HISTORY OF MEDICINE

A Brief History of the Johns Hopkins Medical Curriculum

2010-01-28T02:53:00.000-08:00

A Brief History of the Johns Hopkins Medical Curriculum
The opening of the Medical school in 1893, four years after the Johns Hopkins Hospital received its first patients, was delayed because the university lacked the funds to establish the kind of medical school that had been envisioned.

Only with the action of powerful committee of women who raised the required $500,000 could the medical school finally begin to admit its first class of students.

The women who founded the Johns Hopkins University School of Medicine incorporated into its curriculum various elements of the European methods of education that they had witnessed during their own training.

The teaching of the basic sciences in Baltimore was heavily influenced by the German model. The clinical sciences were taught in a way that blended British and Continental models.

The history of the curriculum of the Johns Hopkins University School of Medicine is both unique and typical for American medical schools of the last hundred years.

It is unique because at the school’s inception in 1893, a remarkable talented young and innovative faculty began with a blank slate.

While the new venture in medical education in Baltimore, where six other medical schools were already teaching medical students, had no traditions to overcome, a second unique aspect of its history is that in the subsequent century the successor of the original faculty had always to measure themselves against the high standard and unique accomplishment founders.

At Johns Hopkins, as in all other medical schools, a dean or the faculty was periodically moved to assess the state of the curriculum by means of committees, reports and faculty discussions.

Typically, changes were minor in nature, and even reform measures that had wide faculty and administration approval were implemented only slowly.
A Brief History of the Johns Hopkins Medical Curriculum

Renaissance and Industrial Revolution

2010-01-15T17:36:00.001-08:00

Renaissance and Industrial Revolution
The first medical school was started in Salermo, Italy in the thirteenth century. The renaissance led to revolutionary changes in the theory of medicine.

In the fifteenth century, Vesalius repudiated Galen’s incorrect anatomical theories and Paracelsus advocated the use of chemical instead of vegetables medicines.

From the sixteenth century development of the microscope to the seventeenth century theory of the circulation of blood, scientist learned about the actual finding of the human body.

The eighteenth century saw the development of modern medicine with the isolation of foxglove by Withering, the use of inoculation (against small pox) by Jenner and the postulation of the existence of vitamins by Lind.

In Scotland, Brown decided that heath represented the conflict between strong and weak forces in the body.

Cullen preached a strict following of the media orthodox of the time and recommended complex prescription to treat illness.

Hahnemann was disturbed by the used of strong chemicals to cure, and developed the theory of homeopathy.

Based upon the theory that like cures like, he prescribed medications in doses that were so minute that current atomic analysis cannot find even one molecule of the original substance in the solution.
Renaissance and Industrial Revolution

Paleopathology in History of Medicine

2009-12-11T17:27:00.000-08:00

Paleopathology in History of Medicine
The study of history of medicine is greatly helped by paleopathology, which is “the science of the disease which can be demonstrated in human and animal remains of ancient time.”

Paleopathology is concerned with evidence of disease that occurred during the long period that includes prehistory and continues until the beginning of scientific pathological anatomy.

By necessity, therefore, its object of study are almost exclusively biological specimens capable of lasting centuries and even millennia, namely bones and mummies.

The first study of bone paleopathology was published in 1774 by Esper, who described the femur of a cave bear with a lesion that he thought to be an osteosarcoma but which he later found to be fracture callus.

Subsequently, other naturalists (e.g Goldfuss, Cuvier, Walther, Schmerling, Mayer) described pathological lesions in bones of cave bears and lions.

About the middle of the nineteenth century, anthropologists and paleontologists became interested in the subject and the number of publications increased.

In the first decades of this century, Egyptian mummies were extensively studied, especially by Ruffer, whose papers were posthumously collected in a volume that became a classic on the subject.

In 1923, the American anatomist and anthropologist Roy L. Moonie published the first comprehensive book on paleopathology.

In 1930, a French army physician, Leon Pales, published another comprehensive monograph on the subject with the most complete bibliography up to that time.

Since 1930, interest in the field has continued and modern techniques have been applied to paleopathology.
Paleopathology in History of Medicine

Supernatural in Primitive Medicine

2009-10-30T18:55:00.001-07:00

Supernatural in Primitive Medicine
In primitive medicine, the supernatural is involved in all aspect of disease and healing. Because disease and misfortune are attributed to supernatural agents, magic is essential to the prevention, diagnosis and treatment of disease.

All events must have a cause visible or invisible.

Thus the disease for which there are no obvious immediate causes must be due to ghosts, spirits, gods, sorcery, witchcraft or the loss of one of the individual’s special “soul.”

Illness called for consultation with those have the power to control the supernatural agents of disease: the shaman, medicine man, wise man, diviner, witch-smeller, priests, chief, soul-catcher, or sorcerer.

A close examination of the roles and powers assigned to such figures reveals many specific differences, but for our purpose the general term “healer” will generally suffice.

However, we should note that most societies differentiate between healers and herbalists who dispense ordinary remedies and the shamans or priests like healers who can intercede with the spirits that affect, weather, harvest, hunting, warfare, conception, childbirth, disease and misfortune.

Although the shaman performs magical acts, including deliberate deceptions, she or he neither a fake nor a neurotic.

The shaman is as sincere as a modern physician or psychiatrists in the performance of healing rituals.

When sick, the shaman will undergo therapy with another shaman, despite, knowledge of all tricks of the trade.

For shaman, the cause of the disorder is more significant than the symptoms because the cause determines the manner of treatment, be it penicillin or exorcism.

Diagnostic aids may include a spirit medium, crystal gazing and divination.

Having performed the preliminary diagnostic tests, the healer conducts a complex ritual involving magic spells, incantations, the extraction of visible or invisible objects, or the capture and the return of the patient’s lost soul.

