c.1700 AD - c.1900 AD Flashcards
When were the smallpox national epidemics
1722, 1723 and 1740-42
When was the worst smallpox epidemic and how many died
1796 where 3,548 people died
What was incolation
Giving someone the virus so they couldn’t get it again in the future by rubbing pus from scabs into a cut
Why did people use inoculation
They noticed if you survived a mild strain then you didn’t get it again in the future
Why was inoculation popular with doctors
They were able to become very rich from it for example a thomas Dimsdale was paid £10,000, became a baron and was awarded a salary of £500 a year from inoculating
What did Edward Jenner discover
Milk maids in his local area who had suffered from cowpox didn’t get smallpox
How did Jenner test his theory
He infected a boy named James Phipps and 25 other with cowpox and six weeks later with smallpox and Phipps and the other didn’t catch it.
What did Jenner do with his findings
Published them in his book “An Enquiry in the Causes and Effects of the Variola Vaccinae”
He named his work vaccinations after the Latin word for cow
What short term impacts did Jenners discovery have
100,000 lives were saved by 1800 and vaccines become compulsory
What long term impact did Jenner’s discovery have on medicine
19th century doctors creating new vaccines
WHO declared smallpox eridicated from around the world in 1979
Limitations on Jenner’s impact
-Vaccines were slow to become popular due to anti-Jenner propaganda.
-It wasn’t until 1840 vaccinations were made free and inoculation was banned
-Inoculators didn’t want to lose money
-Slow government response
-Royal Society refused to publish his work
How did institution help Jenners impact
-1840 vaccines were made free inoculations were banned
-1852 compulsory vaccination for children
-1871 enforced with fines for those refusing
How many monarchs were killed and what percentage of children were killed by smallpox
-5 reigning monarchs killed
-80% of children who got it
Methods used by people to try and stop Cholera in 1854
-Burning barrels of tar, cleaning houses and smoking cigars to ward off miasma
-Praying or wearing lucky charms for religion or superstition
-Burning victims clothes - 14th, 17th and 19th century
What period was this topic between
c.1700AD - c.1900AD
What did people believe caused cholera
Main belief was miasma however there were a lot of irrational and superstitious ideas aswelll
What were the four characteristics of cholera
-Diarrhoea and sickness that caused dehydration
-Usually fatal and people die between 2-6days
-The blood would become dehydrated and get thicker, rupturing blood vessel
-It was spread through person to person contact or water
Who was John Snow
-A surgeon and London’s leading anaesthetist
-Hegave Queen Victoria chloroform during the brith of Prince Leopold in 1851
What did John Snow notice about cholera
It couldn’t be spread by miasma as it didn’t affect the lungs, but the gut. Drinking water was contaminated by cholera-ridden faeces in the city’s drains, therefore cholera was transmitted by dirty drinking water.
Where did John Snow record his findings on cholera
“On the Mode of Communication of Cholera”
How did Snow prove cholera was spread by water
He created a spot map to show where deaths in his local area had taken place, in the area around Golden Square and Broad Street. It showed infection was most likely from the Broad Street water pump, so he removed the handle so locals couldn’t pump water and the cholera outbreak went away
Why was Snow’s impact limited
-Many people rejected his work and scientists said there were other deaths that lived further away from the pump
-Board of Health still believed in miasma and they argued there was no scientific proof and cleaning the water would have been expensive
-7 years before the germ theory and 30 before Koch isolated the bacterium causing the disease
Outline the Broad Street Investigation
-Snow interviewed people to find out where they get their water from in the Soho area door to door
-Found people who died mostly go to BSP
-Brewery in BroadStreet had no brewers due as they had drunk from a well in the brewery
-Local council permitted him to remove handle
-They found a liner in a cesspit was leaking into the ground and then to the water system
How did science and technology help Snow
He used the scientific method to investigate and record his findings, so he interviewed victims and families and used a dot map
How did attitudes and institutions hinder Snow’s impact
Continued belief in miasma and reluctant to spend money without convincing/indisputable evidence
What theories about the cause of disease were popular before Pasteurs discovery
Theories such as the 4 humours had been discarded and miasma was becoming less popular
Theories like spontaneous generation had developed
What was spontaneous generation
The theory that microbes could spontaneously appear
What did microscopes make people believe in 1855
Because of improvement in the quality of glass lenses decaying matter was observed so people were urged more than ever to avoid bad smells and decaying matter like rotten food
What did Pasteur get employed as in 1857 and what did he discover
He got employed by the French wine industry to investigate why barrels of wine going off and he found that the barrels were full of microorganisms. He went on to prove they caused the wine to go bad and were causing the decay not produced by it
When and why does Pasteur challenge spontaneous generation
1860 the French Academy of Science challenged scientists to prove or disprove the theory of spontaneous generation so he took up this challenge,
What were the four key points of Louis Pasteurs of germ theory
- The air contains living microorganisms
- Microbes in the air cause decay
- Microbes are not evenly distributed in the air
- They can be killed by heating
How and when did Pasteur prove his theory was correct
He developed a swan necked flask which proved germs must exist in the air and are not produced by decay
1864
What else did Pasteur theorise about germs after finding they caused decay
That they caused disease in the human body because he observed one particular type of microorganism killing of France’s silkworm population. However he didn’t publish this until 1878 and he couldn’t identify what bacteria caused what disease
Why was Dr Bastian a limitation on Pasteurs impact
He didn’t agree with Pasteur as people have so many microbes in their system and skin that it doesn’t make sense that everyone hasn’t been made sick by the microbes
Why was Pasteurs impact limited
He didn’t have a large short term impact because his theories weren’t accepted by other doctors in the community
He originally struggled to link his germ theory to disease and infection because he couldn’t explain the logic behind his reasoning as he could not identify which bacteria caused what disease
Who ran 18th century hospitals
Founded using donations from wealthy people and from members of the new middle classes (Lawyers, businessmen etc,)
Who worked in hospitals
Some doctors offered to work for free to practice their skills. Doctors visited patients regularly, surgeon or apothecary for daily treatments and small stuff or untrained nurses for care
How did patients in the hospitals change
More sick people are cared for and treated, and less about care for the elderly
Who went to hospitals for treatment
The rich often chose o be treated at home as it was safer. Most patients admitted were the deserving poor, giving them more access to trained doctors for the first time
Why were hospital unsanitary
More people were let in and they didn’t turn away infectious patients as much. People didn’t understand germs caused disease so they didn’t try prevent them.
