Exam Flashcards
1
Q
How did scientific research in roentgenography shape medicine in the 19/20th centuries? Who was responsible for this progress?
A
- Karl Roentgen discovered x-rays and x-ray photography. He incorporated these into medicine with the first x-rays used in 1896
1
Q
Who was Gerhard Domagk and what was his contribution to medicine?
A
- He investigated azo dyes as antibacterials. - Found red dye, Prontosil, cured mice injected with lethal numbers of streptococci - Active component in drug was sulfanilamide, the first sulfa drug.
2
Q
How is traditional Chinese medicine similar / dissimilar to Greco-Roman medicine?
A
- Empedoclean elements are seen in Yin/Yang - Chinese rejected venisection - Actual body parts made up Greco-Roman anatomy, while anatomy in Chinese medicine was based on non-body parts, but perceived function of structure - Chinese medicine knew about pulse like Greek Herophilus (first person to study it)
2
Q
What is bonesetting?
A
- Historically were disreputable non-physicians that were family trained and kept/handed their skills down in families. Used manipulation to correct dislocations, fractures and painful joints. - Still once advertised himself as a lightning bonesetter.
3
Q
Who was Paul Ehrlich and what was his contribution to medicine?
A
- He was a researcher with Sahachiro Hata who helped found modern chemotherapy. Developed Salvarsan (preparation 606) that was a specific treatment for 1909.
4
Q
Who is Simeon Taylor?
A
- Was the president of Des Moines Still College of Osteopathy in 1911. He was and MD and DO and broad osteopath. He trained under William Halsted in surgery at Johns Hopkins.
6
Q
What is Hellenistic medicine? What is the role of ancient Alexandria in medical education, research and what were the contributions by Erasistratus and Herophilus?
A
- After death of Alexander, generals known as Hellenes divided world into kingdoms. Alexandria (Egypt) because a center for education, including site of the Alexandria medical school founded by Herophilus/Erasistratus (Greeks) around 330-260 BCE. - Herophilus dissected human cadavers, described and named internal organ, discovered the duodenum and prostate and dissected brain and nerves. - Erisastratus called the body a machine (used by AT Still), dissected cadavers, described valves of hear, differentiated sensory and motor nerves, believed brain to be seat of intelligence, concluded hear was not the center of sensation, but functioned as a pump, denied teleology (purposeful creation of things).
6
Q
Who was credited with the first public use of anesthesia? Was this the first time it was used?
A
- William Morton was publicly credited for first successful use of anesthesia at Mass Gen in 1846. Crawford Long first used it publicly in 1842, but was not credited as it was not reported.
7
Q
Who was Imhotep? How did he add to Western medical traditions?
A
- Ancestor of modern physicians (first known healer whose name we know of) from ~ 2700 BCE, physician to Pharaoh
8
Q
Who is the father of pharmacology?
A
- Paracelsus
8
Q
Who was Francis Bacon and what was his contribution to medicine?
A
- English lawyer, scientist and legislator. - He was minister to queen and king - While in public office, he was convicted on charges of corruption and fined. As a result, he was ineligible for office and dedicated the remainder of his life to study. - Developed inductive reasoning rather than Aristotle’s deductive reasoning. - Result of his work is scientific method.
8
Q
Who made advancements and refined EKG?
A
- Willem Einthoven
8
Q
When and where was AT Still born?
A
- Born in 1828 near Jonesville, VA
9
Q
Explains the origins/roots/traditions of Islamic Medicine.
A
- Islamic medicine, like other regions, had it roots in folk medicine that had beliefs in animism (everything has spirit), amulets, charms, incantations, etc. - Health / illness was attributed to spirits, ie. jinn and evil eye - Many practices from Egypt, Byzantium, Europe and India, such as bloodletting, cupping, cautery and leeching were practiced. - Complex pharmacopeia was developed for use during this time - Region faced similar sanitary proplems, nutritional issues and diseases seen in Europe - Central tenet to Islam is that of human well-being; duty is to take care of body and spirit - Prophet Muhammad provided guidelines for achieving/maintaining health, eg. Washing, cleanliness, sensible eating, proper hygiene etc. - In the 7th/8th centuries, Islam was formalized, traditional healing practices were eliminated, eg. Animism, Jinn etc. - Idea of “learned medicine” arose in 9th century through translation of Greek medical texts and establishment of Bayt al-Hikma under Johannitius - Thought by Islamic traditionalist that medicine is foreign to Islam (Devil is physician etc.) - Madrasas (schools where religious learning took place) developed medical curricula - Galenistic / Hippocratic medicine was practiced under scientists/physicians: Johannitius, Rhazes, Avicenna and Maimonides
9
Q
Who was Werner Forssman and what was his contribution to medicine?
A
- He demonstrated safe cardiac cartheterization on himself in 1929, which lead to anatomic demonstration of coronary arteries and real-time physiologic recordings of cardiac function
10
Q
Who is Asclepius? Explain the rise of his followers and their contributions to Western medical traditions?
A
- Asclepius (from ~600 BCE) is the son of Apollo and a Greek warrior in the Iliad, known as a blameless physician. He is known as god of healing. His rod, entwined by serpent, symbolizes medicine / health care today. Asclepiads are the cults/families/clans are the healers that claimed ancestry to Asclepius. Hippocrates was born into an asclepiad around 500 BCE. His Oath may actually be a pledge of loyalty to Asclepius/cult.
10
Q
Who was Robert Boyle and what was his contribution to medicine?
A
- Was a natural philospher who refined many ideas of Paracelsus, Bacon and Descartes, establishing a paradigm for empiric research. - He argued against traditional elements of various systems (including empedoclean). - He showed that air was necessary for combustion, life and sound. Was interested in blood and its function.
11
Q
Who were William and John Hunter and what were their contributions to medicine?
A
- William Hunter was a Scottish anatomist, physician and obstetrician in London who studied in Edinburgh - He taught privately in London on dissecting and operative procedures. Was also physician to Queen. - With his brother, John, built a famous anatomy theater in London comprising thousands of specimens for hundreds of species. - Wrote famously about the anatomy of the gravid uterus - John Hunter was a Scottish anatomist and surgeon who initially worked alongside is brother teaching anatomy in London - He was a very famous bodysnatcher. - He was an energetic researcher and thinker and contributed much to medicine, including: study of inflammation, work on GSWs, study of venereal diseases, absorption of fat by lacteals, anatomical development of a child, separation of materal / fetal blood supplies and role of lymphatic system.
11
Q
Who was Johannes Muller?
A
- He is considered one of the father’s of modern anatomy. He began the process of separating physiology and anatomy and called for physiology based on chemistry and physics
12
Q
What does Ayurveda mean?
A
- knowledge of long life
12
Q
Who was Rudolf Virchow?
A
- He ended the idea of humoral physiology and stated the cell was the center of pathologic processes.
12
Q
Who was Karl Roentgen?
A
- Karl Roentgen discovered x-rays and x-ray photography. He incorporated these into medicine with the first x-rays used in 1896.
13
Q
Who was Thomas Sydenham and what was his contribution to medicine?
A
- considered English Hippocrates - studied at Oxford Uni - emphasized bedside medicine and personal observation - believed diseases were specific entities, as opposed to symptoms being diseases
13
Q
Who was the first DO?
