NAME

________________________________________________________________________________ DATE ____________________________________

UNIVERSITY SUCCESS Transition| Reading

TEST 2-1 | The Evolution of Health Care Practices

READ

A Read the passage. As you read, mark and annotate as necessary.

The Evolution of Health Care Practices
1 Before knowledge of germ theory and the development of modern clinical medicine, people died
frequently from illnesses that have common diagnoses and treatments today. Medical care prior to the 1800s
was largely unregulated, and treatment of illness ranged from symptomatic care to remedies associated with
the humoral theory of the human body, such as bloodletting. Known as “domestic medicine,” patient care
before the rise of modern medicine often took place within the family, with doctors calling on patients only if
the illness became serious. Medical care changed drastically in the 19th century, not only because of the
awareness of how diseases spread, but also because of technological advances and the professionalization of
doctors. There are three major aspects of medicine from the medieval period up to the 19th century: the way
physicians understood disease, common treatments for patients, and the organization of medical
practitioners.
2 The understanding of disease in Western medicine, for many centuries, was based on the research and
writings of the ancient Greeks, particularly Hippocrates, who lived from 460 to 370 BCE and wrote about the
humoral theory of the body. Though Hippocrates predated the Renaissance by 1,000 years, many practices
and beliefs remained staggeringly unchanged from his time, including the idea that illnesses did not result
extraneously but rather came about because of an imbalance of the “humors” of the body. The humors,
which were thought to be the fluids of the body, were called black bile, yellow bile, blood, and phlegm.
According to the disproven theory, each individual has a unique, particular constituency made up of a
combination of these four humors, and an imbalance of one’s humors is what inevitably results in illness. The
concept of the humors persisted into the 1800s, dissolving only after scientists began to postulate that
specific diseases could be caused by microscopic organisms.
3 During the long stretch between the medieval period and the advancements of modern medicine in the
19th century, there were important revelations that furthered understanding of microbiology and the human
body, such as independent discoveries of bacteria and blood circulation, both of which took place in the
1600s. While these early discoveries helped human understanding of anatomy and the world, they did not
result in a clear picture of what causes infectious illness—that would not become clear for another several
hundred years. In addition to scientific discoveries during this period, there were also physicians who
postulated accurately about germ theory concepts, such as Venetian scientist Girolamo Fracastoro, who
argued in the 1600s that particles imperceptible to the naked eye caused disease transmission. Such ideas did
not find a foothold at the time, however, and faded into the opaque understanding of disease transmission.
Germ theory was not fully understood until well into the 1800s, and this limited knowledge of contagious
diseases affected the way illnesses were treated. Infectious diseases swept through populations before there
were sanitation standards or awareness of how the illness was spread, creating epidemics that resulted in
high death rates, particularly in urban areas. There was also a certain amount of superstition involved in the
assessment and treatment of diseases, including the beliefs that mental illness was caused by demon
possession, that human behavior caused diseases, and that the touch of a monarch could cure a person’s
illness.
4 Common treatments for illness in America from colonial times until the 19th century most often addressed
the symptoms with folk remedies such as rest, warm baths, and gruel, along with topical or dissolvable
medicines made from herbs. Most illnesses were treated at home, with doctor intervention and surgery only
if the illness became markedly worse. Medicines often included herbal treatments such as willow bark and
meadowsweet, which treated fever. When pain was present, doctors prescribed painkillers such as opium,
morphine, and alcohol. Physicians also practiced venesection, also known as bloodletting, which was believed
to balance the humors and make an individual healthy again. The bloodletting occurred primarily through
incisions to the arteries of the arm, but also through scarification and leeches.

UNIVERSITY SUCCESS Transition | Reading | Test 2
© 2017 by Pearson Education, Inc. Permission granted to reproduce for classroom use.



NAME ________________________________________________________________________________ DATE ____________________________________

5 The organization of physicians—or disorganization, as it may be more aptly described—influenced the

treatment of patients. In the early years of the American colonies, care was separated into three distinct
categories of physician, surgeon, and apothecary. Physicians—the most prestigious of the group—typically
held university degrees, and their services were expensive. Surgeons, on the other hand, were not typically
university-trained, though they apprenticed. These surgeons, unlike surgeons today, were known as “barber-
surgeons,” and in addition to performing surgeries, they also pulled teeth, made salves, cared for fractures,
shaved, washed, and cut hair. Barber-surgeons also acted as trauma surgeons during wartime. The
apothecary was the medicine-maker, and was also responsible for prescribing and dispensing medicines.
These separate categories of medical practitioners created a fractured system of care until the 1700s, when
the distinct categories began to merge. Medical professionals in the 1700s and 1800s also began to form
professional organizations that established regulations and licensing requirements, such as the American
Medical Association, founded in 1847.
6 In addition to the rise of the professionalization of physicians, there was a shift from home care to care in
medical facilities. Most people in America lived in rural communities prior to the industrialization and
urbanization of the 1800s. Doctors, most of whom practiced rural medicine and attended people in their
homes, began to treat patients in hospitals or private clinics. After the American Civil War in 1865, hospitals,
which had previously been offshoots of almshouses to care for the poor, became either public or private; they
grew along with economic expansion and urban growth, eventually becoming the system of hospitals and
care facilities that we find today.
7 Medical care has come a long way since the Middle Ages. From misunderstanding of basic physiology,
uncertainty about the spread of contagious disease, and unregulated physicians, medicine has experienced
one of the largest advances of any field. It has also had a significant impact on much of the human population
because it has significantly improved to extend life expectancy. While it is tempting to review the history of
medicine from a lofty position, believing we have gained all the wisdom there is to gain, it is important to
remember that physicians along the road of history likely believed they, too, had reached a pinnacle of
understanding about their field. In hindsight, they had not. Much the same may be the case one hundred
years from now, as humankind reviews the medical achievements of the early 21st century.

