20th Century Medicine

Question 1

Who was he first person to discover penicillin?

Answer 1

Alexandra Fleming.

Question 2

Who was Paul Ehrlich?

Answer 2

He was a German doctor doctor who joined Koch’s research team in 1889.

Question 3

What was Paul Ehrlich significant for? (What did he discover?)

Answer 3

He was convinced that the body produced antibodies to ward off specific germs inside a person without damaging the rest of their body. He found the cure to syphilis.

Question 4

Why did Paul Ehrlich refer to antibodies as ‘magic bullets’?

Answer 4

He referred to antibodies as a ‘magic bullet’ because they sort out their specific target. He looked for an external magic bullet. Eventually he found a chemical that worked like this that cured syphilis.

Question 5

What is an antiseptic?

Answer 5

A chemical applied to wounds to prevent the growth of disease causing microbes.

Question 6

What is an antibiotic?

Answer 6

A drug made from bacteria that kills other microbes and so cures an infection or an illness.

Question 7

What is staphylococci?

Answer 7

The germ which turns wounds septic. (Septicaemia)

Question 8

Why was Alexandra Fleming researching antibiotics when he accident you found penicillin?

Answer 8

After WW1 Fleming became determined to find a better way to treat infected wounds. In 1928 Fleming was working on the hard to kill staphylococci germ. He was a very messy person and while on holiday left the germ. When he came back he noticed that the germs had been killed by mould. This mould was penicillin.

Question 9

How did Alexandra Fleming discover penicillin?

Answer 9

He discovered that mould had grown in a discarded staphylococci culture dish and that germs had stopped growing around the mould. The mould was a member of the penicillium notatum family. Fleming found that the mould juice stopped other deadly germs from growing.

Question 10

What set back did Fleming experience when he found penicillin?

Answer 10

He concluded it was a natural antiseptic. The one test that was missing from his work was the test of injecting penicillin into an infected animal. This would have shown that penicillin could be used as a medicine, to kill infection in the body without harming living cells. As a result few people regarded his work as significant.

Question 11

What was the eventual outcome/impact of Flemings work?

Answer 11

His discovery allowed other people to develop penicillin into a drug as he eventually gave up.

Question 12

Why was Howard Florey and Ernst Chain researching pencilling?

Answer 12

In the 1930’s a research team from Oxford university began compiling a list of all the natural substances that could kill germs. They got hold of Flemings article about penicillin.

Question 13

How did Florey and Chain discover the properties and potential use of penicillin?

Answer 13

They decided to study germ killing substances and produced pure penicillin powder from mould juice. Hey injected 8 mice with streptococci and only the 4 with penicillin survived.

Question 14

What setbacks and problems did Florey and Chain experience during the production of penicillin?

Answer 14

They found penicillin was extremely difficult to grow and extract from the mould.

Question 15

What was the impact of Florey and Chain’s work on penicillin?

Answer 15

• it is estimated in WW2 around 15% of British and American soldiers would have died without being given penicillin to fight infections.
• the discovery of penicillin led to huge government sponsored programmes to develop and produce it. This in turn DEVELOPED THE PHARMACEUTICAL INDUSTRY as it had both the finance and technology to research and develop medicine for all types of diseases.

Question 16

What other drugs and antibiotics were developed as a result of penicillin?

Answer 16

Penicillin developed the pharmaceutical industry so this meant they had the money and tech to make new discoveries and develop their research, this in turn led to development of more antibiotics:
1944-streptomycin proved to treat TB.
1953-tetracycline was used for clearing up infections.
1956-Mitomycin was used in chemotherapy for cancer.

Question 17

What was the chain of events that led to the production of penicillin?

Answer 17

1928: Fleming discovered mould had killed germs.
1929: Fleming writes articles about penicillin.
1937: Chain and Florey begin research in Oxford on penicillin after reading an article by Fleming.
1940: They experiment on mice.
1941: Penicillin first tested on a human in Oxford.
1942: US and British governments cooperate to fund production of penicillin.
1944: Enough penicillin to treat all the allied forces wounded in day to day invasions in Europe.

Question 18

Who was responsible for the finding of penicillin and who was responsible for the production of penicillin?

Answer 18

Alexandra Fleming discovered penicillin but without Florey and Chain the production of penicillin during WW2 would have never taken place.

Question 19

When was penicillin discovered?

