Medicine Flashcards

1
Q

What was used to treat pain in the mid 19th Century?

A

Opium, alcohol and knocking someone out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What type of surgeon was best in the mid-19th Century?

A

A quick one

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

In the mid-19th Century, medicine was still based on the findings of which Greek and Roman doctors?

A

Hippocrates and Galen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What was the miasma theory?

A

Germs were caused by poisonous vapours (bad air)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Who discovered that a small dose of cowpox protected you from smallpox?

A

Edward Jenner

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Who is the father of microbiology?

A

Pasteur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which animal did Pasteur first experiment on?

A

Silkworms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pasteur and Koch were spurred by the competition of which war?

A

Franco-Prussian war

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Koch was the first to use which technique?

A

Stain and grow bacteria in a petri dish

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

In 1881, Pasteur claimed he had a vaccination for which disease?

A

Anthrax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Ehrlich worked for who?

A

Koch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Ehrlich and Behring found chemical vaccines for what?

A

Syphilis - Salvarson 606

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What did Domagk discover?

A

The 2nd magic bullet - Prontosil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What type of drug is penicillin?

A

Antibiotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Who discovered penicillin?

A

Fleming - although Sanderson and Lister had noted it beforehand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Who developed penicillin?

A

Florey and Chain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How much did the US government give to drug companies in WWII to mass produce penicillin?

A

$80 million

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Who amputated 200 limbs in 24 hours?

A

Napoleon’s surgeon Dubois at the Battle of Borodino

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Name an operation that could be carried out in 1880?

A

Amputation, trephining, removal of superficial tumours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What did Sir Humphry Davy discover in 1799?

A

Laughing Gas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Who used ether as an anaesthetic in 1847?

A

Lister

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Who used chloroform as an anaesthetic in 1847?

A

Simpson

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Who died in 1848 after being given chloroform to remove her toenail?

A

Hannah Greener

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Chloroform was accepted after who used it?

A

Queen Victoria after the birth of her 8th child

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Who launched a hand washing crusade?

A

Semmelweiss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which antiseptic did Lister first use?

A

Carbolic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Between 1864 and 1870 what did the death rate of Lister’s patients fall to?

A

From 45.7% to 15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the limitations of carbolic acid?

A

Causes cracked skin, it smells, it’s extra work for surgeons and it was an added expense

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

By the 1890s Lister’s antiseptic methods had led to what type of surgery

A

Aseptic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What was used in 1894 for the first time?

A

Sterilised rubber gloves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Who discovered x-rays?

A

Wilhelm Rontgen in 1895

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

When was it discovered that there were different blood types?

A

1901

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What were three main improvements to surgery during WWI

A

X-rays, blood transfusions, fighting infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Who made advances in burns patients during WWII?

A

Archibald McIndoe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Which Russian pioneered work on skin grafts during WWII?

A

Filatov

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

When was the Medical Registration Act passed which prevented women becoming doctors?

A

1852

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Which American doctor was Elizabeth Garrett inspired by?

A

Elizabeth Blackwell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Which hospital did Garrett start attending lectures for doctors?

A

Middlesex Hospital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Which Society did Garrett pass the exams for in 1865?

A

Society of Apothecaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Where did Garrett get her medical degree from?

A

University of Paris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Which hospital did Garrett found in 1872?

A

New Hospital for Women in London

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Which Turkish hospital did Nightingale work in?

A

Scutari

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

In Scutari hospital what did the mortality rate fall to?

A

From 60% to 2.2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What was the name of the nursing school Nightingale set up in England?

A

Nightingale Training School and Home for Nurses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What was the name of the military nursing unit in WWI and WWII?

A

Queen Alexandra Imperial Military Training Services or QAIMNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What was the name of the Glasgow doctor who became a medical officer?

A

Dr Constance Ross

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is the term for governments not interfering?

A

Laissez-Faire

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Cholera hit which town in 1831?

A

Sunderland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

In 1854, who proved that there was a link between cholera and the water supply?

A

John Snow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Did Snow come before or after Pasteur?

A

Before - he died 3 years before Germ Theory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What was Chadwick’s 1842 report called?

A

The Sanitary Conditions of the Labouring Population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What were the main findings of Chadwick’s 1842 report?

A

The working classes could not work hard because of poverty and poor public health

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What did the 1848 Public Health Act do?

A

Permissive, encouraged local authorities to make improvements, provide a medical officer, allowed them to borrow money

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What were the limitation of the 1848 Public Health Act?

A

Permissive, costs too high, only a few local authorities took measures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

When was the Great Stink?

A

1858

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Which northern town led the way in terms of public health?

A

Leeds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Who was the mayor of Birmingham in the 1870s?

A

Joseph Chamberlain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

When did some working class men living in towns get the vote?

A

1867

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What did the 1875 Public Health Act do?

A

Local councils responsible for clean water, public toilets, rubbish removal, sewers and drains

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Who built Bourneville model city in Birmingham?

A

Cadbury family

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Name a social reformer of the 19th Century/early 20th Century

A

Rowntree, Booth, Galt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What percentage of volunteers for the Boer War were unfit?

A

50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Which countries had overtaken Britain in the Industrial Revolution?

A

Germany and USA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

When did Liberals introduce free school medical inspections?

A

1907

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What was a limitation of the medical inspections?

A

Parents still had to pay for medicine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

When was the Old Age Pensions Act?

A

1908

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

How did Lloyd George fund Old Age Pensions?

A

The People’s Budget

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Which National Insurance Act covered sickness?

A

1911 Part II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What did the death rate for broken thighs go down by due to splints?

A

80% in 1914 to 20% in 1918

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Who developed mobile x-ray machines?

A

Marie Curie

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Who added sodium citrate to blood to stop it clotting?

A

Agote and Hustin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

When did the British set up blood banks for type O blood?

A

1917

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Who set up a British army plastic surgery unit?

A

Harold Gillies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Who led the Blood for Britain campaign in WWII?

A

Dr Charles Drew

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

How many of the 17,000 injured troops at Dunkirk developed tetanus?

A

None

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Who developed better plastic surgery techniques during WWII?

A

Archibald McIndoe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

When was the NHS set up?

A

1948

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What were the ideas of Hippocrates and Galen?

A

Hippocrates had practiced medicine in Greece and it is through him that we have the Hippocratic Oath. He pushed the idea of monitoring patients and writing down their symptoms. He developed the idea of the Four Humours Galen had practiced medicine in Rome and contributed a lot to the understanding of anatomy and believed in the Four Humours and the idea that if they were unbalanced that was why you were ill.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What advancements had been made by the 17th and 18th Centuries?

A

During the scientific revolution of the 18th century new advances in anatomy and science had been made and the ideas of Galen were questioned.In the 16th century Vesalius had encouraged doctors to do their own dissectionsIn the 17th century doctors increasingly used microscopesScientists began to question the idea of the Four Humours on discovering that air itself is made up of different gasses.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What is miasma theory?

A

There had always been a connection between dirt and disease.The idea was that a poisonous vapour which consisted of particles of decaying matter created a foul smell.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Why did the miasma theory make sense in the 19th Century?

A

The theory of miasma made sense because rapid urbanisation and industrialisation created poor and foul-smelling areas that tended to have epidemics.If these were improved there was an improvement in disease ratesFlorence Nightingale believed this theory and this is why she wanted hospitals to be well-ventilated, clean and airy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

What is Spontaneous Generation?

A

People did not understand the link between microorganisms and disease. The theory of Spontaneous Generation claimed that rotting material created maggots, fleas and disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

List some of the positive developments made before 1850 to help improve knowledge and understanding of illness

A

Late 17th century – Microscopes developed by a Dutch clockmaker called Anthony van Leeuwenhoek. He discovered that everything he looked at contained tiny organisms which he called animalcules – water, faeces, animal intestines, even the scrapings from his teeth. He wrote 200 papers for the Royal Society in London1796 – Edward Jenner discovered that a small dose of cowpox protects humans from smallpox and called the technique vaccination. In 1805 Napoleon had all of his soldiers vaccinated. In 1852 the British government made vaccination compulsory.1830 – A British Scientist, developed a microscope that magnified 1000x without distortion. With these improved microscopes scientists could observe in detail the behaviour of microorganisms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Who was Louis Pasteur?

A

A French chemist in the late 1850s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

How did Pasteur prove that bacteria was spreading disease?

A
  • He was asked by a brewery company to investigate the sour beer.- He took two flasks, heated a liquid in one to make it sterile and drove the air out of it. Ge sealed the flasks. Approx 10 years later, the cleaned flask was sterile and the other was full of bacteria.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

In 1860 what challenge did the French Academy put forward?

