Medicine Flashcards

1
Q

Women in 1850

A

Women could not be doctors, women could be nurses
* Doctors had to go to Uni (closed to women)
* Doctors had to belong to a college (all closed to women)

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2
Q

Florence Nightingale

Improvements at Scitari

A
  • Arrived November 1854
  • Spring 1855 death rate had fallen from 60% to 2.2%
  • Deaths pealed in January 1855 with 3,168 that month
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3
Q

Florence Nightingale

Improvements in England

A
  • 1859 Wrote 2 books called “Advice on Nursing”
  • 1860 Established ‘Nightingalge training school for nurses’:
    1. Nurses should have practical training
    2. Nurses should live in a moral, disciplined home
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4
Q

Elizabeth Garret

Path to Doctorate

A
  • Attended classes for men before being banned from Middlesex
  • Joined society for Apothecaries in 1865
  • Went to Paris University to gain Medical degree
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5
Q

Elizabeth Garret

New Hospital for Women

A
  • Founded 1872 by Garret
  • Staffed entirely by women
  • 1873 Garret joined BMA, was the last woman for 19 years as they voted against further women being allowed
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6
Q

1876 Medical act

A

Allowed women to enter medicine, numbers remained low anyway

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7
Q

WW1

QAIMNS

A
  • Founded in 1902 during boer war
  • 300 women in 1914
  • 10,000 members by 1918
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8
Q

WW1

FANY

A
  • Launched in 1907
  • Specialists in First Aid
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9
Q

WW1

Women Doctors

A
  • Women were not permitted at the front
  • Dr Louisa Garret and Dr Murray led an all womens war hospital in London
  • Lack of staff at home meant more women qualified, 610 by 1911 and 1500 by 1921
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10
Q

WW2

QAIMNS and FANY

A

QAIMNS:
* Given military ranks
* Served in a range of Countries in high danger
FANY:
* Attached to the 24,000 poles that escaped Poland
* Served as radio operators

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11
Q

WW2

Women Doctors

A
  • Less impactful than WW1
  • Femal medical students 2000 in 1939 to 2900 in 1946
  • Women worked closer to battle than in WW1
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12
Q

‘Sanitary conditions of the Labouring Population’

A
  • Published 1842
  • James Chadwick
  • Highlighted the terrible conditions under which poor people were living
  • Suggested this was limiting economic growth
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13
Q

Broad Street Pump

A
  • 1854, John Snow
  • Proved Cholera was a water-borne disease
  • Deaths from an outbreak were centralised around this pump
  • When the handle was removed the deaths stopped
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14
Q

Causes of liberal reform

A

Demands of empire
* Men too weak to fight in war
* Boer War highlighted
* some areas up to 69%
Politics
* Rivalry with Conservatives and Labour pushed liberals further left
* Labour 2 seats 1900, 29 by 1906

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15
Q

Cause of reform: Demands of Empire

A
  • Britain needed strong army
  • Concern over health of troops
  • In Boer War up to 69% of soldiers unfit to fight
  • Boer war 1899
  • Committee on Physical Deterioration
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16
Q

Cause of reform: Politics

A
  • Rise of socialism in Britain
  • Conservatives promies changes
  • 1900 Labour Party formed
  • Labour, 2 seats in 1900, 29 by 1906
  • Threat led to Liberals being even further left leaning
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17
Q

2 Liberal Reforms for Children

A
  1. 1908 Children and young people act. illegal to abuse kids, commitees set up to ensure welfare, different childrens prisons, child care regulated (Difficult to enforce, conditions still harsh)
  2. 1912 School clinics, Medical treatment for Children free in schools (Standard of care varied)
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18
Q

Liberal Reform for Elderly

A

1908 Old Age Pensions act, Over 70s received 5s a week. Claimed by 650,000 people in first year, saved elderly from workhouse, same benfits nationwide. (raised taxes, not generous and could be refused to some people, rich were in uproar)

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19
Q

2 Liberal reforms for Workers

A

National Insurance Act 1911
1. Part 1, sickness benefit of 10s for 13 weeks. 16 million in scheme, included doctor fees, saved families from ruin. (Decreased after 13 weeks off, forced contribution of 4d a week, no family cover)
2. Part 2, Unemployed workers got 7s 6d a week. 2.5 million workers recieved, helped those in seasonal jobs or short term lay offs. (Families could not survive on this, only for 15 weeks, only for some trades not all)

