History of Medicine Flashcards
Which disease did these animals bring? Clostridium botulinum Cattle Horses Cats and dogs Hen and mice Cattle and dogs Pigs and ducks
Gangrene. Anthrax, brucellosis, tuberculosis and small pox. Rhinovirus/common cold. Rabies and salmonella. Salmonella Measles Influenza
Medicine was …
conceived in sympathy and born out of necessity.
Medicine in antiquity: Egyptian Indian Chinese Mesopotamian Greek Roman
Medicine was mixed with witchcraft, superstition, magic, religion. Man believed in supernatural causation of disease: punishment by gods, evil spirits, negative cosmic influence.
Remedy: amulet, sacrifices, prayers, casting out spirits.
Stone and flint used for circumcision and amputation.
Egyptian medicine
Egyptian god of medicine: Imhotep Physician was coequal with priest. Illness was from absorbing foul material from intestine. Treatment: blood letting, enema, drugs. Embalment, no study of anatomy. Public health; drainages, public baths, immunisation against small pox.
Egyptian papyri discovered in 19th century
Edwin Smith papyrus : a treatise on treatment of wound and injury.
Ebers papyrus: remedies with incantations and spells.
Illnesses recorded: schistosomiasis, gout, tuberculosis of the bone, tooth decay, worms, diabetes, arthritis, gall stones, eye diseases.
Indian medicine/Ayurveda(knowledge of life)
Dhavantari, god of medicine received it from god Brahma.
Magic to treat illness, charms to expel demons.
Treated diseases: abscess, edema, cough, fever, diarrhea, tumours, leprosy.
No dossection, limited anatomy knowledge.
Trodohsa: vata
phlegm(kapha,mucus)
Gall(bile)
Indian medical figures and their role
Sushruta Atreya the surgeon Charaka the physician Charaka (500) and Sushruta (760) vegetable-based diseases. Treatment: oil and water enema, purgatives, emetics, sneezing powder. Developed personal hygiene code: Laws of Manu. Prognostication of diseases.
Chinese medicine
Yin: feminine
Yang: masculine
Balance leads to good health, imbalance to ill-health.
Immunisation pioneers.
Acupuncture, hygiene, hydrotherapy.
Barefoot doctors, from house to house treating common ailments.
Mesopotamian medicine
Cradle of civilisation
Disease was spiritual and rational, herb/knife doctor and spell doctor
Only one disease per god.
Medical students classified demons according to diseases they caused.
Types of doctors:
Ashipu(sorcerer): made diagnosis, prognosis, god that caused it. Treated with spells, charms, sacrifices.
Asu(physician): treated with herbs, knifes, oils.
By the code of Hammurabi, doctor is compensated for patients recovery from his surgical procedure and sanctioned for patients death.
Treatments:
Spiritual: charms, spells, sacrifices, rituals.
Empirical: surgery, empathy and encouragement, treatment of fractures, pharmaceuticals, delivery.
Who ended the tradition of divination and magic in medicine?
Hippocrates
Father of medicine and his achievements?
Hippocrates
The first to apply science and clinical methods in the practice of medicine.
Corpus Hippocratum is a 72-volume book that has his lectures and writings.
Studied man, his diet and environment.
Specialised in bedside clinical practice.
Museum of Alexandria– first uni in the world.
Propounded original Hippocratic oath.
Modified and adopted by WMA in Geneva, Switzerland in September 1948 as Physicians oath.
Last modification was at 68th WMA General Assembly in Chicago on 14th October 2017. Now Physicians pledge.
Belief system of Hippocratic doctors
The body is in equilibrium ; the humours were in balance: blood, phlegm, water, bile.
They were clinically acute, conservative, operating only when necessary.
Guiding principle: primum non nocere(first and foremost, do not harm).
Who was Aesculapius?
Greek god of medicine, blameless physician/ tribal leader.
Staff of Aesculapius entwined by a snake is symbol of medicine.
goddess of cure
Panacea
goddess of prevention
Hygea
Roman medicine
They excelled in public health practice.
It was personal. Students attached themselves to teachers.
Galen
Pioneer in Roman medicine.
Comparative anatomist, prolific writer- over 350 titles. Dictatorial and arrogant.
Taught on blood letting, pulse, blood circulation as treatment for fever and other conditions.
Blood was from liver, mixed with chyle.
Dissection on pigs, apes, sheeps, not in humans, thought animal and human anatomy is same.
