Contents (i) The Ancient World The Prehistoric World Evidence about the prehistoric period is limited but comes from two main sources: ‐ Archaeological finds, e.g. Bones and the remains of tools and plants ‐ The culture of current peoples whose lives haven’t changed much since p rehistoric times,e.g. The aborigines of Australia Based on this evidence, historians can draw some fairly reliable conclusions:. Prehistoric people largely explained disease and infection through the spirits they believed in. A bad spirit could enter the body and cause an illness. In order to treat illness a patient might be given a herbal remedy by someone in their family.

1. Gcse Medicine Through Time Revision

The patient could also go and see a medicine man who was a half‐priest, half‐doctor figure.The medicine man would put the patient into a trance, use herbal remedies, and chant spells and prayers to get the bad spirits to leave the body. Therefore, prehistoric people had a supernatural approach to disease and infection. Ancient Egypt Egyptians also had a supernatural approach to disease and infection. They had temples of healing and several gods and goddesses to whom people prayed to get better. Sekhmet was a goddess who could cause and cure epidemics and Imhotep was a god of healing. Other Egyptian sources mention people going to see ‘priest‐magicians’ in search of cures.

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Other supernatural ideas the Egyptians had to prevent or cure disease and infection were:. Wearing magic charms to ward off evil spirits. Making ointments out of the fat of animals which they believed had healing powers, e.g.cats, crocodiles and snakes. Bathing in water that had been blessed by a priest.

Swallowing mice whole was believed to cure certain conditions. However, the Egyptians also developed a natural approach to disease and infection. They observed the River Nile and how the irrigation channels from the river brought life to their fields.

They developed the theory that the body has channels through which blood, air and water flow. They believed that you became ill when these channels were blocked. One cause of blocked channels they thought of was rotting food. They believed that this is why you are sick when you are ill – your body is trying to get rid of the rotten food. The rotten food could also cause other symptoms such as wind and diarrhoea. The flooding and draining of the Nile inspired the Channels Theory Other natural ideas the Egyptians had about how to prevent and cure disease and infection were:.

Herbal remedies – many Egyptian medicines contained honey which has been shown by modern science to have anti‐bacterial properties. Using mosquito nets to keep the insects off the body. The Egyptians had clearly realised that insects could spread diseases.

Keeping the body clean and washing regularly. Making yourself or the patient sick – this was to get rid of the rotten food blocking thechannels. Ancient Greece Some of the Ancient Greeks had a supernatural approach to disease and infection. They believed that illness was caused by the gods and that the only way to get better was to pray at an Asclepion which was a temple built to worship Asclepius, the god of healing. At an Asclepion they would:. Make offerings to Asclepius and his two daughters – Panacea and Hygeia. Sleep in the abaton – a building next to the temple where they believed that Asclepius wouldvisit them in their sleep and cure their illness.

Asclepions also had baths, gymnasiums and were built in the fresh air of the countryside. These things would have helped people to recover as well, but they believed it was the power of the god that was curing them. Other Greeks rejected supernatural ideas and developed more natural approaches. They used herbal remedies in the same way as the Egyptians had. The best known of the Greeks’ natural approaches is the Theory of the Four Humours which was developed by Hippocrates. This theory said: - The body is made up of four liquids (humours) – blood, phlegm, black bile and yellow bile. If the humours are in balance then you are healthy, however, if there is too much of one humour then you are ill.

The Theory of the Four Humours The Theory of the Four Humours seemed to be a very good idea because:. It explained the symptoms of many illnesses, for example in the winter when you get runny noses the theory said that you had too much phlegm. If you were sick, your body was trying to get rid of yellow bile. Diarrhoea was a symptom of having too much black bile.

It fitted in with the Greeks’ beliefs about the four elements (earth, air, fire and water) and also the four seasons. Therefore winter was cold and wet, which was why you had too much phlegm in that season. Water which is also cold and wet was the dominant element in winter. It also fitted in with the Greeks’ belief in leading a balanced lifestyle. They thought that not eating or drinking too much would help to keep you healthy. Hippocrates is a very important figure in the history of medicine because:.

He developed the Theory of the Four Humours which was believed for the next 2000 years. He totally rejected any supernatural beliefs about disease and infection. He insisted that all illness had a natural cause and could only be treated with natural remedies. He said that doctors should carefully observe and record the symptoms of their patients.

