Miss Hillss Legendary

Idiots guide to Medicine Through Time

Contents:

The Egyptians
When was Ancient Egypt? The Ancient Egyptian civilisation was in existence rom approximately !"""#$ to %""A&' In reality the era is a num(er o di erent periods in Egyptian history) when di erent amilies *dynasties+ ruled Egypt' How was Society different to prehistoric times? The Egyptians developed a system o writing things down' They used hieroglyphics to record their indings' They also lived in organi,ed) permanent settlements and (uilt towns and cities' -nli.e prehistoric man) the Egyptians had also a system o law and order (ased on a system o government led (y a ruling /haraoh' Other than writing, what advances were made in the Egyptian period? The Egyptian period was very long so lots changed over the course o the era' The Egyptians developed a complicated set o religious (elie s and rituals) many o which related to medicine and the human (ody' They also (ecame expert (uilders and engineers) (uilding the great pyramids) temples and roads' Religio s !eliefs? How do they affect medicine? The Egyptians (elieved that li e on earth was part o a cycle' 0nce a person died their spirit passed into the a terli e' The 1uality o the a terli e would (e improved i the persons remains were treated in certain ways' This meant that Egyptian doctors couldnt dissect (odies as they had to remain intact or the a terli e' However the process o preserving the (ody) mummi ication) did mean that some .nowledge o the human anatomy was ac1uired' So, religion " st prevented them from c tting p !odies? 2o' 3eligious (elie s also re1uired cleanliness in temples which had a .noc. on e ect o improving health' 3eligion also meant that prayer was used extensively (y doctors as their (elie s led them to re1uire doctors to as. the gods or orgiveness and mercy' This (elie in gods causing and sending disease meant that doctors would not loo. or alternative causes o illnesses' What a!o t s rgery? The Egyptians o(served that water rom the 3iver 2ile could (ecome (loc.ed in irrigation channels' They used this simple o(servation to esta(lish that (loc.ages in the veins could (e removed in much the same way as a (loc.ed channel was opened up' #ased on these o(servations they (egan per orming operations to remove cists and a(scesses' How wo ld they try and c re illnesses then?

A com(ination o natural and supernatural cures was used' These were (ased on their (elie s a(out the cause o disease and an element o trial and error' Her(al remedies were used to help cure things such as stomach pains' $om(inations o natural elements could (e used to induce vomiting or example' These were o ten prescri(ed alongside a prayer though) as the disease was thought to have (een sent (y the gods' 4ometimes the illness would simply (e treated with a prescri(ed prayer' E#amples: The ollowing are all ta.en rom the /apyrus E(ers) an Egyptian scroll that &octors had to use when treating a patient' C re for Cataracts: Mix (rain5o 5tortoise with honey' /lace on the eye and say6 There is a shouting in the southern s.y in dar.ness) There is an uproar in the northern s.y) The Hall o /illars alls into the waters' The crew o the sun god (ent their oars so that the heads at his side all into the water) 7ho leads hither what he inds8 I lead orth what I ind' I lead orth your heads' I li t up your nec.s' I asten what has (een cut rom you in its place' I lead you orth to drive away the god o 9evers and all possi(le deadly arts' C re for $ rns: $reate a mixture o mil. o a woman who has (orne a male child) gum) and) rams hair' 7hile administering this mixture say6 Thy son Horus is (urnt in the desert' Is there any water there8 There is no water' I have water in my mouth and a 2ile (etween my thighs' I have come to extinguish the ire' Head Wo nds I thou examines a man having a gaping wound in his head penetrating to the (one) smashing his s.ull) and rending open the (rain o his s.ull) thou shouldst palpate his wound' 4houldst thou ind that smash which in his s.ull li.e those corrugations which orm in molten copper) and something therein thro((ing and luttering under thy ingers) li.e the wea. place o an in ants crown (e ore it (ecomes whole5 when it has happened there is no thro((ing and luttering under thy ingers until the (rain o his s.ull is rent open and he discharges (lood rom (oth his nostrils) and he su ers with sti ness in his nec.'

The :ree.s
When was Ancient %reece? Ancient :reece emerged rom a(out ;""#$ and lasted until it was su(sumed into the 3oman Empire in <%; A&' Even a ter this date :ree. culture was strong' How was Ancient %reece organi&ed? -nli.e Egypt) Ancient :reece was not one .ingdom' :reece was a collection o independent city5states' These city states had their own leaders and government' 7hat they shared was a common culture) though this didnt stop them alling out and ighting= What was %ree' C lt re li'e then? The :ree.s are renowned or having (een great thin.ers' /hilosophy prospered in these city states as people developed new ideas and loo.ed to explain them' This led to many people thin.ing o ways in which the human (ody wor.ed and o reasons or the illnesses and diseases that plagued the Ancient 7orld' The :ree.s also communicated with people rom other civili,ations and were open to new ideas' They were aware o the (elie s o the Ancient Egyptians and too. on (oard many o the natural elements o the Egyptian culture' Who were these philosophers and what did they achieve? There were many :ree. philosophers' The most signi icant ones or this course were Hippocrates and Aristotle' Aristotle was (orn in !;% #$' He developed a theory that lin.ed the seasons to di erent symptoms o disease' -sing natural (elie s he developed these lin.s into a theory (ased on li1uids in the (ody and the way that they (alanced' This theory (ecame .nown as the theory o the our humors' Hippocrates (ased many o his ideas on the wor. that Aristotle had conducted' He developed his theory o the our humours and made the lin.s (etween the seasons) luids and im(alances very clear' This led to the development o theories a(out how to treat disease' Hippocrates contri(ution to Medicine is immense' He wrote hundreds o articles a(out health) .nown collectively as the Hippocratic $orpus and is remem(ered now as (eing >The 9ather o Medicine' /erhaps the (iggest contri(ution he made was the development o something called $linical 0(servation' Here he devised a system or doctors to ollow when a patient visited them' He encouraged care ul o(servation o the patient and the way that an illness progressed' This would lead to an understanding o the ways in which an illness should (e treated and a more e ective diagnosis and treatment (eing made'

What a!o t Religion, did they " st forget a!o t it? 2ot all :ree.s were philosophers) nor did everyone loo. or a natural cause o disease' Many people remained very spiritual in their (elie s a(out the cause o disease' 0ne o the (est examples o this continued (elie is the $ult o Asclepios' Asclepios was a :ree. god o health' /eople (elieved that diseases were sent (y him and that in order to cure themselves they needed to pray to him and worship him' To do this they visited temples dedicated to his name' At these temples a num(er o rituals would ta.e place' Many o these are now .nown to (e good or improving the health o people6 or example) they washed and (athed prior to praying) they ate healthily and used soothing lotions and relaxing methods to alleviate pain' 7hilst these were o ten done to please the god) it shows that natural orms o medicine were (eing adopted alongside supernatural orms o medicine to treat people' Asclepions were extremely popular' 4everal huge temple complexes were (uilt throughout :reece and the cult spread as ar as 3ome at the height o the 3oman Empire'

