Anatomy and Medicine

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Anatomy and Medicine
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Discoveries in Biology and Anatomy
Just as astronomers moved away from the works of
ancient Greeks, other scientists used the
scientific method to acquire new knowledge and
make great discoveries in the fields of Biology
and Anatomy.
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• Antony van Leeuwenhoek
• Dutch scientist, 1600s
• Used interest in developing magnifying lens to
  invent microscope
• First to describe appearance of bacteria, red
  blood cells, yeast, other microorganisms

• Robert Hooke
• English physician, inventor
• Used early microscope to describe appearance of
  plants at microscopic level
• Credited with creating the term cell

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Scientific Revolution Paracelsus Philippus
Aureolus Theophrastus Bombastus von Hohenheim

• 1493 to 1541 AD
• Swiss
• One of the first to challenge the ideas of Galen
• Said that people could only learn by experience
• So when he became a teacher, he burned the books
  of Galen

• He was the first to realize that poisoning could
  causes diseases like breathing metal vapors
• He was the first to think of chemicals as
  medicine
• Unfortunately his favorite medicine was mercury,
  so he actually poisoned the people he was trying
  to heal

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Paracelsus (1493-1541)

• Rejected the work of both Aristotle and Galen
• Replace the traditional system with a new
  chemical philosophy based upon a new
  understanding of nature derived from fresh
  observation experiment
• Believed disease was caused by chemical imbalance
  in the organs which could be solved by chemical
  remedies
• Although chemical remedies had been used,
  Paracelsus and his followers differed by giving
  careful attention to the proper dosages of their
  chemically prepared metals materials

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Paracelsus

• Paracelsus (11 November or 17 December 1493 in
  Einsiedeln, Switzerland - 24 September 1541) was
  an alchemist, physician, astrologer, and general
  occultist. Born Phillip von Hohenheim, he later
  took up the name Philippus Theophrastus Aureolus
  Bombastus von Hohenheim, and still later took the
  title Paracelsus, meaning "equal to or greater
  than Celsus", a Roman physician from the first
  century BC.

Bier is a really divine medicine. Paracelsus
(1493 1541).
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Paracelcus
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Paracelsus Genius with bad press agent

• Attended Universities of Heidelberg, Freiburg,
  Ingolstadt, Cologne, Tübingen, Vienna, Erfurt and
  Ferrara, left without degree, drank to excess,
  and wandered over most of known world, took part
  in the Peasants War (1525)
• Practiced medicine in Spain, Portugal, England,
  Denmark, Poland, Prussia, Hungary, Arabia, Egypt,
  Turkey, probably other places as well, frequently
  aggravating established practitioners.
• Investigated the use of opium, coined the term
  laudanum for tincture of opium, an opium extract
  containing 40-80 ethanol.
• Pioneered use of chemicals, elements in medicine
  (Zn, Hg, Au)
• Introduced draining to replace amputation or
  cauterization
• Introduced dose-response concept
• Recognized the first industrial disease in miners

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Paracelsus

• Alle Ding' sind Gift und nichts ohn' Gift
  allein die Dosis macht, dass ein Ding kein Gift
  ist. ("All things are poison and nothing is
  without poison, only the dose permits something
  not to be poisonous.)

Paracelsus crater photographed by Apollo 15. An
83 km crater on the far side of the moon.
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Paracelsus a few weird facts

• Paracelsus a 1943 film by Georg Wilhelm Pabst,
  essentially a Nazi propaganda film.
• Professor Bulwer in 1922 Murnau film 'Nosferatu'
  is a follower of Paracelsus
• Paracelsus (lengthy dramatic poem by Robert
  Browning)
• Paracelsus is mentioned as an inspiration to
  Victor Frankenstein, the main character in Mary
  Shelley's Frankenstein.
• Paracelsus is one of the people featured on a
  Chocolate Frog card in Harry Potter. A bust of
  Paracelsus is in the castle at Hogwarts, near
  Gryffindor, between the entrance to the
  Gryffindor common room and the Owlry, as
  mentioned in Order of the Phoenix

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Andreas Vesalius (1514 to 1564)

• Barber surgeon (combination barber, dentist,
  doctor).
• Got special permission from the Pope to dissect
  criminals.
• First scientist to understand human anatomy.
• Wrote the first accurate book on human anatomy
  Fabrica.