What hospitals were created for mentally i’ll and infectious patients
Asylum and fever hospitals
What did Nightingale do for hospitals
-Brought the death rate in the hospitals in Crimea from 42% to 2%
-She ensured the soldiers got good food and towels were boiled and wounds were cleaned
-Convinced Queen Vic and Prince Albert in 1856 to commission the improvement of the British Army’s health
-Set up the first training school for nurses in St. Thomas’ Hospitals in London in 1860
What were the 3 main problems in surgery in the 1800s
-Infection
-Blood loss
-Pain
Outline the surgery Robert Liston performed
A two and a half minute operation amputating the leg of a patient who later died from gangrene
Then sliced the fingers off of his assistant who later died from blood poisoning
He then slashed through the coat tails of a spectator who dropped dead from fright.
Outline Fanny Burney’s mastectomy from 1816
-Surrounded by 7 men and her nurse
-Was in pain the whole time and felt the knife scraping against the breast bone
-Had to endure the whole operation in immense pain
What drug was used before 1847 for anaesthesia and what was the problem with it
Ether was used but was highly flammable and it irritated the patients throat and made them thrash around. Only for mild pain relief.
What did James Simpson discover and how did it improve surgery
-Chloroform
-It completely knocked out the patient so they can’t feel pain making more effective than other anaesthetics
What serious side effect did chloroform as an anaesthetic have?
Doctors were not all of the correct dosage so many died. This is because younger and fearful patients needed a higher dosage which could stop their heart.
How was chloroforms side effect dealt with
John Snow created an inhaler in 1848
Why did people oppose Simpson’s discovery
They felt it was unnatural to feel no pain and it interfered with Gods design of the body and they were worried of danger as a woman died from an overdose whilst in surgery for an ingrown toenail
What negative impacts did chloroform have
-Doctors did complex surgeries as they felt they had more time without their patients screaming meaning more may have died due to blood loss and infection
What influential figure used chloroform during childbirth
Used by Queen Victoria during the birth of her 8th child in 1857
Who was Joseph Lister
A surgeon
Who was James Simpson
A Professor of Midwifery
Whose work was Lister influenced by
Louis Pasteur as he was convinced germs must be causing infections in wounds so searched for a way to stop them.
What chemical did Lister use for killing germs and why?
Used carbolic acid because he read they killed germs in sewage so he could use it on wounds.
What two things did Lister develop that helped reduce blood loss and germs
-A spray to kill germs in the air around an operating table
-An antiseptic ligature that helped reduce blood loss
What did his antiseptic methods go on to develop
Aseptic surgery which meant removing all germs from an operating theatre
How was aseptic surgery achieved
-Instruments were steam sterilised
-Operating theatres throughly cleaned
-Surgeons wore gowns, face masks and rubber gloves
What short term impacts did Lister’s discovery have on surgery
-The problems of pain and infection were solved so more complex surgery could be carried out
-The first successful operation to remove an appendix was carried out in 1880s and in 1896 surgeons repaired a stab wound in a heart.
What limitations did Lister’s discovery have
-People were slow to use carbolic acid as they were sceptical of germ theory and they thought the idea of germs was ridiculous and only began to accept the idea once Koch began to prove the theory
-There was a joke that surgeons should close doors so germs couldn’t get in
-No solution for blood loss
What is Laissez-faire
The government believed it was not their job to get involved in people’s everyday lives
Why was public health so bad in late 18th and early 19th century
-Due to the industrial revolution more people were migrating to industrial towns so they became overcrowded.
