Edexcel GCSE (9-1) History of Medicine Revision Guide and Workbook PDF

REVISE EDEXCEL GCSE (9–1) History REVISE EDEXCEL GCSE (9–1)...

REVISE EDEXCEL GCSE (9–1) History REVISE EDEXCEL GCSE (9–1) REVISE EDEXCEL GCSE (9–1) History MEDICINE IN BRITAIN REVISION GUIDE & WORKBOOK MEDICINE IN BRITAIN, c1250–present REVISION GUIDE AND WORKBOOK Our revision resources are the smart choice for those revising for Edexcel GCSE (9–1) Medicine in Britain, c1250–present. This book will help you to: History Organise your revision with the one-topic-per-page format MEDICINE IN BRITAIN Speed up your revision with summary notes in short, memorable chunks Track your revision progress with at-a-glance check boxes c1250–present Check your understanding with worked examples REVISION Develop your exam technique with exam-style practice questions and full answers. Revision Guide and Workbooks are available for these history topics: GUIDE AND WORKBOOK 9781292169743 9781292169729 Revise Edexcel GCSE (9–1) Anglo-Saxon and Norman Revise Edexcel GCSE (9–1) Medicine in Britain, c1250– England, c1060–88 Revision Guide and Workbook present Revision Guide and Workbook 9781292176376 9781292176437 Revise Edexcel GCSE (9–1) British America, 1713–83: Revise Edexcel GCSE (9–1) Russia and the Soviet Union, empire and revolution Revision Guide and Workbook 1917–41 Revision Guide and Workbook 9781292176420 9781292176444 Revise Edexcel GCSE (9–1) Conflict in the Middle East, Revise Edexcel GCSE (9–1) Spain and the 'New World', 5 – c 18 9 nt 1945–95 Revision Guide and Workbook c1490–1555 Revision Guide and Workbook 5 191 c 18 3 7– 19 9781292169705 9781292169750 e se n t c 10 6 41 se pr 0– 1 Revise Edexcel GCSE (9–1) Crime and punishment, Revise Edexcel GCSE (9–1) Superpower relations and the 0 00 – 08 8 re c1 1945–95 Revision Guide and Workbook Cold War, 1941–91 Revision Guide and Workbook 0–p 9781292169712 9781292169774 11 Revise Edexcel GCSE (9–1) Early Elizabethan England, Revise Edexcel GCSE (9–1) The American West, 89 c125 191 1558–88 Revision Guide and Workbook c1835–c1895 Revision Guide and Workbook –1 216 8 –1 9 9781292176390 9781292169767 Revise Edexcel GCSE (9–1) Henry VIII and his ministers, Revise Edexcel GCSE (9–1) The USA, 1954–75: conflict at 39 r the 1509–40 Revision Guide and Workbook home and abroad Revision Guide and Workbook o 1 25 0– p re s F 3 9781292176406 9781292176451 3 – 17 8 1 9 75 9–1 Revise Edexcel GCSE (9–1) The reigns of King Richard I Revise Edexcel GCSE (9–1) Warfare and British Society, and King John, 1189–1216 Revision Guide and Workbook c1250–present Revision Guide and Workbook 171 ent 54 – 194 9781292176383 9781292169736 19 Revise Edexcel GCSE (9–1) Mao's China, 1945–76 Revise Edexcel GCSE (9–1) Weimar and Nazi Germany, 1– n c1 Revision Guide and Workbook 1918–39 Revision Guide and Workbook 1 88 49 iti o exa ms 99 5 0– –1 Inc c1 1 58 55 15 5 THE REVISE SERIES ed de 6 lu 1 50 9 –1 54 0 97 For the full range of Pearson revision titles across KS2, KS3, GCSE, s fr e n e 1 c1 e o n li 5– 945 194 Functional Skills, AS/A Level and BTEC visit: www.pearsonschools.co.uk/revise –1 9 95 www.pearsonschools.co.uk [email protected] CVR_ED_GCSE_HISTORY_MEDICINE_RGRW_9729_CVR.indd 1 25/10/2016 09:43  How to get your free Online Edition Just go to www.pearsonactivelearn.com/register.asp and enter this code... Remember to include the hyphens! Once you have entered your code, you will create an ActiveLearn Digital Service account to access your Online Edition in future. If you already have an account, enter your code then click ‘Log in and activate product’. By the way, this code only works for one person. If somebody else has used this book before you, they might have already claimed the Online Edition. IFC_SCRATCH_PANEL_0000.indd 1 06/11/2015 10:02  Scratch panel IFC_SCRATCH_PANEL_0000.indd 2 06/11/2015 10:02  Revise EDEXCEL GCSE (9–1) History MEDICINE IN BRITAIN, c1250–present REVISION GUIDE AND WORKBOOK Series Consultant: Harry Smith Author: Kirsty Taylor A note from the publisher In order to ensure that this resource offers high-quality is accurate, the official specification and associated support for the associated Pearson qualification, it has assessment guidance materials are the only authoritative been through a review process by the awarding body. source of information and should always be referred to This process confirms that this resource fully covers for definitive guidance. the teaching and learning content of the specification Pearson examiners have not contributed to any sections or part of a specification at which it is aimed. It also in this resource relevant to examination papers for which confirms that it demonstrates an appropriate balance they have responsibility. between the development of subject skills, knowledge and understanding, in addition to preparation for Examiners will not use endorsed resources as a source assessment. of material for any assessment set by Pearson. Endorsement does not cover any guidance on Endorsement of a resource does not mean that the assessment activities or processes (e.g. practice resource is required to achieve