Nosology: History of Western Medicine – Flashcards

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- Physician and Teacher at University of Kansas (trained in internal medicine and also a historian on medicine) -Great influence to Wall -Wrote Disease and It's Control
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Dr. Robert P. Hudson
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The concept of disease is a dynamic human creations which is changing now just as it always has. Because our conventions of disease dictates our response to disease it is important for clinicians to understand how diseases come in and out of fashion
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Hudson's View on Disease
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Suicide is now being added to DSM-V as a disease 18th Century= Sin 19th Century= Crime 20th Century= Disease
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Give an example that shows how notions of "disease" change through time
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-Grand mal seizure of epilepsy -Someone who is otherwise in great health can have these grotesque episodes and awaken unharmed and unable to remember anything from the event -Practically decrees a supernatural explanation -Since there is no apparent natural force capable of "seizing" a resort to the supernatural becomes logical under such circumstances
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Example that shows the obscurity of disease
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When diseases are obscure (like in the case of grand mal seizure), supernatural belief provides the solace of explanation when the human mind can not explain the reason for disease or its course
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Why do supernatural beliefs about disease causation often make sense?
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Human Agency Supernatural Agency Natural Agency
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WHR Rivers: 3 Categories of Disease Causation
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That consistent, detailed observations is the only way to find out whether or not a remedy is working to cure people Can't explain away therapeutic failings using concepts like witchcraft -doing so prevents us from advancing beyond the level of Zande therapeutics!
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The development of western medicine throughout history has hinged on what particular concept?
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Ancient Egypt Edwin Smith Surgical Papyrus
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What is the first instance in history of medicine beginning to rely on consistent, detailed observations in diagnosis and treatment?
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Ancient Egyptian treatise on surgical diseases, and more importantly on the prognoses of the conditions it describes Remember: Prognosis= "forseeing"
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Edwin Smith Surgical Papyrus
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48 cases Also contains medicinal recipes and magical incantations which are very similar to what we would find in other folk medical symptoms
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How many case descriptions, with their own proposed treatments and prognoses are included in the Edwin Smith Surgical Papyrus? What else does it contain?
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Based on long experience and careful observation which was set down in writing for reference by medical practitioners and probably even as a textbook for Egyptian medical students
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Why is the Edwin Smith Surgical Papyrus considered the first real glimmer of scientific medical thinking?
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o Arranged anatomically, starting with head and progressing downwards discussing ailments
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How is the papyrus organized?
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(1) Physically examine the man with the wound, palpate wound, should you find skull exposed but uninjured, you should say that you know what it this is and that you know how to treat it. (2) Bind with fresh meat the first day and treat afterwards with grease, honey and lint until the man recovers.
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Describe how the Edwin Smith Surgical Papyrus describes: Case 1: A WOUND IN THE HEAD PENETRATING TO THE BONE
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Honey has such a high sugar content that bacteria cant grow in it! Plus it adheres to the edges of wounds so that when you pull off a wrap, it pulls out all of the debris as well.
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Why is honey an excellent substance for wound care?
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(1) Physically examine the man with the wound, should you find some crazy stuff and the man has blood running out of his nose and ears and stiffness in the neck, the medical man should say (unlike case #1 the treatise) that that he will CONTEND with the illness (prognosis isn't good, but I'll give it a try). (2) Do not bind the man's head but immobilize the man, telling him to sit while applying grease to his head and shoulders and wait to see if he pulls through.
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Describe how the Edwin Smith Surgical Papyrus describes: Case 4: A GAPING WOUND IN THE HEAD PENETRATING TO THE BONE AND SPLITTING THE SKULL
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(1) Palpate wound, should you find material that is like "ripples of puss" and something is throbbing underneath your hand, you should say concerning him that this is a case that is not to be treated. (2) Anoint wound with grease, don't bind, don't apply bandages until you know he has reached a decisive point
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Describe how the Edwin Smith Surgical Papyrus describes: Case: A GAPING WOUND IN THE HEAD, SMASHING THE SKULL AND EXPOSING THE BRAIN
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(1) Should you find his mouth open and that it cannot close, tell the man you will treat him. (2) You should put your thumbs next to 2 rami of mandible and 2 other fingers outside the face, and replace the mandible. give him honey.
