Independent Learning Book

Medicine Through Time

Exam Guidance for AQA- Medicine

There are 4 types of questions on this paper-

Interpretations- How useful is this source… (8) Compare surgery in… to……..(8) How significant is……. to…….(8) ……..been the main factor in understanding… the causes of disease? (16

+ SPAG)

1 - How useful is Source A for a historian…………..?

Example-

How useful is Source A to an historian studying vaccination? (8)

Tip

CONTENT: Source A is (say how useful you think it is – very, partially, quite) l to an historian studying …………… because it tells them about… (summarise the content of the source to finish off the opening sentence. Then explain the content of the source, with own knowledge)

ORIGIN and PURPOSE. This source comes from ………… This means that it is…

(explain reliability of the source – is a medical journal reliable?) (Put the source in context) Is the source representative? (again think about the date)

Overall, the source is… (give final judgement on usefulness which is the same as the opening sentence.)

Cartoon by James Gillray called ‘The wonderful effects of the new inoculation.

2 - Compare X with Y. In what ways were they similar? Explain your answer with reference to both.

Example_

Compare surgery in the Middle Ages with surgery at the time of John Hunter.(8)

Tips

In this answer you need: Two examples that are described AND explained Two paragraphs Descriptions should include specific detail i.e. Theodoric of Lucca tried to deal with infection in

the Middle Ages with wine Explanations should discuss similarities i.e. examining why barber surgeons were used in both

periods A direct comparison of both periods MUST be made i.e. examining the importance of religion in

both periods e.g. discussing how religion prevented dissections in either period

For top Level 3 and Level 4 as above AND: Historical context is used to show similarities i.e. despite the Reformation meaning dissections

became allowed this was only limited to criminals sentenced to death so limited their impact

3-Explain the significance of…. to……………….?(8)Example-E xplain the significance of penicillin in the development of medicine. (8)

In this answer you need: Two examples that are described AND explained Two paragraphs Descriptions should include specific detail i.e. when and how penicillin was discovered Explanations should discuss significance i.e. how penicillin was a step forward compared to what

come before it e.g. antiseptics Clear links to short and long term significance to focus explanation i.e. limited short term

impact as Fleming did little to develop the drug, but massive long term impact as the drug saved many lives during WWII.

For top Level 3 and Level 4 as above AND: Consideration of the factors that helped i.e. how chance helped with the development of the

drug An examination of the wider context i.e. how penicillin was the first antibiotic and led to further

development, or the problems that have been created by antibiotics e.g. bacteria developing a resistance for example MRS

4- ‘X was the main reason for Y’. How far do you agree with this statement? 16 marks + SPAG

Example

Has science and technology been the main factor in understanding the causes of disease in Britain?Explain your answer with reference to science and technology and other factors.Use a range of examples from across your study of Health and the people: c1000 to the present day. [16 marks + 4 SPAG]

Tips

Three examples that are described AND explained Three/Four factors are discussed i.e. Science and technology AND government, individuals,

religion, war, communication or education. A conclusion is reached Descriptions should include specific detail i.e. Pasteur moved ideas forward by publishing the

Germ Theory Explanations should discuss development of understanding i.e. examining how improving

technology like the microscope allowed Koch to identify the tuberculosis germ. Consequences of the factors are discussed in their historical context e.g. Consequence of

religion in the Middle Ages and Renaissance was that little understanding of disease developed.

For top Level 3 and Level 4 as above AND: Comparison of the periods is made i.e. communication in the Middle Ages was poor and that

resulted in little shared knowledge, however with the creation and development of the printing press after the 1440s it meant that knowledge could more effectively be shared and developed e.g. helping John Tyndall spread the Germ Theory in Britain.

