Independent Learning Book

Medicine Through Time

Exam Guidance for AQA- Medicine

There are 4 types of questions on this paper-

 Interpretations- How useful is this source… (8)

 Compare surgery in… to……..(8)
 How significant is……. to…….(8)
 ……..been the main factor in understanding… the causes of disease? (16
+ SPAG)

1-How useful is Source A for a historian…………..?

Example-
How useful is Source A to an historian studying
vaccination? (8)
Cartoon by James
Gillray called ‘The
wonderful effects of
the new inoculation.

Tip
CONTENT: Source A is (say how useful you think it is – very, partially, quite) l to an historian studying
…………… because it tells them about… (summarise the content of the source to finish off the opening
sentence. Then explain the content of the source, with own knowledge)

ORIGIN and PURPOSE. This source comes from ………… This means that it is…

 (explain reliability of the source – is a medical journal reliable?) (Put the source in context)
 Is the source representative? (again think about the date)

Overall, the source is… (give final judgement on usefulness which is the same as the opening
sentence.)
2- Compare X with Y. In what ways were they similar?
Explain your answer with reference to both.
Example_
Compare surgery in the Middle Ages with surgery at the time of John Hunter.(8)

Tips
In this answer you need:
 Two examples that are described AND explained
 Two paragraphs
 Descriptions should include specific detail i.e. Theodoric of Lucca tried to deal with infection in
the Middle Ages with wine
 Explanations should discuss similarities i.e. examining why barber surgeons were used in both
periods
 A direct comparison of both periods MUST be made i.e. examining the importance of religion in
both periods e.g. discussing how religion prevented dissections in either period

For top Level 3 and Level 4 as above AND:

 Historical context is used to show similarities i.e. despite the Reformation meaning dissections
became allowed this was only limited to criminals sentenced to death so limited their impact

3-Explain the significance of…. to……………….?(8)

Example-
Explain the significance of penicillin in the development of medicine. (8)
In this answer you need:
 Two examples that are described AND explained
 Two paragraphs
 Descriptions should include specific detail i.e. when and how penicillin was discovered
 Explanations should discuss significance i.e. how penicillin was a step forward compared to what
come before it e.g. antiseptics
 Clear links to short and long term significance to focus explanation i.e. limited short term
impact as Fleming did little to develop the drug, but massive long term impact as the drug saved
many lives during WWII.

For top Level 3 and Level 4 as above AND:

 Consideration of the factors that helped i.e. how chance helped with the development of the
drug
 An examination of the wider context i.e. how penicillin was the first antibiotic and led to further
development, or the problems that have been created by antibiotics e.g. bacteria developing a
resistance for example MRS
4- ‘X was the main reason for Y’. How far do you agree with
this statement? 16 marks + SPAG
Example
Has science and technology been the main factor in understanding the causes of
disease in Britain?
Explain your answer with reference to science and technology and other factors.
Use a range of examples from across your study of Health and the people: c1000
to the present day. [16 marks + 4 SPAG]

Tips
 Three examples that are described AND explained
 Three/Four factors are discussed i.e. Science and technology AND government, individuals,
religion, war, communication or education.
 A conclusion is reached
 Descriptions should include specific detail i.e. Pasteur moved ideas forward by publishing the
Germ Theory
 Explanations should discuss development of understanding i.e. examining how improving
technology like the microscope allowed Koch to identify the tuberculosis germ.
 Consequences of the factors are discussed in their historical context e.g. Consequence of
religion in the Middle Ages and Renaissance was that little understanding of disease developed.

