The History of Medicine

The birth of Medicine

- Few remedies - from plants, animals, minerals = priests
- Spiritualism and shamanism (cure you by entering a trance and using powers)
- First recorded physician = Imhotep - Ancient Egyptian Medicine
- Imhotep - author of Edwin Smith papyrus containing anatomical observations,
around 50 injuries + treatments

Rationalisation of Medicine with Hippocrates

- Greek physician = father of Medicine - foundations for rational medical
approach
- Dismissed supernatural explanations - suggested due to imbalance of bodily
humours (excess or deficit) - black/yellow bile, phlegm and blood - dominated
Western area for 1300 years
- Described many diseases and medical conditions: clubbing of the fingers -
diseases with low oxygen levels: lung disease/cancer and cyanotic heart
disease
- Most famous for setting duties + responsibilities for doctors = Hippocratic
Oath: free access to care, beneficence (best interest of patient),
non-maleficence (not harming patient), confidentiality
- Hippocratic Oath principles used as foundation for GMC Good Medical
Practice and Duties of a Doctor

Roman Empire
- Roman with Greek descent = Galen of Pergamon (father of medicine)
supported humorism
- Greatest surgeon of Ancient world - brain and eye surgery (cataracts removal)
- Interest in dissection = dissected pigs as Romans forbade humans -
understood anatomy of trachea
- First to demonstrate larynx generates voice + diff between venous (dark) +
arteriole (bright) blood
- First civilization to introduce public healthcare system - lack of water so built
aqueducts, drained marshes to stop malaria

The Middle Ages

- Work from fathers of medicine translated to Arabic used by Islamic physicians
- Rhazes questioned validity of humorism, wrote 200 books, and differentiated
between smallpox and measles, discovered many chemical compounds
- Introduced competence - doctors didn't have all answers to medical problems
- continuous learning
- Introduced hospitals and medical schools
 - 14/15th century rejected traditional authority (someone of authority said
something), and more evidence based

The 16th and 17th century

- Renaissance period
- Leonardo da Vinci - helped medical advancement through detailed
observations. Participated in autopsies to create detailed anatomical
drawings, planning work of human anatomy
- Proposed that epidemic diseases = objects outside of body through contact
- Explained circulation of blood flow
- Richard Lower discovered blood picking up substances + performed first
blood transfusion
- A Dutchman invented microscope and discovered red blood cells, bacteria,
protozoa
- Discovered insulin in diabetics urine
- Neurology began

The 18th century

- Diagnostic advancement: thermometers
- Therapeutic advancement: vitamin deficiencies cured by foods high in vitamin
content. For eg: scurvy by citrus fruits.
- Digitalis used for heart diseases
- Edward Jenner - smallpox vaccine (from cowpox lesions) - now eradicated
- Many physicians still used old practices - many patients lost through new
techniques

The 19th century

- Microscope improvement = tissues + cells in detail leds to a new science
called cytology and led to cell theory - cornerstone of modern Medicine
- Cell theory = understanding cancer
- Germ theory is another cornerstone of Medicine: life isn’t randomly generated,
microorganisms are present everywhere (Louis Pasteur - through experiment
where milk turned sour) - led to pasteurisation of milk. Vaccine against rabies.
- Beginning of microbiology - understood what bacteria caused what disease
- Development of anaesthesia from the 16th century where chicken breathed
sweet vitriol - fell asleep and no pain. Named ‘ether’ too many side effects so
replaced by chloroform in England
- Antiseptics = deaths in obstetrics during childbirth - not washing hands
- Led to pouring acids on wounds - sterilisation + start of antiseptic surgery

The 20th century

- Increased research into chemical composition of plants + synthesis of drugs
- German scientist developed 1st treatment for syphilis - first antibiotic
- Alexander Fleming saw mould on bacterial samples in lab = penicillin
 - Treatment for TB
- Vaccines against tetanus, smallpox, polio, measles, HPV
- Developed contraceptive pill ad chlorpromazine
- Antiviral drugs in 1970s to combat herpes led to development of antiretroviral
drugs to combat AIDS
- Development of ECG, ultrasounds, CT scans, PET scans, MRI scans
- Surgery (heart-lung machines used in heart surgeries), artificial organs
(hearts and kidneys), prosthetics (through discovery of plastics and C fibres),
computers (scans + medical records + prescriptions + mapping the human
genome)
- Increased understanding of immune system: phagocytosis, autoimmune
diseases, development of immunosuppressant drugs for organ donation

The 21st century

- Rise in genetics: knowledge of DNA structure helped determine location of
each gene which led to the mapping out of the human genome
- Understanding genetics code allowed understanding and recognising early on
for genetic disorder eg: cystic fibrosis
- Gene therapy - adding one gene to another cell using virus