2.

03 Foundations of Scientific Medicine II HPM

LE 2
Rafael M. Valenzuela, MD | October 1, 2018
TRANS 3

OUTLINE → boil broth on flask and let it stand ; microbes would grow
I. Theory of Germ Disease → boil broth on flask and keep it sealed ; no microbes will grow
A. Spontaneous Generation Theory of Life
B. Francesco Redi
C. Lazzaro Spallanzani
D. Louis Pasteur
E. Robert Koch
F. Rene Laennec
II. Monumental Shift in Medicine
III. Modernization of Surgery
A. John Hunter
IV. 19th Century: The Age of Surgery
A. Humphry Davy
B. Horace Wells
C. William Morton
D. Anesthesia
E. Joseph Lister
V. Great Surgeons of 19th Century
A. William Steward Halstead Figure 1. Spallanzani Spontaneous Generation Experiment
B. Sir Frederick Treves
C. Dr. James Barry D. LOUIS PASTEUR (1822-1895)
D. Elizabeth Blackwell
E. Florence Nightingale ● French microbiologist and chemist
VI. Summary ● Determined the cause of beer spoiling which was causing
economic loss to breweries.
● He used techniques and flasks similar to Spallanzani’s vials and
OBJECTIVES was able to isolate microbes and yeasts that contaminated
beer, milk, and wine.
1. To understand how Greco-Roman concepts of medicine and → He showed that contaminating particles from air caused
health were challenged by the Age of Enlightenment. spoilage in flasks whose protective long necks were broken
2. To analyze how Francis Bacon’s scientific method catalyzed off.
changes in clinical practice and medical research.
3. To understand the impact of William Harvey’s discovery of
blood circulation.
4. To know that plagues and epidemic stimulated advances in
public health medicine and vaccination.
5. To realize how the accumulated work of microscopists,
epidemiologists and other researchers gave rise to the Germ
Theory of Disease.
6. To understand how the Germ Theory of Louis Pasteur and
Robert Koch caused a paradigm shift in Medicine.
7. To recognize how the advent of anesthesia and antisepsis gave
rise to Modern Surgery.

I. THEORY OF GERM DISEASE

• Theory that disease is caused by germs and microbe

• Introduced by rivals Louis Pasteur & Robert Koch

A. SPONTANEOUS GENERATION THEORY OF LIFE

Figure 2. Test of Spontaneous Generation
• “Abiogenesis.” proposed by Greek philosopher Aristotle
→ Denotes that living matter originates from non-living matter ● In 1860, Pasteur published his result and contributed to the
(Ex: maggots found in rotten meat) “Germ Theory” by disproving “Spontaneous Generation”.
• Persisted for centuries, supported by the Catholic church (God ● First scientist to validate that cells are formed from pre-existing
made Adam from inanimate clay) cells.
● He suspected that if germs were the cause of beer spoiling, it
could also be a cause for disease.
B. FRANCESCO REDI (1626-1697) → Three of his daughters died between 1859 and 1865; two
from typhoid fever - this motivated him to investigate the
● An Italian naturalist and microscopist relation of germs to human disease.
● Experimented with old meat and concluded that maggots only → He suffered a stroke that debilitated him.
appear on meat if flies land and lay eggs on it (maggots do not
● In 1865, he was asked to investigate “pebrine” which is a
appear spontaneously on meat) disease that devastated the silkworm industry.
→ Pebrine - larvae shows slow growth, undersized body, and
poor appetite. Reveals pale and flaccid body with tiny black
C. LAZZARO SPALLANZANI (1729-1799) spots on the skin.
→ He discovered that protozoan parasite was causing pebrine.
● Italian physiologist → His opponents believed that disease arose from a weakness
● Spontaneous generation experiment: or imbalance in the internal state of afflicted individual.

TRANS Lim, K., Lim, M., Lopez, C., Lopez, L. CORE Mangente, Olaer HEAD Natural HPM 1 / 4

