Who was Hippocrates?
Hippocrates was a physician who was born on the Greek Island of Cos in around 460BC. He became famous in his lifetime and is considered by many to be the founder of modern medicine. Indeed he is referred to as ‘the father of medicine’ and doctors still take the Hippocratic Oath, named after him, when they qualify.
What was his big idea?
Hippocrates had a few big ideas! He developed the Theory of the Four Humors which explains disease through looking at the liquids in the body and the way that they are balanced. He also advocated clinical observation, a method still used today in which the symtoms of a disease are observed before treatment is given. Prior to this, many doctors had ‘jumped in’ when seeing or hearing of one symptom which could lead to misdiagnosis or unwarranted treatments. His other big idea was professionalism. Everything was recorded carefully, ideas tested before being stated as fact and ‘bedside manner’ was promoted.
Why is this significant?
Many of the things that Hippocrates wrote about were ground breaking. The theory of the four humors works on the principle of the healing power of nature; clinical observation leads to accurate diagnosis and his advice on how to treat different diseases is generally sound. And becuase all of his ideas are carefully recorded they can be used by later generations who can develop and refine the ideas.
What influenced his work?
Historians think that Hippocrates received training at the Asclepion on the island of Cos and that he also had lessons from Herodicus. It is also thought that his father and grandfather were physicians. If true, these experiences would have been highly influencial, as perhaps were the works of philosophers of that age.
How long did his ideas last for?
The Theory of the Four Humors was still being commonly used in the late medieval period and into the Renaissance. Clinical Observation in the format that Hippocrates advised was used for a similar period of time, until doctors had access to high quality medical laboritories (though not universally, there were criticisms of hippocratic medicine with some arguing that the method of observation led to medication being given too late). The notion of professionalism and carefully recording things has continued to the modern day.
Where can I find out more about Hippocrates?
The main part of this website has details of Hippocratic medicine, the Theory of the Four Humors and other aspects of medicine at this time.
You can read translations of some of his work on the Internet Classics Archives website.
The historylearningsite has a good introduction to Hippocrates on it.
Wikipedia has a detailed account of Hippocrates’ life and works.
What is an Antibiotic?
An antibiotic is a substance created by one organism that has the properties to destroy another organism. It can be used to kill the organisms that carry diseases and infections.
When did scientists start looking for them?
After Louis Pasteur’s Germ Theory became accepted it was clear that Germa were the cause of disease and scientists started looking for ways of preventing these diseases (through vaccinations) and of stopping infections. There were experiments from the 1870’s onwards that looked at how effective different moulds were in fighting infection. Hoewever the ideas in that period were not particularly successful.
Who made the breakthrough?
In 1928 a Scientist called Alexander Fleming noticed that a mould called Penicillin was effective at killing the bacteria Staphylococcus aureus. However he didn’t really do much the discovery. It wasn’t until the 1940’s that the discovery was worked on and Penicillin was mass prodiced at an affordable price. Fleming’s had been a chance discovery, the development of Penicillin was due to team work led by Ernst Florey and Howard Chain with significant investment in the development of the drug coming from the US government as a result of the forthcoming D Day landings.
What other antibiotics are there?
Even though Penicillin was discovered first, it wasn’t the first antibiotic to be made available to the public. That was Prontosil, the first ‘Magic Bulet’ which was developed by a German Scientist called Gerhard Domagk in 1935. Other antibiotics include Streptomycin, Amoxicillin and Nystatin.
Are antibiotics a wonder drug?
Antibiotics are very good at killing infections. However the bugs that they are designed to kill have fought back and there are examples of ’superbugs’ which have developed resistance to antibiotics. In hospitals you will hear about the need for cleanliness to stop the spread of MRSA (Multi Resistant Staphylococcus Aureus). This infection can’t yet be killed off and is the result of bugs mutating to avoid being killed by the antibiotics that are currently available.
Throughout time people have made use of herbal remedies for a range of ailments. This post identifies a number of common illnesses and shows how herbal remedies have been used to alleviate the problem at different points in time.
Headaches:
Indigestion: The Ancient Egyptians used Camomile as a remedy for indigestion. In the Middle Ages it was used in Europe. We now know that Camomile has a chemical in it which acts as an anti-inflamatory and it continues to be used today. Another herbal remedy that was popular before the introduction of aspirin was Feverfew. This herb was eaten in a sandwich.
Diarrhoea: Portuguese explorers brought Cinnamon into European medicine. This was used for Diarrhoea and other bowel problems. Ginger has also been used for stomach problems. For example the Anglo-Saxons developed Ginger Beer as a remedy for stomach pains.
Coughs: Throughout the Ancient World Liquorice was commonly used to sooth sore throats and to ease coughs. It is also commonly used in traditional Chinese medicines.