To drive out or confuse evil spirits, the shaman may give the patient a special disguise or a new name, offer attractive substitute targets, or prescribe noxious medicines to transform the patient onto an undesirable host.

The shaman may dispense powerful drugs but it is the ritual, with its attempts to compel the cooperation of supernatural powers, which is of prime importance to healer, patient and community.

Outsiders may see the healing ritual in terms of “magical” and “practical” elements, but for healer and patient there is no separation between the magical and empirical aspects of therapy.
Supernatural in Primitive Medicine

Medicine during Ancient Egypt

2009-10-06T10:22:00.000-07:00

Medicine during Ancient Egypt
The influence of Sumerian civilization upon that of Egypt is a subject of interesting and continuing debate, but certainly as long as 4000 BC there was a well organized governmental system in the Nile delta.

With it came the development of the pictorial writing of hieroglyphics and the discovery that writing material could be prepared from the papyrus reed, a more convenient medium than clay bricks.

Around 2900 BC lived the first famous individual whose name has come down to us in medicine.

Imhotep, visier to King Zoser. An administrator political and builder of the great stepped pyramid of Sakkara, still to be seen today, he must also have been distinguished as a physician, although we know nothing on his medical contribution.

He was worshipped for many centuries after his death as god of medicine.

A number of medical papyn have come down to us which are of great interest. The Ebers papyrus was found in a tomb at Thebes in 1862 by Professor George Ebers and is now preserved in the University of Leipzig.

It consists of 110 sheets and contains 900 prescriptions.

As a calendar has been written on the back of the manuscript, the date of its writing can be fixed with reasonable accuracy at about 1500 BC.

However, there is good evidence to show that much of it has been copied from other works many centuries before.

The writings are sprinkled with incantations, which suggest that the remedies were given with the intention of driving out of demons of disease.

Amulets were also advised; these often consisted of images of the gods and were to be hung around the neck or tied to the foot.

A whole variety of drugs are mentioned including castor oil, which was used as purgative.

All sorts of animal substances were used, including the fat of various animals and bile.

Medicine in ancient Egypt would appear to have been of an empirical or magical variety.
Medicine during Ancient Egypt

Pre- and Ancient History of Medicine

2009-09-09T23:44:00.000-07:00

Pre- and Ancient History of Medicine
Prehistoric man looked upon illness as a spiritual event. The ill person was seen as having a spiritual failing or being possessed by demons. Medicine practiced during this period and for centuries onward focused on removing these demons and cleansing the body (and/or spirit) of the ill person.

Trephination (holes made in the skull to vent evil spirits or vapors) and religious rituals were the means to heal.

With advanced in civilization, healers focused on “treatments” that seemed to work. They used herbal (vegetable) medicines and became more skilled as surgeons.

About 4000 years ago the Code of Hammurabi listed penalties for bad outcomes in surgery. The surgeon lost his hand if the patient died.

The prevailing medical theories of this area and the next few millennia involved manipulation of various forms of energy passing through the body.

Health required a balance of these energies. The energy had different names depending on where the theory was developed.

The ancient Chinese system of medicine as based upon the duality o the universe.

Yin and Yang represented the fundamental forces in a dualistic cosmic theory that bound the universe together.

The first systematic study of human anatomy didn’t occur until the mid eighteenth century.

It consisted of the inspection of children who had died of plaque and been torn apart by dogs.

Medicine in ancient India was also very complex. Medical theory included seven substances: blood, flesh, fat, marrow, chyle and semen. From extant records, we know that surgical operations were performed in India as early as 800 BC, including kidney-stone removal and plastic surgery (replacement of amputated noses, the punishment for adultery).

Diet and hygiene were crucial to curing in Indian medicine and clinical diagnosis was highly developed, depending as much on the nature of the life of the patient as on his symptoms.

Other remedies included herbal medications, surgery, and the “five procedures”: emetics, purgatives, water enemas, oil enemas and sneezing powders.

Anatomy was learned from bodies that were soaked in the river for a week and then pulled apart. Indian physician knows a lot about bones, muscles, ligaments and joints but not much about nerves, blood vessels, or internal organs.

Greek began to systematize medicine about the same time as the Nei Ching (oldest medical textbooks in China) appeared in China.

Although Hippocratic medical principles are considered archaic, his principles of the doctor patent relationship are still followed today.

In Rome, Galen created anatomical descriptions of the human body based primarily on the dissection of animals.

The Middle Ages saw the continued practice of Greek and Roman medicine. Most people turned to folk medicine that was usually performed by village elders who healed using their experiences with local herbs.

Arab medicine introduced the use of chemical medications, the study of chemistry and more expensive surgery.
Pre- and Ancient History of Medicine

Paleomedicine

2009-08-22T16:18:00.000-07:00

Paleomedicine
Evidence of disease and injuries among ancient humans and other animals is incomplete for epidemiological purposes, but more than sufficient to establish the general notion of their abundance.

Therefore, we would able to determine when uniquely human responses to the suffering caused by disease and injury began.

In other words, at what stage did human beings begin to practice medicine and surgery?

Clues to the existence of paleomedicine must be evaluated even more cautiously than evidence of disease.

For example, the “negative imprints” that appear to be tracings of mutilated hands found in Paleolithic cave paintings may record deliberate amputations, loss of fingers to frostbite, magical symbols of unknown significance, or even some kind of game.

Early humans may have learned to splint fractured arms or legs to alleviate the pain caused by movement, but there is little evidence that they learned to reduce fractures.

Moreover, well healed fractures can be found wild apes.

Thus, the discovery of healed fractures and splints does not necessarily prove the existence of prehistoric orthopedic surgeons or bone setters.

