Lesson video

Hello, I'm Mr. Marchant, and thank you for joining me for today's history lesson.

My top priority today is to help guide you through all of our resources and make sure that you can meet today's learning objective.

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 explain how and why diagnosis improved after 1900.

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

Those are diagnosis and invasive.

Diagnosis is the process of saying what is wrong with someone who is sick, and invasive, in this context, refers to medical treatments which involve cutting into the body.

Today's lesson will be split into three parts, and we'll begin by focusing on diagnosis by 1900.

Diagnosis is a key aspect of modern medical practise, but a start of the 20th century there had been improvements in diagnosis.

Despite this, by 1900, there were still issues with the accuracy and reliability of medical diagnosis.

Making an accurate diagnosis highly important as correctly understanding what a patient's sickness is allows effective methods of treatment to be adopted.

As the 20th century began, doctors diagnosing their patients had abandoned many of the flawed ideas accepted by physicians at the beginning of the 19th century and before.

For instance, the inaccurate theory of the four humours was no longer accepted, and so doctors no longer blamed their patient's sickness on causes like an excess of blood.

By 1900, to make their diagnoses, doctors still relied upon close observation of their patients just as physicians had for centuries.

In particular, physicians observed the symptoms which a patient was showing.

Increasingly, doctors also focused on collecting certain measurements from their patients such as their pulse, blood pressure, and body temperature.

Doctors could then combine these observations and measurements with their own knowledge of illnesses and diseases to make a diagnosis.

However, diagnoses at this time were not always accurate.

While some equipment was available to help doctors take measurements from patients, these were generally basic and not fully developed.

For instance, the sphygmomanometers which were used to measure blood pressure in 1900, only measured one of two types of blood pressure.

Similarly, doctors had no convenient method for testing whether their patients were suffering from common diseases and infections like tuberculosis and syphilis.

This made doctors more reliant on interpreting symptoms which can sometimes be similar between different diseases and infections.

All of this made it easier for mistakes to be made when diagnosing a patient, especially depending on the knowledge and experience of individual doctors.

So let's check our understanding of everything we've just heard.

What did doctors use sphygmomanometers to measure? Was it: blood pressure, body temperature, or heart rate? 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 A, sphygmomanometers are used to measure blood pressure.

Let's try another question.

This time I want you to write the missing word for the following sentence.

By 1900, to make a diagnosis, doctors closely observed their patients blank.

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 symptoms. By 1900, to make a diagnosis, doctors closely observed their patient's symptoms. And let's try another question.

This time we have a statement which says, common diseases and infections like to tuberculosis and syphilis were difficult for doctors to diagnose by 1900.

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, no standard tests existed for these diseases and infections in 1900, meaning diagnosis relied upon the knowledge and experience of individual doctors.

So we're now in a good position to put our knowledge of diagnosis by 1900 into practise.

I want you to study Jacob's claim.

Jacob says that, "In 1900, diagnoses of patients were not always reliable or accurate." I want you to explain why Jacob's view is correct.

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 explain why Jacob's view was correct, and your answer may have included: "Jacob is correct because diagnosis in 1900 was still limited by the equipment available to doctors and a lack of testing.

For example, doctors were generally unable to test patients for common diseases like syphilis and tuberculosis.

Consequently, doctors were more reliant upon interpreting a patient's symptoms which could lead to mistakes.

Furthermore, while some equipment, such as sphygmomanometers were in use to help make measurements which could support diagnoses, these tools were often basic and not fully developed." So well done if your own response look something like that model, which we've just seen.

And now we're ready to move on to the second part of our lesson today where we are going to think about testing and diagnosis.

In the early 20th century, there was a shift towards laboratory testing when making diagnoses.

This shift reduced the reliance of diagnoses on the knowledge and experience of individual doctors, and helped to make them more reliable and more accurate.

In the modern period, diagnosis of patients has increasingly involved taking samples from a patient's body and testing these in laboratories.