Infections: The Ancient Greeks often placed Honey onto wounds to speed up the healing process. Recent research has also shown that Honey is good at combatting staphylococcus aureus, a particularly nasty bug that is found in hospitals.
Fever: In the 15th and 16th centuries herbalists prescribed the use of Willow for fevers. The wilow bark would be boiled up then drunk once it had coled down.
Herbal potions have also been used over time as ‘tonics’ designed to keep people fit and healthy. Galric has been used in this way from Ancient times.
For a longer list of examples of herbal remedies, see this site which looks at how the herbs were used in the past and what modern uses there are of each herb.
This site lists herbal and ‘common sense’ cures that have been passed down from generation to generation.
Ayurvedic Medicines originated in India and make use of herbal remedies. See this site for more information.
Hospitals in the Ancient World
There are several examples of places where people could go to get treatment in the Ancient World. One was borne out of Religious beliefs, the Asclepion, the other, Roman Military Hospitals, out of pragmatism.
Asclepions were temples to the Greek god of Healing, Asclepios. Invalids could go to the temple where they would be looked after in dormitories. There was an emphasis on rest and cleansing, called incubation. Priests would administer remedies and cures which they attributed to the work of the god. Asclepions were popular from the 4th century BC and spread through the Greek and Roman worlds. See this site for more about the cult.
The Romans built military hospitals throughout their vast empire. These were usually attached to a military fort. These hospitals provided relieve and rest for the sick in and around the fort. They would also serve as a place for some operations to take place. They were also often used as a place in which visitors could be housed, so the purpose wasn’t entirely health based. See this site for further information.
Nursing in the Ancient World
In Asclepions the ‘nursing’ was done by Priests. The Romans used slaves to assist surgeons in their hospital. During the Ancient period the role of Midwives was clearly established and within Greek and Roman worlds they were highly respected and rules were in place about who could and couldn’t become a midwife.
Hospitals in Medieval Europe
There were several types of ‘hospital’ available in the Middle Ages. There were Leper Houses where people with Lepresy were housed and cared for; Hostels, often for pilgrims where care could be sought; Almshouses, which are a bit like a medieval care home and; hospital buildings.
These buildings varied greatly in size. Some were designed to look after just a handful of people, often with a specific condition. Others, like the Great Hospital, Norwich, were able to cater for many more and had designs that are recognisable as being hospitals. In France the Hotel Dieu was founded in the 7th century and was incredibly busy – over 9000 sheets were washed a week. These hospitals were paid for by donations and endowments from wealthy lords and taxes raised by the church.
Hospitals in the Islamic World (Medieval)
European hospital development at this time was rather mixed and access to hospitals varied greatly in terms of quality, availability and the standard of medical knowledge deployed there. For these reasons some people argue that it was a period of medical stagnation or regression. This certainly wasn’t the case everywwhere in the world though. The Islamic Empire retained and developed the knowledge of the Ancient world and placed a high value on investment in public health, hospitals and the training of doctors. Unlike European hospitals, the primary and only function of Islamic hospitals of this period was to provide healthcare. Doctors were well trained and large hospitals were built throughout the empire. See this site for further information and examples.
Nursing in the Middle Ages
In this period there was a lack of training available for nurses. Many ‘nurses’ were indeed nuns who were caring for people out of religious conviction. In the late middle ages the dissolution of the monasteries and nunneries resulted in many of the nursing institutions ceasing to exist and consequently the ‘word of mouth’ training that would have happened in the monasteries no longer happened. This led to a period in which the standard of nursing in England was, generally speaking, very poor. See this page for a more detailed account.
The Development of Modern Nursing
Nursing as we know it began to develop in the mid 19th century, largely as a result of work done by Florence Nightingale. She trained in Germany – which in itself says something about training of Nurses in Britain! – and began working as a superintendent of a Gentlemans hospital in London. When the Crimean War broke out she was asked to lead a team of nurses to lok after the wounded soldiers. Her team were very successful in reducing the number of deaths and she was widely praised in the media. When she returned to England after the war she established a Training school for nurses. In it she instilled the need for clean wards, seperation of diseases and other things we take for granted today. As the graduates of her school found jobs, they introduced these ideas into hospitals and soon they became accepted as the best way of nursing.
Royal College of Nursing
The RCN was established in 1916. It looks after the interests of the nursing profession and also ensures that there are suitable standards of training and ongoing development of nurses throughout their career. This helps to make sure that nursing is up to date and able to respond to new technologies, methods and diseases.
