18th and 19th Century

Question 1

continuity in theory of causes of disease

Answer 1

few new ideas
spontaneous generation - germs produced by decay
miasma, becoming less popular

Question 2

microscopes

Answer 2

developed
(1700) cloudy images of bacteria/germs seen
(1850) tiny images seen clearly
essential - enabled breakthroughs

Question 3

germ theory - Louis Pasteur

Answer 3

1861 - published
suggesting that :
spontaneous generation is wrong
bacteria caused disease
and microbes in the air caused decay

Question 4

Robert Koch

Answer 4

used Pasteur's work
discovered:
specific microbes cause specific diseases
tb - 1882
cholera - 1883

Question 5

influence of Pasteur and Koch

Answer 5

Pasteurs germ theory:
little impact on medicine in Britain
spontaneous generation still believed in
yet some used his work

Koch:
more impact
inspired others to research other microbes
took time to accept theory
no impact yet on prevention/treatment

Question 6

Florence Nightingale

Answer 6

nursing:
little training
not respectable job

she attended the first training school
asked to lead nurses during Crimean War
believed in miasma, emphasised hygiene/fresh air etc
work widely reported - newspapers

Question 7

changes in hospital care

Answer 7

new hospitals opened
first GP
middle and upper classes could be treated at home
cleanliness/organisation improved
nurses had a bigger role, assisted doctors more
homely atmosphere tried to be created
infirmaries, for the poorest in society
specialist hospitals (asylums ect)

Question 8

search for an anaesthetic

Answer 8

before 1800, alcohol/opium had little effect easing pain
1844, laughing gas, still pain
1846, ether, lasted long time + unconscious, but could cause them to cough, sick, and flammable
1847, chloroform, effective, few side effects, difficult to get right does and could kill if wrong
cocaine, local anaesthetic 1884
1905 novocaine, less addictive

Question 9

james simpson

Answer 9

chloroform
experimented with chemicals
very effective, used during child birth
John Snow made an inhaler to regulate dose, reducing danger of death

Question 10

aseptic surgery

Answer 10

listers work inspired others to search for methods to prevent the spread of infection in hospitals
by 1900:
operating theatres and wards thoroughly cleaned
using aseptic technique
sterilised clothing worn
sterilised instruments

Question 11

opposition to anaesthetics

Answer 11

thought being unconscious increased chances of death
very religious, believed God made pain for a reason
and shouldn’t be interfered
long time to believe in the Germ Theory and accept Listers discoveries

Question 12

impact of anaesthetics and antiseptics

Answer 12

surgery became pain free
surgeons could take more time and be more careful
more complex surgery possible
infection reduced - because of more successful operations
led to aseptic surgery

Question 13

surgery black period

Answer 13

as patients were asleep
surgeons attempted more complex operations
carrying infection further into the body
more loss of blood
number of people dying increased

Question 14

development of vaccinations

Answer 14

Pasteur published germ theory
discovered a weakened version of a disease could create immunity
admired Jenner, called it a vaccination, tribute to jenner
developed vaccines for animals against anthrax, rabies etc
inspired others to make ones for human diseases

Question 15

1875 Public Health Act

Answer 15

city authorities must provide:
clean waters
sewers
public toilets
street lighting
public parks

lodging houses inspected for cleanliness
monster building of new houses - damp, overcrowded
check quality of food
public officer of health to monitor disease

Question 16

reasons for the Public Health Act

Answer 16

previously the government didn’t believe it’s role was to improve conditions, but to interfere in peoples lives
attitude began to change
due to several epidemics e.g. cholera
increasing scientific evidence, that poor conditions caused disease

Question 17

smallpox

Answer 17

18th century
killed more children than any other disease
thousands of adults died too
disease spread quickly from person to person

Question 18

Edward Jenner

Answer 18

born in 1749
trained in London as a surgeon and apothecary
worked at St George’s Hospital
returned to Gloucestershire to work as a GP
then made his discovery

Question 19

vaccination and smallpox

Answer 19

inoculating had been done since the 1720’s
yet could still kill, but only rich could afford it

Jenner collected evidence of failures of smallpox innoculations, regularly treated people for cowpox, and saw they never caught smallpox

carried out experiments, none caught smallpox that he had infected with cowpox

printed his findings in An enquiry into the causes and effects of the various vaccine in 1798
the royal society refused

1800, 100,000 had been vaccinated worldwide

took time to become popular In Britain

1802 Royal Jennerian Society set up to promote it

Question 20

when were vaccines compulsory in Britain

Answer 20

1840, government paid for vaccines
1852, they were compulsory
1979, WHO, announced smallpox had been wiped out

Question 21

was Jenner important?

Answer 21

proved scientific methods could lead to a disease being wiped out
yet:
he didn’t know why it worked
link between cowpox and smallpox was unique, couldn’t lead to other vaccines
other diseases were still killing people

Question 22

opposition to Jenner

Answer 22

thought it was wrong to give people an animals disease
interfered with God’s plan
doctors lost money as gov provided it for free
some doctors didn’t vaccinate properly, didn’t work

Question 23

attempts to prevent the spread of cholera

Answer 23

believed it was caused by miasma/spontaneous generation
homes kept clean
clean streets and rubbish
clean water supplies suggested by public health act, but not compulsory, so few did it.

Question 24

cholera

Answer 24

affected mainly the poor areas, some wealthy also
severe diarrhoea and vomiting
led to dehydration
no treatment, those who caught it died

Question 25

the work of John Snow

Answer 25

well-respected doctor/surgeon
observed cholera epidemic
worked on his theory it was spread through contaminated drinking water, not miasma
he mapped all deaths in soho = strong link with one water pump in broad street
removed handle, couldn’t get water
deaths decreased dramatically
later found a cesspit leaked waste into the well
1855, Snow presented his findings

Question 26

significance of John Snow’s work

Answer 26

cholera deaths in Soho prevented, after pump stopped being in use
many didn’t believe the theory
germ theory didn’t emerge until 1861
gov didn’t make a new sewer system, Snow’s recommendation
longer term = snows work and other evidence made a new sewer system in 1875
also made link between dirty water and disease, leading to Public Health Act in 1875, forced to provide clean water.