Progress in the mid 19th century

• What are the four humours?

  Blood, phlegm, yellow bile, black bile.
• what was the theory of opposites?

  balancing of humours - eating or drinking something with opposite qualities
• what was miasma?


  disease came from unpleasant smells or harmful fumes in the air
• what was the supposed evidence of miasma?

  • higher disease rate in poorer countries
  • unhygienic and smelly conditions
  • disease spread in hot weather
• what is spontaneous generation?

  rotting material created maggots, fleas and disease
• why did people believe spontaneous generation?

  they didn’t know disease is caused by microorganisms as they didn’t have microscopes
• what did the doctors know?

  they couldn’t do research as people wanted to be buried as they believed in life after death
• What were the factors affecting progress?

  • level of technology
  • Lack of funding - government didn’t feel responsible
  • attitudes
• What are the points for Florence nightingales background?

  • wealthy middle class
  • 3 months in 1851 in Germany training
  • 1853 she was a superintendent of a small nursing home
  • Sidney Herbert asked her to work with 38 other nurses at a hospital in Scutari
• what were the conditions at scutari before FN?


  • lice and fleas
  • sharing beds and on floors
  • food and water quality was bad
• what were the conditions at Scutari after FN?


  • clean
  • windows open
  • more supplies
• why was the death rate still high in FNs hospital?

  Bad drinking water and she didn’t acknowledge germ theory
• why was pain an issue?

  • only relieved with opium or being knocked unconscious
  • it meant speed was valued most
• who was Robert Liston?

  • best surgeon because he was fast and strong
  • 28 seconds
• why was blood loss an issue?


  • torniquet to reduce blood loss in the arteries
  • if they lost too much they died
• why was infection an issue?

  • peoples homes were unhygienic
  • dirty clothes and tools
  • lots of people while operating
• when was ether first used and by who?

  1848 by William Morton and Robert Liston
• what were the 5 problems with ether?

  • caused vomiting
  • irritated lungs
  • coughing
  • left patient asleep for days in some cases
  • highly flammable
• who discovered chloroform?


  James simpson
• what and when did Simpson use on queen victoria?

  • birth of 8th child
  • Chloroform
  • 1853
• what was the negatives of chloroform?

  • Christians against it
  • May affect the baby
  • Difficult to get the dose right
• what did John snow do?

  • chloroform inhaler - 1848
  • discovered cause of cholera
• how did chloroform affect infection?

  • doctors could take time
  • so the unhygienic tools went deeper causing deeper infection
  • caused gangrene and sepsis
• what were living conditions like?

  • overpopulated
  • Damp
  • No light or ventilation
  • Bad water
• what were the main diseases?

  • smallpox
  • typhus
  • influenza
  • pneumonia
  • cholera
• how many died in the cholera epidemic of 1831/32?

  20,000
• why was no one taking action about cholera?

  • believed miasma only affected poor people
• what and who made the public health act of 1848?

  • Edwin Chadwick
  • Local authorities could set up a board of health, appoint a medical officer, build a sewer system and organise rubbish removal
• why was the success of the public health act of 1948 limited?

  • terms were temporary
  • general board of health ended after 5 years
  • not forceful
• what was Chadwick like?

  • arrogant and aggressive
  • hard to get ideas accepted
• What was John snows work on cholera?

  • he believed cholera was a result of polluted water
  • Investigated outbreak in soho and made map of deaths
  • Removed the handle and outbreak stopped
  • Put pressure on water companies
• what was the cause of the new sewer system?

  • the great stink
  • 1858
  • so hot so the Thames water level dropped and the rubbish and excrement was exposed
• Who designed the new sewer system?

  Joseph Bazalgette
• how much did the sewage system cost?

  3 million