changes in medicine c1848 - c1948 Flashcards
what were the four humours
yellow bile, black bile, phlegm and blood
what was the theory of opposites
the idea that illness was caused by too much of one humour, and eating or drinking something with the opposite of those qualities would restore balance
what was spontaneous generation
rotting material created maggots, fleas and disease
why wasn’t there a lot of research to do with microorganisms
people didn’t know the link between microorganisms and disease, and microscopes were rare and expensive.
government didn’t feel responsible for issues like public health.
doctors didn’t want to learn new methods of doing things
why were Nightingale’s parents surprised when she wanted to be a nurse
it was a low status job
how many patients were there at Scutari
10,000
where did the patients at Scutari sleep
on the floor or sharing beds
what common diseases were at Scutari
typhoid fever, cholera and diarrhoea
what were supplies like at Scutari
limited medical supplies
poor quality and limited food supplies
were the patients at Scutari clean and hygenic
they were infested with lice and fleas
what was the quality of the hospital at Scutari
infested with rats and mice
built on an underground cesspool
what did Nightingale do at Scutari to improve conditions
scrubbed everything clean washed everything opened windows new supplies improved quality of food and cleaned kitchen
when did the death rate at Scutari start decreasing
only after a government commission repaired drains and improved water quality
what are microorganisms
single celled living organisms which are too small to be seen without a microscope
what types of surgery were available c.1840
basic (cutting open a boil) or life threatening (cutting off a tumour or performing an amputation).
what did being the best surgeon mean
you were the quickest at your job
pain relief available c.1840
opium
alcohol
being knocked unconscious
tourniquet
something wrapped tightly around a limb to reduce blood loss
why was infection common in surgery patients
unhygenic conditions surgeons wore dirty clothes reused bandages and dressings surgeons didn't wash their hands many people watched the surgery
advantages of using ether
it was a pain relief
disadvantages of using ether
side effects like vomiting
irritated lungs
patients could be unconscious for days
what was new and good about chloroform
it had no side effects
who and what popularised using chloroform
Queen Victoria used it in childbirth
who was James Simpson
Professor of Medicine and Midwifery at Edinburgh University
give reservations some people had about chloroform
“the bible said childbirth was meant to be painful”
how would chloroform affect the unborn baby?
what dose of chloroform is right?
“one unconscious might be more likely to die than one kept conscious from the pain.”
how did chloroform alter how surgeons worked
they felt more ambitious and did longer, deeper more complicated operations.
what was the black period in surgery
partly as a result of new pain relief, death rates rose, blood loss and infection remained a huge problem.
what types of infection were common in surgery patients
gangrene and sepsis
what was the living conditions like in london c.1840
families living in a single room 90 people in a single house houses were usually damp with little light or ventilation in bad weather there was flooding a privy might be used by 100 people
how did families collect water
from a pump shared by 20-30 families often from polluted rivers, available for a few hours 3-5 times a week.
what did Chadwick write arguing for the improvement of working class living conditions
the sanitary conditions of the labouring population, stating it was worth people’s time to improve their living conditions, as better health meant more of them could work and make profits. he said they should spend taxes on improving housing for the poor.
when was the public health act c.1840
1848
what did the 1848 public health act do
set up a general board of health
allow local boards of health
have 3 commissioners for the board of health
did the 1848 public health act do much
no, it was very temporary improvements and were suggestions, so some local authorities took no action.
what did Snow do to prove the link betwen cholera and water
mapped out all of the cholera deaths close to the Broad Street Pump, and linked them to the infected polluted water supply they were drinking from the pump.
why did Parliment pass a new act funding a sewer system in 1858
the great stink (rubbish and excrement in the Themes becoming exposed as a result of high heat) made MP’s pass an act.
who was louis pasteur
french research chemist
what did pasteur realise initally
microorganisms infect liquids
heating the liquid stopped them going sour
what were the main ideas of germ theory
the air contains living microorganisms
microorgainisms are not evenly distributed in the air
microorganisms can be killed by heating them
microorganisms in the air cause decay
where was air clearer
in mountains (as opposed to in cities)
was the germ theory believed and valued by other scientists
no, it was resisted and even ridiculed.
how did pasteur find the link between microorganisms and disease
he realised silkworms were being killed by a disease caused by a microorganism
what impact did pasteur and his work have in the next 30 years
it eventually led to an understanding of why infection developed after an operation.
when did Robert Liston use ether as an anathestic
1846
when did james simpson discover chloroform as an anathestic
1847
when was the first public health act
1848
when was the cholera epidemic and john snow’s work on the broad street pump
1854
when was the great stink
1858
when did florence nightingale publish Notes on Hospitals and Notes on Nursing
1859
when was the Nightingale school for the training of nurses established
1860
when was Pasteur’s germ theory
1861
what happened in 1865
Lister’s first use of carbolic acid in surgery
Elizabeth Garrett Anderson officially qualifies to practice medicine
when was the 2nd public health act
1875
when was the artisans dwellings act
1875
when was the Medical act that allowed women to study medicine and qualify as doctors
1876
when did Pasteur publish germ theory and its applications to medicine
1878
when did edwin chadwick publish the sanitary conditions of the labouring population
1842
where was the broad street pump
soho, london
what did semmelweiss find
death rates were higher at vienna general hospital than at home births
why were death rates higher at vienna general hospital than home births
doctors came straight from the dissecting room without washing their hands
was semmelweiss taken seriously
no his ideas were ridiculed and ignored by the medical community.
