c.1700 - c.1900: Medicine in 18th and 19th Century Britain Flashcards
1
Q
What period was Edward Jenner in?
A
1700-1900
2
Q
Who discovered the smallpox vaccine?
A
Edward Jenner
3
Q
Before Edward Jenner how did people prevent smallpox?
A
Inoculation
4
Q
How many people died in 1751 from smallpox?
A
3,500
5
Q
Who introduced inoculations to Britain and when?
A
Mary Wortley Montagu in 1718
6
Q
How did inoculations work?
A
By making a cut in a patient’s arm and soaking it in pus taken from the swelling of somebody who already had a mild form of smallpox.
7
Q
When was Edward Jenner born?
A
1749
8
Q
What did Edward Jenner hear about cowpox and smallpox?
A
That milk maddens didn’t get small pox but did get cow pox which was much milder.
9
Q
What did Jenner test about cow pox and small pox?
A
He injected a small boy, James Phipps, with pus from the sores of a milkmaid who had cowpox.
He then injected him with smallpox but the boy didn’t catch the disease.
10
Q
When did Jenner publish his findings about smallpox?
A
1789
11
Q
Why did people resist Jenner’s smallpox vaccination discovery?
A
Doctors who gave inoculation saw it as a threat to their livelihood.
Many people were worried about giving themselves a disease from cows.
12
Q
Who did Jenner get approval from?
A
Parliament
13
Q
How much money did Parliament give Jenner for him to open a vaccination clinic?
A
£10,000 in 1802
£20,000 a few years later
14
Q
When were vaccination against smallpox made free for infants?
A
1840
15
Q
When was vaccination against smallpox made compulsory for infants?
A
1853
16
Q
Was the smallpox vaccination a success?
A
Yes - it contributed to a big fall in the number of smallpox cases in Britain.
17
Q
What was one limit to do with Jenner’s discovery of the smallpox vaccine?
A
He didn’t understand how it worked.
Therefore, this lack of understanding meant Jenner couldn’t develop any other vaccines.
18
Q
Who was the first to suggest that germs cause disease?
A
Louis Pasteur
19
Q
When were germs and other micro-organisms discovered?
A
17th century
20
Q
What did scientists think that microbes were created by?
A
Decaying matter - like rotting food or human waste.
This theory was known as spontaneous generation.
21
Q
How did Pasteur prove that there were germs in the air?
A
He showed that sterilized water in a closed flask stayed sterile.
But sterilized water in an open flask bred germs.
22
Q
When did Pasteur publish his germ theory?
A
1861
23
Q
What did Pasteur argue in his Germ Theory?
A
That microbes in the air caused decay, not the other way around.
He also suggested that some germs caused disease.
24
Q
How was the Germ Theory met?
A
With skepticism at first.
People couldn’t believe that tiny microbes caused disease.
25
Why was it several years before the Germ Theory could be useful?
Because the germ responsible for each disease had to be identified individually, this took a lot of time.
26
What/ who did the Germ Theory later link to?
- it helped inspire Joseph Lister to develop antiseptics
- it confirmed John Snow's finding about cholera
- it linked disease to poor living conditions (like contaminated water). This put pressure on the government to pass the 1875 Public Health Act.
27
How did Robert Koch build on Pasteur's work?
He linked specific disease to the particular microbe that caused them.
28
When did Koch identify anthrax bacteria?
1876
29
When did Koch identify the bacteria that caused septicaemia?
1878
30
When did Koch identify tuberculosis?
1882
31
When did Koch identify cholera?
1883
32
What diseases did Koch link to the particular microbes that caused them?
Anthrax
Septicaemia
Tuberculosis
Cholera
33
What revolutionary scientific methods did Koch use?
- agar jelly to create solid cultures, allowing him to bread lots of bacteria
- dyes to stain the bacteria so they were more visible under the microscope
- used photography to record his findings
34
What fuelled Pasteur and Koch's discoveries?
The national and personal rivalry. Germany vs. France.
35
What did Pasteur find vaccines for after Koch discovered the microbes that caused them?
