Medicine - Unit 3 : Industrial Revolution Medicine

Question 1

Medical beliefs post 1800s

Answer 1

• An infection is the invasion of the body by microbes ; different microbes cause different diseases
• Medicines made by machines = accurate doses given and mass production = increased variety of medicine = companies founded like Boots the Chemist
• Public health reformers argued that cleaning up the environment would stop epidemics
• Bacteria, or germs, were the real cause of medical infections; infections were a biological, not chemical process = Germ Theory
• Self help books like Mrs Beeton’s ‘The Bookof Household Managements’ told people how to treat themselves at home using Laudanum and opium

Question 2

Why was Louis Pasteur significant to the development of medicine?

Answer 2

• Came up with the Germ Theory in 1861
• Known as the ‘father of microbiology’ : he discovered that germs existed in food and drink = invented pasteurisation (long term significance)
• Knew that bacteria caused illness and knew how to treat them
• Found vaccines to chicken cholera, anthrax and rabies (long term significance)
• Influenced other key individuals (Robert Koch and Paul Ehrlich)

Question 3

What did Robert Koch do?

Answer 3

• Identified that not all bacteria was the same : some germs were more responsible than others for causing diseases
• Used experiments to back up his work

Question 4

What did Paul Ehrlich do?

Answer 4

• Worked won’t Robert Koch to discover chemical cures for a bacterium
• Called them ‘magic bullets’

Question 5

Why was Louis Pasteur less significant to the development of medicine?

Answer 5

• His ideas were ridiculed by some scientists
• His ideas weren’t immediately accepted in Britain
• Koch had a greater influence on treatments and preventions as he managed to differentiate the germs

Question 6

What is an anaesthetic?

Answer 6

A substance that induces insensitivity to pain

Question 7

Anaesthetic - NITROUS OXIDE

Answer 7

• Thomas Beddoes and his assistant, Humphrey Davy experimented inhaling the gas
• Davy = gas made him laugh and feel giddy but they didn’t recognise its medial value
• Was used for a while as a fairground novelty : ‘laughing gas’
• An American dentist used it as anaesthetic to remove one of his own teeth

Question 8

Positives and negatives NITROUS OXIDE

Answer 8

Positives:
- Cheap and readily available

Negatives :
- Didn’t take away any pain and didn’t keep the patient asleep
- Wasn’t used in medicine until a long time after it was discovered

Question 9

Anaesthetic - ETHER

Answer 9

• Used by William Clark in 1842 (American dentist) for a tooth extraction and doctors took notice when another doctor used it to remove a neck growth in another patient
• Robert Liston (renowned British surgeon) used it in a leg amputation

Question 10

Positives and negatives of ETHER

Answer 10

Positives :
- Could be used in both minor and major surgeries/ procedures from tooth extraction and amputations

Negatives :
- Difficult to inhale
- Caused vomiting and it was highly flammable : lots of surgeries occurred in front of open fires at home as people preferred this
- it was very expensive

Question 11

Anaesthetic - CHLOROFORM

Answer 11

• 1847 : Scottish doctor James Simpson discovered it when one of his friends knocked over a bottle of it and when his wife came round with dinner they were all asleep peacefully

Question 12

Positives and negatives of CHLOROFORM

Answer 12

Positives :
- Induced sleep easily
- Still commonly used as anaesthetic today
- Queen Victoria used it during childbirth

Negatives:
- Needed specific doses for different sized people = easy to get wrong and do harm to a patient
- e.g. Hannah Greener died in 1848 in a procedure to remove an ingrown toenail as she was given too much
- Lots of people criticised it as he discovered it by accident not through experimentation

Question 13

Opposition to Anaesthetic

Answer 13

• Religious objections (believed that experiencing pain was God’s will
• inconsistency: dosage made it dangerous to some patients
• Discoveries were prior to the Germ Theory = people believed they died by the anaesthetics when it was actually from infection

Question 14

Public health in the 1800s in Industrial Towns

Answer 14

• Overcrowded = disease spread quickly
• Houses were built quickly with little attention due to rapid migration
• Up to 30 people shared a communal toilet (privy) with the waste transferred to a cesspit
• Waste would go into open sewers or drains
• Water from a shared water pump
• Very smelly due to both human and animal waste in the streets - the ‘Great Stink’ in 1858
• Industrial diseases : chimney sweeps with soot and gases; phossy - jaw caused by phosphorous fumes from making match heads; coal miners developed pneumoconiosis; machines in textile factories were unsafe
• Food : chalk added to flour and milk
• Contagious disease : typhoid, measles, chicken pox, whooping cough spread in poor and overcrowded conditions
• 57% of children died before the age of 5
• Avg death for a labourer = 15

