Medicine Unit 4 - Government Action and War, 1905-1920 Flashcards
1
Q
Government attitudes
A
- 1891-1903 - Charles Booth & Seebohm Rowntree - showed large numbers of people lived on or below the poverty line - hence poor conditions & disease + poor nutrition
- Politicians motivated to improve health when 1/3 of British volunteers for the Boer Wars in Africa (1899-190) were unfit for service - need for effective army due to it being a large empire
- liberal party won huge majority in 1906 - wanted to make improvements with health - introduced measures that were seen as the beginning of the modern welfare state
2
Q
Improving the health of children
A
- 1906 - Free school meals introduced for children from poor families - local authorities received a grant to cover half the cost- went from 3 million meals in 1906 to 14 million in 1914
- Booklet produced by Board of Education in 1906 on how children should be taught hygiene
- 1907 - School Medical Service set ip to check schoolchildren for illness & conditions e.g. lice - health visitors could visit homes but many couldn’t afford treatment if diagnosed with something
- 1908 - The Children and Young Persons Act - illegal to sell tobacco or alcohol to children & crime to send a child out begging or to neglect a child
3
Q
Other groups in society
A
- 1908 - old age pensions introduced for people over 70 earning less than £31,.50 a year - received 25p a week = 1/6th of working man’s wage
- Pensions could be refused if people were alcoholics or in prison in the last 10 years
- 600,000 pensions granted in 1908 - helped people financially and hence w/health
- 1909 - Labour Exchanges set up - placed for unemployed to work
4
Q
Cost of public health improvements
A
- Many not keen to pay for reforms e.g. 1909 when the taxes were put up
- Reforms showed government was involved & aware
- Only parliament had authority to make laws & collect taxes - local authorities couldn’t do such
5
Q
Access to treatment
A
- People had to pay for every visit to the doctor & for prescribed medicine - normal for families close to the poverty line - many avoided seeing doctors to not pay
- Hospitals in towns & cities usually had free dispensaries to queue for treatment - however people relied on ready-made medicine & pills + traditional folk remedies
- Many doctors made ‘sick clubs’ where patients could pay weekly to save money to cover the cost of treatment when necessary - ordinary people usually couldn’t do so
6
Q
National Insurance Act of 1911
A
- 1911 - National Insurance Act
- Money paid to National Insurance Scheme by workers & employers - ill workers could receive free medical care from a doctor & sickness benefit - maternity grant given to help for baby essentials & additional option to pay for an unemployment fund
- Could prevent a family from falling below the poverty lines & help when ill or a job has been lost
- First time that some groups in society had access to a trained doctor & treatment
- Act only applied for workers - not members of families, unemployed or self-employed
7
Q
Care for wounded and sick soldiers
A
- WW1 led to more casualties than any previous - most caused by infection of wounds & gangrene
- Medical teams had to deal with poison gases for the first time e.g. chlorine or phosphene gas - victims needed oxygen & kept in hospital for 2 months & mustard gas needed hot soap & water
- Portable shower units developed & new clothing issued
8
Q
Conditions in the trenches
A
- Unhealthy - rats & lice
- Trench foot - swelling of feet & gangrene, treated by prevention, rubbing of whale oil on feet, keeping feet dry & amputating upon gangrene
- Trench fever - flu-like e.g. high temp, headache & aching muscles - identified source was lice contact in 1918, hence delousing stations set up
- Shell shock - tiredness, nightmares, mental breakdown - 80,000 British troops experienced it - condition was not well understood - accused of cowardice & punished + even shot - some cases involved treatment back in Britain
- Dysentery - causes stomach pains, diarrhea, vomiting & fever, some dying of dehydration & caused by infect food & water - chlorine of lime began to be added to purify water
- Cases of influenza & STDs when soldiers visited prostitutes on leave
9
Q
Casualty Clearing Stations and Base Hospitals
A
- System of treatment centers to help casualties at the front
- Immediate aid given at Regimental First Aid Posts (RAP)
- More advanced help at Dressing Stations & soldiers with critical injuries treated at Casualty Clearing Stations
- Most severe cases brought to base Hospitals behind the lines
- Became clear sooner surgeries reduced infection chances - more operations done at Casualty Clearing Stations and Base Hospitals became long- term treatment - would have wards based on injury
- Nature of injuries forced doctors to try new techniques
10
Q
The Work of the RAMC and of the Nurses
A
