Medicine

Question	Answer
What were the problems in surgery before 1850? (2)	Patients could be anaesthetised so doctors could take more time during surgery, i.e. more germs entered the wound. Dirty conditions e.g. wooden tables, unwashed instruments.
When was the Germ Theory discovered and published? Who discovered it?	Louis Pasteur discovered it in 1861. Discovered that germs made milk turn bad and that they could be killed of with heat.
What did Louis Pasteur recommend to Surgeons? (3)	They should wash their utensils, cleanse their hands carefully and only use lint bandages and sponges previously exposed to temperatures of 130°C to 150°C.
What was the main problem with the Germ Theory? (2)	It was developed by Louis Pasteur, who wasn’t a doctor, so doctors were reluctant to believe it. He couldn’t identify which germs caused which diseases.
When and who discovered Carbolic Acid? What was it?	Joseph Lister discovered Carbolic Acid in 1867. He used it as an antiseptic and sprayed anything that came into contact with a wound.
Problems with Carbolic Acid? (5)	It irritated the surgeon’s hands. It made everything smell. Time consuming. Made operations expensive and unpleasant. Some argued it prevented the body’s defense mechanisms.
Who invented Latex gloves and when?	William S Halstead in 1889. His nurse Caroline Hampton hands were sore from chemicals so he asked Goodyear Rubber company to make gloves.
Where did Aseptic surgery originate?	Originated in Germany and Aseptic surgery quickly became the normal procedure in the operating theatre.
Who invented Steam Sterilisation and when? What did this include?	1887, Professor Neuber made the idea and Ernst Bergmann developed it. A chamber passed superheated-steam over the instruments. (Killed germs without disinfectant).
What were the main affects of the Germ Theory? (2)	He invented Pasteurisation that kept liquids free from germs and safe to drink. He proved that germs caused disease in animals such as chicken disease and anthrax.
Who is said to discover penicillin? When? (2)	Alexander Fleming ‘discovered’ it because he published his notes first. He left the plates of germs when he went on holiday and noticed the mould had grown when he got back. (Staphylococcus) 1928.
What did Florey and Chain do for penicillin? (2)	They discovered all the properties of the drug and were the first to develop a method to produce large quantities of it in a vat and inject it into a human body.
How was penicillin discovered? The original discovery? When? (2)	1870s John Sanderson noticed that very little grew near the mould and John Lister (different guy) treated a nurse who had an infected wound.
The US government’s role in penicillin? (2)	Agreed to pay several hu8ge chemical companies to make millions of gallons. By 1944 there was enough for 40 000 cases.
Effect of War on Penicillin? (2)	Originally slowed the discovery-government couldn’t provide instead saved for war. Then penicillin was required during the war and lots of money was invested in production.
What did Koch do with anthrax disease? (2)	Found a way to stain and grow the germ responsible for disease in a Petri dish. Injected the disease into mice which made them ill.
Pasteur’s action after Koch’s discoveries? (3)	Developed vaccines for two animal diseases: chicken cholera and anthrax. Developed vaccination for rabies.
Effect of Luck on Penicillin? (2)	Fleming discovered mould by accident. The timing of the war also meant the process of production could be sped up.
What was Albert Alexander’s role in penicillin? (2)	He was a police officer with an infection on his face. First human to be injected with penicillin. Dramatically improved but drug ran out (he passed away)
Properties of Prontosil? Discovered when? (3)	Discovered 1935. Red dye that prevents germs of blood poisoning. Active ingredient is sulphonamide.
Effect of Koch’s theories? (5)	Proved Pasteur’s germ theory. Inspired Pasteur to develop vaccines. Proved different bacteria caused different diseases. German government set up the Institute for Infectious Diseases in Berlin in 1891. Inspired other scientists to start work on germs.
Why did US government step in? Results of their actions. (2)	Realised the life saving potential during the war. Made it possible to treat 250 000 soldiers and made production lines for increased manufacture.
