History- Medicine – Flashcards

You would become sick if one of the four humours were unbalanced

There was no big change in medicine and treatment in the Middle Ages. The buildings built by the Romans went to ruins as no one looked after them. This affected hygiene but not ideas about the causes and treatment of disease. The only impact the Romans had on Britain was Galen's theory of the Opposites. Further treatment was still based on herbs and plant remedies. The treatments that worked were remembered but with no medical understanding of why they worked. Remedies were passed down through the family and knowledge of plants and herbs was written in the Leechbook of Bald (Bald the person who owned the book.) Written like a recipes, written in latin =, therefore the uneducated could not be helped , there was no printing therefore there was no mass produced and it was all individually produced. After the romans leaving, Illness got worse as Roman central collapsed, there were no real breakthroughs due to still believing in miasma.

No treatment other than herbal remedies Bad public health Age was young when people died

Other theories of how the black death occurred Stagnant water Looking at someone who is sick Astrology Bad children Earthquakes Imbalance of the four humours Bad digestion (linked with four humours) Other theories of how the black death occurred

Observe a physician dissect a body whilst a priest preached Galen No women were allowed to become doctors even though women did most of the village treatment until 1876 Due to lack of training some doctors would fail and there treatments would not work due to lack of treating an actual human body -source in 1864 therefore it shows how bad medicine was in that time period There were codes of behaviour for doctors that developed through Europe in the period after AD 1000 Trainee doctors did not do human dissections in their training rather, they would observe a physician's assistant do the dissection whilst the well trained physician read Galen to the students, this would happen once a year Training doctors normally read books like Bald's Leechbook (circa 900) Salerno within Italy first university ever that taught medicine Learning was based around the work of Greek physicians such as Hippocrates, 460 BC- 377 BC and Galen born in 130

In Europe in the Middle Ages there were some Jews and Muslims, but most people were Christians and followed the teachings of the Catholic Church. Religion was a very important part of people's lives because it provided explanations for so much that happened. Religion told them that certain things happened because God was displeased with them, or because God was testing them to see if they stayed faithful even when bad things happened. The idea that the plague was a punishment or a test from God meant that groups called flagellants walked in procession to the church, whipping themselves, to show God how sorry they were and to ask for his mercy. People may go to a priest rather than a doctor for many reasons, one being financially physicians could be very expensive, people believed there was most likely no scientific reason by more religious or spiritual therefore if they went to a church they might be more likely to be treated or cured. The spread was more in towns and cities because the population was more cramped and condensed whereas in the countryside the population is more sparsely situated. People continued to followed the priests and doctors theories and treatment even after so many people died because it was a sense of false hope and God might stop if they did spiritual intervention and hopefully you will be forgiven of your sins

Changes in religion known as the Reformation (Henry vIII divorced Anne Boleyn - break from catholic church this caused the authority which the church had as some people became protestant rather than catholic) , led to a decline in the Church's authority, even though most people remained strongly religious. People finally going against the church and physicians such as Galen Printers were beginning to be invented therefore more of the church's ideas were being challenged as scriptures were beginning to be found in places other than the monasteries. A new attitude began to spread. Instead of relying on the views of an accepted authority, educated people wanted to check knowledge for themselves. This led to a scientific approach of testing and recording details, then sharing these results with other people. 1543: Andreas Vesalius, a Belgian professor of Surgery, publishes "the Fabric of the Human Body" (De Fabrica Corporis") Realism (art movement) was part of his books He stole bodies to be able to study them He questioned and disproved Galen He did his own dissections Before him people did not question the work of Galen and other ancient authors. They thought this work was complete and contained everything they needed to know. There was a need to find out more about anatomy through dissection. After him people realised Galen had made serious mistakes because he relied on animal dissection. Vesalius insisted that students dissect human bodies and constantly challenge Galen's ideas Showed the septum does not have holes Showed the liver did not have separate parts Showed it was true for monkeys and pigs but human lower jaw only a single bone N Showed sternum had 3 parts.

Printing press - Massive development 1400 The invention of the printing press in Germany in the mid - 15th century meant that printed copies of works such as those by Vesalius which described plants and herbs used in medicine could be produced quickly and cheaply. This was a significant development because work could be published in English and not just Latin (more could access information). Furthermore, the control the church had on medical knowledge decreased because books were no longer solely written by monks.

