A Revolution In Surgery and Germ Theory

Question 1

What did factories mean for disease, what impact did the industrial revolution have on medicine?

Answer 1

They meant disease was common due to poor sanitation as factories caused towns to grow and increase slum housing. Overall, the industrial revolution allowed medicine to progress at a fast pace on from the mid 19th century

Question 2

Give some continuity between the industrial revolution and before the 1859s

Answer 2

-wars acted as a forcing agent for change for example in ww2 the use of metal plates to heal fractures were developed and paré c
Used ligatures in battlefields in the 1500s
-public health measures - in both great plague and later on when public health act was released in 1875
-gifted individuals e.g. William Harvey who discovered blood circulation and 1928 Alexander Fleming who came up with penicillin

Question 3

Give some developments made to medicine after the industrial revolution

Answer 3

• more accurate microscopes became available as they helped discover germ theory and bacteriology
• scientific methods were used and applied to medical research allowing research teams to set up and new drugs to develop while in the 11th century, everyone used to just follow galens works
• there were better communications like railways, electric telegraph and cars which allowed ideas and knowledge to spread further and quicker

Question 4

What were the roles of individuals for nitrous oxide?

Answer 4

• In 1775 Thomas bedoes physician and assistant Humphrey Davy experimented with inhaling nitrous oxide
• in 1800 Davy published an account saying the gas made him laugh and it made him feel relaxed

Question 5

What was the extent of success for nitrous oxide?

Answer 5

It was considered more of a fairground novelty that a serious anaesthetic so it didn’t really help advance medicine

Question 6

What three anaesthetics were being used to revolutionise surgery?

Answer 6

Nitrous oxide, ether, chloroform

Question 7

What were the roles of individuals for ether?

Answer 7

• In 1846 Boston hospital, William Morton demonstrated ether and so surgeon Robert Liston used it to amputate a leg
• in 1842 as a dentist
• used by Crawford long to remove a neck growth from a patient

Question 8

What was the extent of success for ether?

Answer 8

It was used in a range of surgeries and became successful in tooth extraction

Question 9

What were individuals roles in use of chloroform?

Answer 9

-in 1847, Scottish doctor James Simpson discovered it by experimenting on himself and his friends with different substances when someone knocked chloroform and his wife found them all sleeping

Question 10

What was chloroform’s extent of success in medicine? Give an example

Answer 10

It was very successful as:
-chloroform introduces dizziness and unconsciousness so Simpson used it to reduce pain in childbirth
For example, he gave it to queen Victoria in 1853 when giving birth to prince leopold

Question 11

Give 3 oppositions to chloroform

Answer 11

• People said chloroform was from the devil as it’s effects were going against god’s will
• Dr green said it caused people to have erotic dreams
• some said it was unknown what it could do to the body and what it’s long term effects could be because of doctor’s uncertainty

Question 12

How were oppositions to chloroform combated?

Answer 12

• it was successfully used on queen Victoria delivering prince Leopold
• James Simpson produced many writings on it to reassure people

Question 13

Give a positive way anaesthetics were significant to medicine

Answer 13

They allowed procedures to take longer so more complicated surgery could take place

Question 14

Give 3 negative impacts anaesthetics had to medicine

Answer 14

• Chloroform was new and untested so no-one knew the long term side effects
• longer surgeries increased the risk of infection
• there was difficulty in deciding the dose of anaesthetic

Question 15

What did scientists think caused infection and explain each one

Answer 15

• spontaneous generation: the idea microbes appeared as if by magic when something rotted so believed disease caused microbes not vice versa
• specificity: the idea not all microbes were the same, certain ones caused certain diseases
• miasma: the idea that there was ‘bad air’ that spread diseases

Question 16

What did Louis Pasteur create?

Answer 16

The concept of germ theory

Question 17

What did Louis Pasteur discover? What was it’s significance?