this Pearson qualification, questions or advice on how to answer assessment nor does it mean that it is the only suitable material questions), included in the resource nor does it available to support the qualification, and any resource prescribe any particular approach to the teaching or lists produced by the awarding body shall include this delivery of a related course. and other appropriate resources. While the publishers have made every attempt to ensure that advice on the qualification and its assessment For the full range of Pearson revision titles across KS2, KS3, GCSE, Functional Skills, AS/A Level and BTEC visit: www.pearsonschools.co.uk/revise F01_ED_GCSE_HISTORY_MEDICINE_RGRW_69729_Prelims_i-ii.indd 1 24/10/2016 17:59  Contents SUBJECT CONTENT The British sector of the Western Front, Medicine in Britain, c1250-present 1914-18: injuries, treatment and the trenches c1250–c1500: The Middle Ages The historic environment 1 Ideas: supernatural and religious 24 The Western Front – the trenches 2 Rational explanations for disease 25 Injuries and illnesses 3 Approaches to prevention and treatment 26 RAMC and FANY 4 Approaches to caring for the sick 27 Medicine in the early 20th century 5 The Black Death 1348–9 28 Medical advances c1500-c1700: The Renaissance SKILLS 6 Ideas: a scientific approach 29 Exam overview 7 Transmission of ideas 30 Question 1: Describing features 8 Continuity in prevention, treatment 31 Source skills 1 and care 32 Source skills 2 9 Change in care and treatment 33 Question 2(a): Usefulness of sources 10 The Great Plague, 1665 34 Question 2(b): Following up sources 11 William Harvey 35 Question 3: Making comparisons 36 Question 4: Explaining why c1700-c1900 18th and 19th Century 37 Question 5/6: Making a judgement 12 Germ Theory and microbes 13 Improvements in hospital care PRACTICE 14 Anaesthetics and antiseptics 38 Practice questions 15 Approaches to prevention of disease 55 Practice sources booklet 16 Jenner and vaccination 56 ANSWERS 17 Fighting cholera in London, 1854 c1900-present: Modern Britain A small bit of small print 18 Ideas: genetics and lifestyles Edexcel publishes Sample Assessment Material 19 Improvements in diagnosis and the Specification on its website. This is the 20 Change in care and treatment official content and this book should be used in 21 Preventing disease conjunction with it. The questions in Now try this have been written to help you practise every 22 The development of penicillin topic in the book. Remember: the real exam 23 The fight against lung cancer questions may not look like this. F01_ED_GCSE_HISTORY_MEDICINE_RGRW_69729_Prelims_i-ii.indd 2 24/10/2016 17:59  c1250–c1500: Had a look Nearly there Nailed it! The Middle Ages Ideas: supernatural and religious The Christian Church was dominant in medieval society. Supernatural ideas were common. This impacted on people’s beliefs about the causes of illness. God and the cause of disease Astrology The Church taught and people believed that God made them ill because He was either The alignment of planets and stars was displeased with them or was testing their thought to cause some diseases. faith. This meant that people believed that Astrology was used to help diagnose there was no need to search for other, what was wrong with a patient. rational explanations for disease, which held Use of astrology wasn’t new in 1250 back medical research and meant that few new but it increased through this period, ideas about the causes of disease appeared especially after the Black Death when in medieval times. the Church became more accepting. The Church’s control of ideas Most of what ordinary people learned was taught by the Church. The Church was also the centre of formal learning; it set up and ran universities where physicians were trained. The Church discouraged dissection and in general did not approve of people challenging ideas and authority. Unlike most people, monks and priests could read and write. Most large collections of books were in monasteries. This meant the Church was effectively in charge of what books were read. The Church approved of traditional, rational explanations for disease. In particular, it promoted the ideas of Galen as his theories fitted easingly important Abbeys and monasteries were incr Christian beliefs that the body had inated many aspects during the Middle Ages and dom a soul and that all parts had been of life including medicine. created by God to work together. The Church also taught that people should follow Jesus’ example and care for the sick. Many hospitals theories were housed in monasteries and See page 2 for details on Galen’s med ieva l hospitals. nunneries. and page 4 for details on In what ways did the Christian Church (a) help and (b) hinder medicine in the Middle Ages? 1 M01_ED_GCSE_HISTORY_MEDICINE_RGRW_69729_001-017.indd 1 25/10/2016 10:15  c1250–c1500: The Middle Had a look Nearly there Nailed it! Ages Rational explanations for disease Rational explanations for disease in Medieval England were still based on ideas from the Ancient world, in particular those of Hippocrates and Galen. Spring The Four