Final Exam Flashcards

Question

definition of presentism

Answer 1

uncritical adherence to present-day attitudes, especially the tendency to interpret past events in terms of modern values and concepts

Answer 2

a version of history that presents that past as the inexorable march or progress towards enlightenment. Critically in reference to a history of science that focuses on “heroes” and the successful chain of theories and experiments the led to present-day science. It ignores failed theory and dead end. Puts its faith in the power of human reason to reshape society for the better, regardless of past history and tradition.

Answer 3

diseases/viruses that are spread to humans from animals

Answer 4

drilling a hole in the skull for medical treatment purposes

Answer 5

usual term for doctor

Answer 6

"first do no harm" stated in hippocrates corpus

Answer 7

Apollo Olympian god of prophecy, and oracles, healing, disease, and plague, song/poetry, and archery. Typically depicted with a wreath and branch of laurel; bow and quiver; raven; and lyre.

Answer 8

Aesclepius - 8th century BCE - Was likely an actual historical figure, known for his healing abilities (parallel to Imhotep). Mentioned with his sons in the Iliad in the 8th BCE and were not gods (yet… late became deified) - Recognizable by staff with single snake

Answer 9

Apollo was his father, mortal woman named Coronis was his mother

Answer 10

he received the name Asklepios, "to cut open" 2 possible stories behind the name: 1. His mother was killed for being unfaithful to Apollo and was laid out on a funeral pyre to be consumed, but the unborn child was rescued from her womb 2. his mother died in labor and was laid out on the pyre to be consumed, but his father rescued the child, cutting him from her womb.

Answer 11

He was raised chiron/centar and instructed in the art of medicine (from Chiron) - snake licked his ears clean and taught him secret knowledge. Snakes are considered sacred beings of wisdom, healing, and resurrection (shed their skin and kind or Reborn) - Asclepius bore a rod wreathed with a snake, which became associated with healing

Answer 12

- Snakes are considered sacred beings of wisdom, healing, and resurrection (shed their skin and kind or Reborn) - snakes in the healing temples too

Answer 13

Staff of Hermes: - has 2 snakes around the rod - messenger of the God’s Rod of Aesclepius - Rod of Asclepius has one snake and signals healing - symbol still associated and recognized with medical practice today

Answer 14

Chiron, master of medicine taught and raised aesclepius half horse half human

Answer 15

- Temples were sites of pilgrimage where prayers, sacrifices, monetary gifts were offered. Usually on beautiful hills with fresh breezes. Women who were about to give birth could not enter because it was too dangerous and the temples were not a place of death, they were for a place of healing. - Healing ceremonies in temples in which a healing dream was hoped for - they would go to sleep and pray for a healing dream the priests will interpret them to find your cure/treatment - Temples used a type of non-venomous snake in healing rituals, that slithered around freely on the floor among the sick and injured (aesculpian snake) - Aesclapian temples and Hippocratic physicians were practicing at the same time (parallel to modern medicine and naturopathic medicine today)

Answer 16

foundation of evidence based medicine

Answer 17

Hygeia Daughter of Aesclepius Goddess of good health, cleanliness, and sanitation

Answer 18

Panacea Daughter of Aesclepius goddess of universal health

Answer 19

First mention of aesclepius was in the Iliad by Homer in book one: The Rage of Achilles

Answer 20

- Blood—heart or liver; spring and air; sanguine - Black bile—spleen; autumn and earth; melancholic - Yellow bile—liver or gallbladder; summer and fire; choleretic - Phlegm—brain or lungs; winter and water; phlegmatic

Answer 21

- Large body of writings, over about 200 years (Hippocrates did not write most (if any of these) - Compiled by students of Hippocrates and physicians who trained in the Hippocratic school

Answer 22

Hippocrates (460-370 BCE) - He is from Greece, but today it is modern day Turkey - Born on Island of Cos near the western coast of Asia Minor (Turkey) - Traditionally taught under a famous tree. Paul from the Bible was also said to teach under this tree - “Father of Medicine” - Was taught medicine by his father (Heraclides) and his grandfather - Travelled and practiced as a roving physician - Lectured and taught and was paid fees by patients and students - Plato and Aristotle both mention him - Lived to be 90. Life spanned Socrates and Plato. Died 10 years before the birth of alexander the great

Answer 23

The medical academy at Cos had a rival school in with a medical philosophy that competed with the Hippocratic physicians but was not quite as popular or successful. Rival school was Cnidian

Answer 24

- Hippocratic Medicine known for clinical observation, diagnosis, and prognosis. Discoveries were written down. - Medicine divorced from religion and devoted to systematic observation, with no reference to supernatural forces

Answer 25

Hippocratic Oath

Answer 26

Hippocratic Ideal

Answer 27

Hippocratic Ideal

Answer 28

an enclosure in the temple of Asclepios where patients slept

Answer 29

the first human anatomist (335-280 BC) - Trained in Cos, influenced by physicians from Cnido - Most of his life spent in Alexandria - Dissected more than 600 bodies - One of the first to compare human and animal morphology - Established distinction between nerves and tendons - First to identify difference between cerebrum and cerebellum - Established distinction between motor and sensory nerves - Celsus in De Medicina and the church leader Tertullina state that he Vivisected at least 600 live prisoners

Answer 30

Erarsistratus

Answer 31

All of his books were lost in the burning of the library of Alexandria. We know about his books because galen commented on them

Answer 32

(310 BC) - His father and brother were physicians - Studied first in Athens under disciples of Aristotle, later at Cos - “father of physiology” - First description of cardiac rhythm - Associated hardening of the liver (cirrhosis) with ascites (fluid build up in the abdominal cavity) - Advocate for experimentation - Believes more in TISSUES than HUMORS (ahead of his time) - All of his works were lost as well but we also know about him from Galen

Answer 33

Herophilus and Erasistratus both anatomists

Answer 34

Erasistratus

Answer 35

Herophilus

Answer 36

- Pergamon is modern day Bergama in Turkey. Rival to Alexandria and Rome in terms of splendor. It was favorite of roman emperors - Parchment was invented in Pergamon because of competition with the library of Alexandria- export of papyrus was banned to keep Pergamon from catching up to library of Alexandria - Red Basilica in Pergamon. Erected by Hadrian. Early 2nd century. One of the largest roman structures that survives from antiquity

Answer 37

- Parchment is made of skin from sheep, goats, and calves

Answer 38

- Galen of Pergamon - Roman 131-201 AD - Dissected animals - Prolific writer - Detailed descriptions of animal anatomy – no illustrations - Accuracy of descriptions as applied to human anatomy not disputed until the Renaissance

Answer 39

- Church came to believe that galen was divinely inspired HOWEVER galen was not Christian he believed in the demiurge - Questioning Galen was considered questioning the church which was considered questioning God

Answer 40

His father had a dream in which Aesclepius appeared and said that Galen must study to become a physician

Answer 41

De Usu Partium: "on the usefulness of the parts of the body"

Answer 42

latin for: "wonderful net" used in medicine: complex of arteries and veins lying very close to each other

Answer 43

an ointment or medical compound that is used on the skin

Answer 44

an extract or tincture- containing usually one or more active constituents of a plant

Answer 45

a supremely intelligent and powerful divine Craftsman (divine creator; not God)

Answer 46

ancient greek: breath air in motion

Answer 47

believed by the Greeks to be mix and to move and to balance the humors in the body

Answer 48

anatomical votives found in ancient greek medicine

Answer 49

- Monastic (first half of the middle ages – “Dark Ages”): Council of Clermont in 1130 forbids practice of medicine by monks as “too disruptive an occupation for an orderly life in monastic sequestration” - Monastic (first half of the middle ages – “Dark Ages”): Council of Clermont in 1130 forbids practice of medicine by monks as “too disruptive an occupation for an orderly life in monastic sequestration”

Answer 50

first famous medical center of the Middle Ages - Worlds first “medical school” founded in the 8th century - Considered “the most important center for the introduction of Arabic medicine into Western Europe Characteristics of Salerno - Wealthy - Progessive, intellectual openness - During most of the history of the school it was the “only medical school in Europe that opened its doors to women” women physicians were taught and published medical works - They did not focus only on female diseases, taught and practiced all branches of medicine.

Answer 51

1. Book on the conditions of women 2. On treatments for women 3. On women’s cosmetics

Answer 52

- Catholic church gradually recognized its own interest in allowing dissection of the human body for two groups: physicians and artists - In 1482, pope sixtus IV was petitioned by one of the german schools to use the corpses of executed criminals for dissection to confirm Galenic anatomy - Issued a papal bull allowing local bishops to determine whether the bodies of executed criminals or others who died without wills could be given to universities for doctors to dissect

Answer 53

Were sometimes effective. Use of Wound Man. Would do bleeding and purging and other surgeries like a barber shop

Answer 54

Red is linked to bloodletting, white represents bandages. Pole symbolizes stick patients would hold onto to make their veins pop out. Blue is symbolic of veins cut during bloodletting, other theories suggest it was later added to show patriotism as a nod to the nations flag

Answer 55

Doctors would use zodiac signs to understand illness and best course of treatments

Answer 56

- Medieval medicine showed doctors holding flasks of urine up to the light. Urine would be different colors which would help doctors determine their course of treatment - The Hippocratic Aphorisms include advice on urine-based diagnosis and prognosis. For example: “Colourless urine is bad; it is especially common in those with disease on the brain” and “The presence of particles like coarse meal in the urine of patients with fever signifies a long illness”.