Anthrax and rabies.
36
Who discovered the first magic bullet Salvarsan 606?
Paul Ehrlich
37
What did Paul Ehrlich discover about antibodies?
That antibodies were a natural defense mechanism of the body against germs.
Antibodies only attacked specific microbes - so they were nicknames magic bullets.
38
What did Paul Ehrlich do in 1889?
He set out to find chemicals that could act as synthetic antibodies.
39
What did Paul Ehrlich first discover in his hunt for chemicals that could act as synthetic antibodies?
Dyes that could kill the malaria and sleeping sickness germs.
40
When was the bacteria that caused the STD syphilis identified?
1905
41
What did Ehrlich and his team want to do in relation to syphilis?
They wanted to find an arsenic compound that was a magic bullet for syphilis.
They hoped that it would target the bacteria without poisoning the rest of the body.
42
What did Sahachiro Hata do to do with Salvarsan 606?
When he joined the team in 1909 he rechecked the results and saw the compound number 606 actually appeared to work.
43
When was Salvarsan 606 first tested on humans?
1911
44
What was the second magic bullet, who discovered it and when?
Prontosil, Gerhard Domagk, 1932.
45
What did the prontosil magic bullet combat?
Streptococcus - a type of bacteria that can cause blood poisoning.
46
What was John Hunters main impact on treatment?
He introduced a new way to treat an aneurysm (a bulge in a blood vessel). He tied off the blood vessel to encourage blood to flow through other vessels in the leg, stopping it from needing to be amputated.
47
What did John Hunter encourage?
Better approaches to surgery, including good scientific habits like:
- learning about the body to understand illness
- experimenting to find better ways to treat disease
- testing treatments before using them on people.
48
When was John Hunter born?
1728
49
Who did John Hunter teach?
Doctors like Edward Jenner.
50
In the years c.1700-c.1900 what were hospitals more focused on?
Treatment and learning.
51
What were opened for the first time in the 18th century?
Charity hospitals.
52
Why were charity hospitals able to be opened in the 18th century?
Because they were funded by the rich.
53
What did the charity hospitals in the 18th century offer?
They offered largely free treatment to the poor.
54
Who were admitted to the charity hospitals in the 18th century?
Only those that were likely to recover quickly because of a lack of space and the risk of illnesses spreading.
The 'deserving' poor had more chance of being admitted.
55
Where were most poor people treated between 1700-1900?
In workhouses.
56
How were conditions in workhouses?
Poor. But from the 1850s a partially successful movement began to improve conditions in workhouse infirmaries.
57
How did Florence Nightingale improve hospitals?
By improving hospital hygiene and raising nursing standards.
58
How were conditions in hospitals before the 1800s?
Hospitals were often dirty places that people associated with death and infection.
59
When was Florence Nightingale born?
1820
60
What was Florence Nightingale asked to do during the Crimean War?
To go to the Barrack Hospital in Scutari and sort out the hospital's nursing care.
61
Who opposed female nurses during the war?
The military opposed women nurses, as they were considered a distraction and inferior to male nurses.
62
Where had Nightingale learned her methods?
From training in Europe.
63
What did Nightingale make sure when she went to the hospitals in Scutari?
- That all the wards were clean and hygienic.
- That water supplies were adequate.
- That patients were fed properly.
64
What was the death rate before Nightingale arrived?
42%
65
What was the death rate after Nightingale improved the hospitals during the Crimean War?
2%
66
Who else nursed in Crimea as well as Nightingale?
Mary Seacole
67
What did Mary Seacole do?
- volunteered as a Nurse in the Crimean War (was rejected)
- went anyway
- nursed soldiers on the battlefields
- built the British Hotel, a small group of makeshift buildings that served as a hospital, shop and canteen for soldiers
68
When did Nightingale publish 'Notes on Nursing'?
1859
69
What was said in 'Notes on Nursing'?
It explained her methods - it emphasized the need for hygiene and a professional attitude.
