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8/9/2019 Medicine in the 19th Century in Europe
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Medicine in the 19th century in Europe
Savu Andrei
Toma Alexandru
Cantoneru Iulian
Voicu Ana
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Cocaine for children?
Cocaine wa le!al" even a late a thi ad #1$$%&"
and wa not conidered harmful in moderate doe' Many
other dru!" now retricted (y law" were alo le!al then"includin! opium" which wa old under city permit on the
treet of Victoria'
In the nineteenth century many u(tance were
ued a medicine" ome of which are now )nown to (e
harmful over the lon! term" uch a mercury and lead'
*+atent medicine*" li)e thee Cocaine Toothache ,rop"
were very popular and re-uired no precription. they
were indeed */or ale (y all dru!!it'*
0y the 1$2" the practice of medicine wa !oin!
throu!h many chan!e' The !erm theory of dieae wa a
controverial idea and not yet widely accepted' The 3rt
of the !eneral anethetic " chloroform and ether" had
recently (ecome availa(le" ma)in! ur!ery potentially lifeavin! rather than life threatenin!" thou!h the routine
ue of antieptic wa till ome year in the future'
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Many medical practitioner till u(cri(ed #at leat
in ome form& to the ancient theory of the *four humor*
developed (y the 4oman phyician 5alen #1617199 A,&'
Accordin! to thi theory" the (ody i made up of four
humor 7 (lood" phle!m" (lac) (ile" and yellow (ile' The
relative amount of each humor in the (ody determined
tate of health and temperament #a peron with more
(lood wa *an!uine*. with more phle!m *phle!matic*.
with (lac) (ile *melancholic*. and if yellow (ile
predominated" *choleric* or *(iliou*&' Too much or too
little of any humor wa aid to caue illne" which could(e cured (y retorin! the (alance' Many nineteenth
century medicine and practice were intended to do thi'
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Cell Theory' 4o(ert 8oo)e aw and named cell in the
early 1th century" when he viewed dead plant cell' Van
:eeuwenhoe) wa the 3rt to ee live cell under a
microcope' In the 19th century the wor) of three5erman cientit" Theodore Schwann #1$127$;&"
Matthia
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5erm Theory' The other
cornertone wa the development of !erm
theory' Even in the heyday of humoral
medicine" there were healer whoreco!nied that ome dieae were
pread (y conta!ion' The earliet
mention of *minute creature* that
caue dieae came in the Veda" the
acred text of 8induim" which were
written (etween 1%22 and %22 0CE'
Avicenna undertood that
tu(erculoi and other dieae were
conta!iou' :ater Mulim cholar
attri(uted the (u(onic pla!ue to
microor!anim' /racatoro" a
noted a(ove" propoed that
dieae wa pread (y
*eed'* In !eneral" however" mot cientit (elieved
that dieae7cauin! !erm aroe from pontaneou
!eneration" @ut a creature uch a ie" worm" and
other mall animal appeared to arie pontaneouly
from decayin! matter' Aritotle (elieved thi" and the
idea perited into the 19th century'
Another theory from the 5ree) continued to hold
way into the 19th century' Thi theory wa (aed on theidea that dieae uch a the pla!ue and cholera were
caued (y foul7mellin! miama" air containin! particle
of rottin! matter' The theory that uch air wa poionou
eemed (elieva(le (ecaue it aociated dieae with
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poor anitation" and the importance of hy!iene wa
reco!nied early' The 0ritih
nurin! pioneer" /lorence Bi!htin!ale #1$;27
1912& who cared for 0ritih oldierdurin! the Crimean ar #1$%671$%&" 3rmly
(elieved that miama caued
dieae'
0y then" however" tudie were well
under way that 3nally put to ret (oth
thee miconception' In 1$%=
the En!lih phyician
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+ateur (elieved paionately that microor!anim
were reponi(le for infectiou dieae in human and
animal and for their tranmiion amon! them' And he
developed eective vaccine a!aint anthrax and ra(ie
(y harvetin! tiue from animal that had died from
thee dieae' 0ut it wa the wor) of a 5erman doctor"
4o(ert Foch #1$=671912&" which 3nally validated the
!erm theory of dieae' 8e identi3ed the peci3c (acteria
that caued anthrax" tu(erculoi" and cholera' 8e
developed a et of rule #FochG potulate& for
determinin! concluively whether a microor!anim i the
ource of a dieae in a peron rather than imply (ein!
