Medicine Revision Guide from Sept 24 v1 PDF

1hr 15 min exam 7 questions 1) Use Sources A, B and Changes C above to identify one similarity and one difference in……………...

1hr 15 min exam 7 questions 1) Use Sources A, B and Changes C above to identify one similarity and one difference in…………… in Health 2) Which of the two sources is the more reliable to an historian studying…… and 3) Describe the development of ………………………….. Medicine 4) Explain why developments in …………. were important in…(Focus) in Britain From September 2024 version ……(dates) 5) Outline how…… to …….. have changed1 from c.500 to the Pages 47- Pages 38- Pages 28-35 Pages 19- Pages 10- Pages 4- 57 46 25 16 8 2  INDUSTRIAL Medieval EARLY MODERN 2OTH CENTURY REVOLUTION 500 - 1500 1500 - 1750 1900 - 2000 1750 - 1900 HUMAN  Life expectancy: 35 years  Life expectancy: 36 years  Life expectancy: 46 years  Life expectancy: 80 years HEALTH  Poverty -> malnutrition  The Great Plague 1665  Snow - Cholera- John Snow’s  Bacterial infections -> resistance  Famine  Overcrowding map to drugs  Warfare -> infection  Great Fire of London  Movement of people from the  Troop movement -> spread  The Black Death 1348- 1349 country to the city -> over disease KQ1- CAUSES population -> increase of  Viruses e.g. Spanish Flu and AIDS OF ILLNESS housing -> low standard of living  Miasma theory (dirty, city air causing disease)  Alchemy, Soothsayers, Mother  Clean living, fresh air  Immunology  Koch- developed Jenner’s findings Shipton  Cold water treatment - spas  Jenner- developed vaccinations  Antibodies- the use of bacteria to KQ2-  Medieval Doctors  Diet and exercise (he noticed milk maids who prevent illness PREVENTING  Superstition  Vegetarianism became got cowpox never got  Ehrlich Magic bullets (first ILLNESS  Barber Surgeons fashionable smallpox) effective treatment for Syphilis  Pasteur  Public Health NHS Vaccine  Koch programmes - MMR  Astrology – zodiac charts  Amputation  Lister- antiseptics  Curie- radiotherapy  Herbs  Barber Surgeon  Opium and alcohol to numb  Fleming- antibiotics KQ3-  Barber Surgeon  Blood letting pain during surgery  Florey & Chain - antibiotics TREATMENT  Leeches and bloodletting  Laughing gas  Barnard- transplant surgery  Simpson - Chloroform  Alternative therapies  Microsurgery  Galen - astrology  Vesalius- dissected humans  Pasteur- Germ Theory  X Rays  Hippocrates- 4 Humours  Pare- surgeon, prosthetic limbs  Koch- isolated different germs  CT, PET and MRI scanning KQ4-  Church influence  Harvey- blood circulation  Ehrlich Magic bullets  Ultrasound  Microscope invented (compounds that target and MEDICAL kill disease-causing microbes KNOWLEDGE in the body) first effective treatment for Syphilis  Hospitals ran by the church  Henry VIII closed church-ran  Nightingale- hygiene standards  Liberal Reforms – National  Alms-houses (care homes for hospitals  Dispensaries set up Insurance. School Health KQ5- the elderly)  Charities and town councils  Teaching hospitals ->  Beveridge report, NHS set up  Money given by rich people took over professional nursing 1946 PATIENT CARE believing they would go for  Government Welfare- pensions heaven for helping others and insurance  Medical inspections  No Public Health / accidental  Link made between dirt and  Bazalgette – London sewer  Council housing KQ6-  Limited knowledge or disease  Chadwick- link sanitation and  Running water, electricity understanding  The Great Fire of London -> health  Clean air act (smog) 3 PUBLIC  Seen as unimportant rebuild London -> better  Slum clearance  Healthy lifestyle campaigns (5 a  KEY VOCAB: Key Qu- 1 Famine Cholera People starve An infectious What have been the because of a lack of food grown and often fatal disease caused Miasma causes of illness and Mist causing by bad water supplies disease over time? Bubonic illness as a Plague result of bad Disease air Typho spread by Anid infectious You need to know about: fleas of Epidemi causes bacteria which red spots small Problems in the medieval era: animals Disease caffecting aon the chest and poverty, famine, warfare: eg rats.. whole population. stomach lack of Black Pandem A pandemic affects the Spanish flu ic hygiene (p5) Death which spread whole world An infectious flu through Europe Black Death of the fourteenth in the middle pandemic that swept through century ages, not Poverty Europe after World directly linked to War 1 Great Plague of the the Bubonic The state of being very poor Plague seventeenth century; (p6-7) the effects of industrialisation and 4  20th century and Medieval Early Modern Industrial beyond 106 150 175 190 200 6 0 0 0 0 Causes of disease in Medieval times POVERTY FAMINE The population of Medieval England was about 5 million Bad harvests would lead to famine and this was a regular people. Most people in the countryside in agriculture. About occurrence. The worst recorded famines occurred in 1082, 25% of rural families owned and farmed their own land. But 1086, 1087, 1258, 1315 – 1317, 1437 – 1449. most owned no land at all. They were peasants who worked on land that was owned by the Lord of the Manor. They were dependent on him for work and food. They might keep a few animals: chickens or a pig. These were killed in the In 1315 – 1317 terrible weather ruined planting and harvesting for 3 years. The poor harvests were compounded But what did autumn and their meat preserved with salt to try to make it last through the winter. (made worse) by the death of animals from disease and a Medieval people shortage of fodder (animal food). Peasants couldn’t even.preserve the meat to keep for later as they couldn’t think at the time…. afford to buy the salt. It wasn’t until 1324 that things fully recovered. Historians estimate that this famine killed Most peasants ate pottage (a kind of stew made from beans about 15% of England’s total population. and oats). Peasants might be able to hunt and kill a rabbit or fish but if they were caught poaching they would be severely punished. WARFARE Child mortality was high and malnutrition was common. Warfare could also lead to poverty. An army would take food, animals and fodder from towns and villages, usually Landowners began to enclose more land in order