For top Level 3 and Level 4 as above AND:

 Comparison of the periods is made i.e. communication in the Middle Ages was poor and that
resulted in little shared knowledge, however with the creation and development of the printing
press after the 1440s it meant that knowledge could more effectively be shared and developed
e.g. helping John Tyndall spread the Germ Theory in Britain.
 An examination of the relationship between the factors is discussed i.e. Communication was a
factor that allowed knowledge to be effectively spread, especially after the invention of the
printing press. However, this knowledge would not have existed were it not for the individuals
making discoveries. An example of this being Robert Koch using improved scientific technique,
created via Pasteur’s Germ Theory, and equipment such as the microscope to discovering
specific germs like tuberculosis. As such I believe that the main factor for improving
understanding of disease as the hard work of the individual. Relationship of factors can be done
in just the conclusion
Medicine c1000-Present Knowledge Quiz. BASIC DEVELOPED
COMPLEX
1) To which two people could Medieval people go for medical treatment and surgery, if they could not
afford a doctor?
_________________________________________________________________________________
_____________

2) On which Ancient Greek theory did Medieval doctors base their treatments?
_______________________________

3) Whose work dominated medical understanding for hundreds of years?

___________________________________

4) Why did Medieval Christian hospitals prefer to look after patients rather than treat them?
_____________________
_________________________________________________________________________________
_____________

5) Explain three reasons why the Christian Church held back medical progress in the Medieval period.
____________
_________________________________________________________________________________
_____________
_________________________________________________________________________________
_____________

6) Which two Muslim doctors had a great influence on medicine in Western Europe?
__________________________

7) What were the two most common Medieval surgical procedures?

_______________________________________

8) Which diagram helped army surgeons to treat wounds?

_______________________________________________

9) Why was surgery only performed as a last resort in Medieval England?

___________________________________
_________________________________________________________________________________
_____________

10) Who was the most famous surgeon in Medieval England, and how did he improve surgery?
__________________
_________________________________________________________________________________
_____________

11) Why did the increase in public dissections not improve anatomical understanding?
_________________________
_________________________________________________________________________________
_____________

12) Explain three reasons why public health was so poor in Medieval towns.
_________________________________
_________________________________________________________________________________
_____________
_________________________________________________________________________________
_____________
13) Why were the laws passed by some Medieval town councils to improve public health not
successful? __________
_________________________________________________________________________________
_____________

14) Explain two reasons why health was often better in Medieval monasteries than it was in towns.
_______________
_________________________________________________________________________________
_____________
_________________________________________________________________________________
_____________

15) Name the two different types of plague that came to England in 1348.
___________________________________

16) Why did the Black Death spread so quickly, and what were two of the things people thought
caused it? _________
_________________________________________________________________________________
_____________
_________________________________________________________________________________
_____________

17) What proportion of the English population was killed by the Black Death?
________________________________

18) Why did life get worse as a result of the Black Death?
_______________________________________________
_________________________________________________________________________________
____________

19) Why did life soon get better for Medieval peasants?
_________________________________________________
_________________________________________________________________________________
_____________

20) Why was this only temporary?

__________________________________________________________________

21) The ‘Renaissance’ began in _____ and was a period in which people no longer __________ what
they were told but instead ____________ existing views. The _______ lost much of its influence.
Artists used new methods to make their paintings more _________ and the invention of the
_________ _______ in 1451 allowed knowledge to be spread more quickly throughout Europe. This
meant that ordinary people could learn about new ____________. New technology such as
_____________ meant that injured soldiers got new types of wounds, forcing surgeons to find new
ways of coping. The discovery of the _____________ in the late 1400s brought new foods and
medicines.

22) Answer these questions about the work of Andreas Vesalius in improving anatomical
understanding.
a) How did Vesalius realise that Galen had made mistakes?
_______________________________________
b) Why were Galen’s findings not as accurate as Vesalius’s?
______________________________________
c) What was the name of Vesalius’s illustrated textbook (1543)?
____________________________________
d) What was the response to Vesalius’s work (short-term impact)?
__________________________________
23) Explain why Vesalius’s work had a more significant long-term impact.
___________________________________
_________________________________________________________________________________
_____________

24) How did Henry VIII improve the work of barber-surgeons in 1540?
______________________________________
_________________________________________________________________________________
_____________

25) Answer these questions about the work of Ambroise Paré in improving surgery.
a) Why was war an important factor in the work of Paré?
__________________________________________
b) How were gunshot wounds treated before Paré’s discovery?
_____________________________________
c) Why and how did this change because of Paré?
_______________________________________________
d) How did Paré improve the practice of amputation?
_____________________________________________
e) How did Paré improve post-surgery life for wounded soldiers?
___________________________________

26) Whose work on anatomy did Paré learn from?

