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Medicine and Surgery
The 20th Century
The First World War
Some 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 germs
Scientists were looking for a “magic bullet” to kill
infection inside the body
The German, Paul Ehlich found Salvarsan 600 in 1910 –
after a lot of experimentation
Other “Magic Bullet” drugs were found in the 1930s
Gerhard Domagk experimented with a red dye – Prontosil
– on his daughter and cured the blood poisoning that was
killing her
These drugs became known as Sulphonamides
Penicillin
Wounded soldiers in World War One often died as
a result of infection from the mud and filth of the
trenches
Dr Alexander Fleming looked for a cure for these
bacterial infections
He made his great discovery by accident
In 1928 he noticed some mould which had grown
on a dish and realised that the mould had killed the
bacteria
This mould was “Penicillin”
But little notice was taken at the time
Manufacturing Penicillin
Fleming 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 Service
WW2 changed attitudes in Britain
There was a desire to improve people’s lives – the
idea that the whole nation was fighting the war
for a purpose
The 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 Idleness
Before the war health care was very patchy
Doctors 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 election
They created the modern Welfare State
The Health Minister, Aneurin Bevan, created the
National Health Service in 1948
Suddenly everyone was entitled to free medical
care
Millions now demanded treatments, false teeth,
free spectacles . Surgeries were overrun as people
now sought treatment for illnesses they would
previously ignored
NHS Difficulties
The NHS was not popular with doctors who did not want
to work for the state, but wanted private paying patients
Bevan managed to achieve a compromise with the doctors
and allowed some private “pay” beds in NHS hospitals
The NHS was very costly and became more expensive as
demand from patients increased
This meant a great increase in taxation to pay for it – this
caused opposition
In 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 Care
X-Rays were the first of the modern way of
screening and diagnosis – modern scanners and
ultra-sound technologies allow doctors to make
diagnoses very early
Surgery has continued to make major strides –
Transplants(including heart), Key-hole surgery,
and artificial organs
Better housing (slum clearances), cleaner air –The
Clean Air Act 1956, and Health and Safety at
Work Laws have also improved the nation’s health
Life expectancy has improved from about 45 on
1900 to about 75 now
Child 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 research
Smoking, drug abuse, lack of exercise, pollution are now
considered to be the main threats to health – so a lot of
focus is on prevention
New diseases have appeared that are as frightening perhaps
as smallpox and cholera must have been – AIDS (Acquired
Immune Deficiency Syndrome) and CJD
The antibiotics are losing their effectiveness as germs
develop their own resistance to them
Living conditions are still poor for many and the quality of
health care tends to vary from area to area
Costs continue to rise