Medicine in 18th and 19th century Britain, 1700‐1900 The breakthroughs th 1798: Edward Jenner – The development of How had society changed to make medical What was behind the 19 C breakthroughs? Changing ideas of causes breakthroughs possible? vaccinations Jenner trained by leading surgeon who taught The first major breakthrough came with Louis Pasteur’s germ theory which he published in 1861. His later students to observe carefully and carry out own Proved vaccination prevented people catching smallpox, experiments proved that bacteria (also known as microbes or germs) cause diseases. However, this did not put an end The changes described in the Renaissance were experiments instead of relying on knowledge in one of the great killer diseases. Based on observation and to all earlier ideas. Belief that bad air was to blame continued, which is not surprising given the conditions in many the result of rapid changes in society, but they did books – Jenner followed these methods. scientific experiment. However, did not understand what industrial towns. In addition, Pasteur’s theory was a very general one until scientists begun to identify the individual also build on changes and ideas from earlier caused smallpox all how vaccination worked. At first dad bacteria which cause particular diseases. So, while this was one of the two most important breakthroughs in ideas centuries. The flushing toilet important late 19th C invention wants opposition to making vaccination compulsory by law about what causes disease and illness it did not revolutionise medicine immediately. Scientists and doctors where the 1500s Renaissance – flushing system sent waste instantly down into – overtime saved many people’s lives and wiped‐out first to be convinced of this theory, but it took time for most people to understand it. This is shown in the example of Beginning of challenges to old ideas. Vesalius sewers. At first only for rich but marks important smallpox. a little girl who was treated by a local wise woman who tried to charm her back to health – in 1892, 30 years after showed that Galen could be wrong about anatomy change. 1853, government also stopped tax on Pasteur’s theory was published. 1847: James Simpson – the first effective anaesthetic 1600s Scientific Revolution soap, so many more people could afford it. It is also important to remember that bacteria do not cause all illnesses. Many have other causes which we find out Showed that Carl foam could be used as effective Development of scientific method – asking about in medicine in modern Britain. anaesthetic during surgery. Helped women in childbirth and questions and testing hypotheses by observation Simpson deliberately tested chemicals to see in other operations. He wrote articles which lead to other and experiment. Harvey used this method to effectiveness as anaesthetics, discovering Methods of treatments in Industrial England surgeons using it. However, Core phone had many discover the circulation of the blood. chloroform with his friends in 1847 Treatments in this period were an incredible mix of improved new ideas and very unhelpful old methods! There were problems such as dying from too much or death from 1700s infections that couldn’t be cured yet. important breakthroughs in surgery with James Simpson’s use of chloroform as an anaesthetic and Joseph Lister’s use Doctors increasingly trained to use Scientific 1802 and 1807 Parliament gave Jenner £30,000 of carbolic acid to kill infections. These laid the basis for the wonders of modern surgery. Hospitals, influenced by 1854: John Snow – preventing Cholera method. Beginning of more professional training to develop work on vaccination. Government Florence Nightingale, became cleaner and placed much more emphasis on the importance of good food and sanitation Carla killed over 500 people around Snow’s surgery – he of doctors in hospitals wards. later made vaccinations compulsory. to help patients recover. However, at the same time, ‘cure‐all’ tablets were sold in the millions, making fortunes for mapped out the deaths showing it was from the water they The final leap was made in 1800s, below is a men such as Thomas Holloway. These tablets were at first made of lard, wax, turpentine and other items until the used for washing and drinking. Proved that clean water 1798 – Jenner published discovery, spreading list of changes in society that contributed to government in the 1880s introduce laws controlling the use of such ingredients. Herbal remedies continued, and many prevented cholera, but governments did not force towns to details of experiments worldwide. Details of new continue to do good, such as the use of mashed turnips to ease the pain of chilblains, I remedy that had been used improve living conditions and mini scientist continued to medical change: discoveries published in scientific journals, so since the Romans. believe that diseases what’s spread by ‘bad‐air’. scientists could learn from each other. E.g. Lister Consequences of the Industrial Revolution: 1861: Louis Pasteur – germ theory used work of Pasteur, Koch and others in Urbanisation Preventing disease and illness in industrial England Published theory suggesting bacteria cause human diseases developing ideas about using antiseptics in For the first time, more people lived in towns than The first breakthroughs came in the battle against smallpox. Inoculation was useful but it Edward Jenner’s – based on experiments which proved germs make milk go surgery. in the countryside. Conditions were often development of vaccination was the first major triumph over an infectious disease, even if it took decades for bad and cause diseases in animals. 