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(17) History 2 > A Revolution in Medicine (1800-1900) > Flashcards

A Revolution in Medicine (1800-1900) Flashcards

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1
Q

How much did population grow by in the 19th Century?

A

1801 - 16.3 million

1901 - 41.6 million

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2
Q

What were the biggest changes to the UK in the 19th century

A
  1. by 1851 more people in towns than countryside
  2. more people in industry than agriculture
  3. industry became richer than landownership
  4. workers badly treated - long hours low wages
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3
Q

What was life in 19th century towns like?

A
  • overcrowded and filthy
  • people argued whether it was the government’s responsibility to get involved or not (Chadwick/Bentham)
  • technology brought “penny post”, telegraph, newspapers, railways etc - news/people travelled fast
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4
Q

What were the biggest changes to healthcare in 19th century England?

A
  • medicine development e.g. Pasteur and Koch
  • Investigations e.g. Snow helped conquer cholera
  • Nightingale improved care for sick
  • 1899 thousands of volunteers too sick to serve in Boer War
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5
Q

Who were involved in the germ theory?

A
  • Pasteur
  • Koch
  • Ehrlich
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6
Q

What did Pasteur do?

A
  • established link between germs and disease
  • thought micro-organisms were responsible and that a vaccine could be developed from this
  • first work on chicken cholera led to effective rabies vaccine in 1880
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7
Q

What led to the first effective rabies vaccine?

A

Pasteur did work on chicken cholera which led to rabies vaccine in 1880

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8
Q

What did Koch do?

A
  • linked germs to particular diseases
  • 1883/4 identified bacteria that caused tb and cholera
  • isolated causes of many diseases e.g. diphtheria, typhoid, tetanus, plague etc
  • 1905 nobel prize
  • invented way to stain bacteria
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9
Q

What did bacteria did Koch identify?

A
  • tuberculosis and cholera bacteria in 1883-4
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10
Q

What did Ehrlich do?

A
  • Koch’s student who epitomised scientific approach to identifying/treating disease
  • syphilis treatment 1910
  • “magic bullets” drugs designed to target specific germs
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11
Q

How did science and training change in the 19th century?

A
  • 1850 stethoscope widely used
  • thermometers
  • powerful microscopes
  • x-ray machine invented in 1895
  • clinical trials held as the importance of observation was realised
  • training improved and specialisation within medicine increased e.g. 1850 better knowledge of tropical disease e.g. malaria and yellow fever
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12
Q

When was the x-ray machine invented?

A

1895 (stethoscope and tropical disease: 1850)

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13
Q

Who had “magic bullets”?

A

Ehrlich

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14
Q

When was Ehlrich’s syphilis treatment used?

A

1910

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15
Q

What was the impact of the Germ Theory in Britain?

A

Koch identified bacteria causing diphtheria in 1891 - serum produced 1894 - Lister used it from 1895 and within 10 years death rate had halved

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16
Q

What was the impact of Koch’s diphtheria serum?

A

it halved diphtheria death rate in the UK within 10 years

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17
Q

What was the rate of infant mortality in Britain in the 19th century?

A

1899 - number of babies that died before their first birthday was 142/1000 (neglected, overcrowded, no fresh food)

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18
Q

How did medicine improve in the 19th century? (4)

A
  1. machines to make tablets and sugar-coated pills allowed accurate doses and mass production
  2. aspirin on sale 1899 as everyday painkiller
  3. Beecham made cold powders in factories in 1859
  4. Boots chemist began
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19
Q

How did medicine get worse in the 19th century? (5)

A
  1. The Book of Household Management 1861 recommended opium powders and laudanum (alcohol/opium) given to children to sent them to sleep/keep them quiet
  2. no control over medicines
  3. alcohol major ingredient
  4. arsenic and mercury in some medicines
  5. addictive with cocaine and opium
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20
Q

How did surgery mortality rates change in the 19th century?

