Medicine through time Flashcards
What happened in 1942 which aided the development of public health?
1942: During the Second World War, the need to give people something to fight for led the government to commission up the Beveridge Report. Beveridge recommended a Welfare State, which would provide social security, free health care, free education, council housing and full employment.
What was invented in 1931?
1931: The invention of the electron microscope allowed doctors to see bacteria and viruses for the first time.
What was discovered in 1910?
1910: Henry Dale (Britain) discovered the chemical histamine, which is produced by the body during an allergic reaction. This allowed him to understand allergic response and surgical shock.
What did the Black Report show and when?
1980: The Black Report stated that huge inequalities in health still existed between the rich and the poor in Britain.
What happened in 2002?
Specialists at Massachusetts General Hospital, watching digital x-rays transmitted by satellite, helped the medical officer at a research station from the South Pole operate on a damaged knee.
What was developed in the 1940’s?
1940s: Archibald McIndoe (British) learned how to rebuild surgically the faces of airmen (the ‘Guinea Pigs’) burned in the war - this was very early plastic surgery.
What happened in 1918 which aided the development of public health?
1918: After the First World War, the British Prime Minister Lloyd George promised the soldiers returning from the battlegrounds of Europe ‘homes fit for heroes’. The government set itself a target of building half-a-million decent homes by 1933.
What happened in 1962?
1962: Surgeons at Massachusetts General Hospital re-attached the arm of a 12-year-old boy.
Who was the first specialist neuro-surgeon?
1890s: Victor Horsley (British): first specialist neuro-surgeon
What was confidence in doctors like?
Towards the end of the century, confidence in doctors began to wane. Even so, a National Health Service survey in 2002 found that 82 per cent of the population had visited a doctor at least once during the year, and that 90 per cent of those people were satisfied with their treatment.
What happened in 1946 which aided the development of public health?
1946: The New Towns Act planned new towns such as Stevenage and Newton Aycliffe to replace the inner-city slums. The Town and Country Planning Act of 1947 set a target of 300,000 new homes a year, and identified ‘green belts’ where housing would not be allowed to continue to swallow up the countryside.
How did medicine begin to aid pregnancy and prevent it?
After the 1950s, doctors (through contraception) were able to prevent pregnancy, and after the 1970s (through IVF) to help childless women become pregnant (although side effects of the contraceptive pill are thromboses, migraine and jaundice). In 2005, a 66-year-old Romanian woman gave birth to twins.
What increased during the 1990’s?
Increasing use of keyhole surgery, using endoscopes and ultrasound scanning, allowed minimally invasive surgery.
What was discovered in the 1970’s?
1970s: Patrick Steptoe (Britain) developed IVF fertility treatment; in 1978 Louise Brown became the first ‘test-tube’ baby.
1970s: Endoscopes - fibre optic cables with a light source - enabled doctors to ‘see’ inside the body.
How did the modernization of medicine change the role of the doctor?
Sixty per cent of new doctors are now women. Familiar illnesses, previously dangerous, can often be treated by a course of pills. Many other diseases now call for the use of expensive technology so, by the end of the century, most medicine was delivered in hospitals
What developments in the 20th century impacted medicine?
There was a great explosion of scientific understanding and technological innovation.
Many societies became hugely rich, though wealth was still unequally shared.
There was considerable urbanisation (explosive growth of cities).
Communications technology made the world seem smaller and more cosmopolitan. This allowed medical ideas to spread rapidly, but also allowed diseases such as SARS to spread.
There was more time for leisure, less time spent on work.
People became less religious - so more inclined to look for medical solutions even to spiritual and psychological problems.
Many societies were democratic, and thought the duty of the state was to care for its citizens - hence demands for a welfare state.
American military and economic power, and American values, were dominant.
Stress due to terrorism, the undermining of traditional values and the rapid pace of life took a great toll on people’s general health.
Wars, epidemics and famines killed more people in the 20th century than they had in the whole of the rest of history.
What was developed in the 1980’s?
MRI scans were developed to monitor the electrical activity of the brain.
How did the polio vaccine aid medicine?
In 1954, Joseph Salk (America) discovered a polio vaccine, which helped eradicate polio from the western world in the 20th century, and which may make it extinct worldwide early in the 21st century.
How did Penicillin aid medicine?
During the Second World War, Florey and Chain learned how to mass-produce penicillin - discovered (by chance) in 1928 by the Scottish bacteriologist Alexander Fleming - the first antibiotic. Now, doctors could effectively cure acute infectious disease (although misuse of antibiotics has led to the development of drug-resistant strains of killer diseases such as TB and the MRSA hospital superbug).
