- remained high: many couldn’t afford doctors, many children neglected as parents work - overcrowding & bad housing: disease spread fast - lack of fresh food: hard to fight off illness

A Revolution in Medicine: c1800-c1900 Flashcards by Eleanor Swannell

Context: POPULATION & KILLER DISEASES

Population: 
1801-16.3 mill
1901- 41.6 mill
Killer Diseases: 
Cholera, Smallpox, Dyptheria, Whooping Cough

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Development of Germ Theory: RIVAL THEORIES

1) Spontaneous Generation: decay causes germs

2) The Germ Theory: germs cause decay

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Development of Germ Theory: LOUIS PASTEUR

‘Father of microbiology’

discovered germs grew in bats of beer and boiling killed germs, tried w. milk
PASTUERISATION

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Development of Germ Theory: LOUIS PASTEUR: Vaccines

1879: Chicken Cholera vaccine
1881: Anthrax vaccine
1884-85: Rabies vaccine

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Development of Germ Theory: ROBERT KOCH

1878: identified blood poisoning germs
1882: identified TB germ
1883: identified cholera germ
- BACTERIOLOGY ( staining germ so can see it)

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Development of Germ Theory: PAUL ERLICH

1908: won Nobel prize
1910: discovered compound called Salvarsan 606- could cure syphilis by ‘magic bullets’
- CHEMOTHERAPY

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Infant Mortality (3)

remained high: many couldn’t afford doctors, many children neglected as parents work
overcrowding & bad housing: disease spread fast
lack of fresh food: hard to fight off illness

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Development of Germ Theory: IMPACT ON BRITAIN

Death rates decreased- especially in cities

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Florence Nightingale (3)

Reduced mortality rate from 49% to 2% during Crimean War
Raised money to open first nurse training school to make it honourable career
‘Notes on Nursing’ and ‘Notes on Hospitals’

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A Revolution in Surgery: SURGERY MORTALITY RATES: Beg. & End C19th

Beginning of C19th- 40% (operation & infection)

End of C19th- 10%

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A Revolution in Surgery: DEVELOPMENT OF ANAESTHETICS: Ether (2)

Dr William Morton- first use of inhaled ether as surgical anaesthetic in 1846
Problems w. Ether- not reliable, high volatility, extreme flammability

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A Revolution in Surgery: JAMES SIMPSON & CHLOROFORM (1847, 1853)

1847- used chloroform to reduce pain after experimenting on himself
1853- Queen Victoria used it in childbirth
Help women in labour/ most long-lasting & reliable anaesthetic

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A Revolution in Surgery: CHLOROFORM OPPOSITION

1)religion
2)distrust
3) easier for patient to die if unconscious
1848- Hannah Greener died after using chloroform in op

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A Revolution in Surgery: BLACK PERIOD OF SURGERY

20 yrs when death rate increased because of attempts at harder surgeries: exposed patients to blood loss and infection

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A Revolution in Surgery: BECOMING A SURGEON

1828
Bransby Blake Cooper- killed patient in 1hr op (supposed to be 6mins)
1858
General Medical Council- regulated profession so no nepotism

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A Revolution in Surgery: IMPACT OF CHANGES: Success

Anaesthetics: careful surgery
Antiseptic: reduce risk of infection
Aseptic surgery: “

A Revolution in Surgery: IMPACT OF CHANGES: Opposition (4)

Jealousy of Lister & Simpson
Opposition to changes
Worries about inaccuracies
Some thought they knew best

A Revolution in Surgery: DEVELOPMENT OF ANTISEPTIC SURGERY

Ignaz Semmelweiss:

dramatically decreased death rate 35% to <1%
insisted on hand washing in calcium chloride before treatment

A Revolution in Surgery: JOSEPH LISTER & CARBOLIC ACID (3)

Carbolic Acid: operating room sterilised in it
Reduction in mortality rate: 46% to 15% in 3 yrs
1871: invented machine to spray acid over everything

