Government adopted the laissez-faire
EVENT DESCRIPTION/EFFECT
Industrial revolution More industrial town, migration to cities for
work - poor living standards
Poor Living conditions 1 family in 1 room. 50 people per house
Privy used by 100 people.
Pump shared by 30 families
Water from polluted rivers.
Little light and ventilation
Women not in medicine - only good wives,
- not as intelligent as men - didn’t
receive the same sort of education as
men,
- women couldn’t cope with gory details
of medicine (e.g. dissections).
- Some men refused to work alongside
women.
By 1931 10% of doctors were women.
Catgut ligatures Lister developed these fibers made of
sheep’s intestines and soaked in carbolic acid
to seek blood vessels. Came from an animal,
did not create infection, dissolved in the body
after 2-3 weeks.
start of WW1 More casualties than any other war. New,
powerful weapons. Gangrene was a huge
problem. Had to deal with poison gas
(186,000 soldiers injured but only 2.6% died).
Half the male doctors in England went to war.
approach to medicine( not to interfere with it)
YEAR KEY WORDS, PURPOSE, EFFECT
1831-1832 - cholera: general pain, muscle spasms, vomiting, diarrhoea,
death.
Cholera outbreak
- 20,000 dead
1842 - Edwin - Eiffel Tower has the cleanest air
- Theory of miasma: disease was carried in dirty, smelly air
Chadwick’s report on
which spread quicker in hot weather.
sanitary conditions of the - SPONTANEOUS GENERATION: disease carried in rotting
Labouring population material.
- Microscopes weren’t strong- doctors weren’t as curious about
germs.
- Hospitals relied on charity, not government for funds- no
progression.
- Spend tax money on improving housing and living conditions
of the poor (clean water, removing rubbish and sewage).
-
1846 - used to amputate a leg
- Good for pain relief,
Robert Liston uses
- DISADVANTAGES WERE: vomiting, coughing, irritated lungs,
ether as anaesthetic
left patient asleep for hours or days, highly flammable gas
(theatre was lit by candles).
1847: Florence - Sidney Herbert - minister of war
- Dirty conditions: lice infested clothes, typhoid fever+cholera,
Nightingale goes to
difficult to get medical supplies(bandages/medicine) to the
military hospital in
hospital, low food supplies, rats
Scutari (38 nurses)
- Hospital was built over a cesspool.
- She cleaned the whole hospital (believed in miasma), opened
windows, and bought new linen.
- Times Newspaper fund
- Death rate of wounded fell (40% - 2%)
- She wrote ‘ Notes on Hospitals’ in 1963
James Simpson
discovered chloroform as
- Didn’t have the same side effects as Ether
anaesthetic
- Queen Victoria used it in childbirth in 1853
- Widely used as a result of royal approval and newspaper
publicity
- PROBLEMS WITH CHLOROFORM:
- Christian opposition - childbirth should be painful.
- Not known how chloroform would affect the baby.
- Difficult dosage (put them to sleep but not kill them).
- Some doctors thought a sleeping patient was more
likely to die than one kept awake by pain.
- Confidence for longer surgeries deeper in the body.
- Still infections: dirty linen, surgery tools, bandages - gangrene
and sepsis.
- Set up a General Board of Health
1848
Public Health Act - Town to employ medical officers - remove rubbish, sewer system.
(Chadwick) - 3 commissioners of the Board of Health (one was Chadwick)
- Terms were temporary (only 5 years)
- Didn’t force local authorities to improve hygiene
- Four Humours developed by Ancient Greeks
Chloroform inhaler - Theory of Opposites - illness was caused by too much of one
humour. Balance humours by eating/drinking something with
opposite qualities.
- Invented by John Snow
- Controlled dose of chloroform
- Infection and blood loss problems remained - death rate rose.
1854 - Dr. John Snow believed Cholera was spreading in polluted
water.
Cholera epidemic
- Investigation in Soho - most of the people who drank from the
Broad Street pump died of Cholera. (500)
John Snow and the - Nearby workhouses (5) and Breweries (0) with their own
Broad Street Pump water supply weren’t badly affected.
