Unit 3 History of Health Sciences PDF

UNIT III: History of Health Sciences Foundations of Physiotherapy https://www.youtube.com/watch?v=OptEth-pPnc https://www.dailymotion.com/video/x7wec9b HISTORY OF HEALTH SCIENCES I. II. III. PREHISTORIC STAGE EARLY STAGE. PRETECHNICAL MEDICINE END OF PRE-TECHNICAL AND BIRTH OF TECHNICAL MED...

UNIT III: History of Health Sciences Foundations of Physiotherapy https://www.youtube.com/watch?v=OptEth-pPnc https://www.dailymotion.com/video/x7wec9b HISTORY OF HEALTH SCIENCES I. II. III. PREHISTORIC STAGE EARLY STAGE. PRETECHNICAL MEDICINE END OF PRE-TECHNICAL AND BIRTH OF TECHNICAL MEDICINE IV. MEDICINE IN ROME V. MIDDLE AGES VI. RENAISSANCE IV. S. XIX- S.XX 2 PREHISTORIC STAGE ● Life appeared on Earth- 3200BC ● Nomadic ● System of beliefs: unpredictable spirits: ● Functions of the body ● Death ● Health ● Disease PREHISTORIC STAGE MODERN AGE PRIMITIVE PEOPLE OBSERVATION ANIMAL REACTIONS ARTISTIC EXPRESSION (Cave paintings) Archaeological discoveries SKELETAL REMAINS PREHISTORIC STAGE Prehistoric evidence of illness: PREHISTORIC STAGE Archaeologists Trepanned skulls: ● An attempt to cure diseases or free the victim of demons and evil spirits PREHISTORIC STAGE Similar to remaining primitive peoples of the modern age: Australian Aborigines: ● ● ● Illness occurred when a person's spirit was lost or stolen by an enemy. Able to stitch up wounds and to set broken bones by encasing them in mud. Witch-doctors would have combined healing with other spiritual functions HISTORY OF HEALTH SCIENCES I. II. III. PREHISTORIC STAGE ANCIENT EGYPT. PRETECHNICAL MEDICINE ANCIENT GREECE. BIRTH OF TECHNICAL MEDICINE IV. MEDICINE IN ROME V. MIDDLE AGES VI. RENAISSANCE IV. S. XIX- S.XX ANCIENT EGYPT. 3000bc-500bc RELIGIOUS PRACTICE Priests Divine Punishment MAGIC MEDICINE Wizards/ Shamans Demonic possession EMPIRICAL MEDICINE (based on facts and observation) Physician Organic disease Ancient Egypt. Egyptian civilisation • First of the world's great civilisations • Hieroglyphic writing dates to 3200 BC • Beginnings of medical care as we know it today • Mummification: they learned about the internal organs of the human body • First to develop the profession of medicine. Training Specialization Ancient Egypt. Empirical medicine Medical Knowledge (collected in medical papyrus): • Channel Theory: heart as the center of a system of 46 tubes, or 'channels'. Unblock the 'channels' of the body by: vomit, bleed, empty bowels • First aid: stitch wounds, bandaging, herbal antiseptics • Public health: bath, toilets, personal cleanlinesss (Social reasons) • Simple surgery • Medical interview, evaluation and diagnosis Bronze surgical knives, from Egypt and Mesopotamia, (c.600-200bc) may have been used for mummification "Egyptian doctors made the break from superstition and began the march towards modern medical care." Imhotep 2630 – 2611 BC Some consider Imhotep: "Father of Medicine" “The first figure of a physician to stand out clearly from the mists of antiquity.“ Doctor, priest, architect: elevated to the category of GOD Wrote Edwin Smith papyrus: anatomical / injury observations, ailments, and cures. Devoid of magical thinking. https://www.youtube.com/watch?v=2cW2t1NOnlI Papyrus Edwin Smith', c.1500BC “If you examine a man whose nose is disfigured part of it being squashed in while the other part is swollen and both his nostrils are bleeding, then you shall say: "You have a broken nose and this is an ailment I can treat." You should clean his nose with two plugs of linen and then insert two plugs soaked in grease into his nostrils. You should make him rest until the swelling has gone down. You should bandage his nose with stiff rolls of linen and treat him with lint every day until he recovers.” There are vessels from the heart to every limb. When any physician, priest of Sekhmet or exorcist puts his hands or his fingers