What are the hopes for genetic engineering?
Modern doctors believe that stem cells and genetic engineering will allow doctors to cure or prevent most diseases in the 21st century.
What was developed in 1951?
1951: The Mexican company Syntex developed norethisterone, which prevents ovulation - leading to production of the first contraceptive pills.
What was discovered in 1932 and how did it aid medicine?
In 1932, the German scientist Gerhard Domagk discovered that a coal tar product (a sulphonamide called prontosil) killed streptococci bacteria. Other sulphonamides were discovered which could cure pneumonia, meningitis and acne.
What happened in 1956 which aided the development of public health?
1956: The Clean Air Act imposed smokeless zones in cities and reduced smog.
What happened in 1919 which aided the development of public health?
1919: A Ministry of Health was set up to look after sanitation, health care and disease, as well as the training of doctors, nurses and dentists, and maternity and children’s welfare.
What happened in 1997?
In 1997 Scottish researchers bred Dolly, the first cloned sheep.
What were doctors like at the beginning of the century?
local doctors still visited the sick in their homes, usually carrying their sturdy Gladstone bag. Doctors could do little to cure disease, although they had learned some ways of preventing it, and some new techniques of caring for patients.
How did sex-change operations start to develop?
In 1952, the Danish surgeon Christian Hamburger used large doses of hormones and surgical operations to change the sex of George Jorgenson, an American army vet, who returned to the US as Christine.
Why did confidence in doctors start to wane?
A survey in America in 1974 found that 2.4 million unnecessary operations were performed every year, at a cost of $4billion a year. In Britain in the 2000s, a number of scandals (eg that of the GP Harold Shipman, who murdered his elderly patients) reduced confidence.
What happened in 1896?
1896: Walter Cannon (America) used a barium meal with x-rays to track the passage of food through the digestive system.
What was invented in 1972?
1972: Geoffrey Hounsfield (Britain) invented the CAT scanner, which uses x-ray images from a number of angles to build up a 3D image of the inside of the body
What was discovered in 1921?
1921: Frederick Banting and Charles Best discovered insulin, which breaks down sugar in the bloodstream. Thus he found the cause of diabetes.
What two things were discovered in 1953?
1953: Francis Crick and James Watson (Britain) discovered DNA.
1953: Leroy Stevens (America) discovered stem cells.
What happened in 1921 which aided the development of public health?
1921: Local authorities were required to set up TB sanatoria.
What was developed in 1921 and how did it aid medicine?
In 1921 Banting and Best developed insulin. They could not cure diabetes, but they were able to alleviate its results. Today, doctors use hormone treatments to correct thyroid problems, help children grow, improve sexual performance and shrink cancers.
How did the work of Peter Medawar aid medicine?
The work of Peter Medawar (1950s: Britain) on immuno-suppressants led to the development of anti-histamine, which prevents allergies and operative shock.
What happened in 1986?
In the Visible Human project undertaken in the US, the bodies of two criminals (a male and a female) were frozen, cut into 1mm slices, stained, photographed and stored as 3-d images on the internet
What happened in 1967?
1967: Christiaan Barnard (South Africa) performed the first heart transplant - the patient lived for 18 days.
What happened in the 1990’s?
1990s: The Human Genome project undertaken in the US mapped all the genes in the human body - 40,000 of them.
When was the national health service set up?
5 July 1948: The ‘appointed day’ for the start of the National Health Service
When was oestrogen and testosterone discovered?
1923: Edgar Allen (America) discovered oestrogen (the hormone that powers femaleness). In 1935 Ernst Laqueur isolated testosterone, the hormone that creates maleness.
How did the use of technology aid medicine?
Doctors started using technology - such as incubators and pacemakers - to help patients.
What was developed in 1972?
1972: John Charnley (Britain) developed hip replacements.
What happened in 2002?
2002: Gunther von Hagens (Germany) performed live dissections on TV.
What happened in 1934 which aided the development of public health?
1934: Although the economic depression of the 1930s caused government to cut back on spending, it passed the Free School Milk Act and encouraged local councils to give poor children free school meals.
What happened in 1950?
William Bigelow (Canadian) performed the first open-heart surgery to repair a ‘hole’ in a baby’s heart, using hypothermia.
What did some people still prefer to conventional medicine?
