History of medicine

Created by: A.B.
Created on: 27-03-13 21:36

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Medicine Through Time
- The Middle Ages 1350 - 1500
  - Key People
    - Galen 120AD
      - Wrote books which were the first examples of Greek thought. Dismissed magic. Created Theory of four humours.
      - Anatomical. Dissected animals and therefore made mistakes however was very advanced at the time and influenced training and many of the training for a long time.
      - Continued on Hippocrates (400BC) Theory of Opposites
  - Beliefs about causes of disease
    - Supernatural
      - Astrology and Astronomy
    - Religious
      - Punishment from God
    - Ancient
      - Four Humours and Theory of Opposites
    - Natural
      - Miasma
  - Key Events
    - Black Death 1348
  - Medical Treatments
    - Padua Univeristy
      - For the rich:
        Surgeons who had studied at Padua. They had studied Galen.
      - For the poorer:
        Barber Surgeons
        No formal training, sometimes had an apprenticeship
        
        Performed some surgery, blood letting, pulled teeth, sold medicine and cut hair
        
        Apothecaries
        Prepared and sold medicines to surgeons and directly to patients
        
        Often diagnosed illness and were sometimes accused of practising witchcraft
        
        Wise Women, House Wives and Midwives
        Delivered babies and, occasionally, carried out abortions
        
        Administered herbal remedies
        
        Founded branches of alternative medicine
        
        Belittled by more professional branches of medicine, and often by men
  - Impact of Church
    - Help
      - Invested in training institutions
      - Monasteries provided care and some medical help
      - Medical books were copied by monks
    - Hinder
      - Catholic Church was unchallenged
      - Church's teaching was accepted as being the truth
      - Church taught that God punished people for wrongdoing
      - The clergy accepted the works of Hippocrates and Galen therefore medicine was not encouraged to continue
  - Since Roman period -
    - Change
      - Lack of public health due to no strong government
      - Wars that led to the fall of Rome meant books were lost
    - Continuity
      - Continued to study Hippocrates and Galen
  - Public Health Through Time
    - 1350- 1750 (Middle Ages & Renaissance)
      - Key Events
        1348 Black Death
        Standards Improved after as population had fallen.
        People struggled to deal both epidemics. Most methods of prevention were ineffective.
        
        Only short term improvements to medicine.
        
        1665 Great Plague
        Standards Improved after as population had fallen.
        People struggled to deal both epidemics. Most methods of prevention were ineffective.
        
        Only short term improvements to medicine.
      - Stagnation
        Problem of sewage and rubbish disposal.
        Contamination of water.
        Only monasteries had fresh water.
        
        Middle Ages - water carriers. Renaissance - some piped.
      - Role of Government
        Laws passed to try and keep cities cleaner i.e. 1372 Fine for throwing waste out of houses.
        
        Ordered days of fasting and praying
      - Disposal of waste
        No flushing toilets
        
        Rakers attempted to keep streets clean
      - Problem of population explosion - over 100,000 during Renaissance
    - 20th Century
      - Key People
        Aneurin Bavin 1945
        Minister for health - wanted to set up NHS but faced opposition. Set up in 1948. Resigned in 1951 because prescription charges were introduced.
      - Liberal Welfare Reforms
        1948 Welfare State
      - NHS 1948
        Minister for health - wanted to set up NHS but faced opposition. Set up in 1948. Resigned in 1951 because prescription charges were introduced.
      - Role of Government, Technology and Wealth
        1911 National Insurance
        
        1956 Clean Air Act
        
        NHS 1948
      - By 1931 life expectancy was 60yrs
      - Industrialisation - 1900 Boer War 1/3 medically unfit
    - 1750 - 1900 (Industrial Revolution)
      - Key People
        John Snow 1854
        Investigated deaths due to Cholera.
        
        Edwin Chadwick 1842
        Wrote report on "The Sanitary Conditions of the Labouring Population". Nothing done until 1848 Cholera epidemic.
      - 1848 and 1875 Public Health Acts
        Wrote report on "The Sanitary Conditions of the Labouring Population". Nothing done until 1848 Cholera epidemic.
      - Impact of Industrialisation
        Population explosion
        Manchester grew from 70,000 to 303,000 from 1801-51
        
        Poor quality housing
        
        High death rate due to infectious disease
        TB
        
        Typhoid
        
        Cholera
        Outbreaks in 1848, 1854 and 1866
      - Government Involvement
        End of Laissez Faire
        
