1.1 History of Healthcare Early beginnings People believed illnesses were from evil spirits Exorcism Trephining Trephining: tribal doctor removed part of the cranium to exorcise demons

Herbs & plants Digitalis: Chewed leaves of foxglove to slow heartbeat Quinine: from bark. For fever, muscle spasms, and to prevent malaria Beladonna & Atropine: relieve muscle spasms, esp GI Morphine from poppies: pain medication Digitalis: now for CHF and heart rhythm problems

Egyptians Earliest people to keep accurate health records Priests acted as physicians Splinted fractures Bloodletting with leeches Superstitious

Chinese Acupuncture

Greeks Physicians housed in sacred temples of healing First to study disease as natural, not spiritual, process Kept detailed records Research helped eliminate superstition Further developed uses of massage and herbal therapies

Hippocrates, ca. 469-377 BC Greek Father of Medicine No dissection allowed in ancient times Based knowledge of anatomy and physiology by studying external body Wrote Oath of Hippocrates Standard of ethics

Hippocratic Oath Original Modern https://www.youtube.com/watch?v=0ZOWXKt0TGY Modern https://www.youtube.com/watch?v=KBDFGSZX8ck

Sanitation Greeks discovered some disease from lack of sanitation Romans learned from Greeks Developed sanitation systems Aquaducts Sewers Public baths with filtering systems

Romans

Roman Bath Houses

Roman Sewage

Romans Sent medical equipment and physicians with armies Physicians kept a room in their houses for the ill Beginning of hospitals Physicians paid by Roman government

Romans Physicians wore “death mask” Had a beak filled with spices Believed it protected them from infection and bad odors

Dark Ages and Middle Ages Medicine practices only in convents and monasteries Primary treatment was prayer Care was custodial Writings of Greek and Roman physicians collected and translated by monks

Dark Ages and Middle Ages Epidemics caused millions of deaths Bubonic plague Smallpox Diptheria Syphillis Tuberculosis Today controlled by vaccines

Renaissance Rebirth of learning Built universities and medical schools for research Dissection (autopsy) became accepted Development of printing press and publishing of books

16th and 17th Centuries Leonardo da Vinci: studied and recorded anatomy of the human body

Leonardo da Vinci

16th and 17th centuries William Harvey Gabriele Fallopius Described physiology of the heart Gabriele Fallopius Discovered fallopian tubes Bartolommeo Eustachio Discovered tube leading from ear to throat Antonie van Leewenhoek Invented microscope Found that bacteria causes tooth decay

16th and 17th centuries Quackery Mass death from childbed fever Disease Causes of infection and disease not understood

18th Century Elizabeth Blackwell: first female physician Rene Laennec: invented stethoscope Joseph Priestly: Discovered element oxygen, and that plants refresh oxygen for respiration Benjamin Franklin: bifocals, transmission of colds Edward Jenner: smallpox vaccination

First stethoscope Made of wood

19th and 20th centuries Beginning of organized advancement of medical science Ignaz Semmelweis Identified cause of childbed fever Women were dying after giving birth Women who used midwives instead of physicians had higher survival rates

19th and 20th centuries (cont’d) Difference between physicians and midwives? HANDWASHING Physicians conducted dissections on dead bodies in “dead rooms.” Did not wash hands or change aprons before going in to deliver babies Other physicians laughed at Semmelweis Eventually proven

19th and 20th centuries Louis Pasteur: Father of Microbiology Discovered microorganisms everywhere and that they caused disease Before this discovery, doctors thought microorganisms were created by disease Invented process of pasteurization Created Rabies vaccine

19th and 20th centuries Joseph Lister: first doctor to use antiseptic in surgery to prevent infection Ernst von Bergmann: developed asepsis (sterility) Robert Koch: identified the bacterium that causes tuerculosis Wilhelm Roentgen: discovered x-rays Paul Ehrlich: found treatment for syphillis

19th and 20th centuries Anesthesia used for first time in surgery Nitrous oxide, ether, chloroform Before anesthesia Herbs Hashish Alcohol Choking unconscious

19th and 20th centuries Other discoveries included: Sulfa drugs Viruses Psychology/psychiatry (Freud) Penicillin (Fleming) Polio Vaccine (dead – Salk; live – Sabin) Molecular structure of DNA (Crick and Watson)

21st Century Holistic medicine Telemedicine Transplants/reattachments Treat whole patient Alternative/complimentary methods Telemedicine Transplants/reattachments Use of technology Noninvasive techniques Prenatal care/surgery

21st century People living longer Geriatric medicine, assisted living

Florence Nightingale Opened school of nursing Prior to this time, nursing not a respectable occupation “too old, too weak, too drunken, too dirty, or too bad to do anything else” Nightingale cared for soldiers during Crimean War – dying from cholera In recognition of her services, funding set up for training of nurses. Designed a hospital ward to improve environment and care of patients

Clara Barton Volunteer nurse in American Civil War After the war, established bureau of records to help find missing soldiers Campaigned for Treaty of Geneva – provided relief for sick and wounded soldiers Established American Red Cross

Patient care today Team approach Registered nurse (RN), Licensed Vocational Nurse (LVN) Certified Nurse Assistant (CNA) Patient Care Technician (PCT) Support techs

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