Changes in Health and Medicine in Britain c.500 to the Present

Medieval Medicine (c.500–1500)

Medieval medicine was dominated by ideas from the ancient world — particularly Galen (2nd century AD) and Hippocrates. These theories were preserved by the Church and Arab scholars.

Theory of the Four Humours:

• The body contained four humours: blood, yellow bile, black bile and phlegm.
• Illness occurred when these were out of balance.
• Treatment: bloodletting (removing blood to balance humours), purging, herbal remedies.

Other beliefs:

• Miasma theory: Disease spread through bad air (miasma), not contagion.
• Astrology: Doctors consulted star charts before treating patients.
• Religion: Illness as God's punishment for sin; prayer and pilgrimage as treatments.

The Black Death (1348–49): Killed around a third of England's population. Responses included prayer, flagellant processions, quarantine (some towns), and bloodletting. No one understood bacteria — the real cause (Yersinia pestis, spread by fleas on rats).

Early Modern Period (1500–1750)

The Renaissance challenged classical ideas through direct observation and dissection.

Andreas Vesalius (1543): Published De Humani Corporis Fabrica — based on actual human dissection. Corrected many of Galen's errors (Galen had used animal bodies). Established anatomy as a science.

William Harvey (1628): Published De Motu Cordis — proved blood circulates continuously through the heart (circulation of the blood). Overturned the idea that blood was produced by the liver and consumed.

Limitations: These discoveries did not immediately improve treatments — understanding anatomy/circulation didn't yet translate to cures.

Industrial and Victorian Period (1750–1900)

Edward Jenner (1796): Noticed milkmaids who got cowpox seemed immune to smallpox. Tested vaccination — a deliberate infection with cowpox to prevent smallpox. By 1852, vaccination was compulsory. This was the beginning of immunology.

Germ theory: Louis Pasteur (France, 1860s) proved that disease was caused by micro-organisms (germs), not miasma. Robert Koch identified specific bacteria — anthrax (1876), tuberculosis (1882).

Joseph Lister (1867): Applied germ theory to surgery — used carbolic acid spray to kill bacteria during operations (antiseptic surgery). Surgical death rates fell dramatically.

Anaesthetics: Chloroform (James Young Simpson, 1847) enabled pain-free surgery.

John Snow (1854): During the Broad Street cholera outbreak, mapped cases and identified the water pump as the source — an early example of epidemiology, long before germ theory was widely accepted.

Public health reform: Edwin Chadwick's Report on the Sanitary Condition of the Labouring Population (1842) → Public Health Acts 1848 and 1875 (compulsory sewers, clean water, medical officers of health).

20th Century to Present

Fleming and penicillin (1928): Alexander Fleming discovered penicillin (an antibiotic that kills bacteria). By WWII, penicillin was mass-produced — saved millions of soldiers' lives.

NHS (1948): National Health Service established — free healthcare for all at point of use. Beveridge Report (1942) identified disease as one of the "Five Giants." Aneurin Bevan as Health Minister.

DNA (1953): Watson and Crick's discovery of the double helix structure of DNA opened the door to genetic medicine — understanding inherited disease, genome mapping.

Modern challenges: antibiotic resistance; cancer treatment advances; mental health; pandemics (COVID-19 2020).

WJEC Exam Technique

Thematic questions across time: always identify periods (medieval, early modern, industrial, modern) and show change AND continuity. Use connecting phrases: "By contrast...", "This represented a turning point because...", "However, continuity can be seen in..."