Transcript A Brief History Of Medicine

A Brief History Of Medicine
Part 4
Renaissance to
early 1900’s
Throughout History
People have had illness.
 People have tried to explain the cause of
disease.
 Humans have sought cures for
sicknesses.

The Renaissance
Time Period

1300 AD to 1600 AD
 “Re-birth” of
knowledge
Major Advancements

1543 Flemish Scholar
Andreas Vesalius
began to use human
bodies for anatomy
study
 Wrote the first complete
textbook on human
anatomy: "De Humani
Corporis Fabrica",
meaning "On the Fabric
of the Human Body".
Major Advancements

Girolamo Fracastoro
1546
 Theory of contagion
 Said disease infection can
be caused by minute
bodies (“germs”) capable
of self-replication,
transmitted from infector
to infected.
Major Advancements

The French army doctor
Ambroise Paré, born in 1510,
revived the ancient Greek
method of tying off blood
vessels.
 After amputation the
common procedure was to
cauterize the open end of the
amputated appendage to
stop the hemorrhaging. This
was done by heating oil,
water, or metal and touching
it to the wound to seal off the
blood vessels.
Major Advancements

Pare also believed in
dressing wounds with clean
bandages and ointments.
 He was the first to design
artificial hands and limbs for
amputation patients. On one
of the artificial hands, the
two pairs of fingers could be
moved for simple grabbing
and releasing tasks and the
hand look perfectly natural
underneath a glove.
Major Advancements

1628, William
Harvey explained the
circulation of blood
through the body in
veins and arteries.
 It was previously
thought that blood
was the product of
food and was
absorbed by muscle
tissue.
William Harvey
The Heart is a
pump – it does not
make blood (as
most doctors
thought)
 Blood circulates
around and
through the body.

Microscope Used for Science

Antonie van
Leeuwenhoek , 1670’s
 Dutch scientist
 Improved microscope*
with smaller, superior
lenses
 *Actually “invented” in
1590 by Zacharius
Jannssen.
Leeuwenhoek





Was actually studying
various fabrics
First to observe bacteria
1676
“Little beasties”
Also observed protists
and muscle fibers
Discovered blood cells
Marcello Malpighi
Italian physician &
biologist
 Malpighi first to study
blood with microscope
in 1690’s
 Also studied skin,
kidney & liver tissues
 Revolutionized the
study of biology

Treatment Changed Little

Despite changes in
knowledge, the major
treatments were still


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
Bleed
Blister
Purge
Avoid sickness
Who’s Who?
Physician –
university trained
doctor who could
prescribe medicine &
do surgery (most
expensive!)
 Apothecary –
shopkeepers with a
little training; skilled
at mixing herbs

Surgeon – “bone
cutter” who did
amputations
 Barber – minor
surgery (like
removing moles)
 Midwife – women
who assisted with
childbirth

Beginnings of Modern
Medicine
Time Period 1700’s to 1900’s
Hospitals in the 1700’s & 1800’s

Hospitals were often
unsanitary
 People were mixed
in large rooms
regardless of their
disease
 They were a “last
resort” when all else
failed.
Surgery Was Crude & Dangerous


Operations were still likely to
lead to death as a result of
infection - even if the patient
had survived the operation.
Doctors wore dirty overcoats
over their normal day coat in
the operating theatre in
anticipation of the blood and
other fluids that might be spilt
in quantity - they did not want
to spoil their day-to-day
clothes !!
Surgery Was Crude & Dangerous


Surgical instruments were not
disinfected afterwards as they
did not know about germs.
Operating tools would be
used form one patient to
another and not cleaned. One
set of operating tools found at
the old Guy’s Hospital had
three sets of blood types on
them - dried and stained into
the wooden handles of the
instruments.
William Morton, 1846

American Dentist
 Used ether as an
anesthetic to put the
patient to sleep
before surgery
Major Advancements - Nursing


The participation of women
in medical care (beyond
serving as midwives, sitters
and cleaning women) was
brought about by the likes
of Florence Nightingale and
Clara Barton.
These women showed a
previously male dominated
profession the importance
of nursing in order to
lessen the death rate which
resulted from lack of
hygiene and nutrition.
Major Advancements - Nursing

Florence Nightingale (18201910) was a nurse in London
(rare for a woman from a
wealthy family)
 Nightingale took over the St
Thomas hospital in 1852.
 In 1854, the British army asked
her to help during the Crimean
War.
 She revolutionized hospital
care with cleanliness and
organization
 Set up school for nurses; soon
all nurses were well-trained
Florence Nightingale
Nursing in America

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Clara Barton (1821-1912)
Coordinated medical supplies
for the Union Army in the Civil
War
After the War, she coordinated
the search from missing Union
soldiers
Founded the American Red
Cross in 1881
Clara Barton, Civil War
nurse
Smallpox
Known since 10,000 BC
 Smallpox affected all levels of society.
 In the 1700’s in Europe, 400,000 people
died each year
 Up to 60% who got it died
 Smallpox killed thousands of Native
Americans when the Europeans brought
the infection to the New World

Smallpox Symptoms

High fever, body-aches (like many
viruses)
 Pus-filled bumps covered the body,
especially face, arms, and legs.
 Bumps were hard and itchy then
burst and spread the pus
 1/3 of survivors went blind
 Most had disfiguring pock-marks
 Smallpox was highly contagious
and caused epidemics
Inoculation or Variolation

Lady Mary Wortley
Montague (1689–
1762).
Lady Montague learned this
process in Turkey
 Introduced variolation to
England in 1721
 This process introduced a
tiny amount of smallpox pus
into a healthy person
 Most people got a very mild
case of smallpox and were
then immune for life
Edward Jenner

