EOY exam

Question 1

what was surgery like in the medieval period of 1250-1500?

Answer 1

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

Question 2

Why did early anaesthetics of the 1700’s lead to a rise in death rates?

Answer 2

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

Question 3

Discuss aseptic technique reducing the need for nasty chemicals since late 1800’s

Answer 3

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

Question 4

who discovered chloroform and what was it like?

Answer 4

James Simpson
used from 1847
very effective but difficult to control dosage and had bad effects on the heart
inhaler helped regulate dosage

Question 5

what was anaesthetic like before the 1800’s

Answer 5

alcohol and opium had little success

Question 6

anaesthetic after the 1800’s?

Answer 6

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

Question 7

What were the impacts of anaesthetic and antiseptic and why did some people oppose in 1700-1900

Answer 7

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

Question 8

Describe a timeline of lister

Answer 8

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

Question 9

describe the differences in hospital care from the 1700- 1900

Answer 9

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

Question 10

how did Florence nightingale improve hospital care?

Answer 10

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%

Question 11

what was germ theory

Answer 11

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

Question 12

what did Robert Koch do

Answer 12

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

Question 13

why was Koch more important then Pasteur?

Answer 13

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

Question 14

How did Jenner discover smallpox vaccination?

Answer 14

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

Question 15

what were the positive impacts of jenners work but why did some people oppose?

Answer 15

• 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

Question 16

what did jenner publish

Answer 16

he published his findings in an enquiry to the causes and effects of variola vaccination because the royal society refused to publish them

Question 17

what were the attempt to prevent cholera

Answer 17

clean homes and streets

public health act of 1848 suggested that clean water should be supplied to cities but it wasn’t compulsory

Question 18

what did john snow do to contain cholera

Answer 18

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

Question 19

what did john snows research do in the longer term

Answer 19

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

Question 20

what was the public health act of 1848?

Answer 20

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

Question 21

what was the public health act of 1875

Answer 21

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

Question 22

what is the laissez faire approach

Answer 22

the policy of not interfering and leaving things to work themselves out

Question 23

what did Edwin chadwick do ?

Answer 23

in 1842 he published a report saying that poor living conditions caused poor health
this led to the public health act of 1848

Question 24

when was the great stink and what did it cause

Answer 24

1858 and caused new sewer system of 1865

Question 25

what happened in 1867

Answer 25

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

Question 26

what was in 1876

Answer 26

the river pollution prevention act stopping people from dumping sewage into rivers