industrial

• Louis Pasteur - developed germ theory
• Robert Koch - identified specific microbes, developed methods to study them better
• Florence Nightingale - came up ideas of modern nursing / hospital design
• James Simpson - discovered chloroform
• Joseph Lister - developed use of carbolic acid to tackle infection in surgery
• John Snow - worked out that cholera caused by dirty water and used chloroform on queen victoria
• Edward Jenner - came up with the concept of using vaccination
• Anaesthetic - a drug which makes a patient unconscious during surgery
• Germ - a small organism which can cause disease
• Antiseptic - germ-free
• Microbe - germ that can cause disease
• Spontaneous generation - idea about cause of decay
• Epidemic - rapid spread of a disease
• Ideas about CAUSE of disease

  C18th Age of “Enlightenment” – people thinking for themselves, not just following ideas of church

  1861 -Louis Pasteur published Germ Theory.

  Observed that “microbes” are present in the air, these made liquids rot (he was investigating rotting beer).

  Proved microbes could be killed by heat (pasteurisation).

  1878 published Germ Theory of infection, proving microbes caused disease in humans.
• Ideas about CAUSE of disease

  Robert Koch identified that different microbes caused different diseases.

  First discovered cholera 1883.

  Came up with methods to study bacteria (grow in petri dish, stain with dye to make easier to see) – these methods made it possible for other scientists to make further discoveries.

  Koch’s work meant that scientists studied diseases, not symptoms.
• Ideas about CAUSE of disease

  Impact in Britain GB doctors – led by Henry Bastian – did not believe in Germ Theory.

  They still believed in Spontaneous Generation (microbes spread from rotting matter by miasma).

  GB government rejected germ theory until end of C19th.
• Approaches to TREATMENT and PREVENTION

  Hospitals:

  Florence Nightingale was a nurse in the Crimean War 1854;

  hospitals were appalling so she made changes to way wounded soldiers were treated

  - Sanitation (clean hospital, bedding)

  - Nurses to provide care

  - Good meals provided Mortality rate (% of wounded dying) fell from 40% to 2% Nightingale returned to GB

  - Set up nursing college; designed hospitals with wards to stop disease spreading; wrote “Notes on Nursing”
• Approaches to TREATMENT and PREVENTION

  Surgery: 3 major problems: pain, infection, blood loss (this was not “solved” until C20th)

  Anaesthetic developed to deal with pain. Other drugs had been used (eg ether), but problems.

  James Simpson discovered chloroform. Some opposed as though pain was sent by God, but when Queen Victoria used chloroform, it became popular

  Antiseptic developed to deal with infection. After reading Pasteur’s Germ Theory Joseph Lister used carbolic acid during operations to keep wound clean. Many doctors opposed at first, as carbolic was unpleasant
• Approaches to TREATMENT and PREVENTION

  Prevention Edward Jenner develop vaccination to protect against smallpox. Previously people had been inoculated (given small dose of disease to develop immunity.

  1776 Jenner worked out you could make someone immune to smallpox by injecting a small amount of cowpox. Lots of opposition from church, inoculators and scientists
• Approaches to TREATMENT and PREVENTION


  Public Health 1848:

  Public Health Act encouraged cities to provide clean water, but not compulsory.

  1852 government makes smallpox vaccinations compulsory

  1875 Public Health Act. Realisation government should intervene to improve living conditions in cities. City authorities forced to: provide clean water, dispose of sewage properly, public health officer to monitor outbreak of disease, ensure good new housing.
• Case Study: Cholera (1854)


  Disease first arrived London 1831.

  Particularly affected the poor – those living in slums and workhouses. Three “epidemics” (major outbreaks, killing thousands).

  Government tried to prevent by cleaning slums to reduce miasma – did not work.

  1854 outbreak studied by John Snow. Snow plotted where all deaths had occurred on a map. Identified that they were centred around Broad St water Pump. Took handle off pump, no more victims Discovered Broad St well was next to a cesspit (toilet pit). Proved that cholera was spread by dirty water.
• Examples of Change


  - Germ Theory

  – understanding that germs cause disease

  - Surgery became safer

  - Hospitals more clean

  - Government became involved more involved in health / medicine - Vaccines developed to prevent diseas
• Examples of Continuity 


  Many people still believed in miasma

  - Still major public health issues in cities. Widespread poverty

  -No cure for blood loss in surgery

  - There was better understanding of cause of disease, but still few cures