Medicine of the New Time Lecture 5. Lecture Plan 1. Introduction to the New Time. 2.Medical research and major breakthroughs. Hospitals and healthcare

Medicine of the Medicine of the New TimeNew Time

Lecture 5Lecture 5

Lecture PlanLecture Plan1. Introduction to the New

Time.

2. Medical research and major breakthroughs. Hospitals and healthcare.

3. 18-th century medicine. Inoculation. Practical measures.

INTRODUCTION TO THE NEW TIME

Medical practice began to greatly improve during the 17th and 18th centuries. Professional societies were formed in all major European capitals, and scientists shared their research by publishing in journals.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.

INTRODUCTION TO THE NEW TIMEINTRODUCTION TO THE NEW TIMEDue 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.

INTRODUCTION TO THE INTRODUCTION TO THE NEW TIMENEW TIME

In many towns charitable hospitals and In many towns charitable hospitals and dispensaries also offered basic healthcare: to poor dispensaries also offered basic healthcare: to poor children and expectant mothers, or to old sailors children and expectant mothers, or to old sailors and soldiers. And as a last resort, dozens of quacks and soldiers. And as a last resort, dozens of quacks were on hand to offer an array of potions, powders were on hand to offer an array of potions, powders to those most desperate for relief from pain or to those most desperate for relief from pain or discomfort.discomfort.Dirty surgical instruments caused wounds to be Dirty surgical instruments caused wounds to be infected, and this caused the death of many infected, and this caused the death of many patients. Flea and rat infestations were also patients. Flea and rat infestations were also common, even in wealthy households, and many common, even in wealthy households, and many diseases were spread this way in crowded urban diseases were spread this way in crowded urban environments.environments.

INTRODUCTION TO THE NEW INTRODUCTION TO THE NEW TIMETIME

Many women died in childbirth Many women died in childbirth because of infection. Even having because of infection. Even having your teeth pulled out could be fatal. your teeth pulled out could be fatal. Major surgery was particularly Major surgery was particularly dangerous. in crowded urban dangerous. in crowded urban environments.environments.


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.


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.

Medical research and major breakthroughs

Medical researchers made some astounding discoveries. William Harvey determined how blood circulated through the body. William Harvey


When Harvey by his discovery of the circulation furnished an explanation of many vital processes which was reconcileable with the ordinary laws of mechanics, the efforts of medical theorists were naturally directed to bringing all the medical theorists were naturally directed to bringing all the departments of medicine under similar laws.


Published in 1628 in the city of Frankfurt, this 72 page book contains the matured account of the circulation of the blood.

Image of veins from Harvey's Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus


Anton van Leeuwenhoek used a microscope and discovered red blood cells, bacteria, and protozoa. Van Leeuwenhoek made more than 500 optical lenses. He also created at least 25 microscopes, of differing types, of which only nine survive.

Anton van Leeuwenhoek


Marcello Malpighi, a lecturer in theoretical medicine at the University of Bologna, has been pioneering the use of the microscope in biology.

Marcello Malpighi


Malpighi thus becomes the first scientist to observe the capillaries, the tiny blood vessels in which blood circulates through flesh . They are so fine, and so numerous, that each of our bodies contains more than 100,000 kilometres of these microscopic ducts. Malpighi's tomb

in Bologna


With their discovery, the missing link in Harvey's circulation of the blood has been found. For the capillaries are literally the link through which oxygen-rich blood from the arteries first delivers its energy to the cells of the body and then finds its way back to the veins to be returned to the heart.

18-TH CENTURY MEDICINE

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.

18-TH CENTURY MEDICINEDiseases were common during

the 18th century and there was little medical protection against them. Death rates from certain diseases were high. In Europe, the close-confines of cities were breeding grounds for illnesses and disease. The lack of understanding of how such ailments were passed along and a subsequent inability to adequately prevent the spread of diseases many times resulted in epidemics of varying severity.


Diseases of the eighteenth century were a major part of daily life. A vast number of colonists died from many horrible diseases including small pox, yellow fever, and diphtheria, just to name a few, because only a minute about of people had medical knowledge.

Diphtheria


Inoculation: 17th - 18th century

Inoculation is based on an easily observed medical fact - that those who contact an infectious disease and survive are protected against catching it again. Inoculation is a precautionary measure, though in the case of smallpox a dangerous one.


Edward Jenner invented vaccination after discovering the relationship between cowpox and smallpox. Jenner publishes his findings in 1798 in the splendidly titled An Inquiry into the Causes and Effects of the Variolae Vaccinae, a disease discovered in some of the Western Counties of England, particularly Gloucestershire, and known by the name of Cow Pox.


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.

Edward Jenner


Smallpox took the lives of millions, killing at least 400,000 a year in Europe alone throughout the 18th Century - from peasant to king.

A child is inoculated

against smallpox


Vitamins were discovered and their importance to health recognized. New drugs, including digitalis, were developed, and vaccination was perfected by Edward Jenner. Giovanni B Margagni founded pathologic anatomy, and Marie Francois Bichat created the field of histology.

Giovanni B Margagni


Practical measures: 1752-1785The middle years of the 18th century are

notable for practical advances in medicine, based on close observation by

working practitioners. Some of those who record their experiences are at the

academic end of the medical profession; others are country doctors paying

attention to detail. Their efforts raise the scientific standards of medicine and

introduce techniques and drugs of lasting benefit.


An early example is William Smellie, the first obstetrician to make a scientific study of the physical process of childbirth. Use of forceps by W.Smellie


Smellie publishes his findings in the three-volume Treatises on the Theory and Practice of Midwifery (1752-64). His text provides a new scientific basis for the ancient skills of the midwife.

Smellie illustrates a number of complications possible in childbirth and gives detailed directions for delivery.

This is Smellie’s engraving of twins in utero


Morgagni's book is De Sedibus et Causis Morborum per Anatomen Indagatis (On the Seats and Causes of Diseases, investigated by Anatomy). It describes 640 post-mortems with the related clinical records. Symptoms from now on can be interpreted as external signs of known internal conditions. Giovanni Battista Morgagni


In the year of Morgagni's publication, 1761, a book comes out in Vienna offering the general practitioner a useful new technique in the analysis of a patient's internal condition. It is the work of Leopold Auenbrugger, an Austrian physician employed in a military hospital. Many of his patients have fluid in the chest. To discover how much, he adapts a technique learnt in his childhood.

18-TH CENTURY MEDICINEGeorge Martine (1702-1743)

was the first to perform a tracheotomy in Britain. Martine is recognized for having been the first to suggest the use of a double tracheotomy tube. The second inner tube could be easily removed and cleaned, thereby keeping the tube clear of mucus without having to remove the tracheotomy tube altogether.


Everyone probably knows that cocaine is bad for your health. In the 1800s the people did not exactly know that cocaine was dangerous. Actually cocaine and other modern drugs were considered medicinal.

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Medicine of the New Time Lecture 5. Lecture Plan 1. Introduction to the New Time. 2.Medical research and major breakthroughs. Hospitals and healthcare