Meningitis

After a recent visit to the cinema I decided to research further into Meningitis which is a terminal disease if left untreated. The meninges are a layer of protective membranes engulfing the Spinal cord and Brain. An inflammation (namely meningitis) may be caused by an infection through viruses, bacteria or other microorganisms. Certain medicinal and recreational drugs have also been known to cause a similar infection. Meningitis is classed as a terminal disease because of the inflammations proximity to the Brain and Spinal cord.

Symptoms include a headache and neck stiffness in conjunction with a fever, confusion, vomiting, photophobia (aversion to light) and phonophobia (aversion to noise). If a rash is present and does not fade under pressure then the meningitis may be caused by meningococcal bacteria. Infants often exhibit only non-specific symptoms such as drowsiness and irritability.

For a formal diagnosis a lumbar puncture may be carried out. A needle is inserted into the spinal cord in the lumbar area of the spine (around the dural sac). Then a sample of cerebrospinal fluid is extracted. This fluid covers the Brain and Spinal cord. The CSF is then examined in a medical laboratory and if the inflammation is present antibiotics and sometimes antivirals may be administered in the early stages of infection. Corticosteroids have also been known to prevent complications from excessive inflammation. Meningitis can lead to some long term consequences such as deafness, hydrocephalus and epilepsy. Certain forms of meningitis may also be prevented by immunization.  

The Roman Occupation of Britain transformed people’s health. How far do you agree?

During the Roman occupation of Britain, the Romans built many Public Health related structures, in order to maintain a healthy army and population. The increased the opportunities for sanitation which in Celtic Britain did not exist. However, these Public Health structures where more for the use of the Roman army, the upper classes and the inhabitants of large towns; therefore, I believe that in the bigger picture the Romans did not make much of a difference for the average Briton.

Nevertheless, the Romans did help to transform town life, along with looking after their armies posted in Britain and of course the rich upper classes. They did this through building structures like, baths, aqueducts, public toilets and sewers. This helped transform the mentality of uncleanliness, and encouraged people to take regular washes, drink from safer water supplies and dispose of sewage in a more effective way, than the previous method of burying the excrements or throwing it into the river which was also the main source of drinking water during the Celtic period. Each major town had stone sewers, public baths, toilets and water supplies along with doctors who were trained in Hippocratic and Galenic medicine who were employed to treat town’s people, the rich and soldiers. The Romans also brought with them the cult of Asclepius, and built Asclepions in major towns. Although these did rely on spiritual medicine it was a place where people could exercise and also be healed with new medicinal herbs, like belladonna, which were brought in from across the empire. The rich also had the advantage of having their own toilets and water supplies directly into their house which meant that they didn’t have to use public drinking fountains or public toilets.

However, these transformations only really affected better off town’s people, the rich and soldiers, as for most doctors and herbal remedies you had to pay. These changes also did not affect people who were still living in minor towns and villages as the priorities for public health was towns and specifically forts which even had hospitals to treat wounded soldiers. The Public health measures were also not 100% effective as in some towns there were open or timber sewers which encouraged the spread of diseases, along with the fact that not all houses had toilets so waste was thrown out the window and on to the street. In addition to this, once you were ill there were not many treatments available for a serious leg infection (where the treatment was a painful and probably fatal amputation), or the fact that people still prayed to the gods in Asclepions to help them cure their ailments. In Gloucester, there is evidence of a mass grave which was used to bury the victims of Galen’s plague despite public health measures and doctors trained in Hippocratic and Galenic medicine.

In conclusion, although the Romans had introduced many public health related buildings, and employed doctors of Hippocratic and Galenic medicine, these were not always 100% in preventing illness and highly ineffective in successful treatment. On top of this everything to do with public health was concentrated in forts, large towns and in the villas of the rich; therefore, not transforming the access to sanitation for the majority of Britons who still lived in villages and minor towns in the countryside. As a result of this I believe that the Roman occupation of Briton did not transform the average people’s public health.  

Did the medieval church help or hinder medicine?

The medieval church hindered the progress of medicine as they primarily believed in the idea of supernatural healing. They thought illness was sent by god to punish people for their sins. This hindered an advance in medicine as people still believed in an almighty power causing disease and sickness. The church also discouraged dissection because it tampered with human remains. This ban on human dissection did not allow surgeons and physicians to further study anatomy and increase their knowledge therefore this church law did not help progress. Another example of hindrance was that the Church punished anyone who dared disagree with Galen, who the church thought was an example of an early Christian, this hindered the introduction of new medical theories and as people who tried to spread new medical findings were punished for their disagreement with Galen. The Church was also very suspicious of women and prevented them from training as doctors, which may have set medical fields like midwifery back.

