Modern Medicine: 20th Century Britain

W/c 6th July

What was the impact of the First World War (1914-18), the Second World War (1939-45) and penicillin on medicine?

Warning - the next 2 slides are rather difficult to look at; if you are sensitive, approach with care.

Look at the next slide What do you think these are?Why do you think they have been made? Note down some ideas.

How did WWI lead to progress in medicine?

Warning-some graphic facial injuries on clip. https://www.youtube.com/watch?v=SS1dO0JC2EE

Warning, the clip below shows facial injuries sustained by soldiers in World War One.It also shows soldiers with shell shock - this is a form of post traumatic stress disorder. Soldiers who had been under extreme stress in the trenches could no longer function as they once had. During the early stages of World War One this mental health condition was not understood and treated as cowardice and soldiers were

Throughout history, a key time that the latest medical techniques and medical technology is needed is during wartime. If medical services are good, more soldiers have a chance of survival. The more soldiers that are available, the greater a country’s chance of victory.

Medicine usually develops at a more rapid rate during war than it does in peacetime. This is because governments pour a lot of money into getting soldiers ‘fighting fit’ as soon as possible. Doctors and surgeons have worked very hard during wartime to develop their ideas to treat the injured. The huge numbers of wounded soldiers during a war also give doctors and surgeons more opportunity than during peacetime to test their ideas.

However, some historians argue that war can have a negative effect on medical development. They say this because 1000s of doctors and surgeons were taken away from their normal work to treat war casualties. Furthermore, lots of medical research was stopped during wartime so that countries could focus everything on the war effort.

The nature of war also means that places of learning in towns and cities were destroyed. This could have resulted in delaying or losing medical advances because medical manuscripts and medical research was lost.

Task

1. Why is there debate among historians as to whether war progresses or hinders medicine? Use the previous two slides for your answer.

TaskThe impact of the First World War on medicine

1. Read p128 of the revision guide.

2. Use the headings and make a mind map to show medical developments in World War One. Write in plenty of detail and include examples to reinforce the concept (idea) of change and development.

3. Explain in what ways War can have a positive and negative effect on the development of medicine?

4. What do you think was the most significant medical development of World War One? Explain your answer. (No right or wrong answer, what you think that counts).

There was an accidental discovery in 1928 which was to revolutionise medicine in the 20th

century and nearly 100 years on, it is still of great significance.

Makes a huge difference to the outcomes for people with infection.

1. What do you think this accidental discovery could have been?

2. What can you learn from this source?

https://www.youtube.com/watch?v=N2-7UQWrYPY

• Watch the clip carefully.

• Take notes on the discovery of penicillin . . . make sure you include Fleming, Florey and Chain.

• Think about our factors for the big mark question and how these are involved in the study and manufacture of penicillin . . . role of the individual, war, government, science and technology.

During the First World War (1914-18), Alexander Fleming observed that antiseptics seemed unable to prevent infection – especially in deep wounds so he wanted to try and find something that would kill the microbes that caused infection.

Staphylococci was a dangerous microbe that caused infection. In 1928, when Fleming returned to his lab following a holiday he noticed a mould growing in one of his petri dishes full of staphylococci. He noticed that the staphylococci next to the mould had been killed off.

He called this an “antibiotic” meaning “destructive of life” and published his results in 1929. But he couldn’t raise enough money to develop it further.

In 1937, Florey and Chain, working at Oxford University began to research penicillin after reading an article by Fleming. They found that the drug worked – after first testing on mice, they tested on humans. A policeman who had developed an infection following being scratched by a rose bud stayed alive whilst on the drug but died when the drug ran out. Penicillin worked!

During World War II the drug was mass produced and it saved thousands of soldiers lives. It was used by the armed forces for the first time in 1943 on troops in North Africa with great success.

1. How was penicillin discovered? –Put the information in the correct

order…

2. For each stage, which factor was the most significant? Label

each stage with a logo.

