1. Board Assignment
Please identify 3 significant figures in history and their impact on modern medicine.

2. The History of Medicine
How did we get where we are today?

3. Ancient Medicine The condensed version

4. Part 1 - Introduction ANCIENT TIMES
People believed that diseases and illnesses were caused by …
… demons and evil spirits.

5. ANCIENT TIMES
People also believed that treatments were directed toward …
… eliminating evil spirits.

6. Part 2 - History of Health Care
4000 BC - PRIMITIVE TIMES
Herb and plants were used as medicines. Do you know which ones are still used today?
Morphine for pain and
digitalis for the heart.
Digitalis or digoxin is a drug that strengthens the contraction of the heart, slows the heart rate and helps eliminate fluid from body tissues. It is derived from the foxglove plant.
Morphine is a naturally occurring substance in the opium poppy. It is a potent narcotic analgesic, and its primary clinical use is in the management of moderately severe and severe pain

7. 4000 BC - PRIMITIVE TIMES 20 years.
Trepanation was the treatment for insanity, epilepsy and headache.
That means boring a hole in the skull.
Average Life Span…….
20 years.

8. 3000 BC – Ancient Egyptians
Called upon the gods to heal them when disease occurred.
Therefore, physicians were priests who studied medicine and surgery in temple medical schools.

9. 3000 BC – Ancient Egyptians
Earliest people known to keep accurate medical records.
The first physician may have been Imhotep.
Magic and medicinal plants were used to treat disease.

10. 3000 BC – Ancient Egyptians Average life span … 20 to 30 years.
Believed the body was a system of channels for air, tears, blood, urine, sperm, and feces.
If a channel became “clogged”, bloodletting or leeches were used to “open” them.
Leeches are used today as treatments for various conditions. Used only in conditions of venous congestion with good arterial blood flow. Sometimes used in reattached fingers, etc.
Average life span …
20 to 30 years.

11. 1700 BC – ANCIENT CHINESE
Believed in the need to treat the whole body by curing the spirit and nourishing the body.
Carefully monitored the pulse to determine the condition of the body.
Pharmacopoeia (literally, the art of the drug compounder), in its modern technical sense, is a book containing directions for the identification of samples and the preparation of compound medicines, and published by the authority of a government or a medical or pharmaceutical society. The name has also been applied to similar compendiums issued by private individuals.
A pharmacopoeia, today, is kind of like a recipe book. Lets say that your mom makes the BEST chicken noodle soup in the world. If you wanted to make it yourself, you would need the recipe or you would just be guessing.
Recorded a pharmacopoeia of medications based mainly on the use of herbs.

12. 1700 BC – ANCIENT CHINESE
Used acupuncture to relieve pain and congestion.
Used moxibustion to treat disease.
Acupuncture (from Lat. acus, "needle" (noun), and pungere, "prick" (verb) or in Standard Mandarin, zhēn jiǔ (針灸) is a technique of inserting and manipulating needles into "acupuncture points" on the body. According to acupunctural teachings this will restore health and well-being. The definition and characterization of these points is controversial. Acupuncture is thought to have originated in China and is most commonly associated with Traditional Chinese medicine. Other types of acupuncture (Japanese, Korean, and classical Chinese acupuncture) are practiced and taught throughout the world.
Moxibustion (Chinese: 灸; pinyin: jiŭ) is an oriental medicine therapy utilizing moxa, or mugwort herb. It plays an important role in the traditional medical systems of China, Japan, Korea, Vietnam, Tibet, and Mongolia. Suppliers usually age the mugwort and grind it up to a fluff; practitioners burn the fluff or process it further into a stick that resembles a (non-smokable) cigar. They can use it indirectly, with acupuncture needles, or sometimes burn it on a patient's skin. Practitioners use moxa to warm regions and acupuncture points with the intention of stimulating circulation through the points and inducing a smoother flow of blood and qi.
Began to search for medical reasons for illness.
Average life span was …
20 to 30 years.

