HEALTH AND THE PEOPLE - AQA history
● Thematic study: we need to know the change in medicine, surgery and public health over
the period of 1000 years
● Also need to know a bit about the year before 1000 which is why timeline starts around
Ancient Greek time 776-323 BCE and c460-365 Hippocrates
The factors that cause change according to AQA
● War (WW1 & WW2, barber-surgeons learning in battle)
● Superstition and religion
● Chance
● Government
● Communication
● Science and technology
● The role of the individual
● Has x been the main cause of the development of surgical techniques/medicine/public
health since Medieval times? (16)
Medicine stands still (1066-1450: Middle Ages)
● Whilst medieval medicine stood still surgery did not. Surgery made surprising leaps
forward
● This was partly due to barber-surgeons on the battlefield and partly due to discovery of
natural anaesthetics and antiseptics
● Middle ages surgery was done by barber-surgeons rather than doctors. This changed in the
late 18th Century and early 19th Century when doctors were trained in hospitals
● Due to constant fighting and wars, it meant surgeons skills were much in demand. Perhaps
this is why surgeons actually progressed in Medieval times
● “Every day we see new instruments and new methods (to extract arrows) being invented
by clever ingenious surgeons” - Theodoric of Lucca
● This is completely different from the normal picture of stagnation given to us about
medieval medicine
● Medieval surgeons realised how to use wine as an antiseptic and they used natural
substances like opium, hemlock and mandrake root
● Therefore, medieval surgeons could do external surgery like facial ulcers and even eye
cataracts
● Internal surgery like removal of gall bladder also undertaken
Being ill in Medieval times
● Life for many people in middle ages was nasty hard and short. Rich were more likely to
afford treatment by a doctor than the poor
● It was more likely to find a doctor in the town than elsewhere
● Towns were deadlier to live in than villages
● Young people were more at risk than adults
● Both winter and summer brought problems
Medieval Diseases
● Famine and war were the main killers of this period
, ● Bad harvest due to flood or drought, too hot or too cold weather meant malnourishment
for many
● This meant people more easily caught diseases
● Saint Anthony’s disease was caused by a fungus growing on stored rye in damp conditions.
Once rye ground into flour and baked into bread, those that ate the bread developed
painful rashes and in some cases died
● Dysentery, typhoid, smallpox and measles were all widespread
● Historians estimate that 10% of England’s population in the early 14th century died of
these diseases
● Childbirth was a dangerous time for women
● It is likely 30% of children died before the age of 7
Towns - unhealthy places to live:
● People lived so closely together that diseases spread quickly
● There were no sewers and no rules for getting rid of waste, and no rubbish collection (as
there is today)
● Most people obtained their water from streams and rivers which were often contaminated
with human waste that was just thrown into the streets
● Everywhere there were animals, cows, pigs, horses defecating everywhere. If you were
unlucky the overnight ‘piss pot’ might have been emptied out of an upstairs window as you
were passing by below
● Cesspits (pits for disposal of sewage) were often built close to the water wells so this water
was contaminated too
● Butchers slaughtered their animals in the streets and left the waste
● Keeping food fresh was difficult so you had to shop every day. Butchers would try to sell
food that was going off rather than throw it out
● No ‘zoning’ in towns, so industry and houses were mixed together
● Towns were usually so dirty that they smelled very bad. This is why miasmas (bad smells)
was believed to be the cause of the disease, and this idea lasted until 1880
● Open drains that overflowed after rain
● Some councils did try to clean up towns. Some were better than others at public health
Leadership, money and initiative were the biggest factors in whether a town was successful with
public health
● Some towns like Coventry did make efforts to clean up
● The town council banned dumping rubbish in the streets and river
● In 1421 the Council ordered that all toilets built over a local stream had to be demolished
● This is a good piece of information for talking about the role of government in public
health, as it shows that goal government was trying to change things even in Medieval
times
Difficulties keeping medieval towns clean
● Town populations grew and public health facilities couldn’t cope
● Rivers were used for drinking water, for transport and to remove waste
● People had no knowledge of germs and their link to disease and infection. They thought
that disease was spread by ‘bad air’, so they were keen to remove unpleasant smells
● Some places had better public health than many towns eg wealthy families could afford