        Public Health Acts
- Renaissance 1500 - 1750
  - Key Discoveries
    - Printing Press
      - Discovered around 1450, meant that medical ideas could be written down and spread further more quickly.
    - Work in obstetrics and created forceps.
    - Water pump gave Harvey inspiration
    - Microscopes, first in 1590
  - Key Individuals
    - Vesalius 1543
      - Studied at Padua. Conducted his own dissections. Found faults in Galen's work. Helped with blood-letting. Created anatomical drawings. Moved people on from studying Galen.
    - Harvey 1628
      - Studied medicine at Cambridge. Was a Doctor and Lecturer. Discovered the heart was a pump and that humans come from eggs.
    - Pare 1575
      - French Barber Surgeon. Found alternatives to cauterising. Introduced ligatures. Experienced through war. Ligatures were less painful but increased infections so not popular. Also involved in obstetrics.
    - Hunter brothers
      - Work in obstetrics and created forceps.
  - Changes in training
    - Physicians
      - No longer used urine or astronomy charts.
    - Surgeons
      - Work of Hunter brothers improved training.
        Hunter brothers
    - Midwives
      - Discovery of forceps meant men began to dominate midwifery.
  - Impact of Church
    - Reduced influence as people started to question Galen and criticise Church.
    - Dissections carried out, especially at Padua even though against Church.
      - Reduced influence as people started to question Galen and criticise Church.
  - The Royal Society 1660
    - Scientists shared ideas. experimentation encouraged.
  - Medicine and healthcare in home and hospitals
    - Still usually run by monasteries.
      - Impact of Church
        Dissections carried out, especially at Padua even though against Church.
      - Until reformation when new hospitals created, helped by Royal Society
- Industrial Revolution 1750 - 1900
  - Key Individuals
    - Edward Jenner 1798
      - First breakthrough of fight against infectious disease. Studied inoculations and produced vaccination for cowpox. Got idea from Turkey.
    - Louis Pasteur 1861
      - French Scientist, not a Doctor. Worked with beer - realised it went off due to "germs in the air". Unusual because people thought germs were the product of decay.
        Produced a vaccine for Anthrax, Cholera and Rabies.
    - Robert Koch 1880s
      - German Scientist. Used Pasteur's findings to begin own study for cause of disease. Identified specific microbe that caused Anthrax which caused Jenner's work to be understood. Industrialisation helped Koch produce a die that stained and showed septicaemia microbe.
    - Elizabeth Garrett Anderson 1866
      - First female Doctor to qualify in England. Opened a school of medicine for women. Went to France to study.
    - Florence Nightingale 1856
      - Nursed in the Crimean War and caused death toll to fall significantly. Set up a school of nursing.
    - Rontgen 1895
      - Discovered X-Rays
    - Simpson 1847
      - Anaesthetics. Discovered chloroform when experimenting with friends. Very successful but dangerous. Extended length of operations and improved complexity.
    - Snow 1848
      - Worked in anaesthetics (Ether). First to monitor prescription of chloroform with inhaler.
    - Lister 1867
      - Antiseptics. Carbolic Acid spray. Cleanliness already studied by Semmelweis (who caused deaths to fall from 12% to 1%). Others not as systematic and kept changing ideas.
    - Paul Ehrlich 1890s
  - Beliefs about causes of disease
    - Miasma (bad air causing illness)
      - Both disproved by germ theory (Pasteur), which showed that disease was caused by microorganisms.
    - Spontaneous Generation (decay caused germs)
      - Both disproved by germ theory (Pasteur), which showed that disease was caused by microorganisms.
  - Influence of Industrial Revolution on medicine
    - Development of pharmacies and patent medicine
      - Produced branded products available to sell to the public.
    - Discovery of microbes and 'magic bullet'.
      - Specific compounds that target and kill specific disease: Salvarsan (for Syphilis), Methylene Blue (for Malaria) and Trypan Red (for Sleeping Sickness).
        Paul Ehrlich 1890s
    - Improvements in communication and technology
      - 1895 Discovery of X-Rays
  - Improvements in hospitals and training
    - 1815 Apothecaries Act - introduced compulsory apprenticeship and formal exams.
    - 1858 General Medical Act
    - Voluntary Hospitals and sick clubs
  - End of Laissez Faire
- 20th and 21st Century 1900 - 2013
  - Development of Magic Bullets
    - Specific compounds that target and kill specific disease: Salvarsan (for Syphilis), Methylene Blue (for Malaria) and Trypan Red (for Sleeping Sickness).
  - Key Individuals
    - Crick and Watson 1953
      - Discovered double helix structure of DNA. Studied at the same time as Wilkins and Franklin, whose Crystallography helped.
    - Alexander Fleming 1928
      - Scientist working on Staphylococci. Noticed that culture dish mould killed germs without side effects. Developed penicillin.
    - Florey and Chain 1930s & 40s
      - Developed Penicillin after Fleming
  - Beliefs about cause of disease
    - Understanding microbes
      - Scientist working on Staphylococci. Noticed that culture dish mould killed germs without side effects. Developed penicillin.
      - Increase in use of vaccinations - many diseases wiped out.
    - Genetic Conditions
      - Discovered double helix structure of DNA. Studied at the same time as Wilkins and Franklin, whose Crystallography helped.
      - 2000 Human Genome mapped
  - Treatments
    - Development of pharmaceutical industry
    - NHS 1948
    - Changes in the training of doctors, nurses and midwives.
    - Alternative medicine
      - Acupuncture
      - Hypnosis
      - Homeopathy
  - Science and Technology
    - Transplants, first in 1952.
    - Key hole surgery
  - Blood
    - 1902 Landsteiner
      - Blood groups
    - 1915 Lewison
      - Blood Storage
    - 1967 Bernard
      - Heart Transplant

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