History - Britain: Health & the People

Question 1

In Medieval England, what did people think caused disease? (3)
And how did they work to treat them? (3)

Answer 1

1. Punishment from God for people’s sins. - to cure was through prayer and repentance.
2. Some thought that disease was caused by evil supernatural beings such as demons and witches. - many people were tried as witches and executed.
3. Evil spirits living inside someone. - members of the Church would perform exorcisms, using chants to remove the spirits from the person’s body.

Question 2

Why did then control and how did they control

How did the Church have a big influence on medieval medicine? (3)

Answer 2

1. They would make sure people believed that disease was a punishment from God which prevented people from trying to find cures for diseases, if it was a punishment from God, all you could do was pray and repent.
2. The Church made sure that scholars of medicine learned the works of Galen because his ideas fit the Christian belief that God created human bodies and made them to be perfect. It also stopped anyone from disagreeing with Galen.
3. The Chruch outlawed disssection, this meant that medieval doctors couldn’t discover ideas about human anatomy for themeselves, they instead had to learn Galen’s incorrect ideas.

Question 3

1. What 2. Who?When 3. How

How was astrology used to diagnose diseases? (3)

Answer 3

1. The movement of the plantes and stars had an effect on Earth and people. Astrologers beleived that the movements could cause disease.
2. It was a new way of diagnosing disease, first developed in Islamic medicine and brought to Europe between 1100 and 1300.
3. A type of calender called an almanac included information about where planets and starts were at a given time, which was used to predict how patients’ health could be affected. Where different star signs were thought to affect different parts of the body.

Question 4

Who?What?How?

What was the Four Humours Theory? (3)

Answer 4

1. Created by an Ancient Greek doctor Hippocrates.
2. The body was made up of 4 fluids, blood, phlegm, yellow bile and black bile. These were linked to the four seasons and the four elements. Like someone would get a cold in winter.
3. The theory was further developed by another Greek doctor Galen. He believed that the different foods, drinks, herbs and spices had a humour, which could balance the excessive humour that was causing the disease. e.g. if someone had a cold - too much phlegm - they coule be given chicken, pepper or wine - all considered hot and dry - to correct the imbalance.

Question 5

What?Who?

What was Miasma? (4)

Answer 5

1. A theory that bad air causes disease when someone breathes it in.
2. Galen incorporated the idea into the 4 humours.
3. The theory was influential until the 1860’s when it was replaced by the Germ Theory.
4. Miasma and 4 humours often prompted people to be more sanitary but for all the wrong reasons.

Question 6

Why were Hippocrates and Galen so influential? (3)

Answer 6

1. Many of their beliefs were written down and translated into latin, which were considered important by the Roman Catholic Church.
2. People were not allowed to do their own dissections of humans so could not discover all the mistakes that Hippocrates and Galen made.
3. Some of their beliefs are still used today such as the Hippocratic Oath. And that doctors should observe their patients as they treat them.

Question 7

How? What happened to the information later on?

How did Islamic doctors keep classical knowledge alive? (4)

Answer 7

1. A lot of medical knowledge was lost in the West after the fall of the Roman Empire.
2. In the 9th century, Hunain ibn Ishaq (also known by his Latin name Johannitius) travelled from Baghdad to Byzantium to collect Greek medical text which he translated into Arabic.
3. The knowledge was eventually brought to Europe by Avicenna (or Ibn Sina), a Persian who lived from around AD 980-1037. Avicenna wrote the ‘Canon of Medicine’, which brought together the ideas of Galen and Hippocrates and was the most important way in which classical ideas got back into Western Europe.
4. The work and other Islamic text were translated into Latin in Spain or Italy. The Crusades made Europeans awares of the scientific knowledge of Islamic doctors.

Question 8

What did Islamic doctors discover? (3)

Answer 8

1. Albucasis (or Abu al-Qasim) wrote a book describing amputations, the removal of bladder stones and dental surgery, as well as methods for handling fractures, dislocation and the stitching of wounds.
2. In the 12th centuary, Avenzoar (or Ibn Zuhr), described the parasite that causes scabies and began to question the reliability of Galen.
3. ibn al-Nafis, who lived in the 13th century, also questioned Galen’s ideas. He suggested (correctly) that blood flows from one side of the heart to the the other via the lungs - and doesn’t cross the septum. Ibn al-Nafis’ wasn’t recognised in the west until the 20th century.

Question 9

What?How?

How did alchemy help develop new drugs? (4)

Answer 9

1. Alchemy was the attempt to turn base (ordinary) metals into gold and to discover the elixir of eternal life.
2. Alchemy traces its origins back to the Egyptians and it was preserved in the Islamic world.
3. Unlike modern chemistry, much superstition was included - an unsuccessful experiment was as likely to be blamed on the position of the stars or the spiritual purity of the alchemist as anything else.
4. Even so, Islamic alchemists invented useful techniques such as distillation and sublimation, and prepared drugs such as luadanum, benzoin and camphor.