An examination of the relationship between the factors is discussed i.e. Communication was a factor that allowed knowledge to be effectively spread, especially after the invention of the printing press. However, this knowledge would not have existed were it not for the individuals making discoveries. An example of this being Robert Koch using improved scientific technique, created via Pasteur’s Germ Theory, and equipment such as the microscope to discovering specific germs like tuberculosis. As such I believe that the main factor for improving understanding of disease as the hard work of the individual. Relationship of factors can be done in just the conclusion

Medicine c1000-Present Knowledge Quiz. BASIC DEVELOPED COMPLEX1) To which two people could Medieval people go for medical treatment and surgery, if they could not afford a doctor? ______________________________________________________________________________________________

2) On which Ancient Greek theory did Medieval doctors base their treatments? _______________________________

3) Whose work dominated medical understanding for hundreds of years? ___________________________________

4) Why did Medieval Christian hospitals prefer to look after patients rather than treat them? ___________________________________________________________________________________________________________________

5) Explain three reasons why the Christian Church held back medical progress in the Medieval period. ________________________________________________________________________________________________________________________________________________________________________________________________________

6) Which two Muslim doctors had a great influence on medicine in Western Europe? __________________________

7) What were the two most common Medieval surgical procedures? _______________________________________

8) Which diagram helped army surgeons to treat wounds? _______________________________________________

9) Why was surgery only performed as a last resort in Medieval England? _________________________________________________________________________________________________________________________________

10) Who was the most famous surgeon in Medieval England, and how did he improve surgery? ________________________________________________________________________________________________________________

11) Why did the increase in public dissections not improve anatomical understanding? _______________________________________________________________________________________________________________________

12) Explain three reasons why public health was so poor in Medieval towns. _____________________________________________________________________________________________________________________________________________________________________________________________________________________________

13) Why were the laws passed by some Medieval town councils to improve public health not successful? ________________________________________________________________________________________________________

14) Explain two reasons why health was often better in Medieval monasteries than it was in towns. ___________________________________________________________________________________________________________________________________________________________________________________________________________

15) Name the two different types of plague that came to England in 1348. ___________________________________

16) Why did the Black Death spread so quickly, and what were two of the things people thought caused it? _____________________________________________________________________________________________________________________________________________________________________________________________________

17) What proportion of the English population was killed by the Black Death? ________________________________

18) Why did life get worse as a result of the Black Death? ____________________________________________________________________________________________________________________________________________

19) Why did life soon get better for Medieval peasants? _______________________________________________________________________________________________________________________________________________

20) Why was this only temporary? __________________________________________________________________

21) The ‘Renaissance’ began in _____ and was a period in which people no longer __________ what they were told but instead ____________ existing views. The _______ lost much of its influence. Artists used new methods to make their paintings more _________ and the invention of the _________ _______ in 1451 allowed knowledge to be spread more quickly throughout Europe. This meant that ordinary people could learn about new ____________. New technology such as _____________ meant that injured soldiers got new types of wounds, forcing surgeons to find new ways of coping. The discovery of the _____________ in the late 1400s brought new foods and medicines.

22) Answer these questions about the work of Andreas Vesalius in improving anatomical understanding.

a) How did Vesalius realise that Galen had made mistakes? _______________________________________

b) Why were Galen’s findings not as accurate as Vesalius’s? ______________________________________

c) What was the name of Vesalius’s illustrated textbook (1543)? ____________________________________

d) What was the response to Vesalius’s work (short-term impact)? __________________________________23) Explain why Vesalius’s work had a more significant long-term impact. _________________________________________________________________________________________________________________________________

24) How did Henry VIII improve the work of barber-surgeons in 1540? ______________________________________

______________________________________________________________________________________________

25) Answer these questions about the work of Ambroise Paré in improving surgery.a) Why was war an important factor in the work of Paré?

__________________________________________b) How were gunshot wounds treated before Paré’s discovery?

_____________________________________c) Why and how did this change because of Paré?

_______________________________________________d) How did Paré improve the practice of amputation?

_____________________________________________e) How did Paré improve post-surgery life for wounded soldiers?

___________________________________

26) Whose work on anatomy did Paré learn from? _____________________________________________________

27) Explain two ways in which Paré’s work improved surgery in England in the long-term. ______________________ ____________________________________________________________________________________________________________________________________________________________________________________________

28) What did Galen believe happened to blood? _______________________________________________________

29) Answer these questions about the work of William Harvey in understanding how blood circulates around the body.

a) How did Harvey discover how blood circulated? _______________________________________________b) Why did Harvey take 12 years to publish his ideas? ____________________________________________c) What could Harvey not provide an answer for? ________________________________________________d) Which popular medical treatment did this challenge? ___________________________________________

30) Explain (with specific detail) how significant Harvey’s discovery was in the short-term and the long-term.

