Medicine Questions Flashcards
Explain TWO ways in which the role of women in medical care during WWI was similar to the role of women in medical care during WWII
They were still mostly GPs and nurses and often away from the frontline, although they were eventually brought there.
In both wars, they used VADs (Voluntary Aid Detachments) who drove ambulances and acted as nurses in RAMC (Royal Army Medical Corps) hospitals. They often helped with basic tasks such as changing bed linen and cleaning floors.
Explain TWO ways in which blood transfusions in 1905 were different from blood transfusions in 1920
In 1905, blood had to be fresh for surgery or it would clot. However, Lewisohn’s discovered sodium citrate (1915) stopped blood from clotting, then Weil found that refrigerated blood (1915) could be stored for slightly longer. Later, Rous and Turner found that glucose citrate increased blood storage (1916) to 4 weeks, building up massive stores.
In 1905, blood had to be transferred directly and both donor and patient had to be present. However, in 1915, Lawrence Bruce Robertson pioneered the use of indirect transfusion. In this way, blood was transfused through a syringe and a tube before surgery, improving chances of survival but increasing demand of blood.
Explain TWO ways in which surgery during the First World War was different from surgery during the second world war
In World War one there was no general antibiotic to cure gas gangrene and this also made all forms of surgery much more dangerous. In World War two, a method of mass-producing penicillin was made in America and so could be used to mitigate risk of infection during surgery. + DDAY
Another way surgery was different in the two wars was through developments in plastic surgery. Before World War two, the way to treat burns was through a chemical coating which coagulated the blood. The chemical method was dangerous. A saline bath was developed in world war two as a much safer method to heal burns in preparation for skin grafts to improve function in operated area.
Explain TWO ways in which the 1848 Public Health Act was different to the 1875 Public Health Act
In the 1848 PHA, the law was enacted in a laissez-faire manner. Although towns could set up their own local BOH, which could fix rubbish and sewage problems, these were not mandatory. However, the 1875 PHA made it mandatory for public hygiene to be kept, and laissez-faire attitudes were shifting due to increased working-class voters.
The 1848 PHA was not very effective and very limited. This was due to the act being temporary; the GBOH was only set up for 5 years and ended in 1854. Also due to the law not being enforced, many authorities took no action. People also didn’t accept the ideas behind the Act, as there was no proof linking disease to hygiene. The 1875 PHA was very effective and significant as it ensured clean water, sewage, proper housing, health regulations etc. These factors all combined to boost public health
Explain TWO ways in which government involvement in 1860 was different from government involvement in 1875
A difference in government involvement on a local scale was the 1866 Sanitary Act which required enforcing inspectors on water supply and sewage. This was made possible by local authorities and funding was predominantly from local taxes which vary between regions.
A difference in government involvement on a national scale was the 1875 Public Health Act. 1875 PHA ensured sewage was properly treated, clean water was provided, streets were kept clean, streets were sufficiently lit by lamps, new housing was inspected and up to standard, made it illegal for factories to put waste into rivers, and quality of food and drink was monitored(learn 3-4). This was a step in changing government’s Laissez Faire attitude and showed that the government was ready to take charge to improve national public health. The passing of this act in 1875 reflects how attitudes had changed by that point.
Explain TWO ways in which ideas about the causes of disease in 1848 were different from the ideas about causes of disease in 1875
In 1848, the theory of spontaneous generation was commonly relied upon, claiming that rotting material created maggots, fleas and disease. However, by 1875, due to Pasteur’s germ theory, SG was disproved as now it was known that microorganisms caused decay rather than rotting matter. The change in ideas were possible due to improvements in technology (microscopes).
In 1848, people believed in the miasma theory, that disease was carried by unpleasant smells and fumes. It was logical as people who lived in dirty, unhygienic, and smelly conditions were more prone to disease, and people believed that cholera was spread by miasma. However, in 1854, John Snow’s cholera case on the Broad Street Pump found that cholera was waterborne, discrediting the theory as cholera had nothing to do with miasma, and his findings influenced changing attitudes towards disease up to 1875.
