Edexcel GCSE History - 3. Medicine in the 18th and 19th Century

Changes in Society in 1700

• influence of the church in decline

• the age of enlightenment - a movement in the 18th century promoting people to think for themselves

• scientific revolution - old theories discredited and replaced

• growth of citites - werent planned well and were crowded and dirty

Ides about causes of disease in Age of enlightenment/ victorian era

• Theory of four humors discarded

• miasma loosley believed in

• spontaneous generation (decay creates microbes) - supported by Dr Henry Bastien

Louis Pasteur and Germ Theory

• aided by the microscope pasteur theorised microbes turned liquids ‘bad‘

• basic principles of germ theory

  • air contains microorganisms

  • microbes not distributed evenly

  • microbes can be killed with heat

  • microbes in the air cause decay

• disproved spontaneous generation because sterilised matter did not decay

Pasteur’s Impact in Britain

• little immediate impact as he was a scientist and not a physician and due to the Influnce of Dr Henry Bastien supporting Spont Gen.

• Joseph Lister linked infections faced by jis patients to germ theory

• John Tyndall discovered small organic particles in the air and linked them with germ theory

Robert Koch

• Koch discovered that microbes caused decay and disproves Spont Gen.

• Koch discovered the bacteria which caused tuberculosis and published ideas on methods to identify disease cuasing micrbes

  • microbe present in every case

  • microbe can be taken and reproduced into a pure culture

  • disease can be reproduced in animals using the culture

  • microbe can be taken out the animal and reproduced into a pure culture

Koch’s Impact in Britain

• Doctors began to study the disease itself rather than it’s symptoms and realised tht the microbe created the symptoms

• When physicians found the microbe that caused diptheria in 1883 scientiststs were able to observe it produced a poison and found a way of attaacking the microbe

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Factors affecting the Understanding of Causes in 1700-1900 - Induviduals and Institutions

• Induviduals such as Koch and Pasteur had a large impact

• The government was not very interested in healthcare until people gained the ability to vote - however they were interested in ending the epidemics of typhoid and cholera. however germ theory dod not provide a solution to disease sp the gov didnt promote it

Factors affecting the Understanding of Causes in 1700-1900 - Science and Technology

• The scientific revolution focused on finding anaswers to the big questions of science and led to more peer review and sharing of work

• Microscope made Germ Theory possible by providing clearer images at higher magnification, allowing most microorganisms to be spotted

Factors affecting the Understanding of Causes in 1700-1900 - Attitudes

• Due to the ‘Age on Enlightenment’ people were more interested in rational explanations of disease

• However other people’s reluctsnce to change their minds slowed the spread of Germ Theory

Hospitals in the 18th Century

• patients usually people who cannor afford their own physician

• separate wards for infectious diseases

• hospitals places of treatment

• founded by donations from ewealthy people

Hospitals by 1900

• Wards were built to sperarte infectious patients into groups

• there were pre and post surgery wards as well as operating theatres

• cleanliness had become very important and hospitals cleaned germs with antiseptics

• Doctors came to test their skills

Florence Nightingale

• Studied in Dusseldorf and then Paris

• Went to crimea to help with the field Hospital

• Introduced the idea of good ventilation

• Came up with the pavilion design for hospitals

• Established a nursing school in St Thomas’ hospital in london

• Made nursing a respectable occupation

Continuity in treatment

• Quack remedies continued to be sold but they were now known as ‘Patent Remedies’

• Most sick people still treated at home

• Apothecaries now known as pharmacies

Dangers of Surgery

• Surgery was very difficult to undertake in the 18th century, patients wers till awake which made precise actions difficult

• Surgeons had attempted to fix the problem by putting patients to sleep with ether, but it was flammable and irritated the lungs

• Additionally even if survived an infection could kill the patient later

James Simpson

• James simpson discovered chloroform with a group of friends and began using it in surgery

• it meant that longer and more complex surgeries could be undertaken, however an overdose of chloroform could kill

• Queen Victory famously benefited from it during the birth of her Son in 1853

Joseph Lister

• infections during surgery were very common

  • instruments werent washed and surgeons often wore their bloodiest coat to show experience

• Lister noticed that flesh would rot when it was infected and thought germs in the air caused it to rot

• in 1865 he operated on a patient and added a bandage soaked in carbolic acid

  • the patient survived the surgery and did not catch an infection

• By 1900 instruments were steam cleaned and gloves gowns ans masks were worn

Edward Jenner

• Made the first vaccine ever which combatted smallpox

• The Church claimed using animal infection in human trials was against God’s Will

• The Royal society did not publish Jenner’s ideas because of opposition within the scientific community

• The Governemnt provided a vaccination programme

Impact of the smallpox vaccine

• In the Short term the vaccine saved many lives and became popular overseas

• In the Long term Vaccination for smallpox became normal. although opposition continued the drop in deaths from smallpox made it clear the method worked

Public Health

• Provision of services by the government to maintain good health and living condition - e.g. sewers, removing rubbish, fresh water supply

• the growth of towns made public health worse because they were often overcrowded and dirty

The Public Health Act 1848

• National board of Health set up

• in towns where the death rate was high the government could force the local council to make public health improvements

• local councils encouraged to collect taxes to pay for public health improvements

• councils allowed to appoint medical officers to overse public health

Public Health Developments after 1850

• in london 1300 miles of sewers were built

• slums were demolished in birmingham

• sewage was no longer drained into the water in leeds

• more people began to recognise it was a shared responsibilty to keep public places clean

2nd Public Health Act

• City authorities HAD to employ a public health official

• City authorities HAD to build better quality houses

• City authorities HAD to build public toilets

• City authorities HAD to provide clean water and dispose of sewage

John Snow

• a surgeon who moved tosoho in 1836

• theorised cholera was transmitted by water npt ait because the gut was affected

• Recorded where all the deaths in soho were and concluded the source of the outbreak was a contaminated pump

• removed the handle of the broad street pump

Impact of John Snow

• Snow reported his findings to the gov and reccomended improving the sewers

• however the government only improved the sewers after the smell of sewage was amplififed by a hot and dry summer, causing ‘the great stink’

• Snow’s theory came out before germ theory and so he had no scientific evidence

• very limited long term impact