GalenBegan studying medicine at 16, travelled to Alexandria to study.Great showman, put on public performances, became doctor to emperors for life after the great plague.

Why his ideas were so widely accepted:•Wrote hundreds of books covering every aspect of medicineincluded work of others including H but added his own work on treatments and structure and workings of the bodyPeople believed his books had all the answers (became basis of medical training for thousands of years•Ideas fitted with the ideas of the Christian Churchchurch controlled education in Europe during middle ages even though not a Christian, believed one God created the body and made all parts fit together perfectly

Vesalius

Renaissance 1500-1700

Harvey

Renaissance 1500-1700

Pare

Renaissance 1500-1700

Edward Jenner

Before Discovery:•Smallpox killed more children than any other disease•Survivors of small pox severely disfigured

Limitations•Jenner’s vaccination only dealt with one discovery•Many opposed vaccinations Anti-Vaccine league formed in 1866•Governments could not decide if it should be made compulsory

1852 Vaccination

made compulsory

Industrial Revolution1750-1900

Germ Theory and Identification of microbes

Led to other scientists developing other

vaccines: Typhoid, TB, Diptheria and Tetanus

Led to other scientists developing other

vaccines: Typhoid, TB, Diptheria and Tetanus

Industrial Revolution1750-1900

DNA: Crick and Watson

Discovered chloroform by chance with colleagues when they were experimenting with anaesthetics.

Realised it was very effective and used it within day son women in childbirth

significant immediate impact

Opposition •Surgeons prided themselves on speed, anaesthetics meant it was no longer important•No one knew long term side effects•Hannah Greener died in 1848 whilst having toenail operation•Increased infection because doctors attempted more complex surgery

Opposition •Surgeons prided themselves on speed, anaesthetics meant it was no longer important•No one knew long term side effects•Hannah Greener died in 1848 whilst having toenail operation•Increased infection because doctors attempted more complex surgery

Surgeons unsure of correct dosage

Chloroform made patients vomit

Surgeons still operated at high

speed

Problem of infection and

bloodloss remained

James Simpson

Limitations

Florence NightingaleConcentrated on cleaning the hospitals and patients in the crimea and wrote to the governmentFocused on:•Sanitation in hospitals•Good ventilation •Good supplies

Oppositiono Wealthy family didn’t want her

to train as nurse

Limitationso Ignored the germ theory as she

believed disease was caused by miasma

o Other factors improved nursingo She didn’t suppot women in

becoming doctors

Development of Penicillin

WarEnglish factories busy helping war effort. Florey and Chain went to America.American Government realised its potential after Pearl Harbour.Made interest free loans to US companies to buy expensive equipment for mass production.Soon British firms were mass producing penicillin

Stag

e fo

ur

Edwin Chadwick1848 became a member of the National Board of Health, argumentative, arrogant and rude but extremely hardworking.

Report1842 wrote ‘Report on the Sanitary conditions of the Labouring Population’Stated that:•Poor lived in dirty, overcrowded conditions•This causes huge amount of illness•Many people too sick to work so became poorer•Therefore other people have to pay higher tax to help the poorSolution:Improve drainage and sewersRemove refuse from streets and homesProvide clean water suppliesAppoint medical officers to check reforms

1848 public health act•National board of health set up•Government could force local councils to improve PH and appoint a medical officer•Local councils encourage to collect taxes for improvements if they had the support

• 1875 public health act• Local councils forced to provide clean water,

public toilets, drains and sewers• Councils forced to appoint a medical officer of

health

OppositionLocal taxpayers didn’t want to pay for improvements even though it would save taxes in the long runGovernment didn’t want to interfere in local matters

LimitationsReport didn’t lead to immediate reform. His influence faded in 1850s

LimitationsReport didn’t lead to immediate reform. His influence faded in 1850s

John Snow• Pioneer in surgery and public health • 1849: Published book saying cholera was spread through water not miasma• Wrote a report detailing his evidence ‘on the mode of communication of cholera’• Provided enough evidence so that handle of the broad street water pump was taken

away.• Later discovered cesspool 1m from pump contaminated the water (500 deaths caused)• 1854: cholera outbreak helped to prove his theory

OppositionHis idea of disease from water was mocked by doctors

LimitationsDidn’t lead to a new public health act Many scientists still believed it was bad airPasteur had not yet published germ theory

Roman Public Health Key Features

Romans developed first ever public health systemBelieved in personal health and hyygeneSettlements such as army camps were ‘healthy places’ as they werent near swamps Aquaducts, Bath houses, sewers and hospitals

Weaknesses

Little changed in countryside as only rich could afford bath houses Lead pipes poisoned waterIf rain was scarce waste built up in the sewers which spread disease Sewers emptied into rivers where people washed their clothes

Medieval Public Health CONTINUITY

Rich people took regular baths and did their best to avoid filth and bad smells

PROGRESS

Monasteries had comprehensive PH systemsFresh water, herbs and food

Rakers employed to empty cesspools

First hospitals built since roman times eg St Bart’s

Medieval kings passed laws to keep streets clean

During plague quarantine laws put in place

REGRESSNo concept of public health

Focus on ‘Care not Cure’ in Monasteries

Government saw PH as a local issue for individuals

Streets very dirty, people disposed of rubbish in rivers and streets

Toilets in London built over Thames

Rennaissance Public Health CONTINUITY

Still some public toilets

Aniimals filled the streets with dirt

Cesspits often overflowed into nearby cellars and water tanks many too poor to afford it

PROGRESS

Night soil men employed to carry away human waste

Increased Travel

Reduced influence of Christian church

Households ordered to put out rubbish every Wednesday and Saturday but too few rakers to maintain this

REGRESSNot enough Rakiers to make a difference

Quite corners or doorways became accepted places to wee

Industrial Revolution Public Health

CONTINUITY

‘Laissez Faire’ attitude

Still very dirty

Cholera large threat

PROGRESS

Individuals eg Pasteur advanced knowledge of cause

Edwin Chadwick led to 1848 public health act

REGRESSSignificant public health problems caused by industrial revolition

Modern day Public Health

CONTINUITY

Dirt and poverty was still a problem

Government initially gave no help to sick or unemployed

PROGRESS

Many laws passed

Eg: 1909 back to back housing banned

1911 National Insurance Act

Facilities improved

Government : NHS

Increased life expectancy

More Spacious wards and hospitals

The development of treatments and cures

Training of Doctors

Middle Ages500-1500

Middle Ages500-1500

Treatments

How effective were medieval hospitals?

Middle Ages500-1500

Middle Ages500-1500

Renaissance 1500-1700

Renaissance 1500-1700

Renaissance: Conservatism VS Enquiry Area of medicine Conservatism VS EnquiryKnowledge of the human body Enquiry: Versealius challenged Galen’s theories of

anatomy and proved them to be incorrect. Harvey proved blood was pumped round body by heart

Growth of Science Enquiry: new experimental approach encouraged discovery.

Physicians Enquiry: New practical training and diseection in Edinburgh. Study of urine and astrology rarely used. Harvey set up own medical story. However women still not allowed to be doctors.

Hospitals Enquiry: New hospitals that cared for poor. Simple surgery carried outConservatism: Most didn’t admit infectious diseases

Everyday treatments Conservatism: still used herbal remedies and bleeding. Thought tobacco and goat’s stomach good cures. (Beliefs preserved)

Cause of disease Conservatism: Still believed in astrologyStill used 4 humours and power of observation.

Industrial Revolution1750-1900