Industrial

• By 1750, the Church and classical ideas had lost their dominant influence and scientific ideas were much more accepted.

  With the growth of new technology, scientists continued to experiment and challenge old ideas.

  The use of new instruments (such as microscopes), chemicals and scientific equipment proved many new theories.

  Further improvements in travel - such as the development of the railways - then enabled these ideas to spread quickly throughout Britain.
• Throughout most of the 18th and 19th centuries, the government adopted a laissez-faire approach to medicine.
• Laissez-faire means people thought it was not the government’s role to interfere in everyday life.
• By the late 19th Century, the government's laissez-faire attitudes began to change and the national government began to pass legislation to force local authorities to improve living conditions and prevent the spread of disease and illness.
• The Industrial Revolution

  • Huge numbers of people moved from the countryside to urban centres. They left rural jobs in farming and agriculture, and found work in factories, mills and mines, which were springing up across the country.
  • By the end of the 19th century, most people in Britain were employed in factories and workshops.
  • Cities became the main centres of production.
• The theory of spontaneous generation was that decaying matter, things that had started to rot, created microbes.
• Spontaneous generation

  • Some people still believed in the harmful effects of miasma, or ‘bad air’, even in the 18th century.
  • However, this theory was rapidly becoming less convincing. Instead, scientists developed the theory of spontaneous generation.
  • Improved microscopes meant that scientists could see microbes. Scientists observed that microbes appeared on things that had started to rot and believed that they were the product of decay.
• Pasteur spoke with a brewer in Lille, who wanted to know more about why the drinks he made sometimes went sour.

  Pasteur’s experiments brought greater understanding of the process of fermentation and how to prevent it.

  Prevention was achieved by heating the liquid to a certain temperature, which would kill bacteria in the liquid and thereby stop it from going bad.

  This process became known as pasteurisation.
• Spontaneous generation (rotting matter causes microbes to appear) was disproven by Pasteur's germ theory as the reality is that bacteria and microbes cause decay.
• • Pasteur used microscopes and other instruments in his work.
  • The swan neck flask helped him to understand more about the role of bacteria - a type of microbe - in fermentation.
  • When air entered the long neck, tiny particles (bacteria) were trapped in the long tube. If they could not reach the liquid, no souring took place. When the flask was tipped and the particles were able to reach the liquid, it would turn sour.
• • Pasteur’s findings challenged the idea of spontaneous generation and he published his germ theory in 1861.
  • Pasteur argued that bacteria were the cause of disease, but he was unable to identify the specific bacteria that caused individual diseases.
• • Pasteur’s ideas were not accepted in Britain straight away and many people continued to believe in the idea of spontaneous generation.
  • However, there were some scientists who continued to research the link between bacteria and disease.
• • Joseph Lister, a surgeon, read Pasteur’s ideas and began to make links between bacteria and infection in surgery.
  • Lister faced challenges proving his ideas as, although microscopes had become more advanced and it was possible to see bacteria using them, it was difficult to separate the bacteria that were causing infection from those already present.
• Robert Koch proved Pasteur's theories as he was able to successfully identify some of the different bacteria that cause common diseases.
• Koch developed a new method of growing bacteria using agar jelly in a Petri dish.

  He then used a dye to stain the bacteria so that it could be seen clearly under a microscope.

  Using this method, he was able to identify individual bacteria.
• Robert Koch's Discoveries

  1876 - Koch found the bacteria that causes anthrax.

  1882 - identified the bacteria that causes tuberculosis (TB).

  1883 - discovery of the bacteria that causes cholera.
• Koch’s research inspired other scientists, which led to the discovery of further bacteria that cause diseases, such as diphtheria, pneumonia and meningitis.
• Koch’s work greatly improved medicine in Britain, as doctors now understood that it was bacteria that caused the symptoms of disease, so it was the bacteria that needed to be removed.
• Koch’s identification of bacteria did not make an immediate difference to the prevention of disease. This only happened when Pasteur took Koch’s work even further by developing other vaccines.
• Pasteur began developing animal vaccines for the diseases anthrax and chicken cholera.