Humours The Ancient Greeks thought everyone had a mix of four humours in their body. They believed people became ill when this mix was Blood ET HO unbalanced, so to make people better they W Air T tried to put this balance right. These ideas continued well into the Middle Ages. Theory of Opposites Summer Winter Water Fire Phlegm Yellow In the 2nd century AD, a doctor called Galen bile developed the idea of the Four Humours further. Besides bleeding and purging to get rid of excess humours, treatment based on Earth his Theory of Opposites aimed to balance the CO Y DR LD humours by giving the patient the ‘opposite’ Black bile of their symptoms. For example, if you had too much phlegm (linked to water and cold) you should eat hot peppers. The Four Humours Autumn Galen Hippocrates a Greek Claudius Galen was Hippocrates was an Ancient in doctor who worked Greek doctor. His ide as and Ro m e. He wr ote ue ntial Ancient books were very infl s ideas many books and hi well into medieval tim es and edical were the basis of m beyond. He dismiss ed th e le Ages. He training in the Midd ly idea that gods caused disease tes’ ideas and main s a physical reason developed Hippocra – he believed there wa purging, to prev t en eded a physical cure. used bloodletting, or for illness, which ne well as his own nts were base d on and treat illness, as Most of his treatme his Theory of st but he also used treatments based on s diet, exercise and re ew detailed diagram to get rid of excess Opposites. He also dr he bleeding and purging using knowledge the Hippocratic Oath , of human anatomy humours. He wrote ing on wounded e to respect lif e an d gained from operat where doctors swor ying out dissections thod of clinical gladiators and carr prevent harm. Hi s me imals’) bodies. ing symptoms, makin g on dead (mostly an observation – study en th similar ca se s, th notes, comparing wi at ing – is the basis of diagnosing and tre ay. the approach used tod Miasma Another theory about the cause of disease was that it was transmitted by ‘bad air’. This was related to God because bad smells indicated sin. The theory originated in the Ancient world but Give four reasons why Ancient explanations continued into the Middle Ages and well and ideas for disease dominated medicine in the into the 19th century. Middle Ages. 2 M01_ED_GCSE_HISTORY_MEDICINE_RGRW_69729_001-017.indd 2 25/10/2016 10:15  c1250–c1500: Had a look Nearly there Nailed it! The Middle Ages Approaches to prevention and treatment Prevention and treatment of disease in the Middle Ages was based on rational and religious methods as well as traditional remedies. Rational treatments in connection with the Four Humours 1 Bloodletting was the most common 2 Purging was another treatment used treatment for an imbalance of humours. It to re-balance the humours. It either was either done by cutting a vein, using involved making a patient vomit or go leeches or by cupping. Different points in to the toilet to remove food from the the body were used for different illnesses. body. Emetics and laxatives were mixed Occasionally bloodletting was performed by apothecaries, wise women or, at the by physicians but, more usually, it was patient’s home, physicians prescribed done by barber-surgeons or non-medical treatments and sometimes gave enemas persons. themselves. Methods to prevent illness Traditional remedies The most common remedies were traditional Living a Christian life – e.g. ones made with herbs, which were drunk, praying, going to church, and sniffed or bathed in. Remedies also included obeying the Commandments different foods to rebalance the humours and ointments to apply to the skin. They were made at home or mixed and sold by an Carrying Religious and apothecary. lucky Chanting charms or supernatural incantations amulets methods Religious treatments Self-punishment, such Praying as flagellation – punishing yourself so God wouldn’t Fasting Going on pilgrimage Trying to keep streets clean Paying for a special Mass to be said Bathing and washing Purifying Rational Supernatural treatments the air methods Supernatural treatments included specific Exercising ideas for certain illnesses, such as hanging a magpie’s beak around your neck to cure toothache. Bleeding and purging Not overeating For each of the six rational prevention methods above, explain why people believed each method would help them stay healthy. 3 M01_ED_GCSE_HISTORY_MEDICINE_RGRW_69729_001-017.indd 3 25/10/2016 10:15  c1250–c1500: The Middle Had a look Nearly there Nailed it! Ages Approaches to caring for the sick There were different people who treated the sick in the Middle Ages. Barber-surgeons Care in the home No training. Most ill people throughout this period were treated Carried out bloodletting, pulling teeth and lancing at home by a female family member. boils. Also cut hair! The village ‘wise woman’, often the Lady of the Manor, Did basic surgery such as amputating limbs (very would also tend to people in their homes for free. low success rate). Cost less than a physician. Who treated the sick? Apothecaries Physicians Received training but no medical qualifications. Medically trained at university and passed exams. Mixed medicines and ointments based on their Diagnosed illnesses and gave treatments, or sent own knowledge or directions of a physician. patients to the apothecary or barber-surgeon. Cost money (but less than a physician). Expensive, so mainly used by the wealthy. Very few of them, with women physicians incredibly rare. What physicians did 1 Commonly, physicians observed a patient’s symptoms and checked their pulse, skin colour and urine (for both colour and taste!). 