Answer 57

Hippocratic Aphorims

Answer 58

Hippocratic Aphorisms

Answer 59

Most people were poor so they did not have access to physicians, barber surgeons, or an apothecary. Most people went to women for care because they had years of ancestral practical knowledge in herbs

Answer 60

First hospitals built in Islamic world were in Bagdhad. By the 1000 there were 30 hospitals in Islamic world Islamic medicine - Guided by sayings of the prophet Muhammad, like, “God never inflicts a disease unless He makes a cure for it,” a goal of restoration of health by rational, empirical means Hospitals in the west - Beds and spaces for the sick were laid out so that the patients could view the daily sacrament of the mass - Plainly (if at all) decorated - Dim and climate and architecture are often damp Hospitals in Islamic Cities - Largely benefited from drier, warmer climates, hospitals were set up to encourage the movement of light and air - Supported treatment according to humoralism, concerned with corporal rather than spiritual balance.

Answer 61

Muhammad heavily influenced islamic medicine

Answer 62

Al-Razi or Rhazes (850-923) - Known as the father of islamic medicine - Born in the persian city of Rey, today it is now a part of Tehran (Iran’s capital) - Details of his life are sparce but he had a talent for music early in life - Studied math, philosophy, literature, alchemy before beginning to study medicine at age 30 - Left Persia to study in Baghdad - Had access to Arabic translations of Hippocrates and Galen - Acknowledged brilliance of Greek and roman scholars but built on their foundational texts. “when he surpassed them, he said so” - WROTE DOUBTS ABOUT GALEN, which added more to the theory of humors. Wrote extensively about medical ethics and the importance of morality in medicine - First to accurately describe and differentiate between smallpox and measles. First to describe allergies/asthma, later called “rose fever.” - Many remarks on his generosity and compassion - He treated the hardest cases no one else could figure out - Became blind but did not have an operation for it - He was chosen as director of one of the first hospitals in bagdhad.

Answer 63

-First to accurately describe and differentiate between smallpox and measles. - First to describe allergies/asthma, later called “rose fever.” - First to recognize pediatrics as an independent specialty

Answer 64

- His book Diseases of Children was the first to deal with pediatrics as an independent field of medicine - His Continenes or Comprehensive Book of Medicine was being used 700 years after his death by European students - Wrote the first medical manual for home use, called Medical Advisor for the General Public (comparable to todays Merk Manual)

Answer 65

Ibn Sina (980-1037) - Known as the “prince of physicians” also called Avicenna - Born in modern day Uzbekistan - Philosopher and physician - Attempted to reconcile aristitole and Islamic thought - Mastered Qur’an by age 10 - Child prodigy. Studied natural sciences, law and philosophy, before studying medicine at age 13. Started practicing medicine at 16 yrs old - The canon of medicine was the greatest medical text in history at the time it was written Important discoveries - Potential for airborne transmission of disease - Research and writing on psychiatric conditions - Many writings focus on the pulse and characteristics of the urine - Many writings on the importance of water purity Famous cases: - Love sickness - Prince who thought he was a cow The floating man: - Predecessor to Decartes - “I think therefore I am” and the difference between mind and body Temperance was not his virtue - wine, women, and work did him in. at end of life he Treated himself with 8 enemas a day resulting in seizures and extreme weakness

Answer 66

Selected location by hanging meat and finding the site where it was slowest to rot.

Answer 67

Ibn Sina (Avicenna)

Answer 68

- Potential for airborne transmission of disease - Research and writing on psychiatric conditions - Many writings focus on the pulse and characteristics of the urine - Many writings on the importance of water purity

Answer 69

Wrote the Canon of Medicine in 1025 greatest medical text in history at the time it was written

Answer 70

- Arab physician mostly famous for being the first to describe to describe the pulmonary circulation of the blood. - His work regarding the right sided (pulmonary) circulation pre-date the very much later work (1628) of William Harvey’s De Motu Cordis - He wrote against against Galen’s theory of the “pores in the septum” - Unknown until rediscovered in 1924 when an Egyptian physician did his doctoral thesis on Al-Nafis - Though his work did not influence later writers, “the fact that his concept was so boldly stated in the thirteenth century should lead us to question our assumptions about progress and originality in the history”

Answer 71

arabian or islamic medicine

Answer 72

Maimondes - 1135-1204; Born in Cordoba Spain. When he was born Jews, Muslims, and Christians lived together in harmony. Eventually fled spain due to mistreatment of Jewish people, fled to Africa. - His father was a rabbi. - Still known as one of the most influential Jews in history - Nickname: RamBam - wanted to be a rabbi but had to practice medicine to support his family - many of his most important books/writings were not medical writings, many of his Jewish writings are still in use today including 13 services and beliefs

Answer 73

Oath and prayer of Maimonides

Answer 74

Judeo-Arabic

Answer 75

-Commentary on the Mishnah -Mishneh Torah -Guide for the Perplexed

Answer 76

13 principles of faith

Answer 77

Middle ages

Answer 78

1098- 1179 - besides medicine she is known from her garden and from her time in the monastery, she was an incredibly nun - Views on women and sexuality - There are more surviving chants by Hildegard than by any other composer from the entire Middle Ages, and she is one of the few known composers to have written both the music and the words. - St. Hildegard of Bingen wrote two medical texts, three books of visions and prophecies, one of the first mystery plays, songs, musical compositions, and letters - Hildegard’s medicine is based on balance, harmony, and holistic healing. She felt that the natural state of the body, when nurtured correctly, was wellness—that “disease [was] not a process, but an absence of process, a failing in the course of nature.” She advocated for moderation, a good diet, and rest, all components of preventive medicine today. She incorporated prayers and charms into her work, but unlike other religious medical writers, she focused on material cures.

Answer 79

intractable migraines, likely what caused her visions

Answer 80

Hildegard recognized and appreciated the distinct power of the female body; she viewed female sexual desire and pleasure as an attribute of the female body itself, as opposed to the result of penetration from outside the body.

Answer 81

hildegards first book of visions

Answer 82

Physica and Causae et curae these two works focused exclusively on healing Physica contains nine books. In them, Hildegard outlines the medical uses (or lack thereof) for herbs, foods, animal parts, and even gemstones, including ingredients like lily, oregano, hare bile, and swallow droppings—all found in her preferred treatment for rabies. Causae et curae is split into sixteen chapters and contains Hildegard’s theories on the body, medicine, diseases, sexuality, and nature as a whole.

Answer 83

surgical knife

Answer 84

religious recluse

Answer 85

Hildegard believed the natural world and human beings contained what she called viriditas, or “greenness,” which was the life essence of things given by God and which nature, through medicine, could restore.

Answer 86

Causae et curae (hildegard)

Answer 87

a partial loss of vision or blind spot in an otherwise normal visual field

Answer 88

Aristotle (384 - 322 BC) - Anatomic descriptions in Parts of Animals - References to illustrations - No evidence of human dissection

Answer 89

Anatomy Lesson of Dr. Nicholas Tulp (1632) - Painted by Rembrandt, first painting he signed his name on - Point of interest: the way the arm looks. Does not look correct with the way it is connected to the body - Not a depiction of a real dissection because the organs were always removed first this one does not have them removed - The person being dissected was real person executed that morning for robbery - commissioned by the surgeons guild - Rembrandt's anatomical portrait radically altered the conventions of the genre, by including a full-length corpse in the center of the image (using Christ-like iconography) and creating not just a portrait but a dramatic mise-en-scène.

Answer 90

aristotle??? no clear answer

Answer 91

Leonardo da Vinci (1452-1519) - illustrated different systems of organs in logical sequence (first to go head down) - illustrations of the skeletal system - illustrating relationships between musculature and the skeleton - the relationship between internal organs and the body surface - all of his work is owned by the british royal family

Answer 92

NO! HE DID NOT PUBLISH HIS OWN WORK - this is why his drawings did not significantly contribute to the history of anatomy most of his notes were not fully translated until 1883

Answer 93

- he was left handed and wrote right-to-left - he had his own way of shaping letters - he did not use punctuation - he had strange word groupings - wrote backward and needed a mirror to read it

Answer 94

Leonardo Da Vinci his drawing of valves

Answer 95

Leonardo Da Vinci

Answer 96

Vesalius - Born: Brussels, Belgium in 1514 - Early education: humanities and classic languages - Attended medical school in Paris at age 19- 1533-1536, received his bachelors in medicine at age 22 - In 1537 attended university of Padua to receive his doctoral degree in medicine and graduated that year as well. He was appointed as head of anatomy and surgery one day after her graduated - Came from a 5 generation long line of doctors - Grew up on an area close to Gallows Hill – where criminals were executed. - By age 10 he was dissecting animals and everything he could get his hands on from the gallows - Found many errors in Galen - De humani corporis fabrica - Like galen he was vain, contentious, and sure of himself - December 1543- last public dissection in padua, destroyed all his papers and left. Left to be a physician to Charles V, the holy roman emperor. Likely planned for some time. Did not like that job because multiple doctors advised the kind and many of them were galentists. Philip II took over but wouldn’t let Vesalius leave. Got permission to go on a pilgrimage and died in a shipwreck on a small island in the mediterranean on his return voyage

Answer 97

Realized that Galen had dissected only animals, thus making errors regarding human anatomy. The insertions and positions of many muscles were wrong - No rete mirabile, the keystone of galenic theory, where pneuma was converted

Answer 98

De humani corporis fabrica (or Fabrica for short). First edition published 1543 - Symbolism of front page: weasles, barber surgeons, dogs and monkeys, story of female cadaver (only women in the picture), skeleton in place of Galen - Composed of 7 books - Use of ecorche - Studying man is a way of giving glory to god - Written in latin and has instructions for performing ones own dissections - Attacked by everyone bc it refuted galen

Answer 99

- First accurate anatomy text ever written - Demonstrated the importance of skepticism: the idea that nothing should be believed that cannot be personally verified

Answer 100

Went on a pilgrimage and died in a shipwreck on a small island in the mediterranean on his return voyage

Answer 101

- Became one of the great centers for studying medicine in the 6th century, with students from every European country. Students were organized into nations, each which elected a ‘president’ to intervene with university authorities. - Less restrictive than most because it was in the Venetian Republic, which traded with the East and all over Europe - Has one of the most important botanical gardens in the world- where doctors would gather plants to makes treatments for their patients

Answer 102

stands above the dissection and reads the textbook

Answer 103

pointed to the part of the body to be dissected

Answer 104

the practice of performing operations on live animals for the purpose of experimentation or scientific research (used only by people who are opposed to such work).