- Woman who lived in Hampstead died of Cholera only because
🤮
she had water retrieved from the Broad Street Pump everyday
because she liked the way it tasted.
- Snow removed the handle - deaths stopped
🤢
- Outbreak caused by cracked cesspool which leaked to Broad
Street Pump - dirty nappies soaked in drinking water
-
- Hot summer - Thames began to dry and rubbish + excrement was
1858
washed up on the banks.
Great Stink - £3 million given to the metropolitan board of works to build a new
sewage system.
- Joseph Bazalgette = chief engineer
- Sewers would be large, brick oval shapes
- Bring sewage to lower stretches of the Thames. Would be
washed out to sea.
- 2,500 km long
- Completed by 1865
1859 - Florence Nightingale wrote ‘Notes On Nursing” - importance
of ventilation, light, bedding, cleanliness and food.
Florence’s notes
- Translated into 11 languages - external influence.
- Florence Nightingale wrote “Notes on Hospitals”
- Wrote over 200 books on hospital design and nursing.
1860 - Local cottage hospitals established
Nightingale’s nurse - Relied on charity
training school - Run by local GPs. Had around 12 beds.
established - Larger hospitals (infirmaries) in the city e.g. The Royal Free
Hospital est. 1828.
-
1861 - Found out that beer turned sour in the presence of microbes.
- Microorganisms caused decay and weren’t created by rotting
Pasteur’s Germ theory
matter (contrary to Spontaneous generation)
- Microorganisms spread through air.
- Microorganisms killed by heating them.
- Led to Joseph Lister’s development of antiseptic techniques.
- Took over 40 years for treatment to develop.
1865 - Carbolic acid killed microorganisms.
- Great stress on hygiene(Snow, Nightingale, Semmelweis) - but
Lister - carbolic acid in
death rate was still high.
surgery
- Carbolic acid used to treat sewage
- Lister had read Pasteur’s Germ theory.
- Death rate dropped from 45% to 15%
- DISADVANTAGES:
- Spray made hands slippery - longer surgery- blood loss
- Many doctors didn’t accept Pasteur's Germ theory
- Some doctors thought soap and water was enough
- Extra time and work involved in dressing wounds
Elizabeth Garrett
- Elizabeth Blackwell became first woman to qualify as a doctor
Anderson qualified to
in the USA.
practise medicine
- She gave a lecture in England to Elizabeth Garrett Anderson
- Garrett - Anderson was a nurse, and attended lectures for
male doctors.
- She was rejected by all the medical schools for being a
woman.
- Her father threatened to sue the Society of Apothecaries if
they didn’t accept her.
- Opened St. Mary’s Dispensary ( later the London School of
medicine for women)- treatment for women.
- Became the only female member of the British Medical
Association (BMA)
- First female mayor in England (mayor of Aldeburgh)
1875 - local authorities responsible for:
- Clean water
Public Health Act
- Dealing with sewage(didn’t contaminate water supply,
so reduced chance of disease).
- Building public toilets
- Inspecting conditions of lodging houses (enough light
and ventilation.
- Slum houses were demolished (Artisans’ Dwelling Act)
- Health Inspectors
- Checking quality of food on sale.
- Laissez - faire attitude changing
1876 - Women can study medicine and qualify as doctors
Medical Act - Universities and medical societies should accept women.
- Number of female medical students still remained low.
1878 - Studying chicken cholera
Germ Theory & - Assistant went on holiday, and a culture of bacteria was
Application to left for a few weeks. Chickens injected with this cultures
Medicine published by DIDNT get cholera and were immune.
Pasteur - Helped develop vaccinations
YEAR KEY WORDS, PURPOSE, EFFECT
1881 - combined his work with Koch’s.
- Publicly vaccinated 24 sheep and cows with anthrax bacteria
Pasteur’s anthrax
- All the vaccinated sheep lived, unvaccinated sheep died.
vaccine
1882 - Injected culture into animals
- Developed the use of agar jelly and petri dishes
Koch identifies
tuberculosis
1883 - Developed the use of agar jelly and Petri dishes.
