Importance of the history of medicine in physicians training. Periods in history of medicine. Primitive society.

History of medicine is
an idea how the medical practice and science developed through the centuries in close relationship with the development of society in order to find the best methods of prevention, diagnostics and treatment of diseases of a human being

The disciplines, which give information to the history of medicine are:

Archeology Paleopathology Paleobotany Paleoanthropology Paleopsychology Findings include manuscripts, books, works of art

Scientists
Anthropologists: study hominids to compare features with other fossil bones to see if brain size or posture was the same then Paleontologists: study the characteristics of prehistoric periods Archaeologists: study the objects left behind by the hominids for ex.

Artifacts
Any object that was shaped by human hands Easy to know the sequence of when they were, difficult to date the artifacts Radiocarbon dating: once-living things contain small amounts of radioactive carbon
Study the decay rate of the radio carbon

Tools from the Stone Age

Contents
Prehistory Ancient Civilizations Medieval Medicine in the East Renaissance Medicine Industrialisation and Enlightenment

Middle Ages

The Modern World

Problems with Studying Prehistoric Medicine

No written Evidence How can we overcome this problem?

Archaeology and Examination of Artefacts Compare with existing prehistoric societies

Aboriginal societies

Archaeology and Artefacts

Skeletons not always helpful

Excavation Techniques Problems with Archaeology

Prehistoric Burial Traditions

Nomadic lifestyle

Warriors/hunters Killed away from Tribe/group

Cave Drawing

Problems with the evidence

We only have archaeological evidence problem is it cannot tell us the whole story We also have cave paintings and other finds One way that we can find out evidence is to look at people around the world who lived similar lifestyles to prehistoric people until relatively recently

Early Man - Timeline

Scientists divide homo into 3 groups

1. Homo habilis: person with ability, lived until 1.5 million yrs. Ago 2. Homo erectus: person who walks upright, 100-200,000 yrs. Ago 3. Homo sapiens: person who thinks

Whats a Hominid?
(3,9 to 3 million years ago)

A hominid is
an animal that lies broadly within the human family tree. (Homo sapiens is the only hominid left.) What set hominids apart from apes? Contrary to popular belief, a bigger brain isnt what tipped the scale. Bipedalismwalking on two legsfirst separated hominids from apes. And as hominids grew more accustomed to walking on two legs, they lost their arboreal arms, long upper limbs and hands suited to tree climbing. Hominids also have thicker dental enamel and smaller canine teeth than their ape ancestors.

Hominid teeth found!!!

Dec. 17, 1992, Gen Suwa from Japan found one of the oldest Homind teeth ever found in Ethiopia at a sight called Aramis After studying with his colleague Tim White, found bones from 17 people
4.4 million years old 65 pounds 4 feet tall

Australopithecus
Southern ape 3 to 5 feet Walked on 2 legs Large faces that jutted out Small brains, flat noses, large teeth Eastern & southern Africa Fruit, leaves, and nuts, fish No evidence of tools, only twigs and sticks

Homo habilis
Lived during the Paleolithic Oldest hominids known to have manufactured tools

Homo habilis

Homo erectus
Began as food gatherers Became hunters by developing weapons Make fire and made clothing from animal skins

Homo erectus

Homo erectus

Homo erectus
Became more developed in their skills Scientists disagree on when people migrated out of Africa Homo erectus was established in China and Europe by about 400,000 yrs. ago

Language
By 50,000 B.C., people had developed speech Before that, grunting and gestures was how people communicated Language is one of humanitys greatest achievement Allows us to pass down through the generations

Neanderthals
Named after the Neander Valley in Germany where their remains were first discovered in A.D. 1850s 5.5 feet tall Brains slightly larger than ours Stocky build, thick bones, muscular necks and shoulders Believe these characteristics helped them adapt to colder climates

NEANDERTHALS

Technological skills
Crafted stone knives, spear points from flint, and bone tools

