Medicine Through Time Flashcards
(180 cards)
1
Q
What does ‘Prehistoric’ mean?
A
Before we had written records. To understand these times in history, we have to look at other evidence, such as bones, paintings and tools.
2
Q
What did prehistoric people have knowledge of?
A
Some knowledge of anatomy - from hunting, killing and eating animals, as well as from when people got torn up by them. Understood enough to know the quickest way to kill animals - cave paintings of animals with a spear through the heart. May have known to keep broken bones still/had splints - people with completely healed fractures. They could treat simple surface wounds.
3
Q
What illnesses did prehistoric people suffer from? What illnesses did prehistoric people avoid?
A
They appear to have suffered from rabies, gangrene and arthritis. They would have a healthy diet, as they ate a lot of wild plants and berries. Their water supply wouldn’t be contaminated, and human waste wouldn’t pile up (attracting disease carrying insects) as they moved from place to place regularly. They would not have suffered from modern diseases relating to smoking or alcohol consumption.
4
Q
What is a witch doctor (prehistoric)?
A
Strangely dressed-up tribesmen (and paintings of them) that they believe would scare away evil spirits that caused the body pain, without injury.
5
Q
What is ‘trepanning’?
A
Drilling a hole into the side of somebody’s head to release evil spirits trapped within. This would have been done without anaesthetic, with a piece of flint. Some people would have survived this treatment, as skulls have been found that have regrown and almost closed.
6
Q
What other methods can we use to discover more about life in prehistoric times, other than looking at artefacts?
A
We can study the beliefs of Aborigines in Australia and South America, seeing what herbal remedies they use. Their beliefs are often superstitious and magical, and they use witch doctors to treat diseases.
7
Q
Who provided care in prehistoric times?
A
Medicine men provided medical care, but women were closely involved in treating illness as wives and mothers.
8
Q
What factors in Ancient Egypt affected medicine?
A
Money, The Nile, Writing, Trade and Religion
9
Q
How did money affect medicine in Ancient Egypt?
A
Rich people paid doctors to look after them. The pharaoh had a whole team! However, the law ensured that everybody had access to doctors, whether they were rich or poor.
As Egypt was very wealthy, they had many fine craftsmen that made medical instruments, so doctors had better equipment.
10
Q
How did The Nile affect medicine in Ancient Egypt?
A
It gave doctors a theory about how illness was caused. They had built a system of channels around The Nile, carrying water to fields, and when these became blocked, the crops in the fields suffered. They applied this concept to the body, as they knew it contained many passages for blood, air and food, leading to treatments such as laxatives and bloodletting to clear blockages.
11
Q
How did writing affect medicine in Ancient Egypt?
A
They could keep a record of illnesses and treatments that could be referred back to and also built upon. They used papyrus as paper, and hieroglyphics as letters.
12
Q
How did trade affect medicine in Ancient Egypt?
A
Egyptian merchants traded with India, China and Africa, bringing in new herbs to be used as medicines.
13
Q
How did religion affect medicine in Ancient Egypt?
A
A belief in an afterlife in which you required all the major organs lead to a process called mummification. Vital organs were removed, and the body was wrapped in bandages and soaked in salts to prevent decay. The priests who performed this process must have learnt a bit about anatomy, but not about physiology, as they couldn’t dissect the organs they removed.
14
Q
What kind of treatments did Egyptian doctors use?
A
They used natural treatments, such as herbal remedies, laxatives and bloodletting. They also used supernatural treatments, such as charms and spells and praying.
15
Q
Why were people in Ancient Egypt turned into mummies?
A
They believed people need their bodies in the afterlife, so it needs to be preserved properly.
16
Q
Describe the process of mumification
A
First, they pulled the brain out of the nose and rinsed out the skull with chemicals. Then, they removed the intestines, stomach, lungs, liver and heart. The heart was washed and placed back inside the body, as it was considered very important. The other organs were put in jars and sealed under the protection of the god Horus. The body was washed in palm wine, milk, spices and oil, then left for 40 days with a covering of salt, drying out the body. It was then wrapped in linen bandages and buried in a tomb with the organ jars.
17
Q
What are ‘Asclepeia’?
A
Special healing temples where Ancient Greeks could go to pray to the god Asclepius to come and heal them from their illness.
18
Q
What happened in an Asclepion?
A
When the patient first arrived, they would sacrafice an animal before a statue of Asclepius. Then, they would wash in salts and minerals, hoping the gods would wash away the evil and guilt inside them. When a priest decided the patient was ready, he would be taken to the abaton to sleep, while snakes (sacred) would slither over them in their sleep.
19
Q
How were people cured in an Asclepion?
A
It seems unlikely the gods healed the people, as they thought in Ancient Greece. One possibility is the placebo effect. Another is the good habits patients picked up - no stress, good diet, relaxing.
The priests in an Asclepion may also have helped in the healing process, believing they were acting for the gods.
20
Q
What is the theory of the four humours?
