Outline
 Middle ages – in Europe
 Renaissance – in Europe
 Modern medicine
Time-line
 1543 C.E.
 The first scientific textbook on human anatomy is published
by Andreas Vesalius, physician and professor of medicine at
the University of Padua in Italy. Vesalius based his work on
dissection of human cadavers.
 1628 C.E.
 William Harvey shows (for the first time) that the heart
pumps blood through the arteries to all parts of the body,
and that blood returns to the heart through the veins.
 1600s C.E.
 Antony Leeuwenhoek uses a microscope and discovers red
blood cells, bacteria, and protozoa
Time-line
 1796 C.E.
 The smallpox vaccine is developed by Edward Jenner,
initiating the science of immunology.
 1800s C.E.
 Florence Nightingale, through her work during the Crimean
War, establishes the foundation of modern nursing.
 Circa 1840 C.E.
 Americans Crawford Long and William Morton
independently discover that ether gas can be used as a
general anesthetic, allowing doctors to perform operations
never possible before.
Time-line
 1865 C.E.
 Joseph Lister introduces antiseptic methods to surgery
during a time when close to half of all surgical patients
die of postoperative infection.
 1898 C.E.
 Pierre and Marie Curie discover radium, which becomes
a powerful weapon against cancer.
 1928 C.E.
 Sir Alexander Fleming discovers the germ-killing power
of a mold called penicillium, later isolated as penicillin,
the first antibiotic.
Time-line
 1950s C.E.
 Jonas Salk develops the first successful polio vaccine.
 1954 C.E.
 American surgeons transplant a kidney, the first
successful organ transplant.
 1970s C.E.
 The World Health Organization announces worldwide
eradication of smallpox
Middle Ages (AD 800–1400)
 Disease  Leprosy, Syphilis, Plague, Typhus
 Privation –
 Pillaging, looting and sacking followed by famine,
starvation and disease leading to repeated mortality
crises of 1/3rd of population
 Bubonic Plague killed 75% of the population
in Europe and Asia
 Response  Quarantine introduced in Venice in 1403
Middle Ages (AD 800–1400)
 Influence of Arabic medicine, translations
and new books
 Some studied abroad (scholarships) in
Andalusia
 There was renewed interest in medical
practices of the Greek and Romans
 Colleges opened
Middle Ages (AD 800–1400)
 Medical Care:
 Self-help
 - prayer, pilgrimage, charms, herbs, magic stones, holy
water
 Local noblemen
 knowledge of disease/therapy obtained by formal
education
 Professional healers
 physician-clerics who had studied abroad
 Barber-surgeons
Middle Ages (AD 800–1400)
 Arab physicians used
chemistry to advance
pharmacology
 Arabs begin requiring
physicians to pass
examinations and obtain
licenses
Renaissance (AD 1350–1650)
 Dissection of the body led to
an increased understanding of
anatomy and physiology
 Invention of the printing press
allowed medical knowledge to
be shared.
 First anatomy book by Andreas
Vesalius, was published
Renaissance (AD 1350–1650)
 Healers:




