History of Medicine Test 2
Ichorous pus
"Hospital gangrene" Associated with a terrible odor
Pare's famous quote
"I dress them, but God heals them"
Lister's main publication
"The Antiseptic System: On a New Method of Treating Compound Fracture, Abcess, etc.; with Observations on the Conditions of Suppuration 1867 in The Lancet This was the BC and AD of surgery
Semmelweis's works
"The Etiology of Childbed Fever" - 1858 "The Difference in Opinion Between Myself and the English Physicians Regarding Childbed Fever" - 1860 "The Etiology, Concept, and Prophylaxis of Childbed Fever" - 1861
Who was Louis Pasteur?
- French microbiologist and chemist - Experimented with broth & growth of microbes - Disproved spontaneity; germ theory of disease - Developed 1st vaccine through inoculation of ducks (based on Jenner's vaccination) - 19th century
Semmelweis 5 Observations
1) At the Vienna General Hospital there were two clinics; each delivered approx 3,500 babies each year. Division 1: obstetricians and students (600-800 moms died/year of childbed fever), Division 2: midwives (60 deaths) 2) The epidemic was only in the hospital; women who delivered at home or in the street had low to no mortality rates 3) Mortality was not tied to seasonal variations 4) The greater the injury to the cervix and uterus during delivery, the greater the likelihood that the woman would develop childbed fever 5) Closing down the ward would always stop the infection for a time before it returned.
James Greenlee's significance
11 year old boy run over by a cart in 1865 Compound fracture of the tibia; treated with carbolic acid Leg and life saved Lister started treating other kinds of wounds with carbolic acid after this
What percentage of births are attended to by midwives today?
13%
Ambroise Pare
1510-1590 France Father of Modern Surgery Used ligatures to bind arteries and stop bleeding Did amputations and used prosthetics Treated injury sites with lotion rather than boiling oil Wrote in French vernacular
The Royal College of Physicians formed in what year?
1518
Barber-surgeons were chartered when, granted by which king?
1540, Henry VIII
John Hunter
1728-1793 Father of Scientific Surgery Scottish Worked in the army as a surgeon before switching to dentistry
Hunter's self-experimentation
1766 - broke his Achilles tendon (heel cord in leg); studied the healing process 1767 - inoculated himself with venereal disease to show that gonorrhea and syphilis are two manifestations of the same morbid poison; treated himself with mercury applied to surface of skin (unknowingly, the pus with which he infected himself had both gonorrhea and syphilis)
Who was Horace Wells?
1815-1848 Dentist; discovered that nitrous oxide could be used in dental surgery
Who was Crawford Long?
1815-1878; The only MD in the anesthesia story Long used ether to anesthetize patients before taking cyst off back Friends made him file; mild-mannered man Peacefully died after a delivery
Who was Ignaz Semmelweis?
1818-1865 Born in Hungary Studied at the University of Vienna Pioneer of antiseptic policy Discovered the root cause of childbed fever
Who was Rudolph Virchow?
1821-1902 From Pomerania (Germany) Father was a farmer, got his education through the military Learned how to use a microscope Pope of German Medicine Wrote "Cellular Pathology" and developed the cell theory of disease Discovered that disease is due to pathological physiology, not pathological anatomy
How did Morton die?
1868; Driving through Central Park; threw himself into river and died of stroke later
When was breastfeeding at its lowest?
1970s
Presence of a doula decreases c-section rate by how much?
60-80%
Hunter's works
A Treatise on Venereal Disease - 1786 A Treatise on Blood, Inflammation, and Gunshot Wounds - 1793 (published posthumously)
What is ether?
A volatile liquid
Who is William Morton?
Dentist; experimented with the pain-numbing effects of sulphuric ether
What was Lister's father's contribution?
Developed the microscope lens
John Hunter's early life and education
Did not see the need for formal education (they tried to make an old woman of me) Never let school interfere with his education Obsessed with nature
How did Wells die and using what compound?
Died in prison of suicide using chloroform in 1848; sliced his femoral artery
What was the famous case Lister consulted on?
Edward VII; appendicits; advised on the latest techniques in antisepsis (took an entire generation to accept)
Who was Fanny Burney?
