1900-Present

GCSE 9-1www.stchistory.com

MEDICINE IN MODERN BRITAIN

Diagnosis & Genetics

20TH CENTURY CONTEXT

• By 1900, everything was in place to assess and manage human health. We understood:Microbes and GermsScientists were experimenting – particularly causes of disease that were not related to microbes (Genetics and Lifestyle).

• Chemical treatments and antibiotics were being discovered

• Surgery was now far more advanced, and improving all the time

• The British Government had a new attitude towards its role in the nations health.Medical care was provided free and for all at the point of service (NHS)

• We’re still unable to fight all diseases eg Cancer, new lifestyles have brought about new illnesses eg Obesity

UNIT OUTCOMES:

How is sickness diagnosed today? Make a list of ideas you might have

20TH CENTURY DIAGNOSIS

At the start of the 20th Century, diagnosis happened between the doctor and patient through observation and consulting a text book based on the symptoms (probably Sydenham’s).

During the 20th century there was a move towards laboratory medicine with examinations of samples eg SKIN, BLOOD, FLESH, URINE etc this was called a Biopsy. The samples would be analysed in a lab using super microscopes and technology.

The patient would now also be x-rayed to allow doctors to see what was happening inside the body. This meant that diagnosis in 20th Century was and is more reliable

and accurate.

So… the biggest change to diagnosis in 20th Century was instead of being based on symptoms and experience / knowledge of the doctor, it was now based on medical testing.

GENETICS (DNA)

It was clear that microbes and germs didn't cause all illnesses. Doctors wondered for the first half of the century why babies were born with conditions that

appeared to develop in the womb and have been inherited.

What do you think this might be?

The first ever photograph taken of DNA taken in May 1952 in the lab of Rosalind Franklin

DNA is the building block of life. It is the complex chemical that carries genetic information. It is contained in chromosomes, which are found in the nucleus of most cells.

In other words, DNA is a chemical code and set of instructions that determine how living things physically look and work.

OR EVEN SIMPLER

Some people’s DNA means that they develop like this…….

And others like…

CRICK & WATSON 1953

Crick & Watson discovered the structure of human DNA and how it passed on from parents to children.

In 1990s, the Human Genome Project began working out exactly how each

part of human DNA affects the human body.

Why is this important?

These discoveries have led to treatments for diseases which have genetic causes rather than being caused by bacteria. These include some cancers. Until the

discovery of DNA, these illnesses were untreatable.

HTTPS://WWW.YOUTUBE.COM/WATCH?V=ZWIBGNGE4AY

What is DNA?

HW: Complete the table comparing Jenner, Pasteur, Koch & DNA for SIGNIFICANCECopy pp 108-111 of Edx SHP textbook

Did you know:

Not one single human being on earth has the same DNA(except identical twins)

The complete set of DNA containing all the information needed to build a particular organism (human, plant, animal etc)

DNA’S JOURNEY…

1902: Garrod, an English doctor, theorises that hereditary diseases are caused by missing information in the body’s chemical pathways.

1941: US Scientists Beadle and Tatum prove Garrod’s theory.

1951: King’s College London, Rosalind Franklin created images of DNA

1953: Crick & Watson discover the structure of DNA and how it is passed on

Working with Franklin’s pictures, Crick & Watson made a model of DNA. This model became the Double Helix. This Double Helix was the structure of DNA and it could unzip itself and make copies, which is what is passed on.

They had essentially, discovered the secret of life and could now work on identifying which parts of DNA caused hereditary disease, and eventually, removing it, even as early as in the embryonic stage or womb!

Question: Are we playing ‘God’ with this? Is it ethical? Is it morally right? What consequences could result in this? Good or bad!

Angelina Jolie: What has she got to do with this?

Scientists have now mapped EVERY human genome!

They can identify a problem or missing information in DNA straight away

They have the blueprint to life! Amazing, but maybe very scary too?

FACTORS

Science

Technology

Lifestyle

Understanding DNA required a lot of collaboration in the Scientific community. The Human Genome Project was an example of this ‘BIG SCIENCE’. Scientists from all over the world worked on this and made their work public so it could benefit as many people as possible.

Impact of Science on genetics:

Recognition of genetic disorders such as Huntingdon’s and Down’s Syndrome. These are caused by missing information in the genome. Soon, they might be able to put that information back in thus, treating these disorders.

Discovering the shape of DNA, understanding how it works and then mapping the individual genes has been made possible through technological advances egMicroscopes and higher powered images.

The electron microscope was developed in 1931 and by 1932 Ruska & Knoll had built a model able to magnify more than any optical microscope up to this point. An optical microscope can magnify up to 2000 times, and electron microscope can magnify 10,000,000 times

We’re now understanding lifestyle choices on our health a lot more. Smoking became more popular in the 1920s. By the 1950s doctors started to notice a worrying rise in lung / throat cancers. Doctors today have associated High Blood Pressure, other cancers, heart disease, gum and tooth disease and asthma. It is the biggest cause of preventable disease in the world. It is even dangerous to non smokers who inhale the smoke.

Diet too, what we eat and how much of it affects our health.

How have the government tried to deal with this?

The main problems with food are SUGAR and FAT leading to diabetes and other preventable diseases.

Sex and Drinking. Binge drinking or lots over a long time will destroy our liver and kidneys, again preventable diseases. We also know that unprotected sex (sharing bodily liquids) and sharing needles will spread disease egWarts, HIV (Aids), Heppatitis etc.

Tanning. Sunbeds or too much exposure to the sun causes skin cancer

CREATE AN ADVICE LEAFLET

You have been approached by the government to produce an advice leaflet explaining the threats to our health.

You should include the different lifestyle factors and their associated illnesses.Advice on how to avoid getting associated diseases

Which Factor was most important in the development of our understanding of genetics? Write a paragraph- Science- Technology

BLOOD TESTS, SCANNERS & MONITORS

The development of machines and computers has enabled doctors to have a better understanding of a patient’s symptoms. Eg: X-Rays, CT Scanners.

What does this mean for diagnosis?

No longer need surgery to diagnoseMore accurate diagnosisMore detailed diagnosis Then of course, better TREATMENT

What are your thoughts on this?

Which factor(s) make this possible?

DIAGNOSIS TECHNOLOGY

Endoscopes (1900s): Use of a camera on the end of a thin, flexible tube to see inside the body. Most common in digestive issues. They can also be used to carry small surgical instruments into the body

Blood Pressure Monitors (1880s): Diagnose high and low blood pressure

Blood Tests (1930s): Blood samples test for an enormous number of conditions without the need for invasive diagnosis methods

ECG’s (1900’s): Electro cardiograms track heart activity

Ultrasound Scans (1940s):Sound waves used to build a picture of inside the body. They can diagnose kidney stones, gall stones, tumours and of course a baby in the womb.

CT Scanners (1970s): More advanced form of X-Rays. They can diagnose tumoursand other growths in the body

MRI Scanners (1970s): Use magnets and radio waves to create an internal image of the body. They diagnose soft tissue injuries such as ligament damage

X-Rays (1890s): Help to see inside the body without cutting. Used to diagnose broken bones

Blood Sugar Monitoring 1960s: Diabetics can check their blood sugar regularly to manage their condition and avoid an attack

GENETICS & DIAGNOSIS CHECK POINT