Medicine Through Time- 19th century medicine Flashcards
What is the 19th century typically known as?
The Industrial revolution
What developments happened in the 19th century?
A great explosion of industry Urbanisation The growth of empires The growth of immense wealth, based on trade and industry Great advances in technology Improved communications The growth of science and research Democracy and socialism New ideas about evolution (Darwin) and genetics (Mendel) Wars were waged on a greater scale
How did the great explosion of industry affect medicine?
Led to industrial diseases such as dermatitis, lung disease and ‘phossy jaw’
How did urbanisation affect medicine?
Led to public health problems that included ‘filth diseases’ such as cholera and typhus
How did the growth of empires affect medicine?
Led to contact with new diseases such as yellow fever
How did the growth of immense wealth based on trade and industry affect medicine?
It created the money to spend on medical research and public health
How did advances in technology affect medicine?
Led to medical machines such as the electrocardiograph
How did improved communications affect medicine?
It allowed medical knowledge to spread - doctors gained information from all over the world
How did the growth of science and research affect medicine?
which led to medical breakthroughs
How did democracy and socialism affect medicine?
people believed they had the right to good health). The right to health was one of the ‘rights of man’ claimed by working people during the French Revolution (which was why the medical revolution of the 19th century started in France
How did new medical ideas affect medicine?
New ideas about evolution (Darwin) and genetics (Mendel) - broke the control of the Church over medicine and medical ethics.
How did wars affect medicine?
Wars were waged on a greater scale (creating mass injuries that were hitherto unknown, and required new medical and surgical techniques).
How did William Beaumont help increase knowledge about the body?
America: 1822) studied the digestive system of Alexis St Martin, a Canadian who had an open hole into his stomach.
How did Theodor Schwann help increase knowledge about the body?
(Germany: 1839) realised that animal matter was made up of cells, not ‘humours’. This was the vital breakthrough of knowledge that at last destroyed belief in the old ‘humoral’ pathology of the Greeks.
How did Henry Gray hep increase knowledge about the body?
(Scotland: 1858) wrote ‘Gray’s Anatomy’, which had over 1,000 illustrations. Many people bought a copy to own at home. After the 1870s, pupils started studying anatomy in schools.
How did Starling and Bayliss help increase knowledge about the body?
(England: 1902) discovered the first hormone.
How did Casimir Funk help increase knowledge about the body?
(Poland: 1912) discovered the first vitamins, and realised that some diseases were caused simply by poor diet.
What did Louis Pasteur discover?
Louis Pasteur (France: 1860s) discovered (by using a swan-necked flask) that germs cause disease. Before he made this discovery, doctors had noticed bacteria, but they believed it was the disease that caused the bacteria (the so-called theory of ‘spontaneous generation’) rather than the other way round.
What were one of the things Louis Pasteur’s discovery was used for?
the pasteurisation of milk, which prevented it from going sour by killing the germs and sealing it from the air.
What did Robert Koch discover?
(Germany: 1878), who discovered how to stain and grow bacteria in a Petri dish (named after his assistant Julius Petri). He was thus able to find which bacteria caused which diseases
What did Patrick Manson discover?
Britain: 1876) discovered that elephantiasis was caused by a nematode worm, and that mosquitoes were the vector (carrier). This was a breakthrough discovery, because researchers soon found out that other tropical diseases were transmitted by vectors such as mosquitoes (malaria and yellow fever) or tsetse flies (sleeping sickness).
What did Charles Chamberland discover?
(France: 1884) found that there are organisms even smaller than bacteria that also cause disease - he had discovered viruses.
How did the Industrial revolution and inventions aid the progress of medicine?
There was a general atmosphere of scientific research and advance.
Louis Pasteur’s first commission was to find a cure for sour wine, which set him off on his revolutionary course.
Joseph Jackson Lister (Britain: 1826) invented the multi-lens microscope, which allowed doctors to see very tiny things accurately.
Carl Ludwig (Germany: 1847) invented the kymograph, which allowed more accurate measurement of the pulse.
Wilhelm Roentgen (Germany: 1895) discovered x-rays.
Willem Einthoven (Holland: 1900) invented the electrocardiograph (measured heart activity).
How did scientific knowledge aid the progress of medicine?
Jan Purkinje (Czechoslovakia: 1836) set up the first university department of physiology (science of how the body works).
Louis Pasteur started as a research chemist. He set up a team of researchers at the Pasteur Institute (1888).
