The Bicester School



Year 8 History

Classwork

Booklet

Medical Advancements (Challenge)

Name ……………………………………………………………………..

Teacher……………………………………………………………….…………

Lousy Living Conditions

Activity 1 –

a. Look at the picture above and write down the 5 problems of public health from the image and why they are bad for people’s health:

Problem of public health number 1 is ______________________________________

this is bad for people’s health because ____________________________________

Problem of public health number 2 is ______________________________________ this is bad for people’s health because ____________________________________

Problem of public health number 3 is ______________________________________ this is bad for people’s health because ____________________________________

Problem of public health number 4 is ______________________________________ this is bad for people’s health because ____________________________________

Problem of public health number 5 is ______________________________________ this is bad for people’s health because ____________________________________

b. Be a Star Extension – Can you add any other issues with health and safety from the image of your own knowledge of living and working conditions at this time? ______________________________________________ __________________________________________________________________________________________________________________________________________

Activity 2 - Revision

Answer these questions, based on the topics you have studied in history previously. Use the internet or books to find the answers to any questions you aren’t sure of, or ask a family member

1. What were the beliefs about illness during the Great Plague?

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2. What is Miasma?

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3. Why are these beliefs harmful to people’s health?

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4. Why was God so integral to these beliefs about disease?

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Edward Jenner and cowpox

Smallpox was a very serious disease that killed thousands of people a year. Smallpox caused huge spots filled with pus to appear all over the body. In the 18th century nearly everyone caught the disease and 25% of victims died. Those who lived had terrible scars left by the spots, especially on their faces.

As a young man, Edward Jenner (1749–1823) was given smallpox on purpose. The idea was that by giving it to people when they were young, fit and healthy they would survive better than if they caught it when they were older. This was a very dangerous thing to do and many people died. Jenner survived but later in his life, he set about trying to stop this practice.

Jenner noticed that girls who looked after cows rarely caught smallpox. He came up with a theory that if you gave people a disease caught from cows, called cowpox, they would be protected from smallpox. Many people thought he was mad and some even thought that anyone who was given cowpox would turn into a cow!

He tested his theory in 1796, when a milk maid called Sarah Nelmes caught cowpox. He asked an eight-year-old boy, called James Phipps, to come to his house, where he squeezed pus from a cowpox spot on Sarah’s hand into a cut on James’ arm. The boy caught cowpox. Eight weeks after this, he squeezed pus from a smallpox spot into another cut on James’ arm. The boy did not get smallpox. This was the first vaccine (although Jenner knew nothing of microbes). The word ‘vaccine’ comes from the Latin for cow – vacca. By 1890 after the vaccination had become compulsory & in 1872 the number of people dying of Smallpox had dropped to 10 people per 1,000,000. Thanks to immunisation, smallpox no longer exists in the world (although some of the viruses are kept in laboratories for research).

Be a Star Extension - Watch the Video ‘True Stories Edward Jenner‘



Activity 3 – Answer the Questions using the information in the text and video

1. Why was Jenner given smallpox as a young man?

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2. Describe the symptoms that Jenner might have suffered.

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3. What was Jenner’s theory?

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4. What observations did he make to come up with this theory?

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5. Why did James Phipps not catch smallpox?

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6. What is a vaccine?

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7. Why do you think it got this name?

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8. These are the first two lines of a poem by William Allingham (1824–1889), called ‘The Milk Maid’:

O where are you going so early? he said;

Good luck go with you, my pretty maid;

Why do you think milk maids were renowned for being pretty in the 18th and early 19th centuries?

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9. Describe what is happening in this cartoon (what can you see? What does the caption say?)

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10. What do you think were people’s fears at the time about vaccinations?

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11. What do you think is happening in this painting? Describe what you see

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12. What would be different in an operation today?

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13. Be a Star Extension: What changes would you make if you wanted to make operations better?

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John Snow - Mapping a London Epidemic

Activity 4 – read the information and answer the questions

In 1831 there was a Cholera outbreak in Europe 100,000 died in France and in London alone 6,536 died. In 1848 52,000 people died in England and Wales, with London losing 14,137. As with all of the outbreaks the local authority believed it was caused by Miasma. With this belief the government put in precautions such as don’t burn old rags. Edwin Chadwick had conducted a project looking at health in English towns and cities in 1834. He had decided that disease came with filth and dirt.

In 1854, in a single ten-day period, 500 people suddenly died in London. They all died of the same illness in a single section of the city. The cause of death was determined to be cholera a severe infection of the small intestine. What was the source of the disease and how was it spreading? John Snow a Doctor who worked in London believed that instead of being spread by Miasma (air), cholera was actually spread by water

Dr. Snow began by drawing a map of the afflicted part of the city, a district named Soho. On this map he marked the home of each victim who had died, with a dot. This produced a map like the one on the right (Adapted from: Snow, J., On the Mode of Communication of Cholera. (Second Edition). 1855. Churchill, London.)