_____________________________________________________

27) Explain two ways in which Paré’s work improved surgery in England in the long-term.
______________________
_________________________________________________________________________________
_____________
_________________________________________________________________________________
_____________

28) What did Galen believe happened to blood?

_______________________________________________________

29) Answer these questions about the work of William Harvey in understanding how blood circulates
around the body.
a) How did Harvey discover how blood circulated?
_______________________________________________
b) Why did Harvey take 12 years to publish his ideas?
____________________________________________
c) What could Harvey not provide an answer for?
________________________________________________
d) Which popular medical treatment did this challenge?
___________________________________________

30) Explain (with specific detail) how significant Harvey’s discovery was in the short-term and the
long-term.
Short-term)
______________________________________________________________________________

_________________________________________________________________________________
______

_________________________________________________________________________________
______
Long-term)
______________________________________________________________________________

_________________________________________________________________________________
______
_________________________________________________________________________________
______

31) Which invention proved that Harvey was correct, four years after his death?
______________________________

32) Which four sources of medical advice were available to people in the 1600s and 1700s who could
not afford to see a doctor?
_________________________________________________________________________________
_____

33) Which Medieval treatment was still used in 1685 to treat King Charles II?
________________________________

34) Which other superstitious treatment did 3000 people per year come to London for?
________________________

35) Answer these questions about the Great Plague of 1665.

a) What did people believe caused the plague?
_________________________________________________
b) Name three treatments that were used.
_____________________________________________________
c) What did some people notice about the deaths?
_______________________________________________
d) Explain three ways in which the government tried to stop the spread of plague.
______________________

_________________________________________________________________________________
______

_________________________________________________________________________________
______
e) How many Londoners did the plague kill?
____________________________________________________

36) How did beliefs about what hospitals were for change in the 1700s?
____________________________________
_________________________________________________________________________________
_____________

37) Name three types of specialist hospital set up in the 1700s.

___________________________________________

38) Answer these questions about the work of John Hunter in improving anatomical understanding in
the 1700s.
a) Describe one occasion on which John Hunter tried a radical experiment.
___________________________

_________________________________________________________________________________
______
b) Which important organisation, in charge of training surgeons, was Hunter part of?
____________________
c) Which mistaken idea about gunshot wounds did Hunter prove wrong?
_____________________________
d) How was Hunter’s work significant in the short-term?
___________________________________________

_________________________________________________________________________________
______
e) For long-term significance, which historically important doctor did Hunter train?
______________________
39) What is the difference between inoculation and vaccination?
__________________________________________
_________________________________________________________________________________
____________

40) Answer these questions about the work of Edward Jenner in discovering vaccination and
defeating smallpox.
a) Explain two problems with inoculation.
______________________________________________________

_________________________________________________________________________________
______
b) Which milder disease did Jenner inject an 8-year-old boy with?
___________________________________
c) Why was it difficult for others to accept vaccination in the short-term?
______________________________

_________________________________________________________________________________
______
d) In the long-term, what did the British government do in 1853?
____________________________________
e) In the long-term, which two famous rival doctors built on Jenner’s work?
____________________________

41) Which two anaesthetics were used before the discovery of chloroform in 1847?
___________________________

42) After the microscope was invented in 1677, allowing scientists to see microbes, how did they
believe they got inside the body?
________________________________________________________________________________