Question 10

Why?How?

How was prayer and repentance a form of treatment for disease? (4)

Answer 10

1. People believed that God made people sick because of their sins.
2. So sick people would pray, go on pilgrimages to holy shrines.
3. Some people would do self-flagellation called flagellants.
4. Some doctors would use astrology to diagnose and treat illness. Or that certain words while giving a treatment could make that treatment more effective.

Question 11

What?How?

How was bloodletting and purging a form of treatment that aimed to make the humours balanced? (4)

Answer 11

1. It was popular because it fit the 4 humours theory.
2. If someone apparently had too much blood inside them, the doctor would let blood out eighet by making a small cut, or using blood-sucking leeches.
3. Some people were accidentally killed by letting out too much blood.
4. Purging is the act of getting rid of other fluids from the body by excreting - doctors gave their patients laxatives to help the purging process.

Question 12

How did the belief of purifying the air help prevent disease? (2)

Answer 12

1. Physicians carried posies or organges around with them when visiting patiants to protect themeselves from catching a disease.
2. During the Black Death, juniper, myrrh and incense were burned so the smoke or scent would fill the room and stop bad air from bringing disease inside.

Question 13

What?Examples?

What did Remedies do?(3)

Answer 13

1. Remedies bought from an apothecary, local wise woman or made at home wer all popular in medieval Britain and contained herbs, spices, animal parts and minerals.
2. These remedies were either passed down or written in books explaining how to mix them together. Some of these books were valled ‘herbals’.
3. Other remedies were based on superstition, like lucky charms containing ‘powdered unicorn’s horn’.

Question 14

What were the different healers that people used to go to? (3)

Answer 14

1. Physicians - male doctors who trained at university for at least 7 years, they read ancient texts as well as writings from the Islamic world, but they had little practical experience. They used handbooks (vademecums) and clinical observation. There wer less than 100 physicians in England in 1300, and they were very expensive.
2. Most people saw an apothecary, they prepared and sold remedies, gave advice on how to use them. They were very common and were most accessible for those who could not afford a physician.
3. Apothecaries were trained through apprenticeships. Most apothecaries were men, but there were also many so-called ‘wise women’, who sold herbal remedies.

Question 15

What were public hospitals like? (4)

Answer 15

1. Most public hospitals were set up by the Church, there were few, but they were popular and highly regarded.
2. Hospitals had the purpose to care for the sick and elderly rather than treat disease. They were also more hygienic than elsewhere, because they had developed water and sewerage systems.
3. Some monasteries also cared for the sick, the elderly or the poor.
4. Most sick people were treated at home by members of their family.

Question 16

Who? Issues?

How did surgery happen in Medieval England? (2)

Answer 16

1. It was very dangerous, there was no way to prevent blood loss, infection or pain. - so it was rare, only for minor procedures.
2. There were few inversity-trained, highly paid surgeons, but surgery as a whole was not a respected profession in medieval times - most operations were carried out by barber-surgeons who also cut hair.

Question 17

What progress was made in Surgery? (2)

Answer 17

1. Hugh and Theodoric recognised the importance of practical experience and began dressing wounds with bandages soaked in wine, because they noticed that the wine helped to keep wounds clean and prevent infection - discovered by chance.
2. John of Ardern tried to create a recipe for an anaesthetic in 1376, which included hemlock, opium and henbane. In carefull controlled doese this may have worked but it was very likely to kill.

Question 18

What were living conditions like in a major town such as London? (5)

Answer 18

1. Houses were crammed and fires were common.
2. Many towns did not have clean water supplies or sewage systems, or into rivers to be washed away.
3. Businesses and homes weren’t seperated - butchers, tanners and dyers threw their toxic waste into rivers and residential streets. People had to get their water from contaminated water sources.
4. In the 13th century a water channel called the Great Conduit was built to bring clean water into London, as the thames was getting too toxic.
5. In 1388, the government ordered town authorities to keep the streets free of waste.

Question 19

What were monasteries like? (3)

Answer 19

1. They were cleaner, good sewage systems.
2. They were rich so had enough to spend on infrastructure such as infarmaries for the sick and poor.
3. Many would go here for treatment becasue of the sanitation and the herbal remdies grown their because the books records of the different herbal remedies.

Question 20

What was the Black Death? (3)

Answer 20

1. Happened in the 14th century first arriving in Britain in 1348.
2. Consisted of two illnesses, the Bubonic Plague and the Pnuemonic Plague.
3. It is thought that 1/3 of the British population died.