Voluntary and Charity Hospitals
Before the National Health Service was established many ordinary people would have made use of Voluntary and Charity hospitals. In larger cities, like London, there were several of these (London had 7 large voluntary hospitals by 1809). You can find a detailed account of how these Voluntary hospitals worked on this site. Another source of care were the Poor Law Infirmaries. These were wards attached to workshouses. At first the conditions in these infirmaries were not very good but pressure n the authorities to reform led to improvements being made over the course of the 19th century. See this page for further information. To find out what hospitals were available in your local area before the NHS, enter your towns name into this search engine and it will return the names of all hospitals for which there are records in that town. For example my pupils would enter ‘Halifax’ and find that the General hospital was opened in 1901 and that it had periods as a Poor Law Infirmary, as a war hospital and under local authority control. They’d also find that there was an Infirmary at the Gibbet Street Workhouse.
Modern Hospitals
Following the introduction of the NHS most hospitals in the UK are now managed by Primary Care Trusts. They provide a wide range of services and are equipped with specialist equipment. Some of these hospitals specialise in certain conditions and are regional or national centres of excellence. There are still some criticisms of modern hospitals. Critics argue that they are not clean enoughh, require additional funding for maintenance; increased numbers of beds and speed of service. There also remain a number of companies who run private hospitals.
28 new links have been added to the list of videos for use in medicine lessons.
The links page has been updated t include links sent out via twitter and to add links to most areas.
The have been a few additions to the teachers resources page.
What is the role of Government?
The role of Government in the history of medicine through time is a look at Governments as a factor. This could be a governments decision to increase taxes to pay for healthcare; a government investing in medical research; laws that they introduce about public health or the medical profession or governments doing little or nothing about health issues.
How can Goverment affect the development of medicine?
Governments control what happens in a country. If the government wants to see an aspect of healthcare improved it can channel resources into that area. Likewise if other areas are priorities, funding for medicine and healthcare might be reduced. Since universal suffrage in the UK, governments have (generally speaking) reflected attitudes and beliefs of the people. This has meant that healthcare has been a political priority and funding, whilst still often criticised, has been a relatively high proportion of government spending. Before the vote was given to ordinary’ people the view of many governments was ‘Laisses-Faire’ or ‘leave them alone’ which meant that investment in public health, for example, was limited. Different governments and political parties have different views about what should and shouldn’t be funded by governments. One example of this is the current US debate about Healthcare. See this BBC article and analysis to see the arguments for and against increased investment by the US government.
In what ways have governments improved medicine over time?
An easy way to remember the main ways that governments have improved medicine and health over time is to use a mneumonic. For example
Healthcare
Education
Attitudes
Latrines and clean water
Technology
Housing
Ok, its a simple list but it covers most of the key points. A brief summary of each:
Healthcare: “From the Cradle to the Grave” was a phrase used to describe the Welfare State. It means that the government was willing to invest in healthcare provision for people of all ages, with any kind of illness.
Education: Governments write school curriculums. These can include all sorts of education about healthcare – think about the number of lessons you’ve had about healthy eating, the importance of exercise etc. It also extends to investing in public information broadcasting and advertising. Example: Government video advising people about Swine Flu.
Attitudes. Governments can help to shape attitudes and approaches towards healthy lifestyles and healthy living. This might be through promoting these via adverts etc but has also been the result of religious beliefs that have been central to some past civilisations (Ancient Egypt) or through a desire to ensure a strong and healthy army (The Romans).
Latrines and clean water. Ok, I mean Public Health here but latrines fits the mneumonic so much better…
Technology. Governments have invested in technology and scientific experimentation in order to achieve medical progress. Pasteur and Koch were heavily funded by their respective governments; Penicillin was mass produced as a result of Government investment and many governments through time have invested in the use of communications technology to inform people about health and medicine.
Housing. In the UK there have been many acts of parliament relating to the qualit of housing that is built. This stems from the Industrial Revolution and attempts to solve problems caused by the emergence of slums.
What makes governments invest in medicine and health?
In a democracy, the voters! Examples of this: the Liberal Reforms were influenced by the extended suffrage to working class men and the rise of the Labour Party. The Liberals realised that helping the poor was a vote winner – though they did believe it was the right thing to do.
What things might cause a government to limit its spending on health?
Investment depends on a economy being strong. If the government is struggling to raise taxes, it will struggle to invest in things like healthcare. Likewise there are times when other things are more important. If a country is at war, for example, it will have to prioritise military spending or rebuilding damaged areas. After the collapse of the Roman Empire there was a long period where there was little spent on Public Health. This was caused by the power struggles that occured after the empire collapsed; by the fact that there was no longer a strong government that could organise things and because of the lack of trained soldiers and engineers who could make the improvements.
What has war got to do with the history of medicine?
When wars happen people get injured. This means that surgeons get lots of experience of dealing with different kinds of wounds. As the nature of warfare has changed over time, through the use of new types of weapons, this has led to a greater understanding of the way in which to treat different kinds of injury. This understanding can then be applied in non military situations: for example, treatments for burns developed by military surgeons can be used for people who have been burnt in a house fire.