A
Ancient Greeks came up with the idea that the body was made up of 4 humours: blood, yellow bile, black bile and phlegm. They believed that illness occurred when the humours were out of balance. They linked the humours to the seasons, characteristics and elements as well: blood, spring, hot and wet, air; yellow bile, summer, hot and dry, fire; black bile, autumn, cold and dry, earth; phlegm, winter, cold and wet, water. They treated people to re-balance the humours.
21
Q
How would a Greek doctor treat you?
A
They didn’t believe in interfering too much to restore the balance of the humours, as they believed they would restore themselves. They may help it along with laxatives and bloodletting though. Their main philosophy was one of a healthy life style (right amount of sleep, exercise, bathing etc) - preventing illness in the first place.
22
Q
Who was Hippocrates?
A
A Greek doctor. He came up with the idea of clinical observation, emphasizing the importance of studying the patient’s lifestyle, not the disease. He thought everything should be carefully recorded, then the appropriate treatment selected. He believed in natural causes of disease and cures. He formulated the theory of the four humours, and wrote many books. The Hippocratic Oath was sworn by all students at his medical school, and is still used today.Hippocrates advised against unnecessary operations, and only if the patient was likely to survive.
23
Q
What is the Hippocratic Collection?
A
A selection of books that are named after Hippocrates - he didn’t write them all!! They represent a huge step forward in medicine, as they were the first detailed record in how illnesses develop. They helped doctors for centuries in prescribing treatments.
24
Q
What operations did the Greeks perform?
A
There were some successful amputations, but only one operation was done inside the body: the draining of the lungs (a treatment for pneumonia). With no anaesthetics, other operations would be difficult to perform.
25
Who carried out medical treatment in Ancient Greece?
Doctors were very important, but expensive, and therefore only a last resort. Women and wives did most of the treatments, with old herbal remedies.
26
What result did the Greeks conquering Egypt have on medicine?
The Greek leader, Alexandria the Great, built the city of Alexandria in Egypt in 331BC. A huge university and library were built there that contained medical books from India, China, and many other places. The university attracted medical students fro hundreds of years, and dissections were allowed there, making important discoveries possible.
27
What was the Romans' attitude towards medicine?
They didn't really care much about disease; any doctors they had were mainly Greek. Many were fakes, as you could call yourself a doctor with absolutely no medical experience.
28
What treatments could you get in the Roman Empire?
Herbal remedies, often passed down through generations (modern doctors say 1/5 would have worked!); doctors, though you couldn't be sure if they had studied for years in Alexandria, or were fakes. Travelling doctors were likely to be ex-soldiers and could perform small operations. Votives were sold, which were fake body parts you could put on the altar and pray for that body part to be healed. You could also visit the market, though medicines sold there were often false.
29
What was the role of women in Roman times?
They were vital, as they performed all home treatment, and were therefore experts on herbal remedies. There were some female doctors, and many skilled midwives.
30
Why did the Romans make advances in surgery?
They needed a healthy army to conquer land, so getting soldiers fit and well again quickly suited them.
31
How did the Romans improve public health?
They realised that something in the swamps surrounding Rome was making the people ill, so they drained them. They didn't understand why though. When they built new cities, they used this knowledge to stay away from marshes etc, and checked the health of the locals to see if they could drink the water. When they had to build cities away from a water supply, they built aqueducts to carry water to them. Within cities, they had miles and miles of channels providing clean water to fountains, latrines, houses, baths, public buildings and barracks.
32
What were Roman baths like?
They had changing rooms, gyms, cold, warm and hot baths, places to be massaged and a swimming pool. The bigger ones had shops, racetracks, circuses, theatres and even a gladiator arena! They were hugely popular.
33
What wasn't so great about Roman public health?
Many people lived in small, cramped areas where disease spread quickly. Rome's sewers emptied into the river Tiber, which wasn't so good for the people further up!
34
Where did Galen come from?
He was a Greek doctor, travelling to Rome in AD162. He had been studying medicine for over 15 years, gained experience as a surgeon in a gladiator school, and had some interesting theories!
35
How did Galen make a name for himself in Rome?
He got a fat, noisy pig, and gathered some doctors. He showed them that the kidneys produce urine by pinching the pipes coming from them, and watching them swell. He also proved that nerves, which come from the brain control different parts of the body by cutting some and silencing the pig. He proved that the brain controlled the body.
36
How did Galen treat people?
He used Hippocrates' ideas of clinical observation and the theory of the four humours. He recommended opposites - e.g. if you have too much phlegm, which is cold and wet, have a pepper, as it is hot and dry.
37
What did Galen discover?
He discovered lots of new information about anatomy, but had to base his findings on the dissection of animals, as he didn't get to dissect many humans. Therefore, he made many mistakes which would be believed for many years to come. He wrote down all his ideas in over 350 books.
38
What mistakes did Galen make?
Due to basing his findings on animals, he made many mistakes which were believed for 1500 years. For example, he said the human jaw bone is two separate bones, not one; the heart was separated into two parts, each carrying different lots of blood round the body; and the left kidney was higher than the right kidney.
39
How well did Galen get on with the Church?