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Andreas Vesalius 1514 - 1564

• Belgian
• Proved Galen wrong by stealing bodies and
  dissecting them
• Grave-robbing for corpses became common

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Shortage of cadavers

• In England and Scotland, medical schools began to
  open.
• No one donated bodies to science churchgoers
  believed in literal rising from grave, so
  dissection spoiled chances of resurrection.
• Became a tradition to rely on executed prisoners,
  even up to 18th and 19th centuries.

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Serious Crimes

• The added punishment of being dissected after
  death was considered another deterrent from
  crime.
• Ex. Steal a pig you were hung
• Kill a person you were hung and
  dissected
• Anatomists were often associated with
  executioners.

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Need for Body Parts

• Because they needed body parts, anatomists at
  medical school bought odd things.
• A man could sell the leg of his son if it had to
  be amputated

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Grave Robbing

• Some medical students raided grave yards some
  professors did also.
• In certain Scottish schools in 1700s, you could
  trade a corpse for your tuition.

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Resurrectionists

• By 1828 in London, body snatchers (or
  resurrectionists) provided the medical schools
  with corpses.
• Not a crime a dead body could not be owned or
  stolen.
• (Anatomy studies were only conducted from October
  to May to avoid stench of decomposition.)

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Reactions to Grave Robbing

• Wealthy people chose to be buried in iron cages,
  some covered in concrete.
• Also churches built dead houses which were
  locked and guarded.

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The Body in the Scientific Revolution

• A New Doctor A New Body
• Andreas Vesalius (1514-1564)
• Dutch-born Physician
• Taught medicine at University of Padua (Italy)
• 1543 Publishes new textbook on anatomy, On the
  Workings of the Human Body
• Same year Copernicus publishes On the
  Revolutions of the Heavenly Spheres
• Textbook attacks many of the established theories
  of Aristotle and Galen on the basis of Vesaliuss
  own dissections.
• Book is illustrated with detailed printed
  images.

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Andreas Vesalius(1514-64)

• Belgian anatomist and physician whose work help
  correct many of the misconceptions of the time
• Dissected actual human bodies, in a belief that
  Galens work was inaccurate because it was based
  on animals
• Published his finding in 1543 in On The Structure
  of the Human Body
• wrote De Humani Corporis Fabrica (On the
  Structure of the Human Body) seven volumes on
  the structure of the human body which he
  illustrated himself
• These were the most accurate and comprehensive
  anatomical texts at the time
• Appointed as physician to the Holy Roman Emperor
  Charles V.

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Vesalius

• Images from Vesaliuss
• book

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This anonymous German print shows a thigh wound
being cauterized. Above the action we can see the
various medical instruments used for different
types of wounds
Source Hans von Gersdorff, Feldbuch der
Wundartzey (sSrasbourg, 1540).
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Andreas Vesalius

• The new anatomy of the sixteenth century was
  based on the work of Andreas Vesalius.
• He reported his results from dissecting human
  bodies as a professor of surgery at the
  University of Padua, presenting an accurate view
  of the individual organs and general structure of
  the human body.
• He erroneously believed that the body had two
  kinds of blood

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Andreas Vesalius (1514-1564)

• His studies corrected Galen in relation to
  anatomy - believed practical research as the best
  way for understanding human anatomy
• 1543 published On the Fabric of the Human Body
• Based upon his lectures at Padua
• Deviated from traditional practice by personally
  dissecting a body to illustrate what he was
  discussing
• Through his hands-on approach, Vesalius
  rectified some of Galens more glaring errors
• For example, the belief that the great blood
  vessels originated from the liver, but he still
  clung to Galens belief about the ebb flow of
  two kinds of blood in the veins and arteries

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The Body in the Scientific Revolution
An anatomy lesson from the title page of
Vesaliuss book.
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Giovanni Morgagni 1682 1771AD

