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Medicine Through Time Notes
Medicine Through Time Notes
They believed that good spirits caused good things and bad spirits caused bad things, such as disease and illnesses. Because of a thorough belief in the afterlife there was no reason for people to search for natural, rational explanations about the causes of disease and cures were restricted to supernatural ones, such as charms and amulets and chantings from the Medicine Man. Trephanning, although an early form of surgery, was carried out for religious reasons - pre-historic people believed that trephanning released the evil spirit inside somebodies skull which was the cause of illnesses such as headaches. Education and Communication: There was no written language, no schools, no records of prior knowledge of medicine or education about medicine and skills and ideas were passed along simply by word of mouth.
Ancient Egyptian
Religion: Egyptian religion relied heavily on a belief in the afterlife and in the Gods. The Goddess Sekhmet was believed to have the ability to cause and cure epidemics. A belief in the afterlife meant that bodies were preserved (mummification) and, therefore, not dissected properly. The Egyptians believed that the body was important for the afterlife so they would not have dissected it. Through mummification knowledge of the human anatomy was known - albeit only a little. Natural ideas: Herbs, Purging the body, Mosquito nets, Covering wounds with honey, The use of bronze surgical equipment's. Supernatural ideas: Gods, Charms, Spells, Chanting, Sacrifices. Priest physicians cleaned and shaved themselves frequently so that they were pure for the Gods. They also observed, examined and recorded the treatments they used on papyrus. Writing: They developed their own writing (papyrus) which allowed them to document their medical findings on and use to communicate with others. Trade: Egyptians had many trade links with other countries which brought in new herbs and plants that were useful to medicine and allowed Egyptian healers to build up their knowledge about medicine.
Technology: Primitive tools such as flints and arrow heads. Government: There was no settled government so people lived nomadic lifestyles. Because of the lack of government planning, intervention or funding of medicine was not possible.
Pre-Historic
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Ancient Egyptian
Wealth: Because of the wealth of the Egyptians they could create improvements to surgical equipments, such as bronze tools. The Nile and Farming: Due to the channels in the Nile, Egyptians believed that human bodies contained channels too and that people could become ill if their channels became blocked. The annual flooding of the Nile meant that farming boomed and trade was good. Who treated the sick? Priest Physicians, Priest Magicians, Women, Specialist doctors (such as Imhotep, the doctor of Pharaoh Zoser). Few women doctors were known - Peseshet was a woman physician. What did they know about the body? Egyptians had some knowledge of the heart, liver, lungs, brain, pulse and blood. They believed that the body contained channels like the Nile but did not know how the parts of the body worked. What did they think caused disease? They believed that blockages in the channels in the body caused disease or rotting food in the bowels (which is why they purged themselves regularly). How did they prevent or treat illness? By using herbs, potions and charms. They washed regularly and also cleaned things regularly. They used nets at night to prevent mosquito's from biting them and bathed in holy water to purify themselves.
Change: Herophilus discovered that the brain controlled the body, not the heart - Greeks were beginning to understand about the function of organs. They knew that fitness was important but also that people needed rest when they were ill. Careful observation was stressed. Continuity: Women still treated their families, using remedies that had been passed down through time such as herbs. Herbs and charms were still used in treating and preventing illnesses, The Ancient Greeks also believed that hygiene was important, as can be seen in the layout of Asclepions. A belief in the Gods was still present. Supernatural ideas: Asclepions, Charms, Prayers, Sacrifices and offerings. Rational ideas: Observation, Examination, Diagnosis, Recordings, The Theory of the Four Humours, Asclepions (although Asclepions were set up because of supernatural ideas, the belief in the Gods, they had natural effects). Religion: Religion was still an important influence on people's lives. They believed in the Greek God Asclepius and looked to him to cure illnesses.
Ancient Greece
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Hippocrates also believed that careful observation was important. He wrote many books that wer eused for hundreds of years and even suggested the Hippocratic Oath - an oath which is still used today by doctors and which promises professionalism.
Ancient Rome
Galen explanded on Hippocrates' Theory of the Four Humours. He suggested not only reasons for disease (which is what Hippocrates did) but also suggested how to cure these problems. Galens work relied heavily on a theory of 'opposites'. For example: Spring - Blood - Air - Dysentery and nose bleeds are common. Hippocrates suggests that nose bleeds are common because there is too much blood in the body. Galen suggests that the patient with these symptoms should be bled so that the excess blood in the body is removed. Galen also suggested that there were 'seeds for disease' in the air, but did not expand upon this idea. He wrote many books, which were used for over 1500 years, about his natural apporaches to medicine which stated that he believed the body fitted together perfectly, an idea which Christians approved of. Galen was able to dissect bodies in Alexandria.