3. Who deserves to be called the Father of Penicillin? Explain your

answer.

Penicillin -review task

What is happening in the picture?

How does this show progress in medicine?

The First World War sped up developments in surgery, health and medicine but these might have happened anyway eg scientists had been working on blood transfusions for years but the amount of blood needed by soldiers in the war meant that scientists worked even harder to make this a success. It was a similar story in World War 2 when there were millions of wounded soldiers which meant that doctors, surgeons and scientists worked extremely hard to develop new medicines and to improve those that already existed.

The impact of the Second World War on surgery and health in Britain.

Blood Transfusions

Advances in storing blood after World War One meant that it could be kept fresh and useable for longer. This led to the British National Blood Transfusion Service opening in 1938.

Large blood banks were developed in the USA and GB during World War Two,

Heart Surgery

This progressed during World War Two. An American surgeon called Dwight Harken who was stationed in London, cut into beating hearts and used his bare hands to remove bullets and bits of shrapnel. His findings helped to develop heart surgery after the war.

Plastic Surgery

A doctor from New Zealand who trained and world in GB called Archie McIndoe (cousin of Harold Gillies) used new drugs like penicillin to prevent infection when treating pilots with horrific facial injuries. His work on reconstruction of damaged faces and hands was respected all over the world.

During this war, burns were a more common problem for doctors and surgeons to deal with-due to bombings and pilots being burned in aeroplanes.

NHS

When WW2 broke out in 1939, the government increased its involvement in medical care. After the war, people began to think about how best to organise health care on a national basis. In 1942 (during the war), William Beveridge proposed a free National Health Service for all - and just after the war was finished, the NHS was born.

Diet

Shortages os some foods during WW2 meant that the government encouraged people to grow their own food and many foods were rationed. This improved people’s diets because the food that they encouraged people to grow eg fresh fruit and vegetables was very healthy.

Hygiene and Disease

In order to keep GB ‘fighting fit’, posters were produced to encourage people to keep healthy. These posters warned against the dangers of poor hygiene for example (think of the posters that said ‘coughs and sneezes spread diseases’). A national immunisation programme against diphtheria (a bacterial infection that killed lots of children) was launched too.

Poverty

During the war, over 1 million children were evacuated from the towns and cities of GB into the countryside. Many of these children lived in poverty and people in the countryside were shocked at the state that they were in. However, these children often lived a cleaner and healthier lifestyle in the countryside which improved their overall health. The whole experience highlighted the levels of poverty endured by some families and made the government commit to improving things after the war.

Drug Development

Penicillin, the first antibiotic, was developed in the years leading up to the war. The British and American governments realised how important this new ‘wonder drug’ could be in curing infections in deep wounds. In 1944, enough penicillin was produced to treat all of the Allied forces in Europe.

Task1. Study the previous two slides about the

impact of World War Two. Explain how each of the advances improved surgery and health. You can use the same headings and complete as a series of bullet points or a mind map.

2. Explain which of these developments would not have happened if it wasn’t for World War 2.

• On this question, you need to hit three time periods to maximise marks ie three of medieval, Renaissance, 1800s and 1900s.

Note that you need to write about surgery improvingWrite about war plus 2 of our other factors.

Key marking

Has technology been the main factor in the development of medicine since the Middle Ages?

Explain your answer with reference to technology and other factors. 16 marks 4 SPaG

• Please send your answer to your History teacher • gunnh@bishopperowne.co.uk• reevemckewv@bishopperowne.co.uk

FACTORS FOR CHANGEThere are 7 key factors.We will use these to discover change over time. Sometimes these factors HELP, sometimes they HINDER change.

HOW could each FACTOR create change?

. WARSometimes medical procedures or hygiene were improved as a result of lessons learnt in war such as hygiene in the Crimean War.