B Answer the questions. Use the reading and language skills you have learned.
1 As used in Paragraph 2, staggeringly most nearly means

A forcefully.

B surprisingly.

C in an unbalanced way.

D in an athletic way.

2 Which sentence from the passage suggests that medical treatment was hindered by counterproductive views
held by the average person?

A Paragraph 4, Sentence 1

B Paragraph 5, Sentence 1

C Paragraph 5, Sentence 6

D Paragraph 6, Sentence 1

UNIVERSITY SUCCESS Transition | Reading | Test 2
© 2017 by Pearson Education, Inc. Permission granted to reproduce for classroom use.



NAME ________________________________________________________________________________ DATE ____________________________________

3 Which of the following is implied in Paragraph 5?

A The specialized professional division present before the 18th century sped up medical treatment.

B It was easy for the average person to receive quality medical care during the 17th century.

C Organizational changes improved the quality and consistency of medical care.

D University training was not really necessary for one to be a skilled physician in the past.

4 Which statement summarizes the main idea of Paragraph 7?

A Medical practice has been greatly improved, but we probably will not see any more significant
advancements.

B Medical practice may have been greatly improved, but we should not believe that we have all the
answers.

C Medical practice only appears to have greatly improved, but it has not greatly affected the life of the
average person.

D Medical practice today is still primarily based upon the theories of the four humors, but now in different
forms.

5 Based on the passage, which of the following describes Girolamo Fracastoro’s ideas on medicine during the
17th century?

A They were immediately adopted.

B They were largely ignored.

C They made him widely reviled.

D They were disproven by his peers.

6 Based on the passage, which statement describes the effect of bloodletting on health?

A The humors are brought into balance.

B Infected blood is drained and replaced with fresh blood.

C Scarification helps to create antibodies that fight the infection.

D There is no noticeable change to a person’s health.

UNIVERSITY SUCCESS Transition | Reading | Test 2
© 2017 by Pearson Education, Inc. Permission granted to reproduce for classroom use.



NAME ________________________________________________________________________________ DATE ____________________________________

THINKING CRITICALLY

C The passage mentions Girolamo Fracastoro’s early conception of germ theory and how it was primarily
ignored in his lifetime. Many years later in the mid-19th century, Hungarian physician Ignaz Semmelweis was
ridiculed when he suggested that doctors wash their hands. Based on the information in the passage and
what happened to Fracastoro, why do you think Semmelweis received the response that he did? Explain your
answer, supporting it with evidence from the passage.

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

UNIVERSITY SUCCESS Transition | Reading | Test 2
© 2017 by Pearson Education, Inc. Permission granted to reproduce for classroom use.



NAME ________________________________________________________________________________ DATE ____________________________________

THINKING VISUALLY

D Figure 1 shows an anatomical illustration from the medieval period in Europe. Figure 2 shows a proper,
modern illustration of the same organs. What are some differences between the two? Based on the passage’s
discussion of the medieval period, why do you think doctors of the time had such an inaccurate understanding
of the human body? Explain, using evidence from the passage.

Figure 1 Figure 2

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

UNIVERSITY SUCCESS Transition | Reading | Test 2
© 2017 by Pearson Education, Inc. Permission granted to reproduce for classroom use.



NAME ________________________________________________________________________________ DATE ____________________________________

UNIVERSITY SUCCESS Transition| Reading

TEST 2-2 | The Evolution of Health Care Practices

READ

A Read the passage. As you read, mark and annotate as necessary.

The Evolution of Health Care Practices
1 Before knowledge of germ theory and the development of modern clinical medicine, people died
frequently from illnesses that have common diagnoses and treatments today. Medical care prior to the 1800s
was largely unregulated, and treatment of illness ranged from symptomatic care to remedies associated with
the humoral theory of the human body, such as bloodletting. Known as “domestic medicine,” patient care
before the rise of modern medicine often took place within the family, with doctors calling on patients only if
the illness became serious. Medical care changed drastically in the 19th century, not only because of the
awareness of how diseases spread, but also because of technological advances and the professionalization of
doctors. There are three major aspects of medicine from the medieval period up to the 19th century: the way
physicians understood disease, common treatments for patients, and the organization of medical
practitioners.
2 The understanding of disease in Western medicine, for many centuries, was based on the research and
writings of the ancient Greeks, particularly Hippocrates, who lived from 460 to 370 BCE and wrote about the
humoral theory of the body. Though Hippocrates predated the Renaissance by 1,000 years, many practices
and beliefs remained staggeringly unchanged from his time, including the idea that illnesses did not result
extraneously but rather came about because of an imbalance of the “humors” of the body. The humors,
which were thought to be the fluids of the body, were called black bile, yellow bile, blood, and phlegm.
According to the disproven theory, each individual has a unique, particular constituency made up of a
combination of these four humors, and an imbalance of one’s humors is what inevitably results in illness. The
concept of the humors persisted into the 1800s, dissolving only after scientists began to postulate that
specific diseases could be caused by microscopic organisms.
3 During the long stretch between the medieval period and the advancements of modern medicine in the
19th century, there were important revelations that furthered understanding of microbiology and the human
body, such as independent discoveries of bacteria and blood circulation, both of which took place in the
1600s. While these early discoveries helped human understanding of anatomy and the world, they did not
result in a clear picture of what causes infectious illness—that would not become clear for another several
hundred years. In addition to scientific discoveries during this period, there were also physicians who
postulated accurately about germ theory concepts, such as Venetian scientist Girolamo Fracastoro, who
argued in the 1600s that particles imperceptible to the naked eye caused disease transmission. Such ideas did
not find a foothold at the time, however, and faded into the opaque understanding of disease transmission.
Germ theory was not fully understood until well into the 1800s, and this limited knowledge of contagious
diseases affected the way illnesses were treated. Infectious diseases swept through populations before there
were sanitation standards or awareness of how the illness was spread, creating epidemics that resulted in
high death rates, particularly in urban areas. There was also a certain amount of superstition involved in the
assessment and treatment of diseases, including the beliefs that mental illness was caused by demon
possession, that human behavior caused diseases, and that the touch of a monarch could cure a person’s
illness.
4 Common treatments for illness in America from colonial times until the 19th century most often addressed
the symptoms with folk remedies such as rest, warm baths, and gruel, along with topical or dissolvable
medicines made from herbs. Most illnesses were treated at home, with doctor intervention and surgery only
if the illness became markedly worse. Medicines often included herbal treatments such as willow bark and
meadowsweet, which treated fever. When pain was present, doctors prescribed painkillers such as opium,
morphine, and alcohol. Physicians also practiced venesection, also known as bloodletting, which was believed
to balance the humors and make an individual healthy again. The bloodletting occurred primarily through
incisions to the arteries of the arm, but also through scarification and leeches.

