Anatomy and Medicine

1. Anatomy and Medicine

2. Biology Vesalius William Harvey • European Middle Ages doctors relied on Greek, Galen • Galen’s works inaccurate • Flemish doctor Andreas Vesalius became known for work in anatomy • Used bodies of executed criminals for dissection • Hired artists to produce accurate drawings • On the Workings of the Human Body, 1543 • English physician, early 1600s • Observed, explained workings of human heart • Described blood, circulatory system functions Discoveries in Biology and Anatomy Just as astronomers moved away from the works of ancient Greeks, other scientists used the scientific method to acquire new knowledge and make great discoveries in the fields of Biology and Anatomy.

3. Antony van Leeuwenhoek • Dutch scientist, 1600s • Used interest in developing magnifying lens to invent microscope • First to describe appearance of bacteria, red blood cells, yeast, other microorganisms • Robert Hooke • English physician, inventor • Used early microscope to describe appearance of plants at microscopic level • Credited with creating the term cell

4. Scientific Revolution: Paracelsus: Philippus Aureolus Theophrastus Bombastus von Hohenheim • 1493 to 1541 AD • Swiss • One of the first to challenge the ideas of Galen • Said that people could only learn by experience • So when he became a teacher, he burned the books of Galen • He was the first to realize that poisoning could causes diseases like breathing metal vapors • He was the first to think of chemicals as medicine • Unfortunately his favorite medicine was mercury, so he actually poisoned the people he was trying to heal

5. Paracelsus (1493-1541) Rejected the work of both Aristotle and Galen Replace the traditional system with a new chemical philosophy based upon a new understanding of nature derived from fresh observation & experiment Believed disease was caused by chemical imbalance in the organs which could be solved by chemical remedies Although chemical remedies had been used, Paracelsus and his followers differed by giving careful attention to the proper dosages of their chemically prepared metals & materials

6. Paracelsus Paracelsus (11 November or 17 December 1493 in Einsiedeln, Switzerland - 24 September 1541) was an alchemist, physician, astrologer, and general occultist. Born Phillip von Hohenheim, he later took up the name Philippus Theophrastus Aureolus Bombastus von Hohenheim, and still later took the title Paracelsus, meaning "equal to or greater than Celsus", a Roman physician from the first century BC. “Bier is a really divine medicine”. Paracelsus (1493 – 1541).

7. Paracelcus

8. Paracelsus: Genius with bad press agent • Attended Universities of Heidelberg, Freiburg, Ingolstadt, Cologne, Tübingen, Vienna, Erfurt and Ferrara, left without degree, drank to excess, and wandered over most of known world, took part in the Peasants War (1525) • Practiced medicine in Spain, Portugal, England, Denmark, Poland, Prussia, Hungary, Arabia, Egypt, Turkey, probably other places as well, frequently aggravating established practitioners. • Investigated the use of opium, coined the term laudanum for tincture of opium, an opium extract containing 40-80% ethanol. • Pioneered use of chemicals, elements in medicine (Zn, Hg, Au) • Introduced draining to replace amputation or cauterization • Introduced dose-response concept • Recognized the first industrial disease in miners

10. Paracelsus • Alle Ding' sind Gift und nichts ohn' Gift; allein die Dosis macht, dass ein Ding kein Gift ist. ("All things are poison and nothing is without poison, only the dose permits something not to be poisonous.”) Paracelsus crater photographed by Apollo 15. An 83 km crater on the far side of the moon.

11. Paracelsus: a few weird facts • “Paracelsus” a 1943 film by Georg Wilhelm Pabst, essentially a Nazi propaganda film. • Professor Bulwer in 1922 Murnau film 'Nosferatu' is a follower of Paracelsus • “Paracelsus” (lengthy dramatic poem by Robert Browning) • Paracelsus is mentioned as an inspiration to Victor Frankenstein, the main character in Mary Shelley's Frankenstein. • Paracelsus is one of the people featured on a Chocolate Frog card in Harry Potter. A bust of Paracelsus is in the castle at Hogwarts, near Gryffindor, between the entrance to the Gryffindor common room and the Owlry, as mentioned in Order of the Phoenix

12. Andreas Vesalius (1514 to 1564) Barber surgeon (combination barber, dentist, doctor). Got special permission from the Pope to dissect criminals. First scientist to understand human anatomy. Wrote the first accurate book on human anatomy – Fabrica.

