Health and the People Industrial Revolution and Modern Medicine

Question 1

What were the three problems with surgery at the start of the 19th century?

Answer 1

Pain. Infection. Blood loss.

Due to this surgery had to be quick. High death rates.

Question 2

Who was Robert Liston?

Answer 2

Famous surgeon in the 1840s. He was able to carry out an operation to amputate a leg in under 40 seconds.

Question 3

How was nitrous oxide discovered as an anaesthetic?

Answer 3

In 1799, British surgeon Humphrey Davy discovered that nitrous oxide was effective as anaesthetic and gave it the name “laughing gas”.
In 1844, Horace Wells used it for a tooth extraction but did not give enough of the gas so convinced people it did not work.

Question 4

How was Ether discovered as an anaesthetic?

Answer 4

William Morton. Morton experimented with using ether as an anaesthetic and it became used by English surgeons but it was highly flammable and most patients felt sick after using it.

Question 5

How was Chloroform discovered as an anaesthetic?

Answer 5

In 1847, James Simpson and some friends experimented with chloroform. A bottle was knocked over and Simpson’s wife found them all asleep. It then replaced ether. Surgeons were able to perform more complex operations as patients were unconscious and still.

Question 6

What was the opposition to anaesthetics?

Answer 6

Pain and childbirth was God given so it was interfering with God’s will. They could be dangerous (Hannah Green-died while having toe nail removed). British army banned it because they believed pain helped see how the patient was feeling.

Question 7

How was opposition to anaesthetics solved?

Answer 7

John Snow devised a chloroform inhaler in the 1850s. The inhaler made it possible for doctors to control the amount of chloroform a patient was given. In 1853 Queen Victoria used chloroform during birth and assured the public.

Question 8

How did Louis Pasteur help medical progress in the 19th century?

Answer 8

French winemaker asked why his drinks were going off. Pasteur used a microscope to see that there were bacteria - a type of microbe - in the wine. He successfully heated the wine to kill the bacteria. 1861 Pasteur published his work on germ theory.

Question 9

What further experiments did Pasteur do to further medical progress during the 19th century?

Answer 9

He put some broth in two swan neck flasks and boiled it, which killed any microbes that were already there. He then broke the neck off one of the flasks. The flask that was exposed to the air went bad, but the sealed flask did not.

Question 10

How did Robert Koch help further medical progress in the 19th century?

Answer 10

German doctor.He used dyes to stain bacteria. Made them easier to identify when viewed under a microscope. In 1876, he identified the germ that causes anthrax. This was the first time the bacteria responsible for a specific disease had been identified.

Question 11

How was the chicken cholera vaccine discovered in the 19th century?

Answer 11

Pasteur and Chamberland injected a chicken with cholera germs. It did not become ill. A month later Chamberland injected the chicken with a month-old bacteria culture and found that the old germs gave it immunity. Pasteur knew how it worked unlike Jenner so could replicate it for other diseases.

Question 12

What factors helped further medical progress in the 19th century?

Answer 12

Technology- Koch’s assistant, Julius Richard Petri, invented the Petri dish. This enabled Koch to grow bacteria and use microscope to find which bacteria it was.

Luck- Pasteur found the chicken cholera vaccine by chance

War- Pasteur and Koch were rivals during the Franco-Prussian war and their governments invested in their research for national pride and to show they were more advanced

Role of the individual- individual work relied on careful observation, scientific experiments, and years of work to develop new methods and treatments.

Question 13

How did Joseph Lister help medical progress in the 19th century?

Answer 13

Scottish surgeon. He experimented using carbolic acid to soak bandages before applying them to a wound after reading Pasteur’s work. It would then be sprayed from a pump which sterilised the room and equipment. Mortality rates in his surgery fell from 40 per cent before its use to 15 per cent afterwards he started using it.

Question 14

What was the opposition to carbolic acid in the 19th century?

Answer 14

Some surgeons complained that the acid irritated their eyes and hands and made equipment slippery.

Question 15

How was aseptic surgery encouraged in the 19th century?

Answer 15

American surgeon, William Halsted, asked a tyre company to make him rubber gloves for surgery. The use of gloves helped to make surgery cleaner and therefore safer.

