History Paper 1 — 12 markers

Explain why there was progress in the prevention of illness in the years c1700 - present. (12 marks)

P1: Government legislation / shift from laissez-faire

E: Public Health Act 1875 made it compulsory for cities to provide clean water supplies, sewage disposal, food quality checks, public parks

E: Edwin Chadwick publishes report proved poor lived shorter lives die to filth; encouraged 1867 Reform Act where the poor were allowed to vote in elections

P2: Scientific Advancements

E: 1796: Edward Jenner proved that those infected with cowpox did not catch smallpox afterwards by infecting local boy James Phipps with cowpox — he did not catch smallpox afterwards, but he couldn't explain why

E: Louis Pasteur publishes Germ Theory 1861 and Robert Koch uses agar jelly and dyes to identify specific disease-causing microbes e.g: bac. for anthrax 1876; bac. for TB 1882; bac. for cholera 1883

P3: State education and modern lifestyle campaigns

E: 1950: Doll and Hill prove link between lung cancer and smoking, leading to gov introducing campaigns like Stoptober and putting graphic images on cigarette packs

E: NHS (1948) introduce mass screenings e.g for breast and cervix cancer and carry out national vacc. programmes for diphtheria in 1940 and polio in 1950

Explain why there were improvements in medical knowledge in the years 1500-1700.

P1: Rise of humanism and shift in diagnosis

E: Thomas Sydenham treated patients based on the symptoms shown by a patient. Published Observationes Medicae (1676) suggesting diseases could be organised into groups like plants and animals

E: Sydenham advocated for use of cinchona bark from Peru to treat malaria, observing its success in cooling the specific “ague” (fever) associated with the disease

P: Improved infrastructure of education

E: Printing Press by Johannes Gutenberg (1440) allowed for mass production of medical texts without censorship of the church. Significant for Vesalius’s work (1543).

E: Royal Society (1660) founded at Gresham College, aiming to promote and carry out experiments to share scien knowledge. Published Philosophical Transactions (1665). Received Royal Charter by King Charles II (July 1662)

P: Individuals challenging ancient authority

E: Andreas Vesalius performed dissections on executed criminals. Discovered over 300 errors in Galen’s work e.g proving lower jaw was one bone and not two. Published “OtFotHB” (1543)

E: William Harvey used ligature experiments and dissections of animals to show that blood flowed towards the heart in veins and away in arteries, disproving Galen’s belief that blood was consumed by the body and made in the liver in 1628 book “aAAotMotHaBiA”

Explain why developments in science and technology led to rapid progress in medicine in the years c1900-present.

P: Mapping DNA and field of genetics

E: Watson and Crick (1953) discover structure of DNA as double helix. Opened door for Human Genome Project (completed 2003) which mapped the genes in the human body and their purpose

E: development of gene therapy, where healthy genes are used to replace or supplement defective ones, leading to birth of pharmacogenomics

P: Improved technology and precision surgery

E: development of keyhole surgery — surgeons operating through tiny incisions — and robotic surgery — surgeon controls robotic arms from a computer console — meant surgeons could operate through tiny hoes using Fiber-optic cams

E: prosthetic technology gone evolving from Páre’s simple wooden limbs to myoelectric prosthetics that use electrical signals from patient’s remaining mucles to move robotic fingers or feet

P: Chemical science and engineering

E: following Paul Ehrlich’s Salvarsan 606 (maghic bullet that cured syphilis) in 1909, scientists test new compounds and dyes, developing things like chemotherapy

E: mass production of pills, e.g penicillin during WWII by Florey and Chain using industrial fermentation tanks to treat soldiers

Explain why there were changes in the prevention of illness in the years c1700-c1900.

P: shift to scientific prevention and vaccines

E: In 1796, Jenner observed that milkmaids who caught cowpox didn't get smallpox. He tested this by infecting James Phipps with cowpox and then unsuccessfully trying to infect him with smallpox.

E: despite initial opposition from the Royal Society, Jenner published his findings and gov made smallpox vaccinations compulsory in 1853 and enforced further in 1872

P: End of government laissez-faire

E: following voluntary 1848 Public Health Act, Second Public Health Act (1875) forced local authorties to provude clean water, sewage disposal, public parks, food quality checks

E: accelerated by 1867 Reform Act which gave working-class men the vote

P: Impact of Germ Theory

E: Louis Pasteur (1861) published Germ Theory after using microscopes and other instuments, proving microbes in the air caused decay, disproving spon gen

E: Robert Koch developed new method of growing and identifying specific bacteria using agar jelly and dyes. Found bacteria that causes: anthrax (1876); TB (1882); cholera (1883).

Explain why attitudes towards surgery changed in the period c1800-present.

P: Tackling pain

E: highly dangerous and unsafe chemicals like laughhing gas and ether were previously used; James Simpson sought to find a better anestehtic and expermineted with different chemicals with friends and discovered chloroform in 1847

E: despite initial opposition (e.g from when 14-year-old Hannah Greener died from a chloroform overdose during a toenail surgery), this was overcome when Queen Victoria used chloroform during the birth of Prince Leopold in 1953

P: Tackling infection

E: Following LP’s Germ Theory, Joseph Lister used carbolic acid (used in sewage treatment) soaked onto a bandage on a patient with a broken leg, healing the wound and preventing infection

E: evolved into aseptic surgery — preventing germs from ever reaching wounds — during 1890s, using autoclaves (steam-sterilising tools) and the use of rubber gloves by William Halfsted

P: Modern advancements in surgical technology

E: discovery of X-rays (1895) by Wilhelm Röntgen and later CT/MRI scans allowed surgeons to see inside the body before making any incision

E: dev of keyhole and robotic surgery means major surgery can be done through incisions less than 1cm wide

A: no longer months of recovery post surgery etc.

Explain why access to medical care and treatment improved in the modern period.

P: Free healthcare and state provision

E: NHS launched by Labour government (1948) unified all existing municipal and voluntary hospitals under one national umbrella, providing services like hospitals, vaccinations, general practice, specialists and health centres

E: 1962 Hospital Plan by conservative gov promised 90 new hospitals built and 134 others redevelopments, ensuring every region had a District General Hospital

P: role of the GP

E: under NHS, everyone required to register with a local GP, who provided free consultations and acted as the first point of contact for any health issue. Could provide primary care, vaccinations and maternity services

P: Technology and diagnostic access

E: advanced diagnostic tech e. MRI/CT scans in hospitals + blood tests and endoscopes in local clinics allowed quick, safe internal access to the body without surgery

E: rise of digital health services (NHS app, 111 phone service, and video consultations) has allowed for virtual access to medical advice