Perhaps the most striking proof of ancient surgical skill appeared in the form of trepanned skulls discovered at Neolithic sites in Peru, Europe, Russian and India.

Although this operation is sometimes mistakenly referred to as “prehistoric brain surgery,” trepanation consists of the removal of a disk of bone.

Anthropologists have discovered that contemporary tribal healers perform trepanations for both magical and practical reasons.

Prehistoric surgeons may also have had various reasons for carrying out this difficult and dangerous operation.
Paleomedicine

Code of King Hammurabi

2009-08-01T00:59:00.000-07:00

Code of King Hammurabi
Civilization as we recognize it today, with cities, organized agriculture, government and a legal system. Dates back some 6000 years top the valley of the Nile and the adjacent land Mesopotamia between the Tigris and Euphrates.

Above all, man learned to write, and translation (an extremely difficult task) of carvings on stone, statues and tombs and writings on baked clay from Mesopotamia and papyri from ancient Egypt give us a much clearer idea of what medicine and surgery must have been like in those times.

The medicine of Mesopotamia was primarily medico-religious.

Practitioners were priests and were rule by the strict laws included in the code of King Hammurabi.

This code carved on a black stone about eight feet high which was discovered at Shush on what is now Iran in 1901, can be seen today in the Louvre Museum in Paris.

At its top can be seen the Emperor Hammurabi receiving the laws from the sun god Shamash.

His code details family law, the rights of slaves, the penalties or theft and the rewards for success and the severe punishment for failure on the part of the surgeon.

We have evidence from these writings that surgical conditions such as wounds, fractures and abscesses were treated.

“If a doctor heals a free man’s broken limb and has healed a sprained tendon, the patient is to pay the doctor five shekels of silver. If it is the son of a nobleman, he will give him three shekels of silver.

If the physician has heal a man’s eye of a severe wound by employing a bronze instrument and so healed the man’s eye, he is to be paid ten shekel’s lf silver.

If a doctor has treated a man or a severe wound with a bronze instrument and the man dies an if he has opened the spot in the man’s eye with the instrument of bronze but destroys the man’s eye, his hand are to be cut off.”

It was obviously a dangerous profession on those days.

If it were not for Hammurabi’s code of laws all, memory of surgery in Babylon, nearly 4000 years ago would have been lost. Surgery as a craft was hardly worth mentioning: only when it became of interest to the law was it engraved in stone.
Code of King Hammurabi

Frederick Banting

2009-06-29T18:18:00.000-07:00

Frederick Banting
Frederick Banting received the Nobel Price for Medicine in 1923 for his discovery of insulin as a treatment for diabetes. He was only thirty two year old.

The Nobel Price had only been introduced and awarded since 1901, and Banting was the first Canadian to receive one. As a result of his Nobel Price, he went from obscurity to world fame, from small town doctor to world renowned scientist and he became a national hero overnight.

The discovery of insulin was not vague esoteric or of questionable value to society. Its impact was clear, practical and immediate. There were literally millions of people all over the world who suffered from diabetes and who could previously only look forward to a life with a progressive, debilitating illness that usually led to an early death.

Frederick Banting was born in November 19, 1891 on a farm near Alliston, Ontario. He attended school in Alliston, where he had an average but undistinguished academic career but he excel at athleticism was good at art and was a hard working determined student.

After graduating from high school, Banting entered Divinity College to satisfy his parent’s wishes. He soon realized the medicine was his real interest and he transferred into the medical program.

When he graduated as a doctor in 1916, World War I was at its peak, and he felt compelled to do his part for his country. He enlisted on the Royal Canadian Army medial corps and was sent to Europe to work as a military surgeon in a rear field hospital.

After the war he served for a year as resident surgeon at Toronto’s Hospital for Sick Children. But for a young doctor just out of the army, earning a decent living was practical necessity. So Banting opened a small practice in London, Ontario.

He also lectured at the Medical school of the University of Western Ontario, and conducted research in neurophysiology under Dr. F.R Miller.

One day while Banting was preparing a lecture in the pancreas he read a paper by Moses Barron in a medical journal. The article described changes that occurred in the pancreatic juice when the pancreatic duct was blocked by gallstone.

Banting was intrigued by the possibility that something that occurred in this process might hold the secret to diabetes – a disease that had distressed Banting since school days, when young classmate slowly wasted away from the disease before his eyes and finally died in her teens.

He had the idea but neither a lab nor funds for the necessary research. Banting arranged meeting with Dr. John MacLeod of the University of Toronto to use facilities in the university.

The first human patient treated with insulin was a fourteen year old boy with severe juvenile diabetes. His discovery was remarkable and immediate. Other patients followed with the same impressive results.
Frederick Banting

Paleopathology

2009-06-26T19:43:00.000-07:00

Paleopathology
One of our most appealing and persistent myths is that of the Golden Age, a time before the discovery of good and evil, when death and disease were unknown.

But scientific evidence – meager fragmentary and tantalizing though it often is – proves that disease is older than the human race.

Thus, understanding the pattern of disease and injury that afflicted our earliest ancestors requires the perspective of the paleopathologist.

Si Marc Armand Ruffer (1859-1917), one of the founders of paleopathology, defined it as the science o the disease that can be demonstrated in human and animal remains of ancient times.

Evidence form the study of fossils, stratigraphy, and molecular biology suggest that separation of the human line from that of the apes place in Africa some 5 million years ago.

It took several million years before large-brained, tool making modern human beings evolved.

Homo sapiens sapiens, the oldest human beings of morphologically modern character, appeared approximately 50,000 years ago.

The Paleolithic Era, or Old Stone Age, when the most important steps in cultural evolution occurred, coincides with geological epoch known as the Pleistocene, or Great Ice Age, which ended about 10,000 years ago with the last retreat of the glaciers.

