Edexcel IGCSE History Medicine

Over 21,000 people had died from cholera, a new illness in Britain, in a year

1832

Chadwick publishes his report on the sanitary conditions of the working population

He suggested that it would be cheaper if local taxes were used for improving housing and hygiene

He also suggested providing clean water, removing sewage and clearing rubbish

INVEST IN HOUSING AND SANITATION

1842

Wells discovered nitrous oxide caused people not to feel pain

Public demonstration of tooth extraction

1845

William Morton found that the gas ether was a more long lasting anaesthetic

1846

Liston amputated a man's leg, using Ether

1846

James Simpson discovers the anaesthetic properties of chloroform at Edinburgh university

Simpson started using it to help women in childbirth

LIMITATIONS
- One man died from an overdose
- Army leaders opposed it saying it was 'soft'
- Doctors were unable to prescribe the correct amount

1847

PUBLIC HEALTH ACT

PROVISIONS
-Allowed towns to set up a local board of health
-Appointed local medical officer in towns
-Organised the removal of rubbish from towns
-Built a sewer system in towns

ISSUES
-It allowed towns to do this but did not force them to
-Only 1/3 of towns set up a board of health and fewer appointed a medical officer
-The terms were only temporary
-General board of health was abolished in 1858

1848

The 'BLACK PERIOD' of surgery as anaesthetics existed but antiseptics did not

The absence of pain meant more people agreed to have surgery, however, the death rate went up because many died afterwards from infection - GANGRENE

1846 - 1860

Semmelweiss encourages doctors to wash their hands

1847

Snow creates the chloroform inhaler which makes it safer to administer

1848

Second major Cholera outbreak in Britain

1848

Queen Victoria gave birth to her 8th child under chloroform making it sociably acceptable

LIMITATION - it was not until 1900 people realised it caused liver damage

1853

Vaccination made compulsory

1853

Nightingale goes to the hospital in Scutari during the Crimean War

1854

What ACTIONS did Florence Nightingale take?

SCUTARI (1954)
Florence worked 20 hours a day

She started to clean kitchens and hired a chef to come and cook for the men

She went into town to buy fresh food for the men

She paid workmen to clear the drains

She called for the SANITARY COMMISSION

She sent a plea to The Times newspaper for a government solution

GREAT BRITAIN
Concentrated on Sanitation in Hospitals (good drainage and sewage, clean water supplies, toilet facilities, total cleanliness)

Good ventilation in hospitals

Good supplies, clothing and washing facilities

Wrote two books

What IMPACTS did Florence Nightingale have on hospitals and nursing?

SCUTARI (1954)
Hospital was cleaner and fewer men were dying

The death rate dropped from 42% - 2%

She reduced peacetime deaths in the army and turned attention to the sanitary designs of hospitals

GREAT BRITAIN
The government commissioned Isambard Kingdom Brunel to design a prefabricated hospital (Renkioki Hospital)

Both books were very influential all over the world, providing the basis for training nurses and hospital design

Her nursing schools concentrated on training nurses in practical skills

Snow - Broad street pump as a source of Cholera

IT PROVED THAT CLEAN WATER WAS NECESSARY FOR THE PREVENTION OF CHOLERA

1854

Pasteur was asked to investigate the souring of beetroot alcohol

1857

The Great Stink in London

1858

Nightingale publishes "Notes for nursing" and "Notes on Hospitals"

1859

HOUSING ACTS begins to be passed the started slum clearance and set standards for the construction of new houses

1860s

Garrett trained as a nurse and attended lectures for trainee doctors at middlesex hospital

LIMITATION - Male students at Middlesex hospital protested she should not be able to attend classes

1860s

Nightingale creates the first training school for nurses

1860

Pasteur published the "Germ Theory"

1861

Garett-Anderson is allowed to study medicine by the Society of Apothecaries

1865

Elizabeth Garrett Anderson established a dispensary for women

1866

Lister's death rates fall to 15% due to carbolic acid - Lister spray

LIMITATIONS
- The equipment required was heavy and expensive
- Carbolic Acid irritated the lungs and burnt the skin
- The methods were not copied well by other surgeons
-The nurses resented the extra work