2.03 Foundations of Scientific Medicine II LE 2
Figure 3. Pebrine (Silkworms)
● He was able to prove that germs cause disease by injecting
cultured microbes into lab animals. not digest it, and nutrients could be added.
● Pasteurization
→ Method of killing germs with heat without destroying the
flavor of food.
→ Developed with the help of Claude Bernard, a physiologist
● Vaccination
→ He was able to isolate fowl cholera microbe : Pasteurella
Multocida
→ He tried to emulate Edward Jenner’s work on smallpox
vaccine by injecting the cholera bacterium to chickens but
injected a weakened batch of the microbe to some of the lab
chickens.
→ Cholera Vaccine
▪ Pasteur discovered that by giving weakened germ as
vaccine, the chickens developed immunity to cholera
▪ He found ways to artificially weaken the germ using
oxygen gas.
▪ His vaccine had less virulence and was better compared
to Jenner’s, who used full strength germs.
→ Anthrax Vaccine
▪ Created vaccine for anthrax using attenuated Bacillus
Anthracis
▪ He divided the sheep into 2 groups: the 1st group
received the vaccine while the 2nd group did not. After a
few weeks, the sheep were given the live anthrax bacteria
and the vaccinated group survived while the other group
died.
→ Rabies Vaccine
▪ Rabies virus travels to the CNS and cannot be seen using
normal microscope
▪ Symptoms of rabies : fear of water, inability to move parts
of body, confusion, and loss of consciousness.
▪ Mortality rate : 100%
▪ Vaccine development : he used rabbits as experimental
subjects. He dissected the infected rabbit’s spinal cord,
dried the cords to weaken the rabies virus and use it as
vaccine.
▪ Joseph Meister - little boy that was bitten multiple times
by rabid dog; a human subject that became Pasteur's
biggest challenge
− The vaccine was administered and the little boy
survived, making Pasteur a national hero. Joseph grew
up to be the caretaker of Pasteur’s Institute which is
an institute for the study of vaccine, biology, and
disease.
● Summary : Louis Pasteur
→ “Greatest Biologist of All Time”
→ “Father of Vaccines”
→ Germ Theory of Disease
→ Law of biogenesis which disproved “spontaneous generation”
TRANS Lim, K., Lim, M., Lopez, C., Lopez, L. CORE
TRANS 3
→ Pasteurization of food
→ Developed vaccines for rabies, diphtheria, anthrax, etc.
→ Opposed Darwinism (Theory of Natural Evolution)
E. ROBERT KOCH (1843-1910)
● Pasteur’s rival to the title “ Father of Microbiology”
● Discovered the TB Bacillus
● Also did research on anthrax and cholera
→ Anthrax - an often fatal disease of livestock. Occasionally
affected humans, with fever and skin lesions.
● He developed a new experimental method to test disease
causation by a microbe.
● He discovered anthrax can be transmitted in blood by injecting
mice with blood from anthrax-infected animals, which then
developed the disease.
● Julius Petri
→ Friend and colleague of Koch who developed the culture
dish
→ He suggested a seaweed-based basin (agar) to culture the
microbe.
→ The agar yielded the best result: did not melt, the bacteria did
● Koch’s Postulates
→ The disease agent must be present in every case and absent
in healthy individuals.
→ The agent must be isolated and cultured in vitro (i.e.
cultivated in a laboratory environment)
→ Disease must be produced when a pure culture is inoculated
into susceptible host
→ The agent must be recoverable from infected host.
● Tuberculosis
→ “White plague” or “consumption”
→ A challenge to isolate because it’s invisible to microscopists
using normal histological stains.
→ Physicians insisted it was hereditary.
● Special Acid-Fast Stain
→ Stain produced by Koch which allowed the visualization of
Mycobacterium Tuberculosis, which later became known
as Koch’s Bacillus
● Koch was awarded the Nobel Prize for his work on TB and
paved way for anti-TB medications (1905).
● Koch’s fortune took a downturn when he endorsed a “cure for
TB” called Tuberculin, which proved to be ineffective and
caused toxic reactions (but was useful as diagnostic test).
● Summary : Robert Koch
→ “Father of Microbiology”
→ Established a sequence of experimental steps to show that a
specific microorganism causes a particular disease.
→ Developed pure culture methods (special acid-fast stain)
→ Identified cause of anthrax, TB, and cholera
F. RENE LAENNEC (1781-1826)
● Invented the stethoscope
→ His first stethoscope was a rolled up newspaper.
● Published his work on how to clinically diagnose diseases like
TB by their distinctive lung sounds.
Note:
1. First cultured germ - anthrax
2. Pasteur vs. Koch
a. Vaccines - Pasteur
b. Cultures - Koch
3. Bacteria that can cause gastric cancer - Helicobacter
pylori (H. pylori)
II. MONUMENTAL SHIFT IN MEDICINE
● Germ theory shifted the cause of disease from internal factors
to external invaders.
Mangente, Olaer HEAD Natural HPM 2 / 4

2.03 Foundations of Scientific Medicine II LE 2 TRANS 3
● It discredited the archaic beliefs in spontaneous generation,
miasmas, and humors.
● Gave support to social hygiene movements to help clean up the
environment.
● The new science of bacteriology was spawned and led to the
use of antiseptics and antibiotics.

III. THE MODERNIZATION OF SURGERY

A. JOHN HUNTER (1728-1973)

● Father of Scientific Surgery Figure 5. Humphry Davy

● Built the Hunterian Museum at the Royal College of
Surgeons: A collection of oddities B. HORACE WELLS (1844)
● English surgeon, founder of Pathological Anatomy in England
● Carried out many important studies & experiments in ● American dentist that was inspired to use Nitrous
comparative biology, anatomy, physiology & pathology. Oxide (N2O) for pain relief
● Product of the 18th century Age of Enlightenment, a ● Self-experimented with combinations of N2O and Ether
movement which stressed intellectual and philosophical ● Attempted a demonstration in Massachusetts General
pursuits Hospital
● Gifted anatomist, who trained under his surgeon brother ● Demonstration failed and he never recovered from the
William Hunter disgrace, the patient was unresponsive to Nitrous Oxide and
● By the 1780’s he was recognized as the leading teacher of moaned in pain, causing people to call him a "Humbug" and
Surgery a"Scoundrel"
● Operated on conjoined twins ● Became mentally imbalanced and committed suicide by
● Early advocate of experimentation and investigation cutting his wrist.
● Wanted to collect the body of Charles Byrne, the tallest man
during that time who had pituitary disorder

