Industrial Medicine

Question 1

What was the only way to prevent smallpox before Jenner?

Answer 1

Inoculation

Question 2

How did inoculation work

Answer 2

Involved making a cut in a patients arm and soaking it in pus taken from the swelling if somebody who already had a mild form of small pox

Question 3

Why was inoculation dangerous

Answer 3

It prevented disease however sometimes the doses were excessive resulting in additional fatalities

Question 4

How did Jenner discover a link between small pox and cow pox

Answer 4

Using careful scientific methods Jenner investigated and discovered that it was true that people who had cowpox didn’t get smallpox
Heard milkmaids didn’t get smallpox but caught cow pox a milder disease
In 1796, he tested the theory by injecting a small boy with sores from a milkmaid
After Jenner infected him with smallpox he didn’t catch it
Jenner published his findings in 1798

Question 5

What we’re the short term impacts of jenners discovery

Answer 5

-Shows Theres a clear link between viruses
-Napoleon uses his work to vaccine his soldiers
-American doctors began use it it by 1803 (international impact)

Question 6

What was the long term impact of jenners discovery

Answer 6

-1979- Eradicated the existence of smallpox
Helped clinics set up vaccination centres

Question 7

What was the opposition towards jenners discovery

Answer 7

It was a magic bullet. The lack of understanding towards why his vaccine worked meant he couldn’t develop any other vaccines
Only possible after The Germ Theory was published when Pasteur worked to discover vaccines against other disease such as chicken cholera and anthrax

Question 8

What was spontaneous generation

Answer 8

The belief germs were caused by decaying matter

Question 9

What was the continuity in diseas in the industrial era

Answer 9

Spontaneous generation
Miasma (belief that disease was caused by bad air) was still popular however it slowly decreased in popularity

Question 10

What did Louis Pasteur do in pasteurisation

Answer 10

Heating biological liquid to a certain heat to kill bacteria which saved many lives and is still used to this day. It was a huge step forward In keeping liquids free from germs and safe to drink

Question 11

What experiencing did he conduct for germ theory

Answer 11

He conducted an experiment with 2 flasks. After putting milk in each he boiled it to kill all the germs. He bent the neck of the first flask making it difficult for germs in the air to pass through
Didn’t do this for the other so bacteria could easily pass through

Question 12

What is germ theory

Answer 12

In 1861 Pasteur published Germ theory arguing microbes in the air caused decay which suggested some germs caused disease. Shows bacteria could travel to infect
Miasma didn’t exist- extremely popular theory which Pasteur helped devalue the once influential theory

Question 13

What was the problem with Louis Pasteur

Answer 13

He was unable to prove that germs could also cause disease in which Robert Koch built on his idea

Question 14

Who was Robert Koch

Answer 14

A German doctor and scientist who read pastries work and began to study microbes himself.

Question 15

What did Robert Koch identify

Answer 15

The specific microbes thag caused Tuberculosis in 1882 and cholera in 1883 showing that different germs caused different diseases a discovery Pasteur and Jenner failed to identify
Led to the mass production of vaccinations whcih made it easier for infections to be prevented on a wider scale

Question 16

How did Koch make it easier for future scientist to study bacteria

Answer 16

He developed a new method of growing them using agar jelly in a Petri dish to create solid cultures allowing him to breed lots of bacteria
He used dyes to stain the bacteria so they were more visible under the microscope

Question 17

What impact did Koch have

Answer 17

His research inspired other scientists. Over the next two decades they went on to discover the microbes responsible for other diseases like meningitis, diphtheria and other infections
He is considered to be the father of bacteriology and his methods are still widely used today

Question 18

How did Florence nightingale improve arnt hospitals

Answer 18

When the Crimean war broke out in 1853-54 horror stories emerged about the barrack hospital in Scutari where the british wounded were treated
The military opposed women nurses as they were considered a distraction and inferior to male nurses
Nightingale went away with 38 handpicked nurses

Question 19

What did nightingale do

Answer 19

Using methods she had learned from her training in Europe she made sure that all the wards were clean and hygienic
She improved the hospital a lot. Before she arrived the death rate in the hospital stood at 42% however 2 years later it fell to 2%

Question 20

What did she believe in

Answer 20

Nightingales believes about the importance of hygiene stemmed from miasma a debunked belief