A
- William Smith
14
Q
Describe how the rise of Christianity affected medical practices.
A
- Christianity became the official Roman religion in 313 CE (by edict) - It emphasized the soul and not the body - Manual medicine/healing became more common - Certain diseases were again associated with “God’s punishment” as they were during antiquity – Egyptians and Greeks — sin and sickness = similar states - Church’s charitable missions led to founding of imformal “hospitals” that were derived from poorhouses, hostels and hospices. These were known as “nosokomeia.” - In the late middle ages, regulation of medicine began by the Church. Effort began to restrict monks from becoming physicians for pay and desserting church - Dissection frowned upon, only executed criminals were dissected - Shrines for spiritual healing arose
14
Q
What is the Liber Ysagogarum?
A
- Medical text written by Johannitius that is part of the Articella and was used in European medieval medical practice.
15
Q
Explain changes that were occurring during the “Enlightment” that contributed to advances in medicine.
A
- The 18th century saw vast advances that advanced knowledge and reformed society through: - Use of science and intellect over superstition, romanticism and tradition - Vast dissemination of knowledge through printing and travel - Physicians becoming true scientists
15
Q
What is eclecticism?
A
- Is a medical practice that made use of botanical remedies along with other substances and physical therapy practices.
15
Q
Who were the Littlejohn brothers?
A
- They were highly trained PhDs and MDs who were the earliest faculty members of ASO bringing regular science and medicine to ASO. They were broad osteopaths. After ASO, they founded the American College of Osteopathy and Surgery.
16
Q
Who was responsible for changing clinical practice during the 17th century?
A
- Thomas Sydenham emphasized bedside medicine and personal observation - Herman Boerhaave popularized bedside teaching and was founder of academic teaching hospitals, using medical cases to teach students. Also used thermometer during pt assessment.
17
Q
What diseases were early Ayurvedic practioners aware of?
A
- They were aware of up to 1200 diseases including “fevers”, TB, smallpox, etc.
18
Q
What is the Kitab al-Qanun?
A
- It is a medical text written by Avicenna in the early 11th century. It is a compilation of Hippocrates, Galen and other revered medical scholars. This became the authority on medicine and is still in use. Book discusses contagion and sexually transmitted diseases, proposes microorganisms, standard for drug evaluation.
19
Q
What is the Bayt al-Hikma?
A
- Referred to as the House of Wisdom, is an early university where medical teachings occurred during 9th century.
19
Q
Explain the societal forces that lead to the Renaissance.
A
- The Renaissance is a long, complex period of the “rebirth” of art, science and medicine from 1300 to 1650. - Iberia and Andalusia is reconquested, previously occupied by Arabs. As a result, medical literature is more readily available in Europe - Sociopolitics changes under influence of city-states and Medici family - Bubonic plague decimates ~ 25 % of Europe’s population - Religious art is commissioned, humanistic views are popular - Renaissance begins in Florence: Medieval period which preceded this age, becomes known as “Dark Ages”; Roman and Greek manuscripts are collected and translated - Science, philosophy and medicine written by Plato, Aristotle, Hippocrates and Galen are revived. - New ideas and inventions take place: politics, art, printing, gunpowder, compass etc. - Human dissection improved anatomic knowledge, medical illustration (Da Vinci, Michelangelo) and fine art
20
Q
Who arrived at the idea that the cell was the center of pathologic processes?
A
- Rudolf Virchow
20
Q
What is the difference between lesion and broad osteopaths?
A
- Lesion osteopaths are those who follow strict Still osteopathic principles with complete disregard for “regular medicine” and courses outside of anatomy and osteopathy. They repudiate adjunctive therapies, including drugs. - Broad osteopaths are those who incorporate Still osteopathic principles into “regular medicine.” They embrace all other modalities of regular medicine including pharmacology, drugs and surgery/OB.
21
Q
Who was Albrecht Von Haller and what were his contributions to medicine?
A
- Was a Swiss physician and chair of medicine, anatomy, botany and surgery at Uni of Gottingen. - Known as father of modern physiology, published volumes on Human Physiology
21
Q
Who are the sons of thunder?
A
- AT Still grew up in a strong Methodist family. His father was a circuit-rider and preacher for the Methodist church. These preachers were often called sons of thunder in that they preached hellfire and brimstone sermons.
22
Q
Who is Alcmaeon of Croton? Why is he important?
A
- He was said to have been a pupil of Pythagoras and first suggested health as an equilibrium between opposing body “humors”. Possibly did the first human dissection and described the optic nerve.
22
Q
Who were known as fathers of modern physiology?
A
- Albrecht Von Haller (18th century) - Johannes Muller (19th century)
23
Q
Who is Hunayn ibn Ishaq (aka Johannitius)? What are his contributions to healing / medicine?
A
- known as Johannitius in West, lived in 9th century - Arab Christian, theologian and physician - Served Caliph - Was in charge of Bayt al Hikma - Responsible for translating rare Greek medical texts into Arabic and Syriac - Wrote original works on anatomy, physiology and diseases of eye, including Liber Ysagogarum, which is incorporated into the Articella
24
Q
Explain the impact of the Vietnam era for osteopathic medicine.
A
- Vietnam war really change everything for DOs. It was an unpopular war, military doctors were severely need as physician enlistments were low. MDs and DOs were drafted. Military medicine became proving ground for abilities and education of osteopathic physicians. - War promoted civilian acceptance of DOs into allopathic hospitals and joint practices. Eventually allowed for DO acceptance into military residency programs. - Late 20th century saw postgraduate training extending to DO graduates by all allopathic institutions, allowing for certification in specialty for DOs by osteopathic or allopathic routes.
26
Q
What are the basic tenets/history of traditional Chinese medicine?
A
- Unity of nature, yin-yang dualism and balance, theory of 5 phases, theory of systematic correspondences - Based on Nei Ching (aka bible of traditional Chinese healing) written by Emperor and his physician and Mo Ching (another text) - Anatomy based on interplay between non-body parts - Emphasis on sphygmology (study of pulse): understood blood circulation, heart importance - Rejected venisection - Disease is imabalance of yin and yang - Treatment restores harmony and includes: curing spirit, dietary management, acupuncture, pharmacotherapy and treatment of bowel/viscera/blood and breath
28
Q
What are the similarities between traditional Chinese medicine and Western medicine?
A
- rejection of venisection - Pharmacoagents used in Chinese medicine have been adopted into Western medicine: rhubarb (diarrhea), iron (anemia), Cannabis sativa (sedation), chaulmoogra oil (leprosy), Ephedra vulgaris (asthma), Rauwolfia (HTN), ginseng
30
Q
What are the four humors from Hippocratic medicine and what are they associated with?
A
- Yellow bile (dysentery, vomiting) - Phlegm (winter colds, epilepsy) - Blood (associated with life, plentiful in spring, need to expel if in excess) - Black bile (dried blood, possibly derived from yellow bile?)
30
Q
What is osteopathy vs osteopathic medicine?
A
- Osteopathy refers to the strict adherence and practice of osteopathic principles without drugs or adjunctive therapies, while osteopathic medicine combines the principles of osteopathy with all modalities of “regular medicine,” including pharmacology, drugs and surgery/OB.
