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Changes in medicine

Changes In Medicine

A)

In source A we are looking at a private picture from a 14th century manuscript. First of all we notice that this is a wealthy man being treated because you had to pay for treatment, hospitals were scarce and uncleanly, so he would have been treated in his home. The treatment by two lat sisters (nuns of study); the invalid could have had lay brothers (monks of study) Source A shows the nuns were sought after.

The picture describes the types of medical instruments and practises used by women. Firstly the two lay sisters who are treating him are clean, with their hair tied back with one sister holding a sterilised basin. I can tell this as the artist has over exaggerated the basin’s shininess. One sister can read as she has a book of remedies. She must have seen the man and diagnosed his illness, showing her knowledge of symptoms. The sister must also have knowledge of herbs and drugs. In the picture it looks to me as there is one sister with doctrine knowledge, (the one reading), and one with nursing knowledge (the one with the bowl). This shows women had experience of both medical sides in the 14th century.

There is not much written about the role of women in that period, but we do know that women were important in local areas. There is also some evidence of a woman doctor in the Middle Ages known as Trotula of Salerno. Not only did Trotula study, she taught medicine in the Salerno University and wrote a book called ‘Diseases of women’. Trotula was not alone. There was a women named Calenda Constanza who was noted in 1423 for lecturing in medicine. This was good, but women doctors tended to come from very eastern European cities where the Renaissance started, like Venice and Rome. Very few women were allowed to study doctrine in England and France. Many women could not read so this was a problem. In the 16th century women who could read and were good at herbal remedies suffered, due to the witch hunts when many intelligent local women were seen as witches and burnt or hung.

Also, like it says in source B, new and expensive cures had been developed, while new drugs were imported as a result of trade between Europe and India, China and the New World. These drugs were handled by merchants and businessmen, surgeons and apothecaries. They were not easily available for women to use. They were obtained by men, handled by men, and sold to men. The traditional medicine-woman was starting to be pushed out of medicine.

A medicine women’s remedies were far less successful than the new drugs now available on the market. There were some very good drugs that reached Europe but also a lot of bad drugs which had no effect. One of the good ones was quinine which came from the bark of the cinchona tree (Some call it Jesuits bark, because they were the first to supply quinine in England). It was a drug used to cure malaria. Mastic was believed to be a cure for cholera, it helped but did not cure it. Aloe was used to make laxative pills.

Europe had alcohol as its depressants but lots of new stimulants were brought back from the new world such as tea and coffee, which contained high amounts of caffeine. Cocoa and sugar cane, were brought back from S. America which contained high amounts of sugar and caffeine. One plant was discovered which is infamous, - the opium poppy- which was used to make heroine (It is now used to make cocaine). It was used by wealthy people, Queen Victoria used it to numb her menstrual pains. The biggest discovery of all had to be tobacco which was thought to cure everything and at one point was beleived to revive the deceased if used in time.

Medical training became more formalised, and through most of Europe, surgery continued to be taught by apprenticeship and organised in guilds. Women were excluded from these guilds, and could not attend universities, so their status as healers declined. Also at this time, it became fashionable for male doctors to perform midwifery. It was not long before women were forced out of their traditional role, professional midwifery. In 1620 Peter Chamberlain invented the forceps and put the role of the midwife firmly in the hands of trained physicians (men).

B) William Harvey (1578-1657)

Harvey was born in Folkestone, AfterAttending Caius College, he went to Cambridge University and then on to Padua, the greatest medical school of its time. He was taught there by hieronymus Fabricus who gave Harvey most of his knowledge on veins and valves. At Padua he developed his circulatory theories. He then came back to England and worked at St Bartholomew’s Hospital.

Harvey was the first person to come up with correct theories on the circulation of blood. He found this out like Versalius before him, by making direct observations and making detailed notes. To begin with he had lots of criticism but he soon became a respected anatomist. Amongst other things, Harvey was the physician to king Charles the first who funded Harvey’s experiments. At the battle of Edgehill he looked after king Charles the first’s children in a near by field.

In 1615 Harvey began to work on the idea that blood circulated around the body. By experimenting on live animals and dissecting the bodies of executed criminals, Harvey was able to prove that the heart was a pump, which forced blood around the body through arteries. Veins then returned the blood to the heart where it was recycled. Due to Harvey discovering this fact, blood letting was finally ended 50 years after his death. Harvey's work was helped by the discovery that veins contained valves by Salerno Sari. Harvey realised that these valves stopped the blood from travelling back the wrong way to the heart. Harvey also worked out how much blood was in our bodies and he practised taking a pulse. Galen's theory was that the liver made blood which was sent to the heart which was believed to be a furnace designed to burn the blood. Harvey proved Galen wrong. This upset many people because several high physicians saw Galen’s book as a textbook. In 1628, Harvey published his book entitled 'An Anatomical Disquisition on the Movement of the Heart and Blood’.

