Paper 2
Britain: Health and the People, c.1250-present
Both
Link individuals, dates, and government action for higher marks.
Key Facts
- Four Humours theory dominated medieval medicine for over 1000 years.
- Black Death (1348) killed 30-40% of England's population.
- Vesalius (1543) corrected Galen's errors using human dissection.
- Jenner developed smallpox vaccine in 1796 using cowpox.
- Pasteur proved germ theory in 1861; Koch identified bacteria for TB and cholera in 1880s.
- Public Health Act 1875 made councils provide sewers, clean water, and waste removal.
- Fleming discovered penicillin in 1928; mass production began in 1940s.
- NHS established 1948 by Aneurin Bevan, providing free universal healthcare.
Topics Covered
Medieval Medicine c.1250-1500
What you need to know
- •Four Humours theory (Galen/Hippocrates): blood, phlegm, yellow bile, black bile must balance.
- •Supernatural and religious explanations: disease as punishment from God.
- •Black Death (1348-1350): killed 30-40% of population, no effective treatment.
- •Treatments: bloodletting, purging, herbal remedies, prayer, flagellation.
- •Limited understanding of anatomy due to Church bans on dissection.
- •Physicians were expensive; most people used barber-surgeons or wise women.
Exam Tips
- Use specific examples: Four Humours, Black Death, bloodletting.
- Link religious control to lack of progress in anatomy.
Renaissance and 17th Century c.1500-1700
What you need to know
- •Andreas Vesalius (1543): "The Fabric of the Human Body" - corrected Galen using dissection.
- •William Harvey (1628): discovered circulation of blood, heart acts as pump.
- •Printing press spread new medical ideas across Europe.
- •Royal Society (1660) promoted scientific method and observation.
- •Treatments remained largely ineffective: still used purging, bleeding, and herbal cures.
- •Great Plague (1665) killed 100,000 in London; people still blamed miasma (bad air).
Exam Tips
- Name Vesalius and Harvey with dates for higher marks.
- Explain why anatomy improved but treatments did not.
18th and Early 19th Century c.1700-1850
What you need to know
- •Edward Jenner (1796): developed smallpox vaccination using cowpox.
- •Industrial Revolution caused overcrowding, poor sanitation, and disease spread.
- •Cholera outbreaks (1831, 1848, 1854) killed thousands; miasma theory blamed.
- •Hospitals expanded but lacked hygiene; surgery was painful and risky.
- •Government took laissez-faire approach: minimal public health intervention.
- •Some improvements: hospitals, dispensaries, and voluntary health insurance for workers.
Exam Tips
- Link Jenner to vaccination breakthrough in 1796.
- Explain why rapid urbanisation made health worse.
Germ Theory and Public Health c.1850-1900
What you need to know
- •Louis Pasteur (1861): proved germ theory - microorganisms cause disease.
- •Robert Koch (1882): identified specific bacteria causing TB and cholera.
- •John Snow (1854): mapped cholera outbreak and identified water pump as source.
- •Joseph Lister (1867): introduced carbolic acid as antiseptic in surgery.
- •Public Health Act 1848: created local boards of health (optional, slow progress).
- •Public Health Act 1875: made councils provide clean water, sewers, and remove waste (compulsory).
- •Improvements in surgery: anaesthetics (chloroform 1847), antiseptics (Lister), fewer deaths.
Exam Tips
- Name Pasteur and Koch with germ theory dates.
- Contrast 1848 Act (optional) with 1875 Act (compulsory).
- Link Snow, Lister, and government action together in 16-mark questions.
Modern Medicine c.1900-present
What you need to know
- •Paul Ehrlich (1909): developed Salvarsan 606, first chemical cure for syphilis.
- •Alexander Fleming (1928): discovered penicillin mould kills bacteria.
- •Florey and Chain (1940s): mass-produced penicillin for WW2, saving millions.
- •Liberal Reforms (1906-1914): free school meals, medical inspections, old age pensions.
- •NHS created 1948 by Aneurin Bevan: free healthcare for all, funded by taxes.
- •Post-1948: development of antibiotics, vaccines (polio, MMR), advanced surgery, transplants.
- •Lifestyle campaigns: anti-smoking, obesity prevention, mental health awareness.
Exam Tips
- Link Fleming, Florey, and Chain together for penicillin story.
- Use NHS 1948 as turning point for universal healthcare.
- Mention lifestyle factors as modern focus alongside medical advances.
Key Terms
Four Humours
Blood, phlegm, yellow bile, black bile - balance needed for health (Galen).
Miasma
Bad air believed to cause disease before germ theory.
Germ theory
Diseases are caused by microorganisms (Pasteur 1861).
Vaccination
Giving weakened disease to build immunity (Jenner 1796).
Antiseptic
Chemical that kills germs (Lister used carbolic acid).
Anaesthetic
Substance that stops pain during surgery (chloroform 1847).
Public Health Act
1875 Act forced councils to provide sanitation.
NHS
National Health Service, free universal healthcare from 1948.
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Common Exam Questions
Describe two features of medieval medicine.
Model Answer
Feature 1: Four Humours theory said balance of bodily fluids caused health or sickness. Feature 2: Religious explanations blamed disease on sin and God's punishment.
What examiners want to see
- ✓Two distinct features.
- ✓Use Four Humours and religion.
Explain two ways Pasteur and Koch advanced medical knowledge.
Model Answer
Way 1: Pasteur proved germ theory in 1861, showing microorganisms cause disease and disproving spontaneous generation. Way 2: Koch identified specific bacteria causing TB and cholera, allowing targeted treatments and prevention.
What examiners want to see
- ✓Two individuals with dates.
- ✓Link to germ theory impact.
Explain two reasons for improved public health after 1850.
Model Answer
Reason 1: Germ theory (Pasteur, Koch) showed disease spread through germs, leading to better hygiene and sanitation. Reason 2: Government passed Public Health Act 1875 forcing councils to provide sewers, clean water, and remove waste.
What examiners want to see
- ✓Science and government action.
- ✓Specific dates and laws.
How far do you agree that government action was the main reason for improved public health after 1850?
Model Answer
Government action was crucial: Public Health Act 1875 forced councils to provide sanitation, reducing cholera and typhoid. However, scientific advances (Pasteur's germ theory, Koch's bacteria identification, Snow's cholera research) provided the knowledge for action. Urban planning and engineering (Bazalgette's London sewers) also mattered. Balanced judgment: government legislation was the trigger, but science provided the understanding and technology enabled the solutions.
What examiners want to see
- ✓Multiple factors: government, science, technology.
- ✓Balanced argument with judgment.
- ✓Named individuals and dates.
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