to keep promising to pay later but they usually never did. Soldiers sheep. But this meant peasants were no longer required to were not paid properly so would often steal food – animals work growing crops such as wheat or barley on the land. or crops. This left towns, villages and farms without They had no way of earning money or growing enough enough food for themselves. food, Sheep farming required very few workers so paid work for the peasants became very hard to come by. HYGIENE Storing crops over winter could lead to the spread of ACCIDENTS disease. Saint Anthony’s disease was caused by a fungus which could grow on rye that was stored in a damp barn. Accidents were common and often fatal. Eg 1387 Richard The rye was ground into flour and made into bread. Dousyng fell because the branch of a tree he had been climbing People eating this bread would develop a painful rash broke. He broke his back and died shortly afterwards. and some would then die. 5  20th century and Medieval Early Modern Industrial beyond 106 150 175 190 200 6 0 0 0 0 Causes of Black Early Modern Era (epidemi c) period Death- (pandem The causes of disease from the Medieval continued into the Early modern. ic) In 1348–49 Britain faced the worst crisis in its history. A Medieval deadly disease arrived from Europe which appeared to kill people at random, and no one knew why. This disease was the bubonic plague. Symptoms: fever, headache, tiredness and painful swellings (buboes) the size of an apple in the groin and armpits. Small, oozing red and black spots all over the body, giving the disease the name the Black Death. Patients lasted just a few days before a The plague painful killed the rich and poor. What really death. frightened people, however, was the speed with which the disease swept across Europe and the number it killed. Nearly forty percent of the English died. Never before or since has there been any disaster so horrific. We know the bubonic plague is spread by the fleas which lived on rats passing it to humans- but Medieval + Early modern people had no idea this 6 was the cause  20th century and Medieval Early Modern Industrial beyond 106 150 175 190 200 6 0 0 0 0 Effects of industrialisation in 19th Century (Industrial period) The two most feared diseases of the Victorian period were Cholera and Typhoid. These diseases were spread by contaminated water. Cholera killed very quickly and painfully. Typhoid lasted several weeks and was often fatal. no one knew what caused it or how to cure it Could also be passed through contaminated food and faeces (that’s poo!) 1831 - 32 50,000 deaths During the 1897 Typhoid outbreak nurses treating the 1848 60,000 deaths sick were given bravery medals, such was the view of how dangerous it was. 1854 20,000 deaths The Industrial Revolution resulted in the spread of factories and the growth of industrial towns and cities such as Glasgow, Manchester, Birmingham and Sheffield. Factories needed housing to be built for workers. Public health problems in industrial towns Squalid living conditions meant that outbreaks of disease were common. Tenements were overcrowded, large families lived in cramped conditions. Sewage contaminated drinking water, which led to People in this outbreaks of period cholerathought it and typhoid; people did not know was miasma, terrible smells, infected water spread cholera germs. that caused disease. This is why they were so worried about events like the Great Stink in London in 1858 when sewage made the River Thames smell during the summer heat. It was that bad Parliament was closed down!Dr John Snow proved that cholera Great Stink 7 was a waterborne disease after 1854  20th century and Medieval Early Modern Industrial beyond 106 150 175 190 200 6 0 0 0 0 The spread of bacterial and viral diseases in the In the 20th century, bacterial and viral countries, migration and two world wars. 20th diseases century continued to spread as there was increased travel between Case study 1: Spanish Flu, 1918–19 - In 1918, a pandemic spread around the world. Up to 40 million people died from this strain of bird flu from China. It infected 20% of the world’s population. The end of the First World War helped transmit the disease as returning troops spread it to the civilian population. 7 million deaths were reported in Spain, so the disease was called Spanish Flu. It could kill a person in a day. Hospitals could not cope. It killed 280,000 people in the UK. Case study 2 : Tuberculosis - spread by coughs or sneezes. It used to be known as consumption as sufferers gradually lost weight. It was associated with poor housing and unhealthy working conditions of the Industrial Revolution. ‘Fresh air’ was thought to be the cure. By the 1950s better sanitation and vaccination reduced cases significantly. Isolation hospitals were set up in the countryside to help prevent the spread of the disease, but also to provide fresh air to help sufferers recover. The rise of drug-resistant strains in the 1980s, particularly amongst the homeless, means that the fight against TB continues. Case study 3: The HIV/AIDS threat - In 1981, the first cases of AIDS were reported in the USA. The AIDS virus is spread through the blood or body fluids of infected people – via sexual contact or by sharing injection needles with an infected person. In AIDS a virus called HIV destroys the body’s immune system. The victim does not die of AIDS but of other infections that their body can no longer fight. By 2000 an estimated 30 million people were infected with AIDS, the worst affected area was Africa. By 2000 over 8 million people had died because of AIDS. 21st century Lifestyle diseases New kinds of diseases have also begun to affect people in the modern era. 8 As people are living longer so they become more prone to get cancer – one in KEY QUESTION 1-What have been the causes of illness and disease over time? Causes – medieval Causes – Early Modern period period Chang ed For each time period make notes about what was believed to cause illness and disease. Stayed the Causes – Industrial same Causes – modern period period 9  KEY VOCAB: Key Qu- 2 Alchem Vaccine/ y that The belief vaccinat How effective were base metals