Question 21

How did nightingale change nursing

Answer 21

In 1859 she published a book “notes on nursing” emphasising the need for hygiene. It was the standard textbook for generation of nurses
The public raised 44000 to help her train nurses and set up the nightingales school of nursing. Nurses given 3 years of training before they could qualify
By 1900 there were 64000 trained nurses in Britain

Question 22

What did people believe about water

Answer 22

Before the germ theory people didn’t understand the need for clean water or good sewerage systems. Most houses had no bathroom instead shared an outside toilet called cesspits

Question 23

What did people believe about water (2)

Answer 23

Water companies set up water pumps in the streets which were shared between many houses
The pumps supply was often contaminated by waste from the cesspits

Question 24

What are the statistics with cholera

Answer 24

Cholera reached Britain in 1831. By 1832 over 21000 people in Britain died of cholera
This recurred agaij in 1848, 1853-54 and 1865-66
Cholera spreads when infected sewage gets into drinking water. It caused extreme diarrhoea-suffered often die from loss of water and minerals. Both rich and poor people caught the disease

Question 25

What we’re attempts to prevent the spread of cholera

Answer 25

Believe cholera was caused by miasma and spontaneous generation
The governemnt started regulating the burial of the dead but this did little to halt the spread of disease

Question 26

What happened with John snow

Answer 26

Snow was a popular and well respected doctor and surgeon in London
He observed the cholera epidemic and began work on his theory thay cholera was spread through contaminated drinking water and not by miasma

Question 27

What is the Work of John snow (2)

Answer 27

When cholera broke out again in 1854 he interviewed people living in broad street and made a map of the area showing where cases of the disease had been.he mapped all the deaths and found a strong link to one water pump on broad street
He removed the handle of the pump so people couldn’t collect water from it which made the number of deaths fall dramatically
Later it was discovered that a cesspit close by was leaking waste into the well
In 1855 snow presented his findings to the government

Question 28

What is the significance to John snows work

Answer 28

Snows work combined with other evidence like the Great Stink and a new London sewer system was completed
Snows work helped make the link between dirty water and diseas leading to the public health act in 1875 when cities authorities were finally forced to provide clean water

Question 29

How was jenners vaccination successful

Answer 29

Some people resisted vaccination. Some doctors who have the older type of inoculation saw it as a threat to their livelihood and many people were worried about giving themselves a disease from cows
But jenners discovery soon got approval of Parliament which gave Jenner 10000 in 1802 to open a vaccination clinic. It gave jenner a further 20,000 a few years later
In 1840 vaccination against smallpox was made free for infants. In 1853 it was made compulsory

Question 30

How did earlier attempts to improve public health had limited success

Answer 30

In 1842 Edwin Chadwick published a report suggesting that poor living conditions caused poor health
Chadwick report led to the 1848 public health act. The act set up a central board of health and let local councils set up their own board of health.
In 1858 sewage in the river Thames made a “great stink” in the middle of London. This forced the governemnt to plan a new sewer system which opened in 1865

Question 31

How did public opinion begin to change

Answer 31

For most of the 19th century people believed in a laissez-faire style of government-the thought the government shouldn’t intervene in public health.
However snows discovery of the link between dirty water and cholera and Pasteurs germ theory showed that cleaning up towns could stop the spread of disease
In 1867 the second reform act was passed. It gave an additional 1 million men the vote most of whom were industrial workers. Workers could now put pressure on the government to listen to concerns about health. For the first time politicians had to address workers concerns to stay in power

Question 32

How did the 1875 act improved public health

Answer 32

In 1871-1872 the government followed the royal sanitary commissions proposal to for the local government board and divide Britain into “sanitary areas” administered by officers for public health
In 1875 the government of Benjamin Disraeli passed another public health act. It forced councils to
Appoint health inspectors and sanitary inspectors who made sure that laws of things like water supplies and hygiene were being followed
Maintain sewerage systems to prevent further cholera outbreaks
Keep the towns streets clean

Question 33

How did the 1875 public health act improve health (2)