C19th Public Health: LIVING CONDITIONS

Life Expectancy: east London: 1842: rich- 45 / poor- 16

C19th Public Health: NEW WORK HAZARDS

Scrotal Cancer: climbing chimneys- young boys
Phossy Jaw: match factories- young girls
Pneumoconiosis: disease of lungs- coal miners
Textile Factories: machines and no guards

C19th Public Health: FOOD REGULATIONS

NO regulations:

bakers added white chalk as flour
diaries watered down milk

C19th Public Health: THE ‘GREAT STINK’

Causes: dry weather, build up off effluent & no water to wash it away
Dangers: miasma theory still widely believed

C19th Public Health: CONTAGIOUS DISEASES (3)

Typhoid,Diarrhoea, Smallpox, Measles, Chicken Pox, Scarlet Fever, Whooping Cough
57% children died before 5
‘The English Disease’: common in infants, calcium deficiency etc

C19th Public Health: IMPACT OF CHOLERA

``` 1831-22: Epidemic 1848: “ 1854: “ Origin: Bengal Cause: trade routes ```

C19th Public Health: JOHN SNOW & CAUSE OF CHOLERA (3)

- 1849: published book arguing cholera spread by dirty water - 1854: epidemic, mapped deaths and in common was water pump - Removed pump and cholera abated in Broad street

C19th Public Health: WHY DID IT IMPROVE? (3)

- Laissez Faire: persuaded govt. to act - William Farr: 1837, compulsory birth, marriage & death registrations - Thomas Southwood Smith: 1824, studied diseases caused by poverty

C19th Public Health: EDWIN CHADWICK

- Explored link between health and poverty - 1842: established link & reported findings - 1844: Health of Towns Association set up - ‘Clean’ party vs. ‘Dirty’ party

C19th Public Health: DR BARNARDO (4)

- ‘Ragged School’: school for hungry children could learn better - Boys: servants, Wood-chopping brigade/ City Messenger’s Brigade - Girls: maids, Factory Girls Club & Institute - Funding: Fresh Air Fund/ Children’s Country Holiday Fund

C19th Public Health: GOVERNMENT ACTION (1848, 1858, 1866, 1875)

1848: Public Health Act- cholera epidemics 1858: New Sewers 1866: Sanitary Act 1875: Housing Act 1875: Food & Drugs Act 1875: Public Health Act- clean water & Medical officers

C19th: Role of War (2+)

+ 1870: Franco-Prussian War: Drove on Koch & Pasteur | + Crimean War: Florence Nightingale

C19th: Role of Religion & Superstition (2-)

- Opposition to anaesthetics: interfere w. God’s plan | - Explanation for Diseases: Cholera was miasma

C19th: Role of Chance (1+)

+ Humphrey Davey: discovery of laughing gas (nitrous oxide)

C19th: Role of Government (3+)

+ Public Health Acts: 1848,1858,1866,1875 + Pasteur & Koch: grants to further research + Regulation of Medicines: less resistance to germs, only reliable medicines, no fakes

C19th: Role of Communication (3+, 1-)

+ Steam trains: holidays + Railways: easier to transport goods + Newspapers: faster distribution of newest medical discoveries - Newspapers: advertisement of Quackery

C19th: Role of Science & Technology (3+)

+ Pasteur, Koch, Erlich: bacteriology + Development of medicines: vaccines + Treatment of Diseases: antiseptics & anaesthetics

C19th: Role of the Individual (11+)

``` + Koch- bacteriology + Pasteur- germ theory + Erlich- chemotherapy + James Simpson- chloroform + Joseph Lister- carbolic acid + Dr Barnardo- Ragged sch. + Chadwick- living & life exp. + John Snow- cholera cause + Nightingale- nurse training + Aseptic Surgery- Halstead, Moynihan, Chamberland, Neuber + Public Health- William Farr ```