Medicine and Public Health

When the Europeans came in contact with the Arabists during the crusade, they have rediscovered Galen and Hippocrates' books which where then brought back to Britain in 1100s. These books where then used for universities and although the medical doctors were being taught the wrong ideas, they learnt to observe and record their patient's diseases.

Trained doctors were expensive and therefore limited to only the rich. Most medicines practiced, were provided by the monasteries and the local woman.The Christian churches set up hospitals but only 10% cared for the sick and 47% housed the poor and elderly and provided no medical care. Apothecaries would also providde drugs and medicine, sometimes advice as well but many were quacks.

Doctors would use urine charts to diagnose patients, test their colour, smell and even taste the urine. They believe in the theory of opposites so would often use bleeding in order to balance the humours.There was a huge selection of remedies and some of them did work - garlic and onion kill bacteria. There were also supernatural treatments such as the King's evil or touch (when the King would touch someone with scrofula. Surgery was seen as a job for low-paid assistants and barber-surgeons - the treatments were very simple. 

How it was taught: a physician was in charged and he ordered his assistants to cut the body whilst reading out Galen's passages. The training doctors couldn't touch anything at all and just had to listen and watch the dissection.

Physicians learnt about the anatomy by dissecting bodies like Galen recommended; however, nothing new was learnt from these dissection because they weren't searching for new ideas as they believed Galen's book told them everything about the human body. Thus, the dissections and demonstrations were giving the idea that Galen's ideas were correct. So nothing new was being learnt because people respected and did not challenge the ideas of Galen.

St Bartholomew's Hospital in London was one of the first to be founded in 1123. By 1400, there were over 500 hospitals in England (although many had only 5-6 beds) - they treated specific diseases such as lepers, poor travellers, the sick and elderly. People believed that God was punishing them for their sins and so joined in prayer. Nursing care was provided by nuns that had good knowledge on herbs and remedies. 

Some abbeys, like Canterbury, were designed to help the sick and this also developed the understanding of public health. For example, reservoirs stored water which could then be used as piped water around the abbey. The latrines were flushed with fish pond and then drained into the town's ditch so it didn't cotaminate the supply of water they had. It was very clean and therefore, this made people start to see the connection between disease and dirt. 

If you could afford to pay, you would see the local physician.

However, most illnesses were taken to the women of the household - they treated the majority of illnesses in the Middle Ages.

Mothers and wives had a range of remedies but sometimes a wise woman would be called. Women also acted as midwives; in some towns, midwives had to be apprenticed and were given licences for this. Women could then qualify as surgeons by working as an apprentice.

However, women were not allowed to be physicians and were not allowed to attend university.

Bleeding was the most common treatment used to avoid disease. In some monasteries, they bled 7-12 times a year to avoid illness - sometimes this carried out to the point where monks became unconcious, losing 3-4 pints of blood. Some careless surgeons even bled their patients to death.

The sick were treated by a common list: diagnosing the illness, timing the treatment, use of bleeding chart and home remedies. 

Most medieval remedies were unusual and did not work. For example, put a lion's ear to cure deafness, cure asthma by eating young frogs and to cure ring worm, wash hair in a male's urine. 

Arab and European Medicine: the Arab World did not have problems that came with the collapse of the Roman Empire and so they were able to keep the ideas of Galen and Hippocrates, and build upon them.

Similarities between Arab and European Medicine: both used medical ideas of Galen and Hippocrates, both were strongly influenced by religion (for example, both religions said that the sick should be cared for and dissection was banned) and neither had a cure for the Black Death.

Differences: Arab medicine had better libraries as they didn't suffer from the collapse of the Roman Empire, they also had more hospitals which were to care for the sick and medical ideas were not lost, and were built on instead. 

War - armies took trained doctors to war and so they gained experience on the battlefield. However, war made travelling dangerous and it also caused the collapse of the public health system.

