It was believed that the cause of illness and disease was a punishment from God, an imbalance of the four humours or due to miasma (bad smells). It could be prevented by prayer, bloodletting, purging, purifying the air or using herbal remedies.
Physician – 7 years university study, diagnosed illness by studying blood, urine and star charts.
Apothecary – used herbal remedies and charms
Barber Surgeon – unqualified but did bloodletting and tooth extractions
All of the above were men.
Hippocrates’ theory of the Four Humours Hippocrates and Galen’s ideas about balancing the humours were widely used in the treatment of disease. The humours could be balanced by blood-letting, purging, using laxatives or using herbs to purify the air.
People also turned to the church for relief from illness. They prayed and went on pilgrimages.
Most sick people were cared for at home usually by womenfolk. Hospitals were beginning to be set up by the church. Care was given by monks and nuns, mostly in the form of prayer and bed rest.
An unusual alignment of Mars, Jupiter and Saturn was thought to portend a great catastrophe.
Bubonic plague reached Weymouth, Dorset and Bristol. It had been carried from the East by trading ships and had then spread across Europe. Boccaccio described the symptoms “The first signs of the plague were lumps in the groin or armpits. After this, livid black spots appeared on the arms and thighs and other parts of the body. Almost all died within three days”. The plague became known as The Black Death
People believed the plague was a punishment from God for sin, was due to an imbalance of humours or due to miasma (bad air) that had been released by an earthquake or volcano.
Treatment for those infected consisted of praying for forgiveness, trying to balance the humours, smelling strong herbs or scents to purify the air.
Some attempt was made to prevent the disease from spreading including, removing animal dung from the streets, praying, going on pilgrimages and carrying sweet smelling herbs.
The Black Death reached London.
A religious group called the Flagellants attempted to rid Europe of the Black Death by touring the continent whipping themselves as atonement for people’s sins. They believed that the disease was a punishment from God for people’s sinfulness.
In London, 200 people were dying every day.
The plague reached Wales and the north of England.
The plague reached Scotland.
The plague had largely died out. It would return many times over the next few centuries until health and living standards improved.
The invention of the printing press meant that medical information spread more quickly than before.
People still believed that miasma (bad smells) were responsible for disease. However, fewer believed in supernatural causes.
After the Protestant Reformation the influence of the Catholic church declined and with it the practice of making pilgrimages. Most people did not believe that God sent disease as a punishment.
Surgeons were now better educated due to improvements in education. Although dissection of bodies was allowed after the Reformation, it was not easy to get a supply of bodies. New technologies in warfare also meant that wounds were different and required new surgical skills to be developed.
Andreas Vesalius published ‘On the Fabric of the Human Body’. Vesalius, a lecturer in surgery at the University of Padua, had dissected the bodies of a large number of executed criminals and had discovered 300 mistakes in the ideas of Galen. Vesalius encouraged others to carry out dissection and see for themselves but there were those that did not like the ideas of Galen being challenged and continued their traditional practices.
People started to believe in transference (the belief that disease could be transferred from one person to another). With the rise of science people also began to look for chemical cures rather than spiritual cures.
There were more hospitals and those with wounds or fevers would be treated as in patients.
William Harvey became a lecturer in anatomy at the College of Physicians. Through dissection he deduced that blood pumped by the heart must flow from arteries to veins through tiny vessels (capillaries). However, because he had not observed these tiny vessels through a microscope his theory was largely ignored.
Thomas Sydenham was a doctor practising in London. He believed that diagnosis of disease should be made by close observation of symptoms and then seeking a cure for those symptoms.
1660 (28th November)
The Royal Society was founded in London. The aim of the society was to discuss new ideas in the sciences including medicine.
The Great Plague
Plague returned to London. The causes of the epidemic were believed to be:
An unusual alignment of the planets, punishment from God, imbalance in the four humours or miasma – bad air and contact with sufferers.
Prevention and treatment consisted of:
Prayer, quarantining victims, eating garlic, preventing people from travelling, carrying a pomander (a perfumed ball), smoking tobacco, stopping people from holding meetings or large get-togethers. The plague doctor was a distinctive sight wearing a full length waxed leather gown and head covering with a beak stuffed with herbs.
Thomas Sydenham published ‘Observationes Medicae’. The book had a great observation on medicine.
The theory of the four humours was still believed in by some but most now no longer used by physicians. Microscopes had improved and microbes had been viewed. The theory of spontaneous generation argued that microbes were a product of decay rather than the cause of it. They believed that microbes were then spread by miasma.
More people were treated for illness in hospitals than at home.
Edward Jenner noted that milkmaids who had had cowpox did not get smallpox. He used this link to develop a vaccine against smallpox. James Phipps was given the vaccine then infected with smallpox. He did not catch the disease. However, people did not believe in the vaccination and it took time for the practice to be accepted.
Edwin Chadwick published his ‘Report on the Sanitary Conditions of the Labouring Classes’. The report concluded that people living in cities had a lower life expectancy due to the filthy conditions. The report recommended that cities should have a Board of Health, that clean water should be available for all and that sewage should be disposed of through a sewer system.
James Simpson discovered chloroform could be used as an anaesthetic.