The 3omans
When was Ancient Rome? Historians (elieve 3ome was ounded in ?@!#$' It grew rom (eing a small .ingdom into a large 3epu(lic' 9rom the irst century #$ until the i th century A&) 3ome had a large empire A and its the spread o 3oman ideas around this empire that were interested in= How was Ancient Rome organi&ed? 9or the purposes o this post) well loo. at the Empire' -nli.e the :ree. civili,ation the 3omans were 1uite rigid in their organi,ation' At the top o the pile was the Emperor and (eneath him the senate' The mem(ers o the senate were elected (y citi,ens o 3ome' Around the Empire control would (e handed to a governor' He o ten had a large military orce at his disposal to ensure law and order' In #riton some areas retained their old rulers) who acted as tenant .ings and governed locally under 3oman supervision' In areas where there had (een lots o opposition) 3oman rule was direct and en orced (y the 3oman army' What was Roman C lt re li'e then? The 3omans were pragmatic and (orrowed ideas rom many o the areas that they con1uered or controlled' This meant that a lot o :ree. ideas were widely accepted (y 3omans) as were religions and ideas rom elsewhere in the empire' The 3omans also enBoyed gladiatorial games and chariot racing' In general though the 3omans werent as (ig a set o >thin.ers as the :ree.s) they tended to (e more ocused on the practical side o things and >got on with it' How did this infl ence medicine? 0n a simple level the Empire results in the spread o ideas and practices rom as ar apart as the 2orth o England to /alestine) Egypt and into /ersia' 3oman values also meant that they too. their own way o li e with them6 this meant that their li.ing or (aths) or example) spread 1uite 1uic.ly' The :ladiatorial games gave surgeons loads o opportunities to loo. at di erent .inds o wounds and the importance o the army meant that there were lots o hospitals) surgeons and roads A all o which help to improve health' (id the Romans create anything new then, or was it " st a lot of !orrowed ideas? They certainly (orrowed a lot A supernatural ideas continued) or example A (ut they also created a lot as well' The two >(ig things that this period is (est .nown or are a person and an idea' The person was :alen) the idea6 /u(lic Health' Whats %alen important for then? :alen wrote L0A&4' He came up with lots o new ideas a(out how the (ody wor.ed and developed the ideas o people li.e Hippocrates' His real claim to ame is that his ideas were accepted or so long A all the way into the 3enaissance= He wasnt always right A Cesalius later corrects some o his more glaring errors A (ut he provided airly sound advice on all types o illness D surgical need and) as doctor to the Emperor) had the clout to get his message heard=

Whats important a!o t ) !lic Health? 2owadays were reminded that >coughs and snee,es spread diseases' They doE (ut in ected water does a pretty nasty Bo( o spreading disease too= The 3omans (rought clean water into towns and cities using A1ueducts and too. dirty water away using 4ewers' They also invested in pu(lic toilets and (athhouses' 7hilst they didnt .now it) in doing so they were limiting the num(er o germs that could (e spread through the water supply' 3esult8 Healthier towns and cities A though dont or a second thin. that this means that all 3oman towns were clean and disease ree as that wasnt the case=

The Middle Ages

When was the medieval period? &i erent people put di erent dates on periods' 9or this post Im tal.ing a(out the period (etween the all o 3ome through to roughly <%@"' 2ote A some medicine through time courses start in <!@"E What happened when the Roman Empire collapsed? 7hen the 3omans le t) so did much o the organi,ation and investment' In many areas the all o 3ome was 1uite violent and much was destroyed' This included (oo.s and some o the (uildings that helped with /u(lic Health' 9or a long time a terwards there was relatively little spent on /u(lic Health as it was expensive and the money wasnt availa(le (ecause it was o ten (eing spent on war' This led to some elements o medicine and health going (ac.wards *regression+' (id everything get worse? 2o' /eople still had access to wise women) her(al remedies and could turn to religion or the church or help' 3icher people could still pay to see a doctor and there were still surgeons o varying levels o s.ill' 9or an ordinary person living in #ritain) healthcare would have (een little di erent A the noticea(le change would have (een the reduced num(er o trained doctors D surgeons' 4o whilst there were periods o chaos and war and a lac. o learning a(out medicine) on a day to day level or >normal people things were little di erent in terms o medical practices' What ideas stayed the same? /eople still used common sense cures) went to amily mem(ers or advice and used her(al remedies' There was also continued (elie in supernatural causes o disease' A good example o the varied (elie s are the measures ta.en to try and prevent the #lac. &eath spreading' This ranged rom people whipping themselves to try and punish themselves or (eing sinners *they thought god was punishing them (y sending the /lague+ to 1uarantine (eing introduced in places' $harms) crosses and prayer were used (y someF others lin.ed it to (ad smells and tried to clean the air' *Many tried a com(ination o these+' (id anything get !etter? Lots o people ma.e the mista.e o thin.ing that things either got worse or Bust stayed the same in the middle Ages' Thats not entirely true' As the church (ecame more power ul there were increased num(ers o monasteries' These provided in irmaries and helped the poor' The church also helped spread ideas and was largely responsi(le or the reintroduction o the ideas o people li.e :alen' -niversities (egan to (e (uilt and there were some hospitals (uilt'

What a!o t !rea'thro ghs and !ig ideas? There wasnt a >huge (rea.through or development in this period *in Europe at least+) which is why some people thin. nothing got (etter' There were >little (rea.throughs though= Theodoric o Lucca ound out that it was (est to drain pus rom a wound and hemloc. was (eing used to .ill pain' 4ome o the new ideas (eing developed in the Islamic world started to spread into Europe as well

Islamic Medicine
Ca ses of (isease At the time o Muhammad people in Ara(ia (elieved that evil spirits caused diseases' Through reading the wor.s o Hippocrates and :alen they realised that this was not the case and adopted many o the theories suggested (y these men such as the theory o the 9our Humours' (evelopments of %alen and Hippocrates theories 3a,es said that it was vitally important to o(serve patients and ma.e notes o all minor details' He was the irst man to o(serve and record the di erences (etween smallpox and measles' Avicenna wrote the $anon o medicine *still used as a re erence (oo. today+' This developed some o :alens ideas and was used with aspiring doctors in (oth Ara(ia and later in the 7est' S rgery Al(ucasis said that surgeons should only per orm surgery when they were sure o the cause o the pain' He was also insistent that the surgeons should plan what they intended to do prior to surgery' He also emphasised the need to ignore personal gain *surgeons could (ecome very wealthy rom per orming pointless operations+' Anatomy Islamic law prevented the dissection o (odies' 0nly I(n an52a is made any real progress) stating that :alen was wrong to say that (lood did not pass through the septum'

The 3enaissance
What*s Renaissance and when was it? 3enaissance means re5(irth' Its a period o time when lots o old ideas were challenged' 7hen did it happen8 3oughly the <%th to <?th centuries *A&+' What happened? The churches power and authority were challenged= This might not seem to ma.e much di erence to medicine A (ut it did= #ecause the church had done most o the teaching a(out health) it had (een hard to loo. or new ways o treating illnesses) or to explore the wor.ings o the (ody' To do so could have (een (een seen as (eing anti5god *heresy+' /eople who were thought o li.e that tended to get executed A so naturally people didnt challenge the church o ten= How did this affect medicine? It meant that people were more willing to challenge the wor. o people li.e :alen) and also that they might (e more willing to (rea. some o the rules o the church' 9or example) dissection was still (anned (ut now the authority o the church was 1uestioned some anatomists were willing to ta.e a ris. and started dissecting' 3esults8 Gnowledge o the anatomy improved 1uite dramatically' Andreas Cesalius was a(le to produce a very detailed set o drawing o the human (ody and 7illiam Harvey discovered that (lood circulated around the (ody6 (oth were massive (rea.throughs' +assive !rea'thro ghs? How did this help people at the time? Heres the catch' /eople li.e Cesalius and Harvey made massive improvements to our .nowledge a(out the way that the (ody wor.ed and were a(le to spread their ideas 1uic.ly (ecause o the printing press' However) neither o them .new what caused diseases so their indings were impressive (ut o little immediate use to doctors or patients' The area where there were (rea.throughs that had an immediate and lasting e ect on treatments was in the ield o 4urgery' Here a chance discovery in a (attle ield hospital led to a massive improvement in the way that wounds were treated' A 9rench surgeon) /are) ound that lotions he had concocted out o desperation) wor.ed= He went on to gain a lot o support rom the 9rench monarchy and made several other (rea.throughs A the use o ligatures) or example' So, there were lots of new ideas , what a!o t treatments? Much the same as in earlier periods o time' Most people were still reliant on amily mem(ers or trusted elders' There were an increasing num(er o trained doctors (ut they remained expensive' A ter the dissolution o the monasteries in the -G) there were also ewer places or the poor to go to receive help) though there were some more hospitals (uilt' The doctors o Ging $harles II recorded the medicines they gave him in his dying days' They remained a com(ination o natural and supernatural attempts to tac.le disease'

