industrial revolution

• New understanding of the body and Galen's descriptions were incomplete and sometimes wrong
• The invention of the proved that Harvey's ideas were right
• Theory of the four humours no longer accepted. People initially thought that miasma, caused disease
• Doctors carried out dissections and used microscopes. Galen's books were no longer important
• Inoculation


  • In the 18th century, smallpox was a big killer. Lady Mary Wortley Montagu brought inoculation to Britain
  • She discovered that a health person could be immunised against smallpox using pus from the sores of a sufferer with a mild form of the disease
  • However, inoculation sometimes led to smallpox and death
• Edward Jenner


  • Jenner was a country doctor. He heard that milkmaids didn't get smallpox, but instead a milder cowpox
  • Jenner investigated and discovered people who had already had cowpox didn't get smallpox
  • In 1796 he took a small boy and injected him with pus from the sores of a milkmaid with cowpox. Jenner then injected James with smallpox. James didn't catch the disease!
• Opposition to the Smallpox Vaccination

  • Jenner could not scientifically explain how it worked
  • Inoculators were afraid of losing money
  • Many were worried about side effects; they worried about giving themselves a disease that from cows
  • Some members of the Church believed that vaccination was not natural
• Florence Nightingale


  • Nightingale brought discipline and professionalism to a job that had a bad reputation at the time
  • From a wealthy background, she became a nurse despite the opposition of her family
  • Went out to the Crimean War to sort out nursing care in the English camp
  • She made huge improvements in the death rate, due to improvements in ward hygiene
  • When she returns home, she writes a book 'Notes on Nursing' and sets up a hospital in London
• Mary Seacole


  • From a poor background in Jamaica. Seacole volunteers to help as a nurse in the Crimean War, she is rejected, but goes anyway self-financing her journey
  • She nursed soldiers on the battlefields and built the 'British Hotel'
  • Goes bankrupt when she returns to England – but receives support due to the press interest in her story and she writes an autobiography
• Germ Theory


  • Scientists thought microbes were caused by disease and appeared because of illness. This was the theory of spontaneous generation. Instead of blaming microbes, people looked for miasmas
  • Louis Pasteur was employed in 1857 to find the explanation for the souring of sugar beet used in fermenting industrial alcohol. His answer was to blame germs in the air
  • He proved there are germs in the air by sterilising water and keeping it in a flask that didn't allow airborne particles to enter. This stayed sterile – but sterilised water kept in an open flask bred microbes again
• Robert Koch


  • He began linking diseases to the microbe that caused that specific disease
  • Koch developed a solid medium to grow cultures, and dyeing techniques to colour microbes, which he viewed through high-powered microscopes
  • He identified anthrax spores and the bacteria that cause septicaemia, tuberculosis and cholera
• Louis Pasteur - Chicken Cholera Vaccine

  • Hearing of Koch's, Pasteur came out of retirement and competed to find new microbes and combat them
  • Pasteur looked for cures to anthrax and chicken cholera. Both he and Koch worked with large teams of scientists
  • Chamberland was told to inject chickens with chicken cholera, but it was the day before his holiday and he forgot. He left the germs on his desk and injected the chickens when he returned from his holiday
  • The chickens survived, Pasteur and Chamberlain tried again with new germs, but the chickens survived
  • The cholera had been weakened by being left out, and the weakened cholera made the chickens immune. Chamberland's error had produced a chance discovery
• Louis Pasteur - Anthrax Vaccine


  • Pasteur's team managed to produce a weakened version of the anthrax spore that would make sheep immune to the disease. They demonstrated this in a public experiment
• Problems faced by surgeons in 1800

  • Pain – patients can die of clinical shock during surgery
  • Infection – people were unaware of microbes that cause infection. Surgeons would wear the same dirty apron for every surgical procedure they carried out, passing on infection between patients
  • Bleeding – patients can die if they lose too much blood during surgery
• How was the problem of pain overcome?