Question 21

What? And how did they react?

What did people believe caused the Black Death? (4)

Answer 21

1. Some believed it was punishment by God - so people prayed and fasted.
2. Some believed it was humour imbalance - so people tried to get rid of the Black Death by bloodletting and purging.
3. Some thought it was caused by Maiasma - so carried strong smelling herbs or lit fires to purify the air.
4. Some people also carried charms or used ‘magic’ potions containing arsenic.

Question 22

How ddi the Local Governments try to prevent the spread of the Black Death? (3)

Answer 22

1. Some people in Wichester believed that being close to the bodies of dead victims could cause people to catch the illness, so when the cemetary was full, they requested more to be built, but far from homes.
2. The town of Gloucester tried to shit itself off from the outside world after the Black Death reached Bristol.
3. In November 1348, the disease reached London. In January 1349, King Edward III closed Parliament.

Question 23

What social change did the Black Death cause? (4)

Answer 23

1. There were far less workers, this meant they could demand higher wages from their employers and move around to find better work.
2. The cost of land also decreased, allowing peasants to buy land for the first time.
3. The changes threatened the power of the elite so the government created laws, such as the 1349 Ordinance of Labourers, to try and stop peasants moving around the country.
4. Some people think the Black Death helped cause the Peasant’s Revolt in 1381, and, eventually, the collapse of the feudal system in Britain.

Question 24

Who was Vesalius? And what did he do? (4)

Answer 24

1. Born in 1514, was a medical professor at Padua University, Italy.
2. He was able to perform dissections on criminals who had been executed.
3. He wrote bookes to illustrate accurate diagrams of the human anatomy - ‘Six Anatomical Pictures’ (1538) and ‘The Fabric of the Human Body’ (1543)
4. Vesalius’s questioning attitude led people to also question Galen’s ideas, and people realised there was more to learn about the body and one could do so through dissections.

Question 25

# Education? Job? Who was William Harvey? (2)

Answer 25

1. British doctor, born in 1578, he studied in Padua University. 2. he worked in London at the Royal College of Physicians.

Question 26

What did William Harvey do? (3)

Answer 26

1. He discovered that Galen's theory that there were two different types of blood that flowed seperately in the body was wrong. 2. He thought that the blood must circulate, because from experiments he knew that too much blood was being pumped out of the heart for it to continually formed and consumed. 3. However, not everyone believed his theories and people continued to perform bloodlettings even though they did not work.

Question 27

Who was Ambroise Paré? (2)

Answer 27

1. He was a French barber-surgeon born in 1510. 2. He initially worked for a public hospital then became an army surgeon.

Question 28

What surgical advancements did Paré do? (3)

Answer 28

1. Instead of using a red hot iron to burn a wound shut or boiling hot oil, he used cool slave by chance because he ran out of oil, and it did a better job because patients with that treatment often did better than others. 2. He also improved amputations, instead of cuatarising the ends of blood vessels he would use lignatures and tie the vessel shut at the end. It was less painfull but it did increase the risk of infection. 3. People initially did not believe in him because of his low status, but he then became the surgeon of the King and people started to support his ideas.

Question 29

# During the Renaissance What old and new treatments did people use? (5)

Answer 29

1. Many doctors were reluctant to accept that Galen was wrong, so bloodletting and purging were still used. Doctors were reading books more than treating patients. 2. Doctors were expensive, so people used apothecaries or barber-surgeons, or were treated in the home. Herbs were the main ingredient in many drugs. 3. People though the King's touch would cure scrofula. 4. Some people sold medicines that did not work called Quacker. Quacks. Doctors had to get a licence in order to stop this. 5. Electricity started to be used in some medical tratments by was rarely effective.

Question 30

What were the similarities with the way people reacted to the Great Plague to the Black Death? (3)

Answer 30

1. Many treatments were based on magic, religion and superstition, lucky charms or amulets, saying prayers and fasting. 2. Bloodletting was still used, even though it probably made the plague worse. 3. Some people thought miasma caused the disease, so they carried posies of herbs or flowers to improve the air.

Question 31

What were the differences between how people racted in the Great Plague to the Black Death? (4)

Answer 31

1. Town and Parish Councils tried to prevent the disease's spread. 2. Plague victims were quarantined. The victims hous was locked and a red cross was painted on their door. 3. Areas where people crowded together, such as theatres, were closed. 4. The dead bodies of plague victims were buried in mass graves away from houses.

Question 32

What did people think helped get rid of the Great Plague?