He came up with the Hippocratic Oath which set out how doctors should behave, e.g. They should never give patients anything which could harm them and they should keep their patients’ details totally confidential. These are still rules for doctors nowadays. He wrote many books about his ideas which were still being read 2000 years later. Therefore, Hippocrates is important because he set out the methods which doctors use even in the present day – careful observation and recording; rejecting supernatural beliefs; maintaining high standards of professional behaviour. However, Hippocrates did not come up with many treatments to cure diseases – he could recognise and name many illnesses but he couldn’t effectively cure any.

The most common treatment based on his ideas was bleeding, which was done to get rid of excess blood in line with the Theory of the Four Humours. Ancient Rome The Romans had strong supernatural beliefs in the gods. As a result they also had temples of healing and prayed to different gods to cure illnesses. Salus was a goddess of healing.

The Romans even built temples to Asclepius as they had heard of his supposed healing powers from the Greeks. The Romans also had natural approaches to disease and infection. They used herbal remedies and because their Empire stretched so far they were able to get hold of a wider range of natural ingredients for their medicines. A Roman medical book lists 600 different herbal remedies. Early on, the Romans were very suspicious of Greek doctors and their theories. The Romans liked to think of themselves as practical people who did not get carried away with fancy ideas. Their attitude towards Greek theories began to change with the arrival of Galen in Rome in AD 161.

Galen is important because: - He was trained at Alexandria in the natural ideas of the Greeks including the importance of careful observation and recording and the need to lead a healthy lifestyle. He introduced the Theory of the Four Humours to ancient Rome.

He added his own Theory of Opposites which explained many more treatments that could be offered based on the theory of the four humours, e.g. Giving patients dried pepper to balance out too much phlegm. Galen was enthusiastic about the use of bleeding as a treatment. He became the doctor to the Roman Emperor which allowed him to spread his ideas quickly. He wrote many books which eventually became the most important medical textbooks in medieval Europe 1000 years later and were still being read in the Renaissance.

One of Galen's many books. The Middle Ages and the Renaissance The Dark Ages in Europe (500 – 1000 AD) The Roman Empire collapsed around the year 500 AD. The period that followed is called the Dark Ages because there is not that much information about it.

Gcse Medicine Through Time Revision

During the Dark Ages the standard of medical care and knowledge declined. People relied more heavily on supernatural approaches to medicine and did not continue the Greek and Roman interest in finding out more about the human body. In the Dark Ages, Europe was taken over by warlike tribes.

This led to a decline in medicine because:. The rulers spent far more money on soldiers and weapons than on medical progress and universities.

War disrupted the normal channels of communication which meant that medical ideas could not be shared as easily. Many books were destroyed or hidden during the Dark Ages, for example the books ofHippocrates and Galen. As a result most people relied on prayer and religion to explain and cure illness.

They would still have used herbal remedies passed down through families but not a lot of other natural treatments. The Islamic Empire (700 – 1450 AD) Whilst Europe was in a period of decline during the Dark Ages, the Islamic Empire in the Middle East was far more advanced and civilised.

There was one strong ruler – the Caliph – who was able to invest money in universities and hospitals because he did not have to spend as much of his money on war. The best example of this is the new university and hospital built next to each other in Baghdad in about 800 AD. At the same time a centre for the translation of Greek and Roman books was set up.

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This centre translated the work of Hippocrates and Galen into Arabic. Al‐Razi (Rhazes) The first great Islamic doctor was Al‐Razi. Following the ideas of Hippocrates, he stressed the importance of careful observation and recording.

Using this method he was able to identify the difference between smallpox and measles. He became the first director of the new hospital in Baghdad. Al Razi was a great admirer of Galen but he also prepared to criticise him where he thought Galen was wrong. Ibn Sina (Avicenna) The second great Islamic doctor was Ibn Sina.

He wrote a million‐word encyclopaedia called ‘The Canon’. In it he summarised the whole of medical knowledge up to the year 1000, including Hippocrates, Galen and Islamic doctors. Ibn Sina was an expert on drugs and he listed the properties of 760 different drugs, some of which are still in use today, e.g. Camphor and laudanum. Avicenna, the Italian name given to polymath Ibn Sina Conclusion Islamic medicine was more advanced than European medicine during the Middle Ages. This was something the Crusaders discovered when they invaded the Holy Land in the 11th and 12th centuries.