One in five Britons prefer alternative healthcare to conventional medicine, and many more are looking after their own health by visiting a gym or attending self-help health groups.
What was developed in 1970?
Roy Calne (Britain) developed the use of the immunosuppressant drug cyclosporine, which prevents the body ‘rejecting’ grafts and transplanted organs.
How did the drug thalidomide both aid and interfere with medicine?
In the 1950s, doctors used the drug thalidomide to treat morning sickness during pregnancy. It caused terrible deformities in babies, but today is used in the treatment of AIDS, leprosy and some cancers.
How did the discovery of vitamins aid medicine?
The discovery of vitamins allowed doctors to prescribe vitamin supplements, which cured beriberi, rickets, pernicious anaemia and pellagra.
What was developed in the 1970’s?
he development of plastic lenses allowed cataract surgery. Since 1991 laser eye surgery has obviated the need for glasses.
What can doctors still not cure?
Doctors are still not able to cure viral infections such as AIDS and the common cold, and cancer is still a killer disease.
What happened in 1952?
1952: First kidney transplant (America).
What happened in 1986?
1986: Davina Thompson (Britain) became the first heart, lungs and liver transplant patient.
Why did some people look elsewhere for cures?
Not all vaccinations were successful, and against acute infectious disease, doctors were largely powerless.
Why did the Government start to try and improve individual health of the poor?
When the Boer War revealed that half the population were unfit for military service, the government accepted that it had to pass laws to improve the situation of the individual poor:
How did urbanisation affect medicine?
Led to public health problems that included ‘filth diseases’ such as cholera and typhus
What did Robert Koch discover?
(Germany: 1878), who discovered how to stain and grow bacteria in a Petri dish (named after his assistant Julius Petri). He was thus able to find which bacteria caused which diseases
What developments happened in the 19th century?
A great explosion of industry Urbanisation The growth of empires The growth of immense wealth, based on trade and industry Great advances in technology Improved communications The growth of science and research Democracy and socialism New ideas about evolution (Darwin) and genetics (Mendel) Wars were waged on a greater scale
How did democracy and socialism affect medicine?
people believed they had the right to good health). The right to health was one of the ‘rights of man’ claimed by working people during the French Revolution (which was why the medical revolution of the 19th century started in France
What happened in 1832?
1832 The British Medical Association was formed.
What was discovered in 1901 which aided the process of blood transfusions to prevent blood loss?
1901: Karl Landsteiner (Austria) - discovered blood groups. Transfusions had been tried before but usually killed the patient because of clotting. Matching blood groups stopped this happening.
What did Elizabeth Garrett do?
Elizabeth Garrett: acquired a licence from the Society of Apothecaries (1865) then set up the Dispensary for Women.
What happened in 1823?
1823 The first issue of the the medical journal the ‘Lancet’ was published.
When was chloroform discovered?
1847 by James Simpson.
When was Ether used as an anesthetic?
1842: Crawford W Long (America) used ether as an anaesthetic while operating on a neck tumour (but did not publish details of his operation).
1846: Dr JC Warren (America) removed a tumour from the neck of Gilbert Abbott using ether.
1846: Robert Liston (Britain) removed a leg using ether - ‘this Yankee dodge’.
How did Starling and Bayliss help increase knowledge about the body?
(England: 1902) discovered the first hormone.
What did Charles Chamberland discover?
(France: 1884) found that there are organisms even smaller than bacteria that also cause disease - he had discovered viruses.
What were some of the alternative cures people tried?
A home medicine encyclopaedia of 1910 recommended cures that included electrical shocks, injection with animal hormones, and a range of harmful substances including cocaine, mercury, creosote and strychnine.
Other alternative medical treatments included mesmerism (hypnotism), homeopathy (taking tiny doses of poisons), ‘health reform’ (a religious movement which recommended a healthy lifestyle - it was run by John Kellogg whose brother invented cornflakes) and Christian Science (which taught that disease only existed in the mind).
Travelling ‘quacks’ sold patent medicines (such as Lily the Pink’s medicinal compound).
How did William Beaumont help increase knowledge about the body?
America: 1822) studied the digestive system of Alexis St Martin, a Canadian who had an open hole into his stomach.
How did the great explosion of industry affect medicine?
Led to industrial diseases such as dermatitis, lung disease and ‘phossy jaw’
How did the Industrial revolution and inventions aid the progress of medicine?
There was a general atmosphere of scientific research and advance.