A

Prove or disprove spontaneous generation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

What was the theory developed by Pocuhet?

A

Scientists thought the germs were spontaneously generated by the decay and then spread the disease further

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

What was Pasteur’s Germ Theory?

A

He showed food went off because of contamination through the air. That germs were spread through the air and not spontaneously created

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Why was Germ Theory controversial?

A

Pasteur was a chemist not a doctor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

What was the impact of Pasteurisation?

A
  • This was the start of the method of heating and sterilising liquids- We still use it today! For example, milk. It also paved the way for air-tight food storage such as tins and cans.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

What was Pasteur’s investigation into silkworms?

A

In 1865 he was asked to save the silk industry! He proved that bacteria was spreading the disease and by isolating diseased silkworms you could save the rest.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

What was the impact of Pasteur in surgery?

A

It led to an understanding of why infection often developed after an operation and to Joseph Lister’s antiseptic techniques

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

What was the impact of Pasteur on public health?

A

It helped explain the link between hygiene and health.His ideas led to the identification of various microorganisms causing disease which meant vaccines could be produced.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

What were the limitations to Pasteur’s work?

A

It wasn’t until 1878 that he published Germ Theory and its Application to Medicine and even then, many scientists didn’t accept his ideas.Scientists did not understand how blood had hundreds of microorganisms but only some caused disease.It was not clear how germ theory could CURE disease. It could only identify its spread.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Who was Koch?

A

A German doctor. Especially good at lab work. He stained microbes in order to identify different diseases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Why was there a rivalry between Koch and Pasteur?

A

The Franco-Prussian war of 1870-71

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

How did Koch discover anthrax in animals?

A

Koch wanted to further Pasteur’s ideas and identify specific microbes.In 1868, a French scientist called Davaine had proved that a healthy animal could get anthrax if injected with the blood of an infected animalFound that anthrax produced spores that lived for a long time after an animal had died. Proved that these spores could develop into the anthrax germ that could infect other animals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

Why was Koch important?

A

He did not focus on symptoms of a disease but, instead, investigated the microorganisms and showed that new techniques could be used to investigate a number of diseases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

How did Pasteur solve the problem of chicken cholera?

A

By the 1870s, Pasteur was worried that Koch was getting ahead of him so he tried to find a cure for disease.In 1879, he extracted the germ which causes the disease to make a weak form to inject chickens withOne of his team injected an old sample - the chicken did not die. He then infected it with fresh cholera germs and the chicken still didn’t die.They realised that a weakened form of the disease would stimulate the chicken’s natural defences to find a solution so would fight against further infection.He had proved Jenner’s vaccinations worked.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

How does Pasteur solve anthrax in animals?

A

Anthrax killed 9% of sheep and 7% of cows every year.In 1881 he publicly displayed his findings for the Agricultural Society of Melun in which he demonstrated a vaccine for anthrax.He was criticised by Koch for not accurately measuring his findings but Pasteur became famous.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

How does Pasteur solve rabies?

A

In 1882 he looked into rabies.The disease was passed on by dieased dogs biting humans.He created a vaccine but did not test it on humans until a 9 year old boy came to him with rabies. Pasteur used the vaccine and saved the boys life.People flocked from all over Europe to see him.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

How did Koch use bacteriology?

A

He experimented with industrial chemical dyes to stain microorganisms a different colour and make them easier to study under a microscope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

How does Koch identify septicaemia?

A

He discovered that methyl violet dye showed up the septicaemia germ under a microscope by staining it.He also took photographs so people outside of the lab could see it.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

How did Koch grow perfect cultures?

A

He perfected the technique using a mix of potatoes and gelatine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

How does Koch identify tuberculosis?

A

In 1881 he turned his attention to TB.It was much smaller than anthrax so research was difficultHe used a more specialised version of his dye techniqueIn 1882 they had found the germ.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

Who were microbe hunters?

A

A new generation of young scientists who were inspired by Koch and Pasteur. An example is Ehrlich.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

Why was Koch important?

A

He finally laid to rest the idea of bad air causing disease.Had inspired many young researchers to carry on his workHis work could be developed to create vaccinesBy 1900. 21 germs had been identified in just 21 years.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

What other diseases were found?

A

1882 - Typhoid1886 - Pneumonia1887 - Meningitis1894 - Plague

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

What arguments are there for Pasteur being more important than Koch?

A
  • Disproved Spontaneous Generation- Proved that germs cause decay and not the other way around- Koch wouldn’t have started his work- Invented Pasteurisation- Paved the way for future safe food storage- Found the vaccination for anthrax- Germ Theory
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

What arguments are there for Koch being more important than Pasteur?

A
  • Koch paved the way for other scientists to develop his ideas- Discovered germs for specific disease e.g. TB and anthrax- Started to stain bacteria to identify them - new technique- Worked with a team meaning lots of new ideas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

What limitations were there to Koch?

A

It was a while before these ideas were accepted into medicine and a long time before prevention and treatmentScientists and doctors were doubtful meaning the public knew nearly nothing about itVaccines could not prevent anything if the disease was already in the body.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

Who was Paul Erhlich?

A

He was a physician that had worked in Koch’s bacteriology lab. He reasoned that he could not only stain but attack harmful microbes if he could find a chemical to attach and kill the germ.He called these chemicals magic bullets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

Who was Emil Behring?

A

He was a pioneer in the field of immunology.In 1889 he discovered that it was possible to neutralise bacterial toxins using antitoxinsHis work resulted in the development of blood serums against diphtheria and tetanus and modern methods of immunisation have eradicated diphtheria almost worldwide.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

What did the first Magic Bullet cure?

A

Syphilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Explain the discovery of Salvarson 606 (the First Magic Bullet)

A

Ehrlich opened a research institute to find the Magic BulletHe wanted to kill specific germs but not harm anything else in the body.In 1905 - they tested over 600 chemical compounds In 1909 - Hata joined the team. Retested discarded chemicals and found the 606th worked. In 1911 - First tested on humansEhrlich and other scientists proposed that researchers should develop specific drugs to target specific germs killing the cause of the disease rather than the symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

Who was Marie Curie?

A
  • Born in Warsaw, Poland- Went to Sorbonne University in Paris- Worked on radiation and discovered radium and polonium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

Marie Curies’ research

A
  • Began pioneering work into invisible rays given off by uranium inspired by Professor Henri Becquerel- Marie noticed samples of pitchblende were a great deal more radioactive than pure uranium- They set about finding the unknown element that was causing the radioactivity and extracted a black powder 330x more radioactive than uranium.- They called it polonium- They found that the liquid after extracting polonium- In 1898, the Curies named this radium but it was only officially isolated in 1902.
118
Q

What illnesses and diseases were common in WWI?

A

Shell-shock - a form of PTSDTrench foot - painful swelling of the feet. If gangrene developed the only cure was amputationTrench fever - flu like symptoms caused by contact with liceDysentry - stomach pains, diarrhoea and vomiting caused by infected food, water and people.

119
Q

How did blood transfusions develop during WWI?

A

At the beginning of the war nurses only had salt water to clean wounds.Soldiers did not realise that open wounds were more likely to get infected.Blood was first stored successfully during WWIIt prevented a great many deaths.

120
Q

What were the limitations to chemical cures?

A

Government funding was not forthcoming - it was hard for chemical cures to be mass produced.Salvarson 606 was only effective against syphilisMany doctors denounced Salvarson 606People were less likely to take Marie Curie’s work seriously because she was a woman and her work was highly dangerous

121
Q

Who was Gerhard Domagk?

A

He was a chemist who had been inspired by the achievement of Paul Ehrlich’s teamHe and Josef Klarer were interested in using chemical dyes as antibiotics as dyes had to stick to this bacteria so it might as well kill it too.

122
Q

What year did he test Prontosil?

A

1932

123
Q

What were his experiments in using Prontosil?

A

He used a strain of streptococcus bacteria - the same bacteria responsible for scarlet fever, rheumatic fever, pneumonia and strep throat.He exposed cultures of the bacteria grown in glass dishes to the dyes to determine whether any of the dyes could kill the bacteria outright. But after exposure to Prontosil the bacteria continued to thrive.

124
Q

What was the speed of the discovery thanks to?

A

New powerful Electron Microscopes

125
Q

Explain his experiments of Prontosil in mice

A

He infected a group of mice with a lethal dose of streptococcus.He gave some of the mice Prontosil but not all.The mice that did not receive Prontosil died and the ones that were given Prontosil didn’t get sick.