UNIVERSITY SUCCESS Transition | Reading | Test 2
© 2017 by Pearson Education, Inc. Permission granted to reproduce for classroom use.



NAME ________________________________________________________________________________ DATE ____________________________________

5 The organization of physicians—or disorganization, as it may be more aptly described—influenced the

treatment of patients. In the early years of the American colonies, care was separated into three distinct
categories of physician, surgeon, and apothecary. Physicians—the most prestigious of the group—typically
held university degrees, and their services were expensive. Surgeons, on the other hand, were not typically
university-trained, though they apprenticed. These surgeons, unlike surgeons today, were known as “barber-
surgeons,” and in addition to performing surgeries, they also pulled teeth, made salves, cared for fractures,
shaved, washed, and cut hair. Barber-surgeons also acted as trauma surgeons during wartime. The
apothecary was the medicine-maker, and was also responsible for prescribing and dispensing medicines.
These separate categories of medical practitioners created a fractured system of care until the 1700s, when
the distinct categories began to merge. Medical professionals in the 1700s and 1800s also began to form
professional organizations that established regulations and licensing requirements, such as the American
Medical Association, founded in 1847.
6 In addition to the rise of the professionalization of physicians, there was a shift from home care to care in
medical facilities. Most people in America lived in rural communities prior to the industrialization and
urbanization of the 1800s. Doctors, most of whom practiced rural medicine and attended people in their
homes, began to treat patients in hospitals or private clinics. After the American Civil War in 1865, hospitals,
which had previously been offshoots of almshouses to care for the poor, became either public or private; they
grew along with economic expansion and urban growth, eventually becoming the system of hospitals and
care facilities that we find today.
7 Medical care has come a long way since the Middle Ages. From misunderstanding of basic physiology,
uncertainty about the spread of contagious disease, and unregulated physicians, medicine has experienced
one of the largest advances of any field. It has also had a significant impact on much of the human population
because it has significantly improved to extend life expectancy. While it is tempting to review the history of
medicine from a lofty position, believing we have gained all the wisdom there is to gain, it is important to
remember that physicians along the road of history likely believed they, too, had reached a pinnacle of
understanding about their field. In hindsight, they had not. Much the same may be the case one hundred
years from now, as humankind reviews the medical achievements of the early 21st century.

B Answer the questions. Use the reading and language skills you have learned.
1 In which paragraph does the author state that medical advancement remained stagnant for a millennium?

A Paragraph 1

B Paragraph 2

C Paragraph 4

D Paragraph 6

2 The author includes the phrase “symptomatic care” in Paragraph 1 to suggest that early treatments

A were extremely effective with certain problems despite a lack of theory.

B remained grounded in a realistic diagnosis and assessment of the disease’s cause.

C should have worked in hindsight but were made ineffective by a lack of pharmaceutical manufacturing.

D rarely addressed a disease’s underlying cause but rather only the obvious complaints.

UNIVERSITY SUCCESS Transition | Reading | Test 2
© 2017 by Pearson Education, Inc. Permission granted to reproduce for classroom use.



NAME ________________________________________________________________________________ DATE ____________________________________

3 Which statement summarizes the main idea of Paragraph 7?

A Medical practice may have been greatly improved, but we should not believe that we have all the
answers.

B Medical practice has been greatly improved, but we probably will not see any more significant
advancements.

C Medical practice only appears to have greatly improved, but it has not greatly affected the life of the
average person.

D Medical practice today is still primarily based upon the theories of the four humors, but now in different
forms.

4 Based on the passage, which of the following describes Girolamo Fracastoro’s ideas on medicine during the
17th century?

A They were immediately adopted.

B They were largely ignored.

C They made him widely reviled.

D They were disproven by his peers.

5 Based on the passage, which statement describes the effect of bloodletting on health?

A The humors are brought into balance.

B Infected blood is drained and replaced with fresh blood.

C Scarification helps to create antibodies that fight the infection.

D There is no noticeable change to a person’s health.

6 Based on the passage, which of the following describes the relationship between early urban populations and
disease?

A Larger populations had more money, resulting in improved public health.

B Larger populations had barber-surgeons to trade ideas, improving public health.

C Royal sanitation teams were disorganized and lazy.

D Poor sanitation led to widespread epidemics.

UNIVERSITY SUCCESS Transition | Reading | Test 2
© 2017 by Pearson Education, Inc. Permission granted to reproduce for classroom use.