13. Andreas Vesalius: 1514 - 1564 • Belgian • Proved Galen wrong by stealing bodies and dissecting them • Grave-robbing for corpses became common

14. Shortage of cadavers • In England and Scotland, medical schools began to open. • No one donated bodies to science – churchgoers believed in literal rising from grave, so dissection spoiled chances of resurrection. • Became a tradition to rely on executed prisoners, even up to 18th and 19th centuries.

15. Serious Crimes • The added punishment of being dissected after death was considered another deterrent from crime. • Ex. – Steal a pig: you were hung • Kill a person: you were hung and dissected • Anatomists were often associated withexecutioners.

16. Need for Body Parts • Because they needed body parts, anatomists at medical school bought odd things. • A man could sell the leg of his son if it had to be amputated

17. Grave Robbing • Some medical students raided grave yards; some professors did also. • In certain Scottish schools in 1700s, you could trade a corpse for your tuition.

18. Resurrectionists • By 1828 in London, body snatchers (or resurrectionists) provided the medical schools with corpses. • Not a crime; a dead body could not be owned or stolen. • (Anatomy studies were only conducted from October to May to avoid stench of decomposition.)

19. Reactions to Grave Robbing • Wealthy people chose to be buried in iron cages, some covered in concrete. • Also churches built “dead houses” which were locked and guarded.

22. The Body in the Scientific Revolution • A New Doctor – A New Body • Andreas Vesalius (1514-1564) • Dutch-born Physician • Taught medicine at University of Padua (Italy) • 1543 –Publishes new textbook on anatomy, On the Workings of the Human Body • Same year Copernicus publishes On the Revolutions of the Heavenly Spheres • Textbook attacks many of the established theories of Aristotle and Galen on the basis of Vesalius’s own dissections. • Book is illustrated with detailed printed images.

23. Andreas Vesalius:(1514-64) • Belgian anatomist and physician whose work help correct many of the misconceptions of the time • Dissected actual human bodies, in a belief that Galen’s work was inaccurate because it was based on animals • Published his finding in 1543 in On The Structure of the Human Body • wrote De Humani Corporis Fabrica (On the Structure of the Human Body) – seven volumes on the structure of the human body which he illustrated himself • These were the most accurate and comprehensive anatomical texts at the time Appointed as physician to the Holy Roman Emperor Charles V.

25. Vesalius • Images from Vesalius’s book

26. This anonymous German print shows a thigh wound being cauterized. Above the action we can see the various medical instruments used for different types of wounds Source: Hans von Gersdorff, Feldbuch der Wundartzey (sSrasbourg, 1540).

27. Andreas Vesalius • The new anatomy of the sixteenth century was based on the work of Andreas Vesalius. • He reported his results from dissecting human bodies as a professor of surgery at the University of Padua, presenting an accurate view of the individual organs and general structure of the human body. • He erroneously believed that the body had two kinds of blood

28. Andreas Vesalius (1514-1564) • His studies corrected Galen in relation to anatomy - believed practical research as the best way for understanding human anatomy • 1543 published On the Fabric of the Human Body • Based upon his lectures at Padua • Deviated from traditional practice by personally dissecting a body to illustrate what he was discussing • Through his “hands-on” approach, Vesalius rectified some of Galen’s more glaring errors • For example, the belief that the great blood vessels originated from the liver, but he still clung to Galen’s belief about the ebb & flow of two kinds of blood in the veins and arteries

29. The Body in the Scientific Revolution An anatomy lesson from the title page of Vesalius’s book.

31. Giovanni Morgagni: 1682 – 1771AD • Italian • Studied the effects of disease on the body’s insides • Published a big book listing the effects of diseases on the body’s organs • Proved the ancient doctors wrong and that death was caused by damage to organs and not by humours

32. Morgagni • Giovanni Battista Morgagni was born at Forli, Italy, on February 20, 1682; he died at Padua on December 6, 1771. • He was educated at the University of Bologna, receiving a degree in philosophy and medicine there in 1701. • He studied under A. M. Valsalva (1666-1723), whom he venerated for the rest of his life;when Valsalva left Bologna for Parma, Morgagni succeeded him as demonstrator in anatomy. • He was made President of the Accademia at the age of 24,and he gained a reputation for his dislike of speculation as opposed to accurate observation. • In 1706 he began publication of a series of anatomical works, which led to his becoming known in Europe as an anatomist.