126
Q

Explain Domagk’s tests of Prontosil on humans

A

He had been testing it on humans as he was partnered with a nearby hospital.He tested it on his own daughter and she was cured of the streptococcus bacteria within two days.

127
Q

When did Domagk publish his report on Prontosil?

A

1935

128
Q

How was Domagk’s report viewed?

A

With great skepticism. At the time a lot of doctors didn’t even think it was possible to fight diseases with chemical cures

129
Q

What did British hospitals manage to do with Prontosil?

A

They recreated the results of the clinical trials using it to cure puerperal fever.

130
Q

Which president’s son used Prontosil?

A

Franklin D. Roosevelt’s son. To cure a severe strep throat infection

131
Q

What other advancements were made with Prontosil?

A
  • It was developed by French scientists who found the drug could be used to cure tonsillitis, puerperal fever and scarlet fever- May and Baker, British scientists found a version of the drug could be used against pneumonia
132
Q

What were the disadvantages to Prontosil and other sulphonamide drugs?

A

They could damage the kidney and liverThey were ineffective against highly virulent (severe) microbes

133
Q

What is penicillin?

A

An antibiotic. It kills life that is harmful to living creatures e.g. bacteria.

134
Q

Who had look into penicillin before Fleming?

A

19th Century - John Sanderson discovered a mould called penicillium1880s Joseph Lister noted it should be used to treat infected wounds. Tried this with a nurse but left no notes on it.

135
Q

Who was Alexander Fleming?

A

A scientist at St Mary’s Hospital in LondonWorking on staphylococci. Germs that make wounds go septic.

136
Q

What were his interest in antibiotics?

A

He became interested in the natural bacterial action of the blood and in antiseptics. He was able to continue his studies throughout his military career.

137
Q

Explain the steps of the discovery of penicillin

A

In 1928, he observed that a mould had accidentally developed on a staphylococcus culture and it had created a bacteria free circle.He found that a mould culture prevented the growth of staphylococci, even when diluted 800 times. He called it penicillin.He grew more of it and experimented against anthrax and diphtheria It was the first example of a naturally occurring antibiotic.He treated a friend who had meningitis with itHe wrote a paper in 1929 about it

138
Q

What were the problems with Fleming and penicillin?

A

He did little with his discovery

139
Q

How did Florey and Chain investigate penicillin? (Investigation up til animal trials)

A

In 1939 they assembled a team of pathologists to study penicillin.After the outbreak of war they asked the British government to fund the team’s researchThey used milk bottles, milk churns, a dog bath and a hand pump to make a few grams of pure penicillinThey tested it on 8 mice who were injected with steptococci. Four mice were given penicillin - they lived.

140
Q

What was the first human trial of penicillin?

A

In 1941Albert Alexander was near death as a result of a bacterial infection.His doctor, Fletcher used penicillin on him.They did not have enough and he died but it showed that penicillin could be used on humans.

141
Q

How did the USA joining the war impact the use of penicillin?

A

1942 - The US government gives $80 million to 4 drug companies to find a way to mass produce penicillin1943 - Mass production began. First used by the British army in North Africa1944 - Enough penicillin available to treat all casualties of D-Day1945 - US army uses 2 million doses of penicillin a month.

142
Q

What was the impact of penicillin?

A

Became widely available after the USA’s entry into the warIt is estimated that 12-15% more Allied soldiers would have died without penicillin. It also halved the average amount of time an Allied soldier spent in hospital.

143
Q

What factors were there that influenced changes and developments of the search for cures to infectious diseases

A

Technology - the Industrial Revolution provided scientists with new types of microscopes, dyes, labs and technical equipment.Good luck - some of the discoveries were down to chance e.g. Fleming wasn’t searching for penicillin when he came across itCompetition - scientists were constantly in competition. Koch and Pasteur are an exampleGovernment - The British government-funded research into penicillin in 1939 and the US government offered money for mass productionWar - medical advancements are often accelerated through war as governments want to reduce death.

144
Q

How did working conditions contribute to poor public health by 1850?

A

Workers in mines, workshops and factors had long hours and short breaksToilet and washing facilities were incredibly poor with many people sharing one privy (toilet) and only a pipe to wash itMany fell ill from work, swallowing coal and textile dust which led to lung disease

145
Q

How did diet contribute to poor public health by 1850?

A

Fresh food was hard to get and was expensiveFood was often adulterated - mixed with other things e.g. chalk in bread, sand in sugar for shopkeepers to make more money

146
Q

How did urbanisation contribute to poor public health by 1850?

A

People lived in overcrowded housing with little ventilation and no clean water supplyLandlord made profits from renting out houses and wanted them built quickly.

147
Q

How did lack of access to a doctor contribute to poor public health by 1850?

A

Doctors were not paid by the government and so charged fees for their patientsPoor people could not afford to go to the doctor

148
Q

How did the role of the government contribute to poor public health by 1850?

A

Most politicians had a laissez-faire attitude to the public health and believed each local area and rate payers should make decisionsIncome tax was very new and very low so there was no money to make improvements

149
Q

How did killer diseases contribute to poor public health by 1850?

A

Few people had been vaccinated against smallpox despite it being availableThere was no prevention or treatment for typhus, typhoid fever or influenzaCholera was the most frightening disease. The epidemic of 1931-32 killed approx 20,000

150
Q

What was the problem of cholera by 1848?

A

Cholera was one of the most feared infections of the Industrial Age. 1. Symptoms included vomiting, cramps, eyes sinking and your skin turning black/blue2. You could be dead within 24 hours3. Cholera was a disease of both rich and poor.

151
Q

When and where did cholera arrive?

A

1831 in Sunderland. It killed around 30,000 people within a year.The majority of these deaths were in overcrowded slums with poor housing and little clean water.

152
Q

What did MPs discuss during the 1848 cholera outbreak

A

A day of prayer

153
Q

What did Dr Robert Baker’s report on the 1832 epidemic in Leeds describe the housing as

A
  1. Many of the streets were on bare earth and so mud and filth collected easily2. 19 streets did not have a sewer and another 10 only had a sewer covering part of the street3. Stagnant water caused offensive smells4. In some poorer parts of town, human excrement was collected to sell to farmers.
154
Q

Who was Edwin Chadwick?

A

He was born in Manchester in 1800He trained in lawHe worked for the Poor Law Commission and believed in using science for social improvement.1832 - Asked to serve on a royal commission to investigate the effectiveness of poor laws.He became interested in the problem of sanitation and was a believer in miasma theory.He believed that cleaning, drainage and ventilation would make people healthier and therefore less dependent on welfare.This work contributed to the 1834 Poor Law Amendment Act

155
Q

What was Chadwick’s 1842 report about?

A

He published ‘The Sanitary Conditions of the Labouring Population’ which showed that there was a direct link between poor living conditions and life expectancy and disease.He said that the labouring classes could not labour as well as it could because of poverty and poor healthHe argued that if you improve the standard of living for the working class then the country would benefit as a whole.MPs listened to this report in ‘astonishment, dismay, horror and even incredulity’

156
Q

What did Chadwick’s 1842 report inspire

A

It inspired the Public Health Act of 1848

157
Q

Why was Chadwick’s report important?

A

He realised the poor were living in poor conditions which led to illness. He came up with a solution - improving drainage and sewage, removing waste from the streets, introducing clean water supplies and appointing medical officersHe was hard working so he gathered lots of evidenceHis report was the basis of the 1848 Public Health Act

158
Q

What is the 1848 Public Health Act?

A
  • Influenced by Chadwick’s 1842 report and triggered by a major epidemic of cholera- It was permissive - the Board of Health would encourage local authorities to improve conditions if their ratepayers supported it but could not force them- Provide a local medical officer- Enabled local authorities to borrow money to pay for the improvements- Disbanded in 1878
159
Q

What were the limitations of the 1848 Public Health Act?

A
  • It was permissive. Local authorities were not forced to make change.- It was temporary. The Board of Health was only set up for 5 years.- Cost of improvements was high. £11 million was borrowed between 1848-1872 but only a few local authorities took measures to improve conditions- Chadwick’s personality. He annoyed people and did not win support. He was arrogant and refused to believe Germ Theory.- Attitudes were slow to change. People did not like the idea of increased taxes- By 1872, only 50 councils had appointed Medical Officers of Health.
160
Q

Who was John Snow?

A

He was a pioneer in surgery, public health, improving medical conditions and the use of evidence to challenge old theories.At fourteen he became an apprentice to a surgeon

161
Q

How does Snow formulate his theory of how cholera is spread?