better living conditions. It was the religious buildings like Monasteries and Abbeys that the
largest number of people had good health
, Monasteries were much cleaner
Reason Details
Wealth ● They had enough money to spend on cleaner facilities
● Many people gave money, valuables and land in return for prayers to be said
for them when they died
● Monks made a lot of money from producing wool and used the large areas of
donated land to keep the sheep
Location ● Isolation helped protect monks from epidemics. Monasteries were usually far
away from towns
● Christian monasteries were near to rivers; water was an important resource
to supply mills, kitchens, bakeries and breweries
Knowledge ● Monks and nuns could read and understand books in their library
● They learned the basic idea of separating clean water from the waste water
that came from toilets and wash places
● They understood the ancient roman idea of a simple routine involving
moderation in diet, sleep and exercise to balance the humours
Rules ● Usually monks and nuns knew it was best to take water from upstream for
drinking, brewing and washing rather than downstream where it would be
contaminated by water from the toilets
● Monasteries often had running water systems and sewers
● Monks and nuns were usually the only medical practitioners in the area and
would have to keep their cupboards well stocked with herbs and wine for
treating the sick
● Most hospital were attached to religious houses at this time and monks and
nuns would work in both the monastery and the hospital as part of their
Christian duty
● Monasteries were often kept very clean. The monks and nuns understood
the important of cleanliness for health even if they did not know the science
behind it
● As most hospitals were attached to and run by religious houses, monasteries
would grow herbs by their physic garden and herbalist or apothecary would
offer the herbs to patients for treatment
Approaches to disease
● Medieval people didn’t really understand the cause of most diseases so they focused on
trying to cure the symptoms instead of preventing them
Natural approaches to disease
● Apothecaries (medicine makers) used herbs to make medicines
● Burning herbs to create a sweet smell to get rid of miasma (smells they believed caused
diseases)
Supernatural approaches to disease
● Praying to God or saints - they believed disease was punishment from God
● Flagellation (whipping oneself) - to show God they were sorry for their sins
● Astrology - people believed the stars and planets could be responsible for illness
● Thematic study: we need to know the change in medicine, surgery and public health over
the period of 1000 years
● Also need to know a bit about the year before 1000 which is why timeline starts around
Ancient Greek time 776-323 BCE and c460-365 Hippocrates
The factors that cause change according to AQA
● War (WW1 & WW2, barber-surgeons learning in battle)
● Superstition and religion
● Chance
● Government
● Communication
● Science and technology
● The role of the individual
● Has x been the main cause of the development of surgical techniques/medicine/public
health since Medieval times? (16)
Medicine stands still (1066-1450: Middle Ages)
● Whilst medieval medicine stood still surgery did not. Surgery made surprising leaps
forward
● This was partly due to barber-surgeons on the battlefield and partly due to discovery of
natural anaesthetics and antiseptics
● Middle ages surgery was done by barber-surgeons rather than doctors. This changed in the
late 18th Century and early 19th Century when doctors were trained in hospitals
● Due to constant fighting and wars, it meant surgeons skills were much in demand. Perhaps
this is why surgeons actually progressed in Medieval times
● “Every day we see new instruments and new methods (to extract arrows) being invented
by clever ingenious surgeons” - Theodoric of Lucca
● This is completely different from the normal picture of stagnation given to us about
medieval medicine
● Medieval surgeons realised how to use wine as an antiseptic and they used natural
substances like opium, hemlock and mandrake root
● Therefore, medieval surgeons could do external surgery like facial ulcers and even eye
cataracts
● Internal surgery like removal of gall bladder also undertaken
Being ill in Medieval times
● Life for many people in middle ages was nasty hard and short. Rich were more likely to
afford treatment by a doctor than the poor
● It was more likely to find a doctor in the town than elsewhere
● Towns were deadlier to live in than villages
● Young people were more at risk than adults
● Both winter and summer brought problems
Medieval Diseases
● Famine and war were the main killers of this period
, ● Bad harvest due to flood or drought, too hot or too cold weather meant malnourishment
for many
● This meant people more easily caught diseases
● Saint Anthony’s disease was caused by a fungus growing on stored rye in damp conditions.