• Italian
• Studied the effects of disease on the bodys
  insides
• Published a big book listing the effects of
  diseases on the bodys organs
• Proved the ancient doctors wrong and that death
  was caused by damage to organs and not by humours

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Morgagni

• Giovanni Battista Morgagni was born at Forli,
  Italy, on February 20, 1682 he died at Padua on
  December 6, 1771.
• He was educated at the University of Bologna,
  receiving a degree in philosophy and medicine
  there in 1701.
• He studied under A. M. Valsalva (1666-1723),
  whom he venerated for the rest of his lifewhen
  Valsalva left Bologna for Parma, Morgagni
  succeeded him as demonstrator in anatomy.
• He was made President of the Accademia at the
  age of 24,and he gained a reputation for his
  dislike of speculation as opposed to accurate
  observation.
• In 1706 he began publication of a series of
  anatomical works, which led to his becoming known
  in Europe as an anatomist.

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Morgagni

• In 1712, he left Bologna for Padua, where, except
  for a short unsuccessful attempt at practicing
  medicine in Forli, he was to spend the rest of
  his life as Professor of Anatomy.
• Shortly after settling in Padua, he married Paola
  Vergieri of Forli,with whom he had 15 children.
• His eight daughters all entered convents, which
  is said to have caused him considerable sadness
  near the end of his life.
• After his wife died in 1770, the aged widower did
  not have much desire to continue living.
• Ironically, his life, which had contributed so
  much to the understanding of the pathological
  basis of stroke, came to an end on December 6,
  1771, when he (like his teacher Valsalva before
  him) succumbed to the condition.

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Morgagni

• Morgagni taught at the renowned University of
  Padua for 56 years (1715 to 1771).
• His greatest professional achievement came in
  1761 when, at the age of 79, he published his
  masterpiece, De Sedibus et Causis Morborum
  (translated into English as On the Sites and
  Causes of Disease).
• The book, consisting of five volumes of letters
  (for a total of 70 letters), described Morgagni's
  observations of some 700 autopsies, and it
  included his correlationsbetween clinical
  symptoms and postmortem findings (lesions) for
  each of the cases studied.
• (Morgagni expressed his debt in De Sedibus to
  previouslypublished work by Theophile Bonet,
  1629-1689, although the latter's work,
  Sepulcretum, translated in English as Graves), is
  generally considered to be a poorly organized and
  inconclusive summary of autopsy findings up to
  1679.)

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Morgagni

• It was Morgagni's study that introduced the
  clinical principles and practices that are still
  used today.
• Morgagni also drew on the ideas of Hippocrates,
  whose methods of observation and reasoning formed
  the basis for many of Morgagni's own ideas.
• For example, whereas Hippocrates made systematic
  differentiations of diseases based on observed
  external symptoms,
• Morgagni went farther and related the external
  expressions of the particular disease to the
  internal conditions within the body.
• Morgagni thus focused on theinternal damage
  within the body that gives rise to disease.
• In clinical practice, Morgagni carefully noted
  the symptoms during the course of a patient's
  illness, and then attempted to identify the
  organic or pathological causes off that disease
  during the postmortem examination.

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Morgagni

• Because Morgagni's studies were so extensive, it
  became possible for him to predict or visualize
  internal conditions based on symptomatic
  observations.
• Morgagni's work was also instrumental in
  debunking the ancient humoral theory of disease,
  according to which there is one cause for all
  diseases.
• Morgagni'sDe Sedibus clearly identifies the
  pathologies of a number of diseases, including
  hepatic cirrhosis (acute yellow atrophy),
  cerebral gummata, cardiac valvular lesions, renal
  tuberculosis, pneumonic solidification of the
  lungs, and syphilitic lesions (aneurysms) of the
  brain.
• Morgagni also proved, through many autopsies,
  that cerebral lesion in stroke occurs on the
  opposite side from the resulting paralysis.
• Morgagni has bequeathed his name to many
  anatomical part's and conditions of the human
  body, e.g., the Morgagnian cataract.

