1750-1900 Flashcards
What was PH like at the beginning of the Industrial period?
Poor conditions -overcrowding -waste in streets -child labour -manual labour LE higher in country
What were the 5 killer diseases of the 19th century?
Cholera Diptheria TB Typhoid Smallpox
How is cholera contracted?
What are the symptoms?
What is the DR of those who got it?
Spread through bacteria passing through food and water contaminated w sewage
Sickness
Diarrhoea
-sufferer died often w/in 24 hours from dehydration
2/3
How is diptheria contracted?
What are the symptoms?
What is the DR of those who got it?
Droplets of water from infected person
–>from coughing/sneezing
Bleeding
~paralysis
Suffocation from blocked throat
1/10
How is TB contracted?
What are the symptoms?
What is the DR of those who got it?
Droplets of water
–>Coughing + sneezing
Coughing
Bringing up blood
Chest pains
Severe weight loss
1/2
How is TYPHOID contracted?
What are the symptoms?
What is the DR of those who got it?
Bacteria
–>passed on by food/water contaminated by sewage
OR
Food infected by flies
Headaches
(fever, constipation)
Severe diarrhoea
1/3
(esp young, old, malnoruished)
How is smallpox contracted?
What are the symptoms?
What is the DR of those who got it?
Touch
droplets-> sneezing and coughing
Rash–>Blisters w pus–>fall off–>leave deep scars
1/3
What was the only method of prevention in the 18th century?
Inoculation
What is inoculation from smallpox?
Spreading pus into open wound
–>Caused mild dose that caused immunity
WOULDNT ALWAYS WORK
Who was the first person to promote inoculation methods in Britain?
Lady Mary Wortley Montague
When did Lady Montague bring inoculation over from Turkey?
1721
What was the issue with inoculation?
Some died or became carriers of the disease
–>unreliable
What theory did Jenner test in 1796?
That those infected with cowpox were immune to smallpox
When did Jenner test his theory?
1796
Who did Jenner vaccinate first?
James Phipps
How many people did Jenner vaccinate after Phipps to check his findings?
23
When did Jenner publish his works?
Why did he do this himself?
1798
Royal Society refused to
When did the British finally support Jenner’s work?
1802
(£10,000)
–>1807
(£20,000)
When was the Jennerian Society set up to provide free vaccinations?
How many people had they vaccinated within 2 years?
1802
12,000
When did the govt make smallpox vaccinations compulsory?
When was this enforced?
1852
1872
When was it declared that smallpox had been eradicated?
1980
Why did many people initially oppose Jenner’s vaccination?
He couldn’t explain why it worked
He couldn’t apply the method to any other diseases
Drs. made money from inoculations
Unbelievable that a disease from cows could protect humans
Jenner was a country dr. (establishment underestimated him)
Some died (wrong methods)
What are the arguments that Jenner’s vaccination was significant?
Eradicated smallpox (mass killer)
Showed the possibility of vaccinations
Smallpox vaccination worked better than inoculations
What are the arguments that Jenner’s vaccination was insignificant?
Couldn’t apply to other diseases (couldnt explain link)
Vaccinations weren’t initially compulsory
Short term=limited govt support
What theme does Jenner’s work fall under?
Prevention of disease+PH
What were the conditions in hospitals like pre 1584?
Dependant on money Basic food+bed Run by charity (religious) Nurses=untrained Drs=limited All patients treated together APPALLING CONDITIONS -->Overcrowded -->Lack of sanitation -->HIGH DR
What did Nightingale do in terms of reforming hospital conditions?
Where?
When?
Improved meals
Ventilation
Lots of light
Spaced patients out
PUBLISHED NOTES ON HOSPITALS (1859)
Scutari (CRIMEAN WAR)
1854
What did Nightingale do to establish nursing as a profession?
When?
Created first nursing school (st thomas’ hospital)
1860
Published Notes on Nursing
1859
What was the impact of Nightingale?
Lowered DR in Scutari (50%)
Nursing became a respected profession
Hospitals reformed
What are positive events in terms of nursing and hospital reforms that could be argued to not be a result of Nightingale’s work 1750-1900?
Nursing:
Seacole also took active role in Crimeria
Hospitals:
PH improved
How many trained nurses were there in Britain in 1901?