Early humans were hunter gatherers, that are opportunistic omnivores, who learned to make tools, build shelters carry and share food and create uniquely human social structures.

Although Paleolithic technology is characterized by the manufacture of crude tools made of bone and chipped stones and the absence of pottery and metal objects, the people of this era produced the dramatic cave painting at Lascaux, France and Altamira, Spain.

Presumably, they also produced useful inventions that were fully biodegradable and left no traces in the fossil record.

Indeed, during the 19603 feminist challenged prevailing about the importance of hunting as a source of food among gatherers; the vegetables an small animals gathered by women probably constituted the more reliable component of the Paleolithic diet.

Moreover because women were often burdened by carrying infants, they probably invented disposable digging sticks and biodegradable bags or basket in which to carry and store food.
Paleopathology

Trephination of the skull

2009-05-19T20:08:00.000-07:00

Trephination of the skull
Undoubtedly the most extraordinary story in the history of surgery is that, long before man could read or write, as long ago as 10,000 BC, surgeons were performing the operation of trephination or trepanning – boring or cutting out rings or squares of bones from skull – and just as remarkably, their patients usually recovered from the procedure.

Although the word ‘trepanation’ and trephination’ today are interchangeable in common practice, trepanation comes form the Greek trypanon, meaning a borer, while trephination is or more recent French origin and indicates an instrument revolving around a central spike.

Trepanation thus connotes scraping or cutting, while trephination describes drilling the skull, as in modern neurosurgical operations.

Different techniques of trepanation in ancient times, and in recent primitive communities, involved scraping away bone, making a circular groove so that a central core of the bone would loosen, boring and cutting away the bone, or making rectangular interesting incisions in the skull.

This story begins in 1865 when a general practitioner Dr Prunires, who was also an amateur archeologist, discovered in a prehistoric stone tomb in Central French a skull which bore a large artificial opening on its posterior aspect.

With it, he found a number of irregular pieces of bone which might have been cut from another skull.

He postulated that the skull had been perforated so that it might be used as a drinking cup.

Soon after this, a number of other holed skulls were found in other parts of France and Professor Paul Broca (1824-1880), a distinguished French physician, suggested that these opening were the result of an operation of trepanation and that the instrument employed was a flint scraper.

Broca suggested that survivors of operation were endowed with mythical powers and that, when they died, portions of their skull, especially those that included a part of the edge of the artificial opening, were in great demand as charms.

Following these discoveries, thousands of such specimens have been discovered from many parts of the world: the United Kingdom, Denmark, Spain, Portugal, Poland, the Danube Basin, North Africa, Palestine, the Caucasus, all down the Western coastline of the Americas and especially in Peru, where more than 10,000 specimens have been excavated.
Trephination of the skull

Primitive Medicine

2009-04-29T23:00:00.001-07:00

Primitive Medicine
The fundamental tenet of primitive or supernaturalistic medicine is the belief that diseases and their cure depend on religion and/or magical agents.

This, although characteristics of primitive cultures, is not limited to them and a rule, coexists in advance societies with the naturalistic approach, both scientific and non-scientific.

Therefore when prefer to primitive or supernaturalistic medicine in modern times, it refers not only to the medicine practiced in some contemporary developing societies but also to medical practices and beliefs that exists in the most advanced.

Primitive medicine is timeless, the elements of primitive medicine may be found in all societies, at all times, in the ancient Orient as well a in Greece, in the Middle Ages as well as in the midst of our modern industrial society.

Primitive medicine is a logical structure once its premises are accepted.

When formulated in prehistoric times, those premises were the necessary result of man’s need to explain, coupled with his lack of technical knowledge.

Primitive man had a clear concept of causality: if something took place, there was always a responsible agent.

On the other hand, primitive man, most probably, had no clear idea of chance that is of unwilled events that could occur in a purely random basis.

If primitive man had no concept of chance and randomness, by necessity, for him, every event was willed, every occurrence had a purpose and a meaning.

As a result his ignorance of other possible explanatory factors made a world view based on religion and magic the only one possible.

Supernaturalistic medicine is simply part of such a world view. If disease struck a vigorous warrior, of if his wound did not heal, or if a child withered and died in spite of sufficient food and shelter, an explanation had to be sought.

The options were few: either an enemy, or a god or a spirit had to be responsible.

As a rule, with time, supernaturalistic explanations become unsatisfactorily and naturalistic one are sought.

The latter however, are not necessarily based n a better understanding of phenomenon; for example, to hold that thunder is due to underground winds is not more accurate than to believe that it is due to the barreling chariot of a god.

This applies, of course to medicine as well and for this reason, naturalistic medicine of effectiveness.

Primitive medicine is timeless probably because the naturalistic kind, for so long, was not appreciably more effective.
In spite of a timelessness, however, it is expedient to distinguish the primitive medicine of antiquity from that practice in modern times.
Primitive Medicine

Medicine in Mesopotamia

2009-03-24T01:53:00.000-07:00

Medicine in Mesopotamia
Civilization as we recognize it today with cities, organized agriculture, government and a legal system dates back some 6000 years to the Valley of the Nile and the adjacent land of Mesopotamia between the Tigris and Euphrates.

Great Kings arose, such as Sargon of the city of Akkad (around 2350 BC), who subjugated the whole of Sumeria and Hammurabi (around 1900 BC), who established his capital at Babylon.

In time, Babylon was conquered by Tiglath-Pileser, king of the northern neighbor Assyria, with its capital at Nineveh around 1100 BC.

The medicine of Mesopotamia was primarily medico-religious. Practitioners were priests and were ruled by the strict laws include in the code of King Hammurabi.