Question 16

How was the problem of Blood loss overcome in the 19th century?

Answer 16

1901 Karl Landsteiner discovered blood groups. blood transfusions could now successfully be carried out.

Question 17

Who opposed germ theory in the 19th century?

Answer 17

Henry Bastian argued that germs came from spontaneous generation, so they appeared as a symptom of disease rather than a cause.

Question 18

Who supported germ theory in the 19th century?

Answer 18

John Tyndall- put meat and fish in wooden chamber with sterile air and it did not go off. proved spontaneous generation wrong.

William Roberts- He argued that carbolic acid protected people from infected wounds.

William Cheyne- Cheyne went on to write books on the use of antiseptics in surgery. He also further promoted the work and research of Koch.

Question 19

What were condition like in cities during the industrial revolution?

Answer 19

Terraced houses were common and families shared one room. Lack of clean running water, proper sanitation and sewage systems. Water came from contaminated rivers.

Question 20

How did air pollution affect the population during the industrial revolution?

Answer 20

Thick smog hung over towns and cities where people had moved to in order to live and work. Led to breathing difficulties and damaged lungs.

Question 21

How did conditions during the industrial revolution affect the population?

Answer 21

Overcrowding meant conditions were terrible. Diseases like cholera and typhoid broke out.

Question 22

What were cholera and typhoid? (industrial revolution)

Answer 22

Cholera- Killed around 50,000 people. Spread by contaminated food and water. Caused diarrhoea and vomiting.

Typhoid- Spread by contaminated food or water. Caused a high temperature and fatigue and could be fatal.

Question 23

Who was Edwin Chadwick (Industrial Revolution)?

Answer 23

Lawyer who wanted to reform the conditions poor people lived in. He carried out research into the living conditions in different parts of the country.

Question 24

What report did Edwin Chadwick make? (industrial revolution)

Answer 24

“Report on the Sanitary Conditions of the Labouring Population of Great Britain” in 1842. Highlighted impact of public health conditions and wealth on life expectancy.

Question 25

What did Chadwick find in his research? (industrial revolution)

Answer 25

Labourers from northern towns had LE of 15-19 years. People from rural northern areas had a LE of 52 years

Question 26

What did Edwin Chadwick want as result of his research and how did others reacts? (industrial revolution)

Answer 26

Government action. Clean water supply for all. Proper sanitation systems.

Others kept a laissez-faire attitude and did not want the government interfering in their lives.

Question 27

What was the 1848 Public Health Act? (industrial revolution)

Answer 27

Government responded to Chadwick’s report. If an area had a mortality rate higher than 23 per 1,000 people, the local authority had to set up a board. Local board of health could then raise taxes to pay for clean water supplies and new sewerage systems.

However act was limited and weren’t always compulsory.

Question 28

What did John Snow do to help the discovery of the cause of cholera? (industrial revolution, public health)

Answer 28

He focused on Cholera cases in Soho, London and found that victims all drank from the Board Street water pump. He thought the water to be contaminated from waste in rivers. He persuaded the local council to remove the handle of the pump so it could not be used.

Question 29

What did John Snow learn about those drinking beer instead of water? (Industrial Revolution, public health)

Answer 29

People who worked at a brewery drank beer only and did not catch cholera.

Question 30

What was the significance of John Snow’s investigations? (industrial revolution, public health)

Answer 30

He proved that cholera was a waterborne disease and not caused by miasma. However, without germ theory Snow could not explain that there were germs in the water. This led to further health reforms.

Question 31

What was the Great Stink in 1858? (Industrial Revolution, public health)

Answer 31

The summer of 1858 was warm and dry so water level of the River Thames dropped which meant sewage and waste were not being washed away quickly. This made the smell awful and even Parliament had to be closed.

Question 32

What did people do to try and get rid of the Great Stink? (Industrial Revolution, public health)

Answer 32

They still believed in miasma theory and so washed their walls with chloride of lime to take away the smell.

Question 33

What did Joseph Bazalgette do as a result of the Great Stink? (Industrial Revolution, public health)

Answer 33

The government invested in the construction of a new sewerage system for London. This was designed by Bazalgette in 1858 and finished in 1875. This resulted in the end of significant cholera outbreaks in London.

