DARK AGES SUMMARY: Ideas about causes of illness and disease Supernatural causes – God’s punishment, evil spirits, The Planets Bad Air/ smells Hippocrates/ Galen ideas -The Four Humours – Phlegm, Yellow Bile, Black Bile, Blood Approaches to treatment of illness and disease Supernatural treatments- charms, prayers, planet alignment Herbal Remedies – passed down from older generations Hippocrates ideas about treatment of the four humours and Galen’s theory of Opposites – especially bloodletting and purging begin to form the main natural treatments Urinology, zodiac man etc Methods of prevention of illness and disease Supernatural prevention – prayers, charms Bloodletting Public health regressed due to lack of maintenance and destruction from war of public health systems Who looked after the sick/ Public Health Head of the family – Herbal Remedies Very few Trained Doctors – trained by the Church for 10 years Hospitals in monasteries and convents to take care of travellers or the sick – to take care of the soul not cure Hospitals would not treat those with infectious or incurable disease Factors leading to change in society e.g. war, science, church, attitudes Government – after fall of Roman Empire, Europe disintegrated into individual kingdoms War – destruction of public health structures because of constant war between the different kingdoms Communication – ideas became stagnant as movement around Europe became difficult and dangerous. People tended to stay in one place Church – The only organisation to survive the fall of Rome – It greatly influenced medical development Amount of progress made (including regression) Galens theories accepted as fact for over 1000 years – even though many were wrong because of church control, this hindered medical developments Dissection frowned upon so no new ideas – only proved Galen was right People still believed in supernatural causes of illness – especially Gods punishment

LATER MIDDLE AGES (1066-1500) SUMMARY: Ideas about causes of illness and disease Supernatural causes – God’s punishment, evil spirits, The Planets Bad Air/ smells Hippocrates/ Galen ideas -The Four Humours – Phlegm, Yellow Bile, Black Bile, Blood Case study - Black Death Approaches to treatment of illness and disease Supernatural treatments- charms, prayers, planet alignment Herbal Remedies – passed down from older generations Treatment of the four humours and theory of Opposites – especially bloodletting and purging to stop evil humours building up Urinology, zodiac man etc Diet, rest and exercise Methods of prevention of illness and disease Supernatural prevention – prayers, charms Bloodletting and purging Flagellation Public health – government attempted to improve public health – banning pigs in towns, stewes, piped water into towns, diet, rest & exercise Who looked after the sick/ Public Health Head of the family – Herbal ,minerals and animal parts Remedies Very few Trained Doctors – trained by Church for 10 yrs Hospitals in monasteries and convents to take care of travellers or the sick – to take care of the soul not cure Charity hospitals grew – mostly run by the church Hospitals would not treat infectious or incurable disease – almshouses, lazars Factors leading to change in society e.g. war, science, church, attitudes Government – Britain becomes more stable after 1066 allowing towns to grow again Society – most people live in villages so hygiene is ok, rich towns folk have good hygiene but poor live in terrible conditions Church – Medical Stagnation and fatalism – no new ideas because the Church said illness was caused by Gods Punishment Communication –, the Church sends people on crusade and they meet more advanced Islamic doctors who begin to influence medical development by the end of the medieval period. Amount of progress made (including regression) Galens theories accepted as fact for over 1000 years – but by the end of this period people begin to look for new ideas By the end of the period Medical Training is no longer run by the Church allowing new ideas to develop Closer links were being developed between disease and bad air and dirt

RENAISSANCE 1500-1750 SUMMARY: Ideas about causes of illness and disease Bad Air/ smells – miasma still considered a key cause Supernatural causes – God’s punishment, evil spirits, The Planets – although mainly at times of epidemic Hippocrates/ Galen ideas – most doctors still thought the four humours caused illness although new ideas discredited this Case studies – Great Plague/ Syphilis Approaches to treatment of illness and disease Treatment of the four humours and theory of Opposites – especially bloodletting and purging to stop evil humours building up Urinology no longer used as a way to diagnose and treat patients Supernatural treatments- charms, prayers, planet alignment – particularly at times of epidemic Herbal Remedies – passed down from older generations – used in the communities usually by women healers Medical Training and discoveries provided new methods but many were not believed or patients refused to be experimented on Diet, rest and exercise to improve constitution Methods of prevention of illness and disease Bloodletting and purging by most physicians and healers to prevent an imbalance New discoveries were not really used as people didn’t want to be experimented on Public health – government attempted to improve public health particularly during epidemics – more expectations that Cty Councils would take responsibility. Introduced the Gin Laws to improve health of the poor – first real attempt to use taxation as a form of prevention Good diet, rest & exercise and keeping clean were seen as best prevention Supernatural prevention – prayers, charms Who looked after the sick/ Public Health Local communities still provided most of the care with healers (mainly women ) leading the way Medical training was no longer controlled by the Church, more scientific methods became popular and dissection was allowed Hospitals in Monasteries were closed with Henry VIII’s Reformation – Henry realised his error when crime increased and opened new hospitals controlled by City Councils not Church Specialised hospitals opened foe pestilence and pox Factors leading to change in society e.g. war, science, church, attitudes Science – an age of discovery and new ideas lead to improved medical knowledge, training and technology (eg, microscope) Government – started to take a more proactive role in prevention through Public Health changes Attitudes– General Public did not trust the new discoveries being made and refused to be experimented on. Most physicians therefore treated patients for the 4 humours as before. Church – Reformation led to a removal of the churches influence on science and medicine Communication – invention of the printing press allowed new ideas to be shared and discussed – formation of The Royal Society Amount of progress made (including regression) Massive progress made in knowledge of anatomy and physiology (Harvey and Versalius) Greater ability to challenge and discuss ideas and develop new theories however, new technology was needed to develop treatments and understanding of causes New discoveries and ideas challenged the ideas of Galen and largely discredited his work, however the general population continued to prefer old methods of treatments so very little actually changed However, the new discoveries paved the way for rapid advancement in the Industrial Period.

