Britain: Health and the People, The beginning of change Flashcards
Rough approximation, covers other sections too
Who was Nicholas Culpeper and what did he do?
Wrote The complete herbal and published it in 1653; used plants and astrology in his treatments; highly critical of bloodletting and purging
Who was Thomas Sydenham, when was he born and when did he die, and what did he do?
Born 1624 and died 1689; English doctor stressed careful observation of symptoms and critical of quack medicine; notes symptoms of Scarlet fever and used iron for treating anaemia; dismissed dissections’ value and ignored Harvey’s discovery; still used bleeding for treatment; his book Medical Observations, published 1676 became standard textbook
What were sources of medical treatment in the 17th and 18th centuries?
Barber-surgeons: poorly trained offering small operations; Apothecaries: sold medicines and potions, little medical training; Wise women: treatments often relied on superstition and knowledge of plants and herbs; Quacks: showy, travelling salesmen selling all sorts of medicines; trained doctors: used mixture of new and traditional knowledge including the four humours
What were 17th and 18th century treatments?
Bloodletting; herbal remedies like bark of Cinchona tree from South America containing quinine for malaria; opium from Turkey used as anaesthetic; John Woodall, military surgeon, discovered in 1617 treatment of scurvy using lemons and limes; belief in power of royal touch to cure disease Scrofula
When did the Great Plague occur and where?
1665 in London
How many people did the Great Plague kill?
About 100,000 people in London (quarter of London population)
What were remedies used during the Great Plague?
Bleeding with leeches, smoking to keep away “poisoned” air, sniffing sponge soaked in vinegar, using animals like frogs, pigeons and snakes to draw out poison, moving to countryside like King Charles II and court did
What had people learned by the time of the Great Plague since the Black Death?
Recognised connection between dirt and disease; more organised approach; women searchers identified plague victims; more effective quarantine; bodies buried in mass plague pits; fires lit to remove poisons believed to be in air; streets swept and animals not allowed; gatherings of crowds banned; trade between towns stopped and Scottish border closed
When did the Great Fire of London occur?
1666
What ultimately ended the Great Plague?
Rats developed greater resistance to disease, so fleas didn’t need to find human hosts
How were hospitals paid for in the 17th and 18th centuries?
Paid for by the rich or by private subscription where locals clubbed together to pay
What were hospitals founded in the early 1700s and how were they paid for?
Westminister Hospital in London was founded by a private bank in 1719, Guy’s Hospital founded by merchant called Thomas Guy, who died in 1724
Where were notable hospitals founded during the 1700s, when were they founded, and how were they paid for?
Royal Infirmary of Edinburgh, 1729, local churches and wealthy citizens; Bristol Royal Infirmary, 1735, wealthy merchant Paul Fisher; York County Hospital, 1740, gifts from wealthy local people; Middlesex Hospital, 1745, private subscriptions; Manchester Royal Infirmary, 1752, Local factory owner Joseph Bancroft; Addenbrooke’s Hospital in Cambridge, 1766, Bequest from Dr J Addenbrooke and local subscriptions; Leeds General Infirmary, 1771, 5 local doctors; Birmingham General Hospital, 1779, local businessmen and doctors and landowners
When was the Royal Infirmary of Edinburgh founded and how was it paid for?
Founded in 1729, paid for by local churches and wealthy citizens
When was the Bristol Royal Infirmary founded and how was it paid for?
Founded in 1735 and paid for by wealthy merchant, Paul Fisher
When was the York County Hospital founded and how was it paid for?
Founded in 1740 and paid for by gifts from wealthy local people
When was Middlesex Hospital founded and how was it paid for?
Founded in 1745 and paid for by private subscription
When was Manchester Royal Infirmary founded and how was it paid for?
Founded in 1752 and paid for by local factory owner, Joseph Bancroft
When was Addenbrooke’s Hospital in Cambridge founded and how was it paid for?
Founded in 1766 and paid for by a bequest (inheritance) from Dr J Addenbrooke and local subscriptions
When was Leeds General Infirmary founded and how was it paid for?/
Founded in 1771 and paid for by 5 local doctors
When was Birmingham General Hospital founded and how was it paid for?
Founded in 1779 and paid for by local businessmen, doctors and landowners
How many new general hospitals were build in London from 1720 - 1750 in addition to how many pre-existing ones?
5 added to London’s 2 ancient hospitals
How many patients did London’s hospitals have a year by 1800?
Over 20,000
What were hospitals like in the 18th century?
Had specialist wards for different types of disease, often had medical schools to train doctors, treatment free but still mainly based on four humours approach, some hospitals added pharmacies, giving poor free medicines, specialist hospitals established
When did Edinburgh get pharmacies, giving the poor free medicines?
1776
What were some specialist hospitals or areas and when were they established?
St Luke’s Hospital in London in 1751 became second largest public hospital for mentally ill; London’s Lock Hospital for venereal disease opened in 1746; wards set aside for pregnant women in Middlesex Hospital in 1747; British Hospital for Mothers and Babies set up in 1749
When was the Foundling Hospital established, who established it and what did it do?