Ways of Life
Lived in small groups of 35-50 people Nomads Warm weather: camps along lakes or rivers Cold weather: in caves or under the overhang of cliffs

Culture and Beliefs

They cared for sick and aged May have been 1st to practice medicine
Evidence of wounds completely healed

Had a belief in life after death

Buried dead with food, tools, and weapons and covered in flowers

Homo Sapiens Sapiens

Modern humans Originated in Africa about 50,000 yrs ago Within 20,000 yrs, this group dominated every continent After hominids and homo erectus became extinct, became the only hominids left on Earth

Homo sapiens

The Cro-Magnons
Earliest homo sapiens sapiens Found mostly in Europe Taller but less robust than Neanderthals Improved technology More sophisticated cultures Hunting and gathering techniques more effective

Cro-Magnon Technology
Blades made thinner and sharper Used bone, antler, and ivory to make tools Stone ax used to cut down trees to make into canoes Spear-thrower and bow and arrow
Now could hunt woolly mammoths and bison

Social Life
Had to cooperate with other unrelated groups of CroMagnons to hunt wild game Lead to setting up rules and making leaders Leaders had elaborate burials

Cave Paintings
Accomplished artistry Some were educational to teach for ex. how to hunt Also painted to reach to the spiritual world They also sculpted

Homo sapiens sapiens: Cave art

Humans Populate All the Major Land Masses of the World

Distribution and design of cave art

Homo sapiens sapiens: Important archaeological sites

The Ice Ages

B/t 2 million and t10,000 yrs. Ago, Earth experiences 4 periods called the Ice Age Only middle latitudes were warm enough to support human or plant life Early human beings adapted by migrating or learning strategies to stay warm

Stone Ages - 5 MYA - 2500 BC

PALEOLITHIC: Old Stone Age, 2 million years ago MESOLITHIC: Middle Stone Age, 2018,000 BCE to 12,150 BCE NEOLITHIC : 9000 BCE 4500 BCE

Paleolithic Period

Beginnings of humans to 10,000 BCE people were nomads lived in groups of 20 -30 hunter - gatherers

Paleolithic Period
Division of Labor men hunting game animals women gathering fruits, berries, and other edibles Developed simple tools: spears & axes made from bone, wood, & stone

Paleolithic Age
2,000,000 years ago artifacts chipped stone and flint, use of wood, clay, and animal parts tool kit was extensive: knives, axes, scrapers, hammers, awls, needles, spears, harpoons, clubs, blowguns, and bows and arrows, fire hominids - Homo habilis nomadic hunters and food gatherers lasted until the introduction of agriculture Spirituality and Religion may have begun to develop

Mesolithic Age Middle Stone Age

20-18,000 BC to 12,150 BC small composite flint tools (microliths and microburins), fishing tackle, stone adzes and wooden objects such as canoes and bows characterized by the introduction of agriculture

Neolithic Revolution
Shift from hunting & gathering to agriculture Led to permanent settlements Establishment of social classes Eventual rise of civilizations

Neolithic Revolution Great Discoveries 10,000 BCE: humans cultivate crops and domesticate animals Villages continued to divide work between men and women Women's status declined men took lead in most areas of early societies

NEOLITHIC : New Stone Age

9000 BC - 4500 BC first permanent settlements appear domestication of plants (notably wheat), animals (goats and sheep) produced decorated pottery and figurines from clay may indicate they were a war-like people irrigation systems and more advanced burial site use of alien materials like lapis lazuli, indicate a cultural diversity and the development of external trading

 Calendar to keep track of planting and harvesting Simple metal tools such as plows Used animals to pull plows Metal weapons developed as villages needed to protect their valuable resources.