30
Q
Who was SS Still?
A
- SS Still is the nephew of AT Still and founder of the SS Still College and Infirmary of Osteopathy in 1898.
31
Q
Who was Theodor Billroth?
A
- was a German surgeon who refined Listerian antisepsis. He began daily post-operative evaluation of temperatures (introduced previously by Boerhaave). He developed new abdominal operations including gastric resections and esophagectomies.
32
Q
Who was Alexander Fleming and what was his contribution to medicine?
A
- He was a bacteriologist in London who accidentally discovered that Penicilium mold were destructive to Gram positive bacteria.
33
Q
Who demonstrated efficacy of vaccination?
A
- Edward Jenner
33
Q
Explain the transformation that occurred within the field of surgery during the 19th century? Who were the people responsible for these changes?
A
- Pain and sepsis no longer impeded surgery as a result of major advances in antisepsis and anesthesia. Surgeries previously focused on abscesses, amputations, bone-setting, but now involved peritoneal cavity, which before was limited as outcomes were mostly unfavorable. By the 20th century, abdominal and bowel surgeries were common. The 19th century began the century of surgery. - Theodor Billroth was a German surgeon who refined Listerian antisepsis. He began daily post-operative evaluation of temperatures (introduced previously by Boerhaave). He developed new abdominal operations including gastric resections and esophagectomies. - William Halsted, an American surgeon, was a student of Billroth and disciple of Lister’s antisepsis method, began using rubber gloves in surgery. Idea arose as an idea to prevent one of the nurses (also his girlfriend) from getting a rash as a reaction to the carbolic acid. He is best known as a cancer surgeon (performed radical mastectomies). He trained many 20th century surgeons including Henry Cushing and SL Taylor (former president of DMU)
34
Q
Who was Empedocles and what did he contribute to Western medicine?
A
- He was a pre-socratic philosopher who postulated that all matter is composed of the elements: earth, air, fire, water; known as “roots.” These elements are present in the Hippocratic System (as macrocosms) and correspond to the “humors” of the microcosm.
34
Q
How did osteopathy become osteopathic medicine? How did academic standards change?
A
- Under guidance of William Smith and Littlejohn brothers who served as faculty members at ASO. - They wanted all medical science and surgery with the exception of material medica included in the ASO curriculum. - They discovered historical and scientific evidence for osteopathy while incorporating regular sciences into ASO - Littlejohns later founded the American College of Osteopathy and Surgery in Chicago, becoming leaders for broadening of osteopathic principle. - In Des Moines, SL Taylor, MD from NE, surgeon at Hopkins under Halsted, became president of Still College. He was leader in calling for broad osteopathy. - Journal of American Osteopathic Assn started in 1901 contained mostly anecdotal case histories with rare failures of manipulative therapy. Basic research started and AT Still Research Institue est in 1913, with west coast branch headed by Louisa Burns. She was the first full-time researcher into the osteopathic concept. - AOA followed their lead, mandating longer curricula (3 years), plus broader education and practice in 1904. Many schools closed or merged. - AOA mandated 4 year curriculum in 1916, excluding medica. - 1940 saw instituting of two years of college pre-admission, three years by 1950s. Majority of entering class had baccalaureate degrees by 1960. - Expansion of colleges in 1970s.
35
Q
Who is the inventor of the stethoscope?
A
- Rene Laennec
36
Q
Who is often called the First Heart Specialist?
A
- Jean Nicolas Corvisart
37
Q
Who was William Morton?
A
- Dentist and medical student who was credited with first successful public demonstration of anesthesia at Mass Gen in 1846.
37
Q
Who was Crawford Long?
A
- American physician was the first to use anesthesia publicly in 1842, but was unreported, so credit not given to him.
38
Q
Who was the American Hippocrates?
A
- Benjamin Rush
39
Q
Who was Ignaz Semmelweiss?
A
- Hungarian obstetrician noted puerperal / childbed fever was carried from patient to patient by whomever was delivering babies. Counseled washing of hands in chorine-water solution between deliveries and showed dramatic decline in fever
39
Q
What is Salvarsan?
A
- Specific treatment for syphilis prepared and developed by Paul Ehrlich and Sahachiro Hata
41
Q
What is the Athenian plague?
A
- Pandemic that killed thousands of Greeks, possibly arrived from Egypt with exact cause unknown. May have affected birds/animals too. Symptoms: fever, thirst, rash, rapid death. Sounded like smallpox, but unknown.
42
Q
Who was Anton von Leeuwenhoek and what was his contribution to medicine?
A
- Was a Hollander who without scientific training, designed and built single-lens microscopes capable of 250 x zoom.
43
Q
Who was August Waller?
A
- He demonstrated the first human ECG in the 1880s. First tested on his dog, Jimmy.
43
Q
Explain the influence of Evolution on Still.
A
- First coined by Spencer, a British philosopher, who wrote a popular book on Darwin. Book popularizes ideas about cause and effect in disease, structure and function interrelationship and holistic workings of organisms. - Still embraces/discusses similar/same concepts in osteopathic principles.
44
Q
Who is Louisa Burns?
A
- She was a DO and the first full-time researcher into the osteopathic concept. She headed the west coast branch of the AT Still Research Institute.
46
Q
Describe the origin of hospitals during medieval times.
A
- Hospitals grew out of Christian monasteries’ charitable mission (with Islamic examples) and evolved into larger institutions.
48
Q
What is the importance of nosokomeia?
A
- These are thought to be some of the first informal hospitals during medieval times and were based on Church’s charitable missions. These were poorhouses, hostels and hospices. - Nosocomial infections are those acquired in hospitals.
50
Q
What is a dosha? What are the three in Ayurvedic medicine?
A
- A dosha is a principle. In Ayurvedic medicine, the three are: movement, transformation, lubrication/stability. They are similar to Greek “humors.” Illness is a result of loss of balance among the three doshas
51
Q
Was anatomical dissection allowed in the study of early Ayurvedic medicine?
A
- Hinduism prohits cutting dead, internal anatomy knowledge was scant. To overcome this, Susruta recommended sinking body in river for 7 days and separating structures with feather
52
Q
Who was considered as one of the Greatest Physicians in Europe during his time?
A
- Herman Boerhaave
53
Q
What parts of Ayurvedic medicine are similar to Greco-roman medicine?
A
- Regimen: diet, lifestyle important - Humors: similar to idea of doshas, imbalance leads to illness - Hippocratic Corpus: similar to Charaka samhita
54
Q
Who was Benjamin Rush and what was his contribution to medicine?
A
- Rush was an American physician who studied at the University of Edinburgh - He was one of the US Founding Fathers - Vigorous proponent of heroic medicine - Considered the American Hippocrates - Believed hyperactive arteries/hypertension to be the key to disease
55
Q
Did Edward Jenner invent/discover vaccination?
A
- No. He demonstrated the efficacy of it.
57
Q
What were three important concepts that arose from De Humani Corporis Fabrica?
A
- the anatomist should perform his own dissection - the eye is preferred over reference to authority (don’t rely on what your professor tells you) - anatomy is the key to medicine
58
Q
Who was Ambroise Pare and what was his contribution to the medical renaissance?