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What did he do? He taught that disease was caused through atmosphere (miasma). He was among the first to describe scarlet fever—differentiating it from measles and naming it. Was one of the first to use iron in treating iron-deficiency anemia. He made a link between fleas and typhus, he made these links by observing and recording. How did his work show progress in medicine? He said that doctors should see the patients rather than the patient to see the doctor How did his work show a continuity in medicine? He still encouraged bloodletting, and he didn't agree with William Harvey's theory of circulation.

The Growth of cities and towns in the Renaissance period In the Renaissance period, some cities and towns became very large and in these conditions, infectious diseases were difficult to control. During an epidemic, local authorities often ordered a cleanup and might order barrels of tar to be burned in the streets to purify the air. (Tar would not help, this would not help the plague- this was not helpful as "miasma" was not the actual cause of plague) while the king and central government might order a day of prayer. However, these measures would have little effect. More information about the Plague Plague had been around in England for centuries but in 1665 the so-called Great Plague hit the country - though it was Stuart London that took the worst of the plague. The plague was only finally brought under control in 1666 when the Great Fire of London burned down the areas most affected by plague - the city slums inhabited by the poor. Other difficulties which were tied in with the plague (impact and prevention) 1665 had experienced a very hot summer. London's population had continued to grow and many lived in squalor and poverty. The only way people had to get rid of rubbish was to throw it out into the streets. This would include normal household waste as well as human waste. As a result, London was filthy. But this was a perfect breeding place for rats. A popular belief during the plague was that the disease was caused by dogs and cats. This was not so. The plague was caused by disease-carrying fleas carried on the bodies of rats. A pair of rats in the perfect environment could breed many offspring. The filth found in the streets of London provided the perfect environment for rats The first victims of the plague were found in the poorer districts of the city. The cramped living conditions these people lived in, and the fact that so many actually lived in the slum areas of London, meant that many people could not avoid contact with either the rats or someone who had the disease. More information about the plague The Great Plague killed an estimated 100,000 people, about 15% of London's population This put a lot of pressure on the town authorities and laws were passed to stop the plague spreading. The government tried to make laws Fires should be made in moveable pans and used at all public meetings because the fumes will help correct the air No stranger was allowed to enter or leave a town unless they had a certificate of health (which cost money). No furniture was to be removed from an infected house No dogs, cats or pigeons should be permitted to move down the streets or from house to house Each town and city should provide a convenient place remote from the centre of the town. A pest-house should be made to be ready in case any infection should break out If any house is infected the sick person should be moved to the pest-house to keep the rest of the family safe. The house should be shut for 40 days and have a red cross painted on the door. Why were fires put in the street? Some people fumigated the street with the smoke, this links with getting rid of miasma. What was the problem with certificates of health? Certificates of health costed a lot of money, therefore some people could not afford this due to the poverty in which they were living in. The poor would not be able to escape their situation because they could not flee, the main negative thing about the certificates of health was that only a small amount of people could afford them because they were living in the slums. The main people that required the certificates of health could not afford them.

Were people healthier by 1750? Even though discoveries from that of Vesalius and Harvey were a crucial part of medical history, they didn't actually increase the life expectancy of people much and they didn't make anyone healthier at the time. The work of Ambroise Pare was a lot more useful than that of Harvey and Vesalius, however his idea of using a ligature to seal the wounds caused infection in the soldier's wounds as more germs were present. The cauterising process that was previously used helped stop infection within the wound. It wasn't until 300 years later that Pares ideas could be used effectively as they introduced antiseptic. It was most likely a different medical development that had the greatest impact on treatment. This was when Europeans arrived in America in 1492. Over the next two centuries, they bought back a wide range of plants such as the bark of the cinchona tree which were used in many effective herbal remedies.

The training of doctors and healers after the Medical Renaissance Licensed Healers Physician - Studied for 14 years at university, He would know the work of Galen very well, They would charge large fees, Used by richer people, Lords and Ladies Apothecary -Sold and mixed medicines that had been prescribed by physicians, Smaller fees, were not allowed to prescribe nor treat, Used by desperate poorer people, or people who could afford to be prescribed things by a physician Surgeon- Long apprenticeships, given licenses by the local bishop, looked down by doctors as they were known as "second class doctors" Middle class people Midwife. Licensed by the local bishop, female, if there were complications they would be forced to hand their patients over to a physician. Richer women, some poorer ladies Unlicensed Healers Family, The first person people would go to was normally a wife or a mother of the patient Most poorer/middle class local people Wise woman- Herbal treatment, passed down from generations, usually called a witch, several in each town Poorer people Lady Of the manor- Girls from wealthier families were expected to learn basic treatments, studied from books Family, servants, people who provide the richer families with their produce Travelling quack - where someone could do something such as a tooth- puller, some were genuine and built up knowledge but some just robbed the patient. Poorer people