And ) !lic Health, did that change? 2ot particularly' There were some locali,ed rules a(out waste and so on (ut in general investment was 1uite limited as other things remained more important to our rulers' The most signi icant change in the -G came a ter the :reat /lague and 9ire o London' 7hen the city was re(uilt) it was done so in a much more open and clean manner' So did things get !etter d ring this period? 0n a day to day (asis or ordinary people with common ailments) pro(a(ly not much' 4cientists now had a lot more .nowledge though) medicine was on the (rin. o (eing a(le to ma.e massive leaps orward'

The 4urgical 3evolution

What was the revol tion in s rgery? The term >revolution in surgery is used to descri(e a period o time when a series o (rea.throughs led to surgery (ecoming cleaner) relatively pain ree and much sa er' #e ore this period surgery was 1uic.) dirty and dangerous with patients having a large death rate due to (lood loss) pain and in ection' A ter the revolution in surgery each o these issues was minimi,ed' What period of time are we tal'ing a!o t? 3eally open to interpretation here as some would argue that were still in this period' Here) Im tal.ing a(out surgery rom a(out <?@" to a(out <H""' What was s rgery li'e !efore this period? In simple terms6 it was I-I$G *it had to (e to prevent (lood loss+F &I3TJ *(ecause people werent aware o the causes o in ection+ and /AI29-L *(ecause there were ew e ective pain.illers+' Each o these three pro(lems com(ine to ma.e it very dangerous A though it was sometimes success ul= How was the pro!lem of pain overcome? Throughout time people have tried to overcome the pro(lem o pain during surgery' They used things ranging rom alcohol to hemloc. to try and num( the pain) (ut num(ing it was all that it really did' In the <Hth century surgeons made some huge advances' Through experimentation they developed anesthetics that meant that surgery (ecame much less pain ul' Early attempts were the use o car(on dioxide *<;K"s+ and nitrous oxide *laughing gas+ in <;%L' #oth had some pain relieving 1ualities (ut werent highly success ul' Around the same time $raw ord Long secretly made use o Ether on a patient' The same anesthetic was then used (y 7illiam Morton in <;%L' 2ews o his success ul use o Ether led to it (eing tried (y surgeons around the world' Ether had draw(ac.s though A patients sometimes vomited as a result o (eing given it and it was highly lamma(le' The use o Ether was largely replaced (y the use o $hloro orm in the -G' This was irst used (y Mames 4impson in <;%? and (ecame popular a ter it was made .nown that Iueen Cictoria had used it as a pain.iller during child(irth' -se o these pain.illing anesthetics developed' Local anesthetics were introduced in <;?? and in the K"th century ways o inducing sleep and relaxing muscles were discovered' How was the pro!lem of !lood loss overcome? 4urgeons had always .nown that loss o (lood was a real pro(lem and attempts had (een made to replace it or some time' 9or example) in the <@th century /ope Innocent CIII had (lood rom ! young (oys in used into his (ody *(asically pured

down his mouth+' It didnt wor. A (ut the notion o trans usion was clearly recogni,ed (y some at that time' Experiments on animals and several humans too. place throughout the <Lth and <?th centuries with small amounts o (lood rom animals success ully (eing in used into several humans' All attempts to place large amounts o (lood into people ailed though' The irst success ul trans usion was in <;<; when Mames #lundell extracted % ounces o (lood rom his arm and success ully trans used it into his wi e' #etween <;K@ and <;!" he carried out a urther <" trans usions and in <;%" he was part o the team who per ormed the irst whole (lood trans usion' Even though they had wor.ed out how to replace (lood during surgery many patients still died' This was (ecause the wrong .ind o (lood was o ten used' In <H"< Garl Landsteiner discovered (lood groups' A ter this) surgeons could match (lood groups and reduce the ris. o there (eing a atal reaction D reBection o the (lood' This Bust le t the pro(lem o having enough (lood availa(le' This pro(lem has largely (een solved through the development o (lood (an.s and improved storage methods that have (een developed over the past <"" years' How was the pro!lem of infection overcome? The ultimate rustration or surgeons must have (een to success ully operate) reduce (lood loss and ma.e sure that pain didnt overcome the patient) only to see them die a ew days later rom an in ection' 0 course until :erm Theory was developed and accepted) surgeons werent sure what caused these in ections and so they could only guess at what to do to limit the ris.' 0ne o the irst to do so success ully was Igna, 4emmelweiss' He insisted on cleanliness and had much (etter survival rates than other surgeons doing similar wor. A (ut he wasnt a(le to convince others to do the same' The (rea.through came in <;L?' Moseph Lister was a surgeon in :lasgow' He read a(out :erm Theory and reali,ed that this was connected to the in ections he saw' 7hen he heard a(out a spray (eing used in sewers to reduce the ris. o disease he decided to investigate' He 1uic.ly came to the conclusion that using $ar(olic Acid to clean wounds and (andages would signi icantly reduce in ections' His ideas were adopted (y the :erman army in the 9ranco5/russian war and the positive outcome helped to convince people that his methods were e ective' 9ollowing this) 3o(ert Goch wor.ed on sterili,ation o surgical e1uipment) which led to urther improvements' This >(ig idea is antiseptic surgery A and antiseptics are still widely used today' These ideas have (een developed so that nowadays not only are the (andages) wounds and e1uipment clean) so is the air= Modern operating theatres have iltered air streams and are >aseptic *i'e' totally clean+' (id everyone approve of the changes? 4ome o these developments encountered lots o opposition' #ecause some o them were 1uite experimental they didnt always wor.' This cast dou(t over the merits o the ideas and until scientists >got it right there were many who dou(ted them' There are also moral and religious o(Bections to some o these ideas) or example) #lood Trans usion'

/u(lic Health and the Industrial 3evolution What is ) !lic Health?