2 They consulted urine charts in their vademecum (handbook). 3 They then consulted zodiac charts to help diagnose the illness and to work out the best time to treat the patient. They then either treated patients themselves (though this was rare), or sent them to a 4 barber-surgeon or apothecary. Hospitals Usually, people with infectious diseases or Many hospitals incurable conditions were not admitted. were places where travellers and pilgrims stayed on Patients and their their journeys. surroundings were kept very clean. Hospitals were places of recuperation rather The number than places where increased during patients were treated the Middle Ages. for disease. Patients were given fresh food and plenty of rest. Many were run by the Church, so the Some hospitals were built for emphasis was on God and healing souls. specific infectious diseases. List examples of people and conditions that would have been treated by each of the following: physicians, barber-surgeons, apothecaries, hospitals and the home. 4 M01_ED_GCSE_HISTORY_MEDICINE_RGRW_69729_001-017.indd 4 25/10/2016 10:15  c1250–c1500: Had a look Nearly there Nailed it! The Middle Ages The Black Death, 1348–9 Case The Black Death reached Britain in 1348, killing about one-third of the population. Ideas study about what caused the Black Death and how it could be treated tell us a lot about how people in Late Medieval England thought about illness and disease. What was it? Most historians today think this disease was bubonic plague, carried by fleas living on black rats, which brought the disease to different countries on trading ships. Bubonic plague is passed to humans when an infected flea bites them and the disease enters their blood. Causes and avoidance How people thought the Black Death How people tried to avoid catching it was caused Religion: God sent the plague as a Praying and fasting: because people punishment for people’s sins. believed that God had sent the disease, it Astrology: the position of Mars, Jupiter made sense to show God they were sorry and Saturn was unusual at this time. by punishing themselves. Miasma: bad air or smells caused by Clearing up rubbish in the streets. decaying rubbish. Smelling their toilets or other bad smells, in Volcanoes: poisonous gases from the belief this would overcome the plague. European volcanoes and earthquakes Lighting a fire in the room, ringing bells or carried in the air. having birds flying around the room to keep Four Humours: most physicians believed air moving. that disease was caused by an Carrying herbs and spices to avoid imbalance in the Four Humours. breathing in ‘bad air’. Outsiders: strangers or witches had Not letting unknown people enter the town caused the disease. or village. Symptoms Treatments Symptoms of the Black Death included: Treatments for the Black Death included: swelling of the lymph glands into large lumps praying and holding lucky charms filled with pus (known as buboes) cutting open buboes to drain the pus fever and chills holding bread against the buboes, then headache burying it in the ground vomiting, diarrhoea and abdominal pain. eating cool things and taking cold baths. Medieval people tried to prevent and cure the Black Death in many different ways. What does this tell us about what they thought caused disease? 5 M01_ED_GCSE_HISTORY_MEDICINE_RGRW_69729_001-017.indd 5 25/10/2016 10:15  c1500–c1700: The Had a look Nearly there Nailed it! Renaissance Ideas: a scientific approach ‘Renaissance’ means rebirth and this period in European history saw a ‘rebirth’ of old ideas from Ancient Greece and Rome. People began to question, challenge and test assumptions. However, some things stayed the same. Change in ideas on causes of Continuity in ideas on causes of disease disease Gradually, throughout the Renaissance The theory of miasma continued to be period, fewer people believed in supernatural believed by many to be the cause of or religious causes of disease. Various disease. It was a particularly popular theory new rational explanations for disease were during epidemics. suggested, such as seeds in the air spreading The Theory of the Four Humours continued disease. The real change in this period was the to be an accepted explanation for disease, reduced influence of the Church and a scientific although by 1700 very few physicians still approach to diagnosing illness. believed in it. The changing influence of the Thomas Sydenham Church Sydenham worked as a doctor in London During this time new religious ideas challenged during the 1660s and 70s. His book the authority of the