could be turned Smallpo ion with treatment a vaccine to methods to prevent into gold A virusxthat is contagious produce immunity Soothsa against a illness and disease yer People and causes fever and Germ disease. Theory over time? who, it was believed pustules (infected Germ theory You need to know about: had the blisters states that many Contagiu diseases are Prevention of Black death power to caused by look into s which ismicro-organisms A disease 14th Century Alchemy, soothsayers the future. direct spread by within the body and medieval doctors (p13 – 14) contact from one person to another Anti-bodies Application of science to the Apothecar Produced to prevention of disease late 18th ieswho People protect the body made herbal against disease century and early 19th centuries remedies Inoculat (p14 – 15) ion The introduction by injection of an Work of Edward Jenner and Barber antibody into the MM vaccination Surgeon body to protect from disease. R Measles, Mumps and Influence and spread of inoculation s not only Barbers Rubella cut hair but since 1800 (p16) performed some vaccine 10 surgical operations  20th century and Medieval Early Modern Industrial beyond 106 150 175 190 200 6 What were early methods of preventing 0 0 0 0 disease in Medieval and Early Modern times? The Four The Church Humours The Church was very influential in Medieval times. The Church believed that physical illness was caused by spiritual illness. People believed that people became ill because they were living in an un-Christian way or people were not praying hard enough. The Black Death was stopped according to the Church by processions through the villages and asked Other for God’s to Methods forgiveness prevent catching the Belief in miasma as Most Medieval physicians Some people whipped themselves in the believed in the theory of the Black Death a cause led to the streets (flagellants) Four humours and used it Walk about carrying flowers, herbs and spices, use of pomanders Avoid eating and drinking and too much sex! and potions prevent illness by rebalancing Avoid bathing, Drink vinegar and / or wine Believed scented the body. The theory of the flowers or buckets of Four Humours was developed dung helped avoid in Ancient Greece by Some attempts to prevent illness and disease bad air (miasma) Hippocrates and Galen. Lack worked by accident eg of medical knowledge and King Edward III ordered the streets of London to be Soothsayers were usually old women who claimed to see the future. Their understanding made it difficult cleaned of all the filth. methods sometimes worked by trial and error carried out over many years. to prevent Prevention disease.or of disease They were often accused of witchcraft. There were very few ‘trained’ doctors and their knowledge was limited. prevention of the spread of it led to the use of Most people depended on the local ‘wise woman’ or soothsayer who had built up quarantine of travellers knowledge of sickness and disease over several generations and each would have their own favourite methods. They would collect plants and herbs, special stones, and the isolation of anything that might help, and carry this about with them in a willow basket. They infected people during the would make special charms to protect against evil. Mother Shipton became a Black death famous 15th century soothsayer. 11  20th century and Medieval Early Modern Industrial beyond 106 150 175 190 200 6 What were early methods of preventing 0 0 0 0 disease in Medieval and Early Modern Alchemists times? Early scientists who did experiments, mainly trying to turn base metals like lead or mercury into gold. Some alchemists aimed to find the “Elixir of Life”, which was meant to keep them young forever. Massive step in preventing illness because if you found this, you could keep people free from disease and enable them to live forever. The medieval alchemists were obviously unsuccessful, but they did develop new equipment and processes for carrying out experiments. These became useful in preparing herbal remedies and began the study of chemistry. People consulted alchemists to try to keep themselves well because the doctors were even less help. There were not many doctors in medieval and early modern times, and they knew very little about preventing diseases like the Black Death because they didn’t During the Great Plague of 1665, as understand the causes of illness. during the Black Death of 1348–49, many of the same failed ideas about were used again. However, some things did work: Movement of people was prevented; only those with medical passes could leave London. The Lord Mayor of London ordered that anyone suspected of having plague were quarantined for 40 days. Watchmen locked people in their houses, and parish officials provided food. 12 All trade with London and other plague towns was stopped in  20th century and Medieval Early Modern Industrial beyond 106 150 175 190 200 6 0 0 0 0 Short - Term effect Long - Term effect By end of October 29 1665 29 deaths. This was more deaths in two Population fell sharply immediately after 1666.By 1700 the months than in the previous ten years population figure was still well below what it had been in 1665. Villagers panicked - 50 individuals left, mostly rich people. Ratio of plague deaths to other deaths higher than London Fewer deaths through winter months as rat population dropped. Increase in number of deaths for April 1666 onwards. Sharp rise Farms left uncultivated. through Summer Key businesses left not running until people returned to the Fell again in October. Last single death in November village. Total number of deaths 260 out of a population of 800 The record of baptisms show number declined due to fewer 76 families affect, e.g: Hancock Family, Elizabeth buried her adults of childbearing age. husband an6 children in the space of 8 days. 9 members of the 13 There were no plague deaths outside of Eyam in Derbyshire was Thorpe family all died in the same house affected.  