Although the use of chloroform meant that operations could be carried out painlessly, it was risky because of the difficulty of determining the dose to be used. Hannah Greener died from an overdose during a toenail removal.
The first Public Health Act was published. Although it established a Central Board of Health, it had little authority and was given no money. Boroughs that had formed Corporations were to take responsibility for water supply and drainage. Other Boroughs could follow suit but were not compelled to do so.
The British government made smallpox vaccination compulsory.
1853 (7th April)
was given chloroform for pain relief during the birth of her son, Leopold.
Florence Nightingale and a team of nurses were sent to the Crimea to help care for British soldiers in the military hospital. Nightingale noticed that a large number of soldiers died in a dirty part of the ward. After the wards were scrubbed and cleaned the death rate reduced.
There was an outbreak of cholera in London. The surgeon John Snow decided to investigate the causes of the disease. Using a spot map of casualties he tracked the outbreak to a particular water pump. It was discovered that the well the water was being pumped from had been infected by fecal matter that had leaked from a cesspit. When the water pump was no longer used the numbers of deaths from cholera fell. Snow’s evidence persuaded the British government to install a new sewer system.
Florence Nightingale returned to Britain and began to campaign for cleaner hospitals.
The absence of a proper sewage system meant that raw sewage could be found on the banks of the River Thames in London. The summer was particularly hot and the awful smell of the sewage became known as the ‘Great Stink’.
Florence Nightingale published ‘Notes on Nursing’.
Florence Nightingale set up the Nightingale School for Nurses.
Louis Pasteur published his Germ Theory. This proved that germs caused liquids to decay. This disproved the theory of spontaneous generation and led to a belief that germs caused disease. Unfortunately Pasteur’s work initially had little impact because microbes could not be easily seen.
Joseph Lister discovered the antiseptic properties of using carbolic soap. However, many surgeons disliked using the soap.
The work of John Snow and the ‘Great Stink’ of 1858 had persuaded the government to build a sewer system in London. By this time 1300 miles had been constructed beneath the streets of the capital.
The Anti-Vaccine Society was established. Members did not trust vaccines and published cartoons to dissuade people from being vaccinated. One cartoon showed people changing into cows after being vaccinated against smallpox.
The London sewer system had been completed.
The government passed the Second Public Health Act. This act gave local authorities the power to create and run sewer systems, control water supply, regulate housing and establish laws for new buildings. While this act was a significant step towards improving public health, it was not compulsory.
Robert Koch further developed Pasteur’s work and successfully identified the bacteria that caused anthrax.
Robert Koch successfully identified the bacteria that caused tuberculosis and typhoid.
Robert Koch discovered the disease cholera. However, the British government refused to believe that the disease was caused by microbes.
Robert Koch’s work led to more scientists working to identify the cause of specific diseases.
The Dutch physician Willem Einthoven invented the first electrocardiogram (ECG). However, the machine was cumbersome and was difficult to transport.
X-rays were first used in hospitals, though their use was not widespread at this time.
Scientists had discovered that not all diseases were caused by microbes.
Russian Dr Nikolai Korotkoff discovered systolic and diastolic blood pressures which form the basis for modern blood pressure measurement.
Salvarsan 606 was developed as a cure for syphilis. It was known as a Magic Bullet since it cured the disease without side effects.
Gerald Domagk discovered Prontosil which was able to cure blood poisoning without side effects
The outbreak of World War One
led to an increase in research against various conditions in a bid to reduce deaths of army personnel. Many soldiers suffered from what is now known as post traumatic stress disorder (PTSD). During the war it was known as shell shock. Some soldiers were lucky enough to be treated compassionately and allowed to rest, but many were accused of cowardice and shot as deserters.
The trench warfare of the Western Front led to large numbers of cases of trench foot, which was caused by soldiers spending long periods in waterlogged trenches. Soldiers were encouraged to use whale oil and change socks regularly to keep their feet as dry as possible.
Blood transfusions were used by the British army doctors for the first time.
All British soldiers were issued with gas masks to use in the face of gas attacks on the Western Front.
It was discovered that trench fever was caused by lice. De-lousing stations and the use of disinfectant reduced the number of cases of the disease.
Alexander Fleming discovered penicillin after noticing that mould had killed staphylococcus bacteria.
Howard Florey and Ernest Chain began working with penicillin to produce antibiotics.
Howard Florey and Ernest Chain proved that antibiotics could cure human bacterial infections. However, they were unable to mass produce the drug. They asked the US government to help and a number of pharmaceutical companies were set up to produce the drug.
Immunisation against diphtheria was made compulsory by the British government.
The British government established the National Health Service (NHS) to provide free medical care for the population. All people would have free access to hospitals, general practitioners (GPs), ambulance services, health visitors and dentists.
Immunisation against polio was made compulsory by the British government.
The discovery of DNA provided an reason for hereditary diseases.
Ultrasound was first used in a Glasgow hospital.
The Clean Air Act was passed to reduce the amount of smog in cities.
The first CT scan of a patient’s brain was carried out in Wimbledon.
Smallpox was eradicated from Britain.
The Human Genome Project began to decode and map the human genome (the DNA of a particular organism).
Smoking in enclosed work spaces was made illegal.