Answer 105

- Thucydides wrote about the plague of Athens the plague was in 430 BCE during their war with Sparta, but he wrote about it in 410 BCE (20 years after the plague) - Not bubonic plague likely typhus or typhoid (but no proof of this) Symptoms included fever and red eyes, the throat and tongue becoming bloody and having horrible breath, followed by sneezing, hoarseness, and chest pain with a hard cough. After that had resolved it resulted in an upset stomach and discharge of all different biles. Next was violent spasms. Body was not hot to touch or pale looking, it was red and was covered in small postules and ulcers. Patient would throw themselves in cold water to try and find some form of relief. Death usually occurred on 7th or 8th day of infection, if they didn’t die than it resulted in problems with the bowels, which was generally fatal. If the patient did survive it left them covered in scars.

Answer 106

(born c. 495 BCE, Athens—died 429, Athens) Athenian statesman largely responsible for the full development, in the later 5th century BCE, of both the Athenian democracy and the Athenian empire, making Athens the political and cultural focus of Greece. His achievements included the construction of the Acropolis, begun in 447 - Thucydides admired him profoundly and refused to criticize him.

Answer 107

black death great dying

Answer 108

- Began in central asia before spreading to Europe, middle east, and Mediterranean. Outbreak started with Genoise merchants (spread through trade routes) - European Population declined between 20-50% between 1347-1351 - In 1347, it spread to Sicily, Italy, France and Spain - By 1348, spread throughout France, Low Countries,Germany and England. - By end of 1349, it had spread into Northern Europe,Scandinavia. - By 1351, it had spread to Eastern Europe and Russia.

Answer 109

- “little ice age” a period of climate cooling. 1315-1317 there were heavy rains in northern Europe that destroyed harvest. - 1330s and 1340s southern Europe saw similar temperature changes - Great famine caused by overall temperature drop of 3 F

Answer 110

Yersinia pestis (bacterium)

Answer 111

Xenopsylla cheopis

Answer 112

1. Bubonic - 1st stage of plague: carbuncle or gangrenous black blister surrounded by red pot marks at cite of bite mark, High temperature, Shivering, Violent headache, Nausea and vomiting, And general flu like symptoms - 2nd stage of plague: Bacteria then begin to invade the lymph system. The infection drains into the lymph nodes. A few days later a bubo appears. Lumps the size of an orange under the skin. - 3rd stage of plague: Bacteria release a toxin. It begins to attack the tissues, causing blood vessels hemorrhage, and so as it begins to break down the body. body begins to exhibit spots these are clear markers of the plague. rapid degeneration of the muscles of the heart. Kidneys nerves and central Blood shot eyes, general prostration, progressive neurological damage, slurred speech, derangement. Then leads to delirium and coma, Gangrene. Pneumonic - The most infectious type, is an advanced stage of plague that moves into the lungs. During this stage, the disease is passed directly, person to person, through airborne particles coughed from an infected person’s lungs Septicemic - If untreated, bubonic and pneumonic plague can progress to septicemic plague

Answer 113

If left untreated the pneumonic and septicemic killed nearly 100% of people who became infected with it (most deadly)

Answer 114

The First Plague Pandemic is also known as the Justian Plague The Second Plague Pandemic is known as The Black Death The Third Plague Pandemic in the 1800’s was in what part of the world? - Attracted attention when in attacked Hong Kong and Canton in 1894

Answer 115

No, it infected everyone equally

Answer 116

isolation houses for people who were infected with the plague

Answer 117

Flagellants are practitioners of a form of mortification of the flesh by whipping their skin with various instruments of penance.

Answer 118

the dance of the macabre, or the dans macabre "dance with dead" represented social implications of plague, no one was safe

Answer 119

- Cadaver tombs - New type of tomb that showed the person as they were, but also the decomposition keeping dead alive and exposed - Tombs prior to the black death had a calm demeanor and did not show decay or death

Answer 120

Large postule from the plague. Typically formed around the bite, but could have multiple

Answer 121

Disadvantages: - Contact with animals and other humans led to new diseases and facilitated contagion - Sewage contributes to disease burden Advantages: - Specialized skills develop (healing, bone setting) - Development of written language and preservation of knowledge

Answer 122

2150 BCE - Describes wounds being washed in beer and hot water and other forms of medical treatments - Other texts describe the symptoms and prognosis of epilepsy, scurvy, and bronchitis - A list of 230 medicines using plant, animal, and mineral ingredients was found in an Assyrian pharmacy

Answer 123

- “if a physician performs a major operation on a lord… and causes his death… they shall cut off his hand.” - Only wounds, fractures and abscesses were treated surgically- things that could be observed externally - Disease had a supernatural focus. Thought to be divine punishment of sin

Answer 124

Babylonian: Laws of Hammurabi

Answer 125

Giovanni Battista Morgagni Feb 25, 1682 (forli) - Dec 6, 1771 (padua) - Innovation: write up case studies that correlated with clinical observations correlated with findings at autopsy - His books had an index - went to Bologna for medical school. Studied under Valsalva and got his degree at 19. Invited to assist Valsalva and worked with him after graduation for about 6 years. Afterward he went back to Forli to practice medicine, where he stayed for around 5 years and built a private practice. Invited to Padua to teach at the University of Padua and stayed there as a professor of anatomy until his death - Devout catholic. Married and had 15 children 3 were sons and all surviving daughters (8) became nuns - Started the idea to identify pathology before the autopsy (clinicopathology correlation) - Was one of the most renowned physicians in the world. - After morgagnis death, seat of learning in medicine moved to paris

Answer 126

- Father of Pathological Anatomy - Father of physical examination - Illness had to do with a diseased organ, the humoral theory began to disappear - He is credited with the anatomic concept of disease

Answer 127

De Sedibus et Causes Morborum per Anatomen Indagatis: “of the seats and causes of diseases investigated through anatomy” ONE OF THE TOP THREE MOST IMPORTANT MEDICAL BOOKS IN HISTORY - Published 1761 (age 79) this is a turning point in medical history and they knew it at that time. It is composed of 70 letters and 700 cases divided into 5 books. (diseases of the head, diseases of the thorax, diseases of the abdomen, diseases of a general nature and diseases treated by surgery, supplements (Indices)) - Described symptoms the person had - Nothing do with humors, innate heat, where you lived. It had to do with diseased organs → end of the humoral theory

Answer 128

De Sedibus et Causes Morborum per Anatomen Indagatis

Answer 129

Organismic theory/ the medical model: Ontological theory: - Disease is from outside the patient, causes exist separate from the patient - Disease is a separate being or entity - What the patient HAS Physiological theory - Causes emerge from inside the patient - Diseases do not exist separate from the patient - Who or what the patient IS In either case, disease effects individuals, is “discontinuous” (episodic, intermittent) and bad

Answer 130

- Population based or ECOLOGICAL theory of disease - Disease is a constant - Cannot be eradicated

Answer 131

(careful observation of symptoms) Patterns of suffering

Answer 132

where is the disease (disease was understood to be localized)

Answer 133

an idea about the illness. A theory constructed to explain the illness

Answer 134

designates individual suffering real suffering felt by a particular person

Answer 135

Autopsy: “to see for yourself” Pathology: comes from Greek work “pathos” which means suffering

Answer 136

explain suffering, diagnosis, predicting outcomes (prognosis), justify treatment, proof in the postmortem

Answer 137

Nuland on Morgagni

Answer 138

Harvey on Morgagni

Answer 139

Virchow on Morgagni

Answer 140

William Harvey (1578-1657) - English, studied in padua - Most important work: De Motu Cordis: “on the motion of the heart” 72 pages long - Oldest of 7 boys, his father was a Turkish merchant who was very wealthy - Always in perpetual motion and described as choleric (operating under the idea of the 4 humors) - Went to college in Cambridge and in Canterbury where he studied classics. Hated contemporary literature. He could read in Greek and latin - Went to the best medical school in the world (Padua) - Named president of the English nation at padua - Studied under the famous anatomist: Fabricius - Had a successful career as doctor for nobility and royalty including James I, Charles I and saved the lives of 4 women accused of being witches - 1616: at age 38 he was appointed into the Lumlian Lectureship at the Royal College of Physicians - “on the generation of animals” a book of embryology, 1651 - KNOWN FOR his experiments and the use of the scientific method. FIRST to use QUANTITATIVE methods in research