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20
Q

1848 Public Health Act

A
  • Permissive, Board of Health encouraged action but was not mandatory
  • Allowed towns to: establish a Board of Health, employ a medical officer, organise rubbish and sewage removal
  • Disbanded in 1878
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21
Q

1848 Public Health Act limitations

A
  • Permissive
  • Terms were temporary, Board of Health ended in 1854
  • Very high cost of improving conditions locally
  • Chadwick was difficult to work with
  • Local tax increases not popular
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22
Q

1875 Public Health Act

A

Authorities had to:
* provide clean water
* dispose of sewage
* ensure only safe food was sold

Must search for dangers to public health “nuisances” and take action to fix it.

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23
Q

1876 River Pollution Prevention Act

A

Made it illegal for companies to dump waste , including chemicals into rivers

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24
Q

1875 Artisan Dwelling Act

A

Gave local governments the power to demolish slum housing.

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25
Q

Great Stink

A
  • 1858
  • Heat wave caused excrement in the Thames to dry on shores
  • Caused incredibly bad smell, near parliament
  • Showed that Thames was not a safe waste disposal
26
Q

1858 Sewers act

A
  • Parliament passed an act to build a sewer system
  • Bazalgette assigned to build it
  • £3million assigned
  • Oval shaped sewers made of brick
27
Q

Building of the Sewers

A
  • Most finished by 1865
  • Entirely finished in 1875, for £6.5 million
  • 2000 Km
28
Q

Beveridge report

A

1942 Published Will Beveridge
Wanted to address 5 problems:
1. Want
2. Disease
3. Ignorance
4. Squalor
5. Idleness

29
Q

1946 National Health Act

A
  • NHS Bill
  • Doctors would work for the government rather than privately
  • They would be paid a salary rather than per patient
30
Q

Impact of NHS

A

1948-1949:
1. 187 Million prescriptions
2. 5.25 Million glasses
3. 8.5 Million treated at dentists

31
Q

Ideas in 1850

A
  • Miasma
  • Spontaneous Generation
  • 4 humours (blood,yellow bile, black bile, phlegm)
32
Q

Germ Theory

A
  • 1861 Louis Pasteur
  • Employed to find a way to prevent milk spoiling
  • Discovered micro-organisms and that they could be killed by heating
  • Had little short term effect by 1878
  • Disproved spontaneous generation
33
Q

Effects of Pasteur

A
  • Limited short term impact
  • Surgery - 20 years later led to Joseph Listers development of antiseptic technique
  • Public Health - 30 years later vaccines could be made and treatment created due to Germ theory in 40 years
34
Q

Robert Koch

A
  • Born Germany 1843
  • Doctor who read Pasteurs work
  • Rivalry between Pasteur and Koch during Franco-Prussian war (1870-1871)
35
Q

Pasteur and vaccinations

A
  • 1879 Chicken Cholera vaccine - confirmed Jennas theory
  • 1881 Anthrax vaccine
  • 1882 Rabies Vaccine - treated a 9 year old boy
36
Q

Koch and Anthrax

A
  • 1872 discovered a method of staining microbes
  • 1876 able to identify specific microbe for Anthrax and published findings
37
Q

Koch and Bacteriology

A

Koch is “Father of bacteriology” as he found methods of staining Microbes
* 1878 Septiceamia
* 1880 growing cultures - Agar jelly
* 1882 TB

38
Q

Sylvarson 606

A
  • 1909, discovered by Paul Ehrlich team
  • Treated Syphillis
39
Q

Marie Curie

A
  1. 1910 - led team on use of radiation for use against cancer
  2. 1911 Nobel Prize, means of measuring radioactivity
  3. Outfitted and drove mobile X-ray machines
40
Q

Prontosil

A
  • Discovered by Gerhard Domagk
  • Tested on humans 1935 (on Domagks daughter near death)
  • Gained renown when used to treat FDRs son
41
Q

Penicillin Discovery

A
  • 1928 Alexander Flemming
  • Accidental discovery
  • First Antibiotic (biological killer of bacteria)
  • Flemming did very little with this
42
Q