Quacks and Mountebanks
Apothecaries
Surgeons
Physicians
Renaissance (AD 1350–1650)
 Quacks and Mountebanks
 Set up in town for a few days hen
moved on
 Cheap remedies available to the
masses
 Popular with the people
 Attempts by corporations of
physicians and surgeons to prohibit
them failed
 Magistrates were aware of their
popularity
Renaissance (AD 1350–1650)
 Apothecaries
 Evolved from grocers and spicers to
supply physicians' needs to compound
prescriptions
 Physicians were prevented, by their
code, from dispensing medications
 Apothecaries were prevented from
charging for giving advice although
many patients sought their opinion
 Became rich as a result of physicians'
bizarre prescribing practices
Renaissance (AD 1350-1650)
 Surgeons
 Decree of Pope Innocent III in 1163
discouraged monks from performing
surgery
 Barbers took over surgical work of
monks
 Familiarity with use and care of
sharp, rustprone instruments
 Incorporated with surgeons as a
craft
 Skills acquired by apprenticeship
Renaissance (AD 1350–1650)
 Surgeons
 Wound healing
 Setting of fractures
 Amputations, embalming, removal of teeth, treatment
of skin disease, and blood letting
 Training by apprenticeship
 Converted to college/university degree in 1800's
Renaissance (AD 1350–1650)
 Physicians
 Most prestigious of healers
 Distinguished by education
abroad and large fees
 Because of expense of training,
came from rich families
 Large towns with reasonable
number of rich potential patients
 Management deliberately
elaborate, including complicated
mostly useless prescriptions
16th, 17th, and 18th Centuries
 Invention of the microscope in 1666 allowed
doctors to see disease-causing organisms
 Apothecaries led to development of
pharmacies
17th Century
 Circulation 1628: Harvey
 Advances in physiology
 The microscope 1676 (Antonie van
Leeuwenhoek)
 Pathologic anatomy (1682 – 1771)
 Air was vital to life (1685)
Andreas Vesalius
 Prior to Vesalius learning anatomy consisted of
reading the texts of ancient Greek physicians
 First to use hands on dissections to teach about
anatomy
 Instead of digging up bodies in the dark he
started to be allowed to do dissections on
executed criminals
 Produced fantastic diagrams based on human
experimentation (Galen’s drawings were from
apes)
De Humani Corporis Fabrica
 (On the fabric of the human body)
De Humani Corporis Fabrica
 (On the fabric of the human body)
De Humani Corporis Fabrica
 (On the fabric of the human body)
Ambroise Pare
 Pioneered many surgical
treatments and specialized in the
treatment of wounds
 Used a mixture including
turpentine to heal wounds
(cleaned the wound)
 Used ligatures of arteries to
reduce blood flow and slow
bleeding
Ambroise Pare
 Used cauterization techniques
prior to amputation
 Hypothesized that phantom
pain after amputation arose in
the brain
 Revived the practice of podalic
versiori to deliver babies not
coming out safely
Bezoar Stone Experiment
 The Bezoar stone was reputed to be
able to cure the effects of any poison
 Pare’s cook was caught steeling
silverware
 The cook agreed to be poisoned to
determine if the stone in fact worked
 The cook died days later proving that
the Bezoar stone had no miraculous
healing properties
William Harvey
 Described the process of blood
being pumped around the body by
the heart
 Discovered how valves in the veins
work
 Postulated that the circulatory
system was closed and that the
heart re-circulated throughout the
body
 Clashed with Galen’s concept that
blood was created in the liver and
that there were two types of blood
William Harvey
 Theorized that there are two separate loops
of the circulatory system, one to the lungs
and the other to the rest of the body
 Carried out dissections showing that
embryos do not possess characteristics of
adults
16th, 17th, and 18th Centuries
 Edward Jenner developed the first
vaccination to prevent the spread of
smallpox in 1796
18th Century
 Surgery
 Louis XIV: Fistula
 Separated from barbers 1745
 Child birth: male obstetricians
 Industrial revolution
 Urbanization: overcrowding
 Industrial hygiene and disease of workers
(19th Century)
Modern Medicine
 1840: first clear statement of living agents of
disease
 1842-46: Ether as an anesthetic agent
 1844: nitrous oxide: pain control
 1847: Chloroform anesthetic
(19th Century)
Modern Medicine
 1868: Thermometry
 Hypodermic syringe
 1886: The ampoule
 With all these advances, medical
services were not available to the
average individual
19th Century
 Formal training for nurses led
by Florence Nightingale began
 Infection control methods
were developed once
microorganisms were
associated with disease
(19th Century)
Medical Education
1871 Harvard

Raised entrance requirements

Lengthened to 3 years

Better facilities for lab and clinical
instruction
(19th Century)
Medical Education
1893 John Hopkins

Required Bachelor's Degree

Student serve as clerks

Graduates spent several years as interns
and residents

Research become dominating feature in all
department
(19th Century)
Medical Education
1909 – 1911 Flexner: report

Closed many schools

Raised standards

Revised curricula

Only the elite
(19th Century)
Medical Research
Outstanding scientist in 19th Century

Liebig at Giessen 1824

Virchow in berlin 1856

Pasteur in Paris 1888

Koch in Berlin 1905
(19th Century)
Medical Research
 Huge sums to foster research
 Quest of new knowledge