He got on very well, as he claimed that that everything had a definite purpose, appealing to the idea of an almighty designer. He also claimed that men had one less rib than women, fitting in with the Genesis story.
40
Why did was the life expectancy of the Anglo-Saxons so short (6 reasons)?
Bad treatments: the tribes couldn't read the books on treatments the Romans had left behind, so people would have died from small cuts. Bad diets: families grew their own food, and their diets lacked in red meat containing vital vitamins, lowering their resistance to disease. Bad housing: animals and people lived in one-roomed huts together, with no running water, meaning dysentery was common. Bad work: they worked in all weathers, every day, meaning their clothes were always wet, cuts would get dirty and infected and they would suffer from severe joint pain. Fighting: robbers, animals and other kingdoms provided a source of constant danger, where even the smallest cut could be deadly. Plague: animal plagues would kill the stock, meaning less food and clothing. Also, humans could catch diseases from them.
41
What did the Anglo-Saxons know?
They probably knew how to set bones, and some of their herbal remedies would have worked - garlic rubbed on cuts would kill some bacteria, and willow leaves used for headaches contain a painkiller.
42
How did the Anglo-Saxons treat people?
They wore charms to protect them from disease, along side herbal remedies.
43
How did the Arabs gain their medical knowledge?
They translated books by Galen, Hippocrates and other doctors, containing ideas more advanced than their own. They learnt from them, and other books they found in Africa and India.
44
Who was Rhazes?
A Muslim doctor who agreed with Hippocrates and Galen about clinical observation. He wrote over 100 books on medicine, and warned against following other people blindly.
45
Who was Ibn Sina?
A Muslim doctor who wrote a million-word book on medicine, used as a textbook until the 1600's. It contained lots of treatments for all diseases. Known as Avicenna in Europe
46
Who was Abulcasis?
A Greek medical writer who described how to do simple surgery. Muslim surgeons improved on this.
47
What kind of hospitals did the Muslim world have?
As their faith taught them to care for the sick, they had many hospitals. They were divided into wards for different illnesses, and had different departments for those who did not need to stay in. Most doctors (who had to pass an exam to get a license) treated the poor for free, but made a huge amount of money from treating the rich.
48
How did doctors in the Muslim world treat their patients?
Some used astrological charts and prayers, but usually they used careful observation, then prescribing a natural treatment.
49
When was a law passed in London that was an attempt to clean up the city? What did it say?
1372. Anyone with filth outside their house could be fined 4 shillings, and there was a ban against throwing anything out of a window. Tradesmen weren't allowed to sell off meat.
50
What are 'gong-farmers'?
Teams of people who collected dung from the streets.
51
How did a doctor in the Middle Ages diagnose an illness?
He would examine the colour of your urine, examine your blood, tongue, pulse and perhaps your poo. They believed that different colours of urine meant different things.
52
How did a doctor in the Middle Ages treat illness?
They believed in the theory of the four humours, and therefore divided up medicine into 4 parts: warming, cooling, moistening and drying. They also used herbal remedies from apothecaries, of which over 1/2 would have worked.
53
What was a barber-surgeon?
Somewhere you could visit to be bled, and was cheaper than a doctor. You could also get a haircut!
54
What were hospitals in the Middle Ages like?
They were primarily a house of religion, so patients had to attend compulsory services everyday. They varied in size greatly, and looked after the poor, as well as the sick. The patients were treated by nuns and priests, and occasionally a doctor would stop by. They often didn't take the most seriously ill, as they would stop people from praying, and take too much looking after.
55
How were lepers treated in the Middle Ages?
Leprosy was a well-known disease in the Middle Ages. It was viewed as a living death with no cure, and as a way for God to punish people for their sins. Lepers were restricted from marrying, had to were special clothes and sometimes shake a bell to warn people they were approaching. Leper hospitals were built to keep lepers away by providing a bed and a meal, but no treatment.
56
What were almshouses?
Small houses where the elderly, pregnant and weak could have stayed. A priest might have ran them, and any treatment would have been from his knowledge of herbal remedies. They were funded by the church.
57
What were monasteries, in relation to medicine in the Middle Ages?
They were the key medical centres, as they had copies of medical books from Greek and Roman times. The monks felt it was their duty to care for the sick, so they had an infirmary for monks, and an almonry where poor pilgrims, beggars and the disabled could collect food and clothes. The monks grew herbs to use in medicines.
58
When did the Black Death reach England?
1348
59
What disease was the Black Death?
Primarily, it was the bubonic plague, carried in rats on their fleas. Victims would get buboes (boils), develop a rash, and 7/10 would die. The Black Death also consisted of the pneumonic plague. Carried in the air, it attacked the lungs, making them cough up blood, spraying germs. Their lungs rotted inside them, and most victims died in a few days.
60
What did doctors in the Middle Ages think caused the Black Death?
Some thought it was a punishment from God, others thought it was corrupted air (Miasma). Others blamed the Jews, contagion and the humours.
61
When did the Black Death die out for the first time?
1353, although it returned 5 times before 1400, but not on the same scale.
62
When did the Renaissance begin?