Religion - The Christian church set up universities for doctors to train in. It also built hospitals and housed books in the monasteries. However, the universities didn't encourage training doctors to look for new medical ideas as they said Galen's ideas were correct.

Communication - The Crusades led to the exchange of ideas between the Arab doctors and European doctors. This also led the books of Galen and Hippocrates to be brought back to England.

Government - There were some laws that forced towns and cities to clean up but these were not enforced and the King had little money to pay for improvements. 

A ship in 1348 brought the Black Plague to England and over 40% of the population died during the plague - the dead were quickly buried in large communal graves. There were two kinds of plague: bubonic plague and the pnuemonic plague. 

People believed the plague and disease was caused by the body humours out of balance, bad smells, God's punishment, invisible spirits in the air or because of the effect of the planets. There were also groups called flagellants who whipped themselves to try and rid themselves of their sins as they believed this would stop them from getting the Black Plague. Some people also thought that it was a punishment because of naughty children.

The attempts to treat the Black Death: people thought of carrying herbs to their noise and avoiding slaughter houses, stagnate water and rubbish tips, avoid overeating and baths as they thought it would cause the pores of the skin to open and let in the poisonous air, sit next to a blazing fire (like the Pope did during the hot summer of 1348) or attack foreigners: 20,000 Jews were burnt to death in Stratsbourg during 1348.

Some attempts were actually good in helping public health: for example, all human excrement and dirt should be removed from the streets and you are to clean the city from bad smells. 

The Royal Society (a scientific organisation founded in 1660) - during this time science was replacing explanations of superstition, religion and astrology. The return of the works of Galen and Hippocrates renewed a belief in the four humours, treatment of the opposites and herbal remedies.

Within this period, there was a break from the Roman Catholic Church, 'reformation', and different groups of Christians had different ideas which encouraged debate. This led to the questioning of old ideas and even those of Galen and Hippocrates. 

Johann Gutenburg introduced printing in Britian in 1454 which helped medicine progress. William Caxton set up the first British printing press in 1476  - books were very rare before printing and so new ideas couldn't be spread easily as they weren't written down anywhere. However, the printing press changed this and helped spread ideas by creating new books where knowledge could be stored. This was thus a big factor in helping new ideas spread during the Renaissance. 

He was allowed to dissect but couldn't look at the skeleton properly - but he was so dedicated he stole the body of a criminal from the gallows. He became a professor of surgery in italy where he performed more dissections and wrote books on his observations including the "The Fabric of the Human Body" in 1543. He proved that: Galen thought that blood was passed through septum of the heart through little holes but Vesalius proved there were no holes in the septum. Galen also said the human jaw was made of 7 parts but Vesalius actually proved it was made of 3 parts.

He wasn't important because: many doctors refused to accept that Galen's ideas were wrong. Nobody was healthier from Vesalius' discoveries. 

He was important because: Vesalius insistence on enquiry began to change attitudes towards Galen's ideas and it made doctors realise that there was more to learn. His books spread knowledge and progressed medicine.

Barber surgeon - surgery was still a low status profession. He was an army surgeon. During this time, when limbs were amputated, it would be sealed with cauterisation (burning the end with a hot iron).Pare thus invented a method of tying off vessels with a thread - this was known as ligatures. This was less painful, but still was prone to infection because they didn't know about germs yet. Gunshot wounds at the time, were treated by pouring boiling oil on the wound: during a battle, Pare ran out of oil and resorted to an oinment of egg yolk, turpentine and rose oil - the patients recovered better with this than being scalded with oil. He received opposition to his ideas because doctors didn't want to listen to a low-status surgeon.However, when he became surgeon to the King of France and gained the King's support, people started listening to his ideas. Pare also introduced ligatures to stop the bleeding - silk threads tied around individual blood vessels. He was designed and arranged the making of false limbs for wounded soldiers.

Pare was not important because: stopping bleeding by ligatures was slow whilst cauterisation was faster. Ligatures were dangerous as the thread could carry infections. Pare's discoveries were small scale - there were still no anaesthetic or antiseptics to cure infection.

