History of Medicine: Key Figures and Dates

• These notes cover key dates, individuals, concepts, and developments in the history of medicine and the medical humanities.

Key Organizations & Dates

• 1912: The Medical Council of Canada was formed.
• 1970: Universal healthcare established in Canada.
• 1979: The Committee on the Accreditation of Canadian Medical Schools was formed to assess the quality of medical education programs in Canada.

Key Figures & Their Contributions

• Francis Bacon (1561-1626): Advocated for empiricism and observation to transform society and change the social understanding of disease.
• William Harvey (1578-1657): Discovered the heart is a muscular pump.
• Rene Descartes (1596-1650): Proposed that humans and animals are organic machines.
• Jean-Jacques Rousseau, John Locke, Immanuel Kant: Theorized that science can discover the laws of nature.
• William Cullen: Developed nosology, a classification system for diseases.
• George Engel: Created a biosocial model of medicine, integrating psychological and social factors into patient care.
• Eric Cassell (1990s): Noted that bodies feel pain, but persons suffer, distinguishing between disease and the individual's experience.
• William Osler (1849-1919): Concerned about the human cost of scientific medicine; developed a still-common model of medical education.
• Jenny Tillotson: Founder of eScent and Smart Second Skin; integrates fashion, neuroscience, and AI to address health challenges outside clinical settings.
• Dr. Sam Guglani: Highlights the tension between science and humanity in medical practice.
• Susan Reverby & David Rosner: Pioneers of the new social history of medicine, critical of the healthcare system and physician authority.
• Hippocrates (c. 460-377 BCE): Value observation, experience, and reason. Disease = disequilibrium and health = equilibrium.
• Galen (131-201): Medical texts influenced treatment for 1000 years. "Above all do no harm".
• John Gregory (1724-1773): Created a new ethical context for medicine at the University of Edinburgh and revised Hippocratic Oath, which stressed scientific practice as a moral obligation.
• Thomas Percival (1740-1804): Wrote Medical Ethics (1803); developed code of conduct influencing medical ethics in the UK and North America + feelings and emotions of patients and the right to refuse treatment were key.
• Sir Luke Fields: Painted "The Doctor" (1891).
• Andreas Vesalius: Believed in hands-on learning and produced knowledge based on dissections on bodies.
• Abraham Flexner and the Carnegie Foundation: Investigated medical schools in the US and Canada and found these schools were of poor quality.
• Xavier Bichat (1771-1802): Tissue pathology = empiricism vs patient experience and description of symptoms. Led to treatment of disease vs care of patients.
• Rudolf Virchow (1821-1902): Said disease is at the cellular level; launched cellular pathology.
• Louis Pasteur (1822-1895): Determined that microorganisms are responsible for disease and vaccines can be developed.
• Robert Koch (1843-1910): Founder of bacteriology: discovered bacteria that caused tuberculosis, cholera and others.
• John Snow: Contagion (germ theory) vs miasma (bad air) informed how cholera was understood + reasoning, graphs, etc to demonstrate the impact of dirty water.
• Sir Francis Galton (1822-1911): Coined the term eugenics.
• James Daschuk: Discusses small pox outbreaks.

Key Concepts & Definitions

• Humanities: The study of history, philosophy, religion, languages, literature, arts, media, ethics, jurisprudence, and social sciences using historical or philosophical approaches.
• Humanistic Education: Aims to form compassionate, knowledgeable individuals who act in the world.
• Medical & Health Humanities: Emerged in the 1960s/70s as a response to the dehumanization of medicine. Medical humanities are more focused on doctors, and health humanities are more broad and include health professionals and therapists, and they also democratize healthcare.
• Pellegrino's 3 Elements of Medical Education: Ethical issues, self-examination, educated physician.
• Medical Humanities: Serve as a bridge between science and experience.
• eScent: Mixes fashion design, neuroscience, and artificial intelligence to address health challenges outside clinical contexts, bringing together health and humanities to address a variety of factors.
• Moral Critique in Medical Humanities: Recognizing privilege and history, becoming critical, and acknowledging medicine as a moral undertaking.

