CORE 2

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Before and After

Before

  • people didnt know what caused disease to spread
  • medical treatment was based on the four humours 
  • the influence of the church began to decline
  • a better understanding of the body began to develop
  • more scientific approach

After

  • the role of science and tech improved our ability to diagnose and treat illness
  • emphasis on prevention of illness through vaccinations and changes in lifestyle
  • women have become more involved in medicine
  • government taken on responsibilities for public health
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Life Expectancy

  • Industrial revolution was a time of great changes
  • in the mid 18th century various machines were invented that were powered by water or steam and worked quicker than manual workers
  • people moved to the towns to work in factories
  • the conditions in the factories led to ill health 
  • there were often accidents with the machinery
  • the housing in the towns was of poor quality and rooms were damp
  • living conditions were cramped with more than one family per house
  • sewers often ran into waters where people got drinking water from
  • less access to fresh food in rural areas
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Killer Diseases

  • Cholera arrived in britain in 1881, people could die within a day and it spread quickly
  • other diseases; Diptheria, Smallpox, TB, Typhoid

Ideas about the causes of disease

  • growing interest in science
  • affected peoples ideas about the cause of disease
  • MIASMA- disease was caused by bad air
  • SPONTANEOUS GENERATION- disease was caused by germs that were produced by flesh and vegetables as they rotted

Treating Cholera-

  • burning the clothes and bedding of the dead person
  • praying
  • cleaning the house
  • smoking cigars
  • lucky charms
  • burning vinegar
  • special mixtures of liquids or pills to cure illness
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Edward Jenner and Vaccination

Inoculation

  • a small amount of pus is taken from a sufferers smallpox blister
  • it is spread into a cut of the person being inoculated
  • a mild version of smallpox develops and the person becomes immune

Smallpox Parties

  • Lady Mary Wortley Montague witnessed this procedure in Turkey
  • was keen to protect her children
  • had them inoculated in 1721
  • people had parties where they would be inoculated together
  • not everybody could afford to have it done

Edward Jenner

  • the link only existed between smallpox and cowpox
  • he could not explain how the link worked
  • vaccination was not always successful
  • in 1802 the Jennerian society was set up in London to promote vaccination (vacca is latin for cow)
  • the government provided a grant to pay for people to have vaccinations 
  • doctors opposed Jenners work as they lost money 
  • 1852 government made vaccination compulsary
  • number of smallpox cases dropped dramatically
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Germ Theory

  • proved there are microbes in the air that cause decay
  • disproved the theory of spontaneous generation
  • led Robert Koch to identify specific microbes that caused some diseases
  • progress in the prevention and treatment of illness was slow due to having to identify the microbe responsible for each specific disease
  • in 1875 Robert Koch decided to investigate whether bacteria were linked to disease
  • he was funded by the German Government and identified specific microbes that caused the disease anthrax in sheep
  • Koch also found the microbes causing TB in 1882 and Cholera in 1883
  • he found that chemical dyes could be used to stain specific bacteria so they could be easily identified
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Research Teams

  • by the end of the 19th century scientific research was usually carried out by a team rather than an individual
  • a team would have more funding and be able to afford more technology
  • working in a team made it easier to check others work
  • each person could have different skills
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Doctors and Training

  • in the medieval and renaissance periods doctors learned by studying the works of Galen
  • they would not have done a dissection themselves however may have watched one
  • at the start of the industrial period, a small number of criminals bodys were allowed to be used for dissections in medical schools

Qualifications

  • doctors could set up practises once they had been accepted by the Royal college of surgeons, royal collegeof physicans, or society of apothecaries
  • they introduced examinations before they awarded a certificate

Practical Experience

  • more emphasis on using microscopes and understanding illness aswell as gaining practical experience by observing doctors
  • once qualified, doctors could apply for a position at the hospital working under supervision
  • as medical knowledge advanced doctors divided into specific areas

Dissections

  • body snatchers operated in the 18th and 19th century digging up newly buried corpses for students
  • the government tried to end this practise with the anatomy act of 1832 which allowed licensed anatomists to take the corpse if it wasnt claimed by a relative
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John Hunter