In the 1400s
63
What caused the Renaissance (5 reasons)
New lands, new learning, artists, new weapons and the printing press.
64
How did new lands contribute to the Renaissance?
The discovery of America showed the value of finding new things, not just sticking to old ideas. New foods and medicines were also brought back.
65
How did new learning contribute to the Renaissance?
A scientific method of learning began, involving conducting experiments, collecting observations and coming to conclusions. Scholars began to question old beliefs - a vital development for medicine.
66
How did artists contribute to the Renaissance?
A desire to paint the body in more detail led artists to study the body more carefully, leading to a greater knowledge of anatomy.
67
How did new weapons (like gun powder) contribute to the Renaissance?
New wounds existed, meaning new treatments had to be developed.
68
How did the printing press contribute to the Renaissance?
It allowed ideas to be spread around quickly, and more people wanted to read. Old textbooks were rediscovered, so new knowledge was gained from them. People began to realise that their ideas were wrong, and there were better ways of doing things. They began to question things, and experiment for themselves.
69
What did Leonardo da Vinci do?
He dissected bodies to discover how they worked and to be able to draw them better. This was dangerous as dissection was forbidden. Through his work, he discovered how the eye worked, and was the first to study in detail a human embryo. His drawings were so good, they were studied by doctors before they performed operations.
70
Who was Andreas Vesalius, and what did he do?
He was born in Brussels in the 1500s. He studied medicine at Padua university, where he later became a professor. A popular teacher, Vesalius encouraged dissections. He wrote a book called 'The Fabric of the Human Body', containing detailed sketches of the human body. Vesalius proved that Galen was wrong, causing a sensation, and this provoked others into investigating more of Galen's ideas, to see if others were wrong as well. However, he was criticised greatly by the church for arguing that men and women have equal numbers of ribs, so he left Padua and became a doctor for the Emperor of Spain.
71
Why was Vesalius important?
He corrected many of Galen's mistakes that had been believed for centuries. He also showed the worth in trying to find out things for yourself, contradicting the belief Galen had found out everything there was to know. He encouraged people to test ideas for themselves.
72
Who was Ambriose Paré, and what did he do?
He was an army surgeon who treated many battlefield wounds. He discovered a new way of treating wounds. Instead of pouring boiling oil on them, he put a mixture of egg yolk and cold oil. He discovered this when he ran out of boiling oil on the battle fields. He also invented the idea of sewing up amputated limbs with silk thread, instead of cauterising them, though patients still died, due to infection. He also developed artificial limbs.
73
Who was William Harvey, and what did he do?
He was an English doctor who studied in Padua, and then return to London. He was fascinated with blood, and how it flows around the body. He discovered that the heart pumps the same blood round the body, contradicting the idea that blood is burned like a fuel, and is constantly remade in the liver. He proved this by cutting up frogs (slow heartbeat, so can see how they work), cutting up humans (to see how our bodies work), pushing wires down veins (to show there are valves in them, making blood flow around the body) and calculating how much blood is moved by each heartbeat, and how much blood is in the body. He published is findings in a book called 'On the Movements of the Heart and the Blood in Animals'. However, he couldn't explain how arteries were connected to veins - he believed it was by tiny capillaries that he couldn't see. Unfortunatley, due to this, his ideas were seen as crazy, and he lost patients. A few years after his death, with the invention of the microscope, an Italian doctor proved capillaries did exist.
74
When did the Great Plague hit London?
1655
75
What was done to stop the spread of the Plague?
Houses containing plague sufferers were sealed up for 40 days, and the door marked with a red cross and a plea to the Lord. Searchers were paid 1p to examine bodies for the cause of death. Public entertainments were stopped. Cats and dogs were caught and killed for 1p an animal. Fires were lit in the street. Bodies were buried after dark.
76
What did plague doctors wear, and why?
They wore a beak, stuffed with herbs or flowers (posies), leather gloves to avoid handling the sick, they carried a stick for prodding patients, covered their legs fully and wore a leather coat. These measures were to protect the doctor against contagion and miasma.
77
What methods of treatment were used on King Charles?
Bloodletting, laxatives, an enema, a sacred tincture (a laxative?), a gargle of barley water and syrup, spirit of human skull, half a Julep.
78
How did the medical Renaissance make giving birth easier?
Vesalius' book included the first accurate description of the female reproductive system, and da Vinci studied the human embryo for the first time, but none of this helped women give birth, as they didn't come into contact with any doctors. It wasn't until the late 1600s that men got involved in childbirth, and even then, it didn't improve much. Women were encouraged to go to a hospital, and forceps were used to free a baby's head if it was stuck. However, forceps were very dangerous if not used properly - they could severely harm the mother and the baby.
79
Who was Lady Mary Wortley Montague?
She lived in Turkey, and wrote to a friend in Britain, telling her about how the Turkish inoculated themselves against smallpox.
80
Who was Edward Jenner, and what did he do?
