Archive for the ‘About and for everybody’ Category

Austria’s Healthcare System

Monday, March 9th, 2015

The Austrian health policy follows the principle of ensuring equal access to high-quality care for all, irrespective of income, age and gender. The level of investment in health-care infrastructure is high by international standards. Also, compared to other OECD countries, the Austrian population enjoys above-average access to major medical-technical equipment, particularly in the area of computed tomography and magnetic resonance imaging.

Austria has an extensive network of healthcare institutions. According to Statistics, in Austria, there are 277 hospitals (123 of which were public and/or charitable hospitals) with 64,703 beds in 2012. There are also 23,562 doctors and 86,445 members of other healthcare professions practicing in Austrian hospitals. At 4.8 physicians per 1000 residents, Austria has the second highest physician-to-population ratio in the EU, after Greece. Austria trains an above EU-average number of medical students.

The Austrian health system provides universal coverage for a wide range of benefits and high-quality care. Free choice of providers and unrestricted access to all care levels (general practitioners, specialist physicians and hospitals) are characteristic features of the system. Unsurprisingly, population satisfaction is well above EU average. Income-related inequality in health has increased since 2005, although it is still relatively low compared to other countries

There are around 270 hospitals in Austria, of which 178 provide acute inpatient care. One of the stated aims of Austrian health-care planning has been to reduce the number of hospital beds. Between 2000 and 2010, the average reduction in bed numbers across Austria was 10%, though with much variation between Länder. However, compared to the rest of the EU, bed numbers per head in Austria are still amongst the highest, though approximately level with Germany

If you are interested in working as a doctor in Austria, feel free to apply for a position here: EGV Recruiting

Goodbye Headaches! Hello technology!

Friday, August 22nd, 2014

Something as simple as a common headache can ruin the daily rutine of every person no matter what.

But what would you do if you would commonly have migranes twice or three times per week? 

Think about it… How would you be able to function like a normal human being? 

For Gabriella Iaocovetti, severe headaches three or four times a week can bring her business and family life to a halt.

“No light. No noise. I try to put my head under the covers,” she says.

Like many migraine suffers, Iaocovetti also gets nauseous, which makes taking pills a problem.

“Patients will tell you, ‘Food hangs in my stomach. I’m sick to my stomach,'” says Dr. Stephen Silberstein at Jefferson University Hospital.

Even when Iaocovetti can swallow a pill, she says it takes several doses to find relief. Then, her doctor told her about an alternative now being tested. It is called the Zelrix Patch. It uses Sumatriptan, one of the most common migraine medications.

Since the drug is not normally absorbed through the skin, researchers added a tiny chip which generates a micro-current of electricity, to push it into the pores. It is about the same strength as the chips that power a musical greeting card.

Jane Hollingsworth heads up Nupath, the company that makes the chips.

“There’s a little button that you push and that starts it,” she explains. “A little red light tells you if it’s working or not, so you can see it.”

She says the patch delivers a controlled amount of medication for four hours then shuts off. She says so far, there have been no significant side effects in the clinical trials. Iaocovetti enrolled in the double blind study and while there is no way to know if she received the real patch, she believes her symptoms are already better.

The results of phase three clinical trials showed the patch was effective in treating migraines. 

 

Would you choose this alternative over a common Aspirine?

Mecklenburg-Vorpommern: A German state with a lot to offer!

Sunday, July 13th, 2014

Mecklenburg-Vorpommern  is a federal state in northern Germany. The capital city is Schwerin. The state was formed through the merger of the historic regions of Mecklenburg and Vorpommern after World War II, dissolved in 1952 and recreated prior to the

German reunification in 1990. Mecklenburg-Vorpommern is the sixth largest German state by territory, and the least densely populated one. The coastline of the Baltic Sea, including islands such as Rügen and Usedom, as well as the Mecklenburg Lake District are characterized by many holiday resorts and pristine nature, making Mecklenburg-Vorpommern one of Germany’s leading tourist destinations.