In 1861, Louis Pasteur was the first to discover germs - the cause of disease. (The germ theory) Before he made his discovery, doctors had noticed bacteria, but they believed it was disease that caused the bacteria. (Spontaneous generation) He developed the earliest vaccines against fowl cholera, anthrax and rabies. He realised weakened strains of a disease could help animals develop immunity Louis Pasteur discovered pasteurisation, it's named after him. He proved that microorganisms turned liquid sour, he then proved that microorganisms couldn't grow if the liquids were boiled. (Pasteurisation) He showed people that microorganisms didn't appear out of thin air but transferred from one medium to another. He made his discovery about germs by sterilising some water and putting it in a swan-neck flask to stop any air getting to it - after some time this water stayed pure and germ free. Louis Pasteur was very important because he was the first person to actually find the cause of disease and without finding the cause of illness people wouldn't have been able to treat patients. He opened a door to a new part of medicine nobody had ever discovered. He's more important than others because most people's research about new ideas, treatments or vaccinations would play off his. He disproved the idea of misama which had been around for thousands of years.

She was a nurse in the Crimean war who treated and saved lives of many soldiers. She was born in 1820 and died in 1910. She made hospitals cleaner and showed nurses how to keep them clean. She was the founder of modern nursing. Florence went to Turkey with 34 nurses. Extremely dirty. Overcrowded. Smell was terrible. Not enough beds. Rats everywhere. Mouldy bread. Meat like leather. No proper toilets. Drains were blocked She worked 20 hours a day. Went to town to get fresh food. Cleaned the kitchen. Hired workmen to clean the drains Chef came in to cook better meals.Hospital was overall cleaner.

Born in Edinburgh, Scotland on June 7th 1811 and died 6th May in Edinburgh Qualified as a doctor at the age of 2 As a student he witnessed surgery and horrified by the pain the patient had felt so he changed to being a midwife Became professor of midwifery at Edinburgh in 1840 Started using chloroform (anaesthetic) on the 19th January 1847 but disliked the strong smell chloroform used for childbirth and surgical operations On the advice of Dr Waldie of Liverpool he started experimenting with chloroform Chloroform got royal approval when Queen Victoria got given it at the birth of Leopold by John Snow In 1870s 1 out of 2500 patients died of chloroform He wrote articles and other surgeons started to use it in their operations

Born In 1825 His father was a wine merchant and amateur scientist. He attended the University Of London Graduated As A Doctor In 1850 He soon realised that it was not the surgery that killed people but the infections that came afterwards. He invented sterilisation methods during surgery which lowered the death rate from surgery infections from 80% to just over 0%. He also invented a spray to rid the air of airborne germs. He became President of The Royal Society and Vice President of the Royal College of Surgeons. He was also the queen's surgeon for many years and in 1883 was Knighted by Queen Victoria. He retired from Medicine in 1893 and passed away in 1912 aged 84.

Development of the first magic bullets (chemicals developed to attack different types of) bacteria, and Koch was awarded a Nobel Prize in 1905. Koch developed a new experimental method to test whether a particular micro - organisms (specific bacteria) was the cause of disease. Building on pasteur's work on germ theory, Koch used experiments to prove that the bacterium did cause the diseases. In his time with medicine he also invented his own theory called the Koch Postulates. He won many awards for his work in microbiology including becoming a foreign member of the Royal Society in London and also one the medical Nobel Prize in 1904, he lived between 1843-1910. Robert Koch is considered as a major factor towards the treatment of infectious diseases, due to his role in the identification of specific causative agents for diseases such as Anthrax, Tuberculosis and Cholera, and for creating experimental support for the concept of infectious diseases. He used Pasteur's work to build up a concept that certain bacteria caused these diseases, and developed 'Magic Bullets', which were chemicals designed to attack and destroy these certain bacteria. As well as this, Koch worked on laboratory technologies and techniques used in the field of Microbiology, and made key discoveries in Public Health. This research led to the creation of Koch's postulates, a series of 4 principles linking certain bacteria to their specific diseases, which remain today as the 'Gold Standard' in Microbiology. Robert Koch had a major impact on the treatment of diseases, due to his discovery of the causation between certain bacteria and diseases such as TB, Cholera and Anthrax. His "Magic Bullets" helped to treat these diseases, using chemicals designed specifically to attack them. His impact was affected hugely by the work of Louis Pasteur, who proved that Bacteria as a whole was the cause of disease and Infection. As Well as this, Koch's Postulates form the experimental basis for all study of infectious disease, whether it be in plants, humans or animals. Koch also provided the fundamentals for Microscopic Pathology, which were used frequently in the study of pathogens over the next century. In 1904 he became a foreign member of the Royal society(award In 1904 he won the nobel prize for medicine due to his amazing work in developing his theories He also one another more general Nobel prize in 1905 To this day he has statue in Berlin out of respect for his work Many people say the reason he was so good is due to the wide range of things he helped with, from Laboratory work to public health improvements