- Established the ‘bacteriology’ branch of Chemistry.
Koch finds cholera
- Koch’s methods helped find:
microorganism
- Tetanus, pneumonia, meningitis, diphtheria and
dysentery. (1880s - 1890s)
1885 - 9 year old Joseph Meister
- Boy survived
Pasteur tests rabies
vaccine on a human for
the first time.
1889 - Householders or doctors in London to report cases of
infectious diseases to their Medical Health Officer.
Infectious Disease Act
- Extended to the rest of the country, and led to isolation
hospitals being built.
1895 - German physicist
- As early as 1896, many hospitals had X-ray machines
Röntgen discovers X-ray
installed.
- Helped find tuberculosis (shadow on the the lungs)
- Useful in war. Find bits of shrapnel and bullets.
- DISADVANTAGES:
- Took a long time to get an image
- High dosage of radiation caused burns
- Glass tubes in X-rays overheated after 1 hour, so
couldn’t be used continuously.
1901 - A, B and O
- Discovered AB in 1902
Landsteiner identified
- Discovered in 1907 that O blood could be given to anyone.
different blood groups
- Surgery couldn’t develop until blood clotting, storage of
blood and transfusion was sorted.
1905 - LOCAL ANAESTHETIC: cocaine was used from 1884 for
numbing - but was addictive
Novocaine developed
- Novocaine was safer.
1907 - Free school meals introduced in 1906
- Checked schoolchildren for illness (ringworm,lice etc.)
School Medical Service
- Health Visitors visited homes - families couldn’t afford to pay
introduced
for treatments.
1908 - over 70s who earned less than £31.70 a year.
- Received 25p a week
Old age pensions
introduced
- Children and Young Persons Act: illegal to sell children
Children and Young tobacco or alcohol. Couldn’t send children out begging.
Persons Act
1909 - First chemical cure for a disease.
- Created the ‘magic bullet’ - killed disease, but caused no
Ehrlich develops
other harm.
Salvarsan 606
- Wanted to cure syphilis which could cause dementia and
strokes.
- Mercury was used to cure syphilis, but it was poisonous
- Ehrlich tested 606 compounds.
1910 - Led research to shrink and kill tumours.
Marie Curie develops - Developed radiotherapy by using Radium.
use of radiotherapy to - Radiotherapy was used for epilepsy and acne.
treat Cancer - She won a second Nobel prize in 1911 for Chemistry (first
woman to receive a Nobel prize, and one of two to receive 2
Nobel prizes in 2 different fields)
- He created the mobile X-ray machine during WW1.
- Soldiers could be X-rayed and operated on ASAP.
1911 - Workers and employers payed money into the scheme
- Free medical care + sickness benefit + maternity grant +
National Insurance Act
unemployment benefit
- Only applied to workers : not unemployed, self-employed.
1917 - Developed the pedicle tube: flaps of skin were grown until it
could be attached to the body. - development of skin grafts.
Gillies sets up plastic
- 12,000 operations carried out before 1918.
surgery unit at Queen’s
- When WW2 broke out there were only 4 plastic surgeons in
Hospital in Kent Britain.
- McIndoe (plastic surgeon in East Grinstead) formed the
‘Guinea pig club’.
- Where patients were made to feel at home, and distract
them from their appearance and surgeries.
1914-18 - Trench Foot: keep feet dry, rub feet in whale oil, amputation
if gangrene developed.
WW1: development in
- Trench fever: in 1918 doctors found the cause to be lice.
X-ray, military hospitals,
Delousing stations set up. Decline in number with fever.
blood transfusions, - Shell shock: thought soldiers with shell shock were cowards -
brain and plastic surgery were punished. Some were sent back to Britain for
treatment(e.g. Wilfred Owen).
- Dysentery: Caused by dirty latrines and drinking water.
Chloride of lime was addded to purify water.
Regimental Aid Posts (RAP). 200m - basic first aid
Dressing Stations. 800m - 10 medical officers
Casualty Clearing Station. Critical injuries, near railways
- Royal Army Medical Corps (RAMC) treated soldiers close to
the front
- Red Cross sent out voluntary aid detachments (VAD) who
drove ambulances and acted as nurses.