   
Rügen
   
Usedom
Three of Germany’s fourteen national parks are in Mecklenburg-Vorpommern, in addition to several hundred nature conservation areas.
Major cities in Mecklenburg-Vorpommern include Rostock, Schwerin, Neubrandenburg, Stralsund, Greifswald and Wismar. The University of Rostock and the University of Greifswald are among the oldest in Europe.
  
Schwerin

Culture
Over the centuries, Mecklenburg and Vorpommern have developed and maintained strong regional cultures. It can generally be described as North German and has similar linguistic and historic characteristics to other north German states, such as Schleswig-Holstein.
Architecture
The cities are characterized by a certain “Hanseatic” style also found in other parts of northern Germany as well as in countries bordering the Baltic Sea. A common feature of many towns in Mecklenburg and Vorpommern are Gothic red brick churches dating back to the middle Ages. The old towns are usually built around one or several market places with a church or town hall. Often towns were founded at the Baltic Sea, one of the many lakes or a river for logistical and trade motives.
Greifswald

Museums, art and theaters:
The largest publicly-funded theaters in the state are the Mecklenburg State Theatre, the Rostock People’s Theatre, the Theatre of West Pomerania, with venues in Greifswald, Stralsund and Putbus, and the Mecklenburg State Theatre at Neusterlitz with venues in Neubrandenburg and Neusterlitz.
Since 1993, the Störtebeker Festival has taken place in Ralswiek on the island of Rügen. It is Germany’s most successful open-air theatre.
  
Störtebeker Festival
Notable museums include, for example, the Schwerin State Museum and the Pomeranian State Museum at Greifswald. The German Maritime Museum with its Ozeaneum in Stralsund is the most popular museum in northern Germany.
 
Ozeaneum in Stralsund
Furthermore, the German Amber Museum in Ribnitz-Damagarten, Rostock’s Abbey of the Holy Cross and Rostock Art Gallery are of national importance.
Mecklenburg-Vorpommern is home to many cultural events throughout the year. During summer, many open air concerts and operas are open to visitors. The Mecklenburg-Vorpommern Festival (Festspiele Mecklenburg-Vorpommern) attracts a sizeable audience by performing classical concerts in parks, churches and castles.
  
The Mecklenburg-Vorpommern Festival
Caspar David Friedrich, a famous romanticist painter born in Greifswald, immortalized parts of the state in several of his paintings.
  
Caspar David Friedrich- Greifswald
Food and drinks
Like most German regions, Mecklenburg and Vorpommern have their own traditional dishes, often including fish, beef and pork. Rostock has its own type of bratwurst called Rostocker Bratwurst. An unusual food from Western Pomerania is Tollatsch. Rote Grütze is a popular dessert. The largest brewery produces Lübzer Pils.
  
Tollatsch, Rote Grütze , Lübzer Pils

Economy
In Mecklenburg-Vorpommern, approximately 732,200 people were gainfully employed in 2008 with 657,100 of them were withe and blue collar workers. About 4,200 new jobs were created in 2007. Employees worked an average of 1,455 hours a year. The number of self-employed did not change in 2008. Three out of every four of all people in work are employed in the service sector.
The biggest businesses in Mecklenburg-Vorpommern are the ferry operator Scandlines AG, the NETTO supermarket chain, the shipbuilders Aker MTW Werft, Volkswerft Stralsund GmbH and Aker Warnow Werft GmbH, the Energiewerke Nord GmbH and the shipping company F. Laeisz GmbH.

Tourism
Mecklenburg-Vorpommern is among the top three destinations for inner-German tourism. The main tourist regions are:
  • Islands: Rügen and Usedom
  • Peninsula: Fischland-Darß-Zingst
  • Seaside towns: Heiligendamm, Graal-Müritz or Kühlungsborn
  • Cities: Stralsund and Wismar, both listed as UNESCO World Heritage Sites, Rostock or Greifswald which have a large cultural heritage.
As a relic of the past, nearly 2,000 castles, palaces and manor houses exist in Mecklenburg-Vorpommern, many of which function as venues for public events like concerts and festivals.
 
