history Flashcards
what do the detaile
Detailed information from papyrus records
Disease caused by god/spirit/supernaturalforce
Shaman-Physicians investigated specific causeof disease and adopted magic rituals,talismans and medicines as treatments
Specialist physicians eg eyes, stomach/bowels,internal fluids, “Shepherd of the Royal Anus”
what was the early understanding of human physiology? (Ebers Papyrus)
Body served by system of 46 tubes (channels)with heart at centre
Didn’t appreciate functional differencesbetween blood vessels, intestines, airways etc.
Disease resulted as consequence of channel being blocked by the Wehedu (evil spirit)
Physicians would seek practical solutions (cures)to unblock the channels rather than using onlyspiritual approaches
how did egyptians learn about anatomy?
Egyptians believed in an afterlife -preservation of body after death
Later embalming (Pharaohs and other important/wealthy people)
Organs removed and preserved in jars – kept with mummified body
Mummification -knowledge of internal body structures
what were the common diseases in ancient egypt?
- Schistosomiasis
- Malaria
- Trachoma (eye disease)
- Small pox
- Measles
- Tuberculosis
- Cholera
- Silicosis of the lungs pneumonia
what did ancient greece believe about medicine?
- Asclepius : God of healing
- Greek doctors providing rational theory of disease and search for curesIf body had correct balance of hot & cold,wet & dry then you would have health
- Upsetting balance – illne
who was the father of western medicine?
Hippocrates: “Father of Western medicine” ~460 – 377 BC
what did people believe about medicine during the hippocrates period?
Healing power of nature
Body rebalance four humours and heal itself (physis)
Therapeutic approach aimed at easing natural processImportance of rest and immobilisation
Emphasis on cleanliness
Drugs/specialised treatments used sparingly
Major advances in prognosis of disease progression based on data collected in detailed case histories
what are the four humours?
Four humours: blood, black bile, yellow bile, phlegm
In health, four humours in balance (pepsis)
In disease, humours out of balance (dyscrasia)
Therapy = restoration of balance eg Citrus –> phlegm
what did fever represent during the aristotle period?
Fever = too much blood
this would be treated by cutting the patient to reduce blood
Crisis meaning? (aristotle period)
Crisis = point in progression of disease where illness
leads to death(alternatively patient might recover
Crises occurred on critical days (fixed time after onset of illness)
what did the romans discover in terms of microbiology?
- First suggestion of existence of micro-organismsand their association with disease
- Advised avoidance of swamps and marshland
– “breed minute creatures which cannot be seen by the eyes, but which float in the air and enter the body through the mouth and nose and what cause serious diseases.”
what did the romans discover about human anatomy?
Described properties of muscular tissue and function of principal muscles
Importance of nerves for motion and sensation –sectioning nerve led to paralysis & loss of feeling to body part it served
Nerves communicated information from brain & spinal cord to muscles
Brain & spinal cord were “centre of psychicalforce”
identified distinction between arteries and veins
what did the romans forbid?
Church forbade dissection of “God fearing bodies”Dissections performed on bodies of criminals/’sinners
who was Leonardo Da Vinci?
Leonardo Da Vinci was a highly influential in pioneering dissection of human bodies and making careful anatomical diagrams.
what did william harvey discover about the circulation of blood?
- First accurate description of the movement of blood around the body in a closed circuit Identified:Heart as a co-ordinated pump
- Role of arteries in carrying blood away from the heart role of veins in returning blood to the heart (and the importance of valves)
who was JJR Macleod?
In the early 1920s Frederick Banting and Charles Best discovered insulin under the directorship of John Macleod at the University of Toronto. With the help of James Collip, insulin was purified,making it available for the successful treatment of diabetes
On 23 January 1923, Banting, Collip and Best were awarded U.S.patents on insulin and the method used to make it. They all sold these patents to the University of Toronto for $1 each.
Banting famously said, “Insulin does not belong to me, it belongs to the world.” He wanted everyone who needed it to have access to it.
who was Professor Hans Kosterlitz?
