History: Medicine ALL

Four Humours

Ancient Greek theory, disease was caused by an imbalance of four humours: blood, phlegm, yellow bile, black bile.

Who invented ether and when?

Morton 1846

Who invented chloroform and when?

Simpson 1847

Miasma Theory

Belief that disease was caused by bad air or foul smells from rotting matter.

What war drove medical progress and Pasteur-Koch rivalry? + exam specific phrase

Franco-Prussian War (1870) national pride fuelled scientific competition

Miasma theory impact

Encouraged sanitation and cleanliness, indirectly improving public health.

Spontaneous Generation

The belief that living organisms (including germs) could arise from non-living matter.

Experiment disproving spontaneous generation + year

Pasteur's swan-neck flask experiment (1861) disproved spontaneous generation.

Swan-neck flask experiment showed what?

Showed that broth only spoiled when exposed to airborne microbes.

Pasteur significance

Disproved miasma and spontaneous generation; transformed medical understanding.

Pasteur vaccinations (3)

Developed vaccines for chicken cholera, anthrax, and rabies.

Edward Jenner

Developed the first successful vaccine.

Jenner's discovery

Noticed milkmaids who had cowpox did not catch smallpox.

1796 vaccination Jenner

Jenner injected cowpox into kid to create immunity to smallpox.

Koch's discoveries microbes (2)

Identified the microbes causing tuberculosis (1882) and cholera (1883).

Why was Koch’s most celebrated discovery so effective?

TB killed 1 in 7 in Europe, when he identified it Pasteur reportedly wept (successful application of his germ theory)

Koch's methods (2)

Used staining and agar plates to grow bacteria.

Why were Koch’s methods significant?

the results were easily reproduced → widespread, paved the way for magic bullets

Koch title as Father of _____

Modern Bacteriology

Koch, which vaccine was ineffective?

His tuberculosis vaccine was ineffective.

Magic bullets, what, who made it

Drugs that target specific microbes without harming the body, Paul Erhlich

Salvarsan 606

First effective treatment for syphilis.

Why was the magic bullet “606”?

Erhlich modified arsenic 606 times, until it only killed Syphilis and left human cell unharmed

Why was the first magic bullet limited?

Since the compound was arsenic-based, a slightly wrong dosage could be lethal

What year penicillin discovered?

Discovered penicillin in 1928.

Penicillin discovery

Noticed mould killing bacteria by accident.

How does penicillin kill bacteria, how does it avoid human cells?

Prevents development of new cell walls, causing it to explode. Human cells don’t have cell walls.

Limitation of Fleming

Could not develop or mass-produce penicillin.

Who developed penicillin after Fleming

Florey and Chain

Penicillin distribution and production when?

mass-produced during WWII.

Significance of penicillin

First widely used antibiotic; saved millions of lives.

Ether

Early anaesthetic; effective but caused vomiting and was highly flammable.

Nitrous oxide (laughing gas)

Used in dentistry and some surgery; unreliable and short-lasting.

Early anaesthetics limitation

Difficult to control dosage; risk of overdose or patient waking up mid-surgery.

James Simpson and chloroform

Discovered chloroform as an anaesthetic in 1847.

Why chloroform > ether

More effective and easier to use than ether.

How Queen Victoria gave birth in 1853

Used chloroform during childbirth, increasing public and medical acceptance.

Anaesthetics positve impact on surgery

Allowed longer, more complex operations and reduced pain.

Limitation of anaesthetics

Did not reduce infection; death rates initially increased.

Black Period of Surgery (1846-1860)

Period when anaesthetics existed but infection was uncontrolled.

Why black period was dangerous and led to more deaths?

Surgeons attempted longer operations without understanding germs. Thought anaesthetic solved surgery

Joseph Lister believed in what?

Germ Theory

Carbolic spray is ?(what year?)

1867, Used to kill germs in the air and on wounds.

Antiseptic surgery

Prevented infection by killing bacteria.