NAME ________________________________________________________________________________ DATE ____________________________________

THINKING CRITICALLY

C The ancient world is filled with examples of royal physicians and intellectuals performing surprisingly
advanced medical procedures. For example, the Egyptian scholar Imhotep conducted cranial surgery and even
dental operations thousands of years ago. Consider this fact in light of the passage. Why do you think medical
practice took so long to discard harmful practices, despite similar examples of sophisticated practitioners?
Write a paragraph explaining your view, supporting it with evidence from the passage.

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

UNIVERSITY SUCCESS Transition | Reading | Test 2
© 2017 by Pearson Education, Inc. Permission granted to reproduce for classroom use.



NAME ________________________________________________________________________________ DATE ____________________________________

THINKING VISUALLY

D Figure 1 shows an anatomical illustration from the medieval period in Europe. Figure 2 shows a proper,
modern illustration of the same organs. What are some differences between the two? Based on the passage’s
discussion of the medieval period, why do you think doctors of the time had such an inaccurate understanding
of the human body? Explain, using evidence from the passage.

Figure 1 Figure 2

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

UNIVERSITY SUCCESS Transition | Reading | Test 2
© 2017 by Pearson Education, Inc. Permission granted to reproduce for classroom use.



NAME ________________________________________________________________________________ DATE ____________________________________

UNIVERSITY SUCCESS Transition| Reading

TEST 2-3 | The Evolution of Health Care Practices

READ

A Read the passage. As you read, mark and annotate as necessary.

The Evolution of Health Care Practices
1 Before knowledge of germ theory and the development of modern clinical medicine, people died
frequently from illnesses that have common diagnoses and treatments today. Medical care prior to the 1800s
was largely unregulated, and treatment of illness ranged from symptomatic care to remedies associated with
the humoral theory of the human body, such as bloodletting. Known as “domestic medicine,” patient care
before the rise of modern medicine often took place within the family, with doctors calling on patients only if
the illness became serious. Medical care changed drastically in the 19th century, not only because of the
awareness of how diseases spread, but also because of technological advances and the professionalization of
doctors. There are three major aspects of medicine from the medieval period up to the 19th century: the way
physicians understood disease, common treatments for patients, and the organization of medical
practitioners.
2 The understanding of disease in Western medicine, for many centuries, was based on the research and
writings of the ancient Greeks, particularly Hippocrates, who lived from 460 to 370 BCE and wrote about the
humoral theory of the body. Though Hippocrates predated the Renaissance by 1,000 years, many practices
and beliefs remained staggeringly unchanged from his time, including the idea that illnesses did not result
extraneously but rather came about because of an imbalance of the “humors” of the body. The humors,
which were thought to be the fluids of the body, were called black bile, yellow bile, blood, and phlegm.
According to the disproven theory, each individual has a unique, particular constituency made up of a
combination of these four humors, and an imbalance of one’s humors is what inevitably results in illness. The
concept of the humors persisted into the 1800s, dissolving only after scientists began to postulate that
specific diseases could be caused by microscopic organisms.
3 During the long stretch between the medieval period and the advancements of modern medicine in the
19th century, there were important revelations that furthered understanding of microbiology and the human
body, such as independent discoveries of bacteria and blood circulation, both of which took place in the
1600s. While these early discoveries helped human understanding of anatomy and the world, they did not
result in a clear picture of what causes infectious illness—that would not become clear for another several
hundred years. In addition to scientific discoveries during this period, there were also physicians who
postulated accurately about germ theory concepts, such as Venetian scientist Girolamo Fracastoro, who
argued in the 1600s that particles imperceptible to the naked eye caused disease transmission. Such ideas did
not find a foothold at the time, however, and faded into the opaque understanding of disease transmission.
Germ theory was not fully understood until well into the 1800s, and this limited knowledge of contagious
diseases affected the way illnesses were treated. Infectious diseases swept through populations before there
were sanitation standards or awareness of how the illness was spread, creating epidemics that resulted in
high death rates, particularly in urban areas. There was also a certain amount of superstition involved in the
assessment and treatment of diseases, including the beliefs that mental illness was caused by demon
possession, that human behavior caused diseases, and that the touch of a monarch could cure a person’s
illness.
4 Common treatments for illness in America from colonial times until the 19th century most often addressed
the symptoms with folk remedies such as rest, warm baths, and gruel, along with topical or dissolvable
medicines made from herbs. Most illnesses were treated at home, with doctor intervention and surgery only
if the illness became markedly worse. Medicines often included herbal treatments such as willow bark and
meadowsweet, which treated fever. When pain was present, doctors prescribed painkillers such as opium,
morphine, and alcohol. Physicians also practiced venesection, also known as bloodletting, which was believed
to balance the humors and make an individual healthy again. The bloodletting occurred primarily through
incisions to the arteries of the arm, but also through scarification and leeches.

UNIVERSITY SUCCESS Transition | Reading | Test 2
© 2017 by Pearson Education, Inc. Permission granted to reproduce for classroom use.