/u(lic Health is things that a government does to try and ensure that things are clean and healthy or the pu(lic' Things li.e providing sewers) clean water etc' When was the -nd strial Revol tion? Most o the events that Ill (e tal.ing a(out here happened in the <Hth century' Industriali,ation started a little earlier than this) in the mid <;th century' What was the pro!lem? Industriali,ation led to a really rapid change in the way that people lived and wor.ed' As actories developed people rushed into towns to get Bo(s in them' A lot o the housing that was provided had (een (uilt 1uic.ly and without enough consideration o things li.e cleanliness) removal o human waste) provision o clean water) education o access to a healthy diet' As these areas grew in si,e) the pro(lem got worse' These areas) slums as they are .nown) were ri e or the spread o in ectious diseases and li e expectancy in some o them ell as low as << or <K= How did they solve the pro!lem? It too. a while or much to (e done' In the <;!"s there was a review o the /oor Law which led to some changes in the way that poor relie was given out (ut it was 1uite limited' As diseases li.e $holera and Typhoid hit di erent parts o the country in that decade there were a series o local reports produced a(out health' It started to (ecome clear *to some=+ that something needed to (e done to ensure that there were minimum conditions' This (elie was rein orced (y Edwin $hadwic.s report on Health) which painted a pretty (ad picture o conditions or the people living in poorer areas' The people who elt li.e this ormed the Health o Towns Association which acted as a pressure group trying to persuade government and local councils to ta.e action' As a result the government passed a /u(lic Health act in <;%;' Improvements were limited though in many places and $holera once again returned and ravaged parts o the country' &espite the wor. o Mohn 4now little was done to improve conditions until a ter the second re orm act) when ordinary men were given the vote' This now made /u(lic Health a real political issue A it was a vote winner= 4oon a terwards there was a 3oyal 4anitary $ommission esta(lished *<;LH+ and its indings led to a 4econd /u(lic Health Act *<;?K+' This act placed responsi(ility or health on local authorities' As the implications o /asteurs :erm Theory (ecame more widely understood it was clear that urther action was needed A as some authorities had done little' A !rd /u(lic Health Act was introduced in <;?@ which made the re1uirements very clear' This act was ollowed (y lots o legislation a(out all sorts o health and (uilding issues' In the twentieth century these pieces o legislation were ollowed up with slum clearances *theyd stopped slums (eing (uilt (ut hadnt ordered existing ones to (e .noc.ed down in the <Hth century+ and wor. was done on improving the health o children' The Li(eral 3e orms o the early K"th century and later introduction o the 7el are 4tate are more recent examples o /u(lic Health initiatives'

Why did it ta'e so long to solve the pro!lem? Remem!er: CA.E Cost A who was going to pay or the huge amount o wor. needed8 Attitude A people should learn to help themselves *called a Laisse, 9aire approach+ .ear A what will the wor.ing classes want next8 Evidence A is there any proo that the spending will improve things8 until :erm Theory) there wasnt anyE

The (attle against in ectious diseases

What are infectio s diseases? In ectious diseases are illnesses that can (e transmitted rom person to person or spread through the air or water' They are spread (y micro(es which cannot (e seen (y the na.ed eye' Examples o in ectious diseases in the past are the plague) smallpox and cholera' In recent years we have had out(rea.s o swine lu) which is another in ectious disease' How do we treat infectio s diseases today? In the western world there are vaccines availa(le or many o the most dangerous in ectious diseases' These vaccines mean that the spread o the disease is prevented' However these vaccines are not availa(le in every country A something that the 7orld Health 0rgani,ation is trying to recti y' 9or new variants) li.e swine lu) it is impossi(le to vaccinate in advance o the disease spreading' 7hen this orm o disease emerges scientists wor. hard to try and create a vaccine' 7hilst they are doing this) people with symptoms are o ten 1uarantined) movements are restricted and pain.illers and suppressants are given to people who are ill' Who discovered a way of tac'ling these diseases? The irst vaccinations were carried out (y Edward Menner who created a vaccine or smallpox' However he didnt understand how the vaccine wor.ed so it wasnt until wor. (y Louis /asteur in the <;L"s that the cause o in ectious diseases was proven to (e germs' A ter this was esta(lished scientists li.e /asteur and 3o(ert Goch were a(le to identi y the micro(es that caused certain diseases and develop vaccines or that disease' What factors led to this discovery? Each o the scientists involved in the ight against in ectious disease was a determined and highly motivated individual) so the 3ole o the Individual cannot (e underestimated here' However the vaccines themselves were produced in huge 1uantities with governments unding (oth the research and the production o the vaccines' 0 ten this has (een prompted (y involvement in wars' The development o vaccines has there ore (een the result o a com(ination o actors' How / ic'ly did scientists manage to defeat different diseases? Edward Menners irst experiment with a smallpox vaccine was in <?HK' It too. years or his ideas to (e universally accepted and smallpox was not eradicated until <H;"= *Eradication o smallpox veri ied (y 7H0 on ;th May <H;"+' Even a ter Menners irst use o vaccination it was not until the <;L"s that urther (rea.throughs were made' A ter :erm Theory *<;LK+ there were a num(er o vaccines produced' Even these too. time to create' A vaccine or $holera was developed in <;?H) ollowed (y 3a(ies in <;;@) Tetanus in <;H" and Typhoid in <;HL' In the Twentieth $entury

vaccines have (een developed or numerous other diseases A see http6DDen'wi.ipedia'orgDwi.iDTimelineNo Nvaccines or a list o these' How s ccessf l have scientists and doctors !een in the fight against infectio s disease? In the modern world relatively ew people die as a result o catching an in ectious disease so it loo.s li.e scientists and doctors have (een 1uite success ul in the ight against these diseases' However not all in ectious diseases have vaccines and they are not availa(le everywhere yet' There are still out(rea.s o in ectious diseases that cause widespread concern' 9or example the spread o swine lu in recent years has caused much alarm and #ird 9lu several years earlier also caused concern'

The Li(eral re orms o the early twentieth century'

What were the 0i!eral Reforms? The Li(eral 3e orms were a series o government measures designed to help people who couldnt help themselves' They included the introduction o 2ational Insurance which included a contri(ution rom the employee) employer and government which would (e used to pay sic. pay and unemployment (ene itsF 0ld Age /ensions were introducedF 9ree 4chool Meals were given to children rom impoverished (ac.grounds to ma.e sure that they got at least one good meal a day and also included legislation covering medical chec.s o school pupils) limits to wor.ing hours and the opening o the irst La(our Exchanges *Bo( centres+' When did they ta'e place? The Li(eral 3e orms too. place (etween <H"L and the out(rea. o the 9irst 7orld 7ar in <H<%' The years o some o the .ey components are listed (elow6 <H"L A 9ree 4chool Meals <H"? A Medical Inspections in 4chools <H"; A Joung /ersons Act <H"; A 0ld Age /ensions <H"H A La(our Exchanges <H<< A 2ational Insurance Why were the reforms introd ced? A num(er o actors led to the re orms' Many within the Li(eral party were eager to help ordinary people and had campaigned with this as a .ey policy' The military had noted during the #oer 7ar that many conscripts were not it enough to ight A so something had to (e done a(out it= As wor.ing class men could now vote) it was also very important to ma.e sure that things were o ered that they would vote or' The Li(erals were also wary o the growing strength o the La(our party' 7ith whom they orced a coalition government in <H<"' There was also urther research into /u(lic Health that showed that there was a need or intervention in some areas' 3owntree completed a survey o the wor.ing classes in Jor.) or example) and Margaret McMillan was pioneering wel are wor. or children in #rad ord at this time' Were the reforms welcomed? The ordinary people who (ene itted rom the re orms were o(viously 1uite happy a(out things (ut there were opponents o these measures' Many people o(Bected to the increases in tax to pay or the re ormsF others complained at the 2ational Insurance contri(utions they had to pay and politicians rom other parties critici,ed the measures) to the point where there was a maBor constitutional crisis in <H"H when the House o Lords re used to approve the >/eoples #udget put orward (y the Li(erals' 4ome o these criticisms were rom people who (elieved in the ideas o

Laisse, 59aire which (asically means >leave them to sort it themselves whilst others critici,ed the re orms or not going ar enough' What impact did the 0i!eral Reforms have on health? The Health o $hildren improved as a result o the re orms' #y the out(rea. o war around <@")""" pupils were receiving ree school meals and regular medical inspections' This helped to reduce child mortality igures *as did the introduction o vaccines+' 9ree medical care was availa(le or some and this clearly helped to save lives' The 1uality o li e or the elderly was also improved'