Answer 32

1. The Great Fire of London in 1666.

Question 33

How did Doctors' training and knowledge begin to improve? (5)

Answer 33

1. College of Physicians set up in 1518. Doctors would read books by Galen but also read more recent medical developments. They would also gain a licence which seperated them from Quacks. 2. However a licence did not guarantee they would be better, some more experienced doctors without a licence might be better. 3. New weapons like cannons and guns were used in more so new treatments were needed. 4. Exploration in new ingredients for drugs such a guaiacum - believed to cure syphilis - and quinine, a drug for malaria from the bark of the Cinchona. 5. Dissection, which enable doctors to see how the body actually works, became a key part of medical training in the 1700s.

Question 34

# During the Renaissance How did Surgeons become more important? (2)

Answer 34

1. There were two tpes of surgeons, professional, who trained at university and were highly paid by their rich patients. Then there were the unqualified barber-surgeons. In general surgeons were not respected compared to doctors. 2. In the 1700's and 1800's surgeons began to gain the same status as doctors. In 1800, the London College of Surgeons was created which set training standards.

Question 35

Who was John Hunter?

Answer 35

1. (1729-93) was a well-known surgeon and scientist.

Question 36

What did John Hunter do? (3)

Answer 36

1. He believed as much hands on experience was needed. (over 12 years he had witnessed more than 2000 dissections) 2. He became an army surgeon and learned more about STI's and a new approach to gunshot wounds. 3. In an operation in 1785 he introduced a new way to treat an aneurysm, he tied off the blood cessel to encourage the blood to flow through the other vessel instead of amputation.

Question 37

How did Hospitals change during the Renaissance? (4)

Answer 37

1. There were more that were built by the rich for the poor. 2. Only those who would recover quickly or those who led hardworking respectable lives would be admitted. 3. Dispensaries provided medicines, non-surgical services like dentists and midwives were free. 4. Some universities had hospitals near them for training and scientific research.

Question 38

What did Florence Nightingale do? (4)

Answer 38

1. During the Crimean War she went to the battlfield and helped the nurses there. 2. The hospital there improved a lot, the death rate went from 42% to 2%. 3. in 1859 she wrote a book 'Notes on Nursing' emphising how hygine and a professional attitude were necissary. 4. The public raised £44,000 to help her train nurses, and she set up the Nighingale School of Nursing in St. Thomas' Hostpital, London.

Question 39

How did innoculation help prevent smallpox? (3)

Answer 39

1. In 1751 over 3500 people dies of smallpox in London alone. 2. The only way at the time to prevent smallpox was innoculation. it was promoted by Lady Mary Wortley Montagu. 3. Make a cut put the pus from swealling of somebody who has mild small pox and then build immunity.

Question 40

How did Jenner find a vaccination for Smallpox? (3)

Answer 40

1. Milkmaids who have had cowpox did not get smallpox. 2. Jenner tested this theory in 1796 with James Phipps and innoculated him with sordd from Sarah Nelmes a milkmaid with cowpox. Phipps did not get the disease. 3. Jenner published his finding in 1798. He coined the term vaccination using the latin word for cow, vacca.

Question 41

# When they were first discovered What did people beleive about germs?

Answer 41

1. Discovered in the early 17th century. 2. But were believed to be created by decaying matter, not cause disease. 3. Spontaneous generation - disease caused germs.

Question 42

Who discovered the real impact of germs and how? (4)

Answer 42

1. Louis Paseur - employed in 1857 to find the explaination for the souring fo sugar beet used in fermenting industrial alcohol. 2. Stated that there was germs in the air by showing how closed sterilised water stayed sterile while exposed sterile water bred germs. 3. In 1861, published Germn Theory - argued that microbes caused decay and that some germs caused disease. 4. In 1867, he published evidence proving there was a link between germs and disease, germs caused disease in silk worms.

Question 43

What was the impact of Germn theory on Medicine? (3)

Answer 43

1. Helped Joseph Lister develop antiseptics 2. Confirmed John Snow's findings about cholera 3. Proved contamination so put pressure on the government to pass the 1875 Public Health Act.

Question 44

Who helped identify microbes?

Answer 44

A German scientist - Robert Koch - helped build on Pasteur's work by linking specific diseases to the particular microbe that caused them.

Question 45

How did Robert Koch help identify different diseases? (3) (Microbe Hunting) and Where were his findings? (4)

Answer 45

1. Used agar jelly to create solid cultures to breed bacteria. 2. Used dyes to stain the bacteria so thy were more visible under the microscope. 3. Employed the newly invented photgraphy to record his findings. Discovered: 1. Anthrax bacteria (1876) 2. The bacteria that caused septicaemia (1878) 3. The bacteria that caused Tuberculosis (1882) 4. The bacteria that caused Cholera (1883)

Question 46

How did Pasteur develop new vaccines? (5)

Answer 46

1. In 1877, Charles Chamberland, his assistance injected some chickens with a cholera culture that has accidentally been weakened by being left out on a desk while on holiday. 2. The hcickens survived and they injected cholera again and they still survived. 3. They realised that by injecting weaker cholera they chickens became immune. 4. The team attenuated (weaker) version of the anthrax bacteria to make sheep immune. They showed this in a public experiment in 1881. 5. A similar thing was also done for rabies.