43) What did Louis Pasteur discover in 1861 that disproved this?
__________________________________________
_________________________________________________________________________________
_____________

44) What was the difference between the beliefs of contagionists and anti-contagionists, and who was
right? _______
_________________________________________________________________________________
_____________
_________________________________________________________________________________
_____________

45) Answer these questions about the work of Joseph Lister in developing antiseptic surgery.
a) How is Lister’s work related to Pasteur’s?
____________________________________________________
b) How did Lister stop infections getting in during surgery?
________________________________________
c) What did Lister not do?
__________________________________________________________________
d) In the short-term, how did many doctors respond to Lister’s results?
_______________________________

_________________________________________________________________________________
______
46) Which disease led many British doctors to accept Pasteur’s Germ Theory?
_______________________________

47) Which method of surgery developed in the 1890s, 30 years after Pasteur published his Germ
Theory, and what did this method involve?
__________________________________________________________________________
_________________________________________________________________________________
_____________
_________________________________________________________________________________
_____________

48) Answer these questions about the work of Robert Koch in applying Pasteur’s theories to human
diseases.
a) Koch first become famous for identifying which disease?
________________________________________
b) How did Koch prove specific bacteria were responsible for specific diseases?
_______________________

_________________________________________________________________________________
______
c) Which British doctor promoted the work of Pasteur and Koch, even when it was unpopular?
____________
d) What did Koch’s work allow he and Pasteur to create?
_________________________________________

49) Answer these questions about the discoveries of Pasteur and Koch in the 1880s and 1890s.
a) Why was war an important factor in the work of both men?
______________________________________
b) After Koch identified the germ in Q48a, which two animal diseases did Pasteur’s team
create vaccines for?
__________________________________________________________________________
_____________
c) Which two germs did Koch’s team identify in the 1880s?
________________________________________
d) What did Pasteur prove about vaccines in 1885?
______________________________________________

50) Explain three reasons why Britain’s towns and cities were so dirty in the early 1800s.
_______________________
_________________________________________________________________________________
_____________
_________________________________________________________________________________
_____________

51) What did people think caused the 1800s cholera outbreaks, and what really did?
__________________________

52) What did Edwin Chadwick’s report say caused cholera, and what did it say needed to be done?
______________
_________________________________________________________________________________
_____________

53) Why did the government not do anything despite Chadwick’s report?
____________________________________
_________________________________________________________________________________
_____________

54) What changed the government’s minds and what did the 1848 Public Health Act do?
_______________________
_________________________________________________________________________________
_____________
55) Why was this Act ineffective?
___________________________________________________________________

56) What did Dr John Snow discover, and how did he discover it?
_________________________________________
_________________________________________________________________________________
_____________
_________________________________________________________________________________
_____________

57) What happened to the River Thames in the summer of 1858?

_________________________________________

58) What did Parliament do about this and who did they ask?
_____________________________________________

59) Why did the government begin to take more responsibility for public health after 1867?
_____________________
_________________________________________________________________________________
_____________

60) Explain two ways the Second Public Health Act of 1875 improved public health.
___________________________
_________________________________________________________________________________
_____________
_________________________________________________________________________________
_____________

61) What is a ‘magic bullet’ and who discovered one for syphilis in 1909?
___________________________________
_________________________________________________________________________________
_____________

62) Answer these questions on the work of Alexander Fleming in discovering penicillin, the world’s
first antibiotic.
a) Which nasty germ remained undefeated by the 1920s?
_________________________________________
b) Why was Fleming studying this germ?
______________________________________________________
c) How did he accidentally discover in 1928 that penicillin could kill germs?
___________________________

_________________________________________________________________________________
______

_________________________________________________________________________________
______

63) Why was Fleming’s discovery of penicillin not very significant in the short-term?
___________________________
_________________________________________________________________________________
_____________

64) What made penicillin more significant in the long-term and why were the factors of government
and war vital?
_________________________________________________________________________________
_____________
_________________________________________________________________________________
_____________
_________________________________________________________________________________
_____________

