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The Four Humours- the leading theory of Medieval Medicine

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Health and Medicine in Ancient Rome by Olivia June

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The Hippocratic Oath is a medical oath that expresses the fundamental moral and ethical principles of a doctor's behavior.

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https://www.youtube.com/watch?v=S45Ejn9-nRc
https://www.youtube.com/watch?v=r1BhsWsmjco

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Black Death (plague) 476-1500

Many novel ideas were discredited by the Catholic Church, and scientific experimentation and progress was rarely encouraged.

Plague killed over 40% of population
- the cause was not understood, however, they tried to find explanation in work of Galen, in movement of stars, in God's punishment, some people blamed minorities
Methods to fight with epidemic:
-          Quarantine (Origin: Ships arriving in Venice from infected ports were required to sit at anchor for 40 days before landing)
- Burned corpses (understood that infection lives not only in lifing creatures, but loss in dead bodies)

-          Development of pure water supplies, garbage and sewage disposal, and food inspection

-          Public health : attempts to cope with the unsanitary conditions of the cities, establishment of hospitals and provision of medical care and social assistance
- They used herbal medicine, astrology and balancing humours for treating patients

Church had set universities for training professional doctors. Women were not allowed to be doctors. they only could provide key care for patients and take care of childbirth.

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Plague doctors were wearing ankle-length overcoat and a bird-like beak mask, often filled with sweet or strong-smelling substances (commonly lavender), along with gloves, boots, a wide-brimmed hat. He also had a stick in his hand.

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 "An Anatomical Account of the motion of Heart and Blood in animals"

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 "An Anatomical Account of the motion of Heart and Blood in animals"

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1675: Anton van Leeuwenhoek, who used a microscope with one lens to observe insects and other specimen. Leeuwenhoek was the first to observe bacteria. 

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17th c, Scientists started to use their own observations  and experiments to gain knowledge. Theystarted to disprove old ideas. EX. The theoryof 4 humours.

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Carl Ludwig invented Kymograph, 1847 to measure the pulse.

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Carl Ludwig invented Kymograph, 1847 to measure the pulse.

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Rivalry between Paster and Koch led to discovery of the bacterium that causedthe plague in 1894.

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Rivalry between Paster and Koch led to discovery of the bacterium that causedthe plague in 1894.

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Smallpox was a terrible disease, which didn't only kill people people (mainly children), but also made them scared and ugly. The method to prevent the disease was brought from China in 17th century. A doctor took some scraping from a smallpox scab and spread it onto a wound on person's skin. This method was called inoculation, it mostly prevented the hard forms of disease, but was still risky, because people could become seriously ill and die.
Edward Jenner was the person, who noticed, that people, who already were ill with cowpox, almost never get ill with smallpox. He published his findings, observed some patients and decided to try his method on a little 8-year-old boy Edward Philips. It worked and Jenner called his new invention a vaccine.

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Elisabeth Blackwell  the first woman to qualify as a doctor in the USA 1849

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Elisabeth Blackwell  the first woman to qualify as a doctor in the USA 1849

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Florence Nightingale  Nurse  the Crimean war 1853-56

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Florence Nightingale  Nurse  the Crimean war 1853-56

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Надежда Суслова The first woman doctor in Russia , 1867

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Надежда Суслова The first woman doctor in Russia , 1867

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Surgery was limited by 3 key obstacles: pain, infection and blood loss.

- In London some hospitals had an 80% death rate post-operation.
In the USA doctors experimented new surgeries on black slaves!

In 19th century people succeeded in finding some chemicals used for anaesthetics, however, the problem of blood loss and fatal infections remained unsolved.

ether (USA, 1842)
+ can be used as an anaesthetic and was effective in knocking patients out
- ether was a gas that irritated the lungs and made patients cough throughout a procedure

chloroform (Briton James Simpson, 1847)
+ induced a rapid sleeping state
- sleeping state was difficult to manage, some patients died of the effects or more complex and long operations

cocaine (Carl Koller, 1884)
+ a local aesthetic, was less dangerous as the patient remained awake
- was used only for minor operations
Many people did not believe the theory of cleanliness. "shut the door quickly or one of Mr. Lister's microbes may come in"

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This 1952 painting by Robert Thom is the only known representation of Lucy, Anarcha and Betsey. Pearson Museum, Southern Illinois University School of Medicine

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Black slave women Anarcha, Lucy and Betsey used in gynecological experiments by Marion James Sims

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Black slave women Anarcha, Lucy and Betsey used in gynecological experiments by Marion James Sims

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Sims believed that Black people did not feel pain like white people so he did not use any form of pain relief. Documentation showed how Anarcha, aged just 17, suffered up to 30 brutal operations at the hands of Sims.

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Problem - unsanitary conditions that led to the spread of diseases and infections

Ignaz Semmelweis - his proposal to increase hygiene standards during the process of childbirth was rejected
Florence Nightingale - during the Crimean War, improved the cleanliness of hospitals for faster recovery of soldiers
Joseph Lister carbonic acid increases the rate of wound healing and prevents gangrene
Summation
Strict sanitary standarts (steam cleaning of equipment, rubber gloves, face-masks) led to progress in preventing infections

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Louis Pasteur develop "Germ theory": argued against the theory of spontaneous generation as the cause of delay, suggested that delay happen due to the reaction with tiny organism in the air

Koch (the doctor who brought Louis's ideas into medicine) develop a method of isolating and growing bacteria to observe

Following discoveries
- identified the causes of tuberculosis 1880, cholera 1883, typhus 1880, tetanus (столбняк), pneumonia 1886, meningitis 1887, plague 1894.
- created a vaccine to prevent chicken pox (ветрянка), cholera, anthrax  (сибирская языва)and rabies (бешенство)
- formed the basis for milk pasteralization.

Emil von Behring
Nobel Price in Medicine
- discovered that some animals produce anti-toxins to fight harmful bacteria
+ injecting into humans

Patrick Manson -  mosquitos carry worn that caused elephantiasis

Charles Chamberland - discovering of viruses

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Blood loss remained a key problem in surgery during the nineteenth century:

- Blood could not be stored as it would become unusable

- When blood was directly pumped from a donor, the patient would often die after the transfusion was given