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