Modern Medicine, c.1900-Present

Question 1

What new focus began after knowledge of disease increased?

Answer 1

The search for ways to prevent people getting diseases and to cure those who already had them.

Question 2

What were magic bullets?

Answer 2

Chemical cures for diseases for example:
1) Ehrlich discovered Salvarsan to cure Syphilis in 1909
2) Prontosil worked against germs that caused blood poisoning.
3) Sulpha drugs were developed to cure or control meningitis, pneumonia and scarlet fever.

Question 3

What happened with Staphylococcus by the 1920s?

Answer 3

It was highly resistant and remained undefeated by any magic bullet. Staphylococcus could cause food and blood poisoning.

Question 4

Why was Fleming determined to find a better way of treating wounds?

Answer 4

He had seen first hand during WWI the effects of the Staphylococcus germ.

Question 5

How did Alexander Fleming discover penicillin?

Answer 5

In 1928 he went on holiday and left several plates of Staphylococcus germs on a bench in his lab, when he returned he noticed a large blob of mould in one of the dishes.

It turned out that this mould killed the Staphylococcus and that it was penicillin mould.

Question 6

What did Fleming original decide penicillin was?

Answer 6

A natural antispetic because he never used pencillin on infected nimals and therefore did not show that it could kill infections, there was littel interest in his work at the time.

Question 7

What it Howard Florey and Ernst Chain do for Penicillin?

Answer 7

In the 1930s they tested pencillin on 8 mice and the humans over a period of months. They produced enough penicillin to treat a patient with a bad infection, once the patient was injected with penicillin, the infection began to clear up.

However, the patient died when the pencillin ran out. They were showing it could treat infection, but now needed to mass produce it.

Question 8

How did Florey and Chain mass produce penicillin?

Answer 8

In June 1941, Florey met with the US government who agreed to pay several huge chemical companies to make millions of gallons of penicillin as it was vital in treating soldiers with infected wounds.

As soon as the war ended drug companies made penicillin available for public use.

Question 9

How many soldiers were treated with penicillin by the end of WW2 in 1945?

Answer 9

250,000

Question 10

How did the pharmaceutical industry develop and why?

Answer 10

After penicillin’s discovery government sponsored programmes to develop and produce it meant that the industry had both finance and technology to research and develop medicines for all sorts of diseases.

Question 11

What is the estimated woth of the pharmaceutical industry today?

Answer 11

£200-300 billion and employing nearly 80,000 people in the UK alone as of 2018.

Question 12

What was the impact of pencillin?

Answer 12

1) 15% of wounded British and US soldiers would have died WITHOUT pencillin.
2) Thousands of injured soldiers returned to service quicker
3) After WW2, Penicillin was classified as an anti-biotic and went on to save millions of lives.
4) Other antibiotics followed: streptomycin (1944) which treated TB, tertracycline (1953) treated skin infections and mitomycin (1956) has been used as a chemotherapy drug.

Question 13

Key developments in the science of the body and disease after 1945:

Answer 13

1953 - Stem cells discovered and in 2013 the first human liver was grown from stem cells

1953 - Crick and Watson map out the DNA structure; understanding DNA leads to developments such as gene therapy, genetic screening and genetic engineering.

1970s and 1980s - CAT scanners that produced 3D images of the body developed in 1973. Endoscope probes that allowed doctors to see inside the body in 1975 and in 1987 the MRI Scan developed.

Question 14

Key developments in surgery after 1945:

Answer 14

1950 - first open heart surgery to repair a ‘hole’ in a baby’s heart; first pacemaker is fitted in 1958, followed by the first heart transplant in Britain in 1968

We can now transplant livers, kidneys, pancreases and bone marrow.

1952 - minature hearing aids.

1972 - hip replacements

1984 - skin grafts become common, working off the original work of Harold Gillies in World War 1

Question 15

Key developments in the treatment of disease after 1945:

Answer 15

1946-1968: Free vaccines available in the UK for: TB, diphtheria, whooping cough, tetanus, polio, measles and rubella (German measles).

1957 - the drug thalidomide is developed in Germany and used to treat morning sickness, but it causes terrible deformities in babies creating the thalidomide crisis.

1970 - a British scientist develops the drug cyclosporine which prevents the body from rejecting transplanted organs.

1978 - doctors use IVF fertility treatment to help childless women become pregnant.

Question 16

How did war aid in medical developments in the 20th century?

Answer 16

• Two world wars meant that governments spent a fortune on research and resting drugs and surgical techniques
• Doctors had to find better ways to treat casualities too
• Doctors had an abundance of casualities to practice on and develop new techniques on.

Question 17

How did technology aid in medical developments in the 20th century?