What are the properties of Salvarsan? Discovered when? (3)	Discovered 1909. Fights the STI named syphilis. Sometimes led to heart failure and blindness.
Koch’s other discoveries and achievements? (3)	The germs for deadly diseases TB and cholera. In 1905, he was awarded the Nobel Prize.
When was….discovered: a) Typhus b) Cholera c) Tetanus d) Pneumonia	a) 1880 b) 1883 c) 1884 d) 1886
What tool did Koch use to aid his work? Why? (2)	He used dyes to aid his work as the microbe was too small for the microscope.
When did Paul Ehrlich join Koch’s research team? (1)	1889. He studied chemotherapy.
What did Ehrlich research and when? Which were found? (3)	They researched dyes to see if they killed microbes in 1899. Dyes were found that attacked malaria and sleeping pills.
Significance of Ehrlich’s discoveries? (3)	Invented the first chemical drug cure. He used chemotherapy. He inspired many other scientists.
What were the Sulphonamides made of? What was the problem with them? Which countries were looking? (5)	Made of coal tar. They were highly poisonous. Britain, Germany and USA were desperate to find the new drugs.
What was the first anaesthetic? Discovered by and when? Problems? (5)	1846 – Ether. An American dentist called William Moston. Ether irritated patients’ eyes and made them cough and vomit during operations.
How was chloroform mainly used? (3)	It was used mainly to relieve women’s labour pains. The anaesthetist would pour droplets onto a mask that the patient would wear.
When was….discovered: e) Meningitis f) Plague g) g) Dysentery and scepticimia	e) 1887 f) 1894 g) 1898
Which animal did Koch grow septicaemia germ in? (2)	He grew the germ in his daughter’s pet mice. After 20 generations he had produced a fluid with only septicaemia germ inside.
What problem remained after Koch and Pasteur?	They had identified microbes and their diseases but had not made cures for people who were already infected with the disease.
Who made Salvarsan 606? What was it made from? Which infection did it target? When was it first tested? (4)	Ehrlich and researchers. It is made of arsenic and it targets Syphilis. It was first tested on a human in 1911.
Who first used Prontosil and when? What colour was it? What animal was it tested on? (4)	Gerhardt Domagk tried Prontosil in 1932. It was a red dye. The drug was tested on mice.
Problems with surgery before the 1850s? (5)	High infection risk. Extremely painful for patients. Lack of accuracy due to time pressure. Panic caused injuries. Range of operations was limited. Difficult to stop bleeding (used to burn).
How did Ether work? (3)	The gas put patients to sleep and surgeons worked while they were unconscious. No pain could be felt and 20 minutes later the patient could travel home.
Why was Chloroform better than Ether? (3)	There were less side effects and reduced pain just as well. Less dangerous as chances of vomiting was reduced.
Who used chloroform and therefore promoted it? (2)	Queen Victoria used it for the birth of her eighth child in 1857.
What was the second anaesthetic? Discovered by and when? How discovered? (5)	1847 – Chloroform. A Scottish doctor called James Simpson. He discovered by pouring into a glass and his friends nearby were unconscious in less than a minute.
Example of panic during surgery before 1850s?	Famous surgeon Robert Liston cut off his assistant’s fingers, who then died of an infection, because he was rushing.
Who was the first human test of Prontosil? Why? (2)	Domagk’s own daughter after she pricked her finger on a needle and got severe blood poisoning. She was cured.
What were the problems with Salvarsan? (5)	The chemical could be poisonous and kill the patient. It was not very soluble and was painful to inject. Doctors feared the tendency to be promiscuous now that the disease could be cured.
What did Ehrlich refer to antibodies as?	Magic bullets because they sought a specific target.
New technology used by Robert Koch? (3)	Dyes. Photographing process of his work. Solid culture to breed germs on.
How did Robert Koch identify the microbe of anthrax? (2)	Spent three years to identify anthrax by studying the blood of affected and unaffected animals.