70
How much did the public raise to help Nightingale train nurses and set up the Nightingale School of Nursing in St. Thomas' Hospital?
£44,000
71
How many trained nurses were there in Britain by 1900?
64,000
72
When was the Nurses Registration Act passed?
1919
73
What did the Nurses Registration Act enforce?
This made training compulsory for all nurses.
74
What does anaesthetic do?
Painkiller.
75
What were the problems with the anaesthetics that were used previously?
They made the patient very ill.
76
What anesthetics had been used previously?
Alcohol, opium and mandrake.
77
Why wasn't ether used as an anesthetic?
It is an irritant and is also fairly explosive.
78
Who was James Simpson and what was his occupation?
A Professor of Midwifery at Edinburgh University.
Looking for a safe alternative to ether that women could take during childbirth.
79
When did James Simpson discover the effects of chloroform?
1847
80
What did James Simpson discover?
The effects of chloroform.
81
What encouraged people to start using chloroform?
After Queen Victoria gave birth to her eighth child while using chloroform in 1953, it became widely used in operating theatres and to reduce pain during childbirth.
82
What was the side affect of chloroform?
Sometimes affected the heart, causing patients to die suddenly.
83
What is a general anaesthetic?
Complete unconsciousness.
84
What is local anaesthetic?
Numbing of the part being treated only.
85
Why did early anesthetics actually lead to a rise in death rates?
- longer more complex operations could be carried out
- unconscious patients were easier to operate on
- surgeons could take longer over their work
- however surgeons didn't know that poor hygiene spread disease and caused the death rates to increase from infections
- surgeons used very poor hygiene
86
What are three examples of the unhygienic methods used in the 19th century?
- surgeons didn't wear clean clothes, their coats were covered in years of dried blood and pus from previous operations
- carried out in unhygienic conditions, such as the patients house
- operating instruments were also unwashed and dirty
87
What are antiseptic methods used for?
Used to kill germs that get near surgical wounds.
88
What are aseptic surgical methods aimed at?
To stop germs getting near the wounds.
89
Who pioneered the use of antiseptics?
Joseph Lister
90
What did Joseph Lister do?
He pioneered the use of antiseptics.
91
What antiseptic method did Joseph Lister use?
Carbolic acid sprays on instruments and bandages.
92
What helped Joseph Lister to realize the need for antiseptic methods?
The Germ Theory.
He realised that germs could be in the air, on surgical equipment and on people's hands.
93
What was the effect on death rates once antiseptic methods were used?
Immediately reduced them.
From 50% in 1864-66 to around 15% in 1867-70.
94
What was different about using aseptic methods to using antiseptic methods?
Antiseptic methods involved using chemicals to kill germs whereas aseptic methods involved creating a germ-free environment instead.
95
How were an aseptic environment created?
- equipment was sterilised before use, usually with high temperature steam (120*)
- theatre staff sterilised their hands before entering - and wore sterile gowns, masks, gloves and hats
- the theatres were kept clean and fed sterile air
96
When did the industrial revolution begin?
18th century.
97
How did the industrial revolution affect public health in the 18th and 19th century?
Lots of people moved into cities like London to work in factories. The places they lived in were cramped, dirty, had poor ventilation and great for spreading disease.
98
What meant that pubic health was so bad in the 18th and 19th century?
- overcrowding
- cramped, unventilated, dirty housing
- people didn't understand the need for clean water or good sewage systems
- people mostly used privy's instead of toilets which were built over a cesspit
- cesspit waste was collected and thrown into rivers or piled up for the rain to wash away
- water pumps were often contaminated by waste from the cesspits or rivers
99
When did Cholera reach Britain?
1831
100
How many people died in Britain died from Cholera in 1831?
Over 21,000.
101
How does Cholera spread?
When infected sewage gets into drinking water.
102
What did people who got Cholera suffer from?
Extreme diarrhoea - sufferers often died from loss of water and minerals.
103
Who was the main cause of the first public health act?
Edwin Chadwick.
104
What did Edwin Chadwick do to get the government to pass the 1848 Public Health Act?