But William Harvey was not satisfied with being the most acclaimed anatomist of his day. He was fascinated by everything about the body, and at some point turned his attention to reproduction. He thought that humans and other mammals must reproduce through a sperm fertilizing an egg. It was 200 years before a mammal egg was finally observed, but Harvey's theory was so well thought out that the medical world believed that he was right long before the discovery was finally made

Harvey's work made little difference to general medical practice at the time. Blood letting continued to be a popular practice, and it was not until the 20th century that doctors realised the importance of checking a patient's blood flow by taking a pulse. Harvey's work did encourage others to investigate blood circulation, e.g. the blood's role in carrying air from the lungs discovered by Robert Hooke. His discovery of blood circulation was crucial to the understanding of the body and above all it totally knocked Galens textbook of the shelf. ... Eventually.

Harvey’s work was important. Without his work, Malphigi; Leeuwenhoek and a lot of other anatomists would have been at a loss. Granted his work had holes in it, but he did not have a microscope. Operations on the heart or major surgery were unattainable but with his knowledge people could create reliable theories, new drugs and remedies. Like I stated earlier its like the domino effect -once one falls they all fall. Once Harvey had stated that the lungs put oxygen in the blood Jan Swamberdam put together the theory of oxidisation of the blood.

ii) Harvey’s ideas were influenced greatly by the Renaissance and the scientific revolution. The spirit and attitude of students and teachers in those days were very inspiring. The need for new knowledge and a better understanding were huge; so much of the medical technology and medial knowledge came from this time in History. The way they collected their data as well was so studious. They would dissect people writing copius amounts of notes while artists were on hand to sketch the body. I feel that one invention that helped the medical world dramatically was the movable printing press. The printing press was invented in Germany by a printer called Johannes Gutenberg in 1440. This helped immensly because when people like Versalius and Harvey published their books, they were able to circulate them easily and reached people who probably wouldn’t have read them. But not only was there a scientific revolution but the most famous artists were around plus authors and playwrights were writing classic plays such as William Shakespeare. These inspired Harvey as well.

Harvey’s books are correct even today, and the engravings of Harvey, Versalius and their artists were accurate. The bones and organs picture are perfect observations .

Harvey was more of a 2nd generation anatomist of the Renaissance. The first generation would have been the likes of Da Vinci, Andréa’s Versalius and hieronymus Fabricus; I think Versalius inspired Harvey tremendously. The hardest task I feel was for people such as Andreas Versalius (1514-64) a Belgium artist and anatomist who through the dissection of executed criminals, managed to discover the way our organs and muscles fitted better than anyone before him. One of his most important studies was the discovery of the Septum wall. Versalius dissected a human and in a further dissection of the heart discovered that the septum was very dense and strong. Galen (the greek physicion) said that blood seeped through the heart. This was impossible due to the septum being too thick, proving galen wrong and was the first nail in the coffin.

Doctors in the middle ages relied on Galen, a Greek doctors work nearly 450 years ago. Although galens work was outstanding and his work on animals discovered blood flowed through arteries and not air, the brain, work about nerves and of our spinal cord it was however not entirely correct. Galen thought the source of blood was the liver, which made blood then sent it to the heart to be burnt. Galen also thought the system depended on the coexistence of three "spirits" in the body: the liver was the seat of the natural spirit, the heart of the vital spirit, and the brain of the animal spirit. Galen thought this because religion had restricted him to only dissecting animals; this is why some of his theories were wrong. Galen was not challenged resulting in a lack of new discoveries. Versalius dissected human bodies and made lots of discoveries proving Galen wrong, Versalius had great respect for Galen and it wasn’t until his second version of ‘the fabric....’that he must be wrong. This was ridiculed at first because it is like saying that everything that they have done has been wrong Versalius’s work was later recognised as to be correct. Versalius set the way for many to follow and later published a book called ‘the fabric of the human body’. The book was a big inspiration and versalius ended up teaching other medical greats at Padua the school of medicine in Italy second would have been people like William Harvey and Renaldo Columbus and finally the third being Marcello malphigi and Robert hooke e.t.c. Another major tool that helped Harvey was the printing press, which meant he could get his theory published cheaply instead of a labouring process of a scribe. So yes on the one hand I think that he was influenced by the renaissance but on the other his style of research and technique probably dates back to the days of Aristotle and Galen.

