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Year 11 revision. Medicine!!!!!!. The Egyptians: 3500BC-1550BC. Wealthy Nation Farming was very important Traded with many different countries The Nile was of great significance for farming (flooded) Led to the belief in Channels “May your Channels be sound!”. Attitudes and beliefs.

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year 11 revision

Year 11 revision

Medicine!!!!!!

the egyptians 3500bc 1550bc
The Egyptians: 3500BC-1550BC
  • Wealthy Nation
  • Farming was very important
  • Traded with many different countries
  • The Nile was of great significance for farming (flooded)
  • Led to the belief in Channels
  • “May your Channels be sound!”
attitudes and beliefs
Attitudes and beliefs
  • Highly superstitious: use of charms and amulets to treat illness
  • Dissection forbidden but embalming was used for important people
  • This led to a limited knowledge of Anatomy
individuals
Individuals
  • There doesn’t seem to be any!!!
science and technology
Science and Technology
  • Specialist craftsmen developed the formation of bronze instruments used for minor surgical procedures
slide6
War
  • This was not a significant factor in the Egyptian culture
governments
Governments
  • The Pharaoh had his own physician highlighting the importance of medicine
communication
Communication
  • Traded with China, India, Africa
  • This trade involved many different herbs and plants
  • The development of papyrus (paper reeds) helped people to pass on medicinal knowledge accurately
the greeks

The Greeks

1500 BC-500BC

so what were they like
So what were they like?
  • Skilled fighters
  • Fishermen and farmers
  • High level of trade with other cultures
  • Generally rich and therefore had the luxury of education
  • “Thinkers” traditionally remembered for having enquiring minds and wanting to work things out even if this didn’t lead to practical solutions
attitudes and beliefs11
Attitudes and Beliefs
  • Many, many gods!
  • Goddess of Healing: Asclepius
  • Asclepions
  • BUT not everyone convinced by power of the gods and have many Greek thinkers!
  • HIPPOCRATES!!!!!!!!
  • The Four Humours
hippocrates
Hippocrates
  • Born 460BC in Kos
  • Advocated that all diseases should be treated naturally
  • Observation
  • Advice
  • Treatment
  • Surgery
  • Oath
  • Collection
science and technology14
Science and Technology
  • Iron Steel developed (but few operations done and mainly outside the body)
slide15
War
  • Expansion of the Greek Empire led to the spread of medical knowledge
governments16
Governments
  • The Empire was very rich and this led to a great number of people being educated
communication17
Communication
  • Traded with other Ancient Civilisations
the romans

The Romans

300BC-450AD

so what are they like
So what are they like..
  • Very big
  • Large Cities highly populated
  • Well Organised
  • Practical
  • Very wealthy
attitudes and beliefs20
Attitudes and Beliefs
  • Roman Gods: Salus (goddess of healing)
  • The gods were a FIRST resort
  • Herbs and natural remedies passed down through generations
  • Practical people
  • Exercise, Diet, Herbs
individuals21
Individuals
  • Discorides AD64
  • Army doctor who wrote a book full of 600 herbal remedies (20% of which were actually practical today)
  • GALEN
watch that pig squeal
“Watch that pig squeal”
  • Born in Greece (Ad129)
  • Moved to Egypt and then Rome
  • Was a doctor for Gladiators (lots of experience studying wounds and the body)
  • Advocated Observation
  • Was no copycat developed the theory of humours to “Opposites”
what did he know
GOOD

Brain did not control speech

Arteries and veins carried blood

Advocated dissection

Developed bandaging techniques used for centuries

Believed in only 1 god and used the term “the creator" therefore his ideas were respected for 1000s of years

Wrote over 100 books

He gave lectures to train people

Bad

Deprived of human bodies he used animals instead and therefore made many anatomical mistakes: about the Human brain and the heart

For years after many people were reluctant to question Galen and therefore in the long term it could be argued that he was a hindrance to the development of medicine

What did he know…
science and technology24
Science and technology
  • Observation was strongly recommended by key people
slide25
War
  • Very, Very important
  • The army was essential to the Empire
  • Led to improved public health
  • Spread of ideas and resources
  • Army hospitals/surgeons etc
governments26
Governments
  • A strong centralised government
  • Which could implement many schemes which helped medicine advance
communication28
Communication
  • Knowledge spread around the large Empire
  • Galen's Books (still used 1500 years later!)
where did it all go wrong
Attacks by tribes led to the fall of the Roman Empire