Short-term) ______________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

Long-term) ______________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

31) Which invention proved that Harvey was correct, four years after his death? ______________________________

32) Which four sources of medical advice were available to people in the 1600s and 1700s who could not afford to see a doctor? ______________________________________________________________________________________

33) Which Medieval treatment was still used in 1685 to treat King Charles II? ________________________________

34) Which other superstitious treatment did 3000 people per year come to London for? ________________________

35) Answer these questions about the Great Plague of 1665.a) What did people believe caused the plague?

_________________________________________________b) Name three treatments that were used.

_____________________________________________________c) What did some people notice about the deaths?

_______________________________________________d) Explain three ways in which the government tried to stop the spread of plague.

______________________

_______________________________________________________________________________________

_______________________________________________________________________________________

e) How many Londoners did the plague kill? ____________________________________________________

36) How did beliefs about what hospitals were for change in the 1700s? __________________________________________________________________________________________________________________________________

37) Name three types of specialist hospital set up in the 1700s. ___________________________________________

38) Answer these questions about the work of John Hunter in improving anatomical understanding in the 1700s.

a) Describe one occasion on which John Hunter tried a radical experiment. ___________________________

_______________________________________________________________________________________

b) Which important organisation, in charge of training surgeons, was Hunter part of? ____________________

c) Which mistaken idea about gunshot wounds did Hunter prove wrong? _____________________________

d) How was Hunter’s work significant in the short-term? ___________________________________________

_______________________________________________________________________________________

e) For long-term significance, which historically important doctor did Hunter train? ______________________

39) What is the difference between inoculation and vaccination? _______________________________________________________________________________________________________________________________________

40) Answer these questions about the work of Edward Jenner in discovering vaccination and defeating smallpox.

a) Explain two problems with inoculation. ______________________________________________________

_______________________________________________________________________________________

b) Which milder disease did Jenner inject an 8-year-old boy with? ___________________________________

c) Why was it difficult for others to accept vaccination in the short-term? ______________________________

_______________________________________________________________________________________

d) In the long-term, what did the British government do in 1853? ____________________________________

e) In the long-term, which two famous rival doctors built on Jenner’s work? ____________________________

41) Which two anaesthetics were used before the discovery of chloroform in 1847? ___________________________

42) After the microscope was invented in 1677, allowing scientists to see microbes, how did they believe they got inside the body? ________________________________________________________________________________

43) What did Louis Pasteur discover in 1861 that disproved this? ________________________________________________________________________________________________________________________________________

44) What was the difference between the beliefs of contagionists and anti-contagionists, and who was right? ___________________________________________________________________________________________________________________________________________________________________________________________________

45) Answer these questions about the work of Joseph Lister in developing antiseptic surgery.a) How is Lister’s work related to Pasteur’s?

____________________________________________________b) How did Lister stop infections getting in during surgery?

________________________________________c) What did Lister not do?

__________________________________________________________________d) In the short-term, how did many doctors respond to Lister’s results?

_______________________________

_______________________________________________________________________________________

46) Which disease led many British doctors to accept Pasteur’s Germ Theory? _______________________________

47) Which method of surgery developed in the 1890s, 30 years after Pasteur published his Germ Theory, and what did this method involve? __________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________________

48) Answer these questions about the work of Robert Koch in applying Pasteur’s theories to human diseases.

a) Koch first become famous for identifying which disease? ________________________________________

b) How did Koch prove specific bacteria were responsible for specific diseases? _______________________

_______________________________________________________________________________________

c) Which British doctor promoted the work of Pasteur and Koch, even when it was unpopular? ____________

d) What did Koch’s work allow he and Pasteur to create? _________________________________________

49) Answer these questions about the discoveries of Pasteur and Koch in the 1880s and 1890s.a) Why was war an important factor in the work of both men?

