Medicine - Mid 19th Century Flashcards
Why were doctors knowledge limited
-doctors observed few dissections during their training, people wanted to be buried as they thought there was life after death
-technology: no microscopes
-lack of dunging for research, gov did not feel responsible, hospitals relied on charities
-attitudes of doctors: they did not want to change anything, no proof their methods were wrong
Four Humours reasons for belief
-saw that blood was important in the body
-bile was committed out
-mucus removed from body during cold
-people became hot and flushed when sick, sometimes cold and pale
What was the four humours
-belief that imbalance of humours caused illnesses
-if illness was caused by too much of one humour, it was restored by eating or drinking something with the opposite qualities
Miasma reasons for belief
-high rate of disease in poor areas, where it was smelly
-disease spread quickly in hot weather, and there were bad smells in the summer too
What was the miasma theory
-belief that unpleasant smells and harmful fumes in the air caused and carried disease
Spontaneous generation
-theory claiming that rotting material created maggots, fleas and diseases
-rotting material such as dead animals, vegetables etc
Spontaneous generation reasons for belief
-lack of scientific research on microorganisms, no microscopes to look at microorganisms
Who was Florence nightingale and what was her background
-wealthy
-wanted to go our and train as a nurse, but it was a low status job, and her family was rich
-had no formal training in Britain, and visited many hospitals in Britain during 1840s
-spent 3 months in Kaiserwerth in Germany, where training for nurses began
-was the superintendent of a small nursing home in London
-met the secretary of war who asked her to take a team of nurses to work in the military hospital in Scutari
What did Florence Nightingale do in Scutari and what were the conditions
Conditions
-10k patients
-sharing bed, dirty clothes infested with lice
-lots of diseases
-difficult to get enough medical supplies and good
-roofs leaked and wards were dirty with mice
-hospital built above underground cesspool, affecting water supply and air
Actions
-opened windows for airflow (miasma)
-scrubbed surfaces, washed sheets, equipment etc
-cleaned kitchen, improved quality of food
-bought new supplies including 200 towels using money raised by Times newspaper
Impact of Florence nightingale in Scutari
-became popular with patients in Britain, and raised money. Nicknamed ‘lady with the lamp’
-dramatically dropped death rate in Scutari, but only after the government repaired drains and improved drinking water supply. Death rate was high than other hospitals before that
what were the conditions of towns in the 1840s
-stagnant water with bad smells
-10 sewers covered part of the street
-19 streets did not have a sewer
-water pumps from river shared by 30 families
Diseases in the 1840s
Many, but main one is cholera, where 20k were died between 1831-32 a an epidemic
How were people told to deal with cholera
-MPs left matters to local authorities
-they used measures based on miasma theory
-they burnt tar in the street and told people to keep warm and clean to remove bad air
What did John snow do with cholera
-investigated the cholera outbreak in Soho, and found deaths were around broad street pump
-discovered the epidemic started from a baby that had dirty nappies thrown in the cesspool which cracked and leaked into the pump
-found the link between cholera and infected water, and pressured water companies to improve water supplies
-little done until the great stink, so the MPs passed an act to build a new sewer system with Joseph Bazalgette chosen as the engineer to design it
Edwin Chadwick work
-wrote a report called the Sanitary Conditions of the Labouring population, where he said taxes should be better spent on better housing conditions so workhouses were not needed
-said to provide clean water and remove rubbish and sewage
-ideas had little support until cholera affect middle ad upper classes, drew attention to hygiene, where the public health act of 1848 was introduced
Public health act 1848
-set up a general board of health
-allowed towns to set up a local board of health, employ a medical officer, organise removal of rubbish and build a sewer system
-appointed 3 commissioners and Edwin Chadwick became one too for London sewers
Impact of the public health act of 1848
-very limited as the terms of the act were temporary, only lasted for 5 years
-did not force local authorities to improve hygiene, it was voluntary, only a third of towns created a board of health
-Chadwick was arrogant and aggressive, his ideas were not widely accepted
-attitudes were slow to change about local taxes being increased to help the poor
-there was n o proof that disease was linked to hygiene
How was the problem of blood loss dealt with during the mid 19th century
-tourniquets used to reduce blood flow in arteries
How was the problem of infection dealt with during the mid 19th century, how big was the problem
-very big problem as patients survived operations but often died after due to infections
-it was not dealt with during this period
What were the conditions like during surgery in the mid 19th century
-surgeon rarely washed hands before operations
-wealthy people and med students could watch the operation
-equipment was wiped, not sterilised and bandages were reused
-some operations carried out in patients homes
-surgeons had clothes stained with blood and pus
Problem of pain during the mid 19th century
-patients were awake during operations, held down by assistants
-better surgeons were quick
-only form of pain relief was alcohol, opium, or being knocked unconscious
What was the first anaesthetic and how was it found
Ether - William Morton
Tested by Robert Lister
Positives of Ether
-good pain relief as patients did not need to be held down
-were unaware that the operation had taken place when they woke up
Negatives of Ether
-caused vomitting
-irritated lungs and patients were coughing
-leaves patient asleep for days
-highly flammable and the operating theatres were lit by candles
Second anaesthetic, who founded it and it was used
Chloroform
James Simpson
-official physician to Queen Victoria and used chloroform for childbirth to deliver her 8th child in 1853
-royal approval and newspaper publicity led to chloroform being more widely used
Positives and negatives of chloroform
Benefits: no same side effects as Ether
Negatives of chloroform
-Christian church opposed it, against bible as they thought childbirth was supposed to be painful
-doctors were unsure how it would affect babies in childbirth
-difficult to get right dose and patients sometimes died from overdose
-doctors thought unconscious patients were more likely to die
-surgeons were confident for complex operations, so went deeper in the body and lead to more infections
How were the negatives of chloroform partly solved
John snow invented the chloroform inhaler in 1848
-patients could get the right dose of chloroform nearly every time
What was the black period of surgery and what was it caused by
-the death rate rose due to infection and blood loss after chloroform was invented
-surgeries carried out deeper in the body, and germs went into the body causing infections
-patients took their time in surgeries, infections were more likely
-lead to gangrene and sepsis
-death rate for amputations were around 50%