Answer 33

The 1875 public health act was more effective than the one passed in 1848 because it was compulsory
In 1875 Disraeli also brought in the artisans dwellings act which let local councils buy slums with poor living conditions and rebuild them in a way that fit new government backed housing standards
Other important reforms included the 1876 river pollution prevention act which stopped people from dumping sewage or industrial waste into rivers
Just as the government used the work of Jenner to make vaccination compulsory the 1875 act built in the work of several individuals including John snow and Louis Pasteur. The scientific proof these individuals provided combined with a change of attitudes towards the role of the government helped put pressure on the government

Question 34

How did anaesthetics solve the problem of pain

Answer 34

Pain was a problem for surgeons especially because their patients could die from the trauma of extreme pain. Natural drugs like alcohol, opium and mandrake had long been used but effective anaesthetics that didn’t made the patient very ill were more difficult to produce
Nitrous oxide was identified as a possible anaesthetic by British chemist Humphrey Davy in 1799 but he was ignored by surgeons t the time. The gas had been dismissed as fairground novelty before American dentist Horace Wells suggested it’s use in his area of work. He did a public demonstration in 1845 but had the bad luck to pick a patient unaffected by nitrous oxide-it was again ignored

Question 35

How did anaesthetics solve the problem of pain (2)

Answer 35

In 1842 American doctor Crawford long discovered the anaesthetic qualities of ether but didn’t publish his work. The first public demonstration of ether as an anaesthetic was carried out in 1846 by American dental surgeon William Morton
Ether is an irritant and is also fairly explosive so using it in this way was risky

Question 36

How did James Simpson discover chloroform as an anaesthetic

Answer 36

James Simpson was a professor of midwifery at Edinburgh uni. Looking for a safe alternative to ether that women could take during childbirth he began to experiment on himself. In 1847 he discovered the effects of chloroform
After queen Victoria gave birth to her 8th child while using chloroform in 1853, it became widely used in operating theatres and to reduce pain during childbirth
Surgery became pain free and patients didn’t struggle so surgeons could take more time and be more careful. Deeper more complex surgery became possible and the death rate dramatically decreased as surgery was more successful.

Question 37

What was the opposition towards anaesthetic

Answer 37

Anaesthetics led to longer and more complex operations. This was because surgeons found that unconscious patients were easier to operate on meaning they could take longer over their work
Longer operating times led to higher death rates from infection because surgeons didn’t know that poor hygiene spread disease. Surgeons used very unhygienic methods
Surgeons didn’t know having clean clothes saved lives. Often they wore the same coats for years covered in dirt from previous operations. Instruments also caused infection since they were usually unwashed and dirty

Question 38

What was the black period of surgery

Answer 38

Anaesthetics helped solve the problem of pain but patients were still dying from infection. This meant the attempts at more complicated surgery actually led to increased death rates amongst patients. The period between 1846 and 1870 is sometimes known as the “black period” of surgery for this reason

Question 39

How did Joseph Lister pioneer the use of antiseptics

Answer 39

Ignaz Semmelweis showed that doctors could reduce the spread of infection by washing their hands with chloride of lime solution between patients. However it was really unpleasant so wasn’t widely used
Joseph lister had seen carbolic acid sprays used in sewage works to keep down the smell. He tried this in the operating theatre in the early 1860s and saw reduced infection rates
Lister heard about the germ theory in 1865- he realised that germs could be in the air on surgical instruments and on peoples hands. He started using carbolic acid on instruments and bandages

Question 40

What we’re the important of antiseptics

Answer 40

The use of antiseptics immediately reduced death rates from as high as 50% in 1864-66 to around 15% in 1867-70
Antiseptics allowed surgeons to operate with less fear of patients dying from infection. The number of operations increased tenfold between 1867 and 1912 as a result

Question 41

How did asepsis reduce the need for nasty chemicals

Answer 41

Since the late 1800s surgeons have changed their approach from killing germs to making a germ free environment
Instruments are carefully sterilised before use usually with high temperature steam
Theatre staff sterilise their hands before entering- and wear sterile gowns, masks gloves and hats. Surgical gloves were invented by William halsted in 1889
The theatres themselves are kept scrupulously clean and fed with sterile air. Special tents can be placed around the operating table to maintain an area of even stricter hygiene in high risk cases
Aseptic surgery reduced the need for carbolic spray which is unpleasant to get on your skin or breathe in-many doctors and nurses didn’t like to use it