History of medicine in america


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History of medicine in america

  1. 1. The History of Medicine in America HIST 3323 Brian Regal, PhD Assistant Professor for the History of Science, Department of History Kean University Union, New Jersey USA
  2. 2. • Medicalization vs. DemedicalizationMedicalization: doctors want to be central and important players in society, to gain respect and authority—scientific and technical medicineDemedicalization: dissenters not wanting to be under control of mainstream medical profession: faith healers, folk remedies, do it yourself-alternative medicine
  3. 3. • Heroic Narrative of the history of medicineHistory shows the progressive—ever improving— nature of western medicine: great doctors overcoming great odds to create great cures and discoveries. Medicine is important to the growth of western civilization.Support the supremacy of academically/mainstream trained physicians against non-medical, alternative, folk practitioners
  4. 4. Chinese medicine and the origins of medical ethics and physician practice Kung Fu-tse (Master Kung) Known as Confucius (551-476 BC) Five classical Confucian elements applied to medical practice: Ren ( 仁 , Humanity) Yi ( 義 , Righteousness) Li ( 禮 , Ritual) Zhi ( 智 , Knowledge) Xin ( 信 , Integrity)
  5. 5. Asclepiusmaybe the same as Egyptian Imhotep daughters were: Hygeia (Hygiene) Panacea (cure all)
  6. 6. Hippocratic Oath
  7. 7. Hippocratic OathI swear by Apollo, the healer, Asclepius, Hygieia, and Panacea, and I taketo witness all the gods, all the goddesses, to keep according to my ability andmy judgment, the following Oath and agreement: To consider dear to me, asmy parents, him who taught me this art; to live in common with him and, ifnecessary, to share my goods with him; To look upon his children as my ownbrothers, to teach them this art.I will prescribe regimens for the good of my patients according to my abilityand my judgment and never do harm to anyone.I will not give a lethal drug to anyone if I am asked, nor will I advise such aplan; and similarly I will not give a woman a pessary to cause an abortion.But I will preserve the purity of my life and my arts.I will not cut for stone, even for patients in whom the disease is manifest;I will leave this operation to be performed by practitioners, specialists in this art.In every house where I come I will enter only for the good of my patients,keeping myself far from all intentional ill-doing and all seduction andespecially from the pleasures of love with women or with men, be they free orslaves. All that may come to my knowledge in the exercise of my profession orin daily commerce with men, which ought not to be spread abroad, I will keep secretand will never reveal.If I keep this oath faithfully, may I enjoy my life and practice my art, respected byall men and in all times; but if I swerve from it or violate it, may the reverse be my lot.
  8. 8. Doctors at work
  9. 9. Medical Grimoires
  10. 10. American almanacs
  11. 11. Medical Astrology book (2008)
  12. 12. Bad Doctor
  13. 13. ‘The Regulars,- Allopath-Orthodox practitioners
  14. 14. ‘The Irregulars,-Homeopathic unorthodox practitioners • Samuel Hahnemann (1755-1843), regular MD, German • similia similibus curantur -- “like cures like” • later discovered same beneficial effects with minute doses --> law of infinitesimals, ritual dilutions • drugs acted on some spiritual level, vital forc • popular among German immigrant doctors, educated patients • many homeopaths also regular physicians
  15. 15. ‘The Irregulars,-Homeopathic unorthodox practitioners • Samuel Thomson (1769-1843), N.H., herbalist, farmer
  16. 16. ‘The Irregulars,-Homeopathic unorthodox practitioners James Still (1812-1882) Black Doctor of the Pines • Self-taught • Herbalist • Sold medicines and saw patients • Thomsonian influences
  17. 17. Nicholas Culpeper and his Herbal, 1652
  18. 18. Heroic Medicine – Benjamin Rush (1745-1813)
  19. 19. Medieval Bloodletting
  20. 20. Bleeding procedures and instruments
  21. 21. Heroic Medicine –Leeches
  22. 22. Heroic Medicine –Clyster enemas
  23. 23. London edition (first published in 1680)
  24. 24. New England edition (1821)
