1. Getting Better: 200 Years of Medicine
44 min video-
Getting Better is a short documentary that explores three remarkable stories of medical progress: Cancer, HIV/AIDS, Surgery. The film looks at the role of researchers and clinicians, of patients, their families and their advocates, and how information is translated into action. It is the story of research, clinical practice and patient care, and how we have continued to get better over the last 200 years.

2. The History of Health Care

3. Ancient/Primitive Times 4000 BC-3000 BC
Prevention of injury from predators
Illness/disease caused by supernatural spirits
Average lifespan was 20 years
More concern was safety from predators. If someone got sick, it was out of their control.

4. Ancient/Primitive Times
Herbs and plants were used as medicine examples:
Digitalis from foxglove plants
Then, leaves were chewed to strengthen & slow heart
Now, administered by pills, IV, or injections
Morphine from opium poppy
relieves severe pain
The years between 4000 BC and 3000 BC are considered the primitive era. During this time, people believed that illness was caused by supernatural beings. It was believed that if people were disobedient, the gods would inflict their bodies with sickness or disease. Priests and medicine men treated illness through religious ceremonies, where evil spirits were thought to be driven out of the body.
Several herbs and plants were used as medicine during primitive times. One medicine called morphine (from the opium plant) was developed during this era and is still used today. Morphine is often given to patients after surgery to treat pain.

5. Ancient/Primitive Times
Herbs and plants were used as medicine examples:
Quinine from bark of cinchona tree
Controls fever and muscle spasms
Used to treat malaria

6. Ancient/Primitive Times
Herbs and plants were used as medicine examples:
Belladonna and atropine from poisonous nightshade plant
relieves muscle spasms especially GI
Let’s take a look at some from our household!

7. Stop Here to Discuss History of Healthcare Group Project

8. Egyptians 3000 BC Earliest to keep accurate health records
Superstitious
Called upon gods
Identified certain diseases
Pharaohs kept many specialists

9. Egyptians Priests were the doctors
Temples were places of worship, medical schools, and hospitals
Only the priests could read the medical knowledge from the god Thoth
Imhotep was chancellor to the pharaoh and known to be one of the earliest architects, engineers, and physicians of that time.

10. Egyptians Magicians were also healers Believed demons caused disease
Prescriptions were written on papyrus

11. Egyptians Embalming Done by special priests (NOT the doctor priests)
Advanced the knowledge of anatomy
Strong antiseptics used to prevent decay
Gauze similar to today’s surgical gauze

12. Egyptians Research on mummies has revealed the existence of diseases
Arthritis
Kidney stones
Arteriosclerosis

13. Egyptians Some medical practices still used today Enemas
Circumcision (4000 BC) preceded marriage
Closing wounds
Setting fractures

14. Egyptians Eye of Horus 5000 years ago Magic eye
“lucky charm” to guard against disease, suffering, and evil
History: Horus lost vision in attack by Set; mother (Isis) called on Thoth for help; eye restored
Evolved into modern day Rx sign

15. Ancient Hindus and Chinese
Hindus – 1500 BC
Hospitals and Nurses
Many types of surgeries
Knowledge of drugs
Sewers
Chinese – 3000 BC
Documented over 1000 medical herbs
Acupuncture
Ancient Hindus and Chinese
By 1500 BC, the Hindus in India had developed an advanced medical organization. The Hindus set up hospitals with some of the best nurses in the world. Hindu doctors were trained in many types of surgery, including cataracts and plastic surgery. They also increased knowledge of drugs, in particular those used for anesthesia.
In addition, the Hindus created walled sewer drains and an underground water pipe system. These advancements helped to maintain a sanitary environment and to slow the spread of disease.
The ancient Chinese also developed useful medical practices. The Chinese documented over 1000 medical herbs and established the science of acupuncture. Acupuncture is recognized today as a valid form of alternative treatment.

16. Jewish Medicine Avoided medical practice
Concentrated on health rules concerning food, cleanliness, and quarantine
Moses: pre-Hippocratic medical practice
banned quackery (God was the only physician)
enforced Day of Rest

17. Greek Medicine 2000-400 BC First to study causes of diseases
Research helped eliminate superstitions
Sanitary practices were associated with the spread of disease

18. Ancient Greeks Hippocrates Aristotle Father of Medicine
no dissection, only observations
took careful notes of signs/symptoms of diseases
disease was not caused by supernatural forces
Hippocratic Oath
Aristotle
The first to make a connection between medicine and anatomy by dissecting animals
Ancient Greeks
When the Greeks began to conquer the ancient world, they adopted the medical practices of the countries they now controlled. But as the Greek civilization advanced, they began to question the accepted medical beliefs.
In the late 400’s BC, Hippocrates began his study of medicine in Greece. He made one of the greatest contributions to medical history by stressing the importance of observation and note-taking. Hippocrates taught that disease was a result of natural causes, not supernatural punishment. The only way to cure disease is to observe the sick. Hippocrates also encouraged cleanliness and proper diet to prevent illness. Hippocrates is known as the Father of Medicine. To this day, physicians are required to abide by the Hippocratic Oath, which is a code of behavior written by Hippocrates thousands of years ago.
Aristotle was another Greek contributor to the growing medical field. Aristotle developed the field of anatomy by dissecting animals. He was the first to make a connection between medicine, biology, and the body.