NAME ________________________________________________________________________________ DATE ____________________________________

5 The organization of physicians—or disorganization, as it may be more aptly described—influenced the

treatment of patients. In the early years of the American colonies, care was separated into three distinct
categories of physician, surgeon, and apothecary. Physicians—the most prestigious of the group—typically
held university degrees, and their services were expensive. Surgeons, on the other hand, were not typically
university-trained, though they apprenticed. These surgeons, unlike surgeons today, were known as “barber-
surgeons,” and in addition to performing surgeries, they also pulled teeth, made salves, cared for fractures,
shaved, washed, and cut hair. Barber-surgeons also acted as trauma surgeons during wartime. The
apothecary was the medicine-maker, and was also responsible for prescribing and dispensing medicines.
These separate categories of medical practitioners created a fractured system of care until the 1700s, when
the distinct categories began to merge. Medical professionals in the 1700s and 1800s also began to form
professional organizations that established regulations and licensing requirements, such as the American
Medical Association, founded in 1847.
6 In addition to the rise of the professionalization of physicians, there was a shift from home care to care in
medical facilities. Most people in America lived in rural communities prior to the industrialization and
urbanization of the 1800s. Doctors, most of whom practiced rural medicine and attended people in their
homes, began to treat patients in hospitals or private clinics. After the American Civil War in 1865, hospitals,
which had previously been offshoots of almshouses to care for the poor, became either public or private; they
grew along with economic expansion and urban growth, eventually becoming the system of hospitals and
care facilities that we find today.
7 Medical care has come a long way since the Middle Ages. From misunderstanding of basic physiology,
uncertainty about the spread of contagious disease, and unregulated physicians, medicine has experienced
one of the largest advances of any field. It has also had a significant impact on much of the human population
because it has significantly improved to extend life expectancy. While it is tempting to review the history of
medicine from a lofty position, believing we have gained all the wisdom there is to gain, it is important to
remember that physicians along the road of history likely believed they, too, had reached a pinnacle of
understanding about their field. In hindsight, they had not. Much the same may be the case one hundred
years from now, as humankind reviews the medical achievements of the early 21st century.

B Answer the questions. Use the reading and language skills you have learned.
1 Based on the passage, which statement describes the effect of bloodletting on health?

A The humors are brought into balance.

B Infected blood is drained and replaced with fresh blood.

C Scarification helps to create antibodies that fight the infection.

D There is no noticeable change to a person’s health.

2 Based on the passage, which of the following describes the relationship between early urban populations and
disease?

A Larger populations had more money, resulting in improved public health.

B Larger populations had barber-surgeons to trade ideas, improving public health.

C Royal sanitation teams were disorganized and lazy.

D Poor sanitation led to widespread epidemics.

UNIVERSITY SUCCESS Transition | Reading | Test 2
© 2017 by Pearson Education, Inc. Permission granted to reproduce for classroom use.



NAME ________________________________________________________________________________ DATE ____________________________________

3 It can be reasonably inferred from the passage that

A agrarian society did not realistically require advanced medical knowledge.

B no one could have imagined that germs existed before the Industrial Revolution.

C the Industrial Revolution accelerated the development of hospitals.

D the Renaissance era in Europe would not have benefited from medical improvements.

4 Which statement accurately paraphrases the fourth sentence of Paragraph 3?

A Fracastoro’s ideas were met with indifference and soon forgotten since they did not align with the
period’s widely held beliefs.

B Fracastoro’s views were widely transmitted but unable to create a lasting body of knowledge, largely due
to social and political pressure.

C Fracastoro’s theories were compellingly worded, but unable to stand up to rigorous scientific scrutiny and
analysis.

D Fracastoro’s speeches were so poorly worded and difficult to understand that his contemporaries stopped
attending his lectures.

5 The description of apothecaries in Paragraph 5 indicates that

A the training of an apothecary would have been similar to that offered by a modern medical school.

B apothecaries were well-trained to diagnose illnesses.

C apothecaries did not practice outside of large urban areas.

D the job of an apothecary, at least superficially, resembles the modern duties of a pharmacist.

6 How would the tone of the passage change if the phrase “may be the case” in Paragraph 7 were changed to
“will be the case”?

A From deep respect to wary resentment

B From humble realism to justified anger

C From reasonable skepticism to unreasonable belief

D From cautious optimism to resigned pessimism

UNIVERSITY SUCCESS Transition | Reading | Test 2
© 2017 by Pearson Education, Inc. Permission granted to reproduce for classroom use.



NAME ________________________________________________________________________________ DATE ____________________________________

THINKING CRITICALLY

C The passage mentions Girolamo Fracastoro’s early conception of germ theory and how it was primarily
ignored in his lifetime. Many years later in the mid-19th century, Hungarian physician Ignaz Semmelweis was
ridiculed when he suggested that doctors wash their hands. Based on the information in the passage and
what happened to Fracastoro, why do you think Semmelweis received the response that he did? Explain your
answer, supporting it with evidence from the passage.

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

UNIVERSITY SUCCESS Transition | Reading | Test 2
© 2017 by Pearson Education, Inc. Permission granted to reproduce for classroom use.



NAME ________________________________________________________________________________ DATE ____________________________________

THINKING VISUALLY

D Figure 1 shows an anatomical illustration from the medieval period in Europe. Figure 2 shows a proper,
modern illustration of the same organs. What are some differences between the two? Based on the passage’s
discussion of the medieval period, why do you think doctors of the time had such an inaccurate understanding
of the human body? Explain, using evidence from the passage.

Figure 1 Figure 2

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

UNIVERSITY SUCCESS Transition | Reading | Test 2
© 2017 by Pearson Education, Inc. Permission granted to reproduce for classroom use.



NAME ________________________________________________________________________________ DATE ____________________________________

UNIVERSITY SUCCESS Transition| Reading

TEST 2-4 | The Evolution of Health Care Practices

READ

A Read the passage. As you read, mark and annotate as necessary.