The 2H4
What is the 1HS? The 2H4 is the 2ational Health 4ervice' This is a pu(lically unded service that provides healthcare to people in the -nited Gingdom' This includes doctors) dentists) hospitals) health visitors and the am(ulance service' When was the 1HS started? The 2H4 started on Muly @th) <H%;' This ollowed a series o de(ates and government studies a(out provision o healthcare' #e ore the war the #ritish Medical Association had pu(lished a pamphlet calling or a uni ied health service across the country' The out(rea. o the 4econd 7orld 7ar led to an Emergency Medical 4ervice (eing esta(lished) which e ectively nationali,ed the health service or the duration o the con lict' &uring the war the government set up an en1uiry into healthcare and the resulting >#everidge 3eport o <H%K called or a 2ational Health 4ervice) amongst other things' This was then put (e ore parliament in <H%% and in <H%L a >2ational Health 4ervice Act was passed' This legislation created the 2H4) and set the timescale or it (eing esta(lished in <H%;' Why did the government start the 1HS? #e ore the 2H4 the health system was o ten (ased on the a(ility o someone to pay or treatment' There were ree >voluntary hospitals and charity (ased hospitals (ut there was no guarantee o healthcare or all and services across the country were varied in terms o 1uality and availa(ility' 7hen the 2H4 was launched the minister in charge said that the 2H4 was (ased on three core principles6 O That it meet the needs o everyone O That it (e ree at the point o delivery O That it (e (ased on clinical need) not a(ility to pay What opposition was there to the fo ndation of the 1HS? At the time there was considera(le opposition to the idea o a 2ational Health 4ervice' 4ome people argued that local authorities were (etter placed than the government to run hospitals' 0pposition came rom consultants who were concerned a(out the impact that the 2H4 would have on their income and a(ility to govern their own pro ession' There was also a ear that the poor would over(urden the 2H4 and that there would (e a prolonged >rush or pills) glasses and so on' These pro(lems werent easily overcome and concessions had to (e made to consultants in order to get the medical pro ession to accept the 2H4'

What has !een the impact of the 1HS? Li e Expectancy in the -G has risen' In <H%; it was ?< or women and LL or men' 2ow it is ;< or women and ?? or men' In ant mortality igures have improved' 2ow Bust L'K deaths per <"")""" (irths compared with ;L in <H%;'

Medical Technology
What is medical technology? Medical technology re ers to the machines that can (e used to help identi y an illness or treat it' This includes scanners that can loo. inside the (ody) P53ay machines) $amera technology and e1uipment used to test samples' What medical technologies have !een developed in the 2wentieth Cent ry? Must (e ore the start o the Twentieth $entury 7illiam 3ontgen discovered how to ma.e use o P53ays' The use o P53ays developed in the irst part o the Twentieth $entury and has improved the way that doctors identi y (ro.en (ones etc'

0ne o the irst P53ays ta.en In <H%! the irst &ialysis machine was used' This was invented (y 7illem Gol and replaces the unctions o Gidneys which means that people with certain .inds o Gidney 9ailure can receive daily treatment or their condition' In <H@? the EE: was introduced' This measures (rain activity and is used to identi y whether people have conditions such as Epilepsy' <HL@ saw the irst porta(le de i(rillator' This allows am(ulance crews to use the device to help reesta(lish a normal heart(eat' In the same year the irst commercial ultrasound device was made availa(le' This is another orm o medical imaging which allows doctors to see the inside o the (ody' It is particularly use ul when assessing how well a pregnancy is progressing) or or loo.ing at the way in which speci ic parts o the (ody are unctioning'

0ne o the (est improvements to medical technology in recent years was the introduction o the $T scanner in <H?<' Invented (y :od rey Houns ield this machine scans the whole (ody and produces a !& image o the inside o the (ody' This can (e used to determine where disease is located and to see i it is spreading' In <H;" another improvement to medical imaging was made when the M3I scanner was introduced' This uses magnets to scan and can distinguish (etween healthy and unhealthy tissues) ma.ing it easier to spot things li.e $ancerous cells'

A $T 4canner 7hat has (een the impact o these machines8 Each o these machines ma.es diagnosis much easier and ena(les treatments to (e accurate and underta.en at an early stage in an illness' This means that recovery is more li.ely and the 1uality o li e o patients improves'

$ontinuity and $hange in Medicine

What are contin ity and change? $ontinuity is when something stays the same' This could (e an attitude) (elie o a medical practice' $hange is when something di erent happens' This might (e a new attitude or (elie ) or a new treatment' Why is it important that we st dy contin ity and change? Medicine through time is a development study so its important that we loo. at how and why things have got rom where they were in the past to how they are today' This allows us to compare the .ey eatures o di erent societies at di erent periods o time' What e#amples are there of contin ity over time? Lots o things have stayed the same throughout time' Thing a(out what you do i youre eeling unwell' The odds are that youll as. your parents or advice' This hasnt changed through time' -sually its your mother that youd as.) again this is something that hasnt changed over time' 9or many ilnesses the treatment o ered (y a parent will (e no di erent to treatments o ered in the past' 4imple (ut e ective things li.e resting) having a hot or cold drin.) some her(al remedies etc have (een around or as long as we have recorded these things' 4ome (elie s have also continued to stay the same' 3eligion has always had an in luence on medicineF there have always (een superstitionsF some people have always (een rightened o new treatments and technologies' 4imilarly) >common sense has always had a role in medicine' 9or example the idea o isolating people with disease to prevent it spreading is nothing new' Why have these things stayed the same? 0ne o the main reasons why something stays the same is the simple act that it wor.s= 0ther reasons are (elie s havent changed A people have always (elieved in spirits and gods) or example' Why have some things changed over time? 2ew discoveries and technologies can lead to change' The invention o a new medical techni1ue which is proven to wor. will) over time) lead to a change in the way that things are done' Attitudes can also change' This is o ten (ecause the need or something to change (ecomes apparent' An example o this is the change in attitude o governments towards /u(lic Health' As society changed) so did the attitude o those in power'

What might an e#aminer as' me a!o t contin ity and change? All sorts= Jou could (e as.ed to compare and contrast treatments in two di erent periods o time) in order to gauge the amount o change in that period' 9or example6

$omparing surgical techni1ues in <;"" with those in <H"" or the modern world'

$omparing methods o dealing with the #lac. &eath with the way that people tried to deal with the :reat /lague'

7ar and Medicine

What has war got to do with the history of medicine? 7hen wars happen people get inBured' This means that surgeons get lots o experience o dealing with di erent .inds o wounds' As the nature o war are has changed over time) through the use o new types o weapons) this has led to a greater understanding o the way in which to treat di erent .inds o inBury' This understanding can then (e applied in non military situations6 or example) treatments or (urns developed (y military surgeons can (e used or people who have (een (urnt in a house ire'

What e#amples are there of warfare leading to improvements in medical care? There are lots o examples' Here Ill provide one example rom the Ancient 7orld and one rom the 3enaissance' 2he Ancient World: The 3omans relied on their army to ensure the security o their empire and to expand it' They invested heavily in ensuring that the army was well trained) a(le to move around 1uic.ly and a(le to (e treated 1uic.ly and e ectively i inBured' This in turn meant that the 3omans invested in a1ueducts and sewers in towns with a military presence and that they esta(lished a good communications networ.' The purpose was always to maintain military might (ut the outcome is a very good pu(lic health system that is o (ene it to civilians as well as to soldiers' 2he Renaissance: &uring the 3enaissance /are made his (rea.throughs with the use o ligatures and o potions' 7hilst chance played a role in his use o potions) neither o these developments would have happened i it was not or the act that he was a (attle ield surgeon' Are the improvements all s rgical? There have (een lots o surgical improvements as a result o war are' 9rom the development o di erent ways o extracting things rom the (ody *arrows) (ullets etc+F dealing with (urnsF the development o ligatures and war leading to the introduction o (lood (an.s and increased use o x5rays (e ore surgery is per ormed' Medical developments caused (y war are arent all surgical though' The poor condition o soldiers signing up during the #oer war was one o the reasons why 2ational Insurance was introduced) The 9irst 7orld 7ar led to urther wel are legislation and the 4econd 7orld 7ar was a actor leading to the introduction o the 2ational Health 4ervice'

