Modern Medicine - 20th Century Flashcards
Why was there a growth of alternative medicine in the 20th century?
controversies e.g. thalidomide case made people mistrust mainstream medicine
What kinds of medicines grew in the 20th century?
- alternative medicine - hydrotherapy, aromatherapy (oils from plants), and acupuncture
Who thought alternative medicine (acupuncture e.g.) was witchcraft and nonsense?
the British Medical Association
How many doctors now prescribe alternative medicine?
1 in 10 doctors
How did the role of the doctor change in the 20th century?
- people still had to pay to see a doctor at the start of the 20th century so most used traditional remedies e.g. “[for] headaches we had vinegar and brown paper” - kathleen davys 1930s
- Labour set up NHS in 1948 making seeing GP free - have become central to delivery of medical services
What was set up to treat WW1 soldiers?
Casualty Clearing Stations 1915
What was WW1 in turns of disease/injuries?
The first major conflict where deaths from injuries outweighed deaths from disease
How many people died in WW1?
8 million soldiers died - 20 million injured
What were the five impacts of WW1 on surgery?
- technological improvements
- shell shock improvement
- x-rays
- blood transfusions
- skin grafts/plastic surgery
How did WW1 cause technological improvements?
- mobile x-rat units allowed better identification of injuries
- blood transfusions helped recovery
- soldiers with broken femurs who died dropped 80% died in 1914 and 80% survived in 1916
- improvements in cleaning wounds, convalescent wards and hospitals
How many soldiers died from broken femurs in WW1?
80% died - 80% survived between 1914-16
How did WW1 change shell shock treatment?
- 80,000 men with shell shock
- 306 executed for cowardice
- a’s war progressed it became more accepted and hospitals treated them e.g. Craiglockhart hospital - William Rivers “talking cure” encouraged men to talk about experiences - Wilfred Own treated here
- this technique was used for treating mental illness after the war
How many men had shellshock in WW2?
80,000
How many WW1 soldiers were executed for cowardice?
306 soldiers with shellshock - executed by firing squad
How did WW1 impact X-rays?
- discovered by accident 1895 by Roentgen
- Edison and Eastman invented glass plates and x-ray film - making invention more accurate
- scientists developed radiotherapy to avoid invasive cancer surgery
- X-ray imaging still used for CT scans - surgeons can see tissue in 3D
Who discovered X-rays?
Roentgen in 1895 (but later improved by Edison and Eastman)
How did WW1 impact blood transfusions?
- 1901 blood groups discovered by Landsteiner (meaning donors and patients could be matched and transfusions became practical)
- discovered that anti-coagulants added to blood meant it would last for 28 days
- 1915 first blood banks set up for battle casualties
- 1921 British Red Cross set up voluntary blood scheme - this was copied around the world
- 700,000 blood donors in WW1
- 1940 blood dehydrated into plasma and plastic wallets used for transport
How many blood donors were there in WW2?
700,000
When were blood banks first set up?
1921 by British Red Cross
How did WW1 impact skin grafts/plastic surgery?
- Follows developed techniques to treat facial injuries
- by 1917 - special hospital for facial repairs
- 5000 soldiers treated by Gillies who grafted skin onto injuries - rebuilt damaged faces and became pioneer of plastic surgery
Who was the pioneer of plastic surgery?
Gillies
How many soldiers had skin grafts by Gillies in WW2?
5,000
What developments in medicine were made during WW2? (5)
- heart surgery under Harken - removing bullets and shrapnel increased knowledge
- government encouraged people to grow own food - vegetables made people healthy and evacuation took children to clean countryside - rations ensured healthy lifestyle
- Sir Harold Ridley helped cataract surgery by treating airmen as perspex splinters weren’t rejected by eyes
- Sir Archibald McIndoe - worked on burns (pilots shot down) - improved skin grafting techniques and helped pilots reintegrate into society
- Mepacrine anti-malaria tablet
How many people died from the flu in 1918?
20-40 million worldwide in 1918
How much of the population did the flu effect?
20% infected - mostly 20-40 year olds - mass troop movements at the end of the war helped transmit across the globe
Why was the epidemic i 1918 called the “spanish flu”?
because the government imposed censorship about the spread to prevent panic - but the media could report the 7million deaths in spain
What percentage of people infected with the flu died?
20%
What were the treatments for the spanish flu in 1918? (5)
- wear a gauze mask over nose and mouth
- keeping children away from sick adults
- gargling with salt water
- boiling handkerchiefs
- alcohol/none
What were discovered as a result of technology in the 20th century? (8)
- improves anaesthetics
- transplant surgery
- keyhole surgery
- microsurgery
- radiation therapy
- laser surgery
- DNA discovered
- CAT and MRI scans
What did improved anaesthetics mean for medicine in the 20th century?
it meant patients could be unconscious for longer so more complex surgeries could take place - better antiseptics cut infection
when was the first kidney transplant?