to the head, hands, stomach, arms or feet, then he examines the heart, because all the limbs possess its vessels; the heart speaks out of the vessels of every limb. There are four vessels in his nostrils, two give mucus and two give blood. There are four vessels in the forehead which then give blood to the eyes; all diseases of the eyes arise through them. There are four vessels to the head which produce a bald spot and loss of hair. The breath which enters into the nose enters into the heart and the lung; these join to the whole belly. There are four vessels to his two ears... The breath of life enters into the right ear, and the breath of death enters into the left ear. There are six vessels that lead to the arms; they lead to his fingers. There are six vessels that lead to the feet, until they reach the sole of the foot…. Ebers Papyrus 1570 BC Ancient Egypt. Magic / religious medicine Believed that the gods ultimately controlled their lives: worshiped Imhotep Magic: e.g. pig's eye to try to cure blindness Spells and remedies would give additional 'power‘ Disease prevention: appealed to gods, using charms, amulets and spells Papyrus Edwin Smith', c.1500BC “If you examine a man whose nose is disfigured - part of it being squashed in while the other part is swollen and both his nostrils are bleeding, then you shall say: "You have a broken nose and this is an ailment I can treat." You should clean his nose with two plugs of linen and then insert two plugs soaked in grease into his nostrils. You should make him rest until the swelling has gone down. You should bandage his nose with stiff rolls of linen and treat him with lint every day until he recovers.” HISTORY OF HEALTH SCIENCES I. II. III. PREHISTORIC STAGE EARLY STAGE. PRETECHNICAL MEDICINE END OF PRETECHNICAL AND BIRTH OF TECHNICAL MEDICINE IV. MEDICINE IN ROME V. MIDDLE AGES VI. RENAISSANCE IV. S. XIX- S.XX Ancient Greek civilisation Greek civilisation phylosophic thinking: ● Socrates ● Aristotle ● Plato Use of logic in discussion 300 BC Alexandria, became a center for study and learning, and was famous for its library. Ancient Greek civilisation END OF PRE-TECHNICAL STAGE (800 bc-600 bc): Magical-religious-empirical Vision TECHNICAL STAGE (600 bc-300 bc): No magic and/or divine influence Natural explanations / causes for illness Hippocratic medicine End of pre-technical STAGE (S. VIII-VI BC) Magico-religious medicine: ● ● Disease Etiology God punishment vs Cure through visits from gods ● Evil spirits attack man ● Asclepia: healing centres TECHNICAL STAGE. Hippocratic Medicine Hippocrates of cos: “Father of medicine” Medicine based in the Theory of Four Organic Humors (This theory survived until after 1700 AD) –Humoral balance = HEALTH –Humoral disbalance= DISEASE Humors: each of liquids of a living organism 19 Man's body has blood, phlegm, yellow bile and black bile. These make up his body and through them he feels illness or enjoys health. When all the humours are properly balanced and mingled, he feels the most perfect health. Illness occurs when one of the humours is in excess, or is reduced in amount, or is entirely missing from the body. Hippocrates, 'On the Constitution of Man' (c.500BC) TECHNICAL STAGE. Hippocratic Medicine ● Dissection of corpses and examined the internal workings of human bodies ● Wars: Greek doctors became experts at practical first aid. ● Setting broken and dislocated bones ● Healing centers. Medical process: ● Observation. Interview ● Diagnosis ● Prognosis ● Treatment TECHNICAL STAGE. Hippocratic Medicine Diagnosis: “First of all the doctor should look at the patient's face. The following are bad signs - sharp nose, hollow eyes, dry skin, strange colour of face such as green, black or leaden. If the face is like this, the doctor must ask the patient is he has lost sleep, or had diarrhoea, or not eaten.” Hippocrates, 'On Forecasting