Medicine through time

What is the role of Government?

The role of Government in the history of medicine through time is a look at Governments as a factor. This could be a governments decision to increase taxes to pay for healthcare; a government investing in medical research; laws that they introduce about public health or the medical profession or governments doing little or nothing about health issues.

How can Goverment affect the development of medicine?

Governments control what happens in a country. If the government wants to see an aspect of healthcare improved it can channel resources into that area. Likewise if other areas are priorities, funding for medicine and healthcare might be reduced. Since universal suffrage in the UK, governments have (generally speaking) reflected attitudes and beliefs of the people. This has meant that healthcare has been a political priority and funding, whilst still often criticised, has been a relatively high proportion of government spending. Before the vote was given to ordinary’ people the view of many governments was ‘Laisses-Faire’ or ‘leave them alone’ which meant that investment in public health, for example, was limited. Different governments and political parties have different views about what should and shouldn’t be funded by governments. One example of this is the current US debate about Healthcare. See this BBC article and analysis to see the arguments for and against increased investment by the US government.

In what ways have governments improved medicine over time?

An easy way to remember the main ways that governments have improved medicine and health over time is to use a mneumonic. For example
Healthcare
Education
Attitudes
Latrines and clean water
Technology
Housing

Ok, its a simple list but it covers most of the key points. A brief summary of each:

Healthcare: “From the Cradle to the Grave” was a phrase used to describe the Welfare State. It means that the government was willing to invest in healthcare provision for people of all ages, with any kind of illness.

Education: Governments write school curriculums. These can include all sorts of education about healthcare – think about the number of lessons you’ve had about healthy eating, the importance of exercise etc. It also extends to investing in public information broadcasting and advertising. Example: Government video advising people about Swine Flu.

Attitudes. Governments can help to shape attitudes and approaches towards healthy lifestyles and healthy living. This might be through promoting these via adverts etc but has also been the result of religious beliefs that have been central to some past civilisations (Ancient Egypt) or through a desire to ensure a strong and healthy army (The Romans).

Latrines and clean water. Ok, I mean Public Health here but latrines fits the mneumonic so much better…

Technology. Governments have invested in technology and scientific experimentation in order to achieve medical progress. Pasteur and Koch were heavily funded by their respective governments; Penicillin was mass produced as a result of Government investment and many governments through time have invested in the use of communications technology to inform people about health and medicine.

Housing. In the UK there have been many acts of parliament relating to the qualit of housing that is built. This stems from the Industrial Revolution and attempts to solve problems caused by the emergence of slums.

What makes governments invest in medicine and health?

In a democracy, the voters! Examples of this: the Liberal Reforms were influenced by the extended suffrage to working class men and the rise of the Labour Party. The Liberals realised that helping the poor was a vote winner – though they did believe it was the right thing to do.
What things might cause a government to limit its spending on health?

Investment depends on a economy being strong. If the government is struggling to raise taxes, it will struggle to invest in things like healthcare. Likewise there are times when other things are more important. If a country is at war, for example, it will have to prioritise military spending or rebuilding damaged areas. After the collapse of the Roman Empire there was a long period where there was little spent on Public Health. This was caused by the power struggles that occured after the empire collapsed; by the fact that there was no longer a strong government that could organise things and because of the lack of trained soldiers and engineers who could make the improvements.

What has war got to do with the history of medicine?

When wars happen people get injured. This means that surgeons get lots of experience of dealing with different kinds of wounds. As the nature of warfare has changed over time, through the use of new types of weapons, this has led to a greater understanding of the way in which to treat different kinds of injury. This understanding can then be applied in non military situations: for example, treatments for burns developed by military surgeons can be used for people who have been burnt in a house fire.

What examples are there of warfare leading to improvements in medical care?

There are lots of examples. Here I’ll provide one example from the Ancient World, one from the Renaissance and one from the Twentieth century.

The Ancient World: The Romans relied on their army to ensure the security of their empire and to expand it. They invested heavily in ensuring that the army was well trained, able to move around quickly and able to be treated quickly and effectively if injured. This in turn meant that the Romans invested in aqueducts and sewers in towns with a military presence and that they established a good communications network. The purpose was always to maintain military might but the outcome is a very good public health system that is of benefit to civilians as well as to soldiers.

The Renaissance: During the Renaissance Pare made his breakthroughs with the use of ligatures and of potions. Whilst chance played a role in his use of potions, neither of these developments would have happened if it was not for the fact that he was a battlefield surgeon.

Are the improvements all surgical?

There have been lots of surgical improvements as a result of warfare. From the development of different ways of extracting things from the body (arrows, bullets etc); dealing with burns; the development of ligatures and war leading to the introduction of blood banks and increased use of x-rays before surgery is performed. Medical developments caused by warfare aren’t all surgical though. The poor condition of soldiers signing up during the Boer war was one of the reasons why National Insurance was introduced, The First World War led to further welfare legislation and the Second World War was a factor leading to the introduction of the National Health Service.

How does the role of war link in with other factors?

