1. A Review of 5,000 Years of Medical History

2. Revision guide
This unit is designed to bring together all the information you have studied in the other units. It does so by looking at themes that stretch across the whole 5,000 years of our study.
We will look at change and continuity in medicine during that time and how the eight factors we have been considering have affected medicine and health in each period.
The final section will deal with a number of themes commonly referred to in examinations: the theories about the causes of disease, the role of women and public health.
Most of what you read in this unit will be questions, designed to encourage you to bring all your knowledge from the individual periods together, and to allow you to look at the history of medicine from different angles.

3. The pace of medical change
We have seen that medicine and health progressed over 5,000 years. Yet it progressed at different rates in different places and at different times. Sometimes it even regressed.
Using your notes made during the study, complete the Pace of Change chart on the next slide. Include where, possible, examples of change.

4. The pace of medical change
Period Pace of Progression/ Reasons Regression
Greek
Roman
Middle Ages
Renaissance
Industrial Revolution
20th Century

5. In which period did medicine and health regress?
In which period did it progress the most?
Progress in medicine did not always result in progress in health.
Choose one period to which this applies, discuss the medical progress made and explain why it made little difference to health.

6. Continuity
Sometimes there was continuity of ideas over long periods of time, even during times of progress.
Examples of this are Galen, the Theory of the Four Humours, the wrath of God and blood letting. Choose two of these and describe them. Explain how and why each continued for so long.
How did the continuity of each help or hinder the progress of medicine?

7. Factors affecting medicine
We have studied the history of medicine chronologically, that is period by period. We are now going to consider wider questions based on the factors which have affected medicine.
Developments in medicine have usually happened because of a combination of factors. These factors are:
Religion, war, education, government, chance, individuals, science and technology, and communications.
Using these as your headings, write down a few words which would help you explain how each factor has affected medicine during each period. You may not be able to complete a sentence for every period under each heading. Use your notes in your factors pages to help you. Keep this as a revision aid.

8. Now using just these notes (try not to look at your Factors pages) answer the following questions:
1) “Religion has always obstructed the development of medicine.” Discuss this statement.
2) Describe how war benefited medicine in two different periods. Explain why war caused medicine to regress after the collapse of the Roman Empire.
3) What beneficial effect did education have on medicine in (a) the medical renaissance and (b) the 20th century?

9. 5) Pasteur said “Chance only favours the prepared mind
5) Pasteur said “Chance only favours the prepared mind.” Do you think this applies to the discoveries made by Fleming?
6) Give three examples of individuals who have helped the progress of medicine.
7) Joseph Lister produced the first powerful microscope in How could this have helped William Harvey? Explain how it contributed to the discovery of germs.
8) Improved communications helped the progress of medicine in ancient Egypt. They also helped the spread of the Black Death in the 14th century. Explain both of these statements.

10. Common themes
The following is a list of some of the theories we have come across for the cause of illness.
Theory of the Four Humours
Germ theory
Spirits
Blocked channels
Position of the stars and planets
Wrath of God
Theory of Opposites
Miasma
For each one explain the idea or theory, what treatments were used to cure the disease and during which period, or by whom, it was used.

11. The role of women in medicine
In every period of our study, women have been mentioned as the carers and healers of the sick at home. Mothers, usually, are still the people who observe, diagnose and treat their children in the first instance. At various times in history, however, we have also found women in professional medical roles, sometimes despite the pressures of men or society to keep them out.
Look at this list of roles assumed by women before the 20th century. Copy them down and for each one write in notes the periods in which women could assume these roles. Note also whether this was a new role at that time, and if and when it changed later.
Midwife
Surgeon
Nurse
Doctor
Wise woman
Herbalist

12. Florence Nightingale and Elizabeth Garrett were two of the most famous women in medical history.
How important were their contributions to medicine?
Describe the problems which they had to overcome to achieve what they did.

13. Public health
Public health was first introduced by the Romans, and to a very high standard. Between the collapse of the Roman Empire and the late 19th-century there was very little attempt by governments to look after people’s health.
1) Explain what is meant by ‘public health’.
2) What measures did the Romans take to maintain good public health?
3) What caused the regress in public health in the Middle Ages?

14. Finally, here are two questions which cover the whole topic of the history of medicine:
“Throughout history, medical care has always progressed.” Do you agree or disagree with this statement? Give reasons and examples.
“Once new ideas are discovered in medicine, old ideas are no longer used.”
Do you agree or disagree with this statement? Give reasons and examples.
Questions from the Southern Examining Group.