13. 1200 BC – ANCIENT GREEKS
Began modern medical science by observing human body and effects of disease.
Believed illness was a result of natural causes.
Stressed diet and cleanliness as ways to prevent disease.

14. 1200 BC – ANCIENT GREEKS Used therapies that are still used today …
massage
art therapy
herbal treatment

15. Dissected animals and is called the founder of comparative anatomy.
1200 BC – ANCIENT GREEKS
Important People
Dissected animals and is called the founder of comparative anatomy.
Aristotle
Comparative Anatomy

16. 1200 BC – ANCIENT GREEKS Hippocrates Important People
Called the Father of Medicine
Developed an organizational method to observe the human body
Recorded signs and symptoms of many diseases
Created a high standard of ethics, the Oath of Hippocrates, used by physicians today
Oath of Hippocrates
I SWEAR by Apollo the physician, and Aesculapius, and Health, and All-heal, and all the gods and goddesses, that, according to my ability and judgment, I will keep this Oath and this stipulation- to reckon him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine, but to none others. I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. With purity and with holiness I will pass my life and practice my Art. I will not cut persons laboring under the stone, but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further from the seduction of females or males, of freemen and slaves. Whatever, in connection with my professional practice or not, in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times! But should I trespass and violate this Oath, may the reverse be my lot! Hippocratic Oath—Modern Version I swear to fulfill, to the best of my ability and judgment, this covenant: I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow. I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism. I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug. I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery. I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God. I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick. I will prevent disease whenever I can, for prevention is preferable to cure. I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm. If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help. Written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University, and used in many medical schools today.
Average life span was …
25 to 35 years.

17. 753 – 410 AD – ANCIENT ROMANS
First to organize medical care by providing care for injured soldiers.
Early hospitals developed when physicians cared for ill people in rooms in their homes.
Later hospitals were religious and charitable institutions housed in monasteries and convents.

18. 753 – 410 AD – ANCIENT ROMANS
Began public health and sanitation systems:
Aqueducts to carry clean water to the cities
Sewers to carry waste material away from the cities
Filtering systems in public baths to prevent disease
Drained marshes to reduce the incidence of malaria

19. Claudius Galen 753 – 410 AD – ANCIENT ROMANS
Important People
Dissected animals and determined function of muscles, kidney and bladder
Studied infectious diseases and described symptoms of inflammation

20. 753 – 410 AD – ANCIENT ROMANS
Diseases were treated with diet, exercise, and medications.
Average life span was …
25 to 35 years.

21. DARK AGES – 400 – 800 AD
The study of medicine was prohibited, emphasis was on saving the soul.
Illnesses and diseases were treated by prayer and divine intervention.
Medications were mainly herbal mixtures.

22. DARK AGES – 400 – 800 AD
Monks and priests provided custodial care for sick people.
Average life span was …
20 to 30 years.

23. MIDDLE AGES –1400 AD
Interest in the medical practice of Greeks and Romans was renewed.
Physicians began to obtain knowledge at medical universities in the 9th century
Major diseases were smallpox, diphtheria, tuberculosis, typhoid, the plague, and malaria.

24. MIDDLE AGES –1400 AD
A pandemic of the bubonic plague killed ¾ of the population of Europe and Asia.
Map – spread is from orange to yellow to green to purple to red. Time frame is from orange 1348, yellow 1349, green 1350, purple 1351, red 1352.
A pandemic (from Greek pan all + demos people) is an epidemic (an outbreak of an infectious disease) that spreads worldwide, or at least across a large region.
Bubonic plague is the most well-known variant of the deadly infectious disease plague, which is caused by the enterobacteria Yersinia pestis. Also known as the black death as ends of fingers and toes could turn black. People contract the plague by being bitten by a rat flea that has fed on an infected rodent.

