a revolution in medicine xx-industrail

Question 1

1. why was surgery a terrifying prospect in 1800?

Answer 1

because surgeons could not control or stop pain
during an operation.

Question 2

2. why did surgeons have to operate quickly?

Answer 2

to reduce pain and would not attempt
complicated internal surgery.

Question 3

3. what were some ways to prevent pain before 1800?

Answer 3

some pain deadening substances such as hashish, mandrake and opium. But it was difficult to judge an effective dose.

Question 4

4. what were new anaesthetics?

Answer 4

•nitrous oxide

•ether

•chloroform

Question 5

5. when was chloroform used?

Answer 5

Not used until 1844 when the American dentist Horace Wells used it to remove teeth.

Question 6

6. when was ether used?

Answer 6

in 1842, William Clark, another American dentist, used ether for tooth extraction

1846, William Morton gave a public demonstration of ether anaesthesia. In December 1846, Robert Liston amputated a leg using it. But it was difficult to inhale, caused vomiting, and was highly flammable.

Question 7

7. when was chloroform used?

Answer 7

in 1847, discovered by Dr James simpson. it was a safe effective anaesthetic

Question 8

8. what were the reason for the opposition to anaesthetics?

Answer 8

•In the early days of using chloroform, some patients died because it was not
understood that patients of different sizes needed different amounts of
chloroform.
•There were religious objections as pain in childbirth was thought to be God’s will.

Question 9

9. what made anaesthetic acceptable in 1853?

Answer 9

Queen Victoria used anaesthetics for childbirth

Question 10

10. why didn’t anaesthetics revolutionise surgery?

Answer 10

because there was still a high death rate from infections introduced by operations.

Question 11

11. what did contagionists believe about infection?

Answer 11

was spread by contact and could be controlled by quarantine

Question 12

12. what did anti-contagionists believe about infection?

Answer 12

Believed infection was caused by the environment: epidemics such as cholera could be controlled by cleaning

Question 13

13. what came to the attention of british doctors and revolutionised surgery?

Answer 13

paesturs germ theory because of the work of joseph lister

Question 14

14. what did joesph lister think might explain surgical infections?

Answer 14

pasteur germ theory

Question 15

15. what was lister and the antiseptic approach?

Answer 15

• Spray carbolic acid on the surgeon’s hands and operating area
• Soak the instruments and bandages in carbolic acid
• In August 1865, he mended the fractured leg of a young boy, Jamie Greenlees
• As the skin of Jamie’s leg was broken it was likely to be infected and usually would be amputated
• Instead, Lister set the bones and used dressings that had been soaked in carbolic acid
• After six weeks, Jamie walked out of hospital

Question 16

16. what was listers conclusion from using carbolic acid as an antiseptic?

Answer 16

• In 1867, Lister published the results
and publicised Pasteur’s Germ
Theory
• Lister said that the microbes in the air caused the infection, not spontaneous generation

Question 17

17. what was the reaction to listers ideas?

Answer 17

his ideas were criticised

Question 18

18. what were the reason for opposition to antiseptic surgery?

Answer 18

• Doctors at the time did not accept Pasteur’s Germ Theory and the role of microbes in wounds.
• In the late 1860s, antiseptic chemicals had been widely used. Lister’s methods were not revolutionary even though he claimed they were superior.
• Carbolic acid dried skin and irritated lungs, and it took nurses a long time for to prepare his carbolic methods.

Question 19

19. when did british doctors accept the germ theory?

Answer 19

• By the 1880s, British doctors had accepted Germ Theory and its role in explaining infection.

• By the 1890s, surgeons in Europe and North America went beyond Lister’s antiseptic methods and developed aseptic surgery, aiming to remove microbes before an operation

• Surgeons had to be scrubbed, wearing gowns and new, thin flexible gloves, and using sterilised instruments.

Question 20

20. who was robert koch?

Answer 20

a German doctor who applied Pasteur’s Germ Theory to human diseases. He was the founder of
bacteriology - the study of bacteria.

Question 21

21. what did robert koch do?

Answer 21

• He identified the microbe responsible for anthrax
in 1876.

• He identified the deadly cholera germs in 1884 and
tuberculosis germs in 1882.

Question 22

22. what where robert koch methods?

Answer 22

• He proved that specific bacteria were responsible for a specific disease

• He discovered dyes to stain specific microbes so they stood out under a microscope.

Question 23

23. what where the factors in the struggle to develop vaccines?

Answer 23

•war

•government and finance

•teamwork

•communication

•luck

Question 24

24. how was war a factor in the struggle to develop vaccines?

Answer 24

France and Germany were rivals because France had lost a war
against Germany in 1871

Question 25

25. how was government and finance a factor in the struggle to develop vaccines?