One of the University of Aberdeen’s most famous scientists Professor Hans Kosterlitz co-discovered morphine-like chemicals produced in the brain
who was John Boyd Orr?
1899-1914: Glasgow. Qualifications and degrees in teaching, biology, medicine
1914-1918: Aberdeen and beyond- started at a research institute that would become the Rowettand exposure reality of war in the trenches
1927- proved the value of milk being supplied to school children, which led to free school milk provision in the UK.
1936- “Food, Health and Income” showed that at least one third of the UK population were so poor that they could not afford to buy sufficient food to provide a healthy diet and revealed that there was a link between low-income, malnutrition and under-achievement in schools
Who was THE MRI first tested on?
In 1980, a man with terminal cancer fromFraserburgh in Aberdeenshire took the bold step of consenting to be the first ever scanned by MRI.
The images showed up clear differences in his liver and spleen and also identified a secondary tumour in his spine which had not previously been known.
It was the breakthrough that Mallard and his team had dedicated more than 20 years to bringing to fruition
how can climate change effect pregnancy?
We all know that the climate is warming, and that this is changing our weather and increasing the frequency of heat waves, hurricanes,flooding, and drought. Two additional risk factors to the health effects of extreme heat are pregnancy and working outdoors – something millions of women across the tropics, who perform formal and informal labour, experience
who was Professor John Mallard?
Prof John Mallard : the University’s first Chair of Medical Physics Magnetic Resonance Imaging
how do pharmaceuticals impact the enviorment?
Wasted or unused medicine is a serious and growing problem within the NHS that you can help tackle.It is estimated that as much as £300 million is wasted every year on unused or partially used medication which cannot be recycled or re-used
how should inhalers be disposed of?
All used inhalers should be returned to a pharmacy to be disposed of safely. They can be disposed of by the pharmacist with other drugs waste, this is then thermally treated to destroy the greenhouse gases.This environmentally safe disposal route is available at all pharmacies and is paid for by NHS
why should inhalers not be thrown into the trash?
There are two main types of inhaler, pressurised canisters, known as Metered Dose Inhalers or pMDI, and powder inhalers, known as Dry Powder Inhalers or DPI.
The propellants used in pressurised canister inhalers are powerful greenhouse gases. Even after the inhaler is spent significant amounts of these environmentally damaging gases remain in the canister
While these gases can be extracted cleaned and reused in industrial equipment, such as air conditioning systems, they are being phased out of use in most applications because of their environmental impacts.
The only environmentally safe way to dispose of them is through thermal treatment, such as incineration. Steel and aluminium may be recovered and recycled at some incinerators.
what were the major factors in renaissance medicine?
- Reformation of the Roman Catholic Church
- Galen’s theory of the four humors was disproved
- The church controlled most of the teaching within the universities
- The invention of the printing press
-Allowed news and information to spread quickly and not be held within the monasteries in which they were written - The invention of the microscope and other instruments
- Instrument quality is intrinsically linked with science* The discovery of new lands allowed pharmacists to make new medicines
- Christopher Columbus
what did galen do?
- Claudius Galen (AD 129 – about AD 210)* He used monkeys to study human anatomy
- Some of his ideas were right:* Nerves control muscles* Venous and arterial blood are different
- He could surgically remove cataracts!* Some were wrong:*
- He continues Hippocrates’ bodily humors theory
- Humor imbalances corresponded to different human temperaments
- Venous blood is pumped by the liver
- Arterial blood originated in the heart
- Blood was “consumed” by the organs
what was the reformation?
- Began in Europe in 1517 with the aim of reforming the practices of the Roman Catholic Church
- Martin Luther was a German priest whostarted the reformation
- This was largely due to him going against the church selling indulgences to raise money
- He posted theses (which were printed),sparking the protestant reformation
how did the reformation impact medical science?
- Destroyed the ideas of Galen as the church no longer had control over much of the learning:
- Mainly through the printing press andthe speed at which teachings could be distributed
- The church could do little to stop the spread of knowledge in light of this invention
why was the invention of the printing press so vital to society?