25. MIDDLE AGES –1400 AD
Arab physicians used their knowledge of chemistry to advance pharmacology.
Arabs began requiring that physicians pass examinations and obtain licenses.
Pharmacology (in Greek: pharmacon (φάρμακον) meaning drug, and logos (λόγος) meaning science) is the study of how chemical substances interact with living systems.

26. MIDDLE AGES - 800 –1400 AD Important People Rhazes
Arab physician that became known as the Arab Hippocrates
910 AD – developed criteria for distinguishing between smallpox and measles
Suggested blood was the cause of many infectious diseases
Began the use of animal gut for suture material

27. MIDDLE AGES - 800 –1400 AD Important People Avenzoar
Physician who described the parasite causing scabies in the 12th century
Scabies is an infestation of the skin with the microscopic mite Sarcoptes scabei.
Average life span was …
20 to 35 years.

28. What are the following people known for?
Hippocrates
Imhotep
Galen

29. RENAISSANCE – 1350-1650 AD Rebirth of the science of medicine
Dissection of the body began to allow a better understanding of anatomy and physiology
Artists Michelangelo and Leonardo da Vinci used dissection in order to draw the human body more realistically
Development of the printing press allowed knowledge to be spread to others

30. RENAISSANCE – 1350-1650 AD Firsts! Rebirth of the science of medicine
First chairs (positions of authority) of medicine created at Oxford and Cambridge in England in 1440
First anatomy book published by Andreas Vesalius
First book on dietetics written by Issac Judaeus

31. RENAISSANCE – 1350-1650 AD Average life span was … 30 to 40 years.
Rebirth of the science of medicine
Average life span was …
30 to 40 years.

32. 16th and 17th CENTURIES
Causes of disease were still not known and many people died from infections and puerperal (childbirth) fever
Scientific societies, such as the Royal Society of London, were established
Puerperal –
Ligatures –
Cauterize -
Apothecaries (early pharmacists) made, prescribed, and sold medications

33. 16th and 17th CENTURIES Ambrose Pare Important People
French surgeon who became known as the Father of Modern Surgery
Established the use of ligatures to bind arteries and stop bleeding
Ligature
Cauterize
Eliminated the use of boiling oil to cauterize wounds
Improved treatment of fractures and promoted the use of artificial limbs

34. 16th and 17th CENTURIES Anton van Leewenhoek Important People
Invented the microscope in 1666
Average life span was …
35 to 40 years.

35. 18th CENTURY Important People
Gabriel Fahrenheit created the first mercury thermometer in 1714
John Hunter
English surgeon who established scientific surgical procedures
Benjamin Franklin invented the bifocals for glasses

36. 18th CENTURY Important People
James Lind prescribed lime juice containing vitamin C to prevent scurvy in 1795
Edward Jenner developed a vaccination for smallpox in 1796
Scurvy
What do you think is in lime juice that would prevent scurvy
Average life expectancy was …
40 to 50 years.

37. 19th CENTURY Important People
James Blundell performed the first blood transfusion in 1818.
Rene Laennec invented the first stethoscope in 1819.

38. 19th CENTURY Important People
Florence Nightingale was the Founder of Modern Nursing.
Established efficient and sanitary nursing unites during the Crimean war in 1854
The Crimean War In March 1854 Britain, France and Turkey declared war on Russia. The allies defeated the Russians at the battle of the Alma in September but reports in The Times criticised the British medical facilities for the wounded. In response, Sidney Herbert, the Minister at War, who knew Florence Nightingale socially and through her work at Harley Street, appointed her to oversee the introduction of female nurses into the military hospitals in Turkey. On 4 November 1854, Florence Nightingale arrived at the Barrack Hospital in Scutari, a suburb on the Asian side of Constantinople, with the party of 38 nurses. Initially the doctors did not want the nurses there and did not ask for their help, but within ten days fresh casualties arrived from the battle of Inkermann and the nurses were fully stretched.
Nightingale Training School for Nurses Florence Nightingale's greatest achievement was to raise nursing to the level of a respectable profession for women. In 1860, with the public subscriptions of the Nightingale Fund, she established the Nightingale Training School for nurses at St Thomas' Hospital.
Opened Nightingale School and Home for Nurses at St. Thomas Hospital In London in 1860
Began the professional education of nurses

