Lack of hygiene injury raid risk epidemics sieges

few building regs crowded house limited sanitation straw floors- rats and fleas cesspit water poo on streets

archaeology records from anglo saxon and vikings show people with sword wounds- gangrenous and infected battle of tow ton 1561 estimated 22-28,000 died

1461 22-28,000

medieval armies who passed through towns could take anything said they’d reimburse but didn’t people starved

people lived closely in bad condition s so illness spread quickly and easily

if you were in besieged town you’d be driven out w little to nothing or killed henry 3 captured bedford castle in 1224 and hung all remaining defendants

written in books called herbals widely used advised to pray and pick in line w astrology examples: mugwort- feet chamomile- headaches hemlock- anaesthetic

bloodletting- cups or leeches to remove bad blood

compared to chart to help diagnose, could be smelt/ tasted too

showed which part of the body was associated with each astrological sign aries- avoid incisions to head and fa ce also told when to pick herbs

little to no trainings, pull teeth, set bones, carry out bloodletting and cut hair

suck blood and natural anticoagulant in saliva would anaesthetise wound high in demand nearly extinct in wild

welsh prince at the time stated that medicines should be experts in treating sick, repairing bones and providing potions to ill

had power to break spells from witches wrote charms on paper and sealed in bottles to trap evil spirits

family of physicians from myddfai, carmarthenshire thought to have operated 13-18th century

said to have healing powers could cure illness from rheumatism to warts many became associated with saints in early christian era eg st teilo and st dewi

cistercian and franciscan responsibility- church cistercian- looked after sick and old in isolated areas e.g neath and morgan franciscan- treat sick and infirm e.g carmarthen friary est 1282 grew to be one of wealthiest. others- brecon bangor cardiff

responsibility- volunteers and religious devotees forced to wear special clothes and ring warning bell feared as people thought they were being punished by god lodging and food but no treatment hospitals built on outskirts to limit mixing with others

responsibility- volunteers and religious devotees equivalent to modern care home- looked after old also looked after widows w young kids and single pregnant women accommodation and basic nursing but no treatment

set up by knights of st john of the order of hospitallers cared for pilgrims travelling from bangor to holyhead

didn’t treat sick but made them as comfy as possible seriously ill not allowed in as they distracted from main focus- prayer tried to save souls rather than cure

new drugs discovered in america- quinine tobacco was said to cure everything ‘ladies of the manor’ looked after servants and families on manor land eg lady johanna st john

didn’t know germs caused disease until 19th century- pasteur doctors were still too expensive for most

very influential gave doctors more detailed knowledge on human anatomy published his book in 1543 challenged galen and found 300+ mistakes eg human lower jaw is in one part not two looked at dissecting humans not animals

1282

1543

father of modern surgery made new and more effective dressing to heal wounds used ligatures to tie wounds later was involved in making artificial limbs published his book in 1575

changed medicine forver published “on the motion of the heart” in 1628 more than any other challenged galen discovered that blood was circulated showed the heart was a pump and blood flowed in one way system around body challenged the idea of bloodletting as a cure if harvey was right it was impossible to have too much blood

1628 on the motion of the heart

those who believed in galen and the church rejected his work their main point was that you can’t see capillaries so you couldn’t prove they were there

religious (rc) was significant in people’s lives illness was seen as punishment from god

mortality was higher in closely packed places w lots of people and animals they smelt bad so people linked had smell and ill health

average life expectancy was 31.3 years child mortality was so high it was normal to die before age 5

discovered by hippocrates furthered by galen if they were unbalanced you’d be ill doctors had charts and believed in opposites to treat. if you had lack of phlegm you’d be treated with smth hot and dry like pepper

viking sagas suggest many believed magic caused illness huge fear of witchcraft sudden misfortune was blamed on supernatural

henry 3 closed monasteries so church no longer ran hospitals responsibility- town/city councils looked after elderly and poor first secular medical institution

responsiblity- city authorities served poor people in the area of west smithfield

responsibility- royal charter looked after mentally insane

responsibility- city authorities for sick ands poor and also sufferers of venereal disease

responsibility- edward 6 helped poor and fatherless children have food clothes shelter and basic education

responsibility- royal charter housed homeless and punished disorderly poor

st bartholomews st mary bethlehem st thomas’ christs’ bridewell

james simpson

1847 he and two assistants experimented with chloroform to reduce pain in a month it was successful on 50+ patients

queen victoria used it in childbirth in 1853 john snow made inhaler to regulate doses important in short term- reduced pain important in long term- developed into better anaesthetic novocaine

