19th Century Flashcards
Why was surgery in the early 19th century so dangerous?
Pain
Infection
Bleeding
What is an anaesthetic?
A drug thaf causes temporary loss of bodily sensations and usually makes you sleep.
What was surgery like before anaesthetics?
All operation were carried out as quickly as possible to reduce the pain. Some surgeons felt that if a patient could be knocked out then there would be no resistance and surgeons would have more time to operate. Lots of fear around surgery, people avoided it.
Who used Ether first and when?
William Clark in 1842
How did William Clark first use ether?
In a tooth attraction
Who first used ether in an operation and how?
Robert Lister on a leg amputation
What were the drawbacks of ether?
Difficult to inhale
Caused vomiting
Highly flammable
Benefits of ether
Allowed new surgery types such as on the stomach.
Who found nitrous oxide?
Humphrey Davy
What did Nitrous oxide do?
Found a new anaesthetic that made them laugh and feel relaxed. Not recognized medically and only used recreationally.
Who used nitrous oxide first and how and when?
In 1844, Horace Wells used to it remove teeth but failed to convince doctors as it was too weak to knock patients out.
Who discovered chloroform?
James Simpson , a surgeon and professor at Edinburgh University on midwifery. He was searching on how to relieve pain during childbirth.
When was chloroform discovered and how?
1847, several colleagues and Simpson experimented with different chemicals and poured chloroform into glasses, passing out into the floor.
Who first used chloroform?
He used it on women in childbirth and operations within days for pain free surgery.
Why were people afraid of chloroform?
People were worried that there may be long term side effects on the mind and body e.g. Hannah Greener died having her toenail removed from too bigger dose.
How did chloroform lead to problems in surgery?
Anaesthetics were dangerous as patients were asleep meaning doctors could attempt more complex operations, pushing infection Draper into the body and creating further blood loss.
Why was chloroform opposed in religion?
Religious and moral reasons as it was believed to be unnatural for pain to be eased especially during childbirth.
Why did surgeons oppose chloroform?
Surgeon arrogance meant they took pride in the speed of surgery and anaesthetics made this unimportant.
Why did people begin to see the benefits of chloroform?
Simpson reminded people of Pare and how he managed to reduce suffering and compared it to chloroform. Fewer patients died of shock and no more writhing in pain meaning surgeons could be more precise.
What did John Snow do with chloroform?
Invent a respirator so he could work out the correct dosage.
Who promoted chloroform and how?
Queen Victoria used it in 1857 for the delivery of her baby and supported it meaning it became a standard part of surgery.
Did religion oppose or support anaesthetics?
Oppose as people believed ur was biblical to experience pain in childbirth as it was a blessing from god
Did war oppose or support anaesthetics?
Oppose as surgeons wanted to operate quickly and thought soldiers were brave so didn’t need anaesthetics.
Did individual genius oppose or support anaesthetics?
Support as professors and surgeons wanted to reduce pain in childbirth.
Did chance oppose or support anaesthetics?
Support as Simpson used chloroform by chance and his wife found him passed out.
Did science and technology oppose or support anaesthetics?
Support as more anesthetics continually discovered and John Snow made the respirator.
Who found germ theory and when?
Louis Pasteur in 1861
What did people think caused disease up to 1861?
Spontaneous generation. This said that organisms were the result of decay and some even thought the flies and maggots were the result of decay.
Who was Ignaz Semmelweis?
Be worked on a maternity ward and found midwife’s did not wash their hands when delivering babies so spread infection. He suggested washing of hands.
How did Louis Pasteur discover germ theory?
Anthony Van Leeuwenhoek made early microscopes and found organisms in food and water and excreta and described these in a series of papers to the royal London society.
His discovery interested others but by 1800s microscopes were better and in 1830 Lister developed a large microscope to look at micro organisms.
In 1850s Pasteur was helping a brewing company found out why their cats of alcohol were going bad and discovered an organism in it and developed a theory germs were the cause of the problem. He killed these germs by boiling them.
That’s miasma theory of disease made scientists interested in decay and the competition to see micro organisms meant Pasteur devised experiments to prove his theory and published his germ theory in 1861.
He said germs change mean and animals and thought disease could be caused by this process. Harmful germs enter body and grow rapidly. French silk industry was being destroyed by silkworms so Pasteur found a specific microorganisms in he silkworms that caused their disease.
Robert Kock applied his idea to human disease.
What factors aided germ theory in 1861?
Government - set up a competition making Pasteur compete to prove theory wrong.
Individual skill
Industry
Science and technology
What was surgery like before Pasteur and Lister?
Doctors reused bandages and spread infection
Doctors didn’t wash hands before operating
Doctors wore same clothes they had been in the streets
Used unsterilised instruments with crust blood and pus on them
Operations were watched by students and doctors
How did Lister apply germ theory?
He read Pasteur work and looked for a chemical that could kill bacteria. He found carbolic acid and trued to stop microbes getting into wounds with it. He used antiseptic surgery to disprove spontaneous generation.
What did Lister discover?
Carbolic acid and antiseptic surgery
What were Lister’s antiseptic techniques in surgery?
In 1865 he used a young boy who fractured his leg called Jamie Greenless and set the bones and used dressings soaked in carbolic acid. After taken off, no infection occurred.
When did Lister find carbolic acid?
1867
How did Lister use carbolic acid in surgery?
