Medicine 18/19th Century Flashcards
(24 cards)
Spontaneous Generation
-Micro-organisms were discovered as early as the 17th century
-Scientists thought microbes were created by decaying matter like rotting food or human waste
-Led to the belief that disease caused germs
Invention of the microscope
-Antonie van Leeuwenhoek invented the microscope in the 17th century
-More advanced microscopes were developed during the 1800s
-Allowed scientists like Louis Pasteur to see much clearer images of microbes
Pasteur’s first experiment on the Germ Theory
-French chemist Louis Pasteur was employed in 1857 to find the explanation of sugar beet used in fermenting industrial alcohol
-His answer was to blame germs
-He proved there was germs in the air by showing that sterilised water in a closed flask staying sterile whilst sterile water in an open flask bred germs
-He published Germ Theory in 1861 arguing that microbes in the air caused decay, not the other way around
-He suggested germs caused disease
-In 1867, he published evidence demonstrating that germs caused a disease like silkworms
Impact of Germ Theory
-First met with scepticism as people couldn’t believe tiny microbes caused disease
-Each germ was responsible for each disease, so this meant it took several years before the theory became useful
-Theory inspired Lister to develop antiseptics
-Theory confirmed Snow’s findings on cholera
-Pressured govt to pass 1875 Public Health act
-Led to Koch identifying specific diseases
-Led to magic bullets
Robert Koch using dyes to identify microbes
-German scientist who built on Pasteur’s work by linking specific diseases to the particular microbes that caused them (microbe hunting)
-He identified the anthrax bacteria (1876), septicaemia bacteria (1878), tuberculosis bacteria (1882) and cholera bacteria (1883)
-Used agar jelly to create solid cultures to breed lots of bacteria
-Used dyes to stain the bacteria (more visible)
-Employed newly invented photography to record findings
Pasteur developing anthrax and rabies vaccines
-After hearing Koch’s discovery of anthrax bacteria in 1877, Pasteur started to compete to find and combat new bacteria
-His assistant, Charles Chamberland, injected chickens with a cholera culture that had been weakened by accidentally being left out
-The chickens survived
-They tried again with newly cultured cholera and they still survived
-They worked out that the weakened cholera made chickens immune. The error produced a chance discovery vaccine for chicken cholera
-Team produced an attenuated version of the anthrax bacteria to make sheep immune and used a similar method for rabies vaccine
Koch’s methods helping other microbe hunters
-Diphtheria germ discovered by Edwin Klebs (1883)
-Friedrich Loeffler cultured the diphtheria germ and thought its effect was due to a toxin it produced. Emile Roux proved this right.
-1891, Emil von Behring produced an antitoxin from the blood of animals just recovered from diphtheria to reduce the effect of the disease
-Ronald Ross received 1902 Nobel Prize for discovering how malaria was transmitted
Paul Ehrlich and magic bullets
-Antibodies were nicknamed magic bullets as they were natural defence mechanisms that attacked specific microbes
-1889, Ehrlich set out to find chemicals that could act as synthetic antibodies
-First he discovered dyes that could kill malaria and sleeping sickness germs
-1905, bacteria causing STD’s syphilis was identified
-Ehrlich decided to search for an arsenic compound that was a magic bullet for syphilis hoping it would target bacteria without poisoning the rest of the body.
-Over 600 compounds tried, but none work
-1909, Sahachiro Hata joins the team. He rechecked the results and saw that compound 606 worked
-It was first used on a human in 1911 under the name Salvarsan 606
Gerhard Domagk (Prontosil) and development after
-He tried a chemical mix called Prontosil in 1930’s
-Prontosil killed a bacterium that caused blood poisoning
-He tried it on his daughter after many animals and she lived
-Later, scientists found a chemical in Salvarsan 606 and Prontosil called Sulphonamide which drug companies used to create drugs that treated pneumonia and scarlet fever
-Marked the birth of the modern pharmaceutical industry
Early forms of anaesthetic
-Nitrous oxide (laughing gas) was identified by Humphry Davy (1799) but was ignored
-American dentist Horace Wells also used it in a public demonstration but didn’t work well
-American doctor Crawford Long discovered qualities of Ether but didn’t publish it
-First public demonstration of ether was carried out by William Morton
-Ether is an irritant and fairly explosive so it was risky
James Simpson and Chloroform
-A professor of Midwifery at Edinburgh Uni
-Tried to find a safe alternative to ether for women during childbirth
-Nov 1847, he inhaled chloroform and it knocked him unconscious- it worked quicker than ether and less was needed for the same result
-Some were cautious of it until Queen Victoria used it for her 8th child birth in 1853
-Many then felt much more comfortable
Early anaesthetic leading to high death rates
-Anaesthetic led to longer, complex operations
-Unconscious patients were easier to operate on and so they could work for longer