In 1854 there was another outbreak of cholera in London, and Dr John Snow used it to investigate his theory that cholera was spread through infected water He marked on a map all the deaths in one area, and there was a clear concentration of deaths around the water pump on Broad Street Snow had the handle of that pump removed so that water could not be collected and the number of deaths fell dramatically Parliament slowly became convinced that it should take action to improve public health: Snow's work seemed to prove there was a link between water and cholera Pasteur's germ theory showed how disease spread and why hygiene was important Snow also showed that death rates varied according to the water sources used by different water companies The government started collecting statistics on births, marriages and deaths; William Farr studied these and showed that the death rates were much higher in the towns and the cities than in villages Snow was allowed to remove the handle of the water pump in Broad street, there were no more deaths

Edward Jenner was born in 1749 in the small village of Berkeley in Gloucestershire. From an early age Jenner was a keen observer of nature and after nine years as a surgeon's apprentice he went to St George's Hospital, London to study anatomy and surgery under the surgeon John Hunter. After completing his studies, he returned to Berkeley to set up a medical practice where he stayed until his death in 1823 Jenner worked in a rural community and most of his patients were farmers or worked on farms with cattle. In the 18th century Smallpox was a very common disease and was a major cause of death. The main treatment of smallpox brought to England in 1721 from Turkey by Lady Mary This treatment involved inoculating healthy people with a mild case of the disease, but this often had fatal results In 1788 an epidemic of smallpox hit Gloucestershire and during this outbreak Jenner observed that those of his patients who worked with cattle and had come in contact with the much milder disease called cowpox never came down with smallpox. Jenner needed a way of showing that his theory actually worked Jenner was given the opportunity on the 14 May 1796, when a patient came to see him with sores on her hands like blisters. Jenner identified that she had caught cowpox from the cows she handled each day. He carefully extracted some liquid from her sores and then took some liquid from the sores of a patient with mild smallpox. Jenner believed that if he could inject someone with cowpox, the germs from the cowpox would make the body able to defend itself against the dangerous smallpox germs which he would inject later. Jenner approached a local farmer called Phipps and asked him if he could inoculate his son James against smallpox In 1798 after carrying out further successful tests, he published his findings: An Inquiry into the Causes and Effects of the Variolae Vaccinae, a Disease Known by the Name of Cowpox. Jenner called his idea " vaccination" from the word vaccinia which is Latin for cowpox. Jenner found many people did not like his ideas and made fun of it

Laissez-Faire: Attitude that the government should keep out of people's lives They believed the government should allow each local area to control its own affairs Usually meant letting local ratepayers make all the decisions Didn't want the government to force them to pay for improvements to their town The dirty party: These Laissez-Faire people were nicknamed 'the dirty party' by opponents The battle between local authorities and the government played a central part in the story of public health in the 19th century Britain

Average age of death in 1842 Type of people Leeds (town area) Rutlandshire (country area) Professional persons, gentry and their families 44 52 Farmers, tradesmen and their families 27 41 Cholera statement: Lots of people infected, lots of people died, ../ lots of widowers, lots of orphans under 12 and a lot of subscriptions received East London drank out of the Thames, sewers go into the Thames - dirty water causing diseases Cholera is a waterborne disease People in East London refused to pay taxes because the tax was paying for water that wasn't clean Industrial period, lots of people living on backstreets