1867

LOCAL GOVERNMENT BOARD was set up to oversee the administration of public health

1871

Elizabeth Garett-Anderson co-founds the LONDON SCHOOL OF MEDICINE - the only teaching hospital in Britain to offer places to women

It was entirely staffed by women

She worked there for the rest of her career and was made dean from 1883 - 1902

1872

New Public Health Act (compulsory)

PROVISIONS
-Local councils had to improve drainage and sewers, provide fresh water supplies, appoint medical officers and sanitary officers to inspect public health facilities

-Improved housing

-Stopped rivers being polluted

-Working hours for women and children shortened

-It was illegal to add unhealthy ingredients to food

-Education was compulsory

1875

THE ARTISANS DWELLING ACT allowed local councils to clear slum housing and replace it with good housing

Over 3,000 slums were cleared before 1900

1875

A law is passed allowing women to become doctors

1876

Koch discovers how to stain and observe bacteria in a petri dish

1878

Koch discovers the bacteria that cause septicaemia

1878

Pasteur discovers chicken cholera vaccine

1880

Pasteur discovers anthrax vaccine

1881

Koch discovers the bacteria that cause tuberculosis

1882

Koch discovers the bacteria that causes cholera

1883

SOAP
Tax was taken off soap meaning more people could afford it- result: better hygiene

1883

SEWERS

BAZALGETTE designed and built London's sewage system that is still in use today

83 miles of sewers underground
1100 miles of sewers for each street connecting to main one

Major pumping stations drive the flow of sewage

Core work completed in ....., ready in 1875 and fully completed in 1885

LIMITATIONS
-The system still dumped tons of sewage in the Thames
-In 1878 the boat Princess Alice sank next to one of the main sewage outfalls and 640 passengers died from posing as opposed to drowning

1865

Röntgen discovers X-rays

Marie Curie installed X-rays in field hospitals

1895

Pasteur discovers Rabies vaccine

1885

A member of Koch's team, Emily Von Behring, produced an antitoxin to cure diphtheria

1892

Koch was responsible for establishing the new 'Science of Modern Bacteriology'

By ... he and his students had identified 21 germs causing diseases

1900

There were only 200 trained female doctors in Britain by ....

1900

Karl Landsteiner discovers the 4 main blood groups (A, B, AB and O)

1901

LIBERAL HEALTH REFORM

Training became compulsory for midwives

1902

LIBERAL HEALTH REFORM

Free meals were provided for children in need

1906

LIBERAL HEALTH REFORM

All births had to be notified to the local medical officer of health. A health visitor visited each mother to make sure she knew how to protect her child's health

Nurses or doctors carried out medical checks on children schools

1907

LIBERAL HEALTH REFORM

People in need over the age of 70 were paid an old age pension

1908

Ehrlich discovers the first magic bullet, Salversan 606

1909

Back to back housing was banned. New regulations enforced higher standards of house building

1909

LIBERAL HEALTH REFORM

National Insurance Act
- Gives workers medical help and sick pay
- Meant health insurance and social security were provided by the government

1911

Free medical treatment for children law introduced

1912

Inglis, a former suffragette volunteered to go to France but was turned down by the army.

Instead she gathered a group of doctors and nurses and went on her own accord.

1914

Lewisohn discovers adding citric acid makes blood last longer

1915

Women took a much more prominent role in medicine during the WAR

The war meant far more doctors and nurses were needed

Many women became doctors and the first women's nursing units were set up - THE FIRST AID NURSING YEOMANRY (FANY) was set up

There was a huge increase in women ambulance drivers

Women were closer to the frontline

The number of women in medical training increased in war years - 12 London teaching hospitals accepted a limited number of women as medical students

LIMITATION - Prejudice still remained

1916

Rous and Turner discover adding a citrate-glucose solution makes blood last longer

1916

Giles was appalled by the numbers of facial wounds and saw the benefits of facial surgery

He persuaded the english army to establish a purpose built site in ....