He would spray surgeons hands with carbolic acid along with wound and instruments. He soaked bandages and ligatures and dressings.
Why was there opposition to lister?
People has opinions on the role of microbes in surgery. Lister said his methods were superior but surgeons thought their methods were better. His methods were difficult and unpleasant as acid made hands dry and crack and irritated lungs and took a long time to prepare.
What was aseptic surgery?
Operating theatres cleaned and theatres soaked in carbolic acid to kill microbes from the start. From 1887 all instruments sterilized.
When weee sterilized gloves introduced?
1894 helped dramatically reduce infection.
Who was Robert Koch?
A proud German born in 1843 who was a doctor. He was very interested in the work of Pasteur.
Why did Koch want to improve on germ theory?
Germany and France were at war between 1870 and 1871 so Koch saw France as a great rival.
What did Koch begin to do?
Bought a microscope and started to investigate anthrax. He was very thorough in his research. The German government fully paid for his team and equipment.
Why did Koch have a problem?
He didn’t know which germ caused what disease and so his solution was science and investigation to use new technology to find these germs.
What did Koch do?
Koch took the organs from sheep that had died of anthrax and extracted the bacteria, grew it and gave it to a mouse who contracted anthrax.
He took blood from this mouse, found the bacteria and gave into another mouse.
This was repeated 20 times when he declared the bacteria was anthrax.
He used a process of science and evidence.
What did Koch do after discovering anthrax?
He used slices of potato to grow different bacteria’s and got purple dye from the textiles industry to stain the potato so he could see it under the microscope.
What did Koch then discover and when?
1882 - Tuberculosis
1883 - cholera
What did Koch help in the future?
He created a scientific method to identify different germs and encourage scientists to identify their own. Helped discovery of typhoid in 1882.
What were the limitation with Koch’s discoveries?
Identifying microbes didn’t save people’s lives on its own, vaccines are still needed.
What helped Koch achieve?
New technology
War
Determination
Individual skill
Government
How did Pasteur develop Koch’s ideas?
Pasteur wanted to create other vaccines and by trial and error as he did not know how vaccines worked. He extracted the germ responsible for chicken cholera and made it into a weak form. This was left out accidentally over the holidays and a member of his team injected a chicken with it by accident leading to the discovery thaf the old germ had immunized the chicken.
When did Pasteur find a vaccine for chicken cholera?
1879
What did Pasteur discover about vaccines?
Exposure to air weakened germs to be used as a vaccine.
What other vaccines did Pasteur create?
Anthrax in 1881
Rabies after two years of researching 1882
When was cholera?
In 1831
How many people did cholera kill?
50,000
What did cholera do to people?
Victims were violently sick with painful diarrhea and fell into a coma and died. So many died cemeteries had to be closed as they were too full. No one knew what caused it.
What did people think caused cholera?
Miasma given off by rotting animals, rubbish and human waste. Some towns cleaned their streets.
When were the second significant cholera outbreaks?
1837 and 1838
When did the government act and what did they do?
In 1839 they finally got out of their laissez-faire attitude of leaving things alone and set up an inquiry to find out what living conditions and health of the poor were like. They placed Edwin Chadwick in charge.
Who was Chadwick and what did he do?
He was a lawyer who over a two year period worked on his public health inquiry by sending doctors to many towns and cities with questionnaires. Over 10,000 copies were handed to journalists who could share ideas.
When was the Chadwick report?
1842
Why was the Chadwick report successful?
It highlighted the need for clean streets and a clean water supply and showed how parliament needed to act to save money.
What happened in 1848?
News reached Britain of another epidemic across Europe and government passed Public Health Act but it was not compulsory so some towns did nothing.
When was the Chadwick report?
1842
What did the Chadwick report suggest?
Disease caused by bad air
Bad air from rotting animals and vegetables and crowded houses
A medical officer should be put in charge of each district
More people killed by filth than wars
People need clean water
Poor cost too much and money would be saved if fewer parents died
Healthier workforce would work harder
When was the last cholera outbreak?
1854
What did John Snow find out?
Cholera was being transmitted by the water pump on broad street as faeces leaked into the water. He removed the pump handle and stopped the cholera outbreak.
What did the 1848 public health act involve?
A central board of health created in London.
Some areas can be forced to set up own board where there are high death rates.
Why was the first public health act ineffective?
It was not compulsory so many towns did nothing. By 1853, only 103 toes had set up own boards of health.
What factors helped John Snow?
Luck
Individual skill
Government
Science
When was the Great Stink?
1858
What was the Great Stink?
London was dirty and overcrowded in 1858. The Thames was a dumping ground and so in summer a heat wave caused the Thames to smell awful and MPs had to leave parliament. They didn’t want cholera.
Who was Joseph Bazalgette?
In 1555, Bazalgette was asked to make a plan for a sewage system to intercept waste. He used slope of river basin to cause waste to flow towards the sea.
How much did the government give Bazalgette during the Great Stink?
£3 million and be built 83 miles of sewers. Removed 20 million gallons of sewage a day. Finished in 1866.
How and why did the laissez-faire attitude of the government come to an end?
In 1867, lower class men got the vote and the government realized if the wanted to win then they needed to improve conditions. Conservative Party won and introduced many public health reforms.
When was the second public health act?
1875
Why was the second public health act effective?
It was compulsory