1850 US $ 74 Million

1955 US $ 261 Million

1974 US $ 4 Billion
(19th Century)
Medical Research
 Scientific Journals
 1800
100
 1900
10 000
 2000
1000 000
20th Century
 Gained an increased knowledge about the
role of blood in the body:
 ABO blood groups discovered
 Determined how white blood cells protect
against disease
20th Century
 New medicines were
developed:
 Insulin to treat diabetes
 Antibiotics to fight infections
caused by bacteria
 Vaccines to prevent people from
getting diseases caused by
viruses
20th Century
 New machines were developed:
 Kidney dialysis machine
 Heart lung machine
 Computerized axial tomography (CAT) scan
20th Century
 Surgical and diagnostic techniques were
developed to cure once fatal conditions:
 Organ transplants
 Limbs reattached
 Test tube babies
 Amniocentesis
 Implanted first artificial heart
20th Century
 Ultrasound
 CT scan
 Bone scan
 MRI
 Operative navigation systems
 3-D printing
20th Century
 Health care plans developed to help pay the
cost of health care
 Medicare and Medicaid marked the entry of
the federal government into the health care
arena
 HMO’s provided an alternative to private
insurance
 Hospice was organized
History of medicine highlights
 Plague pandemic started in 1332 in India,
spread through China and Russia to
Constantinople and Italy
 In the middle of 14th c.- whole Asia, Europe
and north Africa
 …wasteland, extinct cities, corps lying
around, with no one to bury them
History of medicine highlights
 “black death" most prominent in Dalmatia
(Split, Zadar, Dubrovnik)
 In Dubrovnik in 1377 – first quarantine in the
world – 40 days of isolation and observation
prior to unloading the cargo and people
 Hadith shareef:
History of medicine highlights
 Girolamo Fracastoro – theory about invisible
germs that spread and cause diseases
 Through direct contact, via objects, ability to
spread far from the source
 Refutes Galen’s "miasm theory” (poisonous
air and fumes)
Girolamo Fracastoro
 "De contagione et contagiosis morbis“ in
1543 – claims that germs multiply, are
poisonous, could be destroyed by fire
 Recommends regular body hygene, clean
environment, water and food sanitation,
disinfection
History of medicine highlights
 Microscope discovery
 Antony van Leeuwenhoek in 1670
 Analyzed blood, saliva, bones, muscles, human eye
lens, ect.
 Achieved magnification up to 40-160 times, later up to
270 times
History of medicine highlights
 In 18th c. doctor from Slovenia Marko Anton
Plenčić supports the theory about small living
creatures which cause communicable
diseases
 He hypothesized that different creature
causes different, specific disease
History of medicine highlights
 At the end of 18th c. British doctor Edward
Jenner noticed that women who milk cows
often get cow pox (much more benign than
smallpox) and never get smallpox, as a
consequence
Edward Jenner
 After 20 years of observation – experiment
on 8yrs old boy James Phipps
 Jenner took the pus from the hand of a
women with cow pox and applied it to the
boy – after 6 weeks the boy was exposed to
smallpox – didn’t get smallpox
 Published a book about vaccination in 1798
(vacca=cow)
History of medicine highlights
 Only in 19th century bacteria have been
discovered
 Pollender discovered one of the largest
bacteria - anthrax in the blood of dead
animals
History of medicine highlights
 Louis Pasteur – foundations for modern
theory about causes of communicable
diseases
 discovered yeasts
 introduced pasteurization for wine and milk
 Noticed how anthrax culture loses virulence – when
applied to healthy animal it didn’t cause the disease
 Created vaccine to immnunize rams against anthrax
 In 1881. discovered streptococcus and staphylococcus
bacteria
Louis Pasteur
 In 1885 L. Pasteur introduced vaccination
agains rabies
 Dried spinal cord from dogs died of rabies
Pasteur applied for 9yrs old boy Joseph
Meistera, who was bitten by a rabid dog –
the boy was saved
 Countless lives were saved all over the world
History of medicine highlights
 During 19th c. in England – great cholera
epidemic
 John Snow – a doctor perticulary interested
in this epidemics in 1854 creates hypothesis
that cholera was transmitted via water
History of medicine highlights
 1882 Robert Koch discovered M. tuberculosis
 1890 discovered tuberculin, first considered
cure, later became diagnostic tool
 Tuberculosis was a pandemic at the end of
19th c. due to poor social and economic
conditions
History of medicine highlights
 At the end of 19th c. Koch and Pasteur
formed new discipline – Microbiology
History of medicine highlights
 Beginning of 20th c. – discovery of viruses
 1908 - Karl Landsteiner - poliomyelitis virus
 1912 - Wilhelm Grueter – herpes virus
History of medicine highlights
 In 1907 Paul Erlich introduced chemotherapy
(chemicals that selectively destroy
microorganisms, without causing damage to
the host)
 1923 – systematic prophylactic BCG vaccine
History of medicine highlights
 1928 Alexander Fleming accidental finding
that the presence of molds blocked coccus
culture growth
 Penicillium notatum - penicillin
History of medicine highlights
 Only from 1940s penicillin was applied during
WWII against coccus bacteria, C. diphtheriae,
anthrax, tetanus
 Over following years – discoveries of other
antibiotics, most important was
streptomycin (Selman A. Waksman – coined
term antibiotic)
Top achievements in
medicine?
 http://science.discovery.com/convergence/10
0discoveries/big100/medicine.html
 http://www.healthfiend.com/weeklytop/top10-greatest-medical-discoveries-of-all-time/
Jon Queijo: Breakthrough!: How the 10 Greatest Discoveries in
Medicine Saved Millions and Changed Our View of the World