______________________________________b) After Koch identified the germ in Q48a, which two animal diseases did Pasteur’s team

create vaccines for?__________________________________________________________________________

_____________c) Which two germs did Koch’s team identify in the 1880s?

________________________________________d) What did Pasteur prove about vaccines in 1885?

______________________________________________

50) Explain three reasons why Britain’s towns and cities were so dirty in the early 1800s. ___________________________________________________________________________________________________________________________________________________________________________________________________________________

51) What did people think caused the 1800s cholera outbreaks, and what really did? __________________________

52) What did Edwin Chadwick’s report say caused cholera, and what did it say needed to be done? ____________________________________________________________________________________________________________

53) Why did the government not do anything despite Chadwick’s report? __________________________________________________________________________________________________________________________________

54) What changed the government’s minds and what did the 1848 Public Health Act do? _____________________________________________________________________________________________________________________

55) Why was this Act ineffective? ___________________________________________________________________

56) What did Dr John Snow discover, and how did he discover it? _________________________________________

____________________________________________________________________________________________________________________________________________________________________________________________

57) What happened to the River Thames in the summer of 1858? _________________________________________

58) What did Parliament do about this and who did they ask? _____________________________________________

59) Why did the government begin to take more responsibility for public health after 1867? ___________________________________________________________________________________________________________________

60) Explain two ways the Second Public Health Act of 1875 improved public health. _______________________________________________________________________________________________________________________________________________________________________________________________________________________

61) What is a ‘magic bullet’ and who discovered one for syphilis in 1909? _________________________________________________________________________________________________________________________________

62) Answer these questions on the work of Alexander Fleming in discovering penicillin, the world’s first antibiotic.

a) Which nasty germ remained undefeated by the 1920s? _________________________________________

b) Why was Fleming studying this germ? ______________________________________________________

c) How did he accidentally discover in 1928 that penicillin could kill germs? ___________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

63) Why was Fleming’s discovery of penicillin not very significant in the short-term? _________________________________________________________________________________________________________________________

64) What made penicillin more significant in the long-term and why were the factors of government and war vital? __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

65) What were the names of the British scientists who first used penicillin to treat infection? _____________________

66) Complete this table to outline post-1945 developments in the human body and our understanding of disease.

1953Scientists Francis Crick and James Watson discover ______. The understanding of this leads to such developments as gene _________, genetic _____________ and genetic engineering.

1973Geoff Hounsfield invents the ______ scanner, which uses __________ images from many angles to build a 3D image of the inside of the body.

1975Endoscopes are developed. These are _________-_________ cables allowing doctors to go under the _____ to see inside the body.

1980 The disease of ____________ is officially eradicated after a global ________________ campaign.

1990-2003The __________ ___________ ___________ successfully identified the roles of all the _________ in the human body. Ongoing research into genetics and treating diseases comes from this research.

67) Complete this table to outline post-1945 developments in surgery.1950 A Canadian surgeon performs the first open-________ surgery.

1968 The first _____ transplant in Britain is performed.

2002American surgeons implant _____________ into a miniature computer inside the visual cortex of a ______ man. This allows him to ‘see’ well enough to drive a car.

2006-2008 The first partial and then full ______ transplant is carried out.

2007 A huge breakthrough with the release of a prosthetic _____ that uses _____________ to stimulate the retina in an attempt to improve the vision of blind individuals.

68) Complete this table to outline post-1945 developments in medical treatments.1948 Free vaccine for _____ made available in the UK.

1954-1955 Free vaccine for diphtheria, whooping cough and __________ (the ‘________ vaccine’) made available in the UK.

1964 Free vaccine for _________ made available in the UK.

2006 The first ____ (anti-_________) vaccine is approved.

69) Explain five ways in which governments now get involved more in public health. _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

70) Name two forms of alternative medicine. __________________________________________________________

71) Which mental condition, previously called ‘shell shock’, was not recognised until after WW1? _________________

72) Answer these questions about the role of World War One in improving surgery and health.a) Which 1900 discovery allowed wartime surgeons to carry out blood transfusions?

____________________b) Which 1895 discovery was used near battlefields to examine wounded soldiers?

_____________________c) How did army doctor Harold Gillies dramatically improve post-wound care?

_________________________d) Which lethal infection did surgeons work out how best to prevent?

________________________________

73) Answer these questions about the role of World War Two in improving surgery and health.a) Which important service opened in 1938?