Disease' (c.500BC) TECHNICAL STAGE. Hippocratic Medicine The care of health begins the moment a man wakes up. After awakening he should not arise at once but should wait until the heaviness of sleep has gone. Then, every day, he should wash his face and eyes using pure water. He should rub his teeth using some fine peppermint powder and taking away any leftover bits of food. He should rub and anoint his head every day but wash it and comb it only occasionally. After this, people who have to or wish to work will do so, but people of leisure will first take a walk. A young man or middleaged man should take a walk of about 10 stadia before sunrise. Long walks before meals clear out the body, prepare it for food and give it more power for digesting. • Hippocrates, 'Regimen' (c.500BC) TECHNICAL STAGE. Hippocratic Medicine MEDICAL ETHICS ● Love the man and his art ● Doctors code of conduct: – Hippocratic Oath Anatomical dissections •Anatomy •Pathology Middle Ages forgotten or banned III and II BC I swear by Apollo the physician, and Aesculapius the surgeon, likewise Hygeia and Panacea, and call all the gods and goddesses to witness, that I will observe and keep this underwritten oath, to the utmost of my power and judgement. I will reverence my master who taught me the art. Equally with my parents, will I allow him things necessary for his support, and will consider his sons as brothers. I will teach them my art without reward or agreement; and I will impart all my acquirements, instructions, and whatever I know, to my master's children, as to my own; and likewise to all my pupils, who shall bind and tie themselves by a professional oath, but to none else. With regard to healing the sick, I will devise and order for them the best diet, according to my judgement and means; and I will take care that they suffer no hurt or damage. Nor shall any man's entreaty prevail upon me to administer poison to anyone; neither will I counsel any man to do so. Moreover, I will get no sort of medicine to any pregnant woman, with a view to destroy the child. Further, I will comport myself and use my knowledge in a godly manner. I will not cut for the stone, but will commit that affair entirely to the surgeons. Whatsoever house I may enter, my visit shall be for the convenience and advantage of the patient; and I will willingly refrain from doing any injury or wrong from falsehood, and (in an especial manner) from acts of an amorous nature, whatever may be the rank of those who it may be my duty to cure, whether mistress or servant, bond or free. HISTORY OF HEALTH SCIENCES I. II. III. PREHISTORIC STAGE EARLY STAGE. PRETECHNICAL MEDICINE END OF PRE-TECHNICAL AND BIRTH OF TECHNICAL MEDICINE IV. MEDICINE IN ROME V. MIDDLE AGES VI. RENAISSANCE IV. S. XIX- S.XX Pre-Hellenic MEDICINE: Etruscan influence ● Health and disease: magic-religious ● Each family served by "pater familiae" practice of medicine---Unworthy PLINIO (s.I AD): "The Roman people stood for over 600 years not without medicine, but without doctors" ROMAN Hellenism 100 BC Greece was annexed to the Roman Empire Greek medical knowledge and practices were imposed. Doctors in Rome were often Greeks, brought to Rome as slaves. This meant their status was low for a long time, although their skills were valued by many people. ROMAN Hellenism GALEN (130-200 AD) : Most important physician of the Roman Empire He was trained at Alexandria. -Gladiators surgeon "Father of sports medicine" Wounds, bone-joint traumatism and muscle injuries Experts at practical first aid and external surgery: no anaesthesics Treatment: Sports massage, exercises, drugs and substances -Anatomist Began systematic knowledge of human anatomy and applied it to diagnosis and treatment. • – Pathology • Described the osteoarticular pathology (bone destruction, osteomyelitis) ROMAN Hellenism GALEN (130-200 AD) : ● Dissection of humans