Started by retired ship captain Thomas Coram in 1741 in London, cared for orphaned children by giving them clean environment, clothing and simple education until age of 15
What were some hospitals started with money siezed from rich Catholic monasteries?
St Bartholomew’s and St Thomas’ in London
How many hospitals outside of London were started between 1720 and 1750 in the country?
9
When was John Hunter born and when did he die?
Born 1728 and died 1793
What different positions did John Hunter obtain and when?
Became army surgeon in 1760; left army after 3 years to establish surgical practice in London; became surgeon at St George’s Hospital in 1768; admitted to Company of Surgeons in 1768; appointed Surgeon to King George III in 1776 and Surgeon-General to army in 1790
Which two famous English surgeons did John Hunter study with?
William Cheselden and Percivall Potts
What books did John Hunter write and when were they published?
The Natural History of the Teeth published in 1771; On Venereal Disease published in 1786; Blood inflammation and gunshot wounds published after his death
Where did John Hunter get his knowledge from?
Based on his observations; his dissection skill (especially on human bodies); willingness to experiment (even on himself); used scientific method
When did John Hunter experiment on himself and try a new approach on a man with a knee joint aneurysm?
Experimented on himself in 1767 by injecting self with pus from sores of gonorrhoea patient who unknowingly also had syphilis; tried new approach in 1785 with man admitted to St George’s Hospital with throbbing lump on knee joint
How large was John Hunter’s specimen collection, what did it contain, and where did it go to?
In collection 3000 stuffed or dried animals, plants, fossils, diseased organs, embryos and other body parts preserved including skeleton of 2.3-metre-tall Irish giant, Charles Byrne, acquired in 1783; collection later given to Royal College of Surgeons in England
When was a Company of Surgeons established, how and what does it do?
1745 Act of Parliament created Company of Surgeons separate to barber-surgeons with base near Newgate gaol; king named it as Royal College of Surgeons in 1800; still exists to oversee surgeons’ training and advise government
In what fields did John Hunter make contributions?
Greatly aided surgical knowledge, showed theoretical knowledge about anatomy surgeons needed, discoveries about disease, infections, cancer and circulation of the blood
What was Smallpox, its symptoms and treatments before vaccination?
One of biggest killer diseases in 18th century, spread by coughing, sneezing or touching of infected person, killed 30% of those catching it, caused fever, headache, rash, pus-filled blisters covered entire body, left survivors often blind or with deep scars, treatment of inoculation controversial and didn’t always work
What was inoculation and its history?
Gave healthy person mild dose of disease, allowed them to build resistance against deadly version, fashionable after 1721 when Lady Mary Wortley Montagu had her children inoculated after seeing it done in Turkey, common from 1740s and enriched many doctors
What were problems with inoculation?
Religious objections about God’s will; lack of understanding, disbelief in effectiveness; risk smallpox dose could kill; inoculated people could still pass on smallpox to others; poor couldn’t afford to be inoculated
When was Edward Jenner born, when did he die and where was he born?
Born in 1749, died in 1823, was a country doctor in Gloucestershire
What was Edward Jenner’s discovery of vaccination and when did it happen?
Jenner tested theory in 1796, worked, repeated experiment over several weeks with 16 patients, all successes; published findings in 1798
Why was there opposition to Edward Jenner’s discovery of vaccination?
Jenner couldn’t explain how it worked; many doctors profited from smallpox inoculation; flawed tests in London Smallpox Hospital caused patient to die; Jenner not fashionable city doctor so snobbery against him
How was Jenner’s vaccination discovery supported?
Parliament agreed to give Jenner £10,000 for research in 1802; in 1853 British government made smallpox vaccination compulsory
What did Edward Jenner do throughout his life and when?
Apprentice to country surgeon from age 13 - 19; went on to study in London with John Hunter; returned to Gloucestershire as country doctor in 1772; published book on vaccination in 1798; appointed physician extraordinary to King George IV in 1821
How and when were Nitrous oxide’s properties discovered?
Bristol physician Thomas Beddoes and assistant Humphry Davy experimented in 1795 with inhaling it, Davy published account in 1800
What pain-deadening substances were used in the Medieval period?
Hashish, mandrake, opium, alcohol
When was nitrous oxide first used as an anaesthetic and how?
Used in 1844 by American dentist Horace Wells in removal of one of his own teeth
When and how was Ether used by William Clark?
William Clark, an American dentist, used ether in January 1842 in tooth extraction
When and how was ether used by Crawford Long?
Used by Crawford Long, an American country doctor, in March 1842, to remove neck growth from patient
When and how was ether used by William Morton?
William Morton gave public demonstration of ether on 16th October 1846, in a Boston hospital
When and how was ether used by Robert Liston?
Robert Liston, Britain’s most acclaimed surgeon, used ether in leg amputation in December 1846
What were the drawbacks of ether?
Difficult to inhale, caused vomiting, highly flammable
When was chloroform discovered and how?