Its very rare that only one factor leads to an improvement. Penicillin is a good example of this. It had been discovered by chance and researched later on by a scientific team. Warfare provided the reason why governments were willing to invest heavily in it and thats the reason why it became so widely available at that time. Without the war the funding might not have been sufficient for it to make much difference for quite a long time – but it was other factors that led to it being discovered and researched. Likewise warfare was one of the main reasons for increased government investment in welfare and health. However it also required factors such as changing attitudes, research and reports and public pressure to get the changes made.

Got another example of war affecting the development of medicine? Feel free to add it as a comment, there are plenty of examples not covered in this guide!

I’m delighted to say that the entire contents of the Hodder Murray Dynamic Learning CD lesson on ‘The Industrial Revolution: Public Health of Pasteur? Why did health improve?’ is now available via this website.

The Industrial Revolution: Public Health of Pasteur? Why did health improve?

What is medical technology?

Medical technology refers to the machines that can be used to help identify an illness or treat it. This includes scanners that can look inside the body, X-Ray machines, Camera technology and equipment used to test samples.

What medical technologies have been developed in the Twentieth Century?

Just before the start of the Twentieth Century William Rontgen discovered how to make use of X-Rays. The use of X-Rays developed in the first part of the Twentieth Century and has improved the way that doctors identify broken bones etc.

One of the first X-Rays taken

In 1943 the first Dialysis machine was used. This was invented by Willem Kolff and replaces the functions of Kidneys which means that people with certain kinds of Kidney Failure can receive daily treatment for their condition.

In 1957 the EEG was introduced. This measures brain activity and is used to identify whether people have conditions such as Epilepsy.

1965 saw the first portable defibrilator. This allows ambulance crews to use the device to help reestablish a normal heartbeat.

Defibrilator

In the same year the first commercial ultrasound device was made available. This is another form of medical imaging which allows doctors to see the inside of the body. It is particularly useful when assessing how well a pregnacy is progressing, or for looking at the way in which specific parts of the body are functioning.

One of the best improvements to medical technology in recent years was the introduction of the CT Scanner in 1971. Invented by Godfrey hounsfield this machine scans the whole body and produces a 3D image of the inside of the body. This can be used to determine where disease is located and to see if it is spreading. In 1980 another improvement to medical imaging was made when the MRI scanner was introdced. This uses magnets to scan and can distinguish between healthy and unhealthy tissues, making it easier to spot things like Cancerous cells.

CT Scanner

What has been the impact of these machines?

Each of these machines makes diagnosis much easier and enables treatments to be accurate and undertaken at an early stage in an illness. This means that recovery is more likely and the quality of life of patients improves.

For a list of other new medical technologies, have a look at this timeline on Wikipedia.

The task noted in my previous post has now been completed. An interactive scheme of work for medicine through time, based largely on the edexcel specification, is now complete. Covering 23 enquiries the scheme provides activities for pupils to complete which will enable them to gain a good understanding of the key concepts covered in their examinations. Whilst the scheme if focussed on the Edexcel specification there are plenty of overlaps with the specifications from other exam boards and I hope that users will find the resources adaptable enough to transfer to these courses. I won’t pretend that all of the ideas are my own, they’re not! I’ve made use of existing resources from trusted colleagues and reputable sites wherever they already cater for the required outcomes. The scheme will no doubt be tinkered with over time (the first 4 units in particular will be revisited) and any feedback would be appreciated.

Interactive Scheme of Work.

I’ve uploaded the first batch of notes, resources and lessons for the Edexcel medicine through time syllabus.

These vary in the amount of detail at the moment – earlier topics tend to simply be notes, whereas issues that I’ve taught recently or am about to teach are closer to online lessons.

Each of the lessons makes use of the suggestions in the EdExcel scheme of work. Where practical I have broken down their suggested activities into bite sized chunks and formatted it in a way that I think / hope my own students will be able to access. The suggestions on the Edexcel site have been complemented through links to videos on the BBC Class Clips website and through a few interactivities.

The remaining lessons will be added as I plan lessons this year and this initial batch of resources will be returned to and improved over time. Please post a comment if you have any suggestions, resources or links that will help improve any of these pages.

The list of topics covered, and of topics that will be covered at a later date, can be found here. Note – these will be linked to from the main part of the site when all of the lessons have been completed and activities incorporated in most if not all of the lesson pages. They are posted here to get some initial feedback and to share resources as they are completed in draft format.

I’ve put together a list of useful videos that are available via youtube on this page of the site.

At the moment theres fairly good coverage of the course contents but I’m sure other people will have come across ones that I’ve not linked to. If so, please add a comment here or contact me via twitter – @medthrutime

Sometime soon this site will be hosting a series of activities from the Hodder Murray publication Dynamic Learning: Medicine through time. These two CD’s provide a range of ICT based lessons, activities and resources and were authored by Ian Dawson and myself. I’m delighted that the nice people at Hodder have asked me to make some of them freely available – further details of which activities and when they’ll appear on the site will be posted as soon as they are confirmed with the publishers.