Importance because: his work became widely known through his book and he encouraged surgeons to think for themselves - he showed improvements were possible and healthier. 

He worked as a lecturer to James I and Charles I. He realised he could observe living animal hearts and his findings would also apply to humans. He chose to work on cold blooded animals because their heart beats slower.In 1628, he published a book about the blood around the body was going round and round and NOT being used up and remade like Galen thought. He also proved the difference between arteries and veins. He proved that blood was not made in the liver like Galen said and calculated the blood going into the arteries every hour was three times the weight of a man.

Harvey was not important because: although his discoveries were usual, they did not change surgery radicall: bleeding continued to be performed and blood transfusions were not generally successful until the discovery of blood groups in 1900. Harvey's discoveries were gradually accepted but some people still ignored his theories.

Harvey was important because: Harvey's discovery laid the foundations for future investigations of blood and physiology (how the body works).Surgery could not develop until Harvey's discovery of the blood system. Harvey also proved Vesalius correct about the importance of dissection. His discoveries also made surgery safer as doctors knew where to not cut.

Quack doctors were healers with no medical training. They were very dramatic - they were accompanied with clowns and chattering monkeys to draw the attention of the people. Their only purpose was to make lots of money by concocting as many lies as possible in order to sell the medicines. Joanna Stephens claimed to have a remedy to cure bladder stones without surgery and Parliament paid her £5000 to buy it in the 1700s. 

When Henry VIII closed the monasteries, many medieval hospitals closed as well. Some were taken over by town councils and others were made into almshouses for the elderly.

But during the 1700s, 11 new hospitals opened in London - they were made by charities, wealthy merchants (like Thomas Guy) and locals - and 46 more hospitals opened in Britain. Most hospitals looked after the poor and unusual remedies were still used (such as bezoar stones from goats were used as an antidote for poison). In St Bartholomew's hospital, most workers were nurses, who were trained in the hospital, and they would get patients herbal remedies and even bled them. Simple surgeries were still carried out using setting fractures and some amputations were performed. 

Where else would you go for if you were sick: Women still played a major role in everyday medicine - they treated most sicknesses. An apothecary sold and mixed medicines that had been prescribed from physicians. Superstition was also the same: between 1660-82, people would visit King Charles II so they can be touched by him and hopefully be cured from scrofula. New ingredients were tried from abroad: a bezoar stone from goats as an antidote for all poisons, rhubarb from Asia was used to purge the bowels and tabacco was recommended for toothache, wounds and protection from the plague. 

The Plague returned in 1665 which killed around 100,000 people in London. Some efforts were made to control the disease: quarantining by painting red crosses on the houses with the disease and people being buried at least 6 feet deep.The measures showed that people began to realise that infection was spread by people, but people still didn't understand about germs. Doctors, chemist and priests were likely to get the plague because people would come to them for help.The Great Fire of London in 1666 sterilised most part of the city, killing off the plague. 

What had changed: the discoveries made by Versalius and Harvey were important because it proved Galen and Hippocrate's ideas to be wrong, and therefore encouraged other doctors to discover new ideas by careful observation.Pare's use of bandaging wounds and using oinment instead of boiling oil helped patients survive as other surgeons saw that it was working. However, his use of ligatures slowed down surgery, causing problems with bleeding and also helped to spread infection as the thread was not sterilised.However, in 1492, America was discovered which brought a wide range of new knowledge to Europe. 

Stayed the same: The discoveries from Harvey and Vesalius didn't make anyone healthier, life expectancy didn't increase much and they didn't find new or better ways of treating disease. Herbal remedies, superstition, the four humours and quacks slowed down the progress of medicine.

Experiment: People were willing to challenge old ideas - by experimenting, they could prove that they were correct. 

Wars: Public health was worse. 

Education: Literacy was increasing and there were more schools and universities.

Printing: printing helped to spread different ideas and new discoveries around.