1853 for childbirth

hard to get dosage right 15 year old hannah green died of overdose on toenail opp affected heart victorians were religious and believed pain relief in childbirth interfered w gods plan

cocaine from coca leaves in south america. operations no longer had to be painful

joseph lister

surgeon concerned of number of deaths on his ward. 45-50% amputees died of sepsis

he compared patients with closed fractures to those with open wounds- only open got sepsis. he found you had to kill germs before they got in

added hygienic practices- clean hands and fresh clothes

carbolic acid donkey engine that sprayed it into the air to kill airborne germs

1867 listers wards were free of sepsis for 9 months 1877 became prof of surgery at kings college london many used his ideas after they were published ‘father of antiseptic surgery’ had his funeral at westminster abbey surgeons began to wear masks and gowns by 1887 all surgical instruments were steam sterilised

listers wards were free of sepsis for 9 months

lister became prof of surgery at kings college london

thanks to lister all surgical instruments were steam sterilised

1867- listers wards free of sepsis for 9 months 1877- became prof of surgery at kings college london 1887- thanks to lister all surgical instrument are steam sterilised

introduced use of catgut to tie ligatures developed a form of catgut that would dissolve in body after several days

many british doctors were unconvinced and joked about ‘mr listers germs’ some disagreed cause microbes couldn’t be seen by naked eye using carbolic acid slowed procedures- led to blood loss

responsible- private individuals eg thomas guy, charities and town councils kept people warm washed and fed simple surgeries carried out by physicians here eg settting bones- turning point treatment was normally free

responsible- dr george cumming (denbigh) treated those who couldn’t afford treated under watch of professional medical staff

responsible- paid for by william owen stanley ran by his wife treated sailors then was taken over by nhs in 1948

responsible- dr henry paine, funded by trading in ports- 2 shillings for 100 tons shipping 10,000 seamen treated a year 54 beds, electric lighting and xrays treated sailors for free

the lady with the lamp took 38 of her best nurses to help in crimean war and had a huge impact

published notes on nursing- translated to 11 languages taught nurses to be as clean as possible nurses were now essential not just minders and cleaners opened nightingale school for nurses trained her nurses well- make sure patients were washed regularly and had clean clothes and bedding

published notes on hospitals said hospitals should have fresh air light warmth and cleanliness designed ‘pavilion principle’ which encouraged good circulation

from bala one of 16 kids ran away at 14 trained as a nurse and age 65 went to crimean disagreed w nightingale and moved to a dif hospital nightingale was won over by betsi’s approach bc is the name of largest health board in wales now

46,000 pop in 1851 houses were built quickly and cheaply they were unsanitary and people were crammed together

46,000 in 1851

beche and rammell beech identified the problems rammell published report bringing light to them

in charge of workhouses and member of ‘clean party’

people got poor because of bad health not laziness it would be cheaper if taxes were spent on improving housing and hygiene rather than paying for sick to be supported in workhouses

set up health of towns association part of ‘clean party’ who opposed ‘dirty party’ suggested providing access to clean water and removing sewage and rubbish

he owned mills in bradford where life expectancy was 20 he built ‘saltaire’ in shipley which was a mill and village for his workers saltaire had running water, reading rooms, hospitals and more salt said he wanted his children and workers to have good lives but some said he was showing off his money

1848- public health act not compulsory 1866- sanitary act compulsory- all towns had to have an inspector to check water supply and drainage 1875- public health act compulsory! forced towns to have clean water rubbish removal and public toilets

food and drugs act 1875- regulated food and medicine enforced new laws about polluting water supplies

1848

1866 all towns had to have inspector to check water supply and drainage

1875 forced towns to have clean water rubbish removal and public toilets

1875- regulated food and medicine

john snow 1854 proved link between cholera and water pastries germ theory showed how hygiene was importany

1854

john snow and pasteur publishing work

william farr showed that death rates were much higher in towns and cities than villages

their town was ill built poor and miserable then joseph chamberlain because mayor and council took over gas and water and used profit to make birmingham better

liverpool and lake vyrnwy first in 1893 birmingham and elan valley the welsh water was transported to england and still supplies to this day

1,800 to 164,000

1801-1901

building of taff railway in 1841 it linked merthyr tydfil to cardiff 1852 it was linked to gwr development of the docks marquis of bite built bute dock in 1839 trade increased so docks enlarged by 1887 there was east dock roath basin and roath dock cardiff competed with barry penarth newport but by 1901 it was main coal port in sw trade money and industry cardiff coal exchange made first million pound deal in 1907

1841

1852

1839 by marquis of bute

1887

by 1901

1907

1849 52,000 deaths

board of guardians split diff into 3 districts and a medical officer was appointed to each the had power to make people clean and get rid of odours later was split into 7 landlords had to ventilate lodgings

irish- area heavily affected and scapegoats, xenophobia