Online archives are a great source of short clips that can be used in lessons. They can be used as nice introductions, e made available on the schol network as additional reference material or made available for pupils working on their own IT based revision materials. The time consming bit, as always, is finding them in the first place. This post is a simple time saver, the following are the clip titles and reference numbers for British Pathe News clips that I’ve used in medicine lessons.

British Pathe clips. How to access them:

Go to the British Pathe website
Select ‘Advanced Search’
Enter the reference number (below) into ‘Film ID’
Add the clip to your basket
Continue searching or proceed to the ‘check out’
If you are in a UK school you should be able to access high quality clips free of charge, if not, select not for profit or education from the use options and you can download a free demo version of the clip (it just has a small banner on it which doesn’t ruin the clip)
Follow the on screen instructions to download the clips to your chosen storage device.

As Pathe may reorganise / renumber items, you should be able to find clips by searching for the clip title if the clip ID is not found.

Pathe Clip names and references:

AMPUTEES LEARN TO USE ARTIFICIAL LIMBS – Clip ID is 1852.38
ANTI POLIO VACCINE – 1666.36
BLOOD BANKS – 1536.53
CAMERA TO SAVE LIFE – 1751.08
CANCER RESEARCH – 3310.01
cancerresearch – 2341.21
CHILDREN_S DENTISTRY 59.08
COFFIN NAILS 1493.03
CYSTIC FIBROSIS 3309.06
DEFENCE AGAINST DISEASE 3382.05
DIPTHERIA TRAILER 1512.37
diseaseofthecentury_overstress 2728.09
EYE OPERATION 3405.06
HEALING – MONOPOLY OR OPEN SHOP 1501.32
HEARING AID MUSEUM 411.03
HEART OPERATION AT THE HEART SURGERY INSTITUTE 2637.02
IMPROVING THE MICROSCOPE 2762.13
INFLUENZA TRAILER 1534.15
MAKING ARTIFICIAL LIMBS 1662.01
MANUFACTURE OF DRUG TO COUNTER 2473.11
MEDICAL SCIENCE CONQUERS POLIO 19.09
Medicine 1884.28
NHS TRAILER 1460.17
OPEN HEART SURGERY 2918.22
OPENING OF NEW CROOKES MIRACLE DRUG LABORATORY 58.39
PENICILLIN DISCOVERY 1944.23
PENICILLIN IN MASS PRODUCTION 2028.22
PLASTIC SURGERY1283.02
RAF INSTITUTE OF AVIATION MEDICINE 2784.17
SCIENCE AIDS MOTHERS 1407.02
SMALLPOX CITY QUEUES FOR VACCINATION 1462.04
SURGERY THROUGH THE AGES 2447.07
SWEEP AWAY ALL SLUMS 693.32
THE DOCTOR_S PROTEST 627.12
THE WAR ON PNEUMONIA 949.47
THREE ROADS TO HEALTH 1378.12
WONDER DRUG CEPORIN 3115.14
WORLD CANCER CONGRESS OPENS 1537.06

Using music in lessons helps some students to remember key points, adds a bit of variety to the delivery of content and is a ‘must’ if you’re getting students to make use of programmes like moviemaker. Music can help to create a mood in the classroom and can calm, energise, engage (or distract!) students. There are plenty of places online to find out about the positive impact of the use of classical music, plenty of examples of songs from, say, the wars, being used – but for a development study like medicine through time, the options can appear to be a litte more difficult.

Here’s a list of the songs I’ve got stored away in my medicine folder. Possible uses are noted underneath each song.

1) Penicillin Penny – Dr Hook and the Medicine Show

Fleming, Florey, Chain etc…

2) Spirit in the sky – Doctor and the Medics

Religious beliefs in the Ancient World

3) Bring me to Life – Evanescence

Black Death

4) Rehab – Amy Winehouse

Modern medicine

5) Sisters are doing it for themselves – Aretha Franklin

Development of nursing

6) Bad medicine – Bon Jovi

Overview – major mistakes or misunderstandings through time?

7) Heroes – David Bowie

Overview – recapping the key people / contributions.

Changes – David Bowie

Overview – continuity / change

9) Do you really want to hurt me – Culture Club

Barber Surgeons

10) Gimme Shelter – The Roling Stones

Public health

11) The Drugs don’t work – The Verve

Fight against infectious disease

12) The Casualty theme tune

Handy as a timing device for starter / plenary tasks

13) Jean Genie – David Bowie

DNA

14) It’s only pain – Katie Melua

Development of anaesthetics

15) The Scientist – Coldplay

Watson and Crick

16) Heaven knows I’m miserable now – The Smiths

Public Health in the Industrial Revolution

17) Spoonful of Sugar – Mary Poppins soundtrack

Treatments through time

18) Everybody Hurts – REM

Various uses

19) Jagged little pill – Alanis Morrisette

Modern medicine / changes in treatments

20) Getting Better – The Beatles

Scientific / technological revolution

21) Hospital Beds – Cold War Kids

Development of hospitals

22) Where’s your head at? – Baseman Jaxx

Trephining

23) Stuck in the middle with you – Bob Dylan

Surgery

24) Take me to the hospital – The Faint

NHS

25) Unwell – Matchbox20

Various