English country
doctor 1749-1823
 Noticed that people
who had cowpox
(mostly milkmaids)
never got smallpox
Edward Jenner’s Experiment

Took pus from a cowpox
blister
 Injected it into a young boy
several times
 Then he injected smallpox
into the boy
 The boy got a mild illness &
survived
Jenner’s Original Report
The End of Smallpox

At first people refused to
believe such a result
 It worked well and
became well-accepted
 Better vaccines were later
developed
 Smallpox was eradicated
worldwide in 1979.
Cleanliness for Doctors

Ignaz Semmelweis -1847
 Dramatically reduced
the death rate of new
mothers from
childbed fever by
simply requiring
physicians to clean
their hands before
attending to women
in childbirth
Ignaz Semmelweis

Streptococcus pyogenes (redstained spheres) is responsible
for most cases of severe
puerperal fever.
Other doctors
refused to accept his
theory
 Most still believed in
humours and
miasmas as the
cause of disease
 20 years later,
Pasteur confirmed
his ideas
John Snow
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“Father of Epidemiology”
1849 – published theory
that cholera was spread
by contaminated food or
water
Solved 1854 cholera
epidemic in London
Showed that bacteria
came from contaminated
water in the Broad
Street pump.
Snow’s Scientific Method

Snow created detailed
maps of London
showing where cholera
deaths were occurring
 Showed greatest
infection rate near
Broad Street pump
 Once the pump was
closed, the epidemic
ceased
Louis Pasteur & Germ Theory

French chemist &
professor 1822-1895
 Started studying
fermentation in beer
and wine
 Discovered that
microorganisms
were causing wine to
spoil
Pasteurization

"the germs of microscopic
organisms abound in the surface
of all objects, in the air and in
water."
 He determined that such microorganisms could be killed by
heating liquid to 55 degrees
Celsius (about 130 degrees
Fahrenheit) or higher for short
periods of time.
 This simple process is now
known as pasteurization
 Used today in milk and many
other beverages.
Germ Theory

Pasteur then turned
his attention to other
aspects of
microorganisms
 Theorized that
germs could cause
disease
 Most doctors thought
germs were a result
of disease
Science of Immunology Begins

Showed that certain
diseases could be
prevented by
vaccination
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Rabies
Chicken cholera
Anthrax
Silkworm disease
Pasteur’s Importance
Linking microorganisms with disease,
Pasteur brought about a revolution in
medicine.
 His experiments confirmed the germ
theory.
 Founded the Pasteur Institute in Paris.

Pioneering clinic for the study of infectious
diseases
 Still active today

Joseph Lister

Pasteur's work on the link
between bacteria and
disease came to the
attention of the famous
Edinburgh surgeon Lord
Edward Lister.
 He was concerned with the
number of people who died
after having operations in
hospital – about 46% of all
surgery patients.
Joseph Lister

Lister introduced disinfectant sprays during
operations, these prevented bacteria from
entering a wound.
 Used a fine spray of carbolic acid in the
operating room (annoying to doctors!)
 He also introduced the use of dressings
soaked in carbolic acid and strict hygiene rules
to combat sepsis.
 The sterile methods introduced by Lister,
drastically reduced the number of hospital
deaths.
Antiseptics

British surgeon Joseph
Lister in 1865 proved
the principles of
antisepsis in the
treatment of wounds.
 Lister’s death rate
dropped to 15%
 Few doctors followed
this advice until a less
annoying system was
invented.
Spray contraption
Robert Koch

German scientist
1843-1910
 Development of
Koch's postulates to
prove which germ
caused which
disease.
http://www.abpischools.org.uk/res/coResourceImport/resources04/history/index-2.cfm
Great Microbiologist

First to isolate
anthrax bacteria
 Discovered bacteria
that causes
tuberculosis
 Identified germ that
causes cholera
Koch’s Postulates
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1. The organism should always be found in
sick animals and never in healthy ones;
 2. It must be grown in pure culture;
 3. The cultured organism must make a
healthy animal sick;
 4. It must be re-isolated from the newly sick
animal and re-cultured and still be the same
Koch’s Importance
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Put an end to miasma theory
Created scientific process to identify diseasecausing organisms
Founded bacteriology as a science
Awarded the Nobel Prize for Medicine in 1905
The Robert Koch Award & Medal now honor
great achievements in microbiology
Major Accomplishments

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It was in the late 1800’s
that actual cures were
developed for certain
common infectious
diseases.
The decine in many
diseases was more due
to improvements in
public health and
nutrition than to
medicine.
Major Accomplishments

Invention of X-rays
1895
 Wilhelm Roentgen,
German physicist
 Led to science of
radiology
Other Advancements

1842 -- Crawford W. Long uses ether as a general
anesthetic
 1896 -- First vaccine developed for typhoid fever
 1897 -- First vaccine developed for Bubonic plague
 1899 – Felix Hoffman develops aspirin
 1901 - Karl Landsteiner introduces the system to
classify blood into A, B, AB, and O groups
 1923 -- First vaccine developed for diphtheria.
 1926 -- First vaccine developed for whooping cough
 1927 -- First vaccines developed for tuberculosis &
tetanus.
Alexander Fleming

Scottish doctor
 Discovered penicillin
in 1928
 First antibiotic
 Won Nobel Prize in
Medicine in 1944
Major Advancements

It was not until the 20th century that the
application of the scientific method to
medical research began to produce
multiple important developments in
medicine, with great advances in
pharmacology and surgery.