Figure 6. Horace Wells

Figure 4. John Hunter
C. WILLIAM MORTON (1845)
IV. 19TH CENTURY: THE AGE OF SURGERY
● Dentist that used ether as an anesthetic
● Scientific progress and a rekindled interest in physiology ● Administered the ether vapor at a demonstration in
produced great development that significantly impacted surgery Massachusetts General Hospital
→ Advent of Anesthesia → Dr. John Warren was the surgeon responsible for
→ Antiseptic Tehnique excising a tumor from the patient’s neck successfully
● Anesthetic use paved the way for longer and more advanced →The surgical amphitheater in Massachusetts General
surgeries Hospital is called “The Ether Dome” to commemorate the
● Traditionally, alcohol and opium were used to relieve pain of use of inhalational anesthesia on October 16, 1846
surgical procedures, thus limiting the extent of what surgeons ● Tried to patent ether as his own discovery, calling it “Ietheon”
could accomplish but was unsuccessful, medical establishment condemned the
action as unjust and inhumane
A. HUMPHRY DAVY (1789) ● Committed suicide by jumping off a carriage in 1868

● Experimented with Nitrous Oxide Gas

● Noted feeling of euphoria and dizziness when he inhaled its
vapors
● Recognized that the gas could be used to dull physical pain in
surgery
● Used Nitrous Oxide in laughing gas parties
● Medical profession ignored his discovery for 50 years

Figure 7. William Morton

D. ANESTHESIA
● 1902 - Birth of modern anesthesia
● Chloroform gas gained favor because it was non-flammable
and quicker acting

TRANS Lim, K., Lim, M., Lopez, C., Lopez, L. CORE Mangente, Olaer HEAD Natural HPM 3 / 4

2.03 Foundations of Scientific Medicine II LE 2 TRANS 3
• Dr. Otto Roth, Physician and professor REVIEW QUESTIONS
→ The Roth-Drager – World’s first anesthetic apparatus for
oxygen and chloroform 1. How did the Industrial Revolution create a new set of health
problems in Europe and America?
2. Why was the Germ Theory of Disease met with resistance for
centuries, despite public awareness that microbes existed?
a. How did the introduction of anesthesia and antisepsis
impact the progress of surgery?

1. Accurately Described pulmonary circulation

2. Stethoscope inventor
3. Introduced anthrax vaccine
4. Innovator in breast cancer surgery
Figure 8. Dr. Otto Roth
5. Isolated anthrax bacillus
6. Investigated puerperal fever
E. JOSEPH LISTER (1850) 7. Used ether as anesthesia
8. Father of Scientific Surgery
● Scottish surgeon that was inspired by the “Germ Theory” of 9. "Seeds of disease"
disease advocated by Louis Pasteur in the 1850’s 10. Used epidemiology to study cholera
● Studied Pasteur’s use of carbolic acid to kill germs
● Invented a machine that sprayed fine carbolic acid mist, A. Robert Koch
which he used prior to surgery B. Ignaz Semmelweiss
● Practiced asepsis: He and his staff kept their hands washed C. William Harvey
and clean in the surgical room D. William Morton
● The results of his efforts improved patient outcomes, thus E. Girolamo Fracastoro
revolutionizing the practice of surgery F. John Snow
→ Before antisepsis, patient mortality after surgery was G. William Halstead
approximately 50% H. Louis Pasteur
● Revolutionized the practice of surgery I. John Hunter
● Initially ridiculed but results of his efforts improved patient J. Rene Laennec
outcomes and won many converts

Answers: C, J, H, G, A, B, D, E, F

REFERENCES
PowerPoint of Dr. Rafael D. Valenzuela , MD
2021 C Trans
2021 A Trans

Figure 9. Joseph Lister

V. SUMMARY

● The rise of freethinking philosophers such as Francis Bacon

marked a trend towards secular thinking that challenged ancient
traditions.
● William Harvey directly challenged Galenic teachings by
accurately describing the circulatory system.
● John Snow used the streets of London as his laboratory to
conduct his epidemiological study of cholera epidemic.
● The contributions of many scientists and pioneers of the
centuries (Fracastro, van Leuwenhoek, Semmelweiss) gradually
led to the birth of Germ Theory
● Louis Pasteur and Robert Koch popularized Germ Theory as
the cause of disease, which caused a seismic shift in Medicine.
● The advent of improved anesthesia and Lister’s antiseptic
methods opened the gates to great advances in surgery
● Women such as Elizabeth Blackwell and Florence Nightingale
were pioneers for those who followed in their footsteps in
Medicine and Nursing.

TRANS Lim, K., Lim, M., Lopez, C., Lopez, L. CORE Mangente, Olaer HEAD Natural HPM 4 / 4