???(1) Medicine:its past, present and future

1
???(1) Medicineits past,
present and future

• ??????? ? ?
• yuhai_at_zju.edu.cn

2
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• ?????,1.5???
• ?7???,????,??11-13??
• ???????
• ????? ?,???????
• ?????????402
• ??88208060, 13605712843
• Emailyuhai_at_zju.edu.cn

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• 11/16 ?????
• 11/23 ???????????
• 11/30 ?????
• 12/7 ??????????
• 12/14 ????????
• 12/21 ????????
• 12/28 ????????????

4
????

• ??? ??????????????? 1999????
• ????????????????? 2007?9????
• Roy Porter? ????????????????? 2000????
• Aturo Castiglioni ? ???????? ?????????
  2003?3????
• Kenneth F Kiple ?? ??? ??  ?????????
  ???????2008? ???
• Frederick Cartwright Michael Biddiss ? ???
  ?????????????????2004?2????

5
????? History of Human Diseases

• ???????
• ?????????????????????????????????
• ?????????????????????????????
• ?????????????????????????????????,????????????????
  ??????

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• ?? ????????????,???????????????????????????,????
  ????????????????????????????????????????????????
  ??????????????
• Disease (dis-ease) an impairment of the normal
  state of an organism that interrupts or modifies
  its vital functions.
• Ailment, Illness, Sickness, Disorder,

7
??(?????,??, ??) ??(??,??,??,
??) ???? (????)
??
??
????
8
?? smallpox

• ????
• poxviridae
• othopoxvirus

?????????????
???????????,???????,????
9
???????Retinoblastoma
Rb(13q14)???????????
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??
Human Evolution
???
??
????
??? ??? ????? ?????? ??? ???? ??? ?? ?? ??
(Denisovans, Neanderthal)
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Human Evolution ??????????????,???????????
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???????

• ??
• Homo Habilis
• Lucy
• (Tanzania)

3-3.5 M yrs
??? Homo erectus Turkana boy (Kenya)
Osteosarcoma in a femoral head fossil
1.65 M yrs
13
???????

• ????????????
• ????
• ????
• ??
• ??????

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???????

• ???????
• ?????
• ??????
• ??????
• ??

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????? Zoonosis
42
50
65
26
35
46
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???? Paleopathology

• Ancient Egypt
• Mummy

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???? Paleopathology

• Pharaoh Ramses V died in
• 1157 B.C from smallpox

A louse found in a mummy of 3000 B.C
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???? Paleopathology

• ??????

Calcification in bladder caused by schistosomiasis
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???? Paleopathology

• ???????
• ????(??)
• ?????165?
• (???15?),
• ????????
• ????????
• ????????

20
??????

• ??????????(????) (??????167 BC)????60???,??52.5??,
  ??1.68? ???AB????????????????????????????????????
  ??????????????????

21
??????????,??????,???????????????
22
?????(??)
1346-1353 ???????(???,black death),?
?2500??,????1/3?
23
?????

• 1918??????????????,?????????????,??2-4??,?????????
  ?????(9M)?

24
??????????????? ??????????????????

• ??
• Epidemics ????????
• (??)???Pandemics
• ????????????

25
??????
???????? Demographic
???????????????
????????
??????? Environmental
Epidemilogical transition
??????? Life style
??????? Med-technology
26
??????????

• ???????????????
• ????????????? ???
• ???????????? ?? ??
• ??
• ????????????? ??
• ???????????? ??? ???(???????)

27
????????
World Life Expectancy
US Life Expectancy 1990-2050
28
????????
????????
?? 73.0 (2007) ?? 80.26 (?77.98, ?82.76
2010.5.11)
29
????????
1990??1997?????????
30
2000?????????
???? 55,694,000
?????? (59.0)
?????, ???? ???????? (31.9)
?? (9.1)
???? 2001???????
31
2000?????????????????

??????
75
??
50
???, ??? ???? ?? ???
25
???
???
???
????
???
???
???? 2001???????
32
Deaths, by broad group, 2000 World
China
Noncommunicable conditions (7 million)
Noncommunicable conditions (33 million)
Injuries (1 million)
Injuries (5 million)
Communicable diseases (18 million)
Communicable diseases (1 million)
????????1957?111.2/10?,???15.11997?0.33/10?,???
1
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???????-??????

