Introduction In Medicine And History Of Medicine Lecture 8 PDF

INTRODUCTION IN MEDICINE AND HISTORY OF MEDICINE LECTURE 8. GENIUS OF MEDICAL THOUGHTS AND PRACTICE RENAISSANCE PERIOD – 16TH CENTURY AND BAROQUE 17TH AND 18TH CENTURY RENAISSANSE VESALIUS FRACASTRO PARACELSUS 16th CENTURY – TURNING POINT IN CULTURE AND SCIENCE...

INTRODUCTION IN MEDICINE AND HISTORY OF MEDICINE LECTURE 8. GENIUS OF MEDICAL THOUGHTS AND PRACTICE RENAISSANCE PERIOD – 16TH CENTURY AND BAROQUE 17TH AND 18TH CENTURY RENAISSANSE VESALIUS FRACASTRO PARACELSUS 16th CENTURY – TURNING POINT IN CULTURE AND SCIENCE DEVELOPMENT 16th century is characterized by :  Reaction against ecclesiastic and religious dogmatism and scholastics,  Against non-critical adoption and support to Antic authorities and models,  And aspiration towards critical experiments and independent opinion and creation.  This new spirit in science is reflected in rejecting Aristotle’s Antic speculative and dogmatic science and establishing scientific experiments by Galileo. SCIENTISTS WHO CHARACTERIZE 16TH CENTURY  In anatomy: Italian anatomists – Vesalius, Eustachio and Fallopio  In epidemiology: Italian physician Fracastoro  In biology and overall medical science: German physician Paracelsus  In surgery: French surgeon Ambroise Pare.  Those physicians characterized progressive way and manner of thinking by their innovative medical theories independent of Antic ones. LEONARDO DA VINCI- CONTRIBUTION TO THE ANATOMY  Leonardo da Vinci is an artist who contributed to understanding human body anatomy and functioning;  He performed sections of around 30 corps in Santo Spirito mortuary and observed structure of 1,000 skeletons together with Marco Antonio della Torre aimed to produce monumental human body anatomy. This effort was not completed as his partner died. However, there are Da Vinci’s works on structure of organs, muscles and skeleton. VESALIUS – AUTHOR OF THE FIRST SCIENTIFIC ANATOMY  Andrea Vesalius, a German from Vesalia was a student and a professor in Padua.  Thanks to his work on corps he was the first one to establish that Galen’s anatomy was wrong.  Results of his research were published in the first scientific anatomy «De humani corporis fabrica» issued in Basel. It included 7 artistically produced volumes with pictures. VESALIUS– UNACCEPTED BY CONSERVATIVE PHYSICIANS  Vesalius progressive and innovative orientation was not appreciated by majority of that time conservative physicians.  When he performed post mortem after death of one of his patients after surgery, he was accused that he did post mortem on still alive patient.  To atone for his sin, he was forced to travel to Palestine to pay reverence to all the sanctuaries there.  On the way back, he was caught in a storm, ended up on a deserted island, allegedly died of hunger and disease. FRACASTRO – DISTINGUISHING VARIOUS EPIDEMIC DISEASES  Girolamo Fracastro was a professor at Padua University. He challenged reputation of antic science in the area of epidemiology.  Fracastoro was the first one to start distinguishing various epidemic diseases, for which, in Antic period, common name pestilences was used.  Syphilis (described in verses and named after a shepherd Syphil) and tuberculosis were among the described communicable diseases.  To destroy TB bacills and eliminate them from lungs, he recommended to swallow arsenic and take expectorans potion. FRACASTORO – GERMS CAUSES OF DISEASE, MANNER OF TRANSMISSION OF GERMS  Fracastro’s starting assumption was that communicable disease are caused by invisible germs, «seminaria prima contagionum». He assumed that they can be transmitted in three ways:  Some germs are transmitted by direct contact between infected and healthy person. This is the case of scabies, TB and leprosy.  Other germs are transmitted by various objects, such as cloth, linen, furniture. He named disease transmitter as «fomites».  Third infective germs, such as causes of variolla and ophtalmia, are transmitted at longer distances by «being attracted by body juices», to which they are pone or attracted by inhaled air, when they penetrate into blood vessels and get to the heart. FRACASTORO – COMMUNICABLE DISEASES INHERENT TO HUMANS ONLY  Fracastoro noticed that not all communicable diseases of plants, are at the same time communicable to animals, nor many communicable disease of animals are transmittable to plants.  Certain communicable disease are inherent to humans only, or animals only, or particular animal species only.  There is «non-communicable rotting» which results in «simple dissolution» as well as rotting in which communicable germs are produced. «Such germs are characterized by fast multiplication and expansion» and are transmitted easily from one person to another «whether they are close to each other or far away». PARACELSUS – “LUTHER IN MEDICINE”  Philip-Theofrast Bombast Paracelsus shook and upset by his ideas until that time sleepy and non-critical conservative physicians philosophy. He was old medicine’s enemy. He demonstrated it by:  Burning Galen and Avicena’s work on main square in Basel where he was elected to be university teacher, and  Disobeying the tradition to give lectures in Latin, dressed in prescribed outfit; his lectures were in German, in common suit. PARACELSUS – CONFLICT WITH COLLEGES  He beheld in contempt Antic physicians «If you hide behind Mahaon, Apoliner, Aristotle, Galen, Avicenna’s authority, it’s worthless, as you should first prove if they lied or not».  Since he had conflict with all the professors and physicians in the town, he was dismissed from the University. He even had to run away. He was gathering students, traveling many countries where he was looking for company of common people and learning about its traditional medicine. PARACELSUS – BLEND OF AND OLD AND A NEW SCIENTIST  Paracelsus was living, thinking and creating at intersection of two opposite periods, Antic and European.  