Medicine Through Time

Medicine Through Time Time Periods, People, and Progress

Contents Prehistory Ancient Civilizations The Egyptians The Greeks Middle Ages Medieval Medicine in the East Industrialisation and Enlightenment Renaissance Medicine The Modern World

Prehistory • 150,000 BC • First Modern Humans evolve • Hunter Gatherers • Estimated World Population – 5 million

Main Features • Nomadic • No Government • Food Supplies – Fresh meat from hunting wild animals, Vegetables fruit and berries gathered • Fresh Water • Exercise

Prehistoric Medicine • Trephination • Illness caused by evil spirits • Sorcerers, ‘Medicine Men,’ ‘Clever Men’ • Some herbal remedies • Broken Bones set in Clay • Open cuts bandaged with bark or animal skin Back to Contents

Ancient Civilisations • From 8000BC • Farming • Settlements appear • Diseases e.g. Malaria • Dirtier • Writing Develops Back to Contents Page

The Egyptians • 6000 BC to 30BC • Country ruled by King or Pharaoh • Farming developed on banks of the Nile • Developed Writing –Hieroglyphics and Papyrus • Worshiped a group of Gods

Features of Egyptian Medicine • Professional Doctors for the wealthy • Most specialised in particular parts of the body • Some Herbal treatments • Lucky charms used to prevent illness • Prayers to the gods

Anatomical Knowledge • Egyptians Embalmed the dead so had some knowledge • Knew about some internal organs – Heart and Lungs • Believed organs were connected by ‘channels’ called Metu • They carried fluids of the body – blood, tears, urine and air • Also carried ‘Wehedu’ – bad substances that caused illness

IMPORTANT NOTE • Embalming added little to medical knowledge • Embalmers worked in secret • Embalmers removed organs through the nose and small slits in the body • They DID NOT OPEN UP BODIES

What did they believe caused Illness? • Natural and supernatural causes • Blocked Channels • Upsetting the Gods Back to Contents Page

The Greeks • 800BC to 338BC • City States • Worshipped the Gods of Olympus • Some started to challenge the Gods • Believed Education was Very important • Science – wanted to make sense of the World • Philosophers

Features of Early Greek Medicine • Supernatural Beliefs • Asklepios – Greek God of Healing • His daughters: Hygeia & Panacea • Asklepions – Temples of Healing

Features of Late Greek Medicine430 BC • Hippocrates • Clinical Observation • 4 Humours • Ethical Behaviour • Rejection of Supernatural Ideas • Ethical Behaviour • Regimen – Diet and exercise – Prevention better than cure

Anatomical Knowledge • Greek Philosopher: Aristotle • Dissected animals NOT humans • The Heart – key organ in the body • Studied the connection between blood vessels and brains

The Romans • 510 BC to 476 AD • Well-Organised Government • Roman Army • Love – Hate relationship with the Greeks • Very practical • Similar religion to Greeks

Features of Early Roman Medicine • No Doctors • Family medicine – male dominated • Used a few farmyard materials • In particular – Wool and Cabbage • Supernatural beliefs – adopted Asklepions from Greeks

Features of Late Roman Medicine • Gradually adopted Hippocratic Doctors • Most Famous –Claudius Galen • Believed in 4 Humours • Became more active in treatment – Treated with opposites e.g. pepper to patients, blood letting • Wrote huge amount of books – became accepted as Gospels

Anatomical Knowledge • Galen improved Knowledge • Treated Gladiators • Dissected Animals – remember the Pig • Made mistakes – the Heart Back to Contents Page

Middle Ages • 476 AD to Circa 1450 • Frequent Wars • Christianity in the West • Islam in the East

Medicine in the Dark Ages 476 to Circa 1000 (West) • Roman and Greek medical books lost • Training for doctors disappeared • Illness was caused and cured by God • It was considered Holy to care for the sick • Mostly Nuns and Monks • Some Herbal Remedies (Provided by God) and blood letting • Four Humours Theory still used.

The Late Middle Ages – 1000 tocirca 1450 (West) • Increase in Hospitals to care for sick and poor • Uroscopy – study of urine to diagnose imbalance in 4 humours • Astrological Ideas – The position of the stars could influence health • Better Training of doctors for the Rich

Things Can Only get Better! • Universities set up – doctors licensed by university qualification • Women could not become doctors • Women continued to care for the poor • University Doctors saw themselves as superior to Apothecaries (sellers of drugs and herbal remedies) and Barber surgeons( barbers who performed simple operations e.g. removing boils)

Medieval doctors believed in preventive medicine • Blood letting of Healthy people to keep the 4 humours in balance (carried out by Barber Surgeons) ‘Venesection’ or Cupping • Treatments – Hot baths, Laxatives, Blood letting, enemas (a purgative mixture squirted into the anus using a long pipe and bellows)

Surgery in Middle Ages (West) • Some Advances due to constant wars – e.g. removal of arrowheads • Early experiments with Anaesthetics – Opium to make patient sleepy • Wine used to stop infection • Some more complicated operations e.g. removal of bladder stones • Most Surgeons not University trained.