  
Notable people:
  • arts and film: Ernst Barlach, Friedrich von Flotow, Caspar David Friedrich, Marianne Hoppe, Till Lindemann, Philipp Otto Runge
  • business: Ernst Heinkel, Carl Heinrich von Siemens, Georg Wertheim
  • literature: Ernst Moritz Arndt, John Brinckman, Hans Fallada, Walter Kempowski, Fritz Reuter, Rudolf Tarnow, Ehm Welk
  • politics: Ernst Moritz Arndt, Dietmar Bartsch, Egon Krenz, Helmuth von Moltke the Elder, Harald Ringstorff, Angela Merkel, Joachim Gauck
  • science: Theodor Billroth, Friedrich Chrysander, Walther Flemming, Gottlob Frege, Otto Lilienthal, Gustav Mie, Ferdinand von Mueller, Paul Pogge, Heinrich Schliemann, Johannes Stark
  • sports: Tim Borowski, Andreas Dittmer, Thomas Doll, Marita Koch, Toni Kroos, Jan Ullrich, Jens Voigt, Sebastian Sylvester
If our article peaked your interest about this lovely German state, why don’t you check out our job-offers here at: www.MeJobs.eu and you’ll be one step closer to working as a doctor in Germany!

Germany – Small Cities with a lot to offer!

Friday, May 30th, 2014

As a healthcare recruiting firm, we often come in contact with young candidates willing to relocate in Germany but mostly target large cities such as Munich, Berlin, Cologne, Stuttgart, etc. and refuse to even think about settling in a smaller city. 

Coming from eastern Europe, it is understandable that some people think that smaller towns = no opportunities and no modern commodities because in some countries this is a reality. In Germany on the other hand, smaller cities have a lot to offer and offer even more than one might expect!

If you drive through Germany and explore its cities and towns, you will experience that many cities are scattered throughout the country. There are however large German cities like Berlin, Hamburg, Munich and Cologne, as well as a lot of towns and villages.

Germany has about 82 million inhabitants. In the largest city, Berlin, live however only about 3.4 million inhabitants. In other words, the German way of life is a bit different to some other countries on earth where most people live concentrated in huge cities.

There are countries in which it seems as if humans would almost flee into the large cities. Germans dare to live comfortable and calm. There is sufficient stress during the day so it’s good to relax in the evening, in a calm environment.

Germany is remarkable for its attractive smaller towns and cities, scattered like gemstones around the country. In these historic hamlets, many of them located less than an hour’s train ride from a major metropolis, you ‘ll find a very different Germany, brimming with the flavors of the past