20th century and Medieval Early Modern Industrial beyond 106 150 175 190 200 6 0 0 0 0 Application of science to prevention of disease late 18th century (Industrial period) In the 1600’s many people were influenced by the Ancient Greek’s and Roman beliefs in fresh air, diet and exercise as a way of preventing illness. Walks in the fresh air and vegetarianism became fashionable. People believed that visiting places such as Lemington spa or seaside resorts like Brighton would help to prevent the disease. Cold water treatments in fashionable resorts became fashionable with the wealthy. These were called Spas. The most famous spa town was Bath. Some scientific understanding was being used to prevent illness eg sailors were given lime or fruit to avoid scurvy and washing hands became more common. An important invention at this time was the microscope, which later allowed scientists to see tiny organisms like bacteria. The continued use of mineral water treatments together with advancements in cleanliness and sterilisation; John Snow and cholera Cholera reached London in February 1832. The authorities were poorly prepared for the epidemic and doctors disagreed on what to do. This resulted in cholera riots. The 1832-33 cholera epidemic claimed 4,000 to 7,000 victims in London. In September 1853 a cholera epidemic was claiming in London and other parts of the country. It was during this epidemic that John Snow, a London doctor, succeeded in tracing the epidemic to a single water pump on Broad Street. Snow carefully plotted a street plan of each and every cholera case around his surgery. He noticed in a nearby area, where there was a brewery, those workers didn’t catch cholera because they drank beer and not the water. He used statistics to illustrate the link between the quality of water from different sources and cholera deaths. He came to the conclusion without really knowing why that the source of the local infection was the water pump in Broad Street. When he took the handle off the pump-the disease declined. Snow did not succeed in convincing the majority of his colleagues of the causes , which cost the lives of some 12,000 people in the city. 14  20th century and Medieval Early Modern Industrial beyond 106 150 175 190 200 6 0 0 0 0 Industrial period Smallpox and inoculation - Smallpox had a high death rate and no cure. Inoculation involved spreading matter from a smallpox scab onto an open cut on a healthy person’s skin, giving them a mild dose of the disease. Inoculation became popular but it was not completely safe Dr Edward Jenner experimented to find out why milkmaids suffered from cowpox but never smallpox. In 1796 he injected James Phipps with the pus from the sores of a milkmaid with cowpox. Phipps developed cowpox but did not develop smallpox. Jenner had found a way of making people immune from a deadly infectious disease. He called this method vaccination (after the Latin word vacca - cow). His book on vaccination was published in 1798. The government gave him £10,000 in 1802 and £20,000 in 1807 to open and run a vaccination clinic in London. In 1852 smallpox vaccination became compulsory in Britain for all children but many parents objected as people still believed miasma caused smallpox- Pasteur had not come up with the Germ theory yet. Discovery of antibodies and developments in field of bacteriology 1800s (Industrial period) Louis Pasteur was a French Scientist. He discovered the presence of good and bad bacteria in wine but if you heated it up it got rid of the bad bacteria. This is now how milk is made safe to drink – it is pasteurised (heated up so the bad bacteria is killed) He further developed the idea that bad bacteria and germs are all Louis around us (Germ Theory) and were the cause of many disease and illnesses Pasteur then went on to develop vaccinations to target disease - s t e ur he knew that the body could learn to fight bad bacteria. A small dose Pa of a disease encourages the bodies immune system to fight the disease. 15  20th century and Medieval Early Modern Industrial beyond 106 150 175 190 200 6 Discovery of antibodies and developments in field 0 0 0 0 of bacteriology 1800s (Industrial period) Robert Robert Koch was German Scientist who took the work of Pasteur a step further. He discovered that certain bacteria caused certain illness In 1882 identified the bacteria which caused TB Koch In 1883/4 identified the bacteria which caused Cholera and confirmed the findings of John Snow He allowed the science of bacteriology to develop He knew that antibodies work specifically on only one bacteria was significant in preventing disease He and his students subsequently isolated the causes of Diphtheria, Typhoid, Pneumonia, Tetanus, plague, Whooping cough and therefore allowing the development of vaccinations. They also developed a technique to identify types of bacteria using dyes to stain them and make them easier to detect under microscopes. Koch realised antibodies could destroy bacteria and build immunity against the disease. Each antibody only worked one bacteria. If you could introduce a weakened form of the disease into the body when the deadly version of the disease attacked, the The Spread of Inoculation since 1800 (Industrial period and body would be able to resist. 20 century + beyond) th Koch won a Nobel Prize in 1905. Diseases and childhood killers such as diphtheria (1940), polio (from 1955), whooping cough (1956) and measles (from 1963), have almost been eliminated through vaccination programmes. The World Health Organization (WHO) says vaccines are available for 25 different preventable infections and has campaigns of immunisation operating across the globe. In 1979, WHO declared smallpox extinct. By the 21st century vaccination fell as a growing reluctance to have children vaccination after the MMR (Measles, Mumps, Rubella) vaccine scandal in the 1990s when Dr Andrew Wakefield wrongly claimed the vaccine caused autism in children. Around the world the Anti-Vax movement has spread over social media trying to persuade people that vaccination is wrong or too dangerous. Government attempts to improve public health and welfare in the 21st century [KQ6 for more details] 16 In the 21st century, governments and agencies have put more and more effort into health education to KEY QUESTION 2- How effective were methods to prevent illness and disease over time? Revision sheet List 3 ways that people believed would prevent Define illness/disease in the Medieval Period. Inoculation – 1. Vaccine/Vaccination – 2. Germ Theory – 3. Contagious – List 3 ways that people believed discovered could prevent illness/disease in the Who were.. Industrialisation period in the 1800s 1. Apothecaries – 1. 