19th cent medicine Flashcards
1
Q
who was paul ehrlich?
A
- student of koch
- 1889 - set out to find chemicals that could synthesise antibodies - known antibodies could attack specific microbes - magic bullets
- tried to find a magic bullet for syphilis - failed 600 times - until produced Salvarsan 606
2
Q
what was the discovery of anaesthetics?
A
- laughing gas identified as possible anaesthetic by humphry davy - but ignored by surgeons at the time
- james simpson - tried to find safe alternative to ether for childbirth - discovered effects of chloroform - made it painless - after queen vic gave birth 8th child - widely used
3
Q
what were living conditions like in 19th + 18th centuries?
A
- people moved countryside to towns to work in factories - overpopulation
- houses built close together
- many houses no bathroom and had to share one outside
- water companies set up water pumps on street - water supply often contaminated
4
Q
what was the cholera epidemic?
A
- affected Britain every few years between 1831 - 1866
- causes extreme diarrhoea - sufferers often due from loss of water + minerals
- didn’t know cause - thought miasma
- government started regulating burial of dead - ineffective
- 1832 - over 21,000 died from cholera in that year in britain
5
Q
who was edwin chadwick?
A
- govt laissez-faire
- social reformer - published report on living conditions- found that much poverty and ill-health was caused by the terrible living conditions
- suggested govt pass laws for proper drainage + sewerage systems - funded by local taxes
- report + another cholera epidemic in 1848 pressure on parliament to pass PHA 1848 - set up a CBOH to encourage local councils to improve conditions
6
Q
who was john snow?
A
- showed there was a connection between contaminated water and cholera in 1854
- studied a cholera outbreak in an area of london - noticed all victims used same water pump - so removed the handle and ended outbreak
7
Q
how did early anaesthetics lead to a rise in death rates?
A
- surgeons found unconscious patients easier to operate on - meaning could take longer on work
- longer operating times - higher death rates from infection because surgeons didn’t know poor hygiene spread disease
unhygienic methods:
- surgeons didn’t know clean clothes - save lives - often wore same clothes years - covered with pus + dried blood
- operations in unhygienic conditions ex. patients house
- operating instruments - unwashed + dirty
8
Q
who was joseph lister?
A
- applied Pasteur’s GT to surgery
- used carbolic acid as a chemical that could kill bacteria - stopped germs from infecting wounds in surgery
- death rate of his patients fell - 46% - 15%
- covered surgical instruments, bandages + surgeons hands in it + reduced chance of infection
- faced opposition - didn’t like its use - found unpleasant on skin or breath in
- antiseptics - surgeons less fear of patients dying from infection
9
Q
what is asepsis? and what does it include?
A
- aseptic surgical methods aim to stop any germs getting near the wound
- surgeons use sterilised instruments + operating theatres got smaller to reduce chance of infection
- surgeons expected to sterilise hands + wear surgical gloves
- these developments advanced by wars - ex crimean war - provided test cases for surgeons to try out new techniques
10
Q
what was the great stink? who was joseph bazalgette?
A
- lot of waste in london drained into water sources - including river thames
- hot weather in summer - caused bacteria to grow in waste - produced bad smell ‘great stink’ - 1858
- to reduce stink - joseph b appointed to build new london sewer system - transported waste away from thames
- sewer system officially opened in 1865 - design became blueprint for most cities in western europe
- to this day same sewers backbone of london’s mondern s system
11
Q
how did public opinion begin to change in the 19th century?
A
- most people 19th cent believed in laissez-faire style govt
- thought govt shouldn’t interfere in PH - but began to change
- evidence from chadwick, snow + pasteur’s germ theory showed cleaning towns could stop spread of disease
- 1867 - second reform act passed - gave nearly 1 mill more men vote - most industrial workers - have more say in PH politicians had to address workers’ concerns to stay in power
- several reformers helped change attitudes towards health. ex. william farr - statistician - used stats to press for reforms where death rates ↑
12
Q
how did govt take action in 1870s?
A
- govt finally took action to improve public health
- 1875 - disraeli’s govt passed another PHA - forced councils to appoint health + sanitary inspectors - also made councils maintain sewerage systems + keep towns clean
- 1875 - PHA more effective than 1848 because compulsory
- Disraeli also brought in artisans’ dwelling act - let local councils buy slums with poor living conditions + rebuild them to fit new govt backed housing standards
- 1876 - laws against pollution of rivers introduced
13
Q
what was the impact of the first-world war on X-rays?
A
- originally x-rays often located in hospitals miles away from battlefields - polish scientist marie curie developed mobile x-ray units - allowed doctors to transport equipment
- originally equipment for x-rays included glass tubes - unreliable + often stopped working - then coolridge invented more reliable tube - ‘coolridge’ tube - still used today
14
Q
how did the first world war impact blood transfusions?
A
- 1900 - ladnsteiner discovered blood groups - helped doctors to work out that a transfusion only worked if donor’s blood type matched receivers
- hustin discovered sodium citrate stopped blood clotting so it could be stored - important as many soldiers died from blood loss
15
Q
how was penicillin discovered?
A
- chance
- returning from holiday, fleming removed tops from some old Petri dishes - noticed bacteria he had grown were being killed by a mould - penicillin - used the word antibiotic to describe it
- published findings in articles
- but no one willing to fund further research
- unable to take work further