65) What were the names of the British scientists who first used penicillin to treat infection?
_____________________

66) Complete this table to outline post-1945 developments in the human body and our understanding
of disease.
Scientists Francis Crick and James Watson discover ______. The understanding of this leads to such
1953 developments as gene _________, genetic _____________ and genetic engineering.
Geoff Hounsfield invents the ______ scanner, which uses __________ images from many angles to
1973 build a 3D image of the inside of the body.
Endoscopes are developed. These are _________-_________ cables allowing doctors to go under the
1975 _____ to see inside the body.
1980 The disease of ____________ is officially eradicated after a global ________________ campaign.
The __________ ___________ ___________ successfully identified the roles of all the _________ in
1990-2003 the human body. Ongoing research into genetics and treating diseases comes from this research.

67) Complete this table to outline post-1945 developments in surgery.

1950 A Canadian surgeon performs the first open-________ surgery.
1968 The first _____ transplant in Britain is performed.
American surgeons implant _____________ into a miniature computer inside the visual cortex of a
2002 ______ man. This allows him to ‘see’ well enough to drive a car.
2006-2008 The first partial and then full ______ transplant is carried out.
A huge breakthrough with the release of a prosthetic _____ that uses _____________ to stimulate the
2007
retina in an attempt to improve the vision of blind individuals.

68) Complete this table to outline post-1945 developments in medical treatments.

1948 Free vaccine for _____ made available in the UK.
Free vaccine for diphtheria, whooping cough and __________ (the ‘________ vaccine’) made
1954-1955
available in the UK.
1964 Free vaccine for _________ made available in the UK.
2006 The first ____ (anti-_________) vaccine is approved.

69) Explain five ways in which governments now get involved more in public health.
___________________________
_________________________________________________________________________________
_____________
_________________________________________________________________________________
_____________
_________________________________________________________________________________
_____________

70) Name two forms of alternative medicine.

__________________________________________________________

71) Which mental condition, previously called ‘shell shock’, was not recognised until after WW1?
_________________

72) Answer these questions about the role of World War One in improving surgery and health.
a) Which 1900 discovery allowed wartime surgeons to carry out blood transfusions?
____________________
b) Which 1895 discovery was used near battlefields to examine wounded soldiers?
_____________________
c) How did army doctor Harold Gillies dramatically improve post-wound care?
_________________________
 d) Which lethal infection did surgeons work out how best to prevent?
________________________________

73) Answer these questions about the role of World War Two in improving surgery and health.
a) Which important service opened in 1938?
___________________________________________________
b) What progressed greatly during the war thanks to US surgeon Dwight Harken?
______________________
c) What was created in 1948 as a result of the public wanting the government to take a
greater role? _______
d) Why did the war improve people’s diets?
____________________________________________________
e) Which ‘wonder drug’ was mass produced in order to treat the Allied forces?
_________________________
f) How did the evacuation of children change public health?
________________________________________

_________________________________________________________________________________
______

74) Why did the 1899-1902 Boer War force the government to improve public health?
_________________________
_________________________________________________________________________________
_____________

75) Explain three improvements to public health as a result of the social reforms of the Liberal Party
after 1906.
_________________________________________________________________________________
_____________
_________________________________________________________________________________
_____________
_________________________________________________________________________________
_____________

76) What was the drawback to this system for the unemployed?
___________________________________________
_________________________________________________________________________________
_____________

77) What is the name for the system by which the government aims to help those in need – mainly the
old, the sick, the unemployed and children?
_____________________________________________________________________

78) Who wrote a report upon in 1942 which the Labour Party based its post-war promises of a health
service and social security providing ‘from the cradle to the grave’ insurance for all?
_____________________________________

