The Edexcel GCSE History unit Medicine through time, 1250-present is a thematic study of how ideas about disease, treatment and public health changed in Britain over 750 years. You need to know the four key periods, understand why change happened, and explain the significance of the people and factors that drove it, such as government, war, science and technology.
This unit is examined with source questions and essay questions. The highest marks come from explaining continuity and change across the whole period, so it helps to keep the big themes in mind: ideas about the causes of disease, the prevention and treatment of illness, surgery, and public health.
Medieval ideas about disease were based on the theory of the four humours, supported by the Church and by the work of the Greek doctor Galen. Most people believed disease was caused by miasma, or bad air, by an imbalance in the humours or by God as a punishment. Treatments included bloodletting, purging and herbal remedies, and barber-surgeons carried out most surgery without anaesthetics. Public health was poor in towns and the government did little, although attempts were made to keep streets clean.
In the Renaissance, the work of Vesalius corrected Galen's anatomy by dissecting human bodies, William Harvey discovered the circulation of the blood, and Thomas Sydenham argued that doctors should observe patients and classify diseases. Printing helped spread these new ideas. However, most ordinary people still believed in the four humours and miasma, and the Great Plague of 1665 was tackled with quarantine and fires rather than a scientific understanding of germs.
The 18th century brought the first vaccinations, with Edward Jenner's smallpox vaccine of 1796. In the 19th century, improved transport and factory work created a stronger government and middle class that pushed for public health reform. Edwin Chadwick's 1842 report led to the Public Health Act of 1848, and John Snow proved that cholera was spread through water in 1854. The Germ Theory, developed by Louis Pasteur in 1861 and built on by Robert Koch, who identified the bacteria that cause tuberculosis and cholera, finally replaced miasma and the four humours as the accepted explanation of disease. Anaesthetics and antiseptics transformed surgery: James Simpson used chloroform in 1847 and Joseph Lister introduced carbolic acid in the 1860s.
In the 20th century, Alexander Fleming discovered penicillin in 1928, and Florey and Chain developed it into a usable drug in the 1940s. DNA was discovered in 1953 and the structure of DNA was mapped, opening the door to genetics and targeted medicine. The National Health Service was founded in 1948, giving everyone free healthcare. More recently, new technology such as CT scanners and keyhole surgery has transformed diagnosis and treatment, while government campaigns have tackled smoking, diet and vaccination.
c1250-1500 – Medieval medicine: four humours and miasma dominate
1543 – Vesalius publishes On the Fabric of the Human Body
1628 – Harvey discovers the circulation of the blood
1665 – The Great Plague of London
1796 – Jenner tests the smallpox vaccine
1842 – Chadwick's Report on the Sanitary Condition of the Labouring Population
1847 – Simpson uses chloroform
1848 – First Public Health Act
1854 – John Snow links cholera to water
1861 – Pasteur's Germ Theory
1860s – Lister develops antiseptic surgery
1928 – Fleming discovers penicillin
1948 – The NHS is founded
1953 – Discovery of the structure of DNA
Download the free Edexcel Medicine through time revision checklist to track your progress through every part of the course. The GCSE Elite Series ebook on Medicine through time includes model answers to past paper questions and video tutorials on the source and essay techniques this unit needs. For 1-to-1 help with this module, Nick Morgan offers online tutoring with a free first lesson — book it here.