Autumn - Black Bile - Earth - Dry Skin, Vomiting. Spring - Blood - Air - Dysentery, Nose Bleeds. Winter - Phlegm - Water - Sneezing, Colds. Summer - Yellow Bile - Fire - Fevers, Vomiting, Yellow skin. Hippocrates believed that there was a natural cause for diseases and illnesses. He put forwards his theory about this. The theory stated that the body contained four humours and we became ill when the humours were unbalanced. For example, in the winter we sneeze and cough becuasr they body contain too much phlegm. The Theory of the Four Humours - Hippocrates:
Ancient Greece
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6. Fixed policies about burying the dead, including introducing graveyards. 5. Extra precautions against preventing fires so that the spread of disease was limited. 4. Public toilets also available to everybody. 3. Public baths available to everybody at only a small fee. 2. Providing fresh water and sewage collection to all cities. 1. Building aqueducts (large lead pipes) to bring fresh water to towns. The Roman Empire was large, wealthy and powerful. The government realised that they needed a clean, healthy empire to keep their soldiers healthy and fighting so they built up Public Health systems and measures which prevented illnesses. These included: Although Galen was an important individual in Roman times, he was not the only person who was looking for causes or cures of illnesses.
Ancient Rome
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Butchers selling bad meat were punished and, in 1343 animals had to be killed away from towns. People were not allowed to throw things into the streets, gutters were installed, rakers were employed to remove waste from streets. Fines were also set up to stop people from throwing items into the streets or if they had filth outside their houses. In 1364 people could be arrested for throwing rubbish into the streets.
London - 13 Hundred to 14 Hundred: Improvements include: Better harvesting, steadier houses with proper roofs and walls were built by carpenters, cesspits were lined with brick or stone and emptied when full, the Abbey of Saint Mary's had a stone built sewer and a supply of clean water. Although over-population was still a problem and specific Public Health measures were not put in place, things did improve during this period. Living conditions improved slightly during the later half of the Middle Ages.
The Great Plague (1665) The Black Death (1348 - 1350) What types of treatment were there? Natural ways included: Plaster of Paris to fix broken bones, ointments, plasters, using Galen's Theory of Opposites to balance the Humours, herbal remedies, amputations, wine and herbs (which were effective as anaesthetics). Supernatural ways included: Charms, cutting crosses into foreheads to ward off the Devil and evil spirits.
Renaissance
Who treated the sick? Some healers had to be licensed, such as physicians (all were men and were expensive), surgeons (both women and men) and midwives (supervised pregnancies). Other healers did not have to be licensed, such as wise women (had a deep knowledge of herbs but wrong treatments caused them to be accused of witchcraft), members of families, the Lady of the Manor (girls from wealthy families would have a few medical books and could treat local people) and travelling quack (would travel around in fairs and markets but not all actually had much knowledge of medicine or anatomy). What did they think caused illness? The imbalance of the Four Humours, 'seeds of disease' settling in the infected part of the body (poisonous air), astrology (stars and planets), God (was punishing them), bad meat. Peopel also believed that disease was passed on through the breath, by sweating or simply by smell. What types of treatment were there? Lady Grace Mildmay used complicated treatments made up of herbs. Other herbs, seeds, metals and minerals, such as amber, gold, turpentinw, mercury, tin, lead, tobacco and more. The use of opposites to balance the humours, cleaning wounds, shaving off hair, rhubarb. Wounds were cauterised using hot oil and bandaged.
Paracelsus (1493 - 1541): He also disagreed with Galen's ideas. He thought that disease was caused by things outside the body attacking the body. Andreas Vesalius (1514 - 1564): Realised that Galen had made mistakes about the anatomy of humans once he dissected human bodies and changed the way dissection was carried out. He also taught students who wanted to learn about medicine and anatomy. He published a book titled: "The Fabric of the Human Body". Important individuals: The role of women and how it changed: The number of women surgeons in the early 17 hundreds declined due to a lack of education as women could not attend universities to qualify as doctors. Men gradually took over delivering babies due to the invention of forceps because they required some knowledge of the human anatomy, something which many women lacked. Amputations were used to remove the painful body part. Supernatural treatments included using amulets and charms, praying to God and the belief in the King's Touch (Many believed that King Charles' touch could cure scruffula).
Renaissance
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The work of Vesalius, Paracelsus, Pare and Harvey all contributed to help develop medicine and knowledge of anatomy. These inviduals proved that Galen's work was wrong, which helped other doctors to realise that they needed to look to other ideas about anatomy and medicine rather than just accept Galen's work. William Harvey (1578 - 1657): Proved the circulation of blood and that it was pumped around the body by the heart and not created and used up by the liver, as Galen had stated. He published books on his work Ambroise Pare (1510 - 1590): Pare worked as an army surgeon and published books. His oil supply ran out so he had to come up with another way to cauterise wounds - he used a combination of egg yolk, oil of roses and turpentine. He decided to tie up arteries (ligatures) and bandage wounds.
