3: revolution of medicine

• before Pasteur's work, what did surgeons believed caused microbes?

  surgeons thought that microbes were caused by disease in spontaneous generation. The microbes were a symptom and diseases developed randomly, creating bacteria.
• what were the 2 main groups who believed different things about how disease spread?

  • contagionists: disease could spread through contact
  • anti-contagionists: disease spread through miasma
• when and how did Pasteur suggest there were germs in the air?

  1857: he found that sterilised water was still sterile if the flask was closed, but was not sterile if the flask was open. This suggested there was germs in the air.
• when did Pasteur publish his germ theory?

  1961: he published that germs were causing infection. Microscopes (invented in the 17th century) allowed Pasteur too see the microorganisms that he described.
• what was the opposition to germ theory?

  Charlton Bastian (a famous doctor) supported the theory of spontaneous generation, which contradicted Pasteur's germ theory. Doctors didn't believe that small germs could cause such harm to humans.
• using Pasteur's germ theory, what did Koch explain?

  he showed that not all germs were the same. He identified different microbes that caused anthrax in 1876 and tuberculosis in 1882. He injected animals with diseases then dyed bacteria and viewed them using microscopes.
• how was William Cheyne significant?

  he translated Koch's work and highlighted that not all microbes caused harmful disease.
• how did Pasteur accidentally show that vaccinations could prevent disease?

  in 1879, after a researcher Charles Chamberland left out a cholera culture over the weekend, they discovered that weakened cholera germs could make a chicken immune from later tronger bouts of cholera.
• why were Koch and Pasteur rivals?

  in 1871, the Franco-Prussian war ended (between France and Germany). Some historians think national rivalry between the 2 of them drove developments. Scientific advancements were propelled forwards by competition.
• who created magic bullets?

  People knew that antobodies attacked different types of microbes. Because of this, they were called magic bullets. Paul Ehrlich decided to create magic bullets that behaved like antibodies using chemicals.
• when did Ehrlich win a nobel prize for medicine?

  1908
• what were the problems in surgery in the 1800s?

  • pain - patients often died from clinical shock due to the pain of surgery.
  • infection - before Germ Theory, people didn't know that microbes caused infection. Surgeons wore the same oufit and used the same medical equipment.
  • bleeding - patients often died due to blood loss.
• what were methods of anaesthetics in the 1800s?

  physicians and surgeons gave patients alcohol (made them drunk) or gave them opium to numb the pain.
• who discovered chloroform?

  James Simpson in 1847: it was effective but led to death in high doses. It killed Hannah Greener in 1848.
• why was there oppositions to anaesthetics?

  • anaesthetics initially increased the number of deaths in surgery, due to too high of doses.
  • some army surgeons thought that soldiers should endure the pain.
  • some religious people thought that the pain suffered during surgery was God's will.
• what did Joseph Lister?

  He applied Pasteur's germ theory to surgery. He thought germs explained why wounds from surgery got infected. Lister used carbolic acid as a chemical which could kill bacteria. This stopped germs from infecting wounds in surgery.
• how was Joseph Lister's work significant?

  the death rate in Lister's patients fell from 46% to 15%. Covering surgical instruments, bandages and the surgeon's hands in carbolic acid reduced the chance of infection.
• what was opposition to Lister's work?

  • most doctors believed that chemicals caused infections, not germs.
  • Pasteur's ideas hasn't been accepted yet, people still believed in spontaneous generation.
  • carbolic acid was unpleasant for doctors to use as it was irritating.
• by when had Pasteur's germ theory been widely accepted in Britain?

  1880
• by when had aseptic surgery become common?

  1900
• what did aseptic surgery involve?

  surgeons were scrubbed clean, wore new clothes, and thin rubber gloves. Surgeons used sterilised instruments and operating theatres got smaller to reduce the chance of infection.
• what were public health problems in industrial britain? (urbanisation)

  Lots of people moved to cities because that is where most manufacturing jobs were located. Thousands of people migrated from the countryside to cities such as London, Manchester, and Birmingham. More people lived in British cities than the countryside.
• what were public health problems in industrial britain? (living conditions)

  Most people living in cities lived in terrible living conditions. Workers lived in very small houses which were very close together and families often lived in one small room. Workers recieved very small wages and lived in poverty.
• what were public health problems in industrial britain? (water + sewage)

  Private toilets were rare, most families used shared toilets outside the house. Sewage would fall into cesspits. Water came from local rivers whoch is where sewage from cesspits often ended up. Peoples' health was lower than any other time in history.
• what were public health problems in industrial britain? (disease)

  because of the poor working conditions and overcrowding, disease was very common, including cholera and tuberculosis. Cholera was caused by contaminated water/food. Tuberculosis was caused by germs was spread by sneezing or coughing, it was spread through crowded areas.
• what were public health problems in industrial britain? (government)

  Local councils were usually responsible for health problems. Some poeple thought the government should intervene but they often didn't (laissez-faire). Local taxpayers made decisions and many of these did not want to pay more money to improve health conditions (for others) n their town.
• when did cholera epidemics affect Britain?

  every few years between 1831 and 1866. Symptoms of cholera included vomiting, and having painful diarrhoea. Although governments were concerned about cholera epidemics they did not know what caused cholera, and therefore, how to prevent it.
• why is Edwin Chadwick's report significant?

  after the cholera epidemics, he wrote a report on living conditions for working classes in 1842. It was called Report on the Sanitary Conditions of the Labouring Population. He thought bad health was caused by people's awful living conditions.
• what did Chadwick suggest after his report?

  he suggested that laws should improve drainage and sewer systems. he thought medical officers should be appointed to improve the situation for the poor. Although the explanation for disease was wrong, he recognised the need to improve public hygiene, particularly the need for clean water and streets.
• when was the first public health act?

  1848: Parliament passed an act that set up a Board of Health to encourage local councils to improve conditions. But not many authorities did much. In 1872, there were only 50 Medical Officers of Health appointed. It didn't have a huge impact and wasn't compulsory.
• when was the cholera epidemic?

  1854
• what was John Snow's work?

  He saw that all victims of the cholera epidemic in 1854 lived near the Broad street water pump. He removed the pump's handle and forced everyone to use another pump. This stopped the spread in this area. The water pump had been contaminated by a leaking street toilet.
• what and when was the Great Stink?

  1858 London: the River Thames was so full of sewage and the weather was so hot that London smelt very bad. Parliament noticed the smell. This prompted them to improve London's hygiene and sewage systems.
• which engineer was funded to build sewage systems in London ?

  Joseph Bazalgette, 1800 kilometres of sewers were built to tale sewage out of Central London. These are still used today.
• when did working class men get the right to vote?

  1867
• when was the second public health act?

  1875: it forced the local authorities to provide clean water, providing proper sewage systems, collect rubbish on the streets, and appoint a medical officer of health. The 1848 public health act was voluntary but the 1875 act was mandatory.