Explain TWO ways in which surgery in 1905 was different from surgery in 1920
Surgery was different in 1920 as neurosurgery was significantly developed in 1915 due to World War one. This was pioneered by Harvey Cushing who experimented with using magnets to draw out shrapnel from the brain. It was also discovered that a local anesthetic needed to be used instead of a general one as it caused brain swelling during operation.
Surgery was made significantly safer in the 1920s due to development in storing and transfusion before surgery. Glucose citrate was first used in 1916 (4 weeks), and indirect transfusions were first used in 1915 by a Canadian doctor, Robertson, which greatly increased survival rates of surgery. Both techniques greatly improved surgery largely sped up due to pressure of WW1
Explain TWO ways in which government action in public health in 1875 was different from government action in public health in 1911
The liberal government reforms in the early 20th century greatly impacted public health. This was impacted by the Boer War as the govt realised it needed a strong and healthy population for war. (extra if you want). The liberal government focused on the health of children through free school meals (1906) to combat malnutrition and School medical centres were set up in 1907 to cure ringworm and lice, and the children and young person’s act of 1908 making it illegal to sell alcohol and tobacco to children.
The liberal government also started caring for the working class and senior citizens through the Old Age pension for those over 70 and the National Insurance Act which gave sickness benefits, free healthcare, and optional unemployment insurance if money was paid by employer and employee. The old age pensions helped cover for some medical expenses and the NIA covered for the working population.
Explain TWO causes of the introduction of the NHS in 1948
One cause of the introduction to the NHS is the role of individuals. William Beveridge’s Beveridge report of 1942 showing the five giant evils, want, squalor, disease, idleness, and ignorance, this was one of the main inspirations of the NHS act in 1946. This also increased the awareness of the people, pressuring the government. Aneurin Bevan was the health minister of the time who encouraged all doctors to join the NHS.
Another cause of the NHS was war. After the second world war people wanted a welfare state in which every person has an acceptable standard of living, as many were shocked by the poverty they grew up in before evacuation in WW2. The prime minister Clement Attlee wanted to protect people from “the cradle to the grave”.
Explain TWO causes of improvements in surgery in the years 1860-1905
One cause of improvement was science and technology. Blood groups were discovered by Karl Landsteiner in 1901. Before this blood transfusions were dangerous as the giving the wrong blood group to a person leads to death. Methods to mitigate blood loss such as cauterisation and ligatures which were painful and lead to infection. The discovery of blood groups allowed for safer direct transfusion, blood banks being formed, type O blood being able to be used as a universal donor.
Another cause of improvement was the role of individuals. Joseph Lister’s discovery that carbolic acid can be used as an antiseptic. Carbolic acid was used to disinfect medical equipment, dressings, ligatures, and open wounds. Robert Koch also invented steam steriliser which could clean equipment. Wilhelm Röntgen also invented the X-Ray in 1895 which could be used to diagnose broken bones and find shrapnel.
Explain TWO causes of the progress of women in medicine in the years 1848-76
One cause of progress of women in medicine was war. The Crimean War began in 1853. Florence Nightingale and a squadron of nurses went to Scutari to improve nursing and conditions in hospitals. Throughout this war, Florence Nightingale made the nursing more professional, keeping everything clean, cooking nutritious meals, and being in frequent contact with doctors keeping them informed on the patients’ conditions. Nightingale wrote “Notes on Nursing” and “Notes on Hospitals” which became renowned worldwide.
Another cause of progress of women in medicine was the work of individuals. Elizabeth Garrett was born into a rich family and aspired to work in the medical field. Although women could not be taught medicine in universities, Garrett had private lessons to teach herself medicine. With help from her father threatening to sue the Society of Apothecaries she was the first woman accepted into the society and set up St Mary’s Dispensary staffed entirely by women which was renamed after her after her death.