2. Barber Surgeons – 2 3. Alchemists -. 3. List 3 ways that people believed discovered What connects John Snow and the Broad Street could prevent illness/disease in the 20th Pump in London? Century 1. 2. 3. What has changed & continued? 17 KEY QUESTION 2- How effective were methods to prevent illness and disease over time? Revision sheet. What did Louis Pasteur discover in wine which Describe the link between Jenner and led him to develop germ theory? smallpox. How did he get rid of bad bacteria in wine? How is this linked to milk? List 3 reasons why the study into bacteriology was important for the prevention of illness What else did Pasteur achieve? and disease. 1. 2. What was Koch famous for? 3. What other 3 key vaccinations have been introduced since WWII? Outline the MMR debate. What links Pasteur, Snow, Koch and Jenner? 18  KEY VOCAB: Key Qu- 3 Herbal Antisept ic How effective were Medicine s based Medicines A method of /Aseptic reducing infection attempts to treat on herbs and plants Leeches during operations. Aseptic is Bleedi and cure disease A type of a bacteria free worm which is ng water based, environment Germ over time? The process of and used to suck blood theory taking Germ theory from the You need to know about: blood body states that many from a Apothec diseases are person to caused by Treatments and remedies in balance arywho micro-organisms a person. and prepared medieval era the 4 within the body Zodiac humours sold medicines Herbal medicines, barber surgeons, and drugs in Chart medieval times Antibioti use of leeches (p23-24) Charts based on cs such a medicine James Simpson- anaesthetics (p26) the astrological as penicillin that symbols. These stops the growth James Lister- antiseptics (p27) were used to Anaesth of or destroys 20th century developments- Marie decide on etic of microorganisms A method treatment reducing pain Curie and radiation, roles of Fleming, Barber during operationsAlternative Florey and Chain regarding Surgeon Medicine healing or antibiotics (p28) Barberssnot only treating not Barnard and transplant surgery cut hair but included in performed some traditional 19 (p29) surgical operations medicine  20 century and Medieval Early Modern Industrial beyond 106 150 175 190 200 6 0 0 0 0 If the cause of illness was God, then logically Different God could also cure the illness. People could treat illness by: Urine Chart. In Medieval times the physician would compare the colour of the patients urine against a chart. How is this types of ∙ ∙ Prayers and spells Paying for mass to be said similar to today? Zodiac Charts treatments in ∙ Fasting (going without food) would tell the ∙ Pilgrimages (journeys to religious physician which parts of the body were places) linked to which parts of the astrological Medieval ∙ Charms and amulets signs. It would indicate how was best to treat an Aries or Aquarius patient, when was the best time to treat them and when was a Times good time in the astrological cycle to pick and mix herbs. Barber Surgeons Four Humours - Bleeding The Four Humours- Purging It was believed that the humours were Phlebotomy (bloodletting) was the most The least qualified medical created from the foods eaten, a common common treatment, bad humours could be professionals. They had sharp knives treatment was therefore to remove any removed by removing some of the blood. It and a steady hand so could perform leftover food. This was done by giving the was usually carried out by Barber Surgeons small surgeries such as extracting teeth patients an emetic (to make them vomit) or a or Wise Women. It could be done in different and bleeding. laxative to clear out anything left in the body. ways They would advertise their services by These were usually strong and bitter herbs, o Cutting a vein: a vein was cut open putting a bowl of blood in the shop often they contained poisons such as window until 1309, after that they with a sharp instrument. Phlebotomy hellebore. Laxatives were very common and charts were used to show points in the displayed a sign of a bandaged, bloody included things like mallow leaves and arm. body were bleeding was recommended linseed. for specific illness Some were highly trained, in Europe o Leeches were collected for those were some doctors were surgically trained If more help was required an enema was alongside medicine. They learned from given – a mixture of herbs and oils were traditional bleeding was too dangerous o Cupping: the skin was pierced until it practical experience instead of books. squirted into a patient’s anus using a greased pipe fixed to a pig’s bladder. bled, a heated cup was then placed over the cut to draw out the blood. Common ingredients included mint, Herbal ingredients camomile, almonds, saffron, absinthe and Use of Leeches honey and a mixture of plants. It was believed in Medieval times that turpentine. Some of these were expensive Books called ‘herbals’ recorded and difficult to find. leeches only removed ‘impure’ blood from ‘recipes’ with ingredients, quantities the body, leaving ‘good’ blood behind. The 20 and prayers sometimes these were use of leeches continued well into the  20th century and Medieval Early Modern Industrial beyond 106 150 175 190 200 6 0 0 0 0 How effective were EARLY MODERN treatments in Medieval Treatments. Everything times? from Medieval Different types of Folk plus.. Remedies and magic. Treatment for Malaria from The New London Dispensary: ‘take the treatments in the hair and nails of the patient, cut them small and either give them to Early Modern birds in a roasted egg or put them Period in a hole in an oak tree or a plane tree. Stop up the hole with a peg of (1500 – 1750) the same tree’ (measures of desperate people. Herbals. As a result of the printing The touch of the king. People press during the Early Modern believed that the king was God’s period representative on earth, therefore