___________________________________________________

b) What progressed greatly during the war thanks to US surgeon Dwight Harken? ______________________

c) What was created in 1948 as a result of the public wanting the government to take a greater role? _______

d) Why did the war improve people’s diets? ____________________________________________________

e) Which ‘wonder drug’ was mass produced in order to treat the Allied forces? _________________________

f) How did the evacuation of children change public health? ________________________________________

_______________________________________________________________________________________

74) Why did the 1899-1902 Boer War force the government to improve public health? _______________________________________________________________________________________________________________________

75) Explain three improvements to public health as a result of the social reforms of the Liberal Party after 1906.__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

76) What was the drawback to this system for the unemployed? _________________________________________________________________________________________________________________________________________

77) What is the name for the system by which the government aims to help those in need – mainly the old, the sick, the unemployed and children? _____________________________________________________________________

78) Who wrote a report upon in 1942 which the Labour Party based its post-war promises of a health service and social security providing ‘from the cradle to the grave’ insurance for all? _____________________________________

79) Answer these questions about the post-war Labour government’s reforms.a) What was the name of the Labour Prime Minister from 1945 to 1951?

_____________________________b) What was the school leaving age raised to?

__________________________________________________c) What was introduced to help with childcare costs?

_____________________________________________d) What was the name of the Minister of Health who introduced the NHS in the face of

opposition from political opponents and from doctors? ______________________________________________________________________

e) In which two areas did the NHS not stay free for long? __________________________________________

80) What is the name of the ‘superbug’ that is resistant to antibiotics? ______________________________________

Key terms/ words/people do you know what they mean or what they did?

1-Vaccination-

2- 4 humours-

3- Monasteries-

4- Dissection-

5- Public Health-

6- Cauterizing-

7- Ligatures-

8- Antibiotics

9- Inoculation

10- Magic bullet-

11- Galen-

12- Ambroise Pare-

13- Vesalius-

14- Harvey-

15- Jenner-

16- Rhazes-

17- Avicenna-

18- John of Arderne-

19- Louis Pasteur-

20-Pasteurisation-

21- Germ Theory-

22- DNA-

23- Blood transfusion

24- Robert Koch

25- Joseph Lister-

26- James Simpson-

27- Edwin Chadwick-

28- John Snow-

29- Alexander Fleming-

30- Florey and Chain-

31- Paul Ehrlich-

32- William Beveridge-

33- Aneurin Bevan-

34- Thomas Sydenham-

35- John Hunter-

36-Christian Barnard-

37- Archibald Mc Indoe-

38-James Watson and Francis Crick-

39- Anaesthetics-

40- Antiseptic-

41- NHS-

42- Cholera-

43- Latrine-

44- Sewage Pit-

45- Sanitation-

46- Blood Chart-

47- Urine Chart-

48- Aseptic Surgery-

49- Florence Nightingale & Mary Seacole-

50-Keyhole surgery-

51- Reform-

52- Seebohm Rowntree-

53- Contaminated-

54- Epidemic

55- Black Death-

56- Plague-

57- Flagellants-

58- Joseph Bazalgette-

Medicine Through Time Timeline 3000 BC Pre-History – understanding is based on spirits and gods. No real medical care. People die very young, normally by the age of 30-35 for men, but only 15-25 for women due to the dangers of childbirth. Most people suffered osteoarthritis (painful swelling of the joints).

2000 BC Egyptian Empire – development of papyrus, trade and a greater understanding of the body (based on irrigation channels from the River Nile). They believed the body had 42 blood channels and that illness was caused by undigested food blocking these channels.

1500 – 300 BC Greek Empire – Medicine still based on religion – Temple of Asclepius. Here, patients would get better, but mainly through the standard of rest, relaxation and exercise (like a Greek health spa)

400 BC Hippocrates – founder of the Four Humours theory. This theory stated that there were four main elements in the body – blood, yellow bile, black bile and phlegm. Illness was caused by having too much of one of these humours inside of you. He also wrote the Hippocratic Collection, more than 60 books detailing symptoms and treatments of many diseases.

