Physicians that changed our Physicians that changed our worldworld

Edward Jenner Edward Jenner was born in 1749 Edward Jenner was born in 1749

in Berkeley, England.in Berkeley, England.

Jenner trained as an apprentice with a surgeon, for Jenner trained as an apprentice with a surgeon, for eight years from the age of 14. Later, he started eight years from the age of 14. Later, he started studying surgery and anatomy atstudying surgery and anatomy at St George's St George's Hospital.Hospital.

Jenner is widely credited as the pioneer ofJenner is widely credited as the pioneer of smallpoxsmallpox vaccinevaccine, and is sometimes referred to as the , and is sometimes referred to as the "Father "Father of Immunology";of Immunology"; his works have been said to have his works have been said to have "saved more lives than the work of any other man "saved more lives than the work of any other man

In the 18th century In the 18th century 'the smallpox'the smallpox' ' was common in Britain – around 20% was common in Britain – around 20% of all deaths were caused by it. of all deaths were caused by it.

Edward Jenner was at that time a Edward Jenner was at that time a country doctor who worked with the country doctor who worked with the farmers in Gloucestershire in the farmers in Gloucestershire in the late 18th century. late 18th century.

He noticed that the girls who He noticed that the girls who

milked the cowsmilked the cows

often caught cowpox, often caught cowpox,

(a disease similar to smallpox, (a disease similar to smallpox,

but much less virulent),but much less virulent),

but they rarely caught smallpox. but they rarely caught smallpox.

In the 18th century no-one In the 18th century no-one knew how the immune system knew how the immune system works. works.

However Jenner began to However Jenner began to wonder if deliberately infecting wonder if deliberately infecting people with people with cowpoxcowpox might might protect them against smallpox.protect them against smallpox.

Finally in 1794 Jenner decided Finally in 1794 Jenner decided to try out his idea. to try out his idea.

He took pus from the He took pus from the cowpox cowpox spotsspots of a milkmaid and he of a milkmaid and he

scratched it into the skin of a scratched it into the skin of a healthy young boy called James healthy young boy called James Phipps, who then Phipps, who then developed developed cowpox. cowpox.

– Jenner's idea met with quite a lot of opposition.Jenner's idea met with quite a lot of opposition.– But in the end the technique was so successful But in the end the technique was so successful

that protecting someone against a serious illness that protecting someone against a serious illness by exposing them to a similar but mild illness by exposing them to a similar but mild illness

became widely acceptedbecame widely accepted. .

The technique was called The technique was called vaccinationvaccination

Two months later Jenner Two months later Jenner scratched pus from a smallpox scratched pus from a smallpox victim into James's arm. The victim into James's arm. The

little boy showed little boy showed no signs at no signs at all of the terrible infectionall of the terrible infection

A massive A massive international vaccination international vaccination programmeprogramme meant that in 1980 the meant that in 1980 the World Health OrganizationWorld Health Organization  declared  declared that smallpox had officially been that smallpox had officially been eliminated from the world. eliminated from the world.

Interestingly, Jenner's work would not be Interestingly, Jenner's work would not be allowed today – it would be completely allowed today – it would be completely unethical to use a healthy child in an unethical to use a healthy child in an

experiment in this way!experiment in this way!

Ignaz Semmelweiss and Ignaz Semmelweiss and the spread of infectionthe spread of infection

When most women had their babies at home, helped by When most women had their babies at home, helped by midwivesmidwives, , serious infections after the birth were quite , , serious infections after the birth were quite rare. But in the late 18th and 19th century doctors rare. But in the late 18th and 19th century doctors began to deliver babies more often, hospitals created began to deliver babies more often, hospitals created maternity wardsmaternity wards and the problems began. and the problems began.

Soon after giving birth many women developed Soon after giving birth many women developed symptoms like pain, fever, inflammation of the womb, symptoms like pain, fever, inflammation of the womb, vomiting and convulsions. They usually died in less vomiting and convulsions. They usually died in less than 5 days. This illness, known as than 5 days. This illness, known as puerperal feverpuerperal fever, , killed many women who had a baby in hospital. killed many women who had a baby in hospital.

Nobody really understood why this was happeningNobody really understood why this was happening

Ignaz Semmelweiss (1818) was a Hungarian Ignaz Semmelweiss (1818) was a Hungarian doctor who worked in the maternity clinic at doctor who worked in the maternity clinic at

the Vienna Hospitalthe Vienna Hospital

The hospital had The hospital had two delivery roomstwo delivery rooms, , in one of them in one of them midwivesmidwives helped women helped women and in the other and in the other medical studentsmedical students helped the women. helped the women.

