Medicine: 18th/19th Centuries

?

Medicine 18th/19th Century

Edward Jenner

Edward Jenner (1749-1823) discovered the method of vacciantion agaisnt smallpox in 1796 through observation of his patients.                                                                                                                                                                 

The old method to fight smallpox was innoculation.                                                                                                                                          

He experimented successfully on a young boy named James Phipps.                                                                                                                           

He published his results in 1798.                                                                                                                                                                          

Although he faced much opposition because he was unable to explain how his method worked, he had a lot more support.                                                                                                                                                                           

As a result of this support, he recieved money from parliment which, in 1840, made vaccination free for all infants.                                                                                                                                                                                               

In 1853, the government made vaccination compulsory - a very unusual decision. 

1 of 6

Medicine 18th/19th Century

Pasteur and Koch

By 1800, many people believed in the theory of 'Spontaneous Generation.'

In 1849, Louis Pasteur began to work as an industrial chemist and, by accident, found the link between germs and disease. He discovered that a particular micro-organism was growing vigorously in a liquid and that germs were the cause of this problem. 

Robert Koch then went on to show how a particular germ caused a particular disease. 

In 1875, Koch discovered the Anthrax microbe and in 1878, he found how germs make wounds go septic. He then discovered the germs causing TB and Cholera. 

The steps to finding a cure for those already infected with a disease:

1. Pasteur and his team discovered a vaccine for chicken cholera and then went onto find a vaccine agaisnt anthrax in animals. One of his teams successfully demonstrated this in public.

2. In 1882, Pasteur set up a team to find a cure for rabies in animals and by chance he was forced to test it on a human and a series of injections stopped the boy from getting the disease.

3. One of Kochs assistants found that some animals produce an anti-toxin to fight 

2 of 6

Medicine 18th/19th Century

Nightingale's Work:

  • Before Nightingale’s work: nurses had a poor reputation.  They were seen as untrained drunks.  Hospitals were dirty and patients often died from infection.
  • Nightingale’s work in the Crimean War: Nightingale cut the death rate of British soldiers in military hospitals in Turkey by improving hygiene, sanitation and ventilation (fresh air) in the hospital wards.
  • Nightingale’s work after Crimean War: she set up a training school for nurses.This changed the reputation of nursing. Now people saw it as a respectable profession.
  • Nightingale also advised the government on how to improve the layout of hospitals in Britain so nurses could do their jobs better.

Factors which helped Nightingale:

  • War - Nightingale was sent to Crimea because the British government wanted to cut the number of dying soldiers during the Crimean War.
  • Communication - British newspapers printed heroic stories about her work in the Crimean war. This improved the reputation of nursing in Britain.
  • Religion - Nightingale said that she was inspired to work as a nurse by her belief in God.

Fighting Disease (19th&20th Centuries):

Nightingale's Work cont. :

Obstacles for Nightingale:

  • Attitudes to women – Men in the British army did not like being told what to do by a woman. Wealthy Victorian women were expected to stay in the background.
  • Attitudes to nursing – Nightingale’s parents tried to stop her nursing career, because nursing had such a poor reputation
  • Beliefs about disease – Nightingale never understood what caused disease. She based her ideas about ventilation and cleanliness on the miasma theory, which was incorrect.

Fighting Disease (19th&20th Centuries):

Pasteur's Work:

Pasteur made three major discoveries:

  • 1861 Germ theory – discovered germs and proved they cause animal diseases
  • 1879 Discovery of how vaccination works – While working on chicken cholera germs, Pasteur discovered how to make a new vaccination for chicken cholera. He realised that vaccines could be made by using a milder form of the disease. This is something that Jenner never knew when he made his smallpox vaccination.
  • 1882 Vaccines for anthrax, rabies and cholera

Factors which helped him:

  • War between Germany and France.  Pasteur wanted to give France the advantage in the race to beat germs.
  • Government - The French government gave Pasteur a team of scientists to help him with his research.This allowed Pasteur to make his discoveries quicker.
  • Science & Technology - Pasteur used better microscopes to study germs.