Midwifery Nursing No real importance No vote

Worked for government and poor law society ( a law that helped the poor in 1815). Made a report in 1842. Disease is caused by filth, miasma, cramped living conditions and poor ventilation according to Chadwick. His discussed how poorer people became ill more because of the cramped living conditions. To improve these conditions and prevent disease Chadwick stated that the government should improve ventilation and drainage system. Also he asked for a medical officer to control illness. The government were not willing to do what Chadwick suggested because it was going to cost local taxpayers money. Alienate the classes who have to pay the building. If the government get rid of the back to back housing lots of people would be homeless and the government would have to force the local councils to pay out. He justifies his argument by addressing living conditions would be a long term investment because it will save the government money as they would not have to pay medical bills or funeral expenses. The board of health was something set up by the government to inspect conditions and if they are not good enough, make the pay for improvements. The government listened to Chadwick's suggestions but it was unpopular. Chadwick's were recognised by the people and the government but it was adopted half heartedly. In 1842, Edwin Chadwick published a 'Report on the Sanitary Condition of the Labouring population of Great Britain'. His revolutionary idea was that improved health provision and a healthy workforce would save money rather than cost money

Apothecaries began to move away from using herbs to cure illnesses Instead like the one you just saw, they began to work out of shops that would sell 'preparations' which they felt would cure any illness Ingredients were made into a paste and shaped by HAND into pills Rich people could buy gold and silver coloured pills In 1844 WILLIAM BROCKEDON invented a machine to produce pills more quickly Beechams, boots and Wellcome would use papers to advertise their medicines on a national basis and this is what formed the pharmaceutical industry. What were workhouses? Workhouses were where poor people who had no job or home lived. They earned their keep by doing jobs in the workhouse. Also in the workhouses were orphaned (children without parents) and abandoned children, the physically and mentally sick, the disabled, the elderly and unmarried mothers. Possible Reasons that encouraged change in Hospitals Pasteur's Germ Theory The cleanliness of hospitals Professionalization of women Qualifications and training The Royal Society of Doctors and Surgeons Florence Nightingale The Government Change in hospitals The late 19th century saw a great change in the development of hospitals. Since the discovery of the Germ Theory in 1861 we had more knowledge about how disease spread. Hospitals were built to show their new knowledge. Wards were introduced to combat the spread of infection. Sinks and toilets were kept away from the wards

Although the use of anaesthetics was a major breakthrough in surgery, it actually helped to create a new set of problems. Surgeons could now perform longer, more complicated operations, but they still did not understand about infection and germs. Although many patients might survive an operation, they would often die days later of gangrene (also known as sepsis) - infection and decay that would cause flesh to rot, and would poison the blood. Operations were often carried out in a patient's home - surgeons would wear their 'special' clothes, as would their assistants - these would be the same blood and pus-stained clothes they wore for every operation. The problem of blood loss was not solved until the early 20th century. In the 1850s - 1870s, deaths in surgery actually increased, and this period was known as the 'Black Period' in surgery.

Far from being a respected medical person, the surgeon in the Middle Ages was usually a bar Although surgery has become more scientific by the end of the 18th century thanks to the work of John Hunter, people usually had to be desperate before they agreed to have an operation. Even if patients survived the operation, many patients still died later from infection or blood loss.

The First Magic Bullet: Salvarsan 606 Although important, remember Salvarsan was difficult to use - it not only killed the microbes but could kill the patient What was Ehrlich's relationship with Koch? Ehrlich worked on the same team with Koch, researching things and trying to develop Koch`s discoveries. What was Ehrlich fascinated by and what did Ehrlich mean by 'magic bullet'? Ehrlich was fascinated as to how the body created antibodies that killed bacteria and did not harm anything else. What research was Ehrlich's TEAM doing in 1905? Ehrlich`s team in 1905 was searching for a magic bullet to cure syphilis. Why was Ehrlich's discovery so important? The importance was that a chemical compound had been used for the first time to destroy bacteria. The First Magic Bullet - Salvarsan 606 - a cure for syphilis Behring studied diphtheria, this made Ehrlich fascinated about the ways in which the body created antibodies. He developed Kochs ideas and then found a cure for diphtheria by injecting antibodies into the body. ⇩ Ehrlich`s research showed that you can make man-made antibodies from chemical compounds, these are used to destroy antibodies much like antibiotics. ⇩ Hata noticed that Salvarsan 606 worked whilst retesting it, he realised that salvarsan 606 had killed the syphilis bacteria. Hata reviewed experiments and joined the research team. ⇩ Magic bullets were an important medical breakthrough because chemical compound had been used for the first time to destroy bacteria. The Second Magic Bullet - Prontosil and Sulphonamides Things were interrupted by ww1, but in the 1920`s Gerhardt domagk tried out prontosil, testing with mice, this had an effect on the bacteria which caused blood poisoning His daughter then became ill, from blood poisoning, he tested his hypothesis on his daughter and the second magic bullet was found The next step was to find out the active ingredient was in prontosil, it only took two years for french researchers to find it. The discovery was made speedily as a result of the invention in 1931 of new powerful microbes Soon lots more drug companies joined a race to find the sulphonamides , within a few years drugs had been developed to cure and control, scarlet fever, meningitis, gonorrhoea and pneumonia. The new drugs then heavily improved health, lots of problems like infection during childbirth were massively reduced due to the new drugs. How the science of chemistry helped in the development of medical cures The science of chemistry helped in the development of medical cures as a chemical compound had been used for the first time to destroy bacteria. Therefore more chemistry could possibly be applied to find more magic bullets. Factors affecting the discovery of magic bullets Chance Strategic research Not giving up and continuing the research Checking research How the discovery of magic bullets can be seen as a turning point for medicine in the 20th century Magic bullets were a turning point for medicine as it was the first time a chemical compound was used to destroy bacteria, this made it a turning point in medicine as it proved that chemistry and chemical compounds could be used to destroy specific bacteria. This is important as if you can do it for one, if there is a chemical compound it is most likely that there are more of them to find if you get the right mix of chance and strategic research there will be more magic bullets to find. Obviously magic bullets are very effective therefore if there is one for each illness lots of deadly illnesses could finally be cured.

