dying techniques to colour microbes, which he viewed through microscopes. Identified anthrax spores and bacteria causing septicaemia, tuberculosis + cholera.
- 131750- 1900: How did scientists discover the causes of disease?; (continued)-Louis Pasteur's Germ Theory (1857)~ Scientists thought microbes were caused by disease + appeared because of illness (spontaneous generation). Instead of blaming microbes, people looked for miasmas. Pasteur proved that there are germs in the air by sterilising water and keeping it in a flask that didn't allow airborne particles to enter. This stayed sterile~ but sterilised water kept in an open flask bred microbes.
- 141750- 1900: How did scientists discover the causes of disease?; (continued)-Pasteur~ Chicken Cholera Vaccine~ Hearing of Koch's work Pasteur decided to find new microbes and combat them. Looked for cures to anthrax + chicken cholera. Chamberland (worked for Pasteur) was supposed to inject chickens with chicken cholera but forgot. Left germs and injected them when he returned from holiday. Chickens survived, and survived when new germs were injected. Cholera was weakened by being left out and had made the chicken's immune.
-Pasteur~ Anthrax vaccine~ Produced weakened version of anthrax spore that would make sheep immune. - 151750- 1900: Overcoming the problems of surgery;-Surgery in the 18000s was dangerous + painful.
Main problems.
Pain~ die of shock.
How was the problem of pain overcome?-
Opposition~ uncomfortable for patients, pain good of healing, didn't understand how they worked or side effects, pain from God, encouraged riskier operations.
Final acceptance~ Queen Vic used chloroform in delivery of 8th child.
-In 1800, surgeons would ease suffering of patients by getting the drunk, knocking them out, opium etc.
Anaesthetics-
Nitrous Oxide~ 'laughing gas' discovered by Sir Humphrey Davy.
Ether~ used by J.R. Listen during leg amputation. Unpleasant side effects. - 161750- 1900: Overcoming the problems of surgery; (continued)Blood loss.
How was the problem of blood loss overcome?
Once William Harvey discovered the circulation of blood, the first blood transfusions were attempted.
Early blood transfusions were often disastrous because....
Blood groups were not discovered.
Couldn't prevent blood clotting.
Infection. - 171750- 1900: Overcoming the problems of surgery; (continued)How was the problem of infection overcome?-
Final development of ASEPTIC surgery~ by late 1890s Listers methods led to aseptic surgery (removal of all possible germs from theatres to ensure absolute cleanliness).
All surgical instruments steam sterilised.
Operating theatres + hospitals rigorously cleaned.
Sterilised rubber gloves first used and surgeon's hands scrubbed.
Joseph Lister + the discovery of antiseptics~ He heard that carbolic spray was used on sewage + knew sewage had similar smell to gangrene. Read Pasteur's germ theory. Prepared to take risks.
Opposition-
Lister's methods slowed down surgery.
Germ theory not widely accepted in 1857.
Spray was uncomfortable for doctors to use (affected skin).
Surgeons didn't copy methods correctly so were disappointed with results.
Until Germ Theory in 1850s, surgeons didn't take precautions to protect open wounds (reused bandages, didn't wash hands, didn't sterilise surgical equipment etc.) - 181750- 1900: Developments in Public Health;-Public Health Problems in early 1800s~ conditions in British towns became increasingly worse. Crowded towns + cities due to industrial revolution. Towns couldn't cope with providing water + sewage to more people. In squalid conditions, disease spread rapidly.
-Battle to improve public health~ some thought government should force local councils to clean up towns. But, many believed in 'laissez-faire' attitude + that government should allow local areas to control its own affairs. - 191750- 1900: Developments in Public Health; (continued)-Edwin Chadwick~ 1842~ asked by government to report on living conditions in towns. Concluded that poverty was caused by ill health which was caused by terrible living conditions. Said in 'Report on the Sanitary Conditions of the Labouring Population' that towns should;
1) organise drainage + refuse collection.
2) provide water supply.
3) appoint medical officer of health. - 201750- 1900: Developments in Public Health; (continued)-1848 Public Health Act~ outbreak of cholera put pressure on government to pass Public Health Act. Not compulsory. Government set up Board of Health to encourage local authorities to improve conditions. Gave them money to make improvements, but only a few local authorities took new measures. 1854~ Board of Health abandoned.
- 211750- 1900: Developments in Public Health; (continued)-1853 John Snow ~ proved there was a link between cholera + water supply. Used research, observation + door-to-door interviews to build a detailed map of cholera epidemic in Broad Street. Nearly all deaths had taken place within short distance from water pump. Near to pump, there was a brewery and none of the people had cholera because the brewery had its own water pump. So they didn't use the Broad Street Pump. Snow removed the handle + there were no more deaths. Later came to light that ta cesspit near the pump had cracked, leaking into the water supply. Put pressure on water companies to clean up their water supplies.
