A major breakthrough in epidemiology came with the introduction of statistical maps and graphs. They allowed careful analysis of seasonality issues in disease incidents, and the maps allowed public health officials to identify critical loci for the dissemination of disease. John Snow in London developed the methods. In 1849, he observed that the symptoms of cholera, which had already claimed around 500 lives within a month, were vomiting and diarrhoea. He concluded that the source of contamination must be through ingestion, rather than inhalation as was previously thought. It was this insight that resulted in the removal of The Pump On Broad Street, after which deaths from cholera plummeted afterwards. English nurse Florence Nightingale pioneered analysis of large amounts of statistical data, using graphs and tables, regarding the condition of thousands of patients in the Crimean War to evaluate the efficacy of hospital services. Her methods proved convincing and led to reforms in military and civilian hospitals, usually with the full support of the government.
Being a king in ancient times was exhaustingly dangerous; there was always someone plotting to get rid of you. So, according to legend, Mithradates (aka Mithridates) VI of Pontus (on the shores of the Black Sea in Turkey) attempted to become resistant to poisons by taking gradually increasing doses. He was also reputed to have conducted toxicological experiments on condemned prisoners, culminating in the creation of mithridate – a medicine that combined all known antidotes in one potent formula.
Cartier repaid Dom Agaya by kidnapping him again along with nine other people. By the time of Cartier’s next voyage – to Canada in 1541 – most of the prisoners were dead, but Cartier informed their relatives that they were living in style in France. The scurvy cure did not gain widespread recognition and the disease continued to claim the lives of sailors for more than 200 years.
Until the nineteenth century, the care of the insane was largely a communal and family responsibility rather than a medical one. The vast majority of the mentally ill were treated in domestic contexts with only the most unmanageable or burdensome likely to be institutionally confined. This situation was transformed radically from the late eighteenth century as, amid changing cultural conceptions of madness, a new-found optimism in the curability of insanity within the asylum setting emerged. Increasingly, lunacy was perceived less as a physiological condition than as a mental and moral one to which the correct response was persuasion, aimed at inculcating internal restraint, rather than external coercion. This new therapeutic sensibility, referred to as moral treatment, was epitomised in French physician Philippe Pinel's quasi-mythological unchaining of the lunatics of the Bicêtre Hospital in Paris and realised in an institutional setting with the foundation in 1796 of the Quaker-run York Retreat in England.
In the 19th and early 20th centuries anthropologists studied primitive societies. Among them treatment for injury and sickness was a mixture of common sense and magic. People knew, of course, that falls cause broken bones and fire causes burns. Animal bites or human weapons cause wounds. Primitive people had simple treatments for these things e.g. Australian Aborigines covered broken arms in clay, which hardened in the hot sun. Cuts were covered with fat or clay and bound up with animal skins or bark. However primitive people had no idea what caused illness. They assumed it was caused by evil spirits or magic performed by an enemy. The 'cure' was magic to drive out the evil spirit or break the enemies spell.
Pasteur realized the germs that had been left exposed to the air had been weakened. When the chickens were injected with the weakened germs they had developed immunity to the disease. Pasteur and his team went on to create a vaccine for anthrax by keeping anthrax germs heated to 42-43 degrees centigrade for 8 days. In 1882 they created a vaccine for rabies. A co-worker dried the spines of rabbits that had contracted the disease in glass jars. Pasteur tried giving a series of injections made from the dried spines to animals to test the remedy. Then, in 1885, Pasteur successfully used the vaccine on a boy who had been bitten by a rabid dog. Pasteur also invented a way of sterilizing liquids by heating them (called pasteurization). It was first used for wine (in 1864) and later for milk.
Medicine embraced skills such as acupuncture, obstetrics, dentistry, laryngology, ophthalmology, and treatment of rheumatism and paralysis. The demand for improved technology, aided by certain concerns of the Neo-Confucian philosophy, helped to promote numerous investigations that approached the use of scientific methods. Literacy spread with printing,…
This week, we feature the keynote presentation from the summit by Dr. Jeffrey Bland. You can get this talk and many other gifts by registering for the summit. In his talk, Dr. Jeffrey Bland shares his view of the current state of genetics. Even If you're not interested in genetic testing, we hope that you will take a few minutes and listen to the godfather of functional medicine, as he shares his thoughts on genomics and why it will be the catalyst for functional medicine to become the operating system for a new era of predictive preventative medicine.
But the most impactful change to the old system is the transition to patient-centered diagnoses. Medicine evolving from a doctor-centered structure to a patient-centered structure and this reflects Dr. Galland's unique contribution to the operating system. In this podcast, Dr. Galland addresses how this new model was developed and why it's such an important part of the evolution of medicine.
The Greeks were also surgeons and some of the equipment they used is recognizable today. Some of the tools of the Greek physicians included forceps, scalpels, tooth-extraction forceps and catheters, and there were even syringes for drawing pus from wounds. One instrument, the spoon of Diocles, was used by the surgeon Kritoboulos, to remove the injured eye of Phillip of Macedon without undue scarring. Finally, the Greeks knew how to splint and treat bone fractures, as well as add compresses to prevent infection.
Evolutionary principles may also improve our vaccine strategy. Vaccines are another way to create selective pressures on infectious organisms. We may inadvertently target vaccines against proteins that select out less virulent strains, selecting for the more virulent or infectious strains. Understanding of this allows us to instead target vaccines against virulence without targeting less deadly strains.
Across Europe medical schools relied primarily on lectures and readings. The final year student would have limited clinical experience by trailing the professor through the wards. Laboratory work was uncommon, and dissections were rarely done because of legal restrictions on cadavers. Most schools were small, and only Edinburgh, Scotland, with 11,000 alumni, produced large numbers of graduates.
The term ‘technology’ is based on the ancient Greek techné (‘art’, ‘skill’, ‘craft’) (logos means ‘study’). Greek medical texts describe medicine as a techné, suggesting that it was a skill to know why and how to treat a condition. For us, ‘medicine’ is “the science or practice of the diagnosis, treatment, and prevention of disease” (Oxford English Dictionary).
Another of Hippocrates's major contributions may be found in his descriptions of the symptomatology, physical findings, surgical treatment and prognosis of thoracic empyema, i.e. suppuration of the lining of the chest cavity. His teachings remain relevant to present-day students of pulmonary medicine and surgery. Hippocrates was the first documented person to practise cardiothoracic surgery, and his findings are still valid.
The Roman contribution to the history of medicine is often overlooked, with only Galen, of Greek origin, believed to be notable of mention. However, this does the Romans a great disservice and they put their excellent engineering skills to use in preventative medicine. The Romans understood the role of dirt and poor hygiene in spreading disease and created aqueducts to ensure that the inhabitants of a city received clean water. The Roman engineers also installed elaborate sewage systems to carry away waste. This is something that Europeans did not fully understand until the 19th Century; before this period, sewage was still discharged close to drinking water.
As you pointed out, 80% just want a prescription and are not willing to find the causes of their illness, I have chosen to focus on the 20% who are willing to discover the causes and make lifestyle changes. Patient satisfaction is up, and I am getting control back of my practice. I believe this the medicine of the future, that will appeal to my grandchildren.