39. 19th CENTURY Important People
Ignaz Semmelweis, in the 1840s, encouraged physicians to wash hands with lime after performing autopsies and before delivering babies to prevent puerperal (childbirth) fever. (This idea was resisted by hospital and medical personnel)
Puerperal Fever
Elizabeth Blackwell became the first female physician in the US in 1849

40. 19th CENTURY Important People
Dorothea Dix was appointed Superintendent of Female Nurses of the Army in 1861
Joseph Lister started using disinfectants and antiseptics during surgery to prevent infection in 1865
Clara Barton founded the American Red Cross in 1881 (International Red Cross was founded in 1863)

41. 19th CENTURY Important People
Louis Pasteur contributed many discoveries to the practice of medicine
Proved the microorganisms cause disease
Pasteurized milk to kill bacteria
Created a vaccine for rabies in 1885

42. 19th CENTURY Important People
Gregory Mendel established principles of heredity and dominant/recessive patterns
Robert Koch, called the Father of Microbiology, developed the culture plate method to identify pathogens and isolated the bacteria causing tuberculosis.

43. 19th CENTURY Important People
Dimitri Ivanofski discovered viruses in 1892
Lillian Wald established the Henry Street Settlement in New York City in 1893 (the start of public health nursing)
Lillian D. Wald was moved by the miserable and unhealthy conditions she witnessed in the tenements of New York City’s Lower East Side. In 1893, two years after graduation from the New York Hospital Training School for Nurses, Ms. Wald founded the forerunner of the Henry Street Settlement in New York City. Henry Street eventually evolved into the Visiting Nurse Service of New York City and was directed by Ms. Wald for more than 40 years.

44. 19th CENTURY Important People 40 to 60 years. Average life span was …
Wilhelm Roentgen discovered Roentgenograms (X-rays) in 1895
Almroth Wright developed vaccine for typhoid fever in 1897
Typhoid Fever -Typhoid and paratyphoid enteric fever are acute, generalized infections caused by Salmonella typhi and Salmonella paratyphoid respectively. The main sources of infection are contaminated water or milk and, especially in urban communities, food handlers who are carriers. Their germs are passed in the faeces and urine of infected people. People become infected after eating food or drinking beverages that have been handled by a person who is infected or by drinking water that has been contaminated by sewage containing the bacteria.
Average life span was …
40 to 60 years.

45. 20th CENTURY Important People
Walter Reed demonstrated that mosquitoes carry yellow fever in 1900
Carl Landsteiner classified the ABO blood groups in 1901
Yellow fever is caused by an arbovirus of the family Flaviviridae, and is one of the smallest RNA viruses isolated.[4] Human infection is begun after deposition of viral particles through the skin in infected arthropod saliva. Mosquitos are the primary vector in transmission of the disease from forest monkeys to humans and in person-to-person transmission. The mosquitos involved are Aedes simpsoni, A. africanus, and A. aegypti in Africa, and the Haemagogus and Sabethes genera in South America.[3]
Index: b = Anti-B antibody in plasma
B = B antigen at RBC surface
a = Anti-A antibody in plasma
A = A antigen at RBC surface

46. 20th CENTURY Important People
Dr. Elie Metchnikoff identified how white blood cells protect against disease
Marie Curie isolated radium in 1910
Marie Klodowska Curie discovered the mysterious element radium. It opened the door to deep changes in the way scientists think about matter and energy. She also led the way to a new era for medical knowledge and the treatment of diseases.
Sigmund Freud - Austrian psychologist; founder of psychoanalysis who made a systematic study of the Unconscious and introduced many key concepts still used in modern psychology.
Sigmund Freud’s studies formed the basis for psychology and psychiatry