-Overcrowding in low quality housing and unsanitary conditions making towns a breeding for illnesses such as TB, typhus and cholera
-Living conditions for lower class families fell as did their living expectations but the governments attitude was one of Laissez-Faire
What year did Chadwick undertake his health report
1842
What did Chadwick suggest should be done about public health
-Living conditions for the poor should be improved as it was directly linked to their health
How did Chadwick make cholera worse
Said human waste should all be put into the Thames, infecting people’s water systems.
Why did Chadwick produce his health report
Because unhealthy workers meant less money for the British economy, and people couldn’t make money if they were sick
How did the government respond to Chadwick and Snow’s findings
They ignored them as they believed in miasma still and had a laissez-faire attitude
How did The Second Reform Act 1867 mean another Public Health Act was introduced in 1875
1 million additional male voters were added to the electorate, so working men in towns were given the right to vote for the first time so politicians had to promise laws which would win the votes of working class men
How did campaigners mean another Public Health Act was introduced in 1875
Campaigners such as Octavia Hill and Charles Dickens publicised what conditions were like in poor areas so that the electorate knew about it.
How did cholera mean another Public Health Act was introduced in 1875
The number of people killed by cholera and the confirmation of John Snow’s research by the emergence of germ theory meant people wanted to start improving living conditions in cities
How did the Great Stink mean another Public Health Act was introduced in 1875
In August 1858 the hot weather increased the smell of untreated human waste on the River Thames prompting parliament to take action. So funds were given to build a large network of modern sewers which opened in 1865 showing the positive impact of government action
How did germ theory mean another Public Health Act was introduced in 1875
Pasteur proved there was a scientific between dirt and disease so the idea of miasma was proven incorrect and faced with scientific proof people were more likely to pay taxes to cover costs of public health reforms
How did the Royal Sanitary Comission 1870-71 mean another Public Health Act was introduced in 1875
The Royal Sanitary Commission proposed that the country should be divided into sanitary areas with officers to oversee the sanitation of them
How did vaccinations mean another Public Health Act was introduced in 1875
Whilst the government said in 1852 it was compulsory to have smallpox vaccine they didn’t enforce until 1871where doctors were employed to carry out vaccinations and in 1872 they were made compulsory showing positive action of government if they moved away from Laissez-Faire
What did the 1875 public health act make compulsory
For local councils to provide public health services
After the 1875 public health act what public health services did councils have to provide (8 things)
-Clean water to stop diseases that were spread in dirty water
-Disposing of sewage to prevent drinking and washing water being polluted
-Public toilets built to avoid pollution and employing public health officer to monitor outbreak
-Parks for exercise
-Inspecting lodging houses to make sure they were clean and health
-Creating street lighting to prevent accidents
-Quality of food in shops checked for harmful substances (e.g. some bakers mixed chalk into flour to make bread whiter)
How did the government follow the 1875 public Health Act
More laws to improve living conditions (e.g. Artisans Dwelling Act and the 1876 River Prevention Act
Apart from the Public Health ActWhat other developments helped improve the publics health by the end of the 19th century
New vaccinations continued to be developed such as the tetanus and diphtheria vaccines in 1890 by Emil von Behring
Who was Robert Koch
A German doctor who built on Pasteur’s germ theory. He was part of a government funded research team
What did Robert Koch discover
-He proved Pasteur’s germ theory by isolating bacteria by using the newly developed petri dishes with agar jelly and the use of dye to identify specific bacteria
Why did Koch allow other doctors to use his isolating germs method
It allowed them to develop vaccines
What two specific bacterias did Koch discover
-Bacteria causing anthrax in 1876
-Bacteria causing tuberculosis in 1882
How did improvements in technology Koch make his discovery
-Improvements in photography meant he was able to make visual recordings of his findings
-Petri dishes with agar jelly allowed him to discover the bacteria using due
How did use of the scientific method allow Koch to make his discovery
-Extracting anthrax bacteria from a sheep and then injecting it into a mouse which also developed the disease and repeating this test ensured his results were correct
How did government funding help Koch make his discovery
Government funding allowed for his team to pay for his experiments
How did rivalry help Koch make his discovery
-He was motivated by a national rivalry between him and Louis Pasteur that made them compete to make scientific discoveries
Why did Pasteur being a scientists mean his discovery had little impact
As he wasn’t a doctor initially people didn’t accept the link between his work and disease and illness. It required other scientists to develop his ideas to be used on humans
What did the physician John Tyndall do that created progress for germ theory
He tried to link Pasteur and Lister’s work together by claiming he found small organic particles in the air
How did Koch prove Snow’s ideas about illness
He identified cholera and showed it was present in water supplies
How did new telescopes limit progress on germ theory
Pasteur’s ideas were dismissed as new telescopes allowed doctors to study the body and find microbes all over the body of unhealthy and healthy people
How did Koch’s work being built on Pasteur’s help progress the germ theory
There was a realisation that the microbes causing disease needed to be dealt with rather than the symptoms
Why did the cholera outbreak in Calcutta, India limit progress for the germ theory
In 1884 British government still believed it was caused by miasma
