WJEC Medicine Through Time

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  • Created by: noor
  • Created on: 05-05-13 17:38

Prehistoric Britain

Tomb at Ibister, Orkney, from 5000BC; archaeologists found:

  • Teeth were healthy; 9 out of 1537 teeth had decay. Fit (except from pain in joints)
  • Women died between 15-24 due to childbirth and poor eating habits (a few lived over 40)
  • Strong muscles, especially leg muscles. Women were shorter than men.
  • People died from disease, infections from cuts, warfare and food shortages

Treatments

  • Spirits - if your spirit left your body/if an evil spirit entered your body you became ill.
  • The medicine man - he would sing and chant so the patient would fall into a trance. He massaged the sore place and asked the evil spirit to come out and into a quartz crystal. The relief of the patient could be great enough for them to recover.
  • Charms - to ward off evil spirits. Buried their hair, nails and excrement to avoid enemies using them to cast spells (prevented diseases due to the act of hygiene)
  • Herbs - knowledge passed down. Used on obvious issues such as cuts or broken legs
  • Surgery - broken bones were set. TREPHINING - cutting a hole in the skull and removing a piece of bone to cure severe headaches or to let out evil spirits. This was sometimes successful; there is evidence of healing in skulls.
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Life In Egypt Affecting Medicine

  • Wealth - The Nile provided fertile soil/more harvest; with Egypt's powerful rulers, international trade and writing, its wealth led to many medical improvements.
  • Specialist doctors - appointed by Pharaohs. Spent a lot of their time understanding medicine and health.
  • Trade - Merchants from India, China and Africa had new herbs and plants recommended as medicines; Egyptian healers built up a wide knowledge of herbal medicines
  • Improved writing - Treatments could be written down and passed on due to papyrus
  • Religion - Believed in afterlife. Embalmment took place; parts of the body were extracted and preserved. Bodies wrapped in spices and bandages (the Mummy).
  • The Nile - if the Nile's channels were blocked water wouldn't come. This made physicians wonder if the body had channels that could become blocked.

Causes and Treatments

  • Blamed blocked channels in the bodu for causing illness
  • Knew about the heart, liver, pulse, brain, lungs and blood; didn't know their functions
  • Used prehistoric treatments, but began to write findings, learnt about anatomy, explored why illness happened and used a range of international herbs as medicine
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Greek Medicine: Hippocrates

  • Asclepius - Greek god of healing. People prayed to him for treatment
  • Peple slowly accept that magic and gods prevented effective medical treatment
  • Hippocrates (400BC, the father of medicine) brings the idea of the Four Humours; blood, phlegm, yellow&black bile. if one was unbalanced, it would have to be balanced to be healthy again.
  • Linked with elements and seasons; Greeks studied carefully the Earth around them
  • Understood some functions of the body, i.e., the brain controlled the body
  • Alexandria became a centre for medical knowledge. Greeks built a library and university, collecting findings from Greek, Indian, Chinese and Egyptian writers.

Treatments

  • Doctors, women and priests treated the sick.
  • Observed symptoms carefully, recording in detailled notes; amateur case-histories.
  • Instructed patients to exercise, keep clean and directed what to eat to avoid illness
  • According to the Four Humours; purging of the bowels, vomiting and bleeding
  • Surgery - amputations and better techniques for setting bones. Draining of the lungs for when patients had pneumonia.
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Roman Medicine: Galen (162 AD)

Galen - 120AD

  • Surgeon gaining practical experience at gladiators' school dissecting pigs and monkeys. 
  • Believed in Four Humours and used opposites to treat illnesses; cold countered by hot. Emphasised on Hippocrates' methods; observed and wrote down everything
  • Dissected animals and made judgements on human bodies based on animal structures. Fit in well with the Christian church; they did not want him to dissect human bodies, and the way in which he explained how intricately designed the body was fitted in with the idea that God created human beings.Was believed for 1000 years.

