Lesson video

Hello, I'm Mr. Marchard, and I'll be your history teacher for today's lesson.

I'm really excited to have you joining me as we explore today's subject.

And my number one priority will be to help ensure that you can meet our lesson objective for today.

Welcome to today's lesson, which is part of our Edexcel unit on medicine in Britain.

By the end of today's lesson, you'll be able to assess the impact of developments in medicine by the start of the 20th century.

There are five key words which will help us navigate our way through today's lesson.

Those are: invasive, sterilise, microbe, transfusion, and clotting.

Invasive, in this context, refers to medical treatments which involve cutting into the body.

Sterilise means to make something free from microbes.

A microbe is any living organism which is too small to be seen without a microscope.

A transfusion is the process of adding an amount of blood to a person's body, and clotting is the process in which blood changes into a solid state to form a thick mass or lump.

Today's lesson will be split into three parts and we'll be begin by focusing on new technologies.

In the late 19th century and the beginning of the 20th century, a number of important advances in medicine and surgery were made.

These improvements provided important foundations for medical practises during World War I.

Among these important advancements was the development of X-rays.

X-rays were first discovered in 1895 by Wilhelm Röntgen.

Röntgen realised that X-rays could pass through many objects, including substances which were less dense, such as paper, wood, and even human flesh.

By contrast, X-rays could not pass through denser substances like metal or bones.

These differences allowed images to be produced, clearly showing any denser substances.

For instance, when Röntgen passed X-rays through the human body, the images he produced clearly showed the bones inside people's bodies.

The medical benefits of X-rays were realised quickly.

Hospitals in Britain began setting up radiology departments with their own X-ray machines from 1896 onwards.

The images produced using X-rays provided doctors and surgeons with internal views of the body, which could help them to diagnose patients more accurately.

Using X-rays, it was possible to identify problems like broken bones and kidney stones, and also to locate foreign objects such as bullets in the body.

Knowledge of these issues allowed surgeons to more targeted and less invasive operations, which in turn reduce the risks of infection and blood loss faced by their patients.

However, the use of X-rays in the early 20th century still suffered from some limitations.

For one, early X-ray machines released a lot of radiation, which could harm patients and cause burns to their skin.

The machines used to produce X-ray images also used some fragile materials, which could break quite easily.

As a result, X-ray machines were not very portable, and the number of locations where X-ray images could be produced was restricted.

Similarly, early X-ray machines often overheated, which restricted the number of images they could be used to produce as time was needed to cool the machines down.

So, thinking about everything we've just heard, which of the following was not an issue encountered when X-rays were used at the start of the 20th century? Was it, doctors could only produce a limited number of images, that high amounts of radiation were released, that the machines broke easily, or that X-ray images could only detect broken bones? Pause the video here and press play when you are ready to see the right answer.

Okay, well done to everybody who said the correct answer was d.

X-ray images could do more than just detect broken bones.

So that was not an issue encountered when X-rays were used at the start of the 20th century.

And let's try another question.

Which of the following statements is correct? The X-rays made surgeries less invasive, the X-rays made surgeries more invasive, or the X-rays had no impact on how invasive surgeries were.

Pause the video here and press play when you are ready to see the right answer.

Okay, well done to everybody who said the correct answer was a.

X-rays made surgeries less invasive.

And now, we have a statement on the screen which says, initially, the use of X-rays was rejected by doctors and surgeons in Britain.

But is that statement true or false? Pause the video here and press play when you're ready to see the right answer.

Okay, well done to everybody who said that that statement was false.

But we need to be able to justify our response.

So how can we tell that that original statement was incorrect? Pause the video here and press play when you are ready to check your answer.

Okay, well done to everybody who said, "The medical benefits of X-rays were realised quickly and hospitals in Britain began using X-rays within a year of their discovery." So, we are now in a good position to put all of our knowledge about new technologies into practise.

Why was the development of X-rays helpful for medicine at the start of the 20th century? You should include the following terms in your answer: invasive, dense, and diagnose.

So pause the video here and press play when you're ready to reflect on your response.

Okay, well done for all of your effort on that task.

So I asked you, why was the development of X-rays helpful for medicine at the start of the 20th century? And your answer may have included, "In the early 20th century, X-rays were used to diagnose issues such as broken bones and to locate foreign objects like bullets in the body.

This was possible because X-rays can be used to produce internal images of a body, showing more dense substances like bones or metal clearly.

