Industrial medicine

• Attempts to prevent spread of plague

  • Stay at home to prevent contact with others
  • Soak coins in vinegar to avoid passing on plague when buying food
  • Herbal remedies (ie poises)
  • Bloodletting approaches to purging
  • Prayer for the Sick
  • Wearing magical/religious charms
• The methods of prevention are similar to its believed cause
• Attempts to prevent spread of plague

  • Place strong-smelling herbs and flowers over doorways and windows to prevent bad air from entering
  • Hold posies to their nose when walking in their house
  • Chew tobacco (which was new to England) hoping the strong smell would drive away any bad air carrying the plague
• All the attempts to prevent the spread of plague are similar to those of the Black Death
• During the Great Plague, Charles II ordered days of public prayer and fasting to allow confession of sins, because they believed God sent the illness
• The mayor of London also tried to prevent the spread of the plague by quarantining victims and families for 40 days, but this was difficult to enforce due to lack of authorities and a police force
• Barrels of tar and bonfires were lit in the streets to clean the air, and large crowds (e.g. plays, games) were banned to prevent the spread
• Animals were banned inside the city as it was thought they spread the disease, and over 20,000 cats and dogs were killed
• The plague returned to England in 1665 and killed thousands, but there had been very little change in medical understanding
• People still believed God controlled everything and sent the plague as punishment for sin, and that the disease spread from person to person or from an unusual alignment of planets that caused miasma
• The methods of prevention were similar to the believed causes, such as using strong-smelling herbs and flowers to prevent bad air from entering
• Britain experienced the most changes during the Industrial Revolution, with large numbers of people moving from the countryside to urban areas to work in factories and workshops
• By the end of the 19th century, most people in Britain were employed in factories and workshops, and cities became overcrowded with poor-quality housing, leading to the easy spread of disease
• By 1750, the church's dominant influence had declined and scientific ideas were more accepted, with new instruments, chemicals and scientific equipment proving many new theories
• In the 18th-19th century, the government had a laissez-faire attitude to medicine, but by the end of the 19th century this changed as the government began to pass legislation to improve living conditions and prevent the spread of disease
• Spontaneous generation

  A theory that stated that decaying matter created microbes, and that things could spontaneously generate microbes
• Improved microscopes meant scientists could see and discover microbes, but it was difficult to separate the infection-causing bacteria from those already present
• Robert Koch


  • Developed a new method of growing bacteria using agar jelly in a petri dish, and used dye to stain the bacteria so it could be seen under a microscope
  • Was the first to successfully match bacteria that caused certain diseases
• Koch's work meant doctors now understood that bacteria caused the symptoms of disease and the disease itself, so it was the bacteria that needed to be removed
• Pasteur read about Jenner's vaccine, and began developing more vaccines now that individual bacteria were identified for separate diseases
• Hospitals in the 19th century


  • Were not very safe, with many patients dying due to poor conditions and lack of cleanliness
  • Were overcrowded with a lack of fresh air and toilets, leading to the spread of infection
• Florence Nightingale

  A trained nurse who was asked by the government to tend to injured soldiers in the Crimean War, and worked hard to improve hospital conditions, reducing the death rate from 40% to 2%
• Mary Seacole


  A businesswoman and healer who volunteered to go to the Crimea and help out, but was refused passage by many powerful figures, so she paid for her own travel and set up a hostel called the 'British Hotel' to provide rest and recovery for British officers
• Surgery in the 1800s


  • Was very dangerous, with common operations including amputations and growth removal
  • Surgeons had to work quickly with no anaesthetics, leading to high rates of death from shock and infection
• James Simpson

  A professor of midwifery who experimented with chemicals to find an effective anaesthetic, eventually discovering chloroform as an effective anaesthetic
• Joseph Lister also made improvements to surgery through the use of antiseptics
• Hospitals in 19th century

  • Varied in size, funding and organisation
  • During industrial times there was an increase in small cottage hospitals
  • Voluntary hospitals were funded by charity from the wealthy whilst doctors worked for free
• Changes in care and treatment - surgery

  1. Surgery improved due to James Simpson (anaesthetics) & Joseph Lister

  2. In 1800, operations were very dangerous and common ones included amputations and growth removal quickly

  3. Surgeons had to work with no anaesthetics, so patients could die from shock during surgery and infections

  4. In early 19th century, surgeons experimented with chemical compounds to find an effective anaesthetic

  5. Laughing gas (nitrous oxide) was used but couldn't completely get rid of pain

  6. Ether had side effects like irritating eyes and lungs, causing coughing and sickness

  7. James Simpson, professor of midwifery, wanted better anaesthetic to ease pain for childbirth

  8. He and other scientists tested chemicals and found an effective anaesthetic: chloroform

  9. There was some opposition to the use of chloroform as some surgeons preferred their patients awake so they could fight for their lives, and some had religious beliefs that humans should experience pain

  10. Hannah Greener's death after being given too much chloroform increased its popularity

  11. John Snow invented an inhaler to measure the dosage of chloroform given

  12. Queen Victoria used chloroform during the birth of one of her children, which helped increase its acceptance

  13. The 'black period of surgery' occurred because pain relief was available, so more complex operations could be carried out, leading to increased deaths from infections and blood loss
• Joseph Lister and antiseptics


  1. Surgeons would still wear dirty clothes and handwashing wasn't always done as bacteria causing infections wasn't known

  2. In 1867, Joseph Lister discovered antiseptics after studying Louis Pasteur's germ theory

  3. Lister used carbolic acid to kill bacteria in open wounds, reducing death rates from 46% to 15%

  4. Lister recommended doctors and nurses wash hands in carbolic acid before operations, use bandages and ligatures soaked in carbolic acid, and use a carbolic spray to clear the operating area

  5. Lister's discovery led to the introduction of aseptic surgery, with more germs removed from the operating theatre, frequent cleaning of other hospital areas, and surgeons wearing sterilised masks, gowns and gloves
• Changes in prevention of disease - Improving public health

  1. Edwin Chadwick, a government official, carried out a detailed report in 1842 on the poor sanitary conditions of the labouring population in cities, which had a much lower life expectancy than the countryside

  2. Chadwick recommended the supply of clean water and more regular removal of waste

  3. The 1848 Public Health Act was passed, but had little impact as it was optional and expensive for local authorities

  4. In 1859, the 'Great Stink' in London led to the government acting, employing engineer Joseph Bazalgette to build a network of sewers to remove waste

  5. The 1875 Public Health Act made it compulsory for local authorities to improve sewers, provide clean water, and appoint medical officers to inspect public health facilities

  6. This was a breakthrough as the government was finally taking responsibility for the health of the British people, partly because Louis Pasteur's germ theory had proven the link between dirt and disease, and working men had gained the right to vote so political parties needed their support
• Vaccination programmes

  By the late 19th century, the government was more willing to consider vaccination programmes, as the work of Pasteur, Koch and Jenner had convinced them vaccination could be successful
• Working class

  Pay for these, be treated in these hospitals IF they paid into a fund to cover the cost of treatment
• Rich people

  CONTINUED paying for doctors to treat them at home
• Very poor

  If their situation was considered desperate they were admitted to a workhouse (place where homeless poor were sent)
• Workhouses after 1867

  Had an infirmary to treat the sick and the elderly
• Fever hospitals

  Where parents could be isolated, established for those suffering with infectious diseases (ie: smallpox, Scarlett fever)
• Fever hospitals

  • Their aim was to treat those suffering whilst separating them
• The authorities assessed the very poor