preent' The cience of (acteriolo!y wa (orn'
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Hther (ranche of micro(iolo!y oon aroe'
Bumerou tropical dieae were found to (e due to
paraitic micro(e" many of them pread (y mo-uitoe'
Amon! thee were two !reat )illermalaria and yellowfever' Jellow fever" thou!h" li)e mallpox and ra(ie"
could not (e aociated with any (acterium' 0uildin! on
the tudie of a 4uian patholo!it" ,mitry Ivanov)y
#1$=719;2&" the American ur!eon alter 4eed #1$%17
192;& dicovered in 1921 that yellow fever wa caued (y
a viru" omethin! even maller than a (acterium'
Virue were thou!ht to (e invii(le until theinvention of the electron microcope in the 19=2" (ut
they were eventually identi3ed a the caue of a hot of
dieae' Thee include not only mallpox" (ut alo
inuena" the common cold" chic)enpox" polio" and more
recently" AI,S' They are alo thou!ht to play a ma@or role
in cancer'
Anetheia and Antieptic' In the middle of the 19th
century other dicoverie 3nally made extenive ur!ery
practical' >ntil then ur!ical option had (een limited (y
the pain of operatin! on a peron who wa awa)e" and
the dan!er of infection after the operation' In the 1$=2
everal American dentit pioneered the ue 3rt of
nitrou oxide and then ether a anethetic' The latter
wa oon adopted in Europe for ur!ical purpoe" 3nally
allowin! ur!eon time to perform lon! and delicate
ur!erie'
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It wa a(out the ame time that 8un!arian phyician
I!na Semmelwei eta(lihed that infection followin!
child(irth were pro(a(ly due the unwahed hand of
phyician in hopital' In the late 1$2 the 0ritihur!eon
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A !rowin! medical indutry
:i)e
otherlearned
profeion" medicine !rew in ie and re!ulation' In the
early Victorian era it wa dominated (y the !entlemen
phyician of the 4oyal Colle!e #founded 1%1$&" with
ur!eon and apothecarie occupyin! lower poition'
The 0ritih Medical Aociation wa eta(lihed in 1$%
and from 1$%$ the 5eneral Medical Council #5MC&
controlled entry throu!h central re!itration' In the ame
pirit" the profeion alo reited the admiion of
women" who tru!!led to have their -uali3cation
reco!nied' +artly in repone to population !rowth"
however" num(er roe. for example" from a total of
1="=1% phyician and ur!eon in En!land and ale in
1$1" to ;;"9$ #of whom ;1; were female& in 1921' At
the turn of the century the 5MC re!iter held 6%"%2
name alto!ether" includin! %$2 in military and imperial
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ervice' The num(er of dentit roe from 1%$= in 1$1
to %629 #includin! 1=2 women& in 1921' A !rowin!
proportion of -uali3ed peronnel wor)ed in pu(lic
intitution" and a new hierarchy aroe" headed (yhopital conultant' Thi reected the rie in hopital7
(aed practice" for thi wa alo the era of heroic hopital
(uildin! in the ma@or citie" accompanied (y municipal
and +oor :aw in3rmarie elewhere' Thee were for
wor)in!7cla patient. thoe in hi!her economic !roup
received treatment at home'
A econdary apect of !rowth and re!ulation wa the
teady medicaliation of child(irth" o that over thi
period traditional female
midwive were upereded (y
male o(tetrician" with all
their KmodernK idea and
intrument' >nder prevailin!
condition" however"
intervention throu!h the
ue of forcep" for example"
often caued puerperal
fever and the hi!h
maternal mortality" which
wa a mid7centuryconcern'
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:ar!ely throu!h the endeavour and
ener!y of /lorence Bi!htin!ale" whoe
nurin! team at Scutari captured the
pu(lic ima!ination amid militaryde3ciencie in the Crimean ar" hopital
and home nurin! wa reformed" chiey
alon! anitary line' 4i!orou
nure trainin! alo raied the
ocial tatu of the profeion
and created a
career tructure
lar!ely occupied
(y women'
,epite thee and other improvement" death rate
remained relatively teady' 4ou!hly one -uarter of all
children died in the 3rt year at the end of VictoriaK rei!n
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a at the (e!innin!" and maternal mortality howed no
decline' In ome 3eld" however" urvival rate improved
and mortality tatitic lowly declined' Thu crude death
rate fell from ;1' per thouand in 1$=1 to 1=' in 1921'8ere" the main factor were pu(lic hy!iene and (etter
nutrition than) to hi!her earnin! 7 that i" prevention
rather than cure' Althou!h doctor made much of their
medicine with :atin name and meaured doe"
eective remedie were few" and chemical pharmacolo!y
a it i )nown in ;221 only (e!an at the end of the
Victorian era' /rom the 1$2 #animal& thyroid extract