English novelist and diarist; describes a mastectomy without anesthesia
How was ether used socially?
Ether frolics
What is trephination?
First known surgical technique Involved drilling holes in the skull that were still visible after death
What is Pasteur's famous maxim?
Fortune favors the prepared mind
Hunter's teaching and speaking
He was not a gifted speaker Would often contradict himself in teaching because he had discovered something that reshaped his ideas Took laudanum before each lecture Was a gifted teacher in small settings; students would pay to train with him for 5 years
Who were all the men involved in the anesthesia story?
Horace Wells (1815-1848) William Morton (1819-1868) Charles Jackson (1805-1880) Crawford Long (1815-1878)
Difference between perception of midwifery in US and Europe
In Europe, they were assoc with witches In US - they were required to be licensed
Why did surgery not take off after the discovery of anesthesia?
Infection rate still high
What were the results of Wells' attempt to demonstrate nitrous oxide as an anesthetic?
January 1845, Mass Gen Hospital Surgeon: John Collins Warren Student volunteer yelled out in pain, laughed out of the room (Humbug)
Who discovered nitrous oxide?
Joseph Priestly; 1772 English minister and chemist
Who were Semmelweis major influences?
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
How does William Morton fit in the anesthesia story?
Knew that Wells had failed in his demonstration of nitrous Demonstrated ether in 1846 using a specific patient with a lymphatic tumor and John Collins Warren Worked "Gentlemen, this is no humbug!" Filed a patent; censured by the American Medical Association
What death led to Semmelweis's life's work?
Kolletschka in 1847 Finger was pricked by the same unclean knife used in autopsy Saw that this death was similar to the women who died of puerperal fever
How was nitrous oxide used socially?
Laughing gas parties
Who was Grantly Dick-Reed?
Leading advocate of natural childbirth British obstetrician Wrote "Fearless Birth" in 1939
What is Virchow's famous maxim?
Learn to see microscopically
What were Virchow's three main discoveries?
Leukemia Thrombosis/embolus Cell Theory of Disease
Know about Lister's background
Lived: 1827-1912 English, but spent most of his career in Scotland Could read in French and German, came from a Quaker home, attended University College in London Expert with a microscope Became a member of the Royal College of Surgeons Married daughter of Symes (a professor)
Hunter's Earl's Court
Menagerie of rare animals collected by Hunter so that he could explore their anatomy Studied comparative anatomy
Did the discovery of anesthesia itself radically effect surgical practice?
No
Patent for LETHEON
November 12th, 1846 Issued to Charles Jackson and William Morton
Where and when was ether used successfully?
October 16th, 1846 Removal of lymphatic tumor Mass Gen Hospital (ether dome)
What date marks the end of anesthesia's long pre-history?
October 1846
How did Congress become involved in the anesthesia dispute?
Offered $100,000 to the person who could successfully make a claim to the origin of ether
Who gave the name "anesthesia" to the process of surgical sleep?
Oliver Wendell Holmes
What was used to numb pain before anesthesia?
Opiates, alcohol
How did Pasteur's life intersect with Lister?
Pasteur's father made lenses for microscopes That made Lister's discoveries possible Then, Lister's discoveries made Pasteur's possible
What did Virchow believe were the cornerstones of medicine?
Pathological anatomy, physiology, clinical medicine
What was Pare the first to describe?
Phantom pain Correctly identified that the sensation of phantom pain arises from the brain
What is carbolic acid now called?
Phenol
Who was Charles Jackson and what were his claims?
Professor of chemistry who claimed to have given the idea for ether to Morton After heated arguments, they filed for the patent together (LETHEON)
Story of the Irish Giant
Real name - Charles Byrne; 8ft 2in Exploited for his height as a spectacle during his life Died of TB Did not want to be autopsied, used for science after death Hunter bribed the mortician for Byrne's body
How did Lister acquire skills with the microscope?
Repeated Pasteur's experiments to gain competence with the microscope
What did Galen think about pus?
The formation of pus was essential to wound healing (laudable pus)
Significance of black women's bodies
They have contributed most to our modern gynecological/obstetrical knowledge
How did Hunter contribute to the evolution of surgery?