Penicillin is made from a mould called penicillium. This mould was first discovered in the early 19th century by John Sanderson who found that very little grew near it. In the 1880s, Joseph Lister noted these observations and wrote to his brother to say that he intended to try penicillin on infected wounds. Lister successfully treated a nurse with an infected wound with penicillin, but did not leave any notes on the case and apparently did not continue his research in this area. Fleming had left a culture plate smeared with Staphylococcus bacteria on his lab bench while he went on a two-week holiday. When he returned, he noticed a clear halo surrounding the yellow-green growth of a mold that had accidentally contaminated the plate. Luckily, Fleming had not stored his culture in a warm incubator. London was then hit by a cold spell, giving the mold a chance to grow. Later, as the temperature rose, the Staphylococcus bacteria grew, covering the entire plate--except for the area surrounding the moldy contaminant. Fleming discovered that Penicillin could stop the most deadly of germs. He needed to find a way of turning it into a drug so it could be used to treat humans. Unbelievably he could not secure the money from the British government or anywhere else for further research. In 1931 he stopped his work on Penicillin.

In the early 20th century scientists knew DNA existed, and knew it carried genetic information. However, they did not know how it did this. The first step in understanding how it worked was to identify the structure of DNA. Many scientists tried and failed to work out this structure. But in 1953 two scientists working the Cavendish Laboratory in Cambridge finally succeeded. Crick and Watson discovered that the structure was a double helix, or pair of interlocking spirals, joined by bases which were like rungs of a ladder. They also proved that this DNA blueprint for life was present in every cell and could make an exact copy of itself and so could pass on information from one generation to the next. This was the vital launch pad for further discoveries over the next fifty years. DNA breakthrough? People regard the DNA breakthrough as a more important scientific event as Pasteur's breakthrough with the germ theory. The reason for this was that with the knowledge of genetics and DNA doctors were able to explain, understand and help prevent certain diseases. Germ theory was a great breakthrough but it does not explain all diseases or solve all medical problems. It does not explain conditions such as Down's Syndrome or diabetes which can be passed from parent to child. Today, the most feared medical problems are not illnesses caused by germs but conditions caused by changes in the body itself. So the discovery of DNA may turn out to be an even more important breakthrough that Pasteur's germ theory because it may help scientists and doctors prevent or cure these illnesses.

The Labour Government of 1945-51 brought in a series of reforms to remove the Five Giants identified by William Beveridge. These reforms finally established a welfare state - that is, a system whereby the government took on the responsibility of helping those who could not help themselves.

Case Study: Fighting lung cancer in the 21st century Explain the most common causes of lung cancer. Smoking, being exposed to chemicals in the air but some develop it for no reason. Explain why lung cancer is difficult to treat. Patients were often diagnosed the wrong thing because symptoms are common in many other illnesses, There are no regular tests, the tests that there are, are not necessarily accurate. How has science and technology helped in the diagnosis of lung cancer? The government has developed, transplants, Chemotherapy, Genetic research and Radiotherapy. How has the government aimed to combat lung cancer? The government aimed to combat lung cancer, they recognised that smoking was a large factor as to how/ why people get lung cancer, this meant that they passed laws, in 2007 they banned smoking in public places, 2015 no smoking in care with anyone under 18, 2007 16 legal age to 18. They also created more campaigns to prevent/show the dangers and harms smoking does to your body, this was shown on packets and through the media.