wa ued for variou complaint includin! contipation
and depreion" while from 1$$9 animal teticular
extract were deployed in puruit of re@uvenation and
miracle cure' At the ame date apirin wa developed to
replace traditional opiate pain)iller'
A a reult" many condition remained chronic or
incura(le' Thee limitation" to!ether with the relatively
hi!h cot of medical attendance" led to the rie #or
extenion& of alternative therapie includin! homeopathy"
naturopathy #Kher(al remedieK&" hydropathy #water
cure&" memerim #hypnotim& and !alvanim #electric
therapy& a well a (latant fraudulence throu!h the
promotion of uele pill" powder and coloured li-uid'/rom 1$ notion that dieae wa caued and cured (y
mental or piritual power alone were circulated (y the
Chritian Science movement'
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Treatin! mental illne
Another hi!hly popular fahion wa
that of phrenolo!y" which claimed to
identify temperamental
characteritic uch a a!!reion or lut #KamativeneK&
(y mean of lump and (ump on the individual )ull" and
facial phyio!nomy' +ycholo!y itelf retained lar!ely
traditional concept uch KmelancholicK and KcholericKtendencie" (ut in 1$= the term KpychiatryK wa coined
to denote medical treatment of dia(lin! mental
condition" which were !enerally held to have hereditary
caue'
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The Victorian period witneed
an impreive !rowth in the
clai3cation andiolation #or trictly the
concentration& of the inane
and mentally impaired in
lar!e" trictly re!ulated
lunatic aylum
outide ma@or citie"
where women andmen were le!ally
incarcerated" uually
for life' Hpened in 1$%1" the
Colney 8atch Aylum in
Middleex houed 1;%2
patient' ealthier familie made ue of private care" in
maller eta(lihment'
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Two ma@or 3!ure in the Victorian mental health
3eld were
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theorie of inanity were teadily impoed on mad
women" in way that were unmita)a(ly manipulative'
Toward the end of the 19th century" the term
KneuratheniaK came into ue to decri(e milder ortemporary nervou condition" epecially amon! the
educated clae'
Throu!hout the era" ince diorder of (oth (ody and
mind were (elieved to (e herita(le condition" the chronic
ic)" the mentally impaired and the deran!ed were
vi!orouly ur!ed a!aint marria!e and parenthood'
niverity of Suex and
i wor)in! on Victorian repreentationof ethnicity'
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Scienti3c Medicine" Alternative Medicine" and Luac)ery
It i worth notin! that" durin! the 19th century thetheoretical ide of medicine wa termed cienti3c
medicineN while the daily practice of medicine within
ociety could (e more accurately decri(ed a the le
cienti3c and more non7traditional alternative medicineN
uch a homeopathy or" in evere cae of malpractice
and fraud" a -uac)ery'N Suppoed medical practice of
the 19th century included Thomonianim" phrenolo!y
#)ull morpholo!y&" memerim" electropathy" and
hydropathy' hile ome were readily accepted while
other were not" over time the dierent practice adopted
each otherG trait in order to reduce confuion and !ain
overall acceptance of the !eneral pu(lic'
Scienti3c 4evolution v' 4omanticim in America
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The
cienti3c revolution" althou!h rapid in term of the entire
hitory of humanity" wa low to unfold' Thi lowne
wa due to (oth the medical conervatim in Europe at
the time" in which new (rea)throu!h in pre7exitin!
cience were reited with upicion" a well a the
American 4omanticim philoophical movement' In revoltto the A!e of 4eaon" 4omanticim arrived in America
from Europe (etween 1$1; and 1$1' 4omanticim
emphaied enitivity" feelin!" and the upernatural
over the rational empirical thou!ht' In America"
4omanticim mixed with the
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licene were now open to all to practice' Thi view" when
com(ined with the removal of profeional tandard of
practice" led the people of the >'S' to alternative
medicine and even -uac)ery' The correpondin! (irth ofthe patent of medicineN in the >nited State alo too)
place durin! thi time' Many of thee medicineN were in
reality nothin! more than alcohol laced with other dru!
and (otanical'
Improved ,ru!" 4eearch" and Techni-ue
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At the (e!innin! of thi
century" cienti3c medicine
conited of heroic medicineD
all dieae were (elieved to(e the reult of uid exce"
with the cure of pur!in!"
vomitin!" (leedin!" and
(literin! precri(ed in order
to retore the natural (alance
of a !iven individual' ,urin!