Queen Mary's Hospital in Roehampton was established as a specialist centre where amputees were fitted with limbs and learnt how to use them

LIMITATION - Waiting lists grew and many left hospitals without adequate training

1917

Elizabeth Garrett Anderson died

1918

In France

Before WW1 there was one doctor for every ....

During WW1 there was one doctor for every ...

25,000
14,000

The MINISTRY OF HEALTH was set up to administer all matters to do with health

1919

LIMITATION (after WW1) - A number of medical schools which had opened their doors to women during the first world war closed them again, and the principle of medical co operation comes under serious threat

1920s

Fleming discovers penicillin

LIMITATION - Scientists paid little attention to his discovery when published in 1939

1928

Women in medicine broke through a number of barriers

- The first female commissioner was appointed to the Board of Control

- The first female chief Medical officer of a London Borough and a Regional Medical officer under National Health Insurance took up their posts

-The London city council decreed that all Medical appointments under its control should be OPEN TO BOTH MEN AND WOMEN

-A number of hospitals finally admitted women onto their honorary staff

1930

Domagk discovered a red dye called PRONTOSIL that stopped the coccus microbe from multiplying in mice without harming the rest of the animal

1932

Plastic surgery - Skin burn were able to be treated by using the living skin of a man to help reconstruct his own facial features

lIMITATION - At this time there were only 3 experienced plastic surgeons in Britain

1939

The terrible burns sustained by pilots in the battle for Britain improved the use of plastic surgery by MCINDOE to cover up the scars

MCINDOE released that the use of TANIC acid created a protective layer to prevent laster skin graft treatment

Immersion in saline began to be used for burn victims as it promoted healing and increased survival rates

MCINDOE also developed new surgical tools for skin grafts

1940

Florey and Chain gather a team to research penicillin

1939

Penicillin tested on mice

1940

50,00 British Women served as nurses during the war

1941

Penicillin's potential demonstrated on Albert Alexander

1941

Beveridge was asked to prepare a report on what should be done at the of end of the war

1941

The Beveridge Report was published

Beverage recommended that the people of Britain should be protected from the FIVE GIANT EVILS

1.Squalor
2.Ignrorance
3.Want
4.Idleness
5.Disease

1942

What was Beveridge's AIMS?

Ensure all people in Britain had an adequate standard of living

He wanted the establishment of a 'national minimum' - this would be a standard of living below which nobody in Britain would be allowed to fall

'UNIVERSALITY' - Benefits should be available to everyone, regardless of wealth, income or social status

Florey and Chain begin to mass produce penicillin through a mould on a melon in the USA, through their drug companies

1943

WWII commissioned Army Nurses were required to undergo additional training such as field sanitation and physical training to build up their endurance

July, 1943

WACs (Women's Auxiliary Corps) landed on the beach of Normandy

July, 1944

Penicillin is used successfully on D-Day

1944

Over 8000 American WACs were stationed in Europe

Overall 73,000 American women served as nurses during the conflict

16 women received the Purple Heart, awarded to soldiers injured due to enemy action

The Bronze Star was awarded to 565 women in meritorious service injured overseas

Over 700 WACs received medals at the end of the war

1945

Penicillin became known as the 'wonder drug' and Florey and Chain were awarded Nobel prizes

1945

The launch of the National Health Service (NHS)

1948

'Describe the Key features of the work in medicine of Ehrlich'

1. Work with Dyes
2.Development of magic bullets to cure Syphilis

1. In 1878 he obtained his doctorate of medicine with dissertation on staining animal tissues by using dyes. Ehrlich discovered that certain chemicals could kill bacteria / certain dyes could stain specific bacteria

2. Chemical substances that would go straight to the organs at which they were aimed. In 1909, Ehrlich's team had tested over 600 dyes. Among the arsenical drugs, Salvarsan 606, was shown to be effective in the development of magic bullets to cure Syphilis

LINK - Ehrlich work with dyes enables him to cure syphilis as it increased his knowledge of compounds and 'magic bullets'