18th & 19th century

• 1861 germ theory : incorrected spontaneous generation, proved that microbes in the air caused decay. he theories that germs also causes disease but was unable to prove it
• robert koch : identified microbes in TB in 1882, cholera in 1883, he also developed an easier way of growing bacteria using chemical dyes bacteria.
• influence of koch and pasteur : took time to accept germ theory, koch had more impact, pasteur wasnt a doctor, lister made links, didnt have an immediate impact
• florence nightingale : improved hospital care and public opinion about hospital conditions; believed in miasma so emphasised hygiene, fresh air, good supplies and training; published notes on nursing; and set up a training school for nurses.
• great ormond street hospital (1856): middle and upper classes could afford doctors to treat them out home; elderly, sick or diseased poor forced to enter workhouses; tried to create a home atmosphere.
• great ormond hospital street hospital (1875): hospital cleanliness and organisation improved and nurses were better trained; nurses were given a central role for caring for patients and assisting doctors; public pressure led to infirmaries; and specialist hospitals developed
• before 1800 alcohol and opium has little success in easing pain during surgery
• 1844: laughing gas used but fail to ease pain
• 1847: use of chloroform was effective but it was difficult to get the correct dose
• 1884: cocaine was the first local anaesthetic used, replaced by novocaine in 1905
• joseph lister : after reading germ theory he began to soak bandages in carbolic acid to avoid infection; also developed a spray to kill air borne germs; and in 1867 he stated his wounds were infection free for 9 months and then he published his ideas
• aseptic surgery : by 1900s ward were throughly cleaned using aseptic techniques and surgeons/nurses wore sterilised clothing and medical instruments
• public health act 1875: city must provide clean water, sewers, public toilets, street lighting, public parks, check food quality, inspect housing, monitor damp in houses, employ a public health officer
• reasons for public health act 1875: government changed their laissez faire attitude towards public health due to epidemics and people recognised it was government responsibility to protect the public
• cholera broke out in 1854
• symptoms of cholera : diarrhoea, sickness, dehydration and blue skin
• people affected by cholera : poorest people, slum dwellings, workhouses, prisons, asylums, but wealthier districts has some cases
• cholera was spread by : drinking water contaminated by faeces and person to person contact
• prevention of cholera : clean up dirty streets, clearing rotting materials, cleaner water supplies however these didnt solve issues regarding people living conditions
• john snow : wrote 'on the mode of communication of cholera' which said cholera wasnt transmitted via miasma and it was drinking water; he also removed a water pump on broad street and the cholera outbreak stoped
• john snow pt2: he showed evidence to house of commons and they changed londons sewer system