Fighting Disease (19th&20th Centuries):

Pasteur's Work cont. :

Criticism of Pasteur’s work:

  • Pasteur’s germ theory was based on animals. It was Koch who went on to show that germs cause human diseases.
  • Pasteur was not the first to discover a vaccine – Jenner was.
  • Pasteur used Koch’s work on identifying germs like cholera to help him create new vaccinations
  • Pasteur’s discovery of a chicken cholera vaccine was partly chance.  His team accidentally left some chicken cholera germs out in the air and they were weakened.  Then they were injected into a chicken.  The chickens recovered and became immune to the germ.

Fighting Disease (19th&20th Centuries):

Koch's Work:

  • Staining bacteria with dye - This made it easier to study them
  • Germs cause human disease - Koch showed that germs could cause people to get sick, not just animals
  • A method to prove which germs caused specific diseases - He injected germs into mice and repeated the experiment to test his results.This led to the discovery of anthrax,tuberculosis & cholera germs.

Factors which helped him:

  • War - Koch wanted to give Germany the advantage in the race to beat germs
  • Government - The German gov. gave Koch a team of scientists to help him with his research
  • Science & Technology - Koch used improved microscopes to study germs. He used new chemicals to dye bacteria.
  • Individual brilliance - Koch repeated his experiments with mice twenty times to prove which bacteria caused anthrax.

Criticism of Koch’s work:

  • Koch’s discoveries were all linked to Pasteur’s discovery of germs. 

Surgery (19th&20th Centuries):

Problems of early 19th Century Surgery:

  • Pain - This makes surgery difficult and patients can die of shock. So surgeons operated fast and sometimes got their patients drunk first. Operating fast made it difficult to be accurate. It also made it impossible to operate deep inside the body.
  • Infection - In 1800 surgeons did not know germs existed. They operated in dirty conditions and patients died of infection. Surgeons still did not know about germs or how infection spread. 
  • Bleeding - Surgeons had to operate fast in order to avoid too much blood loss

Surgery before 1800:

  • Ancient Egyptians – Could only do simple surgery e.g. broken noses 
  • Ancient Greeks – Washed wounds with wine or vinegar to clean them
  • Ancient Romans – Used opium to stop pain, but this was not much use for severe pain.
  • Middle Ages – Used cauterization to stop bleeding and infection, but this was a painful treatment and often infected the wounds. Barber surgeons had to do basic surgery e.g. Tooth pulling and amputation
  • Renaissance – Pare invented ligatures, but they were dirty and spread infection

Surgery (19th&20th Centuries):

Simpson & Chloroform - 19th Century:

Factors which helped him:

  • Individual brilliance – Simpson experimented with many chemicals before finding chloroform worked best.  He wrote articles about his discovery which spread his idea to other surgeons.
  • Science – In the 1800s, new chemicals were being discovered, it was common for scientists to experiment with new chemicals and gases. 
  • Communication – Simpson’s discoveries were published in a medical journal.This helped them spread quickly to other surgeons.

Opposition to Simpson & chloroform:

  • Religious opposition - people thought it was against God's will to stop pain
  • Scientific opposition - people were frightened that chloroform might have side effects. It was difficult to calculate the right dose and sometimes patients died from the anaesthetic.
  • Scientific opposition – using chloroform to send patients to sleep allowed surgeons to operate deeper in the body. But this made the risk of infection and blood loss even worse
  • Moral opposition - in the British army, using anaesthetics was seen as cowardly. Soldiers were expected to cope with pain during surgery.

Surgery (19th&20th Centuries):

Lister & Antiseptics - 19th Century:

Lister read Pasteur’s work on germs and wanted to stop germs causing infection during surgery.  He sprayed carbolic acid across the operating theatre during surgery as an antiseptic to kill germs during surgery. 