when position was Lister in 1859
professor of surgery at glasgow university
when did lister become a surgeon at glasgow royal infirmary
1861
antiseptic definition
something that will kill microorganisms
what did lister realise carbolic acid did
kill microorganisms responsible for the decay and smell
give 2 ways lister used carbolic acid during surgery
carbolic spray
bandages soaked in a solution of carbolic acid
did lister’s carbolic acid work
yes it lowered death rates
opposition to listers ideas about carbolic acid:
surgical instruments became slippy
the doctor’s hands became cracked and sore
if pasteur’s germ theory was not accepted, neither was lister’s.
some doctors used his methods badly and therefore saw no results and no need
nurses frustrated by the extra time it took
if doctors already had a hygenic routine of soap and water they saw no need
lister often experimented with his techniques, suggesting he was unsure of their effectiveness
who was joseph bazalgette
chief engineer at london metropolitian board of works
how much was bazalgette given for the sewers
£3 million
what were the two key features in the sewers
large, oval and built of brick so sewage wouldn’t get stuck.
dispose of the waste in the river thames, where the river was tidal and sewage would be washed out to sea.
how long were the sewers
2000km
when were the sewers built by
1875
factors/causes for bazalgettes sewers
the great stink
snow’s work on cholera
what does laissez-faire mean
the idea that people should be free to run their business without too much government interference or taxation
why did people oppose the government starting to take action in public health
they didnt want to pau more taxes
how did the government get people to support their action in public health
they expanded who could vote so more people would pay taxes.
what did the public health act of 1875 make local authorities responsible for
supply of clean water
building public toilets
ensuring new housing was built to good standards
inspecting conditions in lodging houses
employing health and sanitary inspectors to make sure regulations were obeyed
creating street lighting
checking food quality on sale
did manchester improve public health
yes they formed regulations on the size of rooms and windows for sufficient light and ventilation
did Birmingham improve public health
yes improved water supplies
demolished slums
how did women typically care for patients
look after patients in their own home
were women allowed to be doctors
no, not allowed higher education or medical training
how were hospitals funded
usually through charity
when did local hospitals start to be set up
c1860
how did patients get admitted to hospitals
note of recommendation from a doctor
what were infirmaries
larger hospitals
where were larger infirmaries
in towns and cities
was the standard of care good in hospitals
no it was low
when was notes on hospitals published
1859
what was in notes on hospitals
importance of keeping everything clean, to have lots of fresh air, and to have space between the patients beds.
when was notes on nursing published
1859
what was in notes on nursing
importance of ventilation, light, bedding, cleanliness, and food for the patient
what was set up in 1860
the Nightingale school for nurses
how many books did nightingale write on hospital design and nursing
over 200
suffragist definition
a word used for those who campaigned for women to have the vote
what did the medical act of 1858 say
doctors needed to be officially registered with the general medical council
who inspired garrett into becoming a doctor
blackwell
where did garrett become a nurse
middlesex hospital
apothecaries definition
the people who mixed the ingredients in the physicians prescriptions; early version of a chemist
where did garrett gain a medical degree
society of apothecaries
when did garrett become qualified
1865
when did garrett open st marys dispensary
1866
what was st marys dispensary changed to and when
the Elizabeth Garrett Anderson Hospital in 1918
how did jex-blake and four other women get medical degrees
they got their degrees abroad, just like blackwell, hoggan and garrett.
what did an act of parliment in 1876 say
that universities and medical societies should accept women.
what was garrett a member of
the british medical association.
did germ theory have a large impact on medicine by 1875
no, but it was broadly accepted
what was anthrax
the microorganims causing a disease in farm animals that spread through blood
how did koch prove that anthrax microorganisms caused the disease
a microscope and then staining and photographing microorganims.
when did koch publish his work on anthrax
1875
why was kochs work on anthrax important
it showed these techniques could be used to investigate disease and preventions of disease
when did pasteur publish his germ theory of infection (that linked disease to microorganisms)
1878
pasteur and his team injected chickens with a weakened dose of chicken chloera. how did they react?
they did not develop chicken cholera, even with a fresh culture
what did pasteur vaccinate anthrax baccilli into 1881
24 sheep one goat six cows and a control group of 24 sheep one goat four cows
how did the farm animals respond to the injections
the vaccinated animals survived the anthrax bacilli, whilst the control group all died except the feverish and swollen cows.
who did pasteur vacinate with rabies
9 year old Joseph Meister
what diseases did koch identify the microorganims that caused it
tuberculosis
cholera
how did koch identify the microorganisms that caused different diseases
he developed the use of agar jelly for growing cultures in a petri dish and used industrial chemical dyes to stain microorganisms to study them under a microscope.
what effect did the rivalry between koch and pasteur have
the governments (already international rivals from the franco-prussian war) funded their scientists well in the hopes of having their scientist accomplish more.
what is aseptic (surgery/techniques)
methods used to try to prevent microorganisms from coming into contact with the open wound during an operation
what is antiseptic (surgery/techniques)
something that will fight the infection by killing the microorganisms
how did koch’s steam steriliser improve surgery
it could be used in place of carbolic acid to kill microorganisms by heat
give some aseptic conditions in surgery
clean operating theatres without spectators
clean clothes
masks
rubber gloves