was forbidden in the Roman empire ● Dissections of animals : monkeys and pigs ● ● Galen accepted the Greek theory of the four humours as the cause of disease Maintained the Greek practice of clinical observation of people who were sick ROMAN Hellenism GALEN (130-200 AD) : ● Anatomical errors in Galen Galen based most of his information about anatomy on what he saw when he dissected the bodies of animals. This led him to make mistakes. Some of his errors were: ● ● He thought that blood was created in the liver. He realised that it flowed round the body, but said it was burned up as fuel for the muscles. He thought he saw holes through the septum, which allowed the blood to flow from one side of the heart to the other. ● He made mistakes about the blood vessels in the brain. ● He thought the human jaw-bone was made up of two bones, like a dog's. ● He was mistaken about the shape of the human liver. ROMAN Hellenism PUBLIC HEALTH AND HYGIENE The Romans developed the first-ever system of public health: PREVENTION HYGIENE –Aqueduct: drinking water –Public toilets –Sewer System Epidemics decreased Nursing MILITARY HOSPITAL Wounded soldiers Civilian Hospitals emerged in 600 AD ROMAN Hellenism MILITARY HEALTH: ● Vital importance to keep troops fit and healthy – Each legion: medical assistants – "Medicus" medical officer of combat units. ● Army Military Medical School required ● III AD all physicians (military or civilian) = School of Medicine. ROMAN Hellenism MILITARY MEDICINE Advances in the field of Surgery Use of antiseptic methods: acetum Analgesic treatment Ointments and medicinal plant extracts – keep troops fit and healthy ● ● Army Military Medical School required III AD all physicians (military or civilian) = School of Medicine HISTORY OF HEALTH SCIENCES I. II. III. PREHISTORIC STAGE EARLY STAGE. PRETECHNICAL MEDICINE END OF PRE-TECHNICAL AND BIRTH OF TECHNICAL MEDICINE IV. MEDICINE IN ROME V. MIDDLE AGES VI. RENAISSANCE IV. S. XIX- S.XX Middle Ages (IVAD – XVAD) ● ● The Middle Ages – From Roman Empire (ended in 476 AD). – To Renaissance (dated from 1453 AD). The Middle Ages were initially represented a period of stagnation and ignorance, in between the wonders of the Romans and the glories of the Renaissance. ● 5th century AD, waves of barbarians such as the Saxons and Vikings invaded western Europe. ● Europe disintegrated into a huge number of small fiefdoms: – Could not afford universities, or public health systems. Middle Ages (IVAD – XVAD) ● Communications were difficult and dangerous, so ideas travelled slowly ● Many of the medical ideas of the Greeks and Romans were lost and survived only in the Muslim cities ● Medicine was dominated by the Roman Catholic Church ● Authority - people would believe what they were told against the evidence of their own eyes. ● After 1066, civilisation began to recover. Universities were established (eg in Paris in 1110, Oxford in 1167). Middle Ages (IVAD – XVAD) Causes of medical stagnation in the Middle Ages included: ● The loss of medical knowledge ● The forbidding by the Church of dissection ● The encouragement by the Church of prayer and superstition ● The emphasis on 'authority' rather than on investigation ● The lack of resources to build public health systems ● Social disorder and war, which disrupted communication and learning. Crusades came into contact with Muslim doctors, who were significantly more skilled. The Physician is a novel by Noah Gordon. It is about the life of a Christian English boy apprenticed to an itinerant barber in the 11th century who journeys across Europe in order to study medicine among the Persians Middle Ages (IVAD – XVAD) JUSTINIAN PLAGUE (VI century AD) BLACK PLAGUE (XIV century AD) Middle Ages (IVAD – XVAD) SCHOOL OF SALERNO AND UNIVERSITIES First universities founded XII AD: – 1088 Bologna. – 1110 París. – 1167 Oxford. – 1181 Montpellier