History: Medicine: Modern Medicine

What causes of disease were found following the Germ Theory?

-viruses

-lifestyle factors

-genetics (mutations)

What doctor labelled viruses and found that they had different properties to bacteria?

Martinus Beijernick

What year did Martinus Beijernick do his work?

1898

What discovery did Watson and Crick make?

Structure of DNA, which allowed others to find out about which genes cause conditions

What year was the structure of DNA discovered?

1953

What year were X-Rays discovered?

1895

Who discovered the X-Ray?

Wilhelm Rontgen

How are X-Rays used in medical diagnosis?

Assess for broken bones or things stuck in them, allow earlier treatment

How did Fleming, Florey and Chain and the US Government contribute to penicillin production?

Fleming= 1928 found growing on petri dish and published findings in articles 1929-1931

Florey and Chain= developed freeze-drying techniques to mass produce (purifying technique)

US Government= Provide funding, gave grants to businesses manufacturing it, led British to help military

First two magic bullets, when, who?

1909, Salvarson 606, Paul Ehrlich

1932 Prontosil, Gerhard Domagk

Three advancements in surgery that made it safer?

-Key-hole (1980s), stop opening wound and risk of infection, less recovery time and scarring, also robot-assisted to make smaller cuts and reduce shock or trauma through blood loss, less invasive when you use endoscope.

-Blood transfusions, blood groups in 1901, prevent death through blood loss Karl Landsteiner. 1917 Blood bank Battle of Cambrai

-Transplants, help to completely eliminate problem, 1967 first heart transplant

1970s immunosuppressants developed to make safer and more likely to be successful

When was the NHS set up?

1948

Factors leading to the NHS being set up?

-WW2, powerful took notice of poor's problems, air raid emergency medical service proved successful

-1942 Beveridge report, called for government social security, best seller

-1945 Labour party elected

-Change in public attitudes

-Boer War proved issues

-Scientific knowledge increased

Two government vaccination campaigns?

-Diptheria 1942, set up publicity campaigns, posters, news ads, radio broadcasts, by 1957 deaths reduced to 6 from 3000

-Polio 1956, aim to vaccinate all under 40, only 40 cases 1985-2002, 30,000

How did the lung cancer diagnosis and treatments improve?

-Chest X-Rays, see if any unfamiliarity on lung

-CT scans, give detailed image

-Bronchoscopy, diagnose

-Surgery, remove affected lung

-Radio or chemotherapy

How did the Government try to reduce smoking?

-Campaigns (ads)

-Laws (no public smoking 2007)

-Ban adverts in 1965 on television

-1971 companies had to put health warning on packets

-2005 parliament passed laws that boxes must be plain

-1948-2010 Men= 65% to 20%

Women= 41% to 20%

Two causes of disease investigated during the 20th century

Genetics

Lifestyle choices

When was the first electron microscope developed

1931

Date of the discovery of the structure of DNA by Watson and Crick

1953

Date of Human Genome Project to map the DNA code of humans

1990 - 2000

One example of a human disease caused by missing information in the human genome

Down's syndrome

What has the Human Genome Project allowed?

Scientists can produce a synthetic protein to replicate the work of a faulty gene and treat inherited conditions using treatments such as gene therapy.

Four lifestyle choices linked to disease

Smoking (cancer)

Diet (diabetes/heart disease)

Alcohol (kidney and liver problems)

Unprotected sex (STDs)

Science and technology developed to diagnose disease more effectively

X-rays (from the 1890s)

Blood tests (from the 1930s)= test blood groups, test cholesterol level (heart attack/ stroke), check DNA (cystic fibrosis), which type of cancer (prostate, breast)

MRI scans (from the 1970s) - to diagnose soft tissue injuries

CT scans (from the 1970s), detailed image of part of the body - to diagnose tumours

How can patients now monitor their own bodies?

-Blood pressure monitors 1880s and 1890s

-Blood sugar monitors mid 20th century

Allowed greater control over health

Define a 'magic bullet' cure

A chemical cure that attacks the germs in the body causing a disease without harming the rest of the body

Name the first 'magic bullet' cure

Salvarsan 606 to cure syphilis (discovered by Paul Ehrlich's team)

Name of the second 'magic bullet' cure

Prontosil to cure blood poisoning (discovered by Gerhard Domagk), Streptococcus

What other chemical cures were found?

