MEDICINE IN THE INDUSTRIAL REVOLUTION 1750-1900 REVISION NOTES
PROBLEMS FOR HEALTH AT THE TIME OF INDUSTRIAL REVOLUTION
People move from the countryside into big cities like Manchester and London. (URBANISATION) Conditions in the new FACTORIES led to ill health eg POOR VENTILATION and FIBRES in the air in cotton factories caused lung problems
Working with the UNGUARDED MACHINES often caused accidents eg children had to get inside the machines to fix the cotton threads The new factories caused massive POLLUTION – of the AIR and WATER – which damaged health Workers’ houses were cramped and UNHYGIENIC. DISEASE SPREAD EASILY The new factory houses did not have modern facilities like RUNNING WATER (it had to be got from a pump in the street) Sewers and factory effluent ran into the rivers – CONTAMINATING THE WATER SUPPLY. There was LESS FRESH FOOD in the cities
WHY WAS SO MUCH PROGRESS MADE (1)?
INDIVIDUALS – Work of RENAISSANCE thinkers such as VESALIUS and HARVEY did not help treatment in Renaissance period but helped PAVE THE WAY for further DEVELOPMENTS. They proved ideas of GALEN and HIPPOCRATES to be WRONG. The Medical Revolution witnessed the work of key individuals like Jenner, Pasteur, Koch, Hunter, Nightingale, Garret-Anderson. TECHNOLOGY – INDUSTRIAL REVOLUTION began a RADICAL CHANGE and led to following EFFECTS ON MEDICINE
Provided MONEY to use to tackle ill-health (eg BUILDING HOSPITALS) Produced LARGE CITIES that became BREEDING GROUNDS for KILLER DISEASES and EPIDEMICS – This had to be solved and led to BREAKTHROUGHS Improved KNOWLEDGE of how to build structures such as SEWERS and WATER SUPPLIES
SCIENTIFIC DISCOVERIES – New DISCOVERIES led to IMPROVEMENTS (such as GERMS CAUSING DISEASES)
INVENTION of NEW EQUIPMENT such as THERMOMETERS and SYRINGES
WHY WAS SO MUCH PROGRESS MADE (2)?
COMMUNICATION – TRAVEL meant that SCIENTISTS could meet and DISCUSS NEW IDEAS EASIER THAN BEFORE
GOVERNMENT – In 1800, politicians DID NOT CARE about HEALTH AND MEDICAL PROBLEMS (Laissez-Faire)
More EDUCATION and BOOKS could be spread around QUICKER THAN BEFORE
With the middle classes getting the vote in 1832 and the working classes in 1867, they then had to. By 1900, they took health SERIOUSLY and PASSED A NUMBER OF LAWS to IMPROVE the HEALTH OF PEOPLE
WAR – The need to LOOK AFTER WOUNDED SOLDIERS (e.g. Crimean War in mid C19th) led to BETTER HOSPITALS and NURSING
INNOCULATIONS Invented through OUTBREAKS of SMALLPOX that were responsible for up to 1/5 OF ALL DEATHS INNOCULATIONS were developed by LADY MONTAGUE in 1721
People DELIBERATELY INFECTED themselves with a MILD FORM of SMALLPOX Doctors used this idea during OUTBREAKS and it WORKED!
HOWEVER! INNOCULATIONS DID NOT ALWAYS WORK SOME DIED from even a SMALL DOSE
EDWARD JENNER AND VACCINATIONS
JENNER found that FARMERS often caught a disease called COWPOX – very MILD DISEASE
Those who got COWPOX never got SMALLPOX
JENNER took COWPOX from a girl and put it into a couple of cuts in a boy The boy developed a MILD ILLNESS and then recovered. JENNER then INNOCULATED the boy and he did NOT get SMALLPOX – this was REPEATED and it WORKED
JENNER’S VACCINATION was DEVELOPED and given through SYRINGES SPREAD HIS IDEAS THROUGH BOOKS GOVERNMENT gave JENNER £30,000 to set up a VACCINATION CLINIC IN LONDON.