• ????????????,????CO2????,????????,20?????1000?????
  100?,??140??????0.40.8?(??0.6?)???,???????????100
  ????1.45.8?,??????????????????????????,??????????
  ?????,????????????????????????,??????????????

Carbon Emission Global Warming
34
???????-?????

• ???(ozone,O3)?????????????300nm??????,????????????
  ???????
• ???????????(CFCs),??????,???Cl???,??????????????
  ???? ?
• ???????????,??????????????????
• Ozone Depletion

35
(No Transcript)
36
??????-??? Minamata Disease
????????,????????
37
??????-??? Minamata Disease

• 1925?,???????????,1949??,???????????,????????,????
  ????????????????
• 1956?,????????? ???????????,?????,??????,??????
  ?????,???????????????????????????????,???????????
  ????????????????????????????,??????,???,???,??????
  ,?????
• ?????????????????????,?2955???????,???1784??
  ??

38
??????-??? Minamata Disease
39
??????-??? Minamata Disease
40
?????-??????
??????????500??,???1881???????,?????????????????,?
???????????????????????
41
?????-??????

• ??????????????????350????????,?2030?,?????????????
  ????1000??
• ???????????,?????????????2000???,????????????????
• ???????????????????????????????????????,?????????3
  .5?,???????????????5.4?,????100???????????????

42
?????-??????
Cancer
43
??????
44
?????-????????
???? ?????? ??????
45
?????-????????

• ????BMIKg/M2
• (body mass index)

WHO standard classification of obesity Normal
BMI18.5-24.9 Overweight  25.0-29.9 Obesity class
I 30.0-34.9 Obesity class II 35.0-39.9 Obesity
class III gt 40
46
Obesity Trends Among U.S. AdultsBRFSS, 1990,
1998, 2007
(BMI ?30, or about 30 lbs. overweight for 54
person)
1998
1990
2007
No Data lt10 1014
1519 2024 2529
30
47
Obesity Trends Among U.S. AdultsBRFSS, 1985
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
48
Obesity Trends Among U.S. AdultsBRFSS, 1986
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
49
Obesity Trends Among U.S. AdultsBRFSS, 1987
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
50
Obesity Trends Among U.S. AdultsBRFSS, 1988
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
51
Obesity Trends Among U.S. AdultsBRFSS, 1989
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
52
Obesity Trends Among U.S. AdultsBRFSS, 1990
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
53
Obesity Trends Among U.S. AdultsBRFSS, 1991
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519
54
Obesity Trends Among U.S. AdultsBRFSS, 1992
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519
55
Obesity Trends Among U.S. AdultsBRFSS, 1993
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519
56
Obesity Trends Among U.S. AdultsBRFSS, 1994
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519
57
Obesity Trends Among U.S. AdultsBRFSS, 1995
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519
58
Obesity Trends Among U.S. AdultsBRFSS, 1996
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519
59
Obesity Trends Among U.S. AdultsBRFSS, 1997
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519 20
60
Obesity Trends Among U.S. AdultsBRFSS, 1998
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519 20
61
Obesity Trends Among U.S. AdultsBRFSS, 1999
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519 20
62
Obesity Trends Among U.S. AdultsBRFSS, 2000
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519 20
63
Obesity Trends Among U.S. AdultsBRFSS, 2001
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519 2024 25
64
Obesity Trends Among U.S. AdultsBRFSS, 2002
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519 2024 25
65
Obesity Trends Among U.S. AdultsBRFSS, 2003
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519 2024 25
66
Obesity Trends Among U.S. AdultsBRFSS, 2004
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519 2024 25
67
Obesity Trends Among U.S. AdultsBRFSS, 2005
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519 2024 2529
30
68
Obesity Trends Among U.S. AdultsBRFSS, 2006
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519 2024 2529
30
69
Obesity Trends Among U.S. AdultsBRFSS, 2007
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519 2024 2529
30
70
Obesity Trends Among U.S. AdultsBRFSS, 2008
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519 2024 2529
30
71
Obesity Trends Among U.S. AdultsBRFSS, 2009
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519 2024 2529
30
72
Obesity Trends Among U.S. AdultsBRFSS,
2010(BMI 30, or 30 lbs. overweight for 5 4
person)
73
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75
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• ????7.1 (6 000??),
• ????????30.0?12.3,
• ?????8.1 ?
• ????????????18.6
• ????????????1.6??

