still live as they did
in prehistoric times
What did they die from?
pregnancy + childbirth
famine and food shortages
The people were hunter
gatherers (living nomadic
lives) until 10,000 BC and
Trephining (cutting holes in
people's heads) to release evil
spirits. Skulls found show that
people survived the operation as
the bone continued to grow
Women were in
+ knew about
healing power of
they had range of
bones in mud and
leaves, like a cast.
herbs and honey
for sore throats
Medicine Men dealt with evil spirits
causing disease by praying and using charms.
Evil spirits, witches, spirits of the dead etc.
Lucky charms kept away evil spirits
Society - agricultural
civilisation around River
Nile. Every year the Nile
floods fertilised the
fields and the river
provided water for
Natural Beliefs and treatments
Like the Nile, the body was full of
channels. Sickness was caused by the
blockage of one of your body's
channels. Purging, vomiting and
blood-letting was used to unblock the
Diet was important. Doctors
recommended certain foods to
Hygiene - cleanliness was valued.
They bathed, shaved their heads, had
toilets, changed clothes etc.
Trained specialist doctors
observed their patient's
and recognised the
symptoms. Wrote down
symptoms and treatments.
Supernatural beliefs and treatments
Gods could cause and cause
disease. Priests recorded
treatments and spells.
Some drugs (e.g. opium)
are used today. They were
probably thought of as
driving away evil.
Mummification - Body was needed
in the afterlife, so they were
preserved through mummification.
Experimental dissection not allowed as
believed that destroying someone's body
meant they wouldn't go to the afterlife. This
limited the amount of knowledge gained
(knew about the main organs but not about
Removed soft organs (e.g. brain and
intestines) - dried what remained
with salt - knowledge of anatomy.
Background - used slaves
so had time to educate
themselves, war wounds
needed treatments and
helped doctors learn
about anatomy, wealthy
people employed doctors.
Natural beliefs and treatments
Theory of 4 Humours
The body is made up of 4 humours which
are like dot the 4 seasons and the 4
elements. They need to be in balance for
good health. If you are sick, it is because
your humours are unbalanced.
Treatments aimed at brining
humours back into balance
Believed in natural
causes of disease and
Hippocratic Oath - promised
made by doctors to obey rules of
behaviour in professional lives.
Still happens today!
Hippocratic Corpus - a
collection of medical books
written by Hippocrates
containing symptoms and
recording - 'clinical
observations to help
Hygiene was important
Healthy diet - many
followed a diet that
changed with the seasons -
eating lots in winter +
drinking little, and in
summer drinking more +
Supernatural beliefs and treatments
Asclepois (the Greek God of Healing)
Asclepions were temples
where ill people went.
Visitors bathed, released
and prayed to Asclepios.
Priests performed rituals
which involved placing
snakes on the patient.
The library of Alexandria
attempted to collect all the
knowledge of the world. Unlike
the rest of Greece, human
dissection was allowed.
Alexandria became famous for
training medics and surgeons.
differences between arteries,
veins and nerves.
Advanced slightly, but still risky (a
Good techniques for setting broken
bones and amputations.
Range of surgical instruments from
iron, steel and brass.
Romans were very
wealthy. People of
were taxed. Slave
Bad smells, unclean drinking water,
sewage, swamps and dirt made people sick
Aqueducts carried clean water into cities
Public baths, toilets, sewers
Ideas of public health spread through empire
Developed on Theory of 4 Humours
with Theory of Opposites
had to be
opposite to the
Brain, not heart, controls speech
Arteries, as well as veins,
carry blood through body
Animal's anatomy different
he only used
Said holes in septum of
heart to let blood pass
from right to left side
Believed blood was
consumed not circulated
rare (as still
Beliefs and treatments
Not as interested as Greeks
in developing theories on
causes of disease.
Doctors too expensive for most. Head of family
expected to look after household (using herbal
Wars destroyed Roman public health system
+ medical libraries. Rulers of small kingdoms
built up armies rather than improving
medical skills/public health. War disrupted
trade, so countries became poorer. Travel
become dangerous, reducing communication
between doctors. Training of doctors
abandoned, Galen's books lost/ hidden for
LATER... church set up
universities where doctors were
trained. Armies took trained
doctors to war where they gained
experience as surgeons. Rulers
cleaned up towns. Merchants and
scholars travelled around Europe,
Influence of Christian Church
Church grew stronger.
education, priests and
monks only people who
could read. Church opened
medical schools where
Galen's ideas were taught.
