The History of Medicine

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The History of Medicine
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• In September 1940, four French teenagers stumbled
  upon one of the most famous and astounding
  collection of Paleolithic art in the world the
  cave of Lascaux in the Pyrennes mountains.

• It is the worlds oldest example of medicine in
  art, dating back 15,000 years.

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• The lone human figure among all the animals is
  the man with a head of a bird, who appears to be
  in a confrontation with a bull and beside him is
  a staff.
• It is believed that the
• human figure is some
• sort of shaman
• (medicine man).
• Shaman were in charge of the knowledge of health,
  of life and of death.

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Trepanning

• Primitive man believed that headaches was the
  work of evil spirits who invaded the body of
  unfortunate individuals.
• Letting the spirits out of the skull would bring
  relief. Thus, the surgical procedure
  trepanning was born.

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Imhotep

• Imhotep lived in Egypt 2900 BC
• He seems to have been a successful physician.
• He is one of the first medical men whose name is
  on record and became known as the God of
  Medicine.
• He began using simple surgery instead of just
  magic.

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Ebers papryus oldest collection of medical
writings 1600 BC

• covered 200 diseases
• extracted medicine from plants
• knew position of vital organs
• circulation of blood

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The Two Great Names in the History of Greek
MedicineHippocrates and Galen

• Hippocrates - dominated the beginning of
  scientific creativity, lasted more than 700
  years.
• He was the first to attempt to separate the
  practice of medicine from religion and
  superstition.
• Hippocrates taught against such improper conduct.
  He told his students to treat everyone the same.

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The Hippocratic Oath

• A statement describing proper conduct.
• It was a pledge and is a guideline for honorable
  standards of action.
• I will use treatment to help the sick according
  to my ability and judgment, but never with the
  view to injury and wrong doingInto whatsoever
  houses I enter, I will enter to help the sick.

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Galen Described wounds as Windows to the Body

• Galen, the great 2nd century physician and
  anatomist, spent his early medical career as a
  surgeon to the gladiators.
• He employed as many as 20 scribes to write down
  all that he said in during his work.
• He dissected animals in his medical research.
• He thought that infections were caused by clouds
  of poisonous gases.

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More on Galen

• Galen believed that disease resulted from an
  imbalance of the vital fluids, or humors, of the
  body.

• The body has in itself blood, phlegm, yellow
  bile, and black bileWe enjoy the most perfect
  health when these elements are in the right
  proportion.

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Rome Falls in 476A.D.

• As the Roman Empire ended, Europe fell into
• the Dark Ages. Superstition crept back into
• beliefs about medicine, and people were
  taught
• that diseases were punishment from God.

Some saints were almost specialists
St. Hubert for suffering of rabies
St. Dymphna was favored for mental diseases
St. Roch for plague
St. Blaise for throat complaints
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The Middle Ages

• Europe was hit with a terrible epidemic that
  killed millions of people called the plague, or
  Black Death.
• Two deadly forms of the plague.
• pneumonic plague was spread in the air from
  person to person
• bubonic plague was caused by bites from infected
  fleas. The fleas bit rats and then bit humans
  causing the disease to spread quickly in dirty
  cities.

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The Arab Influence

• Much of what was learned from the Greeks and
  Romans was transferred to the new Islamic
  regions of Northern Africa, the Middle East and
  Spain.
• Medical schools and hospitals were built to
  support the work of Arabic doctors who further
  explored medicine as a science.
• Avicenna(980-1037 A.D.), the prince of
  physicians, is noted for his Canon of Medicine.

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Avicenna(980-1037 A.D.) and the Canon of Medicine
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The Development of University Medicine

• First occurred in northern Italy, in the wealthy
  towns of Bologna and Padua, then in France and in
  England.
• Germany lagged behind, but by 1400 AD, many areas
  of Western Europe had their own institutions of
  higher learning.

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Leonardo Da Vinci (1452 to 1519)

• Artist in the Renaissance period interested in
  the human form, so he studied anatomy.
• Da Vinci made hundreds of anatomically
  correct drawings.
• He dissected bodies in secret.

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Andreas Versalius (1514-1564)

• Was the first master of human anatomy.
• His careful studies provided doctors with
  accurate information.
• Versalius did not accept the teachings of Galen
  without experimenting on his own.
• Versalius kept a copy of Galens books on hand
  and made changes in them. He found over 200
  mistakes in the ancient book!

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The Fabric of the Human Body

• Varesalius was just 28 when he published his
  book.
• It was published in 1543, contained 663 pages and
  300 illustrations.
• Versalius spent his personal fortune and all his
  enthusiasm on it.
• The publication of Fabric marked a turning point
  in the history of medicine.

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The Origins of Modern Surgery

• Professors in medical schools seldom performed
  surgery.
• They did not think that it was proper for a
  professional man to do such work.
• Surgeon is from a French word meaning one who
  works with his hands.
• In the Europe of the 1500s, barbers, not
  doctors, performed minor operations, pulled
  teeth, and treated cuts.
• Barbers who gained skill in closing wounds were
  called barber-surgeons.

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Ambroise Pare (1510-1590)

• Pare used ointments and silk thread to repair
  injuries in place of burning oil and hot pokers.
• Pare did not have a formal education. He never
  earned a medical degree. Yet he became Frances
  most skilled surgeon. In 1562, he was given the
  dignified title, First Surgeon of the King.