C)

Elizabeth acted as a pioneer because she was the first woman in England to be allowed to become a physicion. She inspired every woman aspiring to learn medicine after her. Elizabeths actions brought women’s education forward by 50 years.

Elizabeth’s father Newson Garrett had 12 children and he owned a pawnshop, which in 1850 became very successful and he had earned enough money for his children to go to boarding school. This was quite good for the time as there were not many secondary schools for women. When Elizabeth finished her education she wanted to do nothing else apart from becoming a doctor. Her father was dead against the idea and in a letter to Emily Davies (a friend) states "father finds the idea disgusting and he could not entertain it for a moment" and at the end it reads "I mean to renew this subject pretty often". This shows her resilience and determination also that she wont take no for an answer.

In 1859 Elizabeth was introduced to Elizabeth Blackwell who was the actual pioneer in women’s medicine as she was the first woman to achieve doctor status and a medical diploma in the world. She graduated at the Geneva medical school after being turned down by 29 other colleges and denied the rights to some displays of dissection.

Mr garret gave in but, the BMA changed its rules after Elizabeth Blackwell to only women who studied in British universities to continue study, this eliminated everyone but Elizabeth was determined. Her father got her a job as a nurse and she was allowed to take lectures at Middlesex hospital, she also had private tutoring with some of the best doctors in the profession. Elizabeth passed all the tests but there was a problem to become a doctor you had to become a member of the college of physicians, the college of surgeons or the society of apothecaries. Hope was not looking good because Elizabeth was not allowed to join any of them. The Garrett’s pursued ruthlessly.

In source C we see a letter to her father which states "I think my work is plain: to go on acting as pioneer to achieve this. Even though by doing so I spend the best years of my life because other students will reap the benefit". This shows her dedication, Her father filled a lawsuit and a loophole was found that nowhere in the rules did it say anything about not taking women. She passed all the tests laid before her at the hospital but she has to fight on and become a pioneer so that other women can become doctors and not have to fight like her. I think that Elizabeth doesn’t want to do this but she must ‘I think my work is plain’ is almost like saying I know what I have to do, I have to be the first so that other women can become doctors but I don’t think she wants to fight.

Three years later Elizabeth sits the apothecary test and pass’s becoming a doctor. The sad part is as soon as she gets her certificate the rules are changed so that no women are allowed in the apothecaries. Her father sets up a medical practise for her.

Elizabeth inspired many people and the two most crucial people that she inspired were Sophia jex Blake and Edith peachy, Sophia was the daughter of Thomas Jex-Blake and Mary Cubitt, was born in Hastings in 1840. Thomas Jex-Blake was a leading physician, but he had retired at the time of her birth. Sophia's parents were Evangelical Anglicans who held very traditional views on education and at first refused permission for her to study at college.

Eventually Dr. Jex-Blake gave his permission and in 1858 Sophia began attending classes at Queen's College. Sophia did so well that she was asked to become a tutor of mathematics at the college. Sophia's parents believed it was wrong for middle-class women to work and only gave their approval after she agreed not to accept a salary. Sophia went to America but when she came back and learned about Elizabeth she desperately wanted to become a doctor. She inspired a friend Edith Peachy.
Sophia Jex-Blake eventually persuaded Edinburgh University to allow her and her friend, Edith Pechy, to attend medical lectures. This annoyed the male students and attempts were made to stop them receiving teaching and taking their examinations. Jex-Blake and Pechy both passed their examinations, but university regulations only allowed medical degrees to be given to men. The British Medical Association therefore refused to register the women as doctors. Sophia Jex-Blake's case generated a great deal of publicity and Russell Gurney, a M.P. who supported women's rights, decided to try and change the law. In 1876 Gurney managed to persuade Parliament to pass a bill that empowered all medical training bodies to educate and graduate women on the same terms as men. The first educational institution to offer this opportunity to women was the Irish College of Physicians. Sophia took up their offer and qualified as a doctor in 1877.

ii) Elizabeth had too make a clear distinction between herself and the male doctors if she was to path the way for women in the future, she would have to be a woman in a mans world not acting masculine but feminine. One of Elizabeth’s influences was very much Florence Nightingale. Elizabeth admired her especially in the way she went about the situation, Florence campaigned to take a team of nurses to the Crimean war, which was one easily. When Florence arrived at the Hospital in scutari she was appalled condition were terrible and only one in six deaths was on the battlefield. Florence Decided to reform the barracks but officers and Physicians were insulted and thought it as a stab at their professionalism. Florence acted in a very tactful way by using her connections and informing the times that wrote articles on the condition of the war. To this response she was allowed to organize the barracks after the battle of inkerman. In 1865 Florence returned a hero and ended up having talks with Queen Victoria and resulted in the formation of the Royal Army Medical College.

