Treatment of illness and disease

Question 1

Belief of miasma

Answer 1

• The miasma theory meant that diseases were caused by the presence of a poisonous vapour in the air which was easily understood by its foul smell
• The theory originated in the Middle Ages
• It made sense to sanitary reformers as the dirtier the area (and by default more smelly) you tended to see a lot more disease.
• It did have its merits as by removing the causes of bad smells, you tended to remove bacteria inadvertently.

Question 2

Belief of spontaneous generation

Answer 2

• Microorganisms are very small and so could not be seen without a microscope. People did not know the link between microorganisms and disease.
• The theory claimed that rotting material (e.g. food, excrement or dead animals) created maggots, fleas and disease.

Question 3

Edward Jenner (1796)

Answer 3

discovered a small dose of cowpox protected humans from smallpox and called the technique vaccination

Question 4

Louis Pasteur and Germ Theory

Answer 4

• A French scientist in the late 1850s
• Experiments into milk, wine and vinegar
  
  • Asked by a brewery company to look into why their beer was going sour.
  • He took two flasks and drove the air out of one so that no more bacteria could grow. He sealed the flasks with some liquid inside - the cleaned flask was still sterile - the other was full of bacteria
• In 1860 the French Academy challenged scientists to prove or disprove ‘spontaneous generation’
  
  • Pouchet argued for this
  • Pasteur disproved this theory and showed that food went off because of contamination by microbes in the air and that this could cause disease (1861)
  • His Germ Theory was controversial.
  • Application published in 1878
• Silkworms
  
  • In 1865 he was asked to investigate diseases in silkworms and proved that bacteria was spreading the diseases.
  • This linked germs to disease

Question 5

Pasteurisation

Answer 5

• The method of heating and sterilising liquids
• Method paved the way for air-tight food storage

Question 6

Impact of Pasteur

Answer 6

• Surgery: His work led to an understanding of infection and why it often developed after operations
• Public Health: It helped to explain the link between hygiene and health.
• He disproved spontaneous generation
• Without his work, Koch would not have started his work
• He developed pastuerisation
• He thought of Germ Theory

Question 7

Limitations of Germ Theory

Answer 7

• It was not until 1878 that Germ Theory and its Application to Medicine was actually published
• Many scientists did not accept his ideas - there were healthy microorganisms so how would they differentiate?
• It was not clear how germ theory could actually help medicine

Question 8

Background on Koch

Answer 8

• Born in Germany
• A doctor that read Pasteur’s work
• Rivalry between Koch and Pasteur because of the Franco-Prussian War (1870-71)

Question 9

Koch and anthrax

Answer 9

• He wanted to find specific microbes/bacteria
• He investigated anthrax which affected farm animals
• In 1872, he set up a small lab in his home and spent his spare time researching
• He found that the anthrax microbe produced spores that lived for a long time after the animal had died

Question 10

Pasteur and chicken cholera

Answer 10

• Pasteur was spurred by his rivalry with Koch
• In 1879, he was researching chicken cholera
• One of his team accidentally injected a chicken with some old chicken cholera germs that had been exposed to air - the chicken did not die
• He realised that injecting a weakened form of the disease would stimulate the chicken’s natural defences
• This led to work within humans

Question 11

Pasteur and anthrax

Answer 11

• After experimenting, Pasteur’s team announced they had produced an attenuated (weakened) culture which could immunise against anthrax
• In 1881, he publicly displayed his findings
• Sheep were protected and Pasteur’s fame quickly spread

Question 12

Pasteur and rabies

Answer 12

• In 1882, Pasteur works on rabies
• He injected a boy who already had rabies with the rabies vaccine he had spent 2 years working on and he saved the boy’s life
• His fame grew and people flocked to him from all over Europe

Question 13

Koch and Bacteriology

Answer 13

• Koch wanted to work on germs that specifically affected humans
• In 1878, he identified the germ that caused blood poisoning and septicaemia
  
  • He discovered that methyl violet dye showed up the germ under a microscope
  • He took pictures of the germs so people could see them
• He devised a method of proving which germ caused an infection and he perfected the technique of growing pure cultures of germs

Question 14

Koch and TB (tuberculosis)

Answer 14

• In 1881, he gathered a team in Berlin to work on tuberculosis
• It was much smaller than the anthrax germ so it was difficult to look for
• In 1882, Koch announced that his team had found the germ
• It generated the ‘microbe hunters’ who were inspired by his work - one of those was Paul Ehrlich

Question 15

Koch’s legacy

Answer 15

• He finally laid to rest the belief of ‘bad air’ causing diseases
• He inspired younger researchers to build on his work
• By 1900, 21 germs had been identified in just 21 years - he had developed the correct methods that led to this
• His method of staining bacteria was incredibly effective