79) Answer these questions about the post-war Labour government’s reforms.
a) What was the name of the Labour Prime Minister from 1945 to 1951?
_____________________________
b) What was the school leaving age raised to?
__________________________________________________
c) What was introduced to help with childcare costs?
_____________________________________________
d) What was the name of the Minister of Health who introduced the NHS in the face of
opposition from political opponents and from doctors?
______________________________________________________________________
e) In which two areas did the NHS not stay free for long?
__________________________________________
80) What is the name of the ‘superbug’ that is resistant to antibiotics?
______________________________________

Key terms/ words/people do you know what they mean or what

they did?
1-Vaccination-

2- 4 humours-

3- Monasteries-

4- Dissection-

5- Public Health-

6- Cauterizing-

7- Ligatures-

8- Antibiotics

9- Inoculation
10- Magic bullet-

11- Galen-

12- Ambroise Pare-

13- Vesalius-

14- Harvey-

15- Jenner-

16- Rhazes-

17- Avicenna-

18- John of Arderne-

19- Louis Pasteur-

20-Pasteurisation-

21- Germ Theory-

22- DNA-

23- Blood transfusion

24- Robert Koch

25- Joseph Lister-

26- James Simpson-

27- Edwin Chadwick-

28- John Snow-

29- Alexander Fleming-

30- Florey and Chain-

31- Paul Ehrlich-

32- William Beveridge-

33- Aneurin Bevan-

34- Thomas Sydenham-

35- John Hunter-

36-Christian Barnard-

37- Archibald Mc Indoe-

38-James Watson and Francis Crick-

39- Anaesthetics-
40- Antiseptic-

41- NHS-

42- Cholera-

43- Latrine-

44- Sewage Pit-

45- Sanitation-

46- Blood Chart-

47- Urine Chart-

48- Aseptic Surgery-

49- Florence Nightingale & Mary Seacole-

50-Keyhole surgery-

51- Reform-

52- Seebohm Rowntree-

53- Contaminated-

54- Epidemic
55- Black Death-

56- Plague-

57- Flagellants-

58- Joseph Bazalgette-

Medicine Through Time Timeline 3000 BC Pre-History – understanding is based on spirits

and gods. No real medical care. People die
very young, normally by the age of 30-35 for
men, but only 15-25 for women due to the
dangers of childbirth. Most people suffered
osteoarthritis (painful swelling of the joints).

2000 BC Egyptian Empire – development of papyrus,

trade and a greater understanding of the body
(based on irrigation channels from the River
Nile). They believed the body had 42 blood
channels and that illness was caused by
undigested food blocking these channels.

1500 – 300 BC Greek Empire – Medicine still based on religion

– Temple of Asclepius. Here, patients would
get better, but mainly through the standard of
rest, relaxation and exercise (like a Greek
health spa)

400 BC Hippocrates – founder of the Four Humours

theory. This theory stated that there were four
main elements in the body – blood, yellow bile,
black bile and phlegm. Illness was caused by
having too much of one of these humours
inside of you. He also wrote the Hippocratic
Collection, more than 60 books detailing
symptoms and treatments of many diseases.

400 BC – 500 AD Roman Empire – The Romans were renowned

for excellent public health facilities. The
Romans introduced aqueducts, public baths,
 sewers and drains, etc. In the citcy of Rome,
water commissioners were appointed to ensure
good supplies of clean water.

162 AD Galen – continues the four humours theory but

extends it to have the humours in opposition to
each other. This meant that an illness could be
treated in one of two ways, either removing the
“excess” humour or by adding more to its
opposite. Galen also proves the brain is
important in the body (operation on the pig).
Galen’s books would become the foundation of
medical treatment in Europe for the next 1500
years.

1100s – 1200s When Europeans went on crusades to the Holy

Land in the 12th and 13th centuries, their
doctors gained first-hand knowledge of Arab
medicine, which was advanced by Western
standards.

