Industrial Medicine

• Industrial Medicine 1700-1900


  • 4 humours are discontinued
  • Miasma is still used
  • Religion is still prevalent
  • Astrology is not as prevalent
• Spontaneous generation


  • Replaces the four humours
  • Idea that rotting material creates microbes
  • Microbes are then spread through the air
• Germ Theory


  1. Pasteur argues against spontaneous generation

  2. Pasteur tried to prove this wrong by carrying out an experiment

  3. 1861 - Germ theory - states that microbes are in the air, these microbes caused decay, they were unevenly distributed, they were killed by heat

  4. Robert Koch - he managed to isolate the germ that caused anthrax - the first time someone discovered the specific microorganism causing a specific disease

  5. 1882 - Koch published his findings on tuberculosis and proved that it was infectious rather than hereditary

  6. 1884 - discovered the microorganism that caused cholera
• Government intervention in preventing disease

  1. 1848 - government passed the Public Health Act

  2. A national board of health was established

  3. Local council encouraged to collect taxes to pay for public health improvement

  4. 1858 - The Great Stink - so much human waste was thrown into the river Thames that the river started to pollute the air with fumes of faecal matter

  5. 1852-1871 - compulsory vaccinations strictly enforced

  6. 1875 - Public Health Act - this was much stricter than the first one and was compulsory - states the local government must provide clean water, clean toilets, proper drainage and sewer systems, medical officers in every area

  7. 1876 - new homes for living conditions

  8. 1876 - law that prevents polluting rivers
• John Snow - Cholera


  1. First appeared in 1832

  2. 1854 was the first cholera epidemic that killed over 20000 people

  3. Diarrheal infection caused by the ingestion of contaminated food or water

  4. Bad sewage system - waste was thrown into the river Thames which is repumped into the water supply that people consume

  5. People thought cholera was caused miasma

  6. John Snow released a book saying that cholera was from water, but he was discounted

  7. 1854 - snow went to the centre of the cholera outbreak and maps out the location of deaths from cholera - he noticed that whoever gets their water from a specific pump died

  8. Snow removed the handle of the pump, so people stopped using it - this caused less deaths which proves the water supply was causing cholera

  9. Government was slow to react - 1865 second cholera outbreak which killed 14000 people

  10. Germ theory was not yet formulated, and people were attached to the belief of miasma

  11. A lot of money was needed to improve the water supply and wealthy people did not want to pay taxes to help
• Preventing and treating disease - hospital care

  1. New hospitals were established in the 18th century

  2. Treated patients but were overcrowded - poor conditions

  3. High death rates from infection - poor hygiene

  4. Nursing staff was poor and overworked
• Florence Nightingale


  • Crimean War - 1853-56
  • Conditions in military hospitals were bad
  • Nightingale convinced the government to let her and another 38 nurses to Crimea and help improve conditions
  • Vast majority of people in the war died from infectious disease rather than battle wounds
  • Nightingale asked for help from the times newspaper and received a prefabricated hospital, scrubbing brushes and clean bedding
  • She focused on hygiene - the death rate dropped from 40% to 2%
• Surgery - problem of pain


  1. Amputations had to be carried out quickly due to the pain

  2. Robert Liston - Victorian surgeon

  3. Nitrous oxide (laughing gas) and ether were used as an early anaesthetic - was not effective

  4. James Simpson discovered chloroform - 1847 discovered whole experimenting

  5. Used it on women in labour

  6. Caused the Surgery's Black period - 1850-1870 - effectiveness of chloroform led to longer and more complex operations

  7. Increased risks of blood loss and infection as they were two problems that were not solved yet - more deaths during surgery
• Surgery - infection


  1. Surgeons wore old, stained clothes and had bad hygiene (no washing hands, no sterilising equipment)

  2. Gangrene often set in because of surgery

  3. Joseph Lister - surgeon who had read Pasteur's theory

  4. He had used bandages soaked in carbolic acid to dress a fractured leg and there was no infection

  5. He instructed doctors to wash their hands with carbolic acid before surgery

  6. He developed a carbolic spray to kill germs in the air

  7. He developed aseptic surgery - sterilising the area so no bacteria enter in the first place - prevention

  8. Antiseptic surgery - use antiseptic to kill infection in wound - treatment

  9. He developed antiseptic stitches

  10. Death rate dropped from 46% to 15%
• Preventing disease - smallpox & vaccination

  1. Infectious disease cause by a virus - 30% death rate

  2. Survivors had scarring and blindness

  3. Epidemics happened in 1722, 1723, 1740-42

  4. Over 3500 died in 1796

  5. People tried using inoculation to prevent smallpox

  6. Inoculation - a small cut was made in the skin and some smallpox pus was given to the individual in the hopes that they won't contract smallpox - 50% success rate

  7. Edward Jenner - noticed that diary maids who contracted cowpox did not contract smallpox

  8. He tested this theory by giving a young boy cowpox - the young boy got sick then got better - he then gave the young boy smallpox - the young boy did not get sick - proved his idea

  9. Discovered the first vaccine - a weakened strain of a disease that stops the disease

  10. Sent his finding to the royal society

  11. This was significant because Jenner showed the values of the scientific method, vaccination had a major impact on medicine, less people were dying, vaccination was cheap and eventually made free by the government, by 1970 smallpox was eradicated worldwide

  12. There was a lot of opposition to vaccination, vaccination did not lead to other breakthroughs and there was no way to make vaccinations for other diseases

  13. Pasteur was the first person to create a vaccine that was not provided by nature
• Florence Nightingale

  • Nightingale wrote 'Notes on Nursing' outlining the key role of nursing and how nurses need to be trained
  • 1860 - opened a Nightingale school for nurses and turned nursing into a highly skilled job
  • She recommended the hospitals should be built out of material that can be cleaned easily
  • Promoted the pavilion plan - large, ventilated rooms, separated wards for different diseases and more windows