Explain TWO causes of improvements of care in hospitals in the years 1848-75
One cause of improvement in care in hospitals was due to advancements in science and technology. Pasteur’s Germ theory in 1861 provided new understanding of how people became ill which led to more understanding of how hospitals needed to be clean to prevent risk of infection. This was different to the Spontaneous Generation as they believed that rotting material causes pests, germs and disease. People were now informed that it was the microorganisms everywhere, from different surfaces to the air that caused germs and disease.
Another cause was Florence Nightingale. Nightingale went to Scutari in Crimean war 1853, makes nursing more professional (keeping a high standard of cleanliness, cleaning the hospitals, cooking food, being in contact with doctors), writing “Notes on Nursing” and “Notes on Hospitals” which became known worldwide. She also made the Rose Diagram showing percentages of people who could be saved due to preventable measures such as infection..
Explain TWO causes of the dangers in surgery in the years 1848-60
One cause of danger in surgery was infection. Even if the patient survived the operation, many would die afterwards due to infection. They would develop gangrene, which would often develop into sepsis. Infection was due to operations carried out in the patient’s home, the surgeon’s clothes stained with blood and pus, unsterilized equipment, reused bandages, lots of people in the operating theatre etc. However, Lister solved this problem when he used carbolic acid as an antiseptic, using it to clean wounds and equipment; due to this, the death rate from infection dropped dramatically (45.7% to 15%). He also invented a carbolic spray that prevented microorganisms on the surgeon’s hands and equipment from entering the open wound.
Another cause of danger in surgery was blood loss. Operations had to be completed quickly before the patient lost too much blood and died. A tourniquet was used to reduce blood flow in the artery, but this was not too successful. Blood vessels were sealed by cauterization which was extremely painful as immense heat was used. However, Lister solved this by using catgut as ligatures. He would soak it in carbolic acid to not infect the wound, and it dissolved in the body after 2-3 weeks, so catgut ligatures did not prevent proper healing.
Explain TWO causes of the improvements in medical treatment in the years 1920-48
One cause of improvement in medical treatment in this period are stand out individuals. Penicillin was discovered in 1929 by Alexander Fleming. The potential of penicillin as a general antibiotic was not realised until work was also done by Florey and Chain who made mass production of penicillin feasible. Penicillin was fully utilised after America joined WW2 as pharmaceutical companies and the US government poured funding into mass production techniques. This was the first general antibiotic which increased life expectancy and surgery survival rates.
Another cause of improvement in medical treatment was the introduction of the NHS due to the government and the Beveridge Report. The post war Labour government lead by Clement Attlee was determined to create a welfare state protecting people from “the cradle to the grave” with decent standards of living. Particularly the work of Aneurin Bevan, the health minister, who convinced doctors to join the NHS scheme. This gave the public free medical diagnosis and surgery, free medication, ambulance transport, and blood transfusions to name a few which greatly increased average life expectancy of the nation.
Explain TWO causes of the development of penicillin in the years 1920-48
One cause of the development of penicillin was standout individuals. Alexander Fleming discovered penicillin in 1929 after finding a mold that killed staphylococcus bacteria and later published his findings. Howard Florey and Ernst Chain also read his findings and followed up on his research, and Florey also travelled to America to gain support and funding for mass production from pharm companies, and his presentation was the reason of success. + Norman Heatley was a skilled biochemist who constructed equipment to produce pure penicillin cheaply. + Florey refused a patent. Their work was so significant that they won the Nobel Prize in 1945
Another cause of the development of penicillin was funding from the USA. As Fleming’s team could not produce enough penicillin, they sought help from the USA, as they were not involved in the war and their factories could still be used to grow and purify penicillin in large quantities. Key American scientists and 35 institutions contributed – unis, gov. agencies, pharm comps; this accelerated development.
Explain TWO causes of the progress of women in medicine in the years 1920-48
One cause of the progress of women in medicine during this timeframe is War, specifically