Financial disadvantages Quicker findings as sense of urgency Less people to contribute therefore shortage of doctors and nurses People quicker training as you have to get people ready for going to war and helping the soldiers (conscientious objectors)

The printing press was invented in the 14th century, this widened communication between people as individual writings/ scriptures had to be written; whereas once the printing press was created these writings could be shown to lots more people (and translated into other languages.) This was used when Vesalius had new ideas, this spread his ideas a lot quicker than before. Furthermore, the control the church had on medical knowledge decreased because books were no longer solely written by monks. The invention of the printing press helped change this for the better. Medical ideas were also widely shared through newspapers. The first ever newspaper printed in Britain - The Oxford Gazette was published on 7th November 1665, at a time when London was in the grip of the devastating Bubonic plague. More recently, the communications between local people and the government, 1948 and 1975 health acts were publically communicated through media, without them no one would of been able to try and make any changes to improve public health. Linking to this Without the communication between local people and the government, no one would of been able to actually realise how bad public health in britain was and therefore we could've still have the awful healthcare which British people had before things like the NHS (1911) were put into place. Causing Medical Stagnation; was mainly the social disorder and war. This disrupted communication and learning as new ideas couldn't be transferred; therefore this hindered improvement within the Medical field. Between 1750 and 1900; scientific knowledge and technology improved rapidly, allowing new ideas to be passed around - benefitting people's health. Several diseases; such as Smallpox was beaten quicker than usual, due to better communication. Jenner was able to understand the significance of Cowpox in this case, and with the help of improved transmission, the news of Jenner's discovery spread much more easily - under the Government recognition, vaccination was therefore made compulsory. The Royal Society helped communication improve as they published books and held a regular journal publishing new ideas. This was an important idea; because unlike Universities and the Church, it was not afraid of change and was ready to accept new ideas which were not necessary in line with those of Galen. 1250: Word-by-mouth - people heard about new medical treatments and ideas was passed around.

During the Middle ages the Government became weak and the christian church had a much bigger influence on health, medicine and treatments. Didn't really do much most 'ran for the hills' as no one could really be saved Government in Great Plague 1665 - Government action towards the great plague: Fires should be made in moveable pans and used at all public meetings because the fumes will help correct the air. No stranger was allowed to enter or leave a town unless they had a certificate of health (which cost money). No furniture was to be removed from an infected house. A pest-house should be made to be ready in case any infection should break out. If any house is infected the sick person should be moved to the pest-house to keep the rest of the family safe. The house should be shut for 40 days and have a red cross painted on the door. 18th and 19th century public health acts - 1802 - Factory acts improved people's working conditions 1848 - Public health acts, wasn't enforced, only encouraged 1852 - Compulsory vaccination 1858 - Regulation of doctor's qualifications 1866 - Sanitary Act, all towns had to appoint inspectors to check water supplies and drainage 1870's onwards - Every local authority had to set up schools. Health education was taught at many schools. Improved literacy made it possible for people to read pamphlets from Medical Officers giving advice about drainage, ventilation, diet, personal cleanliness, care of children and care of sick. 1875 - Artisans Dwelling Act, local authorities were given the power to builld and abolish slum housing 1875 - Public Health Act, enforce regulations on water supplies and sanitation 1876 - Laws against pollution of rivers, Building regulations and Food regulations improve the quality of food sold in shops 1878 - Public Health Act, consolidated exsisting laws 1889 - Isolation hospitals for infectious diseases Government and Cholera 1854 - The government started collecting statistics on births, marriages and deaths 20th century Public Health acts - In 1900 when the army needed recruits for the boer war they realised that 38% of volunteers were too unfit to be soldiers this made the government realised that things needed to change. These were some of the measures made to improve health, especially in children. 1902- compulsory training of midwives, 1906 - meals provided for school children, 1907 - schools to provide medical care and checks, 1909 - Overcrowded back to back housing was banned, 1911 - Government introduced the national insurance scheme which benefited workers as if they contributed to a fund it was used to give them free medical care. (this had no impact on women and children). 1919 - Local authorities required to build new houses for the working class 1930 - Five year slum clearance program began 1956 Clean Air Act, dealt with problem of smog These acts were part of the reason why the infant mortality rate decreased so rapidly after 1900 NHS 1948- The government was concerned about the inequalities of health care in the early 20th century especially once women got the vote in 1918 The Beveridge report in 1942 identified disease as a problem for the government to deal with after WW2 and plans were made for the NHS which was set up in 1948 Fight against lung cancer, government action - Government has produced many campaigns to advertise the dangers of smoking over past decades, highlighted the impact of pregnant women smoking, number of chemicals in cigarette smoke and statistics about health impacts and diseases from regular use 1965 - ban on tobacco advertising in on television 2005 - government banned cigarette advertising entirely 2007 - banned smoking in all workplaces 2007 - government raised the age of buying tobacco from 16 to 18 to stop smoking in teenagers 2012 - cigarettes weren't allowed to be displayed in shops 2015 - ban was extended to cars carrying children under the age of 18 In western Belgium The town of Ypres on the most direct route to the Channel ports such as Calais and Dunkirk. If captured by Germany, they'd cut off most of the supplies to the British army - equipment, men and food. Ypres and surrounding area had to be defended for British The Ypres salient ('buldge') was a vulnerable part of the allied line. German forces occupied a ridge of high ground overlooking the Salient meaning they could fire down on British and Allied forces, and they could see the layout of defences and the movement of Allied troops. The higher German positions were drained, healthier and better for transport and stronger defences could be created. The British trenches were in low-lying ground with heavy-soil which easily became water-logged and flooded, especially when churned up by shell fire. What was the purpose? The aim was to control the city and North coast of Belgium since some positions on the cast would have given Britain an advantage in terms of fighting. Race to the Sea In late September 1914, an event now known as the "race to the sea" began. This was where the German advance and the Allied troops were both trying to get to the coast. During this process, each side constructed many fortifications on the way. The race ended in mid October that year and Britain had claimed Ypres Significance for Britain At the end of the battle although the British had lost around 50,000 troops, they managed to stop the German army from capturing Ypres If they hadn't stopped Germany could have cut off most of the supplies for the British army. This was significant for Britain as it meant they controlled the English Channel ports, this meant supplies and reinforcements could be provided.