He is unavoidably blend of an old and a new – non- systematic, non-steadily, full of contrasts. Paracelsus is:  The first physician – chemist performing chemical experiments in laboratory and thinking in chemical way.  The first among physicians to promote methodological principle of «experiment and common sense»  He is theologian, cosmologist and mystic. PARACELSUS - NOTION OF HEALTH AND DISEASE  Paracelsus defines health as harmony among various parts of body and their functions.  Paracelsus explains diseases as opposite condition, where «chemical distress», occurs, when physical and psychological cause of disease are present, «enses».  According to Paracelsus «ens is a force which manages body» together with chemical factors. PARACELSUS – “ENSES” DISEASE CAUSES Paracelsus distinguishes 5 types of eneses:  «ens astrale» - cosmic cause of disease;  «ens deale» - cause of disease sent by God’s providence;  «ens naturale» - genetic cause;  «ens spirituale» - unhealthy spiritual influence to body;  «ens veneni» - food poisons. PARACELSUS – MEDICINES FOUND IN NATURE  Paracelsus noticed that similarly to diseases having their causes and signs, medicines have their internal, hidden healing features «arcana». They correspond to external signs on medicines «signatura», indicating disease they treat – Examples:  «Gold is a medicine for heart, since Sun is heart of the world, and Suns is gold».  « «Pulmonaria» herb is multicolored like lungs and medicines made of it cure lungs diseases».  « «Helidonia» and «Crocus» herbs help treat jaundice (icterus) because of their yellow color». PARACELSUS – CHEMICAL MEDICINES, WOUNDS HEALING  Paracelsus was among first physicians who introduced chemical or according to him «spagiric» medicines – metals, as follow: antimon, arsenic mercury, iron, lead, copper and sulfur.  Although he was not a surgeon, Paracelsus made right instruction for treating wounds by cleaning them, changing dry bandages and imobilization. PARACELSUS –APPRECIATED AND CONTESTED  By his innovative views and rebellious temper, Paracelsus influenced physicians’ philosophy of his contemporaries, and even more of subsequent generations of physicians.  Many of his thoughts were accepted and further developed, but many others were rejected as delusion.  For his lifetime, he had large number of followers, but even larger number of opponents. Upon his death, after some biographic data were revealed, number of opponent grew.  Those data presented his personality as more complex and intriguing, and creating a legend of him.. 17th and 18th CENTURY INDEPENDENT DEVELOPMENT OF SOME MEDICAL THEORIES NON-CRITICAL SUPPORT TO ANTIC MODELS  UK philosopher Francis Bacon said that Aristotle’s work presented «light panels» which were «floating on the time river» only because they were light, while all heavier Antic values fell into oblivion.  Bacon pointed out importance of experiments for scientific progress. He promoted experiments, repeating that «nature cannot be obsesrved otherwise» HARVEY- DISCOVERY OF BLOOD CIRCULATION IMPORTANCE OF EXPERIMENT IN  William Harvey, UK physician and physiologist, proved by calculation method that heart pumps 200 l of blood per hour.  He complemented his discovery by experiment. He was cutting experimental animal’s arteries, proving that they are not empty, as Galen thought wrongly, but filled with blood.  He established that blood from veins flows towards heard.  Microscope discovery. THEORIES OF MEDICINE Some of interesting theories in 17th and 18th century are the following:  Animism theory  Vitalism theory  Clinical theory  Incitation theory  Homeopathic theory... ANIMISM, VITALISM THEORIES Animism theory  George Ernest Stahl, professor of physiology and pharmacology, is founder of «Animism theory»  He thinks that life phenomena are managed by, «anima rationalis» and that it is responsible for self-healing.  He helped «natural forces» achieve their healing effect by extensive bleeding. He made himself, at age of 69, bleeding102 times. Vitalism theory  Teophilo Bordoa , physician from Paris, is author of «Vitalism theory». According to him, life is maintained by «heart, brain and stomach», which are «tripod of life». CLINICAL THEORY, INCITATION THEORY  Herman Boerhaave, professor of theoretical medicine in Leiden is founder of clinical school which follows Hippocrates’ spirit. In practical work he did not pay much attention to theoretical premises. As Hippocrates follower he was driven by his empirical sense. In terms of medical treatment he relied more on expectations and diet, and less on proactive therapy. With such approach he achieved great success and got reputation of most famous physician of his time.  John Brown, physician from Edinburgh is fonder of incitation theory. This theory is based on treatment by substance which strengthen life vigor and activity (meat, alcohol, opium and coldness). HOMEOPATHIC THEORY  Samuel Hahnemann, German physician is founder of «homeopathic theory».  He administered medicines which cause condition similar to pathological one.  He was treating burns by hot compresses. He thought medicines cannot cure disease, but only eliminate its symptoms.  By their dynamic effect only, medicines strengthen vitality of organism, thereby contributing to organism’s own fight against disease. 17th and 18th CENTURY - - PERIOD OF PROGRESS IN MEDICINE  Elimination of non-critical support to Antic and Arab models  Maintaining fruitful cultural heritage based on Hippocratism.  Elimination of religious dogmatism and ecclesiastic scholastics  Independent development of first medical theories based on scientific grounds  Independent scientific work in terms of developing theoretical branches of medicine, such as anatomy, physiology, embryology, pathology...  Establishing grounds of scientific methods, by doing experiments