Context of Medicine in the Early 20th Century (Edexcel GCSE History)

Medicine in the 20th Century - Summary

The type and extent of injuries on the Western Front led to a variety of new techniques used to treat wounds and infections. It is important to recognise the foundations of these techniques occurred before the First World War.

The work of Joseph Lister on antiseptics and the development of aseptic surgery led to higher survival rates. Doctors in Base Hospitals and Casualty Clearing Stations applied these principles.

Geoffrey Keynes improved on the techniques established by James Blundell and Karl Landsteiner’s work on blood transfusions. The use of mobile x-rays on the Western Front was thanks to the work of Wilhelm Röntgen and his discovery of x-rays in 1895.

To gain an understanding of the medical developments in the British Sector of the Western Front, it is important to have an understanding of medicine before the First World War and in the early 20th century

Understanding of Infection and the Move to Aseptic Surgery

Understanding infection 

• By the end of the 19th century, there was an understanding of what caused infection in surgery:

  • In 1861, Louis Pasteur’s Germ Theory identified that germs cause decay

  • Inspired by Pasteur, Joseph Lister used carbolic acid to clean the wound after a leg operation in 1865

• Although carbolic acid was only popular for a short time, doctors understood the importance of carrying out aseptic surgery by the early 1900s

Aseptic surgery

• Joseph Lister’s methods provided the medical community with a greater understanding of the importance of aseptic surgery

• By the beginning of the 20th-century, the foundations for aseptic surgery had been established:

Aseptic surgery in the early 20th-century

Blood Transfusions & Storage

• More complex surgery was possible due to the development of aseptic surgery and x-rays:

• Aseptic surgery saved many lives but blood loss was still an issue because:

  • Blood loss was common during complex surgery

  • If a patient lost too much blood, they went into shock and died

• James Blundell performed the first blood transfusions between 1818 and 1829:

  • He developed the first basic techniques and equipment

  • A tube was used between patient and donor to complete the transfusion

• Karl Landsteiner discovered the three main blood groups (A, B and O) by 1901

  • This solved the problem of donors rejecting transfused blood because it did not match their own type

  • Reuben Ottenberg identified Group O as the universal blood group

• Before the First World War, there were still problems with preventing blood from clotting. This made storing blood difficult:

  • In 1915, Richard Lewisohn added sodium citrate to blood to stop it from clotting

  • In 1915, Richard Weil discovered sodium citrate allowed blood storage of blood and it could be refrigerated for up to two days 

  • In 1916, Francis Rous and James Turner established citrate glucose allowed storage of blood for up to four weeks