18th & 19th Century Medical Advances

18th Century Advances

• John Hunter recognized as an experimental surgeon; he developed methods for closing aneurysms and made significant contributions to comparative anatomy.
• Philippe Pinel introduced humane treatment for mentally ill patients at the Asylum de Bicetre in Paris.

19th Century Medical Progress

• Medicine in the 19th century focused predominantly on autopsies.
• Carl Rokitansky became a leading morphologic pathologist.
• Rudolf Virchow discovered that all cells arise from pre-existing cells, foundational to cell theory.
• Claude Bernard, a pioneer of experimental physiology, linked pancreatic function to diabetes and established internal medicine.
• Rene-Theophile Hyacinthe Laennec advanced the pathological and clinical understanding of chest diseases and introduced the stethoscope.
• Ephraim McDowell completed the first successful abdominal surgery to remove a large cyst from an ovary.
• J. Marion Sims laid the groundwork for gynecology, invented the Sims position, and founded the Women's Hospital of the State of New York.
• Discovery of nitrous oxide gas and chloroform in 1831, although surgical applications were initially overlooked.
• Joseph Priestly discovered nitrous oxide gas, while Humphry Davy suggested its use in surgery.
• Surgical techniques improved during this period, paving the way for advanced medical practices.

20th Century Innovations

• Watson and Crick provided a detailed description of the DNA molecule in 1962.
• Christiaan Barnard performed the first successful human heart transplant.
• Significant advancements in medical technologies including imaging equipment, major organ transplants, coronary bypass surgery, arthroscopic surgery, laparoscopic surgery, and lithotripsy.
• Introduction of lasers enhanced surgical procedures.
• Development of artificial hips and knees, alongside advances in plastic surgery.

21st Century Developments

• Technological and information expansion in healthcare has accelerated.
• Research in genetics has greatly enhanced understanding of heredity and disease predisposition.
• Advances in biotechnology and robotic surgery have improved precision and recovery times.
• Mapping of the heart's electrical conduction system has helped in understanding cardiac health.

Health and Disease Definitions

• The WHO defines health as encompassing complete physical, mental, and social well-being, not merely the absence of illness.
• Disease is characterized as any condition impairing normal body function, marked by specific signs and symptoms.
• Mortality refers to the death rate; morbidity indicates the prevalence of disease.
• Healthcare delivery is influenced by social, ethical, and economic factors.

Historical Outline of Hospitals

• Ancient medicine often integrated culture and religion, with temples of healing recognized.
• King Ashoka founded a network of hospitals in Hindustan around 230 BC.
• The Romans established valetudinaria for wounded soldiers around 100 BC.
• Constantine I shaped the modern hospital concept in 331 AD, linked to Christian care traditions.
• St. Basil the Great created a hospital and isolation unit for leprosy sufferers in 370 AD.
• St. Benedict of Nursia emphasized care for the sick in the 6th century, influencing hospital practices through the Middle Ages.
• In the 11th century, hospitals established by the Order of St. John in the Holy Land catered to large patient numbers.
• By the 12th century, Arab hospitals in Baghdad and Damascus admitted patients regardless of their background.

Outpatient/Ambulatory Care

• Ambulatory wellness services focus on preventive and basic healthcare, such as primary care and mental health counseling.
• Diagnostic services include X-rays, lab tests, and cancer screenings, critical for early disease detection.
• Treatment options encompass same-day surgery centers and various therapeutic clinics.
• Rehabilitation services help patients recover post-surgery or from substance abuse.
• Telemedicine is an emerging field, allowing remote patient-provider interactions.

Home Health Care Approaches

• Home health care offers a variety of services in a patient's residence, often seen as more convenient and cost-effective than hospital care.
• Skilled services include wound care, patient education, intravenous therapy, injections, and health monitoring.
• Goals of home health care include improving patient health, fostering independence, and maintaining quality of life.
• Medical orders are required to initiate home health care services.