thi time" ur!ery wa alway
a lat reort" a it wa
extremely painful and often
deadlyD the only availa(le
early anethetic were opium
and alcohol' 0y the 1$=2" dru! uch a chloroform"
nitrou oxide" and ether (e!an to (e ued (y hi!h ociety
a ocial dru! O dru! that were eventually ued in
ur!ery' ith the introduction of anethetic" the often
extremely intene pain of ur!ery wa removed' Thi
pain7free tate allowed for lon!er and more complex
operation'
In addition" >'S' phyician were alo expandin! their
medical )nowled!e durin! thi time period" trein! thetudy and determination of a dia!noi over the
indicriminate procedure involved with heroic' Three
>'S' doctor encoura!ed thi hift in medical thou!ht and
practice early on' The 3rt doctor" ,r' ,aniel ,ra)e"
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attempted to tandardie medical practice in 1$19 when
he founded the Medical Colle!e of Hhio in Cincinnati' The
econd doctor" a >'S' Army doctor (y the name of ,r'
illiam 0eaumont" too) advanta!e of a tra!ic ituation totudy the tructure and function of the di!etive ytemD
he tudied the tomach wound of a military patient' Thi
wound would not heal" o 0eaumont tudied the wor)in!
of the tomach throu!h thi openin! and in 1$66 wa
a(le to pu(lih a wor) on the chemitry of di!etion
entitled Experiment and H(ervation on the 5atric
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peer until nearly twenty year later" with the dicoverie
of 'S'
ur!eon ,r' illiam Mayo (e!an practicin! antieptic
ur!ery' Alo in thi century wa the development of
cure for ome endemic infectiou dieae (e!an to ta)e
place" for the mot part" a decline in the mot lethal of
the dieae wa due more to improvement in
anitation" pu(lic health" and nutrition than to actual
medicine'
Scienti3c Method" ,ieae Identi3cation" P 5enetic
It wa Claude 0ernard who et the foundation for the
eta(lihment of the cienti3c method in medicine' In
1$% he pu(lihed An Introduction to the Study of
Experimental Medicine' 8owever" it would not (e until the
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followin! century that the application of the cienti3c
method to medical reearch would produce numerou )ey
development in medicine" includin! !reat advance in
pharmacolo!y and ur!ery'
In term of dieae identi3cation" +ateur and +ruian
phyician 4o(ert Foch #1$=671912& O the latter of whom
wa awarded the Bo(el +rie in 192% O to!ether founded
the cience of (acteriolo!y" which later on would (e
!rouped with other cienti3c (ranche uch a mycolo!y"
paraitolo!y" and virolo!y under the more (road cience
cate!oriation of micro(iolo!y' Foch wa alo famou for
the dicovery of the tu(ercle (acillu in 1$$; a well a
the dicovery of the cholera (acillu one year later' In
1$$=" with 5erman (acteriolo!it /riedrich :oeQer #1$%;7
191%&" Foch developed the four criteria dei!ned to
eta(lih a caual lin) (etween a !iven cauative micro(e
and a dieae" which came to (e called FochG potulate'
The econd half of the 19th century wa alo a time for
!enetic dicoverie' In 1$%9 En!lih naturalit Charle
,arwin #1$2971$$;& pu(lihed The Hri!in of Specie'
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omen and Medicine
The 19th century leader of women in medicine wa
0ritih nure" writer" and tatitician /lorence Bi!htin!ale
#1$;271912&' Bi!htin!ale" who (ecame )nown a the
:ady with the :ampN for her ni!ht viit to her patient"
howed the then male dominated profeion that hy!iene
and nutrition were the critical )ey to the reduction of
patient mortality' In 1$%9" Bi!htin!ale pu(lihed Bote onBurin!" which (ecame re-uired readin! for all nurin!
tudent' In 1$2" Bi!htin!ale et up the St ThomaG
8opital" the 3rt ecular nurin! chool" with En!lih
phyician Elia(eth 0lac)well #1$;1O1912& and (ecame
the 3rt woman to formally tudy" and u(e-uently
practice" medicine in the >nited State" durin! a time
when the a mater7apprentice model of intruction wacommon' 0y 1$1" a profeional nurin! chool wa
eta(lihed within the >nited State in Bew Jor) City and
other oon followed throu!hout the nation" (oth durin!
and after the American Civil ar" when the need for
hopital )yroc)eted'
The 4ole of the Church" Science" and +ychiatry
,urin! the 19th century and early ;2th century" medicine
wa cloely related to the church" (oth within the >nited
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State and throu!hout Europe' 8owever" technolo!y and
cience oon replaced any reli!iou authority' Mental
health reearch (e!an with the mentally ill in the lunatic
aylum of the 1$th and 19th centurie" which led to thereco!nition of the cience of pychiatry' 5erman
pychiatrit Emil Fraepelin #1$%719;& i deemed to (e
the founder of modern cienti3c pychiatry' In the >nited
State" it wa not until after the Civil ar and really not
until the end of the 19th century that cienti3c medical
advance (e!an to catch up with the need of ociety' /or
example" the caualtie of the American Civil ar" it
hopital" and the new (acteriolo!y theorie !radually
reulted in critical chan!e in the medical practice and
profeion" which eventually led to todayG cuttin!7ed!e
>'S' medical and pharmaceutical indutrie'
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