He published a report on poverty and health showing that living conditions in towns were worse for people's health than conditions in the countryside.
105
What did Chadwick's report suggest?
That the government should pass laws for proper drainage and sewerage systems, funded by local taxes.
106
What were the two reason that the government passed a Public Health Act in 1848?
Chadwick's report.
Another cholera epidemic in 1948 (which killed 53,000).
107
What did the 1848 Act involve?
The setting up of a central Board of Health (including Chadwick).
Allowed any town to set up its own local board of health - as long as the town's taxpayers agreed.
108
What limited the impact of the 1848 Act?
Because towns were given the choice of setting up a health board very few did.
Those that did often refused to spend any money to improve conditions.
Chadwick annoyed a lot of people and was forced to retire in 1854, the central Board of Health was dismantled in 1858.
109
Who was John Snow?
A doctor from London who showed that there was a connection between contaminated water and cholera.
110
Where did John Snow test his theory on Cholera?
Broad Street.
111
When did John Snow test his theory on Cholera?
1854
112
What did John Snow do to test his theory on Cholera at Broad Street?
He interviewed people and made a map of the area showing where cases of the disease had been.
113
What did John Snow's investigation show?
That all victims used the same water pump on Broad Street.
114
What did John Snow do after making his discovery about the Broad Street pump?
He convinced the local council to remove the handle of the pump. This brought the Cholera outbreak to an end.
115
What was later discovered about the cause of the outbreak of Cholera from the pump on Broad Street?
That nearby a cesspit had a split lining - its waste had leaked into the pump's water supply.
116
What did John Snow publish in 1855?
'On the Mode of Communication of Cholera'
117
When did John Snow publish 'On the Mode of Communication of Cholera'?
1855
118
What were the impacts of John Snow's findings?
It took a while to make an impact - it wasn't until the Germ Theory was published that his theory became widely accepted.
But eventually it helped lead to a change in attitudes - people realised that a waterborne disease like Cholera needed a government response.
Later influenced the 1875 Public Health Act.
119
When did the Great Stink hit London?
1858
120
What was the great stink?
In the summer of 1858, hot weather caused the river's water level to drop and bacteria to grow in the waster.
This produced a smell that was so bad it affected large parts of London and stopped Parliament from meeting.
121
What did the Great Stink push the authorities in London to do?
They agreed to build a new, expensive sewer system.
122
Who designed the new sewerage system?
Joseph Bazalgette
123
Who was Joseph Bazalgette?
The chief engineer of the Metropolitan Board of Works, which was responsible for public works in London.
124
When was Bazalgette appointed?
1859
125
What caused Bazalgette to be appointed?
The Great Stink caused the authorities to realise they needed a new sewerage system.
126
How did Bazalgette improve the sewers?
He designed the sewers to transport waste that was normally dumped into the Thames away from heavily populated areas to the Thames Estuary.
127
How many miles of sewers were built after the Great Stink?
About 1300 miles.
128
When did the new sewerage system officially open?
1865
129
When was the second Public Health Act passed?
1875
130
When did the governments laissez-faire belief begin to change?
Late 19th century
131
When was the Second Reform Act passed?
1967
132
What was the Second Reform Act?
It gave nearly 1 million more men the vote, most of whom were industrial workers.
133
Why did the Second Reform Act significantly change the governments attitude about public health?
Now industrial workers could put pressure on the government to listen to concerns about health.
For the first time politicians had to address workers' concerns in order to stay in power.
134
What were the three main things that caused the Second Public Health Act to be passed?
- Evidence from Chadwick and Snow and Pasteur's Germ Theory showed that cleaning towns could stop the spread of disease
- the Second Reform Act
- the Great Stink
135
What did the Public Health Act of 1875 involve?
It forced councils to appoint health inspectors and sanitary inspectors to make sure that laws on things like water supplies and hygiene were followed.
It also made councils maintain sewerage systems and keep their towns' streets clean.
136
Why was the 1875 Public Health Act more effective than the 1848 one?
Because it was compulsory.