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Morgagni

• Morgagni was held in high esteem by his
  colleagues and students he was the friend of
  many Venetian senators and several popes.
• His international reputation was attested to by
  his election to the Academia Naturae
  Curiosorum(1708) the Academy of Science, Paris
  (1731) the Imperial Academy of St. Petersburg
  (1735) and the Berlin Academy (1754).
• Morgagni was largely responsible during the more
  than 50 years he spent as a professor at the
  University of Padua for that university's
  foremost reputation in Europe during the 18th
  century.
• Besides being recognized today as one of the
  leading figures in 18th-century medicine, he is
  considered the father of morbid anatomy, and a
  founder of modern anatomy and pathology.

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William Harvey

• English Physician
• Also disproved many of Galens hypotheses
• discovered the circulation of blood, the
  function of valves in the heart
• Worked with small animals and with humans
• Published his observations in Exercitatio
  Anatornica de Moto Cordis et Sanguinis in
  Animalibus aka De Moto Cordis
• Discovered the lack of circulation to the lungs
  in the fetal stage and therefore that lungs were
  collapsed and inactive in this phase
• Largely influenced by the mechanical philosophy
  in his work with the flow of blood
• First doctor to use quantitative and
  observational methods in his experiments
• Very skeptical of spontaneous generation
  proposed that all animals originated from an egg

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Harvey

• The heart is the household divinity which,
  discharging its function, nourishes, cherishes,
  quickens the whole body, and is indeed the
  foundation of life, the source of all action -
  Harvey

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William Harvey

• He also showed that the same blood runs through
  veins and arteries and that the blood makes a
  complete circuit through the body.
• Harveys work was based on close observation and
  experiment.

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William Harvey and the Human Blood System

• It was only with the discoveries of William
  Harvey that this belief was corrected
• Through his research observations, Harvey
  demonstrated that the heart, not the liver, was
  the beginning point of circulation of blood in
  the body, that the same blood flows in both veins
  and arteries, and most important, blood makes a
  complete circuit as it passes through the body

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The Body in the Scientific Revolution
From Observation to Experimentation William
Harveys experiments to demonstrate the
circulation of blood (1628). This illustrates
an experiment to show that blood in the veins
only flows toward the heart because of valves
that stop blood from flowing back away from it.
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• LADY MARY WORTLEY MONTAGU (1689-1762)
•  A famous poet
•  Herself a smallpox victim
• In December 1715 smallpox ruined her good looks
  left her without eyelashes and with deeply
  pitted skin
• Lady Mary was the wife of the British Ambassador
  to Turkey (1716-1718). Learned how to variolate
  persons in Turkey and variolated her son in 1717
  and her daughter in England in 1721.
•  
•  Although there was much resistance to the
  acceptance of this vaccination method and Lady
  Mary was heavily criticized by the higher society
  in England, the permission to vaccinate the
  children of the Prince and Princess of Wales in
  1772 dramatically promoted the adaptation of this
  method in England and in other part of Europe.
•  
•   By the second half of the 18th century, Europe
  was being ravaged by smallpox epidemics.
• By this time, in rural England, it was noticed
  that women who milked cows were frequently spared
  clinical smallpox disease and several
  undocumented accounts suggest that the connection
  was made between contact with cowpox virus and
  protection from smallpox.

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Edward Jenner 1749 - 1823

• Developed the first vaccination in 1796
• It was to treat smallpox.
• His vaccine used smallpox pus from the less
  deadly disease cowpox.
• by 1800 most were using it. Jenner was awarded
  30 000 by Parliament to enable him to continue
  carrying out his tests.
• Deaths from smallpox plummeted and vaccination
  spread through Europe and North America.

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• Jenner worked in a rural community and most of
  his patients were farmers or worked on farms with
  cattle.
• In the 18th century smallpox was a very common
  disease and was a major cause of death.
• The main treatment was by a method which had
  brought success to a Dutch physiologist Jan
  Ingenhaus and was brought to England in 1721 from
  Turkey by Lady Mary Wortly Montague.
• This method involved inoculating healthy people
  with substances from the pustules of those who
  had a mild case of the disease, but this often
  had fatal results
• In 1788 an epidemic of smallpox hit
  Gloucestershire and during this outbreak Jenner
  observed that those of his patients who worked
  with cattle and had come in contact with the much
  milder disease called cowpox never came down with
  smallpox.
• Jenner needed a way of showing that his theory
  actually worked.
• Jenner was given the opportunity on the 14 May
  1796, when a young milkmaid called Sarah Nelmes
  came to see him with sores on her hands like
  blisters.
• Jenner identified that she had caught cowpox from
  the cows she handled each day.