1347-1348 Black Death – across Europe more than 25

million people die. Two main types of plague

1. Bubonic – 50-75% chance of death. Carried

by fleas on rats. Death usually within 8 days

2. Pneumonic – airborne disease. 90-95%

chance of death within only 2-3 days

People had no idea how to stop the plague.

People thought it was caused by various
factors, i.e. the Jews, the Planets, the Gods,
etc etc etc

1455 The Printing Press was invented by Johannes

Gutenberg. This allowed for the massive
reproduction of works without using the Church
as a medium.

1540s Andreus Vesalius – proved Galen wrong

regarding the jawbone and that blood flows
through the septum in the heart. He published
“The Fabric of the Body” in 1543. His work
encouraged other to question Galen’s theories.

1570s Ambroise Paré – developed ligatures to stop

bleeding during and after surgery. This reduced
the risk of infection. He also developed an
ointment to use instead of cauterising wounds.
1620s William Harvey – proved that blood flows
around the body, is carried away from the heart
by the arteries and is returned through the
veins. He proved that the heart acts as a pump
re-circulating the blood and that blood does not
“burn up”.

1665 The Great Plague – little improvement since

1348 – still have no idea what is causing it and
still no understanding of how to control or
prevent it. In London, almost 69,000 people
died that year.

1668 Antony van Leeuwenhoek creates a superior

microscope that magnifies up to 200 times.
This is a huge improvement on Robert Hooke’s
original microscope.

1721 Inoculation first used in Europe, brought over

from Turkey by Lady Montague.

1796 Edward Jenner – discovered vaccinations

using cowpox to treat smallpox. Jenner
published his findings in 1798. The impact
was slow and sporadic. In 1805 Napoleon had
all his soldiers vaccinated. However,
vaccination was not made compulsory in
Britain until 1852.

1799 Humphrey Davy discovers the pain-killing

attributes of Nitrous Oxide (Laughing Gas).
It would become the main anaesthetic used in
Dentistry. Horace Wells would try and get the
gas international recognition. He committed
suicide the day before it got the recognition it
deserved.

1830s Industrial Revolution. This had a dramatic

effect on public health. As more and more
families moved into town and cities, the
standards of public health declined. Families
often shared housing, and living and working
conditions were poor. People worked 15 hour
days and had very little money.

1831 Cholera Epidemic. People infected with

cholera suffered muscle cramps, diarrhoea ,
dehydration and a fever. The patient would
most likely be killed by dehydration. Cholera
returned regularly throughout the century, with
 major outbreaks in 1848 and 1854.

1842 Edwin Chadwick reports on the state of

health of the people in cities, towns and
villages to the Poor Law Commission (fore-
runner to the Public Health Reforms). He
highlights the differences in life-expectancy
caused by living and working conditions. He
proposes that simple changes could extend
the lives of the working class by an average of
13 years.

1846 First successful use of Ether as an

anaesthetic in surgery. The anaesthetic had
some very severe drawbacks. In particular, it
irritated the lungs and was highly inflammable.

1847 James Simpson discovers Chloroform

during an after dinner sampling session with
friends. He struggles to get the medical world
to accept the drug above Ether. Doctors were
wary of how much to give patients. Only 11
weeks after its first use by Simpson, a patient
died under chloroform in Newcastle. The
patient was only having an in-growing toenail
removed (non-life threatening). It took the
backing of Queen Victoria for chloroform and
Simpson to gain worldwide publicity.

1847 Ignaz Semmelweiss orders his students to

wash their hands before surgery (but only
after they had been in the morgue).

1847 Elizabeth Blackwell becomes the first

woman doctor in USA

1848 First Public Health Act in Britain – It

allowed local authorities to make
improvements if they wanted to & if
ratepayers gave them their support. It
enabled local authorities to borrow money
to pay for the improvements. It was largely
ineffective as it was not made compulsory
for Councils to enforce it. This was an
element of the “Laissez-Faire” style of
government.
1854 Crimean War – Florence Nightingale and
Mary Seacole contribute majorly to the
improvements in Hospitals.