A
- French barber-surgeon in 16th century - Royal surgeon - Educated by apprenticeship (possible under Jacobus Sylvius) - Made advances in field of surgery: no more oil cautery, gentle treatment of wounds (Turpentine use), ligatures for blood control, gunshot treatments - Known as “father of Surgery”
59
Q
Who was Robert Koch?
A
- a small town family doctor, not researcher, in Germany made bacteriology into a real science. He discovered many microorganisms responsible for many diseases. Won nobel prize in medicine in 1905.
60
Q
What is Yin and Yang?
A
- Yin: dark element, femine, passive, down-ward seeking, night, water and earth - Yang: bright element, masculine, active, up-ward seeking, day, fire and wind - These are complementary opposites that are kept in balance for health
61
Q
Explain the rediscovery of Galen during the Renaissance.
A
- Under the Aldine Press (printing office in Venice), copy of Galen’s work was translated from Arabic into Greek - Lead to reappraisal of dissection inspired by Galen - Galen’s work had 590 editions in the 16th century - Medical schools incorporated Galen into their curricula - Jacobus Sylvius, French anatomist and physician, upheld Galen and Hippocrates. Advocated that they never wrote anything in medicine that wasn’t entirely true. Advocated true return to Galen from Greek language, not derived from Arabic, etc.
62
Q
Who is Charles Hartupee?
A
- He is the first DO to settle permanently in Iowa and opened an office in DSM.
63
Q
What is calomel? What was it used for?
A
- Calomel is mercury chloride and it was used in the 18th through 19th centuries as part of heroic medical treatments for purging bowels to cure disease.
64
Q
Who was Joseph Lister?
A
- Surgeon, who know Pasteur’s work, used carbolic acid (phenol) as antisepsis during surgeries, showing dramatic decrease in post-operative infections
65
Q
What contribution did Marie/Pierre Curie make towards progression of medicine?
A
- They discovered polonium and radium. Radius was used as a chemotherapeutic.
67
Q
What are the similarities between Ayurvedic medicine and Western medicine?
A
- surgery - branches of medicine - diet/lifestyle important
67
Q
Describe medical education and practice in the 19th century and its effects on the thought of AT Still?
A
- There were no licensing laws and no formal training required to practice medicine. - Early medical training for Still was from his father by precept during the 1840s. Father was not formally medically trained. - He helped his father with treatments at various missions setup, including on Indians. He exhumed Indian bodies to study anatomy. - Infectious diseases were common at the time, from which many died especially on the frontier where Still grew up and lived. - Heroic medicine was still central/key to medicine during the 19th century. - In 1861, Still enlisted as hospital steward (claiming to be a military surgeon) and practiced using standard medicines for the time. He said that his medical service disgusted him. - His disgust was not unique, many shared similar sentiments. - Late 1850s, he studied mechanical/anatomical relationships, tried manipulation and spoke against drugs. - His wife died in 1859 after childbirth and he lost his 3 children to spinal meningitis in 1864. Believed that their deaths were due to medical ignorance. He was convinced of uselessness of drugs and gave up medicine. - Many systems of drug-free medical practice were present during this time including: eclecticism, homeopathy, phrenology, bonesetting, mesmerism/magnetic healing and spiritualism. - Still sought better medical education. May have attended KC medical school, disgusted with curriculum. Explored drugless alternatives, including bonesetting. Returned to practice in late 1860s, started manipulation in early 1870s. Advocated drugless, magnetic healing. - He advertised himself as a magnetic healer, was not very successful. Became itinerant physician. - In 1883, advertised himself as a lightning bonesetter, treating people from town to town.
68
Q
Who was William Smith?
A
- William Smith, MD was the first DO. He was one of the earliest faculty members of ASO and brought regular science and medicine to ASO. He was a broad osteopath.
69
Q
When does Still first use the term Osteopathy?
A
- In June 1874, he writes: “I flung to the breeze the banner of Osteopathy.”
71
Q
What are the contributions of Islamic medicine.
A
- preserved Greek and Roman medicine and therapeutics - translated many Greek and Roman medical writings - contributed to original scholarship into disease and symtomatology - hospitals (first true hospitals)
73
Q
Describe acupuncture and moxa/moxibustion.
A
- Acupuncture makes use of placing thin needles at within meridians and acupuncture points for the purpose of purging emerging and restoring yin / yang harmony - Moxibustion warms regions and acupuncture points with Moxa (plant) which is burned on acupuncture needles or directly on the skin. This is said to stimulate the circulation of the life force known as “chi.”
75
Q
Discuss/describe Islamic center hospitals.
A
- First true hospital was established in Baghdad in ~ 805 CE - Known as bimaristan: place for sick people. - Possibly inspired by early Christian “hospitals” at monasteries, but were more elaborate - Often had medical schools on site - Had water supplies - Separated male-female wards with same-gender nurses - Inpatient and outpatient areas - Wards for different complaints - Had pharmacies, mosques, libraries and lectures halls - Were models for later European hospitals - Many Islamic cities had at least one hospital, some had many
76
Q
What is homeopathy?
A
- Is a medical practice that upholds Samuel Hahnemanns principle of like curing like with drugs given in miniscule / single molecule amounts. Substances that cause symptoms of disease will likely cure sick people with similar symptoms.
77
Q
How did scientific research in physiology shape medicine in the 19/20th centuries? Who were the people responsible for these changes?
A
- Johannes Muller who chaired departments of anatomy and physiology at the Uni of Berlin advocated separating sciences of physiology and anatomy. He was considered one of the fathers of modern physiology. He called for physiology based on chemistry and physics and taught many students who elucidated much that we know today about human physiology. He wrote about human physiology. - Rudolf Virchow ended the idea of humoral physiology. States the cell was the center of pathologic processes. - The first physiological journals were published in the 19th centuries.
79
Q
What are the Egyptian papyri? How did they add to Western medical traditions?
A
- Medical papyri are medical texts that discuss diseases, therapeutics. There are about a dozen or more of these, but the most important is the Georg Ebers papyrus from ~ 1550 BCE.
80
Q
Describe some diseases of the middle ages: include treatment and consequences.
A
- a.) Bubonic plague (1340s) – “black death”, killed ~ 25% of Europe, no treatment, consequence: quarantines - b.) Leprosy (1179-1350) – Hansen disease, no cure, thought to be a result of being “unclean”, associated with sin, associated with sexual intercourse, consequences: leper colonies, quarantines - c.) Insanity – thought to be a humoral imbalance, causal theories (moon, sin, witchcraft etc.), many remedies, none curative; affected were tortured or executed as witches, received care in monasteries and special hostels. St. Mary’s of Bethlehem (“Bedlam”) was psychiatric hospital in 1247. - d.) Women’s Health – obstetrics was duty of all-female midwives or relatives (some man-midwives were known); female anatomy and physiology were considered imperfect, thought to be vessels for development of infant containing male seed
81
Q
Who was Jean Nicolas Corvisart and what was his contribution to medicine?
A
- French physician who studied in Paris, including attending the Hotel Dieu hospital - Translated Auenbrugger’s book on percussion - Called the “First Heart Specialist,” writing on diseases and lesions of the heart and great vessels. - Was physician to Napoleon - Was professor to Rene Laennec
82
Q
Who was Giovanni Battista Morgagni and what were his contributions to medicine?