Catholic Church, making Observationes Medicae (1676) outlined his it more difficult for the Catholic Church to theories and observations. promote its ideas about science. People were He didn’t rely on medical books when still very religious but they began to look for making a diagnosis, but observed patients new explanations for the cause of disease, and recorded symptoms in detail. rather than believing that disease was caused by God. He was instrumental in the ‘new’ idea that a disease had nothing to do with Change in the work of physicians the nature of the person who had it. and scientists He based treatment on the disease During this period, as a new scientific approach as a whole and didn’t treat individual was adopted, the way in which disease was symptoms. diagnosed by physicians gradually began to improve. This was largely influenced by people like Thomas Sydenham. As fewer people believed that astrology He became caused disease, physicians stopped using known as astrology charts for diagnosis and timing the ‘English treatment. Hippocrates’ due to his Due to improved knowledge of digestion, influence physicians realised that urine was not a good on doctors indicator of disease and stopped using urine (mostly after charts for diagnosis. his death). Physicians carried out more direct observations and examinations of their patients, rather than relying on the patient explaining their symptoms. Write a sentence explaining what happened to belief in each of the following as a cause of disease during the Renaissance: Miasma, Theory of the Four Humours, God. 6 M01_ED_GCSE_HISTORY_MEDICINE_RGRW_69729_001-017.indd 6 25/10/2016 10:15  c1500–c1700: Had a look Nearly there Nailed it! The Renaissance Transmission of ideas One of the major changes in the Renaissance period was in the communication and transmission of medical ideas. The development of the printing press press It meant that many uce the The printing ound exact copies of texts It helped red ol of ar co n tr w as in ve nt ed Church’s G ut en berg. could be produced s, as it co uld no 1440 by idea th e in a short amount of re ve n t the By the start of longer p sa nc e in 15 00 time. b lic at io n o f ideas it Renais pu ndreds ve of. th ere w ere hu did not appro esses of printing pr. across Europe The books, and therefore the ideas and discoveries of scientists and doctors contained within those books, could be shared more effectively and much faster across a wider area. The printing press, invented in 1440. The setting up of the Royal Society The Royal Society aimed to further scientific understanding by carrying out and recording the results of experiments, sharing scientific knowledge and encouraging new theories and ideas. Most significantly, it sponsored scientists to enable them to carry out research. From 1665 the Royal Society published a journal called Philosophical Transactions, in which scientists could share their work and ideas. This meant that doctors and scientists could study, challenge and build on each other’s research. In this way, theories could be confirmed or dismissed and news of the findings could spread through the medical community quickly. King Charles II granted a Royal Charter to the society. He was very inte rested in science and his approval of the society helped it to gain credibilit y. Explain how the invention of the printing press led to developments in medicine. 7 M01_ED_GCSE_HISTORY_MEDICINE_RGRW_69729_001-017.indd 7 25/10/2016 10:15  c1500–c1700: The Had a look Nearly there Nailed it! Renaissance Continuity in prevention, treatment and care Although there were some changes in hospital care, most treatment and preventions during the Renaissance remained the same. Hospitals 1 By 1500, hospitals were treating more sick people and were being used less by travellers and pilgrims. Most had their own apothecary to mix medicines and physicians frequently visited patients. 2 In 1536, the dissolution of the monasteries in England by Henry VIII caused most hospitals to close. 3 Some free, charity-funded hospitals were set up but it wasn’t until well into the 1700s that the number of hospitals returned to pre-dissolution levels. 4 More pest houses began to appear, where people suffering from a particular contagious disease could go for care. St Bartholomew's Hospital 5 When hospitals did re-appear, they were run by physicians focused on treating the sick rather than by religion. Traditional herbal remedies Community care As in medieval times, most people who became ill Continuing were cared for at home, usually by a female relative. Healthy Bleeding and Physicians were still too expensive for the majority. living treatments and purging Members of the community (again, usually women) preventions helped with advice and remedies. Some were paid for their services. Superstitions and prayer Cleanliness Changes in prevention and treatments More emphasis on removing miasma through draining Lack of change swamps, and removing sewage and rubbish. The improved knowledge and discoveries People regularly changed their clothes to keep clean of the Renaissance had a limited impact rather than bathing. at the time because: New herbal remedies from newly discovered countries the ideas were slow to be accepted appeared in England, and some were effective. they had no direct use in improving The theory of transference led people to try and treatment or preventing disease rub objects on themselves to transfer the disease their discoveries did not improve to the object. understanding of the cause of Alchemy caused chemical cures using metals or disease. minerals to become popular. Explain why there were few totally new treatments for disease in the period 1500–1700. 