Anatomical Knowledge • Human Dissection was disapproved of • Several attempts to ban it all together • Little increase in knowledge Back to Contents Page

Influence of Islamic Medicine • Caliphs maintained order • Greek and Roman Manuscripts preserved • Medical schools and libraries part of hospitals • Called ‘Bimaristans’ • Maristans – Hospitals for mentally ill. • Hospital sites selected by hanging meat up

East Continued • Al-Rhazi • Clinical Observation distinguished measles from Small Pox • Challenged Galen’s theory about the heart • Ibn Sina • ‘al-Qanun’ Encyclopaedia of medical knowledge • 760 drugs Back to Contents Page

Renaissance Medicine • Circa 1450 to Circa 1650 • Rebirth of Greek Ideas about understanding the world • Exploration • Illustration • Printing Press • Scientific Research • Reduction of power of the church

Medical Knowledge in the Renaissance • During this period there are a number of individuals that increased medical knowledge

Leonardo da Vinci • Inventor and artist • Wanted to produce more realistic paintings • Carried out dissections so he could understand how the human body worked • More accurate drawings

Vesalius – Anatomist1514-1564 • Carried out dissections on dead bodies • Originally a follower of Galen • Later challenged some of Galen’s theories (Septum of Heart – Not Porous) • Published a book on Anatomy using a renaissance artist to illustrate. • De Humani Corporis Fabrica

William Harvey – Physiologist 1578 -1657 • Studied how the body worked • Proved how blood circulated around the body – simple experiments • His work was initially rejected • Only accepted in 1673 when Paris University began to teach his findings

Ambroise Pare 1510-1590 • Barber Surgeon • Became military surgeon • Changed treatment of gunshot wounds (accidentally discovered that dressing wounds was more effective than cauterising) • Developed ligatures for use with amputations • Proved Bezoar didn’t work • Developed technique of ‘Podalic Version’ – turning baby in the womb

His ideas were also rejected and criticised by the medical establishment • He was ‘only’ a surgeon

Progress? • These new ideas were rejected initially • Increase in knowledge about the body – little advance in treatments • When King Charles II was dying (1685) he received the following treatments: • Blood letting, laxatives, ground up human skull, bark of Perwian Tree and Bezoar Back to Contents Page

Industrialisation and Enlightenment • Circa 1700 to Circa 1900 • Production of goods changes to factories led to growth in towns • Clear logical thought • Improvements in Science and technology • Doctors start to work in a way we would recognise today

Edward Jenner 1796 • Introduced Vaccination as a way of preventing Small Pox • Infected people with cow pox to help them build up a resistance to small pox • Great resistance at first! • Others had tried similar experiments but had not proved it scientifically or published their work.

Louis Pasteur 1861 • Germ Theory • Made the connection between germs and disease. • Showed that microbes carried in dust in the air caused decay. • These microbes/germs could be killed if heated – PASTEURISATION • Also Identified germ that caused Anthrax • Developed Vaccines for Chicken Cholera and Rabies

Robert Koch 1870s • Identified the germs that caused: • Tuberculosis, Cholera, • Developed Dyes to help identify Germs • Helped develop the Petri dish – Uses Agar jelly to grow microbes/germs and makes it possible to photograph • Others used his methods to discover the causes of pneumonia, meningitis, plague and dysentery

Improvements in Surgery • Anaesthetics developed – Nitrous Oxide, Ether, Chloroform invented by James Simpson. • Pain Free operations – More complex invasive surgery could be attempted. • But Patients still died

Fighting Infection in Surgery • Antiseptic surgery • Use of carbolic acid to kill germs by surgeon Joseph Lister • Aseptic Surgery • Keeping germs away from the operation – washing hands, clean gowns and masks, sterilising equipment, wearing gloves and keeping theatres clean Back to Contents Page

The Modern World • 1900 onwards • Huge improvements in Science and Technology • World Wars

Paul Erlich • Developed the first ‘Magic Bullet’ Salvarsan 606 – a chemical drug that kills the specific germ that causes syphilis

Gerhard Domagk • Developed the second magic bullet – based on a dye called Prontosil – kills streptococcal bacteria • Much more powerful than Salvarsan 606 • Stops infections like pneumonia and meningitis

Alexander Flemming • Wanted to find a drug that would fight simple infections caused by germs getting into soldiers wounds in WW1 • Accidentally discovered a mould that killed staphylococci bacteria – published his findings – Known as Penicillin • Failed to test it on live tissue • Others may have made the discovery before him.

Howard Florey and Ernst Chain • Read about Flemming’s discovery • Chain worked out the structure of Penicillin and was able to grow the mould in brewers yeast • Florey used Penicillin on a Policeman suffering from Staphylococcal septicaemia • Policeman improved but died because they did not have enough penicillin

Andrew J. Moyer • Developed a method of mass producing penicillin using a culture broth of corn steep liquor and lactose. • Funded by US Government. • Thousands of lives were saved during WW2 as a result

Surgery • Blood transfusions – blood grouping, prevention of clotting and storage (Blood Plasma). • Improvements in Plastic Surgery (WWI) • Skin grafts – treatment of severe burns (Guinea Pig Club WW2 Fighter Pilots)

Genetics • DNA • Identification of Genetic Disorders

Medicine Through Time