Medicine: 18-19th Century Flashcards
Reasons for medical process in the 18th and 19the centuries:
- Church
- Government
- New technology
- University
- Questioning
- Industry
- Many were Christians but the Church had little power over people’s lives (fewer would believe in superstitious causes and treatments)
- There was a monarch but an elected gov. ran the country (gov. would have to start improving health to get votes)
- New forms of travel (e.g. railway) and communication meant ideas spread quickly (new medical research could be shared and developed)
- Many university educated individuals made key discoveries (several medical breakthroughs made)
- People asked questions and challenged old ideas (idea of miasma was challenged)
- Industrialisation meant new machines, chemicals and materials were made (better research equipment meant new treatments could be developed)
How significant was Edward Jenner in the history of medicine?
Smallpox
- Spread quickly through coughing and killed 1/3 of those infected
- Left horrific scars which left victims outcasts from society if they survived
How significant was Edward Jenner in the history of medicine?
Inoculations
- Built up a person’s immunity to the disease but was too expensive for most
- Some people died from the small dose of smallpox or also became carriers of the disease
How significant was Edward Jenner in the history of medicine?
Jenner’s vaccine
- He realised local dairy maids rarely caught smallpox but believed they caught the milder cowpox instead
- 1796 he cut open a cowpox pustule on a dairy maid’s arm, injected it into 8 year old James Phipps, inoculating him with a mild form of smallpox
- A few days later and James Phipps never caught smallpox
- Jenner tested his theory 23 more times after this
- 1798 published his results and sent it to the Royal Society
Jenner’s discovery was significant:
- Encouraged other scientists to solve medical problems and use scientific methods
- Inoculation was only other treatment for smallpox and was very expensive and risky
- Vaccination was risk-free and free since government gave money to pay for free vaccinations
Jenner’s discovery was not significant:
- People didn’t like idea of treatment linked to animals
- They thought that they would develop cow features
- Didn’t believe Jenner as he wasn’t a famous doctor
- Governments were slow to make vaccinations compulsory
Who was Robert Koch?
- German doctor
- Part of government-funded research team
- Motivated by national rivalry against France after recent Franco-Prussian War
- He competed with Pasteur to make scientific discoveries
What did Robert Koch discover?
- Discovered The specific bacteria that caused anthrax (1876) then the specific bacteria causing tuberculosis (1882)
- The process of isolating these different germs allowed other doctors to produce vaccines for different diseases
What did Robert Koch do to test his theory?
- He extracted the anthrax bacteria from an infected sheep then injected it into a mouse, watching the mouse develop anthrax
- He repeated the scientific method many times to prove it was correct
What did scientists believe were the causes of disease in 1855?
- Miasma
- Spontaneous generation (scientists observed with microscopes that decaying matter produced microorganisms, which leads to rotten food)
What did Pasteur discover in 1857?
- Wine industry had payed him to investigate why barrels of wine were going off
- He used microscope on wine and found microorganisms
- This means that microorganisms was the cause of decay, not the product of decay
When did Pasteur publish his ‘Germ Theory’ and what did other scientists think of it?
1861
- Pasteur said that if wine is effected by germs, humans can be too
- Many leading scientists and politicians doubted this as he had little proof
What experiment did Pasteur conduct in 1864 to prove his Germ Theory correct?
Swan necked flask experiment
-Proved that germs must exist in the air and are not produced by decay
Who influenced Pasteur’s work in 1880?
- Koch had previously found ways to isolate germs, proving Pasteur’s Germ Theory (on germs causing disease) correct
- Pasteur studied Koch and Jenner’s work to help him isolate and weaken the germ causing chicken cholera
- He successfully developed a vaccine
When did other scientists start believing and using Pasteur’s work?
1885
- Pasteur used air to weaken a disease
- He used this weakened strain of a disease to create a Rabies vaccine which he used to save the live of a boy bitten by a rabid dog
- Scientists started to use his work to develop many more vaccines
What did Florence Nightingale do?
- Although she came from a wealthy family, she trained as a nurse.
- When Crimean War broke out in 1854, she took 38 nurses to Crimea.
- At the army hospital in Scutari she was appalled by the dirty conditions and concentrated on cleaning the hospital and patients.
- This was so effective that the death rate in the hospital fell from 40% to 2%. She invented the pie-chart to present her data.
- She wrote about this to the British government.
- Being seen as a heroine helped her raise money to set up her first Nightingale School For Nurses In 1860.
- She wrote Notes On Nursing’s in 1859 and Notes On Hospitals In 1863.
There was change in hospital care due to Florence Nightingale:
+ Nightingale made nurses keep wards and patients clean, therefore preventing the spread of infection in hospitals.
+ She improved equipment and sanitation: water was clean, sewers, drainage and toilets were improved.
+ Nightingale ensured that ventilation was improved so that fresh air could circulate and patients could breathe clean air.
+ Hospitals went from being a ‘gateway of death’ where patients did not expect to leave, to a place for them to recover.
+ Her work was published due to her wealthy family having connections in The Times, so more people were alerted on sanitation.
+ Nightingale wrote a book on nurse training and set up a school for nurses. This turned nursing into a profession and trained them to care for patients and keep hospitals clean.
There was continuation in hospital care due to Florence Nightingale:
- Nightingale still believed in the miasma theory for the causes of disease.
- When Pasteur’s germ theory was published she refused to let nurses be taught about it because she feared it would get in the way of their duties of keeping hospitals and patients hygienic and clean.
- The poor still had to pay to use hospitals until 1867 (when the gov used taxes to pay for hospitals, which took time to develop).
- Partially the reason she became famous and her ideas became noticed was because she came from a wealthy family, so had connections in The Times.
What was James Simpson’s discovery?
- Simpson was a Professor of Midwifery and wanted to find a better anaesthetic to help women during childbirth because anaesthetics like ether had dangerous side effects like coughing during surgery.
- 1847 whilst experimenting at home with his colleagues, he found that chloroform was an effective anaesthetic.
- Chloroform has no side effects that has and is stronger than alcohol and laughing gas.
James Simpson’s discovery was an important breakthrough:
+ He published his findings in the paper.
+ 1857 Queen Victoria used chloroform during the birth of her 8th child.
+ Lead to more deaths from blood loss and infection as doctors attempted more complex operations as they felt like they had more time without patients screaming.
James Simpson’s discovery was not an important breakthrough:
- Chloroform had already been discovered 15 years prior.
- The young, fit and fearful were dying as they breathed in more chloroform at a time.
- Chloroform slows down heart cells and only half a teaspoon is enough to kill.
- Simpson didn’t accept the dangers of chloroform despite the fact that hundreds of patients were dying.
- John Snow invented the inhaler to regulate the dosage and make Chloroform safe.
What was Joseph Lister’s discovery?
- Pasteur’s discovery convinced him that germs must be the cause of infections in wounds so he searched for a way to stop them.
- 1864 Lister read about carbolic acid killing germs in sewage and thought he could use it on wounds.
- He also encouraged using carbolic acid as hand wash.
- Lister developed a spray to kill germs in the air around the operating table.
Joseph Lister’s discovery was an important breakthrough:
+ Carbolic acid was an effective antiseptic which prevented infection in surgical wounds.
+ The surgical death rate fell from 46% to 15%.
+ Later his ideas were developed into aseptic surgery.
Joseph Lister’s discovery was not an important breakthrough:
- Many were slow to start using carbolic acid.
- They thought the idea of germs was ridiculous until Koch proved it to test Pasteur’s theory.