1952
When was the first hip replacement?
1972
What did keyhole surgery do?
surgeons could do surgery through very small cuts as small fibre optic cameras could be used
What did microsurgery do?
surgeons could magnify the areas they are working on so could re-join nerves/blood vessels
What did radiation therapy do?
uses high-energy radiation to shrink tumours - used for over 100 years
What did laser surgery do?
first used in eye surgery 1987 - now used to help skin conditions, clear blocked arteries, remove rumours and ulcers and control bleeding
When was DNA discovered and what did this mean?
1953 - “human genome” project has helped understanding
What did CAT and MRI scans do?
allow surgeons to see inside the body - endoscopy cameras inserted in openings to look around body and spot issues
What were the problems in the 1900s that led to government action? (3)
1 the boer war
2 charles booth
3. seebohm rowntree
What was the problem in the Boer War?
1899-02 40% of all young men who volunteered were deemed unfit to serve - 90% in some cities
What was the solution to the Boer War problem?
government set up committee to enquire the “Physical Deterioration of the People” - 1904 publishes hat too many had unhealthy lives (poor food/jobs etc)
What did Charles Booth do in the late 1800s?
- refused official reports that 25% of the working population were living in poverty - employed his own investigators - investigated 4,000 families and found 31% of Londoners were below poverty line and that 85% was due to unemployment/low wages
How many Londoners did Booth find to be living under the poverty line?
31% - 85% was due to unemployment or low wages
What did Seebohm Rowntree do in the 1900s? (york)
- following Booth’s findings he looked at York and found that 28% was in poverty
- poverty divided into two groups: primary (would never earn enough to take them out) and secondary (could survive as long as no more calls on resources)
- 10% of York in primary poverty
- his findings also highlighted that Germany and USA had overtaken in industrial power as workers were too weak (germany already had welfare system)
What happened as a result of Booth/Rowntree’s findings?
people began to feel it was government responsibility - some of the Liberal Party (e.g. Churchill) wanted direct government action as they were worried the labour party taking over (so they wanted to help the poor for votes) - this worked and in 1906 Liberals elected on a manifesto which promised social reform
What were the Liberal Social Reforms in the 1900s? (incl dates) (6)
1906 - free school meals 1907 - school medical inspections 1907 - education act 1908 - the children’s act 1911 - national insurance act (1) 1912 - school clinics
How many children were fed by the free school meals reform (1906)?
158,000 by 1914
What did the school medical inspections 1907 do?
doctors and nurses went to schools for compulsory medical checks - free but had to pay for treatment (until 1912)
What did the Education Act 1907 do?
scholarships available for children from poor families - all secondary schools with local authority funding must reserve 25% of places for poor children
What did the Children’s Act 1908 do?
- children became protected persons
- neglected children were visited and children’s homes inspected
- under 14
What was the story of penicillin?
19th century - Lister first discovered
WW1 - Fleming started looking for something to kill infection
1928 - penicillin found on petri dish
1929 - Fleming’s results published
1937 - Florey and Chain started researching and developing
1941 - experimented on humans (policeman)
1943 - US paid drug companies to produce - used on allied troops in North Africa - enough to treat 1000 soldiers
1944 - other antibiotics e.g. streptomycin for tuberculosis
1945 - enough to treat 250,000 soldiers - Fleming, Florey and Chain received Nobel Prize
How significant was Penicillin in WW2?
15% of soldiers would’ve died without it
1943 - enough to treat 1000 soldiers 1945 - enough for 250,000
Who first discovered Penicillin?
Lister - 19th century - used to treat a wound but notes were never published
When did Fleming publish his results on penicillin?
1929
What happened with Fleming in WW1?
Sent by St Mary’s Hospital to study the treatment of wounded soldiers - observed that antiseptics were unable to prevent infection so wanted to find something to kill the microbes which caused infection
What did Fleming discover when he came home from his holiday?
A mould on a petri dish that had killed the staphylococcus in 1928
Why didnt Fleming develop penicillin?
He didn’t have the funds :(
Who developed penicillin after reading Fleming’s articles and when?
Florey and Chain in 1937 - experimented on mice and then humans in 1941 (policeman had infection but ran out of drug so died 5 days later but they had seen success)
What did WW2 do for the development of penicillin?
Sped up production - US paid drug companies to produce in large quantities - 1943 used on allied troops in North Africa - 1945 enough to treat 250,000 soldiers - 15% would’ve died without
What was the “wonder drug”?
After WW2 a government sponsored programme to develop and produce “Wonder drug” - used widely to treat diseases like pneumonia, tonsillitis, syphilis, meningitis, wounds etc
What antibiotics followed the discovery of penicillin?
Streptomycin in 1944 - good for treating tuberculosis
What has happened recently as a result of the superbug (MRSA and norovirus)?
there has been a call to return to the victorian style of clean hospitals in an effort to fight them