Changes in Rome

  • Sewers created
  • Fresh Aquaducts supplied water all over the empire 
  • Public baths open to anyone
  • Public toilets built
  • Doctors trained only by watching others or reading the Hippocratic collection
  • Turpentine was an antiseptic; opium a weak anaesthetic.
  • Roman empire took over Greek empire, and ideas were broadened.
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Factors Affecting Medicine 1400s

Chaos in Western Europe

  • Collapse of the Roman Empire - Europe split into small kingdoms instead of having a central government. Wars destroyed Roman achievements and trade/travel decreased

The Christian Church

  • Grew stronger during Middle Ages. Each village had its own church and priest
  • Strict control - every new idea was checked to make sure it did not challenge the bible
  • Only priests and monks knew how to read; monasteries control education. 
  • Libraries in monasteries; the Church banned books they didnt want people to read
  • Greeks promoted rational explanations; Church promoted belief in superstitions

Changes in 1300s

  • Church set up universities where doctors could be trained. Practical exp in battlefields
  • Harvest improved; trade increased
  • Towns were being cleaned up again
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The Black Death; 1350s

Causes - What Was Believed

  • Spiritual interferences - Devil and evil spirits
  • movement of the Sun and Planets
  • Four humours out of balance
  • Invisible fumes or poisons in the air (bad smells)

Causes - Actual

  • Poor hygiene in the Middle Ages; although it was redeveloped it was still less than the Roman era.
  • 1348 - one trading ship (mediterranean) brought a plague to England. Over 40% of population died.

Symptoms

  • Prayed to God fervently; king sent out orders for churchmen to lead processions pleading to God to save England.
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Public Health and Medical Training in 14th Century

Public Health

  • Fines and arrests for littering. 1372 - anyone who had filth outside their house was fined four shillings
  • 1380s - atleast 13 common privies in the city. Thomas Scott fined for urinating in a lane in 1307
  • Open sewers carrying refuse to the river

Doctors in The Middle Ages

  • Studied in universities. Anyone who wanted to be a doctor trained at medical schools
  • Study was based around four humours. Diagnosis would take place using urine charts and astrology
  • Bleeding was used constantly to sharpen hearing, drive away anxiety and cure pains.
  • Monks were bled 7-12 times a year
  • Used leeches to **** blood. Strict rules for blood-letting; examiners had to ensure it was being sone properly
  • Women couldn't go to university but remained midwives and "surgeons"
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Treatment in the Middle Ages

Surgery

  • People became surgeons by apprenticeship to another surgeon.
  • Master surgeons had to have licenses and pass lengthly tests organised by the guild of surgeons
  • Women could become surgeons; they simply watched surgeons and copied them

Herbal Remedies

  • Women healers in villages had a large store of potions and lots of knowledge on herbs
  • Locally grown plants used aswell as international herbs. Sugar was imported in large quantities in 1400s.
  • Herbal treatments work. Example: plantain was used in 48 remedies; 25 of the 48 helped to stop infection because plantain is an antibiotic
  • Herbal remedies based on the Roman's ideas to balance the four humours

Hospitals cared but did not treat. According to the Christian church's belief that it was duty to care for the sick, only housing, bed, food and herbal remedies were provided by nuns; that too onlyif you weren't too infectious in fear of harming others. Doctors only treated kings, nobles and worthy merchants. 

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The Growth of Arab Medicine

  • Muslim faith required people to care for the sick. This resulted in large hospitals in major cities
  • Arab scholars translated Galen and Hippocrates' work into arabic - used by students
  • Arab doctors increased knowledge by learning from Indian and Persian doctors
  • Libraries for medical works in cities like Baghdad
  • Avicenna wrote an important textbook on medicine; used for 600 years in Europe and the Islamic world
  • Dissection forbidden; it was not recommended for doctors to dabble in surgery
  • Due to crusades, doctors from western Europe came in direct contact with arab medicine

Little Change in the Middle Ages - why?

  • Medicine stopped improving after Galen due to collapse of the Roman Empire 
  • Religion discouraged change; leaders of the Church suppressed new ideas in case they challenged the Church's authority.
  • People believed God and the Devil controlled illness and disease
  • Astrology became very important; they believed planets affected health
  • People believed worms caused illness; Bald's Leechbook identified illnesses where worms ate flesh, lived in intestines or ate teeth.
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Renaissance 1400-1750: Vesalius

Background

  • Studied medicine in Paris and Italy, where he met artists dissecting bodies. 
  • Professor of Surgery in Padua, Italy. Specialism in anatomy.

Before Vesalius

  • Doctors believe Galen had covered everything needed; it was completely accurate so there was no need to lern more about anatomy.