Florey and Chain

A
  • Formed research team 1939
  • 1941 tested on humans sucessfully, on a policeman near death
  • Florey and Chain recieved huge amounts of American Goverment Funding
43
Q

Mass Production of Penicillin

A
  1. 1942, US government invest largely in Penicillin
  2. 1944, Penicillin used on mass on D-Day
  3. 1945, US army uses 2 million doses a month
44
Q

Surgery in 1850

A

3 main issues:
* Pain - all surgery very painful and had to be very fast
* Blood - large numbers of patients died from blood loss
* Infection - No knowledge of sterlisation or germs

45
Q

Anaesthetics

Use of Ether

A
  • Ether used in 1847 by Robert Liston
  • John Snow later used it
    Limitations - High Flammable, irritated lungs, unknown length of effects
46
Q

Anaesthetics

Chloroform

A
  • 1847 James Simpson discovered
  • 1848 John Snow invents Chloroform inhaler
  • 1853 John Snow used on Queen Victoria
    Limitations - Christian opposition, untested
    Longer surgeries meant more blood loss and infection
47
Q

Anaesthetics

Other Anaesthetics

A
  • 1884 Cocaine (addictive)
  • 1898 Heroine (addictive)
  • 1905 Novocaine (less addictive)
48
Q

Antiseptic

Semmelweis hand washing

A
  1. Semmelweis encouraged doctors to wash hands after handling corpses before delivering babies. Decreased infection in child birth. Semmelweis seen as crazy and later incarcirated.
49
Q

Antiseptic

Carbolic Acid

A
  • First used 1860s, Lister
  • Added onto surgical wounds
  • Noticed more survival in compound fractures and other air-exposed injuries
  • 1866-70 Listers death rate fell from 45% to 15%
50
Q

Limitations to Antiseptic

A
  • Methods were not reproduced correctly, so thought to be false
  • Opposition to Germ theory
  • Carbolic Acid irritated surgeons skin and was expensive
51
Q

Antiseptic

Aseptic surgery

A
  • 1878 Koch Steam Steriliser
  • By 1887 all instruments had to be sterilised before use
  • Ensured no germs ever entered the surgery
52
Q

Bloodloss

Lister and Catgut

A
  • 1881
  • Lister discovered Catgut ligatures
  • These prevented blood loss but later dissolved in the body
  • Could be soaked in Carbolic Acid
53
Q

Blood loss

Blood Groups

A
  • 1901
  • Landsteiner discovers blood groups
  • Makes it possible to give succesful blood transfusions
54
Q

WW1

Blood

A
  • 1910s discovered that anticoagulant meant blood could be stored
  • First non-direct transfusion in 1914
  • First blood bank on Western front in 1917
55
Q

WW1

X-rays

A
  • X-rays discovered 1895 by Rontgen
  • Marie Curie payed for mobile X ray machines with her own money
  • More machines in Field Hospitals
  • Limitations, could not detect clothing in wounds and required patients to be still
56
Q

WW1

Infection

A
  • A-septic conditions were impossible
  • Cut away infection and bathe in saline was preffered method
  • This was the Carrel-Dakin method
  • Injuries often still led to amputation
57
Q

WW1

Thomas Splint

A
  • Held femur fractures open to prevent compounding of break
  • 1914 80% of femur fractures died, 1916 80% survived
58
Q

WW1

Skin Grafts

A
  • Shrapnel lead to terrible face injuries
  • Harold Gillies assigned to solve issue of facial injuries
  • Specific hospital in Sidcup, treated 2,000 patients after the Somme
  • Facial reconstruction became a key part of rehabilitation
59
Q

1920s to 1940s

Blood transfusions

A
  • Soviet Union set up national blood banks in 1930s
  • Dr Charles Drew discovered blood could be seperated into blood and plasma 1940s
60
Q

1920s to 1940s

Plastic surgery

A
  • 1916, Vladmir Filatov developed first Skin Grafts
  • 1920 Gillies and Kilner published Plastic Surgery of the face
61
Q

1920s to 1940s

Burns

A
  • McIndoe made RAF surgeon in 1938
  • McIndoe operated highly experimentally on burned pilots, ‘guinea pig club’
  • Got East Grinstead residents involved with visits to normalise the patients