A Revolution in Medicine

Laissez-faire

• “let it be”

• the government should take a hands-off approach to public health

19th century hospitals

• small organisations that relied on charitable funding

• cottage hospitals - accommodated about 12 patients

• infirmaries - larger hospitals that were crowded and dirty

• specialist hospitals

Florence Nightingale

• cared for patients during the crimean war

• believed in miasma and that places should be kept clean

• death rate from 42% to 2%

• wrote the book Notes of Nursing

• created a nurse training school from raising her own funds

Louis Pasteur

• published his work on germ theory in 1861

• created a process called pasteurisation

• paved the way for antiseptic and aseptic surgery

The Germ Theory

• germs caused disease

• air contained living microorganisms

• spontaneous generation was wrong

• led to an understanding of infection

John Tyndall

• helped the germ theory become accepted

Robert Koch

• developed a method for staining and photographing microorganisms

• in 1884 he found cholera in drinking water and confirmed John Snow’s theory

• doctors began to study the disease itself rather than just the symptoms

• made it easier for other scientist to identify and study bacteria

William Roberts

• created a link between laboratory research and practical evidence

• publicised Kock’s work

William Cheyne

• translated Kock’s work into English

• argued that some microbes are harmless

Surgery in the 19th century

• pain, infection, blood loss

• surgeons tried alcohol and opium as pain relief

• nitrous oxide, ether and chloroform were developed

Nitrous Oxide

• too weak for major surgeries

• discovered by Humphry Davy

• first used in 1844

Ether

• caused vomiting and was highly flammable

• first used in 1846 by Liston

Robert Liston

• a surgeon renowned for his speed

• first used ether as an anaesthetic

Chloroform

• developed by James Simpson in 1847

• was used by Queen Victoria which made it become accepted

• John Snow developed a type of inhaler and calculated the correct dosage

Antiseptics

• substances used to kill microorganism and prevent infection

• the first antiseptic was carbolic acid

Carbolic Acid

• first antiseptic

• Joseph Lister was the first to use carbolic acid in 1865

• death rate from 46% to 15%

Aseptic surgery

• ensures operations are carried out in sterile conditions

• became common by 1900

Industrialisation

• led to overcrowding and the spread of disease

• houses were built cheaply and close together

Edwin Chadwick

• wrote the Report on the Sanitary Conditions of the Labouring Population, published in 1842

• towns needed to be cleaner

• believed a drainage system should be organised and a medical officer appointed to each area

• it wasn’t until a cholera epidemic that the gov started listening

1st Public Health Act

• 1848

• first attempt by the gov to enforce a clean up of the towns

• each town had a medical officer of health, rubbish removals were organised, clean water

• the terms or the act were only temporary and voluntary

Cholera

• first arrived in Britain in 1831 with 21,000 deaths

• Dr Snow discovered the causes by creating a map of Broad Street in 1854

The Great Stink

• summer of 1858

• so bad that politicians had to move

• caused the sewer system to be built and marked the end of laissez-faire

Joseph Bazalegette

• chief designer and engineer of the new London sewage system

• official opened in 1865

• cost £3 mil

2nd Public Health Act

• 1875

• gov attempt to reduct public health related illnesses and diseases

• clean water and proper regulation of rubbish and sewage disposal

• new standards for housing

• was compulsary