76
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• 1885 Karl Benz ?????????????????2500???????
• 2004?????????????50?????,???????????10.4??,???????
  ????????????,???8.6???4???2.6???
  (2009?,???????????238351?,??67759???)
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79
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80
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• WHO??,????????1.2??2??,???2020????????????????????
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• ?????????6.19.5,?1320???????????????????

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• 2009????????13????????,????????,2010??????????????
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86
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???????????????50???????????????(????????????????
???????)????
???? Tetracycline-stained teeth

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87
??????-?????

• ???(Thalidomide)??Chemie Gruenenthal??1957???,????
  ????,?1959?,?????????100??????1960?,??????????????
  ???????????????????????
• ???????1961?11????????????????1??12????????,???40
  00???????????

• ????? phocomelia

88

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  ??????

89
Break
90
??????,??????

• The history of mankind is the history of its
  diseases
  Folke Henschen
• ?????????
• ????????
• ??????
• ??????

91
??????????

• ???,???? ?????????????,???(???
  202?-??9?)?1840?,???????321?????????????????????(
  1-3??)????????(??16-17??)
• ??????????????????,????????,????"?"???????,???
  ????,?????,??????" "???????,???????,??????,????,??
  ??" ?????,??????????,?????

92
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• ???????,?????,??????????????
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• ?????????????????

93
??????????

• ????????,???????????1000??6000????????????,???1???
  ?
• ??????????????????????

94
??????????

• 430427 BC,???????,?1/2????, 165180?,?????????,1/
  4?????
• 13481351???????????,3???????6200?(????3000?),????
  ???1/4-1/3,300????????????70,???58,???
  3/4?1348??????,?????????????????????10????
• 1918???????,???????,?1/4??????,67.5?????????20005
  000?????????????

95
?????????
2011 2000 1987 1975 1960 1930 1800
70? 60 50 40 30 20 10

????????
96
?? ????????

• ???????
• ?????
• ???430? ???
• ??????,20?
• ?????????
• ???,??1/3,?
• ?????????
• ?(Golden Ages)
• ???????

97
??????????
Antonine plague

• ????????
• ???
• ??166-180 ??????,
• 4-5?????,????
• ??????211-266??
• ?????????, ?
• ?????,??????
• ??????

Marcus Aurelius 121-180 Meditation
98
??????????

1492???????????,????????????????????????
Columbus voyage 1492
99
?? ????????-????
??(Maya) ????(Aztec) ??(Inca)
100
?? ????????

• ????Cortes?1519-1521???????(1500? vs
  300??),10??????100?
• Pizarro?1553??????,???????????????

101
??????????

• 1518???????,?????
• ????????????????
• ????????????????
• ???,??????????

102
??????????

• 16???????????
• 1518-1529 ??
• 1530-1531 ??
• ????
• 1558-1559 ??
• 16??? ??????????90-95

103
??????-???????
104
??????-?????????

• ???????
• Sickle cell anemia

A T Glycin Valine

A T Gl Val
105
???????????????

• 
  ????????

???????????
106
??????-?????????
???????????????1/400, ???????8-10 ???????????????
?,??????????????? ????????6?????(G-6-PD)???
107
???????????
1870-1924
1817-1901
108
??? Hemophilia

• ???????????
• A?80-85 ????????, B?15-20,?????????

109
Victoria and Royal Family
110
??? Hemophilia
?????????????????,???????,????????????????????????
????????????????,?????????????????????????????????
,???????????????????????????????,????????????????,
?????????????????????????????,????????????,???????
????????????
111
???????????
112
The European Royal Family
113

• ??Nicholas II ???????Alexandra,?????????Alexis,???
  ??????????

114
Russian October Revolution
115
?? Summary

• ??????????????,????????????
• ??????????????????????????????,???????????????????
  ??????????????????????????????????????????????
• ??????????????????????????????????
• ????????????????,??????????????

116
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