Medicine: Modern

Question 1

Who discovered DNA and how does it link to health?

Answer 1

• Crick + Watson worked out 3D structure of DNA (double helix), following on from the work of Franklin + Wilkins, who studied DNA using X-rays.
• Genetic diseases include cystic fibrosis, some forms of cancer, Down syndrome and diabetes.

Question 2

Who discovered the factors effecting lifestyle and how does it link to health?

Answer 2

Government paid for research on the effects of lifestyle on health:

• Chadwick wrote a report stating that on average, people living in towns had much shorter lives than people living in country regions.
• Booth + Rowntree both also wrote about how living in poverty had serious impacts on people’s health.
• Problems caused by lifestyle include poverty, stress, poor diet, lack of exercise and smoking.

Question 3

Technological developments that improved diagnosis

-Nuclear medicine

Answer 3

• Radioactive elements are injected into the bloodstream.
• These track changes in the blood.
• This helps doctors diagnose disease.

Question 4

Technological developments that improved diagnosis

-Microscopes

Answer 4

• Electron microscope invented in 1931 to allow doctors to see much smaller objects.
• Human cells could be seen in finer detail, allowing doctors to see bacteria and viruses for the first time.

Question 5

Technological developments that improved diagnosis

-Scans and monitors

Answer 5

• Machines scan the body to identify illnesses.

* The mammogram is widely used in breast cancer to detect the disease as early as possible.

Question 6

Technological developments that improved diagnosis

-Endoscopes

Answer 6

•A camera inside a flexible tube is passed into the body so doctors can see inside without using surgery.

Question 7

Technological developments that improved diagnosis

-Blood tests

Answer 7

• Can diagnose a range of viruses from a drop of blood.
• Very complicated machines needed to do this which requires lots of money from government, health groups, charities and universities.
• Also blood tests that can be brought from pharmacies like heart monitors, cholesterol monitors, tests for blood pressure and tests for blood sugar.

Question 8

How treatments developed in the 20th century - e.g. willow bark

Answer 8

1) For 100 years willow bark had been used as a natural remedy to cure fevers, but nobody knew how it worked.
2) By 1900s, developments in science (such as research, scientific experiments + equipment) allowed scientists to identify the precise chemical in willow bark worked. This became known as aspirin.
3) Through scientific experiments, scientists could work out how much of each treatment to give to patients. Therefore specific doses were given.
4) The new treatments could now be mass produced + sold all over the world.
5) By 1900s, companies like Boots became worldwide businesses, making money from these new treatments.

Question 9

Why did treatments improve in the 20th century?

MAGIC BULLETS

Answer 9

• 1909 Paul Ehrlich (part of Koch’s research team in Germany) developed first chemical that killed bacteria inside body.
• It was called Salvarsan 606, also known as ‘magic bullet’ because it homed in on and destroyed the bacteria that causes syphilis.
• However, Salvarsan 606 also killed the patient.
• 1930s Gerald Domagk developed Prontosil on mice and discovered it killed bacteria causing blood poisoning.
• He didn’t try it on humans until his daughter was dying of blood poisoning. Normally she would have died, but when he gave her Prontosil she survived.
• The chemical in Salvarsan 606 and Prontosil was sulphonamide. Scientists have used sulphonamides to cure pneumonia and scarlet fever. It is now mass produced.

Question 10

Why did treatments improve in the 20th century?

ANTIBIOTICS

Answer 10

• WW2 helped penicillin to be mass produced to cure troops.
• When war ended 1945, many developments were needed to make antibiotics available to everyone, rather than just soldiers.
• Investment into discovery and developments of antibiotics by companies like Boots helped.
• Scientific techniques and equipment were improved to help develop antibiotics.
• After 1948 the NHS provided free antibiotics.
• Scientists and doctors communicated their research so they could learn from each other.

Question 11

Why did the government make changes to improve the access to healthcare for the poor?

Answer 11

• 1899 Britain entered Boer War and 1/3 of volunteers for army were rejected because they were in such poor health.
• This worried the government and made them think more about improving healthcare.
• The Liberal Government from 1906-1914 carried out many changes aimed at improving access to healthcare for the poor.

Question 12

What changes did the government make to improve the access to healthcare for the poor?

Answer 12

1902 - training for midwives made compulsory

1907 - health checks for babies + children in schools

1911 - National Insurance Act provided help for workers who were ill, based on contributions from employers, government, + workers themselves to a sickness fund
(didn’t include care for elderly, women, children or unemployed)

1912 - clinics gave children free medical treatment

1919 - Ministry of Health set up (first government department to have an overview of health throughout country)
- Nursing Act set up General Nursing Council to enforce nursing standards

Question 13

Why introduce a National Health Service?

Democracy

Answer 13

1928 all adults over age of 21 could vote.

Development of real democracy increased demands from working people for government to make changes to improve healthcare.

Question 14

Why introduce a National Health Service?

War

Answer 14

War caused a crucial change in attitudes.

Feelings of togetherness built up the belief that everyone should have good healthcare, not just the wealthy.

Question 15

How did the National Health Service come about in 1948?

Answer 15

Beveridge Report 1942

Wartime coalition government asked leading civil servant, Sir William Beveridge, to write a report on what should be done to improve people’s lives.

Question 16

How did people feel about the National Health Service In 1948?

Answer 16

Some felt enthusiasm for the report and the idea of creating a free NHS paid through tax.

Opposition was chiefly from doctors, however this ended when Bevan, the Minister of Health, agreed that doctors could still charge fees.

Question 17

What made the National Health Service so revolutionary?