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Describe how the Edwin Smith Surgical Papyrus describes: Case 25: INSTRUCTIONS CONCERNING A DISLOCATION IN THE MANDIBLE
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(1) It demonstrates empiricism and rationalism much greater than any other previous medical treatise, suggesting considerable time and energy put into observations (2) The clinical methods it contains and medical procedures written about indicate a LOCALIZED view of disease rather than generalized (important conceptual shift)
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Name the 2 reasons why the Edwin Smith Surgical Papyrus is significant:
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3500 years later!
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The practical advantages of thinking in localized terms when it comes to disease were clearly beneficial to Ancient Egyptians. When is the next time in history the advantages of thinking locally were realized?
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(1) First people culturally to embrace the notion that disease is a natural phenomenon and therefore can be studied and observed and intervened to change its course (2) Great observers of clinical facts (Hippocrates!)
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What beliefs did Ancient Greeks hold that advanced medicine?
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Generalized -o Huge consequences for history of western medicine -we adopted ancient Greek medicine as our paradigm for a long time
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Did the ancient Greeks believe that disease was the product of generalized or localized physiological processes? What is the consequence of this?
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Humoral Theory of Greek Medicines
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Name the fundamental paradigm underlying Greek medicine:
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Enhanced clinical/ bedside medicine and notions of the importance of observation
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How was the humoral theory a beneficial contribution to medicine?
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Galen of Pergamon 2nd century AD Galen elaborated and clarified it so extensively that it became the "holy scripture of medicine" for well over a millennium to follow (1500 years).
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Who is responsible for the humoral theory of disease? What effect did he have on the theory? When was it articulated?
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The notion that illness is caused by a basic imbalance of 4 humors in the body
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What aspect of Galen's humoral theory was false?
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Paracelsus Late 15th/ Early 16th century Viewed as someone of disrepute by many
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Who was the first medical thinker who broke away from Galenic tradition? When?
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(1) Medical knowledge needs to be based on personal experience (2) Rejects medical authority (3) Humoral theory is not accurate
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Paracelsus Beliefs: (3)
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German All medical writings were in Latin -writing in German was a symbol of his rejection of medical authority
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What language did Paracelsus write in? What the significance of this?
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Paracelsus essentially replaced the 4 humors with a slightly fancier version that substituted mercury, sulphur and salt He couldn't abandon influence of astrology in notions of medical understanding
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Paracelsus's theory of disease as compared to Galen's:
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Sudden onset of "phlegmatic complexion" from drinking too much cold water and not exercising enough Notion that excess water produces excess phlegm was an accepted medical diagnosis under humoral theory
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What killed Giovanna de Medici at age 42 in Florence?
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Substances the circulated in the body -kind of like water in a pipe
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What is a humour?
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Phlegm Yellow Bile Black BIle Blood
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What 4 humours did the humor theory of illness involve?
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BLOOD > sanguine (pleasure-seeking and sociable) YELLOW BILE > choleric (ambitious and leader-like) BLACK BILE > melancholic (introverted and thoughtful) PHLEGM >phlegmatic (relaxed and quiet) Individual temperament was the product of the variation in proportions of the 4 humours in the body -account for psychology, emotions, health and sickness
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How do excesses of each humour affect mood?
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Through heat produced in the digestive processes in the stomach
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How was it thought that humours were concocted?
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Cerebellum refines "vital spirits" into smaller animal spirits -heat and cold, dampness and dryness determined the health and wellbeing of a person?
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Role of cerebellum in humoral theory
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Children's Brains= REALLY moist, which is how they learn so much! Women= moist Old= dry
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On the dry-moist spectrum, who was considered "moist"? Dry?