This was due to the continuation of Greek and Roman knowledge in the Islamic Empire which had been lost in Europe. However, there were limitations on the advances of the Islamic Empire: ‐ Islamic beliefs prevented the dissection of human bodies ‐ Most Islamic doctors did not believe it was right to dabble in surgery ‐ The Islamic Empire suffered as much from the Black Death as medieval Europe did The Middle Ages in Europe(1000 – 1450 AD) The Middle Ages were dominated by the Church, which was the most powerful and wealthy international organisation. The Church controlled all of the universities and therefore the training of doctors. The Church helped medical progress in some ways but hindered its development in others.

The Church helped by: ‐ setting up universities where doctors could train, e.g. Salerno, Padua. After the Dark Ages, the books of Galen and Hippocrates were slowly rediscovered and doctors could study these. ‐ running and paying for hospitals. These were often part of monasteries or cathedrals and offered some medical care by the monks or nuns who had some skill with herbal remedies. The Church hindered medical progress by:  Banning dissections because it was believed that the whole body would be needed in the afterlife. (This ban was relaxed a little in the 14th century when each university could do one dissection per year)  Encouraging people to believe that God caused diseases and to pray or go on pilgrimages to cure illnesses.

This meant that most people in the Middle Ages had a supernatural approach to illness. The Church also hindered progress by:  Insisting that Galen was right about everything. The Church liked Galen because he said the human body is like a perfectly interconnecting machine. This fitted in with their belief that God had designed the human body. This attitude prevented doctors from challenging some of Galen’s mistakes. If a body being dissected was different from Galen’s book, they said that the body was wrong not Galen. A floor plan of the Great Hospital at Norwich Doctors in the Middle Ages Doctors in the Middle Ages had both natural and supernatural approaches to disease and infection.

Their natural approaches included:. Following the Theory of the Four Humours and using treatments like bleeding based on the theory. Using herbal remedies. Inspecting the urine of patients to diagnose their illnesses (although some doctors relied on this so much they didn’t actually bother to meet their patients) Their supernatural approaches included:.

Consulting Zodiac charts to find out what was wrong with their patients. The Black Death In 1348, the Black Death struck western Europe. It had already swept across Asia and the Middle East killing millions of people. The disease was the bubonic and pneumonic plagues which killed 90% of people who caught within about five days.

The people of medieval Europe were desperate to avoid catching the plague and to cure it if they got it. They tried both natural and supernatural methods: Their natural approaches included:. Cleaning up streets because they believed that the bad smells (miasma) spread the disease. Bleeding or purging (being sick) the body because the humours were out of balance.

Burning herbs to take away the bad smells (miasma). Blaming Jews for poisoning the water supply. Hundreds of Jewish people were murderedbecause of this belief during the Black Death outbreak. A doctor with herb-filled nosepiece Their supernatural approaches included:.

The belief that the plague was caused by the position of the planets. Praying to God to take the plague away because he had sent it as a punishment for people’ssins. One group of people – the flagellants – whipped themselves as they walked through townsand villages to show God how sorry they were for sinning. Saying magic spells and wearing charms to keep the plague away The Renaissance (1450 – 1700 AD) The Renaissance was very different from the Middle Ages because the power of the Church was reduced.

This meant that the restrictions on dissecting bodies at universities were slowly lifted and that doctors could now challenge Galen’s ideas openly. One good example of a Renaissance doctor is Paracelsus, he is a good example because:. He burned Galen’s books in public to show that he thought they were wrong. (It is important toremember that Galen got a lot of things right but he did make some mistakes). He chose his name because it means ‘Better than Celsus’.

Celsus was a famous Roman doctorand Paraclesus believed that his new ideas were better than the old ones from Rome. He came up with new ideas of his own, e.g.

That diseases should be treated with medicinesmade from chemicals. He used mercury in several of his medicines which is unfortunatelypoisonous. He gave lectures in German rather than Latin so everyone could understand them. However, Paracelsus’ influence was limited because he was regarded as a bit of an eccentric – some of his ideas were very supernatural.

For example, he believed that God had sent messages about themedicinal qualities of plants through their shape. Overall, the Renaissance was a period of significant advances in the understanding of anatomy (Vesalius and Harvey) but there wasn’t much progress in the understanding of the causes of disease or discovering effective cures. Supernatural approaches continued alongside natural ones. Most doctors continued to believe in the Theory of the Four Humours.