Scottish doctor, James Simpson, discovered chloroform in 1847
When did the Crimean War occur?
1853 - 1856
What was the opposition to anaesthetics?
A few army surgeons during Crimean War thought soldiers should put up with pain; some patients died from chloroform, most famous was Hannah Greener who died in 1848 operation to remove toenail; religious belief childbirth pain was God’s will
How was opposition to anaesthetics overcome?
Queen Victoria gave birth to Prince Leopold on 7th April 1853 with Dr John Snow using chloroform
What book on anaesthetics, specifically ether and chloroform, did Dr John Snow write and when was it published?
Published On Chloroform and other Anaesthetics in 1858
When was the first basic microscope invented?
1677
What experiments regarding microbes were done, when, by who and how did they give conflicting results?
Francesco Redi boiled liquid and sealed against air in 1699, no microbes appeared; John Needham repeated Redi’s experiment in 1748 and microbes appeared (depnded on equipment cleanliness and scientist carefulness)
What was the theory of sepsis scientists believed in before they knew microbes caused infection?
Believed when person was weak, sepsis (poison) began inside wound and caused it to be infected; mistook infections for chemical reactions
What were false theories regarding infection?
Spontaneous generation; microbes appeared when something rotted (disease caused microbes); anti-contagionists: epidemics caused when infections interacted with environment and created disease then attacked weak; miasma: disease spread an infectious mist
Who were the first to link microbes to diseases and when?
In 1835 Agostino Bassi linkedd specific microbe (fungus) to silkworm disease muscarine; in 1840 Swiss Professor of Anatomy Friedrich Henle suggested microbes caused infection, based on Bassi
Who were people who were contagionists and anti-contagionists?
Public health reformers William Farr and Florence Nightingale anti-contagionists, John Simon contagionist
When was Joseph Lister born and when did he die?
Born 1827 and died 1912
Where did Joseph Lister work and who helped give him ideas?
Lister was a Professor of Surgery in Glasgow and shown Pasteur’s research by Thomas Anderson, a Professor of Chemistry, Anderson also recommended carbolic acid as a chemical that killed bacteria
What was Lister’s antiseptic approach?
Sprayed carbolic acid on surgeon’s hands and operating area, soaked instruments and bandages in carbolic acid
How did Lister prove his antiseptic method worked?
Mended fractured leg of young boy, Jamie Greenlees, in August 1865; didn’t amputate leg and instead set bones and used dressings soaked in carbolic acid, Jamie left hospital after 6 weeks
How did Lister show his antiseptic methods to the world?
In 1867 Lister published results of 11 cases of compound fracture, explained his techniques in lectures and publicised Pasteur’s Germ Theory through explanation of antiseptic technique, said microbes in air caused infection, not spontaneous generation
What were reactions to Lister’s work and the reasons behind them?
Lister’s ideas were criticised, Lister biological explanation unfamiliar as debate focused on chemical causes of infection, British surgeons offered alternative explanations, spontaneous generation supported by Charlton Bastian
Why was there opposition to antiseptic surgery?
Doctors at time didn’t accept Pasteur’s Germ Theory; in late 1860s antiseptic chemical widely used, Lister’s methods not revolutionary though he claimed superiority; carbolic acid dried skin, irritated lungs, long time to prepare carbolic methods; Lister changed techniques, surgeons claimed due to ineffectiveness, Lister himself did make mistakes
What mistakes did Lister make despite his better antiseptic approach?
Lister still believed microbes were simple things and that there might only be 1 type that caused disease, only rinsed hands in carbolic acid and still operated in street clothes
When had British surgeons moved to aseptic surgery instead of antiseptic surgery?
By the 1890s
What is aseptic surgery and its difference from antiseptic surgery?
In antiseptic surgery microbes killed in operating theatres; in aseptic surgery microbes excluded from start
How does aseptic surgery work?
Surgeons well-scrubbed, wear surgical gowns, facemasks, flexible rubber gloves, huge operating theatres replaced with smaller rooms
When did the cattle plague occur?
1866
How did the government respond to the cattle plague of 1866?
Government appointed Professor Lionel Beale, leading microscope user, to investigate crisis
When did Beale’s findings show the specific microbe responsible for the 1866 cattle plague?
June 1866
Who was Charlton Bastian?
Professor of Anatomy at University College London
When did Charlton Bastian come against the arguments of physicist John Tyndall for Germ Theory?
January 1870
When did Charlton Bastian write many articles supporting spontaneous generation?
Late 1860s
How did John Tyndall defend Pasteur’s Germ Theory?
Publicly defended Pasteur’s Germ Theory, argued against Bastian, lectured on dust and disease, brought together Pasteur and Lister’s work with light experiments to show tiny microbes in ordinary air
When did Prince Albert die and of what?
Died in 1861 of typhoid fever
What was typhoid fever and its symptoms?
Infectious bacterial fever, symptoms included red spots and severe intestinal irritation
When did scientist Emanuel Klein mistakenly announce he had identified the typhoid microbe?
1874