33. Morgagni • In 1712, he left Bologna for Padua, where, except for a short unsuccessful attempt at practicing medicine in Forli, he was to spend the rest of his life as Professor of Anatomy. • Shortly after settling in Padua, he married Paola Vergieri of Forli,with whom he had 15 children. • His eight daughters all entered convents, which is said to have caused him considerable sadness near the end of his life. • After his wife died in 1770, the aged widower did not have much desire to continue living. • Ironically, his life, which had contributed so much to the understanding of the pathological basis of stroke, came to an end on December 6, 1771, when he (like his teacher Valsalva before him) succumbed to the condition.

34. Morgagni • Morgagni taught at the renowned University of Padua for 56 years (1715 to 1771). • His greatest professional achievement came in 1761 when, at the age of 79, he published his masterpiece, De Sedibus et Causis Morborum (translated into English as On the Sites and Causes of Disease). • The book, consisting of five volumes of letters (for a total of 70 letters), described Morgagni's observations of some 700 autopsies, and it included his correlationsbetween clinical symptoms and postmortem findings (lesions) for each of the cases studied. • (Morgagni expressed his debt in De Sedibus to previouslypublished work by Theophile Bonet, 1629-1689, although the latter's work, Sepulcretum, translated in English as Graves), is generally considered to be a poorly organized and inconclusive summary of autopsy findings up to 1679.)

35. Morgagni • It was Morgagni's study that introduced the clinical principles and practices that are still used today. • Morgagni also drew on the ideas of Hippocrates, whose methods of observation and reasoning formed the basis for many of Morgagni's own ideas. • For example, whereas Hippocrates made systematic differentiations of diseases based on observed external symptoms, • Morgagni went farther and related the external expressions of the particular disease to the internal conditions within the body. • Morgagni thus focused on theinternal damage within the body that gives rise to disease. • In clinical practice, Morgagni carefully noted the symptoms during the course of a patient's illness, and then attempted to identify the organic or pathological causes off that disease during the postmortem examination.

36. Morgagni • Because Morgagni's studies were so extensive, it became possible for him to predict or visualize internal conditions based on symptomatic observations. • Morgagni's work was also instrumental in debunking the ancient humoral theory of disease, according to which there is one cause for all diseases. • Morgagni'sDe Sedibus clearly identifies the pathologies of a number of diseases, including hepatic cirrhosis (acute yellow atrophy), cerebral gummata, cardiac valvular lesions, renal tuberculosis, pneumonic solidification of the lungs, and syphilitic lesions (aneurysms) of the brain. • Morgagni also proved, through many autopsies, that cerebral lesion in stroke occurs on the opposite side from the resulting paralysis. • Morgagni has bequeathed his name to many anatomical part's and conditions of the human body, e.g., the Morgagnian cataract.

37. Morgagni • Morgagni was held in high esteem by his colleagues and students; he was the friend of many Venetian senators and several popes. • His international reputation was attested to by his election to the Academia Naturae Curiosorum(1708); the Academy of Science, Paris (1731); the Imperial Academy of St. Petersburg (1735); and the Berlin Academy (1754). • Morgagni was largely responsible during the more than 50 years he spent as a professor at the University of Padua for that university's foremost reputation in Europe during the 18th century. • Besides being recognized today as one of the leading figures in 18th-century medicine, he is considered the father of morbid anatomy, and a founder of modern anatomy and pathology.