47. 20th CENTURY Important People
Frederick Banting and Charles Best discovered and used insulin to treat diabetes in 1922
Following the birth of an idea, nine months of experimentation, and through the combined efforts of four men at the University of Toronto, insulin was discovered and later purified for human use. The first successful test on a human patient with diabetes occured on January 23, The death sentence for diabetes sufferers around the world had finally been lifted. (were able to make a pancreatic extract which had anti diabetic characteristics – was tested on diabetic dogs)
Alexander Fleming returned to his research laboratory at St. Mary's Hospital in London after World War I. His battlefront experience had shown him how serious a killer bacteria could be, much worse even than enemy artillery. He wanted to find a chemical that could stop bacterial infection. He discovered lysozyme, an enzyme occurring in many body fluids, such as tears. It had a natural antibacterial effect, but not against the strongest infectious agents. He kept looking. Fleming had so much going on in his lab that it was often in a jumble. This disorder proved very fortunate. In 1928, he was straightening up a pile of Petri dishes where he had been growing bacteria, but which had been piled in the sink. He opened each one and examined it before tossing it into the cleaning solution. One made him stop and say, "That's funny." Some mold was growing on one of the dishes... not too unusual, but all around the mold, the staph bacteria had been killed... very unusual. He took a sample of the mold. He found that it was from the penicillium family, later specified as Penicillium notatum. Fleming presented his findings in 1929, but they raised little interest. He published a report on penicillin and its potential uses in the British Journal of Experimental Pathology.
Sir Alexander Fleming discovered penicillin in 1928

48. 20th CENTURY Important People
Dr. George Papanicolaou developed the Pap test to detect cervical cancer in females
Dialysis (short for "hemodialysis") is a treatment for people whose kidneys have ceased to work properly. The two most common causes of kidney failure are diabetes and high blood pressure. A dialysis machine (pictured) does the work of the kidneys by removing excess fluids and cleansing the patient's blood through a filter to remove toxins. Some patients on long-term dialysis eventually receive a kidney transplant.
The first kidney dialysis machine was developed in 1944

49. 20th CENTURY Important People
Frances Crick and James Watson described the structure of DNA and how it carries genetic information in 1953
Watson and Crick showed that each strand of the DNA molecule was a template for the other. During cell division the two strands separate and on each strand a new "other half" is built, just like the one before. This way DNA can reproduce itself without changing its structure -- except for occasional errors, or mutations.The structure so perfectly fit the experimental data that it was almost immediately accepted. DNA's discovery has been called the most important biological work of the last 100 years, and the field it opened may be the scientific frontier for the next 100.
The first heart-lung machine was used for open-heart surgery in 1953
animation

50. 20th CENTURY Important People
Jonas Salk developed the polio vaccine using dead polio virus in 1952
Polio is transmitted primarily through the ingestion of material contaminated with the virus found in stool (poop). Not washing hands after using the bathroom and drinking contaminated water were common culprits in the transmission of the disease.
Polio (also called poliomyelitis) is a contagious, historically devastating disease that was virtually eliminated from the Western hemisphere in the second half of the 20th century. Although polio has plagued humans since ancient times, its most extensive outbreak occurred in the first half of the 1900s before the vaccination, created by Jonas Salk, became widely available in 1955.
Albert Sabin developed an oral live-virus polio vaccine in the mid 1950s

51. 20th CENTURY Important People
The first successful kidney transplant in humans was performed by Joseph Murray in 1954
The first successful heart transplant was performed by Christian Barnard in 1968