Only libraries were in
manned book they
disapproved of. Monasteries
provided clean water and
Medical care for poor - hospitals
sets up by monasteries, provided
'hospitality for visitors.'
Genuinely ill turned away -
fear of spreading disease.
Return of Hippocrates
Galen's ideas rediscovered. Church look at Galen's
works and decided what fitted with Christian ideas
(e.g of a 'Creator'). Doctors believed he was correct
and was impossible to improve his work.
Medical schools in Western Europe where
translations of Galen's and Hippocrates'
work accepted as absolute truth.
4 Humours - still believed by doctors.
Theory developed into more complex
system using position of stars. Human
dissection carried out in medical
schools, findings were interpreted as
theory of 4 humours - but later doctors
challenged traditional theories
Islamic scholars picked up and
developed Greek ideas. 4 Humours,
treatment of opposites and clinical
observation lived on.
Books brought together
ideas of Galen and
Attitude of Muslims towards
Koran meant they were unwilling
to criticise Galen
More schools, human
dissection allowed. Doubts
about classical texts.
New techniques -
diagnosis by urine sample
Stars caused disease - used
astrology to decide treatments
expensive, most treated
by monks and
Warfare caused a big demand for surgery. Wine
used as antiseptic, surgical treatments were simple
and major surgery risky.
Black Death - 1348
Spread by coughs sneezes,
black rat flea bites (rates
carried overseas by ships).
Supernatural beliefs + treatments -
Church believed illness was
punishment for sins (prayed to God).
Pilgrimages to holy shrines to cure
illness. Doctors had superstitious
beliefs, saying magical words and
cesspits, wells, waste
disposed of in streets,
drank beer not water etc.
close study of
classic texts +
being critical of
greater interest on how
human body worked
(observation + dissection)
return of classical
faith in 4 Humours
+ Opposites theory
Vesalius - Anatomy
Studied anatomy, became
professor of surgery and
anatomy. Did dissections +
wrote books based on his
observations using accurate
diagrams. 1543 - wrote 'On The
Fabric of the Human Body.'
Pointed out Galen's mistakes by proving...
No holes in septum of heart
Jaw bone one
bone, not two
Paré - Surgery
Battlefield surgeon, in battle
he ran out of boiling oil (used
to treat gunshot wounds) so
made an ointment of roses,
turpentine + egg yolk.
ligatures to seal
Disproves Galen by proving the bezoar
stone ins't a treatment for poison
Harvey - circulation of blood
Disproves Galen by
circulation of blood
between arteries + veins
Black Death 1665
Worst appearance. Death toll = 100 000
To control spread households locked
in + red crosses painted on doors
Carts organised by police roamed city
collecting corpses for mass burial
People realised disease was contagious,
but not that germs caused it
Many wars which took
Increasing urban population -
strain on clean water supplies
+ sewage systems
Printing Press - ideas spread
Weakening power of Church -
no religious beliefs on causes of
disease -> looked for natural
causes + could dissect
Renewed interest in Ancient learning
- people wanted to learn how to read,
challenged old medical ideas
Artists drawing from life -
medical drawings drawn + shared
1750 - 1900
Why did they stop reading Galen in 19c?
of body and Galen's
4 Humours not accepted.
People initially thought
miasma caused disease.
Doctors did dissections +
used microscopes. Galen's
books not important.
Smallpox + Edward Jenner
In 18c, small pox was a big killer.
People immunised against
smallpox using pus from sores of
a sufferer. But sometimes led to
Country doctors, heard that
milkmaids didn't get smallpox, instead
milder cowpox. Discovered that people
who had cowpox didn't get small pox.
1796 - inoculated small boy with pus
from sores of cowpox sufferer. Then
injected James with smallpox, James
didn't catch the disease!
Jenner could't scientifically explain who it
worked. Inoculators afraid of losing money.
Worried about side effects (e.g cowpox).
Church believed vaccination wasn't natural.
