Starter: Please sit in the following groups What advancements took place in medical understanding in the 20th and 21st Centuries? Starter: Please sit in the following groups Team Galen: Team Vesalius: Team Harvey: Team Pasteur: Team Nightingale:

Learning Task – Jigsaw Learning Collect an A3 piece of paper and divide it up into 6 separate boxes. You will be divided up into small groups and have 1 hour to research and gather information on the question below. In the next lesson, you will be placed in a new group and will have to ‘teach’ what you have learned to the group. Magic bullets (pp.107-109) The NHS (pp.110 – 111) To what extent had care and treatment changed? (pp.112) Strategies to prevent disease in the 20th Century (pp.113-115) The fight against lung cancer in the 21st Century (pp.122-126)

The role of magic bullets in 20th Century medicine Magic bullet = a chemical cure that attacks the microbes in the body causing a disease but doesn’t harm the body/patient. First breakthrough was made with syphilis (an STI). Treatments remained unchanged since the 16th Century (using mercury). In 1909, Hata found that compound number 606 cured syphilis. A drug was developed named Salvarsan 606 – the first ‘magic bullet’. In 1932, Gerhard Domagk discovered a red dye called Prontosil killed infections in mice. He tested this on his daughter to cure blood poisoning. In 1938, British scientists developed M&B 693 – a bacteriostatic antibiotic. It was successfully used to treat Winston Churchill from pneumonia during the Second World War. The first true antibiotic was penicillin – it was created using microorganism, not chemicals. Fleming isolated it from mould in 1928. Inspired by this, other scientists began to investigate mould. Streptomycin was discovered by Selman Wakston in 1943 which could treat TB. Scientists worry that humans may develop immunity to antibiotics.

The role of the NHS in 20th Century medicine Launched in 1948 by the post-war Labour government led by Clement Attlee. It aimed to provide medical care for the entire population, paid by National Insurance. It was made up of hospitals, GPs, dentists and additional services such as ambulances. The aim was very socialist in nature – it wanted to provide the same level of service for everybody in the country, no matter how rich or poor they were. It aimed to create a Welfare State to protect all citizens. E.g. workers earning under a certain amount were already entitled to medical care (since 1911), but not women. Hospitals were still underfunded – the government was massively in debt by the war but still responsible for over 2,000 city hospitals. Many of these buildings were still outdated and in need of refurbishments. Many GP surgeries were outdated. In the 1950s, over 25% of all GP surgeries were not satisfactory. As the NHS was instantly popular, waiting lists increased and appointment times decreased. Overall, access had improved but provisions had not improved. By 21st Century, NHS offers a wide variety of new high-tech treatments.

To what extent had care and treatment changed? By the end of the 20th Century, medical science had made huge leaps forwards towards Syndenham’s dream of each disease having its own cure. E.g. in 1900 infection killed 25% of all people, this was only 1% by 1990. In 1900 most people were still using herbal remedies such as Beechams which was bought from a chemist. Now there are a wide variety of specific, effective medicines matched with the diseases that they treat. However, some viruses are still difficult to create vaccines for e.g. flu. New diseases keep appearing which we don’t know how to treat. Scientists need to go back to the lab and continue to test compounds. Lifestyle factors have caused an increase in illnesses such as heart disease and cancer for which there are no known cures. Microbes have developed to beat some cures e.g. MRSA which is a bacteria resistance to any known drugs.

How have we tried to prevent disease? Since the 1900s, the laissez-faire style of government has slowly disappeared. Governments now see it as a priority to intervene in society to help people. Many strategies have been used to prevent disease: Compulsory vaccinations (e.g. smallpox, diphtheria in 1942, polio in the 1950s) Passing laws to provide a healthy environment (Clean Air Acts, 1956 – 1968, Health Act 2006)) Advertising health risks (e.g. smoking, binge drinking, junk food) Role of charities (e.g. British Heart Foundation)

How have we combatted lung cancer? In the 1950s, the British Medical Research Council published a study showing that cigarette smoking caused lung cancer. Due to the massive advertising since WW1, there were a lot of smokers in Britain. Deaths from smoking related lung cancer peaked in 1973 at 26,000. Difficult to treat as it is usually detected too late. Due to no screening in UK, it is 100% down to patient vigilance. Treatments have developed e.g. organ transplants, radiotherapy and chemotherapy. The UK government was slow to react to this. By 1985 smoking caused the NHS £165 million per year, but the UK government made £4 billion on tax and many people were employed in the tobacco industry. Eventually government did respond with legislation e.g. Smoking Ban, age raised to 18, increased taxation, advertising, blank packaging