Question 16

Limitations to Koch and Pasteur’s vaccine work

Answer 16

• Both men published their work but it was some time before they were accepted into medicine
• The attitude of doubtful scientists and doctors meant that their work was largely unnoticed by the general public
• Vaccines can prevent a disease from developing but cannot treat a disease after a person has become ill

Question 17

First Magic Bullet

Answer 17

• Paul Erhlich, who worked under Koch, along with Emil Behring, developed an interest in the antibodies produced by the human body
• Ehrlich reasoned that he could find a chemical to attack specific germs, calling them magic bullets
• Magic Bullets would hit the specific germ but not damage anything else in the body
• In 1905, he was looking to treat syphilis using a variety of chemical compounds
• He tested over 600 of them
• In 1909, Sahachiro Hata began working with them and retested all compounds. The 606th compound worked.
• In 1911, Salvarsan 606 was used for the first time on humans

Limitations: Side effects such as rashes, liver damage and ‘risks of life and limb’, some denounced 606 leading to the ‘Salvarsan wars’

Question 18

Marie Curie and radioactivity

Answer 18

• She and her husband, Pierre were research workers in Paris
• They began work on invisible rays given off by uranium (a phenomenon discovered by Henri Becquerel)
• Curie noticed samples called pitchblende were more radioactive than pure uranium and managed to separate the different elements present
• In 1898, polonium was discovered
• They realised another, more radioactive element, was present in the pitchblende and managed to separate radium in 1902
• She helped to set up the first radium institute which helped to research the treatment of cancer using radium
• Helpful to treat cancers and use in x-rays
• First woman to win nobel prize (1903 for discovery), first person to win 2 nobel prizes (1911 for isolating radium)

Limitations: It continued to be difficult for women to enter scientific research, only one other woman has joined Marie Curie in winning the physics Nobel Prize

Question 19

Problems with treatment of disease during WW1

Answer 19

• Conditions such as trench foot were common, as were new injuries by the high velocity gun fire.
• Shell shock was considered as a physical condition or a sign of mental instability
• Trench foot was treated with clean socks. If gangrene set in, it was amputation
• Trench fever was caused by contact with lice and caused flu like symptoms. Delousing stations were set up
• Dysentery was caused by infected food, water and people and chloride was used to purify water

Question 20

Limitations to treatment during WW1

Answer 20

• The money for research teams from the government was not always forthcoming
• Salvarsan 606 was the only magic bullet and only effective against syphilis, not the wide range of bacterial diseases from WWI

Question 21

Second Magic Bullet

Answer 21

• Gerhard Domagk was inspired by Erhlich. He and Klarer were interested in using chemical dyes as antibiotics.
• In 1932, Domagk tested Prontosil against a strain of streptococcus bacteria
• He infected mice with streptococcus - the mice that did not receive Prontosil died
• Prontosil gained widespread recognition when it was used on President Roosevelt’s son
• They found it could be used against tonsillitis, puerperal fever and scarlet fever

Limitations: It could damage the kidney, liver and are ineffective against highly virulent microbes

Question 22

Fleming and the development of Penicillin

Answer 22

• Fleming worked on staphylococcus germ
• In 1928, he observed that mould had developed accidentally on a staphylococcus culture plate and that a mould had a bacteria-free circle around itself.
• He found that the mould prevented the growth of staphylococci even when diluted 800x. He named it penicillin.
• He grew more and experimented, finding that it acted against anthrax and diphtheria
• It was the first time that an antibiotic drug had been developed
• In August 1942, he successfully treated a friend that had meningitis
• Limitations: He did very little with his own discovery and wasn’t until 1935 and Florey and Chain developed it further that it could help people further

Question 23

Florey, Chain and the development of penicillin

Answer 23

• In 1939, Florey and Chain assembled a team of pathologists
• They asked the British government for funding into research
• They used thousands of milk bottles, milk churns, a dog bath and a hand pump to gather a few micrograms of pure penicillin
• They tested it on mice - the mice that were given penicillin were healthy with no traces of the streptococci bacteria. The ones that were not injected with penicillin, died.
• In 1941, police officer Albert Alexander was given penicillin to combat bacteria - with penicillin he was able to recover but they did not have enough and he died a few weeks later. It showed that, with enough penicillin, it could be a powerful drug
• In 1942, the US gave $80 million to 4 drug companies to mass produce penicillin
• It was used at D-Day
• By 1945, the US Army was using 2 million doses of penicillin a month

Impact:

• It is estimated that 12-15% more allied soldiers would have died without penicillin
• It halved the amount of time an Allied soldier spent in hospital
• We still use penicillin and penicillin-type drugs today