History Paper 2

• Natural explanations


  Rather than supernatural explanations were used to explain disease
• Belief in religious causes of disease

  Declined after The Germ Theory (1861) – Louis Pasteur
• GB doctors


  • Led by Henry Bastian – did not believe in Germ Theory
  • Still believed in Spontaneous Generation (microbes spread from rotting matter by miasma)
• Specific Bacteria identification


  1. Koch identified the bacteria that caused TB, Cholera and Typhoid

  2. Move towards preventing disease through vaccinations – Pasteur developed vaccinations for Chicken Cholera and Anthrax
• Salvarsan 606


  The first 'Magic Bullet' in 1909
• Dr John Snow – proved Cholera was caused by contaminated water in 1851
• Early 1800s surgery


  • Limited – operated without effective anaesthetic
  • Risk of infection (no understanding of germs)
  • Blood loss was still a cause of death
• Experiments with anaesthetics early 1800s

  Ether and Nitrous Oxide were used as painkillers with some success
• Chloroform


  Discovered by James Simpson that it could be used as an anaesthetic
• Joseph Lister


  1. Used Carbolic acid as an antiseptic to kill germs during surgery

  2. Cleaned surgical equipment – developed A-Septic surgery
• By 1900 – Anaesthetics and antiseptics allowed surgeons to operate for longer and carry out more complex surgery deeper in the body with reduced risk of infection
• The risk of blood loss remained – not resolved until the development of blood transfusions in the 20th century
• The Great Stink 1858


  Extremely hot weather meant that the level of the river Thames was low and the smell of exposed sewage along its banks was so great that parliament could not meet
• Joseph Bazalgette's plans for a new sewer system in London were approved

  1,300 miles of sewers, plus pumping stations and embankments besides the river Thames to house the stations
• Miasma


  Believed to be the cause of Cholera until John Snow
• Acceptance of a link between poor living conditions and disease


  Resulted in Public Health Acts of 1848 and 1875
• Working class men in towns and cities got the vote in 1867 and they used their vote to put pressure on government to improve their living conditions
• Living conditions in towns and cities

  • Clean water was in short supply – water pumps
  • Slum housing – cramped, over-crowded, diseases like Cholera spread easily
• Edwin Chadwick's report of 1842


  Highlighted poor living conditions and influenced the government to pass the 1848 Public Health Act
• John Snow proved that Cholera was caused by contaminated water
• Joseph Bazalgette designed a new sewage system for London
• 1848 Public Health Act


  • Set up a general board of health, with Chadwick as one of its three commissioners
  • Allowed towns to set up their own local board of health BUT it was voluntary
• 1875 Public Health Act


  Made local councils responsible for ensuring the following were provided: clean water, public toilets, rubbish removal, sewers, and drains
• Florence Nightingale


  • Nurse in Crimean War 1854
  • Hospitals appalling
  • Made changes to way wounded soldiers treated: Sanitation (clean hospital, bedding), Nurses to provide care, Good meals provided
  • Mortality rate (% of wounded dying) fell from 40% to 2%
  • Set up nursing college, designed hospitals with wards to stop disease spreading, wrote "Notes on Nursing"
• Fleming


  • Left a petri dish when he went on holiday
  • When he returned he noticed that penicillin had killed harmful bacteria in the dish
  • Wrote all his ideas in a book but did not inject penicillin into an animal which would have shown that it could be used to kill infections
  • Penicillin was hard to make and expensive – Fleming did not do anything else with the discovery
• Florey and Chain


  1. Tested penicillin on 8 mice

  2. Wanted to test it on humans, and over a period of months, they produced enough penicillin to use on a patient with a bad infection called Albert Alexander

  3. When the patient was injected with penicillin, the infection began to clear up

  4. However, the patient died when the penicillin ran out

  5. The next step was to try to work out how to mass produce it
• During World War Two penicillin was needed to treat soldiers with infected wounds
• In June 1941, Florey met with the US government who agreed to pay several huge chemical companies to make millions of gallons of penicillin
• Genetics


  Scientists realised that microbes could not cause all disease – some were passed from parent to child (hereditary illness)
• A German scientist first came up with the theory of genetics, but microscopes were not powerful enough to prove the idea


  1900
• Watson and Crick discovered the shape of DNA (an acid in every human cell carrying info about characteristics)

  1953
• This meant they could find the part of the DNA which caused hereditary disease
• Using this information, doctors can know if someone is likely to suffer from a hereditary illness, and take steps to prevent the impact
• 1. rays


  • Discovered in 1895, hospitals used them to look at broken bones before WW1
  • During the war, proved their effectiveness on the battlefield when mobile x-ray machines were used, developed by Marie Curie
• Blood Transfusions


  • In 1900, Landsteiner discovered blood groups, which helped doctors work out that a transfusion only worked if the donor's blood type matched the receivers
  • It was not possible to store blood for long until 1914 when Hustin discovered that sodium citrate stopped blood from clotting
• Keyhole surgery


  To perform operations through small cuts and using cameras
• Radiation therapy


  Used to shrink tumours and kill cancer cells
• Laser surgery


  Using lasers to treat skin conditions, remove tumours
• Plastic Surgery


  During the First World War, Gillies set up a special unit to graft skin and treat men suffering from severe facial wounds
• Britain in 1900; Millions were still living in poverty, overcrowded and unsanitary housing was still common, and people worked long hours for low wages