Neolithic Age-New Technologies

Prehistory
150,000 BC First Modern Humans evolve Hunter Gatherers Estimated World Population 5 million

Main Features
Nomadic No Government Food Supplies Fresh meat from hunting wild animals, Vegetables fruit and berries gathered Fresh Water Exercise

Lifestyle of prehistoric man

Hunter gathers Followed the animals that they hunted Did not farm Rarely lived beyond 30 years Did not write things down Used flint and had a basic understanding of the world Very religious blamed spirits for good and bad things

Prehistoric Medicine
Spiritual treatments Rational treatments Surgery

Prehistoric Medicine
Trephination Illness caused by evil spirits Sorcerers, Medicine Men, Clever Men Some herbal remedies Broken Bones set in Clay Open cuts bandaged with bark or animal skin

Medical knowledge and beliefs

Archaeologists have found some evidence that suggests what the beliefs of prehistoric people were. Cave paintings give clues about what people thought caused some diseases. Other evidence, such as charms, provide further clues about these beliefs. To confirm their ideas, historians have talked to groups of people, such as some Aborigines in Australia, whose lifestyles have not changed for thousands of years. By examining their beliefs and practices we can get an insight into prehistoric life.

Medicine men
Prehistoric men used medicine men to help them to get rid of the evil spirits that thy thought caused disease Used lucky charms to help Used chants and magic spells to help people to get better

The image of "sorcerer" in a cave of Three Brothers

Practical ideas
Have evidence that they used herbs and spices to treat diseases Evidence that they may have healed broken bones using casts and splints Used berries to cure common conditions such as constipation and diarrhoea

Aboriginal beliefs and treatments

Those Aborigines who still follow their traditional culture believe that everyone has their own spirit inside themselves. If a person becomes ill, it is because their spirit has left them, or an evil spirit has entered their body. To get treatment, Aborigines go to a Medicine Man who knows all about spirits. He puts his patient into a trance by singing and chanting and then massages the sick area which releases the spirit and the patient is cured.

Traditionally, Aborigines also wore charms to keep evil spirits away, and buried their cut-off nails and hair and their excrement, probably to prevent spirits casting spells on them.

All through the history of medicine we find the use of herbal medicine to cure illness and disease, and the Aborigines are no exception. Many women treat their families with herbal remedies and use recipes handed down over thousands of years.

 Spirit healers would perform ceremonies and cast spells to treat the sick. We also believe that they dispensed the first medicines. Drinking the blood of a wild animal killed in the hunt would give hunters special powers or eating special plants known only to the shaman could treat sickness. It is possible that these treatments would sometimes have a beneficial effect and it is thought that drugs like digitalis and morphine were first discovered in this way.

Spirit healing

Alternative therapies
Western medicine is based on scientific observation and experimentation. We no longer live in the mystical spirit world of the ancients but that does not mean that beliefs no longer play a part in healing. Many people still visit faith healers or follow alternative therapies that claim to tap into invisible forces of nature. Indeed, Shamen still play an important part in certain Native American and African cultures.

Taino people of the period 1400500 years B.P

Surgery
There was very limited use of surgery in prehistoric times. One amazing operation did take place. This was trepanning or trephining, which involved cutting a hole in the skull, possibly to release evil spirits which were causing illness.

Archaeological evidence suggests that people did survive trepanning, although we don't know whether it had any positive effects.

What do you think were the dangers of trepanning?

Trepanning
PH man performed this operation without anaesthetic removed a piece of the skull to relieve pressure on the brain We know that people survived because we have found skulls where the bone has started to grow back Evidence of early knowledge of surgical techniques

 Yet this reason was done for supernatural as opposed to natural reasons They did in order to create a hole through which an evil spirit (which they thought caused the disease) could escape. Also did surgery to remove cysts and moles

Skulls of primitive people (neoantrop), survived operation of cranial trepanation (at the left), and the person who has lost owing to ritual cranial trepanation

Most diseases were attributed to the influence :

of malevolent demons, who were believed to project an alien spirit, a stone, a worm into the body of the unsuspecting patient.

Members of primitive society do not distinguish between medicine, magic and religion.

All elements of primitive medicine religion, sacred dances, magic, prayers, hymns, mythology.