Once rye ground into flour and baked into bread, those that ate the bread developed
painful rashes and in some cases died
● Dysentery, typhoid, smallpox and measles were all widespread
● Historians estimate that 10% of England’s population in the early 14th century died of
these diseases
● Childbirth was a dangerous time for women
● It is likely 30% of children died before the age of 7
Towns - unhealthy places to live:
● People lived so closely together that diseases spread quickly
● There were no sewers and no rules for getting rid of waste, and no rubbish collection (as
there is today)
● Most people obtained their water from streams and rivers which were often contaminated
with human waste that was just thrown into the streets
● Everywhere there were animals, cows, pigs, horses defecating everywhere. If you were
unlucky the overnight ‘piss pot’ might have been emptied out of an upstairs window as you
were passing by below
● Cesspits (pits for disposal of sewage) were often built close to the water wells so this water
was contaminated too
● Butchers slaughtered their animals in the streets and left the waste
● Keeping food fresh was difficult so you had to shop every day. Butchers would try to sell
food that was going off rather than throw it out
● No ‘zoning’ in towns, so industry and houses were mixed together
● Towns were usually so dirty that they smelled very bad. This is why miasmas (bad smells)
was believed to be the cause of the disease, and this idea lasted until 1880
● Open drains that overflowed after rain
● Some councils did try to clean up towns. Some were better than others at public health
Leadership, money and initiative were the biggest factors in whether a town was successful with
public health
● Some towns like Coventry did make efforts to clean up
● The town council banned dumping rubbish in the streets and river
● In 1421 the Council ordered that all toilets built over a local stream had to be demolished
● This is a good piece of information for talking about the role of government in public
health, as it shows that goal government was trying to change things even in Medieval
times
Difficulties keeping medieval towns clean
● Town populations grew and public health facilities couldn’t cope
● Rivers were used for drinking water, for transport and to remove waste
● People had no knowledge of germs and their link to disease and infection. They thought
that disease was spread by ‘bad air’, so they were keen to remove unpleasant smells
● Some places had better public health than many towns eg wealthy families could afford
better living conditions. It was the religious buildings like Monasteries and Abbeys that the
largest number of people had good health
, Monasteries were much cleaner
Reason Details
Wealth ● They had enough money to spend on cleaner facilities
● Many people gave money, valuables and land in return for prayers to be said
for them when they died
● Monks made a lot of money from producing wool and used the large areas of
donated land to keep the sheep
Location ● Isolation helped protect monks from epidemics. Monasteries were usually far
away from towns
● Christian monasteries were near to rivers; water was an important resource
to supply mills, kitchens, bakeries and breweries
Knowledge ● Monks and nuns could read and understand books in their library
● They learned the basic idea of separating clean water from the waste water
that came from toilets and wash places
● They understood the ancient roman idea of a simple routine involving
moderation in diet, sleep and exercise to balance the humours
Rules ● Usually monks and nuns knew it was best to take water from upstream for
drinking, brewing and washing rather than downstream where it would be
contaminated by water from the toilets
● Monasteries often had running water systems and sewers
● Monks and nuns were usually the only medical practitioners in the area and
would have to keep their cupboards well stocked with herbs and wine for
treating the sick
● Most hospital were attached to religious houses at this time and monks and
nuns would work in both the monastery and the hospital as part of their
Christian duty
● Monasteries were often kept very clean. The monks and nuns understood
the important of cleanliness for health even if they did not know the science
behind it
● As most hospitals were attached to and run by religious houses, monasteries
would grow herbs by their physic garden and herbalist or apothecary would
offer the herbs to patients for treatment
Approaches to disease
● Medieval people didn’t really understand the cause of most diseases so they focused on
trying to cure the symptoms instead of preventing them
Natural approaches to disease
● Apothecaries (medicine makers) used herbs to make medicines
● Burning herbs to create a sweet smell to get rid of miasma (smells they believed caused
diseases)
Supernatural approaches to disease
● Praying to God or saints - they believed disease was punishment from God
● Flagellation (whipping oneself) - to show God they were sorry for their sins
● Astrology - people believed the stars and planets could be responsible for illness