How does the role of war lin' in with other factors? Its very rare that only one actor leads to an improvement' /enicillin is a good example o this' It had (een discovered (y chance and researched later on (y a scienti ic team' 7ar are provided the reason why governments were willing to invest heavily in it and thats the reason why it (ecame so widely availa(le at that time' 7ithout the war the unding might not have (een su icient or it to ma.e much di erence or 1uite a long time A (ut it was other actors that led to it (eing discovered and researched' Li.ewise war are was one o the main reasons or increased government investment in wel are and health' However it also re1uired actors such as changing attitudes) research and reports and pu(lic pressure to get the changes made'

The role o government

What is the role of %overnment? The role o :overnment in the history o medicine through time is a loo. at :overnments as a actor' This could (e a governments decision to increase taxes to pay or healthcareF a government investing in medical researchF laws that they introduce a(out pu(lic health or the medical pro ession or governments doing little or nothing a(out health issues' How can %overment affect the development of medicine? :overnments control what happens in a country' I the government wants to see an aspect o healthcare improved it can channel resources into that area' Li.ewise i other areas are priorities) unding or medicine and healthcare might (e reduced' 4ince universal su rage in the -G) governments have *generally spea.ing+ re lected attitudes and (elie s o the people' This has meant that healthcare has (een a political priority and unding) whilst still o ten critici,ed) has (een a relatively high proportion o government spending' #e ore the vote was given to ordinary people the view o many governments was >Laisses59aire or >leave them alone which meant that investment in pu(lic health) or example) was limited' &i erent governments and political parties have di erent views a(out what should and shouldnt (e unded (y governments' 0ne example o this is the current -4 de(ate a(out Healthcare' -n what ways have governments improved medicine over time? An easy way to remem(er the main ways that governments have improved medicine and health over time is to use a mnemonic' 9or example Healthcare Education Attitudes 0atrines and clean water 2echnology Housing 0.) its a simple list (ut it covers most o the .ey points' A (rie summary o each6 Healthcare: 9rom the $radle to the :rave was a phrase used to descri(e the 7el are 4tate' It means that the government was willing to invest in healthcare provision or people o all ages) with any .ind o illness' Ed cation: :overnments write school curriculums' These can include all sorts o education a(out healthcare A thin. a(out the num(er o lessons youve had a(out

healthy eating) the importance o exercise etc' It also extends to investing in pu(lic in ormation (roadcasting and advertising'' Attit des3 :overnments can help to shape attitudes and approaches towards healthy li estyles and healthy living' This might (e through promoting these via adverts etc (ut has also (een the result o religious (elie s that have (een central to some past civili,ations *Ancient Egypt+ or through a desire to ensure a strong and healthy army *The 3omans+' 0atrines and clean water' 0.) I mean /u(lic Health here (ut latrines its the mnemonic so much (etterE 2echnology3 :overnments have invested in technology and scienti ic experimentation in order to achieve medical progress' /asteur and Goch were heavily unded (y their respective governmentsF /enicillin was mass produced as a result o :overnment investment and many governments through time have invested in the use o communications technology to in orm people a(out health and medicine' Ho sing' In the -G there have (een many acts o parliament relating to the 1uality o housing that is (uilt' This stems rom the Industrial 3evolution and attempts to solve pro(lems caused (y the emergence o slums' What ma'es governments invest in medicine and health? In a democracy) the voters= Examples o this6 the Li(eral 3e orms were in luenced (y the extended su rage to wor.ing class men and the rise o the La(our /arty' The Li(erals reali,ed that helping the poor was a vote winner A though they did (elieve it was the right thing to do' What things might ca se a government to limit its spending on health? Investment depends on an economy (eing strong' I the government is struggling to raise taxes) it will struggle to invest in things li.e healthcare' Li.ewise there are times when other things are more important' I a country is at war) or example) it will have to prioriti,e military spending or re(uilding damaged areas' A ter the collapse o the 3oman Empire there was a long period where there was little spent on /u(lic Health' This was caused (y the power struggles that occurred a ter the empire collapsedF (y the act that there was no longer a strong government that could organi,e things and (ecause o the lac. o trained soldiers and engineers who could ma.e the improvements'

&evelopment o Hospitals
Hospitals in the Ancient World There are several examples o places where people could go to get treatment in the Ancient 7orld' 0ne was (orne out o 3eligious (elie s) the Asclepion) the other) 3oman Military Hospitals) out o pragmatism' Asclepions were temples to the :ree. god o Healing) Asclepios' Invalids could go to the temple where they would (e loo.ed a ter in dormitories' There was an emphasis on rest and cleansing) called incu(ation' /riests would administer remedies and cures which they attri(uted to the wor. o the god' Asclepions were popular rom the %th century #$ and spread through the :ree. and 3oman worlds' The 3omans (uilt military hospitals throughout their vast empire' These were usually attached to a military ort' These hospitals provided relieve and rest or the sic. in and around the ort' They would also serve as a place or some operations to ta.e place' They were also o ten used as a place in which visitors could (e housed) so the purpose wasnt entirely health (ased' 1 rsing in the Ancient World In Asclepions the >nursing was done (y /riests' The 3omans used slaves to assist surgeons in their hospital' &uring the Ancient period the role o Midwives was clearly esta(lished and within :ree. and 3oman worlds they were highly respected and rules were in place a(out who could and couldnt (ecome a midwi e' Hospitals in +edieval E rope There were several types o >hospital availa(le in the Middle Ages' There were Leper Houses where people with Leprosy were housed and cared orF Hostels) o ten or pilgrims where care could (e soughtF Almshouses) which are a (it li.e a medieval care home andF hospital (uildings' These (uildings varied greatly in si,e' 4ome were designed to loo. a ter Bust a hand ul o people) o ten with a speci ic condition' 0thers) li.e the :reat Hospital) 2orwich) were a(le to cater or many more and had designs that are recogni,a(le as (eing hospitals' In 9rance the Hotel &ieu was ounded in the ?th century and was incredi(ly (usy A over H""" sheets were washed a wee.' These hospitals were paid or (y donations and endowments rom wealthy lords and taxes raised (y the church'

Hospitals in the -slamic World 4+edieval5 European hospital development at this time was rather mixed and access to hospitals varied greatly in terms o 1uality) availa(ility and the standard o medical .nowledge deployed there' 9or these reasons some people argue that it was a period o medical stagnation or regression' This certainly wasnt the case everywhere in the world though' The Islamic Empire retained and developed the .nowledge o the Ancient world and placed a high value on investment in pu(lic health) hospitals and the training o doctors' -nli.e European hospitals) the primary and only unction o Islamic hospitals o this period was to provide healthcare' &octors were well trained and large hospitals were (uilt throughout the empire' 4ee this site or urther in ormation and examples' 1 rsing in the middle Ages In this period there was a lac. o training availa(le or nurses' Many >nurses were indeed nuns who were caring or people out o religious conviction' In the late Middle Ages the dissolution o the monasteries and nunneries resulted in many o the nursing institutions ceasing to exist and conse1uently the >word o mouth training that would have happened in the monasteries no longer happened' This led to a period in which the standard o nursing in England was) generally spea.ing) very poor' 2he (evelopment of +odern 1 rsing 2ursing as we .now it (egan to develop in the mid <Hth century) largely as a result o wor. done (y 9lorence 2ightingale' 4he trained in :ermany A which in itsel says something a(out training o 2urses in #ritain= A And (egan wor.ing as a superintendent o a :entlemans hospital in London' 7hen the $rimean 7ar (ro.e out she was as.ed to lead a team o nurses to loo. a ter the wounded soldiers' Her team was very success ul in reducing the num(er o deaths and she was widely praised in the media' 7hen she returned to England a ter the war she esta(lished a Training school or nurses' In it she instilled the need or clean wards) separation o diseases and other things we ta.e or granted today' As the graduates o her school ound Bo(s) they introduced these ideas into hospitals and soon they (ecame accepted as the (est way o nursing' Royal College of 1 rsing The 3$2 was esta(lished in <H<L' It loo.s a ter the interests o the nursing pro ession and also ensures that there are suita(le standards o training and ongoing development o nurses throughout their career' This helps to ma.e sure that nursing is up to date and a(le to respond to new technologies) methods and diseases'

