Medicine 1800-1900 Flashcards
A Revolution in medicine
Previous ways to dull pain
alcohol religious (pray/sing hymns) mandrake, opium, hashish
problems with medieval painkillers
opium - difficult to judge an effective does from a lethal one alcohol - made the heart beat faster so bleeding became harder to control religious - did not work
When was nitrous oxide (laughing gas) discovered?
discovered in 1795 1800 - Humphry Davey published an account on its effects
what were the effects of Nitrous oxide?
made you laugh, feel giddy and relaxed
problems with nitrous oxide
it was difficult to find the right dose sometimes patients woke up in the middle of operations
first uses of ether
1842 - (william morton) made a public demonstration of ether 1842 - (crawford long) removed a neck growth from a patient 1846 - (robert liston) leg amputation
disadvantages of ether
difficult to inhale (administer) caused vomiting highly flammable (no electricity most used torch light)
discovery of chloroform
1847
who discovered chloroform
James Simpson (when he was testing out mixtures of chemicals and then spilt it causing him and his fiends to fall asleep/unconscious)
problems with chloroform
- it was hard to gain an exact does and it could be dangerous/lethal - the healthier the more likely you were to die because you inhaled more in - Hannah Greener died from an overdose in 1848 during an operation to remove her toenail
how anaesthetics made a contribution
- surgeons could do longer operation - 1850 - Queen Victoria successfully gave birth using chloroform which changed attitudes towards painkillers
how anaesthetics did not make a contribution
- army surgeons in the Crimean War (1853-56) thought that soldiers should put up with the pain - anaesthetics did not battle infections so death rates were still high - religious oppositions was that childbirth pain was a punishment from God - patients died from incorrect dosage
why did surgeons stop using chloroform/painkillers
- having no pain allowed for longer operations = more exposure to unclean environment = patients often got infections that would later kill them - death rates rose - surgeons stopped using painkillers in 1870s
Coca leaves
1850 - coca leaves from South America were used to produce cocaine as a local anaesthetic
why did cocaine become popular?
- only affected small regions of the body - safer doses and easier operation - 1891 - it could be chemically produced
louis pasteur background
- son of a sergeant major in the Napoleonic war - strong passion for his country, France - 1843 - became a research chemist
germ theory date
1859
germ theory explanaintion
disproved spontaneous generation but rather that infection/breakdown was due to microbes in the air (that could cause disease)
germ theory proof/experiment
- an open top flask and a specially designed swan neck flask, both had beetroot juice - left out for a few days - open flask gained an odor whereas the swan neck flask remained perfectly fresh
why did the swan neck flask work
the curve in the neck allowed for air to reach the juice but didn’t allow any dust particles through thus stopping bacterial growth
what did pasteur do in 1848?
- proved identical molecules can exist as mirror images but noticed living things created left-handed molecules - step forward in microbiology - underpins modern drug development
what did Napoleon III ask louis pasteur?
1863 - why wines would go off and how to prevent it - French economy was suffering due to the wine spoiling before reaching client countries
development of pasteurisation
spoiled wine contained microbes so pasteur tired killing microbes with heat - high temperature = bad taste -low temperature = not all the microbes killed
pasteurisation (finished process)
pastuer found that 55°C was high enough to kill microbes but low enough to not spoil the taste
pasteur on silk worms
1865 - asked to investigate disease affecting silkworms (that was causing problems in the economy) - he worked out that the infection was transmitted by parasites and showed how infected worms could be isolated and destroyed
how did pasteur immunise chickens against cholera?
- accidentally left a culture of chicken cholera out - injected some healthy chickens with it - the chickens survived - injected with fresh cholera culture - survived, they were immune
what did the chicken cholera vaccine show?
that you could create vaccine in a laboratory by weakening the disease through exposure to air, thus creating a weaker strain
when did pasteur discover the vaccine for anthrax?