Problems with Chloroform? Who died and why? (5)	The long term side effects were unknown. It breached religious grounds. ‘It was unnatural’, and went against the Gospel. Hannah Greener died- 1848 whilst her toenail was removed.
Who discovered blood groups? When? How did this help in medicine? Problem? (3)	Karl Landsteiner in 1900 therefore allowing successful blood transfusions. Although blood couldn’t be stored long, as it clotted quickly.
When were X-Rays discovered? When were they most important and why? (3)	1895 and during World War One. Mobile x-rays were used near the battlefield to locate bomb shrapnel.
What was the pedicle tube procedure? (4)	A narrow layer of skin was lifted and stitched to one end of a tube. The other end was attached to the body and kept healthy blood flow.
Problems with hospitals before 1850? (4)	The patients had to pay for treatment therefore the poor couldn’t afford care. They were unsanitary and selective so could not cope during the war. No toilet facilities, soap, mops.
Nightingale’s first effects in nursing? (2)	Cleaned up army hospital in Scutari and became the ‘Lady with the Lamp’.
What was her reputation in Britain? What action did she take? (3)	She returned from Scutari a national hero. She wrote a book in 1860 called ‘Notes on Nursing’.
What and when was the General Medical Act? (3)	In 1858, government introduced General Medical Act which required all qualified doctors to put their names on the register.
Which schools did Elizabeth Garrett Anderson attempt to go to? Why was she turned down? (3)	Universities: St Andrew’s and Edinburgh because she was a woman.
Problems with Nightingale’s work? (4)	Public health improvements helped her job greatly. She didn’t believe in the germ theory.
What was Nightingale’s first book about and when published? How successful? What was Nightingale’s funds from first book used for? (4)	800 page report to the government about improving hospitals in 1860. Became bestseller and raised £44,000. Money set up St Thomas’ Hospital.
Problems with nursing before 1850? (3)	The nurses had bad reputations; untrained and drunkards. Doctors objected to taking nurses opinions seriously.
How was infection prevented at Battlefields? Problem? (3)	All the flesh was cut away and soaked in salty (saline) solution. It was a very short term answer.
Who discovered plastic surgery and when? How was it used? (4)	Harold Gillies in WW1. He considered a patients appearance when treating facial wounds.
What stopped blood clotting and who and when discovered this? How did this help? (5)	Sodium Citrate plus glucose. Albert Hustin in 1914. Blood could be bottled, packed in ice and taken to operations for other soldiers.
What three other things were used as anaesthetics after 1850? When? (6)	Cocaine – 1884. Novocaine – 1905. Used in dentistry and minor surgeries. South American poison, curare – 1942. Relaxed muscles so less anaesthetic was needed.
What does antiseptic mean? What does aseptic mean? (2)	Antiseptic – clean surfaces, preventing the growth of disease-causing microbes. Aseptic – surgically sterile, free from all contamination.
What advancements were made in prosthetic limbs? Which problems remained? (4)	Light metal alloys and new mechanisms were used. Long waiting lists for fittings remained and patients needed training for them to be used properly.
What did Harold Gillies set up? What did it provide? (4)	He set up Queens Hospital in Kent in 1917. It provided 1000 beds and 5000 men had been treated by 1921.
How were broken bones repaired? What was a common splint? (3)	Splints were developed. The Army Leg Splint/Keller-Blake Splint elevated and extended the broken leg. It is still in use today.
When was Florence Nightingale born? Why did she become a nurse? Where did she train? (3)	Born in 1820, and thought that God wanted her to become a nurse. In 1950, she trained in Germany for three months.
What did Nightingale do in Scutari? (4)	With a group of 38 nurses, she ordered cleaning products from the government and 200 builders rebuilt a ward. Reduced the death rate from 40% to 2% in six months.
