Medicine Through time

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Medicine through Time History	...
What did the Greeks believed caused diesease?	-The imbalance of the Four Humours -The gods
How did the Greeks deal with disease?	-They attempted to balance the four humours, this may have involved blood letting and purging -They visited an Asclepion
What were Asclepious' daughters called?	Panacea and Hygieia
What did Hipporates come up with?	The theory of the Four Humours and Clinical diagnosis
What were the stages of Clinical diagnosis	Diagnosis --> Prognosis --> Observation --> Treatment
Why did the Romans invent Public health?	-They needed healthy soldiers to control the Empire -Healthy workers and Merchants were also needed to keep the Empire prosperous
Name 6 different features of Roman Public Health	-Aqueducts -Reservoir -Sewers -Public Latrines -Public fountains -Bath-houses
What was Britain like before the Romans invaded?	-There were no towns -Britons often lived in roundhouses -Hygiene was not a priority
When was the Roman invasion?	AD43
Did Galen deserve his reputation?	Some may say yes because: -He was a skilled doctor -He could prove his theories -He developed old ideas -He used knowledge of other cultures -He wrote over 60 books
Who was more important in the history of Medicine: Galen or Hippocrates?	See below
...Hippocrates	Hippocrates: -Created many ideas that were believed for a long time e.g. The Theory of the Four Humours -Created a new way of treating patients which is still used today (Clinical Diagnosis)
...Galen	-Devolped on old ideas and came up with new ones e.g Theory of four Humours to the Teory of Opposites -Disscoverd that the brain controls the body not the Heart
When was the Medieval period?	500AD-1500
What three tribes invaded Roman Britain?	-Angles -Jutes -Saxons
What was the Medieval public health like? Why?	-It began to deteriorate -The invaders did not have the skill to fix the broken down buildings -They also concentrated on wars so they built temporary buildings from wood
What were the beliefs of the cause of disease in Medieval London?	-The theory of the four humours -Miasma -Astrology -Jews
What were the main treatments of disease in the Medieval period?	-Herbs and remedies -Balancing the four humours -Praying to a God (Christianity)
How was the public health like in the Medieval period?	-Streams and lakes provided drinking water (No aqueducts) -Wells provided drinking water (No public fountains) -Cesspools were used (No public latrines or good sewage system
Why were people still reading Galen in 1350?	-Nobody could test or challange against him. -He had scientific evidence -Most of the other knowledge was destroy when the Empire collapsed -Communication between doctors was very limited -The Church believed that Galens work fitted in tith Christian ideas
How did the Church have such a big impact on the development of medicine?	-The Church controlled education -It told people how to behave -Universities were set up by the Church and students were trained about what the Church wanted them to believe.
Why was there medical stagnation in the medieval period?	-Loss of medical knowledge - Emphasis on authority rather than observation and investigation -Lack of resources and skill to rebuild Public health -Socially stagnant: no comunication
How did the Church help the development of medicine?	-Set up medical schools and trained doctors e.g in Paris -Churches and monasteries looked after the sick -Cathedrals and monatries had clean water -The Church set up the first hospitals (St Barts in 1123)
In what ways did the Church hinder the development of medicine, during the Medieval period?	-Doctors were only trained using Galen's ideas (experiments were only done to prove Galen's theories) -Dissection was banned by the Church until the 14th Century because people could potentially find new ideas -People were severely punished for going against the Church's ways -There was an over emphasis on Religious based cures instead of scientfic
When was the Black Death?	1348-1350
What can we learn about Medieval beliefs about the causes of disease from the Black Death?	-Many beliefs were very superstitious. e.g. -The wrath of God Astrology and the atmosphere Evil humours
What can we learn about the cures of disease believed in the medieval period?	They were very superstitious. e.g -Avoid overeating or overdrinking -Drinking 10 yr/o treacle -Flogging to please God -The King's evil But also believed in balancing the four humours
Name 3 old ideas about the cause of the Black Death	-Miasma -Astrology -The gods/God
