Medical Treatments in Modern Britain (Edexcel GCSE History): Revision Note

Approaches to treatment in the 20th century - Summary

• Modern scientists built on the work of Renaissance scientists to create chemical cures such as:

  • 'Magic bullets'

  • Antibiotics

• Technology and teamwork allowed the discovery and mass production of new medicines

• Surgery became safer and more effective with new tools like:

  • X-rays

  • Robotic surgery

• The government took action by launching the NHS in 1948, improving access to care

• Despite huge progress, resistance to antibiotics, new diseases and stretched services are 21st century challenges

Antibiotics - Ehrlich & Domagk

'Magic bullets'

• A 'magic bullet' was an early 20th-century concept

  • The idea was that one chemical treatment could attack harmful bacteria without hurting the rest of the body

Ehrlich and syphilis

• Syphilis continued to be a problem in the 19th and 20th centuries

• Paul Ehrlich tested arsenic compounds to find a cure for syphilis

  • By 1907, Ehrlich had tested more than 600 versions of arsenic but had not found a cure

• In 1909, Japanese scientist Hata retested the discovered that compound 606 cured syphilis

  • He named the chemical cure Salvarsan 606

    • This became the world's first 'magic bullet'

Domagk and Prontosil

• Gerhard Domagk discovered that a red dye called Prontosil killed infections in mice

• In 1932, Domagk tested Prontosil on his daughter, who was dying from blood poisoning

  • Prontosil saved her life

• Queen Charlotte's Maternity Hospital in London used Prontosil to treat puerperal fever

  • Death rates in puerperal fever dropped from 20% to 4.7%

• Domagk's and Ehrlich's success encouraged scientists to pursue the development of antibiotics

Fleming and penicillin

Who was Alexander Fleming?

• Fleming, a Scottish doctor working at St. Mary's Hospital in London

• During the 1920s, Fleming began to study a type of bacteria called Staphylococcus

What was Staphylococcus?

• Staphylococcus was resistant to the 'magic bullets' available at the time

  • It is a deadly bacteria which can cause blood poisoning and toxic shock syndrome

Fleming's discovery of penicillin

• In 1928, Fleming accidentally discovered penicillin by forgetting to clean a petri dish with staphylococcus

  • Mould prevented staphylococcus from growing

  • Fleming published his findings in 1929

• Fleming didn't realise the potential of penicillin

  • Scientists were focused on chemical cures

  • Germ Theory states that microbes are dangerous

  • Fleming's first experiment showed penicillin was ineffective when combined with blood

Florey and Chain and the development of penicillin

• Florey and Chain worked together at Oxford Medical School

  • Howard Florey was an Australian pathologist

  • Ernst Chain was a German biochemist who had escaped from Nazi Germany

• In 1939, Florey and Chain discovered Fleming's work on penicillin

• In 1940, they successfully tested penicillin on mice

• Florey and Chain received £25 from the government to fund their research into penicillin

  • Today, this would be approximately £1100

• By 1941, Albert Alexander, a local policeman, was treated with penicillin

  • Florey and Chain ran out of their supply of penicillin and Albert died

    • Despite Albert's death, the trial proved that penicillin worked on humans

Mass production of penicillin

• In July 1941, Florey flew to America to persuade pharmaceutical companies to mass-produce penicillin

• US companies used beer vats to produce penicillin

• Despite a slow start, US and British mass-produced enough penicillin to treat wounded soldiers in the Second World War

  • By 1945, the US Army had access to two million doses of penicillin per month

  • An estimated 50% of wounded soldiers survived their injuries because of penicillin

Factors which enabled the development of penicillin

Institutions

• The UK and US governments funded research and production

Technology

• The use of beer vats and milk churns to mass-produce penicillin

Attitudes in society

• The Second World War created an urgency for penicillin to prevent soldiers from dying from infection

Science

• Observations and experiments from the Oxford scientists proved that penicillin worked on humans

Individuals

• Alexander Fleming discovered penicillin

• Florey and Chain mass produced penicillin, refusing to patent penicillin

Modern development of antibiotics

• Scientists discovered new antibiotics

  • Streptomycin (1943) cured tuberculosis

  • Dorothy Hodgkin mapped the chemical structure of penicillin (1945)

    • John C. Sheehan used this to make a chemical copy (1957)

Forms of antibiotics

• Antibiotics are now given in:

  • Capsules

  • Injections

• Drug trials check for effectiveness and side effects.

  • Drug trials ensured that new antibiotics worked and had limited side effects

Antibiotic resistance

• Overuse has led to resistant bacteria like MRSA

  • Penicillin-resistant strains appeared as early as 1942

• A 2018 report found 1 in 5 GPs in England incorrectly prescribed antibiotics 

Modern surgery - transplants, transfusions & keyhole surgery

• Modern surgery has methods to cope with the three major problems of surgery:

  • Blood transfusions combated blood loss

  • Anaesthetics solved the issue of pain

  • Antiseptics reduced infection

• Complex operations like brain surgery is common

New surgical technology

• Microsurgery allowed organ transplants

• Laparoscopic (keyhole) surgery allowed the body to heal from surgery more quickly

• Robotic surgery

  • Ensured more precise surgery

  • Patients can be fitted with robotics, such as artificial limbs

• X-rays can find and reduce cancerous and benign tumours

• Mechanised organs

  • Dialysis can perform the function of the kidneys

  • A heart bypass is a machine which performs like the heart

Medical care: The impact of the NHS

Healthcare before the NHS

• Hospitals were outdated, especially outside London and the South East

• National Insurance did not cover women or a worker's family

• Treatment was not free

  • Many people still bought herbal remedies, like Beecham's

Structure of the NHS

• Introduced by Aneurin Bevan and the Labour government in 1948

• It provided free care at the point of use

  • Funded by National Insurance contributions

• The government took control of existing hospitals and medical services

Positive impacts of the NHS

• Women, children, and the poor could access medical care

• GPs and hospitals were better connected

• Increased access to specialist care

Negative impacts of the NHS

• There were a lack of funds to upgrade all hospitals

• GPs resisted change, fearing the extra work and loss of income

• Many GPs had outdated knowledge in the 1950s due to being too busy

• Waiting times increased as more people accessed medical services

The extent of change in care & treatment

Improved access to care

• In 1919, the Ministry of Health was created to raise standards

• In 1948, the NHS made medical care free and universal

• Hospitals focused more on treatment and less on providing shelter

Improvements to treatments

• Deaths by infectious diseases fell significantly

  • In 1900, 25% of all deaths were the result of infectious diseases

  • By 1990, this percentage had fallen to less than 1%

• Chemical treatments were available

  • At the start of the 20th century, people relied on herbal remedies

  • After 1945, a range of 'magic bullets' were available to treat a variety of illnesses

Issues with treatments

• Viruses are hard to treat so vaccines must change each year, for example, the flu

• Microbes can evolve to become resistant to certain treatments

• New or complex diseases, such as cancer, still lack cures

• Lifestyle factors have caused diseases like heart disease to increase

  • Scientists do not fully understand the impact of all lifestyle choices on public health