Government Action and War: Changes in Medicine, c1848-c1948

GOVERNMENT ACTION AND WAR

Changes in Medicine, c1848-c1948

4. GOVERNMENT ACTION AND WAR 1905-20
Learning Objectives

  • Understand the impact on public health of reforms introduced by Liberal governments.

  • Understand the impact on medicine and surgery due to the First World War.

  • Evaluate improvements in public health, medicine, and surgery.

Introduction

  • The early 20th century involved significant evolution in the role of government regarding public health, expanding from basic hygiene and housing issues into comprehensive healthcare reforms.

  • The period from 1906 to 1911 saw the passage of laws aimed at enhancing national health by providing medical checks and support for at-risk populations.

  • The First World War escalated the demand for medical advancements due to unprecedented injuries, leading to innovations in treatment and surgery, and fostering increased participation from women in the healthcare field.

4.1 THE LIBERAL GOVERNMENT PUBLIC HEALTH MEASURES (1906-11)

Government Attitudes

  • Despite late 19th-century improvements in hygiene and housing, many individuals continued living in poor health conditions.

  • Reports from 1891-1903 by Charles Booth and Seebohm Rowntree highlighted that a significant portion of the population was below the poverty line, significantly affecting health due to poor living conditions and nutrition.

  • The Boer War (1899-1902) revealed that over one-third of British army volunteers were unfit for service, with some regions reporting unfitness rates as high as 90%. This critical issue prompted political action towards improving national health as Britain needed a strong military force for an expansive empire. Made the health and fitness of the nation especially men become important

Liberal Government Reforms

  • Upon winning the 1906 general election, the Liberal Party was in a position to introduce significant reforms, becoming aligned with the needs of common citizens.

  • The reforms instituted during 1906-1911 became foundational for the welfare state as we understand it today, emphasizing governmental responsibility for health, housing, unemployment, and basic living standards.

Improving the Health of Children

  • In 1906, the enactment of free school meals targeted children from impoverished families, partially funded by government grants.

  • The program expanded impressively, increasing from 3 million meals served in 1906 to 14 million by 1914, thus ensuring children received nutritious meals necessary for growth and health development.

  • The Board of Education also promoted hygiene education in schools, aiming to reduce disease spread among children.

  • The School Medical Service initiated in 1907 included health checks and home visits to monitor young children's health, albeit financial barriers for treatment still existed.

Protection for Children and Other Groups in Society

  • The Children and Young Persons Act of 1908 prohibited the sale of tobacco and alcohol to minors and made child neglect a crime, highlighting a growing recognition of children's rights.

  • The introduction of the Old Age Pensions Act in 1908 provided financial assistance to the elderly, contributing to improved quality of life for the most vulnerable.

  • 1909 marked the establishment of Labour Exchanges to assist unemployed individuals in finding work, aiding families to afford better living conditions.

The Cost of Public Health Improvements

  • As early 20th-century reforms gained acceptance, the public was generally reluctant to bear the costs associated with them. Complaints arose when taxes increased to fund these initiatives.

  • The significance of these reforms lies in their acknowledgment of the relationship between poverty, poor hygiene, and susceptibility to disease.

  • The Liberal government recognized its duty to protect public health, with only parliamentary authority able to enact laws regarding public welfare, contrasting previous municipal efforts.

Access to treatment

  • Many people had to pay for their visit to the doctors as well as the medicine and this was a n issue for families near the poverty line because of this many people avaoided doctors when they became ill only went with it was critical/ too late for anything.

  • Hospotals in towns and cties had dispensiers but pople relied on ready made medicines and pills from a pharmacist. Also used traditional remedies.

    • Sick clubs made where patient paid regular amounnt each wee to cover cost of treatment when required

The National Insurance Act 1911

  • under the terms money was paid into scheme by workers and by employers, anyone ill could receive free healthcare from doctor linked to scheme. Maternity grant was given to help for supplies and pay a fund to provide unemployent benefit if job lost.

  • Significant as prevent a family falling below poverty line and allow them to cope if the mian wage earner fell ill

  • Act only for workers no famil memebers selp employed or unemployed nt covered

4.2 THE FIRST WORLD WAR

Context of the War

  • The First World War, beginning in 1914, surprised many with its scale and intensity; it was anticipated to be a brief conflict but stretched into four years of extensive global engagement.

  • New warfare methods, including advanced weaponry and trench warfare, resulted in unprecedented military casualties, necessitating rapid medical responses.

Care for Wounded and Sick Soldiers

  • Casualties from the war far exceeded those of previous conflicts, with most injuries involving bullet wounds, shrapnel, and gas exposure.

  • Infectious wounds, particularly gangrene, became prevalent due to battlefield conditions, with gangrene leading to high mortality rates.

  • Poison gas introduced an additional medical dilemma, resulting in numerous soldiers requiring prolonged hospital care.

  • Portable showers developed and mew clothing provided

  • 186,000 soliders injuried by gas 80% by mustard gas and 2.6% died

Conditions in trenches

  • Extremely unhealthy, rats in the trenches became big and attacked dead bodies

  • body lice

  • Trench foot developed by the soil getttng muddy when rained as feet could be kept dry

  • clothing was dirty increasing chance of infected wounds

  • Trench fever - flu like symptomps high fever, headache and aching muscles, Shell shock- tiredness, headaches, nightmares,loss of speech,shacking, dysentary - stomach pains diaoreahe dehydrration

Casulaty clearing and Base hospitals

  • Regimental first aid where immediate aid given, severe cases sent to base hospitals, more surgery being done at base

Medical Services Innovations

  • The war emphasized the need for rapid medical interventions and the establishment of effective casualty treatment protocols.

  • Casualty Clearing Stations and Base Hospitals emerged as key medical hubs which expedited the treatment process, reinforcing the importance of timely surgery to reduce infection risks.

  • The Royal Army Medical Corps (RAMC) was pivotal in managing medical services, illustrating how wartime exigencies led to significant medical innovations.

Women's Contribution to Medicine

  • The high casualty rates prompted women to assume diverse roles in medical fields, with many volunteering through various organisations.

  • Female nurses worked in front-line conditions, providing acute care while public attitudes toward women in medicine began to shift.

  • Women physicians faced both increased responsibilities and persistent resistance from the male-dominated medical establishment, often relegated to support roles despite significant contributions in wartime medical care.

4.3 - Improvements in Surgery

x-rays

  • couldn’t find fragments of clothes in a wound

  • person had to stay still during x-ray which was a problem

  • glass tubes overheated so can’t use continiiuolsy

  • high dose of radiation was harmful and cause burns

New techniques in surgery

  • excision involved cutting away infected tissue so that all danger of gangerene was removed

  • feeding a sterilised salt soltion through the wond

  • methods were time consumng if not done in time only option left amoutation

Thomas splint

  • Increased survival rate of leg injuries from 20 to 82 percent

  • prostetichs limbs improved now made of alloys and had more advanced mechanisms toll time to male.

  • brains surgery soldier soft caps replaced with steel helmetts in 1915 used magnet to drawout pieces of metal from wound better to use local anesthatic

  • Plastic surgery using pieces of bones or cartilage to create new features, pedicle tube using a flap of skin was grown until it could be atttached to a new part of the body required several operations ver a long time