people could have a copy of if they were to receive a ‘touch Nicholas Culpepper’s Complete from the king’ they would be cured. Herbal which recommended simple Between 1660 and 1692 92,000 herbal treatments (1652). people visited the court of King Charles II seeking healing. ‘Ladies of the manor’- ladies Some physicians began writing began compiling recipe books of in English rather than Latin to cures eg Lady Johanna St John help more people. Quinine. In the Renaissance period Herbs were continued to be the bark of the cinchona tree was used alongside astronomy. imported from South America because it treated fevers New ingredients- rhubarb was effectively. It became known as hailed as ‘wonder drug’. quinine and was used to treat Tobacco from N.America. malaria. Blood Transfusions. In 1665 Blood Transfusions. In 1665 Richard Lower made his first Richard Lower made his first experimental blood transfusion by 21 experimental blood transfusion by transfusing blood from a dog to a transfusing blood from a dog to a  20th century and Medieval Early Modern Industrial beyond 106 150 175 190 200 6 0 0 0 0 Anaesthetics from Industria Joseph Lister and use of timesAnaesthetic – Ether In 1846 Robert Antiseptics in later 19 century Liston th used Ether as an Cocaine was used anaesthetic when he as a painkiller first in Joseph Lister, Professor of Surgery at several universities, believed amputated a leg. the 1850s when coco Pasteur’s ‘germ theory’ and began experiments to prevent patients (interestingly, he leaves were brought from dying from blood poisoning after an operation. amputated a man’s leg form South America. used carbolic acid to wash his hands and all his instruments in 2.5 minutes but Initially, given as before an operation, accidentally cut off his drops in the eye; to soak bandages before applying them to wounds, testicles as well)Ether later (1891) it was to soak silk threads in it before tying up wounds. He reduced the was being used by produced chemically dentists in America. after which use of infection rate from 46% to 15% in 3 years. Wasn’t fully effective- cocaine as pain relief patients sometimes in operations became He invented a spray machine in 1871 so that carbolic acid could be woke up during the common practice. sprayed over a patient’s wound during an operation. He published his operation. findings in 1867. Lister’s methods marked a turning point in surgery. caused severe Anaesthetic – The discovery of the bacteria that caused septicaemia (blood irritation to the eyes These included: poisoning) in 1878 helped the acceptance of Lister’s ideas. and lungs. Chloroform was first used in 1847 by Thorough cleaning of hospitals and theatres James Simpson to Nitrous Oxide (Laughing reduce pain in steam-sterilization of all instruments Gas) 1799 Sir Humphrey childbirth. It has be use of sterilized rubber gloves. Davy was the first to use to inhaled carefully this in. He tried it on his as it causes friends getting them to dizziness, sleepiness This led to creating a sterile operating environment – known inhale the gas from oiled as Aseptic Surgery and Aseptic sterile operating environment- Developed from the work silk bags. It was used unconsciousness. of Robert Koch who discovered in 1878 that most disease was not during operations but it was difficult to control the There was spread by air but by infected surfaces. In 1881 Charles Chamberland dose and some surgeons widespread invented a steam steriliser for medical instruments, which heated had higher death rates opposition to using them to 140c for 20 mins and therefore completely sterilised them. when using anaesthetics. chloroform until From the 1890s operating theatres were rigorously cleaned and this Queen Victorian used continues to be a key focus to reduce risks of infection and death. This Anaesthetics. in 1853 whilst giving made surgery much safer. 1930s Helmut birth. In 1870s some Wesse developed surgeons 22stopped Protective clothing using chloroform due anaesthetics that could American William Halsted started his team wearing surgical gloves and  20th century and Medieval Early Modern Industrial 6 Marie Curie and the development of radiation in 106 150 0 175 0 190 0 beyond 200 0 20th century Marie Curie and her husband Pierre were the first to discover and isolate Radium and Polonium. Modern advances in cancer treatment following the Radioactive elements play a key role in destroying work of Curie… tissue - this breakthrough has led to the Radiation therapy has been used to treat cancer in treatment of some types of Cancer. 20th century. She was a pioneer in Radiography This has been supplemented by chemotherapy- By October 1914 she had developed 20 portable powerful drugs to kill cancerous cells. This has X-Ray machine to be used at the front line of become more widespread since WW2. fighting in WWI. Encouraging results from radiation and By 1916 most casualty hospitals on the Western chemotherapy. Front had X-Ray equipment. Made diagnosis and Cancer is still a major killer but more and more treatment much quicker. types of cancer are being cured or controlled by Became standard equipment in hospitals in 20th these treatments. Century. Used to investigate problems especially Surgery also used to remove cancerous cells. with bones and teeth. Mastectomy (removal of woman’s breast) or lung Marie Curie was awarded two Nobel Prizes in 1903 transplants are most common forms of surgery. Roles of Fleming, Florey and Chain in and 1911 She died in 1934 of Leukaemia - a result of too With different scanning techniques it is easier to diagnose and treat. antibiotics in 20th century much exposure to radiation. 23  20th century and Medieval Early Modern Industrial beyond 106 150 175 190 200 6 0 0 0 0 Different Magic Bullets. In Dialysis the 1930s Sulphonamide machines. Crucial types of was the chemical in both Salvarsan 606 and modern treatment for kidney patients – these treatments Prontosil. It was an important scientific machines keep patients alive by dialysing their development and in the subsequently mass produced to treat blood until a kidney becomes available for 20th patients suffering from pneumonia and scarlet transplant. Century fever. Blood Radiation Transplants. 