Name two new ideas about the cause of the Black Death	Quack doctor theories Jews
Where did the Black death originate from?	Asia. It then started to spread across Europe
Name 5 different types of Doctors in the Medieval period.	- Trained Physician -Apothecary -Barber-surgeon -Housewife-physician -Quack doctors
How did medieval surgery progress?	-Frequent warfare meant that surgeon's skills were in hugh demand -Surgeons realised that wine could be used as an antiseptic and other natural substances as an anaesthetic. -This meant that they could perform external as well as internal surgery
Give an example of a type of surgical proceedure that may have been carried out in the medieval period.	Treaphining; drilling the skull to let the demon out
How dirty was Britain, in the middle ages?	They were quite clean, personally: - They had their own programme for health -Kings passed laws to keep the streets clean -Guy de Chauliac realised the importance of a good diet -Many towns produced quarintine laws and boarded up the houses of infected ones, at the time of the Plauge
Describe the knowledge of the time of 500AD-1500	-Knowledge went in reverse; -many Greek and Roman books were destroyed - Many people became superstitious -Lectures in Uni became so basic -The Church banned dissections which lead to numerous errors (Alderotti--> combing the hair "comforts the brain")
How did people see the doctors of the Medieval period?	"...doctors were useless and indeed shameful as they dared not visit the sick for fear of becoming infected"- Guy de Chauliac
What did doctors usually carry around with them?	-The Vadmecum which cotained a urine chart ad some nice smelling items as they believed in the idea of Miasma
What does "Renaissance" mean?	The Re-birth
What was there a re-birth in?	-Art -Geography -Scientific understandings
Who was Andreas Vesalius?	A professer in Pauda
What were some of Vesalius' achievements?	-He had written a book called "on the fabric of the Human body" 1543 -He was able to prove Galen wrong
In what ways did Vesalius prove Galen wrong?	-He proved that the jaw is only one bone -Our kidneys are the same height
How and why did Vesalius develop opposition?	-Many critiscied his books because they found it hard to "accept [that] there were somethings that [Galen] was wrong about"
Who was William Harvey?	He was the physician to the English kings (James I & Charles I)
What achievements did Harvey make?	-Wrote a book called "On the Motion of the Heart" in 1628 -Able to prove Galen wrong
In what ways did Harvey prove Galen wrong?	-Proved that the blood circulates and is re-used in the body, not absorbed by the muscles
How and why did people oppose his ideas?	-They didn't really care because it "didn't cure disease"
When was the Great Plauge?	1665-1666
How many people died (approx.) in the Great plauge?	80,000
What were one of the factors that helped the Great Plague to spread?	-The fact that houses were so close together
Name two things that the government did during the plague.	-Sent out watchmen to keep the sick in their houses and Plague doctors, who cared and recorded the sick
What were the three main beliefs for the cause of the Great Plague?	-Miasma -Cats/Dogs -Bad quarintine
What was the impact of the plague in London?	-People became extremely cautious. So much so that they "would not take [the meat] off the butcher's hands but off the hooks themselves." -Defoe 1665 -People fled the town: "all the town almost going out of town"
Name three of the governments response, at the time of the plague.	-Locked up the sick -Paid people to record and care for the sick -Organised public prayers and fasting
Name some similarities between the Great Plague and The Black Death.	-Many thought caused by cats/dogs -caused by rats but nobody knew -Disease spread very quickly - God and Miasma were very important factors
Name some differences between the Great Plague and the Black Death.	-Government did more in the Great Plague -More people died in the Black Death -The Great Plague had more scientific theories whereas the Black Death was more religious
What are some of the differences between Medieval and Renaissance doctors?	-Renaissance doctors started to use Harvey and Vesalius' ideas more -Medieval doctors were not as trained -Students were more practical during the renaissance -The royal college of Physicians trained and licensed university-educated doctors -Training was organised by the Church in the Medieval period, rather than Universities
When was the Industrial Revolution?	1500-1900
