medicine key people

someone who PRACTICES MEDICINE

DIDNT HAVE TO BECOME SAME LEVEL AS MODERN PHYSICIAN

ANCIENT GREEK PHYSICIAN 

he observed patients carefully and recorded findings

ideas of four humours fitted what he saw

PHYSICIAN IN ANCIENT ROME DEVELOPED THEORY FURTHER

CREATED THEORY OF OPPOSITES 

EXAMPLE-PHLEGM CURED BY EATING RED PEPPERS

FEVER CURED BY CUCUMBERS TO COOL PATIENT DOWN

SAID blood created in liver and CIRCULATED AROUND BODY

HIS INFLUENCE-

-VERY POPULAR

-although written in time of ancient rome latin translations started appearing in europe 11th century 800 yaers afer written

-translations copied and recopied by monks 

-monks passed them to medical universities

-first european medical school taught students based on texts rather than practical experience 

VERY INFLUENCIAL IN MIDDLE AGES BECAUSE-

1-INFLUENCE OF CHURCH 

2-IMPORTANCE OF BOOK LEARNING

3-LACK OF ALTERNATIVE THEORIES

-MAINLY MIXED HERBAL REMEDIES

-GOOD AMOUT KNOWLEDGE

-NOT AS SKILLED AND KNOWLEDGABLE AS PHYSICIANS

-CHEAPER THAN DOCTOR

-could prescribe potions but went against HIPPOCRATIC OATH that doctors should do no harm

-NOT GOOD FORMAL EDUCATION

-NOT TRUSTED TO DO NO HARM

-SOME PROVIDED AMULETS AND CHARMS

new unis set up across europe making medicine more PROFESSIONA 

degree-7-10 year to complete

MAIN ROLE-DIAGNOSE AND RECOMMEND TREATMENT

RARELY TTEATED PATIENTS THEMSELVES AN DIDNT EXAMINE PATIENT IN PERSON

would take sample urine, faeces and blood

then consult astrological charts and humoural charts

MANY DOCTORS PRIESTS SO FORBIDDEN BLEED A PATIENT

EXPENSIVE AS WERENT ALOT THEM AND TRAINING TOOK LONG

LEAST QUALIFIES MEDICAL PROFESSIONALS

HAD SHARP KNIVES AND STAEDY HAND SO PERFORMED SMALL SURGERIES LIKE EXTRACTING TEETH AND BLEEDING

ADVERTISE -put bowl blook in window untill 1309 THEN DISPLAY BANDAGED BLOOFY ARM

SOME HIGHLY TRAINED

SOME DOCTORS SURGICALLY TRAINED ALONGSIDE MEDICINE

LEARNED FROM PRACTICAL EXPERINCE NOT BOOKS

MOST PEOPLE TRATED BY WOMEN AT HOME

INVOLVED MAKING PATIENT COMFORTABLE,PREPARING FOOD AND MIXING HERBAL REMDIES

GREW PLANTS FOR HEALING PROPERTIES

SOME EVIDENCE CARRIES OUT MINOR SURGERY AND BLEEDING

1628- he suggested blood circulated around body

1676-SUGGESTED ILLNESS CAUSED BY EXTERNAL FACTORS NOT FOUR HUMOURS

PHYSICIAN  recognized as a founder of CLINICAL MEDICINE 

as emphasised detailed observations of patients and maintained accurate records called'HE ENGLISH HIPPOCRATES'

Practised 1656 london and made exciting study of epidemics -rapid spread of disease-

this work formed basis of his book on fever 1666

this expanded into OBSERVATIONES MEDICAE 1676-STANDARD TEXTBOOK FOR 2 CENTURIES

AMOUNG 1ST DESCRIBE SCARLET FEVER

INTRODUCED LAUDANUM INTO MEDICAL PRACTICE

ONE OF FIRST USE IRON TREAT ANEMIA

-HELPED POPULISE QUININE TRATING MALARIA

-INSISTED DOCTORS VISIT SICK RATHER OTHER WAY ROUND-SHOWED PRGRESS IN HIS THINKING 

BUT TAUGHT DIASESE CAUSED BY 'ATMOSPHERES'

-SCIENSTISTS WANTED SHARE IDEAS

-THIS LED TO ROYAL SOCIETY 1660

-aim-carry out experiments to further understand science and ecoiraged sharing ideas