6ol ntary and Charity Hospitals #e ore the 2ational Health 4ervice was esta(lished many ordinary people would have made use o Coluntary and $harity hospitals' In larger cities) li.e London) there were several o these *London had ? large voluntary hospitals (y <;"H+' Another source o care was the /oor Law In irmaries' These were wards attached to wor.houses' At irst the conditions in these in irmaries were not very good (ut pressure n the authorities to re orm led to improvements (eing made over the course o the <Hth century' 9or example in Hali ax the :eneral hospital was opened in <H"< and that it had periods as a /oor Law In irmary) as a war hospital and under local authority control' Theyd also ind that there was an In irmary at the :i((et 4treet 7or.house' +odern Hospitals 9ollowing the introduction o the 2H4 most hospitals in the -G are now managed (y /rimary $are Trusts' They provide a wide range o services and are e1uipped with specialist e1uipment' 4ome o these hospitals speciali,e in certain conditions and are regional or national centers o excellence' There are still some criticisms o modern hospitals' $ritics argue that they are not clean enough) re1uire additional unding or maintenanceF increased num(ers o (eds and speed o service' There also remain a num(er o companies who run private hospitals'

Her(al 3emedies through the Ages

Throughout time people have made use o her(al remedies or a range o ailments' This post identi ies a num(er o common illnesses and shows how her(al remedies have (een used to alleviate the pro(lem at di erent points in time'

-ndigestion: The Ancient Egyptians used $hamomile as a remedy or indigestion' In the middle Ages it was used in Europe' 7e now .now that $hamomile has a chemical in it which acts as an anti5in lammatory and it continues to (e used today' Another her(al remedy that was popular (e ore the introduction o aspirin was 9ever ew' This her( was eaten in a sandwich'

(iarrhea6 /ortuguese explorers (rought $innamon into European medicine' This was used or &iarrhea and other (owel pro(lems' :inger has also (een used or stomach pro(lems' 9or example the Anglo54axons developed :inger #eer as a remedy or stomach pains'

Co ghs: Throughout the Ancient 7orld Li1uorices was commonly used to sooth sore throats and to ease coughs' It is also commonly used in traditional $hinese medicines'

-nfections: The Ancient :ree.s o ten placed Honey onto wounds to speed up the healing process' 3ecent research has also shown that Honey is good at com(ating staphylococcus aureus) a particularly nasty (ug that is ound in hospitals'

.ever: In the <@th and <Lth centuries her(alists prescri(ed the use o 7illow or evers' The willow (ar. would (e (oiled up then drun. once it had cooled down'

Her(al potions have also (een used over time as >tonics designed to .eep people it and healthy' :arlic has (een used in this way rom Ancient times'

Anti(iotics
What is an Anti!iotic? An anti(iotic is a su(stance created (y one organism that has the properties to destroy another organism' It can (e used to .ill the organisms that carry diseases and in ections'

When did scientists start loo'ing for them? A ter Louis /asteurs :erm Theory (ecame accepted it was clear that :erms were the cause o disease and scientists started loo.ing or ways o preventing these diseases *through vaccinations+ and o stopping in ections' There were experiments rom the <;?"s onwards that loo.ed at how e ective di erent moulds were in ighting in ection' However the ideas in that period were not particularly success ul'

Who made the !rea'thro gh? In <HK; a 4cientist called Alexander 9leming noticed that a mould called /enicillin was e ective at .illing the (acteria 4taphylococcus aureus' However he didnt really do much the discovery' It wasnt until the <H%"s that the discovery was wor.ed on and /enicillin was mass produced at an a orda(le price' 9lemings had (een a chance discovery) the development o /enicillin was due to team wor. led (y Ernst 9lorey and Howard $hain with signi icant investment in the development o the drug coming rom the -4 government as a result o the orthcoming & &ay landings' What other anti!iotics are there? Even though /enicillin was discovered irst) it wasnt the irst anti(iotic to (e made availa(le to the pu(lic' That was /rontosil) the irst >Magic #ullet which was developed (y a :erman 4cientist called :erhard &omag. in <H!@' 0ther anti(iotics include 4treptomycin) Amoxicillin and 2ystatin' Are anti!iotics a wonder dr g? Anti(iotics are very good at .illing in ections' However the (ugs that they are designed to .ill have ought (ac. and there are examples o super(ugs which have developed resistance to anti(iotics' In hospitals you will hear a(out the need or cleanliness to stop the spread o M34A *Multi 3esistant 4taphylococcus Aureus+' This in ection cant yet (e .illed o and is the result o (ugs mutating to avoid (eing .illed (y the anti(iotics that are currently availa(le'

An A to Q o &eadly &iseases
Why an A 7 8 of diseases? A simple A to Q list o diseases with notes can (e used to compare and contrast treatments) the way that di erent cultures approach illnesses and the varied levels o success that scientists have had in tac.ling diseases' A 5 Anthra# 5 Anthrax is one o the oldest surviving diseases and was mentioned in the writings o Hippocrates and in the 0ld Testament' It is a highly lethal disease that can a ect (oth animals and humans' Louis /asteur developed an e ective vaccine or Anthrax in <;;< and deaths have greatly reduced since then (ut the disease has not yet (een eradicated' # 5 $lac' (eath 5 The #lac. &eath spread through Asia into Europe in the mid <%th century A&' It .illed (etween !"R and L"R o Europes population' 4cientists are de(ating whether it was caused (y a (ug called Jersinia /estis or a viral ever *most text(oo.s say the irst o these as the alternative is a relatively new argument+' $ 5 Cholera 7 $holera originated in the Indian su(5continent' It spread along trade routes and irst struc. this country in <;!<' There were several maBor out(rea.s o the disease) nota(ly in <;%H and <;@%' The latter o these prompted Mohn 4now to conduct research into the cause o the disease' $holera spreads 1uic.ly in areas where the water supply is contaminated' In K""" the 7orld Health 0rganisation pu(lished statistics showing that ;?R o recent cases were in A rica' & 5 (iphtheria 5 &iphtheria is a contagious disease that can .ill' Its most o(vious symptom is a sore throat' In <;?; it claimed the lives o two mem(ers o the #ritish 3oyal 9amily' An SAnti5toxinS which tac.les the disease was introduced (y Emil von #ehring in <;H" and a vaccine was later introduced' E 5 Epilepsy 5 Epilepsy is a neurological disease characterised (y unpredicta(le sei,ures' It has existed since ancient times' In the past Epilepsy was o ten thought to (e the wor. o the devil or evil spirits and su erers were o ten ostracised or treated with supernatural cures' 2owadays people with epilepsy have medication which limits the chances o them having a sei,ure' 9 5 .ever 5 9evers have (een around or as long as man.ind' :ree. treatments o 9evers were (ased on the Theory o the 9our Humours' The theory was that a ever was caused (y having too much (lood rushing around so the treatment was to (leed the patient' The theory o opposites was also used' I you were too hot) you are given cold drin.s etc to cool you down' : 5 %angrene 5 :angrene occurs when (lood stops getting into veins and in ection sets in' It was common or (attle ield wounds to (ecome in ected in this way and the onset o gangrene o ten resulted in an amputation' 0ne o the more e ective historical treatments o :angrene was urine therapy) where the area is cleaned with urine' This helped to clear up the in ection' H 5 H-6 5 Human Immunode iciency Cirus is a condition where the cells that tac.le in ections are attac.ed and wea.ened' This then leads to AI&4 Ac1uired Immunode iciency 4yndrome+ or which there is no cure' HIC D AI&4 has .illed more

