2. GCSE SCHOOLS HISTORY Medicine Through Time INTERACTIVE 1800-2000 Why was so much progress made in medicine between 1800 and 2000?

3. 13 17 Therefore, preventing the bad smells would prevent the generation of microbes and therefore, prevent disease. Before Pasteur, the most accepted theory of the cause of disease was ‘spontaneous generation’. This was the idea that germs (microbes) were made by disease. Another theory was that disease was caused by poisonous gases called miasmas given off from rotting rubbish, food or sewage. We now know that microbes are already present in the air, and it is the germs which cause the rotting and decay and the bad smells, not the other way round as people had believed. This was a real breakthrough in understanding the cause of disease. A German doctor, Robert Koch took Pasteur’s work further.microbes GCSE Schools History Medicine 1800-2000 Spontaneous Generation Versus The Germ Theory Scientists and doctors made discoveries regarding the cause of illness, they discovered ways to prevent killer diseases and made some improvement in public health. By 1800, people knew of the existence of germs, but they thought that disease caused germs, not the other way round. This idea was called the Theory of Spontaneous Generation. The real turning point was Pasteur who discovered the Germ Theory of disease.

4. What was the state of surgery before 1800? Before 1800, anatomical knowledge increased enormously. William Harvey demonstrated the function of the heart and the circulation of the blood. However, surgery remained an extremely painful and risky business in 1800. The level of hygiene was very poor. Surgeons operated in dirty theatres and used instruments that were rarely washed between operations. They did not wash their hands before or between operations, or wear clean clothes. There were no anaesthetics so few operations were done. Surgery was usually limited to amputating limbs or removing large tumours. No internal surgery was possible. Patients, who survived the shock and pain of the operation, often died of infection. If a patient lost a lot of blood there was no way of replacing it, as blood transfusions were not perfected until the early 20th century. Two important surgeons of the 18th century were William Cheselden and John Hunter but the best surgeons were judged by their speed. In the late 1700s, a record was set for removing a leg in 35 seconds, although the surgeon managed to cut off the patients left testicle and two of his assistant’s fingers too!anatomical anaesthetics William CheseldenJohn Hunter In 1800, the Royal College of Surgeons was founded and the poor reputations of surgeons improved. In large hospitals the teaching of anatomy was increasing.anatomy What was the state of surgery before 1800? Before 1800, anatomical knowledge increased enormously. William Harvey demonstrated the function of the heart and the circulation of the blood. However, surgery remained an extremely painful and risky business in 1800. The level of hygiene was very poor. Surgeons operated in dirty theatres and used instruments that were rarely washed between operations. They did not wash their hands before or between operations, or wear clean clothes. There were no anaesthetics so few operations were done. Surgery was usually limited to amputating limbs or removing large tumours. No internal surgery was possible. Patients, who survived the shock and pain of the operation, often died of infection. If a patient lost a lot of blood there was no way of replacing it, as blood transfusions were not perfected until the early 20th century. Two important surgeons of the 18th century were William Cheselden and John Hunter but the best surgeons were judged by their speed. In the late 1700s, a record was set for removing a leg in 35 seconds, although the surgeon managed to cut off the patients left testicle and two of his assistant’s fingers too!anatomical anaesthetics William CheseldenJohn Hunter In 1800, the Royal College of Surgeons was founded and the poor reputations of surgeons improved. In large hospitals the teaching of anatomy was increasing.anatomy Learning Outcomes By the end of this section you will learn about some of the major problems doctors and patients had when undertaking surgery and the changes which helped to overcome them. You will understand the importance of the work of individuals such as Simpson and Lister. Why did some doctors oppose the introduction of anaesthetics and antiseptics? Read the learning outcomes first. 24 GCSE Schools History Medicine 1800-2000

5. Problem: Paré's ligatures often introduced infection into a wound.ligatures Solution: Lister introduced sterilized catgut to tie off blood vessels. Problem: Blood transfusions human to human had failed. Solution: In 1901 Karl Landsteiner discovered blood groups. Successful transfusions were now possible. transfusions Problem: A blood donor had to be present as blood clotting still caused storage problems. Solution: In 1915 Lewisohn found that sodium citrate stopped blood clotting in a syringe. Blood cells were separated from the liquid part and were stored in bottles.clotting Problem: Loss of blood pressure Solution: Dr Harvey Cushing, an American neurosurgeon, monitored blood pressure and developed a technique to seal blood vessels with electric currents. Problem: Large amounts of blood needed during war. Solution: The National Blood Transfusion Service was set up during the First World War so people could donate blood. 30 GCSE Schools History Medicine 1800-2000 Solving the problem of blood loss during surgery. What solutions were developed to deal with blood loss? Blood loss was still a major problem in surgery. Bleeding makes it difficult for the surgeon to see what he is doing, and if the patient lost too much blood, they often died. Wounds or amputations were sealed by placing a hot iron on the wound or pouring hot oil over it to seal the blood vessels. Pare [1536] had used ligatures to tie the blood vessels. This was a far less painful method but did not always stop the bleeding if they were not tied properly. Important developments to solve the problem of blood did not come until after 1900.amputationsligatures