Answer 17

Discovered that when milk and beer went off, they were in open air and so theorised they were being contaminated by something in the air
Significant as:
-this caused surgery to be then done under sterile conditions
-further research made him realise different microbes caused differ t diseases
-this allowed vaccinations for certain diseases to develop as they dealt with specific bacteria

Question 18

How did Louis Pasteur make his discoveries (in order)

Answer 18

1. Pasteur proved silk worms were dying of a disease caused by a germ after the French silk industry was being ruined
2. In 1857 Pasteur discovered that germs were harming a company’s beetroot alcohol after they asked why it turned sour. He did the same for milk and beer
3. Pasteur was able to solve the issue by heating the alcohol and he did the same for the milk and beer creating pasteurisation
4. Pasteur wanted to prove germs came from air so using 2 glass containers with liquid he boiled them to kill the germs
5. Then he heated the spout of one flask so it dropped down claiming it would stay for years and the other straight one was to soon go bad as it easily let germs in
6. He said the curvy one stopped the movement of aid so germs would settle in the lowest curve and not reach the liquid
7. Pasteur successfully proved the spontaneous generation wrong

Question 19

What did Pasteur go on to do after he proved germs did not come alive on their own? Include dates

Answer 19

In 1861 he published his ‘Germ Theory’ and in 1865 he tested his theory that disease in animals was caused by germs

Question 20

What were anti-contagionists? Give examples of people who were this

Answer 20

Those who believed cleaning up the environment would stop epidemics because they thought epidemics like cholera, plague, typhoid were caused when infections interacted with soil and water and created the disease that would attack the week
For example William Farr and Florence Nightingale

Question 21

Who were contagionists? Give an example of one

Answer 21

Those who believed infection was spread by contact with an infected person or bacteria. They believed any contact between an infected person to a healthy person would lead to the illness being transmitted
For example Jhon Simon

Question 22

Why did Louis Pasteur’s initial theory prove the anti contagionists wrong? What did this lead onto?

Answer 22

As his theory says that germs interacted with the environment to create disease but Louis Pasteurs theory proved that only germs in the air could cause disease so germs couldn’t just appear.
This lead onto him realising the human body got infected when there were open wounds as they were exposed to air so he made people realise operating theatres needed to be sterile

Question 23

What was Joseph lister’s discovery?

What impact did this have?

Answer 23

-He discovered antiseptic surgery after realising carbolic acid could kill germs.
Impact:
- the once 50% death rate in surgery reduced
-surgeons started to wash their hands before operating and after
-instruments used in surgery were now being washed

Question 24

Give some ways Pasteur influenced lister and his theory

Answer 24

• in Glasgow in 1860, lister realised operations went well as long as the wound was kept free of infection so a colleague referred him to Pasteur’s work
• in March 1867, lister published results and publicised Pasteur’s germ theory through aseptic techniques
• lister thought Pasteur’s germ theory could explain the problems of infection

Question 25

When did lister publish his results and what did they consist of?

Answer 25

In March 1867, giving details of 11 patients with compound fractures, none of whom died of infection

Question 26

Outline listers experiment in chronological order

Answer 26

1. Lister believed infections could only happen when the skin was broken so microbes could get in 2. Instead of skin lister put a chemical barrier and in 1865 he experimented on a young boy who’s legs was fractured where bones where sticking through his skin 3. Lister set the bones and used dressing soaked in carbolic acid, he kept the dressing for 4 days and the boy complained of irritation after 4. Lister removed the dressing and found the fracture and skin healing well which irritation being caused by strength of carbolic acid 5. The dressings were replaced and after 6 weeks the boy walked out of hospital with the wound infection free

Question 27

What was lister’s aseptic approach?

Answer 27

- Spray carbolic acid to coat the surgeons hands, the wounds and the instruments used in the op. - soak the bandages, ligatures and dressings it be applied to the wound in diluted carbolic acid

Question 28

What was listerism? Explain

Answer 28

Lister’s form of antiseptic surgery where he said infection in the wound was caused by microbes in the air and that sepsis came from outside the body and not spontaneous generation hence why he recommended his antiseptic surgery

Question 29

Give ways lister had advanced surgery

Answer 29

- the basic issues of pain and infection were now solved so surgeons could attempt more ambitious operations - in the 1880s there was the first successful op to remove an appendix - in 1896, the first heart op happened to repair a heart damaged by a stab wound

