Industrial Medicine

• Robert Koch:

  • Discovered that different germs caused different disease.
  • Discovered bacteria that caused tuberculosis and cholera.
  • Koch also developed a method of growing and studying bacteria.
• Developments in industrial period:

  • Sterilising surgical equipment.
  • Sir Almoth Edward Wright developed a vaccine against typhoids.
  • Public health act (1875), managing quality of sewage, food and green spaces.
  • John Tydall confirmed that germs are in the air.
• England hospitals before 17th century:

  • By 1550, approximately 1100 hospitals were ran by monks and nuns.
  • Clean bedding and good diet was the most common cure.
  • Early 1500 hospitals provided visits from physiscians and employ apothecaries to mix the medicine.
  • Most hospitals were gone after the dissolution of the monsatries by King Henry VIII (1536).
  • New hospitals funded by charites but were never the same after the dissolution of the monastries.
• Nitingale Stats:

  • Got 300 scrubbing brushes to get rid of dirt near where the patients were treated.
  • Ensured that soldiers had clean bedding and good meals.
  • Mortality rate dropped from 40% to 2%.
• What Nightingale did:

  • Wrote a book called 'Notes on Nursing' in 1859.
  • Set up a nursing school called 'Nightingale School for Nurses', which turned nursing into a profession not unskilled work (women were allowed to study).
  • Built hospitals with materials that can be easily cleaned, help with the use of antiseptics.
  • Promoted the 'pavilion' style hospitals with seperate wards to ensure infected patients would be kept seperate.
• Joseph Lister:

  • In 1865, he tested the effects of carbolic acid (chemical already used in sewage treatment). He applied a bandage that was soaked in carbolic acid after operating on a pateint. The wound healed cleanly.
  • Wrote up his findings in the 'lancet' (medical journal widely read by docters and surgeons).
  • Basicaclly invented aseptic surgery.
  • Took a while for people to catch onto Lister's ideas, by 1900 instruments were steam cleaned, operating theatres were scrubbed spotless and rubber gloves, surgical gowns and face masks were introduces.
• Government interventions:

  • Edwin Chadwick published his report on sanitary conditions of working classes in 1842, report showed that people living in cities had lower life expectancies than people living in the countryside due to filthy living conditions. Campaigned that there should be a board of health who were responsible in providing clean water, and disposing of sewage. More evidence of Chadwick's report emerged which made government more willing to act.
• Government Intervetions:

  The first public health act was issued in 1848, with aims of improvinf sanitary conditions of towns by encouraging cities to set up baord of health and provide clean water supply. However this was not compulsary.
• Government interventions:

  • From 1860s, slums were destroyed in Birmingham.
  • Many cities including Birmingham, London and Leeds recieved new sewage systems.
• Government interventions:

  Second public health act was issued in 1875 which was compulsary which required to do things like :

  • Providing clean water.
  • Disposing of sewage.
  • Employing public officer of health to monitor outbreaks of disease.
  • Ensuring new house were better quality.
  • Provide public parks.
  • Creating street lamps to prevent accidents.
• In the 18th centruy medicine, the government followed the laissez-faire ideology meaning they kept out of people's everyday lives.
• First cholera outbreak in England was in 1831-33.

  The deadliest cholera outbreak was in 1848-49 with around 53,000 deaths.

  The total number of deaths due to cholera was just under 110,000.
• John Snow:

  • Plotted all the placea people had died from cholera, then found out that most death occured near water pumps ,broad street pump being the worst.
  • He broke the water pumps because the goverment wouldn't accept Snow's ideas, there were no more choldera cases.
• Snow discovered in the second outbreak of cholera (1848-9):

  • Cholera couldn't be transmitted by miasma beccause it affected the gut not the lungs.
  • Drinking water was contaminated with cholera ridden faeces.
• What was Nitingale's nursing school called?

  Nitingale school for nurses.
• What were reasons of change in medicine in the 19th century:

  • Men had more rights to vote.
  • Thousands of death from cholera put pressure on the government to act.
  • More and more reports emerging about livining conditions in urban areas, put pressure on the government to act.