Answer 19

1928 but it’s medical properties were not recognised until the late 1930s.

Question 20

What were the dates of WW1 and WW2?

Answer 20

WW1: 1914-1918
WW2: 1939-1945

Question 21

Why did the government invest a lot of money into developing medicine to get their soldiers ‘fighting fit’ during WW2?

Answer 21

If medical services are good, then more soldiers have a chance of survival; and the more soldiers that are available, the greater the countries chance of victory. Therefore they invested lots of money into getting their soldiers healthy and well again.

Question 22

How does war allow doctors and surgeons to develop new medical methods and develop their research?

Answer 22

They have to work harder to develop their ideas to treat wounded and injured soldiers. It also allows doctors to experiment and test their ideas out.

Question 23

Who was Harold Gillies?

Answer 23

He was the first person in Britain to practise facial reconstruction during WW1.

Question 24

What was shell shock and how did this help develop the understanding of mental health disorders?

Answer 24

The mental strain of war could cause psychological damage known as shell shock. Some shells shocked soldiers had panic attacks; others shook all the time or were unable to speak or move. To begin with the British army refused to believe shell shock exited and the men were just cowards but by the end of the war there were so many cases of it that it had to be recognised.

Question 25

Was the discovery of shell shock a long or short term impact?

Answer 25

This is a long term impact because soldiers suffer from PTSD till today when they come home from war and being aware if it is important in order to treat it correctly.

Question 26

How did the use if blood transfusions develop in the early 20th century and how did it develop medical knowledge?

Answer 26

Although blood transfusions had been tries for centuries it wasn’t until 1900 that scientists worked out how to do them successfully. Karl Landsteiner discovered blood groups, which helped doctors work out that blood transfusions only worked if the donates blood type matched the receivers.

Question 27

What problem did scientists still face with blood transfusions in the early 20th century even though they new how to do them successfully?

Answer 27

It was impossible to stop blood for long because it clotted. As a result many people died so there was a solution needed for storing blood.

Question 28

How did plastic surgery develop during WW1?

Answer 28

Harold Gillies developed plastic surgery during WW1, when he reconstructed the face of soldiers who had their face blown off. He set up a unit for to graft/transplant skin and treat men suffering from severe facial wounds. Queens hospital in Kent opened on 1917 and by 1921 they had provided 1000+ beds to soldiers with severe facial wounds. Him and his team treated 5000 service men by 1921.

Question 29

What the development of blood transfusions a long do short term impact?

Answer 29

Long term as we still use blood transfusions today in surgery and many other things. It solved the problem of blood loss.
In 1914 Albert Huslin discovered that glucose and sodium nitrate stopped blood clotting in the air.

Question 30

When were X-rays discovered and how were they used?

Answer 30

Discovered in 1895 and soon hospitals used them to look for broken bones and disease. During WW1 they became important because mobile X-Ray machines were used near battle fields to find out exactly where the bullets or pieces of shrapnel were in the body without having to cut the solider side open.

Question 31

What was infection like during WW1 and what measures were taken to prevent/reduce infection and was this a long or short term impact?

Answer 31

Battle fields were dirty places and lethal would infections like gangrene were common. Trail and error surgeons worked out the best way to prevent this was cut away infected flesh and soak wounds in soak saline. This wasn’t ideal but a short term solution. This was a,so a short term impact because it didn’t improve the development of medicine greatly and penicillin was found in 1928 which had a better effect.

Question 32

How were broken bones treated in WW1 and is this a long or short term impact on medical knowledge?

Answer 32

New techniques were developed to repair broken bones. E.g the Army Leg Splint was developed which elevated the and extended the broken leg in ‘traction’ this helped bones knit together securely. This is a long term impact because the splint is still used today.

Question 33

How did the develop met of hygiene, particularly in the mid 1900s improve public health?

Answer 33

In order to keep Britain ‘fighting fit’ posters were produced to encourage people to keep healthy. They warned against dangers of poor hygiene. E.g a national immunisation programme against diphtheria was launched.

Question 34

How did the development of The National Health Service improve public health?

Answer 34

When WW2 broke out, the British government increased its involvement in medical care. After the war people started to think about how best to organise health care. In 1942 William Beveridge proposed a free NHS. After the war the NHS was born.

Question 35

How did the development of surgery improve public health?

