Medicine Through Time (Unit 1 )

Medicine in 1350
1. The four humours
  1. Blood
    1. Spring
  2. Phlegm
    1. Winter
  3. Yellow Bile
    1. Summer
  4. Black Blie
    1. Autumn
2. Opposites Theory
  1. Galen (who developed the idea of the four humours) based his treatment on the theory of opposites, therefore if you had to much phlegm (which is linked to water and cold) you should eat hot peppers.
    1. Claudius Galen : Greek Doctor, worked in "Ancient Rome", wrote many books about his theorums and the human anatomy and treatments for disease, he was the basis of medical training
3. During the 12th century universities set up medical schools where physicians trained.
4. Understanding Genetics
  1. 1) During the 19th Century Mendel showed how human characteristics could be passed between generations.
  2. 2) In the 20th Century new technology (Electronic microscopes, X-Rays) let scientists analyse human cells in greater detail, they found that every cells contains DNA.
  3. 3) Watson and Crick worked together on how genetic codes of DNA fitted together.
  4. 4) They analysed X-Rays from crystallography by Maurice Wilkins and Rosalind Franklin at Kings College Hospital (London) and eventually worked out the "double helix" structure of DNA in (1953).
  5. 5) In 1990 James Watson led the Human Genome Project and started identifying and mapping every gene in human DNA.
Treating the sick 1350
1. Who treated the sick?
  1. Physicians: Medically trained at university and passed exams, expensive, diagnosed illnesses, used mostly by welthy.
  2. Barber Surgeons: No Training, Carried out bloodletting, teeth, lancing boils, did basic surgery. Cost less than a physician.
  3. Monks and Nun: Ran hospitals using church donations, cared for the ill, elderly and poor. And was free.
  4. House wife Physicians: Village house woman, treated local people, childbirth and common illnesses, remedies and herbs / charms and spells. Cheapest and most accessible.
  5. Apothecaires: Received training, no qualifications, mixed medicine and ointments, based on knowledge or direction from physicians.
The Black Death
1. What it was: Bubonic plague, carried by flees living on black rat, is passed to humans when infected flees bite and the disease enters the blood.
The Renaissance
1. Term given go a period in European history meaning "rebirth" and renewed interest in Ancient Greek and Roman ideas. Its saw a rebirth of theories and ideas in medicine that people tested and challenged. It was a great period for exploration, when the people of Europe "discovered" new parts of the world bringing new plants from Africa and America, that was useful in medicine.
2. Andreas Vesalius: Professor of Surgery at Padua University (Italy), proved many of Galen's ideas wrong/ incorrect. Wrote the book "The Fabric Of The Human Body", including scetches of muscles, nerves, organs and skeletons of the human body from dissections.
3. William Harvey: A London doctor, discovered and proved that Galen's ideas about the blood was wrong, he discovered that veins carry only blood, which was pumped through the body by the heart . And published his findings in "A Anatomical Account" of the motion of the heart and blood in animals.
4. Technology Improvement; Better microscope lenses, helped discover bacteria, invention of mechanical pumps helped people understand that the human body works like a machine.
5. Impact on medicine: Causes of diseases still not understood, Harvey's and Versalius' were slow to be accepted over Galen's due to the church, old treatment was still being used.
Industrialisation
1. The Industrial Revolution (1750- 1900)
  1. Changing Society: Invention of machines (MAJOR FACTOR) meant that there was less work for people in the countryside. Towns and cites grew rapidly in population, factories were built, this had a big impact on peoples health
  2. Causes of disease: Between 1750 and 1850 people came to believe more strongly in a rational, scientific explanation for disease. With ideas such as Miasma- "Bad Air" filled with fumes from rotting materials, and Germs- produced by rotting animals and plants "spontaneous generation".
  3. The Problems:
    1. poor quality, housing- little ventilation, damp rooms.
    2. overcrowding, cramped living conditions-several families lived in one house.
    3. little fresh food in big towns cities
    4. poor working conditions- factories were often damp, with little ventilation
    5. accidents in factories
    6. working long hours
    7. Drinking water often polluted by sewers
  4. Killer diseases: cholera, diphtheria, smallpox, tuberculosis(TB) and typhoid. Often caused by contaminated water and easily spread in poor living conditions, two thirds who caught cholera died!
    1. Treatments for cholera included burning the dead bodies, clothes and bedding, praying and having lucky charms, clean houses using chloride of lime, smoke cigars and burn tar or vinegar to crate smoke on the streets.
Breakthroughs 1750- 1900
1. Jenner and Vaccinations: Smallpox was a common disease in the 1720's and it was sometimes deadly depending on the severity of it, Edward Jenner inoculated several people with the pus from a cowpox blister and found that they developed immunity to smallpox. (Cowpox is not deadly)