A
  • He dealt with cholera in 1832 in Killingworth. The poor sanitation did not escape John Snow’s observation.- He settled in London and began to study cholera- He began to believe that cholera was spread by something other than poisonous vapours - if it was surely it would affect the lungs.- He believed that London’s dirty and polluted water supply had something to do with it. That Londoners were drinking their own waste.- He published ‘On the Mode of Communication of Cholera’ in which he outlined his theories.- Many rejected these ideas.
162
Q

How does John Snow use the 1854 cholera outbreak to prove his theories?

A
  • He used research, observation and door-to-door interviews to build a detailed map of a cholera epidemic in Broad Street- Nearly all the deaths had taken place within a short distance of the water pump- Near to the pump, there was a brewery and none of the people there had cholera. The brewery had its own water pump and the men had free beer.- Snow removed the handle from the Broad Street pump- There were no more deaths. It was later found that a cesspool near the pump had been contaminating the drinking water- Snow put pressure on water companies to clean up their supplies.
163
Q

What limitations were there to change during this period?

A
  • Little was done to improve public health, even with Snow’s findings.- MPs refused to debate the issue because the idea of consuming human waste was too disgusting and embarrassing to consider.- Miasma theory was still incredibly popular - Germ Theory had not been discovered- There was still an idea that people were being punished for their sins. Reverend Henry Whitehead was a key proponent of this idea.
164
Q

What was the Great Stink

A

In 1858, extremely hot weather and the low level of the River Thames exposed sewage along its banks. The smell was so bad that parliament couldn’t meet even though sheets of disinfectant were covered up at the windows to help with the smell.

165
Q

How did Bazalgette solve the problem of the Great Stink?

A

MPs passed an Act (within 18 days) to provide money for a new sewer systemBazalgette was chosen to design it and £3 million was given to the London Metropolitan Board of Works.His plans included:- The sewers would be very large and built of brick. Sewage would be less likely to get stuck in oval tunnels.- The whole system planned to bring waste down to the lower stretches of the Thames where the river was tidal and it would be swept out to seeThe whole project was expensive and took several years to complete. Most of the 2000km of sewers had been built by 1865. They mainly used gravity to keep the sewage flowing but also built 4 pumping stations between 1864-1875 and two treatment works to deal with sewage not sent out to sea.By 1875 the whole project had cost £6.5 million.When the sewers first opened, a small railway was installed so people could travel through it - they could even buy souvenirs.

166
Q

What other reasons were attitudes starting to change in order to lead to the 1875 Public Health Act?

A
  • Parliament became convinced they should take action to improve public health. In 1852 and 1871, laws were passed making smallpox vaccination compulsory for children. and the 1866 Sanitary Act said that all towns had to employ medical inspectors.- Snow’s work in 1854 seemed to prove a link between water and cholera.- Pasteur’s germ theory showed how disease was spread.- The government started collecting statistics on birth, marriages and deaths; William Farr studied these and showed that death rates were higher in towns and cities than villages- An outbreak of cholera in 1866 least affected towns where there had been improvements in public health- In 1866, Leeds appointed a medical officer, had a pressure group to force the council to make changes and had sewage purification works. Manchester made regulations about the size of rooms and windows in new houses. Towns began to compete with each other to be the cleanest.- When working class men got the vote in 1867, they used their voice to put pressure on the government. In the 1870s, Mayor Joseph Chamberlain of Birmingham carried out several reforms including the demolition of 40 slums.- From 1870 every local authority had to set up schools. Health education was taught and improved literacy meant people could read medical pamphlets.- In 1875 the Artisans Dwelling Act gave local authorities the power to buy and demolish slum housing.
167
Q

What was the 1875 Public Health Act?

A

It was largely seen as a mechanism for consolidating the previous Acts of Parliament relating to public health from the 19th Century.The act established name local authorities as rural and urban sanitary authorities, replacing the old boards of health. Authorities were obliged to provide clean water, dispose of sewage and refuse and ensure that only safe food was sold. The act forbade the building of homes without connection to a main sewage system.In short:- Clean water- Public toilets- Rubbish removal- Sewers and drains- The Act also made towns appoint Health and Sanitary Inspectors and a Medical Officer of Health

168
Q

What other Acts of Parliament were there in the 19th Century?

A

1875 Artisans Dwelling Act - gave local authorities the power to demolish slum housing1875 Food and Drugs Act tried to improve the standard of food being solved. Dangerous malpractices were common e.g shopkeepers would mix flour with sand to make it weigh more.1876 River Pollution Prevention Act made it illegal for factories to put their waste into rivers1889 Infectious Diseases Act ordered householders of doctors in London to report cases of infectious diseases to the Medical Health officer. It was extended to the rest of the country in 1899 and led to new isolation hospitals.

169
Q

What other improvements were made in the 19th Century?

A
  • Park Hospital opened in 1897. It had 48 wards for scarlet fever, 24 wards for diphtheria and fever and isolation wards for highly contagious diseases.- Joseph Chamberlain (Mayor of Birmingham) bought the companies that provided water and gas light and provided these for the city. He cleared 40 acres of slum housing.- The Cadbury’s family in Birmingham built a village for their workers (Bournville). It was a model community with good housing, parks, sports facilities, schools and community buildings.- Titus Salt built Saltaire for his workers near Bradford. It had 800 houses, piped gas, water and toilets. It had parks, a hospital and other facilities for the workers.- The Lever family near Liverpool built a village for their workers called Port Sunlight. It had decent housing, parks, schools, art galleries and other community buildings.
170
Q

What were the limitations to change during the 19th Century?

A

In many towns, basic services such as water, lighting and paving were still in the hands of individuals and private companies.Many people still lived in appalling poverty and ill health. General standards of health remained poor.Studies by Charles Booth and Seebohm Rowntree showed that large numbers of people lived below the poverty line in conditions where disease spread quickly.Poverty meant poor nutrition, which affected people’s health and death during childhood was commonFrom 1881, infant mortality started to increase againThere was no comprehensive system to improve public health by tackling its causes - poverty.

171
Q

Why did the Liberals introduce public health reform?

A
  • There was a history of social reform in Britain. New Liberals were determined to make change.- Attitudes to the poor had changed by 1906. There was more recognition that poverty was a problem that could be solved and the government was best placed to solve it.- The problem of poverty - had received great publicity. Britain was one of the richest countries and so many citizens lived below the poverty line. Life expectancy for the poor was 45.- The social reformers such as Charles Booth, Seebohm Rowntree and John Galt influenced the government to take action. Booth researched poverty in London. Rowntree studied poverty in York and John Galt was a missionary in the east end of London and photographed poverty. Researches found at least 30% of the population lived below the poverty line.- Demands of the Empire meant that Britain needed a strong army. During the Boer War, half the volunteers were unfit to serve. In some poor areas it was as high as 69% and the army had to lower its minimum height requirement.- The Industrial decline of Britain. There was a worry that Britain wouldn’t be able to compete with Germany who offered their workers sickness benefits and so Britain out to follow their lead.- Political rivalry and the rise of socialism. The newly formed Labour Party posed a threat to the Liberals and Conservatives. The Liberals hoped that social changes would stop people voting Labour.- Lloyd George and Winston Churchill pushed changes through parliament. They were influenced by Booth and Rowntree.
172
Q

What were the successes and limitations of 1906 Free School Meals?

A

Successes: Received by over 158,000 children per day by 1914. Guaranteed children from the poorest families at least one meal per dayLimitations: Provided by councils. Free school meals were not compulsory and not all councils provided them. Only half of local authorities set this up.

173
Q

What were the successes and limitations of 1907 Free School Medical Inspections?

A

Successes: Children got free, compulsory medical checks. Provided by doctors and nurses in schools.Limitations: Checkups were free but until 1912 parents had to pay for any medical treatment that was found to be required.

174
Q

What were the successes and limitations of 1912 School clinics set up?

A

Successes: Medical treatment for children was provided free of charge after 1912Limitations: Standards of care still varied around the country. However, by 1914 most local councils were providing some free medical treatments.

175
Q

What were the successes and limitations of 1908 Children and Young Persons Act (Children’s Charter)?

A

Successes: Children became protected persons. Parents who abused or neglected their children could be prosecuted. Child care committees tried to support families in difficulties. Borstals were set up so young offenders did not have to go to adult prisons. There were special juvenile courts and the probation service began. All children’s’ care homes had to be registered and inspected.Limitations: Measures to protect children were difficult to enforce. Some borstals were no better than adult prisons. Children’s homes could still be harsh and some local authorities provided better standards of care than others.