Sulphonmaides, which worked on pneumonia

What did magic bullets help?

Showed synthetic, targeted treatments for specific diseases were possible. Huge pharmaceutical industry grown, dedicated to research and production of new treatments.

Define an 'antibiotic'

A treatment which destroys or limits the growth of bacteria in the body. Antibiotics are usually produced by or synthesized from other microorganisms.

Name of the first antibiotic

Penicillin

What has been the problem with the use of antibiotics in the 21st century

Some bacteria have become resistant to antibiotics, such as MRSA

Types of technology developed for treating patients

Mass production of pills

Hypodermic needles for giving precise dosages

Development of capsules to dissolve in the stomach to release the drug

Name of drug which caused birth defects in the 1960s before the standard use of drug testing

Thalidomide

When was the NHS set up

1948

Aim of the NHS in 1948

To provide access to free medical care for everyone in Britain. Before, access for poor very limited.

e.g. 140 infant deaths per 1000, now less than 5

What was the National Insurance Act

1911, some workers health insurance for medical attention, but economic slumps and WW1 drained government resources, couldn't expand provision

Why did the government implement further changes to the NHS in the 1960s

Access to health care had improved after 1948, but the government wanted to improve the quality of care and provision too.

Two examples of high-tech medical treatments provided by hospitals in the NHS

Radiotherapy

Prosthetic limbs

Two examples of surgical treatments provided by hospitals in the NHS

Micro-surgery

Keyhole surgery

Percentage of deaths in Britain caused by infectious disease in 1900

25%

Percentage of deaths in Britain caused by infectious disease in 1990

1%

How did the purpose of hospitals change in the 20th century

They became places for treating the sick only, not places for the elderly to rest

When was the first national vaccination campaign organised by the government

1942 - Diphtheria vaccine

Two other government vaccination campaigns in the 20th century

Polio (1956) and Tetanus (1961)

Two laws introduced by the government to improve public health

1956/1968 Clean Air Act - to prevent the ill-effects of smog caused by air pollution

Health Act 2006 - became illegal to smoke on enclosed workplaces

Two examples of government lifestyle campaigns

Change4life - encourages a healthier diet and more exercise

Stoptober - encourages smokers to quit smoking for one month

How had government invention changed in the modern period?

-Campaigns showed shift in attitude from laissez-faire. Trying to treat and vaccine, but actively intervening in people's lives to prevent them.

When did Fleming discover penicillin by chance

1928 (yet not originally funded, needed the production process to be developed)

When was penicillin developed into a usable treatment by Florey and Chain using freeze-drying techniques

1938-1940

When was the first human trial of penicillin

1941 - used on a policeman suffering from blood poisoning

How did the US government help the development of penicillin

Following the entry of the USA into World War II in 1941, the US government funded 21 pharmaceutical companies to mass produce penicillin.

When was penicillin available for treating Allied troops in the war

D-day, June 1944

What happened after war for penicillin?

Cost fell, making more accessible for general use

What is penicillin used to treat today?

Range of bacterial infections (chest, skin)

Other antibiotics discovered after 1945, e.g. for lung infections, acne, bacterial meningitis

How did Dorothy Hodgkin contribute to the development of penicillin

She mapped the chemical structure of penicillin so that scientists could develop synthetic versions of penicillin that were slightly modified to treat other specific diseases.

What percentage of lung cancer cases are caused by smoking

85%

In which year did the British Medical Council publish a study showing a link between smoking and lung cancer

1950

Two reasons why lung cancer is difficult to diagnose

Symptoms often mistaken for other diseases

No national screening programme

Two types of technology used to diagnose lung cancer

CT scans (detailed image)

Bronchoscopy (using an instrument called a bronchoscope)

Chest X-Ray, anything on lung

Two uses of science and technology in the treatment of lung cancer

Radiotherapy (to shrink the tumour)

Chemotherapy (to shrink the tumour of provide relief from symptoms)

Surgery (e.g. transplant)

Action taken by the government to force people to change their behaviour concerning smoking

2007 - legal age for buying cigarettes raised from 16 to 18

2015 - ban on smoking in cars carrying children under 18

Action taken by the government to influence people to change their behaviour concerning smoking

Ban on tobacco advertising

Removal of cigarettes from display in shops

Many campaigns to advertise the dangers of smoking