Medicine in Britain, c1250-present: Change and Continuity in Ideas About the Cause of Disease
Change and continuity in ideas about the cause of disease, part of the story of medicine in Britain, traces how explanations for why people fall ill changed across the whole period c1250 to the present, and, just as importantly, why change was often slow. Ideas moved from supernatural and religious explanations and the Theory of the Four Humours, dominant c1250-c1700, when illness was explained as an imbalance of blood, phlegm, black bile and yellow bile inherited from the Greek physician Galen, to miasma theory (bad air, increasingly blamed alongside or instead of the humours by the eighteenth and nineteenth centuries) to germ theory, proved by Louis Pasteur in 1861 and developed by Robert Koch, which finally identified specific micro-organisms as the true cause of infectious disease. In the twentieth century, understanding of the structure of DNA in 1953 added a further, genetic explanation for disease alongside germs. Across all of this, change was slow because it needed both scientific tools capable of identifying a real cause and, separately, the social and institutional acceptance to abandon deeply trusted older ideas such as Galen's.
Before you start
Make sure you're comfortable with these topics first:
Method
- Build a simple timeline in your head before answering any question on this topic: supernatural/four humours (c1250 onwards) then miasma growing in importance (especially c1700-c1850) then germ theory (from 1861) then genetics (from 1953) - most questions want you to place specific evidence correctly on this timeline.
- Learn which explanations OVERLAPPED rather than neatly replaced one another: miasma theory and the four humours coexisted for centuries, and even after Pasteur's 1861 germ theory, some doctors continued to blame miasma for years afterwards, because old ideas do not disappear the moment a new one is proven.
- For questions across the WHOLE period, always be ready to identify what caused change to speed up: name at least one turning point, e.g. Pasteur's 1861 publication of germ theory, and explain specifically why it was more convincing or more testable than what came before.
- For questions about why change was SLOW, use named blocking factors: the Church's protection of Galen's authority in the medieval and Renaissance periods, the centuries-long absence of a way to see micro-organisms or test theories scientifically, and the fact that respected physicians had strong professional reasons to defend ideas they had spent years learning.
- For a 4-mark 'explain one way X was similar to/different from Y' question spanning two periods far apart in this topic, choose the clearest possible contrast (an explained, tested cause versus an unproven belief) and support both sides with a named, dated example.
- For a 12-mark 'explain why' question, organise your answer using named factors (individuals, science and technology, the Church/religion, government, chance) and explain HOW each factor specifically slowed down or sped up the acceptance of a new explanation, rather than just describing what changed.
- For the 16-mark 'how far do you agree' judgement question, plan a paragraph of specific evidence supporting the given statement, a paragraph of specific evidence challenging it, and a conclusion that directly answers 'how far', rather than simply repeating both sides without deciding.
- Keep at least one precise, dated example ready for each major turning point: Galen (c.129-c.216 AD), the Black Death of 1348, Pasteur's germ theory of 1861, and the 1953 discovery of the structure of DNA.
Worked example
Explain one way in which ideas about the cause of disease in Britain in the period c1861-present were different from ideas in the period c1250-c1700.
- Choose a precise, contrasting pair: from 1861, ideas were increasingly based on scientifically identified causes (germs, later genes), while c1250-c1700 ideas rested mainly on the Theory of the Four Humours and supernatural belief.
- Support the earlier period with detail: between c1250 and c1700, physicians explained illness as an imbalance of the four humours, sometimes alongside supernatural causes such as God's punishment for sin, based on the inherited authority of Galen rather than direct evidence of a cause.
- Support the later period with detail: from 1861, Pasteur's germ theory identified specific micro-organisms as the real cause of many diseases, a claim that could be tested and observed rather than simply trusted, and this was later joined by genetic explanations after the 1953 discovery of the structure of DNA.
- State the difference clearly: ideas after 1861 were increasingly evidence-based and testable, while ideas before c1700 rested mainly on inherited authority and belief that had rarely been directly tested.
Practice questions
Try each question, then tap to reveal the answer.
Q1Name the theory that dominated explanations of disease from medieval times through most of the Renaissance.Show answer
Answer: The Theory of the Four Humours, developed by Galen from the earlier ideas of Hippocrates.
Q2Which explanation for disease grew increasingly important during the eighteenth and early nineteenth centuries, before germ theory was proven?Show answer
Answer: Miasma theory - the belief that disease was spread by poisonous 'bad air'.
Q3In what year did Louis Pasteur publish germ theory, and what did it prove?Show answer
Answer: 1861; it proved that specific micro-organisms, not miasma or spontaneous generation, cause disease and decay.
Q4What scientific discovery in 1953 added a further explanation for some diseases, alongside germs?Show answer
Answer: The discovery of the double helix structure of DNA by Watson and Crick, building on Rosalind Franklin's research, which underpinned later understanding of genetic causes of disease.
Q5Give one reason belief in the four humours survived for so long, even after some evidence against it appeared.Show answer
Answer: Galen's authority was protected by the Church and by centuries of medical tradition, and there was no scientific method or technology, such as the microscope, capable of directly testing or disproving it.
Q6Did miasma theory disappear as soon as germ theory was proven in 1861? Explain your answer in one sentence.Show answer
Answer: No - some doctors and officials continued to blame miasma for years after 1861, since old, familiar explanations are rarely abandoned the instant a new one is proven.
Q7Give one example of continuity in ideas about the cause of disease across this whole period.Show answer
Answer: Even after germ theory and genetics offered scientific explanations, some people continued to blame lifestyle or moral behaviour for illness, showing that older ways of thinking about disease never disappeared completely.
Exam-style questions
Written in the style of a GCSE History exam paper, with a full mark scheme.
Explain one way in which ideas about the cause of disease in the period c1700-c1900 were similar to ideas in the period c1250-c1500.
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Explain why ideas about the cause of disease changed more quickly in the nineteenth century than in the medieval and Renaissance periods.
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'Science and technology were the main reason ideas about the cause of disease changed between c1250 and the present day.' How far do you agree with this statement? Explain your answer. You may use Pasteur's germ theory and the discovery of the structure of DNA in your answer, as well as any other information you know.
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