1854 John Snow proves the link between the

cholera epidemic and the water pump in
Broad Street, London. Unfortunately, he
was unable to convince the government to
make any substantial reforms.

1857 Queen Victoria publicly advocates use of

Chloroform after birth of her eighth child.

1858 Doctors’ Qualifications had to be regulated

through the General Medical Council.

1861 Germ Theory developed by Louis Pasteur

whilst he was working on a method to keep
beer and wine fresh – changed the whole
understanding of how illnesses are
caused.

1865 Elizabeth Garrett-Anderson – first female

doctor in the UK

1867 Joseph Lister begins using Carbolic Spray

during surgery to fight infection. It reduces
the casualty rate of his operations from
45.7% of deaths to just 15.0 % dying.

1875 Second Public Health Act – now made

compulsory. Major requirement is that
sewers must be moved away from housing
and that houses must be a certain distance
apart.

1876 Public Health improvements – in the UK,

the government introduced new laws
against the pollution of rivers, the sale of
poor quality food and new building
regulations were enforced.

1881 Robert Koch discovers the bacteria that

causes anthrax. He establishes a new
method of staining bacteria. Using Koch’s
methods, the causes of many diseases
were identified quickly:
 Typhus/TB/Cholera/Pneuminia/Meningitis.

1889 Isolation Hospitals were set up to treat patients

with highly infectious diseases.

1895 William Röntgen discovers X-Rays. Though

it is an important discovery, it is only WW1 and
the treatment of soldiers that propels it into the
medical spotlight.

1895 Marie Curie discovers radioactive elements

radium and polonium

1901 Scientists discover that there are different blood

groups- this leads to the first 100% successful
blood transfusions.

1905 Paul Ehrlich discovers first “magic bullet” –

Salvarsan 606 to treat Syphilis. The problem
was it was based on arsenic and so could kill
the patient too easily.

1911 National Health Insurance introduced in

Britain

1914-1918 World War One – development of skin grafts

to treat victims of shelling

1928 Alexander Fleming – discovers Penicillin.

The mould had grown on a petri dish that was
accidentally left out. Fleming writes articles
about the properties of Penicillin, but was
unable to properly develop the mould into a
drug.

1932 Gerhardt Domagk discovers Prontosil (the

second magic bullet). Slight problem is that it
turns the patient red.

1937-45 Florey, Chain & Heatley work on producing

penicillin as a drug. Their success will make the
drug the second most finded project by the
USA in WW2. They fund it to the tune of $800
million and every soldier landing on D-Day in
1944 has Penicillin as part of his medical kit.

1939 Emergency hospital scheme introduced –

Funded and run by Government

1942 William Beveridge publishes the Beveridge

Report. The report was the blueprint for the
NHS
1946 National Health Service Act – provides for a
free and comprehensive health service.
Aneurin Bevan convinces 90% of the private
doctors to enrol.

1948 First day of the NHS. Hospitals were

nationalised, health centres were set up and
doctors were more evenly distributed
around the country. However, the popularity
and costs of the NHS would rapidly spiral
out of control. The £2 million put aside to
pay for free spectacles over the first nine
months of the NHS went in six weeks. The
government had estimated that the NHS
would cost £140 million a year by 1950. In
fact, by 1950 the NHS was costing £358
million.

1950 William Bigelow (Canadian) performed the

first open-heart surgery to repair a 'hole' in
a baby's heart, using hypothermia.

1952 First kidney transplant (America)

1952 Charges introduced in NHS - 1s for a

prescription

1953 Description of the structure of DNA

1961 Contraceptive pill introduced

1967 Christiaan Barnard (South Africa) performed

the first heart transplant - the patient lived
for 18 days

1978 First test tube baby

1990s Increasing use of keyhole surgery, using

endoscopes and ultrasound scanning,
allowed minimally invasive surgery.

1994 National Organ Donor register created