EOY exam Flashcards
what was surgery like in the medieval period of 1250-1500?
Dangerous and there was no way to prevent pain, blood loss or infection
Only attempted rarely and on minor procedures
Carried out by barber surgeons who had little medical training who had neither the desire or ability to experiment with new treatments or operate successfully
Why did early anaesthetics of the 1700’s lead to a rise in death rates?
led to more complex and longer operations because unconscious patients were easier to operate on
longer operations led to more infection
poor hygiene spread disease like blood covered gowns and unhygienic conditions and instruments
Black period of surgery of 1846-1870
Discuss aseptic technique reducing the need for nasty chemicals since late 1800’s
since late 1800’s changed spproach from killing germs to making a germ-free environment (aseptic)
instruments were sterilised
surgical gloved invented by William halsted in 1889
sterilise, hands and gowns and wear masks gloves and hats
clean theatre with tents of sterile air
aseptic technique reduced the need for carbolic spray which is unpleasant on skin and when breathed in
who discovered chloroform and what was it like?
James Simpson
used from 1847
very effective but difficult to control dosage and had bad effects on the heart
inhaler helped regulate dosage
what was anaesthetic like before the 1800’s
alcohol and opium had little success
anaesthetic after the 1800’s?
chloroform
laughing gas (1844) failed to ease all pain and patients were still conscious
ether (1846) totally unconscious/ lasted a while / patients coughed during operations / sick afterwards / flammable/ heavy glass bottle
Cocaine (1884) as first local anaesthetic
Novocaine (1905) less addictive/ general anaesthetic
What were the impacts of anaesthetic and antiseptic and why did some people oppose in 1700-1900
surgery became painless and patients didn’t struggle
more complex and more time to be careful
death rate decreased
surgery more successful and infection reduced
led to aseptic technique
People opposed because they were worried about the long term effects of the use of anaesthetics and thought being unconscious made you more likely to die. Victorians were religious and thought God sent pain for a reason (cause of disease in medieval period) so it was wrong to interfere with his plan .
Germ theory and listers technique took a while to be accepted
Describe a timeline of lister
1861 - lister starts work as surgeon and half of patients die from postoperative infection
1864- reads pasters germ theory and discovers carbolic acid
1865- soaks bandages in carbolic acid to avoid infection
1866- used acid to clean wounds and equipment /invents a spray to kill germs in the air
1867- his wards freer of infection for 9 months /publishes ideas
describe the differences in hospital care from the 1700- 1900
1856- hospitals had a home atmosphere
high death rates
lack of cleanliness
nursing wasn’t seen as a respectable job for women
1875- practical and hospital organisation and cleanliness improved
nurses better trained
Pasteur’s germ theory led to better hygiene
nurses assisted doctors and had a more central role
public pressure led to separate infirmaries for the poorest people
specialist hospitals for mentally ill and fever houses developed
how did Florence nightingale improve hospital care?
she believed in miasma so emphasised hygiene, fresh air, good supplies and training for nurses lowering death rate at Scutari hospital from 42% to 2%
what was germ theory
he germ theory of disease states that many diseases are caused by microorganisms. These small organisms, too small to see without magnification, invade humans, animals, and other living hosts. Their growth and reproduction within their hosts can cause a disease.
by Louis Pasteur in 1861
contradicted spontaneous generation the theory that decaying matter caused disease
what did Robert Koch do
read Pasteur’s work about germ theory and began to study microbes himself. He proved that Pasteur’s theory was correct and microbes caused disease as well as decay
He discovered:
1882 - specific microbes that caused TB
1883 - specific microbes that caused cholera
chemical dyes stain bacteria
easy way of growing bacteria on agar jelly
why was Koch more important then Pasteur?
Few people believed Pasteur’s work and although some people like Joseph Lister made the link between microbes and disease
Koch inspired others to research microbes
Pasteur was more focused on the brewing industry
but germ theory wasn’t accepted straight away
How did Jenner discover smallpox vaccination?
treated people for cowpox and realised these people never caught the disease (helped by a milkmaid who made the observation) He then tried the theory out on a boy called james phibbs who got given both diseases and was fine he used scientific methods and experiments and then observed and recoreded
what were the positive impacts of jenners work but why did some people oppose?
- encouraged more work regarding vaccinations to be carried out
- prevented small pox
- vaccination available for people of all wealth’s
opposition:
- wrong to give human animal disease
- interfered with God’s plan
- doctors lost money because vaccination was free from the government
- some doctors didn’t vaccinate properly
- Jenner didn’t know why it worked
- other diseases still killing people
- took time to become popular in Britain
what did jenner publish
he published his findings in an enquiry to the causes and effects of variola vaccination because the royal society refused to publish them
what were the attempt to prevent cholera
clean homes and streets
public health act of 1848 suggested that clean water should be supplied to cities but it wasn’t compulsory
what did john snow do to contain cholera
explored the link between living conditions and public health
cholera struck in 1848 and in 1831 and 1854
1849 published a book claiming that dirty water was the cause of disease
1854, 700 dead around broad street
he mapped the area and found:
1) he removed the pump handle and no one else died
2) A lady who ordered water from the ump but lived far away also died
3) no one died at brewery bc they were all drinking beer
4) discovered a cesspit leaking into the pump
he proved cholera was NOT caused by miasma by observation and research
But his ideas weren’t accepted till 30 years later because of the laissez- Faire approach and the devotion to miasma until Robert Koch helped prove it
what did john snows research do in the longer term
combined with other evidence a new sewer system was completed in 1875
helped make the link between dirty water and disease leading to public health act of 1875 were authorities were forced to provide clean water
what was the public health act of 1848?
local boards of health set up
local medical officers
rubbish removal
build a sewer system
death rate had to reach certain percent for act to be in place
only 1/3 of towns set up local boards of health
general board of health abolished in 1858
what was the public health act of 1875
more effective than the 1848 one because it was compulsory
parliament took more charge and provided essential facilities and clean water sanitary and medical officers appointed food quality checked housing improved water pollution law
water, lighting and paving in the hands of the individual
what is the laissez faire approach
the policy of not interfering and leaving things to work themselves out
what did Edwin chadwick do ?
in 1842 he published a report saying that poor living conditions caused poor health
this led to the public health act of 1848
when was the great stink and what did it cause
1858 and caused new sewer system of 1865
what happened in 1867
The second reform act was passed giving 1 million men the vote allowing them to pressure the government to listen to concerns regarding public health
what was in 1876
the river pollution prevention act stopping people from dumping sewage into rivers