Answer 141

Fabricius discovered valves in the veins but did not know what they were for. Thought they might be to slow the blood down

Answer 142

De Motu Cordis ("on the motion of the heart") - his most important/famous work "on the generation of animals" book on embryology, 1651

Answer 143

use of the scientific method and quantitative research methods

Answer 144

- Published in 1628 “of the motion of the heart” (harvey) - First published in latin and then after 25 years published in English - During the time of galen most info would’ve been in Greek. During the renaissance is when most of this got translated to latin - full name “Exercitatio anatomica de motu cordis et sanguinis in animalibus” on the motion of the heart and blood in animals

Answer 145

De Motu Cordis - Harvey

Answer 146

De Motu Cordis - Harvey

Answer 147

His ideas were not accepted at this time (contradicting galen) and he was accused of quackery and lost many patients; however, his theory of circulation WAS widely accepted by the time of his death in 1657

Answer 148

Vesalius disproved galens anatomy Harvey focused more on physiology

Answer 149

Harvey beginning to question Galen "It is astounding that nobody actually thought to address this obvious question before. Because of his privileged position as the king’s personal physician, he was allowed to study the king’s deer. By looking at the hearts of animals, he estimated that each time the heart beats, it squeezes 2 ounces of blood during systole (not a bad estimate). Because the heart beats on average 72 times per minute, he calculated that 8640 ounces (or 540 pounds) of blood should be pumped per hour, which was 4 times the weight of an average human being at Harvey’s time (though only 3 times today, given the current epidemic of obesity). Obviously, it was impossible for the liver to make that much blood in 1 hour. These calculations led Harvey to refute the 1500-year-old Galenic idea that blood is continuously produced in the liver.”

Answer 150

since he worked for the king he could study his deer

Answer 151

- European medicine and surgery were separate. Physicians learned in universities not in hospitals. - French revolution: radical changes in medical education and training. Medical schools close and re-open, old guard of medical schools done away with, surgery and medicine combine and doctors are expected to maintain the health of the people, not just treat the sick - Before the French revolution getting the history from the patient and careful observation is what doctors did. Physical exam was “cursory” - After the revolution acquiring rank of professor depended on your own achievements and scholarship (rather than who you knew) - French school of medicine is associated with careful exam skills . - Invention of the stethoscope in 1816 was the single most important development in the progress of the physical exam

Answer 152

Leopold Auenberger (1722-1809) - Before Laenec Son of tavern keeper who would thump kegs to see how full or empty they were (Austrian, Vienna) - Used percussion to examine tubercular patients, based on observation from the kegs - Just after morgagnis work, but his work was not well accepted or translated so it was forgotten (published in latin) - Published Inventum Novum ex Percussione Thoracies Humani Interni Pectoris Morbos Detergendi, 1761; “a new discovery that enables the physician from the percussion of the human thorax to detect the diseases hidden within the chest”

Answer 153

Published Inventum Novum ex Percussione Thoracies Humani Interni Pectoris Morbos Detergendi, 1761; “a new discovery that enables the physician from the percussion of the human thorax to detect the diseases hidden within the chest”

Answer 154

- Jean-Nicolas Corvisart 1755-1821: founder of French method of physical examination. - Supported the revolution; religious sceptic; hostile to classics and the church - Discovered Auenbrugger’s work and translated it to French. - Predicted anatomical findings with success (predicted what was found in autopsies, but in living patients): start of bedside medicine - known for “walking the wards” - Inspection, percussion, palpation, auscultation - Developed a three part system for examination: 1. Careful history and physical examination; 2. The autopsy/postmortem exam; 3. Clinical correlation - All incorporated into medical education. Teaching focus shifted from the university to the hospital

Answer 155

1. Careful history and physical examination 2. The autopsy/postmortem exam 3. Clinical correlation

Answer 156

Rene Laennec - 1781-1826; born in Brittany, France - Mother died of TB when he was 5/6 - moved around a lot. Went to live with his grand uncle the abbe Laennec (priest). At 12 live with his uncle guillaime-francois Laennec who worked in the faculty of medicine at the university. He began studying medicine under his uncle. - Learned English and german - His father (lawyer) discouraged him from continuing as a doctor and Rene then had a period of time where he took long walks in the country, danced, studied Greek, wrote poetry, and played the flute - Began to develop symptoms of ‘asthma’. In 1799 at 18 yrs old he asked his dad for money and then walked all the ways to paris to study medicine - Studied med in paris under several famous physicians including Dupuytren and Corvisart. - Joined Corivasrts clinic in 1801 - Exciting time – golden age of French medicine: “Peu lu, beaucoup voir, beacoup faire” meaning “read little, see much, do much” - cant learn medicine from just reading you must do! - 1802 (age 21) published a paper on valvular disease of the heart, later one on veneral disease, and another on peritonitis - 1803: wins medal for the most accomplished medical/surgical student

Answer 157

- Describes cirrhosis and melanoma - The first who described cirrhosis in the liver: laennec’s cirrhosis - First to describe melanoma and metastatic melanoma

Answer 158

- Laennec studied TB also known as consumption, extremely common - Named the lesions tubercles, which eventually lead to cavitary lesions - Begins a trend where disease come to be named after the pathological finding not the actual symptom

Answer 159

Inspiration of the stethoscope: In 1816, I was consulted by a young woman laboring under general symptoms of diseased heart, and in whose case percussion and the application of the hand were of little avail on account of the great degree of fatness. The other method just mentioned [direct auscultation] being rendered inadmissible by the age and sex of the patient, I happened to recollect a simple and well-known fact in acoustics, ... the great distinctness with which we hear the scratch of a pin at one end of a piece of wood on applying our ear to the other. Immediately, on this suggestion, I rolled a quire of paper into a kind of cylinder and applied one end of it to the region of the heart and the other to my ear, and was not a little surprised and pleased to find that I could thereby perceive the action of the heart in a manner much more clear and distinct than I had ever been able to do by the immediate application of my ear. When you bought the book if you paid a little extra you got a stethoscope made be Laennec himself made in two parts so you could take it apart and store it in your top hat

Answer 160

mediate, something mediating sound; immediate, ear to skin

Answer 161

“On mediate auscultation, or a treatise on the diagnosis of diseases of the lungs and heart principally on the new method of investigation” 1818

Answer 162

New book, new instrument (stethoscope), new method of classification, new philosophy of diagnosis

Answer 163

- Returned to Brittany and married his housekeeper - Died at 45 due to TB - Left all his medical books and papers to his nephew

Answer 164

Technology, from the Greek “techne” word for craft, skill, craftmanship, or art

Answer 165

a philosophy of knowledge characterized by the use of the senses, of careful observation (as contracted with theory or ‘pure’ reason)

Answer 166

Guy de Chauliac 1300-1368 - Father of Surgery - “what surgeons ought to be” - Notable for promoting professionalism and nontechnical skills - Poor peasant family but was able to study medicine because the church paid for it through scholarship - Studied in Bologna and Paris - Became physician to three popes - Caught, but survived, the black plague - Surgeons should not only know the principles of surgery but the theory of practice and art. - Chirugia Manga "The Great Surgery"

Answer 167

Chirugia Manga, “The Great Surgery” in 1363 - Most influential surgical text particularly in France for more than 200 years

Answer 168

Granted by Henry VIII in 1540

Answer 169

"what surgeons ought to be" Chaulic

Answer 170

- Ambroise Pare 1510-1590 - “gentle surgeon” - “father of military medicine” - Italian wars of 1495-1559 - Wars of religion 1562-1598 - born and died in France - Father was cabinet maker, his older brother was a barber surgeon - Famous during his lifetime - most famous 16th century surgeon - Renowned for his expertise in military medicine - Served four french kings: Henry II, Francis II, Charles IX, and Henry III - Hotel Dieu: renowned hospital in paris near notre dame cathedral. Established in 500-600s and still standing - Nicknames: The Gentle Surgeon and the Father of Military Medicine

Answer 171

yes he was one of the most famous surgeons in the 16th century

Answer 172

- Huge advance as military tool, mobile siege guns were used to breach city walls - Did not kill people at time of injury but would usually result in death afterward due to infection. Almost all gunshot wounds became infected due to injury in itself, unsanitary conditions following the injury, surgeon probing wound with unwashed fingers, or by being deliberately introduced by the surgeon in an effort to promote healing. - Force generated from musket balls produced shattered bones creating the need to amputate. Amputation often resulted in death from shock or infection - Led to people also trying to purposely create infections to promote healing

Answer 173

- Ran out of oil to cauterize wounds, so he used egg yolk, rose oil, and turpentine – ended up being much nicer way of treating gun wounds - “I bandage them, but God heals them” - Wrote in French - “his conversion from primitive healer to modern was instaneous and complete” - “gentleness in the treatment of wounds”

Answer 174

Did not know latin, wrote in French for which he was criticized, but insisted that ‘hippocrates himself had written in his own native tongue’

Answer 175

- Leonardo Da Vinci just preceded pare (1452-1519) - Ambroise Pare (1510-1590) - Andrew Vesalius (1514-1564) - Hunter came after (1728-1793)

Answer 176

pare Discovered/popularized ligature rather than cauterization -- this was before antisepsis so there were still many fatalities from infection

