1. Medicine of the New Time Lecture 4

2. Lecture Plan 1. Introduction 2. Medicine during the 1700s. 3. Medicine 1800-1899.

3. Medicine during the 1700s The growth of cities and towns during the 1700s placed enormous pressures on the availability of cheap housing. With many people coming to towns to find work, slum areas grew quickly. Living conditions in many towns consequently became unimaginable. Many families were forced to live in single rooms in ramshackle tenements or in damp cellars, with no sanitation or fresh air. Drinking water was often contaminated by raw sewage and garbage was left rotting in the street. Problems with the disposal of the dead often added to the stench and decay.

4. Medicine during the 1700s The death rate in most towns remained extremely high. In London, perhaps one in five children died before their second birthday. In certain districts the infant mortality rate reached 75% of all births whenever epidemics struck. During the 1700s more people died in London than were baptized every year.

5. Medicine during the 1700s Due to the growing use of dissection as part of medical training, most doctors in the 1700s had a practical knowledge of the human body. Diagnosing and successfully treating disease, however, was often hit and miss. The connection between uncleanliness and the spread of diseases was not properly understood, and many people continued to die simply as a result of poor hygiene. Many women died in childbirth because of infection. Even having your teeth pulled out could be fatal. Major surgery was particularly dangerous. Dirty surgical instruments caused wounds to be infected, and this caused the death of many patients. Flea and rat infestations were also common, even in wealthy households, and many diseases were spread this way in crowded urban environments.

6. Medicine during the 1700s A doctor’s consultation was costly and often inconclusive. Most doctors dealt with only the wealthiest members of society, and the poor were often left to seek alternative forms of help. Lower down the scale, barber-surgeons might be called on to perform a range of surgical procedures: the removal of kidney stones, the lancing of boils or setting of broken bones, or simply ‘letting the blood’ of patients for a whole range of ailments and conditions. In many towns charitable hospitals and dispensaries also offered basic healthcare: to poor children and expectant mothers, for example, or to old sailors and soldiers. And as a last resort, dozens of quacks were on hand to offer an array of potions, powders to those most desperate for relief from pain or discomfort.

7. A general system of surgery

8. Medicine during the 1700s Yellow Fever was one of the many diseases that killed many people in the 1700s. It was very common to die from it because they didn't have cures for it. The symptoms start with head aches, chills, and an ache in back, arms, and legs. Next comes a high fever for about 3 days. After 3 days, the person's fever goes away, but only for a couple of hours. After that, the high fever returns and as red blood cells are destroyed the skin and eyes turn yellow. Next the person vomits black blood because of bleeding in the nose, gums, and intestines. As the person's pulse grows weak they start to become confused and delirious. Also, tiny red bumps may appear on the skin. Death follows shortly after.

9. Medicine during the 1700s In 1678 doctors found a cure for smallpox and measles, but didn't use the cure until 1721. They also had a vaccine to prevent smallpox. Zabdiel Boylston of Boston successfully gave his son the vaccine which encouraged many other people to get the vaccine. This was especially true in the great University centers in Europe. Each had their own simplistic versions of the ills of the human body. They thought that the ills of the human body were due to maladjustment of the bodies system.

10. Medicine during the 1700s Doctors based their diagnosis of illness on the ancient beliefs of "humors", bodily "tension", or other cruder doctrinaire dogmas. The practice of "bleeding" with leeches to cure illness was common during the 18th century. In fact, the practice of medicine caused more harm than good. Doctors did not sterilize their hands, or instruments.

11. The medicines prescribed for ailments were just as bad. In Europe anything and everything was used in the mixing and making of drugs. In America the more common sense approach to medicine prevailed. In fact, lay healers were better doctors than learned physicians. Medicine during the 1700s

12. During the 18th century America the most commonly used medicines were botanical. In fact, the most widely read material were the "herbals" catalogues, which explained where and how healing herbs grew. In addition, these materials explained their uses. There were improvements in the 18th century. For instance, public health and hygiene received more attention. Population statistics were beginning to be kept and suggestions arose concerning health legislation.

13. Medicine during the 1700s Unlike today, 18th century medical sciences were not as advanced in scientific knowledge because the body and its functions were still a mystery. In Europe, the doctors still adhered to the dogmas of vitalists, iatrochemists, and iatrophysicists. Each follower of these "brands" of medical practice argued over which of their single causes explained all human health. vitalists

14. Medicine during the 1700s The use of vaccination began in the 18th century. The smallpox was the main target for this type of therapy. Smallpox was a disfiguring and often, fatal disease. In fact, at times it was an epidemic, which ravaged the cities and countries in Europe.smallpox

15. Medicine during the 1700s Everyone probably knows that cocaine is bad for your health. In the 1800s the people in Victoria did not exactly know that cocaine was dangerous. Actually cocaine and other modern drugs were considered medicinal. Back then a lot of substances were used as medicines. These medicines were called Patent Medicines. Patent medicines required no prescription which meant they were For sale by all druggists.