Developments in nursing
Mary Seacole - poor Jamaican
background. Volunteers to be
nurse in Crimean war, is rejected
but does anyway self-financing
journey. Nursed soldiers on
battlefields and built 'British
Hotel.' Goes bankrupt when
returns to UK - receives support
due to press interest in story +
Florence Nightingale - Brought discipline +
professionalism to a job with bad
reputation. Wealthy background, became
nurse despite family opposing. Went to
Crimean War to sort out nursing care in
English camp. Improved death rates, due
to improvements in ward hygiene.
Returned home + wrote book 'Notes on
Nursing' + sets up hospital in London.
How did scientists discover the causes of disease?
Louis Pasteur's Germ Theory (1857) -
Scientists thought microbes were caused
by disease + appeared because of illness
(spontaneous generation). Instead of
blaming microbes, people looked for
miasmas. Pasteur proved that there are
germs in the air by sterilising water and
keeping it in a flask that didn't allow
airborne particles to enter. This stayed
sterile - but sterilised water kept in an
open flask bred microbes.
Robert Koch - German scientist.
Linked diseases to the specific
microbe. Developed dying
techniques to colour microbes,
which he viewed through
microscopes. Identified anthrax
spores and bacteria causing
septicaemia, tuberculosis + cholera.
Pasteur - Chicken Cholera Vaccine - Hearing of Koch's
work Pasteur decided to find new microbes and
combat them. Looked for cures to anthrax + chicken
cholera. Chamberland (worked for Pasteur) was
supposed to inject chickens with chicken cholera but
forgot. Left germs and injected them when he
returned from holiday. Chickens survived, and
survived when new germs were injected. Cholera was
weakened by being left out and had made the
Pasteur - Anthrax
vaccine - Produced
of anthrax spore
that would make
Overcoming the problems of surgery
Surgery in the 18000s
was dangerous + painful.
Pain - die of shock
How was the problem of pain
In 1800, surgeons would ease
suffering of patients by getting the
drunk, knocking them out, opium etc.
Nitrous Oxide - 'laughing gas'
discovered by Sir Humphrey Davy.
Ether - used by J.R. Listen
during leg amputation.
Unpleasant side effects.
Chloroform - used by James
Simpson + friends at home. Realised
it could be used during surgery. But,
led to unexplained deaths. Dosage
Opposition - uncomfortable for patients,
pain good of healing, didn't understand
how they worked or side effects, pain from
God, encouraged riskier operations
Final acceptance - Queen Vic used
chloroform in delivery of 8th child
How was the problem of infection overcome?
Until Germ Theory in
1850s, surgeons didn't take
precautions to protect
open wounds (reused
bandages, didn't wash
hands, didn't sterilise
surgical equipment etc.)
Joseph Lister + the discovery of antiseptics -
He heard that carbolic spray was used on
sewage + knew sewage had similar smell to
gangrene. Read Pasteur's germ theory.
Prepared to take risks.
Lister's methods slowed down surgery
Spray was uncomfortable for doctors to use (affected skin)
Germ theory not widely accepted in 1857
Surgeons didn't copy methods correctly so were disappointed with results
Final development of ASEPTIC surgery - by late
1890s Listers methods led to aseptic surgery
(removal of all possible germs form theatres to
ensure absolute cleanliness).
Operating theatres + hospitals rigorously cleaned
All surgical instruments steam sterilised
Sterilised rubber gloves first used and surgeon's hands scrubbed
How was the problem of
blood loss overcome?
Once William Harvey
circulation of blood, the
first blood transfusions
Early blood transfusions were
often disastrous because....
Developments in Public Health
Public Health Problems in early 1800s - conditions in British towns
became increasingly worse. Crowded towns + cities due to industrial
revolution. Towns couldn't cope with providing water + sewage to more
people. In squalid conditions, disease spread rapidly.
Battle to improve public health - some thought government should force local councils
to clean up towns. But, many believed in 'laissez-faire' attitude + that government should
allow local areas to control its own affairs.
Edwin Chadwick - 1842 - asked by government to report on living conditions in towns. Concluded that
poverty was caused by ill health which was caused by terrible living conditions. Said in 'Report on the
Sanitary Conditions of the Labouring Population' that towns should 1) organise drainage + refuse
collection. 2) provide water supply. 3) appoint medical officer of health.