52. 20th CENTURY
Physicians used amniocentesis to diagnose inherited diseases before birth in 1975
Computerized Axial Tomography (CAT) scan was developed in 1975
What is an amniocentesis?
An amniocentesis is a procedure used to obtain a small sample of the amniotic fluid that surrounds the fetus to diagnose chromosomal disorders and open neural tube defects (ONTDs) such as spina bifida. Testing is available for other genetic defects and disorders depending on the family history and availability of laboratory testing at the time of the procedure. An amniocentesis is generally offered to women between the 15th and 20th weeks of pregnancy who are at increased risk for chromosome abnormalities, such as women who are over age 35 years of age at delivery, or those who have had an abnormal maternal serum screening test, indicating an increased risk for a chromosomal abnormality or neural tube defect.
CT (computed tomography), sometimes called CAT scan, uses special x-ray equipment to obtain image data from different angles around the body, and then uses computer processing of the information to show a cross-section of body tissues and organs.

53. 20th CENTURY
The first “test tube” baby, Louise Brown, was born in England in 1978
Acquired Immune Deficiency Syndrome (AIDS) was identified in (The Human Immunodeficiency Virus (HIV) was identified in 1984.)
AIDS – Acquired Immune Deficiency Syndrome –
HIV – Human Immunodeficiency Virus -

54. 20th CENTURY
Dr. William DeVries implanted the first artificial heart, the Jarvik-7, in 1982
Cyclosporine -
Cyclosporine, a drug to suppress the immune system after organ transplant, approved in 1983

55. 20th CENTURY The first gene therapy to treat disease occurred in 1990
A sheep was cloned in 1997
Gene Therapy - The aim of gene therapy is to introduce genes into somatic cells. Once the genes are introduced, they will be synthesized to create products that can aid in restoring normal function.
Somatic Cells - Definition: (so-MAT-ik) All of the body cells except the reproductive germ cells.
Average life span was …
60 to 70 years.

56. 21st Century April 2003 – Completion of the Human Genome Project
The first successful partial face transplant is performed in France.
The Human Genome Project (HGP) was an international scientific research project with a primary goal to determine the sequence of chemical base pairs which make up DNA and to identify and map the approximately 20,000-25,000 genes of the human genome from both a physical and functional standpoint.
The project began in 1990 initially headed by James D. Watson at the U.S. National Institutes of Health. A working draft of the genome was released in 2000 and a complete one in 2003, with further analysis still being published. A parallel project was conducted outside of government by the Celera Corporation. Most of the government-sponsored sequencing was performed in universities and research centers from the United States, Canada, New Zealand and Britain. The mapping of human genes is an important step in the development of medicines and other aspects of health care.
Partial face transplant
The world's first partial face transplant on a living human was carried out on November 27, 2005[5][6] by Professor Jean-Michel Dubernard, a plastic and microsurgeon in Amiens, France. Isabelle Dinoire[5] underwent surgery to replace her original face that had been ravaged by her dog. A triangle of face tissue from a brain-dead human's nose and mouth was grafted onto the patient.
The first full face transplant is performed in the U.S.

57. 21st Century
Australian of the Year Dr Ian Frazer develops a vaccine for cervical cancer
Vaccine for Cervical Cancer - Then in 2005 Frazer and his research groups undertook clinical study of a vaccine against human papillomavirus, which was 100% effective in preventing common cervical cancers caused by the virus types covered by the vaccine. One version of the vaccine named Gardasil, has been approved by the US Food and Drug Administration and has been approved for use in the European Union. Ian Frazer personally administered the first publicly available injection of the vaccine in Australia in August 2006.
The 2009 flu pandemic is a global outbreak of a new strain of influenza virus, officially named the "new H1N1", first identified in April 2009, and commonly called "Swine flu." It is thought to be a mutation of four known strains of the influenza A virus, subtype H1N1: one endemic in (normally infecting) humans, one endemic in birds, and two endemic in pigs (swine). Experts assume the virus "most likely" emerged from pigs in Asia, and was carried to North America by infected persons.
Swine flu spreads around the globe

58. 21st Century What will the future hold? ?????????
Human genetic engineering?
Artificial Intelligence?
Cloning of body parts?
Average life span …
?????????