  • An easy daytrip from Hamburg, lovely Lübeck epitomizes the maritime culture and redbrick architecture of northern Germany. So many architectural gems are located here that the entire Old Town is a UNESCO World Heritage Site – a place judged to be of exceptional cultural value.
  • Weimar, in eastern Germany, was a cradle of the German Enlightenment of the late 18th and early 19th centuries. This small unspoiled town was home to Goethe and Schiller, among others, and provides a glimpse into 18th-century German life and culture.
  • Rothenburg ob der Tauber, a major highlight among the Romantic Road, it is a walled medieval city loaded with picturesque charm. You can walk along the old city walls of this perfectly preserved gem and stroll down streets that haven’t changed much in hundreds of years.
  • A stop on the Romantic Road or an easy daytrip from Munch,Augsburg is full of historic panache and architectural surprises, including Renaissance-era palaces and the oldest almshouse in Germany.
  • Located in the Bavarian Alps near Neuschwanstein Castle, Füssen invites you to stroll along its cobblestone streets past stone houses and a rushing mountain river.
  • One of the most sophisticated spa towns in Europe, Baden-Badenoffers an extraordinary range of spa treatments during the day and elegant gaming rooms at night.
  • Heidelberg, an old university town on the Neckar River, enchants visitors with its romantic setting, historic streets, and enormous castle.
  • Quedlinburg: Spared in part from the ravages of World War II, this town in the Harz mountains still evokes the Middle Ages with its, 1600 half-timbered buildings, more than any other town in the country. Named a UNESCO World Heritage Site, Quedlingburg is a gem of yesterday and was an imperial residence for 2 centuries.
  • Meissen, situated 25km north of Dresden, this is a romantic little town built along the banks of the River Elbe. It’s celebrated for its porcelain, which carries a trademark of two crossed blue swords and is valued by collectors the world over. Even without its porcelain factory, the town merits a visit for its quiet charm, its old buildings, and its 15th-century castle.
  • Dinkelsblüh, situated along the Romantic Road, it is not as grand as the more celebrated Rothenburg, it has fewer tourists and therefore retains more old-time charm.
  • Mittenwald, has long been celebrated as the most beautiful in the Bavarian Alps, with magnificently decorated houses, painted facedes and ornately carved gables. In the mid-17th century, it was known as “the Village of a Thousand Violins” because of the stringed instruments made here.
  • Lindau, dates back to the 9th century, this former free imperial town of the Holy Roman Empire is like a fantasy of what a charming Bavarian lakeside village should look like. This garden city under landmark protection is enveloped by aquamarine waters, and one part of it is known as the Gardenstadt because of its luxuriant flowers and shrubs.
  • Rüdesheim, is the most popular wine town in the Rhine Valley, being set along the edge ot he mighty river. Rüdesheim is known for its half-timbered buildings and its Drosselgasse, a narrow cobblestone lane stretching for 180m and lined with wine taverns and cozy restaurants.
  • Cochem, is an idyllic medieval riverside town situated in the wine country on the banks of the Mosel river. It is famous for its towering castle, dating from 1027. On the left bank of the Mosel, Cochem lies in a picture-postcard setting of vineyards. Little inns serving a regional cuisine along with plenty of Mosel wine make Cochem a highly desirable overnight stop and a nice alternative to the more commercial centers found along the nearby Rhine.

Adding my personal opinion to this article I have to state that the charm, history and romance of the smaller cities and towns in Germany have captured my heart and imagination.

If our article has sparked your interest you are more than welcome to apply for a job at info@MeJobs.eu

EGV Recruiting

 

Weird stepstones into modern medicine

Thursday, February 20th, 2014

Browsing trough the internet we stubled upon an interesting blog posting interesting and disturbing pictures of early medical devices, strange medical conduct (according to today’s standards) and things that for today’s doctors would just seem weird and creepy.

Brain hemorrhage, post-mortem

Corset damage to a ribcage. 19th century London

Dr. Kilmer’s Female Remedy

 

Tanning babies at the Chicago Orphan Asylum, 1925, to offset winter rickets

Woman with an artificial leg, too embarrassed to show her face c. 1890 – 1900

Wooden prosthetic hand, c. 1800

Selection of some items used to disguise facial injuries. Early plastic surgery.

Blood transfusion bottle, England 1978

Dr. Clark’s Spinal Apparatus advertisement, 1878

Neurological exam with electrical device, c. 1884

Antique prosthetic leg

US Civil War surgeon’s kit

“Walter Reed physiotherapy store” 1920’s

Boy in rolling “invalid cart” c. 1915

Obstetric phantom, Italy 1700-1800. Tool to teach medical students and midwives about childbirth

Radioactive yummies

Lewis Sayre’s scoliosis treatment

Claude Beck’s early defibulator

Antique birthing chair used until the 1800s

Anatomical Model. Doctors were not allowed to touch the women’s bodies, so they would point to describe pain locations

Radiology nurse technician, WWI France 1918

1855 – 1860. One of first surgical procedures using ether as an anesthetic

Masks worn by doctors during the Plague. The beaks held scented substances

 

Regardless, these pictures represent evolution. Who knows, maybe in 100 years, people looking at pictures from today’s medical conduct will react the same as we do to these pictures. What do you think?

 

Source of the article here: http://imgur.com/a/QagTz 

 

Health and ageing

Friday, October 18th, 2013

Hamburg: Since the 1960s, the life expectancy in most European countries has risen with 11 years. Still, most European citizens (60%) over 65 have at least 3 chronic diseases.