A
- Italian Anatomist who studied and wrote volumes on pathologic anatomy, turning it into a science - Demonstrated need to base diagnosis, prognosis and treatment on full knowledge of anatomical conditions in a patient - Began era on cumulative progress in pathology
84
Q
What are the basic tenets/history of Ayurvedic medicine?
A
- Ayurveda means knowledge of long life. - It is based on 4 important texts: Agnivesh tantra, Susruta samhita, Charaka samhita and the Asthanga sangraha. - Arose in India in remote antiquity (unknown when exactly) - Body functions as a result of three dosha (aka principles): movement, transformation and lubrication / stability. Dosha are sometimes called “humors” similar to Greek - Illness results from a loss of balance among three dosha - Have practioners in two classes: surgeons and physicians - 4 qualities of ayurvedic physicians: theoretical knowledge, clarity of reasoning, wide clinical experience and personal skill - 8 branches of medicine including surgery
85
Q
Cogito ergo sum. Who wrote this statement? What does it mean?
A
- Rene Descartes. I think, therefore I exist.
86
Q
What is spiritualism?
A
- Involved communication with spirits of the departed via a trace. Not a healing system per se, but uses ideas of: harmony of body parts and free flow of spirit fluid. Emphasizes healing with hands and refers to body as machine. - AT Still knew of spiritualism and many concepts show up in his early thinking of osteopathy.
87
Q
What is the Hill-Burton Act of 1946?
A
- It is a federal act that made construction of new osteopathic hospitals easier by providing federal support.
89
Q
What are the basic tenets of Hippocratic Medicine?
A
- Health is equilibrium; empedoclean elements in macrocosm related to humors (yellow bile, blood, phlegm and black bile) – Alcmaeon suggestion - in microcosm - Patient-oriented - Favored “regimen”, not drugs: proper diet, enough sleep, exercise, right living to alter disease process, athletic training - diagnosis (least important): derived from pt’s diet, dwelling, work habit etc. - emphasis placed on prognosis (based on what pt looked like) and expectative therapy (body’s inherent ability to heal) - disapproved of: heroic interventions, risky procedures - Hippocrates believed in professionalism, discipline, rigorous practice, observation / records
90
Q
What is Prontosil?
A
- It is a red dye discovered by Gerhard Domagk that cured mice of streptococci infection. It is the first sulfa drug.
91
Q
Who was James Simpson?
A
- British obstetrician who discovered anesthesia with chloroform in 1847 and introduced it for use during childbirth.
93
Q
What diseases did the Greeks know about?
A
- Epilepsy (known as the sacred disease) - Amenorrhea, puerperal fever (childbed fever: infection of fem repro tract following childbirth), dysentery, malaria, TB, varicella, diphtheria
93
Q
Who was Herman Boerhaave and what was his contribution to medicine?
A
- dutch physician and founder of modern academic hospitals - popularized bedside teaching like Sydenham - advocated observation of cases by medical students and used certain hospital wards for teaching cases - understood body to be a mechanism with joints, pipes, pumps etc. - first to use post-mortem exams to determine illnesses, thermometer during assessment and described esophageal rupture known as Boerhaave’s syndrome - considered as one of the Greatest Physicians in Europe during his time
95
Q
Who was Horace Wells?
A
- American dentist colleague of William Mortan who demonstrated unsuccessful use of nitrous oxide at Mass Gen in 1845.
96
Q
Who is considered the English Hippocrates?
A
- Thomas Sydenham
97
Q
Explain how the medieval social / political climate altered the practice of healing.
A
- In the early middle ages (~330 CE), cities were becoming much smaller, people were spreading out/ venturing to the countryside - Medical learning regressed to a state of that before Hippocrates - Galenism arose - Medicine was rural, based on remedies in books known as “leechbooks” - Herbalist and quacksalvers practiced medicine - Monasteries preserved books/texts for the preservation of language, incidentally preserved medical texts
99
Q
What are the ancient texts that traditional Chinese medicine relies on?
A
- Nei Ching and Mo Ching
100
Q
How did scientific research in bacteriology shape medicine in 19th/20th centuries? Who were the people responsible for these changes?
A
- Ignaz Semmelweiss, Hungarian obstetrician noted puerperal / childbed fever was carried from patient to patient by whomever was delivering babies. Counseled washing of hands in chorine-water solution between deliveries and showed dramatic decline in fever - Louis Pasteur was a researcher who espoused the germ theory of disease and proved many microorganisms were responsible for many diseases. - Joseph Lister, a surgeon, who know Pasteur’s work, used carbolic acid (phenol) as antisepsis during surgeries, showing dramatic decrease in post-operative infections - Robert Koch, a small town family doctor, not researcher, in Germany made bacteriology into a real science. He discovered many microorganisms responsible for many diseases. Won nobel prize in medicine in 1905.
102
Q
Who is Hippocrates?
A
- Hippocrates is a Greek who lives during the period of ~460-390 BCE and is considered the “Father of Medicine” in western tradition. He headed the authorship of the Corpus Hippocraticum, a text that establishes medicine as an art, science and profession. - Hippocrates believed in professionalism, discipline, rigorous practice, observation / records. Practioners of medicine ought to be clean, calm, serious and honest according to him. He was the first to describe many diseases and medical conditions.
104
Q
Who is credited for developing the scientific method?
A
- Francis Bacon
105
Q
Who was Selman Waksman and what was his contribution to medicine?
A
- He was a soil microbiologist who discovered Streptomyces griseus, the source of streptomycin used as the first anti-TB drug. He coined term antibiotics
107
Q
Who is Abu Ali al-Husayn ibn ‘Abdallah ibn Sina (Avicenna)? What are his contributions to healing / medicine?
A
- known as Avicenna in West, lived in late 10th and early 11th centuries - One of the most revered natural philosophers / scientists to this day - Known as the Islamic Galen - Polymath: Islamic law, geometry, anatomy, logic, philosophy - Completed his medical studies by age 18, possibly self-taught (?) - Wrote many medical texts - Was PM and physician to Prince - Wrote entire medical text known as Kitab al-Qanun, which is a compilation of Hippocrates, Galen and other revered medical scholars. This became the authority on medicine and is still in use. Book discusses contagion and sexually transmitted diseases, proposes microorganisms, standard for drug evaluation.
108
Q
Who researched percussion as a diagnostic measure?
A
- Leopold Auenbrugger
109
Q
Discuss the early spread of osteopathy?
A
- In the 1890s, word spread that osteopathy was effective. - It got favorable press in surrounding states, including Iowa. - There were huge increases in people arriving in Kirksville. - Celebrities and others gave public testimonials, including Roosevelt, Twain and the Rockefellers.
110
Q
Who was Howard Florey and what was his contribution to medicine?
A
- During his studies on antibacterial substances, he discovered Fleming’s research. He ended up isolating penicillin from Penicilium mold.
112
Q
What is the Articella?
A
- English translation: the Little Art of Medicine - It is an important medical text of the 11th Century that originated in Italy. Galen predominated throughout this text, but also included Islamic and Greek views. - Used in university-based medical teaching during medieval times
113
Q
What is the history of osteopathy in Iowa and at the SS Still College of Osteopathy?
