Industrial Britain 1745–1901, Year 11: germ theory, surgery and public health (Health and the people option)

1861

HintTwo years after Darwin's 'On the Origin of Species'.

The whyPasteur was a chemist who had been asked by a drinks manufacturer to find out why its alcohol was going sour. His work on decay led him, and others, to the idea that microbes might also cause disease.

Spontaneous generation

HintPasteur's experiment with swan-necked flasks disproved it.

The whyBroth in a flask whose neck kept out dust stayed fresh; broth open to the air went bad. So the microbes came from outside and caused the decay, not the other way round.

Tuberculosis

HintIt was then often called consumption.

The whyKoch had already identified the bacterium that causes anthrax in 1876, and he went on to find the one that causes cholera. His methods allowed others to find many more.

Chemical dyes that stained them

HintA product borrowed from the textile industry.

The whyHe also grew bacteria on a solid jelly in a dish, so that each kind could be studied separately, and he photographed what he saw. These techniques made 'microbe hunting' possible.

Magic bullet

HintThe phrase pictures a shot that hits only its target.

The whyThe phrase was Paul Ehrlich's. His team tested hundreds of compounds before finding in 1909 that number 606, later sold as Salvarsan, worked against syphilis. It was the first modern chemical cure aimed at a specific disease.

Rabies

HintThe boy, Joseph Meister, had been attacked by an infected animal.

The whyPasteur had already made vaccines for animals, against chicken cholera and anthrax, using weakened germs. Jenner had found one vaccine by observation; germ theory showed how to make others on purpose.

1847

HintThe year after ether was first used in an operation in London.

The whySimpson, a professor in Edinburgh, tried the vapour on himself and his friends one evening. Chloroform soon replaced ether in many operating theatres.

Queen Victoria

HintThe most famous mother in the country.

The whySome doctors and clergy had argued that pain in childbirth was natural or intended by God. After the Queen accepted chloroform for the birth of Prince Leopold, such objections faded.

Carbolic acid

HintIt was already used to treat sewage.

The whyHe first used it with success in August 1865, on a boy with a badly broken leg. Deaths from infection among his patients fell.

Louis Pasteur's

HintA French chemist.

The whyLister reasoned that if microbes in the air cause decay, they might also cause wounds to rot. It is a clear case of science in one field changing practice in another.

Aseptic surgery

HintAntiseptic methods kill germs that are present; this goes one step further.

The whyIt developed from the 1880s and 1890s. Instruments were steam-sterilised, and the American surgeon William Halsted introduced rubber gloves.

Surgeons attempted longer, deeper operations, so more patients died of infection and blood loss

HintPain had been dealt with before the other two great problems of surgery.

The whyWith the patient asleep, surgeons no longer had to rush, and they tried more complicated and time-consuming operations. Until antiseptics arrived, that meant more deaths from infection, not fewer.

John Snow

HintThe pump was in Broad Street, Soho.

The whyHe persuaded the local authorities to remove the pump handle. His evidence was strong, but he could not say what in the water caused the disease, and most officials went on blaming bad air.

Edwin Chadwick

HintA civil servant who had worked on the Poor Law.

The whyHe showed how badly living conditions in the industrial towns damaged the health of working people. He believed in miasma, so he was right about cleaning up for the wrong reason.

It was not compulsory: most towns could choose whether to act

HintIt permitted; it did not order.

The whyIt set up a central Board of Health and allowed towns to set up local boards. Many ratepayers did not want to pay, and many people thought government had no business interfering.

The 1875 Act was compulsory

HintCompare what councils were allowed to do with what they were made to do.

The whyLocal authorities now had to provide clean water, drains and sewers and to appoint a medical officer of health. By then germ theory was known, and working men in towns had the vote, which gave governments a reason to act.

Joseph Bazalgette

HintMuch of his system is still in use.

The whyIn the hot summer of 1858 the smell from the Thames was so bad that Parliament could hardly sit. A law to pay for a new network of sewers was passed on 2 August, within weeks.

Laissez-faire

HintA French phrase.

The whyIts literal meaning is 'let do': leave things alone. It was a powerful idea in the first half of the 19th century and one reason public health reform came slowly. Its hold weakened as cholera returned again and again and the evidence for action grew.