19. Greek Medicine Aesculapius staff and serpent symbol of medicine
temples built in his honor because the first true clinics and hospitals

20. Roman Medicine 200 BC to 500 AD
Learned from the Greeks and developed a sanitation system
Aqueducts and sewers
Public baths
Beginning of public health

21. Roman Medicine First to organize medical care Army medicine
Room in doctors’ house became first hospital
Public hygiene
flood control
solid construction of homes

22. Ancient Romans 200 BC to 500 AD Claudius Galen
Ignored the practice of patient observation
Four body fluids
Many flawed theories
Ancient Romans
The Greeks made many advancements in medicine. But in 146 BC, Greece was conquered by the Roman Empire. The Romans did not accept these medical practices. The teachings of Hippocrates were forgotten, and the medical field returned its focus to supernatural causes and cures.
In the mid 100’s AD, a Greek physician named Claudius Galen went to Rome and quickly became famous for curing the emperor’s stomach ache. Galen re-introduced the ideas of Hippocrates to the Romans. However, he ignored the practice of careful observation and note-taking. Instead, he taught that the body was composed of four fluids. If the fluids became unbalanced, sickness would occur. Galen also developed theories of human anatomy by dissecting pigs. Many of Galen’s theories were flawed, and true medical progress was held back for centuries.
As a result of Galen’s theories, the Romans contributed very little to medical advancement. However, the Romans did recognize that disease was often caused by filth and overcrowding. They installed superior drainage and sanitation systems and also set up public hospitals.

23. Dark Ages (400-800 A.D.) and Middle Ages (800-1400 A.D.)
542 AD – First episode of the bubonic plague.
Rome is overthrown by barbarians, and the study of medicine is forbidden.
People return to religion, magic, and folklore to cure disease.

24. Dark Ages (400-800 A.D.) and Middle Ages (800-1400 A.D.)
Terrible epidemics
Bubonic plague (Black Death)
Small pox
Diphtheria
Syphilis
Measles
Typhoid fever
Tuberculosis

25. Black Death 1347 to 1352 AD Second episode of the bubonic plague
Over one-third of Europe’s population died.
Many Europeans challenge the belief that religion is the cure for disease.
Black Death
The bubonic plague struck the world for a second time in the 1300’s. Between 1347 and 1352, over one-third of Europe’s population died. This wave of the plague is called the Black Death. Because of the lack of medical progress in Europe, the cause of the Black Death was unknown for many years. It was later determined that the fatal disease was caused by a bacteria from fleas on infected rats.
The Black Death was devastating for Europe. However, fear of the plague caused many Europeans to challenge the belief that religion was the cure for disease.

26. Dark Ages (400 –800 A.D.) and Middle Ages (800-1400 A. D.)
Crusaders spread disease
Cities became common
Special officers to deal with sanitary problems
Realization that diseases are contagious
Quarantine laws passed

27. Middle Ages 800 to 1300 AD Moslem Arab Empire First medical school
Pharmacology
Rhazes
First medical school
Common people are treated by barber surgeons.
Middle Ages
When the Middle Ages began around 800 AD, several cultures started researching medicine again. Progress was slow. But by 1000 AD, the Moslem Arab Empire created a medical revival. The Arab’s vast knowledge of chemistry led to advancements in pharmacology, the study of medicines and their uses. They also set up a system of hospitals with specialized wards for certain illnesses.
During this time, the physician Rhazes became known as the Arab Hippocrates. Through careful observation of the human body, Rhazes discovered that blood was the cause of many infectious diseases. Additionally, he developed the first form of stitches by using animal-gut sutures to sew wounds.
Another major medical advancement in the Middle Ages was the formation of the first true medical school. The school was located in Salerno, Italy, and it was open to all nationalities. It taught both anatomy and surgery based on the studies of Hippocrates and Galen. Anatomy was limited, however, because students were forced to dissect animals. In most parts of the world, human dissection was illegal.
In the Middle Ages, medical doctors treated only the wealthy. As a result, common people received medical treatment from barbers. The barbers were not trained in medical procedures, but they often performed surgeries, such as amputations and cataracts. The methods were unsanitary, and many patients developed infections or died.