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• Jenner now had the opportunity to obtain the
  material try out his theories. He carefully
  extracted some liquid from her sores and then
  took some liquid from the sores of a patient with
  mild smallpox.
• Jenner believed that if he could inject someone
  with cowpox, the germs from the cowpox would make
  the body able to defend itself against the
  dangerous smallpox germs which he would inject
  later.
• Jenner approached a local farmer called Phipps
  and asked him if he could inoculate his son James
  against smallpox.

• He explained to the farmer that if his theory was
  correct, James would never contract smallpox.
  Surprisingly, the farmer agreed.
• Jenner made two small cuts on James's left arm.
• He then poured the liquid from Sarah's cowpox
  sores into the open wounds which he bandaged.
• James went down with cowpox but was not very ill.
• Six weeks later when James had recovered, Jenner
  vaccinated him again, this time with the smallpox
  virus.
• This was an extremely dangerous experiment. If
  James lived Jenner would have found a way of
  preventing smallpox.
• If James developed smallpox and died he would be
  a murderer.

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• Jenner wrote a paper in 1798 explaining his
  experiments, and wanted to report his first case
  study in the Transactions of the Royal Society
  of London His study was rejected.
• He then went to London to demonstrate his theory.
  
• No one would submit to his vaccination.
  Discouraged, Jenner returned to Berkeley.
•  
•        In 1801, Jenner published The Origin of
  the Vaccine Inoculation describing how cowpox
  virus was prepared and used to protect
  ("vaccinate") healthy persons against smallpox.
• Material used as the vaccine was prepared from
  the arm of a vaccinated child, thus the
  distribution of vaccine involved the
  transportation of vaccinated children all over
  Europe.
• Orphans were often used for this purpose.
• Eventually, material from infected cows was used
  directly as vaccine. By 1840, the British
  government had banned other preventive treatments
  against smallpox.
•  
• Vaccination, the word Jenner invented for his
  treatment (from the Latin, vacca, a cow), was
  adopted by Louis Pasteur for immunization against
  any disease.

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Florence Nightingale

• Florence Nightingale (1820 - 1910)
• In 1854 Florence Nightingale took 38 women to
  Turkey to nurse wounded and sick British soldiers
  in the Crimean War.
• This was the first time the government had
  allowed women to do this.
• She suffered from PTSD (Post Traumatic Stress
  Disorder) for the rest of her life.
• She became not only the first modern war nurse
  and nurse commander but its first documented
  psychological casualty.
• She publishes a small booklet titled "Notes on
  Nursing." It is very popular.
• It is expanded and published again in 1860 and in
  1861 with special section on taking care of
  babies.
• This book sold millions all over the world the
  only money she ever earned in her life was her
  royalties from this book.
• This book establishes the foundation for the
  nursing profession

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1854 heard of Crimean War (between Britain
Russia)
Men happy to have cleaner hospitals and good food.
Florence cared for the soldiers by walking round
at night and checking they were alright
The Lady with the Lamp
Bad conditions during war for injured (hurt)
soldiers
Most soldiers sent to Turkey
So, soldiers called Florence...
Florence got supplies and a group of nurses to go
and help
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Florence Nightingale

• In 1854 the Crimean War broke out England was
  at war with Russia
• People in England heard that soldiers in
  hospitals were poorly treated.
• Florence was invited to take a group of 38 female
  nurses to work in hospitals in the Crimea.