8 M01_ED_GCSE_HISTORY_MEDICINE_RGRW_69729_001-017.indd 8 25/10/2016 10:16  c1500–c1700: Had a look Nearly there Nailed it! The Renaissance Change in care and treatment Although there was little practical change in medicine during the Renaissance, there were important changes in medical training and new discoveries made by Vesalius that led to changes in care and treatment after 1700. Training for apothecaries, surgeons and physicians Apothecaries and surgeons Physicians Continuity They were still not given They were still trained at universities and university training and were still the training lasted for many years. considered inferior to physicians Training was still based on learning and cheaper. from textbooks rather than practical experience. Change Both were better trained There was better access to a wider through being in guild systems, variety of medical books and detailed where they were apprentices, drawings due to the printing press. then journeymen, before Gradually, new ideas about anatomy becoming masters. (led by Vesalius) and causes of disease A licence was now needed inspired some physicians to become more to work as an apothecary or practical and experimental. surgeon and these were only Dissection was legalised but took time to issued after completing training. become commonplace. Vesalius The importance of Vesalius Andreas Vesalius He improved understanding of the studied medicine in human body. Paris in 1533, then He made the study of anatomy became a professor fashionable. It became central to of surgery in Padua, the study of medicine. Italy. He carried out a large number of He proved that some of Galen’s dissections on human work was incorrect, which helped bodies and many encourage others to question discoveries on how Galen’s theories. the body worked. He encouraged and inspired other medical professionals to carry out dissections and make further This drawing is taken discoveries. from his most famous book, On the Fabric of His work was widely published in the Human Body, which England and throughout Europe, and was published in 1543. included detailed illustrations of the human body, which were copied into other medical textbooks. List ways in which the work of Vesalius shows the differences between medicine in the Renaissance and Medieval times. 9 M01_ED_GCSE_HISTORY_MEDICINE_RGRW_69729_001-017.indd 9 25/10/2016 10:16  c1500–c1700: The Had a look Nearly there Nailed it! Renaissance The Great Plague, 1665 Case The Great Plague of 1665 was the first serious outbreak of plague in England since the study Black Death. There were many similarities and some differences in how people tried to treat and prevent it. Causes The Black Death and Great People’s beliefs about the causes of the Great Plague were mostly the same as their beliefs Plague about the causes of the Black Death. There These two diseases were the same, so were a few differences: comparing the methods used to treat miasma was by far the most commonly and prevent them is a useful guide to believed cause understanding what changed and what stayed the same in over 300 years of medicine. far fewer people believed it was caused by Remember to use examples from both an imbalance in the Four Humours outbreaks to show how much or how little people knew that disease could be passed change there had been in understanding and from person to person. treating disease. ut the See page 5 for more details abo disease and its symptoms. Government action A real difference between 1665 and 1348 was Treatments a far greater reaction by local councils, who Like its causes, many treatments for the Great were ordered by the King to try and stop the Plague were similar to those for the Black plague from spreading. Death. As most people with the disease were Theatres were closed and large gatherings quarantined, little is known about treatments, were banned. though many used herbal remedies, either Dogs and cats were killed. mixed in the home or by apothecaries, and ‘quack’ doctors. There were some new Streets were regularly cleaned. treatments for disease that had an impact: Barrels of tar were burned in the streets. The theory of transference meant that Every day, carts collected the dead who people tried to ‘transfer’ the disease to were then buried in deep mass graves. something else, especially birds, such as A household was boarded into its home for chickens. 