Thus since 2007, the Ministry of Education and Research emphasizes on the importance of a healthy ageing process.

“The research conducted aims to educate and help with the early recognition of potential threats to the state of health of an individual. Prevention should be a priority.” Stated Johanna Wanka, the Minister of Education and Research.

This approach aims to have the individual in the center of attention and should be aiming to provide a longer disease-free life and not a longer life with disease.

What makes the UK unique (part 3)

Tuesday, September 24th, 2013

Yep, part three of “What makes the UK unique”!

 

7. Visit London for a day:

London is one of the most visited cities in the world and is renowned for many things, obviously the House of Parliament, Big Ben, the London Eye, the Tower of London….

Another thing that puts London in the center of the map is shopping! Here one can buy anything from the latest fashion to tid-bits at the infamous Camden market. The many tourists that visit London often travel to see the same places every time, however if you look a little deeper you will be able to find a lot more than what meets the eye.

It is advisable to plan your journey ahead before arriving in London, not just because there is so much to see, but also because it can be quite daunting when visiting for the first time. If it is the first time in London, then I’d highly recommend visiting both the Big Ben but also Oxford Street for plenty of opportunities to buy the latest fashion or even a souvenir to remember the trip!

 

8. Be a spectator at the Silverstone Grand Prix:

Silverstone is one of the world’s hottest Motor Sport destinations in the whole of the UK. It is home to many various racing events, but the most famous of these it the Silverstone Formula One Grand Prix. This is really a day out for those of you that are petrol heads but can be enjoyed by the whole family if you feel inclined to take them with you.

So what can you do here? Well obviously you will be able to see some of the greatest racing machines in history, rushing past you at lightning speeds, driven by some of the most famous drivers in history.

The racetrack is also a great party atmosphere where one can camp over night between the two races (qualifications and the race).

 

9. Visit the Ancient Monument of Stonehenge:

Stonehenge is one of the most visited in-land attractions in the United Kingdom. It is shrouded in mystery and has been the source of many theories over the past few centuries. Stonehenge itself is actually a prehistoric structure which is in the country of Wiltshire and to this day archeologists still quarrel over the nature of this creation and when it was built.

Stonehenge is more than just a structure or monument. It is a reminder of the history surrounding the area and it is a tribute to those who actually built this amazing man-made monument. The surrounding areas have also been known to reveal Roman artifacts: coins and even remains overt the past few centuries.

It’s amazing that Stonehenge has even survived till today. Visiting Stonehenge will certainly be a memory that will last forever.

 

Did these facts made you consider not only visiting the United Kingdom but also the possibility of working in the UK?

Are you an experienced doctor?

Would you consider working as an RMO in the UK?

Than check out our job offers here and don’t forget to apply!

Smartphones want to dethrone the doctor

Tuesday, May 21st, 2013

Smartphones want to dethrone the doctor

 

Electrocardiogram, urinary test, analysis of a nevus. These analyses can soon be made within a few seconds.

Do I have to make an appointment at the doctor? As the medical systems are more and more lacking of doctors, the problem has taken a new dimension.  On the basis of the lack of doctors and the spectacular technological advancements, new tools appear on the market. These products filled with miniature sensors, connected to smartphones, promise to replace the doctors, at least partially. Innovations which fascinate, calling into question the limits of technology.

The exponential success of the smartphones is the main vector of these innovations. ˝The iPhone has an advantage: it is always at hands ˝, explains thus to the Figaro David Sullivan, the owner of AliveCor, a Californian start-up who has been commercializing for a few months a new electrocardiogram incorporated in a phone shell. The tool, easy and simple to use, has been validated in December by the FDA, Food and Drug Administration, and obtained the CE label from the European Union, where it should be available in the current year at the price of 199 $ (about 150 euros). The patient has only to hold the object in two hands pushing on the sensors, the result appears within 30 seconds. It can be then stocked or sent by e-mail to one´s doctor. Soon, an application should even issue a short analysis of the results. Sold at the moment on the basis of a prescription – but AliveCor hopes to quickly obtain the green light for its free sale. The aimed clients are both the non-cardiologist doctors who wish to equip themselves at a lower price to ward the emergencies, and the private individuals. ˝The patients who have already suffered an infarction might worry when feeling a pain. The AliveCor ECG allows them to get quickly reassured˝, explains David Sullivan.