Louis Pasteur’s first commission was to find a cure for sour wine, which set him off on his revolutionary course.
Joseph Jackson Lister (Britain: 1826) invented the multi-lens microscope, which allowed doctors to see very tiny things accurately.
Carl Ludwig (Germany: 1847) invented the kymograph, which allowed more accurate measurement of the pulse.
Wilhelm Roentgen (Germany: 1895) discovered x-rays.
Willem Einthoven (Holland: 1900) invented the electrocardiograph (measured heart activity).
How did new medical ideas affect medicine?
New ideas about evolution (Darwin) and genetics (Mendel) - broke the control of the Church over medicine and medical ethics.
What happened in 1938 which aided the process of blood transfusions to prevent blood loss?
1938: The National Blood Transfusion Service was set up in Britain.
How did improved communications affect medicine?
It allowed medical knowledge to spread - doctors gained information from all over the world
How did scientific knowledge aid the progress of medicine?
Jan Purkinje (Czechoslovakia: 1836) set up the first university department of physiology (science of how the body works).
Louis Pasteur started as a research chemist. He set up a team of researchers at the Pasteur Institute (1888).
Robert Koch developed his Postulates of how researchers should find a disease. These led to four basic procedures - make sure the germ in question is present in the sick specimen - grow a culture of that germ - inject it into a healthy specimen - see if the disease develops.How did social factors aid progress in surgery?
Queen Victoria gave birth to her children under anaesthesia (after which the general public’s fear of anaesthesia lessened). Edward VII’s appendectomy helped reduce fear of operations.
What main factor led to the government trying to improve public health?
In 1848, a cholera epidemic terrified the government into doing something about prevention of disease - through both public and individual health measures.
How did wars affect medicine?
Wars were waged on a greater scale (creating mass injuries that were hitherto unknown, and required new medical and surgical techniques).
What did Charles Chamberland discover?
Charles Chamberland (France: 1880) discovered by chance (when he left bacteria exposed to air) that injecting chickens with an attenuated (weakened) form of chicken cholera gave them immunity to the disease (ie he discovered the principle of inoculation).
Why weren’t there many female doctors?
Most male doctors were opposed to women doctors, and each time a woman found a loophole that allowed her to progress in her career, the medical profession changed the rules to stop it happening again. In 1911 there were only 495 women on the Medical Register in Britain.
What did Paul Ehrlich theorize?
Paul Ehrlich (Germany: 1890s) reasoned that, if certain dyes could stain bacteria, perhaps certain chemicals could kill them without harming healthy tissues. He set up a private laboratory and a team of scientists. By 1914 they had discovered several ‘magic bullets’ - compounds that would have a specific attraction to disease-causing microorganisms in the body, and that would target and kill them. These were methylene blue (for malaria), trypan red (for sleeping sickness) and Salvarsan (for syphilis) - although Salvarsan was more effective than the other two.
What did René Laennec develop?
France: 1816) invented the stethoscope and started the practice of ‘auscultation’ (listening to the patient’s chest).
What were one of the things Louis Pasteur’s discovery was used for?
the pasteurisation of milk, which prevented it from going sour by killing the germs and sealing it from the air.
What social factors aided the progress of medicine?
Nationalism - eg the rivalry of Pasteur and Koch. Shibasaburo Kitasato (Japan) and Alexandre Yersin (France) raced to discover the plague bacterium in 1894.
The deaths of his two daughters motivated Louis Pasteur to redouble his efforts in the fight against disease.
How did the industrial revolution and invention aid progress in surgery?
Wilhelm Roentgen discovered x-rays - helped internal surgery.
Public demonstrations (eg of anaesthesia) allowed knowledge of new procedures to spread.What did Carl Ruge develop?
(Germany: 1878) developed the technique of biopsy (removing cells to determine if they were cancerous).
How did Henry Gray hep increase knowledge about the body?
(Scotland: 1858) wrote ‘Gray’s Anatomy’, which had over 1,000 illustrations. Many people bought a copy to own at home. After the 1870s, pupils started studying anatomy in schools.
What did Thomas Percival do?
1803 Thomas Percival wrote the first book on medical behaviour.
What did Charles Chamberland’s discovery lead to?
Louis Pasteur developed an effective inoculation against anthrax (1881), and rabies (1885).
Albert Calmette and Camille Guérin (France: 1906) developed the BCG injection against TB.
Emil von Behring (Germany: 1913) developed an anti-toxin against diphtheria.
What were doctors like in the 1800?