1864 – more crowded and filthy, leading to devastating governments to enforce the use of vaccination. Other vaccines when not developed until Pasteur had published his experiments convinced doctors he was correct however Huge engineering projects to build sewers and epidemics of disease. This increased demands for germ theory and even then, it was several decades before effective vaccines for individual diseases were widely some still insisted ‘bad‐air’ caused disease. Later developed water pipes under city streets – knowledge not available. In the meantime, governments were beginning to take action to clean‐up conditions in the industrial towns. solutions. available 100 years earlier before great first vaccine to prevent disease since Jenner’s smallpox one. The 1848 public health Act was a start, though a small one, permitted local councils to collect taxes to pay for cleaning Political attitudes improvements made in technology during Germ theory was the most important of all as it had water supplies and sewerage, but it was the 1875 that made such improvements compulsory. At the same time In 1800 governments believed they should Industrial Revolution and building of railways. improvements in technology led to the building of much safer and more effective sewerage and water systems such as the biggest effect for future developments! interfere in people’s lives as little as possible. If Joseph Bazalgette designed and built London’s Balzagette’s immense scheme in London. A Critical change had taken place in that governments were now beginning 1850s onwards: Florence Nightingale – hospitals and people were unhealthy that was their business. By sewer system after the ‘Great Stink’ of 1858. to become involved in protecting health and preventing disease, but this development remained a slow process. nursing 1900 Parliament was making laws to improve Developments in medicine greatly helped by Great organiser, working to improve conditions in hospitals people’s health, forcing changes on people. This Enquiry: Why were there so many medical breakthroughs in the nineteenth century? Remember not all improvements in technology resulting from and training of nurses. She improved hygiene and would have been unthinkable a century earlier. factors are as important as others, some not at all! Industrial Revolution – creation of more precise cleanliness of wounded soldiers in Crimean war. Her Changes in voting The Factors: equipment such as microscope – maginified1000! schools trained nurses to keep wards clean, provide fresh In 1867 working man able to vote for the first Institution: Government air and keep patients clean and well fed. How work time. It was still only a minority of working men, 1848 and 1875 – landmark years where Communications improved hospitals a great deal. Pasteur’s discoveries later but a major change had taken place and, in 1884, government made new laws about public health. Individuals – Important to identify the qualities of the individual such as determination, observation and insight. provide more evidence to show why she was correct to do the numbers were increased. Now politicians had 1875 especially as it forced changes whereas Attitudes clearly linked to individuals work as they were willing to ask questions, challenge old ideas, experiment and so. to make changes to win the votes of working men 1848 merely suggested changes! collect evidence. Their attitude was that there was great deal to discover. Each new discovery spurred on others. 1867: Joseph Lister – effective antiseptics against and this led to major reforms aimed at improving Science and Technology infection health. Simpsons discovery of chloroform did not happen Chance After reading Pasteur’s germ theory, he experimented with Technology ‘out of the blue’. Doctors had tried other Attitudes: seeking improvement carbolic acid spray to produce first antiseptic. Greatly Industrialisation was not just about coal‐mining chemicals such as ether as scientist learnt about Institution: The church reduced chances of patients dying from infection and made and Mills producing cloth and clothes from wool impact of chemicals on human body. War longer, more complex operations possible. However, he still and cotton. Developments in steelmaking helped Teamwork had opposition at first as some surgeons refused to accept the produce a thin syringe needle that did not Pasteur’s theory. Word Wall – Words related to: break; improvements in glass making lead to

1875: Public Health Act better microscope lenses and better The History of Medicine: Major change in the attitudes of governments to improving thermometers. microbes – anaesthetics – cottage hospital –

people’s health. First Law to say it was compulsory for local Communications chloroform – cholera – antiseptics – carbolic councils to improve sewers and drainage, provide fresh, Communications were revolutionised. Trains acid – infant mortality – vaccinations – clean water supplies and a point medical offices and allowed scientist and doctors to travel more inoculation – sanitation – ether – patent sanitary inspectors. medicines – antibodies – immunity – stand‐ quickly to attend conferences and learn from each pipes – Black Period Robert Koch – identifying bacteria that cause other’s ideas. News was reported to more quickly, diseases especially off. The telegraph was developed in the Make your arguments/ideas clear to reader: Used Pasteur’s work to discover bacteria that caused 1850s, so details of scientific experiments could be minimal – compulsory – voluntary – individual diseases such as TB and typhoid which killed reported in other countries on the next day. permissive – beginning to – essential – rapid thousands. His methods copied by other scientists who Scientific journals spread detailed accounts of new – crucial – fundamental – highly/most discovered bacteria which caused other diseases. Once medical methods, so they could be used significant – pre‐requisite – critical – vital – bacteria identified, they could develop vaccine. worldwide. of some value