1954 – kidney transplant. Transfusions. Therapy. Following 1963 liver transplant. 1901 Karl Landsteiner on from the work done 1967 the first heart discovered blood by Marie Curie, transplant was carried out in radiation therapy has South Africa by Dr groups which meant Christiaan Barnard. transfusions could been used throughout 1980 first bone marrow happen with patients the 20th century to treat transplant. who had the same cancerous cells. As 1982 first heart and lung blood group. Storing technology has transplant. blood was still an issue developed it has All a result of technical and become more refined scientific expertise. until it was discovered that if sodium citrate and easier to target the *Transplant surgery - In was added to blood to diseased cells. This led December 1967, Christiaan prevent clotting during to development of Barnard performed the WWI and further Chemotherapy world’s first human heart developments by transplant on Louis Washkansky. He survived the British surgeon operation but lived for only Geoffrey Keynes led to 18 days, dying of first blood depot pneumonia. Barnard created before battle of performed ten heart Cambrai in France in transplants between 1967 1917. and 1973, but rejection of the transplanted organ remained a problem. Immunosuppressive drugs solved transplant rejection. 24 Keyhole and micro- Scans. After 1945 the Gene therapy.  20th century and Medieval Early Modern Industrial beyond 106 150 175 190 200 6 0 0 0 0 Spotlight story- WW1 Vaccination Amputation and artificial limbs The Thomas Splint Brain surgery Leg wounds were the most commonly recorded area of injury. Up to 1915 only 20% of soldiers who had their thigh bone (femur) broken by gunfire survived. The Thomas Splint, invented by Hugh Thomas and used from 1916, dramatically reduced these deaths. The splint stretched the leg to Plastic surgery stop the ends of the broken bone grinding against one another and reduced blood loss. It also kept the bone still, preventing further Antiseptics damage. On the Western Front it was difficult to carry out surgery in Frontline medics were trained aseptic conditions. Infection was often carried deep into wounds to use the splint and deaths by shrapnel Doctors and machine experimented gun with fire. different techniques and found reduced to less than 20% of antiseptics, such as Carrel-Dakin Solution and saline, that those injured in this way. could be used to flush or ‘irrigate’ wounds.. They used carbolic acid and hydrogen peroxide to kill bacteria in wounds. They learned to not sew up wounds straight away so that 25 KEY QUESTION 3- How effective were attempts to treat and cure disease over time? Revision sheet Medieval Treatments Key Words Antiseptics – What was a ‘Zodiac Chart’? Anaesthetics – In Medieval times cuts and wounds were treated with which two Aseptics – items? Antibiotics - List four ways people treated illness in this period. Early Modern Treatments What was Quinine used for? List four ways people treated illness in this period. Who performed surgical operations on people and what were operating conditions like at this time? Who operated on people and what were operating conditions like at this time? What types of anaesthetic were used in Medieval times? What types of anaesthetic were used in this period? 26 KEY QUESTION 3- How effective were attempts to treat and cure disease over time? Revision sheet 20th Century –Treatments 19th Century Industrial Period continued… Treatments What does the phrase ‘magic bullets’ mean? Ether was used as an anaesthetic by Robert Liston in 1846 but what was the problem with it? Explain the significance of Magic Bullets. What did James Simpson use as an effective anaesthetic? Who performed the first heart transplant and when?. Describe what Joseph Lister did which was quiet revolutionary in this period. List the different types of scanning techniques and their uses What was produced chemically after 1891 and used as an anaesthetic?(clue its origins are found in coco leaves) 20th Century –Treatments Who, in 1901, made the discovery about blood groups which made blood transfusions possible? What is gene therapy? What did Marie and Pierre Curies discover? What did this lead to? How is modern day surgery different from 1500? Who discovered Penicillin? Who was responsible for developing the manufacture of penicillin? 27 Describe ‘alternative’ treatments  KEY VOCAB: Key Qu- 4 4 Scanner too much or too machine that Humours s How much progress little of any of four bodily fluids examines the body through by has been made in in a person— known as X - Rays using radiation, ultrasound, or medical knowledge A photographic imaging, as an aid humours— directly image of the body to identifying influences their used to detect diseases.. DNA over time? health Indulgen disease and broken bones, genetic material in all life forms You need to know about: A paymentcesto the illness. which creates catholic church for the ‘Magic the distinctive Influence of alchemy, astrology and forgiveness of Bullets’ characteristics of someone or theory of four humours (p34-35) sins. A type of anti- something. Influence of Vesalius, Pare and biotic which PET Scan Harvey in 16th and 17th centuries Cauterisattargets a specific Positron emission disease (p36) ion a medical tomography (PET) technique of scans are used to 19th century advances in medical burning a part produce detailed of a body to Ultrasou three-dimensional knowledge (p37) remove or close A type ndof medical images of body Improved knowledge of germ theory off a part of it. imaging which Pasteur and Koch (p38-39) Ligature uses sound waves CT/CAT the UsesScan Development of scanning techniques used for stying or to penetrate body computers and rotating X- binding part of the X-rays, ultrasound and MRI scans body tightly to cut ray machines to off the blood create cross- (p40) supply sectional28images Discovery of DNA and genetic during surgery of  20th century and Medieval Early Modern Industrial beyond 106 150 175 190 200 6 0 0 0 0 Medieval knowledge- The influence of Alchemy and Astrology, theory of Four Humours Hippocrates, Galen and the 4 Influence of alchemy