A

start of 19th century - 40%

end of 19th century - 10%

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21
Q

Which common ingredients were used in 19th century england?

A
  • Alcohol and opium
  • laughing gas (Davy’s Nitrous Oxide)
  • Simpson’s chloroform
  • Coca leaves
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22
Q

What were the effects of alcohol and opium?

A
  • subdued patients
  • could be lethal with wrong dosage
  • unreliable
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23
Q

What were the effects of laughing gas?

A
  • Davy invited his friends to inhale the gas and realised it relieved pain in operations (published findings in 1800)
  • difficult to control doses
  • caused vomiting
  • flammable
  • patient may wake up
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24
Q

What were the effects of Simpson’s chloroform?

A
  • 1847 used after experiments on himself and friends to reduce childbirth pain
  • caused dizziness, sleepiness and unconsciousness
  • 1853 Victoria used in childbirth (increasing credibility)
  • inhaled
  • painkillers seen as unnatural
  • stopped being used in 1870s after higher death rates
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25
Q

What were the effects of coca leaves?

A
  • 1850s, eye drops as local anaesthetic in South America
  • chemically made in 1891 increased use, operations no longer needed to be painful
  • doses had to be carefully controlled
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26
Q

Who were important in antiseptic surgery?

A
  1. Lister

2. Semmelweiss

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27
Q

Who was important in aseptic surgery?

A
  1. Chamberland and Neuber
  2. Halsted
  3. Moyniham
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28
Q

What did Lister do in the development in the development in antiseptic surgery?

A
  1. biggest killer in surgery was sepsis infection
  2. Lister experimented on frogs and a boy with a broken leg
  3. started to use operating rooms sterilised with carbolic acid - as well as wounds and dressings
  4. reduced mortality rates in his operations from 46-15% in 3 years
  5. 1871 invented machine that sprayed carbolic acid everywhere
  6. published results in 1867 and became known as father of antiseptic surgery
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29
Q

What did Lister do in 1867?

A

published findings on carbolic acid and how it reduced sepsis infection

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30
Q

What did Lister do in 1971?

A

invented machine that sprayed carbolic acid everywhere in 1971

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31
Q

How much did Lister’s operation mortality rates drop by?

A

46 - 15% in 3 years

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32
Q

What was Lister’s opposition?

A
  • surgeons refused to accept that they could be spreading infection
  • carbolic acid irritated lungs/skin and had to be prepared
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33
Q

What did Semmelweiss do?

A
  • 1847 in charge of maternity ward in Vienna where he reduced death rate to 1% through washing hands with calcium chloride (however few hospitals followed this procedure)
34
Q

What did Chamberland and Neuber do?

A
  1. 1881 Chamberland invented a steam steriliser to create a germ-free atmosphere
  2. 1886 Neuber then created a sterile operating theatre and published results - setting standards for others to follow
    - these were only gradually adopted though
35
Q

What did Halsted do?

A

Halsted had his team wear surgical clothing asked company to make him ultra thin gloves - only gradually adopted

36
Q

What did Moyniham do?

A

first Briton to wear gloves and always wore surgical gowns in theatre

37
Q

How many specialist hospitals were there in London by 1860?

A

36 specialist hospitals in London by 1860

38
Q

What was set up to collect donations from workmen and arranged tickets for treatment (like an insurance)?

A

London Hospital Saturday Fund

39
Q

Who was Nightingale?

A
  • Crimean war nurse - cleaned hospitals cutting death rates 40-2%
  • “Notes On Nursing” explaining how to be trained and treat the sick and ideas to run clean, safe, well-ventilated hospitals
  • ## set up first nurse training school raising £44,000 herself
40
Q

What did Nightingale write?

A

Notes On Nurses 1863 - explaining clean, well-ventilated hospitals and how nurses should be trained and how they should treat the suck

41
Q

How much did Nightingale cut mortality rates in the Crimean war through her clean hospitals?