School-based empiricism and observation ● Good clinical descriptions ● Indications pharmacological ● Treaties anatomy (in pigs) ● Surgery Middle Ages (IVAD – XVAD) Different in the Islamic Middle East: ● Books of Hippocrates were translated into Arabic ● Developed new ideas ● ● Islamic physicians and scholars developed a large and complex medical literature Muslim ideas spread only slowly to western Europe 34 ARABIC MEDICINE Multiple contributions of Islamic scientists in the various fields of knowledge from the 8th to the 16th centuries: Islamic golden age Major contributors: ● ● Rhazes was a persian physician: ● “Father of Islamic medicine” ● Criticized and refuted Galen's theory of humours Avicenna: ● ● "Father of Early Modern Medicine“ Book: The Canon of Medicine. Translated into Latin and disseminated throughout Europe ARABIC MEDICINE ISLAMIC HOSPITALS: (VIII-… AD) Key Features: – Patient andmission: Name + food intake + drugs. – Medical workday: Morning: Visit patient, Medication Prescription Afternoon: Revisit patient and 3 hr of class with students – Patient distributed in rooms by condition – Mosque and Library – Clinical and scientific sessions HISTORY OF HEALTH SCIENCES I. II. III. PREHISTORIC STAGE EARLY STAGE. PRETECHNICAL MEDICINE END OF PRE-TECHNICAL AND BIRTH OF TECHNICAL MEDICINE IV. MEDICINE IN ROME V. MIDDLE AGES VI. RENAISSANCE IV. S. XIX- S.XX THE RENAISSANCE 1400 AD – 1750 AD Decisive factors of the time: – Printing (1454): Disseminating information – Development of trade and exchange – Growth of cities - Northern Italy UNIVERSITIES AND EDUCATION MEDICINE ANATOMY AND SURGERY 48 THE RENAISSANCE ● Rebirth of learning ● Scientific REVOLUTION ● Ancient and medieval influence: greek writtings ● Disprovements of previous assuptions ● Develop in medicine THE RENAISSANCE ANATOMY They separated from the galenic theory Anatomy studies focused on osteology and myology Leonardo da Vinci (1452 - 1519) In 1513 he made anatomical research in a Roman Hospital SACRILEGE End of anatomical studies POPE LEO X https://www.youtube.com/watch?v=J9xUL5Yi_8M THE RENAISSANCE: Public health ● Early Modern towns were similar to Medieval towns. ● They did not have systems of sewers or water pipes. ● Rats, lice and fleas on the clay floors of their houses ● The Great Plague in England: from 1665 to 1666. THE RENAISSANCE (1514 – 1564) Andreas Vesalius: – Best anatomist – Surgery Professor: performed dissections by himself (not the barber-surgeon) (1510 – 1590) Ambroise Paré: Most important figure. Father frech surgery – New method glenohumeral dislocation reduction – Described various bone fractures – Designed surgical instruments – Seal wounds without boiling oil. Own ointment 50 THE RENAISSANCE GEORGE STAHL ERNS Medical paper WILLIAM HARVEY GASPAR ASELLI THOMAS WILLIS Global vision of illness. Emotions and psychological influence. Psychosomatic Prevent maintain or help Restore order in all body imbalances He described blood circulation and heart function Described lymphatic circulation Anatomy of the brain and nervous system 60 XVII century Birth of scientific societies that publish medical texts. The first medical journals also appear. Cimento Academy (Florencia 1657), la Royal Society of London (London 1662, under the influence of the Oxford university), la Tertulia Hispalense Medico-Chimica (Sevilla, 1697), la Regia Sociedad de Medicina (Madrid, 1700) XVIII century AGE OF ENLIGHTENMENT Critical Spirit / Faith in REASON / Confidence in Science 62 SOCIAL MEDICINE AND PUBLIC HEALTH ● Recognize social causes of illnesses. ● Prevention of illnesses. (Hygiene, lifestyle) ● Improve hygienic conditions in prisons, hospitals and factories ● Water channeling ● Installation of public toilets ● Disease is related to work. Eg, intoxication, mines 67 SOCIAL MEDICINE AND PUBLIC HEALTH Most Important health finding 1798 SMALLPOX VACCINE EDWARD