» Demonstration of the AliveCor ECG usage, which might function without network:

The miniaturization of the sensors has also opened the way to the multi-functional tools, as the Scout de Scanadu, another start-up of the Silicon Valley. This small flat and round case which is applied on the forehead measures several ˝vital constants˝ (blood pressure  temperature, saturation of oxygen, pulse…) and treat them on an associated application. ˝We think this tool could be very useful to the families with several children˝ explains the co founder Lounis de Brouwer. The putting on sale of the product is foreseen for the end of the year and the procedures to obtain the green light from the FDA are in progress.

 

Educate the patient

The company prepares as well the launch of Scanaflo, an application associated to a urinary test which must allow to the patient to test oneself for tens of pathogens (gestationel diabetes, pre-enclampsia, urinary infections, kidney dysfunction…). We could still mention the otoscope from CellScope Inc. which allows to inspect the ear canal and read the results on one´s smartphone, reader of photos of nerves to evaluate the risk of melanoma…

For Denise Silber, consultant in digital health, these technologies innovate through the instantaneousness of results, but they wouldn’t meet their public unless their quality is validated. The founder of the annual Parisian congress Doctors 2.0 & You is however skeptical concerning the welcome of these technologies in France. ˝In the USA, where the consultations cost more than 100 dollars, spending 200 for this kind of tool might be interesting. But in France, where the consultation is nearly free of charge for the insured individual, this is different˝. Besides, stresses she, these products are cutting down on a domain reserved only to the doctors so far, the diagnosis. ˝In there resides its added value˝.

At the National Medical Chamber, Dr. Jacques Lucas, delegated to the systems of health information, appears also cautious. ˝The permanent supervision which authorizes these innovations might be counterproductive if it develops the hypochondria. But these tools might be beneficial if they go with the education of the patients, in particular on the limits of the device˝. These tools might be then prescribed by the doctors. The idea is to enrich the exchange of patient-doctor and not to interrupt it…

 

Source of the article

Why women live longer than men

Friday, May 17th, 2013

 A recent study conducted by medical specialist in Japan, underlines the fact that women have a longer life expectancy in comparison to men and the main cause of this is the fact that the female immune system ages at a slower rate than the immune system of men.

The study was conducted on over 356 healthy volunteers and was basically based on blood analysis from healthy male and female suspects with ages ranging from 20-90.

The researchers have tested the blood taken from the volunteers analyzing the white blood cells level and the quality of the immune system.

Men and women alike lose white cells as time goes by the study shows that men tend to lose them faster, thus the decay of the immune system occurs faster in men than in women. The mechanism of the immune system is responsible not only for the prevention of infections and cancer but also protects the individual of certain inflammatory diseases.

“The process of ageing differs a lot from men to women for certain reasons. Women have more estrogen than men. This protects women from cardiovascular diseases till menopause. Because of the fact that people age differently, the parameters of the immune system can be used to establish the body’s biological age,” States the coordinator of the study, Katsuiku Hirokawa.

Regarding to the life expectancy, Romania occupies no. 41 for men and no. 37 for women in a poll consisting of a total of 53 countries, with a life expectancy of 70.2 years for men and 77.6 for women. In Japan where the study is conducted, the life expectancy for men is at 79 years while for women it is at 85. In Great Britain the life expectancy for men is at 79 and for women at 82 years, according to the World Health Organization.

 

Source of the article here

Victorian Medicine – From Fluke to Theory

Friday, April 19th, 2013

We have come across a very interesting article written by Bruce Robinson highlighting the important leap forward of modern medicine in the 19th century.