Renaissance
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By 1803 his vaccination was used in the USA. By 1805 Napoleon's soldiers were vaccinated. By 1812 his work was published in Arabic and Turkish. In 1852 the government made vaccinations compulsory. His work was rejected by the Royal Society so he published it himself. Some people opposed his work, not believing that a disease from cows could be good for them - some even believed they would turn into cows. Jenner realised, through observation, that farmers who had already suffered from cowpox were not likely to suffer from smallpox. He vaccinated a young boy with cowpox and, once the boy recovered, innoculated him with smallpox. The boy did not produce any symptoms of smallpox or suffer in any way from the disease. After retesting this theory many times, Jenner recorded his results and wrote up his findings. Edward Jenner and Vaccinations: Innoculation was used by people before Jenner to try to stop people from developing Smallpox. Jenner's treatment was known as Vaccination. Jenner realised that Cowpox doses could be used to prevent Smallpox. The King supported this and he was granted some money by the government to open a vaccination clinic once his ideas were proved to work.
During World War One the many problems with blood transfusions were solved because an anticlotting chemical was found and an effective way of storing the blood was sorted. Karl Steiner discovered that there were different blood groups in 1900. However, only some were successful because it was not known that there were different Blood Groups. The first human Blood Transfusion took place in 1818. Shock started to become increasingly common. Simpson's use of Chloroform (1847) allowed the patients to be put to sleep meaning less died from shock. The new cleanliness in operations allowed more invasive surgeries, such as abdominal operations.
Opposition women faced: They recieved opposition from men because many men did not believe that women should have the same rights as men, such as going to university, and because the law stated that women could not have a medical degree. Florence Nightingale (Born 1820): Published books about nursing, such as her "Notes for Nursing". She improved the conditions in many hospitals, allowing patients their privacy and improving professionalism and cleanliness.
Sophia Jex-Black (Born 1840): She persuaded universities to allow her to attend lectures and wrote a book. With the help of an MP she got the law to change, allowing women to be awarded a medical degree. Elizabeth Blackwell (Born 1821): She was the first woman physician in America. She opened the first women medical college in America. Elizabeth Garrett Anderson (Born 1836): Recieved a diploma to practice medicine and built a medical school for women. The Role of Women:
6. Increase in diseases and outbreaks of cholera. 5. New votes 4. Statistics - William Farr showed that there was a link between unhealthy living conditions and high deaths rates and Edwin Chadwick showed that there was a link between poor living conditions and disease. 3. Weaking of Laissez-faire and increase in Public Health improvements - the government and public worked together 2. Surgery - Anaesthetics by Simpson and Antiseptics by Lister 1. The Germ Theory - 1861 - Louis Pasteur What factors brought about the medical changes of the 19th Century? The 1875 Public Health Act meant that it was compulsory for local authoraties to provide clean water, proper drainage and sewers to towns. They also had to appoint a Medical Officer of Health qho would check the health standards in towns were maintained.
Many recruits were very unhealthy: The government realised just how unhealthy the general public were. Soldiers who fought in the war were promised good lives back at home for defending their country (Homes for Heroes) and, therefore, Public Health improved. Slum housing was to be demolished. Soldiers bled to death whilst waiting for an operation: Doctors search for a way to store and transfer blood which was found when doctors discovered plasma could be removed. The discovery of blood groups meant that doctors could know if a blood transfusion would work or not. The government pressured public not fighting to give blood to save soldiers. Bullets and shrapnel lodged in soldiers wounds: This could cause infection. Technology, such as X Rays, allowed surgeons to remove the fatal shrapnel without causing damage to body. Doctors tried harder to find a way to prevent infection.
1909 - Back-to-back housing was banned and building regulations were enforced. By 1939, 700,000 houses were built away from towns and with good ventilation. 1907 - All births had to be registered with widwives. 1906 - Meals for school children meant children had at least on proper meal a day. The Liberal Party introduced acts to improve life for the poor. Despite the 1875 Public Health Act, living conditions and health were still bad for the poor. Towns were still overcrowded and infant mortality was worse than before. Public Health in the 20th Century: Expermintation: Florey and Chain expermented with different uses of penicillin in mice before trying the drug on humans. War: There wasa desperate need for a drug which could fight infection inside the body after surgery as many soldiers died from it.
Who were not included in the scheme? Unemployed people were not included in the scheme, which meant most women as the majority did not work due to having children to look after. The chronically ill could not benefit from this either. What benefits did they recieve? People recieved free medical care from a panel doctor and had a sickness benefit. Who contributed? Both workers and employers contributed towards the scheme. National Health Insurance Scheme: Ditheria and TB were still a problem for many people. 1918 - Local authoraties were required to build new houses for the working class (this linked to the idea of 'Homes for Heroes' and meant that peopel lived in less cramped conditions). 1911 - National Health Insurance was introduced.
3. Doctors - Some did not want to be employed by the government and told where to work. 2. Ratepayers - Because they did not want to pay medical bills for the poor and those who did not work. 1. Local authoraties and voluntary organisations - Because hospitals would be nationalised these people, who ran the hospitals, would lose their jobs. Opposition to the NHS included: What services did the NHS provide? Hospitals, specialist doctors, blood transfusions, dentists, medicines, family doctors, ambulances, vaccination, health centres, home nursing, after-care of sick, maternity and child welfare, controls on medical training and research, teaching hospitals, medical research. The government knew that something had to be done about the death rates and so a Bill to introduce the NHS was passed by parliament in 1946.
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