This code, carved, on a black stone about eight feet high which was discovered at Shush in what is now Iran in 1901, can be seen today in the Louvre Museum in Paris.

His code details family law, the right of slaves, the penalties for theft and rewards for success and severe punishment for failure on the part of the surgeon.

There are evidence from these writings that surgical conditions such wounds, fractures and abscess were treated. Thus it can be read:

If a doctor heals a free man’s broken limb and has healed a sprained tendon, the patient is to pay the doctor five shekels of silver.

If it is the son of nobleman, he will give him three shekels of silver.

If the physician has healed a man’s eye of a severe wound by employing a bronze instrument and so healed the man’s eye, he is to be paid ten shekels of silver.

If a doctor has treated a man for a severe wound with a bronze instrument and the man dies and if he has opened the spot in the man’s eye with the instrument of bronze but destroys the man’s eye, his hands will be cut off.

If it were not for Hammurabi’s code of law, all memory of surgery in Babylon, nearly 4000 years ago, would have been lost.

Surgery as a craft was hardly worth mentioning only when it became of interest to the law was it engraved in stone.
Medicine in Mesopotamia

Egyptian Doctors in 1300 BC

2009-02-18T02:59:00.000-08:00

Egyptian Doctors in 1300 BC
Egyptian doctors were well aware of their limitations, however and were told not to inflict unnecessary suffering on their patients, so there were many cases where they had to say – at least to themselves –‘An aliment not to be treated’.

They were recommended to take note of the treatments and medicine they used and of their effects, so that they had a record for similar cases in the future.

There were medicine to be taken internally, others to be applied to the outside of the body, and others still to be inhaled. Egyptians ingredients that can be identified today appear to be sound herbal remedies.

However some medicines had ingredients such as mice, beetles and dung which aimed o drive out the demons causing the illness.

The Egyptians had a remarkable knowledge of the way the body worked, and knew about its internal arrangement through mummifying the dead.

To them the heart was the most important organ; they knew that it pumped blood round the body and that the pulse ‘spoke the messages of the heart’. They also knew that injuries to one side of the brain affected the opposite side of the body.

Doctors sometime used surgery as well as medicine to treat patients and opened injured skulls to relieve pressure in the brain.

Before an operation the surgeon gave his patient a drink, presumably a painkiller, ‘to render it agreeable’. In the New Kingdom the painkiller might have been opium, imported from Cyprus.

Because of the importance the Egyptians attached to ritual purity the surgeon and his assistants washed themselves and purified the instruments in fire before the operation. Both of these would cut down the risk of infection.

The Egyptians were a deeply religious people and prayers would always be used as well as medicines, even for the simplest ailments.

In difficult cases, magic might be employed. It was also possible to visit the temple of a deity associated with medicine, such as Imhotep, which had priests trained as doctors.

At some temples the sick could spend a night close to the god’s sanctuary. During such a stay, called ‘incubation’, the patient might be cured by the deity, or dream of the god and receive instructions for treatment.

Even if no help was forthcoming, the sufferer was spirituality comforted.
Egyptian Doctors in 1300 BC

Circumcision

2009-01-30T16:11:00.000-08:00

Circumcision
Circumcision might well be claimed to be the most ancient ‘elective’ operation and was practice in Ancient Egypt by assistants to the priests on the priests and on members of Royal families.

There is remarkable evidence for this carved on the tomb of a high ranking royal official which was discovered in the Sakkara cemetery in Memphis and is dated between 2400 and 3000 BC.

The ancient Jews may have learned the art of circumcision during their bondage in Egypt and, indeed, circumcision is the only surgical procedure mentioned in the Old Testament, the practice of circumcision among Jews being attributed to Abraham.

Early ethnological studies revealed that circumcision was practiced very widely among primitive communities, including those of equatorials Africa, the Bantus, Australian Aborigines and in South America and the South Pacific, as well as being traditional among Jews, Muslims and Copts.

Its origin, perhaps as a fertility or initiation rite or possibly for cleanliness or hygiene. Its traditional basis is confirmed by the fact that in many communities, even though metal instruments were available, the operation was still performed with a flint knife.
Circumcision

Dr Michael DeBakey

2009-01-12T19:53:00.000-08:00

Dr Michael DeBakey
He was heart surgeon, who served as an advisor to US presidents for more than 40 years. He died on July 11, 2008 at the age of 99.

DeBakey was the pioneer of bypass surgery and helped develop more than 70 surgical instruments in a career spanning 75 years. He was known as American heart surgeon, innovator, medical educator, and international medical statesman. DeBakey was the chancellor emeritus of Baylor College of Medicine in Houston, Texas and director of the Methodist DeBakey Heart and Vascular Center. He helped turn Baylor College from a provincial school into one of the nation’s great medical institutions.

DeBakey was born September 7, 1908, in Lake Charles, Louisiana, the son of Lebanese immigrants. He got interested in medicine while listening to physicians chat at his father's pharmacy.

He received his bachelor's and medical degrees from Tulane University in New Orleans, where he was elected to Alpha Omega (A.O.A) honorary medical society. He completed his internship and residency in surgery at charity Hospital in New Orleans and his surgical fellowships at the University of Strasburg, France and University of Heidelberg, Germany.

He recalled in 1999 that the time he finished medical school in 1932, "there was virtually nothing you could do for heart disease. If a patient came in with a heart attack, it was up to God."

While still a medical student in 1932 he developed the pump which would be used 20 years later to keep blood moving in the body during open heart surgery.

DeBakey has operated on more than 60 000 patients in Houston alone. His patients include princes and paupers, celebrities and unknowns the world over, all of whom receive the same high standards of excellence in healthcare.

In 1996, aged 87, he flew to Russia to examine President Boris Yeltsin and later oversaw his heart bypass surgery in Moscow and helped save his life. Yeltsin died of heart failure aged 76 last year.