-1662-recieved ROYAL CHARTER from charles 11-MEANT KING APPROVED AND SUPPORTED

-MEANT MORE PEOLE SENT WORK PUBLISHED OR WILLING DONATE MONEY

-1665- BEGAN PUBLISHING SCIENTFIC JOURNAL PHILOSOPHICAL TRANSACTIONS

-WORLDS 1ST SCIENTIFIC JOURNAL-COULD SHARE THEIR WORK

-ENCOURAGED ITS MEMBERS WRITE IN ENGLISH NOT LATIN so accesible for everyone

copies put in reference library

meant sceintisrs access each other research

MOST ADVANCED EARLY MODERN PHYSICIANS

USUALLY TOWN BASED

-well eduacted and trained

-'scientific research' done

-prepared to contradict accepted authoruty

-disseminated their findings

-relied on royal support

-limited success

-HOWEVER CHARGED VERY HIGH FEES AND ONLY RICHEST PEOPLE COULD AFFORD THEM

-CAME FROM FAMILY OF PHYSICIANS AND FATHER AND GRANDFATHER SERVED HOLY ROMAN EMPEROR

-STUDIED MEDICINE IN PARIS AND PAUDA-VERY FAMOUS UNI

-produced diagrams labelling parts of human body

-able to disscet corpes of execited criminals and make DETAILED DRAWINGS

-1543-piblished book 'fabric od the human body'

-book proved glen made made several mistakes-galen had only dissected animals

-corrected over 300 mistakes e.g

1-HUMAN JAWBONE IN 1 PART NOT 2

2-MAIN VEIN LEADING OUT HEART NOT LEAD TO LIVER

3-HUMAN LIVER DID NOT HAVE 5 SEPERATE LOBES

-

-ENCOURAGED OTHER DOCTORS TO DISSECT

-althoug had little practical impact on everyday medicne, LED TO OTHER INEVSTIGATIONS OF HUMAN ANATOMY IN MORE DETAIL

-RENAISSANCE ARTISTS PRODUCED VERY DETAILED DRAWINGS FOR HIS BOOKS

WHY WAS HE IMPORTANT?

-made study of human anatomy fashionable and central part of study of medicine, so doctors RATHER THAN SURGEONS CARRIED OUT DISSECTIONS

-work copied and apperaed medical texts

-inspired anatomists

-BUT TRADITIONAL DOCTORS ANGRY THAT CRITISED GALEN-SAID BODY CHANGED SINCE TIME OF GALEN

WHAT DID HE PROVE?

-blood flowed ONE DIRECTION

-in the lungs where transdormation of venous blood to arterial blood took place

-used versailus theory that VEINS CONTAINED VALVES-PROVING BLOOD FLOWED TOWARDS HEART

-DISSECTED human corpses and cut open COLD BLOODED ANIMALS TO OBSERVE MOVEMENT BLOOD

-PROVES ARTERIES AND VEINS LINKED TOGETHER ONE SYSTEM 

-galen said blood flowed through eartand eins carried blood and 'breath of life' and arteries JUST CARRIED BLOOD-HARVEY PROVED NO HOLES IN HEART AND VEINS CARRIED JUST BLOOD AND HEART ACTED AS PUMP

WHAT HELPED HIM?

-WAS AN INDIVIDUAL GENIUS-talented and built on findings of other docs like versalius

-SCIENCE AND TECHNOLOGY-developement of mechanical firepumps HELPED HIM DISCOVER HIS IDEAS 

-GOVERNMENT-he was emplyed by charles 1-lots people heard about his theories as he had ROYAL SUPPORT

HOW IMPORTANT WAS HE?