Answer 17

• New tech like keyhole surgery and MRI scanning helped doctors and surgeons to develop new techniques for identifying illnesses and operating on them.
• Discoveries, such as understanding more about DNA helped gene researchers find specific genes involved in diseases.

Question 18

How did changing attitudes aid in medical developments in the 20th century?

Answer 18

Modern politicians have realised that one of their main priorities is to help and protect the people they serve. Moving away from a laissez-faire attitude i.e. healthy eating standards in schools and couch to 5k programmes.

Question 19

How did Government and Finance aid in medical developments in the 20th century?

Answer 19

• Governments spend far more money on research and care than ever before.
• Drug companies spend huge amounts on research and development, hoping to make money from cures.

Question 20

How did Communication aid in medical developments in the 20th century?

Answer 20

• New ideas spread rapidly due to the increased use of television, news media and the internet
• Television and radio advertisements have made more people than ever before aware of health risks

Question 21

How did Individuals aid in medical developments in the 20th century?

Answer 21

• Crick and Watson
• Alexander Fleming
• Florey and Chain

Question 22

What issues have come from antibiotics?

Answer 22

Overuse of antibiotics has led to some bacteria evolving to become increasingly resistant to common antibiotics. An example is MRSA first reported in a British study in 1961.

Question 23

What are some alternative treatments that have occurred?

Answer 23

• Acupuncture
• Hypnotherapy
• Aromatherapy

Question 24

What is ‘positive health’?

Answer 24

The idea of prevention rather than cure i.e. people learning about healthy deits and regular exercise to prevent issues like obesity and heart disease as well as regular screenings such as cervical cancer screenings and breast and lung cancer screenings to spot early signs of serious illness.

Question 25

What happened to medicine during wartime?

Answer 25

Medicine and surgery developed at a greater rate during wartime than peace time.

Question 26

Why did medicine develop at a greater rate during wartime?

Answer 26

1) Governments spend a lot of money on the development of medical techniques and echnologies
2) Governments know that if medical services are good, then more soldiers survive; the more soldiers available to fight, the greater chance of victory.
3) Doctors and surgeons work very hard in wartime, often in battlefield situation, to develop their ideas in order to threat the injured.
4) Huge numbers of wounded soldiers give doctors and surgeons more opportunities than in peacetime to test out ideas.

Question 27

How and when did X-Rays develop?

Answer 27

Discovered in 1895, hospitals used them to look for broken bones and disease before World War One.

During WWI, proved their effectiveness on the battlefield when mobile x-ray machines were used and developed by Marie Curie.

Allowed surgeons to find out exactly where in the wounded soldier’s body bullets or pieces of shrapnel had lodged - without having to cut him open.

Question 28

How and when did blood transfusions develop?

Answer 28

In 1900, Karl Landsteiner discovered blood groups, which helped doctors to work out that a transfusion only worked if the blood types matched.

Until 1914 blood could not be stored for long, after 1914, Hustin discovered sodium citrate stopped blood clotting.

The British National Blood Transfusion service opened in 1938 and large blood banks developed during the Second World War.

Blood transfusions meant that longer and more complicated surgeries could take place without fear of blood loss and those suffering from blood loss from injuries could be helped.

Question 29

How and when did plastic surgery develop?

Answer 29

Harold Gillies an army doctor set up a special unit to graft (transplant) skin and treat men suffering from severe facial wounds during World War one. He is known as the father of plastic surgery. Although it stemmed from Indian centuries prior, but lack of effective painkillers and knowledge made it dangerous and painful prior to this point.

Queen’s hospital in Kent opened in 1917; by 1921 it provided over 1000 beds for soldiers with severe facial injuries.

During WW2, Archibald McIndoe used new drugs such as pencillin to prevent infection when treating pilots with horrific facial injuries.

Question 30

What other developments occured due to war?

Answer 30

1) Broken bones led to new techniques to repair them usch as the Army Leg Splint/Keller-Blake splint which is still used today.
2) Heart surgery developed in WW2 when US army surgeon Dwight Harken cut into beating hearts and used his bare hands to remove bullets and bits of sharpnel.
3) Diet improved due to war shortages resulting in people growing their own food, people started to eat more fresh vegetables which were much healthier than prior diets.
4) WW2 campaigns warned against the dangers of poor hygiene. A national immunisation programme against diptheria was lunched during the war.
5) By 1944, enough penicillin was produced to treat all the allied forces in Europe.

Question 31

What negative effects did war have on medical progress?

Answer 31

• Thousands of doctors are taken away from normal work to treat casualities
• Some medical research is stopped to concentrate on the war effort
• Warfare can led to libraries and places of learning being destroyed and medical advances may have been delayed by these places being destroyed and manuscripts and research being lost.

Question 32

Why did modern surgery develop?