Ancient learning: there was renewed interest in the theories of Greek/Roman thinkers.

Art: more realistic artwork - people were able to see the anatomy of the body well - for example, Da Vinci watched a dissection and drew a more realistic image which would help doctors and surgeons.

Wealth: there was money to be spent on luxuries and education - 11 hospitals opened up in London and 46 around England that was paid for by locals.

Technology and Machinery: new inventions being made such as printing presses and false limbs. 

Smallpox in the 18th century killed many people; if you suvived the disease, you would be left badly scarred. Lady Montagu learnt about inoculation in Turkey and introduced it to Britian: this was when pus from a sore of someone with mild smallpox was given in a small cut to the person inoculated. After a mild reaction, they were immune to smallpox. However, this sometimes led to full smallpox and death. But, many people feared smallpox and took the risk anyway, making doctors very rich.

Jenner was a country doctor that heard milkmaids catch cowpox rather than smallpox - using his experimentation and observation, he found out this was true. In 1796, he tested this on James Phipps: he injected him with pus from the milkmaid who had cowpox from the cow Blossom. Jenner then injected him with smallpox and he didn't catch small pox. In 1840, the vaccine became free for infants and compulsory by 1853 (this was important because it was the first time the government ever forced a medical treatment on the population). Jenner was also given £30,000 by the government in 1802 and 1807 to develop his work. However, some people opposed the vaccination because: doctors who were making money out of inoculation didn't want to lose their income, Jenner couldn't explain why the vaccine worked, and many people thought you would turn into a cow and vaccination was seen as dangerous because doctors didn't know the correct dosage. Some people just didn't like the fact that the government was forcing them to take it.

From the 1750s, people would call upon local doctors or practitioners after they trained in an apprenticeship.They would often waive the fees of the poor who were unable to pay. But the cost of medicine was an issue: dispensaries began to appear and these provided the poor with cheap medicine. Many illnesses were still treated at home using common sense and herbal treatments. There was also an increase in 'Patent Medicines' which claimed to cure all - they contained very dangerous substances and this hindered the progress of medicine (short-term).

Women doctors in the 1850s - there were none. Due to the number of changes, woman roles in medicine were reduced: in the middle ages, the church allowed only men were allowed to train as physicians. By 1700, surgeons also had to have a university degree and as women were not allowed to go to university, they were unable to become surgeons. With the introduction of medical forceps, midwifery was also taken over by men. In 1852, there was a Medical Registration Act which required all doctors to belong to the College of Physcians, Surgeons and Apothecaries - this was closed for women. However, some women fought against this like Elizabeth Garrett was the first woman to qualify as a doctor in Britain. Woman still played a role as healers in the home, and as nurses. In the 1850s, female nurses went to Crimea and this was the first time women were used as army nurses. 

When the Crimean War broke out in 1854, the secretary of war - who was Florence Nightingale's friend - asked her to go and sort out the nursing care in the hospitals over there. Florence took 38 hand-picked nurses and made changes such as bringing good food and boiling the sheets. The death rate was 42% before she arrived and then was 2% afterwards. When she returned back to England, she set up the Nightingale School of Nursing and wrote her book 'Notes on Nursing' which became the standard textbook. Men were not admitted onto the Royal Colleges of Nurses until 1960.

Mary Seacole learnt nursing from her mother who ran a boarding house for invalid soldiers in Jamaica. She came to England to volunteer for the Crimea.She was rejected, probably due to racism, but raised enough money to make her own way there.She nursed soldiers on the battlefield and was loved by many. However, went she went back to England, she was unable to find work and went bankrupt. 

Micro-organisms had been seen by 18th century microscopes but scientists believe they were caused because of disease: this was known as sponetaneous generation (instead of blaming the germs, they blamed bad smells or miasmas). Louis Pasteur was employed in 1857 to find out why alcohol was going bad in a brewing company. His answer was to blame the germs in the air; Pasteur proved this and showed *********** these germs by boiling the liquid. In 1861, he published his 'Germ Theory': Pasteur was a scientist and he carried out his experiments using silk worms and wine.Robert Koch studied different microbes to see which germ caused what disease. He developed a solid medium to colour the microbes (dyeing technique). He managed to identify the anthrax mircobe in 1875, which linked germs to human disease - he later when on to discover the microbes that caused TB and cholera and won a Noble Peace Prize in 1905.

