1. DEALING WITH INFECTION:
The discovery of Antiseptics (2): Ignaz Semmelweiss and Joseph Lister Learning Objectives: 1) To be able to identify why early discoveries; such as the work of Semmelweiss were unsuccessful 2) To be able to explain why the work of Joseph Lister was a significant step in combating infection.

2. Overview:
Watch the following 2 part documentary about the development of antiseptic methods.
You have a worksheet with 15 questions to complete whilst you are watching!

3. Check your answers:
1. What percentage of patients died in operating theatres despite the discovery of anaesthetics? 50% 2. Where did Semmelweiss work? The maternity ward – Vienna Hospital 3. What condition was killing new mothers whilst in hospital? Child bed fever 4. How many more times likely were you to die from ‘child bed fever’ if a doctor delivered your baby rather than a midwife? 9 times 5. What did Semmelweiss do every day before returning to the maternity wards? Visit the mortuary

4. Check your answers:
6. What was the vital breakthrough? A friend of Semmelweiss cut hi finger whilst performing an autopsy. He died of ‘child bed fever’ like symptoms a few days later. 7. What did Semmelweiss order all doctors to wash their hands in? Chloride of lime 8. What did doctors think about hand washing? A pointless waste of time 9. Why did Semmelweiss leave the Vienna hospital? His contract was not renewed and he left in disgrace 10. In what year did Semmelweis write his book, reporting on his findings? 1860

5. Check your answers:
11. Ironically, what did Semmelweiss die of in 1865? Septicaemia (Sepsis/blood poisoning) – the condition they had named ‘child bed fever’ 12. Who proved the existence of germs in 1861? Louis Pasteur 13. What chemical was used to deodorise sewerage? Carbolic Acid 14. By what rate did Joseph Lister’s death rate fall after he started soaking his equipment in carbolic acid? Two thirds 15. How many years would it take before medical staff really took notice of antiseptic ideas? Twelve

6. The ‘Black Period’ of surgery
The 1850s-1870s is often referred to by historians as the ‘Black Period’ of surgery.
Why do you think this is?
You have 2 minutes to discuss with a partner!

7. Why the ‘Black Period’ of surgery????
Did you get it right....?
Why the ‘Black Period’ of surgery????
The Period actually saw LOTS of developments in the area if surgery, yet despite this historians still view it as a bleak time. This is simply because the number of deaths from surgery actually INCREASED during this time period, despite some great discoveries! Have a look at the mind map on the next slide. Make a copy of it in your book.

8. WHY was 1850-1870 the ‘Black Period’ of surgery?
Despite the discovery of anaesthetic, patients still died from other issues such as infection and blood loss.
Some patients died as a result of these new anaesthetics, as surgeons struggled to get the dosage right
Some people, such as Semmelweiss and Lister had made great discoveries in combating infection, but many doctors simply thought their ideas were daft.
With the development of anaesthetic surgeons no longer needed to operate quickly. This meant wounds were exposed for longer making patients more prone to infection.
WHY was the ‘Black Period’ of surgery?
Even when the French Chemist Louis Pasteur discovered germs in 1861 – it would be some years before his theory was widely believed.
The extra time taken over operations also meant that a patient had more chance of dying from blood loss. The flow of blood was difficult to control.
‘New’ operations were now being tried, which increased the chance of death

9. Early attempts to combat infection:
As you saw from the video, Ignaz Semmelweiss had made a link between dirt and infection, and had been responsible for the saving of many lives in both hospitals which employed him. But the majority of doctors and medical staff in the hospitals did not believe his theory.
Why do you think this is?

10. Florence Nightingale – ‘The Lady with the Lamp’.
Before Florence Nightingale, nursing did not have a very good reputation.
Today we like to think of nurses as kind, caring people. But in the early 19th century it was quite the opposite.
Nursing was not considered to be an important profession and the women who worked as nurses were often drunks, or is some cases even prostitutes!
Florence Nightingale would be amongst those who changed the face of nursing for good, and her journey began in the Crimea where the British were at war, and Doctor John Hall (Chief of Medical Staff for the Army) had already dismissed anaesthetic as ‘unmanly’

11. Florence Nightingale – ‘The Lady with the Lamp’.
Florence changed the way in which people viewed nurses. Her caring nature at the Crimean led to the Times newspaper writing:
“She is a ‘ministering angel’ without any exaggeration in these hospitals, and as her slender form glides quietly along each corridor, every poor fellow's face softens with gratitude at the sight of her. When all the medical officers have retired for the night and silence and darkness have settled down upon those miles of prostrate sick, she may be observed alone, with a little lamp in her hand, making her solitary rounds”
This article helped earn her the nickname ‘The Lady with the Lamp’ – which shows how her caring nature was well respected.

12. What did Florence Nightingale do?
Florence was a great believer in cleanliness and hygiene and insisted on some really simple rules, such as one patient to a bed only!
She also encouraged light, airy wards and insisted on basic training for nurses.
BUT...
She believed in the ‘Miasma’ theory – that disease and infection was caused by poisonous vapours and foul smelling air.
This led to many of her patients having wounds that were tightly bandaged in order to keep miasma out. Although we now know that a tightly wrapped wound increases temperature of the wound and encourages the growth of infection causing bacteria!

13. Answer the following questions in full sentences:
In what ways did Florence Nightingale make improvements to patients care?
What is meant by ‘Miasma’?
Why did tightly wrapped wounds increase a patients chance of getting an infection?
You have 10 minutes!