History - Individuals in Medicine Through Time

GREEK DOCTOR

Hippocratic Oath - must work for the patients good not own, don't use magic, and must have high standards, still used now.

Hippocratic Collection - Books he wrote, still used thousands of years later, included lists of symptoms and treatments. May not all have been ny him.

Observed and recorded symptoms and development of disease - helped with future diagnosis and treatment.

Developed the theory of 4 humours - wrong but believed for centuries later - phlegm, black bile, yellow bile, blood, each linked to a season and the conditions of the seasons, and an element.

Natural treatments - did not believe that gods caused diseases, but that natural treatments should be used.

ROMAN DOCTOR

• Developed better understanding of structure and functions of body - DISSECTED. In Rome used animals so not all correct (only place possible to use humans Alexandria, Greece)
• Proved: brain not heart controlled speech, arteries carry blood as well as veins.
• Told students to dissect humans whenever poss, as realised animals were sometimes different.
• Did experiments on live animals, eg pigs, to prove that nerves control diff things eg the voice, and to teach other doctors.
• Spent time at gladiator school, so became skilled surgeon. Gladiators suffered from many injuries, eg stab wounds and broken bones, for him to treat.
• Observed, recorded and used experience to decide on treatment like Hippocrates.
• Developed Hippocrates 4 humours and introduced idea of opposites to balance humours, eg problem = a cold, symptom = phlegm, opposite = hot, fiery pepper.
• His books made him famous and were used for the next 1500 yrs for teaching and learning. Info was Greek ideas and his own discoveries in Rome and Alexandria. People believed them because his ideas fitted with Christian ones of God creating humans.

RENAISSANCE

• Was an army surgeon for 20 years, doctor to 3 French kings, and wrote "Works on Surgery" 1575
• Before him cauterising was used to treat wounds - boiling oil was poured onto it and bleeding was stopped with a red hot iron. After him bandages were used and silk thread to tie end of arteries to stop bleeding.
• To help the wound to heal and the pain to be overcome, he used egg yolk, oil of roses and turpentine after running out of boiling oil. It was a Roman idea.
• To stop people bleeding to death, he used silk thread instead of the hot iron. But this did not work because it carried germs and therefore infected the wounds
• He didn't overcome 3rd problem of infection.
• Said bandages and clean sheets should be used, made first artificial limbs for amputation, and did detailed drawings of new surgical instruments.
• People thought the bezoar stone was an antidote to all poisons, but Pare proved it wasn't by poisoning a condemned cook and giving him a stone - it didn't help.

• His work shows new attitudes to science and technology, willingness to question old ideas and try out new ones.
• Technology - printing of book, gunpowder made wounds he had to treat. War - opportunity to treat wounds and try out new methods. Chance - ran out of cauterising oil so used own method. Individual genius - knew there was a less painful way, used old Roman mixture. Renaissance - new ideas, challenged old methods.

RENAISSANCE

• Wrote "The Fabric of the Human Body" 1543, containing detailed drawings of the body.
• Professor of Surgery at Padua, Italy.
• Challenged some of Galen's ideas as they were from animals not humans - he proved: The jawbone is made of one bone, where Galen thought it was 2 (true for animals); The septum did not have holes in it, but Galen thought it was how blood got from one side of the heart to the other.
• Helped by University of Padua - allowed him to have new ideas, artists there did detailed drawings of the body, he could get bodies to dissect.
• Helped by Italian artists - detailed and accurate drawings of bodies, and helped him put together atlas of the human body.
• Helped by printing press - book was easily printed, meaning exact copies rather than artists or doctors copying it inaccurately.
• Opposition: doctors had been taught to believe every word of Galen's work, but he proved some of it was wrong.

19TH CENTURY

• Realised people who suffered from cowpox didn't get smallpox. Experimented on James Phipps. Gave him cowpox then smallpox - he didn't get it. Did lots of other experiments - NOT COMPLACENT.
• Saved lives and produced new method of preventing diseases.
• First immuniser - became basis of the work of others later, eg Pasteur

Problems:

• Doctors - didn't like that it was cheap, would lose money after large income of inoculation
• People - scared that getting a cows disease might be harmful
• Himself - as he couldn't explain why it worked people became suspicious.

Factors:

• Chance - noticed people who got cowpox didn't get smallpox.
• Government - English gov gave him £50,000 to fund his work. President of USA supported him. Napoleon had all his soldiers vaccinated.

Factors:

• Science - microscopes were more powerful so he could study micro-organisms.
• War - The Franco-Prussian War caused rivalry between Pasteur and Koch.
• Government - French gov supported him to outdo Germans, funded research.
• Chance - Assistant didn't inject chickens with germ broth, left uncovered on hols.

Problems:

• Scientist, meaning he couldn't test on humans as he wasn't a doctor.
• Had to prove spontanoeous generation wrong - it was believed to be true.
• Criticised - people thought he was sloppy so did public demonstrations.

• Before him, spontaneous generation (decaying matter produced germs) - MIASMA - explained bad living conditions - 1800s.
• After - he discovered that germs landed on matter and made it decay.

• Published his germ theory in 1861.
• Used experiments eg Sterile flask = no decay, normal flask = normal decay.
• Chicken cholera - Chicken was infected with cholera but germs were old from being left out by assistant, so didn't get ill. Was infected with new germs but didn't get ill again. Test carried out on the new germs - killed other chickens. Old germs protected chicken from new.

• Anthrax - Anthrax bacteria taken from organs of sheep dead from it. Injected into mouse, got anthrax. Taken out of the blood of the infected mouse and given to another mouse. Continued in 20 generations, all got anthrax. Experimented in public - worked and increased confidence in vaccines across the world, but risk.
• Rabies - after years of careful research, developed vaccine for the rare, deadly disease from dogs. Tried on Joseph Meister untested, but it worked.
• Developed attenuation - way the vaccine's made(too weak to kill,made immune)

19TH CENTURY

Factors:

• Science - Microscopes were stronger meaning he could study the behaviour of micro-organisms.
• War - Franco-Prussian war caused rivalry between Koch and Pasteur.
• Government - German gov gave him a support team and a full time job to allow research.

Probs:

• People believed spontaneous generation, so this had to be proved wrong before his work meant anything.

• Before - the cause of diseases spreading was not known, and neither was how to find cures, so couldn't treat many diseases.

• After - they knew how to treat more diseases and there was a way to find cures for even more diseases. Others could follow the system he developed.

• He developed a way to extract bacteria which caused diseases, meaning he could identify the cause.
• Developed staining of the bacteria so he could see them more easily.
• He dentified the germs that caused tuberculosis and cholera.
• Paved the way for discovery of new cures in the next century.

19TH CENTURY

Factors:

• Science - Pasteur's germ theory proved that micro-organisms caused infection and could spread disease.
• Support - Recieved an award from a Parisian university that highlighted his work.
• Genius - He saw carbolic spray used in sewers, so thought he could try the same in hospitals.

Problems:

• The spray was unpopular - it soaked everything, cracked skin, and made everything smell.
• He didn't do public demonstrations - made people suspicious.
• The spray slowed things down - some surgeons believed speed was necessary.

• Before him - infection in 19th century = BIG problem (open wounds, reused bandages unwashed hands and equipment)
• After him - Infection spread less and operating theatres were cleaner, process of aseptic surgery with sterilised equipment and clean clothing and environment being normal.

• He sprayed a fine mist of carbolic acid over everything during ops reduced the infection.
• He used this and careful bandaging to help the wound heal without infection.
• Before this, he healed a compound fracture using a splint padded with lint dipped in carbolic acid.