Name three factors that lead to the change in medicine.	-People's attitudes toward the sick changed: the wealthy wanted to improve everybody's health -Scientific and medical knowledge improved rapidly -Te attitude of the government changed: it began to force councils to improve public health
When was the first inoculation discovered?	1850
Why were some against receiving an inoculation?	-Some had died from the mild dose and some had become carriers
How was the realisation of vaccinations founded?	-Jenner realised that if dairy maids had caught cowpox, then they were less likely to catch smallpox -He thought this could be a way to preventing smallpox -He recorded 23 different cases and came to a conclusion that "the cowpox prevents the human constitution from the infection smallpox"
When and where Jenner submit his findings?	-The royal society 1798
What does revolution mean?	A rapid change
Name three inventions that happened during this time.	-The spinning Jenny -The locomotive -The steam train -Factories
Why did Jenner have such big oppositions?	-He did not fully understand his theory himself, which meant that he could not respond to the criticism -Some people just didn't like anything new -Some did not accept the evidence and saw vaccinations as dangerous -Also doctors who were making money wanted vested intrest
When was the first vaccination?	1796
When was vaccination first made compulsory?	1852. However it was not strictly enforced
When were vaccinations compulsory and strictly enforced?	1872
Who invented the microscope?	Anton van Leeuwenhoek
Why were vaccinations successful?	-The government gave him a 30,000 grant -He published a book which improved the communication around the world -Other countries helped show that it worked (e.g. France & USA)
What did Pasteur discover?	-Micro-organisms were in the air and floated down rather than them being created as result of the beer going sour
In what year was Pastuer's Beer investigation?	1857
When was the Germ Theory discovered?	1861
When were theses vaccine created? Chicken Cholera Anthrax	1880 1881
Who was Koch?	He became a pioneer of the new science of bacteriology
What did Koch prove?	-That one specific germ is the cause for one specific disease
What and when were the microbes which caused Anthrax Tuberculosis Cholera found?	-1875 -1882 -1883
How did Koch prove his findings?	-He used microscope and cameras. For smaller microbes he used industrial dye to stain them
Why were Pasteur and Koch so successful?	-The Government supported them -They could prove their theories and findings -The use of improved scientific knowledge and technology -
How were cities like in the Industrial revolution?	-Population increased rapidly so people were more cramped, meaning that disease spread more quickly
Why did disease spread so quickly during the industrial revolution?	-Contamination -Cramped and poor housing -Poor living conditions and sanitation -No building regulation
When was the first cholera outbreak?	1832
What was the Boards of health?	-A group of experts who were in charge of public health in certain areas
When were the boards of health set up?	1832
When was the second cholera outbreak?	1848
Who was Chadwick?	-He wrote a report that showed a direct link between living conditions and disease and life expectancy
What did Chadwick recommend?	-Removing the waste from the streets -Drainage system -An improved water supply
When was Chadwick's report?	1842
Why did nothing happen after Chadwick's report?	The government didn't see public health as a priority
What happened in 1848?	The second cholera outbreak. This caused the government to change and focus on public health
Why did people oppose the governments changes to public health after 1848?	-Taxes would have had to increase -The belief of Laissez-faire
Describe the first public health act.	-It was set up in 1848 as a result of the second cholera outbreak -It was compulsory -It was not strictly enforced
What were some of the main diseases in the 19th century?	-Typhoid -Tuberculosis -Cholera -Smallpox
When was the third cholera outbreak?	1854
What was John Snow's theory?	That cholera was spread by water
When and what was Snow's discovery?	-1854 -That when the handle from the water pump on Broad St. was removed, the number of deaths fell dramatically
What happened in 1854?	-2nd cholera outbreak -John snow's discovery -The Crimean war
Where did Florence nightingale take 38 nurses to?	A hospital in Scutari
How were the hospitals?	The had dirty conditions and many soldiers died from preventable conditions