Question 47

How did Koch's methods also help other Microbe Hunters? (4)

Answer 47

1. The diphtheria germ was discovered by Edwin Klebs in 1883. 2. Friedrich Loeffler cultured teh diphtheria germ and that that its effect on people was due to a toxin produced. Emile Roux proved Loeffler right. 3. In 1891, Emil von Behring produced an antitoxin from the blood of animals that had just recovered from diphteria. Reduced effects of the disease. 4. Ronald Ross, recieved the Novel Prize in 1902 for his discovery of how malaria is tranmitted.

Question 48

Who discovered the first Magic Bullet - Slavarsan 606? And How? (5)

Answer 48

1. Antibodies only attacked specific microbes, and in 1889, Paul Ehrlich set out to find chemicals that could act as synthetic antibodies. 2. First discovered dyes that could kill the malaria and sleeping sickness germs. 3. In 1905, the bacteria that causes the STI syphilis was identified. 4. Tried to find an arsenic compound that was a magic bullet for syphilis. Over 600 sompound were tried by none seemed to work. 5. in 1909, Sahachiro Hata, doubles checked results to find that compound 606 worked. First used on a human in 1911.

Question 49

What were the 3 first types effective anaesthetics?

Answer 49

1. Nitrous oxide 2. Ether 3. Chloroform

Question 50

How was nitrous oxide discovered to be an anaesthetic? (2)

Answer 50

1. Identified by British chemist Humphry Davy in 1799 byt was ifnored by surgeons. 2. The gas dismissed until used by American dentist Horace wells in his area of work. He did a public demonstration in 1845 but had the bad luck of picking a patient that was unaffected by nitrous oxide. So was ignored.

Question 51

How was ether discovered to be an anaesthetic? (2)

Answer 51

1. In 1842, American doctor Crawford Long discovered it but did not publish his findings. First public demosntration was caried out in 1845 by and American dental surgeon William Morton. 2. Ether is an irritant and is also fairly explosive so using it in this way was risky.

Question 52

How was Chloroform discovered to be an anaesthetic? (3)

Answer 52

1. James Simpson tried to find a safe alternative to ether that women could take during childbirth. He tested chemicals by testing them on himself. 2. In 1847, he discovered the effects of cholorform. It was easier to use than ether, took effect quicker and less was needed to achieve the same result. 3. After Queen victoria gave birth to her eigth child while using chloroform in 1853, it became widely used in operating theatres and to reduce pain during childbirth.

Question 53

What was the short term impact of early anaesthetics? (3)

Answer 53

1. Longer operations 2. More complex operations 3. More infections because more exposure to unhygenic condistions, surgary done at home, using instruments that were dirty and unwashed and the surgeons would be wearing dirty clothes with the blood and puss from other surgaries.

Question 54

# Definitions What is the difference between Aseptic and Antiseptic?

Answer 54

1. Antiseptic - methods used to kill germs that get near surgical wounds. 2. Aseptic - surgical methods aim to stop any germs getting near the wound.

Question 55

Who discovered Antiseptics and how? (7)

Answer 55

1. Ignaz Semmelweis showed doctors they could reduce the spread of infection by washing their hands ith chloride of lime, but this was unpleasant so was not widely used. 2. Joseph Lister had seen the use of carbolic acid in sewage. So was used in surgary. 3. Lister heard about Germ Theory so used the acid on instruments and bandages. 4. This reduced death rates from 50% in 1864-66 to around 15% in 1867-70. 5. He faced opposition because of the unpleasent sensation and smell. 6. In 1877, he did an operation at King's College Hospital to promote the use of his carbolic spray. 7. Number of operations increase ten times in 1912 that 1867 as a result.

Question 56

How was Asepsis developed? (4)

Answer 56

1. Instruments were carefully steralised usually with high temp steam (120C) 2. Theatre staff sterilise their hands before entering. 3. Surgical gloves were invented by William Halsted in 1889. 4. Theatres were kept clean and fed sterile air.

Question 57

How did overcrowding in towns lead to poor living conditions? (3)

Answer 57

1. Between 18th and 19th centuries many people moved to cities and small houses were quickly build very close together. 2. Large families often lived in small rooms and had to share toilets outside called privy's over cesspits that were collected and dumped in rivers or were washed away by the rain. 3. Some water pumps were set up but those were also used by many people and were contaminated by the cesspits.

