Economic activity grew rapidly during the 18th Century in Western Europe and the Americas. It was the beginning of the Industrial Revolution. During the 19th century economic and industrial growth gathered pace; it was also a period of scientific discovery and invention.
Old ideas of infectious disease epidemiology (incidence, distribution, and control of diseases) made way to virology and bacteriology. Microbiology made advances, a science that started with Antonie Philips van Leeuwenhoek (1632 - 1723), who first observed microorganisms with a microscope.
Enormous development s were made in identifying and preventing illnesses. However, one problem still persisted, and that was treating and curing infectious diseases.
During the 19th century the world changed dramatically:
Louis Pasteur (1822-1895), a chemist and microbiologist from France, is known as one of the founders of medical microbiology. After working for several years as a teacher in Strasbourg and Dijon, he became professor of chemistry at the University of Lille in 1854. The science faculty had among other things, been asked to find solutions to some of the problems that existed in local industries, such as the manufacture of alcoholic beverages.
Pasteur demonstrated that bacteria caused the souring of wine and beer, and later on showed that a similar process occurred in milk. He also explained that by boiling and the cooling a liquid, such as milk, the bacteria could be removed. The process we know as pasteurization comes from his surname.
He then set out to determine where these bacteria originated from, and eventually proved that they came from the environment. Initially, the scientific community disagreed with him, saying that germs could appear out of nowhere (spontaneously generate). However, in 1864, his findings were accepted by the French Academy of Sciences.
Later on, as head of scientific studies at the École Normale, he was given the job deciding what to do about an epidemic among silkworms in the silk industry in the south of France. He eventually determined that parasites were the cause and that only healthy silkworm eggs (with no parasites) should be used. The epidemic was resolved and the silk industry recovered.
His subsequent research convinced him further that pathogens attack the body from outside (germ theory of disease). Many scientists could not conceive that microscopic beings could harm and even kill comparatively huge ones, like us. He went a step further and said that many diseases, including TB, cholera, anthrax, and smallpox are caused by germs that come into the body from the environment. He believed they could be prevented with vaccines.
He went on to develop vaccines for rabies, for which he is probably the most famous.
In 1888 the Institute Pasteur was founded. He was director there until 1885, when he died. Louis Pasteur was given a state funeral. In France he is a national hero.
Louis Pasteur worked closely with Claude Bernard (1813-1878) a physiologist; together they perfected pasteurization of liquids. Bernard was the first to define milieu intérieur (homeostasis - a healthy state that is maintained by the continuous adjustment of biochemical and physiological pathways). Bernard was the first to suggest using "blind" experiments when aiming for maximum objectivity in scientific observations. Harvard University Professor, Bernard Cohen says that Bernard was "one of the greatest of all men of science".
Florence Nightingale (1820-1910) was a British nurse, statistician and writer. Her pioneering nursing work during the Crimean War, where she cared for wounded soldiers, brought her to prominence. Nightingale was thea daughter of wealthy parents who were in Florence, Italy, as part of a tour when she was born - hence her name.
In 1837 she sensed a "calling from God", telling her to do some work, even though at the time she said she had no idea what that work was. She was interested in nursing, but well-to-do women in those days did not go into the medical professions. Her parents did not allow her to study nursing. She had been expected to marry well and have children.
Nightingale eventually got her way and went to Kaiserwerth, Germany, in 1851 to do a three-month nursing course. By 1853 she became superintendent of a hospital for well-off women in Harley Street, London (a street famous for top doctors).
The Crimean War broke out a year later. Nightingale read reports of dreadful lack of medical facilities for British soldiers who had been wounded in action. Nightingale, who already knew Sidney Herbert, Minister for War, was asked by Herbert her to be in charge of a team of nurses in the military hospitals in Turkey. She arrived in Scutari, Turkey in 1854 with 38 women volunteer nurses who had all been trained by her, including her aunt Mai Smith.
Nightingale was shocked by what she saw at Scutari - wounded soldiers in unbearable pain, many of them dying unnecessarily, being tended by overly-tired medical staff and official indifference. There was a serious shortage of medications, hygiene standards were shocking, and there were mass infections. There was nothing to process food for the patients; no equipment at all.
She sent a pleas to The Times asking the government to do something about the atrocious conditions in Scutari. A prefabricated hospital was built in England and transported to the Dardenelles. When it was built it was called the Renkioi Hospital, which had a death rate 90% lower than what existed before in Scutari.
The presence of Nightingale and her team of nurses resulted in a significant drop in the mortality rate of wounded soldiers.
In 1860 Nightingale founded the Nightingale Training School for nurses at St Thomas' Hospital, London. It was the first secular nursing school in the world. Nurses who trained there worked all over the UK, and spread what they had learnt.
Her book Notes of Nursing was published in 1860. In it she stressed the importance of sanitation and hygiene, good hospital planning, and the best ways to achieve optimum military health - many of her practices are still in force today.
Nightingale reduced death rates from 42% to 2%, according to the 1911 edition of the Dictionary of National Biography.
The arrival of Florence Nightingale is seen as a turning point for women in the medical profession. Before she came onto the scene, women in hospital and medical settings possibly worked as midwives, cleaning ladies and sitters, and not much else.
Targeted Cancer Therapy - seen as a major advancement in cancer treatment. Cancer treatment had focused on destroying rapidly dividing cells, which also destroyed a number of healthy rapidly-dividing cells. Cancer patients had to endure some extremely unpleasant side effects from radiation therapy and chemotherapy because of this.
Targeted cancer therapies focus just on specific molecules; the ones that cause tumors to grow. Only the cancer cells are hunted down, resulting in considerably less damage to healthy cells, and subsequently fewer and less severe side effects.
At the moment, this technology is only effective for some forms of cancer. However, experts are sure that eventually most cancers will be effectively treated with Targeted Cancer Therapy.
Anti-smoking legislation - several countries, initially in Western Europe and North America introduced legislation forbidding smoking in public places. Despite resistance from the smoking lobby and organizations representing bars and restaurants, there has been a considerable drop in national smoking rates in several countries, as well as non-smokers' exposure to second-hand smoke (passive smoking).
A Scottish study found that since the country introduced a national comprehensive smoke-free legislation, rates of preterm deliveries and small-for-date infants have fallen dramatically.
A European study found that smoking bans may even encourage smokers to consume fewer cigarettes at home.
HIV survival extended with combination drug therapy - a 20-year-old AIDS patient in 1996 had an expected survival time of three to five years, today he/she is expected to live till the age of 69 years (average). This is thanks to the introduction of HAART (highly active retroviral therapy), a combination therapy, which has turned HIV/AIDS from a deadly disease into a serious but chronic one with good long-term survival.
Combination drug therapy has also improved treatment outcomes for patients with cancer, heart disease and other illnesses.
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