- Allowed discoveries to be communicated quickly
- It also allowed the printing of detailed anatomical drawings far more quickly than hand-copying as had been previously carried out
- De humani corporis fabrica by AndreasVesalius – published in 1543e
who was Andreas Vesalius?
- Flemish anatomist Vesalius revolutionized anatomical misconceptions by Galen.
- He utilized dissections as an independent tool.
- Before Vesalius, teachings relied on classic texts like Galen, alongside animal dissections by barbersurgeons.
- Vesalius meticulously documented his work through highly detailed drawings.
- In 1539, a judge approved the use of executed criminals for dissection after discovering Vesalius’ work.
- Prior to this approval, Vesalius discreetly used executed prisoners for his dissections.
- The permission significantly hastened Vesalius’ discoveries, leading to the publication of his renowned work, De Corporis Fabrica, in 1543.
what are barber-surgeons?
- Very common medical practitioners in medieval Europe
- Usually worked on wounded soldiers
- They would also conduct tooth extractions,bloodletting and enemas (!?!)
- Poles were used as hand grips so that veins would show to allow for easier bloodletting either through leeches or razor blades
- Washed bandages from this practice would be hung in a pole to dry outside and the story goes that they would twist around the pole, which was painted red to hide the blood
what is altered self control associated with?
Studies in twins suggest changes in underlying fronto-striatal structural changes are associated with altered self-control
what is the homeostatic control of feeding?
homeostatic control of feeding is concerned primarily with regulation of energy balance. Hunger as a feeling stems from the hypothalamus, and is influenced by peptides and neuropeptides such as insulin, leptin, grehlin, and also by blood glucose level.
what is hedonistic feeding stimulated by?
VTA: stimulated by sensory input
what does the Nucleus accumbens control?
reinforces reward behaviour
what does the prefrontal cortex control?
thoughts and actions
what are the three discaplines is pharmacology a combination of?
pharmacology combines chemistry, pathology and physiology
what was opioid pharmacology focused on during the end of the 1800s?
Chemistry- the structure of the main active analgesic in opium (morphine)
- struggle to control its effects
Physiology - not sure how morphine has its effects
- not sure how pain is communicated
- these are critical to understanding the true mode of action of these opioid analgesics
Pathology
- understand the problem of pain and the need for its relief
- pain results from a wide range of diseases/injuries- most types of pain relieved by opium
Describe Descartes pain pathway?
- Particles of heat (A), activate a spot onthe skin surface (B).
- Activation of B pulls thread connected to a valve in the brain (de).
- Allows “animal spirits” stored in cavity Fto flow out.
- These spirits are responsible for:- the pain itself- withdrawal of the leg from the heat- turning the head toward the origin of the pain
what is the modern pain pathway?
pain is sensed and the individual responds
- connects to the thalamus, relays pain message to different parts of the brain
sensory nerve enters spinal cord and connects to another nerve fibre
nerve fibre ascends spinal cord into the brain
how do opioids regulate the pain pathway?
Solomon Snyder discovered the opioid receptor in 1972
- these receptors present in the brain and spinal cord
- specifically bind to morphine and other similar opioids e.g. codeine and heroin
- several different receptor sub-types discovered this
explains spectrum of opioid actions (analgesia, sedation, anti-diarrhoea) - binding of opioid to receptor inhibits nerve fibre and prevents it firing opioid
how does morphine work?
binds opioid receptors inhibits pain fibres in brain & spinal cord hence effectiveness
how did the discovery of morphine and the pain pathway influence pharmacology
- synthetic chemistry permitted drugs to be developed based on morphine but with subtle differences
- these altered the activity and properties of the new drug
- many drugs like this in use today
- 1st isolation of an active ingredient for any drug
- provided first proof that pure chemicals in plants and natural products were responsible for biological responses
what are some examples of synthetic opioid drugs?
buprenorphine, methadone, pethidine and fentanyl
what is the first mechanism in pain response?
when we are in pain, a fibre inhibits the pain signal in the spinal cord - less pain signals to go to the brain and we suffer less
rubbing activates another type of sensory receptor connected to a fibre that enters the spinal cord
what is the 2nd mechanism in pain response?