Question 34

What was the 1867 Reform Act?

Answer 34

It gave the vote to more working-class men.

Question 35

What was the 1875 Public Health Act? (Industrial Revolution, public health)

Answer 35

John Snow and Louis Pasteur’s work made people move away from their laissez-faire attitude. Local authorities had to provide clean water supplies, build sewerage systems and appoint a medical officer.

Question 36

What were other reforms passed to improve public health? (industrial revolution, public health)

Answer 36

1875 Artisans’ and Labourers’ Dwellings Improvement Act for housing quality.

1875 Sale of Food and Drugs Act tightened laws around food labelling.

1876 Rivers Pollution Prevention Act aimed to clean up rivers and the water supply.

Question 37

Who was Charles Booth and what did he do to help improve public health in the early modern period?

Answer 37

He was a social reformer and made a colour-coded map in 1889 that showed the divide between wealthier and poorer areas of the city. He found that 35 per cent of people lived in extreme poverty even with full time jobs and so more needed to be done.

Question 38

Who was Seebohm Rowntree and what did he do to help improve public health in the early modern period?

Answer 38

A philanthropist and social reformer who conducted an investigation in York in 1900. He found that people needed to be earning 21 shillings a week to stay out of poverty. He came up with the term ‘poverty line’ for people earning less than this amount.

Question 39

How did the Second Boer War contribute to the improvement of public health in the early modern period?

Answer 39

In 1899, at the start of the war, one in three of the men who volunteered to fight were unfit to be recruited for health reasons.

Question 40

What were the contents of the Liberal reforms? (public health)

Answer 40

1906- free school meals

1907- medical inspections of school pupils

1911- National Insurance Act came in. This set up a system where workers had a sum of money deducted from their wages to pay for health care and sick pay if needed

Question 41

What was the opposition to the Liberal reforms? (public health)

Answer 41

Some people argued that the Liberal reforms did not go far enough. The Labour Party said more should be done to help women, who were less likely to benefit from National Insurance. Conservatives said that giving people too much from the state would make them dependent on being given aid and support.

Question 42

What were the Public health milestones of the Industrial Revolution?

Answer 42

Question 43

What was the idea of a ‘magic bullet’? (20th century, treatment of disease)

Answer 43

Following Germ theory and Robert Koch’s work on identifying specific bacteria, ways of killing germs inside the body without harming healthy human tissue was investigated.

Question 44

What did Paul Ehrlic do to improve treatment of disease in the 20th century?

Answer 44

He had worked with Robert Koch with the dyes. He had a theory that some chemicals could kill specific germs without harmful effects. He investigated chemicals that would kill syphilis germs by injecting rabbits with it then giving them a chemical to see if the rabbit would be cured without the medication making them ill.

Question 45

How was the first ‘magic bullet’ discovered? (20th century, treatment of disease)

Answer 45

Ehrlich and his assistant Sahachiro Hata tried hundreds of compounds. Hata discovered that the 606th compound Salvarsan was effective in 1909. It was then made available after successful human trials.

Question 46

Why were magic bullets significant in improving the treatment of disease in the 20th century?

Answer 46

It led to research into other chemicals that might be magic bullets.

In 1935, Gerhard Domagk discovered Prontosil - an antibacterial drug - which became the second magic bullet and killed the bacteria streptococcal which could cause life threatening infections.

Led to the discovery and development of penicillin.

Question 47

Who was Alexander Fleming? (20th century, public health)

Answer 47

Scottish doctor who worked at St Mary’s Hospital in London.

Question 48

How was penicillin discovered by Alexander Fleming? (20th century, public health)

Answer 48

In 1928, he went on holiday while researching Staphylococcus bacteria. He found that a mould had grown on one of his Petri dishes and realised that it was Penicillium fungi. He did more research and found that it could kill Staphylococcus bacteria. He wrote his findings in a medical journal.

Question 49

What did Howard Florey and Ernst Chain do to further the development of penicillin in the 20th century?

Answer 49

In 1935, they used Fleming’s work as to try and purify penicillin so it could be given as a medicine. They achieved this by 1941 and could do human trials.