Towns broke up

Many medical books were destroyed

A belief in magic and faith became popular again

The church became very important again

The Monasteries kept ideas about medicine and hygiene alive

St Benedict advocated that the cure of the sick should be the most important job of a monk

Most of the books were written in Latin and only the monks were educated in this

Where did it all go wrong?
the middle ages

The Middle Ages

1100AD-1500

attitudes and beliefs33
Attitudes and Beliefs
  • Great number of people still believed in superstitions: Black Death
  • Zodiac Man
  • Whatever people thought caused diseases most people used herbal remedies
  • The Christian Church was very important! But often hindered medical Progress!
  • Works of Galen still studied
black death
Black Death
  • Struck in 1348
  • Numerous ideas about what caused it: Bad air, dirt, planets, god, evil, Jews
  • Led to ridiculous cures: Amulets, clean ups, killing Jews, mass prayer etc
  • 40% people died
was the christian church a help or a hindrance
The Christian church was the only strong organisation in a time of chaos

The Clergy generally read Latin and therefore could interpret the works of Galen

Part of all religious duty was to look after the sick

Universities founded after 1200 were controlled by the church

The church believed truth would be found by studying old ideas from the bible and Galen

Christ was seen as a carer of the sick: lepers

From 1300 some schools enable pupils to dissect, which increased the knowledge of anatomy

Greek ideas fitted well into the Christian beliefs i.e. nature causes illness, when god was seen as the main creator

Although the church taught that it was good to look after the sick they believed this could be achieved in prayer, belief and saints

People still relied on charms and spells to cure them

By studying past ideas they were not encouraged to develop new ones!

Divine right of Kings gave power of healing

Evil spirits caused disease (S5)

Most churches disallowed dissection

Was the Christian Church a help or a hindrance?
individuals37
Individuals
  • Galen
  • Theory of Four Humours
science and technology38
Science and Technology
  • Little knowledge of cause of disease led to few scientific methods being adopted
  • No idea of cause of disease due to lack of technology
  • Observation of dissection
slide39
War
  • Kingdoms more interested in building up an army and having wars rather than improving health of nations
  • Wars lead to poor countries
  • But on plus side helped to increase surgical knowledge through necessity
governments40
Governments
  • No formal structure
  • Public health measures disregarded during dark ages Slight improvements but impractical
  • Kings more concerned with wars/money and law and order
communication41
Communication
  • Galen’s books
  • Written in Latin so only church members understood?
  • War disrupted communication
attitudes and beliefs43
Attitudes and Beliefs
  • This was a time of change for peoples attitudes and beliefs
  • Experiments: people willing to challenge old ideas
  • Wealth: increased led to better education
  • A rebirth in thinking
  • Despite this many people still believed superstitious beliefs (Great Plague)
slide45
William Harvey

Born 1578

Proved Galen’s theory of blood being replaced by the lungs wrong

Proved the heart acted as a pump

Wrote “An anatomical account of the motion of the heart and blood in animals”

science and technology46
Science and Technology
  • Improvements in machinery
  • Development of microscopes (Dutch watchmaker 1600)
slide47
War
  • Numerous wars in the 16th and 17th century
  • Pro: surgical experiments
  • Cons: Governments more interested in supplying wars rather than medical improvements
governments48
Governments
  • The King’s Evil
  • The monarch was considered to be “gods deputy” and could therefore cure illness
  • Town councils took over hospitals (charity councils)
  • St Bartholomew's Hospital (London)
a changing britain
Development of technology