Question 58

What impact did Cholera have on the people of Britain? (4)

Answer 58

1. Cholera reached Britain in 1831, and was an epidemic by 1832 over 21,000 died that year due to cholera. 2. It spreads through infecrted sewage can causes extreme diarrhoea. 3. People did not know what caused the disease. 4. Cholera epidemics recurred in 1848, 1853-54 and 1865-66.

Question 59

What impact did Edwin Chadwick have on public health? (4)

Answer 59

1. In 1842, he published a report on poverty and health. Showing how living conditions in towns were worse for poeple's health than conditions in the countryside. 2. It suggested that the gov should pass laws to improve sewage and drainage through taxes. 3. Another cholera epidemic in 1948 killing 53,000 people put pressure on Parliament to pass. Public Health Act. 4. The 1848 Act set a central Board of Health. But it was not effective.

Question 60

What did John Snow do?(3)

Answer 60

1. In 1853-54 he showed that there was a connection between contaminated water and cholera. 2. He studied a cholera outbreak in the Broad Stree area of London and noticed that the victims all used the same water pump. So he removed the ahndle from the pump and ended the outbreak. 3. Most poeple still believed in miasma so his work recieved little attention.

Question 61

What was the Great Stink? (4)

Answer 61

1. Lots of waste drained into the Thames River. 2. In the summer of 1858, the hot weather caused the river's water level to drop and bacteria to grow in the wast. This produced a bad smell that even stopped Parliament from meeting. 3. To reduce the stink, the government appointed engineer Joseph Bazalgette in 1859 to build a new London sewer system. The waste was redirected to the Thames Estruary away from heavily populated areas. About 1300 miles of sewers were built. 4. It was officially opened in 1865.

Question 62

How did public opinion start to change about public health? (4)

Answer 62

1. For most of the 19th century people believed in laissez-faire where the government wouldn't intervene with public health. 2. Evidence from Chadwick, Snow and Pasteur's Germ Theory showed that cleaning towns could stop the spread of disease. 3. In 1867 the Second Reform Act was passed giving nearly 1 million more men the vote most of whom were industrial workers. 4. William Farr was a statistician who recorede causes of death, he used statistics to press for reforms in areas with high death rates.

Question 63

How did the 1875 Act help improve public health? (4)

Answer 63

1. In 1871-72, the gov followed the Roayl Sanitary Commission's proposal to form the Loval Government Board and divide Britain into 'sanitary areas'/ 2. In 1875, Benjamin Disraeli's government passed another Public Health Act. It forced councils to appoint health ispectors and anistary inspectors to make sure that laws on things like water supplies and hygiene were followed. It made councils maintain sewerage systems and keeps their towns' streets clean. 3. This act was more effective than the one in 1848 because this was compulsory. 4. Disraeli also brought the Artisans' Dwellings Act in 1875 to let councils to buy slums to rebuild them. Although this was not used much.

Question 64

What was the impact of WW1 on x-rays? (4)

Answer 64

1. Wilhelm Röntgen discovered X-rays in 1895. 2. X-rays were used during the war to identify broken bones but were often far away from battlefields and included glass tubes that were unreliable. 3. American scientist William Coolidge had invented a more reliable x-ray tube in 1913. The 'Coolidge tube' became more widely used by the end of the war and is still used today. 4. In 1914, the Polish scientist Marie Curie developed mobile X-ray units.

Question 65

How was blood loss impacted by war? (4)

Answer 65

1. in 1900, Karl Landsteiner discovered blood groups. Certain blood groups couldn;t mix together without clotting. This made blood transfusions more successful. 2. Blood needed to be stored because wounds from gunshots and explosive shells meant that there was a lot of blood loss. 3. In 1914, doctors found that sodium citrate stopped blood clotting. In 1917 this discovery allowed the first ever blood depot to be set up at the Battle of Cambrai. 4. In 1946, the British National Blood Transfusion Service was established.

Question 66

How did war help develop plastic surgary? (3)

Answer 66

1. Doctors in France and Germany had been working on skin graft techniques since before the First World War. Their work helped Harold Gillies who set up a plastic surgery unit for the British Army during the war. 2. Gillies was interested in reconstructing facial injuries so that patients could have a normal appearance. He developed pedicle tubes, and jept detailed records of his achievements. 3. Archibald McIndoe continued Gillies' work during WW2.

