Industrial

• Pain relief methods in the early 1800s:

  • Nitrous oxide (laughing gas) discovered by Humphry Davy in England in 1799, eased pain but kept a person conscious
  • Ether noticed by Crawford Long in America, which did not cause pain
  • Horace Wells, a dentist in the USA, used nitrous oxide in 1844-45 to extract a tooth
  • Ether had a longer lasting effect than nitrous oxide
  • Nitrous oxide had limited use as some people were not affected by it
  • Ether had a stronger effect but was disliked due to being inflammable, having a strong smell, and irritating the lungs
• James Simpson was significant in the development of surgery for discovering chloroform as an anaesthetic
• Queen Victoria helped end opposition to anaesthetics by using chloroform during childbirth
• Death rates started to increase after the use of chloroform due to longer and more complex operations leading to higher death rates from infection, as surgeons didn't understand the importance of hygiene in preventing the spread of disease
• The Black Period of surgery was from 1847-1867, where anaesthetics led to longer and more complex operations, resulting in higher death rates from infection due to poor hygiene practices
• Opposition to chloroform came from surgeons, the army, the church, and patients
• The legacy of James Simpson's work led to the specialization of anaesthetists, the development of new substances, and the crucial role of anaesthetists in the surgical team
• Public health started to improve after 1848 due to the collaboration of four key individuals with the government: Edwin Chadwick, William Farr, John Snow, and Joseph Bazalgette
• Cholera caused a serious crisis in 1832, resulting in 21,000 deaths
• Edwin Chadwick believed there was a link between poverty and sickness, leading to his investigation and report on the Sanitary Condition of the Labouring Population in 1842
• Chadwick's report inspired the sanitary reform movement, demanding improvements in living conditions
• Opposition faced by Chadwick included 'The Dirty Party' who believed in laissez faire and argued against government intervention in cleaning up towns
• William Farr confirmed Chadwick's work by building evidence of the links between poverty, dirt, and ill-health through analyzing birth, death, and marriage registrations after 1837
• The 1st Public Health Act of 1848 was not compulsory and was not fully applied across the whole country
• The opposition to public health reforms ended in 1848 when cholera struck again, leading to the passing of the 1st Public Health Act which established the Central Board of Health in London and allowed for the setup of Local Boards of Health in towns
• The most important factor in bringing about the 1848 Public Health Act was the collaboration of key individuals like Edwin Chadwick, William Farr, John Snow, and Joseph Bazalgette
• Robert Koch developed the work of Louis Pasteur by identifying specific bacteria that caused Anthrax, cholera, and tuberculosis
• Pasteur believed that germs cause disease, while Koch discovered that different germs cause different diseases
• Koch used scientific methods to test his theory, including identifying the specific bacteria responsible for Anthrax
• Koch grew the microbes, dyed them, and photographed the specific microbe to prove his findings
• Factors that helped Koch and Pasteur in the fight against disease and infection include the acceptance of Germ Theory in the 1870s/80s
• Smallpox is a highly contagious disease, similar to chickenpox, with symptoms including fever, headache, and nausea for about 12 days
• Effects of smallpox include a chickenpox-like rash spreading across the body and hardening into blisters, with 1/3 of victims dying and survivors potentially being left blind or scarred
• No treatment was available for smallpox, only prevention methods were used
• Inoculation was a method used to prevent catching smallpox by scratching the pus from a smallpox victim onto a healthy person's skin, giving most people a mild dose of the disease and building up resistance
• Edward Jenner was significant in the fight against smallpox by conducting an experiment to create a vaccination against the disease
• Jenner's vaccination worked by providing immunity to smallpox, although this mechanism was not understood at the time
• Opposition to Jenner's work existed despite scientific evidence supporting vaccination
• Jenner's discovery had a significant impact, with the vaccination becoming compulsory by the government in 1852 and smallpox being eradicated in 1979
• Jenner's work marked a turning point in the fight against disease in 1796
• Improvements in medicine by the end of the 18th century included advancements in disease prevention, public health, surgery, and anatomy, although challenges still remained
• Issues of public health in the 1800s:

  • Average age of death for men was 30, in Liverpool it was 15
  • Workers were badly paid and could not afford decent housing
  • People lived in crowded buildings in tiny streets packed together
  • Buildings were cheap and poor quality, allowing rats and draughts to easily get in and out
  • Builders didn't prioritize fresh water supplies and sewage systems
  • Waste was thrown in streams and water supplies were polluted
  • Government took a 'laissez-faire' approach
• Diseases in the slums:

  • Typhoid: bacterial infection affecting many organs
  • Tuberculosis (TB): bacterial infection spread through inhaling droplets, serious if untreated
  • Cholera: bacterial disease spread through contaminated water, causing severe diarrhea and dehydration
• Reasons why Industrial towns were deadly:

  • Population increase in towns and cities between 1801 and 1851
  • Diseases like cholera, typhoid, and tuberculosis existed in the slums
  • Disease spread due to poor living conditions and contaminated water supplies
• Dr. John Snow's discovery in 1849:

  • Published a book stating that cholera spread through water, not bad air
  • In 1854, over 700 people near Snow's surgery in London died from cholera
  • Discovered that all victims got their water from the Broad Street water pump
  • Removed the handle from the pump, and there were no more deaths
  • Found a street toilet 1m from the pump with a cracked lining allowing polluted water to trickle into the drinking water
• Impact of the Great Stink of 1858:

  • River Thames in London was a dumping ground for human sewage, household rubbish, and for washing and cooking
  • Summer of 1858 was very hot with little rain, making the river smell worse
  • MPs in the Houses of Parliament were sent home due to the unbearable smell
• Joseph Bazalgette's contribution to public health:

  • Built sewers in London to remove waste from the city
  • Used 318 million bricks to build 83 miles of sewers, removing 420 million gallons of sewage a day
  • Finished in 1866, and cholera never returned
• Laws passed in 1875 to improve public health
• Living conditions in 1900:

  • All the poor had the shadow of the workhouses hanging over them, as there was no other system of helping them
  • The British Government did not have a history of helping the poor
  • Most people believed that the poor were somehow responsible for their own poverty, blaming idleness, gambling, and drinking for causing poverty and believing it was people's own responsibility to look after themselves
• Significance of the Boer War (1899) for public health:

  • Shock at the poor state of physical fitness of new recruits, with 40% unfit to fight
  • Rickets (lack of Vitamin D - Calcium) was a concern