a revolution in medicine

Question 1

what developments in 19th century lead to changes in health and medicine?

Answer 1

1)popultion increased by 250% over the century- more people=more disease=pressure to do something to stop disease.
2)by middle of the century more people lived in urban areas than rural- appaling overcrowding in towns and cities led to epidemics.
3) tech advancements such as ‘penny post’ and rise of yellow press meant information travelled faster- news about disease and iving conditions spread quickly
4) development of factories led to large no. people living and working in close contact with each other - rise of politically conscious and active working class put pressure on govs to improve living conditions
5) Lois Pasteur and Robert Kock were developing germ theory- the scientific developments helped to prove how diseases spread and could be stopped
6) development of industry + international trade meant lots of money being mde gov gaining lots due to income tax - govs had more money to spend on social problems
7) indutril development lead to the manufacture of new products - e.g soap and medicines improved living standrds
8) international trade led to import of cheap food - people were better fed=better at resisting disease.
9) Elementary action (1870) meant that all children 5-12 had to go to school - more literate population able to read leaflets which helped them take care of themselves

Question 2

Who was Rene-Theophile Hyacinthe Laennec?

Answer 2

invented stethescope in 1816 which allowed doctors to listen to heart + lungs with more precision and better dagnose diseases. used in England form 1820 but use not widespread until 1850.

Question 3

who was Louis Pasteur?

Answer 3

discovered germ theory. grew vaccines in lab. invented rabies vaccine. invented pasteurisation - to preserve liquids from going off. was given awards for his work in 1853,856,1869 by royal society

Question 4

Who was Robert Koch?

Answer 4

invented way to stain bacteria so could be seen undermicroscope. developed experimental approach that was able to identify bacteria that causes anthrax, TB and cholera.did research in Eygpt and India, brought him to attention of British scientists, honoured by the London School of Tropical medicine and Hygeine in 1899

Question 5

Paul Ehrlich

Answer 5

used staining techniques to study blood cells. Developed ant-diphtheria serum. work on chemotherapy led to idea of magic bullets that would target specific organisms in the body. developed salvarsan as treatment for syphilis. honoured by oxford in 1907 and medicines based on his work used from 1910.

Question 6

What did Sir James Simpson do?

Answer 6

experimented with use of chloroform as aneasthetic. Queen victoria was the first women to have anaesthetic in 1853. invented simpson forceps

Question 7

How did simpsons work improve 19th century surgery?

Answer 7

relieved pain during operations = fewer people died of shock.
opertions no longer needed to be completed like a speed trail
used arguement from Genesis Chpt 2 to give anaesthetics religious justification

Question 8

what were the limitations of simpsons development?

Answer 8

still no knowledge of antiseptics so patients still died ofsepsis or blood poisoning.
opposition to use and difficult to get dose right.
some surgeons tried difficult/longer surgeries with anaesthetics and more mortalities.

Question 9

What did sir Joseph Lister do?

Answer 9

pioneered antiseptic surgery using carbolic acid sprayed over patient to keep infection at bay. Biggest killer after surgery was sepsis. carbolic spray was sed to sterilise surgical instruments + dressings.

Question 10

How did listers work improve surgery in 19th century?

Answer 10

improved peoples chances of surviving surgery. reduced the mortality rate on his ward at Glasgow Royal infirmary from 46% to 15% in 3 years.

Question 11

what were the limitations of Listers developments?

Answer 11

surgeons still not wearing surgical clothing, Asepectic surgery came along later. still some opposition nd mistakes being made with carbolic acid.

Question 12

What did florence nightingale do?

Answer 12

reduced mortality rate at scutari (crimean war) from 40% to 2%. cleaned hospital for wrong reasons (miasma) but returned heroine.
instrumental in set up of nursing as a profession- set up training college, wrote a handbook, instilled ideas about cleanliness and quickly adopted germ theory

Question 13

How did Florence Nightingales work improve 19th cnetury surgery?

Answer 13

not really about surgery but improved cleanlness before and after so improving success rate.

Question 14

what were the limitations of Nightingale’s work?

Answer 14

not aware of germ theory when she started.

Question 15

What did the establishment of the GMC (1858) do?

Answer 15

General Medicl council established stamdards od education and training, licensed doctors and could strike off doctors

Question 16

how did GMC improve 19th century surgery?

Answer 16

high standard could be set up and maintained

Question 17

What public health problems were there during indutrial revolution?