After Vesalius

  • Vesalius proved 200+ Galen's ideas wrong in his book. Artists like Da Vinci helped him prove that to know the human body's structure and functions, it was vital to dissect humans (Galen dissected animals). Doctors had to test Galen's ideas instead of believing them blindly. 

Legacy

  • Inspired doctors to challenge Galen. Published 'The Fabric Of The Human Body' 1543
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Renaissance 1400-1750: Pare

Background

  • Apprenticed to barber surgeon; became surgeon in Paris. 
  • Became army surgeon treating sword/gunshot wounds for 20 years. Specialism: surgery

Before Pare

  • Wounds treated by pouring boiling oil on the wound and sealing it with a red hot iron (cauterising). Soldiers were in pain and died often.

After Pare

  • Used a Roman ointment of egg yolk, oil of roses and turpentine and wrapped them in simple bandages. Soldiers healed quickly. Used silk threads (ligatures) to tie the ends of arteries

Legacy

  • Published 'Works on Surgery' in 1575
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Renaissance 1400-1750: Harvey

Background

  • Studied medicine at Cambridge. Became a doctor in London then a lecturer in anatomy.

Before Harvey

  • Dcotor's believed Galen's idea of new blood constantly being manufactured in the liver to replace blood burnt up by the heart. 

After Harvey

  • Proved that blood moves from the heart in arteries and to the heart in veins by dissecting bodies and pushing thin metal rods through the system.
  • Proved that the heart acts as a pump, recirculating blood.
  • Harvey couldn't see capillaries, but predicted them; microscopes proved them.

Legacy

  • Published 'An Anatomical Account of the Motion of the Heart and Blood in Animals' 1628
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What caused these discoveries?

  • Experiment and Challenge - people willing to challenge old ideas. Protestants challenged the Pope and Catholic Church.
  • Education and Ancient Learning - literacy incresed with the number of schools between 16th-17th century. Renewed interest in Roman/Greek thinkers.
  • Machinery and Printing - improvements in clocks, watches and pumps. Printed books meant new ideas spread rapidly (1400s)
  • Wealth - People grew wealthier after the Black Death. Spent more on luxuries/education
  • Wars - many wars in 16th-27th century Europe.
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1750-1900: Jenner

Background

  • Smallpox (greatest killer of 18th century) killed 15% of population in 18th century.

Before Jenner

  • No way of protecting people against deadly infection diseases

After Jenner

  • Jenner used cowpox to develop smallpox vaccine. Tested in 1798 on James Phipps. Called the treatment vaccination after the word "vacca"=cow. 

Legacy

  • Vaccine made compulsory in 1852. 
  • Encouraged others like PAsteur and Koch to find vaccines for diseases like cholera/TB.
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Why did people oppose vaccination?

Reasons

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Microscopes

Before Lister

  • Leeuwenhock invented the microscope in the late 1600s. He found organisms in everything he studied; this interested scientists.

After Lister

  • Purer glass meant Lister could develop a microscope magnifying 1000 times without distortion (1830). They could observe the MOs' behaviour.

Legacy

  • Produced a model of the microscope that based every other model. Allowed the study of microorganisms to be clearer and precise.
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1750-1900: Pasteur

Background

  • French scientist. Believes disease was caused by miasma. Doctors knew but couldn't explain the link between dirt and disease.

Before Pasteur

  • Brewing companies wondered why alcohol, beer and milk went bad.

After Pasteur

  • (1850) Developed a theory that germs caused the problem; particular microorganism grew vigorously in the liquids. Killed harmful germs by boiling the liquids.
  • Germ Theory (1861) proves that silk worms could die from bacteria and bacteria could make liquids go bad.

Legacy

  • Pasteur developed vaccines for Anthrax (1879) and Rabies (1885)
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1750-1900: Koch

  • Built on Germ Theory. Realised that different bacteria cause different diseases.
  • Found a way of staining bacteria so they could be seen under microscope
  • Identified germs causing Anthrax, TB (1882) and Cholera (1883) to which Pasteur could later develop vaccines.
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1750-1900: Simpson

Background

  • Surgeon. Able to amputate a leg in 2 minutes.