Middle ages (1250 - 1450) The church had a lot of power meaning it could decide what people were educated with, such as what books they could read from and how they would be taught. For example they: read from Galen who believed that the body was made up of 4 humours (blood, phlegm, yellow bile and black bile) Human dissections were not allowed, only animal dissections In the middle ages people had very little confidence in doctors because doctors were able to just set up their own business without any organisation,There was no requirement for doctors to be formally trained,People also had little confidence as many of their treatments did not work and Doctors had not received good medical training After the church's power over medical training decreased and medical training became independent from the church and this was significant because they were able to develop new ideas and not be forced to treat using Galen's ideas,There was room for medical studies to progress and Books other than Galen could be read Medical schools gradually became independent from the church so by the reformation in the 16th Century the Church had lost control in medical training. Very few human dissections occurred but only to demonstrate Galens' teachings as his works were read by the lecturer during the dissection Only men could study to become a physician at medical school Many treatments didn't work so people weren't very trusting of doctors Hospitals were run by nuns and monks and women over 50 could work as nurses herbal remedies were passed down from generations in families which were at times effective 1750-1900 In the 1700s modern science began to develop as doctors relied less on the old ideas of Galen and ancient books doctors began to question these ideas and come up with new ideas using their own experimental observations to form new ideas New scientific developments helped the education of doctors as it provided them with new ideas for example pasteur's germ theory which proved the link between germs and disease More people could be educated because in 1870, the government made every local authority set up schools At the beginning of the 19th century (1801-1900) doctors were unable to help their patients but by the end of the 19th century there was a greater understanding of diseases, the cause of diseases and how to prevent it During the 1800s doctors could do little to treat their patients 1803 Thomas Percival wrote the first book on medical behaviour. 1823 The first issue of the the medical journal the 'Lancet' was published. 1832 The British Medical Association was formed. By the end of the nineteenth century,doctors could provide better treatment through hospitals provisions and doctors and surgeons were respected more 1900-1948 The beveridge report by William Beveridge in 1942 identified the problems in society which were poverty, lack of national health care, unemployment lack of education and poor housing 1948 onwards The NHS was set up in 1948 and provided maternity and child welfare,health visiting,home nursing, health centre, vaccination, ambulances, family doctors, medicines, dentists, blood transfusion, specialists and hospitals available to all for free apart from the prescription charge introduced in 1968