and Role of the Catholic humours astronomy church in developing medical knowledge Hippocrates (born BCE460) ‘father of modern Alchemists were usually The church reigned medicine’ with over 60 surviving documents on the monks/priests and were best supreme in medieval topic educated in medieval society society-so their opinion on Galen (born CE130) he built on Hippocrates’ ideas Along side their study for medical progress and but also believed in dissection (of animals) to learn turning lead into gold, many developments was crucial about the human body also sought to make the elixir of Most believed that sin Galen looked after gladiators, so had a good life-an end to death could cause illness and many knowledge of anatomy, promoted using patient’s Alchemists had big impact prayed or went on pilgrimages pulse as a diagnostic tool (still used today) on medical and scientific world- to seek forgiveness but the Galen’s work survived due to Islamic inventing new chemicals (nitric rich could buy forgiveness medicine, the Catholic church promoted his acid) and discovering new through indulgences ideas because he referred to everyone having elements (antimony/arsenic) The church helped to a soul Medieval doctors believed establish places of learning Both promoted the idea of the body as a in the influence of the stars on for physicians based on mini-universe, having 4 elements (water, earth, people’s personality and health Hippocrates and Galen’s wind and fire) but these were renamed and In 1500’s doctors were principles. called humours required to study astronomy as Many of Hippocrates and Proportion of each humour different in part of their training. Galen’s works survived everyone and changed as they aged. Everyone’s Doctors believed every part thanks to Islamic translations health depended on keeping these in the correct of the body was linked to a star which were then retranslated balance sign, so medicines were thought by monks in the medieval The doctor’s skill was in working out these to be at their best when the period proportions and rebalancing them when ill. This was herbs were collected and The church supported done through diet, exercise and bleeding/purging. administered at the right phase Galen’s (incorrect) Hippocrates and Galen’s ideas reined of the moon teachings on anatomy/ unchallenged until the Early Modern period and to some Many historians now believe dissection because he extent up to mid-C19th. that doctors sought to make promoted the idea of a soul. medicine more complicated to The church discouraged 29 stop unqualified anyone who challenged  20th century and Medieval Early Modern Industrial beyond 106 150 175 190 200 6 0 0 0 0 The Early Modern Period – breakthroughs! Harvey and blood Vesalius and Anatomy Pare and Surgery circulation Why were Vesalius, Pare and Harvey important in medicine ? What impact did their discoveries Vesalius was born in have? Pare was a barber surgeon William Harvey’s most 1514 and studied medicine in born in 1510. He became an famous work, On the Paris and Italy. He was allowed to army surgeon. Motion of the Heart, was published in 1628. More perform dissections but At the time the wound left than any other work at couldn’t look closely at the by amputation was sealed the time challenged the skeleton. He was so dedicated by burning the end with a work of Galen. he stole the body of criminals red hot iron, known as Whilst studying, Harvey had cauterisation. This was very been taught that the veins in He became professor of surgery at Padua in Italy where he painful. the human body had valves, performed more dissections. He wrote books on his Pare invented the method of and blood pumped just one way, observations including The Fabric of the Human Body in but no one knew how or why. tying off vessels with thread, 1543. Later in his life, Harvey known as ligatures. This was less experimented on frogs and painful, but may have caused lizards. His illustrations were carefully labelled and he used his infection as they did not yet know powers of observation to point out some of Galen’s His most famous experiment, about germs. mistakes. showed convincingly that the Gunshot wounds were, at the heart worked as a pump, and Galen thought that blood passed through the septum of time, treated by pouring boiling that blood flowed in a one way the heart through little holes. Vesalius proved there were oil into the wound. During one system around the human body. no holes in the Septum. battle, Pare ran out of oil and He was also able to show the resorted to an ointment of his Galen believed that human jaw bones were made of two Galen’s theory that the liver was own. the centre of the human body, pieces. Vesalius proved it was one. It proved Galen could To his surprise, these patients and created new blood was be wrong! recovered better than the ones wrong. scalded with oil. 30the idea Harvey also challenged Other doctors opposed to his of ‘Bleeding’ as a cure, as he  20th century and Medieval Early Modern Industrial beyond 106 150 175 190 200 6 0 0 0 0 In Summary: How much had changed in medical discoveries between Medieval and Early Modern period? Changed Stayed the same 1. The discoveries made by Harvey and Vesalius were important as they The discoveries of Harvey and Vesalius did not make anyone proved to doctors that Galen was wrong and that careful dissection and healthier at the time. experimentation were the way to new ideas about how the body worked. Life expectancy did not increase much. They hadn’t discovered new and better ways of treating 2. Pare’s use of bandaging wounds and using ointment instead of boiling oil helped patients survive as other surgeons could see it working. illnesses. However his use of ligatures slowed down surgery, causing problems Treatments: Herbal remedies were still widely used. with bleeding, and also helped spread infection as these were not Surgery only improved a little. sterilised. Treatments from the Four Humours were still widely used; this had not yet been disproved. 3. In 1492, America was discovered. This brought a wide range of new Superstitious treatments were still widely used, including knowledge to Europe including many n