History of Medicine

Question 1

Which disease did these animals bring?
Clostridium botulinum
Cattle
Horses
Cats and dogs 
Hen and mice
Cattle and dogs
Pigs and ducks

Answer 1

Gangrene.
Anthrax, brucellosis, tuberculosis and small pox.  
Rhinovirus/common cold.
Rabies and salmonella.
Salmonella
Measles 
Influenza

Question 2

Medicine was …

Answer 2

conceived in sympathy and born out of necessity.

Question 3

Medicine in antiquity:
Egyptian
Indian
Chinese 
Mesopotamian
Greek
Roman

Answer 3

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.

Question 4

Egyptian medicine

Answer 4

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.

Question 5

Egyptian papyri discovered in 19th century

Answer 5

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.

Question 6

Indian medicine/Ayurveda(knowledge of life)

Answer 6

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)

Question 7

Indian medical figures and their role

Answer 7

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.

Question 8

Chinese medicine

Answer 8

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.

Question 9

Mesopotamian medicine

Answer 9

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.

Question 10

Who ended the tradition of divination and magic in medicine?

Answer 10

Hippocrates

Question 11

Father of medicine and his achievements?

Answer 11

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.

Question 12

Belief system of Hippocratic doctors

Answer 12

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).

Question 13

Who was Aesculapius?

Answer 13

Greek god of medicine, blameless physician/ tribal leader.

Staff of Aesculapius entwined by a snake is symbol of medicine.

Question 14

goddess of cure

Answer 14

Panacea

Question 15

goddess of prevention

Answer 15

Hygea

Question 16

Roman medicine

Answer 16

They excelled in public health practice.

It was personal. Students attached themselves to teachers.

Question 17

Galen

Answer 17

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.

Question 18

The middle ages

Answer 18

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.

Question 19

Abu Beer’s achievements

Answer 19

A.K.A Rhazes

First to note pupillary reaction to light, use mercurial purgatives, write book on children’s diseases.

Question 20

Ibn Sina’s achievements

Answer 20

A.K.A Avicenna
Wrote canon of medicine of medical theories.
Popularised Islamic medicine.

Question 21

Era of scientific medicine

Answer 21

From Paracelsus to Edward Jenner

Question 22

Paracelsus

Answer 22

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.

Question 23

Heironymus Fracastorius

Answer 23

Proposed theory of contagion.

First to describe syphilis, its symptoms, mode of transmission, used special prep of mercury to treat it.

Question 24

Andreas Vesalius

Answer 24

Discovered Galen’s errors from dissection.

Started new approach to studying anatomy by dissecting, not just using textbooks.

Question 25

William Harvey

Answer 25

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.

Question 26

Robert Hooke

Answer 26

Discovered basic unit of life and named it cell in 1665. Viewed them with X50 microscope and counted them.

Question 27

Anton Van Leewenhoek

Answer 27

Viewed animacules with X270 microscope in 1670.

He and Hooke established cell theory.

Question 28

James Lind

Answer 28

British Naval physician. Noticed scurvy in sailors in 1747 and conducted first ever randomised, controlled trial. (12 sailors in 6 pairs).

Question 29

What is variolation?

Answer 29

It is innoculation of a healthy person with small pox from infected person, to facilitate immunity against small pox.

Question 30

Vaccination began with

Answer 30

James Phipps and Sarah Nelms.

Question 31

Edward Jenner

Answer 31

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.

Question 32

Benjamin Jesty

Answer 32

Vaccinated his wife and sons against small pox in 1774.

Question 33

Pre– The Great Sanitary Awakening in England

Answer 33

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.

Question 34

Edwin Chadwick

Answer 34

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.

Question 35

Lemuel Shattuck

Answer 35

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.

Question 36

William Farr

Answer 36

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.