A

40-2%

42
Q

How much did Nightingale raise to set up the first nurse training school in England?

A

£44,000

43
Q

What was lie expectancy like in the 19th century (3 facts to know)?

A
  1. Bethnal Green 1842 - rich average of 45
  2. where as poor was 16
  3. manchester - 57% died before their 5th birthday
44
Q

What were living conditions like in the 19th century?

A
  • many families lived in one room or in cellars liable to flooding e.g. 1847 Liverpool 40 people in one room
  • toilets/water pumps shared by many in back to back housing and no rubbish collection
45
Q

How many people lived in one room in Liverpool in the 19th century?

A

1847 Liverpool 40 people in one room

46
Q

What was food quality like in the 19th century?

A
  • no regulations
  • bakers added chalk to flour and milk (watered down and added to make white again)
  • Luby saw man mix brown paint with candle wax to make chocolate and men sweeping sugar from floor to make toffee
47
Q

What was The Great Stink?

A

1858 parliament left because the dry weather had combined with human/industrial waste build up (no rain to wash away) and festered - Dickens called Thames a “deadly sewer” - many still believed in miasma

48
Q

What did Dickens call the Thames?

A

“deadly sewer”

49
Q

What were the contagious diseases of the 19th century (3 facts)?

A
  1. 1861 Albert died of typhoid caught from sewers of Windsor Castle
  2. Rickets known as the “English Disease” crippling bone disease in children from lack of calcium and fresh air - malnutrition
  3. Cholera was biggest killer
50
Q

What were some common accidents associated with 19th century lifestyle? (4)

A
  1. young boys forced to clean chimneys - gas and soot contact meant scrotal cancer
  2. match-making factory girls suffered from Phossy-jaw and brain damage caused by phosphorous fumes
  3. coal miners had lung diseases from inhaling dust etc
  4. textile factory machinery had no guards - arms caught in machines with no compensation or chance of further work
51
Q

How many people died from cholera in 1848?

A

60,000 in 1848

52
Q

How was cholera stopped? (important)

A
  1. Snow had a surgery in London
  2. published a book in 1849 arguing that cholera spread by dirty water
  3. 1854 - 700 people died in his locality, Snow mapped the locations and found they all used a water pump in Broad Street
  4. men in local brewery who drank beer didn’t catch cholera either
  5. removed the pump handle so people had to go elsewhere - disease stopped and it was discovered a cess pit was leaking into the supply
  6. discoveries helped to influence the Public Health Act 1875 and the Sanitary Act 1866
53
Q

What did Farr do?

A

1837 - helped to make birth, death and marriage registers compulsory

54
Q

What did Southwood Smith do?

A

Southwood Smith was appointed physician to London Fever Hospital in 1824 where he studied diseases that caused poverty - papers he published provided examples that supported Chadwick

55
Q

What did Chadwick do? (3)

A
  1. secretary to the Poor Law Commissioners 1834
  2. 1842 Report on the Sanitary Conditions of the Labouring Population - made link between ill-health and poverty
  3. contributed to set up of Health of Towns Association 1844 and the “clean party”
56
Q

What was the “clean party”?

A

the “Clean Party” pushed for government action to improve town conditions - “dirty party” opposed to it (eg due to costs, the wealthy didn’t want change as increased tax and didn’t affect them)

57
Q

Who was Barnardo?

A
  • Barnardo trained as doctor in 1866
  • appalled by poverty he saw in east end
  • set up “Ragged School” w cheap breakfasts and sometimes unemployment meals and evening/sunday classes
  • wood-chopping brigade and Factory Girls’ Club and Institute helped people find work and taught skills
  • school taught skills to become maid/servant and helped to find work e.g. local Tate and Lyle Sugar refinery
  • “Fresh Air Fund” provides escape for poor children - schemes that sent boys to other countries as farm workers for a better life
58
Q

What schemes did Barnardo influence? (6)

A
  1. “Ragged School”
  2. Wood-Chopping brigade
  3. Factory Girl’s Club and Institute
  4. “no destitute child ever turned away” homes
  5. “Fresh Air Fund”
  6. schemes to send children abroad as farm workers
59
Q

Which acts were introduced to improve public health in the 19th century? (6)

A
  1. Public Health Act (1848)
  2. Bazalgette’s Sewers (1858)
  3. Sanitary Act (1866)
  4. Housing Act (1875)
  5. Public Health Act (1875)
  6. Food and Drugs Act (1875)
60
Q

What did the Public Health Act 1848 do?