Dr. DeBakey was a member of the most distinguished medical societies, having served as President of many of them. He was a founder and the first Editor of the Journal of Vascular Surgery. He was Editor of the Year Book of General Surgery for fourteen years.
Dr Michael DeBakey

Water

2009-01-05T07:58:00.000-08:00

Water
Water is one of the oldest known beverages and one of the first to be medicinally characterized with respect to effect on health. The Chakara-Samhita document is the oldest known Asian medical text (1500 BCE). The text presents a classification of common beverages for physician and addresses their presumed medical properties and attributes:

“Water by nature has six qualities: cold, pure, wholesome, palatability, clean, light. When water falls to earth it depends for its properties on the containing soil. Water in white soil is astringent. Water in pale soil is bitter. Water in brown soil is alkaline. Water in hilly areas is pungent. Water in black soil is sweet. Water derived from rain, hailstone, and snow has unmanifested ‘rasa’ (taste); Fresh rain water of the rainy season is heavy blocks body channels and is sweet; ….Rivers with water polluted with soil, feces, insects, snakes, and rats and carrying rain water aggravates all ‘dosas’.”

The Nei Ching dates to Han dynasty times (207 BCE – 220 CE) in ancient China and demonstrated the wide range in beverage choices that had rapidly become available and how they were closely associated with medicine and the healing process. The ancient Chinese medical system defined five organs (heart, liver, lung, kidney and spleen) and integrated factors of hot cold, wet dry, male-female, set within a complex integration of Yang, Neutrality and Yin. Alcoholic beverages (except beer) and coffee are classified as Yang or hot/heating, whereas fruit juices, milk, tea and unboiled water are classified as Yin or cold/cooling.

Furthermore, Chinese Buddhist monks followed strict dietary codes that limited their eating time to morning hours, and the foods/beverages forbidden to them included: fermented items, milk, cream, fish and meat.
Water

Surgery in Prehistoric Times

2008-12-26T16:17:00.000-08:00

Surgery in Prehistoric Times
The word ‘surgery’ derives from the Greek cheiros, a hand and ergon, work. It applies therefore to the manual manipulations carried out by the surgical practitioner in effort to assuage the injuries and diseases of his or her fellows.

There seems no reason to doubt that since Homo sapiens appeared on this earth, probably some quarter of a million years ago, there were people with a particular attitude to carry out such treatments. After all, there is an innate instincts for self preservation among all mammals, let alone man, so that a dog will lick its wounds, limp on three limps if injured, hide in a hole if ill and even seek out purging or vomit making grasses and herbs if sick.

Palaeopathologists have, however discovered abundant evidence in excavations of ancient skeletons that fractures, bone diseases and rotten teeth tortured out oldest ancestors. Of course, animals were subject to all sports of diseases. Indeed, a bony tumor was obvious in the tail vertebrae of a dinosaur that lived millions of years ago in Wyoming. Other excavations also reveal that injuries were inflicted by man upon man and that broken bones were splinted and skull operated upon.

Injuries inflicted by falls, crushing, savage animals, and by man upon man, demand treatment; among primitive tribes in the aforementioned studies, open wounds were invariably covered by some sort of dressing. This might take form of leaves, parts of various plants, cobwebs, ashes, natural balsams or cow dung.

Indeed, even in a recent times, the use of dung as a dressing for the cut umbilical cord in West Africa village babies still took place and was responsible for many cases of ‘neonatal tetanus’ from the tetanus spores that are almost invariably present in faeces.

Among Masai of East Africa, wounds were stitched together by sticking acacia thorns along the two edges of a deep cut and then plaiting the thorns against each other with plant fiber. In both India and South Americans termites or beetle were employed to bite across the edges of the wound whose lips were held together by the surgeon.

The bodies of the insects were then twisted off, leaving the jaws to hold the laceration closed, remarkably like the metal skin clips employed in operating theaters today. Splints of bark or soft clay were used to immobilize fractured limps and such bark splints have been excavated from ancient Egyptian burial sites.

Apart form dealing with wounds and fractures, early surgeon carried out three types of operative procedure, namely cutting for the bladder stone, circumcision and trephination of the skull.
Surgery in Prehistoric Times

Measles – History of discovery

2008-12-15T20:32:00.000-08:00

Measles – History of discovery

Measles is a relatively new disease of humans and probably evolved from an animal morbilivirus.

Measles or rubeola is a highly communicable viral disease that is characterized by a reddish brown rash that lasts for five to six days. Although a rare side effect, post-infection encephalitis can lead to permanent brain damage. Almost every susceptible child exposed to another child in the early stages of measles will contract the disease.

The first scientific description of measles and its distinction from smallpox and chickenpox is credited to the Persian physician, Muhammad ibn Zakariya ar-Razi (860-932), known to the West as "Rhazes", who published a book entitled The Book of Smallpox and Measles (in Arabic: Kitab fi al-jadari wa-al-hasbah).

Rhazes referred to measles as ‘hasbah’ (eruption) and regarded it as a modification of smallpox. One distinction noted was that ‘anxiety of mind, sick qualms and heaviness of heart oppress more in the measles than in the smallpox. Repeated epidemics of illness characterized by a rash are recorded in European and Far Eastern populations between AD 1 and 1200.

In roughly the last 150 years, measles has been estimated to have killed about 200 million people worldwide. In 1954, the virus causing the disease was isolated from an 11-year old boy from the United States, and adapted and propagated on chick embryo tissue culture. To date, 21 strains of the measles virus have been identified. Licensed vaccines to prevent the disease became available in 1963.

