HIPPOCRATES

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HIPPOCRATES

• Theory of the 4 humours abandon supernatural
  ideas about causes of disease - doctors must
  observe then treat. (D.P.O.T.)
• Treatment to balance the humours
  purging/vomiting/ bleeding.
• Encourages healthy lifestyle regimen.
• Greatest weakness of Greek medicine was ignorance
  of anatomy dissection was forbidden.

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GALEN

• Wrote 350 books.
• Stole corpses to dissect. Served as surgeon to
  gladiators. Gained lots of experience and
  practical anatomical knowledge from the combat
  wounds he treated. Doctor to emperor.
• Theory of the opposites based on theory of 4
  humors.
• Dissected animals famous pig experiment to show
  brain controls the body not the heart.
• Some anatomy wrong e.g. 2 bones in jawbone/
  holes in septum.
• Believed liver continuously creates blood.
• Talked of Creator Being making the body Church
  accepts Galens ideas.

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VESALIUS

• Able to dissect humans (criminals) did
  dissections himself
• Showed errors in Galen single jawbone, liver not
  5-lobed, no holes in the septum.
• Wrote Fabric of the Human Body atlas of
  anatomy.
• Died aged 50 after suffering shipwreck on
  Zakynthos, on a pilgrimage to the Holy Land.
  Buried in paupers grave.

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• AMBROISE PARE
• Famous case of boiling oil running out uses
  Roman mixture of egg yolk, oil of roses and
  turpentine.
• Use ligatures rather than cautery iron to stop
  bleeding.
• Wrote Works on Surgery translated and used by
  other surgeons.
• Limited impact since a) many refused to accept
  new ideas b) ligatures spread infection c) still
  no way to stop infection, pain, blood
  transfusions. Ideas accepted later when germ
  theory established.

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Paré
Drawings from Pares Works on Surgery
mechanical limbs.
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WILLIAM HARVEY

• He was personal physician to James I and Charles
  I.
• He took advantage of his royal position by
  dissecting deer from the royal parks
• Famous experiments - dissected cold blooded
  lizards/ observed beating heart in egg/ pumped
  liquids through heart/ pushed rods into veins.
• Proves that the heart acts like a pump and that
  there is a fixed amount of blood which circulates
  around body.
• Many opposed him and work could not be put to
  practical use until later scientific advances
  made.

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Edward Jenner

• Doctor in Gloucester 1780s.
• Notices that milk maids who catch cowpox did not
  get smallpox. Vacciantes people with cowpox to
  prevent smallpox. First tried on young boy, James
  Phipps.
• Much opposition to his methods.
• Vaccination much used after Germ Theory
  established in 19th century.

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SEMMELWEISS

• 1840s noted that medical students fresh from
  dissecting bodies did not wash hands before
  attending maternity wards. Infection and deaths
  in childbirth high. Insists that hands are
  washed. Deaths decrease.
• Hostility from colleagues saw him as a crank.
  Note Semmelweiss was before germ theory so no
  theory to back up his ideas.

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JAMES SIMPSON

• Went to Edinburgh University at 14, qualified at
  18. Professor at 28.
• Ether used as anaesthetic but an irritant -
  patient coughs
• Introduces use of chloroform numbers of deaths
  actually increases and lots of opposition.
• 1853 Queen Victoria uses chlofororm at birth of
  her 8th child, Prince Leopold. (Chloroform
  administered by John Snow) The effect was
  soothing, quieting and delightful beyond measure.

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LOUIS PASTEUR

• Germ Theory 1861 key turning point.
• How did he come up with this theory?
• What was the impact of this theory on the work of
  Robert Koch? e.g. vaccines for specific
  diseases.
• How did theory affect other branches of medicine
  and health?

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JOSEPH LISTER

• Studied Pasteur used carbolic spray to kill
  germs during operations and to reduce infection
  in open wounds.
• Much opposition to his work.
• Gradually his ideas accepted and aseptic surgery
  praciticed (removing all possible germs from the
  operating theatre.) Theatres were cleaned
  instruments sterilised rubber gloves used
  sterilised ligatures introduced.

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JOHN SNOW

• On proceeding to the spot, I found that nearly
  all the deaths had taken place within a short
  distance of the Broad Street pump.
• There were only ten deaths in houses situated
  decidedly nearer to another street-pump.
• In five of these cases the families of the
  deceased persons informed me that they always
  sent to the pump in Broad Street, as they
  preferred the water to that of the pumps which
  were nearer.
• In three other cases, the deceased were children
  who went to school near the pump in Broad
  Street...

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JOHN SNOW (continued)

• The cases that clinched it for Snow concerned two
  ladies who died not in Soho, but in Hampstead,
  over five miles away, and in Islington, where
  there was no outbreak. Puzzled, Snow visited the
  house where one had died, and was told that every
  day a cart took a large bottle of water from the
  Broad Street pump all the way to Hampstead
  because the lady liked the taste. A delivery of
  water arrived on Thursday 31st August, and she
  drank then and on the Friday. By Saturday she was
  dead. The other lady was her niece, who paid a
  visit, drank the water, and then died at home in
  Islington.

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JOHN SNOW (continued)

• With regard to the deaths occurring in the
  locality belonging to the pump, there were 61
  instances in which I was informed that the
  deceased persons used to drink the pump water
  from Broad Street, either constantly or
  occasionally...
• I had an interview with the Board of Guardians
  of St James's parish, on the evening of the 7th
  inst Sept 7, and represented the above
  circumstances to them. In consequence of what I
  said, the handle of the pump was removed on the
  following day.
• N.B. Snow did NOT know about germs, or the real
  cause of cholera

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WHAT DO YOU KNOW ABOUT THE FOLLOWING? - If
nothing, then do some revision!
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Edwin Chadwick and public health reforms in the
19th century.
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FLEMING, FLOREY, CHAIN
Penicillin
Watson and Crick Franklin and Wilkins DNA.
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David Lloyd George Liberal Reforms
Bevan - NHS