28. The Renaissance
1350 to 1700 AD
Many Europeans reject their commitment to religion.
Andreas Vesalius published the first human anatomy book.
The microscope is invented.
The Renaissance
The Renaissance, which began around 1350, was a time of enlightenment. Europeans began to reject their commitment to religion, and they formed new ideas about the arts and sciences.
Several medical researchers stole corpses and dissected them. One anatomist named Andreas Vesalius compared the human corpse to the human anatomy described in Claudius Galen’s teachings. Vesalius quickly realized that Galen’s theories were based on animal corpses, not human corpses. In the mid 1500’s, Vesalius published the first human anatomy book which proved Galen’s many errors.
Another major breakthrough during the Renaissance was the invention of the microscope. Anton van Leeuwenhoek created a single lens microscope in the mid 1600’s. This invention led him to the discovery of red blood cells. A few years later, Robert Hooke developed a stronger, compound lens microscope. Hooke’s microscope proved that all living things are made of cells.

29. Renaissance Medicine
Universities and medical schools for research
Dissection
Book publishing

30. The Industrial Revolution
1700 and 1800’s
Advances in chemistry and physics
Louis Pasteur develops pasteurization.
Joseph Lister develops methods of medical asepsis.
The Industrial Revolution
The “Age of Reason” that began in the Renaissance period had a great effect on the following centuries. Human curiosity and experimentation led to the Industrial Revolution in the 1700’s and 1800’s. Huge advances were made in the fields of chemistry and physics, which provided many new medical tools and methods.
One of the greatest discoveries during the Industrial Revolution was made by Louis Pasteur and Joseph Lister. Pasteur was a chemist who worked in a winery. He wanted to determine what caused the wines to become sour. Using a microscope, he discovered that microorganisms were to blame. He then developed a system of destroying these dangerous microorganisms through heating and sealing. This procedure became known as pasteurization. It is still used today, specifically on milk and dairy products.
Joseph Lister was a surgeon in England in the 1800’s. He became frustrated by the many infections his patients acquired after surgery. Using the research provided by Pasteur, Lister discovered that microorganisms were the cause of infection in people. Lister continued his study and developed methods of medical asepsis, which are cleaning procedures that kill microorganisms and help to eliminate infection.

31. People who made an impact on medicine during the 16th and 17th century
Leonardo da Vinci
anatomy of the body
Anton van Leeuwekhoek (1676)
invented microscope
observed microorganisms

32. People who made an impact on medicine during the 16th and 17th century
William Harvey
circulation of blood
Gabriele Fallopian
discovered fallopian tube
Bartholomew Eustachus
discovered the eustachian tube

33. People who made an impact on medicine during the 17th and 18th century
John Hunter inserts a feeding tube into a patient.
Edward Jenner gives the first smallpox vaccination.
William Beaumont fully describes the digestive system.
Mid 1800’s - Anesthetics are used for surgeries.
Early 1900’s - Elie Metchnikoff explains the function of white blood cells.
Structure and Function
By the end of the Industrial Revolution, connections between the structure and function in an organism were finally known. This medical breakthrough led to many more discoveries.
John Hunter inserted a feeding tube into a patient’s stomach in 1778.
Edward Jenner administered the first vaccination in 1796.
William Beaumont fully described the digestive system in 1822.
Anesthetics, such as ether and chloroform, were used to “put patients to sleep” during surgeries in the mid 1800’s.
Elie Metchnikoff explained how white blood cells protect humans from diseases in the early 1900’s.
Almost every discovery during this time led to another one. The Industrial Revolution paved the way for modern medical practices.

34. 18th Century Benjamin Franklin invented bifocals
found that colds could be passed from person to person
Laennec
invented the stethoscope

35. 19th & 20th Century Inez Semmelweiss
identified the cause of puerperal fever which led to the importance of hand washing

36. 19th & 20th Century Ernest von Bergman developed asepsis Robert Koch
Father of Microbiology
identified germ causing TB

37. 19th & 20th Century Wilhelm Roentgen discovered X-rays Paul Ehrlick
discovered effect of medicine on disease causing microorganisms
Anesthesia discovered
nitrous oxide, ether, chloroform

38. 19th & 20th Century Alexander Fleming discovered penicillin Jonas Salk
discovered that a killed polio virus would cause immunity to polio
Alfred Sabin
discovered that a live virus provided more effective immunity
Early 1900’s – Wilhelm von Roentgen developed the X-ray machine

39. Modern Age (1900 to 1945)
Acute infectious diseases (diphtheria, TB, rheumatic fever)
No antibiotics, DDT for mosquitoes, rest for TB, water sanitation to help stop spread of typhoid fever, diphtheria vaccination
Hospitals were places to die
Most doctors were general practitioners

40. Modern Age (1945 to 1975) Immunization common antibiotic cures
safer surgery
Transplants
increased lifespan
chronic degenerative diseases

41. Modern Age (1945 to 1975) new health hazards obesity neurosis
lung cancer
hypertension
disintegrating families
greatly increasing medical costs

42. Search a person who had an impact in health care, medicine, public health, etc.
Example:
Florence Nightingale