176
Q

What were the objections to these reforms for children?

A
  • Some objected that the government should not interfere in family life, saying it was not up to the government to tell parents how to look after their children. The cost of feeding and caring for the poorest children was a further burden upon local councils who increased rates to cover the cost. (Rates were a local tax paid by property owners)- Others said the reforms were insufficient and that children needed even more protection. Voluntary schemes meant some areas gave better care than others.
177
Q

What were the successes and limitations of 1908 Old Age Pensions Act - Those over 70 received 5 shillings a week or 7s 6d for a married couple - later increased to 10 shillings.

A

Limitations: In the first year alone it was claimed by over 650,000 old people saving many from extreme poverty. Gave independence to the elderly and they no longer had to rely on charities. Saved many old people from the shame of the workhouse. Pensions were paid by the government the same benefits applied throughout the country.Limitations: Non-contributory scheme, paid for by the government who increased taxes to pay for it. Benefits were not generous and could be denied to old people who failed to work to the best of their ability during their work years. Not all old people qualified. Pensions were restricted to those who had an income of less than £21 per year.

178
Q

What objections were there to the reforms of the elderly?

A
  • Taxes had to be raised to cover the cost and many objected to paying more- Lloyd George’s People’s Budget of 1909 raised taxes for the wealthy causing uproar in the House of Lords- There were concerns that providing pensions would make people irresponsible and not save for their own retirement- Objectors were critical that the recipients of the scheme bore no cost as it was non-contributory- It was suggested that providing a pension robbed old people of their independence by making them reliant on the state.- The government seriously underestimated the number of people who would qualify. They estimated 500,000 but by 1913 it was nearly a million.
179
Q

What were the successes and limitations of 1911 National Insurance Part 1?It provided sickness benefit of 10 shillings a week for 13 weeks. It was paid for by workers, employers and government contributions

A

Successes: Around 16 million workers were covered under the scheme. All workers earning less than £160 a year had to join. Benefits included the cost of medical care by a doctor. Sickness benefit saved many workers and their families from debt and misery due to illness. Workers were able to take time off work when ill and so did less damage to their health.Limitations: The scheme was compulsory and the poorest workers resented having to pay 4d for contributions from their wages (some said Lloyd George was a thief). After 13 weeks sickness benefits was reduced to 5s a week and after 26 weeks they stopped altogether. It did not include the cost of medicines, hospital or dental treatment. Only covered the worker and not their families.

180
Q

What were the successes and limitations of 1911 National Insurance Part 2?Unemployed workers received unemployment benefits of 7s 6d a week. Paid for by workers, employers and government contributions

A

2.5 million workers, mostly skilled men, could receive unemployment benefit. Unemployment money was sufficient to help for a short period between jobs or when workers were laid off in seasonal trades. Many were saved from losing their homes and debt.Limitations: The average family could not survive on 7s 6d a week. Unemployment benefit ran out after 15 weeks. The scheme did not include all workers. Millions were not included as it was limited to certain trades such as building and engineering where there were seasonal layoffs. Benefits were kept deliberately low to discourage scroungers.

181
Q

What objections were there to reforms for the unemployed?

A
  • There was much opposition as the reforms were seen as an attack on market forces (the government was interfering too much in business practices)- Taxpayers objected to any part of their taxes being used to subsidise the unemployed as it would encourage idleness- Some employers and workers objected to having to pay towards the insurance scheme- Doctors at first objected to the sickness benefit scheme as they were used to having fee paying private patients. They later found that increased patients on their books more than compensated.- The scheme was compulsory and so some objected due to lack of choice.- Benefits were too low and did not cover enough workers or their families.- The benefits introduced were below subsistence level and inadequate to discourage dependency. They were in no way intended to discourage hard work and self-reliance.
182
Q

What problems in public health remained by the 1930s?

A

Unemployment was still over (over 3m). All the unemployed were outside of the National Insurance SchemeThose in work could not afford to pay and so they could not get free medical helpThe death rate for under 1 year olds was highIn most areas affected by the depression, infant mortality was increasing againIn 1934, there were 4m insurance policies on which people owed payments

183
Q

When was the Beveridge Report?

A

1942

184
Q

Who was the Beveridge Report written by?

A

William Beveridge

185
Q

What were the 5 giants that Beveridge wanted to tackle?

A

WantDiseaseIgnoranceSqualorIdleness

186
Q

What did the Beveridge Report suggest?

A

Setting up the NHS (healthcare from the cradle to grave), free for all, paid from taxes, staff were government employees and so they were paid through them. All people in work would pay National Insurance out of their wages (this would pay benefits when needed)

187
Q

What did the government do during WWII to intervene in public health?

A

The Emergency Medical Service was set up with central control over hospitals and medical staffFood was rationed to ensure that people got food to eatEvacuation meant that the government took a major role in keeping the population safe. The Middle Classes were shocked at the poor conditions of the children they received from big cities.

188
Q

How did Attlee’s Labour government lead to the NHS

A

In 1945, Labour won a landslide victory.Clement Attlee, the new Prime Minister announced that a welfare state would be set up to protect peopleThe welfare state would be paid for through National Insurance contributions by employers and employees.The 1946 National Insurance Act provided old age pensions, maternity benefits and payments to the sick and unemployed

189
Q

What was the 1946 National Health Act?

A

Aneurin ‘Nye’ Bevan proposed the National Health Act.This included:1. All hospitals would be taken over and put under thirteen regional health boards. These in turn would be controlled by the Ministry of Health2. All doctors would be paid a salary, instead of receiving fees for each of their patients3. Doctors would not be allowed to buy and sell practices and with them, lists of patients4. Doctors would not be allowed to set up new practices in areas where there were already enough doctors

190
Q

What was the opposition to the NHS Bill?

A
  • The BMA (representing 51,000 GPs) thrweatened to boycott the NHS if Bevan’s plans went through unchanged- The BMA likened Bevan to Hitler because he was trying to enforce change- Bevan’s responde was to take a more moderate line and he made a number of compromises
191
Q

What compromises did Bevan make to the NHS Bill?

A
  • Consultants would be able to work part-time for the NHS and continue with private patients too. They would also be allowed to use private beds in NHS hospitals to treat their private patients- He agreed that doctors would not be paid solely by a salary and would also receive a fee for every patient on their list.- He also agreed that doctors who joined the NHS would be able to retain private patients and the fees they got and the fees they received for treating them
192
Q

How did the NHS improve health?

A
  • Everyone in Britain was entitled to free medical care. This included visits to the doctor, perscriptions, hospital treatment and operations, emergency services, dental treatment and false teeth, opticians and free spectacles, vaccinations, and clinicsAll hospitals in the country (about 3,000) were taken over by the government and GPs were paid by the state
193
Q

What was the impact of the NHS?

A

By October 1949:- 187 million perscriptions had been provided- 5,250,000 pairs of glasses had been perscripted- 8.5 million people had been treated at dentists- The GP soon became the ‘family doctor’- The first charges were introduced for dental and optical treatment in 1951 (Bevan resigned in protest)- People no longer had to worry about treatment- Life expectancy increased from the year 1919 to 1992- The NHS offered many services: midwifery, after-care, dentists, hospitals, medical research, teaching hosptials, vaccination, and ambulances

194
Q

How did doctors train in the mid-19th Century?

A

In the mid-1840s, the medical training course for a doctor took 4 years. It included lectures on illness and treatment, practical experience in a hospital, and practical experience of midwifery and surgery.

195
Q

Why was surgery so dangerous in the mid-19th Century?

A
  • Blood loss was a problem so a tourniquet would be used to reduce the flow of blood.- There was no way of completely relieving the pain - the only type of of pain relief was alcohol, opium, or being knocked unconscious. In most operations the patient was away, held down by the surgeon’s assistants and usually screaming. By the 1840s there were only 3 operations which surgeons could carry out with some success1. Amputation of limbs2. Trephining3. Removal of superficial tumours.All were carried out quickly and pain was ignored. As medical knowledge advanced, many surgeons believed that if the patient could be ‘knocked out’ then this would give them more time to operate and refine their techniques.
196
Q

What had Sir Humphry Davy discovered in 1799?

A

Laughing gas. In the 1840s dentists began to use it for tooth extractions.

197
Q

Why was infection such a danger?

