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History Of Medical Science

History Of Medical Science. Why History Matters. Constant Change for 150+ Years Limited Development of Societal Consensus Always Ahead (or Behind) The Law Classic Divisions Still Prevail Shamanism Greco-Roman Rationalism The Best and Worst of Times. Shamanism. Oldest Medicine

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History Of Medical Science

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  1. History Of Medical Science

  2. Why History Matters • Constant Change for 150+ Years • Limited Development of Societal Consensus • Always Ahead (or Behind) The Law • Classic Divisions Still Prevail • Shamanism • Greco-Roman Rationalism • The Best and Worst of Times

  3. Shamanism • Oldest Medicine • Primitive Tribes • Alternative Medicine • Integrates Religion And Medicine • Persists Even Today In So Called Modern Cultures

  4. Explicitly Ministers To The Psyche And The Body • Driven By Myths • Trial And Error And Careful Observation • Often Sophisticated Rituals And Herbals • Some Cure, Most Do Not • Leviticus • Public Health Code • Rules Reduce Food Poisoning

  5. Useful Pharmacopeia • Ethnobotany • Study Of Plants Used By Ritual Healer • Many Drugs Have Been Discovered This Way • Witches Used Foxglove - Digitalis • Medicinal Chemists • Refine And Modify Botanicals • Conflicts Over Ownership of Indigenous Remedies

  6. Greco-Roman Rationalism • Galen And Successors • Driven By Rational Theories • Religion Is Left To Priests • Observations Forced To Fit Into The Theory • Plato Was Terrible About This • Mistakes Are Not Corrected • Predominant Until 16th Century • Still Lurks in Clinical Decisionmaking

  7. Modern Medicine/Scientific Medicine • Not The Philosopher's Scientific Method • The Imperative To Disprove Theories • The Full Disclosure Of Information • Science Is Constantly Questioning And Rethinking

  8. Systematic Observation is the Key • Diseases Have Variable Courses • Patient's Have Variable Conditions • Serious Participant-Observer Problem • Controlled Studies Are Key

  9. Problems With Controlled Studies • CCU • Cannot Control Variables Well • Many Things Do Not Work • Rating The Severity Of The Patient's Condition • Treatment Of Controls • Someone Gets The Old/No Treatment • Cannot Use Drugs Until Trials Are Over • AIDS Example

  10. Science Versus Scientists • Scientists Are Just People • Probably More Honest Than Most • Some Are Corrupt • Some Are Naïve • Science Is Process, Not People • Weeds out the Bad Stuff • Can Take Time • Lawyers Seek Out The Worst

  11. A Brief Chronology of Medicine

  12. Paracelsus • Philippus Aureolus Theophrastus Bombastus Von Hohenheim • Early 16th Century • Transition From Alchemy • Experiments And Systematic Observations • Antimony

  13. Anatomy And Function • Andreas Vesalius • Mid 16th Century • Accurate Anatomy • William Harvey • Early 17th Century • Flow Of The Blood And Operation Of The Heart

  14. Edward Jenner • Smallpox • Major Killer • Wiped Out The Indigenous Peoples • 1798 – Published His Book On Cowpox

  15. John Snow • Cholera In London • Broad Street Pump • Proved Cholera Is Waterborne • 1854

  16. Ignaz Philipp Semmelweis • Childbed Fever • Fellow Medical Student Died • Controlled Studies • 1849

  17. Louis Pasteur • Scientific Method • Germ Theory • Vaccination For Rabies • Pasteurization • 1860s-1880s

  18. Foundation of Modern Surgery • William Morton • Anesthesia • 1846 • Joseph Lister • Antisepsis • 1867-1880s • Surgery Became Big Business • Drove Development of Hospitals

  19. Infectious Diseases • Koch’s Postulates - 1880s • Agent Must Be Present In Every Case; • Agent Must Be Isolated From The Host And Grown In Vitro [In A Lab Dish]; • Agent Must Cause Disease When Inoculated Into A Healthy Susceptible Host; And • Agent Must Be Recovered Again From The Experimentally Infected Host. • Limitations

  20. Tuberculosis Control - 1900 • The Major Killer • Koch And Pasteur • Sanatoria • Pasteurization Of Milk • Disease Control Of Dairy Herds

  21. Drug Chemistry – 1880s • German/Swiss Dye Industry • Bayer • Hoffman La Roche • Ciba

  22. Antibiotics • Sulfa Drugs In The 1930s • Penicillin • Alexander Flemming – 1928 • Purified By Chain And Florey In 1939 • World War II - Coconut Grove Fire (1942) • Streptomycin – 1944 • First Antituberculosis Drug • Selman Abraham Waksman – 1944 • (Coined The Term Antibiotic

  23. Post World War II • Conquering Microbial Diseases • Vaccines • Antibiotics • Chronic Diseases • Better Drugs • Better Studies • Leukemia

  24. Technology • Microelectronics • Monitors • Pacemakers • Ventilators • Heart-Lung Machines • Dialysis • Most Depend On Drugs • Infections • Rejections

  25. New Challenges • Aging Population • Failure of Public Health • Antimicrobial Resistance • Justice Issues • How To Pay For Health Care • How To Deliver Health Care • Should Health Care be a Right?

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