As a result, surgeons treating these types of issues could perform less invasive operations as they were better informed about their patients' problems." So really well done if your own response looks something like that model, especially if you also manage to include all three of those terms I asked you to.

And so now, we're ready to move on to the second part of our lesson for today where we are going to think about managing infections.

In the first half of the 19th century, infection remained a major problem for surgeries.

However, advances in medical knowledge, led by Louis Pasteur, and in surgical practises, led by Joseph Lister, led to rapid progress in the management of infections during surgery by the start of the 20th century.

In 1861, Louis Pasteur developed Germ Theory in which he claimed that microbes like bacteria were responsible for causing decay.

In Britain, the surgeon, Joseph Lister, was inspired by Germ Theory, believing that it could help explain why so many surgical patients died from infections.

Lister believed that if any bacteria in or around a patient's wounds could be destroyed during and after surgeries, fewer infections would occur.

To achieve this, Lister used carbolic acid to sterilise his patient's wounds, a practise that became known as antiseptic surgery.

Although there was initially significant opposition to antiseptic surgery, Lister's methods were effective.

And by the 1880s, they had become widespread in Britain.

So, thinking about what we've just heard, I want you to write the missing key word from the following sentence.

Antiseptic surgery aimed to blank patients' wounds by destroying any microbes present in or around them.

So what's the missing word? Pause the video here and press play when you're ready to see the right answer.

Okay, well done to everybody who said that the missing word was sterilise.

Antiseptic surgery aimed to sterilise patients' wounds by destroying any microbes present in or around them.

By 1900, the success of antiseptic surgery had inspired further methods to manage infection and the emphasis of surgeons increasingly shifted towards aseptic surgery.

Whereas antiseptic methods focused on destroying microbes which were already present, aseptic surgery prioritised preventing harmful microbes from being introduced to surgical environments in the first place.

By the start of the 20th century, aseptic surgery incorporated a number of methods designed to keep surgical environments sterile.

Firstly, any medical staff involved in surgeries wash their hands, face, and arms before entering an operating theatre.

Staff also wore face masks as well as rubber gloves and gowns over their clothes unlike 19th century surgeons who'd commonly operated in just their regular clothes.

These rubber gloves and gowns were sterile and created a barrier to prevent any microbes present in a surgeon's clothing from entering a patient's wounds.

Attention was also paid to the surgical instruments used to perform operations.

These were steam-sterilized using autoclaves.

Operating theatres themselves were regularly cleaned.

And by 1900, the air itself was often sterilised by being pumped over a heating system to kill any microbes.

So, thinking about what we've just heard, wearing face masks, rubber gowns and gloves are examples of what type of surgery? Antiseptic surgery, aseptic surgery, or assisted surgery? Pause the video here and press play when you're ready to see the right answer.

Okay, well done to everybody who said that the correct answer was b.

Wearing face masks, rubber gowns, and gloves are examples of aseptic surgery.

Let's try another question.

By 1900, what machine was used to steam-sterilize surgical equipment? Pause video here and press play when you're ready to see the right answer.

Okay, well done to everybody who said autoclaves were used by 1900 to help steam-sterilize surgical equipment before an operation.

So, we're now in a good position to put all of our knowledge about managing infections into practise.

I want you to study the image.

Firstly, I want you to identify one feature in the image which demonstrates advances in managing infections by 1900.

Then, I want you to explain how the feature you identified from the image helped to manage infections during surgeries.

So pause the video here and press play when you're ready to reflect on your responses.

Okay, well done for all of your hard work on that task.

So firstly, I asked you to identify one feature in the image which demonstrates advances in managing infections by 1900.

And your answer may have included, "In the image, surgeons and nurses in an operating theatre can be seen wearing gowns and rubber gloves." So then, for the second part of task B, I asked you to explain how the feature you identified helped to manage infections.

And your answer may have included, "By 1900, surgeons and nurses usually wore rubber gloves and gowns when they were in an operating theatre.

This was an example of aseptic surgery being practised, and the purpose was to keep surgical environments free from microbes.

Rubber gloves and gowns were designed to be sterile and provided an additional barrier between medical staff in an operating theatre and their patient, reducing the chance that any microbes could infect the patient's wounds." So, really well done if your own response looks something like that model, which we've just seen.

And so now, we're ready to move on to the third and final part of today's lesson where we are going to think about managing blood loss.

Patients with serious injuries and those undergoing complex surgeries could suffer from major blood loss.