Robert Koch developed his Postulates of how researchers should find a disease. These led to four basic procedures - make sure the germ in question is present in the sick specimen - grow a culture of that germ - inject it into a healthy specimen - see if the disease develops.What social factors aided the progress of medicine?
Nationalism - eg the rivalry of Pasteur and Koch. Shibasaburo Kitasato (Japan) and Alexandre Yersin (France) raced to discover the plague bacterium in 1894.
The deaths of his two daughters motivated Louis Pasteur to redouble his efforts in the fight against disease.
When was Ether used as an anesthetic?
1842: Crawford W Long (America) used ether as an anaesthetic while operating on a neck tumour (but did not publish details of his operation).
1846: Dr JC Warren (America) removed a tumour from the neck of Gilbert Abbott using ether.
1846: Robert Liston (Britain) removed a leg using ether - ‘this Yankee dodge’.
What other anesthetics were used and when?
1845: Horace Wells (America) tried unsuccessfully to demonstrate that laughing gas would allow him to extract a tooth painlessly.
1847: James Simpson (Britain) discovered chloroform.
1884: Carl Koller (Germany) discovered that cocaine is a local anaesthetic.
When was chloroform discovered?
1847 by James Simpson.
What happened in 1847 which helped lower the risk of infection?
1847: Ignaz Semmelweiss (Hungary) cut the death rate in his maternity ward by making the doctors wash their hands in calcium chloride solution before treating their patients.
What happened in 1854 which helped lower the risk of infection?
1854: Standards of hospital cleanliness and nursing care rose rapidly under the influence of Florence Nightingale.
What happened in 1865 which helped lower the risk of infection?
1865: Joseph Lister (Scotland) - basing his ideas on Pasteur’s Germ Theory cut the death rate among his patients from 46 to 15 per cent by spraying instruments and bandages with a 1-in-20 solution of carbolic acid.
What happened in 1890 which helped lower the risk of infection?
1890: Beginnings of aseptic surgery - surgeons started boiling their instruments to sterilise them - WS Halstead (America) started using rubber gloves when operating - German surgeons started to use face masks.
What was discovered in 1901 which aided the process of blood transfusions to prevent blood loss?
1901: Karl Landsteiner (Austria) - discovered blood groups. Transfusions had been tried before but usually killed the patient because of clotting. Matching blood groups stopped this happening.
What was discovered in 1913 which aided the process of blood transfusions to prevent blood loss?
1913: Richard Lewisohn discovered that sodium citrate stopped blood clotting during an operation.
What happened in 1938 which aided the process of blood transfusions to prevent blood loss?
1938: The National Blood Transfusion Service was set up in Britain.
How did the industrial revolution and invention aid progress in surgery?
Wilhelm Roentgen discovered x-rays - helped internal surgery.
Public demonstrations (eg of anaesthesia) allowed knowledge of new procedures to spread.How did scientific knowledge aid progress in surgery?
The scientist Humphrey Davy had first discovered that laughing gas was an anaesthetic when working on the properties of gases in 1800.
Joseph Lister lectured in King’s College London, and published his findings in ‘The Lancet’.
How did social factors aid progress in surgery?
Queen Victoria gave birth to her children under anaesthesia (after which the general public’s fear of anaesthesia lessened). Edward VII’s appendectomy helped reduce fear of operations.
How did war aid progress in surgery?
The needs of army surgeons treating soldiers injured in battle (often requiring amputations) stimulated advance.
The Crimean War led to the development of nursing (Florence Nightingale at Scutari).
World War One led directly to the development of the National Blood Transfusion Service.
What did René Laennec develop?
France: 1816) invented the stethoscope and started the practice of ‘auscultation’ (listening to the patient’s chest).
How did Pierre Louis impact the method of diagnosis used by doctors?
(France: 1834) argued that symptoms were irrelevant, and that what was happening inside the body was much more important when it came to diagnosing illness. As a result, doctors made diagnoses on the basis of a full clinical examination of the ‘signs’ made by the disease on the body.
What did Carl Ruge develop?
(Germany: 1878) developed the technique of biopsy (removing cells to determine if they were cancerous).
What inventions allowed doctors to measure the function of the body precisely?
Carl Ludwig (Germany: 1847) invented the kymograph (which measured the pulse).
Wilhelm Roentgen (Germany: 1895) discovered x-rays.
Willem Einthoven (Holland: 1900) invented the electrocardiograph (which measures heart activity).What did Charles Chamberland discover?
Charles Chamberland (France: 1880) discovered by chance (when he left bacteria exposed to air) that injecting chickens with an attenuated (weakened) form of chicken cholera gave them immunity to the disease (ie he discovered the principle of inoculation).
