How did hospitals change/stay the same in the 1700s from the medieval period? Complete this sheet using information from the next slide.

HospitalsHow did they change in the 1700s from the medieval period?

HospitalsHow did they stay the same in the 1700s from the medieval period.

How important do you think this change was?

How did hospitals change in the 18th century (1700s)?

1. We have seen that medieval infirmaries or hospitals in England were run by the Catholic Church. Remember that these were small places where people went to be cared for (the main form of medical care was prayer) rather than be cured. Many of these early medieval hospitals were funded by the rich who wanted to have their sins absolved. However, when Henry VIII changed the church in England from Catholic to Protestant (Break with Rome) in the 1530s, his actions affected hospitals.

2.Who built hospitals in the 18th century (1700s)? Until the 1600s, hospitals were places for the sick to rest, pray and receive simple remedies. They were run by the church. But there were changes in the 1700s as more modern methods to cure patients began. They were also different because hospitals were started and supported by the charitable gifts of private individuals/businesses rather than the church. Eg Westminster Hospital was started in 1719 by a private bank. Sometimes people would club together to pay for a hospital (called ‘private subscription’.

3. What happened in an 18th century (1700s) hospital?The sick were cared for and doctors were trained in medical schools attached to hospitals. There were also different wards for different types of disease. Previously, many hospitals did not allow the very sick entry as they would be a distraction to the praying! There were no doctors in a hospital before the 1700s, instead priests and nuns looked after the sick. The sick even had to share beds. However, there were some similarities between the hospitals in different time periods because the main beliefs about the causes of disease were still based on the Four Humours and treatments were based on bleeding and purging.

4. Types of hospitals In the 1700s, specialist hospitals were developed. This was very different to what had gone before. St Luke’s Hospital was built in 1751 for the mentally ill, Lock Hospital in London was built for people with STIs. Maternity hospitals were also built at this time. Thomas Coram started the Foundling Hospital in 1741; it cared for orphaned children by giving them a clean environment, clothing, and a simple education until the age of 15. This was in response to a huge social issue of the day-the number of abandoned children and high death rates amongst them.

5. Hospital Boom1720-1750, five new general hospitals were built in London (there were only two hospitals in London until this time). By 1800, London’s hospitals were handling 20, 000 patients a year. In 1400, the 470 hospitals the whole of England only had room for 10 patients at most so this was a huge increase.Attitudes to disease were changing too. People began to abandon the idea that illness was a punishment for sin. Instead, they began to think that illness should be dealt with from a more scientific point of view.

Killer QuestionHow did Edward Jenner help

to defeat smallpox?

Starter. Look at the pictures. Describe the symptoms that these people have.What do you think is wrong with these people? Do you think that they will survive?

History Dictionary Endemic - disease regularly found in that part of the world.Epidemic - a sudden, widespread outbreak of an infectious disease.Inoculation - use of weakened but live germs of a disease in a healthy person to build up immunity to the stronger form of that disease. Skin scratched rather than injected.Vaccination - use of dead germs of a disease (or one similar to it) to build up immunity to the stronger form of the disease.

One of the biggest killers in the 18th century (1700s) was smallpox. It was highly infection and spread through coughing, touch and sneezing. However, at the time, people thought that it spread by miasma. It killed 30% - 60% of those who caught it. The symptoms were fever, headache and a rash followed by pus filled blisters that covered the entire body. If you survived, you could be left blind or badly scarred. In 1796, there was a major outbreak that killed at least 35 000 people.

Your task

You have statements.

Categorise them.

Using the key on the sheet,

categorise the statements.

In medieval China and other parts of Asia, people had used a form of inoculation for years. They put pus or scabs from a smallpox victim onto a healthy person’s skin (usually a scratch between finger and thumb) and, although they didn’t realise it, it gave them a small dose of the disease which built up resistance to attacks of the killer form of the disease.