Rivalry: Pasteur (French) and Koch (Germany) were rivals because France had recently lost the war to Germany in 1870-71 and it bothered Pasteur that Koch was ahead on the medical front. Pasteur joined the race to cures for anthrax and cholera: both Pasteur and Koch were given large teams to help them. In 1879, some chicken cholera was left out over the holidays and when Pasteur's team returned, this was injected in the chickens. Then when they injected the new cholera, the chickens still lived. They realised that the cholera was weakened (like Jenner's vaccination) and in 1881, the cure for anthrax was discovered and then rabies in 1882 by Pasteur!

3 main problems: Pain, Infection and Bleeding 

Although natural drugs like alcohol and opium could reduce pain, there were not effective and could make the patient ill. Laughing gas was introduce by Humphry Davy in 1799, but it did not work on all patients. Ether was then introduced in 1840s but it was an irritant and fairly explosive. In 1847, James Simpson was 'testing' drugs and discovered chloroform was an effective anaesthetic. It then started to be used in surgery. 

However, these new anaesthetics weren't a good thing: many people objected to them on religious grounds whilst others were afraid of the dangers of an overdose (Hannah Greener died of an overdose when removing a toe nail). Although it allowed surgeons to perform more complicated surgeries, infection and bleeding were still a problem and so actually caused more deaths. It was hard to get the dosage right because some people were paralysed by the drug whilst others could still feel the pain.

His father develops better microscopes and Lister had the best medical training. In 1867, Lister thought that bacteria could be causing infection after reading Pasteur's book about bacteria. Lister thus used carbolic acid to kill these bacteria - this was antiseptic surgery.

Lister's work was important because: the percentage of his patients who died after the operation fell from 46% to 15%. His ideas spread and were used by other doctors, although at first many doctors didn't believe his discovery. Other doctors built on his ideas, hospitals and operation theatres became a lot cleaner. All medical instruments and rooms were sterilised effectively, killing all germs. This was aspetic surgery. Lister enabled surgeons to perform longer and more complex surgeries without infection becoming a problem - this progressed surgery.

Crowding during the Medieval times wasn't a problem because there were gardens and crop fields. However, industry changed this: space was filled with factories and poor quality housing. People didn't believe the government should tell them what to do with their homes, and the government believed in leaving things alone (Laissez-faire). With this attitude, sewage was put into rivers, overflowing cesspits and even on the street. Smoke from the factories were also dangerous (they release toxic gases like carbon monoxide). Diseases like small pox and typhus was also common. 

Cholera reached Britain in 1831.Cholera spreads when infected sewage gets into drinking water: this causes extreme diarrhoea that could possible kill due to loss of water and minerals. People didn't know what caused cholera and it broke out in 1848, 1854, and 1866.

Chadwick published a "Report on the Sanitary Conditions of the Labouring Population of Great Britain" in 1842. He said that improving public health will save money rather than cost money.The statistics used to describe the death rates shocked members of the upper class. However, the first Public Health Act was passed in 1848 (after the second outbreak of cholera) and this led to the Central and Local Health Boards - the local board had to be approved by local taxpayers. The central board however was dismantled in 1954.

His idea was that: overcrowding and dirty living conditions spread illness and if people got sick, they would be unable to work which could cost more money as people would have to pay higher taxes. His solution was: improve drainage and sewers, provide clean water supplies, removing the poor from the streets and appointing medical officers to check the reforms. But taxpayers didn't want to pay for this even though it might lower taxes in the long run.The government was not happy either as they knew the local councils didn't want them to interfere in local matters. But his ideas won after the second outbreak in 1848 and this was when the Public Health Acts were introduced. A national Board of Health was set up and in towns where death rates were very high, the government could force them the local council to make public health improvements to the sewers and appoint a Medical Officer of Health. Local councils were encouraged to collect tax for public health improvements if they had the support of the local tax-payers (or rate payers).