Many of the basic principles of measles epidemiology and infection were elucidated by the studies of Peter Panum, a Danish physician who went to the France Islands in 1846 during a large scale measles epidemic. Panum deduced the highly contagious nature of the disease the 14-day incubation period, the lifelong immunity present in older residents, and postulated a respiratory route of transmission.
Measles – History of discovery

History of Filariasis

2008-12-08T08:00:00.000-08:00

History of Filariasis
Filariasis is a helminthic infection found principally in tropical and subtropical areas in Africa, and in the South Pacific regions. The disease is transmitted from man through several genera and species of mosquitoes. The acute disease is manifested by recurrent chills and fever and by visible swelling or nodules of the lymphatics and redness of the overlaying skin due to parasitic involvement.

The illness usually subsides gradually with or without therapy. But in those who have been repeatedly infected and are chronically ill, the inflammatory reaction and scarring of the tissues surrounding the vessels may impede the flow of lymph and blood, and mammoth enlargement (“elephantiasis”) of the arms, legs, scrotum and breasts can occur. During World War II approximately fifteen thousand American military personnel became infected, but prompted withdrawal of these patients from the endemic zones prevented chronic disease and elephantiasis.

Filariasis was the first human disease described in which transmission through the skin was cause by the bites of arthropods. Doctor O. Wucherer (1868) found the embryonic filarial worms in the urine of a patient in Bahia, Brazil. T. R. Lewis (1872), working in India, observed the embryos in the urine and also in the blood, and Joseph Bancroft (1878) in Brisbane, Australia first described the adult worm. The parasite has been designated Wuchereria bancrofti.

The momentous discovery of the role of the mosquito in transmitting the disease was made by the Scotsman Patrick Mansion (1877) while he was practicing medicine in the Far East with the Chinese Imperial Maritime Customs. He became interested in the disease that confronted him, including filariasis. In that disease he recognized the parasites in peripheral blood films and also in postmortems material.

He noted the nocturnal appearance of the parasites in the peripheral blood and postulated that a blood sucking insect might be responsible for transmitting the infection. Manson proved the presence of the microfilaria in the mosquito Culex fatigans, thus supplying the missing link in the life cycle of the disease.
History of Filariasis

History of Maryland School of Medicine

2008-11-25T08:00:00.000-08:00

History of Maryland School of Medicine
The University of Maryland School of Medicine is located on the Baltimore City Campus, and is the fifth oldest medical school in the United States. It was founded in 1807. The first class graduated in 1810. University of Maryland School of Medicine is the first public medical school in the United States.

This school owes its origin to Dr. John B. Davidge, who in 1804 commenced a course of lectures in Baltimore on midwifery to a class of six students. In 1807 two eminent physicians, Dr. Cocke of Virginia, and Dr. Shaw of Maryland, united in the school and lectures were given on the different branches of medicine; in the same year a charter was granted, and the school became regularly organized by the style of the “College of Medicine of Maryland.” By the influence and zeal of its distinguished founder, and the labors of other eminent teachers, this institution has been rapidly rising into importance, and at the present time is one of the most respectable institutions in the country.
History of Maryland School of Medicine

Book of Optics (Opticae Thesaurus)

2008-11-06T22:53:00.000-08:00

Book of Optics (Opticae Thesaurus)
Book of Optics or Kitab al-Manazir, was written by Abū ‘Alī al-Ḥasan ibn al-Ḥasan ibn al-Haytham in year of 1101 to 1021 while under house arrest in Cairo. Abū ‘Alī al-Ḥasan ibn al-Ḥasan ibn al-Haytham was regarded as the father of Modern Optics and known as Alhacen or Al-Hazen since Middle Ages. Al-Hazen was an expert and a serious researcher in philosophy, physics and mathematics. He is considered the most important researcher in optics between antiquity and the seventh century. He made a significant contribution to understanding of the visual process and systemically investigated the optical properties of air.

In the book Al-Hazen correctly explained and proved modern intromission theory of vision. He recognized for his experimentation on optics, including experiment on lenses, mirror, refraction, reflection and the dispersion of light into its constituent colors. He studied binocular vision and the Moon illusion, described the finite speed of light, and argued that it is made of particles traveling in straight lines. Due to his formulation of a modern quantitative and empirical approach to physics and science, he is considered the pioneer of the modern scientific method and the originator of the experimental nature of physics and science.

In his Kitab al-Manazir, Al-Hazen asserted that optics is a synthetic branch of inquiry that combines mathematical and physical consideration. This not only a new doctrine of vision, but also a new methodology. Al-Hazen was led to formulate problems which either would not have made sense from the stand point of the visual-ray theory or had been ignored by philosophers aiming primarily to give an account of what vision rather than an explanation of how to take place.

For reason that are not entirely clear, the Kitab al-Manazir seems to have been virtually unknown in the Islamic world until the end of the thirteenth century. Only then did the Arabic text receive the attention it deserved in the form of a critical commentary written in Arabic by the Persian Kamal al-Din al-Farisi. The Book of Optics was translated into Latin, and had much influence especially on and though Roger Bacon.
Book of Optics (Opticae Thesaurus)

The Book of Healing by Ibnu Sina

2008-10-24T01:22:00.000-07:00

The Book of Healing by Ibnu Sina
Abu ‘Ali al-Husayn ibn Sina (980 – 1037) was born in the neighborhood of Bukhara, in what is now modern Uzbekistan. By age of 10, Avicenna had already memorized The Quran, the holy book of Islam. By age 21, Avicenna was recognized as a philosopher, physician and legal expert. The breadth of his study which included grammar, law, logic, mathematic, natural philosophy, medicine and theology, is reflected in the list of his work, which includes no fewer than 242 titles.

