Britain: Health and the people, c1000 to the present · GCSE History

Medieval medicine, c1000–c1500

Most doctors followed the Theory of the Four Humours, from Hippocrates and Galen: illness came from an imbalance of blood, phlegm, yellow bile and black bile. Treatments included bloodletting and purging.
The Church was very powerful. Illness could be seen as a punishment from God, so people prayed and went on pilgrimages. Monasteries cared for the sick and copied Galen's books, and challenging Galen was discouraged. Islamic doctors, such as Ibn Sina (Avicenna), preserved and developed Greek medicine.
Miasma (bad air) was blamed for disease. The Black Death (1348–49) killed between a third and a half of England's population. People blamed God, bad air and the planets.
Barber-surgeons did simple operations. Hospitals, mostly run by the Church, gave care rather than cures.

Andreas Vesalius (1543) used dissection to show that Galen had made mistakes, such as saying the jawbone was made of two bones. Ambroise Paré treated wounds with ligatures and soothing ointment instead of boiling oil. William Harvey (1628) proved that the heart pumps blood around the body.
The printing press spread new ideas, and the Royal Society (1660) encouraged experiments. But treatments changed little: the Great Plague of 1665 was blamed on miasma and God, although towns tried quarantine.
John Hunter made surgery more scientific. Edward Jenner developed vaccination against smallpox (1796), using cowpox. Some people opposed it, but it was made compulsory in 1853.

Germ theory: Louis Pasteur (1861) proved that microbes cause decay. Robert Koch identified the microbes that cause particular diseases, such as tuberculosis (1882) and cholera (1883).
Surgery: James Simpson used chloroform as an anaesthetic in 1847, and Joseph Lister used carbolic acid as an antiseptic from 1867, cutting infection. Later, aseptic surgery kept operating theatres sterile. Florence Nightingale improved hospital hygiene and trained nurses after the Crimean War.
Public health: towns grew fast, and cholera struck again and again. John Snow linked cholera to a water pump in Broad Street, London (1854). After the 'Great Stink' (1858), Joseph Bazalgette built London's sewers. The Public Health Act of 1848 let councils improve their towns; the 1875 Act made them provide clean water, sewers and medical officers.

'Magic bullets': Paul Ehrlich's Salvarsan 606 (1909) cured syphilis. Alexander Fleming discovered penicillin in 1928; Howard Florey and Ernst Chain developed it into a drug in the 1940s, and it was mass-produced during the Second World War.
Government action: the Liberal reforms (1906–14) brought free school meals, old age pensions and National Insurance. The Beveridge Report (1942) led to the NHS, set up by Aneurin Bevan on 5 July 1948, free at the point of use.
Modern medicine: the structure of DNA was discovered in 1953 (Crick and Watson, using Rosalind Franklin's work), and the Human Genome Project was completed in 2003. Transplants, keyhole surgery and new vaccines followed. Campaigns tackle lifestyle risks: Doll and Hill linked smoking to lung cancer in 1950.

War, individuals, government, religion, science and technology (such as microscopes and printing), chance (such as Fleming's discovery) and communication all helped or held back medical progress.

Four Humours: The theory that illness came from an imbalance of four body fluids.
Miasma: Bad air, once thought to cause disease.
Dissection: Cutting up a body to study it.
Vaccination: Giving a mild or weakened form of a disease to make a person immune.
Germ theory: The theory that microbes cause disease.
Anaesthetic: A drug that stops a patient feeling pain.
Antiseptic: A chemical that kills germs to prevent infection.
Public health: The health of the whole population, protected by things like clean water and sewers.
Magic bullet: A chemical cure that kills a specific microbe without harming the body.
NHS: The National Health Service, set up in 1948.