Model of Key Features of MHs

• Context: Understanding cultural and historical dimensions of medicine, recognizing gender, race, class, age, and sexuality.
• Experience: Understanding the perspectives of patients, doctors, and communities affected by health conditions.
• Conceptual and Critical Analysis: Being reflexive, asking key questions about disease, illness, healing, curing, health, and the goals of medicine.
• Formation: Cultivating professional identity, developing resilience, and dealing with trauma.

Key differences

• Medical humanities vs. health humanities: Medical humanities typically focus on doctors and sometimes nurses, while health humanities encompass a broader range of health professionals and therapists.
• Medical humanities vs. health humanities: Medical humanities tend to "binarize" health (healthy vs. sick), while health humanities are concerned with health at all stages of life.

Historical Developments in Medicine

Ancient Times

• 2600 BC: Egyptian Imhotep describes the diagnosis and treatment of 200 diseases.
• 500 BC: Alcmaeon of Croton distinguished veins from arteries.
• 460 BC: Birth of Hippocrates; scientific study of medicine begins.
• 300 BC: Diocles wrote the first known anatomy book.
• 280 BC: Herophilus studies the nervous system.
• 130 AD: Birth of Galen.
• 160 AD: Pedanius Dioscorides writes De Materia Medica.

Middle Ages

• 910: Persian physician Rhazes identifies smallpox.
• 1010: Avicenna writes The Book of Healing and The Canon of Medicine.
• 1249: Roger Bacon invents spectacles.
• Rise of Christianity: Some Christian values incorporated into medicine.

Renaissance

• 1489: Leonardo da Vinci dissects corpses.
• 1543: Vesalius publishes findings on human anatomy in De Fabrica Corporis Humani.
• 1590: Zacharius Jannssen invents the microscope.
• Arrival of the printing press & increased literacy: greater individually-validated knowledge was relied on.

17th and 18th Centuries

• 1628: William Harvey publishes An Anatomical Study of the Motion of the Heart and the Blood in Animals.
• 18th century: Medicine was unregulated, with medical education formalized through universities in Europe.
• University of Edinburgh: Leader of medical education in the 18th century.

19th & 20th Centuries

• 1824: First program of medical education in Canada at the Montreal Medical Institution.
• 1847: American Medical Association adopted code of ethics based on Percival's writing.
• 1870-1914: 10,000 physicians were trained at German universities.
• 1913: Medical school at the U of A established.
• 1930's: The electron microscope was invented, allowing for the ability to detect viruses.
• Post WWII (1950's and 1960's): Rapid expansion of medical knowledge.
• 1970: Universal healthcare in Canada.
• Innovation at McMaster: Problem-based learning approach and the development of ability and self-reliance.

Disease Theories & Social Context

• Diseases are social constructions: Understood differently by various social groups, biomedically, socially, and culturally.
• Social Constructionism: Examines how individuals and groups contribute to producing perceived social reality and knowledge.
• Humoral Theory: Until the 1800s said health requires balance of four humors: yellow bile, blood, phlegm, black bile. Disease = imbalance vs specific pathology.
• Middle Ages: Leprosy thought to be disease found in Leviticus 13-14 because of the symptoms, and those with it were impure and stigmatized.
• Renaissance: Syphilis was deemed a humoral disease resulting from congenital factors, unhealthy environment or sinful behaviour, but know now it is caused by a spirochete organism, Treponema pallidum.

Theories that shifted away from Humoral Theory

• Tissue pathology: Empiricism vs patient experience and description of symptoms. Led to treatment of disease vs care of patients.
• Cellular pathology: Disease is at the cellular level.
• Microorganisms: Are responsible for disease and vaccines can be developed.
• Bacteriology: Discovered bacteria that caused tuberculosis, cholera and others.

Key Developments in Understanding Disease Causation

• John Snow and Cholera: Showed the harmful effect of contaminated water in two nearly equivalent London populations.
• Eugenics: Sir Francis Galton coined the term eugenics (a set of beliefs and practices that aim to improve the genetic quality of a human population).
• Clearing the Plains: James Daschuk discusses small pox outbreaks.

Explore key dates, individuals, and concepts in medical history, including the formation of the Medical Council of Canada and the contributions of figures like Francis Bacon and William Harvey. Learn about the evolution of medical thought and practice. Also covers universal healthcare in Canada.