Mock Flashcards
Picture 8 marks
. On the floor lies a bag of surgeons’s instruments. The bag of surgeon’s tools clearly includes a large bone (a thigh bone or femur from a previous operation - bag’s contents are spilled over the floor suggesting carelessness?
. A skeleton raises its hand to its head in exasperation in the background and a poster hangs on the wall listing the names of ‘Examined and Approved Surgeons.’
. In 1811 the regulations insisted that to be a surgeon you had to attend at least one course in anatomy and one course in surgery. In 1813 it was further decreed that to be a surgeon you mush have a minimum of one year’s experience in a hospital. The world of the surgeon was becoming more regulated.
. Bowl to catch the blood as it pours out and no tourniquet has been applied, This has been omitted on purpose and is thereby passing very critical judgement on the surgeon’s competence.
. Not as useful as surgery is usually a last resort and the leg the surgeon is cutting doesn’t seem to be particularly in need of amputation as it is being bent powerfully
. The victim is held by a strong attendant and his left leg is tied by a rope to the leg of a chair.
. No concern is being shown for the patient. The man at the back even uses the patient’s head for support so that he can get a better look.
. At that time, 1785, there was no form of anaesthetic or antiseptics,
. Until Louis Pasteur’s pioneering work on germ theory in the 1850s, surgeons left wounds unprotected. They reused bandages and rarely washed their hands or surgical equipment before operations.
. Operations during the early modern period were dangerous and were carried out as quickly as possible. This was because the longer the operation was performed the less chance there was of surviving it. William Cheselden, of St Thomas’ Hospital in London was known for his speed and dexterity. He was able to remove a stone from the bladder in less than a minute.
NHS P 1
. Start of World War Two the government realised that, if it was to cope with the huge number of anticipated casualties, it needed to increase spending on healthcare
. Began to plan for the future.
. 1942 William Beveridge Beveridge Report - five evil giants
. Were a barrier to progress
. Proposed a free national health service
. 1946, the new Labour government passed the National Health Service Act which was led by Minister for Health Aneurin Bevan
. 5 July 1948
. Part of a series of reforms which aimed to use money from taxes to provide support from the cradle to the grave.
. Introduced free medical treatment for all British citizens
. Nationalisation of hospitals under the Ministry of Health and organised into regional health authorities.
. Creation of health centres provided services like vaccinations, maternity care, district nurses etc.
. A better distribution of doctors around the country with GPs, opticians and dentists in every area.
. Up until 1948 about eight million people had never seen a doctor
. People were known to rush out to get free wigs, free false teeth and glasses, didn’t want to miss out.
NHS P2
. Healthcare accessible to all
. Life expectancy has increased since 1948 from 66-83 for women and 64-79 for men
. Continuing reduction in child mortality and in maternal mortality.
. Major medical breakthroughs in many areas, eg transplant surgery, cancer treatment etc.
. Wide range of services has been made available, eg cancer screening, asthma clinics etc.
. Increasing emphasis on preventive medicine, eg mass vaccination against a variety of illnesses and health campaigns, eg to reduce smoking
. Reduce the pressure many women felt as main carers
. 1952 prescription charges
Hospitals P1
. In 1700s, specialist hospitals were developed
. St Luke’s Hospital was built in 1751 for the mentally ill, Lock Hospital in London was built for people with STIs. Maternity hospitals were also built at this time.
. Thomas Coram started the Foundling Hospital in 1741; it cared for orphaned children by giving them a clean environment, clothing, and a simple education until the age of 15
. In response to a huge social issue of the day-the number of abandoned children and high death rates amongst them.
.. Middle Ages Islamic world in the 1100s, Baghdad alone had 60 bimaristans (hospital) - at a time when London only had one hospital
. Served all people regardless of race, religion, class or gender, with separate wards for different illnesses - mental illness, contagious diseases, non-contagious diseases, surgery and eye diseases.
Hospitals P2
. Though the royal endowments of land were given in the 18th century not that generous and the hospitals were always short of money.
. Medieval times government did not believe it was their responsibility to help the sick and poor.
. In the 18th century in Europe admission was restricted and the medical care available was limited and possibly sometimes counter-productive
. Monks who ran medieval hospitals had only basic medical knowledge
. Certain people were excluded, eg those with contagious diseases, lepers, cripples and the insane. It was felt that they would infect the others.
. Main beliefs about the causes of disease were still based on the Four Humours and treatments were based on bleeding and purging.
. No understanding that bacteria caused disease, no antiseptics
Individuals
. Louis Pasteur + Robert Koch’s work in bacteriology helped to identify thousands of different types of germs and led to the development of the magic bullet by his student, chemical compounds that were able to fight off specific diseases.
. Robert Koch was driven by his personal interests and ambitions as well as his rivalry with Louis Pasteur, who first discovered the germ theory, and then a vaccine to chicken Cholera.
. Louis Pasteur (1822-95) was French chemist and biologist who was investigating why wine and beer often went sour.
. Before the germ theory people believed in Spontaneous generation.
. He identified the specific microbe responsible for souring wine, and showed that heating it to the right temperature could kill all the microbes.
. He proved that germs did not come alive on their own.
. Bacteria, or germs, were the cause and that it was a biological process.
. Jenner developed the cure for small pox.
. Vaccination is when a small dose of a weakened disease is injected into a patient to develop the patient’s immune system to prevent them from getting the disease.
. Edward Jenner invented the concept of vaccination in 1798
. Jenner made his discovery through careful observation, experimentation and testing to prove his theories.
Government
. Governments funded the work of both Pasteur and Koch to help develop the germ theory and ultimately the vaccinations and treatments for diseases.
. Parliament thought Jenner’s work was very significant and he was given a grant of £30,000 to open a vaccination clinic in London.
. Initially people rejected Jenner’s discovery until the government made it compulsory in 1852 where the disease was eradicated in 1980.
Science and technology
. None of the new research possible without the development of the microscope, which allowed scientists to see images of bacteria.
. X-Ray machines made a big difference to how diseases were treated.
. X-rays were discovered by accident, in 1895 by Wilhelm Roentgen
. Enabled doctors to see inside patients to aid diagnosis
. Edison and Eastman invented glass plates and X-ray film which made the invention even more accurate
.. Between the wars scientists developed radiotherapy to target cancerous cells to avoid invasive surgery.
. Laser surgery has replaced scalpels in some surge
. First used in an eye surgery in 198
. Used to help skin conditions, clear blocked arteries, remove tumours and ulcers and control bleeding.
Conclusion
. Individuals were the main factor
. Without them the diseases themselves would not have been identified
. Whilst the government funded the research and science and technology helped see the bacteria, it was the individuals who identified that germs caused diseases and therefore this led to further research for treatment for specific diseases including vaccinations and magic bullets.
