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history of medicine Flashcards

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1
Q

who were the first forms of healers?

A

shaman from indigenous communities

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2
Q

what was the first form of medicine based on?

A

power of folk healer, sorcerer, seer, teacher and priest and claimed spiritual power

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3
Q

what were diseases attributed to?

A
  • loss of soul
  • dinive punishment
  • possession
  • parasitic/external bodies
  • evil eye
    NOT physiological factors
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4
Q

where did the first physician appear?

A

mesopotamia / egypt

  • imhotep (famous healer, chief minister to pharaoh)
  • 1st forms of empirical treatments
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5
Q

what was the greek physician figure?

A

asklepios: - god of healing ‘tribal wound healer, son of Apollo’
- portrayed with staff and snake -> origin of caduceus sign

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6
Q

when did non-religious medicine arise?

A

5th BC, birth of Hippocrates

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7
Q

what did the non-religious idea of medicine mean?

A
  • idea of a disease caused naturally not because of superstition and gods
  • developed elitist ideal of professional identity -> promoted natural theories of health and sickness
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8
Q

what was the ethical approach of greek physicians?

A

DO NOT HARM ‘primum non nocere’

  • physicians devotion to his art rather than fame and fortune
  • creates a proximal relationship with a patient
  • consoled anxious patients
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9
Q

what were the 4 vital fluids?

A
  • illness was caused when one fluid exceeded or diminished -> solved through regimen, blood letting, changing diet
    • blood= vitality >body hot and wet
    • yellow bile= digestion (gastric juice) > hot and dry
    • black bile=melancholy, darkening other fluids > cold and dry
    • phlegm = lubricant and coolant (mucus, sweat, tears, in excess cold and fever) > cold and wet
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10
Q

medical paternalism vs patient’s autonomy

A

medical paternalism: attitude and practices in which a physician decides what the patients should do to improve their health
patient’s autonomy: right of patient to make their decision about medical care without their physician trying to influence their decision

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11
Q

medical methodology steps

A
  • diagnosis: identifying a disease from its signs and symptoms
  • prognostic: prospect of recovery as anticipated from usual course of disease or peculiarities of the case
  • observation
  • treatment
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12
Q

how did galen contribute to medical advancement?

A

162, Rome
anatomist work-> explained body from his dissection data
- created first explanation of blood system and circulation

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13
Q

western world origin of hospitals

A

greece-> asclepeia, health complex
rome-> valetudinaria, hospital for particular categories of people, dedicated to agriculutal workers who got sick, slaves, soldiers (those thought needed by the empire)

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14
Q

eastern world origin of hospitals

A

after fall of rome, islamic world becomes centre of medical knowledge
- byzantine hospital & arab-islamic bimaristan (320-1100 AD)

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15
Q

describe the role of nestorians

A

armenians in alexandria (converted to christianity, 132BC), established 2 schools:

  • medical school of Nisibis - Edessa (346, mesopotamia)
  • school of Jundi-Shapur - school of medicine is born as well as hospitalisation
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16
Q

how were bimaristan organised?

A
  • transportable bimaristan -> meat hygiene in market
  • permanent bimaristan -> madrassah library and bimaristan hospital have to be present for the wellbeing assurance (training students on text and lab - practice + theory)
    • hierarchies of doctors
    • proto-peer reviews for publications
    • libraries
    • places for other cults
17
Q

what caused the focus to shift back to western worlds for medical developments?

A

crusades->1095-1291

  • created a system of medical training
    • bediside clinical instructions
    • specialised personnel made of doctors and surgeons
    • resident and external doctors
    • systematic hospital guard shifts
    • large number of patients arranged in wards per disease
18
Q

what was the problem that slowed down development of medical care in the western world?

A

clash between science and religion
ancient ‘physician’ refused the surgical aspect:
- lithotomy (removing bladder stone) were performed by specialised lithotomists

19
Q

according to what was medical care given in the middle ages?

A
  • ocial status of patient:
    • slaves treatments were quick and obligatory
    • free but poor people: emetics, purges and bloodletting
    • wealthy: more attention
20
Q

what was the medical college?

A

italian invention (venice college, 1316)

  • created new approach for the birth of 4th medical discipline
  • bologna (1088) created hierarchy of practitioners -> formalises structure connoted by the position of excellence of the internist doctor
21
Q

when was a permit first required to practice medicine?

A

1217, Paris

concept of caritas -> caring for the sick, more welcomed in hospices for the first time

22
Q

describe the work of william harvey

A 
1578-1657
discovered circulatory system through use of animals and vessels : heart acts as a muscular pump that pushes blood through body in continuous cycle
creation of scientific proof: 
- logical deduction 
- empirical proof
- experimental proofs
- plausibility through analigy 
- faculty of prediction  
demolished idea of humours
23
Q

what idea did the plague introduce to medical science?

A

idea of contagious spreading

  • deterioration of air (malaria)
  • miamsa -> putrified and contagious air which caused infections (miasmatic approach)
  • miasma -> spread of poison and corruption
24
Q

describe the refutation of miasmatic approach by girolamo fracastoro

A
  • middle 16th century -> very small, unseeable particles cause disease are alive (seminaria)
    • macro theory of disease
  • spread by air, multiply by themselves, destroyable by fire
  • 1543-> De contagione et contagiosis morbis -> promote personal and environmental hygiene to prevent disease
25
Q

describe the work of andrea vesalius

A

1514-1564

  • started from observing reality (anatomy of corpses) and then described his observations, disputing Galenic and Hippocratic texts
  • ‘De Humani Corporis Fabrica’
26
Q

describe the work of giovanni battista morgani

A

1682-1771

  • de sedibus et causis morborum per anatomen law investigatis -> causes of disease are anatomical
    • close to pathology expertise
    • describe evolutions of symptoms
    • in the form of epistolary (700 cases explained)
    • describes evolution of symptoms, sex, age, occupation, hereditary factors, seasonal incidence
    • description of physical examination of the body through palpation and auscultation
    • animal testing
    • statistical evaluation through literature and experience
27
Q

describe the work of anton van leeuwenhoek

A 
1674
grinding lenses (magnification of 300) -> described common bacterial morphologies and estimated their size as microscopic mobile beings 'swim close to each other like a swarm of fruit flies in the air'
28
Q

describe the work of marcello marpigli

A

1628

  • founder of microscopic anatomy
    • layers of epidemics
    • taste buds
    • discovered and described alveoli
    • identified capillary anastomosis
    • renal glomeruli
  • used microscope as medical tool
29
Q

describe the work of james lind

A

1700 - birth of epidemiology

  • assigned different possible treatments to different units from his sample to find the best cure
    • randomised control trial -> find which one works best from many options
  • cholera theory (studied scurvy)
30
Q

describe the work of John snow

A

1853-54 - origin of cholera

  • ecological design: cholera rates by region
  • cohort design: compare cholera rates in exposed and non-exposed
  • case control analysis: compare exposure history in cholera cases and non-cases
31
Q

describe the work of Ignaz Semmelweis

A

1818-1865 - father of antiseptic procedures
17% of women who gave birth dies from corporal fever (childbirth fever)
- compared 2 control groups
- conclusion: students were transferring something from cadavers to mothers on their hands
- could reduce deaths by having students disinfect their hands with chlorine hand-wash (eliminated bacteria)

Medical History (3 decks)

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