He was a doctor, who came up with the idea of vaccinating people against smallpox. He noticed milkmaids never caught smallpox, but they caught cowpox, a similar disease. He carried out an experiment by giving a child, James Phipps some cowpox germs, and 6 weeks later, some smallpox germs. He repeated the experiment 23 times, finding that cowpox protects people from smallpox. He self-published his findings and set up a vaccination clinic with a government grant.
81
When was the smallpox vaccination made compulsory?
1853 (book is wrong - says 1852 on pg 89, it's not!! says 1853 on pg 106, internet agrees!)
82
How was Jenner's vaccination accepted?
He faced a lot of opposition, as many people were getting lots of money from inoculation. Also, he couldn't explain how it worked, making it difficult to accept, and he didn't have a big reputation as a London doctor
83
When were germs discovered?
In 1677, with a microscope. They were first called 'animalcules', and nobody connected their existence with disease.
84
What is the theory of 'spontaneous generation'?
The idea that living things - germs, maggots, flies - could appear out of nowhere if conditions were right. This was used to explain the presence of germs in sick people's blood.
85
How did Louis Pasteur discover 'Germ Theroy'?
He was asked to find what was making a company's beetroot alcohol turn sour, and concluded it was germs (and that they had the same effect on milk and beer). He found that by gently heating the liquid, the germs died - this became known as 'pasteurisation'. He was convinced germs came from the air around him, and so set up an experiment to disprove spontaneous generation. He took 2 glass containers with long spouts, and poured liquid into them. He bent one of the spouts, so germs in the air couldn't reach the liquid, unlike the one with the straight spout. The liquid in the straight spout went off, and the liquid in the bent spout didn't, thus disproving the theory of spontaneous generation. He published his 'Germ Theory', then tested it in animals. He proved that silkworms were dying as a result of germs in the air.
86
When did Louis Pasteur publish his 'Germ Theory'
1861
87
Who was Robert Koch, and what did he do?
He was a German, interested in Pasteur's Germ Theory. He investigated anthrax, and proved germs could harm humans, as well as milk and silkworms. He grew anthrax in a Petri dish, and injected it into mice, giving them the disease. After that, he also identified the germs causing TB and cholera.
88
Who was Louis Pasteur, and what did he do?
He discovered Germ Theory. After his German rival, Robert Koch, made advancements in this field, he developed vaccines for chicken cholera, anthrax and rabies. These discoveries, along with Koch's, sparked an investigation into germs and vaccines.
89
Why were Robert Koch and Louis Pasteur rivals?
Germany had defeated France in a bitter war, making their countries rivals. French Pasteur hated Germany, and German Koch. They competed through science, and made huge advancements because of it!
90
Why was public health so bad in the nineteenth century?
Lots of towns and cities grew very fast in the first half of the nineteenth century, as many workers flocked there to get a job in one of the new factories. Therefore, lots of housing was built very quickly, in rows and back-to-back, to squeeze as many people in as possible.
91
What were conditions like in back-to-back housing?
They were all very crowded, and none of them had a toilet - just a bucket in the corner. Sometimes, there was a shared toilet for the block. Occassionally, there was a water pump to provide water, but often, the only water came from the local, filthy river. Sewage trickled down the streets and into the same river where people drank and washed from, meaning typhoid, tuberculosis and cholera were really common.
92
When did cholera arrive in Britain?
1831
93
When were the outbreaks of cholera?
1831, 1837, 1838, 1848, 1854
94
When did the government decide to do find out what living conditions and health were like for the poor in Britain?
1839
95
Who was Edwin Chadwick, and what did he do?
He conducted an inquiry into living conditions in Britain, over 2 years, for the government. He sent out doctors to most major towns and cities, who filled in questionnaires and interviewed hundreds of people.
96
When was Chadwick's report published, what was it called, and what did it show?
1842 - Report on the Sanitary Conditions of the Labouring Population of Great Britain. It highlighted the need for cleaner water and streets, and showed that the poor weren't responsible for their bad living conditions.
97
What did Chadwick conclude from his report?
Chadwick believed in miasma, and that the bad air was caused by rotting food, by damp and filth and by stuffy, overcrowded housing. He suggested a medical officer should be appointed in each district, that people can't be clean until they have clean water, the poor conditions result in a populations that dies quickly, is poor and brutal and rough. He said that the poor cost the rich in clothing and feeding orphans, and pointed out a healthier work force would be able to work harder. He told the government they needed to improve sewers, water supply and rubbish removal.
98
What were the results of Chadwick's report?
Despite 10,000 free copies being handed out to politicians, journalists, writers etc, as well as being sold to the public, the government did nothing. They thought the job of the government was to keep law and order, not meddle in the private lives of citizens, keeping them clean - an attitude known as 'laissez faire'. Also, some members of parliament made lots of money from rent in the slums, and it would cost them a fortune to tear them down and rebuild them.
99
What does 'laissez faire' mean?
A 'leave alone' attitude, had by the government in the nineteenth century. They thought the job of the government was to keep law and order, not meddle in the private lives of citizens, keeping them clean.
100
When was the first Public Health Act passed, and what did it say?