Question 30

Give ways lister introduced sterile methods

Answer 30

- surgeons were now scrubbing hands and arms, wearing face masks and changing operating gowns before surgery - by late 1890s listers antiseptic methods became aseptic surgery which meant removing all possible germs to the operating theatre to create a sterile environment - operating theatres and hospitals were now vigorously cleaned e.g. from 1887 all instruments were steam sterilised and in 1904, rubber gloves were used for the first time

Question 31

Give 2 examples that show lister’s theory of infection developed

Answer 31

- When in 1878 Koch found the bacteria causing septicaemia and proved the disease spread through contact with an infected surface giving a boost to listers ideas - in 1892, lister and Pasteur were both given an award at the sherbonne uni In Paris for their contribution to the fight against disease

Question 32

Give 5 oppositions lister faced

Answer 32

- his method was time consuming as you had to coat everything in carbolic acid and so this made ops cost more money - his method slowed down operations like leg amputation which had to be which to minimise the issue of bleeding - his method did not always work and lister told them it was because they were not systematic enough - people didn’t see how microorganisms could harm something as big as the human body - some didn’t like lister as he was described as arrogant, cold, presenting boring lectures and criticising others

Question 33

What did Koch discover?

Answer 33

That there were different bacteria and that not all bacteria were the same using a disease that was very dangerous to sheep and cattle called anthrax

Question 34

What discovery did Pasteur make on vaccines?

Answer 34

That you could make them in a lab allowing for them to be mass produced later on

Question 35

What was the joint significance of Koch and Pasteur?

Answer 35

- Both their works were being taught in universities | - by 1900, 21 new diseases were discovered as a result of both their work

Question 36

Give 3 discoveries made by Pasteur and a method

Answer 36

- proved spontaneous theory wrong and that germs were in the air and caused decay - realised weakened versions of germs were useful when it came to inoculation - helped create vaccines for typhoid, tuberculosis, diphtheria and tetanus - built up research teams to help him discover the germs which caused disease faster than Koch

Question 37

Between Pasteur and Koch, who did more of what role?

Answer 37

Pasteur did more discoveries and Koch made more methods to which he applied the knowledge from Pasteur’s discovery

Question 38

Give 3 of Kochs method and one thing he discovered

Answer 38

- developed a method to prove that certain germs caused a specific disease and could be used by scientists including Pasteur - improves methods of studying bacteria by staining them so they could be photographed - discovered how to grow bacteria on potatoes making them easier to study than in a liquid - discovered the specific germ that caused anthrax and helped discover the germs that caused typhoid, TB, meningitis, tetanus and cholera

Question 39

From 1870-1909, how did other individuals contribute to germs and vaccinations on top of Pasteur and Koch? State in chronological order with each date (find more detailed version in the table in history book)

Answer 39

Find the page in the history book or iPad photos

Question 40

How were Pasteur and Koch significant in the key theme of war?

Answer 40

In 1871, the Franco Prussian war of Germany and France meant Pasteur being french and Koch being German were at rivalry at the battlefield as they were in science as each side wanted to loose less men and make discoveries first

Question 41

How were Pasteur and Koch significant in the key theme of government?

Answer 41

The government payed for both Pasteur and Koch’s research giving a Nobel prize to Koch in 1905 and Copley medal for Pasteur in 1874

Question 42

How were Pasteur and Koch significant in the key theme of chance?

Answer 42

Pasteur was investigating chicken cholera and by accident, his assistant (Charles Chamberland) used an old sample of diseased microbes which had weakened and so when the chickens were injected, they survived and so Pasteur concluded his discovery of vaccines

Question 43

How were Pasteur and Koch significant in the key theme of communication?

Answer 43

- Koch spread his discoveries via scientific article at conferences - with the anthrax vaccine, Pasteur demonstrated it in front of politicians, farmers and journalists in France in May 1881. The news was then sent around Europe via electric telegram

Question 44

How were Pasteur and Koch significant in the key theme of role of individuals?

Answer 44

Koch mainly based his work and methods of Pasteur’s discovery and ideas