Answer 17

1) A range of treatments given free at point of delivery.
2) Life expectancy improved, particularly reducing the numbers of women dying during or after childbirth.
3) Many hospitals were rebuilt and have improved equipment.
4) Many nurses developed specialist skills, for example, some have the ability to prescribe a limited range of medicines, which could only be done by doctors in the past.
5) Prevention has become a major aspect of hospitals’ work through protecting patients from acquiring new illnesses.

Question 18

High tech medical and surgical treatments in hospitals: X-rays

Answer 18

• 1895 Wilhelm Röntgen discovered rays of light could pass through black paper, wood, flesh and still light up a wall. He called these X-rays + were used in hospitals within months.
• WW1 led to increase in use of X-ray machines to locate shrapnel + bullets in wounded.
• After this X-rays became routine and used in many different ways (e.g. monitor development of babies in womb, broken bones).

Question 19

High tech medical and surgical treatments in hospitals: Radiotherapy and Chemotherapy

Answer 19

• Marie Curie and her husband continued research on X-rays and discovered radium, which has been used ever since to diagnose cancers and in radiotherapy to treat cancers.
• Their research was the beginning of modern treatment of cancers.
• As research continued it became so complex they built up a team of research scientists to share ideas.

Question 20

High tech medical and surgical treatments in hospitals: Blood transfusions

Answer 20

• Attempted in the 1800s but rarely worked. No one knew why until 1901 when Karl Landsteiner discovered blood groups. Blood transfusions became possible, provided the patient and the donor had the same type of blood and were in the same place.
• The problem of storing blood was solved in WW1: sodium citrate was added to stop blood clotting + the discovery of how to separate and store crucial blood cells and keep them in bottles for future.
• This has made the huge blood banks that supply blood today possible.

Question 21

The development of penicillin: 1928 Fleming

Answer 21

• 1928 he came back from holiday to find green mould on his Petri dishes killing all the bacteria.
• Fleming experimented with penicillin on living cells and discovered that it could heal small infections.

Question 22

The development of penicillin: 1938 Florey and Chain

Answer 22

• 1938 Florey and Chain read Fleming’s article on penicillin and wanted to continue the research funded by the American government.
• 1941 they had enough penicillin to test on a person, Albert Alexander, who had a serious infection. It worked and wasn’t harmful to humans, but they couldn’t afford to make enough.

Question 23

The development of penicillin: 1941 WW2

Answer 23

• British factories were busy making supplies for war, so couldn’t make mass amounts of penicillin. Florey went to America to ask them to produce the drug.
• Due to the attack on Pearl Harbour, America had just joined the war and the American government realised the potential of penicillin to treat armed forces and made interest-free loans to companies to produce it.
• Soon British firms were also mass-producing it enough to treat soldiers on D-Day in 1944.

Question 24

The development of penicillin: After the war

Answer 24

• 1945 penicillin began to be manufactured for everyone. Dorothy Hodgkin determined the chemical structure of penicillin so it could be made more easily.
• Antibiotics became more common when new ways of making synthetic penicillin were discovered in the 1950-60s.

Question 25

Why were there new approaches to prevention of illness from 1900 onwards?

Science and Technology

Answer 25

Breakthroughs such as the discovery of DNA led to new tests and treatments.

Question 26

Why were there new approaches to prevention of illness from 1900 onwards?

Government

Answer 26

Investment in science and public awareness campaigns were important (led to new discoveries and healthier lifestyles).

Question 27

Why were there new approaches to prevention of illness from 1900 onwards?

Attitudes

Answer 27

Many people realised that living a healthier lifestyle could help them stay well (which encouraged more exercise and a good diets).

Question 28

Why were there new approaches to prevention of illness from 1900 onwards?

Chance

Answer 28

Luck played a part in Fleming’s discovery of penicillin in 1928 (the Petri dish was left on the shelf at St. Mary’s Hospital).

Question 29

Why were there new approaches to prevention of illness from 1900 onwards?

Teamwork

Answer 29

Florey and Chain met at Oxford and were able to continue the work started by Fleming. They worked with the US government to develop the drug (funding).

Crick and Watson worked together on the 3D structure of DNA following on from the work of Franklin and Wilkins.

Question 30

Why were there new approaches to prevention of illness from 1900 onwards?

Individuals

Answer 30

The brilliance of scientists such as Fleming, Florey, Chain, Crick and Watson played a vital role in new discoveries.

Question 31

Why were there new approaches to prevention of illness from 1900 onwards?

War

Answer 31

The Crimean War led to Florence Nightingale improving sanitation in hospitals.

The Boer War led to the government improving access to healthcare for the poor as 1/3 volunteers for the army were rejected.

In WW1 Fleming served in the Army Medical Corps and too many soldiers dying from infected wounds encouraged Fleming to find a treatment for wounds.

WW2 drove Chain out of Germany, leading him to work with Florey on developing penicillin further.

Question 32

Lung cancer case study

Answer 32

• Extremely rare 150 years ago (lower life expectancies due to poor healthcare meant that people died before they could develop cancer)
• 90% cases are the result of smoking, in some cases passive smoking.
• Particularly deadly as it is very difficult to diagnose in its early stages. Usually it has spread through the body by the time it’s been diagnosed.

Question 33

How has the government helped prevent illnesses?

Answer 33

• NHS posters aim to increase awareness and improve rates of early diagnosis.
• Advertising campaigns warn people of the health risks of smoking.
• Advertising cigarettes have been banned and packets carry health warnings.
• New laws have made public places smoke free in a bid to tackle passive smoking.

Question 34

How has science and technology helped prevent illnesses?

Answer 34

• Cameras are used inside the lungs to aid surgery so there is less of an impact on the body, speeding up recovery.
• Radiotherapy aims to kill cancer cells using beams of radiation.
• Techniques have improved to target cancers more precisely.
• Much of the early work that led to chemotherapy is attributed to a Paul Ehrlich, who was part of a scientific research team.