Question 67

Who discovered Penicillin and how? (4)

Answer 67

1. Alexander Fleming saw many soldiers die due to staphylococcal bacteria in WW1. 2. He identified the antiseptic substance in tears, Iysozyme, in 1922 but this only worked on some Germs. 3. In 1928, he was clearing up some old cultur dishes of staphylococci and found that a fungal spore had landed and grown on one of the dishes. The fungus was Penicillium notatum which killed the bacteria. 4. Fleming published his findings in articles between 1929 and 1931. However, nobody was willing to fund further research, so he was unable to take his work further.

Question 68

How did Florey and Chain help purify Penicillin? (2)

Answer 68

1. Since it is a natural product it needs to be purified. A breakthrough was made by Howard Florey;s team in Oxford btween 1938 and 1940. Ernst Chain, a member of the team, devised the freeze-dying technique which was an important part of the purification process. 2. They made penicillin for their first clinical trial, by growing Penicillium notatum in every container they could find in their lab. Their patient becan to recover, only to die when the penicillin ran out.

Question 69

How was Penicillin first mass produced? (5)

Answer 69

1. Florey knew that penicillin could be vital in treating the wounds of soldiers fighting in WW2. 2. British chemical firms were too busy making explosives for the war so he went to America. 3. American firms were also not keen to help - until America joined the war in 1941. In December 1941m the US government began to five out grants to businesses that manufactured penicillin. 4. By 1943, British business had also started mss-producing penicillin. Madd production was sufficient for the needs of the military medics by 1944. 5. After the war the cost of penicillin fell and was available for general use. Fleming, FLorey and Chain were awarded the Nobel Prize in 1945.

Question 70

In what ways did the pharmaceutical industry take off? (5)

Answer 70

1. In the late 1800's chemical industries in places like Britain, Germany, Switzerland and the United states were booming along with the discoveries in the 19th and 20th century of aspirin, insulin, sulphonamides and penicillin 2. Themass production of drugs in the 1940's helped the modern pharmaceutical industry take off. 3. Chemotherapy has been happening since WW2 and pharmaceutical companies have been producing cancer drubs since the 1960's. 4. In 1981, doctors identified a new illness, AIDS. In 1987, pharmaceutical companies began mass producing a drug called AZT which was the first approved drug to treat HIV. 5. In 2022, there was an outbreak of SARS in China. Companies produced drugs that reduce symptoms.

Question 71

Why is there thorough clinical drug testing now before being released to the public? (2)

Answer 71

1. In the 1950's, the drug thalidomide was released without thorough testing. It was originally a sleeping pill but soon became used as a treatment for morning sickness in pregnant women. However, this affected the women's unborn babies casuing thousands of children to be born with under developed limbs. 2. This tragedy forced companies to test drugs first. In 1963, the government set up a Comitte on Savety of Drugs to make sure all drugs were d=safe before being given to patients.

Question 72

How did the introdution of antibiotic resistance impact medicine? (2)

Answer 72

1. Antibiotic resistence started because doctors and patients overuse antibiotics and this meant bacteria became resistent to them. 2. Around 25,000 people in the European Union die every year as a result of infections caused by antibiotic resistance bacteria.

Question 73

How have transplants been made more successful? (4)

Answer 73

1. In 1905, the first successful transplant of the cornea of the eye was performed. 2. The first organ to be successfully transplanted was the kidney. 3. The first successful heart transplant was carried out by the South African surgeon Christaan Barnard in 1967. The patient only survived for 18 days as he dies of pneumonia. 4. The problem with transplants was rejection. Early transplants were not successful because doctors lacked effective immunosuppressants. Since the 1970's, researchers have developed increasingly effective immunosppressants.

Question 74

How has technology improved modern surgery? (3)

Answer 74

1. The discovery of radiation in 1896-1898 by Antoine Henri becquerel, Marie Curie and Pierre Curie allowed radiation therapy to be used as cancer treatment. 2. The development of lasers since the 1950's allowed them to be used as laser surgary in vision problems and also in cnancer treatment and dentistry. 3. Advancments in video technology led to the development of keyhole surgery in the 1980's. A small camera called an endoscope is put through t=a small cut allowing the surgeon to see inside the body, and use smaller cuts in the body. This ise useful for investigation infertility or causes of pain. It is also used for vasectomise, remocving cysts or the appendix, mending hernias and other minor operations. It leaves people with smaller scars and less risk of infection.

Question 75

How might patients use alternative treatments to modern medicine? (4)

Answer 75

1. Some people do not trust modern medicine. 2. Other treatments include acupuncture - putting needles in specific points of the patient's skin to relieve pain, or homeotherapy where extremely weak solutions of natural substances are used. 3. They are not based on evidence and there is little scientific evidence to prove that alternative methods work, some doctors believe they do more harm than good. 4. However, some doctors are working with alternative therapists to see if using a mix of alternative and mainstream medicine might result in benefits to the patient.