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• Proportions were always changing, so someone could be sanguine one day and melancholy the next because of what they ate etc.
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How did humoral theory explain changes in temperament?
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17th century Blood circulations was beginning to become better understood But in practice, humoral theory was still used for a few more centuries (some medical manuals were still recommending treatment based on humoral theory into the 1900s)
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When did humoral theory begin to lose medical credibility?
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The theory illustrates a complete, rational system for classifying illness and treating sickness based on humoral theories.
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Why was humoral theory persistent for so long?
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The system was not good at resolving clinical problems and healing the sick...DUH.
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What was the main problem with humoral theory (other than it being blatantly wrong)?
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Incorporates temperature, climate, seasons -everything really! Its quite impressive **See notes -clearly its logically coherent and empirically unverifiable *Make sure you can re-create the quadrant!
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How does humoral healing act as a complete self-affirming logical system>
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With the renaissance came resistance to humoral theory. Throughout the renaissance to the end of the 18th century, the battle raged between humoral theory and modern scientific theory
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How did the renaissance affect the development of western medicine?
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Anatomy
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What was THE critical discipline to the rise of modern scientific medicine?
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14th century Legal reasons -Medici family in Italy were so concerned about being poisoned
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When did human dissection begin to increase? Why?
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Art! Artists (esp. Leonardo Da Vinci) wanted to depict the human body more accurately
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What was the driving force behind the study of human anatomy during the renaissance?
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No. They were made for his own benefit -not for publishing -the anatomy that painters and sculptors needed was different than the knowledge that would be needed for a surgeon or doctor.
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Were Da Vinci's anatomical drawings influential? Why?
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In order to medically relevant information from anatomical dissection, a physician must be asking the right questions -humoral theory was not dependent on anatomical functioning and/or structures
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What was anatomy a useless study as one as disease was viewed as a generalized process derived from imbalances of humors?
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Andreas Vesalius
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Who changed the whole approach to anatomy to make it medically relevant?
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-Founder of modern humans anatomy -Brussels (1514-64) -Received doctoral degree in 1537 in Padua, Italy and immediately became a professor at one of the top universities in Europe.
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Andreas Vesalius
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-Professor gave 1 dissection a year, sitting on a raised chair (CATHEDRA) from where he gave his lecture. -Lecture consisted of professor reading an anatomy textbook while the actual dissection was carried out by a low life/ barber/medical student -Second assistant would point out structures to which professor was referring
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At the time that Vesalius began teaching, how was anatomy taught?
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The system guaranteed to promulgate current knowledge rather than spur NEW knowledge
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What is most notable about the system of teaching anatomy prior to Vesalius?
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He hated it! He wanted to be in the thick of dissection
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What did Vesalius think of the way anatomy was being taught?
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A printer who wanted to produce a new version of Galen's anatomical works gave the complete works to review. So, while Vesalius was grubbing around in cadavers he had the rare access to all of Galen's works as well -starting finding error after error!
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What event began Vesalius' revolution into how he understood human anatomy?
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(1) Liver did not have 4-5 lobes (2) The lower jaw did not consist of 2 parts (3) The uterus was not horned
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List 3 errors that Vesalius noted in Galen's understanding of human anatomy
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Difficult to get anatomical specimens to dissect!
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Based on the countless errors Vesalius found in Galen's works he decided to produce is own work. What was the main problem with this bold plan?
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(1) Criminals usually as part of a sentence for particularly bad crimes. (2) Grave robbing (therefore associating criminal offense with dissection)
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What were the two ways in which anatomical specimens were generally accumulated in the 16th century?
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On the Fabric of the Human Body in Seven Books (1543, in Latin) To historians of medicine it was known simply as "Fabrica"
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Name of Vesalius' new anatomical text.