What examples are there of warfare leading to improvements in medical care?
There are lots of examples. Here I’ll provide one example from the Ancient World, one from the Renaissance and one from the Twentieth century.
The Ancient World: The Romans relied on their army to ensure the security of their empire and to expand it. They invested heavily in ensuring that the army was well trained, able to move around quickly and able to be treated quickly and effectively if injured. This in turn meant that the Romans invested in aqueducts and sewers in towns with a military presence and that they established a good communications network. The purpose was always to maintain military might but the outcome is a very good public health system that is of benefit to civilians as well as to soldiers.
The Renaissance: During the Renaissance Pare made his breakthroughs with the use of ligatures and of potions. Whilst chance played a role in his use of potions, neither of these developments would have happened if it was not for the fact that he was a battlefield surgeon.
Are the improvements all surgical?
There have been lots of surgical improvements as a result of warfare. From the development of different ways of extracting things from the body (arrows, bullets etc); dealing with burns; the development of ligatures and war leading to the introduction of blood banks and increased use of x-rays before surgery is performed. Medical developments caused by warfare aren’t all surgical though. The poor condition of soldiers signing up during the Boer war was one of the reasons why National Insurance was introduced, The First World War led to further welfare legislation and the Second World War was a factor leading to the introduction of the National Health Service.
How does the role of war link in with other factors?
Its very rare that only one factor leads to an improvement. Penicillin is a good example of this. It had been discovered by chance and researched later on by a scientific team. Warfare provided the reason why governments were willing to invest heavily in it and thats the reason why it became so widely available at that time. Without the war the funding might not have been sufficient for it to make much difference for quite a long time – but it was other factors that led to it being discovered and researched. Likewise warfare was one of the main reasons for increased government investment in welfare and health. However it also required factors such as changing attitudes, research and reports and public pressure to get the changes made.
Got another example of war affecting the development of medicine? Feel free to add it as a comment, there are plenty of examples not covered in this guide!
I’m delighted to say that the entire contents of the Hodder Murray Dynamic Learning CD lesson on ‘The Industrial Revolution: Public Health of Pasteur? Why did health improve?’ is now available via this website.
The Industrial Revolution: Public Health of Pasteur? Why did health improve?
What is medical technology?
Medical technology refers to the machines that can be used to help identify an illness or treat it. This includes scanners that can look inside the body, X-Ray machines, Camera technology and equipment used to test samples.
What medical technologies have been developed in the Twentieth Century?
Just before the start of the Twentieth Century William Rontgen discovered how to make use of X-Rays. The use of X-Rays developed in the first part of the Twentieth Century and has improved the way that doctors identify broken bones etc.
One of the first X-Rays taken
In 1943 the first Dialysis machine was used. This was invented by Willem Kolff and replaces the functions of Kidneys which means that people with certain kinds of Kidney Failure can receive daily treatment for their condition.
In 1957 the EEG was introduced. This measures brain activity and is used to identify whether people have conditions such as Epilepsy.
1965 saw the first portable defibrilator. This allows ambulance crews to use the device to help reestablish a normal heartbeat.
Defibrilator
In the same year the first commercial ultrasound device was made available. This is another form of medical imaging which allows doctors to see the inside of the body. It is particularly useful when assessing how well a pregnacy is progressing, or for looking at the way in which specific parts of the body are functioning.
One of the best improvements to medical technology in recent years was the introduction of the CT Scanner in 1971. Invented by Godfrey hounsfield this machine scans the whole body and produces a 3D image of the inside of the body. This can be used to determine where disease is located and to see if it is spreading. In 1980 another improvement to medical imaging was made when the MRI scanner was introdced. This uses magnets to scan and can distinguish between healthy and unhealthy tissues, making it easier to spot things like Cancerous cells.
CT Scanner
What has been the impact of these machines?
Each of these machines makes diagnosis much easier and enables treatments to be accurate and undertaken at an early stage in an illness. This means that recovery is more likely and the quality of life of patients improves.
For a list of other new medical technologies, have a look at this timeline on Wikipedia.
The task noted in my previous post has now been completed. An interactive scheme of work for medicine through time, based largely on the edexcel specification, is now complete. Covering 23 enquiries the scheme provides activities for pupils to complete which will enable them to gain a good understanding of the key concepts covered in their examinations. Whilst the scheme if focussed on the Edexcel specification there are plenty of overlaps with the specifications from other exam boards and I hope that users will find the resources adaptable enough to transfer to these courses. I won’t pretend that all of the ideas are my own, they’re not! I’ve made use of existing resources from trusted colleagues and reputable sites wherever they already cater for the required outcomes. The scheme will no doubt be tinkered with over time (the first 4 units in particular will be revisited) and any feedback would be appreciated.
Interactive Scheme of Work.
