Chapter 2: Medical Science: History and Practice. Lesson #1: The History of Medicine

The First Doctors
1. Shamans
2. Witch Doctors
3. Sorcerers

Code of Hammurabi
-used by Babylonian physicians in 3000 BC
-Named after Hammurabi, an early king of Babylon
-Laws relate to the practice of medicine
-Included severe penalties for errors

Hammurabi
– An early king of Babylon

Egyptian Civilizations
– Lists of remedies
– Surgical treatments of wounds and injuries
– Records for sanitation

Jewish Religion & Culture
– Personal hygiene practices
– Sanitary preparation of food
– Other matters of public health

Greek Civilization
– Use of nonpoisonous snakes to treat wounds
– The caduceus, the recognized symbol for medicine, depicts a healing staff with two snakes coiled around it

Indian Civilizations
– Herbal medical remedies as early as 800 BC

Chinese Civilizations
– Writings about human blood pulses around 250 BC

Japanese and Chinese Civilizations
– Practice of acupuncture

Early Medicinal Remedies Still Used Today
– Opium derivates used in medication
– Nitroglycerin to treat heart patients
– Digitalis from the foxglove plant to regulate and strengthen the heartbeat
– Sulfur and cayenne pepper to stop bleeding
– Chamomile and licorice to aid digestion
– Cranberry to treat urinary tract infections

5th Century to 16th Century
– Medieval period
– Often called “the dark ages”
– Time of little or no progress in medical practices
– Poor personal hygiene, poor nutrition, and lack of sanitation led to many epidemics
– 14th Century bubonic plague considered a pandemic
– Called black plague, or black death, becasue corpses appeared dark from hemorrhaging under the skin
– Cause of plague; bacterium that grown primarily in fleas or infected rats and rodents
– Medical teaching primarily verbal
– Surgeons Treated only the wealthy
– Other patients relied on local barber to perform surgical procedures

Hippocrates (460-377) BC
– Known as “Father of Western Medicine”
– Took medicine from realm of mysticism and philosophy and transformed it into scientific discovery and practice
– Stressed body’s healing nature
– Formed clinical descriptions of diseases
– Discovered ability to identify some diseases by listening to the chest

Hippocratic Oath
– Part of the writings of Hippocrates
– Serves as a widely used ethical guide for physicians

Hippocratic Oath
Includes the Physicians Pledge to:

– Work for the good of the patient
– Do the patient no harm
– Prescribe no deadly drugs
– Give no advice that could cause death
– Keep confidential medical information regarding the patient

Galen (130-201) AD
– Greek physician who practiced in Rome
– Initially followed Hippocratic method
– Stressed the value of anatomy
– Founded experimental physiology
– Based his theories on examination of pigs and apes
– Known as the “Prince of Physicians”

Galileo (1564-1642)
– First to use a telescope to study the skies, leading to the invention of the microscope

William Harvey (1578-1657)
– Wrote on the topic of blood circulation and using experimental method in medicine
– Could not view capillaries due to microscope not being invented yet

Zacharias Jansses (1580-1638)
– Dutch eyeglass maker who invented the microscope

Anton Van Leeuwenhoek (1632-1723)
– Known as the first person to observe and describe bacteria, which he refereed to as “tiny little beasties”
– Responsible for describing spermatozoa and protozoa

John Hunter (1728-1793)
– Developed surgery and surgical pathology into a science
– Known as Founder of Scientific Surgery

Edward Jenner (1749-1823)
– Performed the 1st vaccination using the cowpox vaccine
– Observed that dairy maids who had become infected with the disease cowpox would not become infected with the deadly disease smallpox

Rene Laennec (1781-1826)
– Invented the stethoscope

Benjamin Franklin (1706-1790)
– Discovered that colds could be passed from one person to another

Medicine During the 19th Century
– Documentation of accurate anatomy and physiology
– Use of sophisticated microscopes
– Use of injection materials
– Use of instruments such as ophthalmoscope
– Discovery of the cell
– Discovery certain diseases and wound infections caused by microorganisms

Louis Pasteur (1822-1895)
– Creditied for establishing the science of bacteriology
– His experiments proved that putrefaction, or decay, was caused by living organisms known as bacteria
– His work solved medical problems including rabies, anthrax in sheep and cattle, and chicken cholera
– Process of pasteurization is named after him

Pasteurization
– Named after Louis Pasteur
– The process during which substances, such as milk and cheese, are heated to a certain temperature to eliminate bacteria.