Chapter 1. The World’s First Physician: Hippocrates and the Discovery of Medicine

Chapter 2. How Cholera Saved Civilization: The Discovery of Sanitation

Chapter 3. Invisible Invaders: The Discovery of Germs and How They Cause Disease

Chapter 4. For the Relief of Unbearable Pain: The Discovery of Anesthesia

Chapter 5. I’m Looking Through You: The Discovery of X-Rays

Chapter 6. The Scratch that Saved a Million Lives: The Discovery of Vaccines

Chapter 7. From Ancient Molds to Modern Miracles: The Discovery of Antibiotics

Chapter 8. Breaking God’s Code: The Discovery of Heredity, Genetics, and DNA

Chapter 9. Medicines for the Mind: The Discovery of Drugs for Madness, Sadness, and Fear

Chapter 10. A Return to Tradition: The Rediscovery of Alternative Medicine
Landmark Advances
Year
Landmark
Inventor
C. 1280
Spectacles
?
1540
Artificial limb
Ambrose Pare
1714
Mercury Thermometer
Gabriel Fahrenheit
17715
Bifocal lenses
Benjamin Franklin
1792
Ambulance
Jean Dominique Larrey
1796
Vaccination
Edward Jenner
1816
Stethoscope
Theophile Laennec
1817
Dental Plate
Antony Plantson
Running Press Cyclopedia,
Landmark Advances
Year
Landmark
Inventor
1827
Endoscope
Pierre Segalas
1846
Anesthetics
William Morton
1851
Ophthalmoscope
Hermann von Helmholtz
1853
Hypodermic syringe
Alexander Wood
1865
Antiseptic
Joseph Lister
18815
Rabies Vaccination
Louis Pasteur
1867
Contact lenses
Adolf Fick
1895
X-ray
Wilhelm Rontgen
Running Press Cyclopedia,
Landmark Advances
Year
Landmark
Inventor
1903
Electrocardiography
William Einthoven
1928
Antibiotics
Alexander Fleming
1957
Pacemaker
Clarence W Lillehie and Earl
Bakken
1967
Heart transplant
Christiaan Bernard
1973
CAT scan
Godfrey Hounsfield and Allan
Cormack
1979
Ultrasound scan
Ian Donald
1982
Artificial Heart
Robert Jarvik
Running Press Cyclopedia,
 http://www.kaahe.org/health/ar/class/173-‫أعالم‬‫األطباء‬-‫المسلمين‬-‫والعرب‬.html
 http://www.nytimes.com/interactive/2012/10/05/
health/digitaldoctor.html?ref=thedigitaldoctor&_r=0#/#time15
_375
 http://en.wikipedia.org/wiki/Timeline_of_medici
ne_and_medical_technology
 Detailed timeline from 2600 BC to 2013 AC
 http://www.historylearningsite.co.uk/history_of
_medicine.htm
Look for
 Arabic / Muslim Medicine
 Prehistoric Medicine
 Chinese Medicine
 Medicine in the Middle
Ages
 Egyptian Medicine
 Greek Medicine
 Native American Medicine
 Old Indian Medicine
 Roman Medicine
 Eastern Medicine
 Nobel prize winners in
Medicine
Look for
 History of herbalism
 History of Epidemiology
 History of hospitals
 History of Nursing
 History of medicine
 History of Psychiatry (Medicine
of the mind)