-encouraged other scientists experiment on bodies

-book 'AN ANATOMICAL ACCOUNT OF MOTION OF HEART AND BLOOD IN ANIMALS' widely read

-paved way for modern understanding of anatomy

BUT

DISCOVERIES VERY LITTLE PRACTICAL USE IN MEDICAL TREATMENT

LOT DOCTORS IGNORED AND CRITICISED HIM

-sone of local viacr 1749

-as young boy was INOCULATED WITH SMALLPOX-experince made him determined find another way to prevnt this disease

-trained as doctor in lodon and then became local doctor

-during this time GATHERED EVDIENCE WHERE INCULATION HAD FAILED

-NOTICED THAT MILKMAIDS WHO GOT COWPOX DID NOT DEVELOP SMALL AND THOUGHT 2 MUST BE CONNECTED

-local milkamid came to him with cowpox and jenner used COWPOX MATTER TO INJECT INTO 8 YEAR OLD JAMES PHILLIP

-6 weeks later HE INJECTED HIM WITH SMALLPOX BUT HEDIDNT CTAHC IT

-REPEATED THIS EXPERIEMTN ON JAMES AND LOCALS

-1798-WROTE UP FINDINGS IN 'AN INQUIRY INTO THE CAUSES AND EFFECTS OF THE VARIOLA VACCINAE' and named techinque VACCINE 

-SENT FINDINGS TO ROYAL SOCIETY-refused to publish

-MADE SURE INTRSUCTIONS VERY CLEAR SO DOCTORS COULD FOLLOW THEM

HOW DOES IT WORK?

-cowpox simlar smallpox so when body reacts cowpox becomes immune to smallpox-

JENNER DID NOT KNWO THIS AS NO POWERFUL MISCOPES SO COULDNT OBSETVE VIRUS

-VACCINATION RESULT OF CAREFUL EXPERIEMNTATION

HOW DID PEEOPLE REACT?

-some opposed as-ONLY WORKED FOR THAT DISEASE-scientists coudlnt use to develop other vaccines

-HE COULDNT EXPLAIN HOW LINK SMALLPOX AND COWPOX WORKED

-VACCINATION NOT ALWAYS SUCCESSFUL AND SOME DEVELOPED SMALLPOX AS DOCTORS NOT CAREFUL ENOUGH

-governemnt provided grant pay for free vaccinations but DOCTORS LOST MONYE AS PEOPLE NO LONGER PAID FOR INOCULATIONS

-CHURCH SAID USONG ANIMLA MTTER PROTECT AGAINST HUMAN DISEASE AGAINST GODS WILL

BUT

-1800S onwards bristsihs government supported method of vaccination as safer more reliable and cheaper

-became VERY POPULA IN BRITAIN

-ROYAL JENNERIAN SOCIETY FOUNDED 1803 VACCINATED 12000 PEOPLE IN 2 YEARS

-NAPOLEON VACCINATED ENTIRE ARMY 1805

-1872 GOVERNMENT ENFORCED COMPULSORY VACCINATION

-1978-WORLD HEALTHY ORGANISATION ANNOUNCED DISEASE COMPLETELY WIPED OUT

-1ST SCIENTIST TO INDENTIFY MICROBES AND THER ROLE IN DISEASE

-1850s- french chemist louis investigated problem of liquids turning sour in brewing and viengar industries

-more powerful microscopes had become available so he could observe growth of unwanted small organims in liquids