Industrial Age: 1750-1900 SUMMARY: Ideas about causes of illness and disease Bad Air/ smells – miasma still considered a key cause Spontaneous generation – the idea was that certain forms such as fleas could arise from inanimate matter such as dust, or that maggots could arise from dead flesh Both these theories were disproved by Pasteur’s Germ Theory - microbes caused disease and decay New health problems caused by terrible living and working conditions Approaches to treatment of illness and disease New mass produced pharmaceuticals were cheap and became more widely available Pasteur’s Germ Theory led to improvements in hygiene standards in hospitals Focus moved onto treating the microbes causing disease rather than treating the symptoms of the disease. Work of Florence Nightingale to improve treatment of patients in hospitals Koch’s identification of different microbes causing different illnesses Methods of prevention of illness and disease Improved public health reforms – Chadwick, Snow, Bazelgette Public Health Acts introduced 1848, 1875 along with other acts which improve health – factory act, education act etc Programme of innoculation Jenner’s discovery of vaccination of smallpox Mass compulsory vaccinations introduced Pasteur’s Germ Theory and Koch’s work on microbes leads to mass vaccinations of other illnesses and diseases Improved hygiene in hospitals and towns Who looked after the sick/ Public Health Medical training and education became regulated – Doctors sat an exam and attended a training hospital before qualification Charity hospitals provided cheap care Cottage Hospitals with dedicated nursing care developed Isolaiton hospitals for infectious diseases New hospitals were built replacing the old poor law unions and Mental asylums for those with mental health problems were built Nursing became a more reputable profession Factors leading to change in society e.g. war, science, church, attitudes Science and technology – new ideas lead to improved medical knowledge and training with advancements in technology leading to great public health improvements Government – ended laissez-faire attitude and passed numerous laws to improve public health Attitudes– General Public accepted new ideas more readily as many were now educated and could read, there was an expectation that government would act. More voters meant more action by government Church – reduced influence Communication – invention of railways, newspapers, photography etc made information much more accessible Amount of progress made (including regression) Massive progress made in knowledge of causes, treatment and prevention of disease – Jenner, Pasteur, Koch Greater understanding of technology and science which improved public health Great engineering improved public health greatly - Bazelgette sewerage system Government introduced many laws which would improve public health Improvements in hospital care and nursing First female doctor However, progress in the prevention and treatment of diseases was slow because each disease had to be researched individually – research teams improved this Improved records and statistical analysis - Farr

Modern Age: 1900- Present Day SUMMARY: Ideas about causes of illness and disease People understood that microbes cause illness and disease – different microbes identified causing individual diseases Scientists have looked into lifestyle factors causing disease – things like smoking, alcohol and obesity have created new challenges for doctors Scientists have discovered and continue to investigate Genetics as a cause of disease and illness Diseases such as cancer continue to puzzle scientists and much is still to be discovered about what causes cancer Approaches to treatment of illness and disease Research Teams researched different microbes to develop vaccinations for individual diseases. Development of Chemical cures for disease – first magic bullet (Salvarsan 606 - Syphilis) and second magic bullet (Prontosil – blood poisoning) Development of Penicillin – ‘wonder drug’ of 20th Century – used to treat bacterial infections – saved millions in WWII Genetic research into vaccinations and treatments Treatments for diseases such as cancer, diabetes are improving Blood Transfusions – allow improved life expectancy Methods of prevention of illness and disease Pasteur’s Germ Theory and Koch’s work on microbes leads to mass vaccinations of other illnesses and diseases Mapping of DNA allows new preventative gene therapies to be researched Improved hygiene in hospitals and towns due to public health reforms Government began to take more responsibility for public health with new acts of parliament passed between 1905-1911 NHS Campaigns to promote healthy living Who looked after the sick/ Public Health At the start of 20th Century it was still women responsible for treating illnesses because doctors expensive GP may do some minor operations in a cottage hospital but most serious operations were referred to hospitals Social care and creation of NHS changed medical care for all – free! Nurses, midwives and doctors all fully trained and registered Factors leading to change in society e.g. war, science, church, attitudes Government – full responsibility for Health of the nation – Responsibility of the Dept. of Health Attitudes– General public expect the best care for free from the NHS Church – reduced influence although many ethical questions are posed regarding genetics Communication – creation of the internet is a major factor in the spread of knowledge New technology – x-ray machines, radiotherapy and chemotherapy, microscopes, endoscopes, scans, nuclear medicine, dialysis machines, pacemakers, dispensing machines need specialised training Amount of progress made (including regression) Massive progress made in knowledge of causes, treatment and prevention of disease – Greater understanding of technology and science which improved public health Government introduced many laws which improved public health, hospitals etc, especially the creation of the welfare state and NHS Improved records and statistical analysis Growth of pharmaceutical companies funding research and development