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Florence became famous when war ended in 1856
Queen Victoria wanted to meet her.
1860 Florence set up the Nightingale School of
Nursing in London
Lots of people wanted her help and advice
She died in 1910
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Florence Nightingale
Florence is remembered today as the person
responsible for improving conditions in hospitals
and making nursing an acceptable job
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Why was Florence called The Lady with the Lamp?
because Florence cared for the soldiers by
walking round at night and checking they were
alright. She gave them good food to eat.
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The Men of Biology

• Louis Pasteur
• Confirmed the theory of diseases
• Introduced the process of pasteurization
• First to create a vaccine against rabies
• Disproved the theory of spontaneous generation

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Medical Breakthroughs

• Preventing Disease
• Breakthroughs in late 1800s as result of
  scientific advances earlier in century
• Fundamental concepts of disease, medical care,
  sanitation revealed
• Mysteries of what caused diseases began to be
  solved

• Microbes and Disease
• Louis Pasteur showed link between the two, 1870
• Disproved spontaneous generation concept of
  bacteria from nonliving matter
• Showed bacteria always present though unseen, can
  reproduce

• Fermentation
• Bacteria in the air causes grape juice to turn to
  wine, milk to sour
• Heating liquids, foods can kill bacteria, prevent
  fermentation
• Process became known as pasteurization, makes
  foods germ-free

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Medical Breakthroughs

• Anthrax
• Deadly disease a constant threat to people,
  livestock
• Pasteur sought to prevent anthrax
• Injected animals with vaccine containing weakened
  anthrax germs

• Antibodies
• Vaccine worked because body builds antibodies
• Antibodies fight weakened germs when they enter
  body

• Rabies
• Pasteurs next goal
• Developed vaccine, 1885
• Saved life of young boy bitten by rabid dog

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Louis Pasteur

• Louis Pasteur (1822 - 1881)
• He proved that air contains living organisms
  (bacteria)
• That these microbes can produce putrefaction
• That these microbes could be killed by the
  heating of the liquid they were in -
  sterilization by high temperature -gt
  Pasteurization
• He proved that the old idea that diseases start
  out of nothing (spontaneous generation) was
  inaccurate and that micro-organisms cause
  disease.
• Demonstrates the presence of bacteria in air and
  explains how disease can be transmitted by
  airborne route.

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Louis Pasteur 1822 1895AD

• French
• Developed the theory that the bacteria we call
  germs caused disease and not bad smells
• Found out how to preserve wine by heating it to
  kill germs---pasteurization

• Found the causes of anthrax and cholera
• Discovered how to weaken germs by heating them up
  until they are damaged and can no longer multiply
• He used this to develop vaccinations for rabies

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Louis Pasteur (1822-1895)     Stereochemistist
molecular asymmetry   Fermentation and silk
worker disease, Pasteurisation , Germ Theory of
disease Thus started microbilogy Attenuated
vaccines for cholera, anthrax, and rabies On
July 4, 1886, 9-year-old Joseph Meister was
bitten repeatedly by a rabid dog. Pasteur treated
him with his attenuated rabies vaccine two days
later. Meister survived. Joseph Meister later
become a gatekeeper for the Pasteur Institute.
In 1940, when he was ordered by the German
occupiers to open Pasteur's crypt, Joseph Meister
refused and committed suicide!     Another way
to look at Louis Pasteur   THE DREAM AND LIE OF
LOUIS PASTEUR by R. B. Pearson   http//whale.to/a
/b/pearson.html
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Pasteurs contributions        First,
championed changes in hospital practices to
minimize the spread of disease by
microbes.        Second, discovered that
weakened forms of a microbe could be used to
immunize against more virulent forms of the
microbe.        Third, found that rabies was
transmitted by agents so small they could not be
seen under a microscope, thus revealing the world
of viruses. As a result he developed techniques
to vaccinate dogs against rabies, and to treat
humans bitten by rabid dogs.        And
fourth, developed "pasteurization," a process by
which harmful microbes in perishable food
products are destroyed by heat, without
destroying the food.
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Pasteur and the Defeat of Spontaneous Generation

• Louis Pasteur (1822-1895)
• Discovered that alcoholic fermentation was a
  biologically mediated process (originally thought
  to be purely chemical)
• Disproved theory of spontaneous generation
• Led to the development of methods for controlling
  the growth of microorganisms
• Developed vaccines for anthrax, fowl cholera, and
  rabies

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The Defeat of Spontaneous Generation Pasteurs
Experiment
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What Causes Fermentation?