Urbanisation

Entrepreneurs

Overcrowding

Development of transport

Change in government attitudes

Machines: factories

Slum housing

Exploitation of the poor

Poor living/working conditions

Communication of knowledge

Decrease in lassiez faire approach

A changing Britain…
attitudes and beliefs51
Attitudes and Beliefs
  • Old ideas being challenged
  • Many of these built on the work completed during the renaissance
  • Change in political attitudes: Lassiez faire
  • But don’t overestimate these changes: For each new reform and step forward there was almost certainly opposition to it: Vaccination, public health reform, anaesthetics, NHS etc
individuals52
Individuals
  • Where to start?
  • The battle against disease….
edward jenner
Edward Jenner
  • Before Jenner Smallpox was treated by inoculation (lady Mary Montague)
  • Jenner, A doctor from Gloucestershire noted that those dairy maids who caught the mild disease cowpox was immune to smallpox
  • Experimented on 8 year old boy and further 23 experiments
  • Submitted his findings to the Royal Society
louis pasteur
Louis Pasteur
  • A French Scientist
  • Employed by brewing company to find out why beer went bad
  • Using new technology he was able to ascertain that micro-organisms were making it bad and these could be killed by heating
  • He soon related this too milk, beer, wine and vinegar
  • His ambition led him to enter a competition to prove or disprove whether the old theory spontaneous generation were true
spontaneous generation
Spontaneous Generation

Flies Maggots

Decaying Matter

The idea that organisms are the result of decay.

Microbes

pasteur cont
Pasteur cont…
  • Pasteur proved that…
  • The air contains living organisms
  • Microbes are NOT evenly distrusted in the air
  • Microbes in the air CAUSED decay
  • Microbes can be Killed by heating
  • BUT Pasteur was not a Doctor and despite Publishing his Germ Theory in 1861 it took the work of other doctors to carry on his ideas.
robert koch
Robert Koch
  • A German Doctor
  • Took up the challenge of extracting and identifying individual Germs which cause various diseases
  • Used industrial dyes to stain germs to observe them
  • ID..
  • 1880 Typhus
  • 1882: TB
  • 1883: Cholera
  • 1884: Tetanus
  • 1886: Pneumonia
  • 1887: Meningitis
  • 1894: Plague
  • 1898: Dysentery
but don t get too excited
But don’t get too excited!!!!
  • All of these are just the identification of germs and NOT cures
  • Until…
  • Other Doctors alongside Koch and Pasteur's work were able to build on these developments and find vaccines for the prevention of: Anthrax, Chicken Pox, Cholera, Rabies.
  • Microbe hunters: Behring (Anti-toxin), Ehrlich (development of dyes to kill germs: Magic Bullets, Salversan 606)
  • Penicillin
how did it come about
How did it come about…
  • In 1928 Fleming discovered that a mould which could be used to kill many harmful bacteria, preventing infection spreading around the body. This discovery was called penicillin. However, another 14 years passed before it was fully developed and mass-produced in 1942 in America.
  • Chance - was an important factor in Fleming's original discovery of the mould which was the basis for penicillin.
  • World War II - the outbreak war in 1939 stimulated governments into funding the mass production of penicillin.
surgery
Surgery
  • 3 main problems facing surgery at the start of the industrial revolution:
  • Pain
  • Infection
  • Bleeding
slide61
PAIN!!!
  • The discovery of anaesthetics can be attributed to many men.
  • In 1799 Humphrey Davy accidentally discovered that Laughing gas (Nitrous Oxide) relieved pain.
  • Ether was used by Crawford Long in 1842 to remove a tumour. No one knew of Long’s discovery, though, because he did not publish his findings.
  • Three other people used ether as an anaesthetic. They were William Morton in 1846, John Warren and Robert Liston.
  • But it was James Young Simpson in 1847 who discovered that Chloroform was more effective anaesthetic for childbirth.
  • But this led to somewhat of a Black period in medicine:
  • “The operation was a complete success but the patient died!”
  • Increased infection
  • The complacent patient
infection
Infection
  • In 1860 1/3 of all patient died from infection
  • Dirtier the surgeons coat the more experienced they were deemed to be
  • Joseph Lister advocated:
  • Soaked bandages
  • Washing hands
  • Carbolic spray
  • But got opposition “Shut that door or one of listers microbes may get in!”
  • Antiseptic
  • Aseptic
blood loss
Blood Loss
  • 1667 Doctor used blood from a lamb in the body (boy lived but the next died)
  • 1818 first human blood transfusion but was hit and miss
  • 1900 Karl Landstiener discovered blood groups
  • WW1 and methods of storing blood developed
  • 1938 National Blood Transfusion Service set up
public health
Public Health
  • The Industrial revolution was a time of great change for public health reforms and this can be attributed to the work of many key individuals:
  • John Snow
  • William Farr
  • Edwin Chadwick
  • Pasteur and his germ theory
cholera
Cholera
  • In 1832 John Snow successfully proved that the cholera was spread by water, by studying the infected pipe in Broad Street
  • William’s Farr’s statistics backed up the notion of poor living conditions impacting the health of people
edwin chadwick
Edwin Chadwick
  • In 1839 Chadwick was employed by the government to undertake the investigation into a link between poverty and disease
  • His report in 1842 recommended sanitary reform
  • This led to a divide in the country
  • The Clean Party v Dirty Party
why would some people oppose reform
High number of diseases spreading within poor living conditions: typhus, TB, Cholera etc.