Various samples can be taken from patients for this testing, including blood, saliva, urine, and flesh.

In these instances, the tests are known as biopsies.

Resources from tests on these samples can then be used to support doctors in making a diagnosis.

In 1907, building on knowledge of the bacteria which caused tuberculosis, a skin test was developed, which allowed doctors to diagnose patients suffering from the disease.

This type of testing remains in widespread use in the UK to this day.

Meanwhile, blood tests are used to support diagnosis for a range of diseases and infections, including syphilis, diabetes, and prostate cancer.

In the case of prostate cancer, doctors often conduct both blood tests and biopsies to increase the confidence of which they can make a diagnosis.

Some modern laboratory tests also focus on urine to help doctors make a diagnosis.

Urine testing is not unique to modern medicine, though, many mediaeval physicians believed that urine samples could be used to help them diagnose their patients.

However, whereas mediaeval physicians focused on aspects such as the colour and even taste of urine, modern tests have proved to be significantly more accurate by focusing on the presence of specific substances which might be found in urine.

For instance, diabetes can be diagnosed by analysing glucose levels in a person's urine.

Nevertheless, whilst laboratory testing has improved the accuracy and reliability of modern diagnosis, it still faces some limits.

In particular, there are some diseases for which doctors have been unable to develop standard tests such as Parkinson's and dementia.

In these instances, diagnosis can remain very difficult for doctors.

So thinking about what we've just heard, which of the following is not used to provide samples for laboratory testing? Blood, flesh, humours, or urine? 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 C, humours are not used to provide samples for laboratory testing.

And now we have a statement on the screen which reads, doctors only began to conduct laboratory tests to help with diagnosis in the 21st 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 false, but we need to be able to justify our response.

So why is it 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, "Skin tests which helped doctors to diagnose tuberculosis have been in use since 1907 which is in the 20th century." And let's try another question.

How do modern doctors investigate urine samples to test whether a patient has diabetes? Is it by analysing glucose levels, by analysing the colour, or by analysing the smell and taste? 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 A, that modern doctors can investigate urine samples to test for diabetes by analysing the glucose levels of that urine.

And let's try one final question.

I want you to identify one disease which is still difficult for modern doctors to diagnose.

Pause the video here and press play when you're ready to check your answer.

Okay, so your answer to this question may have included conditions such as dementia and Parkinson's, which are still very difficult for modern doctors to diagnose.

So we are now in a good position to put all of our knowledge of testing and diagnosis into practise.

I want you to describe one way in which diagnosis changed after 1900.

As part of your answer, you should refer to two different historical periods and provide examples from both.

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

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

So I asked you to describe one way in which diagnosis changed after 1900, and your answer may have included: "One way in which diagnosis changed after 1900 was in the use of laboratory testing to help accurately identify what sickness patients were suffering from.

For instance, patients can now be tested for diabetes by analysing glucose levels in their urine.

This process is different from how mediaeval physicians diagnose patients.

For example, mediaeval physicians also used urine to support diagnosis, but usually focused on colour and even taste, which did not provide a reliable insight for diagnosis, unlike modern tests." So well done if your own response looks something like that model, which we've just seen.

And now we're ready to move on to the third and final part of our lesson for today, where we are going to think about technology and diagnosis.

As well as laboratory testing, the accuracy of modern diagnosis has also been improved through the use of technology.

Technology has also been able to change diagnosis by giving patients more ability to understand their own health.

As new technologies have been developed in the 20th and 21st centuries, some of these have been deployed to provide more information which can be used for diagnoses.

For example, some modern sphygmomanometers are digital and use electronic sensors to measure blood pressure.

These digital devices can store measurements and share them with other devices such as computers and smartphones.

Digital devices have also helped to give patients themselves more information about their own health.

For example, continuous glucose monitors have been developed to measure blood sugar levels for people with diabetes.

These monitors are attached to the arm or stomach, and their readings can be shared to other devices like smartphones.