The Evolution of Health Care Practices
1 Before knowledge of germ theory and the development of modern clinical medicine, people died
frequently from illnesses that have common diagnoses and treatments today. Medical care prior to the 1800s
was largely unregulated, and treatment of illness ranged from symptomatic care to remedies associated with
the humoral theory of the human body, such as bloodletting. Known as “domestic medicine,” patient care
before the rise of modern medicine often took place within the family, with doctors calling on patients only if
the illness became serious. Medical care changed drastically in the 19th century, not only because of the
awareness of how diseases spread, but also because of technological advances and the professionalization of
doctors. There are three major aspects of medicine from the medieval period up to the 19th century: the way
physicians understood disease, common treatments for patients, and the organization of medical
practitioners.
2 The understanding of disease in Western medicine, for many centuries, was based on the research and
writings of the ancient Greeks, particularly Hippocrates, who lived from 460 to 370 BCE and wrote about the
humoral theory of the body. Though Hippocrates predated the Renaissance by 1,000 years, many practices
and beliefs remained staggeringly unchanged from his time, including the idea that illnesses did not result
extraneously but rather came about because of an imbalance of the “humors” of the body. The humors,
which were thought to be the fluids of the body, were called black bile, yellow bile, blood, and phlegm.
According to the disproven theory, each individual has a unique, particular constituency made up of a
combination of these four humors, and an imbalance of one’s humors is what inevitably results in illness. The
concept of the humors persisted into the 1800s, dissolving only after scientists began to postulate that
specific diseases could be caused by microscopic organisms.
3 During the long stretch between the medieval period and the advancements of modern medicine in the
19th century, there were important revelations that furthered understanding of microbiology and the human
body, such as independent discoveries of bacteria and blood circulation, both of which took place in the
1600s. While these early discoveries helped human understanding of anatomy and the world, they did not
result in a clear picture of what causes infectious illness—that would not become clear for another several
hundred years. In addition to scientific discoveries during this period, there were also physicians who
postulated accurately about germ theory concepts, such as Venetian scientist Girolamo Fracastoro, who
argued in the 1600s that particles imperceptible to the naked eye caused disease transmission. Such ideas did
not find a foothold at the time, however, and faded into the opaque understanding of disease transmission.
Germ theory was not fully understood until well into the 1800s, and this limited knowledge of contagious
diseases affected the way illnesses were treated. Infectious diseases swept through populations before there
were sanitation standards or awareness of how the illness was spread, creating epidemics that resulted in
high death rates, particularly in urban areas. There was also a certain amount of superstition involved in the
assessment and treatment of diseases, including the beliefs that mental illness was caused by demon
possession, that human behavior caused diseases, and that the touch of a monarch could cure a person’s
illness.
4 Common treatments for illness in America from colonial times until the 19th century most often addressed
the symptoms with folk remedies such as rest, warm baths, and gruel, along with topical or dissolvable
medicines made from herbs. Most illnesses were treated at home, with doctor intervention and surgery only
if the illness became markedly worse. Medicines often included herbal treatments such as willow bark and
meadowsweet, which treated fever. When pain was present, doctors prescribed painkillers such as opium,
morphine, and alcohol. Physicians also practiced venesection, also known as bloodletting, which was believed
to balance the humors and make an individual healthy again. The bloodletting occurred primarily through
incisions to the arteries of the arm, but also through scarification and leeches.

UNIVERSITY SUCCESS Transition | Reading | Test 2
© 2017 by Pearson Education, Inc. Permission granted to reproduce for classroom use.



NAME ________________________________________________________________________________ DATE ____________________________________

5 The organization of physicians—or disorganization, as it may be more aptly described—influenced the

treatment of patients. In the early years of the American colonies, care was separated into three distinct
categories of physician, surgeon, and apothecary. Physicians—the most prestigious of the group—typically
held university degrees, and their services were expensive. Surgeons, on the other hand, were not typically
university-trained, though they apprenticed. These surgeons, unlike surgeons today, were known as “barber-
surgeons,” and in addition to performing surgeries, they also pulled teeth, made salves, cared for fractures,
shaved, washed, and cut hair. Barber-surgeons also acted as trauma surgeons during wartime. The
apothecary was the medicine-maker, and was also responsible for prescribing and dispensing medicines.
These separate categories of medical practitioners created a fractured system of care until the 1700s, when
the distinct categories began to merge. Medical professionals in the 1700s and 1800s also began to form
professional organizations that established regulations and licensing requirements, such as the American
Medical Association, founded in 1847.
6 In addition to the rise of the professionalization of physicians, there was a shift from home care to care in
medical facilities. Most people in America lived in rural communities prior to the industrialization and
urbanization of the 1800s. Doctors, most of whom practiced rural medicine and attended people in their
homes, began to treat patients in hospitals or private clinics. After the American Civil War in 1865, hospitals,
which had previously been offshoots of almshouses to care for the poor, became either public or private; they
grew along with economic expansion and urban growth, eventually becoming the system of hospitals and
care facilities that we find today.
7 Medical care has come a long way since the Middle Ages. From misunderstanding of basic physiology,
uncertainty about the spread of contagious disease, and unregulated physicians, medicine has experienced
one of the largest advances of any field. It has also had a significant impact on much of the human population
because it has significantly improved to extend life expectancy. While it is tempting to review the history of
medicine from a lofty position, believing we have gained all the wisdom there is to gain, it is important to
remember that physicians along the road of history likely believed they, too, had reached a pinnacle of
understanding about their field. In hindsight, they had not. Much the same may be the case one hundred
years from now, as humankind reviews the medical achievements of the early 21st century.

B Answer the questions. Use the reading and language skills you have learned.
1 In which paragraph does the author state that medical advancement remained stagnant for a millennium?

A Paragraph 1

B Paragraph 2

C Paragraph 4

D Paragraph 6

2 The word faded in Paragraph 3 is meant to indicate that, until centuries later, Fracastoro’s theory was mostly

A forgotten.

B debated.

C venerated.

D overestimated.

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NAME ________________________________________________________________________________ DATE ____________________________________

3 The author refers to demonic possession and a monarch’s touch primarily to

A provide an example of misguided superstitions.

B emphasize a problem and introduce its solution.

C support the idea that religion and the aristocracy were important to society.

D question the need for more complicated solutions to medical problems.