• Spoiled wine threatening livelihood of vintners,
  so they funded research into how to promote
  production of alcohol, but prevent spoilage by
  acid during fermentation
• Some believed air caused fermentation reactions,
  while others insisted living organisms caused
  fermentation
• This debate also linked to debate over
  spontaneous generation

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Pasteurs Experiments on Pasteurization
Figure 1.14
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Pasteur Strikes it Lucky

• Impressed by Jenners work on Smallpox
• But Jenner and Pasteur did not understand how
  vaccination worked
• Trial and error
• Chicken Cholera, 1879
• Common disease affecting farmers livestock
• Pasteur experiments with injecting weaker forms
  of disease into chickens
• Little success
• His team goes home for the summer
• On return, they accidentally use a strain that
  had been left uncovered for the whole summer
• It works!
• Exposure to the air had weakened the germs
• Chance only favours the mind which is prepared
  

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Medical Breakthroughs

• Treatment of Infections
• Many surgical patients died from infections
• English surgeon Joseph Lister, 1860s
• Began cleaning wounds and equipment with
  antiseptic containing carbolic acid
• Reduced post-surgery deaths in one hospital ward
  from 45 to 15 percent

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Joseph Lister

• Joseph Lister (1827 - 1912)
• A Professor of Surgery at Glasgow University, he
  was very aware that many people survived the
  trauma of an operation but died afterwards of
  what was known as ward fever
• Work on ward cleanliness and the link between
  germs and good post-operative health had already
  been studied by a Hungarian doctor called Ignaz
  Semmelweiss.
• He argued that if a doctor went from one patient
  to another after doing surgery, that doctor would
  pass on to the next visited patient a potentially
  life threatening disease.
• He insisted that those doctors who worked for him
  wash their hands in calcium chloride after an
  operation and before visiting a new patient -gt
  Introduces antiseptic surgery
• At the time, it was not known that the infections
  were caused by bacteria

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Early needs and success for disinfection (Early
1800s) a historic story

• almost half of post-operative patients died of
  sepsis (then called hospital disease). A common
  report by surgeons was operation successful but
  patient died.
• By mid-1800s,
• A hypothesis ? exposing moist body tissue to
  oxygen ? sepsis ? best prevention keeping air
  away from wounds by means of plasters, collodion
  or resins.
• Having tried methods to encourage clean healing
  with no success, surgeon Joseph Lister discarded
  the concept of direct infection by bad air but
  postulated that sepsis might be caused by a
  'pollen-like dust, although he did not know yet
  the dust was living microbes.
• When Louis Pasteur suggested the presence of
  living organisms in the air, Lister made the
  connection with wound sepsis the microbes in the
  air were likely causing the sepsis and should be
  destroyed before they entered the wound.
• Lister had previously heard that 'carbolic acid'
  was used to treat sewage, and that fields treated
  with the affluent were freed of a parasite
  causing disease in cattle. He then began to clean
  wounds and dress them with carbolic acid..

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Biography

• A doctor who was Born in Prussia in 1843
• Interested in Pasteurs Germ Theory
• He received a Microscope as a present in 1873
• Franco Prussian Rivalry
• Franco-Prussian War 1870/1
• German Government gave Koch money to set up a
  research institute to rival Pasteur

Read Dialogue page 130
76
Robert Koch

• In the late 19th century two of the most
  dangerous killer diseases were cholera and
  tuberculosis.
• Cholera was nicknamed 'King Cholera' because no
  one seemed to be able to cure it.
• Tuberculosis was known as the 'White Death'
  because sufferers vomited up white matter as
  their lungs disintegrated.
• The man who made a breakthrough in the fight
  against these diseases was Robert Koch.

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Who Was Robert Koch?

• Koch was a German scientist, born in Hanover in
  1843.
• Koch read Louis Pasteur's work and in 1872 began
  research into the microbes affecting diseased
  animals and people.

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What made Koch famous

• In 1878 Koch discovered that microbes cause
  wounds to go septic, but his big breakthrough
  came when he decided to stain microbes with dye,
  enabling him to photograph them under a
  microscope.
• Using this method he was able to study them more
  effectively and prove that every disease was
  caused by a different germs.
• He identified the microbes that caused
  tuberculosis in 1882 and cholera in 1883.

