Industrial Revolution - 1700c-1900c

• Old ideas on causes of disease from the RENAISSANCE

  Some doctors still believed in the idea of the four humours being out of balance.

  
  

  God was still thought to send disease as a punishment for sin.

  
  

  Miasma could cause illness.
• New ideas in the causes of disease from 1700-1900

  Spontaneous generation - microbes visible on decaying matter were spontaneously generated by decay

  
  

  In the 1861, Pasteur discovered germ theory - germs caused decay.

  
  

  Koch identified the germs that caused the disease of TB.
• Louis Pasteur and his work (1860-1880s)

  1. Pasteur discovered germ theory (1861); proved germs were in the air and pasteurisation (boiling liquids kills germs).

  
  

  2. Pasteur proved theory of four humours, miasma theory and spontaneous generation were wrong. Therefore, scientists could look for causes that worked and not balance the four humours, pray or use potions.

  
  

  3. Better technology meant he was able to do experiments with microscopes and swan-necked flasks.

  
  

  5. Discovered rabies and chicken cholera vaccines (1880's).

  
  

  6. Huge rival of Koch. The French Government set up the Pasteur Research Institute to research germs and experiment on vaccines.
• Problems Louis Pasteur faced

  To begin with, Pasteur's work had very little importance. The idea of spontaneous generation was believed by many people well into the 1870s. Attitudes of some people did not change: Dr Henry Bastian, a famous British doctor, continued to promote spontaneous generation until 1910.

  
  

  There were still no chemical cures to kill germs inside the body.
• Robert Koch (1880s)


  1. Applied germ theory to prove how bacteria caused disease.

  
  

  2. Identified germs in humans: T.B. 1882; cholera 1883 = scientists could look for cures.

  
  

  3. Better technology meant he used chemical dyes to stain germs; microscopes; camera lenses to photograph them.

  
  

  3. The German Government provided funds and research laboratories.
• Florence Nightingale

  During the Crimean War between Britain and Russia in 1854, a nurse called Florence Nightingale improved hospital conditions and nursing. Nightingale and a team of nurses went to Scutari where there was an army (military) hospital.
• What did Nightingale do and why did it help?

  1. Windows were opened, the hospital was cleaned.

  Patients were well fed, fresh water supplies improved.

  
  

  Fresh air got rid of bacteria.

  Better food meant they could recover their strength and fight off infection.

  Fresh water was less likely to spread disease. The death rate fell from 42% to 2%

  
  

  2. The public gave money so that the Nightingale School of Nursing could be built in London in 1860.

  Now there was somewhere to train nurses. They could learn about Nightingale's ideas.

  
  

  3. Her book "Notes on Nursing" was published. She described her methods:

  Other doctors and hospitals could learn about her ideas.

  
  

  4. Changed the image of nurses - By 1900 there were over 50,000 trained nurses.

  Nursing became more popular. They were respected and seen as important by the public.
• Surgery in 1800 ( at the start of 1800s)

  There were no anaesthetics which meant pain could kill patients.

  
  

  No knowledge of germs meant patients often died of infection.

  
  

  There was no knowledge of blood groups so there were few successful blood transfusions. Patients died from loss of blood.

  
  

  There were few complex operations due to the risks of death.
• Surgery in 1900 ( at the end of 1800s)

  Anaesthetics like chloroform put patients to sleep so there was no pain.

  
  

  Knowledge of germs meant aseptic surgery: germs were killed before the operation.

  
  

  Landsteiner discovered the 4 blood groups so transfusions could replace lost blood.

  
  

  More complex surgery was performed because many patients now recovered.
• Anaesthetics in the 1800s

  Anaesthetics are substances that stop pain.

  
  

  Before the 1800s there were no anaesthetics to put the patient to sleep. They might be given alcohol to dull the pain.

  
  

  Operations were carried out at great speed.

  
  

  Ether was used to put patients to sleep but: it could explode; it caused coughing.