Following the outbreaks in 1853 and 1865, the government finally released the Public Health Act in 1875 = it forced ALL local councils to improve sewers and drains, provide clean toilets and appoint a Medical Officer of Health. By 1900, people were living healthier, life expectancy had risen by 46 for men, and 50 for women. Towns and streets were cleaner. Chadwick was thus important because his hard work gave evidence supporting public health reforms, he influenced the government to do something and his recommendation's were the basis of Public Health Act 1848.

Chadwick and Snow were finally proved right after Pasteur's discovered germs in 1861. Another cholera outbreak in 1866, and the Great Stink led to government acting. This is when the Thames smelt so bad the MPs had to leave the houses of Parliament. They knew change was needed. The second Public Health Act in 1875 was brought up and this was more effective as it forced town council to act. Victorian Engineering helped this by producing improvments such as brick-lined sewers and steam-driven water pumps. 

Factors Leading to Change: Rapid growth of towns - increased risk of disease and people realised they need to work together to do something. Government's attitudes changed - in 1875, began to force councils to act. Scientific knowledge - it was improving such as the discovery of germs. People's attitudes to the sickness: the wealthy wanted reforms that would improve everyone's health. The different cholera epidermics in 1848, 1853 and 1866 made people scared and the then decided to take action and take on Chadwick's suggestions. 

The Public Health Act 1875 made it compulsory to improve sewers and drainage, and appoint and medical officer of health to inspect the reforms. They also said: Improve housing standards, stop polluting rivers, shorten working hours for women/children and do not add bad ingredients to food. There were other changes to like Joseph Bazalgette designed and build London's sewer's system after the Great Stink, flushing toilets were invented and in 1853, tax was taken off soap.

How far did the reforms help: although by 1900, people were living healthier and life expectancy rised, poverty was still causing poor health, people who could not get support from friends had to give up their homes and live in workhouses, Booth and Rowntree wrote a report saying that many families did not have enough money to pay for housing, clothese or food, the sick, elderly and unemployed received no help and many men got rejected from fighting in the Boer war because they were so unfit. 

However, liberals under David Lloyd George pushed social reforms: in 1906, local councils were told to provide free school meals for poor children, in 1907, school medical examinations were ordered for all children, in 1908, old-age pensions were introduced, in 1911, National Insurance (free medical insurance for workers that fell ill) was introduced. 

WW1 - new weapons were used like shrapnel bombs and high-explosive shells. These caused terrible injuries that surgeons had never seen before. But this caused a number of improvements in medicine and health:

• Surgery improved - they have opportunities to experiment with new techniques. For example, Harold Gillies developed new techniques to repair broken bones and to perform skin grafts (which started plastic surgery).
• X-rays were discovered before the war - during the war, they were used to find shrapnel and bullets lodged in the body.Governments paid for more and more x-rays to be made.
• Blood transfusion - was effectively used for the first time after the discovery of blood types in 1900. Methods of storing blood and transporting it was improved.
• The poor health recruits to the army made the government very worried about the poor living conditions at home. The soldiers that fought in the war were promised a 'home fit for heroes' when they got home and this caused unhealthy slum houses to be knocked down.

The Second World War improved medicine by:

• Futher improvments in blood transfusion - including better ways of storing blood and there was an introduction of blood donations from civillians.
• Rationing was introduced to improve people's diet and healthy eating was encouraged through government posters. 
• Pencillin was developed which was the first antibiotic.
• There was further development in the use of skin grafts and the treatment of burns.
• 1.5 million children were moved from the city to the countryside for their safety and this showed the difference between the rich and the poor - causing the government to take more seriously the fight against poverty.
• The government improved what services the poor could access. In 1942, William Beveridge, a civil servant, put forward the ideal of a free'National Health Sevice' for all.