-discovered that HEATING LIQUIDS KILLED BACTERIA AND STOPPED LIQUID GOING SOUR CALLED THIS PASTEURISATION

-1861-PUBLISHED HIS GERM THOERY-shpwing microbes in air causing decay

-HIS WORK PROVED IDEA OF SPONTANEUOS GENRATION WRONG AS NO DECAY HAPPNED IF PLACED IN SEALED CONTAINER 

-SHOWED MICROBES CAUSING DECAY NOT PRODUCED BY MATTER ITSELF BUT FROM AIR AROUND IT

WHAT WAS HIS IMPACT-

-as NOT A DOCTOR had LITTLE IMOACT STRAIGHT AWAY

-BRITAIN PEOPLE CONTINUED BELIEVE IN SPONTANEOUS GENERATION  UNTILL 1870S-POWERFUL DOCTORS CONTINUED PROMOTE THIS

-some for example joseph lister-lnked germs to surgical infections

-SCIENTIST JOHN TYNDALL DISCOVERED PARTICLES IN AIR AND LINKED TO GERM THORY AND LISTERS WORK ON INFECTION 

-JON BELIEVED dust particles carried germs 

-BUT WAS A SCIENTIST SO PEOPLE DIDNT BELIEVE HIM

-lister also doubted-BACTERIA COULDNT BE IDENTIFIED 

CAUSED PROBLEM WHEN WORKING OUT WICH BACTERIA LED TO WHICH ILLNESS

-AND FACT EVEN HEALTHY PEOPLE HAD BACTERIA LIVING ON THEM

-THEREFOR ATTITUDES AMOUNGST DOCTORS IN BRITAIN MEANT MEAN PEOLE REFUSED TO RECOGNIZE LINK BETWEEN GERMS AND DISEASE

-identified different germs that caused disease

-1882-DISCOVERED BACTERIA CAUSING TUBERCILOSIS

-published methods in identifying disease causing microbes

-1883- DISCOVERED BACTERIA CAUSING CHOLERA AND PROVED SPREAD THROUGH WATER

-developed techniques in growing bacteria EG AGAR JELLY 

-DEVELOPED METHODS OF STAINING THEM TO AKE EASIER TO SEE

-INSPIRED OTHER SCIENTSIST TO FIND MISCOBES FOR OTHER DISEASES

WHAT WAS HIS IMPACT?

-only when specific disaese causing microbes found work could begin fining cures and vaccines

-british gov rejected germ theory- even when proved thye clung idea of MIASMA

-BUT BATERIOLOGY AND GERM THEORY HAD NA ENORMOUS UNDERSTANDING ON CASE OF DIASEASE AND ILLNESS

EVEN IF TOOK MEDICAL PROFESSION WHILE TO ACCEPT NEW TREATMENTS COULD BE RESEARCHED

-born into wealthy family but decided wanted become nurse

-despite familys resistance, able to train in germany and returned home become superintendent of nurses in london hospital

-WHEN HEARD REPORTS BAD CONDITIONS IN CROMEA TALED TO SYDENEY HERBERT AND AGREED TAKE 38 NURSES THERE

IN THE CRIMEA-

-horrified, made changes take care of wounded soldiers:

-SCRUBBED HOSPTAL WARDS

-NURSES ORGANISED AND COULD TREAT 2000 PATIENTS

-CLEAN BEDDING AND GOOD MEALS

DEATH RATE FELL FROM 40% TO LESS THAN 2% WITHIN 6 MONTHS 

AFTER CRIMEA-

-SHE CHANGED WAY HOSPTALS DESIGNED -better ventilation,more windows,larger rooms and isolation for infectious diseases, built out of matrials easily cleaned

-SET UP NURSING SCHOOL AT ST THOMAS HISPOTAL CALLED NIGHTINGALE SCHOOL FOR NURSES

trainig was hygeine focused and clealiness to PREVENT INFECTIOUS DISEASES SPREADING IN HOSPOTAL

-1859 WROTE BOOK 'NOTES ON NURSING' WGICH SET OUT ROLE OF NURSE AND IMPORTANCE OF PROPER TRAINING

-NURSING BACME RESPECATBLE OCCUPATION

'NIGHTINGALE NURSES'-OFTEN MIDDLE CLASS WOMEN - this REMOED REPUTATION OF DRUNK AND UNCARING NURSES

-prper training turned into profession rather than unskilled job-nurses increased

-beofre 19th cen, no effective pain relife during surgery 

patient held down by surgeons assistants 

sugery without anaesthesia had be fast

-NAPOLEONS SURGEON AMPUTATED 200 LIMBS IN 24 HOURS AT BATTLE OF BORODINO 181

-during 18th and 19th cen, sceintists experiemented with properties of chemicals and effect had on humans

-1799-HUMPHREY DAVIS discovered pain reduced usong LAUGHING GAS BUT DIDNT MAKE PATIENT COMPLETELY UNCONSIOUS

ETHER LATER FOUND PUT PATIENTS TO SLEEPAND USED SUCCESSFULLY AS ANAESTHETIC

BUT CAUSE PATIENT COUGH OR VOMIT 

-james doctor edingborough uni

-had use ether BUT WANTED FIND BETTER ANAESTHTIC

-gathered group friends togetherAND INHALED VAPOURS TO SEE WHAT WORK

-AFTER SNIFFING CHLOROFORM ALL PASSED OUT AND MRS SIMPSON DISCOVERD THEM UNDER TABLE

-REALISED EFFECTOVE AND WITHIN DAYS STARTED SUING WITH WOMEN IN CHILDBIRHT

-WORTE ABOUT HIS DISCOVERY AND OTHER SURGEONS USED IN THEIR SUERGERIES

WHY DID PEOPLE OPPOSE?