Answer 177

- “The Method of Treating Wounds Made by Arquebuses and other Firearms, Darts, and Such; Also on Combustion Made Especially by Cannon Powder” first book he published, 1545 at age 35 - “Ten books of surgery with the Magazine of the Instruments necessary for it” 1564 - The Works or The Oeuvres 1575 - Wrote a textbook for midwives about obstetrics published in french

Answer 178

- Elevated the role of barber surgeons. The role of surgeon and surgery changed by his lives work - only 3 times has there been a major surgical/philosophical revolution: Hippocrates, pare, and hunter - First to discover describe phantom pain and correctly identified that sensation arises from the brain - “Up to the time of John Hunter surgery was entirely in French hands, and Paris was the only place where the subject could be properly studied…” – nuland - “I have attempted to describe his humanity in an age of cruelty…” nuland - “…he saw further than any surgeon had ever done, and he saw more clearly” nuland

Answer 179

Hippocrates, pare, and hunter

Answer 180

WWI: intestine WWII: chest surgery Korean war: vascular surgery Vietnam: Rapid transport of trauma

Answer 181

- Francis I (d. 1547) - Henry II (d. 1559 jousting at his sons wedding) - Francis II (d. 1560 after one year)- married to mary queen of scotts - Henry III (d. 1589, assassinated) - Henry IV (protestant to catholic)

Answer 182

John Hunter - Nationality: Scottish, but spent most of his career in london - One of ten children, initially apprenticed to a carpenter - Father of Scientific Surgery - Never completed formal apprenticeship to a surgeon, he questioned and challenged standard practices. Didn’t learn to revere and respect his masters. Thought for himself, “self-made” - Became an army surgeon because he knew it would give him more autonomy also began to explore more marine biology - “never let school interfere with his education” - started with the study of teeth - Wrote first textbook on dentistry - Did implants - Helped develop the nomenclature of the tooth - Took out normal teeth and implanted into wealthy ladies jaws “guinea for a tooth” - Working alongside a dentist was considered even lower than a barber surgeon - Had an older brother who established himself as a successful surgeon in London - Exceeded his brothers expectations in some ways-less in others. “they wanted to make an old woman of me…” p. 178 - Did not write a lot, mostly spoke. He was not a good lecturer - “this oratorical deficiency was to plague him and his students, for the rest of his life…” - Did not like lectures, preferred teaching one on one - Took opioids before lectures

Answer 183

hunter - - Believed that to understand the complexity of human anatomy. “the entire animal series much be understood.” - Built a home and menargerie at earles court - Excerpt p.181 - Fascinated by comparative anatomy - Believed to understand the complexity of human anatomy - Him and his wifes massive house

Answer 184

Edward jenner, captain cook, ben franklin

Answer 185

- Studied his own ruptured achilles tendon - Injected himself with Gonhorrhea and Syphilis for experimentation

Answer 186

At age 65, he was at board meeting at the hospital and the discussion was about giving hospital privileges to two of his pupils. He got very angry and then felt crushing chest pain, fell into the arms of a physician outside the room and died of a massive heart attack. An autopsy was done and he died of MI, not from syphilis.

Answer 187

- Understanding of human teeth - Bone growth and remodeling - Inflammation - Gunshot wounds - Veneral disease - Digestion - Maternal fetal blood supply - Role of lymphatic system

Answer 188

- “his masterpiece was not a book but himself” - “Hunter found surgery a mechanical art and left it an experimental science” - “he alone made us gentlemen” - Extended pares influence elevating surgery to the point that during the next era, most advances in medicine were made by surgeons - showed that surgery was worthy of the best minds

Answer 189

pare and hunter

Answer 190

8 foot tall man didn’t want hunter to have his bones so he paid a captain to bury him at sea in a led coffin, but hunter paid the captain more and got his bones when he died

Answer 191

staphylococcus (laudable means praise worthy), white pus

Answer 192

of, resembling, or producing serum.

Answer 193

Couching is the earliest documented form of cataract surgery. It involves dislodging the lens of the eye, thus removing the cloudiness caused by the cataract

Answer 194

Burke and Hare

Answer 195

louis pasteur (1822-1895) - French microbiologist and chemist - Germ theory. - Came up with the idea of pasteurization - Found if he heated wine to 130 it would kill the bacteria but not damage the wine - Still used in milk - Married Marie Laurent, daughter of university rector - Had 5 children, 3 died of typhoid - Had first stroke at 45, severe stroke at 71, died of stroke in Paris at age 72 - Did vaccine development - He has some ethical issues with his career, some lab notebooks revealed some scientific misconduct and some improper human experiments - injecting vaccines in humans before animal trials or proven safe. He advocated scientific and medical ethics and said these needed done on animals first, but didn’t really follow this all the time - “as a matter of fact, there is no one living in the entire world to whom the medical sciences owe so much as they do to you..” lister to pastuer when they met at end of their lives - Musee Pasteur in paris Located within institute pastuer; Apartment where he spent last 7 years of life - Some 1000 scientific instruments

Answer 196

Pasteur's experiment consisted of boiled broth in flasks with S-shaped necks. The broth was boiled after being poured into the flasks to destroy any living microorganisms that may have been present in the broth. The S-shaped necks prevented microorganisms from entering and contaminating the broth after boiling.

Answer 197

Spontaneous generation was the excepted theory, but pasteur did biogenesis in 1861: By sterilizing cultures and keeping them isolated from the open air, Pasteur found that contamination of the media only occurred upon exposure to the outside environment, showing that some element was needed to give rise to life. In other words, life does not arise spontaneously

Answer 198

Lister said this to Pasteur when they met at the end of their life

Answer 199

Joseph Lister (1827-1912) - His father was a wine merchant and quaker. He was an amateur at optics. Developed lenses for microscopes that greatly enhanced their capacity – pastuer greatly benefited from this. He made pastuers discoveries possible and Pasteur made listers discoveries possible - Came from a quaker home (not part of church of England so there were a lot of universities he couldn’t go to) - Could read French and german - Attended university college in London - Initially studied botany - ENGLISH but spent most of his life in Scotland - Expert with microscope - Became member of royal college of surgeons at age 26. Then moved to Edinburgh: first (incomplete) - Tall handsome humble and a winsome personality, very easy going - Appointed in 1900 to surgeon to queen Victoria - President of royal society of surgeons - father of modern surgery

Answer 200

- Offered an important position by Dr.Symes, with whose daughter he fell in love, Her name was Agnes and they got married - Honeymoon: Spent three months visiting leading medical institutes in France and Germany - he never would’ve accomplished what he did without her assistance as a researcher - she acted as secretary and assistant and did his writings and such

Answer 201

pasteurs discoveries would have never been made possible without the work on microscopes listers father had done. Listers work would have never been possible with out the discoveries pasteur made - Read pasteurs work on microorganisms, three proposed solutions: filtration, heat, chemical compounds - Could read pastuers work in French and was also and expert at the microscope—repeated pastuers experiments - Lister couldn’t pasteurize his patients so he had to come up with something

Answer 202

- August 12, 1865 - 11 year old boy ran over by a cart - Compound fracture of tibia that lister treated with carbolic acid; saved his life and leg. Lister began treating other wounds with carbolic acid - use of antiseptic!!

Answer 203

- 1867 - The antiseptic system: on a new method of treating compound fracture

Answer 204

- Lister couldn’t pasteurize his patients so he had to come up with something - He had heard the stories about the use of carbolic acid in carlise to trat the stench - Started treating patients with carbolic acid - This discovery is considered the BC and AD of surgery, after this discovery surgery really began to take off. - Still used today (called Phenol) used for toenail removal to keep it from growing back - 16/35 of his patients died before he started using it; 6/40 of his patients died after antisepsis. Took an entire generation to accept antisepsis; Germans and French were more accepting of it (more science oriented), English and Americans were less interested - Germ theory of disease started to become more widely accepted which led to the rise of sterile surgery

Answer 205

development of antiseptic

Answer 206

Carbolic acid was pumped into surgical field using carbolic acid sprayer

Answer 207

- Edward VII Edward VII eldest son of queen Victoria (died 1901), developed appendicitis 2 days before his coronation - Appendectomy still posed extremely high risk of death by post op infection, and surgeons would not operatate on him without consulting lister, Lister told them how to do it he was operated on and survived

Answer 208

discovered by Joseph Priestly (1722) used as a fun social event/exhibtion

Answer 209

Joseph Priestley 1733-1804 - discovered nitrous oxide (1772) - english chemist and minister - most famous for discovering oxygen and its properties (1774)

Answer 210

Humphry Davy (1778-1829) - english chemist - experimented with psychotropic properties of nitrous - described his observation in a book, published 1800 - first did experiments on himself, multiple experiments on animals too - first to describe the properties of nitrous oxide

Answer 211

Horace wells, 1844

Answer 212

Horace Wells (1815-1848) - discovered the use of nitrous oxide as anesthesia: went to nitrous oxide show, used it, his his knee, then realized he could use it to pull teeth. He had his friend pull one of his own teeth, began to use it on patients, found it to be very safe and effective realized nitrous oxide could be used for surgery

Answer 213

January 1845 - dome of Massacuesetts general hospital and observed by a full room of faculty and students - student volunteer patients, administration of nitrous was incomplete and the patient screamed out in pain - wells was humiliated out of the room and nitrous was considered a failure - before this wells had sold his practice to work on nitrous oxide full time