1848 Public Health Act - outbreak of cholera put pressure on government to pass Public Health Act. Not compulsory.
Government set up Board of Health to encourage local authorities to improve conditions. Gave them money to make
improvements, but only a few local authorities took new measures. 1854 - Board of Health abandoned
1853 John Snow - proved there was a link between cholera + water supply. Used research, observation + door-to-door
interviews to build a detailed map of cholera epidemic in Broad Street. Nearly all deaths had taken place within short
distance from water pump. Near to pump, there was a brewery and none of the people had cholera because the brewery
had its own water pump. So they didn't use the Broad Street Pump. Snow removed the handle + there were no more deaths.
Later came to light that ta cesspit near the pump had cracked, leaking into the water supply. Put pressure on water
companies to clean up their water supplies.
1858 Great Stink - The hot weather caused the human waste in the River Thames to stink. Putrid smell right under Parliament's nose, they considered moving and
had to coat curtains with deodorant to get rid of smell. Great Stink prompted Parliament to sort out London's sewage + drainage system + to clean up Thames.
1867 Second Reform Act -
working class men given vote.
MPs wanted to win support of
working class so improved
living conditions of poor.
1875 Second Public Health Act - Forced local authorities to 1) provide clean water 2) provide
drainage + sewage 3) appoint Medical Officer of Health. But why was it introduced?
Results of the Public Health Act of 1875 -
improved standards of living, stopped
pollution of rivers form which people got
water, shortened working hours in
factories for women + children, made it
illegal to add ingredients that made food
unhealthy, made education compulsory.
What medical progress did WW1 bring about?
Surgeons experimented with new techniques
(developed new ways to repair broken bones +
perform skin grafts -plastic surgery).
Soliders promised good housing upon
return. So got rid of unhealthy slum housing.
Surgery of eye, ear, nose + throat
improve rapidly (incl. brain surgery).
Development of X-rays - first discovered 20 years
before WW1. Hospitals installed X-ray machines, but
WW1 confirmed their importance. More were
manufactured to meet demand, installed in hospitals
along Western Front. Immediately improved success
rate of surgeons removing bullets which could have
caused fatal infections.
Blood transfusions - in Renaissance, Harvey proved blood
circulates,e ncnoruaging transfusions, which sometimes
worked + sometimes failed. Blood groups were discovered in
1901 which made transfusions more successful. During WW1
vast amounts of blood was needed. The search of better
method of storage + transfusion was needed. Doctors
discovered how blood can be bottled, packed in ice + stored
1) Fleming discovered mould killed germs.
Writes articles. 2) Florey + Chain begin
research after reading article by Fleming. 3)
Penicillin first tested on human in Oxford. 4)
U.S. + Britain fund production of penicillin. 5)
Enough penicillin produced to treat all allied
forces wounded on D-Day.
How was it discovered? - 1928, Fleming left a
petri dish o bacteria, it had gone mouldy + the
mould had killed the bacteria. Chance.
How was it developed?
1930s, Florey + Chain became interested in
Fleming's paper. 1939, gathered research team +
asked UK Gov to fund team's research into
penicillin. UK firms too busy with war effort to mass
produce - so went to US. US Gov helped by giving
interest free loans. By 1944 mass production was
sufficient for needs of military medics. Fleming,
Florey + Chain given Nobel Prize in 1945.
Government - UK Gov
funded Florey's research, U.S.
Gov funded mass production
Tech - microscopes
Individuals + Chance
War - growing casualties
of WW2 added urgency
to mass produce
Impact of WW2
Blood transfusion - blood could be
stored for longer, civilians donated blood
Diet - rationing improved some people's
diet, government encouraged healthy
Drugs - penicillin developed
as first antibiotic
Poverty - evacuation took children
out of urban areas, highlighted
contrast between rich + poor
Surgery - development in use of
skin grafts + treatment of burns
Hygiene - government posters educating
people about health + hygiene
National Health Service
Influence of WW2
Broke down social distinctions.
Raising armies made powerful
people take notice of health
problems of poor. Evacuation of
children increased awareness of
poor. After WW2 people wanted to
Introduction of NHS
Beveridge Report in 1942 called
for state provision of social
security. Aneurin Behave was
Labour Minister for Helath who
introduced NHS. National
Insurance introduced to pay for
Stills has few problems... Government
reduced how much of NHS free (i.e.
charging for prescriptions). Long
waiting lists + doubts of quality of
treatment mean some go outside NHS.
Longer life expectancies mean more
care for elderly + increased costs for