Question 15

1848 Public Health Act : Successes and Failures

Answer 15

SUCCESSES :
- Set up a General Board of Health
1. Allowed town to organise the removal of rubbish
2. Allowed town to build a sewer system.
3. Allowed towns to set up their own Board of Health

FAILURES :
1. Didn’t force towns unless the death rate surpassed 23 per thousand living
2. Only a third of towns set up a Board of Health and fewer imposed a medical officer
3. Terms of the Act were temporary as in 1858 the General Board of Health was abolished

Question 16

1875 Public Health Act : Successes and Failures

Answer 16

SUCCESSES :
1. 1866 Sanitary Act = forced all towns to appoint inspectors to inspect water and drainage
2. Made local councils responsible for clean water, public toilets, rubbish removal, sewers and drainage
3. After 1975 local councils are responsible for : food quality, improving housing quality and enforcing laws against polluting water supplies

FAILURES :
- Basic services such as water, lighting and paving were still in the hands of private companies and individuals

Question 17

Compulsory Vaccinations : Successes and Failures

Answer 17

SUCCES :
- Made compulsory in 1852

FAILURES
- Not enforced strictly until 1871

Question 18

Similarities in Medieval Public Health and 1800s Public Health

Answer 18

• Cesspits and no sewage systems
• Miasma was a common belief
• Disease were even worse than before due to dense populations in small areas
• Lack of scientific knowledge

Question 19

Differences in Medieval Public Health and 1800s Public Health

Answer 19

• 1800s = began to implement proper drainage systems
• Higher population in towns in 1800s meant dirtier streets = more disease whereas medieval lived very rural with sparsely populated villages
• Industrialisation = worsened public health due to industrial disease and unsafe working conditions

Question 20

Symptoms and treatments for cholera

Answer 20

SYMPTOMS :
- Copious and uncontrollable diarrhoea
- Shrivelled skin
- Collapsed eye sockets
- Blue complexion from oxygen deficiency
- Muscle spasms

TREATMENTS :
- Opiates
- Bleeding
- Burning the skin

Question 21

Response from government cholera outbreak and why they were unsuccessful

Answer 21

• Quarantine
• Cleaning up nuisances - things perceived to be smelly and dirty (miasma

Why these were unsuccessful :
1. People didn’t understand the disease
2. Caregivers didn’t know to wash their hands = spread faster
3. Overcrowding = contamination spread easily

Question 22

Cholera outbreaks

Answer 22

1st : 1832 - Over 55,000 died
2nd : 1848 - was global with high death rates and 52000 died which is 2x as many died in London in 1832

Question 23

Florence Nightingale

Answer 23

• Reduced death rates in field hospitals during the Crimean War by improving sanitation and cleanliness : changing bedsheets, more clean water
• Improved sanitisation and ventilation in British hospitals
• Founded a trading school for nurses at St Thomas’ Hospital in London
• Was significant in the development of public health in the 1800s.

HOWEVER

• Ideas were not supported because the miasma theory was still dominate, as the germ theory was unknown.
• Failed to inspire government officials to take action against public health as they had a laissez-faire attitude.

Question 24

John Snow

Answer 24

• Use observations and experiments to show that cholera was water borne – this was a new methodology.
• Proved that cholera was caused by dirty water rather than miasma
• Was significant in the development of public health in the 1800s.

HOWEVER
- Ideas not supported until after his death when Robert Koch proved that cholera was caused by a specific bacteria - vibrio cholerea

• Ideas were not supported because the miasma theory was still dominate, as the germ theory was unknown.
• Failed to inspire government officials to take action against public health as they had a laissez-faire attitude.

Question 25

Edwin Chadwick

Answer 25

• Wrote a report of public health in 1842 which wanted to improve public health conditions for those living in poverty.
• Supported the government to pass the Public Health Act of 1848.
• Introduced Boards of Health who were responsible for improving public health.
• Was significant in the development of public health in the 1800s.

HOWEVER :
- Ideas were not supported because the miasma theory was still dominate, as the germ theory was unknown.

-Failed to inspire government officials to take action against public health as they had a laissez-faire attitude.