  25. 25. Mary Baker Eddy (1821-1910) and Christian ScienceEddy built her work on a Boston doctor namedPHINEAS PARKHURST QUIMBY  (1802-1866) founder of New ThoughtShe called her book Science and Health – became the ‘bible’ of ChristianScience
  26. 26. Mary Baker Eddy (1821-1910) and Christian ScienceEddy built her work on a Boston doctor namedPHINEAS PARKHURST QUIMBY  (1802-1866) founder of New ThoughtShe called her book Science and Health – became the ‘bible’ of ChristianScience
  27. 27. African American DoctorsJames McCune Smith (1813-1865) first African American to receive a medicaldegree. Travelled to University of Glasgow, Scotland, graduated in 1837
  28. 28. African American DoctorsRebecca Crumply (1831-1895) first African American woman awarded a medicaldegree in the United States. New England Female Medical College (now themedical school of Boston University) 1864Fisrt Black owned hospital, Chicago, 1890s. Opened by Dr. Daniel Hale Williamswho also did the first open heart surgery on an emergency patient who hadbeen stabbed
  29. 29. The Gross Clinic (1875), Thomas Eakins
  30. 30. History of Psychology and Brian functionPhrenology: Franz Joseph Gall, Austrian argued language localised in thebrain not global.Psychology begins 1870s1879 Wilhelm Wundt opens first psychology school at Leipzig, GermanyWundt inspires William James and Ivan Pavlov as well as B.F. Skinner’sbehaviorismNeuroscience: Paul Broca argues different parts of the brain dodifferent thingsUse of the microscope helps show brain function 1860s/70s while CamilloGolgi invents techniques for staining brain tissue to show individualneurons (1890s)
  31. 31. PhrenologyFranz Joseph Gall (1758 – 1828) pioneering German neurologist. His work washijacked and turned into Phrenology
  32. 32. Phrenology Almanac
  33. 33. Phrenology Almanac
  34. 34. PhrenologyLorenzo Fowler (1811-1896) American proponent and popularizer of phrenology
  35. 35. Phineas Gage - afterPhineas Gage (1823-1860)September 13, 1848, Cavendish,VT.
  36. 36. LobotomyManipulate the frontal lobe of the brain, this area controls emotion1890: Friederich Gouz does work on dog brains, found them much tamerafter manipulating them1892: Gottlieb Burkhardt did the first such limited operations on a humanat the Swiss Insane Asylum1935: Yale University, Carlyle Jacobson lobotomizes chimps to calm themdownAntonio Moniz, Lisbon Medical School, first modern operations on humansand lectures on the subjectLater, a former patient, outraged at what had been done to him shot Monizto death.1936: American Walter Freeman starts the lobotomy craze in the US
  37. 37. Lobotomy - theory
  38. 38. Lobotomy - practiceHoward Dully, 1960, 12 years old
  39. 39. Early antiseptic work1500s a ‘miasma’ (poison air) causes infection19th century – British surgical pioneer John Hunter showed how subcutaneouswounds – under the skin– did not get infected while surface wounds open tothe air didYou must cover wounds immediately!Collodion wraps: a syrupy and explosive material seals wounds and protectsthemGeorge Tichnor (US civil war) used alcohol to clean wounds and found lessinfectionIgnaz Semmelwies (Hungarian doctor) used chlorine to was hands of doctorsin 1860s and found dramatic drop in death of post birth mothers
  40. 40. Joseph Lister (1827-1912) British surgeon, Glasgow Infirmary -clean wounds -Sterilize equipment -Remove germs -Suggested Carbolic Acid (which had been used de-stinkify the sewer system Spray it on everyone as you work
  41. 41. Oliver Wendell Holmes Sr. (1809-1894)American (Boston) medical reformer and poet - academically trained but critical of the mainstream profession - must improve hygiene at hospitalsAnti-quack, anti-homeopathyEarly proponent of the belief that doctors unconsciously infected theirpatients with their dirty hands1846: Holmes coins the term ‘antiseptic’ (against putrification) in a letter toBoston dentist William Morton
  42. 42. Antiseptic, carbolic acid
  43. 43. Antiseptic, carbolic acid
  44. 44. Thomas Bartholin. De nivis usu medico observationes variae (1661) Earliest discussion of anesthesia. Chapter XXII of this historically important book makes the first known mention of the use of mixtures of ice and snow for freezing to produce surgical anesthesia . . . The treatise on snow crystals, by Bartholins younger brother, Erasmus, is the earliest publication on crystallography, and preceded Boyle on gems (1672) by eleven years.