This allows people with diabetes to know in real time whether their blood sugar levels are too high or too low.

So what device can people with diabetes use to monitor their blood sugar levels themselves? Pause video here and press play when you're ready to see the right answer.

Okay, well done to everybody who said that continuous glucose monitors can be used by people with diabetes to monitor their blood sugar levels.

Modern technology has also helped to remove the need for invasive surgical procedures to understand problems inside a patient's body.

For example, X-rays have been used since the 1890s and MRI scans since the 1970s to provide doctors with internal images of their patient's bodies.

X-ray scans can be used to identify problems like broken bones, whilst amongst other things, MRI scans are often used for identifying cancerous tumours.

These non-invasive methods avoid some of the risks of surgery such as the chance of a patient becoming infected.

Endoscopes which are cameras at the end of a thin flexible tube, also help modern doctors observe the in insides of a patient's body without having to perform surgery.

Doctors can pass endoscopes through natural openings in a body, such as the mouth, and use these to investigate a patient's internal organs.

In particular, endoscopes are often used to investigate problems related to patients' digestive and reproductive organs.

So thinking about what we've just heard, which statement is correct? That MRI scans and X-rays provide detailed information but are invasive? The MRI scans and X-rays provide little information and are invasive? The MRI scans and X-rays provide little information but are not invasive? Or the MRI scans and X-rays provide detailed information and are non-invasive? Pause video here and press play when you are ready to see the right answer.

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

MRI scans and X-rays provide detailed information and are non-invasive.

And now we have a statement which reads, technology means that doctors are rarely involved in diagnosing patients in the modern period.

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 why is it that that original statement is incorrect? Pause the video here and press play when you're ready to see the right answer.

Okay, so well done to everybody who said, "Technology helps patients to monitor some health conditions for themselves, but most diagnoses still come from doctors who use new technologies like MRI scans to inform their judgments." And so now we're in a good position to put all of our knowledge about technology and diagnosis into practise.

I want you to explain two ways in which technology has helped to improve modern diagnosis.

You may consider: the information provided, who can monitor health, and how diagnosis takes place.

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

Okay, well done to everybody for your hard work on that task.

So I asked you to explain two ways in which technology has helped to improve modern diagnosis.

And your answer may have included: "One way in which technology has benefited modern diagnosis has been by reducing the need for invasive surgeries.

For instance, X-rays have been used throughout the modern period and MRI scans since the 1970s to provide doctors with internal images of their patients' bodies.

These scans can be used to identify problems such as broken bones and even cancerous tumours without having to perform surgeries and cut patients open.

This is important as it helps doctors avoid some of the risks, like infection, which can occur if they needed to perform surgeries." Your answer may also have included: "Another way in which technology has benefited modern diagnosis has been by providing doctors with more detailed information.

For instance, the development of digital devices, including digital sphygmomanometers, has allowed doctors to collect a greater amount of information about their patient's health.

Having large amounts of detailed information like this can help doctors to make a more reliable diagnosis of their patient's illnesses." And your answer may also have included: "Another way in which technology has benefited modern diagnosis has been by helping patients to monitor their health themselves, rather than just depending upon doctors.

For example, people suffering from diabetes can wear continuous glucose monitors on their stomach or arm.

These monitors give the person real time information about their blood sugar levels, helping them monitor whether they rise too high or fall too low." So really well done if your own answers look something like those model answers we've just seen.

And so now we've reached the end of today's lesson, which puts us in a good position to summarise our learning about modern improvements in diagnosis.

We've seen that diagnosis by 1900 was mostly dependent upon individual doctor's knowledge and experience.

Laboratory testing, especially of blood and flesh samples, became more common during the 20th century.

New technology has helped provide doctors and patients with more detailed information to help them make diagnoses.

And new technologies like MRIs and endoscopes have made it easier to diagnose some problems without resorting to invasive surgeries.

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

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