Question 50

Who was the first person to receive penicillin and what happened? (20th century, public health)

Answer 50

Albert Alexander was a policeman who had cut his cheek while gardening. The wound had become infected and he was very ill in hospital. After receiving penicillin he regained consciousness and started to recover but there was not enough so he fell ill again and died. So Florey and Chain had proved that if enough penicillin could be produced, infection could be cured.

Question 51

How did World War Two and mass production improve public health in the 20th century?

Answer 51

Florey and Chain were given $3 million in funding by the US government when WW2 broke out. The US government paid for enough penicillin to be produced that every American soldier injured on D-Day could be given penicillin.

Question 52

What were the factors that contributed to the development of penicillin?

Answer 52

Question 53

Since 1945 what developments were made in new medicines and treatments? (20th century)

Answer 53

During the 1950s Rosalind Franklin used X-rays to take images of DNA which was crucial for researches to understand the structure of DNA.

In 1953, Francis Crick and James Watson used Franklin’s work to discover the double helix structure of DNA. They wrote about their findings in the medical journal ‘Nature’.

Discovery of DNA’s structure was significant in helping researchers to understand the causes of some diseases and develop new treatments based on DNA structure.

Question 54

What advances have been made in surgery since 1945?

Answer 54

1967 Christiaan Barnard (South African cardiac surgeon)- first heart transplant-his patient only lived for 18 days before dying of pneumonia, though his new heart beat strongly to the end.

2005- partial face transplant
2010- full face transplant done in Spain

Keyhole surgery uses microscopic cameras. Small cut to allow the cameras to be inserted and the procedure to be completed reducing the risk of infection and speeds up recovery time.

Question 55

What new treatments have been developed since 1945?

Answer 55

In vitro fertilisation (IVF)
led to the birth of Louise Brown in England in 1978.

New vaccines have been developed e.g. HPV

Question 56

What is the idea of ‘mainstream medicine’? (into the 20th century)

Answer 56

Treatment and care provided by a trained doctor or nurse usually relying on scientific methods to diagnose and treat patients.

Question 57

What are alternative and complementary medicines? (into the 20th century)

Answer 57

Treatments and methods that are not considered to be mainstream. They include some ideas and methods that are believed to be effective but that lack the evidence or testing that apply to a mainstream treatment.

Question 58

What are examples of alternative and complementary medicines? (into the 20th century)

Answer 58

acupuncture - using needles in parts of the body for pain relief

yoga- to improve mental and physical wellbeing

hypnotherapy- using relaxation and focusing of thoughts to support people with mental health challenges.

herbal remedies - to help with mental health challenges, pain or a low immune system.

Question 59

What is the problem with antibiotic resistance in recent years?

Answer 59

Bacteria becoming resistant to antibiotics. For example, the MRSA bacterium (superbug). Superbugs could make infections that have been treated by antibiotics life threatening again. Research is being done to prevent this.

Question 60

How did WW1 impact the development of new treatments and surgery? (modern medicine)

Answer 60

Many new injuries caused by shrapnel, machine guns and shell fire so surgeons had the opportunity to develop new methods and treatments.

Question 61

Who was Harold Gillies and what did he do to improve plastic surgery during WW1? (modern medicine)

Answer 61

A New Zealand doctor who joined the British army as a surgeon during WW1. In 1917 he set up a ward at Queen Mary’s Hospital in London, to treat patients with facial injuries. He used new skin graft techniques. In one technique, he moved a patch of skin on the face, called a pedicle. He left the veins attached to it, so it still had a blood supply and could be moved to a diff part of the face.

Question 62

Who was Francis Derwent Wood and what did he do to improve plastic surgery during WW1? (modern medicine)

Answer 62

A sculptor who worked in hospitals in England treating injured soldiers. He designed and made lifelike facial masks for soldiers who had suffered severe facial injuries. This helped them to regain confidence, supported their mental health and aided their reintegration into normal life.

Question 63

Blood transfusion during WW1: (modern medicine)

Answer 63

Karl Landsteiner had discovered blood groups in 1901 so blood transfusions were possible. Sodium citrate was added to packages of blood which stopped it from clotting straight away meaning blood could be stored for a short amount of time.