A
- Charles Hartuppe was the first DO to settle permanently in Iowa in 1895 and open an office in DSM. - The Iowa legislature passed the first osteopathic licensure act in the state in 1898. - The SSSCIO opens in the fall of 1898, primarily under founders: SS Still and spouse, Ella D Still. This was opened on Locust Ave (location of the current Pappajohn Sculpture Garden and across the street). - Classes began with ~ 40 students with two classes every year - CE Still (AT’s son) purchases school in 1903, sell it to ASO directors in 1904. - Rumored in 1905 that college would close. Possible start of dispute between lesion and broad DOs - Bought by new investors, name Still College of Osteopathy - 1902 curriculum was 2 years. - 1905 added third year - 1909 saw survey of US medical education by Abraham Flexner. He said all medical schools in Iowa were dissatisfactory. He said Still College is a disgrace and should be suppressed. Truth was that most (bar 2) early 20th century medical schools (osteopathic and allopathic) were substandard diploma mills. - AOA commission agreed with Flexner. They led reform of admission standards, facilities, equipment and curricula. Large number of colleges closed. - 1910: Still College Hospital (later DSM General) opens, the first osteopathic hospital in the world. - 1911: Still College of Osteopathy changes name to Des Moines Still College of Osteopathy. Simeon Taylor becomes the college president. - 1914: AOA mandates 4-year curriculum. - 1917: AT Still dies - 1920-21: four year DO degree begins at DSM Still College, initially excluded pharmacology, but drug therapies were actually taught, just not listed in curriculum until 1928. - 1927: college moves to 6th Ave after original building sustains fire. - Des Moines General Hospital is main teaching site for DMSCO students after DO graduates excluded from allopathic facilities. - WWI shows student enrollment at lowest. Osteopathy prospers however owing to absence of MDs at home. - Post-WWI enrollment is boosted by GI bill of rights. - 1946: Still College Hospital opened on 6th Ave. - 1950: Still College Hospital offers residencies. - 1958: DMSCO changes name to The College of Osteopathic Medicine & Surgery (COMS) - 1960s: California Debacle – merger between COA and CMA, purchase of MD degrees for $50 - 1970s: Vigorito president from 68-71: COMS flirts with granting MD degree, trustees affirm only DO degree offered. Possibility of COMS becoming public institution. - Azneer becomes president of COMS in 71. COMs move to current location (previously catholic school), clinic established, AC built, becomes true university in 81 with addition of podiatric medicine and biological sciences. Named University of Osteopathic Medicine and the Health Sciences. Azneer serves as president until 1996. - 1999: renamed Des Moines University
115
Q
Explain how Galenism contributed to medieval stagnation of medicine and medical education.
A
- Contemporary medical texts during medieval times were of Galen and other ancients. - Little original medical writing took place in Europe during medieval times - Galen’s fame and ideas spread widely - By ~ 500 CE, Galen’s work existed at Library of Alexandria and was taught as part of standardized medicine - Monasteries became teaching centers for medicine and also pseudo-hospitals - The Articella (little art of medicine) was written during the 11th century in Italy: Galen predominated in this text, but it also included work from Hunayn, Hippocrates and other ancients. - Oribasius collected excerpts of Galen and others. He simplified, rehashed and publicized this work. When this was summarized, it altered the legacy of Galen - Paul of Aegina: wrote a medical encyclopedia called the Seven Books of Medicine, which mostly referred to Galen - As a result of the profuse mention of Galen’s work, his mistakes in anatomy and physiology were perpetuated: ie. pores in cardiac septum, humans with 3-chambered heart, arteries pump blood, humans with 5-lobed liver, venisection. - University-based medical education arose in the 12-13th century in Italy and France. Most education still was via apprenticeship. MD and MB degrees were established. - Articella was used in universities, together with Avicenna’s (Islamic physician) Qanun. Therefore, much of Galen was upheld. - Islamic medicine contributed highly to medieval medicine: Johannitius, Rhazes and Avicenna
117
Q
Who was William Harvey and what was his contribution to medicine?
A
- Was an English physician who trained at Uni of Padua, same school where Vesalius was head of anatomy. - Physician to Kings of England - Continued studies of heart, circulation and valves using inductive reasoning. Advocate for scientific medical research methodology. Tested an idea and re-tested it for proof. - Ignored superstition and old theories (from Galen, for example) - Determined cardiac output and make strong progress on understanding blood circulation.
118
Q
Discuss the beginning of osteopathic medical education.
A
- Founded the American School of Osteopathy in 1892. First course was 4 months long, graduates received Diplomate of Osteopathy (DO) degree. - Graduates were not licensed anywhere, laws didn’t recognize the degree. MO medical association made it difficult by exorbitant fee to practice manipulation. Later, bill passed in 1897 allow osteopathic practice. - Initially, ASO only taught anatomy and osteopathy. No physiology or pharmacology were taught. By 1896, curriculum included history, chemistry, urinalysis, toxicology, pathology and symptomatology. - New faculty, several with advanced degrees, were hired to teach new subjects. This included William Smith (an MD, also the first DO) and the Littlejohn brothers. These newcomers brought regular science and medicine to ASO. - 13 new schools arose during the end of the 19th century, including the SS Still College of Osteopathy started by AT Stills nephew Summerfield Still.
120
Q
Who said that science and mathematics explain everything?
A
- Rene Descartes
121
Q
What was the influence of the Fabrica written by Vesalius?
A
- the study of anatomy become the central component (still is today); - spurred many to dissect, correct and delineate unknown body - medicine became more about looking inside the body - influenced other disciplines
122
Q
Who was Edward Jenner and what was his contribution to medicine?
A
- English physician, natural philosopher and surgeon apprentice - Studied under John Hunter - Demonstrated efficacy of vaccination (against smallpox using cowpox blister, testing variolation later showing result of no disease), did not discover vaccination or inoculation
123
Q
What is the basic tenet of AT Still’s philosophy?
A
- The body has the capacity for health. If it is normalized, disease can both be prevented and treated. - Structure of body is related to its function - When body’s musculoskeletal system is disordered, it may affect changes in function of other parts - Progress can be achieved in study of disease if study is made of health first
124
Q
Who coined the term antibiotics?
A
- Antibiotics were first coined by Selman Waksman.
126
Q
What is the Corpus Hippocraticum?
A
- Is a text from ~420-350 BCE that establishes medicine as an art, science and profession that has many contributors. It consists of 60-70 essays, which emphasize the patient instead of the illness. Provides a clear foundation of Western medicine, including rejecting idea of diseases borne from gods; respects facts/experience from dogma; asserts physiology, health and disease have rational expectations; stresses observation over theory; calls for “expectative therapy”, not active intervention; based on externals (not internal anatomy); uses deduction of body function by comparing tangible word to body. It includes the primary tenet of Hippocrates which says “first, do no harm” (primum non nocere).
127
Q
Explain the standardization/regulation of medicine during the middle ages.