than K@ million people since it was irst discovered in <H;< and is considered to (e a pandemic (y the 7orld Health 0rganisation' I 5 -nfl en&a 5 In luen,a is more commonly called the 9lu' It is spread through the air) o ten as a result o coughs and snee,es' There are many variants o the lu' 3ecently we have seen S4wine 9luS and S#ird 9luS out(rea.s' At the end o the 9irst 7orld 7ar there was an out(rea. o the 9lu .nown as 4panish In luen,a' This out(rea. .illed more people than the war had= M 5 9a ndice 5 Maundice is a discolouration o the s.in) where it (ecomes more yellow in appearance' In the past people thought that people with Maundice would see things with a yellow tint) pro(a(ly (ecause the eyes can (e Baundiced as well' It is caused (y a dys unctional liver' G 5 :idney .ail re 5 Gidney 9ailure can now (e treated (y use o a &ialysis machine' This machine per orms the unction o the Gidney' It was invented (y &r 7illem Gol in occupied Holland during the 4econd 7orld 7ar' In essence the dialysis machine is attached to a persons (lood low and cleans the (lood (e ore returning it to the (ody' L 5 0eprosy 5 Leprosy is a disease that a ects the s.in' 4u erers o leprosy have s.in legions that loo. as though the s.in is rotting away' The disease has (een around or at least %""" years' Historical treatments include leper colonies where the su erers are isolated rom other people and until the <Hth century it was commonly (elieved that (athing in (lood would help to cure the illness' M 5 +RSA 5 Methicillin5resistant 4taphylococcus Aureus *also .nown as Multidrug resistant+ is a Ssuper(ugS that is resistant to anti(iotics' It attac.s wounds and can cause death' It spreads in places where cleanliness is an issue and is one o the main reasons why there are so many hand washes in hospitals and doctors surgeries' 2 5 1arcolepsy 5 2arcolepsy is a chronic sleep disorder which results in low 1uality sleep that means that someone with the condition will o ten (e very drowsy during the day' It was irst identi ied as a condition in the late <Hth century and treatments over time have included the use o anti5depressants and use o P53ays' 0 5 Osteoporosis 5 0steoporosis is a condition where the (one density is low and (ones are more li.ely to (rea. as a result' It can (e prevented through a (alanced li estyle and diet that is rich in calcium and vitamin &' The condition is more common in people over the age o @" *more than hal o Americans over @" have the condition+ and is treated in a num(er o ways' / 5 )olio 5 /olio is a viral disease that causes paralysis o muscles and can lead to death' It has existed rom Ancient Times and was much eared in the 7estern 7orld (e ore Monas 4al. created a vaccine or the disease in <HL@' 2ow most people in developed countries are vaccinated against the disease and it is rare or someone to catch it' However this is not the case throughout the developing world where /olio continues to (e a serious threat to health'

I 5 ; .ever 7 A disease ound most commonly in people who wor. with cattle' 9irst discovered in <H!? this disease was later considered suita(le as a possi(le (iological weapon' A vaccine or I ever was introduced in K""< in Australia' 3 5 Ra!ies 5 3a(ies is a viral in ection that is passed on rom animals) normally through a (ite' It causes acute headaches) over production o saliva and attac.s the nervous system' It is usually atal' In <;;@ Louis /asteur created a vaccine or 3a(ies' 3a(ies has (een eradicated in the -G (ut still exists in other parts o the world' 4 5 Smallpo# 5 4mallpox was a maBor .iller or over !""" years' 4urvivors o the disease would (e dis igured and o ten (linded' In <?H; Edward Menner managed to introduce an e ective vaccine against 4mallpox' 4ince then glo(al campaigns to vaccine against the disease have led to it success ul (eing eradicated !" years ago' T 5 2 !erc losis 5 Tu(erculosis *T#+ a ects the lungs and can (e deadly' The /asteur Institute in /aris wor.ed on a vaccine rom <H"@ to <HK<) (ut vaccination programmes in the -G werenSt common until a ter the 4econd 7orld 7ar' - 5 <rinary 2ract -nfection 5 a -TI *-rinary Tract In ection+ is caused when the (ladder (ecomes in ected' 2owadays they can (e treated with anti(iotics' /rior to the availa(ility o anti(iotics natural remedies were used' 9or example $ran(erry Buice was 1uite e ective at clearing up -TISs and the 2ative Americans dran. -rva -si Tea to com(at them' C 5 6ertigo 5 Certigo is a .ind o di,,iness caused (y a pro(lem in the inner ear' There are several .inds o Certigo which have di erent causes and treatments' 7 5 Whooping Co gh 5 7hooping $ough is a highly in ectious disease' Its name comes rom the SwhoopS sound made when coughing' A vaccine was developed or 7hooping $ough in the <HK"Ss in America' However the vaccine had some complications and some people died as a result o poor 1uality vaccines so upta.e or the vaccination wasnSt universal' A sa er vaccination was developed in the early <HH"Ss' P 5 = Ray E#pos re 5 7hilst its pretty sa e to have an x5ray it is 1uite dangerous to (e exposed to P53ays on a regular (asis' This is why radiographers are shielded rom the machines' P53ay exposure can lead to cancers developing and radiation poisoning' J 5 >ellow .ever 5 Jellow 9ever is spread (y mos1uito (ites and has led to hundreds o thousands o deaths worldwide' The irst success ul attempts to eradicate the disease were in Havana) where the ideas o &octors 9inlay and 3eed were put into practice a ter <H""' The irst vaccines were developed in the <H!"Ss and cases o Jellow 9ever dropped signi icantly in the years that ollowed' Q 5 8oster 5 Qoster is more commonly .nown as chic.enpox * or a irst in ection+ or shingles * or a second in ection+' It causes pain ul (listers to appear all over the (ody' It can (e treated with steroids) antiviral medicines and lotions'

<K Important people in a sentence

/are A 9rench Army surgeon who ound an e ective treatment or wounds and invented ligatures A :erman 4cientist that used the scienti ic methods o (acteriology to discover the causes o diseases such as cholera

Goch

:alen

A 3oman anatomist that wrote over L" (oo.s) adapted % humours theory and remained in luential or over <""" years

Hippocrates A :ree. doctor who invented the our humours and developed the idea o clinical o(servation

Menner

In <?HL he developed the smallpox vaccination

/asteur

An in luential 9rench scientist that developed >:erm Theory

$hadwic. people

An English $ivil 4ervant that wrote a report on the living conditions o in the <H%"s which led to improvements in pu(lic health

9leming

In <HK; he ound some mould growing in his la(oratory A this was developed into penicillin (y 9lorey and $hain

Cersalius

7riter o >The 9a(ric o The Human #ody and a pioneer o dissection

Harvey

7rote >0n the Motion o the Heart in <LK; and proved the heart was a pump

Lister

-sed $ar(olic Acid to prevent in ection A the irst antiseptic

4impson

&iscovered antiseptics A used chloro orm in <;%?