Lady Mary Montagu saw this in Istanbul and introduced the idea to England in 1721 when she had her children inoculated during a smallpox outbreak and it worked.

Religious objections: some people still thought that God sent illness as a punishment for sin so inoculation was wrong because it prevented illness.

There was no understanding of the role of germs and infection yet and so people found it hard to understand that giving a small dose of the disease could prevent a killer dose of the disease. Doctors argued about the risk of dying from smallpox and the risk of dying after inoculation.

Sometimes, inoculation did go wrong and people got a strong dose of smallpox that killed them.

An inoculated person could pass smallpox to others.

The poor could not afford inoculation so they were not protected.

Inoculation became profitable - 1760s, Robert and Daniel Sutton devised an easier way of inoculation and made lots of money.

❑ The history of

inoculation❑ Problems with inoculation

Edward Jenner Biography Born 1749, died 182313 -19 years old - apprenticed to a surgeon21 - went to work with John Hunter in London.

Hunter was the greatest surgeon in the country at the time. He encouraged Jenner to conduct experiments and to test theories.

1772 (23 years old) he returned to Gloucestershire as a country doctor. He kept in touch with Hunter about medical developments.

1798 he published a book on vaccination (‘An Enquiry into the Causes and Effects of VariolaVaccinae, known by the name of Cowpox’). This showed that vaccination could save people from smallpox.

What is the story of Edward Jenner?

Place the cards in

chronological order to work out

how Edward Jenner thought of

a vaccine for Smallpox.

As for green and consider

which of the 7 factors Edward

Jenner would fit in to.

Justify your reason why.

As for green and explain how

and why Jenner is such a

significant person to the

progress of medicine.

7 factors• Chance

• Individual• Science and Technology

• Government• War

• Religion and

superstition• Communication

Jenner worked in the countryside. He saw that cows often caught

cowpox (the cow version of smallpox). Milkmaids also caught

cowpox too.

He thought that the milkmaids were immune (would not catch)

smallpox because they had already had cowpox. But he had

to prove it!

Jenner followed the advice of Hunter who said that doctors should observe their patients carefully and experiment to test their ideas.

He decided to experiment on a young child named James Phipps who didn’t have/hadn’t ever had cowpox or smallpox.

Jenner injected him with the pus from the sores of a milkmaid who had cowpox. James developed cowpox. Later, when he had recovered, Jenner inoculated him with smallpox but nothing happened.

To check that his theory was correct, Jenner inoculated James with smallpox again a few months later and again, James did not develop the disease.

He kept careful records of his experiments and submitted a paper to the Royal Society in 1797 but was told that he needed more proof.

Jenner carried out more experiments including on his own 11 month old son, all the time keeping detailed notes and records.

Jenner published ‘An Enquiry into the Causes and Effects of the Varioae Vaccinae, Or Cow Pox’. He described 23 cases where his theory worked and he called this theory vaccination because the Latin word for cow is ‘vacca’.

He continued his work on vaccination and was given £10 000 by the government for his work in 1802 and a further £20 000 in 1807 when the Royal College of Physicians confirmed how effective vaccination was.

Why did it take so long for inoculation / vaccination to become common?

So, why did it take a long time for Jenner’s vaccination to be accepted? Reduce and bullet point/mind map

these factors. 10 mins

But . . .

However, in the later 1800s, other factors played a part in keeping people healthier too, eg clean water supplies, better housing and a better diet.

1840 – vaccinations provided by the

government.

1852 – vaccinations made compulsory, but not enforced.

1872 – compulsory vaccinations

enforced. No more smallpox epidemics.

1. An excellent example of experiment and Enquiry . Showed killer disease could be beaten. Encouraged other doctors to and scientists to solve medical problems.

2. Idea used worldwide

3. Vaccination made compulsory in GB in 1852 (though not effectively enforced) leading to a significant reduction in deaths. Other factors like health reforms (government involved) played a part in this.