  • his lectures on anatomy helped to develop a more professional approach to medical training
  • he emphasised the importance of observation and experiment
  • his students included Edward Jenner 
  • he published several important works including one about the changes that occured in pregnancy
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Women in medicine

  • by the mid 19th century women began to demand the right to vote and to be able to attend university
  • womens role in formal medicine was very limited
  • their role in midwifery declined after the invention of forceps in the 17th century because the midwife needed training to use them successfully
  • the most famous male midwife was William Smellie- he would treat the poor for free if his students could attend the birth
  • his lectures were extremely influential 
  • nursing was not yet seen as a respectable career
  • it was not until 1877 that women could qualify as doctors
  • they faced opposition from male doctors who thought they were not intelligent enough
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Florence Nightingale; 1820-1910

  • organised care and supplies at a military hospital
  • emphasised cleanliness
  • believed disease was caused by miasma
  • death rate fell from 42% to 2%
  • wrote over 200 books about hospital design and organisation
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Elizabeth Garrett Anderson 1836-1917

  • applied to the society of apothecaries
  • refused to accept her but her father took them to court
  • in 1865 they agreed to register her 
  • in 1872 she founded the new hospital for women in London
  • 1876 act of parliament allowed women to enter medical professions
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Hospitals and care

Places to be treated

  • 1859 first cottage hospital opened in sussex
  • usually small and provided nursing care
  • 18 voluntary hospitals in london with 4000 beds
  • the middle and upper classes would be treated at home by a doctor
  • some doctors set up a sick club where people pay a weekly fund to cover any treatments
  • the working class could not pay a doctor
  • old, sick, or disabled people entered workhouses 

Government action

  • ordered that poor law unions should join together to build infirmaries that were seperate from the workhouses and had full time doctors appointed to them
  • were paid by local rate payers
  • new asylums for people with mental health issues and fever houses for people with infectious diseases were also built
  • these changes were an improvement but didnt completely seperate the workhouse and medical treatment from the poor
  • in 1887 the birmingham poor law union built a new infirmary with 1100 beds but 1500 people were still housed in workhouses
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factors in the development of hospital care

  • nightingales work in regulating the training of nurses was a signifcant factor
  • pasteurs work on germs also had an impact on hospitals, Joseph Lister began to use carbolic acid for antiseptic conditions 
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Patent Medicines and Pharmacies

  • apothecaries sold many preparations which they advertised as being a cure for everything
  • they came in the form of potions, ointments, pills, and were made of things such as alcohol, lard, wax, turpentine, ginger, and arsenic
  • the ingredients for pills were made into a paste and shaped by hand
  • for the rich, they may be covered in gold or silver to make them attractive and easier to swallow
  • William Brockedon invented a machine to make standardised pills that were produced quicker than hand made
  • Thomas Beecham began selling his pills in 1847 and Jesse Boot a herbalist from Nottingham transformed his family shop into a chain of pharmacies 
  • the growth of the chemical industry meant that companies such as Boots and Beecham could produce their own brand of medicines on a national basis
  • Hospitals could offer care for the sick but not cure, most illneses were still being treated in the home
  • the poor were likely to rely on these patent medicines or on traditional remedies
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Change and Continuity

  • the great ormand street hospital was opened in 1852 and contained only 10 beds
  • the emphasis was on medicine as a science and a professional approach to the design of hospital wards and to nursing care
  • advances in medicine were sometimes slow to reach ordinary people due to resistance to change
  • the role of the newspaper and photographs meant people became more aware of problems and public pressure sometimes forced change
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The Work of the Historian

  • in 1665 when there was an epidemic of the plague, Women were employed as searchers to record the number of the dead
  • if somebody died of the plague their whole family was locked in their house to prevent spreading
  • before the 19th century poplulation detals were not very accurate
  • most priests kept records of births and  deaths but this was not sent to any central government office
  • many of these records have been lost
  • in 1801 the governent ordered every parish to send in details about the number of houses and the number of families in their area
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