1900-Present

This was a time of RAPID CHANGE in medicine

Government:

Institutions became increasingly involved in the health of its population, lassez-faire ideas were ceased, the links between germs, DNA and lifestyle proves that action is needed, the government action in the 1800s although limited did make a difference, therefore other governments were encouraged to continue this involvment

War:

large wars in the 20th century often led to new injuries as new weapons were being used, this resulted in greater practise and understanding for surgeons, during ww2 the public became used the governments help to keep them healthy and they wanted that to continue after the war ends.

Science and Technology:

in the 20th and 21st century we can see a greater cooperation between scientists, called big science, thick led to greater understanding of DNA and lifestyle benefits, aided by technological advances which fund research and communication

Industry:

large profits were to be made as large pharmaceutical companies emerged, many of these industries are built off government funding that allows new techniques to be developed.

Ideas:

Lifestyle + Health

The link between lifestyle and health has been proved and has become common knowledge, its common knowledge that smoking is bad as it has been linked to high blood pressure, lung cancer, and heart disease, it is also common knowledge that unprotected sex can lead to STI’s such as HIV

Diagnosing illness

new technology has allowed doctors to understand and diagnose disease more effectively, e.g. x-rays allow doctors to see inside the body without being intrusive, e.g. MRI scans allow doctors to study internal organs without surgery, and its quicker, e.g. ECG’s to monitor hearts

DNA + Genetics

Now that there is knowledge and understanding of DNA and genetics doctors can ask about family history as they understand that microbes do not cause all diseases, some diseases could be hereditary, e.g. down’s syndrome and cystic fibrosis

Treatment:

Equipment

new high tech medical and surgical equipment can be used, e.g. chemotherapy and radiotherapy can be used to shrink cancerous tumours, e.g. key-hole surgery can be used to reduce scarring, dialysis is used to wash and filter a patients blood.

Remedies

Alternative medicines and herbal remedies are still used and some people are still superstitious, however because scientists are facing new disease new medicines and herbal remedies have to be produced, and some scientists are realsieing that bacteria are becoming resistant to certain drugs, e.g. MRSA

Prevention:

Government health campaigns

Education is provided that promotes a healthy lifestyle and diet, advertising and educational campaigns to focus on smoking, reducing fat intake

Quarantine

During the ebola crisis of 2014-15, the government warned against travelling to west Africa, they tracked who travelled to these nations and quarantined those who were a risk to prevent an epidemic in Britain

Public health

Laws have been passed to ensure the health of citizens, e.g. The Health Act 2006 banned smoking in workplaces to reduce smoking and passive smoking, e.g. The Clean Air Act 1956-68 to reduce air pollution known as smog

Mass vaccination

mass vaccination programs made compulsory, funded by taxation, resulted in major diseases being eliminated from the UK e.g. Polio

Antibiotics + Penicillin

Alexander Flemming - 1914-28

Before - Robert Koch’s work 1870’ to 1880’s that discovered specific microbes causing specific diseases, Louis Pasteur’s work 1880's proving how vaccinations worked, by producing antibodies

Porblems before his work - Scientist had discovered ‘magic bullet's’ however they often had nasty side effects, it was also made aware that some microbes were untreatable such as streptococci and staphylococci

Developments - Penicillium mould blew through his lab window and which he cultures and tests on bacteria, by 1928 he realises that penicillin kills the streptococci and staphylococci microbes, he also discovers that you can dilute penicillin tp make a harmless cure and he writes about this in his medical journal.

Limits to his improvements - he suggested injecting git into the body however he didn’t have enough to test on himself and so gave up on the idea

Florey and Chain - 1938-41

Improvements - they solved the problem of supply by developing a freeze-drying technique to make more penicillin and quickly, with this, they tested it on humans and proved that it worked to cure infections

factors that helped - florey and chain read Flemmings article in the 1930s in the medical journal, they had some UK government funding as they attended oxford but most of their funding was from the US government which funded their work for 5 years, they grew penicillin in hospital bedpans to prove it could cure septicaemia

Mass production after 1941 - after 1941 penicillin could be mass produced, they travelled to the USA to convince drug companies to produce penicillin, the US governtment gave companies $80 million after they entered WW2, they grew using government loans to set up huge factories

DNA + Genetics

Problems - scientists knew microbes caused disease but did not know disease could be inherited

Improvements - The structure of DNA was discovered in 1953, scientists mapped the human genome 1990-2000, they understood all the functions of all the genes in our DNA

Impact - understanding of genetic diseases, they were able to screen people to see if they were at risk of any diseases, they could take preventative measures such as mastectomy, or a hysterectomy

Limitations - it took a long time, genes can be recognised but not treated or altered

Factors - teamwork, big science, technology, communication, the internet

NHS - 1948

Problems - initially there was the national health insurance set up in 1911, however, it didn’t cover the elderly, children, housewives and the unemployed, therefore care was still given at home

Improvements - hospital care and treatments were made free to everyone, vaccinations were free and compulsory, they offered free screenings , hospitals became centres for training and research

Impact - access to healthcare improved, women’s health improved significantly, high tech medical equipment and surgical technology was used.

Limitations - hospitals weren’t improved immediately when it was set up in 1948, prescription for drugs had charges as they funded the NHS, more visits made for greater waiting times

Factors - war, technology, beverage report which argued for a health service in 1942

Lung Cancer

Before better technology lung cancer was diagnosed using x-rays, this led to incorrect diagnoses and abscesses were mistaken for tumours or vise versa.

Diagnosis - CT scans are used to identify cancerous cells, Bronchoscopy can be carried out to extract cells for testing

Treatment - chemotherapy and radiotherapy to shrink tumours, operations to remove tumours, transplants to replace cancerous cells with healthy cells

Preventions - Ban of smoking in public places 2007, ban of tobacco sales to under 18s 2006, increased tax on tobacco, ban of cigarette adverts 2005