A
- Many practitioners were present during the middle ages, such as herbalists, apothecaries, midwives, bone-setters, barber-surgeons etc. - With the rise of university medical education in 12-13th centuries, medical guilds began in Italy during the 13-14th centuries. - There was an increased need for public health initiatives: food, water purity standards, proper waste disposal, regulation of livestock in tows - Guilds/colleges began processes that resulted in medicine becoming a distinct profession: standardized curricula (eg. Articella), formalized education (university vs apprenticeship), examinations, licensing and legal regulation (first steps) - Distinction between “regularly trained” physicians and quacks seen
128
Q
Who was Andreas Gruentzig and what was his contribution to medicine?
A
- He devised coronary balloon angioplasty
129
Q
Who is Charaka and what is the Charaka samhita?
A
- Charaka is a wandering religious student from ~ 300 BCE who was the first to describe digestion, metabolism, immunity. He theorized the three doshas. - Together with other authors, he authored a compilation (aka samhita) that includes: therapeutic medicine, treatment by drugs, modification of diet/lifestyes, describes more than 600 drugs, contains wise quotes and doshas.
130
Q
How did the Renaissance lead to a new kind of scientific inquiry?
A
- A fresh start towards scientific inquiry was possibly driven by political, social issues occurring just prior to it, ie. the reformation, English revolution etc. - Natural philosophers (aka scientists) began to develop a way to think about the world as mechanical and quantifiable, as particles in motion (mathematically described) and less teleologic (things are not created for a purpose). - The Royal Society of London became driving force of new science, promoting criticism of Galenic and Aristotelian science, advocating inductive reasoning. - Academic Royale du Sciences
131
Q
Who was William Halsted?
A
- Was an American surgeon, was a student of Billroth and disciple of Lister’s antisepsis method, began using rubber gloves in surgery. Idea arose as an idea to prevent one of the nurses (also his girlfriend) from getting a rash as a reaction to the carbolic acid. He is best known as a cancer surgeon (performed radical mastectomies). He trained many 20th century surgeons including Henry Cushing and SL Taylor (former president of DMU)
132
Q
What is heroic medicine?
A
- Medicine involving bleeding using venisection and purging of bowels via emetics.
133
Q
How did scientific research in anesthesia shape medicine in the 19/20th centuries? Who were the people responsible for these changes?
A
- Anesthesia was unknown until the mid-19th century. Early agents used were ethyl ether, chloroform and nitrous oxide. Discover of anesthesia changed surgical procedures forever. - Crawford Long (American physician) was the first to use anesthesia publicly in 1842, but was unreported, so credit not given to him. - Horace Wells (American dentist colleague of William Mortan) who demonstrated unsuccessful use of nitrous oxide at Mass Gen in 1845. - William Morton was dentist and medical student was credited with first successful public demonstration of anesthesia at Mass Gen in 1846. - James Simpson (British obstetrician) discovered anesthesia with chloroform in 1847 and introduced it for use during childbirth.
134
Q
Who was Sahachiro Hata and what was his contribution to medicine?
A
- He was a researcher with Paul Ehrlich who helped found modern chemotherapy. Developed Salvarsan (preparation 606) that was a specific treatment for 1909
136
Q
Explain the decades-long battle for full practice recognition in all states.
A
- Osteopathy was omitted from many state licensure laws in the early 20th century. The last state to fully license osteopathic physicians was MS in 1973. - The AOA formed from ASO grads in 1901 battled for recognition and licensure of osteopathic physicians in all states. - DOs were excluded from medical service during WWI, could only function as orderlies or common soldiers. - AMA created a standardization of hospitals policy in 1918 that required hospitals training MD graduates to exclude DO applicants from staff privileges lasting late into 20th century. This meant that no DO could practice in allopathic hospital, DO students could not train in allopathic programs, allopathic CE programs refused DOs and AMA listed osteopathic medicine as cult and made it unethical for MD physicians to associate with DOs. This lead to necessity for creation of osteopathic hospitals in the 1920s. - WWII saw DOs excluded from serving as physicians as in WWI. They remained at home and provided many Americans with their first experiences with osteopathic physicians. GI bill following war created boom in osteopathic education of veterans. - Federal support allowed for easier construction of osteopathic hospitals - CA debacle ensued in 60s. AMA removed osteopathy from list of cults. - Ethics change by AMA allowed MDs to work with DOs - AMA encouraged state associations to allow DO members and by 1969, allowed to join AMA. - Vietnam war really change everything for DOs. It was an unpopular war, military doctors were severely need as physician enlistments were low. MDs and DOs were drafted. Military medicine became proving ground for abilities and education of osteopathic physicians. - War promoted civilian acceptance of DOs into allopathic hospitals and joint practices. Eventually allowed for DO acceptance into military residency programs. - Late 20th century saw postgraduate training extending to DO graduates by all allopathic institutions, allowing for certification in specialty for DOs by osteopathic or allopathic routes.
137
Q
Who made advancements and refined EKG?
A
- Augustus Waller demonstrated the first human ECG in the 1880s, Willem Einthoven refined it.
138
Q
Who was Willem Einthoven?
A
- He experimented with string galvanometers and recorded cardiac electrical activity. Use of this allowed for analysis of cardiac irregularities and differentiation of pathologic rhythms. This served as early form of EKG, which he refined.
139
Q
Who is Moshe ben Maimom (Maimonides)? What are his contributions to healing / medicine?
A
- known as Maimonides in the West, he lived in the 12th and early 13th centuries. - He was Jewish - Studied in Fez (Fas), Morrocco and emigrated to Egypt. - Was a Rabbi of community in Cairo, practiced medicine to support his family - Polymath: philosopher, writer, astronomer - Leader in Islamic medicine (Galenist), served Saladin - Described asthma, diabetes, hepatitis, pneumonia in many texts. Emphasized moderation in diet, exercise. - Translated Avicenna’s Qanun into Hebrew
140
Q
Who made strong progress in the 16th/17th centuries on understanding blood circulation?
A
- William Harvey
141
Q
Explain the reason behind the expansion of the scope of the osteopathic principles.
A
- Early 20th century saw controversy between lesion osteopaths and broad osteopaths. - Lesion osteopaths include: Arthur Hildreth - Broad osteopaths include: Littlejohns, Taylor, Smith - Argument continued for years as evidence for use of newer drugs accumulated - Influenza pandemic gave support to lesion osteopaths who reported better outcomes with OMT. - Broad osteopaths reasoned for disorders that were not amenable to manipulation, including gynecologic cases that couldn’t be treated with manipuation. - Broad osteopaths would win out and profession would break free from drugless roots by 1930.
142
Q
What is phrenology?
A
- Involved character analysis by reading shapes/bumps on the head.
143
Q
Who was Leopold Auenbrugger?
A
- Austrian physician who researched percussion as a diagnostic measure, including detection of cavities in lungs, location and size determination of pathologies using percusson.
144
Q
What are iatroi and why is it important?
A
- Iatroi refer to part-time healers in Greek civilization. Illnesses in which doctors are implicated/blamed are referred to as iatrogenic illnesses.
145
Q
Who challenged Galenic ideas of the heart and circulation during the 17th century and made significant improvements/changes to these ideas?
A
- William Harvey
146
Q
Explain the roots of the California COA/CMA merger and its implications.