Answer 35

A doctor from New Zealand who trained and worked in Britain (cousin of Harold Gillies) used new drugs e.g penicillin to prevent infection when treating pilots with horrific facial injuries. His work on reconstruction damaged faces and hands were respected all over the world.

Question 36

How did the development of disease improve public health?

Answer 36

Heart surgery progressed during WW2. American army surgeon, Dwight Harken, stationed in London cut into beating hearts and used his bare hands to remove bullets and shrapnel. His findings helped heart surgery develop greatly after the war.

Question 37

How did blood transfusions develop public health?

Answer 37

Advances in storing blood after WW1 meant it could be kept fresh and unstable for longer. This led to the British National Blood Transfusion service opening in 1938. Large blood banks were developed in both the USA and Britain during the war.

Question 38

How did the development of a good diet improve public health?

Answer 38

Shortages of some foods during the war meant the government encouraged people to grow their own food. This improved people’s diets because the food they encouraged people to grow - fresh vegetables for example - was very healthy.

Question 39

How did the development of drugs improve public health?

Answer 39

Penicillin, the first antibiotic was developed in the years leading up to the war. The British and American governments realised how important the new ‘wonder drug’ could be curing infections in deep wounds. By 1944 enough penicillin was produced to treat all the allied forces in Europe.

Question 40

How did the development of poverty improve public health in the mid 1900s?

Answer 40

During the war over 1 million children were evacuated from towns and cities into the countryside. Many of the children were very poor and the cleaner, healthier life-style they had in the countryside improved their health. The whole experience highlighted the levels of poverty endured by children and increased the governments commitment to improve things.

Question 41

Why had changes and improvements in public health taken place up to 1945?

Answer 41

• the government started to take more responsibility for health.
• widespread use of anaesthetics and antiseptics meant life expectancy had increased from 46-60 for men and 50-65.

Question 42

What is alternative medicine?

Answer 42

Any practise put forward as having the healing affects of medicine. But is not part of a biology and does is originate from evidence gathered by scientific methods.

Question 43

Give 3 examples of alternative medicine:

Answer 43

• homeopathy
• naturopathy
• chiropractic

Question 44

What is complementary medicine?

Answer 44

This is alternative medicine used together with conventional medicine treatment, in a belief not confirmed using scientific methods, that it improves the efficiency of the treatment.

Question 45

3 criticisms of alternative medicine?

Answer 45

• based on misleading statements e.g quackery, misleading scientific methodology and anti-scientists.
• promoting alternative medicine has been called dangerous and unethical.
• testing alternative medicine has been called a waste of scarce medical research resources.

Question 46

What is aromatherapy?

Answer 46

The use of essential oils from flowers, fruits, roots and leaves. The oils are inhaled or massaged into the skin.

Question 47

What is the affect of aromatherapy?

Answer 47

The inhaled scents are said to stimulate particular parts of the brain, which promote healing, while massaged oils pass into the bloodstream and can influence the nerve nervous system functions, mental function and emotion.

Question 48

What is acupuncture?

Answer 48

Fine needles are placed at key point around the body. The places are chosen are thought to be linked with particular needs or illnesses. Acupuncture has been a key part of traditional Chinese medicine fro thousands of years.

Question 49

What is the effect of acupuncture?

Answer 49

The needles are said to release blocked energy and balance it properly. It allows the energy to flow again; and it stimulates healing and relieves pain. It has been used as an anaesthetic during major surgery.

Question 50

What is hypnotherapy?

Answer 50

A therapist hypnotises the patient. When totally relaxed the patient can be relieved of stress, allergies or even physical addiction, such as smoking.

Question 51

What is the effect of hypnotherapy?

Answer 51

It is based on positive thinking that the power of a patients own mind can bring about their healing.

Question 52

What is homeopathy?

Answer 52

Patients take a medicine ( a plant, animal or mineral material soaked in alcohol) which causes similar symptoms to the illness they are suffering from.

Question 53

What is the effect of homeopathy?

Answer 53

The idea that tiny doses of the medicine that cause similar symptoms to the illness they are suffering from.

Question 54

What is the effect of homeopathy?

Answer 54

The idea that tiny doses of the medicine that cause similar symptoms will cure that patient by stimulating his or her natural defences. Studied have shown homeopathy to be effective in treating hay fever, insomnia, depression and eczema.