Attitudes towards female doctors before 1850? (3)	Women were viewed as incapable and unqualified. In 1700’s a law passed saying one had to have uni degree to practice medicine. Women weren’t allowed in Unis.
When did Garrett Anderson become a doctor? How? (3)	Became doctor in 1869 after studying in Paris and passing her exams with the highest grades.
Garrett Anderson’s action to become a doctor? When did she pass the Apothecaries exam? (3)	She found men to tutor her privately. She passed the exam in 1865 but she was still refused a license to practice.
When was Sophia Jex-Blake born? Why was it difficult for her to become a teacher? (3)	Born in 1840. Her father had traditional views about women’s education and did not approve of her attending university.
What law did SJB get passed? When? (2)	Got a law passed in 1875 enabling women to be awarded degrees.
When were women fully accepted in medicine? What act? (2)	In 1975 when the Sex Discrimination act was passed enabling women to hold the same jobs as men.
The British National Blood Transfusion Service was opened in 1938. Blood Banks were opened in Britain and USA.	What did blood transfusion ideas encourage in WW2? (2)
When and why did the government act against cholera? (3)	There were more outbreaks in 1837 and 1838. There was a complete lack of knowledge. In 1839 an inquiry was set up.
What did Chadwick conclude from the report? (3)	People’s lives were greatly affected by where they lived. He told wealthier people they needed to contribute to funds. Improving the poor areas would help the rich’s health too
What did the 1848 Public Health act entail? (4)	Gave local town councils the power to spend money on cleaning up the towns. A national board of health was created. New houses had to be built with toilets. Medical officers inspected ‘nuisances’.
Limitations on Public Health Act of 1848? (3)	Liverpool and Birmingham made huge changes, but many others did nothing. Only 103 towns had set up health boards by 1853.
What was the government’s reaction to Chadwick’s report? Why? (2)	The government completely ignored his findings. They believed in ‘laissez faire’ attitude.
What was the name of the official who researched living conditions? When? Results? (3)	Edwin Chadwick. Questionnaires were carried out in major towns. The report on the Sanitary Conditions of the Labouring Population of Great Britain was published in 1842.
Impact of antiseptics in WW2 figures?	Newcastle Infirmary, in 1878, show that before antiseptics were introduced, six out of ten people died after operations, after antiseptics one of ten people died
Importance of Penicillin in WW2? (3)	15% more men could have died without penicillin. Sped up recovery time of soldiers. Because of US government, excess was left over for the future.
Challenges to SJB’s success? (3)	Her father was unsupportive. Men complained at university. The court wouldn’t help her sue them. Women weren’t allowed medical degrees despite full training until 1875.
When did Sophia go to Edinburgh with three other women? How? Result? (4)	In 1869. She persuaded the university by being taught separately to men. They complained though and the women were removed and lost the court case.
What did Garrett Anderson do to the people who refused her a license? Result? (3)	She sued them and won, but the society wouldn’t pass any other student who had studied privately.
Limitations on Garrett Anderson’s success? (5)	No other students were allowed to practice. She had to study abroad which was too expensive for others. She couldn’t be hired easily. Barely any other women succeeded.
Sophia Jex-Blake’s achievements? (4)	Her and three women went to university. Qualified to be a doctor in Ireland. Founded the London School of Medicine in 1974.
Impact of WW1 for women’s role in medicine? (2)	Men were away so women took on more roles in medicine. Unfortunately most were still nurses rather than doctors.
Who used penicillin for facial burns during WW2? (2)	Michael McIndoe realised the potential and used it to prevent infections in burns of pilots.
What was the impact of Cholera in the first year? (3)	In 1831, it killed around 50,000 people. Victims were violently sick and suffered from pain diarrhoea. Their skin and nails turned black, they fell into a coma and then died.
How was the Living Conditions report distributed? (2)	10,000 free copies were given to politicians, journalists; people who could influence the public. 20,000 were sold to the public.