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In the chambers of the heart there were all these pores that allowed blood to move back and forth between chambers of the heart (Capillary circulation was not understood fully until microscopes and find dissection became possible)
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How did Galen postulate that circulation worked?
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When Vesalius described the anatomy of the heart he clearly saw that the pores didn't exist. Vesalius writes: "God is wonderful, and Galen says the pores are there, but let me be honest, I can not see them"
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How did Vesalius' theory on circulation differ from Galen's
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Vesalius was violently attacked by others
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How was Fabrica received?
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Led physicians to the fruitful conclusion that disease must be localized at an origin -localization of disease wasn't Vesalius' idea, per se, but a synthesis of notions that developed BECAUSE of Fabrica: Synthesis of notions → Disruption in relationship among units can bring on localized ideas (pathology) whose symptoms are based on the localization of the disease itself
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Why is Fabrica such an important text
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Pathology- a study of anatomy in relation to disease
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The conception of the disease as localized wouldn't begin to knock the props out from humoral theory until a study of what developed?
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A book published by Théophile Bonet, a Swiss physician (from Geneva), in the late 17th century that discusses pathology for the first time!
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Sepulchretum
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- Genovese Physician - Had the hobby of collecting autopsy reports that had been published -He wasn't an anatomist but through his compilation he dawned upon the idea that by studying dead bodies we can understand disease of living (advent of PATHOLOGY!)
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Théophile Bonet
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Clinical-pathological correlation Bonet had no familiarity with the cadavers he studied during life, only after death to see what had happened -therefore there couldn't be any real clinical application of his book until physicians began to understand pathology in LIVING people
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What was missing from Bonet's book?
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Italian anatomist that demonstrated for the first time the evidence of capillary circulation After he died his students carried out an autopsy on him. Autopsy showed a hemorrhage in the right side of the brain -he had died of a massive stroke.
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Marcello Malpighi
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WITCHCRAFT
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What explanation of causation would the Azande have used to explain the findings in Malpighi's 1964 autopsy?
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Giorgio Malvagi (one of Malpighi's students) saw the burst vessels in the head of his professor and concluded that 2 different humors combined in the body and met in the brain and had a malignant effect on the brain.
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What explanation of causation did Malpighi's students use to explain the findings in his 1964 autopsy?
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Giovanni Battista Morgagni
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Vesalius : Anatomy :: x : Pathology
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- 1682-1771 - Father of Pathology - Worked for 50 years on a compilation of 700 autopsies that he arranged anatomically from head to toe. But most importantly: he correlated the signs and symptoms of disease the individuals had during LIFE and compared them to what he found when he did the autopsy after DEATH! - First time anyone said: lets take the case history of the individual during life and compare it to what we find in autopsy!
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Giovanni Battista Morgagni
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Man suffered an aneurism (weakening/ballooning of blood vessel) in the heart and died from a rupture which caused him to bleed to death. After tracing the signs and symptoms Morgagni described how the lining of the blood vessel had become thin and had eroded and expanded so much that it had eroded the bones of the chest wall.
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Give an example that shows how Morgagni merged notions of symptomatology in life with disease causation verified by autopsy after death. (Aneurism)
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Nun seized by chills and fever. Developed a cough in chest pain. Morgagni who saw her in life thought she might have phneumonia. Morgagni predicted when she died that her lungs would have the consistency of liver (solidified and heavy due to infection instead of light and spongey). That is exactly what he found
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Give an example that shows how Morgagni merged notions of symptomatology in life with disease causation verified by autopsy after death. (Nun)
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He published his work in 3 books: "On the Seats and Causes of Disease" (Latin). These books act as a pathological landmark comparable to what Vesalius did for anatomy. This is the death senctence for Galenic anatomy (although it took well into the 20th century for humoral theory to recede)
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What was the name of Morgagni's published works? What was the significance of them?