- In 1915, Dr Louisa Garrett(Elizabeth Garrett’s daughter) and
Flora Murray opened a Women’s Hospital Corps in Paris
before London.
- Treated over 24,000 soldiers. Had surgeons and an
anaesthetists. Had a full staf of women assistants.
- London School of Medicine for Women became the largest
medical school in England.
- 1911: 600 qualified female doctors. - 1921: 1,500
- Voluntary Hospitals.
- By the end of 1916, there were 80 female doctors in Malta.
- 1915: Thomas splint developed to keep a broken leg
straight. Survival rate went from 20% to 82%.
- 1917: Carl-Dakin method(sterilised salt solution) more
efficient than carbolic acid to treat gas gangerene. Only
lasted 6 hours.
- Over 240,000 men lost limbs. Demand for prosthetics was
high. Lighter metal alloys used.
1919
Ministry of Health
Isolation hospitals
created for tuberculosis
patients
1928 - Professor of Bacteriology at Sr. Mary’s HospitalMedical
School.
Fleming discovers
- Left a bacteria sample in a Petri dish when he went on
penicillin
holiday. Mould grew and killed the bacteria.
- Mould was called penicillin and was an antibiotic - wasn’t
chemical like Salvarsan 606.
- DISADVANTAGES:
- Only produced in small quantities.
- Slow to act
- Ineffective when mixed with blood.
-
YEAR KEY WORDS, PURPOSE, EFFECT
1932 - 2nd magic bullet
- Cured needle infection and killed streptococcus bacteria.
Prontosil made by
- Prontosil could also cure a childbirth bacterial infection.
Domagk
- Other sulphonamide drugs are made to cure pneumonia,
scarlet fever and meningitis.
1939 - Purified enough penicillin to test on mice.
- 8 mice given streptococci. 4 given penicillin. Within 16 hours,
Flory and Chain work
the mice without penicillin died. The other mice with penicillin
on penicillin
survived.
- Only tested penicillin on a human in 1941 - patient died
because there wasn’t enough penicillin, but he was getting
Emergency medical better.
service created. - Decided to use penicillin on children who needed smaller
doses.
- Britain was involved in WW2, so there was little funding for
penicillin to be manufactured.
- Florey appealed to American scientists. They weren’t involved
in the war at the time.
- 35 institutions involved.
- Large amount of funding committed to production of penicillin
- Factors for the success of penicillin were:
- Institutions - US funding for 5 years
- Technology-new ways of mass production and storage.
- Attitudes in society - war gave an added urgency to
the development of penicillin. Government funds.
- Florey, Chain, Fleming - working together. Florey didn’t
patent the drug (it should be available to everybody)
so development didn’t cost as much.
- Penicillin saved over 200 million lives since 1942.
- Synthetic version of penicillin produced in 1955 for those
allergic to it.
1942 - 5 key problems (‘giant evils’):
- Want: poverty, not enough money or food
Beveridge Report
- Disease
- Ignorance: lack of education
- Squalor: living in dirty conditions.
- Idleness: unemployment - turn to alcoholism or crime.
- Clement Attlee announced a welfare state would be set up.
- Triggered the NHS.
- In 1940, 17,000 men were wounded at the Battle of Dunkirk. They
1939-45
were all vaccinated so didn’t develop tetanus.
WW2: developments - 18 psychiatric hospitals set up for PTSD sufferers.
in plastic, brain and - Rhesus factor identified ( if blood is positive or negative due to
certain proteins).
heart surgery, blood
transfusions.
1946 - National Health Service
- Included:
NHS Act
- Medical diagnosis and treatment
- access to a GP
- dentist and opticians
- emergency care
- care for long-term illnesses.
- Care for the elderly.
- Pregnancy care
- Set up of the NHS was carried out by the Minister for Health,
1948
Aneurin Bevan.
NHS begins - He grew up poor in Wales, but became an MP.
- Life expectancy increased dramatically.
