Industrial Revolution 1750-1900

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  • Industrial Revolution 1750-1900
    • Urbanisation
      • more and more people moved the the large cities
      • public health facilities decreased
      • houses built quickly to house the new, mass influx of people
    • Causes of disease
      • people thought more scientifically on cause of disease
      • miasmas (bad smells)
      • germs by rotting animals and plants
      • spontaneous generation
    • Problems
      • poor quality housing
      • overcrowding
      • cramped conditions
      • little fresh food in cities
      • polluted drinking water
      • Long working hours
      • poor working conditions
    • Killer diseases
      • smallpox, TB, diphtheria, typhoid, cholera
      • thousands killed
      • no laws to provide public health facilities meant diseases spread quickly
        • Cholera outbreak
          • 1831-1832: 26,000+ killed,     1848-1849: 53,000+ killed,       1853-1854: 20,000+ killed         1865-1866: 14,000+ killed
      • Edwin Chadwick
        • secretary to Poor Law Commission and made reports on conditions of working class people
          • suggested people need access to clean water, sewers need to be improved, rubbish removed to all reduce illness
            • was one of the three commissioners of the Public Health Act
        • linked poverty to disease
        • 1842: Sanitary Conditions of the Labouring Population
        • forced government to act later on and lead to public health act of 1848
    • strong belief in laissez faire
    • Government action
      • Public Health Act of 1848
        • setup General Board of Health, setting up own local board of health, appoint medical officer, organise removal of waste and building a sewage system
        • General Board of Health abolished in 1858
      • London's Great Stink of 1858
        • Made government be made to build a new, expensive sewage system
    • John Snow
      • had theory that cholera was linked to contaminated water
      • cholera outbreak in 1854 had allowed him to map out all the deaths in Broadstreet
        • Linked this to a water supply being contaminated by a leaking cesspit
          • proved the link between contaminated water and cholera
          • once removing pump, deaths decline dramatically
    • William Farr
      • studied statistics on birth and death rates since 1837 and showed causes of deaths being linked to diseases
    • Improvements in medical training and treatment
      • Teaching hospitals developed where students observed doctors at work
        • students dissected bodies to understand the human anatomy
      • Pasteur's germ theory had more emphasis on studying microbes and disease through microbes
      • Increase of technology such as thermometer and stethoscopes helped diagnose illness
      • Qualifications in 18th century needed a certificate from the Royal College of Physicians and after 1815, had to have a exam to be passed before certificates awarded
        • 1858 had all doctors be registered with the General Medical Council
      • Midwives after having forceps in the 17th century, numbers fell as more needed the training necessary to use them and instead 'men-midwives' became more common
      • People still used herbal remedies but more reliant on apothecaries
      • Pills made by hand until William Brockedon invented machine in 1844 leading to slow accounts of usage
      • Quakers still sold 'cure all medicines' but didn't work
      • Money used used to grow pharmaceutical industry
      • Companies like Wellcome, Boots and Beecham financed chemical research and sold own brands of medicine
      • 1900 saw government have regulations to prevent harmful ingredients being used
      • Understanding of causes of disease had little impact on prevention or treatment until 20th century
    • Professionalising Medicine
      • Florence Nightingale
        • Believed miasmas caused disease
        • emphasised hygiene, fresh air, good supplies and training for nurses and lowered death rates in Scutari hospital from 42% to 2%
        • Published books on nursing and hospital organisation and setup training school for nurses/midwives
          • 1863 published Notes on Hospitals
      • Elizabeth Garrett Anderson
        • Went to medical lectures and studied privately to become a nurse, who went to the Society of Apothecaries in 1865 and was certified
          • Set-up medical practice in London and gained medical decree at university in Paris
            • Helped setup New Hospital for Women and London School of Medicine for Women
            • Helped allow women to be able to go to university in 1876 and obtain degrees
    • Hospitals
      • 1856 had them financed by charities and local councils and tried to create a homely atmosphere by having family visitors help nurses
      • 1875 had reformer like Florence Nightingale led hospitals to cleanliness and organisation with some trained using Pasteur's germ theory to improve hygiene and nurses given central role for caring patients and assisting doctors
  • Breakthrough-Jenner, Pastuer and Koch
    • see sheet

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