1. What do the X symbols represent on the map? _______________________

2. What observations can you make about the distribution of the cholera cases?

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3. Which well would you pick as the most likely source of contaminated water?

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4. Why wouldn’t you identify pump C as a possible source?

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5. What reasons could explain why there were no cases of cholera in the people living in the two-block area around the brewery east of pump A?

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Because of the clustering of cases around Public Water Pump A, Snow concentrated on this pump as the source of the cause of the cholera. The absence of clusters around pumps B and C indicated that they were less likely to be the source. Snow found that the water from pump B was so grossly contaminated that residents avoided it and got their water from pump A. Pump C was in a location that made it difficult for the majority of cases to use it.

6. What do you think Snow could do to test his hypothesis that the epidemic was caused by water from Pump A? (Remember that he couldn't actually test the water for bacteria as this wasn’t yet possible.)

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Snow went to the homes with cases of cholera and interviewed people about their source of drinking water. The consumption of water obtained from pump A proved to be the one factor common among these cases. The brewery workers got their water from a deep well on the premises and were also allotted a daily quota of beer so they did not drink water from any of the pumps. Snow’s detailed study of the outbreak convinced the vestrymen of the St. James parish of London to remove the pump handle from pump A, which stopped the cholera epidemic.

7. What did John Snow do to prove that pump A was the source of the cholera?

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8. Compare this answer with your answer for question 6. How did your plan differ from what Snow actually did?

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Be a Star Extension – Go to the back of this booklet and complete the extension activities about John Snow’s further investigations into the causes of disease

Activity 5 - Read through the profiles of James Simpson, Louis Pasteur and Florence Nightingale

James Simpson

One of the major problems faced by surgeons and patients alike was that of the pain of the operation. When an operation was underway the only comfort that the patient had was a piece of leather between their teeth that they could bite on. This meant that during operations the patient would scream and wriggle making the surgeon’s job very difficult.

In 1847 James Simpson decided to conduct an experiment where him and his friends smelt Chloroform. Within minutes they woke up under the table after having fainted. James realised that although they must have fallen heavily none of them felt any pain and therefore the Chloroform had worked in masking the pain.

Although this was a great discovery many Doctors were against it as they felt pain was a sign from God and shouldn’t be masked. Many Doctors who did use it got carried away at first and cut patients too much and this lead to infection or patients bleeding to death.

By 1857 Simpson’s discovery was finally realised when Queen Victoria used Chloroform for the birth of Princess Beatrice.

Video – James Simpson as a Simpson

Louis Pasteur

In 1850 Louis Pasteur started his research. For thousands of years people had not been able to work out what caused illness. Up until the 18th Century many Doctors had followed the belief in the 4 humours which stated that the body was made up of 4 different materials like blood. Each of these made up 25% of the body and if you had over this for any of them you would be ill. Others believed that you became ill because of God or the Devil.

Louis Pasteur however was about to change all this. He helped a brewing company discover why its beer was going off. He used a microscope and discovered that bacteria was growing in the liquid. He then boiled the liquid and the bacteria died.

Louis Pasteur had discovered that if you boil liquid it will stop the bacteria multiplying. Most famously milk is boiled to this day and becomes known as pasteurised milk, stopping the germs that can be in milk from poisoning us. Pasteur had finally began to realise that disease was from bacteria and not bad smells.

Video:

Florence Nightingale

Florence Nightingale had started working in hospitals from about 1851.

Then by 1854 war was declared between Russia and Britain, Florence decided that she was needed there to help nurse the wounded. When she arrived she realised that the conditions for the wounded were disgusting. The wounded were kept in dark damp conditions usually below ground and hundreds were dying from their wounds.

Within 6 months of her being there this death rate had gone down to only 2 out of every 100.

After 2 years Florence returned to Britain and immediately set up a Training School for Nurses. This taught the need to make hospitals more healthy and cleaner. Whenever a new hospital was being built the designers asked Florence for advice on how to lay the hospital out to greater aid the work of nurses.

Further reading & video:





Be a Star Extension - How the Public Became Interested in Medical Science

Activity 6 – Based on what you have learnt about Edward Jenner, John Snow, James Simpson, Louis Pasteur and Florence Nightingale complete the table on the following page

|Individual |Date |What they discovered? |How significant/important was it? |

|Edward Jenner | | | |

|James Simpson | | | |

|John Snow | | | |

|Florence Nightingale | | | |

|Louis Pasteur | | | |

Activity 7 – Based on your learning this lesson, complete the PEEL paragraph in answer to the question

Who made the most significant impact on medicine in the Industrial Period and why?

