Britain: Health and the People c1000–present: overview

This thematic study traces the development of medicine and public health in Britain across over one thousand years. Unlike a period study, a thematic study requires you to make connections and comparisons across time: to explain change, continuity, turning points, and the factors that drove or prevented progress.

The four broad periods

1. Medieval medicine c1000–c1500

Medicine was dominated by Galen's theory of the four humours (blood, phlegm, yellow bile, black bile). Treatment was based on diagnosis of imbalanced humours (bleeding, purging). Hospitals were religious institutions caring for the sick, not curing them. The Black Death (1348–51) killed one-third of Europe's population and exposed the limits of medieval medical understanding.

2. The Medical Renaissance c1500–c1700

Vesalius (1543) corrected Galen through systematic dissection; Paré developed surgical techniques; Harvey (1628) proved blood circulated. The printing press spread ideas rapidly. But change was slow — Galen's authority persisted for generations.

3. Industrial revolution and germ theory c1700–c1900

Jenner's smallpox vaccination (1796) was a major turning point. Pasteur's germ theory (1861) and Koch's identification of specific bacteria transformed understanding. Nightingale improved hospital nursing. Lister introduced antiseptic surgery. Chadwick's report (1842) drove the Public Health Acts of 1848 and 1875.

4. Modern healthcare 20th century

Magic bullets (Ehrlich's Salvarsan 1909; Domagk's Prontosil 1932) were the first chemical cures for bacterial infections. Fleming's penicillin (1928) — developed by Florey and Chain (1940–41) — saved millions. The NHS (1948) provided free universal healthcare based on Beveridge's 1942 report.

The factors that drive change

AQA expects candidates to analyse which factors were most important:

• Individuals (Harvey, Pasteur, Fleming, Nightingale)
• Science and technology (microscopes, X-rays)
• Government (Public Health Acts, NHS)
• War (Paré's surgery; Nightingale; penicillin)
• Attitudes and religion (Church's support for Galen)
• Communications and chance (printing press; Fleming's accidental discovery)