Over 12% of the women helped by the doctors died Over 12% of the women helped by the doctors died of puerperal of puerperal feverfever, more than three times as many as those helped by , more than three times as many as those helped by midwives.midwives.

Semmelweiss realised that his medical students often went Semmelweiss realised that his medical students often went straight from dissecting a dead body to delivering a baby straight from dissecting a dead body to delivering a baby without without washing their hands firstwashing their hands first. He wondered if they were carrying the . He wondered if they were carrying the cause of the disease on their hands from the corpses to their cause of the disease on their hands from the corpses to their patientspatients..

Within 6 months the death rate for Semmelweiss's Within 6 months the death rate for Semmelweiss's patients had dropped to a quarter. In 2 years it had patients had dropped to a quarter. In 2 years it had dropped to just over 1%.dropped to just over 1%.

Without understanding the cause of infectious Without understanding the cause of infectious diseases Semmelweiss had discovered a key factor in diseases Semmelweiss had discovered a key factor in preventing the spread of pathogens which is just as preventing the spread of pathogens which is just as important now in the 21st century as it was in the 19th important now in the 21st century as it was in the 19th century.century.

Semmelweiss was convinced Semmelweiss was convinced that the fever was caused that the fever was caused

by an infectious agent. by an infectious agent. He insisted that the medical He insisted that the medical

students students wash their hands inwash their hands in chlorinated lime chlorinated lime

before they went onto before they went onto the maternity ward. the maternity ward.

John Snow, a historical giant inJohn Snow, a historical giant in epidemiologyepidemiology

Snow was a British physician who is Snow was a British physician who is considered one of the considered one of the founders of founders of epidemiologyepidemiology for his work for his work identifying the identifying the source of a cholera source of a cholera outbreakoutbreak in 1854. in 1854.

John Snow was born into a John Snow was born into a labourer's family on 15 March 1813 labourer's family on 15 March 1813 in York and at 14 was apprenticed in York and at 14 was apprenticed to a surgeon. In 1836, he moved to to a surgeon. In 1836, he moved to London to start his formal medical London to start his formal medical education.education.

A few years later, Snow A few years later, Snow

was able to prove his was able to prove his theory in dramatic theory in dramatic circumstances. In August circumstances. In August 1854, a 1854, a cholera outbreakcholera outbreak occurred in Soho.occurred in Soho. Nearly Nearly 500 people died in 10 500 people died in 10 days. The people of this days. The people of this area got water from area got water from pumpspumps in the street. in the street.

Snow made careful Snow made careful observations of where observations of where and how infected people and how infected people lived. lived.

At the time, it was assumed that cholera was airborne. At the time, it was assumed that cholera was airborne. In fact, a famous doctor of the time, Dr. William Farr supported this idea. In fact, a famous doctor of the time, Dr. William Farr supported this idea.

However, Snow did not accept this 'miasma' (bad air) theory, However, Snow did not accept this 'miasma' (bad air) theory, arguing that in fact entered the body through the moutharguing that in fact entered the body through the mouth

After careful After careful investigation, including investigation, including checking and counting checking and counting cases of cholera on a map cases of cholera on a map of the area, Snow was of the area, Snow was able to identify a able to identify a water water pumppump in Broad Street as in Broad Street as the source of the disease.the source of the disease.

Looking at his map, Snow Looking at his map, Snow predicted that if the predicted that if the Broad street pump was Broad street pump was closed, people would stop closed, people would stop getting cholera. The getting cholera. The pump handle was pump handle was removed and cases of removed and cases of cholera disappeared.cholera disappeared.

Each spot represents a death

Dr Farr didn’t believe this theory and Dr Farr didn’t believe this theory and carried on collecting data to support his carried on collecting data to support his own theory. own theory.

Finally, in 1866, Farr had to accept Snow’s Finally, in 1866, Farr had to accept Snow’s theory when there was another outbreak of theory when there was another outbreak of cholera in East London. Farr observed that cholera in East London. Farr observed that all people who died had taken water from all people who died had taken water from the Old Ford reservoir in East London.the Old Ford reservoir in East London.

The bacterium that causes cholera was The bacterium that causes cholera was discovered in 1883. discovered in 1883.