Chadwick’s report on “The sanitary conditions of the labouring population of Great Britain 1842” Highlighted that ill health was caused by poor living conditions

Chadwick argued looking after the poor would actually decrease money spent (an able workforce)

Epidemics: 1848 and 1865

Disease hitting the rich (a royal victim Prince Albert

Statistic collated by William Farr suggested a link between poverty and deaths

Dr J Snow had concluded that poor water supplies were not helping reduce the spread of Cholera

The “Clean party” were campaigning for reforms

Some Victorian Businessmen were concerned about the welfare of their workforce and were trying to alleviate problems (i.e. Cadbury’s and Rowntree

Local ratepayers were trying to reduce the amount currently spent on the poor

Local businessmen would not appreciate “being told” by the government that they HAD to help

£11 million was spent on public health in 1848-1872 it was not cheap!

Those in a position to help did not want to be bullied into reforms

It would appear it was a problem for the poor

Lassiez Faire had been policy for years and seemed to be working

Those people voting were generally those liable to pay for improvements

Germs had still not been discovered!

“The Dirty” party opposed reforms

Why would some people oppose reform?
so what actually happened
So what actually happened?
  • 1834 Poor Law Amendment Act - Medical officers were appointed to workhouses which provided basic medical care for the poor.
  • 1848 Act (General Board of Health) - The General Board of Health was created and although it was abolished 10 years later, the act also encouraged local boards of health to be set up to appoint a medical officer, provide sewers, inspect lodging houses and check food which was offered for sale.
  • 1853 Act - Vaccinations were made compulsory although no-one was given the power to enforce them.
  • 1855 Nuisance Removal Act - This act made overcrowded housing illegal.
  • 1864 Factory Act - This made unhealthy conditions in the factories illegal.
  • 1866 Sanitary Act - This made local authorities responsible for sewers, water and street cleaning.
  • 1868 Act - This encouraged the improvement of slum housing or its demolition.
  • 1871 Vaccinations Act - This made sure that the previous vaccinations act was obeyed.
  • 1875 Artisans Dwelling Act - This made the house owners responsible for keeping their properties in good order and gave local authorities the right to buy and demolish slums if they were not improved.
  • 1875 Public Health Act - This brought together a range of acts covering sewerage and drains, water supply, housing and disease.
what about the girls
What about the girls?
  • Florence Nightingale fought social conventions with her work in the Crimean war and the establishment of the Nightingale School of Nursing
  • Elizabeth Garrett fought hard to be respected as a Doctor in Britain but had to obtain her degree from Paris
  • Sophia Jex Blake studied medicine and completed the course but had to obtain her award from Dublin, but set up the London School of Medicine for women
science and technology70
Science and Technology
  • So many…
  • Machinery: Printing, microscopes, transport
  • Dyes
  • Chemical compounds
  • Mass production
  • Numerous experiments
communications
Communications
  • With the exception of a few cases this was time of great learning, all experiments appeared to be recorded and built upon. This is clearly shown with the work which developed from the discovery of germs to the eventual success of many cures
slide72
War
  • Wars between governments increased competition: French and German
  • Crimea war and work of nightingale
  • Improvements in Surgery
  • WW1: Homes for Heroes, Surgery and blood transfusions, X Rays
  • WW2: Development of NHS and necessity of penicillin
governments73
Governments
  • Public Health: issue of domestic reform addressed
  • Government funding for research teams
  • Compulsory vaccinations (Jenner)
  • Competition to find cures first
so what s left
So what’s left…
  • 1901: key hole Surgery
  • 1948: NHS
  • 1953: discovery of the structure of DNA
  • 1960s: Transplants
  • 1990s: cloning