400 BC – 500 AD Roman Empire – The Romans were renowned for excellent public health facilities. The Romans introduced aqueducts, public baths, sewers and drains, etc. In the citcy of Rome, water commissioners were appointed to ensure good supplies of clean water.

162 AD Galen – continues the four humours theory but extends it to have the humours in opposition to each other. This meant that an illness could be treated in one of two ways, either removing the

“excess” humour or by adding more to its opposite. Galen also proves the brain is important in the body (operation on the pig). Galen’s books would become the foundation of medical treatment in Europe for the next 1500 years.

1100s – 1200s When Europeans went on crusades to the Holy Land in the 12th and 13th centuries, their doctors gained first-hand knowledge of Arab medicine, which was advanced by Western standards.

1347-1348 Black Death – across Europe more than 25 million people die. Two main types of plague

1. Bubonic – 50-75% chance of death. Carried by fleas on rats. Death usually within 8 days

2. Pneumonic – airborne disease. 90-95% chance of death within only 2-3 days

People had no idea how to stop the plague. People thought it was caused by various factors, i.e. the Jews, the Planets, the Gods, etc etc etc

1455 The Printing Press was invented by Johannes Gutenberg. This allowed for the massive reproduction of works without using the Church as a medium.

1540s Andreus Vesalius – proved Galen wrong regarding the jawbone and that blood flows through the septum in the heart. He published “The Fabric of the Body” in 1543. His work encouraged other to question Galen’s theories.

1570s Ambroise Paré – developed ligatures to stop bleeding during and after surgery. This reduced the risk of infection. He also developed an ointment to use instead of cauterising wounds.

1620s William Harvey – proved that blood flows around the body, is carried away from the heart by the arteries and is returned through the veins. He proved that the heart acts as a pump re-circulating the blood and that blood does not “burn up”.

1665 The Great Plague – little improvement since

1348 – still have no idea what is causing it and still no understanding of how to control or prevent it. In London, almost 69,000 people died that year.

1668 Antony van Leeuwenhoek creates a superior microscope that magnifies up to 200 times. This is a huge improvement on Robert Hooke’s original microscope.

1721 Inoculation first used in Europe, brought over from Turkey by Lady Montague.

1796 Edward Jenner – discovered vaccinations using cowpox to treat smallpox. Jenner published his findings in 1798. The impact was slow and sporadic. In 1805 Napoleon had all his soldiers vaccinated. However, vaccination was not made compulsory in Britain until 1852.

1799 Humphrey Davy discovers the pain-killing attributes of Nitrous Oxide (Laughing Gas). It would become the main anaesthetic used in Dentistry. Horace Wells would try and get the gas international recognition. He committed suicide the day before it got the recognition it deserved.

1830s Industrial Revolution. This had a dramatic effect on public health. As more and more families moved into town and cities, the standards of public health declined. Families often shared housing, and living and working conditions were poor. People worked 15 hour days and had very little money.

1831 Cholera Epidemic. People infected with cholera suffered muscle cramps, diarrhoea , dehydration and a fever. The patient would most likely be killed by dehydration. Cholera returned regularly throughout the century, with major outbreaks in 1848 and 1854.

1842 Edwin Chadwick reports on the state of health of the people in cities, towns and villages to the Poor Law Commission (fore-runner to the Public Health Reforms). He highlights the differences in life-expectancy caused by living and working conditions. He proposes that simple changes could extend

the lives of the working class by an average of 13 years.

1846 First successful use of Ether as an anaesthetic in surgery. The anaesthetic had some very severe drawbacks. In particular, it irritated the lungs and was highly inflammable.

1847 James Simpson discovers Chloroform during an after dinner sampling session with friends. He struggles to get the medical world to accept the drug above Ether. Doctors were wary of how much to give patients. Only 11 weeks after its first use by Simpson, a patient died under chloroform in Newcastle. The patient was only having an in-growing toenail removed (non-life threatening). It took the backing of Queen Victoria for chloroform and Simpson to gain worldwide publicity.

1847 Ignaz Semmelweiss orders his students to wash their hands before surgery (but only after they had been in the morgue).