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What difference did it make if a disease originated in a localized organ instead of circulating organs (humors). The most important organs (tripod of life -lungs, heart, brain) are not sensory They needed an extension of the senses -had to be able to figure out what is going on in the patient when he is still alive. If all we can do is diagnose disease in a dead body, that's not very useful.
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Despite importance of research of Morgagni it is clear that his theories weren't followed by changes in clinical practice in Morgangi's lifetime. Why didn't doctors change the way they practiced?
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Dutch physician and phenomenal teacher Founded school of clinical practice, with a 12 bed hospital, that emphasized teaching medicine at the bed side -before this medical practice had been an individual thing His students took his ideas and spread them across Europe, making him the most famous teacher of clinical medicine in the 1800s
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Herman Boerhaave
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A favorite student of Boerhaave who founded the university of Vienna -premier medical center in Europe
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Van Swieten
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Developed percussion as a diagnostic tool (one of the most famous advancements in historic of medical diagnostics) During his youth he worked in his family's tavern in inn where he was in charge of keeping casks of beer and wine full. He did this by tapping on the cask -fairly common practice. Because he was such a good musician, he had a good ear to notes and tone As a young medical student, the same technique he used for tapping on casks could be used on the human body (percussion)! By tapping on the chest or tapping on the belly and listening for the kind of sounds that are produced you can get a considerable amount of information about what is going on
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Leopold Auenbrugger
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Resonant > air-filled space Dull > fleshy
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When using percussion as a diagnostics tool resonant note = ? dull note = ?
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The normal lung, when filled with puss as in pneumonia, the note becomes dull when it should be resonant
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Using pathology of the lung as an example, why is percussion an important diagnostic tool?
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Vienna
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During the late 18th century, where was the cite of cutting edge medicine?
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One of Auenbreugger's students and one of the many physicians who flocked to Vienna in the late 18th century Learned the art of percussion and became a masterful diagnostician, applying percussive techniques to the heart. Wrote essays on the heart Went back to Paris and become the head of the Paris School of Clinical Medicine, where he implemented the use of taking careful histories of patients, physical examinations using percussive techniques and autopsy
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Jean-Nicolas Corvisart
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One of Carvisart's students who was an expert percussor and physical diagnostician. Employed method of immediate osculation Created first stethoscope
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Rene Laennec
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The practice of leaning down and placing an ear directly up against a patient's chest to hear what is going on inside
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Immediate Osculation
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- Fat patients - Patients who did not bath often (fairly common) - Young women with big boobies
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Problems with Immediate Osculation
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Noted the problems with immediate osculation and was watching kids play a game that consisted of listening to a noise at the end of a long piece of wood by tapping it with a pin and sending messages back and forth Lanec thought he might be able to use a rolled up piece of paper instead of putting his ear directly to his chest -low and behold he could here better The first stethoscope! Essentially was just rolled up paper!
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How did Laennec come up with the idea for the stethoscope?
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YES -was immediately recognized as a technological advancement in medicine and spread quickly
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Was the advent of the stethoscope accepted by the medical community?
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Notions of localization of disease had finally reached a point where it could be useful for the average physician It had become obvious that organs were not just simply homogenous structure Organs had subsets and were composed of various tissues -might be different tissues in different places in different organs.
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How does the advent of the stethoscope indicate a solidification of the notion of localization of disease?
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- French physician and ardent dissector who carried out lots of autopsies (did over 600 in one winter alone) -Father of Histology -Bichat set out on figuring out what organs were made of . He is fully responsible for the shift in anatomical localization theory of disease from ORGANS to TISSUES
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Marie François Xavier Bichat
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Conclusion: Disease arose from one or more of an organs tissues that a disease attacked separately -not just general organs Book Anatomie Générale (1801)
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Bichat's conclusion on disease causation? What book was it published in?
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German Physiologist -Took Bichat's observations even further -wanted to understand what TISSUES were made up of. -Discovered the cell as the basic biological unity in 1839- Developed Cell Theory!
