The History of the Stethoscope Flashcards
When was the transition between traditional and modern medicine?
At the turn of the 19th century
What is a central idea in traditional western medicine?
Balance = health
Imbalance = disease
What was the setting of clinical encounters in traditional western medicine? Who was the social superior?
Setting: domestic
Social superior: patient
“Bedside” medicine
What was the relationship between the doctor and patient in traditional western medicine?
Patronage system: doctor dependent on patient
In the past (before the onset of modern medicine), who was received hospital care?
The poor
When did hospitals become secularized in France?
After the French revolution
What was the main idea behind the “schools of health” established by Antoine Francois Fourcois?
The fusion of medicine and surgery (no longer separate professions).
Main principle: “read little, see much, do much” i.e. learning by doing.
Who was in charge of medical schools and hospitals after the French revolution?
The state and the doctors
The Paris hospitals represent a social reversal compared to bedside medicine. Explain.
In these hospitals, patients are the social inferiors (unlike in bedside medicine).
- Partly because they are not receiving care at home
- Partly because the are poor, have few social resources
How did approach to disease change when surgery and medicine became fused?
Localism: thinking in terms of structures and lesions, i.e. disease defined by pathological anatomy (rather than symptom clusters).
What is the clinical-pathological method introduced in the Paris medical schools?
Correlating anatomical lesions and features to the signs and symptoms of disease experienced by the patients.
How did diagnosis of disease change with localism?
It became de-individualized.
What is Bright’s disease?
Glomerulonephritis
How does Bright’s disease exemplify the changes in the approach to disease at the turn of the 19th century)?
It could be tested for by looking for protein in urine (introduction of laboratory tests).
It was separated from edema (a symptom) by recognizing that certain patients with edema had changes in their kidneys.
Shift from patient’s experience (edema) to anatomical diagnosis (objective sign of the disease).
I.E. This is an example of the clinical-pathological approach.
What are the 4 “tools” of diagnosis of physical examination?
Inspection
Palpation
Percussion
Auscultation