28 days or taken to the pest house if a It was thought that people could sweat member caught the plague. disease out, so sufferers were wrapped up Days of fasting and public prayers were in thick blankets and put by a fire. ordered. Plague doctors wore costumes to prevent them catching the disease. The mas ks included sweet-smelling herbs to ward off miasma and the cloak was waxed so that nothing from the patient could be absorbed into it. Birds were believed to attr act disease so the mask was in the shape of a bird’s beak in the hope that it would cause the plague to leave the patient. Use the image to help you remember prevention methods. List six prevention methods used to try and stop people from catching the Great Plague. For each one, explain why they did this. 10 M01_ED_GCSE_HISTORY_MEDICINE_RGRW_69729_001-017.indd 10 25/10/2016 10:16  c1500–c1700: Had a look Nearly there Nailed it! The Renaissance William Harvey Case William Harvey was one of the most important individuals of the Medical Renaissance. study He was influenced by Vesalius and went on to influence many others, including Sydenham. William Harvey William Harvey, 1578-1657 Studied medicine at Cambridge, then Padua. Became a lecturer of anatomy in London at the College of Physicians. Was one of James I’s doctors. Harvey published his findings in An Anatomical Carried out public dissections. Hea rt and Blood Account of the Mot ion of the Taught the importance of doctors observing in Animals in 1628, which contain ed detailed and recording patients’ symptoms, rather diagrams like this one. than relying on textbooks for diagnosis and treatment. Discovered the process of blood circulation. Discovering the circulation of the The importance of Harvey blood He proved that some of Galen’s theories Harvey researched Vesalius’ theory that were wrong, bringing into question Galen’s blood flowed towards the heart, which other theories. contradicted Galen’s theory. He proved He improved knowledge about how the body Vesalius was right using dissected bodies worked and passed this knowledge on. By and pumps that showed blood only flowed 1700 his work was being taught in medical one way. schools. He then proved that blood could not be As a royal physician, Harvey’s work gained produced by the liver and absorbed into the publicity and credibility, and inspired others body, as Galen had thought. to find out more. He was influenced by new technology, such His scientific methods of observation and as mechanical water pumps, which made him use of dissection had brought results, and think the human body worked in the same so were copied by others. way. His discoveries left many unanswered He discovered that arteries and veins were questions, which encouraged further part of one system and that blood was experiments. pumped around the body by the heart. List the factors that were important in leading Harvey to make his discovery. 11 M01_ED_GCSE_HISTORY_MEDICINE_RGRW_69729_001-017.indd 11 25/10/2016 10:16  c1700–c1900: 18th and 19th Had a look Nearly there Nailed it! Century Germ Theory and microbes Although this period began with little change in ideas about the cause of disease, by 1900, huge breakthroughs had been made in the discovery of the true cause of many diseases. Continuity in theory of Microscopes causes of disease By 1700, microscopes had developed so There were few new ideas about that cloudy images of what would become the cause of disease in the 18th known as bacteria or germs could be century, though some scientists seen. By 1850, microscopes had further thought that germs were produced improved so that extremely tiny images by decaying matter – this was could be seen clearly. This was essential called spontaneous generation. in enabling the scientific breakthroughs of Most people still thought the later 19th century. miasma was a cause of disease, were but this was becoming a less Social attitudes towards science popular theory than it was in the changing – there was an increasing l Renaissance. awareness of the need for rationa of dise ase. explanations for the cause Change in theory of causes of disease: Germ Theory In 1861, Louis Pasteur (a French chemist) published his Germ Theory, which showed that spontaneous generation was incorrect. He proved that microbes (bacteria or germs) in the air cause decay (he discovered this when investigating why liquids turned sour for the brewing industry). He theorised that germs also caused disease but was unable to prove this. Robert Koch (a German doctor and scientist) read Pasteur’s work and began to study microbes himself. He proved that Pasteur’s theory was right, that microbes caused disease as well as decay. He identified the specific microbes that caused TB in 1882, and cholera in 1883. Koch developed a new, easier way of growing bacteria on agar jelly, and also discovered that chemical dyes stained bacteria, which made them easier to see under a microscope. Other scientists used these methods to identify the microbes that caused other diseases. Eventually, these discoveries were to have a direct impact on the prevention and cure of many diseases. The influence of Pasteur and Koch Pasteur’s Germ Theory had very little impact on medicine in Britain to begin with as he was not a doctor and his work focused on food and drink, not disease. Most doctors still believed in the spontaneous generation theory, but there were some (e.g. Joseph Lister) who did make the link between microbes and disease. Koch’s work had more of an impact in Britain than Pasteur’s had, and he inspired others to research other microbes. However, it took time for most doctors and the British government to accept the Germ Theory of disease. Even though the real cause of many diseases had been discovered, it didn’t yet have an impact on their medical treatment and prevention. Explain three factors that led to the development of the Germ Theory. 