20th century

• 74. What were 'magic bullets' and who developed them?

  'Magic bullets' was a name given to chemical cures for diseases. They attacked specific bacteria but not the rest of the body. The first 'magic bullet' was Salvarsan 606 and was developed by Paul Ehrlich and his assistant Hata. This was an arsenic compound and was used to effectively treat syphilis (a terrible sexually transmitted infection). Domagk built on this by developing Prontosil.
• 75. How did Alexander Fleming discover penicillin?

  He was researching substances that might be effective in combating simple infections and noticed that one of his dirty petri dishes had developed some mould. The mould had killed off the staphylococcus bacteria that had been growing in the dish.
• 76. How was Fleming's discovery built on by Florey and Chain?

  They grew as much as they could in Oxford. They were then able to get funding and technical support from the US government to mass produce penicillin. By June 1944, there was enough penicillin to treat all the allied forces wounded in the D Day invasion of Europe.
• 77. How were antibiotics developed further?

  Soon after the war penicillin became available for civilian use and was called an antibiotic. Other antibiotics were discovered. A recent problem has emerged with antibiotic-resistant bacteria.
• 78. What further vaccinations have been created during the 20th century?

  Diphtheria, poliomyelitis, whooping cough, tetanus, measles, rubella. There has continued to be opposition to vaccination (e.g. MMR and Covid 19).
• 79. What other progress in understanding of cause and treatment happened in the modern period?

  Pioneered by Marie Curie, Radiotherapy and Chemotherapy have increasingly been used to treat cancer. James Watson and Francis Crick discovered DNA in 1953 which has led to more understanding of genetic diseases.
• 80. How have the medical professions changed in the modern period?

  The whole medical profession became strictly regulated by the GMC. Specialist 'Royal Colleges' were set up to register and monitor all types of doctor and surgeon. GPs became available as the first port of call when people experienced illness.
• 81. How has the ability to scan the body and diagnose problems developed in the modern period?

  1895: X-rays discovered by accident by Wilhelm Roentgen. 1914: Mobile X ray units developed by Marie Curie, whose work was interrupted by WWI. 1967: CT scans developed to allow surgeons to see tissue as well as bone in 3D images. 1970s: MRI developed, and first MRI scanners installed in hospitals in the early 1980s.
• 82. How was the problem of blood loss in surgery addressed in the modern period?

  World War One was crucial in overcoming this problem. 1901: Austrian Karl Landsteiner discovers different blood groups which leads to reliable transfusions although it had to be directly between donor and patient. 1915: Sodium citrate added to blood allowed it to be stored for two days. 1916: citrate glucose allowed it to be stored for four weeks. First 'blood banks' created. 1938: In preparation for WWII, the Army Blood Supply Depot is set up in Bristol, kept supplied by up to 700,000 donors during the war.
• 83. How has facial reconstruction and rehabilitation developed in the modern period?

  Harold Gillies pioneered facial surgery during WW1 and developed the tube pedicle. 1939-1945: New Zealander Sir Archibald McIndoe pioneered work on burns, especially treating shot down pilots. He improved Gilllies' skin grafting techniques, and recognised the importance of rehabilitation and providing his patients with community. This led to the creation of the 'Guinea Pig Club'.
• 84. How else has technology played a role in surgery in the modern period?

  Heart-and-lung machines were developed in the mid 20th century allowing for open-heart surgery and transplants (in 2014, 181 heart transplants took place in England). Laser treatment for eye correction is now commonplace.
• 85. What motivated the British government to take public health action in the early 20th century?

  Around 1/3rd of British volunteers for the Boer War were rejected due to ill health. Researchers like Booth (1899-1903) and Rowntree (1901) published reports which demonstrated the extent of the problem of poverty and that people were often trapped in it. Booth showed that 35% of London's population lived in poverty.
• 86. What changes were introduced in the Liberal Health Reforms?

  The Liberal Party passed a series of Liberal Health Reforms between 1906 and 1911, including the Education Act (1906) which provided free school meals for children. 1911: A new Liberal government passed the 1911 National Insurance Act.
• 87. What were the public health problems that remained after the liberal reforms?

  The Liberal Health Reforms had serious limitations. E.g. Pensions were introduced for over 70s but only if you had worked all your life. Most poor men had only irregular employment. Poverty continued to be widespread. In WW2, around 15% of the school population was receiving free school meals. New diseases emerged e.g. Spanish Flu (1919)
• 88. What was the importance of the Beveridge Report (1942)?

  Beveridge wrote a government report to tackle poverty and want. He suggested setting up a National Health Service (NHS) which was free for everyone. Doctors, nurses and medical workers would be paid by the government. Everyone would pay national insurance from their wages.This would pay benefits to everyone who needed it. It was a hugely popular idea and sold 600,000 copies.
• 89. When was the NHS introduced and why was this important?

  The NHS was launched by the new Labour government on the 5th of July 1948. Health Minister Aneurin 'Nye' Bevan was crucial in convincing doctors to support the NHS. There had been opposition from doctors but Bevan 'stuffed their mouths with gold' by agreeing to let them continue to make money privately. The NHS meant that everyone in Britain had access to medical care free at the point of access.
• 90. What problems has the NHS faced since its introduction?

  The NHS has had to bear the cost of health issues that some people think are self-inflicted (e.g. smoking). The NHS has been a victim of its own success. As people live longer there are more people to look after. New cures have been found and new diseases have emerged. There has been a heated public debate about how the NHS should be paid for.
• 91. What other examples of government action on public health are there in the modern period?

  In 1909, the Ministry of Health was set up to monitor and improve public health. In 1956, the Clean Air Act was passed in response to London's pollution problem
• 92. What was Covid 19 and how was it understood, treated and prevented?

  Started in Wuhan, China and spread to Europe with Italy being locked down on 9th of March 2020. People had different ideas about how to treat it with Donal Trump suggesting the injection of disinfectant into patients! By September 2022 there had been 23m reported cases and 207,000 deaths. Worldwide numbers were 615 million cases with 6.5 million deaths.