1848. A national board of health was to be created with the power to set up local health boards (committees that try to improve drainage, sewers, rubbish collections, build 'public toilets', water supplies etc) where there is a high death rate. Local boards of health can make sure new houses are built with drains and toilets, charge a local tax to pay for improvements and appoint medical officers who can inspect nuisances.
101
When did John Snow make his breakthrough?
1854
102
Who was John Snow?
He was a famous surgeon, working in Broad Street in London.
103
How did John Snow make his breakthrough, and what was it?
On Broad Street, where he worked, there were over 700 deaths due to cholera in the outbreak of 1854. Through meticulous research, he realised they all got their water from the Broad Street pump. He got permission to take the handle off this pump, and there were no more deaths in the street. He found a street toilet, 1 metre from the pump, had a cracked lining that allowed polluted water to trickle into people's drinking supply. This proved cholera was a water-borne disease, not carried through the air (miasma) as was previously thought.
104
What did the government do with John Snow's discovery?
Nothing!
105
When was the Great Stink, and what was it?
Summer, 1858. A heat wave caused the banks of the Thames to swell, making it smell very bad - so bad the government had to leave parliament.
106
What did the Great Stink inspire the government to do?
They turned to Joseph Bazalgette, who had drawn up plans for a sewer system in London, gave him £3 million and told him to start immediately!
107
When were Bazalgette's sewers finished?
1866, and cholera never returned to London!
108
When, and what, was the Sanitary Act?
1866. Towns must install a proper water supply and sewage disposal system at once. Inspectors will check this has been done.
109
When, and what, was the Housing Act?
1875. Councils have the power to pull down the worst houses in the worst areas and build better homes.
110
When, and what, was the second Public Health Act?
1875. Local councils must keep the pavements lit, paved and cleaned. Sewers must be clean, and rubbish cleared from the streets. They may increase taxes to pay for this.
111
When, and what was the Food and Drugs Act?
1875. The quality of food and medicines on sale was to be regulated.
112
When was the smallpox vaccine made compulsory?
1853
113
Why was the health of children so bad in the late nineteenth century (6 reasons)?
Overcrowding, costly doctors, wrong food, drugs, neglect, filthy housing.
114
How did overcrowding contribute to the poor health of children in the late nineteenth century?
With families of 10 or more sharing two or three rooms, diseases spread very quickly, and small children easily pick up infection.
115
How did costly doctors contribute to the poor health of children in the late nineteenth century?
There was no free medical treatment, so families still used their own homemade medicines. The expense of calling a doctor was often put off until it was too late.
116
How did wrong food contribute to the poor health of children in the late nineteenth century?
Lack of education meant that babies were often given too little, too much or the wrong food. Bread and meat were given to babies at very young ages and their stomach's couldn't cope.
117
How did drugs contribute to the poor health of children in the late nineteenth century?
Tired parents often 'doped' their babies because they couldn't cope with screaming infants who were hungry or ill. Opium could be bought in penny bottles from a chemist. Sometimes the babies never woke up.
118
How did neglect contribute to the poor health of children in the late nineteenth century?
In a period of great darkness, many babies just weren't looked after. The money spent on children was sometimes spent on beer and gin instead.
119
How did filthy housing contribute to the poor health of children in the late nineteenth century?
Ordinary men and women didn't know the value of keeping a clean house. In the 1880s, over 12,000 babies a year died of diarrhoea caused mainly by dirt.
120
When, and by who, was ether first tried?
1846, by William Moston, dentist.
121
Who first used ether in London?
J R Liston.
122
What were the disadvantages of ether?
They irritated the patients' eyes and made them cough and vomit during operations.
123
When, and who, first discovered chloroform?
1847, James Simpson.
124
How was chloroform first used, and what were the reasons for its slow acceptance?
It was originally used to relieve the pain of childbirth. It faced criticisms based on not knowing the long-term side effects, and the religious idea that it was unnatural to ease pain in childbirth. The case wasn't helped when Hannah Greener died in an operation to remove her toenail.
125
What was the reason for chloroform's acceptance?
Queen Victoria used it in the birth of her eighth child in 1857. It didn't take long for anaesthetics to be used commonly in surgery.
126
Who was the first person to apply Pasteur's germ theory to surgery, and how and when did they do it?
1867. Joseph Lister followed Pasteur's advice, and used carbolic acid in a spray can as an antiseptic. He sterilised everything before operations, and his patients stopped dying.
127
What opposition did carbolic acid face?
It irritated surgeon's hands and the patient's flesh, as well as making everything smell.
128
What happened after Lister published his findings with antiseptics?
Hospitals were cleaned up! Floors and walls were scrubbed, equipment was sterilised and surgeons started to wear masks, gloves and gowns. More complex operations were performed successfully.
129
What prevented women being doctors in the nineteenth century?
King Henry V had passed a law forbidding it.
130
When did doctors and surgeons have to take examinations for their certificates?
1815
131
When was the General Medical Act introduced, and what did it require?
1858. All qualified surgeons, doctors and apothecaries had to put their name on the General Medical Register. If you weren't on the list, you were forbidden to practise medicine.
132
Who was Elizabeth Blackwell?