Characteristics of Civilizations
Cities Centralized government, law codes, organized religion System of writing Specialized jobs Division of Labor Social Class Structure Advanced Technology

How did they become civilizations?

Neolithic Revolution domestication of plants & animals Organized Farming & village life Food Surplus was created led to specialization of labor Growth in population Creation of complex socieites requiring complex institutions which governed large scale projects like irrigation

Population Growth & Development of Civilizations

Iron Age = new farms tools = food surplus Farming and Pastoral Nomads replaced huntergatherers Domesticated animals = beasts of burden = food surplus Increased, healthier population living closer together in new urban areas Increased immunities based on close proximity & better health

Population Growth & Development of Civilizations

Cultural connections increased through new trade routes Developments of empires Development of Writing systems to record taxes to pay for expanded governments Development of great road building projects to encourage trade, uniform coinage, uniform weights & measurements (Lydian's & Persians)

The Egyptians
6000 BC to 30BC Country ruled by King or Pharaoh Farming developed on banks of the Nile Developed Writing Hieroglyphics and Papyrus Worshiped a group of Gods

Early River Civilizations: EGYPT 3000BCE Egyptian Science and Technology 1. Irrigation water from Nile River (god) to grow wheat & other foods 2. Preserving the human body after death through mummification 3. Physicians diagnose illness & perform brain & body surgery

Egyptian Science and Technology

Accurate calendar Hieroglyphics: system of writing called Advanced mathematical geometry & engineering skills in the creation of the pyramids irrigation systems

Monarchy Kingdom/Empire Pharaoh God/King Dynasty ruling family EGYPT Polytheistic Advances in medicine, math, calendars, irrigation, cosmetics, mummification, building & architecture, pyramids, jewelry, metal work Social Class Structure: Pharaoh, Priest/Nobles, merchants/artisans (Middle Class), peasants, slaves

Ancient Egypt

Features of Medicine
Professional Doctors for the wealthy Most specialised in particular parts of the body Some Herbal treatments Lucky charms used to prevent illness Prayers to the gods

Anatomical Knowledge
Egyptians Embalmed the dead so had some knowledge Knew about some internal organs Heart and Lungs Believed organs were connected by channels called Metu They carried fluids of the body blood, tears, urine and air Also carried Wehedu bad substances that caused illness

IMPORTANT NOTE
Embalming added little to medical knowledge Embalmers worked in secret Embalmers removed organs through the nose and small slits in the body They DID NOT OPEN UP BODIES

What did they believe caused Illness?

Natural and supernatural causes Blocked Channels Upsetting the Gods

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MESOPOTAMIA FERTILE CRESCENT

Sumerians 1st Civilization: 1st to build wheeled vehicles - 3500 BCE built irrigation systems, dykes, and canals for better farming Cuneiform system of writing 1st Sumerian- algebra and geometry Sumerian: - city-states, Preist/Kings polytheistic,

Fertile Crescent & Mesopotamia

Other Civilizations Fertile Crescent

Babylonians: astronomy, Code of Hammurabi, was the first written laws in history Hittites: first to mine iron ore to produce iron weapons & tools (Iron Age) Assyrians: new military equipment moveable towers and battering rams, 1st library of cuneiform tablets, chariot

Other Civilizations Fertile Crescent

Code on columns in each city-state

Assyrian weapons & chariot

 Persians: controlled empire Asia Minor to India (to Indus River) Persians: divided empire into provinces, governor called a satrap Taxes on resources and wealth Single code of laws for the empire Royal Roads to unify empire, common set of weights & measures, single coinage Zoroastrian Religion good & evil & polytheistic faiths

Other Civilizations Fertile Crescent

Coins

Persian Empire

Royal Roads
Weights & Measures

Other Civilizations Fertile Crescent

Phoenicians: Manufacturing and trade, colonization around Mediterranean Sea, glass, sea snail-purple dye (royal purple), phonetic alphabet-22 letters (adapted by Greeks and Romans)

