Medicine Unit 2 - Discovery and development, 1860-75 Flashcards
(17 cards)
1
Q
Pasteur’s experiments
A
- French chemist
- 1854 - asked to investigate why vats of beer turned sour & discovered microbes in the beer - suggest microbes were affecting the beer
- Discovered microbes could be killed by heating the liquid
- Pasteur also carried out experiments on milk, wine and vinegar and convinced that liquids were contaminated with microorganisms that floated in the air
- When heating milk, wine or vinegar - didn’t go sour
- 1860 French Academy of Science set challenge to prove spontaneous generation - Pasteur published results of microorganisms causing decay and became known as ‘germ’ theory
2
Q
Pasteur’s germ theory
A
- Proved spontaneous generation was wrong
- Decay only occurred when mixture left open to microorganisms in the air
- Carried out further experiments with different airs and found mountain air was cleaner than that of cities
- Date given is 1861 - when the experiments were published
- Ideas often resisted and even ridiculed but published ideas in scientific journals so scientists could check his findings and eventually accepted his ideas
3
Q
Germ theory and medicine
A
- 1865 - Pasteur asked to investigate a problem in the sink industry - found silk worms were being killed by a disease caused by microorganisms - began to make a link with disease
- 1878 - published his Germ Theory and its Applications to Medicine - still not accepted - microorganisms were in blood yet didn’t cause disease & not clear how germ theory could help medicine
- Work had a significant impact on surgery due to reasoning how disease occurred
- His work led to vaccines being made 30 years later but took 40 years for treatments
4
Q
Joseph Lister
A
- 1859 - Professor of Surgery at Glasgow University
- 1861 - Surgeon at Glasgow Royal Infirmary - put in charge of a new building and hoped that deaths after surgery could be reduced with a greater emphasis on hygiene
- Wondered if carbolic acid could be used for infection since it was used at Carlisle sewage works to kill microorganisms responsible for decay and smell
5
Q
Lister and antiseptics
A
- 11-year-old brought to hospital w/broken leg - bone was sticking out through the skin & would lead to infection
- Lister set the broken bone, covered the wound in bandages & soaked it in a solution of carbolic acid - wound healed without infection
- Began to use carbolic acid to clean wounds, equipment & bandages in all operations - death rate dropped dramatically
- Method was called antiseptic
- Also developed a carbolic spray to use in operation to make sure no microorganisms on the surgeon’s hand or equipment would enter the wound
6
Q
Opposition to Lister’s ideas
A
- Carbolic spray made instruments slippery - slowed operation
- Spray made the skin of doctors’ hands cracked & sore
- Many doctors didn’t accept germ theory & hence saw no need for antiseptics
- Some doctors didn’t use techniques properly and hence weren’t effective
- Many nurses irritated by extra time & work to dress wounds
- Some doctors used basic soap & water which worked - no need for additional methods
- Lister frequently experimented & adjusted techniques - others thought he wasn’t confident
7
Q
Joseph Bazalgette & London sewer system
A
- John Snow’s work on cholera & Great stink in 1858 convinced the government that a new sewer system in London was needed - £3 million given to London Metropolitan Board of Works
- Joseph Bazalgette made chief engineer
- Wanted to make sewers very large, oval shaped, built of break & wanted the whole system to bring waste down to the lower stretch of the Thames where river was tidal & sewage would be washed out to sea
- 2000km of sewers built by 1865
- 4 pumping stations built 1864-1875 & two treatment works for sewage not sent out to sea
- 1875 - project was finished & £6.5 million spent
8
Q
Role of the authorities
A
- Previous attitude of ‘laissez-faire’
- Laws often not obeyed e.g. 1852 law for children to get small pox vaccine - not enforced until new act in 1871
- Many didn’t want government action due to taxes
- 1866 - Sanitary Act - towns had to employ inspectors to check on water supplies & drainage & local governments contributed e.g. Manchester w/sizes of rooms & windows in houses
9
Q
Reform acts
A
- Political parties began to offer policies to make them more popular w/voters & get them elected
- Public Health Act of 1875 - government responsible for:
- Supply of clean water, dealing with/sewage to prevent water from being polluted, building public toilets, ensuring new housing built to good standards, inspecting conditions in lodging houses, employing Health Inspectors & Sanitary Inspectors to make sure regulations obeyed, creating street lighting, checking quality of food on sale
10
Q
Hospitals
A
- Usually small organizations relying on charity for funding
- Could only admit a few patients & patients needed a letter of recommendation from a doctor or respected individual
- Patients had to meet standards of behaviour or could be forced to leave
- Local cottage hospitals established in 1860 - usually ran by a local GP & have 12 beds
- Large hospitals / infirmaries in cities & large towns - had outpatient departments where people would queue for a doctor
- Standard of care in hospitals was still low & little progress
11
Q
Florence Nightingale
A
- Newspapers on her work in Crimea made her famous
- Returned to Britain 1856 - regarded as expert on nursing & hospitals
- Book of ‘Notes on Hospitals’ published in 1859 - set out recommendations for space, ventilation & cleanliness
12
Q
Training for nurses
A
- Nightingale also wrote ‘Notes on Nursing’ - 1859 - have advice for nursing a patient e.g. ventilation, light bedding, food
- 1860 - Nightingale School for training of nurses established at St. Thomas’ Hospital in London - also set up midwifery school at King’s College Hospital in 1861
- Nightingale wrote over 200 books on hospital design & nursing
13
Q
Attitudes towards women
A
- Few women became doctors - thought that they weren’t as intelligent
- Many taught by families to be homemakers instead of going to university
- Nightingale made it acceptable for females to be nurses & fit traditional view
- Many thought women couldn’t cope with becoming doctors
- Women dissatisfied at this time - seen by suffragists & voting campaigns - many wanted to challenge female stereotypes
14
Q
Elizabeth Garrett
A
- Many barriers for women - doctors needed a medical degree from a university or teaching hospital
- Medical Act, 1858 - doctors needed to be officially registered w/General Medical Council
– Elizabeth Blackwell - English woman in USA who became first woman to qualify as a doctor - returned to England & spent a year lecturing - met Elizabeth Garrett in 1859 & inspired her
- Garrett came from a wealthy family who were horrified of her becoming a doctor
- Garrett applied to study medicine at several medical schools - all refused a female student
- Then paid for private lessons & dissected corpses in her own bedroom
15
Q
Qualifying as a doctor
A
- Complete a university medical degree
- Pass examinations
- Be accepted by one of the 3 medical societies - Royal College of Surgeons, Royal College of Physicians or Society of Apothecaries
- Be listed on medical register
- Physicians could diagnose illness & prescribe treatment but could not actually give out medicine
- Apothecaries licensed to offer medical advice & prescribe medication
16
Q
Garrett becoming a doctor
A
- Completed a course of medical training but could not be licensed - College of Surgeons & Physicians couldn’t have women but no Apothecaries
- Garrett’s father supported her & threatened to sue if she wasn’t accepted - became accepted & officially qualified to practice medicine in 1865 but society immediately changed their rules so women couldn’t join
- OpenedSt. Mary’s Dispensary in 1866 in London
- Went to Paris later & got a medical degree
- Returned to England in 1872 - Dispensary added 10-bed ward staffed by women - eventually moved site & expanded multiple times - became the New hospital for Women & then London School of medicine for Women - renamed to Elizabeth Garrett Anderson Hospital in 1918 - just a after her death
- 1873 - became member of British Medical Association (BMA) - only woman member for next 19 years - BMA voted against further women
- 1908 - first female mayor in England - mayor of Aldeburgh
17
Q
Other female doctors
A
- Sophia Jex-Blake led 4 other women who persuaded Edinburgh University to study medicine
- Had to pay additional fees to be taught separately
- Faced opposition & harassment
- Edith Pechey won a prize in Chemistry, given to second place male
- 1874 - university decided to force them to leave claiming it didn’t;t have the authority to admit female students in 1869
- Jex-Blake & Pechey gained medical degrees abroad like Blackwell, Hoggan & Garrett
- 1876 - Act of Parliament said universities & medical societies should accept women medical students & allow them to become doctors - numbers still remained low
