1848-1875 Flashcards
When did Florence Nightingale go to Scutari
1854
What did Nightingale observe that was bad about the hospitals in Scutari (6)
- Many men were sharing beds or sleeping on the floor
- Their clothes were infested with lice and fleas
- Waterborne diseases such as typhoid fever and cholera were common
- It was difficult to get enough medical supplies to the hospital
- Food supplies were limited and of poor quality
- Many patients had diarrhoea
What did Nightingale bring to the Scutari hospital (5)
- Cleaned surfaces
- Cleaned sheets, towels, bandages and equipment
- Opened windows to improve flow of air (she believed in miasma)
- Improved food quality
- Raised money to buy supplies
What was the first anaestetic and what were the pros and cons of it
Ether - the patient fell unconscious and could not feel pain when they awoke
However, it caused vomiting and irritated the lungs, and it could leave the patient asleep for hours or even days. The gas was also very flammable; dangerous because the theatres were often lit by candles or gas
Who discovered chloroform and when
James Simpson - 1847
Why was chloroform such a big discovery
It was a powerful anaesthetic, putting people to sleep, but without the same side effects of ether
What were some problems with chloroform (2)
- Many surgeons felt confident enough to attempt longer and more complicated operations, but this caused more blood loss and infection risk
- It was difficult to get the dose right and an overdose would kill the patient
How did John Snow fix the problem of chloroform overdose
He created a chloroform inhaler, which controlled the dosage
What was the ‘black period’ of surgery
When chloroform was used for pain relief but no solution to blood loss or infection had been found - the death rate rose because surgeons attempted deeper and longer operations, increasing the risk of blood loss and infection
What is gangrene
When cells dont receive oxygen due to blood supply being cut off for too long, they begin to rot
What is sepsis
If the body is fighting an infection, the blood supply to organs is reduced, causing organs to fail and the patient to die
What did the 1848 public health act entail (3)
- A general board of health was set up
- Towns were allowed to set up their own local board of health, employ a medical officer, organise the removal of rubbish and build a sewage system
- Appointed 3 commissioners for the board of health - Chadwick was one of them.
What was the extent of the impact of the 1948 public health act and why
Very limited - the effects were only temporary- the board only existed until 1854. It was also only encouraged that towns act, not compulsory, so only 1/3 of towns complied
What did Dr John Snow discover
Cholera was spread by polluted water
How did Snow discover cholera was caused by infected water
He realised that all the deaths in an epidemic in Soho were to people who drank water from the broad street water pump. A woman living several miles away in Hampstead died, but she sent for a bottle of water from the Broad Street pump because she liked the way it tasted
What did pasteur write in his germ theory
- Microorganisms spread through the air
- Microorganisms cause decay
- Microorganisms can be killed by heating
- Microorganisms are not evenly distributed in the air
Why was there limited progress caused by the germ theory
- It was a general theory, not related to the medical field
- It took years for scientists and people to believe it
- It was unclear how it could be used for medicine
- No one knew HOW microorganisms caused disease, especially as microorganisms were also found in healthy people
How did germ theory lead to big medical progress
- Spontaneous generation was disproved
- It was identified that microorganisms in the air caused decay
- It helped to demonstrate the link between health and hygiene
- It helped explain how infections developed after surgery
What was the big stink and when was it
- The Thames was previously the storage for sewage
- In 1858, the weather was hot so lots of the sewage was exposed as the Thames dried up
- This created an awful sight and awful smell
- This caused the government to pass an act to build a new sewage system worth £3m
How long was the London sewer system in 1875
21,000km
What was the 1866 sanitary act
- All towns were made to employ water supply and drainage inspectors
- Compelled councils to locate and address problems to public health (very vague though and often ignored)
What did Edwin Chadwick publish and when
The Sanitary Conditions of the Labouring Population, 1842
Why did the 1848 public health act not work because of attitudes of the rich
They hated paying tax to improve the health of the poor
What was the cause of the 1875 public health act
In 1867, a reform act let 2x more people vote, most of whom were poor men. This meant the government had to improve conditions for the poor if they wanted votes
What did the 1875 public health act make the government responsible for (6)
- Supplying clean water
- Cleaning sewage
- Building public toilets
- Lighting the streets
- Regulating housing standards and inspecting rented accommodation
- Employing health and sanitary inspectors to enforce the new rules, particularly on food quality
What were the effects of the 1875 public health act on the role of government (2)
- It showed a major shift from the ‘laissez-faire’ attitude they previously held
- It showed how reliant the national government was on local authorities who needed to raise local tax rates to make it work
What were the effects of the 1875 public health act on public health (6)
Some prompts:
Water, ventilation, food, street cleanliness
- Less contaminated water meant less disease
- Cleaner drinking water reduced the spread of cholera and typhoid
- Better housing ventilation reduced the spread of airborne disease
- Less people got ill from low quality food
- Cleaner streets meant less mice, rats and flies which could pass on disease
- Proper street lighting meant people could avoid dirt and rubbish
What effect did the 1875 public health act have on the role of medical officers
It became compulsory for medical officers to be in every local authority, their purpose was to be in charge of public health
What did Snow do to halt the cholera epidemic
He removed the handle from the Broad Street pump, so no one could use it. Immediately, the death toll began to decrease
Why did Pasteur come to discover the germ theory
He was working for a brewing company and was tasked to find out why beer turned sour. He realised it was the microorganisms and that they were everywhere
Which towns were hit the hardest by the cholera epidemic 1866
Those who ignored the recommendations to improve water supply in the 1848 Public Health Act
What did the artisans dwelling act 1875 do
It allowed councils to demolish slums and build better homes
How did Elizabeth garrett get her degree
She qualified from the College of Apothecaries after taking them to court because their rules did not say no women could take their exams. Then she moved to France to obtain her degree in paris. The college of apothecaries did change their rules right after she left to allow no women though
Why did the work of Koch have more of an immediate impact than that of pasteur (2)
- Koch was a doctor so was more readily trusted by other doctors
- Koch’s discovery was directly related to medicine, whereas pasteur’s wasnt
Why was the effect of koch’s work limited
Being able to discover the microbe causing the disease did not actually cure the disease
What did lister use to fight infection
Carbolic acid
Why did lister think to apply carbolic acid to wounds
He reallised that carbolic acid was used to kill microorganisms in sewage, so he wanted to see whether it would kill microorganisms that infected wounds too.
How did lister test carbolic acid
He applied it to a compound fracture (bone penetrated skin) of the leg of an 11 year old boy, the only option to fix this before was amputation. The wound healed without infection
When did Pasteur publish germ theory
1861
When did Nightingale’s school for nurses opened
1860
When did Florence nightingale publish notes on nursing
1859
What year did Elizabeth Garrett qualify as a doctor
1865
How many languages was Notes on Nursing translated into
11
How many languages was Notes on Nursing translated into
11
Why did doctors not trust pasteur’s germ theory straight away (2)
- He worked for the brewing industry, not medical
- The existing theorists of spontaneous generation and miasma were deeply embedded and believe by most scientists and doctors. Most did not believe that Pasteur was correct
What were two causes of The Black Period of Surgery
- It was difficult to administer correct does of chloroform - too little and a patient could still feel pain, but too much could cause death.
- Chloroform made surgeons feel confident enough to do longer and deeper surgeries, also taking their time because the person could not feel the pain. This led to more blood loss and an increased infection risk