Hebrews/Jews
Hebrews: Judaism - oldest known monotheistic religion Founder-Abraham Moses-Prophet: Ten Commandments 2000 BCE Laws Significant Writings-Torah and Talmud Book of laws & beliefs, as well as Old Testament of the Bible Places of Worship-Jews worship in temples called synagogues One God who is the creator of all things

India
2500BCE: First cultivation of rice, cotton and tea built ships, navigated seas, international commerce (Indian Ocean & overland) well-planned towns, rectangular patterns Art -copper, bronze, and pottery, including a large collection of terra-cotta toys two-storied and spacious, lined the town streets; they had drainage systems that led into brick-lined sewers

Ancient India
Social Class Structure: Caste System: Brahmana (priests), Kshatriya (warriors), Vaishya (traders and agriculturists), and Shudra (workers). Person's occupation or Sanskrit: writing system group depended upon birth

 HINDUISM: polytheistic religion 3000 BCE Significant Writings-Vedas, Upanishads, Ramayana, Mahabharata, Bhagavad Gita Oral 1st, Written in Sanskrit history & hymns, teachings of Hinduism spiritual oneness of the soul, atman soul obtains moksha or liberation

Ancient India - Religion

Hinduism
Reincarnation: karma you get what you give new life Dharma: Duties of all Hindus in their caste Supports rigid social structure Caste System Cow Sacred

Buddhism
Founder-Siddhartha Gautama Buddha, which means "enlightened one." he did not believe he was a god Dalai Lama:spiritual leader of Buddhism Four Noble Truths beliefs end suffereing, end desire Eightfold Path: represents one of the teachings of the Eightfold Path right thinking, speaking etc.

Buddhism
Reincarnation: karma you get what you give, new life, continuous cycle of life & death Rejected Caste System Salvation possible in this Lifetime
Nirvana spiritual enlightenment

 Shang Dynasty: 2000BCE system of writing pictographs - drawings of objects ideographs thought or idea Oracle Bone early writing: Zhou Dynasty: Mandate of Heaven rise & fall of dynasties Qin Dynasty: Shi huangdi new technologies warfare, cavalry, Legalism you will obey orders! Burned Confucian books

Early China

 Qin China: standardized the language and writing of China currency became standardized circular copper coin Great Wall built in north to protect China Roads and irrigation canals built Burned books

Ancient China

Classical China
Han China: Emperor Wudi: government & economy, Golden Age of China Han scientists wrote textbooks from zoology to botany and chemistry Astronomers accurate clocks & calendars, Paper, wheelbarrow, Acupuncture alleviate pain & herbal remedies Silk Road: trade with the Roman Empire and later empires east & west

Classical China
Artists and architects carvings in jade, wood, or ivory, & the elaborate temples Silk, Ceramics, lacquer and Silk Road 1st journey bamboo wares
Chinese Compass

Chinese Philosophies
Ancestor worship Confucianism: social order and mutual respect - 500 BCE Founder-Kong Fu Zi - Confucius Significant WritingsThe Analects - sayings

 Five Relationships: Ruler to ruled. Father to son. Older brother to younger brother. Husband to wife. Friend to friend Jen-Human kindness should be shown towards one another. Li-Proper etiquette should always be used, and one should strive to achieve perfect virtue. Filial Piety-One should respect their elders

Chinese Philosophies Confucianism

Ancient Civilisations
From 8000BC Farming Settlements appear Diseases e.g. Malaria Dirtier Writing Develops
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The Greeks
800BC to 338BC City States Worshipped the Gods of Olympus Some started to challenge the Gods Believed Education was Very important Science wanted to make sense of the World Philosophers

Features of Early Greek Medicine

Asklepios Greek God of Healing Asklepions Temples of Healing

Features of Late Greek Medicine 430 BC

Hippocrates Clinical Observation 4 Humours Ethical Behaviour Rejection of Supernatural Ideas Ethical Behaviour Regimen Diet and exercise Prevention better than cure

