Paper 2 preparation

1
Paper 2 preparation

• Aim To consider fighting disease in 19th 20th
  Century with the help of a variety of sources

2
Dorothy Fisk, Doctor Jenner of Berkeley 1959.

• The suttons in 11 years inoculated 2514 people,
  for substantial fees. They also sold for anything
  between fifty a hundred pounds, to doctors
  living at a safe distance from them, the secrets
  of their methods. They had their own inoculation
  house in Ingatestone.

• Questions
• What is this source about
• What does the term substantial fees doctors
  living at a safe distance from them refer to?
  What can this source tell us?

3
Inoculation What was it?

• Old Chinese method passed on. It involved
  spreading matter from a smallpox scab onto an
  open cut. This small dose taught the body how to
  fight the disease off

4
Vaccination What was it?

• Edward Jenner local doctor farms
• Cowpox prevents smallpox?
• Test on young boy it worked
• Called it Vaccination ( Latin for cow vacca )
• Question
• Look at the picture on the next slide carefully
  what does this tell us about some peoples views
  on vaccination?

5
The cowpock or wonderful effects of new
inoculation
6
Vaccination why oppostion

• Its odd
• No explanation why it worked
• Doctors doing inoculations didnt want to lose
  money
• Some careless doctors mixed wrong things up and
  killed people!

7
Did doctors Medicine improve

• From 1750s everyone could see doctors. They had
  basic tools like stethoscopes had herbal
  medicines. They could give early inoculations.
  However the poor couldnt always afford
  medicines.
• Women were not allowed to be Doctors as to be a
  doctor you had to train and they were banned from
  1852
• Patent medicines cure all tablets were cheaper
  but didnt work
• By about 1880s tablets like aspirin had been
  developed companies like Boots Beechams
  invested in them

8
What about individual women?

• Statement made in 1861 by people protesting about
  Elizabeth Garrett attending lectures
• we consider that the mixtures of sexes in the
  same class is likely to lead to results of an
  unpleasant character. Lecturers are likely to
  feel some restraint through the presence of
  femalesthe presence of young females as
  spectators in operating theatres is an outrage on
  our natural instincts and feelings..

Question 1) What barriers did women face if they
were to be involved in medicine?
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Elizabeth Garrett became a doctor by overcoming
immense resistance. Women were able to influence
medicine through nursing, eg Florence Nightingale

• Defied father to work as army nurse
• Single handedly transformed hospitals by making
  them give privacy to patients clean sheets
  good food for patients new wards significantly
  reduced death rate
• Wrote a book on good nursing
• Taught young women how to be nurses
• Hospitals much healthier thanks to her

10
Causes of disease Germ theory

• Previous theory Miasma What is that
• 1830 Joseph Lister invents powerful microscope to
  observe organisms
• Louis Pasteur was investigating causes of beer
  going bad, using microscope he discovered
  micro-organisms were growing in it and damaging
  it. Another term for growing is germinating so he
  called them germs this was his germ theory.
  
• Pasteur concluded If wine and beer are changed
  by germs then the same can must happen
  sometimes in men and animals he discovered
  this was true as it happened to french silkworms.
  However, he was a scientist not a doctor, so
  someone else had to take up the challenge of
  developing the theory.

11
Robert Koch

• Govt believed in him invested money in him
• Some scientists thought theyd found the
  bacteria that caused anthrax koch wanted
  definitive proof
• To prove it, he extracted the bacteria, injected
  it into mouse. When it died he took it out that
  mouse, checked it was the same, then did the same
  with 20 generations of mice
• Question Why was his experiment important?
• What did he do after this to help people find
  diseases?

12
Pasteur v Koch They both competed to make the
best cures for disease

• Look at this source, which shows Pasteur
• What is he doing
• Why is he doing it in front of people

Criticism Koch accused Pasteur of sloppy science
as he didnt even measure the innoculated dose.
However, it worked!
Further Vaccinations Pasteur went on to find a
vaccination for Rabies
13
Surgery

• Look at the 2 pictures and answer these
  questions
• 1) What are the problems with the surgery in the
  top picture?
• 2) What is the difference in the patient in the
  bottom picture?
• The next page will tell you more about surgical
  developments

14
What developments improved surgery?
Early experiments started with Ether which sent
people to sleep, but this often made patients
cough during operations so more suitable
alternatives were looked for. See next slide for
questions on this
15
Protests against anaesthetics

• Source 1 letters to the medical journal
• The infliction of pain has been invested by the
  almighty god. Pain may even be considered a
  blessing of the gospel, and being blessed admits
  to being made either well or ill
• Source 2 From an Army chief of staff 1854
• the smart use of a knife is a powerful stimulant
  and it is much better to hear a man bawl lustily
  than to see him sink silently into the grave

• Questions
• Using all the sources on this and the previous
  page, why do you think there was such opposition
  to anaesthetics?
• Which factor lead Simpson to discover the effects
  of chloroform?

16
Choloroform finally accepted after Queen Vic uses
it during pregnancy and then praises it
17
Infection semmelweiss

• Anaesthetics didnt significantly reduce
  infection. Semmelweiss was a doctor who noticed
  that more women died after childbirth when
  medical students delivered the baby, than those
  using midwives. He noticed that often medical
  students wore the same clothes as they had in
  surgery, hence introduced this notice
• From today, any doctor or student coming from
  postmortem room must, before entering maternity
  wards, wash his hands thoroughly in the basin of
  chlorinated water placed at the entrance. This
  order applies to everyone
• Which factor enabled semmelweiss to make his
  discovery?

18
Infection Lister
An article in the medical lancet by Joseph
Lister When it had been shown by the researches
of Pasteur that the septic property of the
atmosphere depended on minute organisms suspended
in it, it occurred to me that decomposition in
the injured part ( following an operation ) might
be avoided by applying as a dressing some
material capable of destroying the life of the
floating particles
Sewage was treated with carbolic spray
Question Whos work enabled Lister to develop
this theory?

• Opposition to carbolic spray
• It cracked surgeons hands
• It slowed things down surgeons thought speed
  was important due to bleeding
• Surgeons that copied Lister were less systematic
  and so got different results
• People still found the idea of micro-organisms
  ridiculous!

19
How did Lister improve surgery?

• His ideas were gradually accepted and by 1890 his
  idea had progressed from killing the Germs on the
  wound to aseptic surgery which was killing all
  germs in the operating theatre.
• This meant rigorous cleaning of operating
  theatres, surgical instruments, surgeons hands
  etc
• In 1892 Pasteur Lister were given an award for
  contribution to fight against disease.
• By 1896 the first successful heart surgery had
  taken place!

20
Cholera Public Health
What do these 2 pictures show us about early
understanding of Cholera ?
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Improvements to Public Health

• John Snow did a report in 1854 in which he said
• As there has been deaths from Cholera just
  before the great outbreak not far from this
  pump-well, and in a situation elevated a few feet
  above it, the evacuations ( excreta ) from the
  patients might of course be amongst the
  impurities finding their way into the water

• Questions
• What does this source suggest is causing the
  disease?
• What improvements would you expect John Snow to
  suggest following this discovery?

22
Why and How was public health improved?

• Use pages 144-147 to find out for yourselves why
  and how it improved. Do this in pairs and at the
  end of the lesson you can present it to the group.