I hope you find the article as interesting as we did!

 

 

The effect of urbanisation

It may be harsh to say so, but to the modern eye medical practice in the early 1800s looks pretty medieval. Harsh, because the 17th century had seen important breakthroughs in the fields of pathology, obstetrics and vaccination that would be built upon in the next century.

The foundations were laid, but there was more to be done. Medicine in 1800 was a scary combination of chance and quackery that Blackadder would have found familiar. Macbeth-like medicines were overwhelmingly botanical, with preparations of mercury, arsenic, iron and phosphorous also popular. Doctors might recommend a ‘change of air’ along with vomiting and laxatives and those old favourites, bleeding or leeches. The power of prayer was regularly used. All in all, not ideal. Yet a century later medicine would be available in a form easily recognisable to anybody today: hospitals, stethoscopes, white coats and x-rays. What happened?

Two things. Together, cities and science forced real progress in both prevention and cure. The Industrial Revolution was in full flow, and the invention of the steam engine meant that factories could go anywhere, not just near natural power sources. They went to the towns and cities. At a time when Britain’s population was increasing rapidly (from six million in 1750 to nine million 50 years later), cities were expanding even faster as now redundant farmworkers migrated to the nearest town to find work. Preston grew sixfold between 1801 and 1851, Bradford and Glasgow eightfold. They were not alone.

This growth had enormous consequences. Death rates were high, and far worse in cities than in the countryside. Smallpox, typhus and tuberculosis were endemic, and cholera alarmingly epidemic. Overcrowding combined with poor sanitation and often grinding poverty to leave many people vulnerable to the latest outbreak of anything nasty. Luckily, the Victorians loved statistics, and these validated the emotive prose of Dickens, Gaskell and Engels. In 1832 Parliament agreed to an official inquiry into the operation of the Poor Laws. Sir Edwin Chadwick was energetic in establishing the links between poverty and disease, and the enquiry resulted in new Poor Laws in 1834. Yet these did not go far enough and continued work resulted in the Public Health Act of 1848, which set up local health boards, investigated sanitary conditions nationwide, and established a General Board of Health.

The appliance of science

Another breakthrough came with the cholera epidemic of 1854. John Snow had experienced previous outbreaks in 1832 and 1848, and was convinced that it was a water-borne disease. This time he provided conclusive proof by mapping out the cases in Soho, central London, implicating a single, contaminated well. The epidemic subsided soon after the pump’s handle was removed. Snow also analysed cholera’s incidence in water that was bought from different suppliers, demonstrating that households buying from companies drawing water from the Thames downstream – after many sewers had flowed in – suffered a deathrate 14 times greater than those buying water from companies drawing upstream. Following on from this research, he recommended boiling water before use.

John Simon, who had replaced Chadwick to become chief medical officer to the General Board of Health, turned this work into action. He successfully diverted public funds into the investigation of communicable diseases – including diphtheria, typhoid and smallpox – and in the 20 years to 1876 oversaw the transition from the state’s mere involvement in reform to a state system of medicine. Having gained some political influence, he found he was able to influence new health legislation. The 1875 Public Health Act comprehensively encompassed housing, sewage and drainage, water supply and contagious diseases and provided Britain with the most extensive public health system in the world. Prevention of disease had come a long way.

Progress in this area was being matched by scientific breakthroughs in both diagnosis and cure. The stethoscope – invented in 1817 – was being widely used in Britain by mid-century, and microscopes had improved sufficiently to allow examination of micro-organisms. The practice of surgery also modernised with the invention of anaesthesia in the late 1840s. Although ether was initially used, chloroform soon became the anaesthetic of choice.

Breakthroughs

Louis Pasteur at workLouis Pasteur’s work from the late 1850s proved that the souring of milk was caused by living organisms and, by verifying the ‘germ theory’, changed pathology and surgery forever. Pasteur’s work led ultimately to the introduction of antiseptic procedures into surgery via Joseph Lister. Infections and deaths fell sharply and, combined with anesthesia, enabled surgeons to operate more slowly, carefully and confidently on patients, in turn reaping new discoveries.