A

Germs might enter the wound and cause poisoning.Many operations were carried out in the patients home, which was not hygienic - although conditions in hospitals were often far worse.There was little understanding of infection and the surgeon would wear old clothes stained with pus and blood.The surgeon might wash his hands and equipment might be wiped clean but there was no knowledge of sterilisation.Bandages were rinsed and reused and the operation would be full of people: the surgeon, his assistance, medical students and wealthy donors.

198
Q

Who amputated 200 limbs in 24 hours?

A

Napoleon’s surgeon at the Battle of Borodino in 1812

199
Q

How did speed go wrong for one surgeon?

A

Robert Liston once amputated a leg in two and a half minutes but woked so fast that he accidentally cut off his patients testicles as well as his assistants fingers. Both the assistant and patient then died of infection.Someone had earlier died during this surgery of a heart attack. It’s the only surgery with a 300% mortality rate.

200
Q

How many patients with leg amputations died?

A

Almost half

201
Q

Who first experimented with ether in 1846?

A

An American dentist - he found it to be stronger than laughing gas

202
Q

Who first used ether in Britain in 1847?

A

Robert Liston

203
Q

What was astonishing about ether?

A

That the patient did not need to be held down to perform surgery.The patient also woke up not knowing that an operation had taken place

204
Q

What are the limitations of ether?

A

It caused vomitingIt irritated the lungsIt caused the patient to cough during the operationThe patient could be asleep for hours or even daysIt was unstable

205
Q

Who discovered the use of chloroform in 1847?

A

James Simpson

206
Q

How did James Simpson discover the use of chloroform?

A

He was experimenting with colleagues and it knocked them all out in under a minute.He realised this was powerful.He used to relieve labour pains in childbirth.

207
Q

How did Queen Victoria make chloroform more acceptable?

A

She used chloroform with the delivery of her 8th child. John Snow administered it.

208
Q

What did John Snow ceate in 1848?

A

The chloroform inhaler to control the dose.

209
Q

What were the limitations of chloroform?

A

Christian Opposition - arguments against relieving the pain of childbirth - it was seen as unnaturalMedical arguments - It was a new and untried gas. Hannah Greener died from chloroform usage in 1848Blood loss - Anaesthetics did not make surgery safer. Doctors tried longer and deeper surgeries which increased the risk of infection. Infection - Surgeons still did not understand the importance of hygiene. This meant that infection was still high.

210
Q

How did the increase in anaesthetics lead to a ‘Black Period’ of surgery

A

There was an increased number of deaths due to blood loss and infections.

211
Q

What was the Black Period of surgery?

A

Until the discovery of Germ Theory, surgeons did not take precautions to stop infection.They reused bandages, spreading gangrene from patient to patient.Doctors did not wash their hands or sterilise equipmentThe death rate increased

212
Q

How did Ignaz Semmelweiss promote cleanliness?

A

He was concerned about the deaths of healthy women after childbirth.He realised that medical students had been dissecting dead bodies before delivering babies and had not washed their hands.He launched a hand-washing crusade and called doctors that didn’t, murderers.

213
Q

Was Semmelweiss listened to?

A

No - he was regarded as a crank and a fanatic.

214
Q

What does aseptic mean?

A

Free from contamination. Surgically sterile.

215
Q

Explain what Joseph Lister did

A
  • Interest in wound healing developed when he worked as a dresser for Sir Erichsen- Realised that the key would be clean wounds which helped stave off infection- He applied carbolic acid compounds as an antiseptic on surgical wounds- This appeared to work.- His death rate went from 45.7% to 15%- He developed antiseptic spray to use in operating theatres- Carbolic acid was not used for long as it damaged tissues and breathing it caused problems.- His work revolutionised surgery and was a turning point.
216
Q

What was the opposition to Lister’s ideas?

A

Time and cost - Carbolic acid cracked surgeons skin and made everything smell. It caused extra work and made operations more expensive.Speed - Bleeding was still a huge problemNot carried out properly - Some surgeons copied his techniques but not properly and therefore believed it wasn’t effective.Human body - Arguments that antiseptics prevented the body’s own mechanisms from operatingGerm Theory - Many surgeons still did not believe that microorganisms caused diseaseModesy - Lister was not a showman. He was perceived as cold and arrogant.Technique - He was accused of constantly changing his ideas (he was looking for better alternatives to carbolic acid because it was corrosive)

217
Q

What helped Lister’s antiseptic ideas to be accepted?

A

Koch discovered the microorganism that caused blood poisoning in 1878

218
Q

What is aseptic surgery?

A

Surgery performed under sterilised conditions. Surgeons wore clean clothes, masks and rubber gloves

219
Q

How did aseptic surgery develop?

A

The discovery of antiseptics by Lister brought a breakthrough.In 1878, Koch discovered the microorganism causing septicaemia which led to more support for Lister. Koch introduced aseptic surgery after discovering heat killed more germs.Later, surgeons hands and nails were found to carry bacteria and so they were told to wear gloves.

220
Q

What did aseptic surgery lead to?

A

Operating theatres and hospitals being rigorously cleanedFrom 1887, instruments were steam-sterilised1894, sterilised rubber gloves were used for the first timeIn 1896, this led to the first heart operation to repair a stab wound.

221
Q

What further experiments were there with anaesthetics?

A

1874 Ore administers the first intravenous general anaesthetic in humans in modern times. 1884 – first clinical use of cocaine in Russia1897 first spinal anaesthetic administered in Germany.1898 Bayer Company introduces heroin, first synthesized from morphine in 1874, for use as a non-addictive painkiller. It was later found to be more addictive than morphine and the company removed it from the market.1903: Working at the Pasteur Institute, Ernest Fourneau develops the first synthetic local anaesthetic - Amylocaine (Stovaine).Ethyl Chloride is popularised as a general anaesthetic.1905: Alfred Einhor develops Procaine (Novocaine).

222
Q

How did Lister try to solve the problem of blood loss?

A

Arteries and veins that were cut open during surgery were sealed through cauterisation or would be tied together with ligaturesLister experimented with silk ligatures soaked in carbolic acidIn 1881, he published the results of using catgut (sheep intestines) soaked in carbolic acid. It would dissolve in the body so did not prevent the body from healing.

223
Q

How had blood transfusions developed?

A

The first attempt at a blood transfusion was described by the 15th CenturyIn 1818, Dr James Blundell performed the first successful blood transfusion.It was not until 1901, when Karl Landsteiner discovered blood groups that it became safer.Blood transfusions could now be carried out safer and had a huge impact on surgery.

224
Q

What were the limitations to changes in blood transfusions?

A

The main problem was that the blood donor had to be present for it to take place.Blood starts to clot as soon as it leaves the body so tubes became blocked.

225
Q

How were x-rays developed?

A

1895, William Rontgen discovered the technology behind X-rays. He published his findingsIn as early as 1896, many hospitals had an X-ray machine installed.They could see broken bones which meant they could be set properly. Surgeons could also see bullets or shrapnel making surgery quicker and safer.

226
Q

What problems were there during the First World War on surgery?

A

Halted medical research - WWI halted medical research as resources were diverted to winning the war. 14,000 doctors were taken from their normal work.Infection - Battlefields were incredibly dirty and most methods were only effective in clean operating theatresNumbers - The sheer number of casualties was overwhelming. The Somme saw 1 million alone.

227
Q

How did WWI improve blood loss?

A

In the 1910s, it was discovered that adding anticoagulant and refrigerating the blood was successful for storing it.Hustin, who used sodium citrate as an anticoagulant performed the first non-direct transfusion in 1914.The need to stockpile blood led to the discovery that you could separate plasma and cells. Cells could be bottled, packed in ice and stored. He established the first blood bank in 1917.

228
Q

How were X-rays improved in WWI?

A

Marie Curie used her own money to equip ambulances with X-ray equipment.The International Red Cross made her head of its Radiological Service and she ran the training courses

229
Q

What were the limitations to progress with X-rays?

A

X-rays could not be used to detect fragments of clothing within a wound.The patient had to remain still while the X-rays were taken - a problem if the soldier was in painThe glass tubes overheated so they could not be continuously used.High doses of radiation could cause burns.

230
Q

How were there improvements with fighting infection during WWI?

A

Prevention of infection was difficult. Operations and bacteria on clothing often caused gangrene.They eventually discovered to cut away the infected tissue and soaking the wound in a saline solution.

231
Q

What were the limitations to improvements in fighting infection?

A

Excision and debridement to cut away tissue and carrel-Dakin salt solution cleaning method were time consuming and often the only solution was amputation.

232
Q

What was the Thomas Splint and how did it help?