SUPERSTITION AND RELIGIONThe setting up of medical schools and universities in medieval times where usually by religious groups but this helped further knowledge.

GOVERNMENT

Some governments have insisted on change e.g. the Liberals and their reforms or Labour and the NHS.

COMMUNICATION

Inventions such as William Caxton’s printing press has allowed new ideas about

medicine and hygiene to be spread fast.

SCIENCE AND TECHNOLOGYInventors developing things such the microscope in the Netherlands in the 1590s has allowedmedical developments.

INDIVIDUALS

Some people have pushed through ideas which seemed crazy to many people such as Edward Jenner and his smallpox vaccination.

CHANCE

Sometimes medical and health improvements have been stumbled upon by accident e.g. Fleming’s discovery of penicillin.

Individuals

Conclusion-Main Factor

Government

Technology

War

• Microscope allowed Louis Pasteur to discovery about germ theory and allowed others like Koch to take the discovery further.

• Helped to improve diagnosis and treatment eg X raised for broken bones

• Helped to develop mass production of drugs like penicillin.

• Hugh of Lucca and his son Theodoric were surgeons in Middle Ages and they realised that pus from a wound was not good; they dressed wounds with bandages soaked in wine because they noticed that wine helped to keep bandages clean. They also questioned some of Galen’s ideas. P113 revision guide.

• Vesalius’ work on human anatomy.

• William Harvey’s work on the heart and circulation of the blood.

Which was the most important factor- explain, which affected the most people for the longest amount of time? Which factor is the bedrock of the others . . .

explain.

• Pare was a war surgeon- used ligatures to prevent blood loss after amputation, found an ointment that deduced the need for cauterisation of wounds.

• Boer war - found that lots of potential army recruits were malnourished and in ill health because of poor living and working conditions, encouraged the government to get involved in caring for the health of the nation.

• World War One resulted in blood transfusions, plastic surgery.

• World War Two took these developments further eg heart surgery, plastic surgery, blood transfusions . . .

How useful is Source A to a historian studying cholera outbreaks in the 19th century? Explain your answer using Source A and your contextual knowledge. 8 marks.

Stuck?For ‘how useful’ look at content and contextual knowledge - how much does what you know match what’s in the source? Look at provenance - where is the source from, is it from the time, would this make it useful?‘I know that . . .’. There are clues on the next slide.

Source A is useful to a historian studying cholera outbreaks in the 19th century because it was produced in 1858 so it shows that cholera was still a problem more than twenty years after it first reached Britain in 1831. The source suggests that London was largely powerless against cholera and the woman representing London has her shield down by her side, unable to stop the disease. This makes the source useful because I know that the government had failed to take effective action against cholera despite epidemics in 1843 and 1853-54. For example, the 1848 Public Health Act did little to prevent the spread of cholera.

Source A is also useful to a historian studying cholera outbreaks in the 19th century because it is a cartoon from Punch which was a popular magazine at the time and therefore, it is likely to reflect widespread views about cholera in the 1850s. One of the corpse like figures rising out of the water in the source actually represents cholera and suggests that the people of London were under attack from the disease. I know that cholera swept through parts of London in 1848 and killed 53 000 people and therefore, this shows the fear surrounding cholera in Britain in 1858.

A further reason that Source A is useful to a historian studying cholera outbreaks in the 19th century is that it provides an insight into how people thought cholera spread in 1858. The figure of cholera rising out of the polluted River Thames (there are dead animals both in the water and washed ashore) shows that there was a shift in thinking about how people contracted cholera by the late 1850s. It seems that by 1858, people had started to recognise that cholera was waterborne and therefore not spread by miasma. I know that Dr John Snow had studied cases of cholera in the Broad Street area of London and had made the link between contaminated water and the disease in 1853-54. This makes the source useful because it suggests that even before Pasteur published his germ theory in 1861, the theory of miasma which had been dominant for centuries was being challenged - at least in relation to certain diseases like cholera.