Medicine Through Time

Prehistory (ã 3000BC)
1. Before written records
2. Knowledge about their way of life comes from archeological finds and the current culture of people who haven't changed their living ways
3. Nomads - people who travelled in search of food, following animals to survive and had temporary shelters
4. Believed in the supernatural and thought that evil spirits caused disease
5. To treat people, herbal remedies would often be given
6. People would go to see a medicine man (half priest, half doctor), so he could use trepanning ( cutting a hole in the skull ) to 'get rid' of evil spirits
7. Slow progress as they believed in superstitions and the supernatural, even though cave paintings show bulls with daggers in their hearts, showing they had little understanding
Ancient Egypt (3000BC - 400BC)
1. Thought the body's channels became blocked just like the Nile
2. The body could only be treated by taking laxatives, vomiting or being leeched
3. Trading meant they gained and shared their knowledge
4. First people to write using hieroglyphics on papyrus
5. Still believed in the supernatural and that wearing charms would ward away evil spirits
6. Carried out simple operations, like cutting tumours
7. Mummification helped them learn about the locations of vital organs but the heart and brain were not allowed to be touched as it was a religious ceremony, so it had to be done as quick as possible
Ancient Greece (800BC - 400BC)
1. Built healing temples called Asclepions, named after the Greek God of healing, Asclepius
2. At an Asclepion the sick would bathe, make a gift to the gods and rest and would sleep in a dormitory and be cured by Asclepius' daughters' and a snake
3. A typical Asclepion consisted of baths, gyms, an athletic stadium and a theatre seating 14,000 people
4. Carried out simple operations using simple surgical tools during wars and learnt about setting broken and dislocated bones, even though it was little surgical progress compared the Egyptians
5. They came to believe that disease had natural causes and could be prevented and believed in keeping themselves clean. they also tried to eat the corret food for the time of year and tried to exercise
6. HIPPOCRATES put forward the theory of the four humours, that the body had to be in balance and were connected to the seasons. It was incorrect but set medical development in the right directions
7. HIPPOCRATES also believed in clinical observation, that doctors had to observe their patient, recognise an illness and suggest a cure. He also stated that personal hygiene and exercise could prevent disease
8. ARISTOTLE'S studies led HIPPOCRATES to suggest that the heart provides heat to the body while the brain cools it down. Although this was wrong, it provided a better understanding of the function of the heart in the body
9. A medical library was built at Alexandria, which became the centre of all medical knowledge throughout the Ancient World. Books were collected from India, China and Mesopotamia as well as by Greek doctors and writers. Human dissection was also allowed for a time at Alexandria
The Romans (500BC - 500AD)
1. Built cities, villas, villages and army forts in healthy places near good springs, rivers or wells
2. Built aqueducts to provide fresh water to the valleys
3. Built public baths and sewers to improve hygiene
4. GALEN built on four humours by saying that if you were too hot, for example,, then you would need cooling down
5. GALEN wrote over 350 medical books, which were the foundation of learning for the next 1400 years. His ideas were accepted because they fitted with the ideas of the Christian Chruch
6. GALEN worked with gladiators, getting a better understanding of the anatomy. He famously demonstrated how the nervous system worked, even though it was on a pig
Medieval Western Europe (500AD - 1500AD)
1. Catholic Church was powerful and returned to believe that God caused and cured disease
2. Education was restricted to Monks and natural ideas were not encouraged as they went against God and the Church
3. Most knowledge from Greeks and Romans was lost
4. The Black Death, from 1347 - 1350, killed more than 25 million people
5. Causes for disease were based around the supernatural, like praying, taking a potion, going on a pilgrimage, and flagellate as a punishment
6. Some natural cures were used, like blood letting, leeching, and testing urine
7. Public health grew worse, rivers were used as dumps for sewage and a source of drinking water
8. Cauterising irons were used, wine was used as a cleaning agent (antiseptic). Most surgery was carried out by barber surgeons, but they weren't qualified. You could be killed if you questioned the work of Galen
9. Fines were put into place in 1372 for littering
Medieval Islamic World (500AD - 1500AD)
1. Medicine was readily accepted in Islam, in direct comparison to Christianity, where new ideas were often forbidden
2. Gained knowledge from people they conquered and books they kept
3. CALIPH AL-MA'MUN built House of Wisdom where medical books were translated written by HIPPOCRATES and GALEN
4. RHAZES stressed need to carefully observe patient but warned against dangers of blindly following H and G. Wrote over 100 books on medicine
5. IBN SINA wrote a million word book on medicine, containing all sorts of treatments for all known diseases and was used by trainees until the 1600s
6. ABULCASIS translated ideas of Paul of Aegina, a Greek medical writer who described how to do simple surgery
Renaissance (1500AD - 1700AD)
1. Rebirth
2. Printing press helped spread new ideas across Europe
3. Artists such as LEORNARDO DA VINCI made detailed anatomical drawings
4. Microscope and telescope were invented for close inspections
5. VESALIUS
  1. Dissected human bodies to understand how they worked
  2. Proved Galen wrong by confirming the human jawbone was made of one bone
  3. Published book "The Fabric of the Human Body", which mapped out bones, organs, and muscles of the body
6. PARÉ