16. Medicine 1800-1899 Despite the exciting advances that took place in science and medicine in the seventeenth and eighteenth centuries, it was only in the nineteenth century that medicine itself became scientific. This was largely the result of the integration of the natural sciences into medical theory. During the eighteenth century the foundations of scientific medicine were first established. The ideas of the Enlightenment had inspired the search for rational systems of medicine, as well as practical means of preventing disease and improving human welfare.

17. Medicine 1800-1899 Social and medical reformers argued that scientific investigations of the abominable conditions of cities, navies, armies, and prisons, as well as the human body and pathological signs and symptoms, could improve the health and prosperity of society as a whole. Advocates of public health and preventive medicine, like Johann Peter Frank (1745-1821), sometimes urged states to adopt authoritarian methods to accomplish their goals and ideals. By studying the lives of peasants and workers, reformers hoped to make physicians and philosophers see how diseases were generated by a social system that kept whole classes of people in conditions of permanent misery.

18. Medicine 1800-1899 Giovanni Battista Morgagni (1682-1771), pioneer of pathological anatomy and author of On the Seat and Cause of Disease (1761) established the existence of correlations between clinical symptoms and postmortem findings. Morgagni's research helped establish a new epoch in medical science and a new attitude toward specific diagnostic and surgical interventions. His work encouraged scientists to find ways of detecting hidden anatomical lesions in living patients.

19. Medicine 1800-1899 This goal was realized by the chest percussion studies of Leopold Auenbrugger (1722-1809), the invention of the stethoscope by René Laënnec (1781-1826), the introduction of increasingly sophisticated medical instruments, the establishment of "hospital medicine" and "pathological anatomy" at the Paris Hospital, the "tissue theory" of Marie François Xavier Bichat (1771-1802), the "numerical method" (clinical statistics) of Pierre Charles Alexandre Louis (1787-1872), and so forth.

20. Medicine 1800-1899 Although hospital reform was difficult and expensive, the hospital was transformed into the new center of medical treatment, teaching, and research. Large urban hospitals offered unprecedented opportunities for clinical experimentation, and statistical studies. As hospitals assumed a more important role in the care of the patient, especially in growing urban areas, nursing emerged as a respectable profession for women. Gaining admission to the medical profession itself was very difficult for women, but Elizabeth Blackwell (1821-1910) and others demonstrated that women could practice medicine, establish clinics, hospitals, and medical colleges.

21. Medicine 1800-1899 Although nutrition is generally regarded as a twentieth century science, the belief that health and long life depend on the regulation of food and drink is one of the most ancient and universal principles of medical philosophy. The chemical revolution of the eighteenth century challenged traditional ways of classifying foods. By the end of the nineteenth century these chemical categories were giving way to a new physiological concept of the role of food substances in the "animal economy." The modern science of nutrition grew out of efforts to understand and isolate the dietary factors that prevented deficiency diseases, but this required considerable progress in chemistry.

22. Medicine 1800-1899 Nevertheless, the scurvy experiments of James Lind (1716-1794) proved it was possible to prevent diseases by specific changes in diet. Lind tested possible antiscorbutics in a controlled dietary experiment and demonstrated that oranges and lemons cured scurvy. Nevertheless, lemons did not become part of standard rations in the American Navy until 1812. During the nineteenth century, the threat of infectious diseases diverted attention from dietary and degenerative diseases.

23. Medicine 1800-1899 Perhaps the greatest medical achievement of the Age of Enlightenment was the discovery that inoculation and vaccination could prevent epidemic smallpox. Smallpox was such a dangerous and widespread threat that it was called "the most terrible of all the ministers of death." In many parts of Asia, India, Turkey, and Africa, folk healers attempted to protect people from virulent smallpox by "inoculation," that is, deliberately giving them a mild case of the disease with the aim of stimulating the body's resistance against subsequent exposures. European doctors dismissed these practices as barbaric superstitions, but during the eighteenth century increasing interest in natural led to closer observation of folk medicine.

24. Medicine 1800-1899 Smallpox inoculation gave medical practitioners and public health officials unprecedented responsibility for the control of epidemic disease. Weighing the risks and benefits of inoculation became an awesome responsibility for parents. Inoculation also paved the way for the rapid acceptance of vaccination.

25. Medicine 1800-1899 Edward Jenner (1749-1823) tested the folk belief that cowpox, a mild disease, provided protection against smallpox. In 1798 Jenner published an account of his experiments. Despite the medical profession's tendency to resist new ideas and methods, Jennerian vaccination spread throughout the world within a decade. Although debates about the safety and efficacy of preventive vaccines have raged ever since the first experiments on smallpox inoculation and vaccination, early in the nineteenth century some physicians predicted that vaccination would soon eradicate smallpox.

26. Medicine 1800-1899 In 1958 the World Health Organization (WHO) adopted a Smallpox Eradication Program that led to the end of smallpox in 1977. Public health authorities hoped that the lessons learned in the smallpox campaign would lead to global immunization programs for controlling diphtheria, whooping cough, tetanus, measles, poliomyelitis, and tuberculosis.