Answer 17

1) govs + councils did not consider public health to be their responability - laissez faire approach
2) no organisation of medical help some areas had no hospitals, doctor ect
3) dev of industrial towns led to large numbers of people liing close together
4) people used flowing water as sewers
5) infectious disease spread quickly in overcrowed conditions
6) indutrial diseases such as pneumoconiosis and phosy jaw spread among workers due to lack of health + safety regs
7) food supply poorly controlled
8) Epidemics of cholera 1831-2, 1848, 1854 and 1866 killed tens of thousands o people
9) lack of drains and sewers meantstreets full of faeces carrying diseases.

Question 18

Gov under pressure?

Answer 18

• faster travel (roads + trains) meant news travelled faster
• real and growing fear of social unrest
• more peoplepolitically active and putting pressure on Mps
• cholera was new and terrifyng pressure to act fast, no known treatment
• Cholera had been known in india for some time but then spread across europe to england
• cholera could develop within few hours of esposure and kill within days
• cholera could kill large numbers quickly
• result of epidemic of 1831-2 meant churches in towns like york ran out of space to bury the dead

Question 19

Who was Dr John snow?

Answer 19

discovered cholera was spread by water not air
tracked local cases to a water pump and had it removed
after 1858 epidemic published book staing cholera traveled through dirty water not miasma.

Question 20

Who was William Farr?

Answer 20

• driving force behind compulsory registration of births, deaths + marriages. causes of deaths were necessary to see impact of cholera

Question 21

Who was Thomas Southward Smith

Answer 21

physician to london fever hospitals
studied diseases caused by poverty
published papers on public health providing data to support work of chadwick

Question 22

Who was Edwin Chadwick?

Answer 22

used statitics to ecplore link between ill health and poverty
was a poor law comisioner
published report on sanitary conditions of labouring population and linked poor living conditions, disease and life expectancy. 1842
report urged gov to improve living conditions which would improve health and enable economy to grow.

Question 23

what was on the 1848 public health act?

Answer 23

-created genral board of health
- it was permissive allowed councils to take action if they wished
- councils had the right ot set up a board of health an medical officer
- councils with particularly high mortality rates could be forced to improve water and sewers
- councils could inspect lodging houses and food that was being offered for sale.

Question 24

what was on the 1875 public health act?

Answer 24

• it was compulsory
• local councils forced to provide medical offices og health + sanitary inspactors
• local councils forced to provide clean water
• local authorites ordered to cover sewers an keep them in good conditions
  -local sanitary insectors appointed to look after slaughter houses an orvent contaminated food from being sold.

Question 25

What did sir Joseph Bazlgette do?

Answer 25

set up Londons sewage system
- late 1800’s
sewage safely dispose of
less contamination
- motives wrong believed in miasma
- only in london
-waste being pumped straight into sea untreated

Question 26

What did thomas crapper do?@

Answer 26

invented flush toilet
-waste could be carried straight into sewers rather than cesspits
- didn’t deal with problem of infection just moved away from densely inhabited areas.

Question 27

1875 housing act

Answer 27

councils could take action against slum land lords
permissive

Question 28

the devlopment of mass produced soap

Answer 28

new products like pears soap became available cheaply making it easier for people to maintain their personal hygeine

Question 29

when was vaccination against smallpox made compulsory

Answer 29

1853
helped reduce no. uk deaths from smallpox
not strongly enorced - laissez faire

Question 30

easy to take tablets and capsules were mass produced

Answer 30

first britsh example was the Beechamd factory (1859) producing laxatives
allowed accurate doses to be taken. meds became cheaper and more accesable
dosage was more consistent

Question 31

self-help books gave advice on remedies in the home

Answer 31

dispensing chemists shops such as bootsband timothy whites were developing into national chains in 1880-1890s
ordinary people now had access to reliable advice rather than resorting to quacks. people could now buy ingredients reliably or buy ready made versions

Question 32

opium powders and laudanum were widely available in victorian england

Answer 32

laudanum recioes had been available in Britain since mid 17th century but laudanum was now being mass produced in reliable forms
much safer
now at correct dosage
people had acces to reliable pain relief

Question 33

Pain killers such as aspirin were sold in Britain

Answer 33

e.g aspirin form 1890’s
cheap, safe and effective painkillers now available

Question 34

Patent medicines (cure alls) available over the counter in shops such as Newberry’s Brain Salts

Answer 34

commercial response to peoples ailments. no controls over these products

Question 35

no control over the production and content of medicines

Answer 35

alcohol was amajor ingredient
some were dangerous containing arsenic and mercury
others were addictive and had a lot of cocaine and opium in them

Question 36

medicine manufacturers and retailers could make fortunes

Answer 36

• there was a ready market for these medicines and fortunes were made
• Thomas Beecham began his working life as a shepherds boy - his son was made into a baronet
  -John Boot began working life a farm labourer before opening herbal remedies shop his son turned it into a national chain and was enobled.