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Theodore Schwann
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Developed the theory of cellular pathology, which was an inevitable deduction from Schwann in 1858 The theory of cellular pathology (cells are the cause of disease) placed modern pathology on a truly scientific basis.
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Rudolf Virchow
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Schwann and many other of his generations including Virchow originally believed that cells come to be from some weird substance (blastema) -Virchow destroyed this notion, replacing it with modern cell theory that says that "ALL CELLS COME FROM PRE-EXISTING CELLS"
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Virchow and Blastema Theory
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Allowed physicians to begin distinguishing between cancer of the lung vs breast. If all cells are from previous cells we can look back to where they came from and determine what turned them from benign to malignant! This indicates a movement of the study of disease to the sub-cellular and genetic level -getting into sharper focus now! Enormous difference from Galenic medicine.
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Using the example of cancer, how did Virchow's development of cell theory influence notions of disease causation?
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(1) Rise of technology which allows tighter and more precise observations to be made about biological structure (2) Application of these technologies to biological science using rules of controlled experimentation and new criteria of proof. While the Hausa and Azande are logically complete systems, they do not use experiment in a rigorously controlled way they explain away surprising findings. They are not forced to accept conclusions which are unpalatable
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What two critical events took place in the 19th century that led to the next major development in medicine: Experimental Medicine?
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No. Galen was a keen observer who was limited with what he had to work with. Although technology with massively limited, he investigated a number of physiological processes in elegant ways!
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Is experimental medicine entirely a phenomenon of the 19th-20th century? Explain why.
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Fluid which we drink passes into the bladder by being resolved into vapours and then returns to its previous form as a liquid Galen tested Asclepiades' theory
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Asclepiades' Theory of Urine Formation
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Galen wanted to prove that urine is formed by the kidneys and transported to the bladder through ureters (1) Open animal's abdomen and find peritoneum and open it and then find the ureter on each side and dissect it. Take a piece of string and tie the ureters off. Then bandage abdomen up let animal run for a while and then re-examine. Took the bandage off and observed that the bladder was empty, the ureters were swollen greatly distended above level of ligature and thin below the ligature. Then he took the ligatures off and the swelling went away and the bladder filled up with urine. Pretty damn cool and elegant....But Galen wasn't content with that.... (2) Tied ligature around penis so they couldn't evacuate bladder and then squeeze bladder. He was unable to get urine to go back up ureters in either dead or living animals. The ureters are a one way street (3) Take ligature off of penis and then ligate one ureter and not the other. In this case what he saw was 1 swollen and distended ureter and 1 normal ureter (4) Then he cut the ureter and examined little streams of urine pulsing out of the ureter. Would bandage the animal up for a bit and then when he re-examined the entire abdomen was filled with urine Clearly, he said the Asclopiates was wrong! -EXAMPLE OF EXPERIMENTAL MEDICINE PRE-19th CENTURY!
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How did Galen test Asclepiades' Theory of Urine Formation?
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NO: Galen was a brilliant anatomical and physiological thinker, his approach just wanted followed by his students, who instead took his findings for granted and placed Galen on a standstill. THAT is why western medicine was at a standstill for 1500 years
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Can we blame Galen for the stall in medical development? Why was western medicine at a standstill for 1500 years??
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- Revered in French educational system - He did not originate experimental medicine but brought it to unprecedented heights -considered a true pioneer of experimental physiology
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François Magendie
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- 1813-1878 -Influenced greatly by François Magendie -He was the first to define "milieu interior" and one of the first to suggest the use of blind experiments to ensure the objectivity of scientific observations -Discovered that the liver is the major storehouse of glucose -developed a more sensitive test that picked up sugar in the blood to show that everyone has glucose
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Claude Bernard
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(1) Animals can break down or "catabolize" food stuffs but they could not build up or "anabolize" substances (2) Glucose/ blood sugar only appears in the blood in pathological conditions like diabetes
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2 Major Theories about Glucose in 19th Century Physiology
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Designed an experiment with animals where he was able to show that sugar showed up in the blood no matter what animals are fed. - Even if animals weren't fed for a few days, glucose was still present - where is the sugar coming from? - Looked at the liver: blood being carried into the liver it didn't have detectable amounts of sugar but when he looked at blood coming out of the liver he found sugar in it
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Describe Bernard's experiments that proved that glucose is in the blood of all animals and is not a sign of pathology
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Liver stored sugar as a substance that has properties similar to starch. Called this substance glycogen. Liver released this substance, which is a precursor to glucose, whenever it was needed in the body
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How did Bernard explain how sugar-levels maintained stable in blood during periods of fasting?