Understanding of human teeth, bone growth and remodeling, inflammation, gunshot wound care, venereal diseases, digestion, maternal fetal blood supply, role of lymphatic system Showed that surgery was worthy of the best minds
How was chloroform being used at this time?
Used in the UK; administered in childbirth to Queen Victoria (social acceptance) on April 7th, 1853
Where is Hunter buried?
Westminster Abbey
Laudable pus
What was "hoped for" after surgery Staphylococcus
What is a doula?
Woman who offers emotional and practical support to a mother or a couple before, during, and after childbirth
What is nitrous oxide?
a gas
Omnis cellula e cellula
every cell originates from another cell; Virchow
What is the germ theory of disease?
microorganisms cause disease
Virchow's law
omnis cellula a cellula; each cell derives from a pre-existing cell this was against the spontaneous generation theory
Pasteurization
process by which beer, milk and milk products are heated to 120-140 to destroy harmful bacteria; discovered by Pasteur using wine
suppuration
the formation or discharge of pus
Cosmas and Damian
two Arab physicians in the town Cyrhus, and were reputedly twin brothers, and early Christian martyrs
Hunter's connection to dentistry
After the army, Hunter started out in dentistry Started with studying teeth, and then did implants Wrote the first textbook on dentistry Helped to develop the nomenclature of teeth
How did Hunter die?
Age 66; in a board meeting at the hospital; got into an argument and had a heart attack
Lister's honeymoon and wife
Agnes Symes (daughter of a professor) Honeymoon was to major medical institutes in France and Germany Agnes loved medicine and research, was Lister's lab partner
John Hunter was the first to demonstrate the existence of what?
Collateral circulation -- collateral vessels (can be used to save an organ or limb from gangrene when a large artery has become plugged by arteriosclerosis)
How did Jackson die?
Comes across grave of William Morton - inscribed with "He who discovered anesthesia and gave the world this great gift" Becomes psychotic, admitted to Belmont, dies 7 years later
What experiment did Pasteur use to disprove spontaneous generation?
Broth; showed that dust had to settle in the broth before microorganisms formed
What is the relationship of feminism and the civil rights movement to childbirth and contraception?
All part of the overall counter-culture movement Took place in the 1960s
What other fields did Virchow contribute to?
Anthropology, public health, and politics
What happened to midwives as there were more restrictions on immigration?
Anti-midwives campaign Began to become less common Targeted attacks on their abilities
When did gunpowder appear and how did it figure into the evolution of surgery?
Appeared in the 15th century Created different kinds of wounds, need for amputations
John Hunter was the first to successfully complete what?
Artificial insemination
What did Hippocrates think about pus?
Asserted that the formation of pus was not a natural component in the healing process Suppuration should be avoided
How did most 16th century doctors treat gunpowder wounds?
Believed that gunpowder infected the injury site; cleaned it with boiling oil This was extremely painful and destroyed the tissue
What did Hunter think about inflammation?
Beneficial to the body but can sometimes be part of the problem
What did Semmelweis think was the mode of transmission for childbed fever?
Cadaverous particles
What chemical did Lister suggest to prevent infection?
Carbolic acid Referred to the process as "antisepsis" Took an entire generation to accept this process
What was Virchow's most important book and the year it was published?
Cellular Pathology, 1858
What is the Edwin Smith papyrus known for?
Surgical papyrus
How did Virchow teach his students?
Table that rotated with several microscopes
What journal did Virchow establish?
The Archive of Pathological Anatomy and Physiology and Clinical Medicine
Lister's nickname
The Father of Modern Surgery
What is Lister's nickname?
The Father of Modern Surgery
Ambroise Pare's nicknames
The Gentle Surgeon The Father of Military Medicine
Pare's works
The Method of Treating Wounds Made by Arquebuses and Other Firearms, Darts, and Such; Also on Combustion Made Especially by Cannon Powder (1545) A Brief Collection on the Conduct of Anatomy (1550) Ten Books of Surgery with the Magazine of the Instruments Necessary for It (1564) The Complete Works of Ambrose Pare, Councilor and Premier Surgeon of the King - also known as "The Works" or Les Oeuvres (1575)
What was Virchow's nickname?
The Pope of German Medicine
What device did Lister use?
The carbolic acid sprayer