The only woman on the General Medical Register when it was first introduced. She got her qualifications in America.
133
Who was Elizabeth Garret?
A woman who strove to become a doctor. She was taught privately by men (she was a woman, and couldn't go to university), and passed the Apothecaries' examination in 1865. They refused to give her a licence to practise, so she sued them and won. However, they barred the door to any other female chemists by saying they wouldn't pass any other students who studied privately. Garret became a doctor in 1869 by studying abroad. She was placed on the General Medical Register.
134
When, and how, were women finally allowed to practise medicine?
1876. Parliament passed a law, saying women shouldn't be restricted from gaining medical qualifications on the grounds of their sex.
135
Who was Florence Nightingale? What is her story? (this is a long one. sorry)
A woman, born into a wealthy family in 1820. Her parents discouraged her from being a nurse, but she went to train in Germany for 3 months in 1850. Back in England, she ran a hospital for rich women, but wasn't happy. When the Crimean war broke out, reports were sent back to Britain about the dreadful conditions in the hospitals. The man in charge of the army knew Florence, and asked her to take control of nursing the troops in the main army hospital. She took a group of 38 nurses with her, and they were horrified by the conditions. She wrote to the government, describing the conditions there, and asking for many cleaning materials. She cleaned up the hospital, and even rebuilt part of it. The death rate quickly fell from 40% to 2%. She returned to Britain a national hero, famed in newspapers as the 'Lady with the Lamp'. She decided to improve hospitals in Britain, and wrote a report to the government, telling them what to do. In 1860, her book 'Notes on Nursing' became a best seller, and she even got to visit Queen Victoria. She raised some money, and set up Britain's first nurse training school, with the aim of turning it into a respectable profession. In 1863, she published another book, 'Notes on Hospitals', introducing ideas about how they should be designed. Mistakenly, she believed in miasma, so she designed large, open space hospitals. Many people consulted her for ideas, and she became the first woman, apart from the queen, to appear of British bank notes.
136
When did the Crimean war break out?
1854, between Britain and Russia.
137
Who was Mary Seacole?
Mary Seacole was a nurse born in Jamaica, who travelled to Britain in 1805. When the Crimean War broke out, she applied to go and work there as a nurse, but was rejected. She didn't give up, and travelled out at her own expense. There, she set up a 'British Hotel' where she provided soldiers with a bed for the night and food. She sometimes went out on to the battle fields, and treated all the wounded troops, from both sides of the conflict.When she returned to Britain in 1856, she went bankrupt. However, she received some sympathy from The Times Newspaper and Punch magazine. A festival was organised for her in 1857, and she published her life story as well. When she died, she was quite well off, but no-one had made use of her nursing skills since the Crimean War.
138
How, and when, did the government discover about the poor health of young people?
In 1899, it was found only 40/100 men were fit to join the army, even by their low standards.
139
What did the government do when they found out about the poor health of children?
They set up a committee to find out why so many people were unfit to join the army. In 1904, the committee released their report, acknowledging that many men couldn't join the army because they had lead a very unhealthy childhood.
140
What changes did the report of 1904 suggest (7 things)?
Getting rid of overcrowded housing, making sure buildings are built correctly, controlling smoke pollution, ensuring regular inspections of school children, setting up day nurseries for the infants of working mothers, run by local councils, ban the sale of tobacco to children, teaching young girls how to feed and look after babies properly.
141
When was the School Meals Act, and what did it do?
1906. It allowed local councils to provide school meals, with poor children getting a free meal.
142
What did the government tell all councils in 1907?
They should have a school medical service. At first, doctors examined the children and then parents paid for treatment, but lots of parents didn't follow through as they couldn't afford it. Therefore, the government paid for school clinics to be set up, where treatment was free.
143
When was the Children and Young Person's act, and what did it state?
1908. That children are 'protected person's', and parents can be prosecuted if they neglect, or are cruel to them. Inspectors visit previously neglected children regularly, children's homes to be regularly inspected, young criminals to be kept away from older ones (youth courts and young offenders' homes), children under 14 not allowed to smoke, shopkeepers can't sell cigarettes to children under 16
144
What happened in in 1909 that improved the health of children?
Overcrowded back-to-back housing banned. This was mainly a public health measure - but certainly improved the health of the children who would have had to live in the crowded, filthy, disease-ridden slums.
145
What happened in in 1918 that improved the health of children?
Local councils were to provide health visitors, clinics for pregnant women and day nurseries.
146
What happened in in 1919 that improved the health of children?
Local councils were to build new houses for poorer families.
147
What happened in in 1930 that improved the health of children?
Huge slum clearance programme, again improving the lifestyle of the children who lived in them.
148
What happened in in 1907 that improved the health of children?
Special schools were set up to teach young women about the benefits of breast feeding, hygiene and childcare.
149
In the late 1920's, what germ still had no 'magic bullet' to kill it?
Staphylococcus.
150
How did Alexander Fleming discover penicillin?
