History Industrial revision.

Jenner was the first doctor to discover a vaccination. One of the most feared diseases was smallpox. 2,000 people in Londondied of smallpox every year. It was horrible.

People with smallpox got spots filled with pus. Many people died of smallpox. Mostly it was children who died. If you didn't die, you were left with nasty sores on your face. One day, Jenner met a dairymaid. 'I never worry about catching smallpox' she told him, 'for I have had cowpox'. Cowpox was a disease passed from cows to people. It was a mild sickness. No-one died from it. Dairymaids working with cows got cowpox easily - but not smallpox. 

He experimented on James Phipps. He took a small amount of pus and put it into his cut. James got cowpox but later when he was injected with smallpox he didn't catch it and he was healthy. Jenner faced opposition because many people thought disease was a punishment so therefore you shouldn't go against God and also that it was wrong to put an animal disease into your body.

At the time, it was assumed that cholera was airborne. However, Snow did not accept this 'miasma' (bad air) theory, arguing that in fact entered the body through the mouth. He published his ideas in an essay 'On the Mode of Communication of Cholera' in 1849. A few years later, Snow was able to prove his theory in dramatic circumstances. In August 1854, a cholera outbreak occurred in Soho. After careful investigation, including plotting cases of cholera on a map of the area, Snow was able to identify a water pump in Broad (now Broadwick) Street as the source of the disease. He had the handle of the pump removed, and cases of cholera immediately began to diminish. However, Snow's 'germ' theory of disease was not widely accepted until the 1860s.

Snow was also a pioneer in the field of anaesthetics. By testing the effects of controlled doses of ether and chloroform on animals and on humans, he made those drugs safer and more effective. In April 1853, he was responsible for giving chloroform to Queen Victoria at the birth of her son Leopold, and performed the same task in April 1857 when her daughter Beatrice was born.

Koch worked on anthrax and tuberculosis (TB) and he further developed the work of Louis Pasteur. Pasteur was convinced that microbes caused diseases in humans but his work on cholera had failed. He was never able to directly link one microbe with a disease. Koch succeeded in doing this.

Koch was a doctor and he had a detailed knowledge of the human body – something that Pasteur, as a research scientist – lacked. He was also skilled in experiments, the result of his work in natural sciences. Qualities that also proved to be important were his ability to work for long periods of time and his patience. However, Koch was also difficult to work with and could not tolerate anyone telling him that his theories were wrong.

Koch moved onto germs that specifically affected humans. In 1878, he identified the germ that caused blood poisoning and septicaemia. He also developed new techniques for conducting experiments that influenced the way many other scientists carried out their experiments. He knew that infected blood contained the septicaemia germ but he could not see these germs under a microscope, and therefore, other scientists were unlikely to believe what he thought to be true without the evidence.

Koch discovered that methyl violet dye showed up the septicaemia germ under a microscope by staining it. He also photographed the germs so that people outside of his laboratory could see them.

Koch also devised a method of proving which germ caused an infection.. In May 1882, Koch announced that his team had found the germ.

Louis Pasteur (France: 1860s) discovered (by using a swan-necked flask) that germs cause disease. Before he made this discovery, doctors had noticed bacteria, but they believed it was the disease that caused the bacteria (the so-called theory of 'spontaneous generation') rather than the other way round.

One of the spin-offs of Pasteur's discovery was the pasteurisation of milk, which prevented it from going sour by killing the germs and sealing it from the air.

Pasteur's oxygen method did eventually produce a vaccine but only after he had been awarded a patent on the production of an anthrax vaccine.

Louis Pasteur and Émile Roux, developed the first rabies vaccination. This vaccine was first used on a human on July 6, 1885, on nine-year-old Joseph Meister, who had been mauled by a rabid dog.

Paul Ehrlich (Germany: 1890s) reasoned that, if certain dyes could stain bacteria, perhaps certain chemicals could kill them. He set up a private laboratory and a team of scientists. By 1914 they had discovered several 'magic bullets' - compounds that would have a specific attraction to disease-causing microorganisms in the body, and that would target and kill them. These were methylene blue (for malaria), trypan red (for sleeping sickness) and Salvarsan (for syphilis) - although Salvarsan was more effective than the other two.

