Chapter 1 History & Trends of Health Care

Why is it important to understand the history of health care? Students (p 3) – Read History of Health care (first paragraph)

Health Care of the Past Patients of the past were passive, dependent Health care provider was the guiding force, unquestioned Health care providers were well respected - Ancient Egyptians, Greeks, Chinese who practiced surgery, were herbalist or “witch doctors” enjoyed stature within the community Many learned the art of healing from family

Ancient Times In primitive times, common belief was that disease & illness were caused by evil spirits and demons. Treatment was aimed at eliminating the evil spirits Many ancient treatments were actually harmful As civilizations developed, changes occurred as people began to study the human body and make observations about how the body functions

Ancient Times Religion played an important role in health care - believed illness/disease were punishment from the gods -exploring the human body was limited b/c most religions did not allow dissection of the body (animals were frequently used to learn)

Ancient Times Ancient Egyptians were the first people to record health records Knowledge limited to the few educated because many could not read or write Most records were recorded on stone & created by priests, who also acted as physicians

Ancient Times Ancient Chinese had a strong belief in the need to cure the spirit and nourish the body - this treatment remains important today - Chinese herbal medicine, acupuncture, and massage are still commonly used

Ancient Times Hippocrates was known as the “Father of Medicine” Ancient Greek physician One of most important physicians Helped establish that disease is caused by natural causes, not supernatural spirits & demons Author of code of conduct for physicians, known as the “Hippocratic Oath” - still used (adapted)

Rod of Asclepius Greek symbol associated with medicine & healing - founded in ancient Greece - in Greek mythology, Asclepius was believed to be the son of Apollo & the god of healing - Symbol consists of a staff entwined by a single serpent Caduceus Symbol Often mistaken as the medical symbol, but it is actually the symbol for commerce

Ancient Times Romans realized some diseases were connected to filth, contaminated water, & poor sanitation - began development of sanitary systems by building sewers to carry away waste & deliver clean water - drained swamps & marshes to reduce incidence of malaria - created laws to keep streets clean & eliminate garbage

Ancient Times The first hospitals were established in ancient Rome Although changes occurred, treatment was still limited Average person had poor hygiene, drank contaminated water, & had unsanitary living conditions Diseases such as typhoid, cholera, malaria, dysentery, leprosy, and smallpox infected many individuals - usually fatal because cause of the diseases had not been discovered - average life span was 20 to 35 years

Dark Ages 400–800 AD Study of medicine fell after the fall of the Roman Empire Individuals again lived in unsanitary conditions Epidemics of smallpox, dysentery, typhus, & plague were rampant Epidemics - An outbreak of a contagious disease that spreads rapidly and extensively by infection and affects many individuals in an area or a population at the same time. Plagues: any widespread and usually highly contagious disease with a high fatality rate (many caused by rodents-human bitten by flea of rat) Monks and priests stressed prayer to treat illness and disease

Middles Ages 800-1400 AD Renewed interest in the medical practices of the Romans & Greeks Monks obtained & translated the writings of the Greek & Roman physicians, and recorded the knowledge in handwritten books Medical universities were created Arabs began requiring physicians to pass exams & obtain licenses In the 1300’s, a major epidemic of bubonic plague killed almost 75 percent of the population of Europe & Asia Many infants died shortly after birth & many children didn’t live into adulthood

Renaissance 1350–1650 AD “rebirth of the science of medicine” Major source of new info about the human body was a result of accepting & allowing human dissection - physicians could now view body organs & see the connection between different systems in the body - artists, such as Michelangelo & Leonardo da Vinci, were able to draw the body accurately Development of the printing press resulted in the publication of medical books

16th, 17th, and 18th Centuries William Harvey described circulation of blood Gabriel Fallopius described tympanic membrane & fallopian tubes Bartolomeo Eustachio identified the tube between the ear and throat Anton van Leeuwenhoek invented the microscope - allowed physicians to see smaller organisms Apothecaries made, prescribed, & sold medications - many meds made from plants & herbs Jenner developed a vaccine to prevent smallpox Average life span increased to 40 to 50 years

19th Century Also known as the Industrial Revolution Major progress in medicine occurred because of the development of machines & ready access to books Rene’ Laennec invented the stethoscope Formal training for nurses began Florence Nightingale established sanitary nursing care units for injured soldiers Major developments in infection control Women became active participants in medical care - Elizabeth Blackwell: first female physician in US - Clara Barton founded the American Red Cross Average life span increased to 40-65 years Treatment for disease more specific b/c causes identified

20th Century Showed the most rapid growth in health care New machines, such as X-rays Meds, including insulin for diabetes, antibiotics to fight infections, & vaccines to prevent diseases were identified Francis Crick & James Watson described the structure of DNA & how it carries genetic information Health care plans started to help pay for medical costs First open-heart surgery Computers used in every aspect of health care Average life span increased to age 60–80 (some live to 100)

21st Century The potential for major advances in health care are unlimited Advances in genetic research Research with embryonic stem cells & development of cloned cells could lead to treatments that will cure many diseases Major threats to healthcare exist - Bioterrorism, New viruses, Pandemics Health care has become a global concern & countries are working together to promote good health in all individuals - organizations such as the World Health Organization (WHO) are constantly monitoring health problems throughout the world & taking steps to prevent pandemics

Health Care of the Present Many of the past diseases are now preventable by: Vaccinations Improved methods of cleanliness & sanitation New technological advances Focus of Health Care has now shifted from prevention of contagious diseases to diseases of lifestyle: Cancer, Drug Abuse, Heart Disease, Obesity Although some communicable diseases remain a primary focus: AIDS, TB, Flu

The “Patient” of Today Takes on more responsibility for his or her own care Obtains second opinions Shops for the lowest health care costs Seeks alternative and complementary providers