  1. Used oil of roses, egg yolks and turpentine to treat gunshot wounds on the battlefield as it was less painful and healed wounds quicker
  2. Used ligatures to tie up arteries to stop bleeding
  3. However, he was unaware that infections could easily be carried into the blood by ligatures
7. HARVEY
  1. Demonstrated function of heart and how blood flows around body through veins and arteries
  2. Heart works like a pump
  3. Blood flows in one direction only around body
  4. One way valves stop blood flowing the wrong way
  5. Blood is re-circulated and not replaced
8. New weapons - more wounds to heal
Edward Jenner - Vaccination - 1796
1. Discovered cure for small pox
2. Carried out an experiment on James Phipps - inserted pus from cowpox and inserted into the boys arm
3. Noticed hat milkmaids who suffered mild disease of cowpox never contracted smallpox
4. Proved that being inoculated with cowpox meant James was immune to smallpox
5. Ridiculed, clergy claimed it was repulsive and ungodly
6. Published his findings and is foundation of modern vaccines
7. In 1853, the government insisted that every baby must be vaccinated for smallpox
Louis Pasteur - Germ Theory - 1861
1. Spontaneous Generation - idea that disease caused germs
2. Invented pasteurisation - heating a liquid to get rid of germs
3. Proved that germs were only found in places they could reach - the spontaneous generation theory was dead
4. Published Germ Theory in 1861 and proved it in 1865 in a silk factory
Robert Koch - 1882
1. Found a way of staining and growing germ responsible for anthrax in a Petri dish, named after his assistant Julius Petri
2. Proved bacterium caused disease by injecting mice and making them ill
3. Proved germs caused disease in humans
4. Identified germs causing anthrax, TB and cholera
5. Awarded Nobel Peace Prize for his work
Edwin Chadwick - Chadwick's Report - 1842
1. Medical officer for each district
2. Improve sewers and drains
3. Improve drainage and remove rubbish from houses
4. Shocked Britain
5. Made everyone aware of public health
Public Health Act 1 - 1948
1. Laissez Faire (Leave alone) attitude of government of public health
2. However, the cholera epidemic changed their mind and they published the Public Health Act
3. National Board of Health to be created to set committees to improve drainage, sewers, rubbish collections, water supplies, etc
4. Local boards to have powers to make sure new houses are built with drains and toilets, charge tax to pay for improvements and appoint medical officers to inspect nuisances
John Snow - Cholera - 1854
1. Surgeon who worked in Broad Street, Soho, London
2. Through research, Snow found that the victims all got their water from the Broad Street water pump
3. Snow asked permission to remove the handle from the water pump so people used other water pumps
4. It worked! There were no more deaths in the street
5. Further research showed that a pipe had cracked at a street toilet one metre away, that was polluting the water
6. Proved cholera was carried through water, not air
James Simpson - Anaesthetics - Chloroform - 1847
1. Alternative to ether, which irritated patients' eyes and made them cough and vomit during operations
2. Some argued that the long-term side effects were unknown whilst others put forwards their arguments on religious grounds
3. Argued it was unnatural to ease women of pain of childbirth
4. In 1857, Queen Victoria used chloroform during the delivery of her eighth baby. With the Queen's support, it wasn't long before the use of anaeatherics became common in surgical practice
Joseph Lister - Antiseptics - Carbolic Acid - 1867
1. Used an aerosol can and sprayed carbolic acid on anything that might come into contact with the wound
2. It worked! His patients didn't get any infections and antiseptics were born
3. From 1864 to 1866, without antiseptics, 46% of patients who had amputations died. From 1867 to 1870, with antiseptics, only 15% of patients who had amputations dies
4. However, carbolic acid irritated the surgeon's hands and patients flesh and made everything smell
5. Soon the whole country was using antiseptics. Hospitals walls were scrubbed, floors were swept and equipment was sterilised. Surgeons started to wear rubber gloves, surgical gowns and facemasks during operations
Alexander Fleming - Penicillin - 1928
1. When Fleming went on holiday, he left several plates of germ on a bench. When he returned, he noticed that the staphylococcus germs next to the mould had been killed
2. Fleming realised the germ-killing abilities of penicillin and published his findings. He concluded that penicillin was a natural antiseptic that killed many germs
3. Development
  1. Florey and Chain applied to government for money (£25) to begin research
  2. Slowly collected enough penicillin to trial on one human
  3. Trialled on Albert Alexander, a policeman, who dies a few days later, however, it had worked
4. Mass Production
  1. In June 1941, Florey went to America to ask for help, The US government agreed to pay several huge chemical companies to make millions of gallons of it
  2. By the end of the war, 250,000 soldiers were being treated, and more was being produced for the public
5. Impact
  1. Officials estimated 15% of wounded soldiers could have died without penicillin
  2. The antibiotic became available for the public and saved millions of lives
  3. Said to have treated bronchitis, pneumonia, syphilis, tonsillitis, meningitis and many more diseases
Why Did Fewer Children Die After 1900?
1. In 1906, the School Meals Act allowed local councils to provide school meals, with poor children getting a free meal. By 1914, 158,000 children were having a free school meal every day
2. The Children's and Young Person's Act of 1908 stated that parents were breaking the law if they neglected their children
3. The NHS was set up in 1948 and it provides care before the baby is even born
World War 1
1. Blood Transfusions - Landsteiner identifying blood groups made it possible. Hustin discovered

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