Lister's statistics

Death rates in his wards fell by around 50%.

Limitations of carbolic spray

Strong smell, damaged skin and lungs; difficult to use for doctors

Aseptic surgery

Surgery that prevents germs from entering wounds in the first place, uses steam

Aseptic methods

Sterilised instruments, gloves, clean operating theatres

Significance of aseptic surgery

Made surgery far safer and more reliable.

What was the major cause of death in surgery (before infection)?

Blood loss

Why did surgery need to be performed quick back in the day

reduce blood loss

Who and when discovered x-rays?

Wilhelm Röntgen (1895)

Impact of X-rays in wartime

Helped surgeons locate bullets and fractures without cutting.

What did Curie develop for use in WWI?

Petite Curies, meaning mobile X-ray units

Who invented skin grafts?

Harold Gillies

When were blood groups discovered and by whom

1901 by Karl Landsteiner

What chemical was developed in 1914 allowing prevention of blood clotting?

Sodium citrate

Who was Hugh Owen Thomas?

Inventor of Thomas Splint

How much did the Thomas splint reduce the mortality rate from femoral fractures

80% to roughly 20%

One medical organization formed during WWI in britain

Voluntary Aid Detachment

Name the 4 stages of the evacuation chain

Regimental Aid Posts -> Advanced Dressing Stations -> Casualty Clearing Stations -> Base hospitals

2 things a WWI soldier might get in trench warfare conditions

Gangrene and trench foot

What was shell shock and why was it stigmatised?

Psychological trauma (PTSD) as a result of warfare conditions. Not taken seriously, due to stiff upper lip + masculine ideals. Seen as cowardice

Who was Harvey Cushing?

Neurosurgeon, father of modern neurosurgery.

2 medical breakthroughs Cushing was responsible for

Using magnets to extract shrapnel inside brain tissue, local anaesthetic to prevent brain swelling

Statistic for mortality rate of brain wounds during WWI

60% to 29%

EGA was the first woman to what?

Qualify as a doctor in Britain

What loophole did EGA exploit?

Discovered the Society of Apothecaries couldn’t legally ban her from obtaining license

What year did EGA obtain medical license?

1865

When did EGA found the London School of medicine for Women?

1874

What law was passed by Parliament in 1876 permitting women to enter the medical profession?

The Medical Act of 1876

What year did Nightingale go to Scutari, and what war was this in?

1854 during the Crimean War

What 4 changes did Nightingale make at Scutari?

Cleaned wards, improved patient food, provided clean beeding, opened windows

Nightingale scutari mortality rate statistic

42% to 2% within 6 months

Nightingale famous book name and year? + significance

Notes on Nursing (1859), became the STANDARD for nurse training

One reason how Nightingale hindered medical progress?

Believed in miasma and ordered windows to be open always even at detriment of patients

What does laissez-faire mean, how did it influence government attitude toward public health.

leave things alone, the best government was the least government.

What was Edwin Chadwick’s report called, what year?

1842 Report on the Sanity Condition of the Labouring Population of Great Britain

What was Chadwick’s main argument for spending money on public health?

Spending money on improving public health would save the country money in the long term.

What year was the Public Health Act passed, what key word described it’s ineffectiveness?

1848, permissive.

What year was the cholera outbreak in Soho

1854

What did John Snow PROVE?

Cholera was a waterborne disease, not an airborne disease (miasma)

What year was the ‘Great Stink'

1858

Who built the sewers and what year was they finished?

Joseph Bazalgette, finished 1865

What year was the second COMPULSORY Public Health Act?

1875

What changed in the government after 1906 election?

Liberals elected, end of ‘laissez-faire’, Liberal Welfare Reforms

How did the Boer War impact attitude toward public health?

Up to 40% of volunteers were rejected on grounds of poor health

3 things that came about after 1906 reforms

free meals for poor children, mandated medical checkups for children, illegal to sell tobacco or alcohol to children

Atabrine is drug for…

malaria