medicine Flashcards
1
Q
Use of ether
A
- Robert Liston in 1846 used ether during an operation to amputate a leg.
- People watching were astonished to see that he didn’t need to be held down, and he woke up not remembering the operation
- There were problems. Caused vomiting and irritated the lungs, making patients cough, and it could leave the patients asleep for either hours or days
2
Q
chloroform
A
- James simpson 1847
- wanted to find a better anaesthetic, and carried out experiments inhaling various gases
- He discovered chloroform was an effective anaesthetic, and did not seem to have the same side effects as ether
- Simpson used chloroform on women in 1847 in childbirth. He used it on Queen Victoria in Scotland in 1853, and due to the royal approval, patients started requesting for chloroform in their operations
3
Q
CHLOROFORM PROBLEMS
A
- The christian church was opposed to the use of it during childbirth
- Many doctors were opposed to the use of it during childbirth because it was not known how it would affect the baby
- It was difficult to get the dose right
4
Q
EFFECTS OF CHLOROFORM
A
- Gave surgeons more time to work, so they could carry out more complicated operations and go deeper into the body
- Still did not understand hygiene and infection, so they would still do the same unhygienic practices, but now going deeper into the body causing horrible infections
- The increased length of time for operations caused problems eg if the blood supply to a part of the body was cut off for too long, increased risk of gangrene
- John snow made an inhaling device that would control the dose of chloroform
5
Q
PROBLEMS IN BRITISH PUBLIC HEALTH
A
- A family would often live in a single room and 50 or more might live in one house
- Houses were damp, with little ventilation
In bad weather, tye ground floor could become flooded - A single privy might be used by 100 people
Water was collected from a local pump sharing 20-30 families - The water was often taken from polluted rivers
Disease spread rapidly
6
Q
THE CHOLERA THREAT
A
- Killed quickly - sometimes within a day
- Symptoms involved general pain, muscle spasms, extreme vomiting and diarrhoea
- Approximately 20,000 people had died in the epidemic of 1831-32
7
Q
EDWIN CHADWICK AND THE 1848 PUBLIC HEALTH ACT
A
- Set up a general board of health
- Allowed towns to set up their own local board of health, employ a medical officer, organise the removal of rubbish and build a sewer system
- Appointed three commissioners for the board of health; Chadwick was one of the three
- Commissioner for london’s metropolitan commission of sewers from 1848-49
- The impact was really limited
- The terms were temporary - the board of health only was set up for 5 years
- Allowed, but didn’t force so most did not take action
8
Q
JOHN SNOW AND THE BROAD STREET PUMP
A
- He investigated an outbreak of cholera in london using scientific methods to observe
- He came to the conclusion that cholera was caused by dirty sewage/drinking water
- Snow’s work had demonstrated the link between cholera and infected water and this put pressure on the water companies, local authorities, and parliament to improve water supplies
9
Q
PASTEUR’S EXPERIMENTS
A
- He carried out experiments on milk, wine and vinegar
- He became convinced that liquids were being contaminated with microorganisms that floated in the air
- He proved that the idea of spontaneous generation was wrong by leaving a mixture in a container that was open, the mixture would go bad and microorganisms would be seen in it - however, if he heated the mixture and prevented air from reaching it, the mixture did not go bad
- General date given for pasteur’s germ theory is 1861 because this is when he published his experiments
10
Q
IMPACT OF GERM THEORY ON SURGERY
A
It led to an understanding of why infection often developed after an operation and to Lister’s development of antiseptic techniques.
11
Q
Improvements in surgery: Lister and the impact of antiseptics
A
- In one case, an 11-year-old boy was brought into the hospital with a broken leg. Usual treatment would be amputation as the bone was sticking out the skin, but lister set the broken bone and covered the wound in carbolic acid-soaked bandages. The wound healed without infection.
- He began to use carbolic acid to clean wounds, equipment and bandages in all his operations
- The death rate from infection dropped dramatically
12
Q
OPPOSITION TO LISTER’S METHODS
A
- The spray made instruments slippery, and difficult to grip which slowed the operation
- Spray made doctor’s hands cracked and sore
- Some doctors didn’t use it properly and didn’t find them effective
- Extra time in dressing wounds
- He kept adjusting techniques - people were worried that he wasn’t confident
13
Q
The significance of Public Health Act (1875)
A
There was pressure on the parliament to get involved
The public health act 1875 made local authorities responsible for:
- the supply of clean water
- dealing with sewage in a way that would prevent it polluting the water used for drinking and washing
- building public toilets
- ensuring that new housing was built to good standards
- inspecting conditions in lodging houses
- employing health inspectors to make sure regulations were obeyed
- creating street lighting to avoid accidents
- checking the quality of food on sale
This act was hugely significant as it reflects the way that the attitude was changing and parliament was now passing laws to enforce a national standard of public health
14
Q
Nightingale and continuing improvements in hospitals and nursing
A
- Newspaper reports of her work in the Crimea had made Nightingale famous
- When she returned to britain in 1856, she was seen as an expert in working on nursing
- She did very little nursing personally but she was an excellent organiser and manager
- For this reason, she had a major impact on hospitals
- She wrote multiple books such as notes on nursing in 1859 which gave advice on the importance of ventilation, bedding, cleanliness and food for patients
- The books had a great influence even outside britain, and was translated into 11 different languages
- In 1860, the nightingale school for the training of nurses was established at st thomas’s hospital in london
15
Q
Elizabeth Garrett and the progress of women in medicine
A
- Elizabeth blackwell was an english woman whose family had moved to the USA, where she became the first woman to qualify as a doctor
- She met garrett in one of her lectures
- Garrett’s family was shocked at her dream of wanting to become a doctor
- She became a nurse at middlesex hospital and attended lectures that were provided for the male doctors - until they complained
- Garrett applied to study medicine at several medical schools but they all refused to accept a woman student
- She completed her course of medical training but she could not be licensed
- Garrett’s father - now supported her and threatened to sue the society of apothecaries if it did not accept her
- She opened st mary’s dispensary in london to provide medical treatment for women
- She went to paris for a medical degree
16
Q
what did he want to do, how did he do it?
Koch.
A
- Koch wanted to prove that it was the anthrax microorganism which caused the disease
- After he was gifted a microscope, he set up a small lab in his home in 1872 and published his work in 76
- He developed methods of staining and photographing microorganisms
- He published his works of bacterial infections in wounds in 1878