1881
pasteur and rabies
1885 - he found the vaccine against rabies by applying the same logic he used for the chicken cholera tests were successful on animals so he later tested on Joseph Meister who was bitten by a rabid dog, it worked.
opinions on pasteur’s findings (French press)
“i am afraid that the experiments you quote, M.Pateur, will turn against you. The world into which you wish to take us is really too fantastic” - La Presse
pasteur’s main problems
Pasteur was convinced that microbes caused disease in humans, but he was never able to directly link one microbe with a disease. People could have doubts because of this.
robert koch - background
- poor mining family - studied medicine, mathematics and natural science - a doctor with a detailed understanding of the human body (unlike Pasteur) - difficult to work with
what happened in 1868 (koch)?
French doctor showed animals injected with anthrax infected blood caught the disease - koch continued this work - koch found the anthrax microbe produced spores that lived after the animals death - proved spores could develop into the germs and infect
koch and septicaemia
1878 - he identified the germ that caused blood poisoning and septicaemia
what did koch develop
new techniques to carry out experiments that influenced many other scientists
koch and dyes
discovered methyl violet dye showed up the septicaemia germ under a microscope by staining it he also photographed germs so that people out side his laboratory could see them
koch and TB
1881 - announced he had found the germ causing TB
what were microbe hunters?
the new generation of scientists inspired by koch and pasteur (including Paul Ehrlich)
Pasteur overview
1848 - mirror image molecules 1859 - germ theory (swan neck experiment) 1863 - pasteurisation 1865 - silkworm isolation/disease 1879 - chicken cholera vaccine 1881 - anthrax vaccine 1885 - rabies vaccine
koch overview
1868 - worked on anthrax, showed infection spread 1878 - identified septicaemia germ - new scientific experiment technique - methyl violet dye discovered - photographed germs/microbes 1882 - found TB germ
Paul Ehrlich - background
- introduced into cellular staining by family - continued work on cellular staining He reasoned that chemical agents could be used to heal diseased cells or to destroy infectious agents
Paul Ehrlich discoveries
- a new way to stain the tuberculosis bacterium - differentiated between different types of blood cells of the body - discovered uses of methylene blue in nervous conditions and for dyes
Paul Ehrlich and syphilis
1909- Salvarsan 606 helped treat syphilis and became known as the magic bullet.
magic bullet
Salvarsan 606 only targeted the infected cells
what happened during the cattle plague?
1866 - many still believed in spontaneous generation - farmers were reluctant to kill infected cows - disease spread very quickly
solution to the cattle plague
- government appointed Lionel Beale to investigate - only quarantining seemed to work but lead to food shortages - found that a specific microbe was responsible
effects of the cattle plague
-showed that the microscope could be useful to everyday life - the germ theory was correct
charles bastion
- professor of anatomy - high level individual - 1860s wrote articles that argued for spontaneous generation theory
john tyndall
- highlighted bastion’s errors - lectured on dust and disease and about koch - demonstrated the existence of tiny microbes in the air
contagionists - causes of disease
infection was spread by contact with infected individual or bacteria
contagionists - solutions
- epidemics controlled by quarantine or preventing contact - they could not explain why some people did not always get the disease despite contact
anti-contagionsist - cause of disease
- diseases like cholera, plague and typhoid were caused when infections interacted with the environment - linked with the miasma theory
anti-contagionsists - solutions
- epidemics controlled by cleaning up the environment - couldnnt explain why it worked
typhoid fever - effects
- changed many ideas on spontaneous generation - germ theory became widely accepted - government attitude started to change
Cheyne and Robert koch
1879 - translated koch’s work and wrote about his findings - having many others support and spread koch and pasteur’s theories persuaded many
william dallinger and john drysdale
1874 - microscope research into life cycle of germs
Franco-prussian war
1870-71 - created a large rivalry between koch and pasteur which pushed them to discovery
ignas semmelweiss
in 1847 used antiseptics to lower death rate from 35% to 1% but few followed suit
Joseph lister - carbolyic acid