Joseph Lister and Joseph Lister and antiseptic surgeryantiseptic surgery

Joseph Lister was a Joseph Lister was a Scottish Scottish surgeon who surgeon who picked up the work of picked up the work of Louis PasteurLouis Pasteur and and used it to change surgery. used it to change surgery.

In 1865 Lister read about Pasteur's work on In 1865 Lister read about Pasteur's work on how wine went bad because of how wine went bad because of microorganismsmicroorganisms in the air. in the air.

Lister was convinced that microorganisms in Lister was convinced that microorganisms in the air were also the cause of the the air were also the cause of the infections infections which killed half of his patients after they which killed half of his patients after they had successfully survived surgery. The open had successfully survived surgery. The open wounds made it easy for the wounds made it easy for the germs to get germs to get into the body.into the body.

He started to clean the wounds of his patients He started to clean the wounds of his patients with with carbolic acidcarbolic acid, and soak the dressings in , and soak the dressings in antiseptic liquidantiseptic liquid as well. In the years from as well. In the years from 1864-66 the death rate for Lister's surgical 1864-66 the death rate for Lister's surgical patients was 45.7%. Between 1867-70, when patients was 45.7%. Between 1867-70, when he introduced his new antiseptic treatment, this he introduced his new antiseptic treatment, this fell to 15%fell to 15%

Lister's work revolutionised surgery once hisLister's work revolutionised surgery once his aseptic aseptic techniques were accepted. techniques were accepted.

Although theAlthough the antiseptics antiseptics and disinfectants used and disinfectants used have changed, aseptic surgery is still the basis have changed, aseptic surgery is still the basis of saving millions of livesof saving millions of lives . .

Alexander Fleming and the Alexander Fleming and the discovery of penicillindiscovery of penicillin

1. 1. Alexander Fleming Alexander Fleming was looking for ways was looking for ways to to destroy bacteriadestroy bacteria. In . In 1928, he was growing 1928, he was growing lots of bacteria known lots of bacteria known as staphylococci on as staphylococci on agar plates.agar plates.

2. 2. Before going on holiday in Before going on holiday in 1928 Alexander made two 1928 Alexander made two mistakes. He didn't put all mistakes. He didn't put all of his plates in of his plates in bleach to bleach to sterilise themsterilise them, and he left , and he left the the lab windows openlab windows open. . When he came back from When he came back from a holiday, Alexander a holiday, Alexander noticed that lots of his noticed that lots of his culture plates were culture plates were mouldy.mouldy.This mistake has  saved millions This mistake has  saved millions

of livesof lives

Before he put all the plates Before he put all the plates toto wash, Fleming noticed wash, Fleming noticed something, there was a clear something, there was a clear ringring in the jelly around some in the jelly around some of the spots of mould where of the spots of mould where no bacteria were growing. no bacteria were growing. Something had killed the Something had killed the bacteriabacteria that was covering that was covering the jelly.the jelly.

Fleming worked hard on his Fleming worked hard on his mould, mould, Penicillium notatumPenicillium notatum, , but he couldn't prove it but he couldn't prove it would actually kill bacteria would actually kill bacteria and make people better.and make people better.

bacteria

mould

Bacteria don’t grow in this area

In In World War IIWorld War II soldiers needed penicillin. They soldiers needed penicillin. They asked the Americans for help and some big chemical asked the Americans for help and some big chemical companies helped them make penicillin on a large companies helped them make penicillin on a large scale. scale.

Penicillin became available to everyone and the Penicillin became available to everyone and the history of infectious diseases changed for ever.history of infectious diseases changed for ever.

In 1938 Howard Florey and Ernst Chain In 1938 Howard Florey and Ernst Chain at Oxford University at Oxford University

decided to do some work on penicillin. decided to do some work on penicillin. They infected eight mice with bacteria They infected eight mice with bacteria

which would normally kill them. which would normally kill them. Four were given penicillin. Four were given penicillin.

The four treated mice stayed healthy – The four treated mice stayed healthy – but the other four died.but the other four died.

After several experiments on persons, After several experiments on persons, they showed the value of penicillin they showed the value of penicillin

in destroying bacteriain destroying bacteria. .

Different antibiotics harm different Different antibiotics harm different bacteria. Some antibiotics are made by bacteria. Some antibiotics are made by chemically altering penicillin to make it chemically altering penicillin to make it kill diffferent bacteria. kill diffferent bacteria.

One of these antibiotics is methicillin. One of these antibiotics is methicillin. Bacteria that are not harmed by an Bacteria that are not harmed by an antibiotic are “resistantantibiotic are “resistant” ”