68,000
What were hospitals like 1854-1948?
Ventilation Beds spaced apart Routine cleaning Standardised training for nurses Organisation of medicine Food+Water
What were beliefs surrounding cause of disease 1750-1861?
Fading beliefs surrounding supernatural and religion
Miasma
(bad smells caused disease)
Spontaneous Generation
(disease causing MOs spontaneously generated from the process of decay
Flies appeared at site of decay–>not attracted to)
Why was spontaneous generation a believed cause of disease 1800-1861?
FACTOR–>TECHNOLOGY
1800s=Lister developed powerful microscope
–>scientists found and studied ‘ANIMALCULES’
What did Louis Pasteur discover and publish in 1861?
GERM THEORY -->worked to discover why wine went sour Microscope: found GERMS Pasteurisation: heat and germs died -->GERMS CAUSE DISEASE IN ANIMALS AND HUMANS
When did Pasteur prove germ theory?
1864
What are the factors contributing to Pasteur’s discovery of germ theory?
Technology
Individual genius
What was Koch’s initial work leading on from studying germ theory?
Studied bacteria in agar jelly
Developed way of staining specific bacteria
–>Discovered specific pathogens that cause specific diseases (CAT)
Which are the three main diseases that Koch identified the bacteria causing?
Cholera
Anthrax
TB
What work did Pasteur do in response to Koch’s work?
when?
Developed vaccinations for:
Chicken cholera
Anthrax
Rabies
1879
Why was there a rivalry between Pasteur and Koch?
WAR
- ->France and Germany had a bitter rivalry following war
- ->Govts. supported the work
What were the factors encouraging Pasteur’s work?
Technology (microscopes)
Individual genius
War (rivalry between F+G)
Communication (read about Kochs work and Jenner’s vaccination)
What were the factors encouraging Koch’s work?
Technology (microscope)
Individual genius
War (rivalry between F+G)
Communication (read about germ theory)
What is the name of the prestigious medical journal?
The Lancet
Describe the attitude of the Government during the early part of the Industrail period
Laissez Faire
Define Laissez Faire
The government left the population alone to do what they wanted in relation to health
What was the public health situation at the start of the industrial period?
Lots of houses built cheaply and quickly w no regulations Overcrowding Child labour High infant mortality rate Stagnant water
What major PH event took place in 1848?
First ever national law regarding PH
–>1948 PH act
State the main terms of the 1848 PH Act
- National Board of Health to be set up
- Govt could force local councils to make improvements and appoint a medical officer in towns w high DRs
- Local councils could collect rates for improvements if they had the support of local ratepayers
- Councils were allowed to appoint Medical Officers of Health to oversee PH in local areas
What was the issue with the 1948 PH Act?
It wasn’t compulsory/enforced
-
State the major terms of the 1875 PH Act
- Compulsory to appoint medical officers and sanitary inspectors to inspect health facilities
- Compulsory for local councils to improve sewers & drainage–>Provide fresh water
- Other laws implicated housing regulations and stopped pollution of rivers
Why was the 1875 PH Act so groundbreaking?
Finally compulsory for local councils to ensure basic living standards across the country
Why did the 1875 PH Act make sanitary conditions compulsory?
GT proved in 1864–> Conclusive evidence between disease and lack of good conditions
Date the major cholera outbreaks
1831-132
Sporadic through 1850-1870
Describe the work of Chadwick
Report ‘The Sanitary Condition of the Labouring Population’ 1842
–>collected statistics on the link between poor conditions of the poor and high DR
What was the impact of Chadwick’s work?
INCREASED GOVT ACTION-PH
-1848 PH ACT
HIGHER LIFE EXPECTANCY
When did Chadwick release The Sanitary Condition of the Labouring Population
1842
What was the name of Chadwick’s report which contributed to an increase in govt action regarding PH?
The Sanitary Condition of the Labouring Population
What work did John Snow do regarding PH in the industrial period?
1854: Worked against cholera outbreak 1854 Mapped out deaths around Broad Street -->tracked back to a single water pump -->TOOK PUMP AWAY =Deaths reduced
Released ‘On the Mode of Communication of Chloera’
Made link between cholera and water–>NOT MIASMA
-Didnt have GT to prove-little impact in st
What was the short term impact of John Snow’s work during a cholera epidemic in 1854?