  • Nitrous Oxide or 'laughing gas' was discovered by Sir Humphry Davy
  • Ether used by J.R. Liston during a leg amputation. However, it had very unpleasant side effects
  • Chloroform used by James Simpson and some friends at his home. They realised that it could be used as during surgery. However, it led to unexplained deaths. The dose given could not be measured or controlled
• Reasons for opposition to anaesthetics

  • They were uncomfortable for patients
  • Some doctors believed that pain was good for healing
  • People didn't understand how they worked
  • Didn't understand the side effects that new substances could have on the body
• The final breakthrough came when Queen Victoria accepted the use of chloroform as an anaesthetic during the delivery of her eighth child
• Until germ theory in the 1850s, surgeons didn't take
• A book that was not well known, the book was given an obscure name
• Ether


  Used by J.R. Liston during a leg amputation, however it had very unpleasant side effects
• Chloroform


  Used by James Simpson and some friends at his home, they realised that it could be used as an anaesthetic during surgery, however it led to unexplained deaths and the dose given could not be measured or controlled
• Reasons for opposition to anaesthetics

  • They were uncomfortable for patients
  • Some doctors believed that pain was good for healing
  • People didn't understand how they worked
  • Didn't understand the side effects that new substances could have on the body
• Final acceptance of anaesthetics

  The final breakthrough came when Queen Victoria accepted the use of chloroform as an anaesthetic during the delivery of her eighth child
• How the problem of infection was overcome

  1. Until germ theory in the 1850s, surgeons didn't take precautions to protect open wounds

  2. Joseph Lister and the discovery of antiseptics

  3. Lister heard that carbolic spray was used on sewage, he knew sewage had a similar smell to gangrene

  4. He had read the work of Pasteur on his germ theory

  5. He was prepared to take risks
• Reasons for opposition to Lister

  • Lister's methods slowed down surgery
  • The spray was uncomfortable for doctors to use, it affected their skin
  • Pasteur's germ theory was not widely accepted in 1857
  • Surgeons did not copy his methods correctly and were therefore disappointed with their results
• The final development of aseptic surgery

  1. Operating theatres and hospitals were rigorously cleaned

  2. All surgical instruments were steam sterilised

  3. Sterilised rubber gloves were first used and surgeon's hands were scrubbed
• Early blood transfusions


  Often ended disastrously because blood groups had not been discovered, they could not prevent the blood from clotting, and infection could be passed on
• During the late 1700s and the first half of C19th, conditions in British towns became worse than ever
• Houses were built as close together as possible as more people crowded into factory towns to work
• Towns could not cope with the need to provide people with water and sewage disposal facilities
• In these squalid conditions, diseases spread easily and rapidly
• The conditions were so bad that many people's health may have even become worse than ever before
• Attitudes towards government intervention in public health


  • Some thought the government should force local councils to clean up their towns
  • Many believed the government shouldn't interfere - this attitude is called laissez-faire
  • Local ratepayers didn't want the government to force them to pay for improvements to their towns
• Edwin Chadwick


  In 1842 he was asked by the government to report on the living conditions and health of the poor, he concluded that poverty was caused by ill health which was caused by the terrible conditions in which people lived, and said that ratepayers can cut their taxes and save money in the long-term by looking after the poor and to spend money improving their health
• For over 30 years an argument went on about the need for town councils or the government to take action
• 1848 Public Health Act


  The government set up a Board of Health to encourage, but not to force, local authorities to improve conditions, and gave local authorities money to make improvements if they wanted to and had the support of local ratepayers, but only a few local authorities took any new measures
• John Snow


  In 1854 he proved that there was a link between cholera and water supply, used research, observation and door-to-door interviews to build a detailed map of a cholera epidemic in Broad Street, and removed the handle from the Broad Street pump which stopped the deaths
• For years human waste made its way from the latrines in London into the River Thames
• In 1858 the hot weather caused a 'great stink', the putrid smell was right under Parliament's nose, and this prompted Parliament to sort out London's sewage and drainage system and to clean up the River Thames
• 1867 Second Reform Act


  Working class men were given the right to vote, for the first time it wasn't just the ratepayers who got a say in improving public health, and MPs were forced to improve the living conditions of the poor