-DOSE HAD TO BE CAREFULLY CONTROLLES -1848 14 year old hannah grenner died from overdose when infcted toenail removed

-ALLOWED SURGEONS OPERATE DEEPER INTO BODY-LED TO BLACK PERIOD ON SURGERY, MORE PEOPLE DIED AS BLEEDING AN INFECTION MUCH BIGGER PROBLEM

-no one noew long term effects would be

-victorians belived pain relife INTERFERING WITH GODS PLAN especially childborth

this opposition only overcome when 1853 QUEEN VICTORIA SUED IT DURING BIRTH OF 8TH CHILD 

-DOCTORS WORRIES PATIENST MORE LIKELY DIE IF UNCONSIOUS 

-HAD STUDIES PASTEURS WORK AND SUGGESTED MISCORBES IN AIR CAUSING INFECTIONS IN HUMANS

-started look for chemical would clear bacteria

-CARBOLIC ACID COMONLY USED IN TREATING SEWAGE AND THOUGHT IF TREATED SMELL OF SEWAGE WOULD HAVE SAME EFFCT ON WOUNDS

-1865-OPERTAED ON PATIENT WITH BROKEN LEG AND USED BANDAGES SOAKED IN CARBOLIC ACID TO COVER WOUND

-deveoped carbolic spray

-oublished research in medical journal THE LANCET showing rediced inefctions 30%

WHY DID PEOPLE OPPOSE?

-GERM THEORY NOT FULLY ACCPETED SO NOT ALL SURGEONS WILLING USE IT

-CRACKED SURGEONS SKIN AND MADE EVERYTHING SMELL

-SURGEONS STILL FOCUSED ON SPEED-antispetics slowed things down

-SOME TRIED COPY METHODS BUT GOT DIFFERENT RESULTS-LESS SYTEMATIC

SOME ARGUED STOPPED BODYS OWN DEFENCES FROM WORKING

-suregons trained idea many patients would die-couldnt accept listers results-AND DIDNT WANT BELEIVE THEY MIGHT HAVE BEE RESPONSIBLE FOR INFECTIONS KILLING PATIENTS

-lister ALWAYS changing emthods to try improve antiseptic surgery 

-doctors said he was changing idaes because thye didnt work

WHAT WAS THE IMPACT?

-SHORT TERM=surgery didnt change that much because of oppostion

-LONG TERM=attitudes CHANGED AND MORE ANTISEPTIC METHODS DEVELOPED

although signifiacnt developemtn, ONLY POPULAR FOR BRIEF TIME AND LISTER STOPPED USING IT IN 1890S

BUT CHNAGED ATTITUDES OF SURGEONS TOWARDS ANTISPRTIC AND ASEPTIC SURGERY

-1890S-listers antispetic methods developed into ASEPTIC SURGERY meaning remving ALL POSSIBLE GERMS FROM OPERATING THEATRE

DONE BY- cleaning all hospotals and theatres throughly, steam cleaning instruments,rubber and sugical gloves introduced, face masks for surgeons

-1842-published HIS REPORT ON SANITARY CONDITIONS OF THE KABOURING CLASSES

PROVED THAT-

-poor lived in dirty, overcrowed conditions

-THIS CAUSED HUGE AMOUNTS ILLNESS

-many TOO SICK TO WORK AND BECAME POORER

-THEREFOR OTHERS HAD OAY HIGHER TAXES TO HELP POOR

-IMPROVING LIVES OF POOR WOULD CUT TAXES AND SAVE MONEY

HE RECOMMENDED THAT-

-drainage and sewers were improved

-rubbish REMOVED FROM STREETS AND HOUSES

-CLEAN WATER SUPPLIES

-MEDICAL OFFICER CHECK THESE THINGS HAPPENED

-LONDONS LEADING ANAESTHETIST

-HE HAD QUEEN VICTORIAS CHLOROFORM DURING BIRTH OF 8TH CHILD

-1848 epidemic-SUGGESTED cholera could not be transmitted by miasma BECAUSE IT AFFECING GUT NOT LUNGS

-SPREAD THROUGH DIRTY WATER

HOEVER NO EVIDENCE TO SUPPORT INTILL 1854

1854 EPIDEMIC=

-500 deaths around broadstreet where snow worked

-mapped out deaths in detail and showed apttern-NUMBER OF DEATHS CENTERED AROUND BROAD STREET WATER PUMP

PROVED THAT-

-in families nearer another water pump only 10 deaths -ALL 10 DRUNK FROM BROAD STREET WATER PUMP

-18 FACTORY WORKERS NEAR PUMP DIED

-residents of local workhouse who had own water supply not badly affected

-NO WOKERS AT LOCAL LOCAL BRWERY DIED AS DRANK BEER

EVIDENCE SO STRONG THAT HANDLE OF PUMP REMOVED

NO MORE DEATHS

LATER DISCOERED A CESSPIT LEAKING INTO DRINKING WATER

WHAT WAS HIS IMPACT?