-Higher death rates from infection as surgeons didn’t know poor hygiene spreads disease
-Surgeons wore coats covered in dried blood and pus
Joseph Lister and antiseptics
-Ignaz Semmelweis showed washing hands with chloride of lime solution reduced infection but many didn’t listen
-Lister saw carbolic acid sprays used in sewage works to keep down the smell
-He tried it in operating theatres in 1860’s and infection rates reduced
-He heard about Germ Theory 1865 and realised germs could be in the air, on instruments and people’s hands
-He started to soak carbolic acid on instruments and bandages
-Reduced death rates from 50% (1844-46) to 15% (1867-70)
Response to Lister’s carbolic acid
-He faced opposition from many doctors
-They didn’t like to use carbolic spray as it was unpleasant to breathe and to be on their skin
-1877, Lister used a well-publicised operation at King’s College Hospital to promote the use of his carbolic spray
-Allowed surgeons to operate with less fear of patients dying from infection
-Number of operations was 10x higher in 1912 than 1867
Asepsis reducing the need for chemicals
-Since the late 1800’s, surgeons changed approach from killing germs to making a germ free environment
-Instruments carefully sterilised before use usually with high temperature steam (120)
-Staff sterilise hands and wear sterile gowns, masks, gloves and hats
-Sterile gloves introduced by William Halstead (1889)
-Theatres kept extremely clean and fed with sterile air
Initial overcrowding and poor living conditions in towns
-18/19th C= People moved to towns for work
-Towns grew so quick that only badly built houses as close together as possible were made, with little outside space and bad ventilation
-Overcrowding saw families with 4 or more children sharing 1 room to save money
-People didn’t understand the need for clean water or good sewage systems
-Only shared an outside toilet called a privy
-Privy’s built over cesspits which was collected and thrown into waste rivers
-Water companies set up water pumps which were shared but they were often contaminated
Impact of cholera epidemic
-Cholera reached Britain in 1831
-By 1832, 21,000 died of cholera
-Spread when infected sewage gets into drinking water causing extreme diarrhoea
-Both rich and poor died
-People didn’t know what caused it, best guess was miasma
-Govt started regulating the burial of the dead but this didn’t help
-Epidemics recurred in 1848, 1853 and 1865
Chadwick’s report
-In 1842, a social reformer Chadwick published a report on poverty and health
-Showed that living conditions in towns were worse for people’s health than living in the countryside
-It suggested that the government should pass laws for proper drainage and sewerage systems funded by local taxes
1848 Public Health Act
-Chadwick’s report and another cholera epidemic in 1848 (killing 53,000) put pressure on parliament to pass a Public Health act
-It set up a central Board of Health and allowed any town to set up its own local board of health as long as the town’s taxpayers agreed
John Snow and Cholera
-1853-54
-Plotted places where people died of cholera
-Used a map to work out that they had all drunk water from the same pump on Broad Street
-Drinking water was contaminated by sewage leaking into the water supply
-Snow knew that none of the workers at a local brewery had been taken ill with cholera
-They had drank beer rather than water from the pump
-Persuaded the local council to remove the handle from the pump so it could not be used
-Disproved miasma theory
-Led to further public health reforms
The Great Stink
-In London, lots of waste drained into water sources, including the River Thames
-Summer of 1858, hot weather caused river levels to drop and bacteria to grow in the waste
-Produced a smell so bad it affected large parts of London and stopped parliament meeting
Joseph Bazalgette and sewage systems
-Bazalgette was an engineer who worked for the Metropolitan Board of engineers
-He was appointed to build a new London sewer system in 1859
-The sewer transported waste normally dumped into the Thames away from heavily populated areas into the Thames Estuary
-About 1300 miles of sewer built, 318 million bricks and removed 420 million gallons of sewage a day
-He was funded 3 million by the government
-Finished 1866 and cholera never returned
Changes in public opinion on public health
-For most of the 19th C, people believed in a laissez-faire government
Evidence from Chadwick, Snow and Germ Theory, govt saw that cleaning towns could stop the spread of disease
-1867, 2nd Reform Act passed giving nearly 1 million more men the vote (industrial workers)
-This meant more pressure on govt to listen
-Several reformers helped change attitudes towards health like William Farr
1870’s public health acts leading up to the 1875 Public Health Act
-1871-1872, govt followed Royal Sanitary Commission’s proposal to form Local Government board and divide Britain into ‘sanitary areas’ administered by officers
-1875, Benjamin Disraeli’s govt passed an act forcing councils to appoint health and sanitary inspectors to make sure laws were followed
-He also brought in Artisans’ Dwelling Act which let local councils buy slums with poor living conditions and rebuild them
