industrial medicine

• until the 1700s, people had few effective ways to prevent the spread of disease. edward jenner’s discovery of the smallpox vaccine was a landmark in the development of preventive medicine
• in the 1700s, smallpox was one of the most deadly diseases. in 1751, over 3,500 people died of smallpox in london alone
• at the time, the only way to prevent smallpox was through inoculation, which was successful in preventing the disease but it meant patients had to experience smallpox before they could become immune - some died as a response
• inoculation involved making a cut in a patient’s arm and soaking it in pus taken from the swelling of somebody who already had a mild form of smallpox
• edward jenner (born 1749) was a country doctor in gloucestershire, he heard that milkmaids didn’t get smallpox, but they did catch the mich milder cowpox
• using careful scientific methods jenner investigated and discovered that it was true that people who had cowpox didn’t get smallpox
• in 1796 jenner tested his theory by injecting a small box, james phipps, with pus from the sores of sarah nelmes, a milkmaid with cowpox. jenner then infected him with smallpox - james didn’t catch the disease
• jenner published his findings in 1798
• some people resisted vaccination and some doctors who gave the older type of inoculation saw it as a threat to their livelihood, many people were worried about giving themselves a disease from cows.
• jenner’s discovery soon got approved by parliament, which gave him £10,000 in 1802 to open a vaccination clinic, it then gave jenner a further £20,000 a few years later
• in 1840, parliament passed an act which made vaccination against smallpox free for infants, in 1853 parliament made it compulsory
• the vaccine was a success as it contributed to a big fall in the number of smallpox cases in britain
• jenner didn’t know why his vaccine worked, this lack of understanding meant he couldn’t develop any other vaccines. this was only possible after the germ theory was published, when pasteur and others worked to discover vaccines against other diseases, like chicken cholera and anthrax
• although people’s understanding of anatomy had improved greatly during the renaissance, there was still plenty to learn as the cause of disease was an area that still needed proper explanation
• germs and other microorganisms were discovered as early as the 17th century, as scientists thought that these microbes were created by decaying matter - known as spontaneous generation which led people to believe that disease caused germs
• people still thought miasma was the main cause of disease, the cholera outbreak of 1831-32 saw the government regulate the burial of the dead bodies to stop them creating bar air
• the french chemist louis pasteur was employed in 1857 to find the explanation for the souring of sugar beet used in fermenting industrial alcohol - he blamed germs
• pasteur proved there were germs in the air, he showed that sterilised water in a closed flask stayed sterile, while sterilised water in an open flask bred germs
• in 1861, pasteur published his germ theory where he argued that microbes in the air caused decay, not the other way round, and also suggested that some germs caused disease
• the germ theory was first met with scepticism as people couldn’t believe tiny microbes caused disease. it didn’t help that the germ responsible for each disease had to be identified individually as this meant it was several years before the theory became useful
• the germ theory soon gained popularity in britain
• the theory inspired joseph lister to develop antiseptics
• it proved john snow’s findings about cholera
• it linked disease to poor living conditions which put pressure on the government to pass the 1875 public health act
• the german scientist robert koch built on pasteur’s work by linking specific diseases to the particular microbe that caused them.
• koch identified anthrax spores (1876)
• koch identified the bacteria that cause septicaemia (1878)
• koch identified the bacteria that cause tuberculosis (1882£
• koch identified the bacteria that cause cholera (1883)
• koch used agar jelly to create solid cultures, allowing him to breed lots of bacteria
• koch used dyes to stain the bacteria so they were more visible under the microscope
• koch employed the newly-invented photography to record his findings
• before the 1800s, hospitals were often dirty places that people associated with death and infection. florence nightingale helped change that by improving hospital hygeine and raising nursing standards
• florence nightingale (1820-1910) bought a new discipline and professionalism to a job that had a very bad reputation at the time. despite opposition from her family, she studied to become a nurse in 1849
• when the crimean war broke out in 1853-54, horror stories emerged about the barrack hospital where the british wounded were treated
• sidney herbert who was both the secretary of war and a friend of her family asked for nightingale to go to barrack hospital and sort out its nursing care
• the military opposed women nurses, as they were considered a distraction and inferior to male nurses. nightingale went anyway, with 38 hand-picked nurses
• using methods she had learned from her training in europe, nightingale made sure that all the wards were clean and hygienic, that water supplies were adequate and that patients were fed properly
• nightingale improved the hospital a lot, the hospitals death rate went fro 42% to 2%
• mary seacole (1805-1881) also nursed in crimea