WHO WERE AGAINST VACCINATION? People were FRIGHTENED by the idea of being INJECTED WITH DISEASE Many DID NOT BELIEVE cowpox could protect you against SMALLPOX DOCTORS resisted change as they were making LOTS OF MONEY from INNOCULATIONS VACCINATIONS had to be given CAREFULLY
Some DOCTORS ADMINSTERED the VACCINATIONS INCORRECTLY
PASTEUR AND GERMS
BEFORE PASTEUR
People knew DISEASE was CONNECTED with DIRTY and UNHYGIENIC conditions
Thought that rubbish on streets gave off MIASMA (BAD AIR)
To stop getting the disease, people PROTECTED THEMSELVES using HERBS AND MASKS
WHAT WAS DISCOVERED?
GERMS were finally discovered in 1800s due to: 1. 2.
3.
4.
5.
INVENTION OF MICROSCOPE IMPROVED MICROSCOPES LOUIS PASTEUR MAKES BREAKTHROUGH 1. Employed by a brewing firm to find out why alcohol went stale 2. Found TINY MICROBES in STALE BEER DEFEATING SPONTANEOUS GENERATION THEORY 1. PASTEUR attacked this theory by saying that MICROBES WERE IN AIR AROUND US and caused food to ROT LINKING GERMS WITH HUMAN DISEASE 1. GERMS got into our bodies through CUTS or the MOUTH OR NOSE
WHY WAS PASTEUR’S WORK IMPORTANT?
BIG SCIENTIFIC BREAKTHROUGH Found out what CAUSED DISEASE for the FIRST TIME Might be possible to TREAT DISEASES properly through VACCINATIONS
There were still some PROBLEMS
Each disease was caused by ONE TYPE OF GERM
This took TIME as there were MANY DIFFERENT TYPES OF GERMS
FLORENCE NIGHTINGALE AND THE DEVELOPMENT OF NURSING
In 1854 Britain went to war with Russia in the CRIMEAN WAR The British army fighting in the Crimea had HARDLY ANY MEDICAL SUPPORT – half of the soldiers wounded in battle died in hospitals This was because the hospitals were DIRTY and there were NO PROPER NURSES When Florence arrived she RE-ORGANISED MILITARY HOSPITALS
New wards were built The wards were scrubbed and kept CLEAN Sheets were BOILED to make them clean PROPER FOOD was given to the soldiers.
Results
The DEATH RATE for the wounded FELL from 42% to just 2%. This was done through VERY SIMPLE MEASURES but also proper nursing She became a HERIONE back in Britain where she was called ‘THE LADY WITH THE LAMP because of her night visits to the wards.
HOW NIGHTINGALE CHANGED NURSING IN BRITAIN
CHANGES She PUBLISHED A BOOK on improving army hospitals 1859 she published ‘Notes on Nursing’ about how nurses should work in hospitals – she argued strongly for FRESH AIR, CLEANLINESS, AND PROPER FOOD 1860 she set up the FIRST PROPER TRAINING SCHOOL FOR NURSES– she trained ‘MATRONS’’ who would then train ordinary nurses She helped set up a school for MIDWIVES at Kings College Hospital in 1861 Her work was reported in newspapers so she got GOOD PUBLICITY
RESULTS People were NO LONGER AFRAID of being treated in hospitals. The SUCCESS RATE HAD MASSIVELY IMPROVED ATTITUDES to nurses changed – they were now PROPERLY TRAINED AND RESPECTED
CHANGES IN TRAINING OF DOCTORS
BEFORE 1750 Doctors were NOT WELL TRAINED Still trained by using the books of GALEN – whose ideas were wrong (4 HUMOURS) They RARELY did DISSECTIONS of bodies to learn about them You trained for years at University The you were accepted at the ‘Royal College of Surgeons’, the ‘Royal College of Physicians’ (physician = another word for doctor) or the ‘Society of Apothecaries’ (APOTHECARY – someone who makes medicines – a CHEMIST)
BY 1900 Improvements in TECHNOLOGY Improvements in the UNDERSTANDING of disease. Improvements in the understanding of ‘PHYSIOLOGY’ – how the human body works Improvements in the TRAINING of doctors Improvements in COMMUNICATION – new ideas could spread Work of individuals such as JOHN HUNTER
Hunter felt that EXPERIMENTS should be undertaken rather than reading books
New Medical schools were set up in major cities
Inventions such as stethoscope helped doctors improve
CHANGES TO TRAINING
Doctors began to use dissections to give better understanding of how body works
Pasteur’s Germ Theory gave doctors better understanding
HOW DID HOSPITALS CARE FOR THE SICK 1750-1900?
