Health

i76

Theme Conveners: Surgeon Vice-Admiral Sir Sheldon Dudley, k.c.b., f.r.s., and Nigel Clayton ◦ Display Designer: Peter Ray

The “Country” Pavilion and “Homes and Gardens” together show what is being done in two quite different spheres to make the best and most pleasant use of the small amount of space that is available for living purposes in Britain. The “Health” Pavilion deals with another aspect of the peoples well-being; it shows what is being done to make the small span of life of the individual as fit and fruitful as it can humanly be.

“Humanly” is important. The thing which has always distinguished British work in medicine, surgery, public health and nursing is the recognition that every patient is an individual human being. It follows, then, that the patient peculiar needs and happiness must be ensured before the “scientific” part of medical treatment – operations, inoculations, and so on – can become really effective. “Care of the patient” in this sense is still something for which Britain is famous.

Knowing your body

A mechanic cannot repair an engine until he knows the way that engine works. Similarly, the great achievements of surgeons and doctors in recent times would be impossible without the knowledge passed on to them by the pioneers who first discovered how the body works, and the scientists who are still revealing the secrets of its many mechanisms.

In such research, the British have played a leading part. What is more, the renown in the names from the past can very often be equalled by that of our men of science in the present time. Hughlings Jackson, Sherrington and Adrian are world-famous in matters relating to the nervous system. It was Harvey, 300 years ago, who first discovered the circulation of the blood; Barcroft and Haldane in our own time have added much to our knowledge of the blood itself and respiration. In nutrition, Hopkins and Mellanby were foremost in recognising the nature of vitamins. In the control of the bodily machine Bayliss and Starling have added greatly to knowledge, while Banting and Best are the benefactors of all sufferers from diabetes by discovering the role of insulin.

The human body, then, is like a land rich in prizes for its explorers, and British initiative here has been characteristically active.

On knowledge follows development. What we have done with what we know is told in the remaining sections of the Pavilion which describe the research, skill and organisation that exists in Britain to maintain the health of fifty million individual human bodies. Mental health is, of course, equally important, but it does not lend itself to display in an exhibition.

Safe water, good drainage and the right food

Much as we differ, as individuals, in our idiosyncrasies, there is a number of requirements common to us all, if the nation is to be secure in health. Three of these in which the British have been pioneers are: safe water, good drainage, and the easy supply of the proper foods, so that there shall be no malnutrition. In all of these, the British way has been to put the emphasis on prevention, as being better than any cure. Our most recent example of this was the scientifically based organisation of mass feeding on a nation-wide scale during the war.

Prevention rather than cure

Safe water and safe drainage are now accepted without a thought by most people in Britain. There is, however, another specific form of prevention of disease in which Britain has led the world, of which the individual is fully conscious because he plays an active part in it. This is vaccination and immunisation. The efficiency of these in maintaining the nation’s health would be altogether vitiated if the individual citizen did not himself make the voluntary act of being vaccinated or inoculated, and of ensuring that his children are similarly protected.

It was Jenner, a Gloucestershire doctor, who started mass immunisation a hundred and fifty years ago, when smallpox was a familiar scourge throughout the country. Later, Wright and Leishman did pioneer work on the enteric fevers, such as typhoid, which becomes particularly menacing in times of war.

Biological standards

i75Some of the more important substances used in medicine, such as anti-toxins for controlling infectious diseases, drugs needed for treatment, and so on, occur as a small part of a complex mixture, and the proportion varies from one sample to another. If treatment is to be successful, therefore, it is vital that the amount of this “active principle” present in any sample shall be precisely known. This is now measured in terms of international units accepted throughout the world. Charged with maintaining these international units and standards for all substances that come within the international scheme, Britain shares the honour with Denmark. Among these substances are the anti-toxins for diphtheria; hormones such as insulin for diabetes; drugs for the heart such as digitalis; vitamins and penicillin.

Penicillin

This, the century’s most important discovery in clinical medicine, sprang from the historic work of Fleming and Florey. The discovery of penicillin has stimulated the search for similar therapeutic substances.

Restoration of health

Since the days of Hunter, whose influence established surgery as a science in Britain, and of Lister, the greatest surgeon of all time, British surgeons have given new principles and technique to the world in various specialised fields – in Thoracic Surgery, whereby operations on the heart and great blood vessels and lungs are now possible; in Orthopaedics, now becoming more and more the surgery of broken bones; and in Plastic Surgery, whereby many sorts of deformities due to wounds and burns have been so effectively repaired.

No scientific surgery at all was possible before the two great discoveries of asepsis and anaesthesia, and, until the recent extensive use of blood transfusions, numbers of deaths continued to result from surgical shock and loss of blood. In all these three saving developments, British research has played a part.

Nursing

Finally, there is one essential factor in the successful cure and rehabilitation of the sick; that is, the human factor of good nursing. All British progress in medical treatment bears the additional stamp of a superb tradition of nursing – the Nightingale tradition. It is through the British nurse of to-day that the community’s care for its sick and injured is focused on to every individual patient in the land.