Answer 25

Both Pasteur and Koch had a laboratory and a scientific team paid for by their governments

Question 26

26. how was teamwork a factor in the struggle to develop vaccines?

Answer 26

Pasteur and his team developed a vaccine for rabies; in 1885 they proved it worked on humans as well

Question 27

27. how was the germ theory accepted in britain in 1870’s?

Answer 27

• John Tyndall continued to lecture British doctors on Koch's discoveries. • In 1879, the surgeon William Cheyne translated Koch's work and explained how the microbes present in wounds did not always produce disease.

Question 28

28. how was communication a factor in the struggle to develop vaccines?

Answer 28

Pasteur's vaccine against anthrax was demonstrated publicly

Question 29

29. how was luck a factor in the struggle to develop vaccines?

Answer 29

In 1879, the accidental use of weakened chicken cholera germs gave the chickens immunity when injected with fresh strong germs; Pasteur had inadvertently shown how vaccines could give immunity and prevent disease

Question 30

30. what was the impact of pasteurs and kochs work in britain?

Answer 30

• By the 1880s, British doctors accepted Germ Theory but deep inside the body they could not use intense heat or powerful antiseptics. • However, scientists found chemicals that attacked specific germs. In 1909, Paul Ehrlich (a former member of Koch's team) developed the first chemical cure for a disease, Salvarsan 606, which cured syphilis. these were called magic bullets , more were developed to cute or control merigitis, pneumonia + scarlet fever

Question 31

31. why did thousands of people move from the countryside to cities like london, sheffield etc?

Answer 31

to work in the new factories of the Industrial Revolution.

Question 32

32. how many people would be working in a single factory?

Answer 32

employ hundreds of people, so factory owners quickly built rows of 'back-to-back' houses.

Question 33

33. what were the conditions like in the cities?

Answer 33

• Few of the houses had toilets; most were outside and shared with other families. • Water for drinking and cooking came from a pump fed by the local pond or river, which would also take away sewage.

Question 34

34. what were the health problems in the cities?

Answer 34

• As a result of the poor living conditions and overcrowding, diseases like typhoid, tuberculosis and cholera were common. • In 1831, a cholera outbreak killed around 50,000 people. • There were further cholera epidemics in 1837, • Cholera was a waterborne disease but at this time many believed it was spread through the air, as a miasma • This led some towns to clean up their streets; the importance of clean drinking water wasn't understood.

Question 35

35. what was edwin chadwick in charge of?

Answer 35

After cholera outbreaks in 1837 and 1838, the government set up an inquiry into living conditions and the health of the poor.

Question 36

36. what did chadwick publish in 1842?

Answer 36

his report which shocked britain

Question 37

37. what did chadwick’s report say?

Answer 37

Although Chadwick believed in the mistaken miasma theory, his report clearly highlighted the need for cleaner streets and clean water.

Question 38

38. what was the reaction to chadwick’s report?

Answer 38

• The government did not act on Chadwick's report because it believed in 'laissez-faire' ideas that said it was not their job to interfere in people's lives and force them to be hygienic.

Question 39

39. why did the government set up the 1848 Public Health Act?

Answer 39

because there was another cholera epidemic in 1848

Question 40

40. what was set up to improve public health in towns?

Answer 40

‘A Central Board of Health’

Question 41

41. why was the central board of health closed down?

Answer 41

because government interference was strongly resented.

Question 42

42. how many people died in the cholera outbreak in 1854?

Answer 42

20,000 people

Question 43

43. what did dr snow find the connection between the 20,000 people was?

Answer 43

all the victims lived near the same water pump in Broad Street,

Question 44

44. what did dr snow do to the infected pump?

Answer 44

He removed the pump handle and so everyone had to use another water pump. The outbreak stopped.

Question 45

45. what did dr snow find was connected to the water pump?

Answer 45

Snow later found that a street toilet was leaking into the pump's water source. Snow suspected that cholera was not airborne (miasma), but contagious and caught by contact with infected water.

Question 46

46. did dr snows finding improve public health?

Answer 46

no.

Question 47

47. what a hole d in the summer of 1858?

Answer 47

a heat wave caused the filthy River Thames to produce the 'Great Stink'. This alarmed politicians so much that, combined with the new evidence about cholera, they agreed to pay for sanitary improvements.

Question 48

48. what did parliament give joesph bazalgette.

Answer 48

enough money to build a new sewer system for London. By 1866, he had built an 83-mile sewer system which removed 420 million gallons of sewage a day

Question 49

49. what did the second public health act of 1875 mean?

Answer 49

local councils had to appoint Medical Officers to be responsible for public health; councils were ordered to build sewers, supply fresh water and collect the rubbish.