1900 - present modern medicine

• Who/when first described DNA's structure and impact

  • The structure of DNA, a double helix that can reproduce by splitting.
  • First described in 1953 by Crick and Watson
  • Allowed other scientists to find the genes that cause genetic conditions - diseases that are passed on from one generation to another like cystic fibrosis, haemophilia and sickle cell anaemia
  • improved treatment and diagnosis
• lifestyle factors that affect the risk of disease

  • smoking ( lung cancer)
  • obesity ( heart disease/diabetes)
  • drinking too much alcohol (liver disease)
• blood tests

  • blood tests can be used to check a patient cholesterol level. this can help diagnose their chance of suffering a heart attack or stroke
  • can be used to check a patients DNA. this helps diagnose a genetic condition
  • some blood tests can be used to show whether a patient has a certain type of cancer
• x-rays

  • discovered 1895. installed in hospitals and allowed image of inside the body
  • enabled doctors to intervene much earlier before the disease is too advanced
  • advancements in tech allow doctors to use ultrasound scanning, they emit high frequency sound waves that bounce off organs to create an image of them on the computer
  • CT (1972) - x rays and computer to make detailed images of parts of the patient body
  • MRI (1970) use extremely powerful radio waves to construct images
• blood pressure and blood sugar monitors

  • blood pressure monitors were invented and developed in 1880s and 1890s. they let doctors and patients see whether disease, lifestyle factors or medicine are causing high blood pressure
  • blood sugar monitors introduced mid 20th century. allow those with diabetes to make sure blood sugar is at the right level
  • this allows people to monitor themselves whilst at home.
• Fleming discovery of the first antibiotic

  • Fleming saw many people die of septic wounds caused by staphylococci in WW1
  • One day in 1928, he came to clean up some old culture dishes on which he had been growing staphylococci for his experiments.
  • By chance a fungal spore had landed and grown on one of the dishes.
  • The staphylococci around the mould had stopped growing
  • Fungus identified as Pencilium.
  • Published findings 1929-1931 but no one funded him so he was unable to take his work further.
• Florey and Chain

  • picked up the research between 1938 and 1940
  • chain discovered freeze drying technique which was an important part of the purification process.
  • they didn't have enough resources to produce penicillin in large amounts. they made penicillin for their first trial by growing penicillin notatum in every container.
  • patient began to recover only to die when penicillin ran out
  • Florey took it to USA for mass production
  • 1941, US government gave out grants to businesses that manufactured penicillin
  • 1943, British businesses also done the same
  • they all won noble prize 1945
• magic bullet

  drugs that attack diseases without damaging your other body cells
• first magic bullet

  • 1905, bacterium that causes sexually transmitted disease syphilis was identified
  • Ehrlich and his team decided to search for an arsenic compound that was a magic bullet for syphilis
  • Over 600 compounds were tried but none seemed to work
  • In 1909, Hata joined the team. He rechecked the results and saw compound number 606 worked.
• second magic bullet

  • in 1932, Domagk found that a red dye (protonsil) stopped streptococcus which causes blood poisoning.
  • in 1935, his daughter pricked herself with a needle and caught it. Domagk gave her a large dose of protonsil
  • she became bright red but recovered
  • serious side effects were discovered
• blood transfusion

  • in 1900, Karl Landsteiner discovered blood groups. certain blood groups cant be mixed as the blood will clot clogging the blood vessels. He found that transfusions were safe as long as the patients blood matched the blood donors.
  • In 1914, during WW1, doctors found that sodium citrate stopped blood clotting so it could be stored outside the body. In 1917, this discovery was vital when the first ever blood bank was set up in the battle of Cambrai.
• transplant

  • first SUCCESSFUL heart transplant was carried out by the South African Surgeon Christian Barnard in 1967. The patient only survived for 18 days.
  • Problems for transplant is rejection. The immune system attacks the implant as if it's a virus. Since the 1970s, researches have developed immunosuppressants making transplant safer and more likely to be successful.
• keyhole surgery

  • technique developed in the 1980s that make surgery less invasive - leaves patient with smaller scars and allows them to recover quickly.
  • useful for investigating causes of pain and infertility
• robot assisted surgery

  first surgical robot was introduced in 1985 but robot assisted surgery only became used after 2000

  allows surgery to make smaller cuts meaning less scarring, less infection and quicker healing of wounds
• how was health care before the NHS

  • severely limited. especially for poor people who couldn't afford to go to the doctor or buy medicine
  • this meant the peoples health was poor. for example in 1901, 140 infant deaths for every 1000 births today it's less than 5.
• NHS

  • established 1948
  • 1942, Beveridge published report. He called for government provision of social security 'from cradle to grave'
  • in 1945, lavour party was elected with a mandate to implement beveridge proposals.
  • Aneurin Bevan was the minister for health who introduced the NHS. He hated the lasses faire attitude. He wanted the NHS to be free
  • By 1948 all hospitals and 92% of doctors joined the NHS
• How has NHS improved health care?

  • Showed that government intervention could make a positive impact on people's health
  • NHS increased the number of people with access to health care - the numbers of doctors double between 1948 and 1973
• Technological development

  • Scans and monitors. They scan the body to identify cancers and other illnesses
  • Microscopes invented in 1931 allowed doctors to see much smaller objects.
  • Endoscopes: Camera inside a flexible tube is passed into the body so doctors can see inside body without surgery
  • Nuclear machine: Radioactive elements used to fight cancer. Marie Curie developed radiology in early 20th century
• government campaigns

  • diptheria is a contagious disease caused by bacteria in the nose and throat. it had 60,000 cases and 300 deaths in 1940.
  • government started vaccination campaign in 1940. using public adverts to get people to immunise their kids
  • polio infection that attacks digestive system. made over 30,000 children disabled. vaccination campaign was successful as it eradicated the disease by 1970s
• lifestyle campaigns

  • passed laws in hope of limiting air pollution
  • government launched change4life campaign with aim of improving diets and promoting daily exercise to prevent obesity (2009)
  • excessive alcohol intake was linked to several diseases. alcohol rose between 1950 and 2004 but since fallen due to the government Drinkaware campaign launched in 2004.
• effects of lifestyle campaign

  • mark a big shift in the government approach from the foundation of NHS and an even a bigger shift from the laissez-faire attitudes of the 19th century when people thought government shouldn't intervene with health. not only is the government trying to treat and vaccinate against known diseases,. they are intervening in peoples lives in order to stop them from getting particular illness
• lung cancer

  • caused by smoking, became common by the 1940s. around 20% of all cancer deaths are due to lung cancer, linked to tobacco smoking.
  • link between smoking and lung cancer was proven by richard doll
• how has lung cancer diagnosis and treatments improved

  • chest x rays are the first means of diagnosing lung cancer. x rays can't show whether the patients have cancer but can show if there's anything on the lungs that shouldn't be there
  • CT scans give detailed image of lungs
  • treated using surgery by removing affected lung
  • radiotherapy involves directing radiation of lungs
  • chemotherapy uses combination of several drugs which are injected into the blood stream
• government smoking campaigns

  • 1962: royal college of physicians recommended ban on tobacco advertising
  • 1965: smoking adverts banned
  • recent years government put a ban on all smoking places