WK4_HISTORY OF MEDICINE.pdf

PREVENTIVE MEDICINE ARC LECTURE 2: HISTORY OF MEDICINE: MEDIEVAL AND RENAISSANCE PERIOD DR. RUFAIDA A. MAHING MEDIEVAL PERIOD - Middle Age (476 CE – 1,453 CE) -...

PREVENTIVE MEDICINE ARC LECTURE 2: HISTORY OF MEDICINE: MEDIEVAL AND RENAISSANCE PERIOD DR. RUFAIDA A. MAHING MEDIEVAL PERIOD - Middle Age (476 CE – 1,453 CE) - Medieval Medical Practice – The Canon of Medicine - Theory of Humors - Medication - Hospitals - Surgery - Plagues – The Black Death CHRISTIANITY - Illness was sent by God - Christian Church – preserved the knowledge from Greeks and Romans - Books of Galen – main books - 1st: Christian Church controlled the universities - 2nd: fitted the Christian belief that God had created human beings HOSPITAL AND HEALERS - Hospice – nursing care ISLAM - Women acted as midwives - Islam religion taught to look after the sick - Apprentice surgeon – local surgeon consulted by - Arab hospitals – first Arab hospital was founded in majority (poor) Baghdad - Guilds of Master-Surgeons – required license (passing - Eight Century – Greek medical books translated into the exam) Arabic - Physicians- highest-ranking doctors (trained at - City of Baghdad – main centre for collecting and universities) translating medical texts - Al-Razi “Rhazes” (c.860-925) – wrote over 200 books BELIEFS ABOUT CAUSES OF DISEASE - Ibn Sina “Avicenna” (c.980-1037) – The Canon; “Galen of - God sent illnesses to punish people for their sins Islam” - Anglo-Saxons – believed that elves and spirits, the Devil’s helpers, shot invisible arrows, knowns as elf-shot, to cause THE THEORY OF HUMORS everyday illnesses (headaches) - The body was a system of four fluid “humors”: black bile, - Explanation: bad air (miasma) caused illness. Some yellow bile, phlegm and blood. If the humor were in people did link the bad air to dirt and filth in the streets balance, then the body was in health. If the humor were in but could not explain exactly what the link was. imbalance, then the person was sick. KNOWLEDGE OF THE BODY HUMOR ORGAN TEMPER SEASON - Dissections of bodies Black Bile Spleen Melancholy Cold and dry - Ibn al-Nafis (1200-1288) – anatomy of the heart & Yellow Bile Lungs Phlegmatic Cold and wet challenged Galen Phlegm Head Sanguine Warm and wet Blood Gallbladder Choleric Warm and dry - Galen - blood moves from one side of the heart to the other through invisible channels - Al-Nafis - these channels did not exist. - Blood moves from the heart to the lungs and then back to the heart, thus circulating round the body. PREVENTIVE MEDICINE ARC LECTURE 2: HISTORY OF MEDICINE: MEDIEVAL AND RENAISSANCE PERIOD DR. RUFAIDA A. MAHING DIAGNOSING AND TREATING ILLNESS SURGERY - Urine chart - John Bradmore - Uroscopy - designed a metal forced to remove an arrow - fitted the Four Humors (ex. very white urine that had become lodged in the cheek of the was a sign of too much phlegm in the body) Prince of Wales - Galen’s Ideas on Pus – wounds were more likely to heal - Hugh & Theodoric – disagreed - Hugh – used wine for wound healing PUBLIC HEALTH - Medieval towns were much dirtier than Roman towns - Water was collected from rive or storage pits - Pigs and chickens roamed the streets - Rats, mice and hawks scavenged in streets full of rotting fish bones, animal dung, food waste and even human faeces. - Horses as transport THE BLACK DEATH - Most frightening outbreaks of diseases in history - Symptomatology - Began in China, spread to India and across Europe - Al-Razi – the difference between Smallpox and Measles reaching England in 1348 (at least 40% Britian’s - Knowledge of astrology – believed that parts of the body population died) were linked to signs of the zodiac and the planets - Beliefs: - Bleeding charts 1. Planets had become misaligned - used to show the surgeon where to take blood 2. It was a punishment from God for sin from 3. Miasma (bad air) - Bleeding was done by warming a bleeding cup, placing it 4. Water supplies poisoned by Jews over a small cut and letting the warmth draw blood out of 5. Evil humours the cut. - Prevention & Treatment: - Leeches 1. Flagellants - used to sink their jaws into the patient and 2. Galen’s opposites theory draw off blood ▪ Humors could be balanced using the - a method still used in the 19th century theory of opposites. For example, if a - Common herbal remedies were based on plants or patient had too much blood and was herbs, minerals and animal plants. hot and dry, they could be treated with - written down in commonplace books cucumber because it was cold and wet. - included prayers to say while collecting the 3. Street cleaning herbs to increase the effectiveness of the 4. Burning Jews remedy. 