The end of the century saw yet more breakthroughs. Robert Koch built upon Pasteur’s work and in 1882 identified the organisms causing tuberculosis, prompting extensive public health campaigns. But the sexy stuff was tropical disease, increasingly important with the ever-expanding Empire thrusting young Brits into unfamiliar climates. In 1898 Robert Ross proved the mosquito’s role in transmitting malaria, and in the same year the Spanish American War prompted new research into yellow fever.

Most dramatic, however, was the X-ray, discovered in Germany in 1895. Within days, the news had crossed the world. Sales of X-ray proof underclothing for ladies followed soon afterwards. In January 1896 the first X-ray was taken for clinical purposes, and they were soon used to diagnose fractures, locate foreign bodies and treat a variety of skin conditions. Radiation followed in 1896, and with it the promise of treatment for dreaded cancer. Medicine in 1900 was truly far removed from that 100 years earlier.

Medicine institutionalised

Florence NightingaleIt wasn’t just prevention and cure that was changing, but also medical institutions. The 7th International Medical Congress in 1881 – with 3,000 delegates from 70 countries – gave medical practice a new pizzazz; a new big thing for a country that had had a crush on commerce and technology for the previous century. The death of Alfred Nobel in 1896 gave rise to the Nobel Prizes, with three of the five awarded for science: chemistry, physics and medicine. From the earliest stages Nobel prizewinners became big news.

Institutes and prizes were the most glamorous face of a medical world that was becoming increasingly adult. Regulation of medical practice had begun with the establishment of the British Medical Association in 1856 and the General Medical Council in 1858. Medical training became more formalised with the establishment of medical schools, and the number of doctors rose considerably, from 14,415 in 1861 to 35,650 in 1900.

However, women remained largely unwelcome in the medical world. The exception to this was nursing. Although nurses had been active in hospitals long before she appeared on the scene, Florence Nightingale’s exploits in the Crimean War (1854 – 6) gave the role a new respectability. Many of the nursing reforms she advocated already existed, but her training school at St Thomas’s Hospital provided a model for many. Nursing enjoyed a reflected glory and, with teaching, became one of the few occupations a middle-class girl might contemplate.

The emergence of modern nursing coincided with changes in hospitals. While initially hospitals just stuck in more beds, newer hospitals were being built. These were often more specialist in orientation, providing treatment for certain patients (eg children), body regions – like ear, nose and throat – or diseases, such as cancer. Funding became an increasing problem and hospitals began to take richer, fee-paying patients to subsidise others.

Significant changes

Meanwhile there was increasing specialisation within the medical profession. This had happened in Germany for some time, but had been resisted by many in Britain as ‘unnatural’. The growth of psychiatry in particular proved very controversial, with many labelled as ‘mad doctors’. However, over time coherent professional psychiatric groups emerged and gained a certain level of respectability, helped by the work of Sigmund Freud at the end of the century.

Marie CurieSo medicine in 1900 had seen significant changes from a century before. Scientific discoveries had given medicine new impetus, and a patient seeking care around this time would have had access to new diagnostic procedures and new technologies. Surgery had undergone massive change, with practitioners now working in gowns, masks and the other accoutrements so familiar from TV today. Doctors had started wearing white coats and stethoscopes, and were able to bask in the reflected glory of scientific pioneers such as Marie Curie.

However, it doesn’t do to exaggerate. Death rates had decreased, but only marginally, from 20.8 per thousand in 1850 to 18.2 in 1900. All else being equal, however, increasing urbanisation would have been expected to increase these. For every disease on the wane – such as smallpox and cholera – another was on the up, including alcoholism and venereal diseases. Many inner city areas still experienced appalling conditions: a high percentages of potential recruits for the Boer War, and for the Great War of 1914 – 18, had to be rejected on medical grounds. Yet advances in public health, science and institutions had taken medicine into grounds of expertise and professionalism few would have expected 50 years earlier. You’d be a lot happier going to the doctor in 1900 than in 1800.

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