In 1800, the doctor may have been a friend of the rich, but many doctors themselves were poor. They could do little to heal disease, and their main role was to provide comfort and reassurance.
What did Patrick Manson discover?
Britain: 1876) discovered that elephantiasis was caused by a nematode worm, and that mosquitoes were the vector (carrier). This was a breakthrough discovery, because researchers soon found out that other tropical diseases were transmitted by vectors such as mosquitoes (malaria and yellow fever) or tsetse flies (sleeping sickness).
What happened in 1865 which helped lower the risk of infection?
1865: Joseph Lister (Scotland) - basing his ideas on Pasteur’s Germ Theory cut the death rate among his patients from 46 to 15 per cent by spraying instruments and bandages with a 1-in-20 solution of carbolic acid.
What happened in 1890 which helped lower the risk of infection?
1890: Beginnings of aseptic surgery - surgeons started boiling their instruments to sterilise them - WS Halstead (America) started using rubber gloves when operating - German surgeons started to use face masks.
What did Sophia Jex-Blake do?
Sophia Jex-Blake: studied medicine at Edinburgh University (1869), but had to take her degree in Switzerland and get her licence to practise medicine in Ireland. In 1874 she founded the London School of Medicine for Women.
What were their first basic health measures based on?
The first public health measures were based upon the idea that miasmas (bad smells) caused disease. Although the idea was wrong, the measures against the miasmas involved a greater focus on cleanliness, and this improved public health.
How did the growth of empires affect medicine?
Led to contact with new diseases such as yellow fever
What happened in 1847 which helped lower the risk of infection?
1847: Ignaz Semmelweiss (Hungary) cut the death rate in his maternity ward by making the doctors wash their hands in calcium chloride solution before treating their patients.
What other anesthetics were used and when?
1845: Horace Wells (America) tried unsuccessfully to demonstrate that laughing gas would allow him to extract a tooth painlessly.
1847: James Simpson (Britain) discovered chloroform.
1884: Carl Koller (Germany) discovered that cocaine is a local anaesthetic.
How did war aid progress in surgery?
The needs of army surgeons treating soldiers injured in battle (often requiring amputations) stimulated advance.
The Crimean War led to the development of nursing (Florence Nightingale at Scutari).
World War One led directly to the development of the National Blood Transfusion Service.
How did the growth of immense wealth based on trade and industry affect medicine?
It created the money to spend on medical research and public health
What inventions allowed doctors to measure the function of the body precisely?
Carl Ludwig (Germany: 1847) invented the kymograph (which measured the pulse).
Wilhelm Roentgen (Germany: 1895) discovered x-rays.
Willem Einthoven (Holland: 1900) invented the electrocardiograph (which measures heart activity).What measures were introduced to aid public health?
In 1848 the first Public Health Act caused the setting up of a Board of Health, and gave towns the right to appoint a Medical Officer of Health.
In 1853 vaccination against smallpox was made compulsory.
In 1854 improvements in hospital hygiene were introduced (thanks in large part to Florence Nightingale).
In 1875 a Public Health Act enforced laws about slum clearance, provision of sewers and clean water, and the removal of nuisances.
What was discovered in 1913 which aided the process of blood transfusions to prevent blood loss?
1913: Richard Lewisohn discovered that sodium citrate stopped blood clotting during an operation.
What did Louis Pasteur discover?
Louis Pasteur (France: 1860s) discovered (by using a swan-necked flask) that germs cause disease. Before he made this discovery, doctors had noticed bacteria, but they believed it was the disease that caused the bacteria (the so-called theory of ‘spontaneous generation’) rather than the other way round.
How did Theodor Schwann help increase knowledge about the body?
(Germany: 1839) realised that animal matter was made up of cells, not ‘humours’. This was the vital breakthrough of knowledge that at last destroyed belief in the old ‘humoral’ pathology of the Greeks.
How did the growth of science and research affect medicine?
which led to medical breakthroughs
What did Elizabeth Blackwell do?
Elizabeth Blackwell: gained a medical degree in America (1849) and set up the New York Infirmary for Poor Women before returning to England, where she was accepted onto the Medical Register in 1858.
What were doctors like in the 1900?
By 1900, doctors and surgeons occupied a highly respected place in society. They provided treatment increasingly through hospital provision, and in certain situations were able to heal their patients with surgery.
What was public health like in the early 19th century?
In the early 19th century, the growing towns of Britain were characterised by overcrowding, poor housing, bad water and disease.