What did Charles Chamberland’s discovery lead to?
Louis Pasteur developed an effective inoculation against anthrax (1881), and rabies (1885).
Albert Calmette and Camille Guérin (France: 1906) developed the BCG injection against TB.
Emil von Behring (Germany: 1913) developed an anti-toxin against diphtheria.
What did Paul Ehrlich theorize?
Paul Ehrlich (Germany: 1890s) reasoned that, if certain dyes could stain bacteria, perhaps certain chemicals could kill them without harming healthy tissues. He set up a private laboratory and a team of scientists. By 1914 they had discovered several ‘magic bullets’ - compounds that would have a specific attraction to disease-causing microorganisms in the body, and that would target and kill them. These were methylene blue (for malaria), trypan red (for sleeping sickness) and Salvarsan (for syphilis) - although Salvarsan was more effective than the other two.
Why did some people look elsewhere for cures?
Not all vaccinations were successful, and against acute infectious disease, doctors were largely powerless.
What were some of the alternative cures people tried?
A home medicine encyclopaedia of 1910 recommended cures that included electrical shocks, injection with animal hormones, and a range of harmful substances including cocaine, mercury, creosote and strychnine.
Other alternative medical treatments included mesmerism (hypnotism), homeopathy (taking tiny doses of poisons), ‘health reform’ (a religious movement which recommended a healthy lifestyle - it was run by John Kellogg whose brother invented cornflakes) and Christian Science (which taught that disease only existed in the mind).
Travelling ‘quacks’ sold patent medicines (such as Lily the Pink’s medicinal compound).
What was public health like in the early 19th century?
In the early 19th century, the growing towns of Britain were characterised by overcrowding, poor housing, bad water and disease.
What main factor led to the government trying to improve public health?
In 1848, a cholera epidemic terrified the government into doing something about prevention of disease - through both public and individual health measures.
What were their first basic health measures based on?
The first public health measures were based upon the idea that miasmas (bad smells) caused disease. Although the idea was wrong, the measures against the miasmas involved a greater focus on cleanliness, and this improved public health.
What measures were introduced to aid public health?
In 1848 the first Public Health Act caused the setting up of a Board of Health, and gave towns the right to appoint a Medical Officer of Health.
In 1853 vaccination against smallpox was made compulsory.
In 1854 improvements in hospital hygiene were introduced (thanks in large part to Florence Nightingale).
In 1875 a Public Health Act enforced laws about slum clearance, provision of sewers and clean water, and the removal of nuisances.
Why did the Government start to try and improve individual health of the poor?
When the Boer War revealed that half the population were unfit for military service, the government accepted that it had to pass laws to improve the situation of the individual poor:
What laws did the government pass to improve individual health?
In 1906 local councils were told to provide free school meals for poor children.
In 1907 school medical examinations were ordered for all children (among these examinations were those of the ‘nitty nurse’).
In 1908 Old-age pensions were introduced.
In 1911 National Insurance (free medical treatment for workers who fell ill) was introduced.
What were doctors like in the 1800?
In 1800, the doctor may have been a friend of the rich, but many doctors themselves were poor. They could do little to heal disease, and their main role was to provide comfort and reassurance.
What were doctors like in the 1900?
By 1900, doctors and surgeons occupied a highly respected place in society. They provided treatment increasingly through hospital provision, and in certain situations were able to heal their patients with surgery.
What did Thomas Percival do?
1803 Thomas Percival wrote the first book on medical behaviour.
What happened in 1823?
1823 The first issue of the the medical journal the ‘Lancet’ was published.
What happened in 1832?
1832 The British Medical Association was formed.
What did Elizabeth Blackwell do?
Elizabeth Blackwell: gained a medical degree in America (1849) and set up the New York Infirmary for Poor Women before returning to England, where she was accepted onto the Medical Register in 1858.
What did Elizabeth Garrett do?
Elizabeth Garrett: acquired a licence from the Society of Apothecaries (1865) then set up the Dispensary for Women.
What did Sophia Jex-Blake do?
Sophia Jex-Blake: studied medicine at Edinburgh University (1869), but had to take her degree in Switzerland and get her licence to practise medicine in Ireland. In 1874 she founded the London School of Medicine for Women.
Why weren’t there many female doctors?
Most male doctors were opposed to women doctors, and each time a woman found a loophole that allowed her to progress in her career, the medical profession changed the rules to stop it happening again. In 1911 there were only 495 women on the Medical Register in Britain.