Why and when did the government act against Cholera? (2)	Cholera returned in 1848. The government passed a public Health Act.
How many people died of cholera in 1848 and 1854?	1848: 60,000 people 1854: 20,000 people
Who was John Snow? Why did he begin investigating cholera outbreaks? (3)	John Snow was a famous surgeon who worked on Broad Street, London. 700 people died of cholera nearby his street in 10 days.
Government’s reaction to Snow’s evidence and research? (3)	Despite evidence of dirty towns and cholera being a water-borne disease, the government still did nothing.
Who was Joseph Bazalgette? How did the government use him? (3)	He had drawn up plans for underground sewers. The government gave him £3 million to build the sewers.
Who won the election in 1874? Why? (3)	The conservative party won because they promised improvements to living conditions for the poor.
What did the Compulsory Vaccination Act entail? (2)	Every baby had to be vaccinated against small pox. From 1853 onwards, the deaths declined dramatically after the injections.
Conclusions of Boer War report for housing? (3)	Overcrowded homes were removed, smoke pollution was controlled, and houses were built properly with plumbing.
What Liberal Reform took place in: a) 1906 b) 1907 (children) c) 1907 (mothers)	a) School meals were introduced b) School Medical service was set up. c) Women were taught about breastfeeding and hygiene.
What Liberal Reform took place in: j) 1940	j) NHS was set up. Free advice and care for babies. Mothers were given free milk, food, vitamins, free education and cheap school meals, dental treatment and eye care.
What was the Beveridge Report? (3)	1942. Set up welfare state after WW2. ‘Cradle to grave’ service provided for the elderly, sick, unemployed and the children.
What Liberal Reform took place in: d) 1908 e) 1909 f) 1911	d) Young person’s act, protected from neglecting. e) Overcrowded housing was banned. f) Pensions for the elderly were introduced.
Conclusions of Boer War report for children? (3)	Regular inspections for school children, day nurseries for working mothers were set up and the sale of tobacco to children was banned.
What was the Boer War and when did it occur?	1899-1902. Was between the English and Afrikaans because the English wanted to overpower South Africa.
Which two public health reforms were introduced and when? (4)	Public Health and Housing Act in 1875. Compulsory vaccination in 1853.
Information about the underground sewers? (3)	Collected waste from 1 million London houses. Finished in 1866. Powerful pumps pushed waste out to the sea.
When was the great stink? How was it caused? (3)	Summer of 1848, a heat wave warmed the Thames filled with human sewage, waste, dead animals and chemicals from factories.
What did Snow’s research help him discover? Street Toilet? (3)	Everyone on the street that died got their water from the same pump. He had it removed and no one else died. A street toilet’s lining had cracked and polluted the drinking water.
What did Snow’s research prove? (3)	Cholera was a water-borne disease caught by contagion. It was passed by drinking the other cholera victims’ faeces.
Why did MPs finally take action about the Great Stink?	The stench was intolerable at the House of Parliament so they had to meet somewhere else.
When did the Working Class get the vote? Results? (2)	1867. Political parties realised that promising to improve living conditions gained them votes.
What did the Public Health Act and Housing Act entail? (3)	It was compulsory for local towns to act. Houses had to be equipped with plumbing. Inspectors were hired to ensure this.
How did the Boer War affect public health in the UK? (2)	Army chiefs realised how unhealthy men were: 40 in 100 were unfit. In 1904 a report was released showing men were unhealthy because of childhood.
When did the Liberal Reforms take place? What were they?	1906-1914. They were acts that ensured the health of citizens by improving food, clothing and housing.
What Liberal Reform took place in: g) 1918 h) 1919 i) 1930	g) Local councils provided health visitors, day nurseries, clinics for pregnant women. h) New houses built for poor people. i) Huge slums were cleared.
Benefits of Welfare State and NHS? (4)	Provided jobs across England. Free treatment for all. Infant mortality declined. Elderly received more care, housing, medical treatment.

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