Question 64

X-rays during WW1: (modern medicine)

Answer 64

Marie Curie and her husband Pierre’s scientific research was crucial in the development of X-rays for use in surgery. During World War One, mobile X-ray units were available. She got 200 X-ray units and 20 mobile X-ray vehicles into field hospitals. Surgeons could see what internal injuries a patient had, meaning surgery could be better planned and was safer.

Question 65

Amputation and the use of prosthetic limbs during WW1: (modern medicine)

Answer 65

Thousands of soldiers had limbs amputated during the war. New and more sophisticated artificial prosthetic limbs were designed. A company in London that made industrial and electric tools began to manufacture a new prosthetic leg made of metal. This was lighter and easier to manoeuvre.

Question 66

Who was James Edward Hanger and what did he do to improve surgery during WW1? (modern medicine)

Answer 66

He became an amputee during the American Civil War. His prosthetic limb was painful and did not fit right so he designed a new one that could bend at the knee and ankle using engineering experience. State government commissioned him to manufacture improved prosthetic limbs for others. He travelled Europe and received contracts with England and France during and after World War One to supply artificial limbs to Allied soldiers.

Question 67

How did WW2 impact the development of medicine?

Answer 67

Evacuation of children to the countryside resulted in pressure to improve health care provision for people who lived in poverty.

Question 68

The Guinea Pig Club and Archibald McIndoe: (WW2)

Answer 68

He worked with soldiers who had suffered severe facial injuries especially from burns. He treated physical injuries and supported his patients with difficult mental health. His patients formed the Guinea Pig Club to help recovering soldiers adapt to civilian life and learn to live with their injuries.

Question 69

Blood transfusion in WW2:

Answer 69

Charles Drew was an American surgeon who came up with new methods to store and transport blood. He was put in charge of a campaign called Blood for Britain which involved US civilians donating blood, which was transported to Britain using Drew’s techniques. It was then used to treat injured British civilians and soldiers in blood transfusions.

Question 70

How did evacuation during WW2 contribute to the development of medicine and public health?

Answer 70

3 million children moved to the countryside. Many people in rural areas were shocked at the levels of poverty they witnessed in some of the evacuated urban children. This led to support for social reform and a commitment to help families in need of assistance leading to the NHS.

Question 71

When and how was the NHS created?

Answer 71

1948
After 1945, Bevan became Minister of Health. He organised the founding of the NHS based on the principles of the Beveridge Report.

Question 72

What was the Beveridge Report? (modern medicine)

Answer 72

1942 William Beveridge (Liberal politician and social reformer) wrote a report called ‘Social Insurance and Allied Services’. He recommended that the government should act to deal with the ‘five giants’.

Question 73

What were the ‘five giants’ found in the Beveridge Report? (modern medicine)

Answer 73

idleness - caused by a lack of employment opportunities

ignorance - caused by people lacking a good education

disease - caused by unaffordable health care

squalor - caused by poor-quality housing

want- caused by poverty

(Beveridge wanted the government to provide ‘cradle-to-grave’ social security)

Question 74

What was the opposition to the creation of the NHS?

Answer 74

General Medical Council- represented doctors and was concerned that doctors would be employees of the government and would lose their independence and receive less pay.

Politicians- argued that the cost of the NHS would be too great and taxpayers should not have to pay.

Question 75

Who was the first person to be treated by the NHS?

Answer 75

13-year-old Sylvia Diggory, who was treated at Trafford General Hospital.

Question 76

How was the NHS ensured to be fully staffed?

Answer 76

Nurses and domestic workers from the Caribbean and Ireland were employed and encouraged to come and work in hospitals in the UK. During the 1960s, NHS employees were also recruited from South Asia and Africa, as well as from the Caribbean.

Question 77

Introduction of prescription charges (modern medicine):

Answer 77

Bevan strongly believed that the NHS should provide free health care for all. NHS had a budget of 437 mill per year but this was a lot because of debt Britain was in after WW2. Bevan resigned from the government when charges for prescriptions were introduced to pay for the cost of the Korean War.

Question 78

What does the NHS do today to help encourage people to live a healthier life?

Answer 78

encourages people to:
-stop smoking
-eat healthily
-practise safe sex
-get vaccinated

note: Decisions have to be made about which medications and services can be paid for by the NHS and which cannot.