Joseph Lister (1827-1912)
– Borrowed Pasteur’s theories and eventually introduced antiseptic system in surgery
– Until his time, surgeons & obstetricians did not wash their hands between patients, so disease was being spread prom one patient to another
– He advised placing an antiseptic barrier between the wound and the germ-containing atmosphere
– Present-day aseptic techniques can be attributed to Lister’s work

Ignaz Semmelweiss (1818-1865)
– Obstetrician in Vienna
– Traced the cause of puerperal sepsis, which was traced to the use of contaminated clothing and contaminated hands of people who attended births

Robert Koch (1843-1910)
– Discovered tubercle bacillus, the cause of tuberculosis
– His investigation into the cause of cholera led to knowledge that contaminated food and water can cause disease
– Showed how bacteria could be cultivated and stained

Paul Ehrlich (1854-1915)
– One of the original “microbe hunters”
– Pioneer in the study of microbiology and in the fields of immunology, bacteriology, and use of chemotherapy
– His greatest achievement was the discovery, on his 606th attempt, of the “magic bullet” to treat syphilis ( an infectious and chronic venereal disease)

William Roentgen (1845-1923)
– Discovered of X-rays

Pierre Curie (1859-1906) & Marie Curie (1867-1934)
– Discovered of radium

Sigmund Freud (1856-1939)
– Discovered of psychiatry

William Morton 1819-1868 & Crawford Long 1815-1878
– First demonstrated the use of ether as a general anesthetic

Walter Reed (1851-1902)
– Helped to conquer yellow fever, which allowed for completion of the construction of the Panama Canal by reducing the death rate for the workers

Medicine During the 20th Century
– Death rates from diseases such as tuberculosis and diphtheria dropped dramatically
– Overall mortality rates decreased
– New emphasis placed on morbidity
– Chemotherapy and specialty of oncology developed
– Development of immunology
– Process in endocrinology
– Advancements in nutrition

Alexander Fleming (1881-1955)
– Discovered antibiotics
– Discovered penicillin in 1928
– He and 2 other scientists won the Nobel Price for their work with penicillin (one of the first chemicals used to treat infections)

Penicillin
– Alexander Fleming accidentally discovered that a stray mold on his culture plate of staphylococci would cause the bacteria to stop growing; he called this mold penicillium

Jonas Salk (1914-1996) & Albert Sabin (1906-1993)
– Developed vaccines that eradicated polio during the 1950s

Study of immunology advanced with the discover of vaccines against:
– Typhoid
– Tetanus
– Diphtheria
– Tuberculosis
– Yellow Fever
– Influenza
– Measles

Elizabeth Blackwell (1821-1910)
– First female physician in the United States
– Awarded degree in 1849 from Geneva Medical College in New York
– Went on to open a medical college for women and her own dispensary

Florence Nightingale (1820-1910)
– Considered the founder of modern nursing
– Referred to as “The Lady with the Lamp” because of her tireless work night and day to supervise the nursing care of wounded soldiers in Europe during the Crimean War

Clara Barton (1821-1912)
– Established The American Red Cross when she became aware of the need for support services for the soldiers
– Was a contemporary of Florence Nightingale, and nursed soldiers in a different war, the Civil War in the United States
– Establised the Federal Bureau of Records to help track injured and dead soldiers

Modern Medicine and the Future
– 1954: First successful kidney transplant
– 1960: Invention of the heart pump
– 1962: Reattachment of limbs
– 1967: First heart transplant
– 1978: First test-tube baby
– 1984: Discovery of HIV as the cause of AIDS
– 1997: Cloning of first sheep
– 2001: Placement of an implantable heart
– 2001: Completion of human genome project

1954
First successful kidney transplant

1960
Invention of the heart pump

1962
Reattachment of limbs

1967
First heart transplant

1978
First test-tube baby

1984
Discovery of HIV as the cause of AIDS

1997
Cloning of first sheep

2001
– Placement of an implantable heart

– Completion of human genome project

Mapping human genes
Has allowed for DNA testing to:
– Identify criminal
– Provide genetic counseling for prospective parents
– Design treatments for diseases
– Identify better treatments and potential cures may be possible for certain diseases

Hope for the Future
– Cure for AIDS
– Vaccine to prevent HIV
– Cloning organs to overcome shortage of donors
– Better treatment and outcomes for mental illness
– Cure for heart disease, cancer, and obesity
– Methods to slow aging
– Regeneration of brain and nerve cells to overcome paralysis
– Development of antibiotics that do not allow bacteria to develop a resistant strain

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