A

The Splint forced the wound to stay still which reduced the chance of infection In 1914, 80% of soldiers with a broken femur died. In 1916, 80% lived.

233
Q

What was skin grafting and how was it developed?

A

Harold Gillies was tasked with dealing with facial injuries caused by shrapnel. He did this through skin grafts.He opened a specifically-designed hospital in Sidcup, treating 200,000 patients after the Battle of the Somme alone. Facial reconstruction became an important part of the post-war healing process.

234
Q

How were prosthetic limbs developed during WWI?

A

Over 240,000 soldiers lost a limb.Prostheses became much more advanced and they were made of lighter metal alloys and had more advanced mechanisms.

235
Q

What were the limitations to prosthetic limbs?

A

They took time to make and there were long waiting listsPatients had to be taught to use it effectively which took a long time.

236
Q

How was brain surgery developed during WWI?

A

American neurosurgeon, Harvey Cushing, experimented with using magnets to draw out pieces of metal from wounds.He found success in using this on brain injuries.He also found that using local anaesthetics did not cause the brain to swell like general anaesthetics did.

237
Q

How did blood transfusions develop from 1920-48?

A

1920s: The first academic institution devoted to the science of blood transfusion was founded by Alexander Bogdanov in Moscow in 1925. 1930s: Flowing Bogdanov’s lead, the Soviet Union set up a national system of blood banks in the 1930s. The USA soon followed and Cook County Hospital in Chicago, established the first hospital blood bank in the United States. 1940s: In the late 1930s and early 1940s, Dr. Charles R. Drew’s research led to the discovery that blood could be separated into blood plasma and red blood cells, and that the plasma could be frozen separately. Blood stored in this way lasted longer and was less likely to become contaminatedWW2 - World War Two also saw the growth of the blood transfusion service from a relatively primitive organisation at the start of the war to a sophisticated well-oiled machine at the end, storing blood and distributing it to where it was needed.Dr. Charles R. Drew’s research led to the discovery that blood could be separated into blood plasma and red blood cells, and that the plasma could be frozen separately. Blood stored in this way lasted longer and was less likely to become contaminated

238
Q

How did plastic surgery develop during 1920-48?

A

Gillies stressed the importance of working with dental and other medical experts.He traveled extensively in order to share his information.He was joined by Archibald McIndoeWhen WWII began, there were only 4 experienced plastic surgeons.McIndoe worked with RAF pilots with burns.The usual treatment involved a chemical coating to protect the area. It shrank the tissue around the burn so McIndoe started to use saline baths instead.

239
Q

What was the Guinea Pig Club?

A

McIndoe’s pioneering work achieved international fame.The pilots worked on by McIndoe were nicknamed Guinea Pigs because of the new techniques.Much of his work was on skin grafts. Some of the pilots had over 30 operations.The club reintroduced pilots with severe burns back into the community to ensure that they were being healed psychologically as well as physically.

240
Q

Explain Filatov’s work on skin grafts

A

In 1916, he developed pedicle skin grafts and developed methods of grafts and transplants for the eyes.

241
Q

Over the 600 years before 1850 how had the role of women in medicine been steadily reduced?

A

Middle Ages - Church only allowed men to train as physicians. Also stopped women getting licenses as healers as they were being suspected of being witches.1700s - Surgeons had to have a medical degree but women couldn’t go to university. Male doctors started to take over the role of midwives for wealthy familiesSchools for girls were rare before the 1860s and they only tended to teach cooking, dressmaking and writing.

242
Q

What did the government introduce in 1852?

A

The Medical Registration Act which required doctors to belong to one of the Royal Colleges (Physicians, Surgeons or Apothecaries). All were closed to women.

243
Q

What could women do in medicine?

A

Women could still be nurses and often they played a huge role as healers in the home where people couldn’t afford the doctor.

244
Q

Who was Mary Seacole?

A

A black nurse who fought racial prejudice and paid her own way to Crimea

245
Q

Who was Florence Nightingale?

A

Born 1820 in Florence1840s - wished to work in hospitalsShe trained in Alexandria, Egypt and then London in 1853. She took an unpaid role as Superintended at the Establishment for Gentle Women During Illness

246
Q

Explain Florence Nightingale’s work during the Crimean War and at Scutari Hospital

A

Florence got a letter inviting her to become the Superintendent of the Female Nursing Establishment of the English General Hospital in TurkeyShe got to Scutari Hospital in 1854 with 38 other nursesShe had to fight military authorities to reform the hospitalConditions were poor and extremely dirty. She collected data to show that if sanitation improved then mortality would improve.By Feb 1855 the mortality rate decreased from 60% to 42%. She got fresh water and bought fresh fruit and vegetables. By Spring 1855, the mortality rate had dropped to 2.2%

247
Q

What were the limitations to Florence Nightingale during the Crimean War

A

Army medical staff did not like the idea of nurses coming out as they felt they couldn’t handle it.They resented Nightingale as they saw her suggestions as criticisms.In Britain it did not change a lot, nurses were only expected to keep records of a patients condition.Nurses had little to no training so it was hard to break into medicine.

248
Q

What improvements did Florence Nightingale make when back in England?

A

She found that even in peacetime, mortality rate was double that of normal civilian hospitals.She used statistics to press for reformIn 1857, a Royal Commission on the Health of the Army was set up to investigate military hospitalsIn 1859, she wrote Notes on Hospitals which included recommendations on space, ventilation and cleanliness (she believed in miasma theory)She set up the Nightingale Training School and Home for Nurses in London and opened with 10 students. It made nursing a more suitable career for respectable women.

249
Q

What did Florence Nightingale do in later life?

A

Florence acted as a government advisor on army and medical care in Canada and advised the US army during the Civil War.She was bedridden for much of her later life but wrote over 200 books including Notes on NursingIn 1883, she was awarded the Royal Red CrossIn 1907, she became the first woman to be awarded the Order of Merit.

250
Q

What other factors helped to improve hospitals?

A

There was better engineering due to the Industrial RevolutionGovernment laws were passed to improve public health (1848, 1875)More complex nurses meant better trained nursesGerm Theory had an impact on all medical areasMary Seacole helped to raise the profile and status of nursing

251
Q

What were the limitations to progress and change?

A

People believed women could not cope with the unpleasant aspects of medical training such as dissectionsDoctors needed a medical degree from a university or teaching hospital and the 1858 Medical Act meant doctors needed to be officially registered with the General Medical Council - which they did not allow women to do.

252
Q

Who inspired Elizabeth Garrett?

A

Elizabeth Blackwell, the first woman doctor in the USA

253
Q

Who was Elizabeth Garrett?

A

Garrett-Anderson was a pioneering physician and political campaigner.She was the first English woman to qualify as a doctor

254
Q

How did Elizabeth Garrett become a doctor?

A
  • She attended classes for male doctors - eventually she was barred after complaints from other students- She passed the Society of Apothecaries exams in 1865 and gained a certificate in order to become a doctor. - They did not have a rule about not allowing women to join so she was able to use this loophole.- In 1866, she opened a dispensary for women in London- She taught herself French and went to the University of Paris and successfully earned her degree. The British Medical Register refused to recognise her qualification
255
Q

When did Elizabeth Garrett-Anderson set up the New Hospital for Women?

A

1872

256
Q

What was the New Hospital for Women?

A
  • It was a hospital staffed entirely by women
257
Q

What year did Elizabeth Garrett-Anderson become a member of the BMA?

A

1873

258
Q

What did the BMA do after Elizabeth Garrett-Anderson joined?

A

The BMA voted against any further women being admitted.Elizabeth Garrett- Anderson was the only woman in the BMA for 19 years

259
Q

What did Garrett-Anderson do in 1883?

A

She was appointed dean of the London School of Medicine for Women

260
Q

What was the 1876 Medical Act?

A

Parliament passed an act that allowed women to permit women entering medical professions

261
Q

What were the limitations to the 1876 Medical Act?

A

By 1881 there were still only 25 women doctors and 64 women medical students

262
Q

What were the overall limitations to Elizabeth Garrett-Anderson’s work?

A
  • Attitudes were slow to change. Women still had societal expectations of being mothers and wives and usually left employment when married.- Despite the fact that Sophia Jex-Blake led four other women in persuading Edinburgh University to admitting them, they had to pay additional fees, faced harassment and were not allowed to do practical work. They were then forced to leave the university in 1874.
263
Q

What does RAMC stand for?

A

Royal Army Medical Corps

264
Q

What did the RAMC do during WWI?

A

The Royal Army Medical Corps was the section the army that dealt with injured soldiers and organised nursing. The high numbers of casualties meant they needed even more additional help

265
Q

What did QAIMNS stand for?