Reduced deaths by taking away source of bad water
What was the long term impact of Snow’s link between cholera and bad water?
After GT: Had proven true cause of a leading killer of the period
What was the Great Stink?
Sewage problems with the Thames caused a smell so bad parliament had to momentarily move
1858
When was the Great Stink?
1858
What was the impact of the Great Stink?
Showed that something had to be done to control water
–>Affected even those in power
Sewage system built but had no way to control PH across country
Describe the work of Bazalgette surrounding PH in London in the industrial period
Fought for improvements of London sewers
-1852
When did Bazalgette fight for improvements in London’s sewer systems?
1852
Why did Bazalgette fight for improvements in London’s sewer systems?
He believed in miasma
–>bad smells had to be washed out
What was the main focus of the 1866 Sanitary Act?
Authorities were responsible for sewers, water and street cleaning
Date the Sanitary Act that made authorities responsible for sewers, water and street cleaning
1866
What was the focus of the Factory Act 1864?
Factories had to have a basic standard of hygiene
Date the Factory Act that emphasised the lawful requirement for factories to have a basic level of hygiene
1864
Why did the govt. get rid of their Laissez-Faire attitude and increase involvement in PH in the 19th century?
Increased voting rights 1867/1884 -had to widen their focus Chadwick's report -indicated need for change Great Stink 1858 -highlighted dire conditions Germ Theory 1861/1864 -proved bad effect of bad conditions
Why had PH not improved until the 19th century?
Refusal to pay for improvements
Selfishness of the rich
Had been used to LF
Didn’t know it was causing ill health
State the areas of medicine on which GT had a large impact
Public Health Life Expectancy Training of Drs. and Nurses Hopsital reforms Increased investment in scientific research Antiseptic surgery Vaccinations
Describe the impact Gt had on PH
Clearly linked disease to poor living conditions
-proven in 1864 ended any controversy surrounding improving
–»>PH ACT 1875=COMPULSORY TO CONFORM
Describe the impact of Gt on hospital reforms
Added weight to existing reforms (Nightingale)
-proved necessity of clean conditions
–>HOPS HAD INCREASED FOCUS ON IMPROVING CONDITIONS
How did GT lead to increased investment into science?
Shown importance of scientific understanding on every day lives
–>increase in LE
–>GOVT INVESTED MORE ON TRAINING< EQUIPMENT AND FUNDING RESEARCH
What was the impact of GT on avergae life expectancy?
=First significant long term increase in history
from 45 to 70
How did GT have an impact on vaccinations?
Knowing the true cause of disease allowed scientists to create vaccinations with weak forms of this
Name the areas of medicine that Koch’s work had an impact on
Vaccinations
Antibiotic Medicine
Magic Bullets
How did Koch’s work have an impact on the development of vaccinations?
Knowing exactly what microbes were causing disease allowed scientists to target these directly, weakening them to form vaccinations
How did Koch’s work allow the development of antibiotic medicine?
-Use one microbe to kill another that’s causing disease
Describe how Koch’s work lead to the production of magic bullets
General: knowing cause of disease allowed scientists to search effectively for treatements
- ->used methods of dyeing microbes
- ->
When were women accepted as doctors?
1876
When did it become compulsory for qualfied doctors to be registered?
What organisation was formed as part of this?
1858
General Medical COuncil
When were exams for doctors introduced?
What organisation did this?
1815
The Society of Apothecaries and Royal College of Surgeons
Describe the training of a doctor 1750-1900
Trained at university
- lectures
- reading
- practical training on wards
- dissections
- observation
- ->not reliant on historical knowledge
NOT GOVT REGULATED
Who decided the curriculum of training doctors in the industrial period?
Professors at university
State and give a brief description of the 6 types of healers during the industrial period
Wise women in family
-relied less on family knowledge and more on apothecaries
Nurses -hired by rich -training varied Pharmaceutical Companies -people encouraged to open shops and produce their own branded medicine
Trained Drs
- only afforded by rich
- 1815: took exams
GPs
- cared for working class
- still fee ‘sick clubs’
Quacks
-healers w no training
Describe a post Nightingale hospital
Good supplies clothing, washing facilities Trained nurses Ventilation Light Sanitation clean water, drains and sewers, toilets