1847 Elizabeth Blackwell becomes the first woman doctor in USA

1848 First Public Health Act in Britain – It allowed local authorities to make improvements if they wanted to & if ratepayers gave them their support. It enabled local authorities to borrow money to pay for the improvements. It was largely ineffective as it was not made compulsory for Councils to enforce it. This was an element of the “Laissez-Faire” style of government.

1854 Crimean War – Florence Nightingale and Mary Seacole contribute majorly to the improvements in Hospitals.

1854 John Snow proves the link between the cholera epidemic and the water pump in Broad Street, London. Unfortunately, he was unable to convince the government to make any substantial reforms.

1857 Queen Victoria publicly advocates use of Chloroform after birth of her eighth child.

1858 Doctors’ Qualifications had to be regulated through the General Medical Council.

1861 Germ Theory developed by Louis Pasteur whilst he was working on a method to keep beer and wine fresh – changed the whole understanding of how illnesses are caused.

1865 Elizabeth Garrett-Anderson – first female doctor in the UK

1867 Joseph Lister begins using Carbolic Spray during surgery to fight infection. It reduces the casualty rate of his operations from 45.7% of deaths to just 15.0 % dying.

1875 Second Public Health Act – now made compulsory. Major requirement is that sewers must be moved away from housing and that houses must be a certain distance apart.

1876 Public Health improvements – in the UK, the government introduced new laws against the pollution of rivers, the sale of poor quality food and new building regulations were enforced.

1881 Robert Koch discovers the bacteria that causes anthrax. He establishes a new method of staining bacteria. Using Koch’s methods, the causes of many diseases were identified quickly: Typhus/TB/Cholera/Pneuminia/Meningitis.

1889 Isolation Hospitals were set up to treat patients with highly infectious diseases.

1895 William Röntgen discovers X-Rays. Though it is an important discovery, it is only WW1 and the treatment of soldiers that propels it into the medical spotlight.

1895 Marie Curie discovers radioactive elements radium and polonium

1901 Scientists discover that there are different blood groups- this leads to the first 100% successful blood transfusions.

1905 Paul Ehrlich discovers first “magic bullet” – Salvarsan 606 to treat Syphilis. The problem was it was based on arsenic and so could kill the patient too easily.

1911 National Health Insurance introduced in Britain

1914-1918 World War One – development of skin grafts to treat victims of shelling

1928 Alexander Fleming – discovers Penicillin. The mould had grown on a petri dish that was accidentally left out. Fleming writes articles about the properties of Penicillin, but was unable to properly develop the mould into a drug.

1932 Gerhardt Domagk discovers Prontosil (the second magic bullet). Slight problem is that it turns the patient red.

1937-45 Florey, Chain & Heatley work on producing penicillin as a drug. Their success will make the drug the second most finded project by the USA in WW2. They fund it to the tune of $800 million and every soldier landing on D-Day in 1944 has Penicillin as part of his medical kit.

1939 Emergency hospital scheme introduced – Funded and run by Government

1942 William Beveridge publishes the Beveridge Report. The report was the blueprint for the NHS

1946 National Health Service Act – provides for a free and comprehensive health service. Aneurin Bevan convinces 90% of the private doctors to enrol.

1948 First day of the NHS. Hospitals were nationalised, health centres were set up and doctors were more evenly distributed around the country. However, the popularity and costs of the NHS would rapidly spiral out of control. The £2 million put aside to pay for free spectacles over the first nine months of the NHS went in six weeks. The government had estimated that the NHS would cost £140 million a year by 1950. In

fact, by 1950 the NHS was costing £358 million.

1950 William Bigelow (Canadian) performed the first open-heart surgery to repair a 'hole' in a baby's heart, using hypothermia.

1952 First kidney transplant (America)

1952 Charges introduced in NHS - 1s for a prescription

1953 Description of the structure of DNA

1961 Contraceptive pill introduced

1967 Christiaan Barnard (South Africa) performed the first heart transplant - the patient lived for 18 days

1978 First test tube baby

1990s Increasing use of keyhole surgery, using endoscopes and ultrasound scanning, allowed minimally invasive surgery.

1994 National Organ Donor register created