Modern medicine

• issue of class

  • 1912 - sinking of titanic - highlighted upper-class importance over working class
  • 1914 - 1918 - world war i - expectation that one's country would look after you
  • 1930s - the great depression - economic hardship
  • 1939 - 1945 - world war ii - free healthcare
  • 1950 - 1960 - new industries, domestic technology, 90% owned televisions
  • 1980s - thatcher encouraged home ownership and renovation
  • 1999 - still the use of food banks, unable to pay for heating etc.
• treatments

  • gp (1948 - nhs)
  • bleeding
  • general first aid
  • 'cure-all' medicine
  • concern that there are antibiotic-resistant superbugs
  • holistic medicine
  • antibiotics
  • pills and potions
  • herbal remedies
  • praying and superstition
  • development of new medicines - better testing and stricter regulations
• 1918 - 1919 - spanish flu

  • 20-40 million died
  • believed it was evolved from bird flu, possibly in the us
  • infected 20% of world population
  • proved most deadly for 20-40 year olds
  • troops returning home spread it across the world
  • symptoms: headaches, sore throat, loss of appetite, fever
  • no treatments or antibiotics
  • death rate was 20%
  • treatment ideas: wearing masks, social distancing, giving up smoking, opium/laudanum etc., gargling with salt water, boiling handkerchiefs, drinking beef tea, rest, drinking no/a lot of alcohol
• development of penicillin

  1. 1872 - joseph lister noticed mold of bacteria. 1884 - treated nurse with infected wound. no further research
  2. 1928 - alexander fleming left petri dishes, noticed penicillium. 1929 - wrote in medical journal, no evidence of usefulness
  3. 1938 - florey and chain realised effectiveness - got funds from america - discoveries. 1941 - tested on volunteer, worked but ran out - died.
  4. war effort - factories unavailable for mass production. 1941 - american government, british firms mass-producing it, 1944 - enough to treat allied wounded on d-day, over 2.3 million doses
• 1953 - francis crick and james watson

  • discovered structure of human dna and genetics
• surgery in war

  world war i

  • 20 million wounded - improvement
  • mobile treatment and equipment e.g x-ray units
  • blood transfusions
  • 'thomas splint'
  • convalescent wards and hospitals
  • therapy (william rivers)
  • skin grafts (harold gillies)

  world war ii

  • reconstructive surgery (archibald mcindoe)
  • cataract surgery (harold ridley)
  • anti-malaria tablets
  • rationing - healthy diet
  • effective gas masks
• technology in surgery

  • x-ray plates and film
  • radiotherapy
  • 1901 - blood groups (karl landsteiner)
  • anti-coagulants
  • voluntary blood donation scheme
  • blood plasma
  • blood storage developments
  • 1952 - first kidney transplant
  • 1961 - first heart pacemaker
  • 1967 - first heart transplant
  • 1972 - hip replacements
  • 1978 - ivf
  • 2014 - 181 heart transplants in england
  • keyhole surgery
  • laser eye treatment
  • robotic operating systems
  • ct and mri scans
  • endoscopes
• positive impacts of interference

  • operations more successful and safe
  • control of pain
  • new medicine and techniques
  • prevention of spread of disease
  • techniques to deal with long-term diseases
  • treatments for mental illness
• negative impacts of interference

  • society getting sicker
  • people aborting babies due to their sex or if they have ailments
  • cloning
  • experimentation - criminal activity
  • forced sterilisation
  • illegal organ trade
  • designer babies
• public health pt. 1

  • 1889 - charles booth's book - 35% population in poverty
  • 1901 - seebohm rowntree found half population in york in poverty
  • 1906 - workmen's compensation act, voluntary free school meals
  • 1907 - school medical inspections, child support
  • 1908 - pensions, illegal to sell tobacco, alcohol to children
  • 1909 - job centre, illegal to build back-to-back housing
  • 1911 - national insurance
  • 1913 - maud pember reeves book about poor wage
• public health pt. 2

  • 1940 - william beveridge government report on '5 giant evils'
  • 1945 - labour government into power, clement atlee new pm, welfare state
  • 1946 - 1970 - new towns built
  • 1948 - introduction of nhs
  • 1952 - end of free nhs, smog where 12 000 died
  • 1956 - 1968 - clean air acts
  • 1960s - slum clearance, high-rise blocks, expansion of council, built housing
• health

  • 'post-code' lottery for treatment
  • government educating population on living healthier lifestyles
  • obesity common and expensive
  • debate over government interference
  • development of new drugs, but need to be tested and approved
  • 'innovation fund' to help develop new products
  • unhealthy lifestyles
  • nhs too expensive to run
  • biggest killers: cancer, respiratory disease
  • government policy - shortage of drugs available
  • aids (modern pandemic), treatment expensive, no cure or vaccine
• continuity

  • vaccinations compulsory for infants
  • herbal remedies
  • cannot treat all diseases
• change

  • common sense
  • education
  • nhs
  • revolutionised medicine
  • clean clothes and antiseptic
  • anaesthetic
  • government policy