Industrial 1750-1900AD

Question 1

Change in attitudes (7)

Answer 1

Explosion in industry and industrial diseases eg dermatitis)
Urbanisation (and growth in health problems eg ‘filth disease’)
Growth of immense wealth
Advances in technology
Growth of science and research
New injuries due to mechanisation of war
New ideas regarding evolution

Question 2

Understanding causes (3)

Answer 2

Germ theory- germs were responsible for disease
Theodor Schwann (Germany 1839) realised animal matter was made of cells, not humours
William Beaumont (America 1822) studied digestive system of Alexis St Martin, a Canadian who had an open hole in the stomach

Question 3

Jenner- work (2)

Answer 3

People noticed for ages that if you caught cow pox, you never got small pox
A young boy named James Phipps was successfully vaccinated with pus after a milkmaid was diagnosed with cow pox

Question 4

Inoculation (3)

Answer 4

Involved taking pus from a scab on a person with the mild form and rubbing onto the scratch of a healthy person
Lady Mary Wortley Monatague brought idea of inoculation back to England in 1721 when her son was inoculated
Significantly reduced deaths from small pox, however was risky- 1783, son of George III died from a serious case of it

Question 5

Limitations of Jenner’s work (8)

Answer 5

Many people who performed inoculations believed it would put an end to their profitable businesses
Germ theory not discovered yet- working ahead of his time
Many unknown doctors did not believe that an unknown doctor could make such an important discovery
Some doctors were not careful and accidentally vaccinated using small pox, rather than cow pox
Failed to understand the significance of what he had discovered
Many objected to being forced to be vaccinated as they believed the government was wrong to interfere with health issues
Government had a Laissez Faire approach, believed it was not their duty to be involved in public affairs
After 1852, vaccination was made compulsory, however was not strictly enforced

Question 6

Progress of Jenner’s work (5)

Answer 6

1805- Napoleon had his army vaccinated
By 1801 100,000 people had been vaccinated in England
By 1811, 1.7 million had been vaccinated in France
In 1979 the World Health Organisation announced that small pox had been completely eradicated from the population
After 1872, vaccinations made compulsory, was strictly enforced

Question 7

Training of doctors (2)

Answer 7

1858- regulation of doctors occurred be government

Training progresses after germ theory discovered, initially some hostility to this

Question 8

Hospitals (3)

Answer 8

More develop
Closely linked to the work of Nightingale from 1860s onwards
Architecture of hospitals now considered

Question 9

Others responsible for curing the sick (3)

Answer 9

Patent medicines- cure-alls
Doctors and nurses mainly responsible for care now
Decline of home remedies- except for the poor who cannot afford doctors

Question 10

Pasteur’s work (2)

Answer 10

Local brewers asked Pasteur why alcohol sometimes went bad during the brewing process. Showed that heating micro-organisms killed them off (pasteurisation)
1880- Pasteur’s assistant injected some chickens with an old culture of chicken cholera. No death, showed that an injection of a weak culture of germs enabled the body to develop immunity

Question 11

Progress of Pasteur’s work (6)

Answer 11

Found missing link between germs and disease in 1861
Disproved theories eg miasma theory and 4 humours
1881- anthrax vaccination discovered
1884- rabies vaccination developed, first used on a young boy
1913- diphtheria vaccination discovered
1906- TB vaccination discovered

Question 12

Limitations of Pasteur’s work (3)

Answer 12

Needs Koch
Did not have knowledge of different diseases
Work initially faced opposition eg was a country doctor, people failed to see the potential of his work

Question 13

Progress of Koch’s work (3)

Answer 13

Could dye different germs different colours, meant that different forms of the weakened pathogen could be used for vaccinations
Was a doctor, meaning he had the skills and knowledge required, more likely to be accepted
Inspired the first ‘microbe hunters’

Question 14

Limitations of Koch’s work (2)

Answer 14

Little progress without Pasteur

Though he could identify different bacteria, was unable to find vaccinations for all diseases

Question 15

Progress of Nightingale’s work (4)

Answer 15

Published 2 books
Washed bedding, opened windows
Death rate reduced
Raised money through Time’s Newspaper to open a nursing school

Question 16

Limitations of Nightingale’s work (2)

Answer 16

Rejects germ theory, supports miasma theory, actions carried out for the wrong reasons
Does not help women get any equality in medicine

Question 17

Why public health declined (4)

Answer 17

King and parliament did not see it as their responsibility to sort out conditions of towns, ordinary people had no MPs so their views were no listened to
People did not understand Germ Theory
Many migrated to towns and cities, houses had o be built quick, in poor condition eg back to back housing
Many factories built, polluting rivers, streams and air

Question 18

Progress of Snow’s work (2)

Answer 18

Proved cholera germ was in the water
Work contributed to Metropolitan Board of Works in 1856
Published data, showing that scientific theories did work (still used today)
Stopped Soho outbreak by removing the handle of the water pump

Question 19

Limitations of Snow’s work (4)

Answer 19

Working before his time as he worked in 1854 and GT not discovered until 1861
Actual cholera germ not discovered until 1883 after Snow’s death
Many scientists still believed in Miasma Theory, refused to accept cholera was passed on via dirty water
Government refused to act on Snow’s advice as they did not water to pay for the clean up of dirty water, cholera came back in 1865, killed 10,000 people

Question 20

Why did the government not care? (4)

Answer 20

Laissez Faire approach- did not see it as their responsibility
Too expensive
Did not appreciate the value of cleanliness, GT not discovered until 1861
Did not have an impact upon them directly, not their issue

Question 21

Edwin Chadwick (4)

Answer 21

1832- given a job regarding how the government can save money
Report ‘ The Sanitary Conditions of the Working Population’
Report stated that more money needed to be invested into improving those living in poverty, otherwise the labourers could not labour as efficiently
Those in parliament listened in “astonishment” , were not aware of the magnitude of poverty

Question 22

Limitations of Chadwick’s work (3)

Answer 22

Expensive, brought Chadwick into conflict with many influential people who were no keen on giving money to improve their living conditions
Conservative government rejected Chadwick’s report in 1842
National Board of Health disbanded in 1854 due to Chadwick’s unpopularity

Question 23

Impact of Chadwick’s work (2)

Answer 23

Public Health Act passed in 1848
Appointed Sanitary Commissioner, set up a new Central Board of Health with the intention of cleaning streets and providing clean water for sanitation and potable use

Question 24

Joseph Bazalgette

Answer 24

Hot Summer in 1858, ‘Great Stink’
By 1866 most of London connected to a sewer network devised by Bazalgette
Flow of foul water from sewers and rivers was intercepted, and diverted on new, low-level sewers behind embankments to waste treatment plants
1,300 miles of sewer, can hold upto 1.8 billion litres of sewage a day

Question 25

Limitations of Bazalgette’s work (1)

Answer 25

System dumped tons of raw sewage into the Thames, death toll of Princess Alice boat sinking would have been lower if it had sunk anywhere else, 640 passengers died from poisoning mainly, rather than drowning

Question 26

William Farr (2)

Answer 26

Collected records of deaths and diseases

Made link between living conditions and death rates, factual evidence, could not be ignored

Question 27

1848 Public Health Act (6)

Answer 27

Central Board of Health created by each council
Local boards of health set up to appoint Medical Officer
Sewers provided
Lodging inspected
Food checked which was offered for sale
Not compulsory, cost of it was supposed to be covered by landlords and the wealthy

Question 28

1875 Public Health Act (4)

Answer 28

Compulsory
Clean water
Drainage systems
Medical officers appointed