Factors which helped Lister:

  • Individual brilliance - Lister’s idea to spray carbolic acid during surgery was brilliant. He recorded his results carefully to check his methods worked.
  • Science - Lister's  use of carbolic acid to kill germs was based on Pasteur's Germ Theory 1861.
  • Science - in the 1800s many scientists were experimenting with new chemicals and gases. This is what Lister was doing when he discovered carbolic acid. 
  • Communication - Lister first discovered carbolic acid when he read about it being used to clean sewage in Germany. He read this in a newspaper, which was the main form of spreading news in the 1800s.

Surgery (19th&20th Centuries):

Lister & Antiseptics cont. :

Opposition to Lister:

  • Side effects - Carbolic acid irritated surgeons skin, eyes and throat.
  • Speed - Carbolic acid made tools slippery and slowed operations down. This made the blood loss worse.
  • Lister’s personality – Lister was shy and did not like to demonstrate his methods in public. This stopped his ideas spreading quickly.

Long-term importance of Lister’s work:

  • Lister’s work was the first step towards aseptic surgery.  This means removing all possible germs from the operating theatre.  This was done by introducing:-
  • Sterilisation of all surgical instruments (after 1887)
  • Sterilised rubber gloves (after 1894) This allowed more serious operations e.g. on the heart

Surgery (19th&20th Centuries):

World War I and Surgery - 20th Century:

World War I led to improvements in surgery because:

  • Wounded soldiers gave surgeons the opportunity to experiment with new methods
  • Powerful guns used during the war created severe wounds which needed new treatments
  • Head wounds were common because soldiers fought in trenches.  This led to developments in eye, ear, head, face and brain surgery.  Plastic surgery was developed.
  • Bullets and shrapnel became stuck in soldiers’ bodies. New methods were needed to remove them.
  • Blood loss needed to be solved, because soldiers were bleeding to death on the battlefields.

X-Rays - 20th Century:

Factors which led to the development of X-rays:

  • Science - X-rays were discovered in 1895.  A German scientist called William Rontgen was experimenting with cathode rays when he discovered they could pass through human flesh, but not bone.
  • World War I – many soldiers had bullets and shrapnel stuck in their bodies, causing infection.So the government paid for X-ray machines in army hospitals to treat soldiers more successfully

Surgery (19th&20th Centuries):

Blood Transfusions - 20th Century:

Factors which led to discovery of blood transfusions:

  • Science - Blood groups were discovered in 1901.  Surgeons realised that blood transfusions only worked if they used compatible blood types. But there was still no way of storing blood, so transfusions had to be person-to-person.
  • World War I - It was impossible to do person-to-person blood transfusions on the battlefield, so doctors found a way of storing blood. This was done by separating the blood plasma from the blood cells

Public Health (19th&20th Centuries):

Public Health After The Romans:

Reasons why there was not much improvement in public health after the Romans:

  • War in the Middle Ages – War destroyed the Roman public health system. Kings spent their money on armies & weapons not public health improvements.
  • Lack of understanding of disease – People in the Middle Ages and Renaissance did not know about germs or understand the cause of disease so they did not build public health systems

Public Health Problems - Early 19th Century:

The main public health problems in British towns were:

  • Overcrowding – Whole families shared single rooms to wash, cook and sleep
  • No sanitation – There were no sewer systems to remove waste
  • Cesspits– Human waste was dumped into pits until they overflowed
  • Privies – Toilets were holes in the ground which had to be emptied by hand.
  • Rivers – Waste was dumped straight into rivers
  • No fresh water – Often water supplies were contaminated from sewage from rivers&cesspits
  • Diseases – Infectious diseases like smallpox and cholera spread quickly

Public Health (19th&20th Centuries):

Opposition To Public Health Improvements:

In the early 19th century people were against cleaning the towns because of:

  • Laissez faire ideas – People believed the government should not interfere in people’s lives and try to keep them clean
  • Money – Tax payers did not want to pay more tax to clean up cities for the poor.  
  • Landlords who rented houses for a profit did not want to pay to connect the houses to the water supply.
  • Science – Most people believed in the miasma theory, that dirty air spread disease.  They did not know about germs, so they did not see a reason to clean up

Public Health (19th&20th Centuries):

SEVEN factors changed these attitudes:

Factor 1 - Edwin Chadwick’s work:

Edwin Chadwick wrote the 1842 Sanitary Report on poor areas of London. He said:

  • Dirty conditions – Poor people were living in overcrowded, dirty conditions.
  • Sickness – Poor people were getting too sick to work
  • Tax – It was costing taxpayers too much to look after sick, poor people 

Impact of Chadwick’s Report

  • Chadwick’s report persuaded the Government to pass the 1848 Public Health Act.  This set up  a National Board of Health whose job was to encourage towns to clean up.  
  • However this was voluntary and many towns and their tax payers did nothing to clean conditions.

Public Health (19th&20th Centuries):

Factor 2 - Cholera Epidemics:

  • What happened?: Cholera  epidemics in Britain in 1832, 1847, 1854
  • Impact: Killed thousands of people in towns.  Frightened people and made them more willing to pay to clean up 
  • However:  many people still saw no reason to clean the water supply, as they still believed the miasma theory.

Factor 3 - John Snow's Work:

  • What happened?: During a cholera outbreak in London In 1854 John Snow proved cholera spreads in dirty water using scientific research.  He recorded the cholera deaths in Soho on a map.  This proved that the deaths were linked to the water pump on Broad Street.
  • Impact: Snow’s work was the first to prove that disease spread in dirty water.  Pasteur’s germ theory hadn’t even been published yet.
  • However: Many scientists still believed in the miasma theory of disease even after Snow’s work.

Public Health (19th&20th Centuries):

Factor 4 - The Great Stink 1858:

  • What happened?:  The summer was hot and the smell from the dirty River Thames became unbearable.
  • Impact: The smell of the river by the Houses of Parliament was so bad, it persuaded the government to build a new sewer system for London.
  • However: there was still no action taken to clean up other towns across the country.

Factor 5 - Pasteur's Germ Theory 1861:

  • What happened?  Pasteur proved that disease was spread by microbes (germs).  
  • Impact:  It finally proved that dirt causes disease.  This persuaded tax payers to cover the cost of public health reforms to clean the towns

Factor 6 - Political Changes:

  • What happened?  In 1867 working class men in towns were given the right to vote.  In 1884 working class men in the country were given the right to vote.
  • Impact:  Politicians had to start making promises which appealed to the working class men too, instead of just the rich.  So they had to promise to clean towns.

Public Health (19th&20th Centuries):

Factor 7 - Technology:

  • Steam powered machinery – This made it possible to build the huge pipelines for sewer systems.
  • Lavatories – Flushing toilets meant that privies no longer needed to be emptied by hand.  Waste was sent straight into the sewers.
  • Soap – In 1853 the government took the tax off soap, so more people could afford to wash.
  • Vaccination – Jenner discovered vaccination in 1798 which made it possible to protect the public from smallpox.

Public Health Improvements (19th Century):

  • Bazalgette’s sewer system – Bazalgette designed and built London’s sewer system after the Great Stink of 1858
  • The 1875 Public Health Act – Made it compulsory for councils to provide better sewers, fresh water supplies and inspectors to check public health facilities
  • Other public health laws – Improved housing standards, food standards and compulsory health education for children.
  • Compulsory vaccination – After 1872 vaccination against smallpox was made compulsory. This led to a huge drop in deaths from smallpox.

Impact: These changes made towns cleaner and infant deaths decreased.

Public Health (19th&20th Centuries):

Liberal Health Reforms (20th Century):

After 1906 the Liberal government introduced many public health improvements:

  • Compulsory training for midwives helped reduce infant deaths
  • Free school meals improved diet of the poorest children
  • Old age pensionsstopped old people from living in poverty
  • National Insurance Act 1911 set up a sickness fund which all workers, employers and the government paid into.  This provided health care to workers when they needed it.

World War II:

World War II changed people’s attitudes to health because:

  • Evacuation – Middle class families in the countryside were shocked at the poor health of working class evacuees.
  • The Blitz spirit – World War 2 created a sense of community and working together.  People began to believe that everyone should have good health care, not just the wealthy.

Public Health (19th&20th Centuries):

The NHS (20th Century):

The British government asked Sir William Beveridge to write a report on how to improve people’s lives.

  • The Beveridge Report 1942 said that a National Health Service should be set up to provide free health care for all.
  • The NHS was set up in 1945.  It provided free healthcare and medicines for all. Doctors and nurses were now employed by the government instead of charging fees.

Opposition To The NHS (20th Century):

  • Doctors did not want to be told what to do by the government.  They wanted their freedom.
  • Attitudes to the poor: Some people still believed the poor were lazy and should not be helped.  Giving them free healthcare might make them lazier.
  • Councils did not want the government to take control of hospitals from them

View cards

PreviousNext

24 of 42

3 of 6

Medicine 18th/19th Century

Jenner's Work:

  • Before Jenner’s work: Doctors protected people from smallpox by inoculation.This means making people immune to smallpox by infecting them with a mild dose of smallpox on the surface of their skin.This was considered as dangerous because it could kill you.
  • Jenner’s discovery 1798: He found out you could vaccinate someone against smallpox by giving them a dose of the milder disease cowpox which was safer because you cannot die from cowpox.

Factors which helped him:

  • Chance - Jenner offered a dairy maid inoculation against smallpox. She told him she did not need not need it because she’d already had cowpox. This inspired him to think of vaccination.
  • Scientific research - Jenner tested his vaccination 23 times to prove it worked.
  • Government - The British government gave Jenner £30,000 to open a vaccination clinic.The gov. made vaccination compulsory in 1852.
4 of 6

Medicine 18th/19th Century

Simpson & Chloroform - 19th Century:

Factors which helped him:

  • Individual brilliance – Simpson experimented with many chemicals before finding chloroform worked best.  He wrote articles about his discovery which spread his idea to other surgeons.
  • Science – In the 1800s, new chemicals were being discovered, it was common for scientists to experiment with new chemicals and gases. 
  • Communication – Simpson’s discoveries were published in a medical journal.This helped them spread quickly to other surgeons.

Opposition to Simpson & chloroform:

  • Religious opposition - people thought it was against God's will to stop pain
  • Scientific opposition - people were frightened that chloroform might have side effects. It was difficult to calculate the right dose and sometimes patients died from the anaesthetic.
  • Scientific opposition – using chloroform to send patients to sleep allowed surgeons to operate deeper in the body. But this made the risk of infection and blood loss even worse
  • Moral opposition - in the British army, using anaesthetics was seen as cowardly. Soldiers were expected to cope with pain during surgery.
5 of 6

Medicine 18th/19th Century

Lister & Antiseptics - 19th Century:

Lister read Pasteur’s work on germs and wanted to stop germs causing infection during surgery.  He sprayed carbolic acid across the operating theatre during surgery as an antiseptic to kill germs during surgery. 

Factors which helped Lister:

  • Individual brilliance - Lister’s idea to spray carbolic acid during surgery was brilliant. He recorded his results carefully to check his methods worked.
  • Science - Lister's  use of carbolic acid to kill germs was based on Pasteur's Germ Theory 1861.
  • Science - in the 1800s many scientists were experimenting with new chemicals and gases. This is what Lister was doing when he discovered carbolic acid. 
  • Communication - Lister first discovered carbolic acid when he read about it being used to clean sewage in Germany. He read this in a newspaper, which was the main form of spreading news in the 1800s.
6 of 6

Comments

No comments have yet been made

Similar History resources:

See all History resources »See all Medicine through time (OCR History A) resources »