recommended the use of carbolic acid for surgery as an antiseptic: room sterilised, surgical equipment sterilised and the wound also wrapped in carbolic acid soaked dressings
Joseph lister - numbers
rate or infection dropped from 50% to 15% in 4 years
joseph lister’s invention
1871 - machine that sprayed carbolic acid around the room and patient during surgery
joseph lister’s invention negatives
- carbolic acid dried skin and irritated lungs - took a long time to prepare
joseph lister downfalls
- still operated in usual clothes - still believed microbes were simple only one type
reasons for opposition to joseph lister
- jelousy - opposed to change - inaccuracies could cause increased mortality rates - british military surgeon said it was good to hear the shout and brawl of patients, not die quietly
charles chamberland
1881 - steam sterilizer for medical instruments
gustav neuber
- insisted on throughly scrubbing staff before entering - first sterile operating theatre - air was sterilized - published results in 1886
berkeley moynihan
- first british surgeon to use rubber gloves but he was ridiculed - facemasks. gloves, surgical gowns, smaller operating theatres reduced infections
joseph lister’s success
1865 - mended a fractured boy’s leg and wrapped it in dressing soaked in carbolic acid, it did not get infected and he recovered (usually gets infected and leads to amputations)
florence nightingale
- during the Crimean War (1853-56) she took notice of the dirtiness and deterioration of the military hospitals so improved cleanliness and sanitation - she helped bring down the death rate from 40-2% - Nightingale fundamentally changed the role of nursing in hospitals - key figure in introducing new professional training standards -she published “notes on hospitals” in 1863 setting out her principals for running clean, safe and well-ventilated hospitals
Elizabeth garret anderson
1872 - set up the New Hospital for Children and Women 1874 - set up the London School of Medicine for Women
how much did population increase?
1801 - 16.3 million 1901 - 41.6 million
main diseases for the general public
typhoid (contaminated food and water) tuberculosis (passed by sneezing and coughing) cholera (contaminated water)
main disease/injury for workers
coal miners - pneumoconosis (lung disease) factories making match heads - “phossy-jaw” (jaaw would be eaten away and could also include brain damage) this was due to the inhaled phosphorus fumes machines in factories didn’t have guards so often limbs got stuck and many people died or needed amputations
when were the cholera epidemics?
1831-32, 1848, 1854, 1866
what did people think caused cholera?
the great stink of the Thames, which was full of sewage
when did parliament leave London due to the Great Stink?
1858
when did John Snow publish?
1849 (after the 1848 epidemic) On the mode of communication of cholera
john snow’s discovery
-he mapped the location of each death and worked out that they all collected their water from the local water pump -he removed handle of pump -later discovered that a cesspit 1 metre from the water pump was leaking dirty water into the drinking supply
what was Laissez-faire
“do nothing” the attitude many people shared that the government should not be involved in public matters or health
edwin chadwick
sectretary to the poor law commissioners from 1834
- used statistical methods of investigation to explore the link between ill-health and poverty
- he wrote the influential 1842 “Report on the Sanitary Conditions of the Labouring Population” (established links between poor living conditions, disease and life expecatancy)
- the report urged to improve living conditions
- healthier workers = better work = better for the rich
joseph balzagette
in 1858 was given £3 million to start planning an underground sewage system for london
(finished in 1866, cholera never returned)
what was the Sanitary Act?
1866 - made councils responsible for sewers, water and street cleaning.
each town had a health inspector
when did the working class men get the right to vote?
1867 - this lead to political parties making promises about improving living and working conditions to get elected
what was the second public health act?
1875 - forced local communites to appoint medical officers to be responsibel for public health
councils were ordered to:
- cover up sewers and keep them in good condition
- supply fresh water
- collect rubbish
what was the artisians dwelling act?
1875 - made house owners responsible for keeping their properties in good order
- it also gave local councils the power to buy and demolish slum housing if it did not improve