  
  

  The best anaesthetic was Chloroform as used by James Simpson in 1847.
• Why were Christians against chloroform

  They thought God had intended childbirth to be painful. They claimed the Bible mentioned pain in childbirth. They thought anaesthetics were against God's wishes.
• Why were patients against chloroform

  Overdoses: Hannah Greener died after receiving chloroform, so did other patients. Chloroform affected the heart.
• Why were surgeons against chloroform

  They thought that if the patient was asleep they were more likely to die.
• What was the BLACK PERIOD

  However, the years after the use of anaesthetics were called THE BLACK PERIOD because more people died from infection after surgery because more germs got into the body.
• Anti-Septic Surgery and who introduced

  Joseph Lister introduced antiseptic surgery, killing germs whilst an operation took place. He invented a spray machine to spray carbolic acid all around the operation and wound.
• Advantages of Lister's work

  There was less infection after an operation.

  
  

  His methods cut the death rate after surgery from 46% to 15%.

  
  

  His methods became known as antiseptic surgery - killing the germs during an operation.

  
  

  By 1900 germs were surgeons wore rubber gloves, uniforms and face masks; operating theatres were sterilised - this was called aseptic

  
  

  surgery.
• Disadvantages of Lister's work

  Some doctors refused to believe in germ theory, they did not accept germs caused infection, they did not use antiseptics.

  
  

  It took too much time, it slowed surgeons down.

  
  

  The acid hurt the lungs and cracked the skin. Nurses and doctors complained about these problems.
• What was inoculation

  Before the work of Edward Jenner inoculation was used to prevent smallpox: a person was scratched on the arm and given smallpox pus; they got ill but recovered; they now had immunity from smallpox. BUT, inoculation wasn't safe, about 3% of patients died from inoculation.
• What did Edward Jenner do?

  In the 1790s Edward Jenner read inoculation (giving someone a weak dose of a disease) and how it was used against smallpox in Turkey.

  
  

  • Jenner was a doctor in the country. He saw milkmaids who got a disease called cowpox, never got smallpox.

  
  

  • Jenner experimented on a boy called James Phipps and got cowpox pus from a milkmaids sore, then gave him smallpox.

  
  

  Phipps never got smallpox, he was immune.

  
  

  • Jenner had discovered a vaccine for smallpox.
• Edward Jenner positives

  The British Government gave Jenner £30,000 to set up a vaccination clinic. This reached vaccines; produced the smallpox vaccine and carried out vaccinations.

  
  

  Vaccination was made compulsory in Great Britain in 1852. Doctors were paid by the government to vaccinate people so there was less smallpox.

  
  

  Smallpox was eventually wiped out as a disease.
• Edward Jenner negatives

  There was still no knowledge of germs; he could not prove why his vaccine worked.

  Some doctors opposed him.

  
  

  Some doctors carried out vaccines wrong so there were deaths. Doctors opposed him.

  
  

  People protested: they feared they would mutate into a cow; they thought it was wrong to inject humans with animal disease.
• Who investigated the spread of cholera and what year

  John Snow in 1854

  
  

  Cholera is a disease that causes sickness and death. It spread in infected water; thousands died.
• John Snow (1854)


  Snow believed cholera could not be spread by miasma because it affected the guts not the lungs.

  
  

  Snow investigated cholera and mapped the outbreak around Broad Street in London. With his map, Snow realised there were 55 deaths centred around the water pump.

  
  

  He also discovered that workers at a brewery who drank free beer were not affected by cholera. He took the handle off the water pump and the number of deaths declined.

  
  

  Later, it was discovered that next to the water was a cesspit filled with sewage that was leaking into the water and contaminating it.
• Impact of Snow's work


  1. People around the area of Broad Street did not catch cholera after the water pump was closed down by Snow.

  
  

  2. Parliament refused to believe his ideas. Many scientists refused to believe in Snow's work.

  
  

  3. In the 1860s the government hired Joseph Bazelgette to plan and build new sewers in London.
• Why did the government introduce the public health acts

  Before the 1870s, most poor workers in cities lived in slums: badly built houses without toilets or fresh water, disease spread easily.

  
  

  A disease called cholera killed thousands of people. A government law called The Second Public Health Act, 1875 was introduced.
• What did The Second Public Health Act (1875) say


  1. Sewers and drains had to be built underground. There was less filth and germs on the streets so less disease.

  
  

  2. New houses had to have toilets and fresh running water. This was good because there was less chance of cholera spreading because people had fresh water.

  
  

  3. Every town/ city had to have a medical officer to ensure the new laws on food, housing, water and hygiene were carried out.

  
  

  4. Public toilets connected to sewers had to be built. This was good because sewage was taken away off the street.

  
  

  5. Towns had to have public parks, a place to exercise.