Anatomical Knowledge
Greek Philosopher: Aristotle Dissected animals NOT humans The Heart key organ in the body Studied the connection between blood vessels and brains

Alexandria 331 BC
In the third Century BC became the most important centre of medicine Herophilos improved understanding of the brain Erasistratos identified Cerebrum and Cerebellum HUMAN DISSECTION Allowed until the Romans took over
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The Romans
510 BC to 476 AD Well-Organised Government Roman Army Love Hate relationship with the Greeks Very practical Similar religion to Greeks

Features of Early Roman Medicine

No Doctors Family medicine male dominated Used a few farmyard materials In particular Wool and Cabbage Supernatural beliefs adopted Asklepions from Greeks Resisted the new Hippocratic Doctors from Greece They didnt like paying them and thought they were dangerous

Features of Late Roman Medicine

Gradually adopted Hippocratic Doctors Most Famous Claudius Galen Believed in 4 Humours Became more active in treatment Treated with opposites e.g. pepper to patients, blood letting Wrote huge amount of books became accepted as Gospels

Anatomical Knowledge
Galen improved Knowledge Treated Gladiators Dissected Animals remember the Pig Made mistakes the Heart

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Middle Ages
476 AD to Circa 1450 Frequent Wars Christianity in the West Islam in the East

Medicine in the Dark Ages 476 to Circa 1000 (West)

Roman and Greek medical books lost Training for doctors disappeared Illness was caused and cured by God It was considered Holy to care for the sick Mostly Nuns and Monks Some Herbal Remedies (Provided by God) and blood letting Four Humours Theory still used.

The Late Middle Ages 1000 to circa 1450 (West)

Increase in Hospitals to care for sick and poor Uroscopy study of urine to diagnose imbalance in 4 humours Astrological Ideas The position of the stars could influence health Better Training of doctors for the Rich

 Universities set up doctors licensed by university qualification Women could not become doctors Women continued to care for the poor University Doctors saw themselves as superior to Apothecaries (sellers of drugs and herbal remedies) and Barber surgeons( barbers who performed simple operations e.g. removing boils)

 Medieval doctors believed in preventive medicine Blood letting of Healthy people to keep the 4 humours in balance (carried out by Barber Surgeons) Venesection or Cupping Treatments Hot baths, Laxatives, Blood letting, enemas (a purgative mixture squirted into the anus using a long pipe and bellows)

Surgery in Middle Ages (West)

Some Advances due to constant wars e.g. removal of arrowheads Early experiments with Anaesthetics Opium to make patient sleepy Wine used to stop infection Some more complicated operations e.g. removal of bladder stones Most Surgeons not University trained.

Anatomical Knowledge
Human Dissection was disapproved of Several attempts to ban it all together Little increase in knowledge

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Medieval Medicine in the East

Caliphs maintained order Greek and Roman Manuscripts preserved Medical schools and libraries part of hospitals Called Bimaristans Maristans Hospitals for mentally ill. Hospital sites selected by hanging meat up

East Continued
Al-Rhazi Clinical Observation distinguished measles from Small Pox Challenged Galens theory about the heart Ibn Sina al-Qanun Encyclopaedia of medical knowledge 760 drugs
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Renaissance Medicine
Circa 1450 to Circa 1650 Rebirth of Greek Ideas about understanding the world Exploration Illustration Printing Press Scientific Research Reduction of power of the church

Medical Knowledge in the Renaissance

During this period there are a number of individuals that increased medical knowledge

Leonardo da Vinci
Inventor and artist Wanted to produce more realistic paintings Carried out dissections so he could understand how the human body worked More accurate drawings

Vesalius Anatomist 1514-1564

Carried out dissections on dead bodies Originally a follower of Galen Later challenged some of Galens theories (Septum of Heart Not Porous) Published a book on Anatomy using a renaissance artist to illustrate. De Humani Corporis Fabrica

Realdo Colombo
Proved blood went from right to left ventricles of the heart via the lungs