A
  • prompted by cholera epidemic 1848
  • allowed councils to improve town conditions if they wanted to pay for it
  • could force towns to take action over water supplies and sewage (if high death rates)
  • could appoint Medical Officers Of Health to towns (but by 1872 only 50 councils had them)
  • inspected lodgings houses and checked food being sold
  • Leeds improved
61
Q

Which city improved as a result of the 1848 Public Health Act?

A

Leeds

62
Q

How many councils had a Medical Officer of Health as a result of the Public Health Act?

A

only 50 councils had a Medical Officer of Health by 1872

63
Q

What did the 1858 Bazalgette’s Sewers action do?

A

Bazalgette made plans for series of underground tunnels to remove waste from 1 million homes in London - 83 miles of sewers removes 420 million gallons of sewage per day - started in 1866 and cholera never returned to London

64
Q

How many sewers did Bazalgette build in 1858?

A

83 miles - removed 420 million gallons of sewage per day

65
Q

When were Bazalgette’s Sewers finished and what did this mean?

A

1866 - cholera never returned to london

66
Q

What did the 1866 Sanitary Act do?

A

made local authorities responsible for;

  1. sewers
  2. water
  3. street cleaning
  4. removal/improvement of slums
67
Q

What did the 1875 Housing Act do?

A
  1. gave local authorities power to redevelop slums

2. councils could knock down bad housing and replace it

68
Q

What did the 1875 Public Health Act do?

A
  1. local councils forced to provide clean water, cover sewers/keep them in good condition, collect rubbish, provide street lighting and appoint medical officials of health and sanitary officers (looked after slaughterhouses to stop contaminated food)
69
Q

What did the 1875 Food and Drugs Act do?

A

regulated food and medicine

70
Q

How much did typhus deaths decrease in the 1800s?

A

1868 - 716 deaths
1885 - 28
1900 - none

71
Q

When were compulsory vaccinations for smallpox introduced?

A

1853

72
Q

What soap became widely used in the 1800s?

A

Pear’s soap

73
Q

What happened in Lincoln in December 1904?

A

outbreak of Typhoid killing 130 people in 3 months

74
Q

What was Lincoln like in the 19th Century?

A

population had grown rapidly - 50,000 by 1901 - engineering was a big industry with 5,000 Rustons employees

75
Q

What mistakes did the Lincoln councillors made in the 1800s?

A

kept expenses to a minimum - new sewers only completed from London government pressure - no efforts to improve water quality

76
Q

What was Lincoln’s water supply like?

A

from a river where raw sewage entered 30 miles up - growing population put stress

77
Q

What was the outbreak of Typhoid in Lincoln in January 1905?

A

typhoid rapidly spread without enough hospitals so most cases treated at home - 23rd feb 732 cases and 61 deaths

78
Q

How many typhoid deaths were there in Lincoln by 23rd feb 1905?

A

732 cases and 61 deaths

79
Q

What did the Lincoln council do to improve health in February 1905?

A

17th feb - railway companies brought water and watering carts used to bring water from nearby towns
march - privies emptied and animals removed from streets

80
Q

How many typhoid cases were there in Lincoln?

A

over 1000 cases in april - most victims found or old

81
Q

What were the longer term improvements made by the Lincoln council?

A

tried to identify new water sources - pumped from Nottinghamshire - new reservoir being used by October 1911

(17) History 2 (7 decks)

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