Overview
This lecture covers key developments in medicine from medieval times to the 20th century, examining causes of disease, major advances, treatments, and healthcare systems, particularly in Britain and during World War I.
Medieval Medicine: Explanations and Treatments
- Disease was often explained by supernatural and religious beliefs, such as divine punishment or evil spirits.
- The theory of the four humors, established by Hippocrates and Galen, linked health to the balance of blood, phlegm, black bile, and yellow bile.
- The miasma theory suggested illness was caused by "bad air" from decaying matter.
- Treatments included prayer, pilgrimages, amulets, bloodletting, purging, herbal remedies, and air purification.
- Physicians (diagnosis/prescription), apothecaries (herbs), and barber surgeons (basic surgery) were key medical professionals.
- Hospitals, usually religious, focused on care, shelter, and spiritual needs more than curing illness.
The Renaissance and Scientific Change
- The Renaissance saw increased questioning of old ideas, with more evidence-based medicine emerging.
- Thomas Sydenham advanced clinical observation and distinguished diseases.
- The printing press and Royal Society enabled wider spread and scrutiny of medical knowledge.
- Anatomy studies, notably by Andreas Vesalius and William Harvey, challenged ancient errors; Harvey proved blood circulates in a closed system.
- Old treatments (bloodletting/purging) persisted alongside new methods (transference, chemical treatments like mercury).
18th and 19th Century Developments
- Miasma theory dominated until germ theory emerged in the 19th century via Louis Pasteur and Robert Koch.
- Pasteur developed vaccines using weakened microbes; Koch identified specific disease-causing bacteria.
- Joseph Lister pioneered antiseptic surgery using carbolic acid.
- The Public Health Act 1875 made sanitation and disease prevention a government responsibility.
- James Simpson (chloroform) and Florence Nightingale (nursing, cleanliness) revolutionized surgery and hospital care.
Modern Medicine and the NHS
- Advances in genetics (DNA structure, Human Genome Project) enabled personalized medicine and gene therapy.
- Lifestyle factors (smoking, diet, alcohol, drugs, sunbeds) are recognized as major health risks.
- Diagnosis improved with technologies like blood tests, X-rays, MRI, CT, ultrasound, ECG.
- Mass vaccination campaigns and public health laws reduced disease rates.
- New treatments include antibiotics (Fleming’s penicillin), chemotherapy, gene therapy, and advanced surgeries (keyhole, robotic, transplants).
- The NHS, established in 1948, provides free healthcare, raising life expectancy and reducing inequalities.
Medicine in World War I: The Western Front
- Battles (e.g., Ypres, Somme) and trench warfare led to unique medical challenges (infection, gas attacks, psychological trauma).
- Medical care was organized via a chain of evacuation: regimental aid posts, dressing stations, casualty clearing stations, and base hospitals.
- Innovations included the Thomas splint, mobile X-ray units, blood transfusions, aseptic techniques, and reconstructive surgery.
- Organizations like the RAMC, FANY, and VAD provided vital medical and nursing support.
Key Terms & Definitions
- Four Humors — Ancient theory that health depended on the balance of four bodily fluids.
- Miasma Theory — Belief that disease was caused by “bad air” from rotting matter.
- Germ Theory — Concept that microorganisms cause disease.
- Antiseptic — Chemicals used to prevent infection by killing microbes.
- NHS (National Health Service) — UK’s publicly funded healthcare system, established 1948.
- Magic Bullet — Drug designed to target specific disease-causing microbes.
- Transference — Historical treatment method transferring illness to an object or animal.
Action Items / Next Steps
- Review the definitions of key theories and terms.
- Complete any provided practice questions and flashcards.
- Read/download supplementary notes from the course website.
- Prepare for questions on cause, treatment, and public health developments in exams.