39. William Harvey: • English Physician • Also disproved many of Galen’s hypotheses • discovered the circulation of blood, the function of valves in the heart • Worked with small animals and with humans • Published his observations in Exercitatio Anatornica de Moto Cordis et Sanguinis in Animalibus aka De Moto Cordis • Discovered the lack of circulation to the lungs in the fetal stage and therefore that lungs were collapsed and inactive in this phase • Largely influenced by the mechanical philosophy in his work with the flow of blood • First doctor to use quantitative and observational methods in his experiments • Very skeptical of spontaneous generation; proposed that all animals originated from an egg

40. Harvey “[The heart] is the household divinity which, discharging its function, nourishes, cherishes, quickens the whole body, and is indeed the foundation of life, the source of all action” - Harvey

42. William Harvey • He also showed that the same blood runs through veins and arteries and that the blood makes a complete circuit through the body. • Harvey’s work was based on close observation and experiment.

43. William Harvey and the Human Blood System • It was only with the discoveries of William Harvey that this belief was corrected • Through his research & observations, Harvey demonstrated that the heart, not the liver, was the beginning point of circulation of blood in the body, that the same blood flows in both veins and arteries, and most important, blood makes a complete circuit as it passes through the body

44. The Body in the Scientific Revolution From Observation to Experimentation William Harvey’s experiments to demonstrate the circulation of blood (1628). This illustrates an experiment to show that blood in the veins only flows toward the heart because of valves that stop blood from flowing back away from it.

45. LADY MARY WORTLEY MONTAGU (1689-1762) • · A famous poet • · Herself a smallpox victim; • In December 1715 smallpox ruined her good looks left her without eyelashes and with deeply pitted skin • Lady Mary was the wife of the British Ambassador to Turkey (1716-1718). Learned how to variolate persons in Turkey and variolated her son in 1717 and her daughter in England in 1721. • · Although there was much resistance to the acceptance of this vaccination method and Lady Mary was heavily criticized by the higher society in England, the permission to vaccinate the children of the Prince and Princess of Wales in 1772 dramatically promoted the adaptation of this method in England and in other part of Europe. • ·  By the second half of the 18th century, Europe was being ravaged by smallpox epidemics. • By this time, in rural England, it was noticed that women who milked cows were frequently spared clinical smallpox disease and several undocumented accounts suggest that the connection was made between contact with cowpox virus and protection from smallpox.

46. Edward Jenner: 1749 - 1823 • Developed the first vaccination in 1796 • It was to treat smallpox. • His vaccine used smallpox pus from the less deadly disease cowpox. • by 1800 most were using it. Jenner was awarded £30 000 by Parliament to enable him to continue carrying out his tests. • Deaths from smallpox plummeted and vaccination spread through Europe and North America.

48. Jenner worked in a rural community and most of his patients were farmers or worked on farms with cattle. • In the 18th century smallpox was a very common disease and was a major cause of death. • The main treatment was by a method which had brought success to a Dutch physiologist Jan Ingenhaus and was brought to England in 1721 from Turkey by Lady Mary Wortly Montague. • This method involved inoculating healthy people with substances from the pustules of those who had a mild case of the disease, but this often had fatal results • In 1788 an epidemic of smallpox hit Gloucestershire and during this outbreak Jenner observed that those of his patients who worked with cattle and had come in contact with the much milder disease called cowpox never came down with smallpox. • Jenner needed a way of showing that his theory actually worked. • Jenner was given the opportunity on the 14 May 1796, when a young milkmaid called Sarah Nelmes came to see him with sores on her hands like blisters. • Jenner identified that she had caught cowpox from the cows she handled each day.

49. Jenner now had the opportunity to obtain the material try out his theories. He carefully extracted some liquid from her sores and then took some liquid from the sores of a patient with mild smallpox. • Jenner believed that if he could inject someone with cowpox, the germs from the cowpox would make the body able to defend itself against the dangerous smallpox germs which he would inject later. • Jenner approached a local farmer called Phipps and asked him if he could inoculate his son James against smallpox. • He explained to the farmer that if his theory was correct, James would never contract smallpox. Surprisingly, the farmer agreed. • Jenner made two small cuts on James's left arm. • He then poured the liquid from Sarah's cowpox sores into the open wounds which he bandaged. • James went down with cowpox but was not very ill. • Six weeks later when James had recovered, Jenner vaccinated him again, this time with the smallpox virus. • This was an extremely dangerous experiment. If James lived Jenner would have found a way of preventing smallpox. • If James developed smallpox and died he would be a murderer.