Patients who lost too much blood could go into shock, a potentially deadly condition.

Advances during the 19th century made blood transfusions a possible solution to manage this problem.

During the 19th century, the first successful transfusions of blood to human patients were carried out.

Although transfusions had become possible, many of these procedures continued to fail, and transfusions were not very common by 1900.

However, a number of advances made at the beginning of the 20th century helped surgeons to address some of the problems associated with blood transfusions.

In 1901, the existence of different blood groups was discovered by Karl Landsteiner.

And by 1902, it was understood that there were four distinct blood groups: A, B, AB, and O.

This discovery helped surgeons understand that patients could not just receive any blood.

For a successful transfusion, patients needed to be given blood that matched their own blood type.

If it didn't, the blood would be rejected.

In fact, it was soon discovered that blood group O was a universal donor group, meaning it could be used in a transfusion for any patient without complications.

From this point onwards, it became easier to perform blood transfusions safely.

Nevertheless, other issues still made blood transfusions challenging.

In particular, blood begins to clot when it's outside the body.

And if this happens, it can no longer be transfused.

This meant that blood could not be stored ready for use before a surgery, or for a person might be in shock.

Instead, any transfusions required a live donor to be connected to the recipient by a tube.

However, it was difficult to ensure that suitable donors could be found when patients required a blood transfusion.

So the inability to store blood restricted the number of transfusions which could be performed.

Although there were experiments in the 1890s to find chemicals which would prevent clotting so that blood could be stored, these were not successful.

So, let's make sure we have a secure understanding of what we've just heard.

Why were many blood transfusions before 1901 unsuccessful? Was it because patients were given blood which did not match their own, because patients were given blood from animals, or because patients were not given enough blood? Pause the video here and press play when you are ready to see the right answer.

Okay, well done to everybody who said the correct answer was a.

Many blood transfusions before 1901 were unsuccessful because patients were given blood which did not match their own.

Let's try another question.

Which blood group was discovered to be a universal donor? Was it A, B, AB or O? Pause video here and press play when you're ready to see the right answer.

Okay, well done to everybody who said the correct answer was d.

It was discovered that blood group O was a universal donor, meaning anyone could receive this type of blood without having any complications.

And let's try another question.

This time, we have a statement which reads, stored blood could not be used for blood transfusions at the start of the 20th century.

But is that statement true or false? Pause the video here and press play when you're ready to see the right answer.

Okay, well done to everybody who said that that statement was true.

But we need to be able to justify our response.

So why is it that that original statement was correct? Pause the video here and press play when you're ready to check your answer.

Okay, well done to everybody who said clotting occurs once blood is outside the body, and doctors did not know how to prevent this at the start of the 20th century, so blood could not be stored and used for transfusions.

And so now, we are in a good position to put all of our knowledge about managing blood loss into practise.

To what extent was blood loss still a serious medical issue at the start of the 20th century? I want you to explain your answer in one paragraph.

So, pause the video here and press play when you're ready to reflect on your response.

Okay, well done for all of your hard work on that task.

So I asked you, to what extent was blood loss still a serious medical issue at the start of the 20th century? And your answer may have included, "Despite some advances, blood loss remained a serious medical issue at the start of the 20th century.

It was possible to perform blood transfusions and a discovery of blood groups meant that compatible donors could be found, reducing the risk of rejection.

Nevertheless, in many circumstances, it remained difficult to perform transfusions because no method for preventing blood clotting had been developed.

This meant that blood could not be stored.

So surgeons often lacked easy access to adequate amounts of blood for transfusions.

Therefore, at the start of the 20th century, blood loss remained hard to treat, and shock remained a very deadly threat." So really well done if your own response looks something like that model, which we've just seen.

And that means we've reached the end of today's lesson, which puts us in a good position to summarise our learning about the historical context of medicine in the early 20th century.

We've seen that X-rays allowed internal images of the body to be produced.

X-rays improved medical diagnosis and allowed less invasive surgeries to be carried out for many patients.

Aseptic surgical methods such as the use of autoclaves, aimed to sterilise surgical environments to reduce the risk of infection.

The discovery of different blood groups in 1901 helped to make it easier to perform successful blood transfusions.

But the inability to prevent blood clotting meant that blood could not be stored to help with transfusions at the start of the 20th century.

So, really well done for all of your efforts during today's lesson.

It's been a pleasure to help guide you for our resources today, and I look forward to seeing you again in future as we continue to think about medicine in Britain.