-SHORT TERM=IMMEDIATE IMPACT BUT MANY REJECTED HIS FINDINGS

-GENERAL BOARD OF HEALTH STILL BELIVED MIASMA 

-if they ADMITTED SPREDA IN WATER, WOULD HAVE TO PROVIDE CLEAN WATER-VERY EXPENSIVE 

-ALTHOUG SNOW HAD PRACTICAL EVIDENCE-LACKED SCIENTIFIC PROOF

-pastuers germ theory NOT YET PUBLISHED AND WOULD BE ANOTHER 30 YEARS BEFORE KOCH ISOLATED BACTERIA CAUSING CHOLERA

1932 SCIENTIST discovered BRIGHT RED DYE CALLED PRONTOSIL, KILLED BACTERIAL INFECTIONS

one day daighter chased guinea pig into his lab and cut herself-DEVELOPED BLOOD POISONING

HE FORCED TRY UNTESTED DRUG ON DAIGHTER-IT WORKED

-THEN USED CUT MATERNITY DEATHS at hospital london-reduced from 20% to less than 5

-discovered that protosil prevented bacteria from multiplying and made bodies immune sytem kill bacteria

-september 1928- gaving clear up cluttered labatorey

one of plates HAD MOULD ON IT 

MOULD IN RING SHAPE AND AREA AROUNF RING FREE OF BACTERIA STAOHYLOCCUS

MOULD WAS PENICLLIN BACTERIA 

-not 1st person to do this-people in middle ages understood mouldy bread had healing properties and lister used it in 1871

-fleming had lifelong interest IN WAYS KILLING OFF BACTERIAAND CONCLUDED BACTERIA ON PLATE AROUND RING HAD BEEN KILLED OFF BY SOME SUBSTANCES THAT CAME FROM MOULD

-wrote about findings in journal but DID NOT BELIVE COULD BACTERIA IN PEOPLE

COUNLDNT FIND WAY EXTRCAT PURE FORM OF BACTERIA NEEDED FOR HUMAN TESTING SO DIDNT PURSUE FURTHER

-howard florey born 1898 trained as doctor and worked discoveries at oxford uni

-ernst chain jewish biochemist JOINED FLOREYS RESEARCH TEAM 

-DECIDED TO DEVELOP FLEMINGS DISCOVERY AND WANTED FIND WAY TURN PENILLIN MOULD JUICE INTO PURE DRUG-MORE SUITABKE FOR TREATMENT OF HUMANS

-DEVELOPEMENT OF OENCILLIN IN EARLY 1940S LED TO AWARD OF NOBEL PRIZE ALONGSIDE FLEMING IN 1945

-CHAIN WAS reasearching penicllin 1929 when reda fe,ings artcle

-encouraged them set up fuller inevstigation into drug

-1940s-floreys team found way purfying penicllin 1st tested on mice then on patient

-patient began recovering after recieving drug BUT THEY RAN OUT

-MASS PRODUCTION OF DRUG NOT POSSIBLE WITHOUT HELP LARGE COMAPNIES 

-florey persuaded US DRUG COMAPNIES MASS PRODUCE PENCILLIN WHEN US ENTERED WAR 1941 AS COULD TREAT INFECTED WOUNDS

-US GOVE GAVE GRANTS TO DRUG COMANIES WHO WANTED BUT EXPENSIVE EQIMENT TO MAKE IT

-MASS PRODUCTION BEGAN 1943 BY BRITISH FIRMS

-1944-ENOUGH PRODUCED TO SUPPLY ALL ALLIED ARMIES

-PRICE OF PENICLLIN FEEL AND SOON USED AROUND WORLD TO TREAT RANGE DISEAES