Gabriele Falloppia
Studied workings of the Womb

Fabricus
Studied Valves of the veins

William Harvey Physiologist 1578 -1657

Studied how the body worked Proved how blood circulated around the body simple experiments His work was initially rejected Only accepted in 1673 when Paris University began to teach his findings

Ambroise Pare 1510-1590

Barber Surgeon Became military surgeon Changed treatment of gunshot wounds (accidentally discovered that dressing wounds was more effective than cauterising) Developed ligatures for use with amputations Proved Bezoar didnt work Developed technique of Podalic Version turning baby in the womb

 His ideas were also rejected and criticised by the medical establishment He was only a surgeon

Paracelsus 1493-1541
Rejected 4 Humours Illness caused by chemicals inside the body Believed Chemicals like salt, sulphur and mercury could be used to treat illness Rejected by Medical establishment during his lifetime.

Progress?
These new ideas were rejected initially Increase in knowledge about the body little advance in treatments When King Charles II was dying (1685) he received the following treatments: Blood letting, laxatives, ground up human skull, bark of Perwian Tree and Bezoar
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Industrialisation and Enlightenment

Circa 1700 to Circa 1900 Production of goods changes to factories led to growth in towns Clear logical thought Improvements in Science and technology Doctors start to work in a way we would reconise today

Edward Jenner
Introduced Vaccination as a way of preventing Small Pox Infected people with cow pox to help them build up a resistance to small pox Great resistance at first! Others had tried similar experiments but had not proved it scientifically or published their work.

Louis Pasteur
Germ Theory Made the connection between germs and disease. Showed that microbes carried in dust in the air caused decay. These microbes/germs could be killed if heated PASTEURISATION Also Identified germ that caused Anthrax Developed Vaccines for Chicken Cholera and Rabies

Robert Koch
Identified the germs that caused: Tuberculosis, Cholera, Developed Dyes to help identify Germs Helped develop the Petri dish Uses Agar jelly to grow microbes/germs and makes it possible to photograph Others used his methods to discover the causes of pneumonia, meningitis, plague and dysentery

Improvements in Surgery
Anaesthetics developed Nitrous Oxide, Ether, Chloroform Pain Free operations More complex invasive surgery could be attempted. But Patients still died

Fighting Infection in Surgery

Antiseptic surgery Use of carbolic acid to kill germs Aseptic Surgery Keeping germs away from the operation washing hands, clean gowns and masks, sterilising equipment, wearing gloves and keeping theatres clean
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The Modern World

1900 onwards Huge improvements in Science and Technology World Wars

Paul Erlich
Developed the first Magic Bullet Salvarsan 606 a chemical drug that kills the specific germ that causes syphilis

Gerhard Domagk
Developed the second magic bullet based on a dye called Prontosil kills streptococcal bacteria Much more powerful than Salvarsan 606 Stops infections like pneumonia and meningitis

Alexander Flemming
Wanted to find a drug that would fight simple infections caused by germs getting into soldiers wounds in WW1 Accidentally discovered a mould that killed staphylococci bacteria published his findings Known as Penicillin Failed to test it on live tissue Others may have made the discovery before him.

Howard Florey and Ernst Chain

Read about Flemmings discovery Chain worked out the structure of Penicillin and was able to grow the mould in brewers yeast Florey used Penicillin on a Policeman suffering from Staphylococcal septicaemia Policeman improved but died because they did not have enough penicillin

Andrew J. Moyer
Developed a method of mass producing penicillin using a culture broth of corn steep liquor and lactose. Thousands of lives were saved during WW2 as a result

Surgery
Blood transfusions blood grouping, prevention of clotting and storage Improvements in Plastic Surgery (WWI) Skin grafts treatment of severe burns (WW2)

Genetics
DNA Identification of Genetic Disorders

Technology
X-Ray machines Body Scanners Ultrasound Laser treatment Pacemakers Artificial limbs

Problems?
STIs HIV and AIDS Famine Cancer Obesity MRSA
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