Answer 32

1) Improved anaesthetics allowed patients to be unconscious for longer, so more complicated surgeries could be attempted
2) Antiseptics increased the success rate of difficult operations because they cut down the chances of a deadly infection occuring.

Question 33

When was the first transplant done?

Answer 33

1952, a kidney was transplanted. For the UK the first was in 1960

Question 34

When was the first open heart transplant and how long did the patient live for?

Answer 34

1967, performed by Christian Barnard. The patient survived for 18 days.

Question 35

When did Calne develop cyclosporine and what did it do?

Answer 35

1970, it prvents the body rejecting transplanted organs

Question 36

Davina Thompson was?

Answer 36

In 1986 the first heart, lung and liver transplant patient.

Question 37

When was the first partial face transplant carried out?

Answer 37

2006

Question 38

When was the first full face transplant carried out?

Answer 38

2008

Question 39

What was the situation for public health in 1900?

Answer 39

By 1900, millions of ordinary Brits were living in desperate poverty.

There was still overcrowded and unsanitary housing in industrial towns.

People still worked long hours for low wages and could not afford decent food or to see a doctor if they were ill.

Question 40

What did Charles Booth’s report ‘Life and Labour of the Poor in London’ say? (1889)

Answer 40

Around 30% of Londoners were so poor that they didn’t have enough money to eat properly, despite having full time jobs.

Showed a link between poverty and a high death rate.

Question 41

What did Seebohm Rowntree’s report ‘Poverty: A Study of Town Life’ say? (1901)

Answer 41

28% of the population did not have the minimum amount of money to live on at some time of their life.

Question 42

What issue was discovered in the Boer War (1899-1901)?

Answer 42

40% of young men who volunteered were unfit for service (to be soldiers), due to poor diet and poverty related illnesses.

A special committee was set up to enquire into the ‘physical deterioration of the people’.

Question 43

What did the 1904 release of the report for the Committee for Physical Deterioration of the People say?

Answer 43

Many men were failing to get into the army because they led such unhealthy lives. This fuelled fear that the unhealthy state of Britain’s workers might lead to the decline of Britain as a great industrial power

Question 44

What did the Liberal party believe/want?

Answer 44

The believed that direct action from the government was the way to improve public health, welfare and the productivity of the nation. In 1906 they wont the general election.

Question 45

What were the key Liberal Reforms?

Answer 45

1906 - Free school meals provided for poor children
1907 - School medical service set up - free medical inspections, followed later by free treatment
1908 - Children and Young Person’s Act introduced; children become ‘protected persons’ which means that parents break the law if they neglect children.
1908 - Old age pensions are introduced, piad for by national tax.
1909 - Britain’s first job centres are built
1911 - National Insurance Act introduces unemployment benefit (‘the dole’/’benefits’), free medical treatment and sickness pay.

Question 46

What did the Beveridge Report say and when was it?

Answer 46

In 1942, this report by William Beveridge said:
That people had a right to be free of the ‘five giants’ that could ruin their lives:
1) Disease
2) Want/Need
3) Ignorance
4) Idleness
5) Squalor (very poor living conditions)

The report suggested ways to improve quality of life and that the government should take charge from ‘cradle to grave’.

Question 47

What were the five giants?

Answer 47

1) Disease
2) Want/Need
3) Ignorance
4) Idleness
5) Squalor (very poor living conditions)

Question 48

Why did the labour party led by Attlee win the election after WW2?

Answer 48

Promised to follow Beveridge’s advice and setup the welfare state to look after the sick, the unemployed and children.

Question 49

What was the Welfare State?

Answer 49

1948 - The National Health Service (NHS) began to provide free health treatment for everyone

A weeklyfamily alloance payment was given to help with childcare costs.

The very poor received financial help or ‘benefits’.

More slums were demolished and new houses built. 12 new towns were created. By 1948, 280,000 council homes were being built each year.

Question 50

Who introduced the NHS?

Answer 50

Aneurin Bevan (Labour Minister for Health)

Question 51

What opposition was there to the development of the NHS?

Answer 51

Doctors who did not wish to come under government control or lose income. They were won over by being promised a salary and allowing them to treat private patients as well.

Question 52

What changes were made to the NHS, when and why?

Answer 52

In 1950 the budget was under pressure and in 1952 charges for spectacles/glasses were introduced, prescriptions now cost 1 shilling and dental treatment £1. The NHS was no longer completely free due to high pressure and demand and still is not today.

Question 53

What issues are there in the 21st century with healthcare?

Answer 53

• Aging population - due to modern medicine people are living longer and older people use the NHS more than younger people.
• Smoking, drinking, poor diets - these have let to healthy eating campaigns and new laws to prevent disease such as banning tabacco advertising in 2005.