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Shortage of Cadavers

• No one donated bodies to science churchgoers
  believed in rising from grave, so dissection
  spoiled chances of resurrection.
• Became a tradition to rely on executed prisoners,
  even up to 18th and 19th centuries.
• 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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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.
• By 1828 in London, body snatchers provided
  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 the smell of decomposition.
• 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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Medicine in the 17th Century

• The greatest advance of the 17th century was the
  discovery of the circulation of blood.
• Credit goes to the Englishman William
  Harvey(1578-1657).
• Harvey dissected his own freshly dead family
  members (his father and sister) before burial.

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Antoni van Leeuwenhoek (1632-1723)

• Developed the most powerful microscopes of his
  day.
• He discovered one-celled protozoans and bacteria.
• His work eventually led to the discovery of the
  causes of diseases, such as the Black Death.

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Edward Jenner (1749-1823)

• Jenner was ridiculed and resented by his fellow
  doctors. He unknowingly created the 1st vaccine.
• This cartoon makes fun of Jenners inoculations.

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The Birth of Anesthesia
A 19th century physician administering chloroform
prior to surgery. Ether was one of the earliest
anesthetics to be used but it was difficult to
administer as it usually made the patients choke.
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Sir Humphry Davy (1778-1829)

• Humphry Davy discovered laughing gas (nitrous
  oxide) which has made going to the dentist much
  less painful.

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James Lind (1716-1794)

• In James Linds experiment, those that ate citrus
  fruit stayed healthier.
• Captain Cook took Linds advice and his crew
  stayed health for a four-year journey.
• The British Navy finally ordered sailors to drink
  lime juice.
• Lind had found the cure for scurvyvitamin C.

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Rene-Theophile-Hyacinthe Laennec and the
stethoscope 1821
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Ignaz Phillipp Semmelweiss

• Discovered that the doctors were spreading
  childbed fever. More women were dying under the
  care of doctors than midwives.
• He proved that doctors were carrying the disease
  from corpses to their patients.
• He proved that cleanliness could prevent childbed
  fever.

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Joseph Lister (1827-1912) and Infection

• Discovered that carbolic acid prevented infection
  on compound infections.
• By insisting that everything be kept clean and
  disinfected, he lowered the death rate in his
  surgeries.
• He discovered it was not the presence of acid but
  the absence of germs that mattered in surgery.

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Louis Pasteur(1822-1895)

• Louis Pasteur argued that diseases were caused by
  germs and so effectively established bacteriology
  as a science.

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What Was It Like to be a Medical Student 140
years ago?

• No one worried about admissions, for entrance
  requirements were lower than they are for a good
  high school student.
• Instruction was superficial and brief.
• The terms lasted only 16 weeks, and after the
  second term the M.D. was automatically given,
  regardless of a students academic performance

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What Was It Like to be a Medical Student 140
years ago?

• Teaching was by lecture alone.
• Thus, students were spared the hassle of
  attending labs, clinics and hospital wards.
• It was not uncommon for students to graduate
  without ever having touched a patient.

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The Birth of Johns Hopkins University and
Medical School

• At Hopkins, a new era of American medicine was
  born, with rigorous admission requirements and a
  quality of training that set new standards in the
  United States and compared favorably with the
  European institutions.

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At Johns Hopkins University and Medical School

• Candidates for admission to Hopkins were required
  to have a four-year college degree, including
  two years of premedical training in biology,
  chemistry and physics, and a reading knowledge of
  French and German.

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Evolution of Disease

• In the 19th century, diarrheal diseases were the
  biggest killer of children, and tuberculosis was
  the leading cause of adult mortality.
• In the 20th and 21st centuries, diseases are now
  the leading cause of disease and death in adults.

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Technology Reigns Supreme

• Wilhelm Roentgen invented the x-ray machine
• Because of its ability to see inside the body,
  x-ray photography is one of the most important
  medical discoveries.

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The Birth of the EKG

• Sir Thomas Lewis mastered the technology of the
  electrocardiogram in 1912.

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Andrew W. Doc Fleischer

• In 1921, he developed the mercurial
  sphygmomanometer that measured blood pressure
  away of assessing the health condition of the
  heart

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The Beginning of Drugs
Dr. Gerhard Domagk(1895-1964) discovered sulfa
drugs. This drug became world famous when Dr.
Perrin H. Long used sulfa drugs to treat Franklin
Roosevelt Jr. Sulfa was called a wonder drug
because it killed bacteria but did not hurt the
cells of human tissue.
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Mold Becomes A Medical Ally in the Battle
Against Bacteria
Alexander Fleming(1881-1955) discovered
penicillin which killed staphylococcal bacteria.
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Technology Transform the Medical Arena

• Dr. Richard Drew(1904-1950) established the use
  of transfusion and blood banks.

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Technology Transform the Medical Arena
Dr. Christian Barnard(1922-2001) performed the
first heart transplant in 1967.
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Technology Transform the Medical Arena
Dr. William Kolff developed an artificial kidney
machine.
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Technology Transform the Medical Arena
James Watson and Francis Crick discovered DNA in
1954.
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Technology and the 20th/21st Century

• Antiseptics
• Antibiotics
• Antiepileptics
• Antipsychotics
• Chemotherapies
• Vaccines
• Aspirin
• Blood Transfusions and Blood Banks

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Technology and the 20th/21st Century

• Electron Microscope
• CT Scans
• MRI Scans
• Pet Scans
• The Human Genome
• Genetic Testing
• Genetic Enzyme Replacements Therapy

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Technology and the 20th/21st Century

• Artificial Kidney MachineDialysisKidney
  Transplants
• Coronary Artery Bypass
• Angioplasty
• Total Hip and Knee Replacements
• Neurosurgery
• Lasik Surgery
• Organ TransplantsHeart, Kidney, Lung, Liver,
  Pancreas, etc.