A
- CA had most DO practitioners in US. COPS (now UC Irvine) and LA County General were excellent training facilities for DOs. - Early talks between COA and CMA arose in 1940s as a result of the broader training of osteopathic physicians who were motivated by the lack of public recognition for their profession, limited educational opportunities/quality and decline in use of manipulation. Talks lead to approval by AMA, AAMC and CMA to approve concept of granting MD to all CA DOs, but no action was taken. - Talks between COA and CMA reappeared in 1950s / 60s. - COA urged removal of AOA policy statements regarding osteopathy as separate and independent system of practice. - Changes were opposed. - AOA leadership became angry over secret COA/CMA negotiations and reaffirmed their separate and complete school of medicine language, censured COA and demanded immediate cessation of negotiations between COA and CMA. - COA ignored, AOA revoked charter. - CMA and COA developed a contract whereby COPS became allopathic school, all graduates of COPS and other DO licensees in CA got MD for $50 and DOs in CA would forever cease to identify themselves as osteopathic physicians. Ratified. - Implications: better practive opportunities, elimination of questions regarding DO degree, access to hospital practices (previously excluding DOs), lack of respect despite “MD” degree and loss of practice and teaching opportunities. AMA attempted to destroy AOA, absorb more DOs after this and actively recruit osteopathic students to transfer to MD schools.
147
Q
What was the medication use as an emetic and as part of heroic medicine?
A
- Calomel, which is mercury chloride.
148
Q
What is mesmerism?
A
- Also known as magnetic healing. It was a medical practice that treated imbalances of invisible magnetic fluid in the body that caused diseases. - Initially referred to as mesmerism, later referred to as magnetic healing when founder Franz Mesmer was denounced as Fraud. Later evolves into hypnosis. - AT Still knew of this practice and even once advertised himself as a magnetic healer.
149
Q
How did Galen of Pergamum transform Roman medicine, including anatomy, physiology and therapeutics?
A
- Galen is considered one of the most, arguably perhaps, the most important / influential ancient physician (Roman). - He was educated in an asclepion, later in Alexandria. - Was a physician to gladiators and emperors. - Most Roman medicine prior to him was “magical”, based on spells, incantations, chants etc., did not have standard/regulation, care was done at home. Public health was good though. Most physicians were uneducated. - Galen performed public animal dissections. - During his time, he authored vast volumes of medical texts ~ 8000 pages. Transformed art of medicine with science. - Ultimate authority in anatomy and physiology until mid-16th century. - Advocated instilling trust from pt by appropriate bedside manner, careful explanations, mastery of prognosis. - Upheld regimen before drugs, drugs before surgery - Believed in mind-body link; interest in stress syndromes - Rejected magical / spiritual care - Got many things wrong: anatomy based on animal studies, supported humoral model of medicine (Hippocratic), incorrect physiological beliefs (separate venous/arterial system; innate arterial pulsations; vital spirit formed when air mixed with blood) and advocate of venisection
150
Q
Who is the father of surgery?
A
- Ambroise Pare
151
Q
Who was Paracelsus and what was his contribution to the medical renaissance?
A
- full name: Theophrastus Phillipus Aureolus Bombastus von Hohenheim - Swiss born - Surgeon, city physician on Basel - Scorned University physicians, burned Avicenna’s Qanun in public, had to leave town under fire - Known as the “father of Pharmacology” because of his expertise in drugs and herbal remedies - Attempted to replace humors with his own metallic system - Contemptuous of learned medicine via university - Spurred group of Paracelsians who spread through Europe in 16th centuries, vehement opponents of Galenism: relied heavily on chemicals
152
Q
Who was Andreas Vesalius and what was his contribution to the medical renaissance?
A
- Belgian born anatomist and student of Jacobus Sylvius in the 16th century - Produced some of the first anatomic illustrations for medical students (Tabulae anatomic sexe). Some of these illustrations perpetuated the errors of Galen, ie. 5-lobed human liver - He wrote De Humani Corporis Fabrica in 1543. - Influenced the study of medical education for several hundred years - Many very successful surgeons, anatomists and physicians studied under him, who ended up discovering pulmonary circulation, Fallopian tube, venous valves etc.
153
Q
Who was Rene Descartes and what was his contribution to medicine?
A
- French natural philosopher from Holland - Studies many things including medicine (including dissection of animals) and algebra/geometry. - Set tone for scientific age through many writings - Dedicated his life to pursuing truth - First principle: cogito ergo sum (I think, therefore I exist) - Proposed duality of human existence, which states that body is tangible and quanitifiable, while soul is immortal, intangible and cannot be quantified - Science and mathematics explained everything - Regarded body as mechanism
154
Q
How did Asclepiads/Asclepions contribute to healing during ancient Greek times?
A
- Asclepions were temples of healing during 300 BCE where asclepiads / priest-healers would work. Inside these temples were abatons / private areas for pilgrims to be healed. Pilgrims testified about their healing by inscribing on walls what intervention took place. Epidouros (most celebrated) / Cos (birthplace of Hippocrates) were two important asclepions.
155
Q
What is the Mycenean Era?
A
- Refers to a Greek period during ~1550-1100 BCE where shamanic folk /priests were healers who believed that illness was caused by anger or whim of gods.
156
Q
Who was Rene Laennec and what was his contribution to medicine?
A
- French physician who studied under many famous physicians, including Jean Nicholas Corvisart in Paris where he learned amongst many other things, percussion - Inventor of stethoscope - Researcher who described many diseases and a number of medical terms including: melanoma, (rales, rhonchi, crepitance and egophony) and cirrhosis - Correlated sounds heard with stethoscope to specific pathologic changes
157
Q
Who was Jacobus Sylvius?
A
- Jacobus Sylvius was a French anatomist and physician in the 15th-16th centuries who upheld Galen and Hippocrates. Advocated that they never wrote anything in medicine that wasn’t entirely true. Advocated true return to Galen from Greek language, not derived from Arabic, etc. He was the professor of Andreas Vesalius and an opponent of his student.
158
Q
What is De Humani Corporis Fabrica?
A
- Anatomy text “on the fabric of the human body” written by Andreas Vesalius in 1543 - Filled with elaborate, accurate anatomical drawings - Laid foundation for observational anatomy - Refuted errors in Galen - Elaborated three concepts: anatomist should perform his own dissection, eye is preferred over reference to authority, anatomy is key to medicine
159
Q
Who was Desiderius Erasmus and what was his contribution to the medical renaissance?
A
- Born in Holland, he was a leader in European scholarship in the late 15th/early 16th century - Not a physician - Inspired edition of Galen and issues his own version of Galenic essays
160
Q
Who was the father of anatomical pathology?
A
- Giovanni Battista Morgagni
161
Q
Who was Louis Pasteur?
A
- researcher who espoused the germ theory of disease and proved many microorganisms were responsible for many diseases.
162
Q
Who is Muhammad ibn Zakariya ya-Razi (Rhazes)? What are his contributions to healing / medicine?
A
- Known as Rhazes in West, he was a Persian who served as chief physician of the first great hospital in Baghdad during the early 10th century. - He is a highly respected physician, often hailed as greatest practitioner of Islamic world - Hippocratic practitioner - Differentiated different kinds of “fevers” - Described differences between measles and smallpox - Wrote the Al-Mansuri, a medical text influential into the 16th century
163
Q
Who was considered as one of the Greatest Physicians in Europe during his time?
A
- Herman Boerhaave