The Book of Healing is often confused with the Canon of Medicine, because of the medical connotation of its title, which is meant to suggest however, only that philosophy constitutes and antidote against illness of false opinions. The Book of Healing divides into sections on logic, mathematics, physics and metaphysics and ends with an abridgement of itself, The Book of Salvation. The author openly declares his debt to al-Farabi for his understanding of metaphysics, but his exposition of it is a great deal more organized.

The Book of Healing also included detailed descriptions of natural phenomena such as rainbows and geological formations including description of igneous and sedimentary rocks and stalagmites, with references to Avicenna’s own childhood observations of Amu Darya River in Bukhara.

There is one special section on the “science of god’ in Book of Healing. This section was translated into Latin and circulated under the title The Metaphysic of Avicenna, thus guaranteeing it would be known to the masters of western scholasticism and exert an exceptional influence on them.

The Book of Healing, a vast eighteenth volume philosophical and scientific encyclopedia which has been described a “probably the largest work its kind ever written by one man”.
The Book of Healing by Ibnu Sina

History of Immunology

2008-10-05T19:27:00.000-07:00

History of Immunology
Ancient Times
Immunology studies the relationship between the body systems, pathogens, and immunity. Primitive man knew about disease and its ravages. The Babylonian Epic of Gilgamesh (2000 B.C. – Mesopotamian hero) records the presence of pestilence and disease. The other writings from old dynasties of ancient Egypt, one finds even more descriptions of disease. They even can identify the disease. In those days, disease and pestilence was punishment rendering as a result of “bad deeds” or “evil thoughts”. Even in the Old Testament is filled with pestilence that God wrought upon those who “crossed” him. From these writings, it is equally apparent that man knew that once he had been afflicted with disease, if he survived, he was normally not able to contract it again.

In 430 B.C. Thucydides recorded that while the plaque was raging in Athens, the sick and dying would have received no attention had it not been for those individuals who had already contracted the disease and recovered and recognized their “immune” status. Beginning around 1000 A.D., the ancient Chinese practiced a form of immunization by inhaling dried powders derived from the crusts of smallpox lesions. Around the fifteenth century, a practice of applying powdered smallpox "crusts" and inserting them with a pin or “poking” device into the skin became commonplace. The process was referred to as variolation and became quite common in the Middle East. However, the primary intent of variolation was that of “preserving” the beauty of their daughters and no mention was made of saving lives.

Modern Times
In 1798, Edward Jenner inoculated a young man by named James Phipps with material obtained from a cowpox lesion. The results were conclusive but were met with great resistance by the Church.

It is the first demonstration of vaccination (smallpox vaccination). Jenner was a physician who practiced in the rural English countryside. As a country doctor, he was familiar with the region’s medical “old wives tales.” One of which was that milkmaids who had caught cowpox never became infected with the more serious smallpox. Jenner suspected there to be a connection between the fact that milkmaids were commonly known to get cowpox, but not smallpox. That’s why he decided to try this theory by pacing the scab from a cowpox lesion into a cut made in arm of a young man James Phipps.

In 1840 the first modern proposal of the germ theory of disease was proposed Jakob Henle. He was a German physician, pathologist and anatomist. He is credited with the discovery of the loop of Henle in the kidney.

Louis Pasteur played a pivotal role in the evolution of the science. While Pasteur's work at the Pasteur Institute in Paris was concerned with bacterial infectious disease, he was most concerned with the prevention of diseases that bacteria caused and how the human body was changed subsequent to infection so as to resist further insults. Louis Pasteur became the first experimental immunologist.

In 1900, Paul Ehrlich who was a German Scientist proposed antibody formation theory. Ehrlich predicted autoimmunity calling it “horror autotoxicus”. He is the one coined the term of “chemotherapy”.

Kendall A. Smith in 1983 discovered of the first interleukins 1 and 2.
History of Immunology

A Course of Treatment by Egyptian Doctors in 1300 BC

2008-09-09T20:19:00.000-07:00

A Course of Treatment by Egyptian Doctors in 1300 BC
Egyptian doctors were well aware of their limitations, however, and were told not to inflict unnecessary suffering on their patients, so there were many case where they had to say at least – ‘An ailment not to be treated’. They were recommended to take note of the treatments and medicines they used and of their effects, so that they had a record for similar cases in the future.

There were medicines to be taken internally, other to be applied to the outside of the body, and others still to be inhaled. Egyptian ingredients that can be identified today appear to be sound herbal remedies. However, some medicines had ingredients such as mice, beetles and dung, which aimed to drive out the demons causing the illness.

The Egyptians had a remarkable knowledge of the way the body worked, and knew about its internal arrangements through mummifying the dead. For them, the heart was the most important organ; they new that it pumped blood round the body, and that the pulse ‘spoke the messages of the heart’. They also knew that injuries to one side of the brain affected the opposite side of the body.

Doctors sometimes used surgery as well as medicine to treat patients, and opened injured skulls to relieve pressure in the brain. Before an operation the surgeon gave his patient a drink, presumably a painkiller, ‘to render it agreeable’. In the New Kingdom the painkiller might have been opium, imported from Cyprus. Because of the importance the Egyptians attached to ritual purity the surgeon and his assistants washed themselves and purified the instruments in fire before the operation. Both of these would cut down the risk of infection.

The Egyptians were a deeply religious people and prayers would always be used as well as medicines, even for the simplest ailments. In difficult cases, magic might be employed. It was also possible to visit temple of a deity associated with medicine, such as Imhotep, which had priests trained as a doctors. At some temples the sick could spend a night close to the god’s sanctuary. During such stay, called ‘incubation’, the patient might be cured by the deity, or dream of the god and receive instructions for treatment. Even if no help was forth coming, the sufferer was spiritually comforted.
A Course of Treatment by Egyptian Doctors in 1300 BC