Canada, USA, UK, Europe,
 History of nursing
 History of pathology
 History of pharmacy
 Thomas Clifford Allbutt History
of medicine[134]
 Timeline of nursing history
 History of surgery
 Timeline of medicine and
medical technology
 History of Virology
 Milestones in history of
medicine
 History of Microbiology
 Major developments in
medicine
Men of Medicine
Period
Name
Discovery – Famous
for
Hippocrates
Father of Medicine
Galen
850-
Rhazes ‫الرازي‬
Ali Ben el-Abbas ‫علي بن العباس‬
Albucasis Zahrawi ‫آبو القاسم‬
‫الزهراوي‬
980-1037
Avicenna ‫ابن سينا‬
Ibn Nafis ‫ابن النفيس‬
AVENZOAR / Ibn-Zohr ‫ابن زهر‬
Averroës (Ibn Rushd) ‫ابن رشد‬
1188 – 1248
Ibn al-Baitar ‫ابن البيطار‬
Men of Medicine
Period
Name
Discovery – Famous for
1493-1541
Parcelsus
1514-1564
Andreas Versalius
1510-1590
Ambroise Pare
1578-1657
William Harvey
1632-1723
Antoni van Leeuwenhoek
1716-1794
James Lind
1749-1823
Edwaed Jenner
1778-1829
Sir Humphry Davy
Nitrous Oxide anesthesia
1811-1870
Sir James Young Simpson
Chloroform anesthesia
1819-1868
William Thomas Green
Glass inhaler - Ether
1802-1887
JEAN boussingault
Iodine cures goiter
Scurvy cured by Vit C
Men of Medicine
Period
Name
Discovery – Famous for
1813-1858§
John Snow
Father of public health
1858-1930
Christian Ejikman
Beriberi cured by brown rice
1816
Rene - Theophile Hyacinthe
The stethoscope
Ignaz Phillipp
Semmelweiss
Childbed fever spread by
doctors
Joseph Lister
Aseptic surgery
Robert Koch
Bacteria caused disease
1822-1895
Louis Pasteur
Bacteriology / Vaccination /
Pasteurization
1881-1955
Alexander Fleming
Penicillin
1904-1950
Richard Drew
Blood transfusion / banks
1922-2001
Christian Barnard
First heart transplant 1967
1827-1912
Men of Medicine
Period
Name
Discovery – Famous for
James Watson / Francis
Crick
Discovered DNA
William Kolf
Artificial Kidney machine
Wilheim Rontgen
X-ray in 1895
Techniques & Procedures
 Abortion
 Anesthesia
 Acupuncture
 Angioplasty
 African traditional Medicine
 Animal/human transplants
 Alchemy
 Antibiotics
 Ambulance
 Antidepressants
 Amniocentesis
 Antimalarial drugs
 Amputation
 Artificial eye
 Amulets and talismans
 Aspirin
 Autopsy
 Ayurveda
Techniques & Procedures
 BCG vaccine
 Burns – treatment skin graft
 Biopsy
 Cancer / anti-cancer
 Blood Groups and
transfusion
 Chemotherapy
 Blood pressure
 Bloodletting
 Bone setters
 Breast implant
 Breathalyzer
 Chloroform
 Clinical trials
 Contact lens
 Corneal transplant
 Cortisone
 CT / CAT scan
 Cupping
Techniques & Procedures

Defibrillator

Genetic testing

Diet

Genes and human genome

Dissection

Germs and germ theory

DNA structure

Gloves, gowns

ECG

Hearing aid

EEG

Heart-Lung Machine

Electroconvulsive Therapy

HeLa Cells

Electrotherapy

Herbal medicine

Electron microscopy

Hippocratic medicine

Endoscope

Hippocratic oath

Homeopathy
Techniques & Procedures
 Hormones
 Intravenous infusion
 Hospitals
 In-Vetro Fertilization (IVF)
 Hydrotherapy
 Informed consent
 Hygiene
 Inhalers
 Hygienic products
 inoculation
 Hypodermic syringe
 Insecticides
 Incubators
 Insulin
Techniques & