- Florence Nightingale (1820-1910) brought a new sense of discipline and professionalism to a job that had a very bad reputation at the time.
- She became a nurse despite the opposition of her family and studied in Europe from 1849.
- The Crimean War broke out in March 1854. The use of telegraphic communications by war correspondents to get stories home fast encouraged people to have opinions and comment.
- Horror stories emerged about the Barrack Hospital in Scutari, where the British wounded were being treated so Sidney Herbert (Secretary of War and friend of Nightingale family) requested that Florence went to Scutari to sort out the nursing care in the hospital.
- Despite opposition from military, Florence went with 38 hand-picked nurses.
- In two years the death rate in the hospital went from 42% to 2%.
- This was partly the result of huge improvements Florence made to ward hygiene.
- She used her fame to help change face of nursing forever.
- 'Notes on Nursing' explained her methods and was the standard textbook for nurses.
- The public raised £44000 to help her train nurses and she set up Nightingale School of Nursing in St. Thomas' Hospital, London. Discipline and attention to detail were important.
- By 1900 there were 64000 trained nurses in Britain.
- Men weren't admitted to the Royal College of Nursing until 1960.
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- Mary Jane Seacole (1805-1881) learnt nursing from her mother who ran a boarding house for invalid soldiers in Jamaica.
- In 1854, she came to England to volunteer as a nurse in the Crimean War. She was rejected - possibly on racist grounds - but went anyway, paying for her own passage.
- Financing herself by selling goods to the soldiers and travellers, she nursed soldiers on the battlefields and built the British Hotel - a small group of makeshift buildings that served as a hospital, shop and canteen for the soldiers.
- She couldn't find work as a nurse in England after the war and went bankrupt but she received support due to the press interest in her story.
- She wrote an autobiography.
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Pasteur's Germ Theory
- Micro-organisms had been seen through 18th century microscopes but scientists thought they were caused by disease and appeared because of illness. Instead of blaming the microbes, people looked for noxious gases called miasmas.
- Louis Pasteur was employed in 1857 to find the explanation for the souring of sugar beet used in fermenting industrial alcohol. His answer was to blame germs in the air.
- Pasteur proved there were germs in the air by sterilising some water and keeping it in a flask that didn't allow airborne particles to enter. This stayed sterile - but sterilised water kept in an open flask bred micro-organisms again.
- When this was discovered, many scientists and doctors refused to believe it even though Pasteur had successfully carried out the experiment in public.
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- The German scientist Robert Koch began the process of linking diseases to the microbe that caused them.
- Koch developed a solid medium to grow cultures and dyeing techniques to colour microbes, which he viewed through high-powered microscopes.
- He experimented with his daughter's pet mice.
- He identified anthrax spores (1875) and the bacteria that caused septicaemia, tuberculosis (1882) and cholera (1883).
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Chicken Cholera Vaccine
- Pasteur came out of retirement in 1877 and started to compete in the race to find new microbes and combat them.
- Many other scientists joined this new field of bacteriology.
- Pasteur looked for cures to anthrax and chicken cholera. He and Koch worked with large teams of scientists and Charles Chamberland was in Pasteur's team.
- Chamberland was supposed to inject the chickens with chicken cholera but he forgot and left the cholera culture on his desk before injected them a while later.
- The chickens surviced. They tried again with some newly cultured cholera but the chickens still survived.
- They worked out that the cholera had been weakened by being left on the desk for a few days and the weakened cholera made the chickens immune - in the same way that Jenner's cowpox vaccine worked for smallpox.
- Chamberland's error had produced a chance discovery.
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- Pasteur's team managed to produce a weakened pathogen of the anthrax spore that would make sheep immune. They demonstrated this in a public experiment in 1881.
- Emile Roux used dried rabbit spines to discover how long the rabies microbe remained dangerous. Pasteur stole Roux's idea to create a series of inoculations of increasing liveliness. He hoped these would lead to immunity.
- In 1885, a woman arrived with her son who had been bitten by a rabid dog. She knew that he would die if nothing was done so Pasteur agreed to try out the new rabies treatment on him and it worked.
- The diptheria germ had been discovered by Edwin Klebs in 1883.
- Friedrich Loeffler cultured the germs and thought that their effect on people was due to a poison or toxin they produced. Emile Roux proved Loeffler right.
- In 1891 Emil von Behring produced an antitoxin or serum - a substance that cancels out the toxins produced by germs - from the blood of animals that had just recovered from diptheria. This could be used to reduce the effect of the disease.
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- Antibodies were identified as a natural defence mechanism of the body against germs.
- In 1889, Paul Ehrlich set out to find chemicals that could act as synthetic antibodies.
- Ehrlich discovered dyes that could kill the malaria and sleeping sickness germs.
- In 1905, the spirochete bacterium that causes the STD syphilis was identified.
- For many years arsenic and mercury had been used with some success to cure syphilis but, they're both poisonous so it was a fine line between curing and killing.
- Ehrlich and his team decided to search for an arsenic compound that was a synthetic antibody for syphilis. They hoped it would target the spirochetes without poisoning the rest of the body.
- Over 600 compounds were tried but none seemed to work.
- In 1909, Sahachiro Hata joined the team. He rechecked the results and found that compound number 606 actually appeared to work. It was first used on a human in 1911 under the trade name Salvarsan 606.
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- The discovery of penicillin is a great example of a chance finding helping science.
- Alexander Fleming saw many soldiers die of septic wounds caused by staphylococcal bacteria when he was working in an army hospital during World War 1.
- In 1922 he discovered the antiseptic substance in tears, lysozyme, but this only worked on some germs.
- One day in 1928 he came to clean up some old culture dishes on which he had been growing staphylococci for his experiments. By chance, a fungal spore had landed and grown on one of the dishes.
- What caught Fleming's eye was that the colonies of staphylococci around the mould had stopped growing. The fungus was identified as Penicillium notatum which produced a substance that killed bacteria. The substance was given the name penicillin.
- Fleming was unable to take his work further. The industrial production of penicillin still needed to be developed.
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- In 1932, Gerhard Domagk found that a red dye, prontosil, stopped the streptococcus microbe from multiplying in mice - without being poisonous to the mice.
- Streptococcus caused a frequently fatal blood poisoning that could be contracted from very minor wounds. Many surgeons contracted it after cutting themselves in the operating theatre.
- In 1935, Domagk's daughter pricked herself with a needle and caught the disease. Afraid she would die, Domagk gave her a large dose of prontosil and she turned red but recovered.
- The active ingredient of prontosil was identified as a sulphonamide by French scientists. A whole group of drugs based on sulphonamides followed, including M&B 693, which worked on pneumonia without turning you any strange colour.
- Sadly more serious side-effects were discovered later. Sulphonamide drugs can damage your liver and kidneys.
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Chain and Florey
- Being a natural product, penicillin needed purifying. The breakthrough was made by Howard Florey's team in Oxford between 1938 and 1940. Ernst Chain, a member of the team, devised the freeze-drying technique which was an important part of the purification process.
- At first Florey and Chain didn't have the resources to produce penicillin in large amounts. They made penicillin for their first clinical trial by growing penicillium notatum in every container they could find in their lab. The patient began to recover but died when the penicllin ran out.
- Florey knew that penicllin could be vital in treating the wounds being received by soldiers during WW2. British chemical firms were too busy making explosives to start mass production - so he went to America.
- American firms were not keen to help until America joined the war in 1941. By 1944 mass production was sufficient for the needs of the military medics.
- Fleming, Florey and Chain were awarded the Nobel Prize in 1945.
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