A

Queen Alexandra’s Imperial Military Nursing Service

266
Q

What did the QAIMNS do during WWI?

A

The main group of trained army nursesWas founded in 1902 at the time of the Boer War and in 1914 was less than 300 strongAt the end of the war in 1918, there were 10,000 nurses

267
Q

What does FANY stand for?

A

First Aid Nursing Yeomanry

268
Q

What did FANY do during the war?

A
  • Launched in 1907- The idea was that the FANY would be the first aid specialists and also have the skills needed to go onto battlefields themselves- The wartime FANY gazettes made note of the appalling conditions- One describes how, in May 1915, they doused their sanitary towels in eau de cologne and held them over the faces of British soldiers during a chlorine gas attack
269
Q

What did volunteer nurses do?

A

Many volunteers were from aristocratic families and their servants. Usually powerful women who ran large families and large estates had management experience so could manage hospitals easily.The most famous of these was the Duchess of Sunderland, nicknamed Meddlesome Millie.Later, nurses worked at casualty clearing stations. Some drove ambulances and this was the closest they could get to the front line.Many worked 14 hour days and the soldiers liked having women around because they reminded them of wives, mothers and sisters.

270
Q

Women doctors in 1914-15

A
  • Women doctors were not welcomed on the Western Front - Dr Elsie Inglis offered to take women’s medical units to the Front but was told that ‘hysterical’ women were the last thing needed there
271
Q

Women’s Hospital Corps

A

Dr Louisa Garrett and Dr Flora Murray founded the Women’s Hospital CorpsHad to open military hospitals in Paris and Boulogne before they were given permission for one in LondonMabel Stobart founded a hospital staffed only by women

272
Q

What did women do on the Front Line?

A

Women doctors were not allowed on the Front but were posted to quieter locationsMembers of several independent women’s groups performed as surgeons in the war zoneIn 1916,the army asked for medical women to work with the RAMC in Malta and by the end of the war there were 80 woman doctors working there

273
Q

What did women do on the Home Front?

A

Over half of the doctors of Britain entered the army so women needed to replace them.Louisa Garrett Anderson and Floray Murray were in charge of a military hospital in London which included 15 women doctorsA shortage of trained staff meant medical colleges did admit more women.The London School of Medicine for Women became the largest medical school in the country. It is believed that there were 610 qualified women doctors in 1911 and 1500 in 1921

274
Q

What were the limitations to change and progress?

A
  • Many experiences were temporary and women were expected to go back to a domestic role at the end of the war- 20% of women doctors carried out hospital work but found it difficult to find positions after the war- There was still little opportunity for women to work in big hospitals and develop specialist skillsBy 1931, approximately 10% of the 30,000 doctors were women but found it difficult to find workAfter the war, women medical students were rejected and discouraged from applying to universityWomen doctors still were dismissed from hospital work when they got married and were paid less than male doctors.
275
Q

What did the QAIMNS do during WWII?

A

Nurses continued to serve in every area where there were soldiersAfter 1941, nurses were given ranks that fitted with the armyNurses served on the front line and were captured and killedBetween 1939 to 1945, members served everywhere from Burma to China to France to Iceland.Some became prisoners of war

276
Q

What did FANY do during WWII?

A

The FANY became involved with Free Poles (Poles that had escaped from Poland in 1939). They were supply drivers, cooks, clerks and admirastive helpers.Free FANYs were recruited as wireless operators for the Home GuardFree FANYs were attached to the British Red Cross, the American Ambluance Corps GB and the Committee for the French Red Cross from 1940-45Others worked as radio officers, encryption specialists, wireless operators and drivers

277
Q

What did volunteers do during WWII

A

The medical service were helped by voluntary organisations. For example, the Red Cross set up first aid posts and mobile first aid unitsWomen served as ambulance drivers, and first aiders treating civilians who had been bombed.

278
Q

What did medical students do during WWII

A

During the 1920s, many medical schools discouraged women from entering training but WWII opened opportunities againThe number of women medical students increased from 2,000 in 1938 to 2,900 in 1946

279
Q

What did women do on the Home Front?

A

Fewer men were called up to serve the armed forces in WWIIWomen were still more likely to work in hospitals at Home than on the Front Line and many worked within the Emergency Medical Service which coordinated hospitals during the warThey were also sent to smaller hospitals rather than working in large city centre hospitals

280
Q

What did women do on the front line?

A

In WWII, some women worked closer to battle lines than every before.They provided faster care to the woundedThe RAMC saw women serve as doctors for the first timeDr Constance Ross, is an example of someone that ended the war as a medical officer.It was still unusual for women to be doctors in the 1940s and Dr Constance Ross’ achievement was even rarer.

281
Q

How were splints developed during WWI?

A

The splint was invented before the war by Hugh Owen ThomasDuring WW1 they were used extensively Sir Robert ThomasIn 1914 80% with broken thighs died. By 1918 80% survived.

282
Q

How were X-rays developed during WWI?

A

Discovered in 1895 by Wilhelm RoentgenWW1 saw doctors was to treat injured soldiers ASAPMobile X-ray machines were developed by Marie Curie for the French army near to the front lineX-rays found broken bones, bullets and shrapnel

283
Q

How were blood transfusions developed during WWI?

A

Blood groups discovered in 1901 and the first transfusion took place in 1907 but no way of storing bloodWW1 saw storage improved. Agote and Hustin added sodium citrate to stop it clotting and citrate glucose to make it last longer. It was discovered that the plasma could be taken out of blood so that it could be stored longer.1917 the British set up blood banks for blood type O

284
Q

How was plastic surgery developed during WWI?

A

French and German doctors had been developing skin graft techniques before WW1Harold Gillies set up a British army plastic surgery unit, using pedicle tubes to help reconstruct faces.

285
Q

What other developments were made during WWI?

A

The huge number of casualties on the Western Front, with injured soldiers being passed from one doctor to another led to the use of medical cards.Anaesthesia and antiseptics meant that many more wounded soldiers were able to survive their wounds than ever before.New areas of medicine were developed, such as false limbs. The terrible scenes witnessed by soldiers meant that many suffered from ‘shell-shock’. From then on progress was made in understanding and treating mental illness.The war meant that far more doctors and nurse were needed than ever before. Many women became doctors and the first women’s nursing units were set up. The First Aid Nursing Yeomanry (FANY) was set up in 1916.

286
Q

How were blood transfusions developed during WWII?

A

The use of plasma was first suggested in 1918There was a Blood for Britain campaign in the USA led by Dr Charles Drew. Blood was collected in NY and sent to Britain.The mass production of dried plasma was developed

287
Q

How was tetanus solved during WWII?

A

Anti-tetanus serum first used in WW1A vaccine was first developed in 1924WW2 tetanus vaccination – largest scale of vaccinations given to troops. Of the 17000 troops injured at Dunkirk, none got tetanus

288
Q

How was plastic surgery developed during WWII?

A

Developed during WW1 and the work of GilliesArchibald McIndoe (who had worked with Gillies) developed better techniques. For example, burns victim had treated with tannafax acid and tannifax jelly but McIndoe changed this to saline baths, which had fewer complications. Airmen who survived the burns and the operations later formed the ‘Guinea Pig Club’ as a tribute to Archibald McIndoe.

289
Q

How was infection solved during WWII?

A

Penicillin had been discovered in 1928WW2 saw more potent strains developed and mass produced in the USA and BritainMass production of sulphonamides which were effective against several infectionsFighting in the Pacific meant malaria was a problem. Atabrine was developed by the USA and Mepacrine by Britain as an anti-malarial drug

290
Q

How was pain solved during WWII?

A

Morphine used as a painkiller and injected into patient

291
Q

How did government action solve problems during WWII?

A

In 1939, all hospitals in Britain were brought under central control for the first time.The health of the nation became very important and rationing was intended to ensure that all people received the right amount of nourishment.In September 1939 and again in April 1940, hundreds of thousands of children were evacuated from inner city areas to the countryside. One effect was that the state of health of these children became apparent for the first time. In 1941, the Women’s Institute published a report describing the condition of evacuees. This was one reason why the Beveridge Report was published in 1942.Beveridge Report 1942 recommended NHS and welfare state. Beveridge recommended that the people of Britain should be protected from Five Giant Evils; Squalor, Ignorance, Want, Idleness and Disease. Mass bombing and egalitarian effects of rationing and evacuation led to calls for implementationNational Insurance ActNational Assistance ActNHS set up in 1946