12 M01_ED_GCSE_HISTORY_MEDICINE_RGRW_69729_001-017.indd 12 25/10/2016 10:16  c1700–c1900: Had a look Nearly there Nailed it! 18th and 19th Century Improvements in hospital care Florence Nightingale was significant in influencing improvements in hospital care. Reports of her changes to hospital conditions after witnessing high death rates in military hospitals in the field had a significant impact on public opinion. Florence Nightingale 1 Nursing wasn’t seen as a 4 She believed that miasma respectable job for women caused disease, so emphasised and there was little training. hygiene, fresh air, good supplies Florence Nightingale attended and training for nurses. Her 2 the first nurses’ training approach lowered the death school in Kaiserwerth hospital, rate at Scutari hospital from Germany. 42% to 2%. She was asked to lead a 5 Her work was widely reported 3 team of nurses at the military in newspapers in Britain. She hospital in Scutari during the published books on nursing and Crimean War (1854–56). hospital organisation and set up a training school for nurses / midwives. Changes in hospital care 1856 New hospitals (financed by Great Ormond Street Hospital, charities and local councils) opened during the 19th The elderly, sick or disabled century to look after the sick. poor were forced to enter workhouses. First cottage hospital (small buildings where nurses gave Most hospitals tried to care and GPs prescribed to create a home atmosphere. create a home treatment) Parents and visitors had to opened in 1859. help nurses look after the Middle and upper classes patients. could afford doctors to treat them at home. Great Ormond Street Hospital, 1875 Due to the work of reformers Public pressure led to like Florence Nightingale, infirmaries (separate from hospital cleanliness and workhouses) being set up organisation improved, and for the poorest in society. nurses were better trained. Pasteur’s germ theory led to improved hygiene. Specialist hospitals (such as Nurses were given a more asylums for the mentally ill and central role caring for patients fever houses for infectious and assisting doctors. diseases) developed. Give three examples of ways in which hospitals had improved by the end of the 19th century. 13 M01_ED_GCSE_HISTORY_MEDICINE_RGRW_69729_001-017.indd 13 25/10/2016 10:16  c1700–c1900: 18th and 19th Had a look Nearly there Nailed it! Century Anaesthetics and antiseptics The three main problems that made surgery so dangerous were blood loss, pain and infection. The 19th century saw important developments in the management of pain and the reduction in infection. Search for an anaesthetic Development of antiseptics Joseph Lister was a surgeon who worked at Before 1800, alcohol and opium had little Glasgow Royal Infirmary. success in easing pain during operations. Laughing gas was used in 1844 in dentistry 1861 Half the patients in in the USA, but failed to ease all pain and surgery die from patients remained conscious. postoperative infections. 1864 Lister reads Lister starts work as a Pasteur’s Germ Theory surgeon. Ether (used from 1846) made patients totally and learns that carbolic unconscious and lasted a long time. However, acid kills parasites in 1865 Lister soaks it could make patients cough during operations sewage. bandages in carbolic and sick afterwards. It was highly flammable acid to avoid wounds and was transported in heavy glass bottles. 1866 Lister uses carbolic getting infected. acid to clean wounds and equipment and 1867 Lister states that Chloroform (used from 1847) was very effective invents a spray to kill his wards have been free with few side effects. However, it was difficult germs in the air. from infection (sepsis) to get the dose right and could kill some for 9 months. people because of the effect on their heart. An He publishes his ideas. inhaler helped to regulate the dosage. 1877 Lister becomes Professor of Surgery at King’s College Hospital, Cocaine was used as the first local anaesthetic London. in 1884. In 1905 a less addictive version – novocaine – was used as a general anaesthetic. Aseptic surgery rm James Simpson discovered chlorofo Lister’s work inspired others to search for to pain when he was looking for solutions methods to prevent the spread of infection e lect ure s and wrote during surgery. He gav in hospitals. By 1900, operating theatres for surg ery and articles to promote its use and wards were thoroughly cleaned using son to for childbirth. He was t