  1. 1798- The Royal Society refused to publish Jenner's ideas, so he paid to print pamphlets explaining his work.
  2. 1802: Jennerian Society was set up to promote vaccinations.
  3. By 1840: The Government began paying for vaccinations.
  4. 1853: The Government made vaccinations compulsory.
  5. 1979: The World Health Organisation (WHO) announced smallpox had been wiped out.
2. Opposition to Jenner: Many thought is was wrong to give humans an animals disease, it interfered with "God's Plan", doctors lost money, some doctors didn't vaccinate patients properly, therefore it didn't work
  1. Jenner's Importance: He wiped out smallpox, and saved millions of lives. However didn't know the theory behind it, was unique therefore other vaccines couldn't be made from it.
3. Germ Theory: 1861, Louis Pasteur (French Chemist) published his "Germ Theory", explaining that microbes (germs) in the air cause decay.
  1. Robert Koch: (who has read Pastuer's work) linked bacteria to disease, and identified that specific microbes cause anthrax in sheep, and microbes causing TB and Cholera. He discovered that that chemical dyes stain bacteria, which made them easier to study underneath a microscope.
    1. After work in 1879, Pastuer's team of scientists discovered that a weakened versions of a disease- causing microbe could be used as a vaccine to create immunity form that disease.
Professionalising Medicine
1. Improvement in medical training: teaching hospitals were developed allowing students to observe the surgery, students dissected bodies to understand human anatomy. Following Pasteur's "Germ Theory" there was more emphasis on studying microbes, though a microscope. Training including how to use improved technology such as thermometers and stethoscopes to help diagnose illness.
2. Midwives: Were mostly women, but after forceps were introduced in the 17th Century their numbers fell because of lack of training and not being needed, instead "Men- Midwives" were more common and treated the richer women.
3. Elizabeth Garrett Anderson:
  1. 1) Women were not allowed to become doctor. Elizabeth (A Nurse) defied the system and went to medical lectures until she was forced to stop, then studied privately.
  2. 2) The Society of Apothecaires did not bar women and Elizabeth passed their exams in 1865. After a court case she was a certified doctor but the Society later changed its rules to prevent women qualifying.
  3. 3) She set up a medical practice in London and gained a medical degree at university in Paris. She helped set up the New Hospital For Women and the London School Of Medicine for Women.
  4. 4) She set up an important precedent, and in 1876 women were allowed to go to university and obtain degrees.
4. Florence Nightingale
  1. 1) Nursing wasn't seen as a respectable job for women and there was little training.
  2. 2) Florence Nightingale attended the first nurses' training school Kaiserweth Hospital, Germany.
  3. 3) She was asked to lead a team of nurses at the military hospital in Scutari during the Crimean Way (1854-56).
  4. 4) She believed in Miasma caused disease, so emphasised hygiene, fresh air, good supplies and training for nurses. Her approach lowered the death rate at Scutari hospital form 42% to 2%.
  5. 5) He work was widely reported in newspapers in Britain. She published books on nursing and hospital organisations and set up a training school for nurses/ midwives.
Treatment 1750-1900
1. Improvement in treatment:
  1. 1) People still used heral remedies but had less access to plants so were more reliant on apothecaires.
  2. 2) Pills were made by hand until William Brockendon 1844 that invented a machine that standardised dosage and increased production speed.
  3. 3) Apothecaires and quack doctors sold patent medicines, advertised as cures for everything.
  4. 4) Money could be made from patent medicines, which encouraged groath of the pharaceutical industry.
  5. 5) Jesse Boot turned one small shop into a chain of pharmacies.
  6. 6) By 1900 The Government brought in regulations to prevent harmful ingredients being used in medicines.
  7. 7) New understanding of the cause s of disease had a little impact on prevention or treatment until the 20th Century.
Key Figures
1. Hippocrates: Created the idea of "The Four Humours"
2. Pare: French army surgeon, discovered soothing lotions were better at healing wounds.
3. Harvey: Discovered and Published that the heart was a pump.
4. Lister: Developed the use of " Carbolic Acid" and used it as an antiseptic, to reduce death rate in surgeries.
5. Simpsons: Used Chloroform as a form of anaesthetic being much more acceptable, as Queen Victoria used it during childbirth, this paved the way for many further improvements in the use of painkillers during operations.
6. Fleming: A Civil Servant who wrote an important report on the living and working conditions of labouring classes, his work resulted in Public Health being improved by The Government of the day.

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Medicine Through Time (Unit 1 )

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