Medicine and Surgery

The 20th Century

The First World WarSome have argued that WW1 improved surgery because army surgeons got lots of practice

On the other hand they did not have the time or conditions to do much more than amputations because there were so many casualties – in this respect surgery went backwards

The war led to the development of Blood Banks

The war led to the discovery of stronger antiseptics

X-rays were developed

Prosthetics – (artificial limbs)- were improved

Because of the large numbers of soldiers who suffered Shell-Shock a lot of research went into Mental Health

“Magic Bullets” - Sulphonamides

By 1900 there were many vaccinations to prevent illness but there were still no cure for many germsScientists were looking for a “magic bullet” to kill infection inside the bodyThe German, Paul Ehlich found Salvarsan 600 in 1910 – after a lot of experimentationOther “Magic Bullet” drugs were found in the 1930sGerhard Domagk experimented with a red dye – Prontosil – on his daughter and cured the blood poisoning that was killing herThese drugs became known as Sulphonamides

PenicillinWounded soldiers in World War One often died as a result of infection from the mud and filth of the trenchesDr Alexander Fleming looked for a cure for these bacterial infectionsHe made his great discovery by accidentIn 1928 he noticed some mould which had grown on a dish and realised that the mould had killed the bacteriaThis mould was “Penicillin” But little notice was taken at the time

Manufacturing PenicillinFleming found it difficult to make large quantities of penicillin

The government funded two scientists at Oxford, Florey and Chain, who succeeded in finding a method of making concentrated penicillin

The Second World War 1939-45, produced a great demand for a drug that could kill infection inside the body

Penicillin was not used on a human until 1941 when a policeman made an amazing recovery from infection after being given the drug – but he died within weeks because the supply ran out

When the USA entered the war in 1941 its government gave $80 million to help drug companies mass produce penicillin

By 1944 penicillin was being used to save the lives of thousands of soldiers

This was the world’s first antibiotic and it was seen as a wonder drug

Since 1945 many other antibiotics have been developed to treat a vast range of diseases

The National Health ServiceWW2 changed attitudes in BritainThere was a desire to improve people’s lives – the idea that the whole nation was fighting the war for a purposeThe Beveridge Report of 1942 said that the government should take responsibility for tackling the 5 great social evils or “giants” – Want, Disease, Squalor, Ignorance and IdlenessBefore the war health care was very patchyDoctors charged fees, very few people had health insurance, most doctors worked in well off areas, hospitals relied on charity

The Labour Government 1945-51

In 1945 Labour won the electionThey created the modern Welfare StateThe Health Minister, Aneurin Bevan, created the National Health Service in 1948Suddenly everyone was entitled to free medical careMillions now demanded treatments, false teeth, free spectacles . Surgeries were overrun as people now sought treatment for illnesses they would previously ignored

NHS DifficultiesThe NHS was not popular with doctors who did not want to work for the state, but wanted private paying patientsBevan managed to achieve a compromise with the doctors and allowed some private “pay” beds in NHS hospitalsThe NHS was very costly and became more expensive as demand from patients increasedThis meant a great increase in taxation to pay for it – this caused oppositionIn 1951 prescription charges and charges for dental and eye care were introduced – this was controversial- and still is!The cost of the NHS remains a great problem because the demand grows, people live longer, more old people tend to have more illnesses, and new treatments, which people expect, are very expensive

Recent Trends in Health CareX-Rays were the first of the modern way of screening and diagnosis – modern scanners and ultra-sound technologies allow doctors to make diagnoses very earlySurgery has continued to make major strides – Transplants(including heart), Key-hole surgery, and artificial organsBetter housing (slum clearances), cleaner air –The Clean Air Act 1956, and Health and Safety at Work Laws have also improved the nation’s healthLife expectancy has improved from about 45 on 1900 to about 75 nowChild mortality has fallen dramatically

Threats to Health at the end of the 20th C

Because people tend to live longer other diseases like cancer and heart disease are now the main killers and the targets of medical researchSmoking, drug abuse, lack of exercise, pollution are now considered to be the main threats to health – so a lot of focus is on preventionNew diseases have appeared that are as frightening perhaps as smallpox and cholera must have been – AIDS (Acquired Immune Deficiency Syndrome) and CJDThe antibiotics are losing their effectiveness as germs develop their own resistance to themLiving conditions are still poor for many and the quality of health care tends to vary from area to areaCosts continue to rise