JENNER obstetrics Medical specialties Psychiatry Anatomy ... https://www.youtube.com/watch?v=l_3dcY_cwN0 HISTORY OF HEALTH SCIENCES I. II. III. PREHISTORIC STAGE EARLY STAGE. PRETECHNICAL MEDICINE END OF PRE-TECHNICAL AND BIRTH OF TECHNICAL MEDICINE IV. MEDICINE IN ROME V. MIDDLE AGES VI. RENAISSANCE VII. VIII. S. XVII - XVIII CENTURY S. XIX- S.XX Nineteenth Century Important Advances in Diagnosis, Treatment and Surgery Matthias Jakob Schleiden (Botanist): – Embryonic cell development theory – Origin of microscopic study of tissues Marie François Xavier Bichat (Anatomist and physiologist): – Histology = Systematic study of human tissues. Louis Pasteur (Chemist and microbiologist) and Robert Koch (Physician and bacteriologist): Germ theory – Contributions to the field of bacteriology. https://www.youtube.com/watch?v=KSLCkT2ttXQ – * Nineteenth Century Large number of studies on industrial diseases: ● Diseases of mining ● Phosphate poisoning ● Toxic used in textil industry, ... Nineteenth Century Junction of Medicine and Surgery ● Initiation and development of anesthesia: – ● ● Development of antisepsis: ● Joseph Lister: Acid carbolic (Phenol) ● Charles Chamberland: Autoclave ● Surgical globes Discovery of X rays: ● ● Surgery is focused on the results, no on speed Bone pathology More complex surgical techniques https://www.youtube.com/watch?v=ZOYA00mE4MQ Twentieth Century Explosion of scientific understanding and technological innovation Communications technology Technification and Collectivization of health care: • Health as a community and social good (right) Treatment of disease versus health care: Health Promotion •Prevention of disease •Quality of Life • Man as a bio-psycho-social. •Physical, social, psychological, emotional, spiritual ...... Twentieth Century Infectious Diseases Chronic and degenerative diseases Autoimmune Diseases Differences between rich / poor countries: –Rich countries: psychological disorders; cardiovascular disease ...... –Poor countries: epidemics, malnutrition Twentieth Century ● ● "Modernization" "Super" -Specialty: – ● of medicine "Localist" Disease Treatment Demand for a more "global" care and "humanist" approach TWENTIETH CENTURY. Methods and diagnosis ● ● ● ● In 1921 Banting and Best developed insulin. 1928 by the Scottish bacteriologist Alexander Fleming - the first antibiotic. Peter Medawar (1950s: Britain) on immunosuppressants led to the development of antihistamine In 1954, Joseph Salk (America) discovered a polio vaccine https://www.youtube.com/watch?v=tMPY-zf8X94 TWENTIETH CENTURY. Surgery ● ● ● ● 1950: William Bigelow (Canadian) performed the first open-heart surgery 1962: Surgeons at Massachusetts General Hospital re-attached the arm of a 12-year-old boy. 1952: First kidney transplant (America) 1967: Christiaan Barnard (South Africa) performed the first heart transplant TWENTIETH CENTURY. Surgery ● ● ● ● 1970s: The development of plastic lenses allowed cataract surgery 1972: John Charnley (Britain) developed hip replacements 1986: Davina Thompson (Britain) became the first heart, lungs and liver transplant patient. In 1997 Scottish researchers bred Dolly, the first cloned sheep. 100 Greatests discoveries in medicine. Discovery cannel This episode shows thirteen important discoveries in medicine, including Andreas Vesalius's anatomical charts, Karl Landsteiner's identification of blood groups, and Alexander Fleming's discovery of penicillin. Here are the thirteen important discoveries: 1. Human Anatomy (1538) 1:14 2. Blood Circulation (1628) 3:43 3. Blood Groups (1902) 4. Anesthesia (1842 - 1846) 8:47 5. X-rays (1895) 12:32 6. Germ Theory (1800s) 16:28 7. Vaccination (1796) 20:58 8. Vitamins (early 1900s) 9. Penicillin (1920s - 1930s) 26:40 10. Sulfa Drugs (1930s) 11. Insulin (1920s) 12. Oncogenes (1975) 13. The Human Retrovirus HIV (1980s) https://www.dailymotion.com/video/x7wec9b