James Simpson was intrigued by the problem of pain in surgery. By 1846 surgeons had begun using ether as an anesthetic. In January 1847 Simpson used ether himself during a difficult delivery and he became an enthusiastic proponent of anesthetic. However ether was not perfect and Simpson looked for an alternative. In November 1847 he tried inhaling chloroform and it knocked him unconscious. James Simpson then tried it on a patient. It was a great success. The use of chloroform made childbirth much less painful for women. Chloroform made James Simpson famous.

Joseph Lister is the surgeon who introduced new principles of cleanliness which transformed surgical practice in the late 1800s. We take it for granted that a surgeon will guard a patient's safety by using aseptic methods. But this was not always the case, and until Lister introduced sterile surgery, a patient could undergo a procedure successfully only to die from a postoperative infection known as ‘ward fever’. 

He read Pasteur's work on micro-organisms and decided to experiment with using one of Pasteur's proposed techniques, that of exposing the wound to chemicals. He chose dressings soaked with carbolic acid (phenol) to cover the wound and the rate of infection was vastly reduced. Lister then experimented with hand-washing, sterilising instruments and spraying carbolic in the theatre while operating, in order to limit infection. His lowered infection rate was very good and Listerian principles were adopted throughout many countries by a number of surgeons.

Carbolic spray was opposed though due to expense, it being very uncomfortable and doctors not liking change. The spray was sticky and didn't smell nice. 

Florence Nightingale went to the Crimean War to help wounded soldiers. Florence Nightingale helped make hospitals a cleaner place. She showed that trained nurses and a clean hospital helped sick patients. She would make sure the hospita had good ventilation, change bandages and steamed things. 

When Florence first came to the hospital, the hospital was overcrowded and filthy. There were not enough beds, so men lay on the floor. They were not washed. There were no proper toilets. Drains were blocked. Rats ran everywhere. The smell was terrible. 

Florence worked 20 hours a day. She went to the town to buy fresh food. She started clean kitchens, and a French chef named Alexis Soyer came to cook better meals. She paid workmen to clear the drains. Soon the hospital was cleaner, and fewer men were dying.

At night Florence walked around the wards, to make sure the men were comfortable. She sat with dying soldiers. She wrote letters home for men who could not write. She carried a lantern, so the soldiers called her 'The Lady with the Lamp'.

Florence's work meant that the Army started training doctors. Hospitals got cleaner. Soldiers got better clothes and food.

In 1860 the Nightingale Training School for nurses was opened at St Thomas's Hospital in London. Florence's book Notes for Nursing helped many student nurses.

1834 Poor Law Amendment Act Medical Officers were appointed to workhouses which provided basic medical care for the poor.

1848 Public Health Act The Central Board of Health was created and although it was abolished 10 years later, the Act also encouraged local Boards of Health to be set up to appoint a Medical Officer, provide sewers, inspect lodging houses and check food which was offered for sale.

1853 Vaccinations were made compulsory although no one was given the power to enforce them.

1855 Nuisance Removal Act This Act made overcrowded housing illegal.

1864 Factory Act This made unhealthy conditions in factories illegal.

1866 Sanitary Act This made local authorities responsible for sewers, water and street cleaning.

1868 This Act encouraged the improvement of slum housing or its demolition.

1871 Vaccinations Act This made sure that the previous Vaccinations Act was obeyed.

1875 Artisans Dwelling Act This made the house owners responsible for keeping their properties in good order and gave local authorities the right to buy and demolish slums if they were not improved.

1875 Public Health Act This brought together a range of Acts covering sewerage and drains, water supply, housing and disease. Local authorities had to appoint Medical Officers in charge of public health. Local sanitary inspectors were appointed to look after slaughterhouses and prevent contaminated food being sold. Local authorities were ordered to cover sewers, keep them in good condition, supply fresh water to their citizens, collect rubbish and provide street lighting.