Progress In The Mid-19th Century Flashcards
Four Humours
Hippocrates also developed the idea of the four humours. This was the idea that the human body was made up of four substances: blood, phlegm, black bile and yellow bile. If the humours were out of balance, this was believed to cause illness. The humours were also thought to be linked to the seasons.
Theory of Opposites
Theory of Opposites the idea that fi your illness was caused by too much
of one humour, the balance of your humours could be restored by eating or
drinking something with the opposite qualities.
Miasma
Idea of miasma - that
disease was carried in unpleasant smells and harmful fumes in the air. People
understood that there was often a high rate of disease in poor areas, where
people lived in dirty, unhygienic - and smelly - conditions. They also knew that disease tended to spread more quickly in hot weather. This made the idea
of miasma logical: the bad smells (which got worse in summer) were somehow linked with disease.
Spontaneous Generation
This theory claimed that rotting material (for example, the remains of food, exdcereamdeannt,imals, rotting vegetables and plants etc.) created
maggots, fleas and disease..
Idea of microorganisms linking to disease in the early 1800s
Microorganisms are too small to be seen without a microscope, although scientists
knew they existed, there was little scientific research being carried out on
them at this time. People didn’t know about the link between microorganisms and disease; instead, a theory developed, called spontaneous generation.
Doctors’ knowledge in early 1800s
Understanding of the body was also limited. Doctors would observe a few
dissections during their training but most people believed in a life after death
and therefore wanted to be buried. The bodies that doctors could use were mainly those of criminals who had been executed. This made it difficult to plan any research on the symptoms of disease or to study particular conditions such as diabetesor arthritis.
Factors affecting progress
This lack of understanding is closely linked with the level of technology available at the time. If microscopes had been stronger, perhaps scientists would have been more curious about germs.
• Other reasons for the lack of progress include the problem of funding for research and the development of new ideas. The government did not feel responsible for issues like this and hospitals usually relied on charity for funding. This meant that little money was left over for research.
• Attitudes were also important. Many doctors wanted to keep on doing what they had always done; they didn’t want to have to learn new ways of treating patients. Also there was no proof that their methods were wrong.
Describe Florence Nightingale’s life (before the Crimean War)
Florence Nightingale came from a wealthy middle-class background. Her family was shocked that she wanted to go out to work and even more surprised that she wanted to train as a nurse; this was considered a very low- status job at the time. There was no formal training for nurses in Britain so she visited various hospitals in Britain during the 1840s. She then spent 3 months in 1851 at a centre in Kaiserwerth, Germany, where training for nurses had begun in 1833.
In 1853, she became superintendent of a small nursing home in London, called the ‘Institution for Sick Gentlewomen in Distressed Circumstances’. However,
she had met Sidney Herbert, the Secretary for War, in 1847 and he now asked her to take a team of 38 nurses to work in the military hospital at Scutari.
Britain was fighting against Russia in the Crimean Peninsula, in the Black Sea. Many British soldiers were being injured in the Crimean War but a large number of the deaths that occurred were caused by infection rather than the original injuries.
When was the Crimean War?
1853
Conditions at Scutari
When she arrived, Nightingale found the hospital was crowded, with almost 10,000 patients in appalling conditions.
• Many men were sharing beds or lying on the floor and in the corridors.
• Their clothesw e r e infested with lice and fleas.
• Diseases such as typhoid fever and cholera were common.
• Many patients diarrhoea.
• It was difficult to get enough medical supplies (such as bandages and medicine) to the hospital.
• Food supplies were limited and of poor quality.
• The roof leaked and the wards were dirty and infested with rats and mice.
• Although Florence Nightingale had no idea that this was the case, the
hospital was actually built on the site of an underground cewsshpeoroel, human waste collected. This affected both the water supply and the air in the hospital.
Nightingale’s Actions
Nightingale and her nurses scrubbed the surfaces clean and washed all the sheets, towels, bandages and equipment. She believed in miasma and the importance of fresh air, so she had windows opened to improve the flow of air. Nightingale and her nurses cleaned the kitchens and improved the quality of the food. A fund of money, a lot of it raised by the Times newspaper, meant that she could buy new supplies, including 200 towels, clean shirts, soap, plates and cutlery.
The impact of Nightingale’s work
Army medical staff had resisted the idea of nurses coming out to work in the Crimea because they felt that women would not be able to cope with the
conditions there. They also felt that the women’s medical knowledge was limited; when Nightingale wanted to make changes, they saw her comments as criticism and resented her. However, her habit of making a final round at night, checking on all the patients, gained her the nickname of ‘The Lady with the Lamp’ and made her very popular with the patients and back in Britain. Nevertheless, the death rate at Nightingale’s hospital was higher than at the other hospitals, even with all her improvements. It was not until 1855, when a government sanitary commission repaired the drains and improved the supply of drinking water, that the death rate began to fall dramatically.
The problem of pain in surgery
Pain had been a major problem in surgery. Before the 1840s, the only types of pain relief available were alcohol, a form of opium or being knocked unconscious. In most operations, the patient was awake and often screaming in pain so the surgeon’s assistants, or dressers, had to hold the patient down. The ‘best’ surgeon was not the one who cut most skilfully but the one who cut the quickest. However, advances in chemistry seemed to be solving this problem.
Blood loss in surgery
Blood loss was obviously a problem so a tourniquet would be used to reduce
the flow of blood in the artery, but there was arisk to the patient if the blood supply was restricted for too long. Additionally, even when patients survived the operation, a high percentage of them died afterwards as a result of infection.
Infection in surgery
Many operations were carried out in the patient’s home, which was not
hygienic - although conditions in hospitals were often far worse! There was
little understanding of how infection happened and the surgeon would wear old clothes that were already stained with blood and pus , rather than spoil
decent clothes. If patients were lucky, the surgeon might wash his hands before the operation. Equipment was wiped clean or washed briefly between patients; it was not sterilised. The sponge used to wipe away blood was just rinsed out, and bandages were washed and then reused. In addition, there were often lots of people in the operating theatre, as well as the surgeon and his assistants: medical students and wealthy people who supported the hospital with money would watch the operation, making infection even more likely.