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Bernard's discovery of "internal environment" Said that the body has a fluid internal environment which mediates between the external environment and the cells. This is necessary because the delicate intra-cellular molecules cant survive exposure to direct external environment.
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Millieu Interior
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American physiologist Walter B. Canon Homeostasis
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Who picked up the term "milieu interior" and transformed it into the term we use today? What is that term?
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The steady state of normal physiological functioning
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Define homeostasis
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An Introduction to the Study of Experimental Medicine -a classic in medical scientific thought
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Bernard's Book
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(1.) OBSERVATION (liver glucose examination is an example) -Planned observation -Serendipitous (2.) HYPOTHESIS (3.) EXPERIMENT - Must be controlled and reproducible (4.) COUNTER-PROOFS -Test in another way or backwards (5.) NEW HYPOTHESIS
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An Introduction to the Study of Experimental Medicine, by Bernard outlines the fundamental principles of the experimental method as it is used in medicine. What are they?
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OBSERVATION: Rabbits brought to Claude from market. They ended up peeing on the table. He noticed that it was clear and chemically acidic. HMM that's interesting because rabbits are herbivores and normally herbivores have an alkaline turbid urine. Why are they producing urine more in line with carnivores? (Seridipitous observation) HYPOTHESIS: Suggested that something must be going on inside the rabbits that is making their urine appear clear and acidic. If the rabbits haven't eaten in a long time perhaps they've been turned into physiological carnivores and maybe being forced to live off own blood somehow? EXPERIMENT: Fed the rabbits grass and a few hours later, their urine was turbid and alkaline. After a fasting period of 24-36 hours it returned to acidic. He tried this on horses (also herbivores) and observed the same thing. Found that the urine of carnivores is acid. My rabbits have acid urine. Therefore they are carnivores, which is to say they are fasting. This was verifyied by experimentation. But to prove that the rabbits were in fact carnivores he had to produce a counter-experiment. COUNTER-PROOF: He made carnivorous rabbits eat cold boiled beef. As long as they were on the meat diet, the rabbits had clear, acid urine. NEW HYPOTHESIS: Hurrah.
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Give an example of Claude using the fundamental principles of the experimental method as it is used in medicine.
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Alexander flemming observed while he was cleaning up petrie dishes in lab that some of them had mold growing on them. Found a "zone of death" around mold in which bacteria couldn't grow- that's how we have penicillin, one of the most potent antibiotics ever made! "Chance only favors the prepared mind" -making serendipitous observations is a rare talent!
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Alexander Flemming
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More opportunities!
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How has the development of technology influenced serendipitous observations?
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Persian fairytale that describes the discoveries and adventures of three princes who were "always making discoveries by accidents and sagacity, of things that they were not in quest for." How the term serendipity developed! Serendipity can be understood as "the faculty of making discoveries by accident". Just like the three princes said, Serendipity is the joy of an epic revelation.
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Three Princes of Serendip
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Objectivity! "Groups of diseases remain confused as long as physicians had to rely on patients accounts of subjective symptons and objective but crude findings from physical examinations. Many disease were separated from their mimes by the use of laboratory developments and process. For the majority of these developments, we had to wait until the 20th century" -Disease and It's Control, Dr. Robert Hudson.
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What is the principle merit of laboratory medicine?
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