In 1928, he was working on staphylococcus germs, and left some plates out on the bench when he went on holiday. When he returned, he noticed some mould had flown in through the window, and landed on a plate. None of the bacteria grew around it. He identified the mould as the penicillin mould. He published his findings about penicillin, concluding it was a natural antiseptic.
151
How was penicillin developed?
Howard Florey and Ernst Chain discovered Fleming's findings about penicillin, and began to investigate further. They only got a £25 grant from the government, as WWII had just started, but they still continued. They managed to produce enough to test it on 8 mice, then on one human. Unfortunately, they ran out of penicillin, and Albert Alexander died. However, the success had been noted, they just needed to work out how to mass produce it.
152
How was penicillin mass produced?
WWII played a vital role in the mass production of penicillin. Florey went to America, and they agreed to pay chemical companies to produce millions of gallons of it in large vats, as they saw the benefit of saving the lives of the soldiers. It was very successful, and after the war was over, they were able to use it with the public.
153
What was the impact of penicillin?
It was hugely successful, saving the lives of many soldiers, and allowing others to return to battle much more quickly. It is now used very successfully in the public domain, having been used to treat a variety of bacterial infections.
154
Who wrote a report near the end of WWII, outlining the problems Britain would face, and how to improve them?
Sir William Beveridge.
155
When was the NHS set up?
1948
156
Why did some people oppose the NHS?
Some doctors didn't want to come under government control. They were pacified with a promise of a salary and allowing them to treat private patients as well.
157
What was included in Beveridge's reforms after WWII?
Setting up the NHS, weekly family allowance payment to help with child care costs, benefits for the very poor, raising the school leaving age to 15, giving children a better chance of a good education and more free university places were created.
158
When were X-rays discovered?
1895, by Wilhelm Rontgen.
159
When were blood groups discovered?
1901, by Scientist Landsteiner.
160
When were blood banks developed?
1914, by Albert Hustin.
161
When was the first plastic surgery?
1940, by Archie McIndoe.
162
When was the first open-heart surgery?
1950, by William Bigelow.
163
When was DNA discovered?
1953, by James Watson and Francis Crick.
164
When was the first pacemaker fitted?
1961
165
When was the first liver transplant?
1963
166
When was the first heart transplant?
1967, by Christian Barnard.
167
When was the CAT scanner invented?
1973, by Geoff Hounsfield.
168
When was Dolly the sheep bred?
1997
169
What factors allowed medicine to improve so much in the twentieth century (6)?
Individual brilliance, science and technology, money, attitudes and government, war, communication.
170
What medical progress did WWI bring about (6 things)?
Blood transfusions, plastic surgery, broken bones (e.g. Keller-Blake Splint), infections (saline solutions), shell shock (officially recognised), X-rays (mobile, discover bullets and shrapnel wounds).
171
How did WWI hinder medicine?
Many doctors were taken away from their normal work, and lots of medical research was stopped.
172
What was the impact of WWII on medicine (8 things)?
Blood banks opened, heart surgery (removing shrapnel), plastic surgery, diet (grow own food encouraged) hygiene and disease (wanted fit nation, diphtheria immunisation, hygiene campaign), the NHS, drug development (e.g. penicillin), poverty (evacuees got better health and highlighted poverty).
173
How do we fight disease in the twenty-first century?
Drug companies invest a lot in developing new drugs and antibiotics. However, we still can't cure viral infections, so more research is done there, whilst we are educated in how to avoid diseases like AIDs. We may be able to cure diseases with gene therapy in the future.
174
What kind of surgery can we perform in the twenty-first century?
We have better anaesthetics, so we can perform longer, and more complicated operations. We have better antibiotics, so there is less chance of dying from infections. We can perform transplant surgery, and have therefore developed drugs to prevent the rejection of the organs. We can perform keyhole surgery, so we can operate through small holes, and microsurgery, so we can join together nerves and blood vessels. We can replace joints with artificial ones.
175
What is ultrasound, and how is it used in the twenty-first century?
It is high-frequency sound waves that bounce off solid objects. They are commonly used in pregnancies, identifying heart disease and checking for problems with the liver, bladder, pancreas, spleen. kidneys, uterus and ovaries.
176
What is 'alternative medicine'?
A term used to describe any other way of treating an illness that doesn't rely on mainstream, doctor-dispensed medicine.
177
What are some examples of alternative medicine (4)?
Aromatherapy (inhaling scents of oils, or massaging them into your skin), acupuncture (fine needles placed at key points throughout the body, releasing blocked energy), homeopathy (taking medicines which cause similar symptoms to the ones they are experiencing) and hypnotherapy (relieving patients of stress, allergies and even addictions).
178
What do we do about positive health?
This is prevention, rather than cure. We recognise the importance of exersise, a good diet and misuse of drugs. There is also an increase in screening procedures, aiming to catch serious diseases like cancer when they are in their early stages.
179
How many of our medical advances are experienced by people all over the world?
Not many. People living in LEDCs often find they are malnourished, aren't immunised against dangerous diseases and have a lower life expectancy.
180
What factors can cause change in medicine (7)?
Science and technology, chance, war, individual brilliance, religion, governments and communications.