Kosterlitz and Hughes discovered the descending pain -inhibitory pathway
these nerve fibres release our own “home-made” (endogenous) opioids called enkephalins/endorphins
why was Hans Kosterlitz interested in pain mechanisms?
intrigued by reports of wounded soldiers not feeling pain during battle
investigated whether our brains can produce their own natural analgesics
describe the pain inhibitory pathway?
inhibits pain transmission in spinal cord
- releases enkephalin
- binds opioid receptors
- inhibits pain fibre firing
this pathway is stimulated by:
- stress (adrenaline)
- emotions
- opioid drugs
this pathway controls pain and suffering
- allows us to escape stress/dange
what does the pain pathway connect?
pain receptors through the spinal cord to the brain
what can the pain pathway be modulated by?
sensory nerve activation
endogenous opioids(descending pain-inhibitory pathway
what are other methods of analgesia?
local anaesthetics + anti-inflammatory drugs (ibuprofen, paracetamol, aspirin)
TENS (transcutaneous electrical nerve stimulation)
- electrical impulses applied across the skin of the lower back activates inhibitory sensory fibres (blue)
general anaesthetics
- induces loss of consciousness
- no perception/memory of pain
acupuncture - stimulates the release of enkephalins
how did we assess injuries before x-rays?
If you broke a bone or damaged yourself the only way of assessing you would be through touch
- Difficult if there’s lots of swelling and pain.
If you managed to lodge something inside you (e.g. swallowed something), the only way of finding it would be through touch, or possibly using a stethoscope to identify changes in the way sound travels through your body
how are photographs and x-rays linked?
- The technological advances of Victorian times lead to a massive increase in photography and photographic equipment
- Photographs flourished as a means of the middle classes having family portraits
- Without this advance in technology the x-ray would not have been possible
what did sir william crookes do?
- Prior to x-rays, Sir William Crookes was investigating cathode rays using vacuum tubes (later known as Crooke’s tubes)
- A high voltage in the tubes causes electrons to pass from one end to the other and generate the image of the cross on the other end of the tube
- The glow created by the electrons is them releasing energy as they hit the end of the tube
- The image of the cross occurs because the metal cross blocks the electrons
who discovered x-rays and how?
- Wilhelm Röntgen was a not very academic individual who ended up discovering x-rays by accident
- He went from high school drop out to a Nobel laureate
- He was working on cathode rays using a similar device to the Crooke’s tube because he thought the cathode rays penetrated the glass of the tube
- They actually barely penetrate the glass
- He then set about testing what the mysterious rays could pass through
- As he held the materials in front of the rays he could see the shadow they projected on the painted screen
- During this process he spotted ghostly shadows of his own bones
- The next obvious thing was to expose his wife to the rays!
- this was the first x-ray image
what were x-rays originally used for?
- Initially the medical world was suspicious of the discovery, but x-ray practices were beginning tobe run from peoples homes
- It was used a lot in the location of foreign bodies and even used to treat skin disorders or make women look beautiful
- These latter uses caused some pretty horrible side effects though
how is an x-ray constructedand how do they work?
- X-ray tubes were developed from Röntgen’s simpletube design
- High-energy electrons pass from the cathode, through the tube, and hit the metal target on the anode,releasing high energy radiation (x-rays)
- These new designs allowed x-rays to be more focused and directed
- This therefore opened the doors for more uses of thex-ray in the medical science
how do x-rays work?
- The x-rays are high energy light waves
- Dense objects can absorb the x-ray photons
- e.g. Bones, which leave a shadow on the photographic film
- Not so dense objects allow x-ray photons to passthrough unhindered
-e.g. Soft tissue, which allow the x-rays to leave an image on the photographic film - This process is akin to the cross generated in Crooke’s cathode ray tube
- Your bones create a shadow of themselves on the photographic film