Answer 214

nitrous oxide: priestly, Davy, Wells ether: Morton, Warren, Jackson, long chloroform: simpson

Answer 215

Wells was in prison, had chloroform and a knife smuggled in. Sniffed the chloroform and then sliced his femoral artery (suicide)

Answer 216

William Morton (1819- 1868) - had been experimenting with sulphuric ether while nitrous was being popularized - despite the fact nitrous had failed he wanted to try ether -tried live demonstation of ether in the ether dome in 1846 and it was a success - dental student of wells

Answer 217

if you rubbed it on the gums it would anesthetize them. Observers had noticed if you sniffed it, it gave you a dopey feeling and numbness successfully used for surgery in 1846

Answer 218

nitrous oxide is a gas ether is a volatile liquid

Answer 219

october 16, 1846 - occured in ether dome filled with faculty and students - specific patient set to be operated on by a specific surgeon - -tumor on the left angle of the jaw composed of lymph vessels - morton administered the ether through a glass globe. At the bottom of the globe was a liquid and the patient would suck on the gas

Answer 220

morton said this to warren (the surgeon) during the first ether demonstration

Answer 221

dr. warren said this after the successful use of either the day modern era of surgery began

Answer 222

Charles Jackson (1805- 1880) - Morton wanted a patent on ether and was going to sell the rights to distribution, he would not tell anyone what it was - charles jackson, a chem prof, claims he gave morton the idea - decided to get a patent together -Letheon

Answer 223

- name virgil gave to the poets that opium induced. comes from mythical river named by homer, named lethe meaning forgetfully - harvard people know what it is and harvard professors suggested the name, no one else knows what it is

Answer 224

12th November 1846 patent No. 4848 is issued to Charles T. Jackson and William T. G. Morton for 10% of all profits on the use of ether in surgical operations. There was loud opposition from the medical and dental communities to such a patent —feeling that Jackson and Morton should quickly make their discovery known and freely available.

Answer 225

wells started to take precedence over docs who were pushing ether 1847: wells goes to french academy of medicine and asks to be named the inventor of the whole notion of anesthesia

Answer 226

James Young Simpson (1811-1870) - scottish surgeon - used chloroform in 1847 - used in obstetrics

Answer 227

John Snow administers chloroform to Queen Victoria for the birth of her eighth child - Prince Leopold. She later wrote in her journal "Dr. Snow gave that blessed chloroform and the effect was soothing, quieting and delightful beyond measure". April 7th 1853 The wife of Charles Dickens was another celebrity who received chloroform in childbirth

Answer 228

15 year old girl with an ingrown toenail

Answer 229

congress offered $100,00 to the person who could make a successful claim regarding anesthesia claimed by crawford long

Answer 230

Crawford W. Long (1815-1878) - used ether to anesthetize on of his patients to take cysts of his back - the only physician associated with who we are learning about in the history of anesthesia - did not think this was a significant finding, had been to ether frolics as a med student - modest man but reluctantly states his claimed, prevailed upon by his friends, to claim to $100,000 from congress - extremely well trained - famous as sone of the most important people in the history of georgia - statue of him in the capitoll building

Answer 231

he was not a physician but he was censured by the american medical association he stormed off to try and persuade legislators - drove through central park and had a stroke and died

Answer 232

after being censured he was driving through central park, got out of the cab, jumped into the lake, had a huge stroke and died

Answer 233

came acorss the monument on the grave of william morton who discovered anesthesia and gave the world this great gift. took one look at that became pyschotic, admitted to Belmont for psychiatric patients, died there 7 years later

Answer 234

died while delivering a baby. took the baby and fell down and died of stroke only long had been destined for a peaceful life and peaceful death of all these men what was to bring peace to millions only brought turmoil and anguish to them

Answer 235

- english novelist and diarist - undergoes mastectomy for suspect breast cancer in 1812 - refused any drugs or alcohol - wrote a detailed letter to her sister describing her experience of surgery - operation lasted 3 hours and 45 minutes - lived another 25 years after the surgery

Answer 236

stupor --> narcotic

Answer 237

free from pain --> anodyne not a word in modern use but it is a medication that relieves pain

Answer 238

Semmelweis (1818-1865) - He was Hungarian and lived in Austria-Hungary - Born in Hungary, Studied at the University of Vienna - Pioneer of antiseptic policy - Discovered the root cause of childbed fever - At this time, women who were taken care of by the midwives always had better outcomes than women who were taken care by doctors. Midwives were often given “lower class” people in society that doctors did not want to treat

Answer 239

His major influences, the death of the colleague that lead to his life’s work - Karl von Rokitansky- Professor of Pathological Anatomy - Josef Skoda - leading clinician at Vienna Medical School - Ferdinand von Hebra - student of the first two, worked in dermatology - Jakob Kolletschka - pathologist - Josef Klein - Head of obstetrics - Applied to work with many people but kept getting rejected - Went to go work as an assistant to Klein in obstetrics (1844-1847) - Started to observe puerperal fever, had a 25% mortality rate (this is prior to Lister, people did not know why this was happening)

Answer 240

in 1861, Semmelweis finally published his main work Die Ätiologie, der Begriff und die Prophylaxis des Kindbettfiebers (German for The Etiology, Concept and Prophylaxis of Childbed Fever)

Answer 241

Semmelweis on the death of professor Kollestschka

Answer 242

- Hand washing with a chlorinated solution because it was the solution that was most effective for removing putrid smell of autopsy tissue. Mortality rate in the first clinic dropped 90% from this - Doctors were offended by the idea that they could be transmitting disease on their hands

Answer 243

- He was an outsider he did not speak German - Had a bad habit of calling doctors murders - People he worked under did not want to hear his ideas- he was there to work for them not to come up with new ideas - He could not scientifically prove with data that lack of handwashing was causing this because germ theory of disease was not around yet (happened right after he died)

Answer 244

- Was admitted against his will to an asylum and the next day when his wife went to see him they wouldn’t let her then he died 2 weeks later - Died from wound on his hand that was a result of being restrained by gaurds and then died from sepsis

Answer 245

A metaphor for a certain type of human behavior characterized by reflex-like rejection of new knowledge because it contradicts entrenches norms, beliefs of paradigms- is names after Semmelweis, whose perfectly reasonable hand-washing suggestions were ridiculed and rejected by his contemporaries

Answer 246

source that Semmelweis thought that puerperal fever originates from. Doctors would go to the morgue and work with the cadavers and then go take care of their patients and it was often described that their hands had a very foul smell

Answer 247

Virchow - From Pomerania in Germany (1821-1902) - Father was a farmer - Got his education by going through the military - Learned how to use a microscope and for the rest of his life, his contributions are related to his work with the microscope. - The Pope of German Medicine - “Cellular Pathology”, p 324 - Cell Theory of Disease - After Virchow it is not pathological ANATOMY but pathological PHYSIOLOGY that is causing disease - How does normal function become ABNORMAL? The Cell Theory answers this question - Small intense man, dynamo of energy - Spoke German, French, Dutch, Italian, Hebrew, Greek, Arabic, Latin, could read Hippocrates directly - Taught, practiced, published, including a 6 volume handbook of what he called Social Pathology and Therapeutics - Famous for being one of the greatest teachers in medical history.

Answer 248

Cellular Pathology, 1858

Answer 249

- Leukemia - Thrombosis/Embolus - Cell Theory of Disease

Answer 250

The move from Anatomy -->Physiology as the etiology of disease

Answer 251

- He had a large oval table, that he could control from a button. He had 10-12 microscopes on which he would set up preparations, instruct the students and when each had seen what he needed to see and the ‘railroad’ would advance. - All students were of course men at this time.

Answer 252

virchows law, means: All cells come from cells. Every cell is born of a previous cell which was born of a previous cell…

Answer 253

- 1847 he established a journal that STILL EXISTS: Virchow’s Archive; The Archive of Pathological Anatomy and Physiology and Clinical Medicine - The title has the triad of what he believes are the cornerstones of medicine: Pathological Anatomy, Physiology, Clinical Medicine

Answer 254

Anthropology - Middle of his life he became devoted to anthropology & took part in a famous dig where Troy was discovered, - Went to Egypt…Roentgen discovered x-rays but Virchow was the person who thought of the idea of examining mummies by using radiation. - Published 1,180 papers in anthropology Public health - Political involvement - Sent by the government to help out with an epidemic of typhoid fever realized that these people were sick because of their grinding poverty - Became devoted to what could only be called public health, and also devoted himself to sanitation of the city. - Served Berlin City Council for over 40 years and even founded a new political party. - He did a study of 6 million school children: head measurement, skin, height, - Published that the typical German youth is not blonde and does not have blue eyes - Not more than 40% fit the stereotype. - Pointed out that 11% of Jewish schoolchildren have blonde hair and blue eyes. - So his work did NOT support what the Nazi’s wanted to hear. Hitler and the Nazi’s trashed him later….