5. Praying and attending extra church services RENAISSANCE PERIOD - The Age of Discovery (1450 onwards) - Ideas about the Causes of Disease - New Ideas and Discoveries - Approaches to Treatment - Girolamo Fracastoro - Andres Vesalius – Anatomy book PREVENTIVE MEDICINE ARC LECTURE 2: HISTORY OF MEDICINE: MEDIEVAL AND RENAISSANCE PERIOD DR. RUFAIDA A. MAHING - William Harvey – Circulatory system ▪ Mercury and Antimony were used to purge the - Approaches to Prevention body, as they encouraged sweating and - Paracelsus vomiting - Leonardo Da Vinci - Hospitals – emphasis on curing patients - Ambroise Pare - Pest houses – type of hospital which cared only for - Infections & Epidemics plague or pox victims - Diagnosis and Treatment - Humoral treatments – purging and bloodletting - Vaccination IMPORTANT INDIVIDUALS - Renaissance = “re-birth” - Andreas Vesalius - Renaissance period – a time of “re-born” interest in ▪ Book: On the Fabric of the Human Body Classical thinking, architecture and art (human anatomy). - Society became more secular ▪ He found out 300 mistakes in Galen’s work CAUSES OF DISEASE - William Harvey - Religious Explanations – God did not send disease. ▪ discovered the circulation of the blood Humanism was on the rise ▪ published An Anatomical Account of the - Astrology – 1665 plague caused by unusual planet Motion of the Heart and Blood in 1628 alignments - Miasma APPROACHES TO PREVENTION - The Four Humors – illness was caused by an imbalance - Lifestyle advice: to practice moderation in all things of humors - Purifying the air - The role of the government NEW IDEAS AND DISCOVERIES - Anthony con Leeuwenhoek – observed “animalcules” THE GREAT PLAGUE 1665 - Girolamo Fracastoro – theorized that disease was - Break out across England in 1665 caused by seed spread in the air. - Spread by fleas on rats, and people were helpless to stop - Thomas Sydenham (The English Hippocrates) it as they had been during the Black Death ▪ refused to rely on medical books but believed Religious and supernatural: that physicians should closely observe the - People thought God had sent the plague to clear patient and record their symptoms. up the kingdom. - There had also been unusual planet alignments WHY WERE IDEAS ABLE TO BE SHARED MORE EASILY? the previous year, which worried people. - Printing press - The Royal Society Miasma: ▪ influential group of scientists formed in 1660 Causes - most popular theory about the cause of the ▪ published a journal: Philosophical Transactions plague APPROACHES TO TREATMENT - bad air, created by rubbish and sewage in cities. - Transference – disease could be transferred to something else Other people: - Herbal remedies – chosen because of their color or - Many correctly realized that plague was spread shape (ex: yellow herbs were used to treat jaundice, from person to person, though they didn’t which turns the skin yellow) know how - Ipecac from Brazil – used to treat dysentery - Chemical cures Not a great deal is known about treatment ▪ Alchemy (an early form of chemistry) led to the Treatments because most victims were isolated in their new science of medical chemistry. homes PREVENTIVE MEDICINE ARC LECTURE 2: HISTORY OF MEDICINE: MEDIEVAL AND RENAISSANCE PERIOD DR. RUFAIDA A. MAHING New ideas: TREATMENTS Physicians suggested wrapping up in thick - Home remedies were handed down through generations woolen clothes and sitting by fire = disease from mother to daughter (ex: honey) could be sweated out. - Rhubarb from Asia – used to purge the bowels - Transference was also tried (ex. - Cinchona tree (Thomas Sydenham) – used for fever. In strapping a live chicken) Europe it became known as Quinine, used to treat Herbal remedies: malaria - Continued to be popular - Opium – used as an anesthetic - Quack doctors – they mixed remedies; - Tobacco – for toothache, poisoned wounds, joint pains people with no medical qualifications, and as protection from plague. people who took advantage of people’s - Scrofula (the King’s Evil) – believed can be cured by the panic to make some easy money touch of Charles II Preventions Religious and supernatural: People were PUBLIC HEALTH advised to pray and repent their sins. - Government order - straw to be hung at the homes of plague Purifying the air: Carrying a pomander (a ball of victims; carrying of white stick in public for sweet-smelling herbs) was advised, and fires those who came from infected houses were lit. - Days of public prayer and fasting Plague doctors: Plague doctors wore special beaked masks and coated their cloak in wax, so that pus and blood did not soak into it. Diet advice: Fasting was suggested, as well as specific foods such as a garlic-heavy diet. Government orders: The government took a much bigger role in public health: Quarantine laws Large crowds banned Stray animals killed Searchers appointed Streets cleaned Other healers: - Apothecaries provided herbal remedies, and others such as "plague water". Chewing and smoking tobacco was also advised to ward off miasma. People also just ran away! HEALERS - The Midwives Book by Mrs. Jane Sharp (1671) – the first English handbook by a woman - Peter Chamberlen (1620) – invented obstetrical forceps - Joanna Stephens - claimed to have a remedy that would dissolve bladder stones without needing painful surgery