The Industrial Age (1750‐1900) During the Renaissance and after, the training of doctors at universities increasingly focused on using a scientific approach based on careful observation and recording of patients’ symptoms and on carrying out experiments to test new ideas and theories. One doctor who used this scientific method to make an important breakthrough was Edward Jenner. Edward Jenner and Smallpox Through his work as a doctor in a countryside area of Gloucestershire, Jenner came across several famers who rejected the offer of being inoculated against smallpox, an horrific killer disease. They did this because they believed they were already protected having suffered from the much milder illness, cowpox. Jenner decided to test this idea out scientifically: 1. Jenner observed and took careful records of milkmaids who had suffered from cowpox. None of those he examined had ever caught smallpox.

Jenner then decided to test his theory. An 8‐year‐old boy called James Phipps was given cowpox by Jenner. After this disease had passed, Jenner then gave him a dose of smallpox but there was no reaction – it appeared that the boy was now immune to smallpox.

Jenner tried this out a further 23 times and each time the patient did not develop smallpox. Jenner called his discovery ‘vaccination’ after the Latin for cow – ‘vacca’. He published his findings but immediately faced a lot of opposition. People were concerned about vaccination because: ‐ Many people were uneasy about new ideas in general but especially one that involved giving humans and animal disease.

‐ Jenner could not explain how vaccination worked which worried some people. ‐ Doctors who made a lot of money out of the old method of inoculation were against vaccination because it would put them out of business. ‐ Vaccination was not totally safe and some doctors did not take as much care as Jenner. Their patients’ cuts became infected or they went on to catch smallpox anyway. Jenner was helped in overcoming this opposition by support from the government and other prominent people: - Parliament granted him £30,000 to set up a vaccination clinic in London - Thomas Jefferson, President of America, promoted vaccination in the USA. Napoleon had all of his soldiers vaccinated in 1805 Edward and James Phipps In 1852, the British government made vaccinations compulsory. Some people resented being told what to do by the government and refused to be vaccinated, however, by 1900 smallpox had nearly died out in Britain as a result of Jenner’s work.

Smallpox was eventually eradicated completely from the world in 1980 as a result of a mass vaccination programme organised by the World Health Organisation. Louis Pasteur and Germ Theory Since the 17th century scientists had used basic microscopes to observe tiny micro‐organisms invisible to the naked eye. They had observed that there were more microbes on matter that was rotting and wondered why. The most popular explanation for a long time was called spontaneous generation. This theory said that as matter rotted or decayed it turned into the microbes.

Therefore, they thought, germs were the result of disease and decay. Some scientists disagreed. They thought that germs were the cause of disease and decay.

This idea was called Germ Theory. One scientist who believed this was Louis Pasteur and he was able to prove it by:. In the 1850s, He was asked by the French wine industry to investigate why their winesometimes went off. He observed through his microscope that there seemed to be a lot of the same germs in the wine that was off. He found that if you heated the wine the germs died and then it would stay fresh. He had shown that the germs were the cause of wine going bad.

In 1864, He entered a competition to show that Germ Theory was correct and spontaneous generation was wrong. He took samples of air in two glass containers. He heated one container until the germs were dead and then sealed it – it stayed fresh. The other container was not heated and the germs began to grow in it until they were visible. In the second half of the 1860s, he was asked by the French silkworm industry to find out why some silkworms were dying.

He observed that all of the dead silkworms seemed to have the same bacteria in them. He and his assistants then tested all the other silkworms and separated the ones with the germs from the healthy ones. The disease stopped spreading in the healthy silkworms. Pasteur had shown that the germs were the cause of the silkworm disease. Pasteur suffered a stroke in the late 1860s which prevented him from following up his work. He had shown that germs cause decay in liquids, and also disease in silkworms. The next step was to show that germs could cause human diseases too.

Robert Koch Koch was the first scientist to identify a specific bacteria which caused a specific human disease. The bacteria he identified was anthrax in 1878.

He did this by:. Extracting what he thought was the anthrax bacteria from a dead sheep. Injecting the bacteria into a mouse which then died of anthrax.

Extracting the bacteria from the dead mouse and injecting it into another one. Repeating this process 20 times after which he still had the same bacteria which he started with. Koch had successfully identified the anthrax bacteria. Robert Koch went on to identify the septicaemia bacteria later in 1878. Using his methods other scientists also discovered typhus, tetanus, pneumonia, meningitis and plague. Koch also developed agar jelly as a better medium for growin.