Answer 255

On Jan 4, 1902, on his way to a meeting, rushing, leapt out of street car, broke his femur, and was never the same died september of 1902

Answer 256

how does cell function become abnormal

Answer 257

2nd Century - Overlapped with Galen - Born in Ephesus, practiced in Alexandria and Rome - Famous for writings on obstetrics and gynecology - First to succeed with podalic version (internal version for breech presentation by using the leg/foot) - His work on obstetrics/gynecology made possible by Herophilus and his followers at the Library of Alexandria - Introduced Roman birthing chair

Answer 258

His work on gynecology is divided into 4 books 1. Midwives, menstruation, virginity, conception, abortives and contraceptives 2. Parturition and the care of the newborn; 3. Various gynecological afflictions, their pathology and treatment 4. Materia Medica and an index of subjects

Answer 259

soranus of ephesus

Answer 260

soranus of ephesus

Answer 261

soranus of ephesus

Answer 262

Salerno was world’s first “medical school” Founded in the 9th century Considered “the most important center for the introduction of Arabic medicine into Western Europe” Salerno was wealthy - Progressive, intellectual openness - During most of the history of the school it was the “only medical school in Europe that opened its doors to women” - Women physicians there taught and published medical works - They did not focus only on female diseases, taught and practiced all branches of medicine

Answer 263

- Little known about her life - First half of 12th century - Salerno - Contributed to Trotula (title of a collection of 3 texts) - Most associated with authorship of Practica Secundum Trotam (Practical Medicine According to Trota), discovered in 1985 in Madrid

Answer 264

Trotula texts 1. Book on the Conditions of Women 2. On Treatments for Women 3. On Women’s Cosmetics

Answer 265

in the Middle Ages, the title was confused with the person of Trota and so “Trotula” was thought to be a real person.

Answer 266

Florence Nightingale (1820-1910) Born in Florence, Italy *Affluent British family (Mother – merchant family, Father – wealthy landowner) - Socially awkward - Received a classical education - German, French, and Italian, Greek, and Latin - A philanthropist from a young age - Decided nursing was her calling—she did not think of herself as religious but when she was 17, felt that God spoke to her, calling her to future “service” * Parents were not pleased * Defied their expectations * Refused a marriage proposal at the age of 17 1851: Travels to Germany for nursing training * 1853 - Became superintendent for a hospital for gentlewomen Returned to England in 1856 Established the Nightingale Training School for Nurses at St. Thomas’ Hospital in London * Commissioned young nurses * Established nursing training on the Nightingale Model Published “Notes on Nursing” in 1859 * Covers sanitation, military nursing, and hospital planning

Answer 267

in the first half of the 19th century, nurses were usually former servants or widows who found no other job not respected socially

Answer 268

Sarah Gamp: Charles Dickens caricatured nurses in a novel, Martin Chuzzlewit. Sarah Gamp is described as being incompetent, negligent, alcoholic and corrupt. She is said to be “more interested in drinking gin than looking after her patients”.

Answer 269

The Crimean War begins (1853- 1856) *Crimea is a Peninsula in Ukraine on the Black Sea

Answer 270

She agreed to lead a team of 38 nurses in Turkish military hospitals Stationed at Scutari in 1854 in Turkey She found the soldiers were getting terrible care. During her first winter: 4,077 soldiers died 10x more died from typhoid and cholera than from battle wounds. Describes “disastrously unsanitary conditions” Develops her “environmental theory”

Answer 271

All were swarming with vermin, huge lice crawling all about their persons and clothes. Many were grimed with mud, dirt, blood and gunpowder stains. Several were completely prostrated by fever and dysentery. The sight was a pitiable one and such as I had never before witnessed... 'There has been somehow unaccountable neglect in the arrangements for this hospital. Until some hours after the arrival of the men there were neither stores, attendants nor the necessary refreshments on the spot. During this afternoon I attended single handed to the wounds and wants of 74 helpless men.’ - Assistant Surgeon Henry Bellew describing Scutari hospital, January 185

Answer 272

“the act of utilizing the patient’s environment to assist him in his recovery”

Answer 273

Florence Nightingale She is a "ministering angel" without any exaggeration in these hospitals, and as her slender form glides quietly along each corridor, every poor fellow's face softens with gratitude at the sight of her. When all the medical officers have retired for the night and silence and darkness have settled down upon those miles of prostrate sick, she may be observed alone, with a little lamp in her hand, making her solitary rounds.

Answer 274

Florence Nightingale 1859

Answer 275

Notes on Nursing - Florence Nightingale 1859

Answer 276

nightingale pledge on nursing like the hippocratic oath for nursing

Answer 277

notes on nursing 1859

Answer 278

Dr. James Barry 1789-1865 - Born in Cork, Ireland - Graduate of Edinburgh - Military Officer and Surgeon - Said to have performed first C-Section in British Empire - Travelled with the British army— England, Canada and South Africa Born Margaret Anne Bulkley - Went with her aunt to Edinburgh to study medicine as James Barry. - Short stature, unbroken voice, delicate features and smooth skin.. - Lived as a James Barry for 56 years

Answer 279

florence nightingale said this about meeting Dr. James Barry

Answer 280

Elizabeth Blackwell (1821-1910) * Born in Bristol, England * 3rd of Nine Children * Father: Samuel Blackwell * Sugar Refinery Owner, Abolitionist * Mother: Hannah Lane Blackwell * Lived with 15 people * Parents + 4 Maiden Aunt + 9 Children In 1830, riots broke out in Bristol * Samuel decided to move family to America * August 1832 the Blackwell family boarded the Cosmo destine for New York * Samuel Blackwell became active in reform circles * In 1836, the family sugar refinery was burned down * Family forced to move to Cincinnati, Ohio * Three weeks after move to Cincinnati, Samuel suddenly died of biliary fever

Answer 281

Samuel Blackwell (father) valued education highly * Believed that each child should be given the opportunity for unlimited development of talents and gifts * Elizabeth had a governess and private tutor * Primarily spent time surrounded by family

Answer 282

Idea to pursue career in medicine arose when Elizabeth’s female friend was dying a painful death. She found females to be more nurturing physicians At first Elizabeth was initially repulsed from idea of attending medical school “I hated everything connected with the body, and could not bear the sight of a medical book.” * Worked several years to earn funds to attend medical school * Admitted to Geneva Medical College in October 1847 at the age of 26 * Rejected from 16 medical schools * Dean and Faculty could not come to decision about Elizabeth’s admission * Decided they needed unanimous vote of 150 male students to grant entrance

Answer 283

Impacted nature of class * Wild young men into gentlemen * Facilitated better learning * Anomaly on campus * Encouraged by colleagues and professors * Isolated herself * Avoided suitors * Worked at Blockley Almshouse in Philadelphia during summers * Clinical experience * Syphilitic Wards and typhus * Graduated first in class on January 23, 1849 first women to graduate an american medical school

Answer 284

Rejected by most hospitals in Europe * Enrolled at La Maternite in Paris as midwife student. * Lost sight in left eye from infection from treating a patient, could not be a surgeon. * Moved to St. Bartholomew’s Hospital in London (1850) where she met a great deal of opposition * Moved back to America in 1851

Answer 285

The Laws of Life with Special Reference to the Physical Education of Girls in 1852

Answer 286

Opened practice in New York City - Did not have many patients partially because of association of “female physicians” with abortionists

Answer 287

In 1853, opened clinic called New York Dispensary for Poor Women and Children - In 1857, Dr. Maria Zakrzewska & Dr. Emily Blackwell, opened the New York Infirmary for Indigent Women and Children - Civil War: Trained nurses for Union Hospitals

Answer 288

Helped open London School of Medicine for Women in 1874

Answer 289

- Never married - She adopted a Irish Orphan from the New York Infirmary - Kitty Barry, half-daughter, half-servant * Lived with Elizabeth till her death - Published autobiography Pioneer Work in Opening the Medical Profession to Women in 1895 - In 1907, fell down flight of stairs - Died May 31 1910 after a stroke at the age of 89

Answer 290

elizabeth blackwell 1895

Answer 291

- First Woman Physician - Social Reformer - Public Health Advocate

Answer 292

Marion Sims (1813-1883) - American surgeon - One of the most famous physicians in the country. - First American physician to become famous in Europe - President of AMA in 1876 - Developed repair of vesicovaginal fistual - incredibly controversial

Answer 293

marion sims

Answer 294

3 of the slaves marion sims did his surgical experiments on

Answer 295

"Mothers of Gynecology" monument of the three known slaves who marion sims did his experiments on

Answer 296

Helen Brooke Taussig (1898-1986) - American cardiologist - Worked in Baltimore and Boston - Founded pediatric cardiology - Blalock Thomas Taussig shunt - Worked at Johns Hopkins - Worked at banning thalidomide - Mother died of TB when she was a child - Struggled with dyslexia as a student - Studied at both Harvard and Boston University though neither allowed her to earn a degree - Accepted to Johns Hopkins - Completed MD in 1927 Worked at Harriet Lane Home 1930 until 1963 - 1946 first “blue baby operation” in humans - 1947 Magnum opus: Congenital Malformations of the Heart - 1959 promoted to full professor - 1963 retirement (formally) - 1965 first woman president of the American Heart Association

Answer 297

Thomas- Blalock-Taussig Shunt - She came up with the idea (even though she wasn’t a surgeon), Thomas perfected it on lab animals (couldn’t get his MD because he was black) - Thomas actually performed the surgery

Answer 298

vesicovaginal fistula

Answer 299

Died a few days short of 88th birthday in a motor vehicle accident, taking other voters to the polls

Answer 300

Couldn’t hear and had dyslexia but was able to practice medicine through feeling for heart murmurs and such

Answer 301

1895: Wurzburg, Germany First X-ray on hand wife of that guy

Answer 302

Marie Curie (1867-1934) - Polish - Spent most of her life in France - Discovered radium and polonium - won 2 nobel prizes