There were 300 ‘COTTAGE HOSPITALS – normally in your local area’ –Your own Doctor will provide you with MEDICATION and you were then looked after by NURSES There were also 18 hospitals in LONDON with 4000 BEDS BUT – the chances of being treated or looked after depended on how RICH you were Well off upper class or middle class people who had money would be treated AT HOME and the doctor would visit them WORKING CLASSES like factory workers (who were the biggest group in Britain) COULD NOT AFFORD DOCTORS OR TREATMENTS Many ended up in WORKHOUSES Conditions were POOR and you had to WORK but at least they would feed you and give you a bed.
WHY DID THINGS CHANGE? In 1850s many EDUCATED people became concerned how poor working class people were being treated when they were ill – Newspapers like THE TIMES ran a PUBLICITY CAMPAIGN to do something for these people 1865 Louisa Twining set up the ‘WORKHOUSE VISITING SOCIETY’ to campaign to get things CHANGED At the same time there was PUBLIC PRESSURE on LOCAL AUTHORITIES
The pressure groups were called ‘Poor Law Unions’
HOW DID THINGS CHANGE?
The GOVERNMENT finally took action to improve treatment for the poor 1867 it ordered the POOR LAW UNIONS to join together and build ‘INFIRMARIES’ (another name for a hospital) for poor people which had TRAINED DOCTORS. They were paid for by the GOVERNMENT so the poor did not have to pay. But there was still NOT ENOUGH SPACE in these new hospitals and many sick poor people had to stay in the WORKHOUSE
Even so the new ‘infirmaries’ were the first real hospitals and founded the hospitals we use today WHAT HELPED THE NEW HOSPITALS WORK FLORENCE NIGHTINGALE’S work in TRAINING NURSES – who now worked in the new hospitals PASTEUR’S breakthrough in discovering GERMS JOSEPH LISTER’S work on ANTISEPTICS
WHAT HELPED CHANGE BETWEEN 1750-1900?
CHANGE Great amounts of change happened due to:
Breakthroughs by INDIVIDUALS – JENNER, PASTEUR, KOCH, NIGHTINGALE ATTITUDES AND PUBLIC PRESSUREusually from educated people for change and improvement eg the changes in the way poor sick people were treated GOVERNMENT ACTION action – which responded to public pressure by building new hospitals and regulating pills and drugs
BUT – some people still RESISTED change due to ATTITUDES –
Some people did not like Jenner’s vaccinations and still would not take them. Some people still refused to believe in Pasteur’s germ theory and would not give up their old ideas Many doctors still refused to adopt the new ideas because they had been trained in the old ideas Many still refused to accept the important role women now played in medicine and as nurses in hospitals
CONTINUITY The new ideas of Pasteur and Koch were still resisted by many old, traditional doctors The poor were still not all looked after in the new system of hospitals – you still got better treatment if you had MONEY and doctors still charged HIGH FEES for their services Medicines were MASS-PRODUCED but still based on OLD IDEAS about herbs and potions and NOT REALLY EFFECTIVE. They were not yet based on SCIENTIFIC IDEAS.