National insurance - at the beginning of the 20th century, the poor could not afford to get help if they were sick. In 1911, the Liberal government passed the Nationa Insurance Act - there aim was to give workers medical help and sick pay if they could not work because they were ill. They did this by paying into a sickness fund. However, it only applied to people in work - the unemployed, long-term sick and elderly were not helped. 

Better housing - in 1900, poor housing was still a major cause of ill health. Many didn't have fresh water or toilets. The Housing Act in 1919 said that the local council had to provide good housing for working people to rent. 250,000 houses were built under this scheme. The next step was to clear the overcrowded slums and this began in the 1930s.1000s of slum houses were cleared and 700,000 new houses were built. The last of the slums did not disappear until 1960s.

NHS - WW2, in which people from all classes worked together, led to a call for a fairer health service that would help everyone. As a result, William Beveridge put forward a plan in 1942 to reform medical health services. This led to the creation of the NHS in 1948 - all services were free. Doctors, dentists are nurses would be paid by the government instead of patients and many doctors opposed this because they thought that their income would be reduced and would not be able to have any freedom of charging patients. 

In the 1900s, infant mortality rates were so high because of - overcrowded, poor-housing. These houses had no fresh water or clean toilets. Disease - infectious diseases spread rapidly because vaccines had not been developed for the most common killers. Medical care - many parents could not afford this. Diet - parents and babies had poor diets. Education - there weren't enough midwives to help and advise new mothers. Some parents didn't know how to keep their babies healthy.

Why did they fall: scientists developed new vaccines and governments made sure that these were given to children. For example, in 1940, it was made compulsory to have diphtheria vaccination.This reduced deaths from 300 per million to 10 per million. In 1902, the government said that all midwives had to be trained and in 1906, the government started providing free school meals for poor children, in 1909, the government banned overcrowded back to back housing and enforced building regulations. In 1919, local councils started clinics for mothers-to-be. They appointed health visitors to visit families and advise on health and hygiene. In 1948, the NHS was set up which provided free health care and medicine for everyone.

What kills people today: cancer, heart disease due to obesity, lung disease due to smoking, aids and malaria. Different diseases affect different countries.

Fleming was searching for a cure for infections. In 1928, he went to clean up culture dishes which had bacteria growing in them. By chance, the penicillin bacteria had blown in through the window. He noticed that bacteria didn't grow in the area around the penicillin. He had found the first penicillin. Fleming however, was unable to take his work further because he didn't have enough government support or money.

Florey and Chain: experimented on penicillin and found a method to take and test penicillin in any container they could. They tried it on a human in 1941, but because they didn't have enough penicillin it made him better but didn't cure him so he died. The trial however, showed how powerful the penicillin was if it was grown in huge amounts. In 1941, America joined the war and gave $80 million to find a way to mass-produce penicillin.

In 1943, scientists used penicillin treat wounded British soldiers for the first time. By June 1944, there was enough penicillin to treat all casualties from D-Day. Pencillin was thus developed by chance, war, government and intelligence.

What treatments were there: at the beginning of the century, people relied on cheap easy-to-find remedies, some people cared for their family when they were sick but after the war, the medicine available increased dramatically including access to more hospitals and vaccines. 

DNA stands for deoxyribonucleic acid. In 1953, Francis Crick and James Watson discovered the structure of DNA. They proved DNA was in every human cell and that it was passed on from parents to child. In 1986, the Human Genome Project began to compile a complete map of human DNA and it was completed 15 years later.

Gene therapy - uses stem cells to cure sick people; e.g. adult stem cells can cure someone with bone marrow disease.

Customised drugs - to cure one person's particular health problems.

Genetic engineering - you can potentially choose the nature of your child, their gender and appearance.

Genetic screening - or testing to identify illnesses people can suffer from and prevent them like checking for Down's Syndrome.