Even though Elizabeth was inspired by her womanliness and tact, she was upset because Florence did not fully support the cause for women doctors, she fought it was much more necessary to have women nurses.

But most of all she needed to show tactfulness, which would show her capability, her intelligence and her manner’s as well. Obviously being tact is more important to her because she put it before womanliness. She knew it wasn’t going to be over quickly so she was patient and tackled every thing in front of her. Elizabeth had to gain the support of the people including the men. She needed to show her critics that she was capable of becoming a doctor physically, mentally and socially because a lot of men thought women were totally unable to be doctors mentally and physically as well. The Prime Minister ‘Mr Gladstone’ said that "women should be placed on a pedestal and worshiped" in other words not to have careers. Her Hard work paid off for her in the end.

d) In 1914 people thought that the war would be short and the attitude from society remained unchanged. There were very few women doctors and the general attitude of men towards women with aspirations in medicine was to over ego and sit quietly at home. However, there were some women doctors but unfortunately, this attitude still hindered their efforts.

As Source D states: In 1914 group led by Dr Elsie Inglis tried to volunteer. Even though they had raised enough money to set up a field hospital (a hospital for soldiers near the battlefields of Northern France). They were told to go and sit quietly at home.

Needless to say, as the war continued the country needed more trained doctors. Conscription took most trained physicians into the field leaving few doctors left back home to practice for the remaining population. Women were already heavily involved in nursing in fact many nurses were women. Whilst the British Red Cross remained reluctant to send women doctors into the field, the French Red Cross didn’t care and sent many to practice medicine in Serbia.

It must be remembered that it took, and still does take, 5 to 6 years to qualify as a doctor so it was important to start training women interested in medicine. More hospitals began to accept women training to be doctors and so did University College London. In conclusion, the main factor that brought about the change was the severe lack of trained doctors in Britain, due to the war, but a shift in attitude to women equality also played a small part.

e) There is no doubt that Elizabeth Garrett Anderson played a very important role in the cause to allow women to train as doctors. Despite not being the first woman to become a doctor, she was the first to publicise her campaign and the first to get people to realise that there was no good reason to disallow women from training as doctors. She knew her cause and was determined to achieve her aim, as she says herself in Source C: I think my work is plain, to go on acting as pioneer to achieve this. In this way she could certainly be called a pioneer. World War I, on the other hand, allowed other women to practice medicine due to the unexpected length of the war, the number of wounded and the lack of doctors due to conscription. Conscription also drove down the number of men training as doctors, particularly after 1916. Around this time there was also a drastic change in attitudes towards women, particularly in medicine. People were used to women treating them, mainly due to the war. For two years (and to a lesser extent the first three years) the doctors and nurses treating the sick and injured were almost all women. Another reason for the change in attitudes towards women was the two suffrage organisations that were protesting around this time. There was the suffragettes and the sufferergisttes the ettes or the wspu were the violent suffrage group and were lead by emileen Pankhurst and her daughters, Millicent Fawcett Elizabeth’s sister was a leader as well. They had a very famous martyr called Emily wilding Davies who through her self in front of the king’s horse at derby. People beginning to come to terms with the fact that women were World War I medical training was very important because a large number of women were able to get changed and once they have been let in they have never been chucked out. But Garrets triumphs opened peoples mind to the prospect of women doctors, it did little to ensure that women were allowed to actually train to become them. Immediately after she qualified, the Society of Apothecaries altered its rules to ensure that no woman could join again. It is a hard question a bit like what came first the chicken or the egg?

It was World War I that opened the doors of medicine to women. Britain was forced to admit that it needed women as physicians. Women were returned to their role as healers, a role that they had held for centuries previously, but this time as equals. It was only due to the depleting supply of doctors that universities were forced to admit women to ensure that there were still people back home who could treat the sick and the wounded.

This rise can be seen from Source E. You can see a massive rise between 1919 and 1920. Considering that it takes 5 to 6 years to quality to become a doctor, these women must have begun training in around 1914 the beginning of World War I. After the representation act in 1918 there was no stopping them.



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