Question 55

How did access to alternative treatment change in the mid 1900s?

Answer 55

Nearly every high street now include its own health food shop where a wide range if alternative herbal remedies are sold.

Some alternative medicine e.g acupuncture is now available on the NHS.

Question 56

How did attitudes change towards alternative medicine in the mid 1900s?

Answer 56

Several major scandals have caused a lack of confidence in conventional doctors and hospital care. E.g. Dr Harold Shipman murdered his patients and stole their money.

There is generally a greater interest in prevention rather than cure - ‘positive health’. An emphasis on is now being placed on healthy diets, exercise and life style.

Question 57

How effective is alternative treatment?

Answer 57

The range if new drugs produced every year is huge but not all drugs works, even antibiotics can fail.

Alternative treatment treat the patients as a whole, instead of beating a disease down by finding the cause and then hitting it with drugs.

Doctors are still it able to cure some diseases (e.g viruses) like aids and and the common cold. Cancer although treatable depending on the type - is still a major killer disease.

Some antibiotics have been overused, promoting bacteria to evolve and become increasingly resistant to common antibiotics.

Question 58

How had surgery developed the twentieth century due to advances in technology?

Answer 58

• In 1967 the first heart transplant operation took place. The patient survived for 18 days. In 2014 181 heart transplant took place.
• Key whole surgery using small fibre-optic cameras linked to computers, means surgeons can perform operations through very small cuts.
• the first kidney transplant took place in 1952. In 1961 the first heart pacemakers, a mechanical device that keeps the heart pumping blood around the body, was developed.

Question 59

How had developments in diagnosis in the twentieth century changed due to advances in technology?

Answer 59

• the discovery of DNA in 1953 and the subsequent ‘human genome’ project have all enhanced the the medical professions understanding of how the body works and how to make it better when it is malfunctioning.
• technology has aided disease diagnosis. CAT scans, MRI scans and endoscope (tubes inserted into the body which contains miniature cameras) all allow surgeons to see inside the body, without the need to cut the person open.

Question 60

How had treatment developed the twentieth century due to advances in technology?

Answer 60

• radiation therapy has been used to treat cancerous cells, making them easier to target as technology has refined the technique.
• his replacements were introduced in 1972, they have brought mobility to many who previously found it hard to walk.
• In 1978 Louise Brown became the worlds first test tube baby, brining hope to many couples desperate for a child.
• surgery using lasers rather than a scalpel has become increasingly popular since the first eye operation in 1987. Lasers are now increasingly being used to treat a variety of skin conditions, help clear blocked arteries, remove tumours and ulcers and control bleeding.

Question 61

When was the NHS proposed and when was it established?

Answer 61

Proposed during WW2 in 1944 and established in 1948.

Question 62

Why did the NHS cause conflict when it was first developed?

Answer 62

Establishment of the NHS in 1948 by Labour created a demand for resources and a feeling of entitlement to medical services never felt before.
This has only continued to increase making it difficult for hospitals to deliver.
Waiting lists exist for most operations, although recent governments have made a great effort to reduce this.

Question 63

What is the NHS post code lottery and why are some people concerned about it?

Answer 63

Differences in access to NHS treatment throughout the country. There are also concerns that where you live can define the quality and availability of the NHS services you can expect.

The gasp between the idea of nationwide, comprehensive service and the reality of local decision making has become increasingly intense.

Question 64

What services have been affected by the post code lottery?

Answer 64

• certain cancer drugs
• fertility treatments
• hernia repair
• hip and knee replacements
• variation in waiting times
• access to cancer screening programmes
• availability of drugs for mental health problems.

Question 65

In 2008 what was proposed about the National Health Lottery?

Answer 65

In 2008 Gordon Brown vowed to end the NHS lottery to mark the 60th anniversary of the NHS. The issue has continues to come under scrutiny in the context of the 2012 Health and Social Care Act.

Question 66

What are some of the arguments against medical developments?

Answer 66

• some argue science and technology have gone too far.some don’t agree with helping childless couples have a baby or chose the sex.
• they’ve been reports about abortions of girl foetuses because the couple wanted a boy.
• there have been reports on illegal trading of kidneys and other body parts in poor parts of the world.
• animal cloning like ‘Dolly the sheep’ has been successful but whose to say the next step isn’t using the same technique to clone humans to perhaps prevent the transmission of diseases (etc).