  45. 45. William Morton, First use of ether/anesthetic for surgery, 1846
  46. 46. Anesthetic
  47. 47. William Morton (1853) A compendium of testimonies, hearings, investigations, etc., both favorable and unfavorable to Mortons claim, including reprints of the 1852 Majority and Minority Committee Reports, the latter supplemented by adverse marginal notes. The appendix contains testimony relating to the competing claim by Horace Wells.
  48. 48. Horace Wells (1815-1848) 1844: Wells had been a partner briefly with Morton and had showed Morton nitrous oxide (which he had already experimented with). 1845 his demo at Mass General Hospital was a disaster. He left dentistry and the country. Returned and became addicted, ended up committing suicide in1848.
  49. 49. Crawford Long (1815-1878) Used nitrous oxide (laughing gas) to remove a tumor from a friend’s neck on March 30, 1842
  50. 50. Anesthetic, ether and nitrous oxide
  51. 51. Clara Barton (1821-1912)
  52. 52. Patent Medicines
  53. 53. Patent Medicines
  54. 54. Patent Medicines
  55. 55. Patent Medicines
  56. 56. EugenicsEugenics: from the Greek for good breedingFirst developed by Francis Galton in the UK then picked up on by Americans Blood is all – biological relations dictate Behavior, future development and nothing Can change it, therefore medical/social amelioration programs are a waste of money Madison Grant (1865-1937) Johnson Act 1925
  57. 57. Public healthSanitary reform comes in three phases3.1840-1890 clean up the environment4.1890-1910 Bacteriology – go after germs5.1910-present clean up peopleConservative response: keep poor and working class people down, they spreadDisease – employ eugenicsGiving the poor and working class health benefits only renders them dependentand leeches upon the state and the healthy (well off) body politicLiberal Response: health care makes the country a better, stronger, and moreEconomically viable place
  58. 58. Public health, 1870s
  59. 59. Public health dispensary, 1870s
  60. 60. Public health, sanitation, NYC 1895
  61. 61. Public health, sanitation, NYC 1898
  62. 62. Public health
  63. 63. Public health, Venereal disease, 1940s
  64. 64. Public health, Venereal disease, 1940s
  65. 65. Bad hospital
  66. 66. Bellevue Hospital
  67. 67. Bad hospital
  68. 68. 19th century hospital, Mass General, 1847
  69. 69. 19th century hospital
  70. 70. The Agnew Clinic (1880)
  71. 71. 1930 hospital
  72. 72. Red Cross nurses, WWI
  73. 73. Modern hospital
  74. 74. Surgery/Amputation kits
  75. 75. Surgery/Amputation
  76. 76. Surgery/Amputation kits
  77. 77. Civil War Surgery part 1
  78. 78. Civil War Surgery part 2
  79. 79. Civil War medicine
  80. 80. Skull with bullet hole, 1893 (stereoscopic photo)
  81. 81. Medical school dissection
  82. 82. US Army lab tech, field station, Korea 1952
  83. 83. Reconstructive surgery, 1917
  84. 84. Monstrous Births
  85. 85. Monstrous Births
  86. 86. Monstrous Births
  87. 87. The Tocci Brothers
  88. 88. The Tocci Brothers
  89. 89. Conjoined twins, Chang & Eng and the Hilton Sisters
  90. 90. Early 19th century birth training model
  91. 91. Aristotle’s Masterpiece
  92. 92. Aristotle’s Masterpiece (1821)
  93. 93. Aristotle’s Masterpiece (1821)
  94. 94. AbortionFirst anti-abortion laws in America – after 4 months – 1820sMany doctors and the AMA pushed for completely outlawing abortion by 19001873: Comstock Law outlawed sale of birth control devices includingprophylactics and ‘pornography’Susan B. Anthony was an anti-abortion advocate1938: government case against Margaret Sanger overturned the ComstockLaw1973: Roe versus Wade makes abortion legal
  95. 95. Abortion Instructions
  96. 96. Abortion in the textbook
  97. 97. Pro choice argument
  98. 98. Pro Life argument