Answer 303

radium and polonium

Answer 304

- The Nobel Prize in Physics 1903 was divided, one half awarded to Antoine Henri Becquerel "in recognition of the extraordinary services he has rendered by his discovery of spontaneous radioactivity", the other half jointly to Pierre Curie and Marie Curie, née Sklodowska "in recognition of the extraordinary services they have rendered by their joint researches on the radiation phenomena discovered by Professor Henri Becquerel - The Nobel Prize in Chemistry 1911 was awarded to Marie Curie, née Sklodowska "in recognition of her services to the advancement of chemistry by the discovery of the elements radium and polonium, by the isolation of radium and the study of the nature and compounds of this remarkable element"

Answer 305

Marie curie on continuing her work after her husbands death

Answer 306

Albert einstein on marie curie

Answer 307

Marie Curie

Answer 308

Marie Curie

Answer 309

Had lectured on x-rays, but never used them. Learned how to drive, auto maintenance, learned anatomy Director of the Red Cross Radiology Service 20 “Petite Curies” 200 radiology equipped field hospitals

Answer 310

- immune system depression - tooth loss - “honeycombed” bones - cancer - cataracts/vision loss - tumors - death

Answer 311

elizabeth blackwell

Answer 312

elizabeth blackwell

Answer 313

elizabeth blackwell

Answer 314

The obstetrical forceps as invention has been credited to the Chamberlen family: the earliest evidence of what was a family trade secret points to his having it in 1630. He continued the family tradition of trying to bring the profession of midwifery under their control.

Answer 315

licked paintbrushes and painted with radium

Answer 316

- Leprosy is a chronic, curable infectious disease caused by a type of rod-shaped bacterium called Mycobacterium leprae - Thought to be disease of the skin, but targets the nervous system - Causes physical deformities and nerve damage - Damages nerve endings that carry pain signals - Contracted via small respiratory droplets - Requires close contact for extended period Different forms: - Tuberculoid; mild, less severe, & less contagious - Lepromatous; more severe & more contagious - Borderline; symptoms of both tuberculoid and lepromatous forms

Answer 317

Vesalius did dissections to understand anatomy, Morgagni did dissections to understand disease and pathology of disease!!

Answer 318

Morgagnis quotes will describe a disease/cause of death and patients symptoms prior to death and then what autopsy after death revealed. Maybe (depending on circumstances) any treatments that they may tried

Answer 319

- The gross clinic: Thomas Eakins (artist), 1875 - It depicts the Philadelphia physician Samuel D. Gross and the members of his “clinic” performing bone surgery on a young man, while a figure often thought to be the patient's mother cringes nearby. Known in his day as “the emperor of American surgery,” the 70-year- old Gross is depicted turning from the patient to address his students in the surgical amphitheater at Jefferson Medical College. Eakins' viewpoint thrusts the viewer into the role of one of Gross' students, observing the operation. - Dark photo color wise

Answer 320

The Agnew clinic: Thomas Eakins, 1889 - In the painting, Agnew, the first John Rhea Barton Professor of Surgery, stands off center, holding a bloodless (as he insisted to Eakins) scalpel in his left hand (he was ambidextrous), and pauses for a moment from his surgery to teach. The viewer's eye is drawn successively to Agnew, the surgical team, and finally the spectators. Unlike The Gross Clinic, this operating area is artificially lit. Asepsis is more in evidence, and even though there are no gloves or masks, the patient is draped, instruments and towels are sterilized,7 Agnew and his staff are dressed in white gowns, and a nurse is in attendance. Instead of chloroform gauze, an ether cone is used with a Squibb ether container. - Physicians in light outfits, lighter photo color theorywise - White coats served as a sartorial marker of the adoption of Lister’s antiseptic practice—they allowed for a more immediate realization of stains or errant bodily fluids, therefore encouraging more frequent washing. The switch from the dark outfits of Gross’s theatre to this pristine white happened gradually from 1860 to 1910.[6] - Fitzharris describes The Agnew Clinic as “the embodiment of antisepsis and hygiene” and as “Listerism, triumphant.”[7] After one looks at The Gross Clinic, where the ungloved and bloodied hand is the narrative and compositional center of the work, the cleanliness of the surgeon’s hand in The Agnew Clinic is striking. The air, the clothing, and the hands in Agnew’s clinic are all markedly lighter, whiter, and cleaner than the clinic portrayed fourteen years previously—before the advent of Lister’s system.

Answer 321

Old Testament? tsara’ath (Hebrew) New Testament? lepros, lepra (Greek)

Answer 322

The Chinese are credited with America's "introduction"

Answer 323

- elephanitia; natural melancholy - leonina; bile - allopicia; blood - tiria; phlegm

Answer 324

- In 1821, Norwegian physician, Gerhard Armauer Hansen, discovered the causative agent of leprosy - Observed multiple rod-shaped bacilli under the microscope when examining a patient’s nasal biopsy - Hansen’s disease as new term for disease

Answer 325

- Purification of blood was the therapeutic target - Cleansing via gold solution - Blood letting - Bathing in blood of infant or virgin

Answer 326

Nelson Mandela

Answer 327

Louisiana Leper Home 1894 – 1921

Answer 328

Dante, 13th century “one who hath the shivering quarten”

Answer 329

August 20, 1897

Answer 330

Charles Laverlan

Answer 331

cinchonism

Answer 332

Hindu texts, Vedic literature

Answer 333

First wave: April -june 1918 Second wave: July 1918 Third wave: feb 1919-1920

Answer 334

Spain was the only country reporting on it due to media regulations so people though it originated from spain

Answer 335

cold symptoms are milder

Answer 336

Camp Fuston in Ks

Answer 337

Edvard munch

Answer 338

25 million

Answer 339

While an epidemic is large, it is also generally contained or expected in its spread, while a pandemic is international and out of control.

Answer 340

- Early stages, patients can present with fatigue, lethargy, bone pain, anemia, or unexplained mucocutaneous bleeding - After several months of vitamin C deficiency, a range of symptoms and signs can occur, including anemia, myalgia, bone pain, easy bruising, swelling, petechiae, gum disease, poor wound healing, and depression - Late stages of scurvy are life threatening due to failure of collagen molecules across the body, leading to hemolysis. Cause of death is typically from bleeding or infection

Answer 341

Ebers papyrus

Answer 342

Age of sail 1500-1800

Answer 343

da Gama’s voyage

Answer 344

James Lind

Answer 345

Royal Navy ship Salisbury in 1747

Answer 346

Gilbert Blane

Answer 347

Edward jenner

Answer 348

Al-Razi/ Rhazes

Answer 349

Variolation: only in reference to smallpox same as inoculation Inoculation: live virus Vaccine: attenuated viruses

Answer 350

Speckled monster

Answer 351

Monkey pox

Answer 352

C. Sore throat

Answer 353

A. Wasting Disease

Answer 354

B. Both A and C

Answer 355

D. Weight loss

Answer 356

“Yellow fever is a communicable disease, traceable to populous centres of the littoral of the tropical Atlantic, and transmitted from man to man by the bite of the Stegomyia (Aedes aegypti) mosquito.”

Answer 357

1. facial appearance (eyes and jaundice) 2. albumin 3. pulse and temp (temp rises as pulse drops)

Answer 358

Mosquito-proof ward, screen windows and doors, fumigate rooms, oil + water

Answer 359

false, cant be treated with quinine

Answer 360

Sub-Saharan Africa and South America

Answer 361

Aedes aegypti mosquito

Answer 362

TB: - caused by Mycobacterium tuberculosis - wasting disease Yellow Fever: - arbovirus Smallpox: - variola virus - speckled monster Syphilis: - caused by bacterium Treponema pallidum Scurvy: - not having enough vitamin C Spanish Flu: - H1N1 virus Cholera: - Vibrio cholerae bacteria Leprosy: - a type of bacteria, Mycobacterium leprae

Answer 363

William Osler (1849-1919) - 1872 received medical degree from Mcgill Uni - 1874 lecturer, then full professor at McGill - 1884 Moves to PHILADELPHIA where he becomes professor of clinical medicine at the University of Pennsylvania - 1888 Johns Hopkins, famous for his educational reforms - 1892 published "The Principles and Practice of Medicine" - 1904: Regius professorship of medicine at Oxford university - Famous for his command of the humanities and his insistence that his students become familiar with history of medicine - considered one of the most influential figures in medicine in the english speaking world

Answer 364

- osler bedside library for medical students

Answer 365

plutarch's lives religio medici shakespeare montaigne marcus aurelius epictetus don Quixote Emerson Oliver wendell holmes the bible

Answer 366

Osler "The Old Humanities and the New Science" 1920

Answer 367

Osler "The Old Humanities and the New Science" 1920

Answer 368

Osler "The Old Humanities and the New Science"

Answer 369

1889- Aequanimiatas 1901 - Books and Men 1903 - The Master-Word in Medicine 1905 - The Student Life 1913 - A Way of Life

Answer 370

- Clinical Physician - Teacher - Pioneer in the application of laboratory methods to medicine - leader in transforming medical education and organizing medical societies - medical writer - historian - as a human being

Answer 371

- subordinate self interest to the interest of others - adhere to high ethical and moral standards - respond to societal needs- social contract - exemplify core humanistic values: honesty, integerity, caring, compassion, altruism, empathy

Answer 372

"The Old Humanities and The New Science" Osler

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