27. Medicine 1800-1899 Historians have called malaria the most devastating disease in history. Even at the end of the twentieth century malaria is still a major public health threat in many parts of the world. Seventeenth-century scientists discovered that quinine was a specific remedy for malaria, and quinine became one of the "tools of empire" that made European exploitation and colonization of Africa and much of Asia possible.

28. Medicine 1800-1899 The isolation of quinine in 1820 was one of the great achievements of nineteenth-century chemistry. Some nineteenth-century scientists predicted the imminent conquest of malaria, but indifference to "tropical medicine" has proved to be as pernicious a disorder as malaria, yellow fever, and other diseases of the tropics.

29. Medicine 1800-1899 As the construction of the Panama Canal demonstrated, scientific knowledge could be used to bring "tropical fevers" under control, if the economic and political incentives were sufficient. At the end of the twentieth century, the central problem in tropical medicine remains the same: the impoverished nations that need medicines and vaccines cannot afford them, and the wealthy nations which can afford to develop remedies for so-called tropical diseases have little motivation to do so.

30. Medicine 1800-1899 Despite considerable difficulty, nineteenth-century clinical medicine was ultimately transformed by the integration of the great discoveries of the basic sciences with the traditional foundations of medical science, that is, clinical observation and autopsy. With the development of new instruments and ways of looking at the human body and pathological signs and symptoms, specialization became a fundamental aspect of the medical profession.

31. Medicine 1800-1899 Certainly, one of the great advances of nineteenth century was the establishment of the germ theory of disease by Louis Pasteur (1822-1895), Robert Koch (1843-1910), and others. Isolating the microbial agents that caused infectious diseases and elucidating their means of transmission promised great advances in the control, prevention, and treatment of epidemic diseases.

32. Medicine 1800-1899 Based on the fundamentals of germ theory, Paul Ehrlich (1854-1915) established the basis of chemotherapy, and along with Ilya Metchnikoff (1845-1916), the science of immunology. The work of Ehrlich, Emil von Behring (1854-1917), and Shibasaburo Kitasato (1852-1931) led to the production of antitoxins for diphtheria, tetanus, and other diseases. Koch's discovery of the microbe that causes tuberculosis and Pasteur's development of a vaccine to treat rabies were among the most dramatic achievements by the pioneers of germ theory.

33. By the beginning of the 19th century, the structure of the human body was almost fully known, due to new methods of microscopy and of injections. Even the body's microscopic structure was understood. But as important as anatomical knowledge was an understanding of physiological processes, which were rapidly being elucidated. By the beginning of the 19th century, the structure of the human body was almost fully known, due to new methods of microscopy and of injections. Even the body's microscopic structure was understood. But as important as anatomical knowledge was an understanding of physiological processes, which were rapidly being elucidated. Medicine 1800-1899

34. Women started stepping out of the box by becoming doctors and nurses. They did not follow the restrictions put on them by society, which said they could not have a medical profession. In 1830 there were no trained nurses in Britain. By 1880 there were over 7,000 female nurses in Britain. Thanks go out to Sophia Jex-Blake, Elizabeth Garrett Anderson, and Elizabeth Blackwell for their struggles to allow women to train as doctors and nurses. There were many more advances in the 19th century than the past 2,000 years. Diphtheria was a disease that often killed people. It wasn't until 1891 that the first cure was available. It was an anti-toxin that was used to cure diphtheria.

35. Medicine 1800-1899 In the early part of the nineteenth century, people who wanted to become doctors went to study in Europe, especially Edinburgh which was reputed to be the best school in Europe at that time. If one takes a look at the Royal Gazette's List of Legally Qualified Practitioners in the Province of Nova Scotia for the years 1827 to 1873, one notices that until the 1840s most qualified doctors in Nova Scotia were trained in Edinburgh and London.

36. Medicine 1800-1899 During this time, medical schools were starting to be established in the United States. After the 1840s the trend for education seems to indicate that doctors were trained in the US at such places as Jefferson Medical College in Philadelphia, Harvard University and the Kentucky School of Medicine. It is understandable that this trend occurred since "training in the Old Country was expensive and few could afford to go. Crossing the Atlantic took three to six weeks in a sailing ship and students had to remain in Europe until training was completed".

37. In addition, spectacular advances in diagnosis and treatment followed the discovery of X rays by Wilhelm Conrad Röntgen, in 1895, and of radium by Pierre and Marie Curie in 1898. Before the turn of the century, too, the vast new field of psychiatry had been opened up by Sigmund Freud. In addition, spectacular advances in diagnosis and treatment followed the discovery of X rays by Wilhelm Conrad Röntgen, in 1895, and of radium by Pierre and Marie Curie in 1898. Before the turn of the century, too, the vast new field of psychiatry had been opened up by Sigmund Freud. MEDICINE IN THE 19TH CENTURY

38. Questions 123123

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