4 Which of the following is implied in Paragraph 5?

A The specialized professional division present before the 18th century sped up medical treatment.

B It was easy for the average person to receive quality medical care during the 17th century.

C Organizational changes improved the quality and consistency of medical care.

D University training was not really necessary for one to be a skilled physician in the past.

5 The author includes a description of the four humors to

A describe the origins of the modern urban hospital.

B support the idea that confusion existed during a period of history.

C discuss why rural doctors were reluctant to move to cities.

D assert that the American Civil War was an important influence on medicine.

6 Viewed together, Paragraphs 5 and 6 provide a comparison of

A the traditional theory of humors and the modern theory of viral spread.

B the lifestyles of rural farmers and the lifestyles of the urban poor.

C an open organizational system and a closed corporate hierarchy.

D disorganized, early medicine and organized, professional medicine.

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NAME ________________________________________________________________________________ DATE ____________________________________

THINKING CRITICALLY

C The ancient world is filled with examples of royal physicians and intellectuals performing surprisingly
advanced medical procedures. For example, the Egyptian scholar Imhotep conducted cranial surgery and even
dental operations thousands of years ago. Consider this fact in light of the passage. Why do you think medical
practice took so long to discard harmful practices, despite similar examples of sophisticated practitioners?
Write a paragraph explaining your view, supporting it with evidence from the passage.

____________________________________________________________________________________

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UNIVERSITY SUCCESS Transition | Reading | Test 2
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NAME ________________________________________________________________________________ DATE ____________________________________

THINKING VISUALLY

D Figure 1 shows an anatomical illustration from the medieval period in Europe. Figure 2 shows a proper,
modern illustration of the same organs. What are some differences between the two? Based on the passage’s
discussion of the medieval period, why do you think doctors of the time had such an inaccurate understanding
of the human body? Explain, using evidence from the passage.

Figure 1 Figure 2

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UNIVERSITY SUCCESS Transition | Reading | Test 2
© 2017 by Pearson Education, Inc. Permission granted to reproduce for classroom use.



NAME ________________________________________________________________________________ DATE ____________________________________

UNIVERSITY SUCCESS Transition| Reading

TEST 2-5 | The Evolution of Health Care Practices

READ

A Read the passage. As you read, mark and annotate as necessary.

The Evolution of Health Care Practices
1 Before knowledge of germ theory and the development of modern clinical medicine, people died
frequently from illnesses that have common diagnoses and treatments today. Medical care prior to the 1800s
was largely unregulated, and treatment of illness ranged from symptomatic care to remedies associated with
the humoral theory of the human body, such as bloodletting. Known as “domestic medicine,” patient care
before the rise of modern medicine often took place within the family, with doctors calling on patients only if
the illness became serious. Medical care changed drastically in the 19th century, not only because of the
awareness of how diseases spread, but also because of technological advances and the professionalization of
doctors. There are three major aspects of medicine from the medieval period up to the 19th century: the way
physicians understood disease, common treatments for patients, and the organization of medical
practitioners.
2 The understanding of disease in Western medicine, for many centuries, was based on the research and
writings of the ancient Greeks, particularly Hippocrates, who lived from 460 to 370 BCE and wrote about the
humoral theory of the body. Though Hippocrates predated the Renaissance by 1,000 years, many practices
and beliefs remained staggeringly unchanged from his time, including the idea that illnesses did not result
extraneously but rather came about because of an imbalance of the “humors” of the body. The humors,
which were thought to be the fluids of the body, were called black bile, yellow bile, blood, and phlegm.
According to the disproven theory, each individual has a unique, particular constituency made up of a
combination of these four humors, and an imbalance of one’s humors is what inevitably results in illness. The
concept of the humors persisted into the 1800s, dissolving only after scientists began to postulate that
specific diseases could be caused by microscopic organisms.
3 During the long stretch between the medieval period and the advancements of modern medicine in the
19th century, there were important revelations that furthered understanding of microbiology and the human
body, such as independent discoveries of bacteria and blood circulation, both of which took place in the
1600s. While these early discoveries helped human understanding of anatomy and the world, they did not
result in a clear picture of what causes infectious illness—that would not become clear for another several
hundred years. In addition to scientific discoveries during this period, there were also physicians who
postulated accurately about germ theory concepts, such as Venetian scientist Girolamo Fracastoro, who
argued in the 1600s that particles imperceptible to the naked eye caused disease transmission. Such ideas did
not find a foothold at the time, however, and faded into the opaque understanding of disease transmission.
Germ theory was not fully understood until well into the 1800s, and this limited knowledge of contagious
diseases affected the way illnesses were treated. Infectious diseases swept through populations before there
were sanitation standards or awareness of how the illness was spread, creating epidemics that resulted in
high death rates, particularly in urban areas. There was also a certain amount of superstition involved in the
assessment and treatment of diseases, including the beliefs that mental illness was caused by demon
possession, that human behavior caused diseases, and that the touch of a monarch could cure a person’s
illness.
4 Common treatments for illness in America from colonial times until the 19th century most often addressed
the symptoms with folk remedies such as rest, warm baths, and gruel, along with topical or dissolvable
medicines made from herbs. Most illnesses were treated at home, with doctor intervention and surgery only
if the illness became markedly worse. Medicines often included herbal treatments such as willow bark and
meadowsweet, which treated fever. When pain was present, doctors prescribed painkillers such as opium,
morphine, and alcohol. Physicians also practiced venesection, also known as bloodletting, which was believed
to balance the humors and make an individual healthy again. The bloodletting occurred primarily through
incisions to the arteries of the arm, but also through scarification and leeches.

UNIVERSITY SUCCESS Transition | Reading | Test 2
© 2017 by Pearson Education, Inc. Permission granted to reproduce for classroom use.



