1. Quiz Take 5 mins to prepare for a quiz.
The topic will be on everything that we have studied.

2. Impact of the factors on Medicine
Aim: To explain (B) and evaluate (A) the impact of the factors on the development of medicine

3. War
Building an Empire involved WAR. The Romans needed fit soldiers so they developed a good public health system.
Roman soldiers also provided the need for progress in battlefield surgery
War wounds give surgeons like Pare ( ) opportunities. Pare developed a soothing lotion to replace cauterisation. Also developed artificial limbs and new surgical tools
Crimean War ( ) helps the development of nursing. Gave Florence Nightingale the opportunity to conduct her work in Scutari.
Franco - Prussian 1871 war helps rivalry between Pasteur and Koch. Both men's work fuelled by nationalist pride.
First World War ( ) and blood transfusions. War created the impetus for the application of Landsteiner's work on blood groups and transfusions.
Second World War helped to develop penicillin and plastic surgery. Penicillin first mass produced in 1942 in response to the demand created by the casualties of War.
Aim: To explain (B) and evaluate (A) the impact of the factors on the development of medicine

4. Technology
Invention of the printing press by Johann Gutenberg 1454 and its use by Caxton in England in 1476 greatly speeded up the spread of new "Renaissance" ideas
Industrial revolution 1750 onwards: better transport; canals, roads, rail.
Medical journals such as the "The Lancet“ allowed scientists to share and develop ideas. (e.g. Lister first read about Pasteur's germ theory in The Lancet which led to his development of carbolic spray in surgery in the1860's).
Surgical technology and scientific progress allowed for the first heart transplant operation by Christian Barnard 1967.
Aim: To explain (B) and evaluate (A) the impact of the factors on the development of medicine

5. Government
Romans had a strong government organisation backed up by an extensive civil service and were thus able to develop their excellent public health system.
French and German governments helped Pasteur and Koch. In the 1860s-1880'stremendous progress in the development of vaccinations e.g. Chicken cholera, rabies, anthrax etc.
Liberal government in Britain ( ) - first social security reforms and National Insurance for health care set up in 1911
British and American governments fund work in penicillin - Florey and Chain
Labour government set up NHS 1948 – free health care for all.
Aim: To explain (B) and evaluate (A) the impact of the factors on the development of medicine

6. Luck/Chance
Pare runs out of oil had to use a mixture including eggs, rose oil and turpentine- proved far more effective than boiling oil!
Charles Chamberland (Pasteur's assistant) injected chickens with weakened strain of chicken cholera by mistake - discovered by chance then the weakened or attenuated culture had made the chickens immune 1880.
Pasteur and his meeting with the boy bitten by a dog - developed rabies vaccination 1885.
Fleming and Penicillin. Fleming noticed by chance the bacteria killing qualities of the mould penicillin notatum by chance in 1928.
William Harvey- London pump- blood around body.
Aim: To explain (B) and evaluate (A) the impact of the factors on the development of medicine

7. Religion
Egyptian religious belief in life after death helps knowledge of the Human body. Bodies were mummified by priests increasing knowledge of anatomy. Surgical tools also advanced.
Roman times- Galen’s work linked with the teachings of Christianity so no one questioned it for centuries.
Islamic belief in looking after the sick and the elderly
Work of Christian monks in the Middle ages - a Christian duty to look after the sick.
Aim: To explain (B) and evaluate (A) the impact of the factors on the development of medicine

8. Individual Genius Hippocrates Aristotle Galen Rhazes Pare Ibn Sina
Vesalius
Harvey
Jenner
Pasteur
Koch
Lister
Chadwick
Simpson
Nightingale
Beveridge
Fleming
Florey and Chain
Barnard
Aristotle
Rhazes
Ibn Sina
Paracelsus
Seacole
Blackwell
Garrett
Anderson
Elrich
Fleming
Crick and Watson
Halsted
McIndoe
Aim: To explain (B) and evaluate (A) the impact of the factors on the development of medicine

9. Factors that hindered medicine

10. War
Barbarian tribes attacked Rome 410AD. The Western Empire collapses and the Dark Ages emerge. Knowledge of the ancient world lost and public health systems collapsed.
Loss of medical learning in the destruction of war.
Finance directed away from research and care in all wars especially during 19th and 20th century conflicts.
Aim: To explain (B) and evaluate (A) the impact of the factors on the development of medicine

11. Religion
Egyptians were not allowed to dissect over and above the removal of soft organs. Lack of experimental dissection for religious reasons limited what they learnt about anatomy.
Religious attitudes hindered Galen. He could only base his work on anatomy on the wounds of gladiators and the dissection of animals. He therefore made mistakes - mistakes not corrected until Vesalius in 1543 AD.
Later religious groups including both medieval Christians and Muslims prevented criticism of Galen because Galen had rejected the pagan gods and had come to believe in one God.
Religious groups opposed the use of anaesthetics in the 19th century as they believed pain was a "natural" part of childbirth. They were almost exclusively men!
Aim: To explain (B) and evaluate (A) the impact of the factors on the development of medicine

12. Conservative attitudes
Conservative doctors opposed Galen.
Opposition to Pare's methods. Many battlefield surgeons continued to use boiling oil because it was what they knew.
Opposition to Jenner and his smallpox vaccination: because doctors feared that they would lose money. The public at large also feared that by being injected with cowpox they would develop the features of cows - not until 1840 that the vaccination was widely available.
Christians opposed the use of chloroform.
Opposition to nursing improvements (e.g. the male doctors at Scutari originally objected most strongly to the idea of Nightingale and other female nurses being in the hospital).
Objections to welfare state (e.g. the British Medical Association feared that doctors would become poor).
Lack of Science & Technology.
Lack of anatomical knowledge.
Aim: To explain (B) and evaluate (A) the impact of the factors on the development of medicine

13. Government
Lack of stability and organisation before the modern period (with the exception of the Romans!)
Prevented progress in public health.
Laissez faire prevented action on public health problems such as cholera during the Industrial Revolution in Britain.
Opposition to increased spending on public health during the debate on the NHS in the 1940s.
Aim: To explain (B) and evaluate (A) the impact of the factors on the development of medicine

14. Evaluation technique
In surgery and anatomy who was the most and least important individual? Explain your answer.
In disease and infection who was the most and least important individual? Explain your answer.
In public health who was the most and least important individual? Explain your answer.
Aim: To explain (B) and evaluate (A) the impact of the factors on the development of medicine

15. Examination technique
Choose one of the medical pioneers below
James Simpson
Joseph Lister
Choose one and explain how he has helped develop surgery and anatomy (4)
Who was most significant?
You must refer to both people in your answer (8)
Aim: To explain (B) and evaluate (A) the impact of the factors on the development of medicine

16. Source work
In the Edinburgh Hospital where Lister worked, almost half of the surgery patients died from infection.... While surgeons regretted this high death rate, they trained themselves to accept this unpleasant aspect of their work...they thought, nothing could be done about these infections, because they arose spontaneously inside the wound.
Source 1 – Anne Lamont 1992
What different attitudes to the work of Joseph Lister are presented by Sources 1 and 2?
(6)
Use both sources and your own knowledge to help you to answer this question.
Joseph Lister had heard of Carbolic Acid being used to remove the odors from sewage and decided to try to use it on a small boy with a compound fracture of his leg.  The wound did not suppurate following surgery and the only injury was that the acid was burning the boys skin.
Source 2 – Lister the Father of Modern Surgery
Aim: To explain (B) and evaluate (A) the impact of the factors on the development of medicine