- Royal Army Medical Corps (RAMC) - section of the army that dealt w/injured soldiers - organized treatment for wounded at first aid posts close to the front & ran Dressing Stations and hospitals
- Main group of trained nurses was Queen Alexandra’s Imperial Military Nursing Service (QAIMNS) - founded un 1902 w/fewer than 300 nurses in 1914 to 10,000 in 1918
- Another set of nurses was the First Aid Nursing Yeomanry (FANY), launched in 1907 - first aid specialists w/skills to allow them to get to casualties on the battlefield
11
Q
Women as volunteers
A
- RAMC needed help due to high casualties
- Many women joined Women’s Army Auxiliary Corps - set up in 1917 - women acted as ambulance drivers & more
- Branches of Red Cross sent Voluntary Aid Detachments (VADs) - drove ambulances & acted as nurses at RAMC hospitals
- No official register for nurses until 1919
- Trained nurses disliked volunteering due to a lack of qualifications being respected
12
Q
Women doctors
A
- Female doctors volunteering on the Western Front were not usually welcomed
- Dr. Elsie Inglis offered to take women’s medical units to the front but ws told ‘hysterical women’ weren’t wanted
- Dr. Louisa Garrett & Dr. Flora Murray founded Women’s Hospital Corps in Paris to do so in London
- Mabel Stobart founded a hospital staffed only by women in Belgium
13
Q
Voluntary hospitals
A
- Many of early volunteers from rich & powerful families
- Transport to France & Belgium organized, taking nurses & equipment to hospitals & Casualty Clearing Stations
- Mairi Chisholm & Elsie Knocker set up a first aid post in Pervyse - 100m from Belgian frontline
- Largest voluntary hospital - ran by Dr. Frances Ivens - had 600 beds & excellent x-ray unit
14
Q
Greater Acceptance of Women
A
- Less than 1% of doctors were female before the war
- War Office still wanted women home to fill the gap of male doctors - 1916 - women asked to help in Malta - 80% of doctors were female in Malta by the end of the year - women wouldn’t become temporary army officers but men did
- 1915 - Louisa Garrett & Flora Murray put in charge of a new military hospital in London stated by only women
- Women expected to go back to GPs after the war
- 12 medical schools during the war accepted women - were rejected after the war & only Royal Free Hospital accepted women
15
Q
X-rays
A
- X-rays couldn’t identify fragments of clothing within a wound
- Wounded person had to remain for some time, in pain, while the x-ray was taken
- Glass tubes used in x-ray overheated after an hour - no continuous use
- High dose of radiation was harmful & could cause burns
16
Q
Blood Transfusions
A
- 1901 - Karl Landsteiner discovers transfusions have to be of the same blood type & later finds O can give to anyone - made transfusions possible
- 1915 - Richard Lewisohn discovered adding sodium citrate stopped clotting - blood could be collected & stored but only for a few days
- 1915 - Richard Weil found blood could be stored longer if refrigerated - store larger volumes of blood
- 1915 - Lawrence Bruce Robertson - indirect transfusions with blood transfused through a syringe & tube before surgery - improved survival
- 1916 - Francis Rous & James Turner - adding glucose citrate blood could be stored up to 4 weeks - blood could be built up before a battle
- 1917 - Blood O created before Battle of Cambrai
17
Q
New Techniques in Surgery
A
- Wound excision or debridement - cutting away of dead, damaged & infected tissue from the ice of the wound - done as quickly as possible & closed by stitching
- Carrel-Dakin method - sterilized salt solution in the wound through a tube - lasted for 6 hours
- Amputation - amputate if neither technique works to halt the spread of the infection
18
Q
Thomas Splint
A
- Problem of keeping broken bones straight when breaking through the skin - injuries often made worse when carried back to Casualty Clearing Stations - usually led to amputation
- Robert Jones used an idea from his uncle, Hugh Thomas, to keep the leg still
- Thomas Splint introduced to the Western Front at the end of 1915 - improved survival rate from 20-82%
- Over 240,000 soldiers lost limbs - need for prosthetics made of light alloys & advanced mechanisms
19
Q
Brain surgery
A
- Soft caps replaced by steel helmets in 1915
- American neurosurgeon - Harvey Cushing - experimented using a magnet to draw out metal pieces from the sound & found using local anesthetic was better since general made the brain swell
20
Q
Plastic surgery
A
- New Zealand doctor - Harold Gillies - experimented using bone or cartilage to create new features & repair facial injuries
- Skin grafts developed before the war but often rejected by the body
- Gillies developed the pedicle tube, kept blood flow to the graft constant& flap of skin grown until it attached to the new part of the bod
- Required several operations - plastic surgery unit set up at Queen’s hospital in Sidcup, Kent in 1917
- 12,000 operations carried out before the end of the war in 1918