NAME ________________________________________________________________________________ DATE ____________________________________

5 The organization of physicians—or disorganization, as it may be more aptly described—influenced the

treatment of patients. In the early years of the American colonies, care was separated into three distinct
categories of physician, surgeon, and apothecary. Physicians—the most prestigious of the group—typically
held university degrees, and their services were expensive. Surgeons, on the other hand, were not typically
university-trained, though they apprenticed. These surgeons, unlike surgeons today, were known as “barber-
surgeons,” and in addition to performing surgeries, they also pulled teeth, made salves, cared for fractures,
shaved, washed, and cut hair. Barber-surgeons also acted as trauma surgeons during wartime. The
apothecary was the medicine-maker, and was also responsible for prescribing and dispensing medicines.
These separate categories of medical practitioners created a fractured system of care until the 1700s, when
the distinct categories began to merge. Medical professionals in the 1700s and 1800s also began to form
professional organizations that established regulations and licensing requirements, such as the American
Medical Association, founded in 1847.
6 In addition to the rise of the professionalization of physicians, there was a shift from home care to care in
medical facilities. Most people in America lived in rural communities prior to the industrialization and
urbanization of the 1800s. Doctors, most of whom practiced rural medicine and attended people in their
homes, began to treat patients in hospitals or private clinics. After the American Civil War in 1865, hospitals,
which had previously been offshoots of almshouses to care for the poor, became either public or private; they
grew along with economic expansion and urban growth, eventually becoming the system of hospitals and
care facilities that we find today.
7 Medical care has come a long way since the Middle Ages. From misunderstanding of basic physiology,
uncertainty about the spread of contagious disease, and unregulated physicians, medicine has experienced
one of the largest advances of any field. It has also had a significant impact on much of the human population
because it has significantly improved to extend life expectancy. While it is tempting to review the history of
medicine from a lofty position, believing we have gained all the wisdom there is to gain, it is important to
remember that physicians along the road of history likely believed they, too, had reached a pinnacle of
understanding about their field. In hindsight, they had not. Much the same may be the case one hundred
years from now, as humankind reviews the medical achievements of the early 21st century.

B Answer the questions. Use the reading and language skills you have learned.
1 The author includes the phrase “symptomatic care” in Paragraph 1 to suggest that early treatments

A were extremely effective with certain problems despite a lack of theory.

B remained grounded in a realistic diagnosis and assessment of the disease’s cause.

C rarely addressed a disease’s underlying cause but rather only the obvious complaints.

D should have worked in hindsight but were made ineffective by a lack of pharmaceutical manufacturing.

2 The author includes a description of the four humors to emphasize

A how modern medical theory began with this early research.

B how fundamentally misguided a long held medical theory was.

C why the idea of balance has always been the foundation of western medicine.

D why Hippocrates is still considered the father of medicine.

UNIVERSITY SUCCESS Transition | Reading | Test 2
© 2017 by Pearson Education, Inc. Permission granted to reproduce for classroom use.



NAME ________________________________________________________________________________ DATE ____________________________________

3 The author refers to the discovery of bacteria and blood circulation to show that

A medical knowledge caused people to immediately discard the idea of humors once an alternative
explanation was discovered.

B apothecaries, despite their lack of training, possessed an intuitive understanding of medical phenomena.

C medical advances were useless without the medical infrastructure of a modern hospital.

D medical advances still occurred even in an era characterized by misinformation.

4 What is the main rhetorical effect of the list of services offered by barber-surgeons in Paragraph 5?

A It encourages readers to learn more about early surgery.

B It emphasizes the contrast with modern doctors.

C It explains the association of hair and medicine.

D It describes why barbers today only cut hair.

5 The description of apothecaries in Paragraph 5 indicates that

A the training of an apothecary would have been similar to that offered by a modern medical school.

B apothecaries were well-trained to diagnose illnesses.

C apothecaries did not practice outside of large urban areas.

D the job of an apothecary, at least superficially, resembles the modern duties of a pharmacist.

6 How would the tone of the passage change if the phrase “may be the case” in Paragraph 7 were changed to
“will be the case”?

A From deep respect to wary resentment

B From humble realism to justified anger

C From reasonable skepticism to unreasonable belief

D From cautious optimism to resigned pessimism

UNIVERSITY SUCCESS Transition | Reading | Test 2
© 2017 by Pearson Education, Inc. Permission granted to reproduce for classroom use.



NAME ________________________________________________________________________________ DATE ____________________________________

THINKING CRITICALLY

C The passage mentions Girolamo Fracastoro’s early conception of germ theory and how it was primarily
ignored in his lifetime. Many years later in the mid-19th century, Hungarian physician Ignaz Semmelweis was
ridiculed when he suggested that doctors wash their hands. Based on the information in the passage and
what happened to Fracastoro, why do you think Semmelweis received the response that he did? Explain your
answer, supporting it with evidence from the passage.

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____________________________________________________________________________________

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UNIVERSITY SUCCESS Transition | Reading | Test 2
© 2017 by Pearson Education, Inc. Permission granted to reproduce for classroom use.



NAME ________________________________________________________________________________ DATE ____________________________________

THINKING VISUALLY

D Figure 1 shows an anatomical illustration from the medieval period in Europe. Figure 2 shows a proper,
modern illustration of the same organs. What are some differences between the two? Based on the passage’s
discussion of the medieval period, why do you think doctors of the time had such an inaccurate understanding
of the human body? Explain, using evidence from the passage.

Figure 1 Figure 2

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____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

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____________________________________________________________________________________

UNIVERSITY SUCCESS Transition | Reading | Test 2
© 2017 by Pearson Education, Inc. Permission granted to reproduce for classroom use.