Question 76

How did Booth and Rowntree show the effects of poverty? (4)

Answer 76

1. Charles Booth's 1889 'Life and Labour of the people in London' showed that 30% of Londoners were living in severe poverty. 2. Seebohm Rowntree had a factory in York. He didn't believe the problem was as bad there as in London - so he did a survey of living conditions. His report 'Poverty, a Study of Town Life' (1901) showed that 28% fo people in York couldn't afford basic food and housing. 3. When the Boer War broke out in 1899, army officers found that 40% of volunteers were physically unfit due to poverty. 4. The government then realised that had to do something to help epole in order to have a good army.

Question 77

How did Liberal Reforms improve health? (7)

Answer 77

1. Booth, Rowntree and the Boer War shoed that there was a link between poverty and ill health. 2. Libral gov made changes. 3. 1906 - Free shcool meals paid by local council taxes. 4. 1907 - Local Education authorities started giving children at their schools, free medical inspections. 5. 1908 - Old age pensions were introduced for the first time - they were for people aged over 70. 6. 1109 - Labour exchanges were introduced to help unemployed people to find work. 7. 1911 - The National Insurance Act was passed. --introduced health insurance for workers.

Question 78

How did the world wars create pressure for social change? (3)

Answer 78

1. Raising armies made the government and military more aware of health problems of the poor. 2. The evacuation of children during WW2 increased awareness in richer rural communities. 3. After WW2, people looked for improvements. This led to the 1945 victory of the Labour party.

Question 79

How was housing and health improved after the WW2? (4)

Answer 79

1. By end of WW1, David Loyd George wanted to build 'homes fit for heroes' but few were build and most were too expensive for the poor. 2. During WW2, destruction due to bombing made things worse. 3. After the War, the Labour government built 800,000 new homes between 1945-51. In 1946, it passed the New Towns Act, this created new towns. Governments in the 1950's and 19060's demolished over 900,000 old, cramped slums and rehoused people. 4. In 1961, a report called 'Homes for Today and Tomorrow' gave specific standards for new housing, including heatng, a flushng tooilet and enough space outside and inside.

Question 80

How was the Welfare State created? (4)

Answer 80

1. The beveridge Report helped create the Welfare State. 2. It stated that everyone should be free from want, disease, ignorance, squalor and idleness. It also suggested a welfare state. 3. The 1954 labour government promised to implement Beveridge's proposals. 4. One of the first acts was national Insurance Act in 1946 to support those who could not work.

Question 81

When was the National Health Service created?

Answer 81

1. 1948

Question 82

What was the NHS?

Answer 82

1. Aneurin Bevan was the Labour Minister for Health who, after a lot of negotion, introduced the National Health Service. The government nationalised hospitals and put them under local authority control. Treatment was made free for all patients.

Question 83

What were the arguments that supported the creation of the NHS? (3)

Answer 83

1. Durinh WW2, the gov took control of all hospitals, creating Emergency Medical Service. Its success led many to support the NHS. 2. The NHS would make medical care free so it was accessible to everyone. 3. Th NHA guaranteed that hospitals would recieve government money, rahter than having to rely on charities for money.

Question 84

What were the arguments against the creation of the NHS? (3)

Answer 84

1. Many Conservatives opposed the NHS, as they belleved the cost would be huge. 2. Doctors saw themselves as independed professionals - they didn't want to be controlled by the government. They also worried that they would lose a lot of income. 3. Many doctors threatened to go on strike in protest agaisnt the NHS. (The government finally convinced ddoctors by offereing them a payment for each patien and letting them continue treating fee-paying patients.)

Question 85

Why was the NHS very popular? (4)

Answer 85

1. When Conservatives came back to power in 1951 they could not get rid of the NHS because it was too popular. 2. The number of doctors doubled between 1948 and 1973 to keep up with demand. 3. Today, the NHS provides many services - A&E, maternity care, parmacies, dentists, mental health, sexual health and GP's. 4. In the long term, it led to a lot of improvements in health. In 1951, men were expected to live to 66 and women to 72, and in 2011, men to 79 and women to 83.

Question 86

What challenges does the NHS face today? (5)

Answer 86

1. With increasing life expectancy there are more old people to take care of who are more likely to have long term illnesses so they take up more of the NHS' resources. 2. People's lifestyle choices are putting strain on the NHS, e.g. smoking obesity and alcohol consumption. 3. Modern equipment is very expensive and there are rising expectaions of what the NHS can offer. 4. As a result - the cost of the NHS is rising - in 2015/16 the NHS budges was £116 billion. In order to stay within its budget, the NHS sometimes has to make difficult choices about which treatments it can and can't provide. 5. A 2015 poll suggested that around 60% of British people are satisfied with the NHS showing that it is still relatively popular.