What changes did Nightingale make?	-Washed the bedding and the wards -Made it more spacious -Gave the soldiers better food
How was the death rate after Nightingale?	It fell from 40% to 2%
Why was Nightingale so successful?	-Wrote books Saved thousands of lives -Could prove it -Decreased the death rate
When were the liberal Reforms?	1906-1911
Why did the L.R occur?	-40% of volunteers for the Boer war(1902) suffered from malnutrition and disease
What were the Liberal Reforms promise?	to "care for the sick, the aged and above all the children" -Churchill 1906
Who realised that poverty was caused by sickeness, old age and lack of employment?	Charles Booth
What were the actions of the Peoples budget?	To tax the rich to help the poor
When was the National insurance act made?	1911
What did the National insurance act (1911) do?	-Gave workers 26 weeks pay and free medical treatment -They offered unemployment benefits
Were there any problem with the Liberal Reforms (1906-1911)	-They left out women. (Pensions were primarily for men)
Name acts dealing with: -Children -Health and sickness	-1907 School medical inspections -1906 workers compensation act
Name some differences between the Renaissance and I.R medical knowledge.	-R: Universities were run by the Church -I.R: Criminals were allowed to be dissected -I.R: You needed qualification to become a doctor -R: Doctors were taught Harvey and Vesalius' ideas -I.R: Doctors were specialised
Who was Paul Ehrlich?	A member of Koch's research team.
What did Ehrlich discover?	The first Magic bullet. It was called Salvarsan 606 and it treated syphilis.
When was the first magic bullet made?	1909
What were some of the factors that contributed to the discovery of the first magic bullet?	-Pastuer's germ theory (1861) showed how disease spread -Koch's discovery that one specific microbe was the cause of a disease -Personal qualities: Teamwork
When was the discovery of penicillin?	1928
Who discovered penicillin?	Fleming
What was the journey of penicillin?	-Fleming discovered mould prevented spread of disease -Too expensive to try and purify it -Left the work in the 1930s -Florey and Chain published Fleming's work and looked into the investigation -By 1940 they had made a purified version of penicilin -Tested it on mice and it worked -First human trial at Oxford -Ran out of Penicilin -Went to drug industry to make enough -Florey went to Russia to spread idea -In wide use by 1944
What were the factors that affected Penicillin?	-War -Key individuals -Chance -Government -Science and technology -Communications
When was the NHS set up?	In 1948 (100 years after the first public health act and the second cholera outbreak)
Was there opposition to the NHS?	-Doctors opposed the NHS because they were making money off of the rich who could pay for healthcare. -They thought that they would lose money in the long run
When was the Beveridge Report?	1942(100 Years after the Chadwick report)
What did the Bevridge report lead to?	The NHS
What did the Beveridge report consist of?	-The belief of the 5 Giant Evils
What were the 5 giant Evils?	-Poverty -Laziness -Unemployment -Mess -Ignorance
Who was the minister for Health that set up the NHS?	Nye Bevan
Who were the biggest opposition to the NHS?	The British Medical Association
Why was the BMA an opposition to the NHS?	-They were afraid that it would take over medicine -They wanted doctors to be paid per patient and not have a salary
What were some differences between doctors in C19th and C20th	-Doctors had to train for 7 years in the C20th and nurses had to train for 3 -The Royal college of nurses only allowed men to be nurses in 1939 -There was little be to be done about the treatment of disease in the C19th -Doctors tended to become specialised in different parts of the body
Name four types of alternative medicine.	-Acupuncture -Radio therapy -Herbal remedies -Crystal healing -Yoga
When was the discovery of the structure of DNA?	1953
Who were the four people who were involved with the discovery of the DNA structure?	-Watson -Crick -Franklin -Wilkins
What project lead from the discovery of the DNA structure and when?	-The Human Genome project 1990-2003
Name some medical treatments that could be performed as a result of DNA discovery	-Genetic therapy -Genetic screening -Customised drugs
How was the structure of DNA found?	Franklin discovered a picture of the DNA structure called "Photograph 51". -It was shown to Watson and Crick by her college Wilkins, without her consent. -They then used their own knowledge and Franklin's picture to form a scientific conlusion.

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