Industrial Medicine Flashcards
Treatment: hospitals
1700 had 5 hospitals
New hospitals funded by rich
Volunteer doctors, untrained nurses
People preferred to be treated at home
Florence nightingale: background
Born 1820 wealthy
When 17 received religious vision telling her to serve
Trained in Germany/Paris
1853: superintendent of nurses at kings college
Florence nightingale: Crimean war
1854- Britain went to war with Russia over crimea
Went to improve hospitals with 38 others
Florence nightingale: impact in war
Ordered 300 scrubbing brushes
Treated 2000 soldiers
Provided clean bedding and good meals
Mortality rate dropped from 40-20% in 1856
Notes on nursing
1859
Gives them uniform
Standardises nurses role
Builds trust and value for nurses
Advises open windows to stop airborne diseases
Pavillion plan hospitals
Pavillion plan hospitals
Designed by Florence nightingale
Separate wards and staff
Stops spread of disease
St Thomas’s
1860
Nurses school
Became a well skilled profession
Set up by Florence nightingale
Problems with surgery
Pain
Infection
Blood loss
Small pox
Fever,scarring,killed more children than any other disease
Most feared disease in 1800
Inoculation
Giving someone a small amount of a disease to give imunity
Smallpox parties (group inoculation)
Lady Mary Worsley Montague witnessed inoculation in turkey in 1700s. Wanted to protect her children. (1721)
Became popular but wasn’t always safe - doctors made a lot from them
Edward Jenner
Born 1749
Outbreaks of smallpox in area
Given a dose for immunity then isolated to recover - many died.
Starved before to lower immunity
Doctor blew infected powder up noses
Jenner wanted to find a better way
Cowpox
Milkmaids believed it stopped them getting smallpox ( cowpox antibodies fought it off)
Tested on young boy buy putting cowpox puss into his arm then smallpox and he was fine.
Tested further 23 times.
Edward Jenner:impacts
Sent finding to royal society
Refused to publish work
1798- published own paper
‘an enquiry into the causes and effects of variola vaccinae’
Government paid him to set up vaccination clinic in London.
1852- became compulsory
Now wiped out completely
Anaesthetics:ether
Killed pain but caused vomit,coughing and was very flammable
1842-william Clarke used ether to pull a tooth
1846-robert Liston used it to amputate a leg
Robert Liston
1794-1847
Famous for quick surgery and amputation to stop deaths from shock
Once had 300% death rate
Used ether
Anaesthetics: chloroform
1847-James Simpson discovered with friends when they inhaled it and it made them unconscious
Too easy to overdose
Hannah greener - chloroform
1848-had infected toenail removed but died from too much chloroform
Hannah greener - chloroform
1848-had infected toenail removed but died from too much chloroform
Queen victoria - chloroform
Used it in childbirth 1853
Dr John snow
Made people trust it more and it became popular
Negatives of chloroform
Inhaler made to regulate doses led to more complex and in-depth surgeries and caused more infections ( still no antiseptics )
Antiseptics:carbolic acid
Joseph lister
Used to clear sewage
1865- used to bandage a broken leg and it didn’t get infected
Joseph lister
English surgeon
Studied infected wounds
Discovered flesh rots
Compared his work to germ theory
Published ‘the lancet’ which detailed 11 of his cases
Opposition to antiseptics
Blocks gods plans
Germ theory wasn’t widely believed so people didn’t understand the idea of killing microbes
Carbolic acid irritated the skins of doctors who used it
Aseptic surgery
Completely sterile
1887- steam sterilisation of instruments and PPE
1894- first time using rubber gloves
1890s- Listers methods led to aseptic surgeries
Bleeding
Ambrose poire used cat git stitches in war
Lister sterilised them
People also experimented with blood transfusions but mostly unsuccessful because of blood types so they were rejected
Public health: government attitudes
‘laissez faire’ (leave alone) at first but became more involved living conditions were squalid and cramped
Disease spread easily
Edwin Chadwick
1832-asked to investigate cholera outbreak
1842-publishes ‘report on the sanitary conditions of the labouring classes’
First public health act
Releases 1848 after another cholera outbreak
Aimed to improve conditions and encouraged health boards but wasn’t compulsory and changes were expensive so it wasn’t popular
Public health:Changes in 1860s
government took more action
1865-london built 1300 miles of sewers
Birmingham demolished slums
Public health was more recognised
Second public health act
1875-city authorities had to follow it
Provide clean water
Dispose of sewage
Built toilets
Better quality houses
Public officers to monitor
Cholera
Severe and infectious
Water born
Diarrhoea, vomiting,cramps
Can be fatal
Bacteria multiplies in small intestine
Beliefs about cholera
Miasma
Bad housing
Alcoholism
Starvation
Old age
Sinful behaviour (amoral)
John snow
Surgeon
Moved to Soho 1836
London’s leading anaesthetist
Well respected
John snow and cholera
Observed it 1848-1849
He believed that it affected gut
It was caused by contaminated water not miasma
Wrote about this in book ‘on the mode of communication of cholera’
Later backed up by germ theory
Broad street pump
Snow looked at links between water sources and cholera deaths
Drew cholera street map saw deaths centered around particular pump
A woman far away also used pump and died
Removed handle to make it unusable and deaths stopped
Germ theory
Disease caused by microbes in body
Louis Pasteur
Proved bacteria caused milk to go off ‘pasteurisation’
Believed it worked the same way in the body -decay
Created vaccines by finding things which were immune (chickens) and giving them weakened versions of diseases
Robert koch
Injected bacteria/virus into mice who became ill to proved how disease worked
Proved different microbes caused different disease
Identified 20 diseases by 1900
Henry bastion
Opposed germ theory
Powerful and influential doctor
People scared to challenge him
Stopped germ theory catching on quickly
Spontaneous generation
Idea that disease formed out of nowhere
Pushed by bastion