Described 473 drugs of mineral, animal and vegetable base.
Teachings were held and standard medical textbooks.
The middle ages
Tuberculosis,plaque, small pox, leprosy devastated Europe and progress was reversed ad superstition in medicine returned.
The Dark Ages Of Medicine.
During this time, the Arabs developed their system of medicine from Romans and Greeks, Hippocrates, Galen, Chinese and Indian works.
Made med schools in Baghdad, Cairo, Damascus.
Unani– Arabic system of medicine was developed.
Several drugs were introduced, words like sugar, syrup, alcohol, drug were made.
The church grew, monasteries with treatment centres were made for monks, then public.
Dissection was forbidden, many of Galen’s teachings upheld.
Abu Beer’s achievements
A.K.A Rhazes
First to note pupillary reaction to light, use mercurial purgatives, write book on children’s diseases.
Ibn Sina’s achievements
A.K.A Avicenna
Wrote canon of medicine of medical theories.
Popularised Islamic medicine.
Era of scientific medicine
From Paracelsus to Edward Jenner
Paracelsus
Philipus Aureolus Theophrastus Bombastus.
Burnt publicly works of Galen, Aviciena, ( Aristotle).
Taught that zinc, mercury and sulphur were essential for maintaining health; physicians ensures their balance, nature gives healing.
Used opiates as anaesthetics for surgery, special prep of mercury to treat syphilis.
Medical chemist and father of medical toxicology, “the dose makes the poison”.
Wrote treatise: On The Miner’s Sickness and Other Diseases of Miners about treatment and prevention of silicosis among metal workers and miners.
Heironymus Fracastorius
Proposed theory of contagion.
First to describe syphilis, its symptoms, mode of transmission, used special prep of mercury to treat it.
Andreas Vesalius
Discovered Galen’s errors from dissection.
Started new approach to studying anatomy by dissecting, not just using textbooks.
William Harvey
English physician to King James and King Charles.
Disproved what Galen and others taught– two separate circulatory systems in the body.
In 1628, he said that there is one circulatory system with blood flowing in one direction.
Robert Hooke
Discovered basic unit of life and named it cell in 1665. Viewed them with X50 microscope and counted them.
Anton Van Leewenhoek
Viewed animacules with X270 microscope in 1670.
He and Hooke established cell theory.
James Lind
British Naval physician. Noticed scurvy in sailors in 1747 and conducted first ever randomised, controlled trial. (12 sailors in 6 pairs).
What is variolation?
It is innoculation of a healthy person with small pox from infected person, to facilitate immunity against small pox.
Vaccination began with
James Phipps and Sarah Nelms.
Edward Jenner
Did extensive research on small pox.
Was variolated, started vaccination, changed practice of vaccination in England.
Built temple of vaccinia in his house for free small pox vaccination.
Benjamin Jesty
Vaccinated his wife and sons against small pox in 1774.
Pre– The Great Sanitary Awakening in England
Before 19th century, cholera, plaque, small pox, tuberculosis were common place.
Isolation centres for the sick, quarantine for almost sick.
Illness and disease was regarded as a problem of the impoverished and immoral.
19th century industrial revolution brought with it urbanisation with population increase and hence filth and environmental pollution in working class areas. Epidemics of infectious diseases became rampant.
Infant mortality was 200 per 100000 live births.
Life expectancy was 22 years for the poor and 44 years for the affluent.
This public health challenge gave rise to The Great Sanitary Awakening in England.
Filth was both a cause for disease and a vehicle for its transmission.
Turning point for public health advance in England.
Edwin Chadwick
Lawyer and Secretary Poor Law Commission in London.
Wrote report: General Report on Sanitary Condition of Labouring Population of Great Britain after investigating health and living conditions of London working class in 1832 and whole country in 1842.
Death between 16 and 36 years due to poor living conditions.
Suggested sanitary regulation if dwellings and offensive trades, provision of drinking water, drainages for sewage and waste.
Suggested formation of national and district board and officers to oversee reforms.
His work led to the establishment of the first British public health act in 1848.
Lemuel Shattuck
Wrote report: Report of the Massachusetts Sanitary Commission.
Suggested comprehensive public health system, supervision of water supplies, sanitation, state and local health boards to educate public on health and endure sanitary measures.
William Farr
Pioneer in the quantitative study of morbidity and mortality.
Helped establish the field of medical statistics.
Developed system for classification of diseases, the forerunner of the current International Classification of Diseases.
First to construct life table.