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How did he do this?

• Koch's discoveries were the result of careful
  research and observation using the microscope,
  photography and dyes.
• As a result of his work, the German government
  also set up an 'Institute of Infectious Diseases'
  in Berlin in 1891 for medical research and
  development.
• These developments set the pattern for the
  future.
• In the 20th century medical research has
  increasingly involved teams of researchers
  supported by large public or private funds.

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Robert Koch (1843-1910)          German
physician also started to work on Anthrax in
1870's. Identified the spore stage. First time
the causative agent of an infectious disease was
identified.          Koch's postulates
conditions that must be satisfied before
accepting that particular bacteria cause
particular diseases.          Discovered the
tubercle bacillus and tuberculin. Detailed
tuberculin skin test (DTH). Awarded 1905
Nobel Prize.
 

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Isolating the Germs that caused Anthrax

• Explain how 1 Sheep and 20 generations of mice
  allowed Koch to prove that a particular germ
  caused Anthrax. Explain why he succeeded?

82
Germ Cultures

• Kochs isolation technique pioneered the use of
  culture plates
• He extracted the blood from an infected animal
• He found that if he injected an animal with the
  infected blood it would catch the disease much
  quicker
• The more times he did this the stronger the
  disease would become
• Eventually, this germ could be extracted and be
  encouraged to breed a pure form in a glass
  culture plate.

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The Floodgates open

• Using Kochs methods, other scientists were able
  to isolate and identify the germs that caused
  particular diseases
• List the causes of diseases discovered in the
  1880s and 1890s
• However, knowing the cause of these diseases
  still did not help to treat any sick patients,
  yet.

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Robert Koch

• Robert Koch (1843-1910)
• Definitively demonstrated the link between
  microbes and infectious diseases
• Identified causative agents of anthrax and
  tuberculosis
• Developed techniques (solid media) for obtaining
  pure cultures of microbes, some still in
  existence today
• Awarded Nobel Prize for Physiology and Medicine
  in 1905
• Kochs postulates

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Kochs Postulates

1. The microbe must be present in every case of the
   disease but absent from healthy organisms
2. The suspected microbe must be isolated and grown
   in a pure culture
3. The same disease must result when the isolated
   microbe is inoculated into a healthy host
4. The same microbe must be isolated again from the
   diseased host

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Kochs Postulates
87
Kochs Postulates
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Robert Koch

• Robert Koch (1843 - 1910)
• Koch was a German doctor, influenced by Pasteur's
  work. In 1872, he began research into the
  microbes affecting animals and people.
• The first animal disease that Koch investigated
  was anthrax. Koch found out that the anthrax
  microbe produced spores that lived for a long
  time after an animal had died. He also proved
  that these spores could then develop into the
  anthrax germ and could infect other animals.
• Koch also devised a method of proving which germ
  caused an infection Koch Postulates
• He perfected the technique of growing pure
  cultures of germs using a mix of potatoes and
  gelatine. This was a solid enough substance to
  allow for the germs to be studied better.
• In 1882 he identified the bacteria causing
  tuberculosis (TB).
• In 1883, he identified the bacteria causing
  cholera.
• By 1900, twenty-one germs that caused diseases
  had been identified in just 21 years

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Results of his Research

• The scientific evidence of microbes helped
  reformers in public health prove that pollution
  spread disease.
• It meant certain kinds of action could be taken
  to prevent certain types of disease, since
  cholera was carried in water, for example, its
  spread could be prevented with clean water
  supplies.

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Long Term Importance

• Koch was responsible for establishing the new
  'Science of Modern Bacteriology'.
• By 1900 he and his students had identified 21
  germs causing diseases.
• Koch's assistant, Emil Behring, developed the
  first anti-toxin that could help to destroy the
  poison spread by bacteria in the blood stream.
• Koch's research on bacteria won him the Nobel
  Prize in 1905.

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The Men of Biology

• Sir Alexander Fleming
• - Isolated and discover the antibiotic properties
  of penicillin.