4. In 1980, smallpox was declared eradicated from the world.

PlenaryWrite a paragraph explaining how important you think Edward Jenner’s contribution to medical progress was. Remember to consider what his idea was, how he proved it, the extent to which it was accepted at the time and its long term impact.

Edward Jenner’s improvement to

medical progress was significant. This

is because…

Practise question to be emailed to your History teacher:

Explain the significance of Edward Jenner in the development of medicine

(8 marks)Email your answers to

gunnh@bishopperowne.co.uk or reevev@bishopperowne.co.uk

Compare the work of Andreas Vesalius and John Hunter. In what ways were they similar? Explain your answer with reference to both. (8 Marks)

Although born over 200 years apart, the works of Andreas Vesalius and john Hunter were very similar. They both had a strong interest in dissections resulting them to carry out

many themselves, believed in careful observation of dead and alive patients and also wrote books about their findings, which were read by many people. Both encouraged and

inspired others to promote change, with influential leaders such as Edward Jenner and Fabricus and Fallopius following their findings in order to allow medicine to be how it is

today.

One major similarity between Vesalius and Hunter was their beliefs on dissections and careful observation. Vesalius was a professor at Padua University and believed that to carry

out successful surgery, people needed to fully understand the workings and anatomy of the human body. To do this, Vesalius performed many dissections and observations on

patients, including criminals who had been executed. This allowed him to further understand the body’s anatomy and he began to realise that the findings of Galen, believed to be

the truth for hundreds of years, were not true. Hunter followed a similar path and began dissecting corpses at his brothers anatomy school in London. He carried out over 2000

dissections over 12 years, developing an extremely detailed understanding of how the body works. During this time, and time spent as an army surgeon, Hunter developed new

ways to treat Gunshot wounds, Venereal Disease, and Aneurysms. Due to his dissections, he made many important discoveries about the nature of disease, infection and the

circulation of blood, allowing him to question the works of Galen because he could back up his findings with his own evidence. This shows that the works of Hunter and Vesalius

were similar because they both had strong beliefs in dissections and observations, allowing them to make new and important findings, questioning the works of Galen.

Additionally, Hunter and Vesalius also both wrote books, allowing their knowledge to be easily spread to everyone. Vesalius’ book ‘The fabric of the human body’ contained highly

detailed illustrations explaining how the systems in the body worked (instead of just individual organs). Due to the invention of the printing press, the book was able to be

distributed across Europe, allowing many doctors, including those in Britain. This meant that others began to question Galen’s ways, and although the effect was not immediate, it

showed thar dissections and observations were very important, providing an essential first step towards change. Like Vesalius, Hunter published his books titled ‘the natural history

of the teeth’ and ‘on venereal disease’, calling upon the knowledge that he had learnt from his many dissections. They were very popular, and were translated into many languages

so that they could be read all over Europe. His books encouraged his beliefs on better approaches towards surgery and as a result he is remembered for his good scientific habits,

including learning lots about the body, finding better ways to treat disease, and testing treatments on animals before being used on humans. This shows that Hunter and Vesalius

were similar because their books were read all across Europe and encouraged people to ask more questions about science and promoted good scientific habits.

Finally, the works of Hunter and Vesalius inspired many other people who took important steps to allow scientific understanding to be where it is today. The work of Vesalius did

not have an immediate effect on the diagnosis or treatment of disease, it produced a detailed map of the human body and encouraged dissection and observation. This made them

more popular, with people such as Fabricus and Fallopius using their own dissections to learn about specific parts of the body. Furthermore, Hunter taught many students in his

time, including Edward Jenner. This meant that his ideas were passed on and used to make new findings such as vaccinations. This demonstrates that Hunter and Vesalius were

similar because they influenced future doctors, allowing them tom make new discoveries.

In conclusion, Vesalius and Hunter were similar, despite being born over 200 years apart. They both had strong beliefs that dissections and observations were important, spread

these ideas through their very popular books, and inspired others to pass on and develop their ideas to further improve medicine.