- 221750- 1900: Developments in Public Health; (continued)-1858 Great Stink~ The hot weather caused the human waste in the River Thames to stink. Putrid smell right under Parliament's nose, they considered moving and had to coat curtains with deodorant to get rid of smell. Great Stink prompted Parliament to sort out London's sewage + drainage system + to clean up Thames.
- 231750- 1900: Developments in Public Health; (continued)-1867 Second Reform Act~ working class men given vote. MPs wanted to win support of working class so improved living conditions of poor.
- 241750- 1900: Developments in Public Health; (continued)-1875 Second Public Health Act~ Forced local authorities to;
1) provide clean water
2) provide drainage + sewage
3) appoint Medical Officer of Health. But why was it introduced? - 251750- 1900: Developments in Public Health; (continued)-Results of the Public Health Act of 1875~ improved standards of living, stopped pollution of rivers form which people got water, shortened working hours in factories for women + children, made it illegal to add ingredients that made food unhealthy, made education compulsory.
- 2620th Century: Impact of WW2;-Drugs~ penicillin developed as first antibiotic.
-Surgery~ development in use of skin grafts + treatment of burns.
-Poverty~ evacuation took children out of urban areas, highlighted contrast between rich + poor.
-Blood transfusion~ blood could be stored for longer, civilians donated blood.
-Diet~ rationing improved some people's diet, government encouraged healthy eating.
-Hygiene~ government posters educating people about health + hygiene. - 2720th Century: What medical progress did WW1 bring about?;-Soldiers promised good housing upon return. So got rid of unhealthy slum housing.
-Surgeons experimented with new techniques (developed new ways to repair broken bones + perform skin grafts~ plastic surgery).
-Blood transfusions~ in Renaissance, Harvey proved blood circulates, encouraging transfusions, which sometimes worked + sometimes failed. Blood groups were discovered in 1901 which made transfusions more successful. During WW1 vast amounts of blood was needed. The search of better method of storage + transfusion was needed. Doctors discovered how blood can be bottled, packed in ice + stored where needed.
-Development of X-rays~ first discovered 20 years before WW1. Hospitals installed X-ray machines, but WW1 confirmed their importance. More were manufactured to meet demand, installed in hospitals along Western Front. Immediately improved success rate of surgeons removing bullets which could have caused fatal infections.
-Surgery of eye, ear, nose + throat improve rapidly (includes brain surgery). - 2820th Century: Penicillin;-1) Fleming discovered mould killed germs. Writes articles.
2) Florey + Chain begin research after reading article by Fleming.
3) Penicillin first tested on human in Oxford.
4) U.S. + Britain fund production of penicillin.
5)Enough penicillin produced to treat all allied forces wounded on D-Day. - 2920th Century: Penicillin; (continued)-How was it discovered?~ 1928, Fleming left a Petri dish of bacteria, it had gone mouldy + the mould had killed the bacteria. Chance.
-Factors leading to development;
Government~ UK Government funded Florey's research, U.S. Government funded mass production.
War~ growing casualties of WW2 added urgency to mass produce.
Individual's + Chance
Technology~ microscopes - 3020th Century: Penicillin; (continued)How was it developed?
1930s, Florey + Chain became interested in Fleming's paper. 1939, gathered research team + asked UK Government to fund team's research into penicillin. UK firms too busy with war effort to mass produce~ so went to US. US Government helped by giving interest free loans. By 1944 mass production was sufficient for needs of military medics. Fleming, Florey + Chain given Nobel Prize in 1945. - 3120th Century: Penicillin; (continued)-National Health Service;
Introduction of NHS
Beveridge Report in 1942 called for state provision of social security. Aneurin Behave was Labour Minister for Health who introduced NHS. National Insurance introduced to pay for NHS.
Influence of WW2
Broke down social distinctions. Raising armies made powerful people take notice of health problems of poor. Evacuation of children increased awareness of poor. After WW2 people wanted to improve society.
Stills has few problems... The government reduced how much of NHS free (i.e. charging for prescriptions). Long waiting lists + doubts of quality of treatment mean some go outside NHS. Longer life expectancies mean more care for elderly + increased costs for NHS.
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- WE NEED A MEDIC
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- Anony mous
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- Creado por Molly Jones · 29 may 2015
- Copiado por Anony mous · 4 feb 2018
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