  1885 - tested a human vaccine for rabies that saved a boy’s life after he had been bitten by a dog - the first successful vaccine since Jenner’s smallpox vaccine.
• Pasteur read about Edward Jenner’s smallpox vaccine, which had been developed in the late 18th century.

  Now that the individual bacteria for specific diseases had been identified, Pasteur began work on developing further vaccines for animals and humans.

  He knew that to prevent each disease, a weakened dose of the disease was needed to build immunity.
• Edward Jenner used cowpox (a weaker, less dangerous version of smallpox) to make a vaccination for smallpox, so people would build immunity to it.
• In 1852, Jenner's smallpox vaccination was made compulsory, but this was not enforced until 1872.
• Smallpox was eradicated in 1979 according to the WHO.
• Joseph Bazalgette was in charge of improving sewers, which he designed in 1858 and were completed in 1875.
• Hospitals in the 19th century

  • Not always safe.
  • Many patients would die because of the conditions on the wards.
  • Few toilets and poor sewerage systems.
  • Overcrowded wards with a lack of fresh air.
  • Lack of cleanliness, which led to the spread of infection.
• Prior to the late 20th century, nurses were usually female.
• Little criticism of standards in hospitals, but often untrained nurses were criticised for being ‘drunk’ on hospital wards.

  Female medical workers were often not properly recognised for the hard work and dedication they displayed towards their patients.
• Florence Nightingale trained to become a nurse in Germany before working in a hospital in London.

  When the Crimean War broke out in 1853, she was asked by the government to look after injured soldiers in the army hospital in Scutari.

  Nightingale accepted and took 38 nurses and 15 nuns with her.
• Nightingale was shocked at the conditions she found.

  Overworked medical staff were not being given the proper supplies of either food or medicine, and things were extremely dirty.

  Infections among the patients were common - the soldiers could come in with a wound or injury but catch an illness such as typhus, typhoid, cholera or dysentery while they were in the hospital.

  The numbers of deaths from infection and illness shocked Nightingale and her staff.
• Immediately, with her nurses, Nightingale worked hard to improve hospital conditions and establish better practices of cleanliness. This led to a fall in the death rate from 40 percent to 2 percent.
• Some of the changes put in place in Nightingale's hospital included:

  • ensuring there was regular hand washing.
  • making improvements to sewerage.
  • making improvements to ventilation.
• Nightingale's Influence

  On her return to Britain, Nightingale continued to improve the care given in hospitals and the training of nurses:

  • She wrote two books that influenced improvements across the world - Notes on Nursing (1859) and Notes on Hospitals (1863).
  • She opened her first Nightingale School for Nurses in 1860.
• Nightingale always believed that disease was caused by miasma.

  Therefore, she concentrated on keeping the wards and patients clean to remove the substances that would cause 'bad air'.

  She passed these ideas on to the nurses who trained in her schools.
• Mary Seacole was a Jamaican businesswoman and healer who had considerable experience of helping British soldiers and treating those with diseases such as cholera.

  She volunteered to travel to Crimea to help the war effort there. However, she was refused passage by several powerful figures. Nightingale was reluctant to meet with her or appoint her to her nursing staff.
• Seacole paid for her own travel to Crimea and set up a hostel there, having met with Nightingale briefly.

  The ‘British Hotel’ offered rest and recovery for British officers and Seacole was affectionately known as Mother Seacole by the soldiers.
• Developments in hospitals

  • Hospitals in the 19th century could vary in size, funding and organisation.
  • There was an increase in small cottage hospitals and voluntary hospitals during this period - which were paid for by charity from the wealthy, while doctors worked there for free.
  • Some working people would be treated in these hospitals if they paid into a fund to cover the cost of their treatments.
  • Rich people continued to pay for doctors to treat them at home.
• The very poor were assessed by the authorities.

  If their situation was considered desperate, they were admitted to a workhouse.

  After 1867, most workhouses had an infirmary to treat the sick and elderly.
• Hospitals where patients could be isolated, known as fever hospitals, were established for those suffering with infectious diseases such as smallpox and scarlet fever.

  Their aim was to treat those suffering whilst separating them from the general public.