Before Simpson

  • Patients suffered pain; often dying form shock. Doctors had to operate quickly and therefore couldn't perform complex operations. Laughing gas was unpredictable

After Simpson

  • Chloroform was reliable anaesthetic; could be used to ease women's pain in childbirth (1847)

Legacy

  • Queen Victoria used chloroform in 1857
  • Development of anaesthetics meant doctors could perform complex operations.
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1750-1900: Lister

Background

Surgeon

Before Lister

  • 50% of amputees died from blood poisoning. Doctors didn't wash their hands or sterilise instruments before operating. Lister read Germ Theory and linked bacteria with infection.

After Lister

  • Sprayed carbolic acid on wounds during operation (1867). Patients dying decreased by 30% (45 to 15)

Legacy

  • Aseptic surgery developed:1887 - steam sterilisation, 1894 - rubber gloves
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1750-1900: Rontgen

Before Rontgen

  • Had to cut patients open to find out what was wrong, leading to infection.

After Rontgen

  • X-rays accidentally discovered in 1895 while experimenting with cathode rays. He found that they didn't pass through bones and metal. Called them x-rays because he didn't know what they were. Used to locate bullet/shrapnel wounds in WW1

Legacy

  • Portable x-ray machines meant that in WW1 broken bones and shrapnel wounds could be loacated.
  • Technological improvements led to several different types of scan: ECG (1906), MRI (1984)
  • Chest x-rays locate diseases like pneumonia and lung cancer.
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20th Century: Sir Alexander Fleming

Background

  • Army doctor in WW1. Soldiers died from infected wounds; he spent his career trying to find a way to kill bacteria.

Before Fleming

  • magic bullets like Prontosil and Salvarsan 606 were designed to kill specific bacteria.

After Fleming

  • 1928 - discovered penicillin by accident; mould was growing in a Petri dish full of bacteria. The Penicillin mould was killing bacteria.

Legacy

  • Saved 200 million in the 20th century.
  • 1944  - Fleming is knighted.
  • 1945 - Fleming, Florey and Chain recieve Nobel Prize for medicine.
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20th Century: Florey and Chain

Before Florey and Chain

  • Penicillin accidentally discovered in 1928 by Fleming; didnt have money for further research.

After Florey and Chain

  • Grew Penicillin in thousands of milk bottles until there was enough to test.
  • Tested the drug on mice.
  • First human trial: 1941. Trial was successful but they didn't have enough Penicillin to prevent PC Albert Alexander from dying.
  • 1942 - American government invested $80 million producing Penicillin.

Legacy

  • Penicillin widely used during WW2. 15% more soldiers would've died without Penicillin.
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20th Century: Crick and Watson

Before

  • Doctors didn't know what caused genetic disease.

After

  • 1953; Crick and Watson discover DNA. They realise it has sections of genes determining sex, height, hair and eye color.
  • Missing/damaged genes cause diseases that can be passed down. 
  • Breast cancer, CF and Huntingtons

Legacy

  • 1990-2003 - Human Genome Project with scientists from 18 different countries.
  • Research in gene therapy means babies can be screened for genetic diseases
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20th Century: Barnard

Before

  • 1954 - surgeons performed world's first successful kidney transplant on identical twins

After

  • 1967 - Barnard performs world's first heart transplant on 54 year old man Louis Washkansky who suffered from diabetes and incurable heart disease.
  • Successful transplant, but he died 18 days later of pneumonia

Legacy

  • 1974 - new drug developed (Cyclosporin) to stop body from rejecting transplanted organs. 
  • New successful transplants such as the hand transplant (1998) and face transplant (2005)
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How far has medical knowledge developed from the m

Middle Ages

  • Limited; Chruch taught that illness was a punishment from God, so scientific research was not used to combat ill ness. Only allowed one dissection per year.
  • Due to discoveries in helath people began to  challenge old ideas about what causes disease.

Renaissance

  • Vesalius fixed over 200 of Galens mistakes (talk about Vesalius and then Harvey & impacts)

18th/19th century

  • Germ theory, pasteur, koch, boiling, disinfecting, koch, identifying, Rontgen, x-ray, wounds

20th century

  • DNA - explained some diseases, inheritance, breakthrough in manipulation, stem cells
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How has medical treatment developed?

Middle Ages

  • Limited; Chruch taught that illness was a punishment from God, so scientific research was not used to combat ill ness. Only allowed one dissection per year.
  • Due to discoveries in helath people began to  challenge old ideas about what causes disease.

Renaissance

18th/19th century

20th century

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Comments

Mariam

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Thank you so much your notes have been a great help

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