 However, the church did also help medical progress as it was seen as a centre of education in the west. Monks preserved the works of Hippocrates and Galen and monasteries became important medical centres, as most had an infirmary for sick monks and hospitals, like the Hospital Dieu in Paris, for the public. As well as providing the sick public with places to stay, the Church provided continuity after the collapse of the Roman Empire. The Church became the main link to Roman civilization and learning. This allowed them to learn about public health which was evident in many wealthy monasteries as they could afford to build water pipes, drains and wash houses which helped medical progress through introducing elements of sanitation.  

In conclusion, the medical church did both help and hinder the progress of medicine. However, in my opinion the church did more to hinder medical progress than help it. In that they punished new ideas, believed ultimately in super natural healing and discouraged important elements of learning like human dissection which forced the dissection of animals, which did not always portray an accurate picture of human anatomy. 

How far was the progress made in medicine by the Romans continued in the Middle Ages?

  

Progress in the fields of medicine and public health during the Roman period included Galen’s anatomical research; the building of Baths, Aqueducts, Toilets and Sewers; the maintenance of libraries which stored the texts of Hippocrates and the Theory of Opposites. However, progress was still made in the medieval period; the building of hospitals and a  more formal training of doctors in universities was introduced; new methods of diagnosis were also invented, for example urine chart analysis. Nevertheless, there was very little progress in the scientific areas of medicine and this led to stagnation in most areas.

Progress did continue after the fall of the Roman Empire in the 5^th century. Hospitals were built by monks and nuns in order to care for the sick, old and weak. The largest of these Hospitals was the Hotel Dieu in Paris. These Hospitals gave a basic standard of care which could be given to anyone in need of it. Monks and Nuns provided a warm bed for patients in addition for hot food and water. As Hospitals were institutions funded by the church supernatural healing also played a large role in the care of patients. A formal training of physicians was introduced. The training took place at a university and consisted of reading texts featuring Galen’s experiments; however, the training was very costly and women were not allowed to study. The introduction of formal training for doctors and the building of Hospitals were fundamental in providing a basis of care for patients, which is still used today; therefore some progress did continue in the Middle Ages.

However, there was evidence of stagnation. The same ideas about the causes of disease and illness along with treatments changed little. During the Roman era doctors thought that illness was caused due to an imbalance of the 4 humours (phlegm, black bile, yellow bile and blood). Galen then further developed these ideas and came up with the theory of opposites which was a way of restoring the balance of the humours, for example bleeding or purging. These ideas were still widely used during the medieval period as Galen’s ideas were widely accepted by the church, as they thought he was an early Christian, who controlled all education during the time. These theories show an element of continuity among the transition of medicine from roman to medieval, and therefore highlight that medicine did not progress much during the Middle Ages.

Following on from the stagnation of progress, there was evidence of deterioration in some areas of care and public health. The public health system built up by the romans which consisted of Baths, Aqueducts, Toilets and Sewers fell into disrepair due to the wars that were being fought and that taxes were used to build defences and armies rather than improve and maintain these valuable structures. Although rulers were fining townsfolk for dumping waste in the streets and affecting the overall cleanliness of the city, these measures were not very successful and many people rather paid the fine than take any consideration on the idea of waste disposal. The fact that education was now controlled by the church meant that new ideas were not accepted and supernatural healing was further encouraged. Anyone who tried to disprove Galen was removed and their work banned, the Church did not allow human dissection as it was classed as desecration and therefore did not allow advances in anatomy. The fact that progress did not continue and that some elements actually deteriorated was highlighted by the church’s control and the lack of consideration by rulers on their part about maintenance of public health systems.

In conclusion, there was very little progress during the middle ages, and most areas seemed to remain stagnant while others became worse. Building of hospitals and formal training of doctors show some progress, while the continuation of ideas used by Galen and Hippocrates show stagnation. In addition, the disappearance of public health structures and the censorship of the church meant that progress and new ideas were not allowed to mature. Therefore, I believe that very little progress was made in comparison to the roman era and that most areas did not change.