Medicine before the Industrial Period was very limited because_____________ ____________________________________________________________________________________________________________________________________________________.

There are many people that helped break through the barriers and begin the advancements in medicine we have today, for example _______________ discovered_______________________________________ this is important because ______________________________________________________________________________________________________________________________________________________________________________________________________________________________.

Another person who is important was ___________________because _________ __________________________________________________________________________ ______________________________________________________________________________________________________________________________________________________________________________________________________________________________

However, overall I think that _________________________made the most significant impact on medicine because __________________________________ ______________________________________________________________________________________________________________________________________________________________________________________________________________________________

Be a Star: John Snow Extension Task - Epidemic 2

In the 1850’s London residents began to obtain their water in their homes rather than from communal pumps. They signed up with one of the many water supply companies competing to supply home water. The water intakes for the water supply companies were in a much polluted part of the Thames River. Sometime between 1849 and 1854, one of the companies, the Lambeth Company, moved its water source to an area of the

Thames where the water was relatively free from the sewage of London.

In 1854, Snow noted that a terrible outbreak of cholera occurred in a few square blocks of an area of London. “Within two hundred and fifty yards of the spot where Cambridge Street joins Broad Street, there were upwards of five hundred fatal attacks of cholera in ten days.” Snow wondered what the cause of this outbreak could be. Using data from the Office of the Registrar General of England and Wales, Snow tabulated the number of deaths from cholera in 1853-1854 according to the two water companies supplying the various sub-districts of London.

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Answer the following questions

1. Refer to Table 2. Does this data support Snow’s hypothesis that polluted water causes cholera? Why or Why not?

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2. Is it conclusive proof that Snow’s hypothesis is correct? Why or why not?

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3. What other factors might be causing the difference in cholera rates in the different London districts?

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Snow also recognized that many factors in these London districts other than the water supplier were different and could be the reason for the difference in cholera rates. Snow’s unique contribution to epidemiology was to recognize a way to test his hypothesis that the water supply caused the cholera epidemic. Snow outlined his investigation in the book On the Mode of Communication of Cholera, published in 1855:

“In sub-districts enumerated in the above table as being supplied by both

Companies, the mixing of the supply is of the most intimate kind. The pipes of each Company go down all the streets, and into nearly all the courts and alleys. A few houses are supplied by one Company and a few by the other, according to the decision of the owner or occupier at the time when the Water Companies were in active competition. In many cases a single house has a supply different from that on either side. Each company supplies both rich and poor, both large houses and small; there is not any difference either in the condition or occupation of the persons receiving the water of different Companies.

The experiment, too, was on the grandest scale. No fewer than three hundred thousand people of both sexes, of every age and occupation, and of every rank and station, from gentle folk down to the very poor, were divided into two groups without their choice, and, in most cases, without their knowledge...

To turn this grand experiment to account, all that was required was to learn the supply of water to each individual house where a fatal attack of cholera might occur.”

Therefore, Snow walked the London district supplied by both water companies, District 1 (Southwark and Vauxhall) and District 2 (Lambeth). He went from house to house and for every dwelling in which a cholera death had occurred, he asked questions to determine the source of the water. Snow summarized his data in the following table:

Answer the following questions

4. Using ratios and proportions, calculate the "Deaths per House" and “Death per 10,000 Houses” and complete Table 3. Type answer onto table)

5. Which data is more meaningful when comparing deaths in the three districts? Why?

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Snow’s data conclusively showed that “one group being supplied with water containing the sewage of London, and amongst it, whatever might have come from the cholera patients. The other group has water quite free from such impurity.” Snow’s publication of his findings led to laws mandating that by 1857 all of the water supply companies in London must filter their water.

Answer the following question

6. From what you know today, would filtering the water completely solve the cholera problem? Why?

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Snow’s investigation utilized the approach used by epidemiologists today. He used his clinical knowledge and his observations concerning the distribution of cholera rates to formulate a hypothesis. Snow then tested his hypothesis while recognizing the need to allow for testing of alternative explanations for his observations.

Answer the following questions

7. What was Snow's hypothesis for the 1853–1854 cholera epidemic?

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8. How did he test his hypothesis?

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9. List at least three possible alternative explanations he considered when testing his hypothesis. (He mentioned many conditions of the people surveyed in the italicised quote from his book)

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10. List at least two possible explanations for the deaths from cholera in the homes supplied by the Lambeth Company.

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11. Write a testable hypothesis for one of your explanations above. Briefly describe how your hypothesis could be tested.

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12. From your knowledge of the London lifestyle, what actions would you take to protect the public’s health? Was there a need to change the way things were? What are your thoughts on disease and unsanitary conditions?

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Cowpox spots on the hand of Sarah Nelmes.

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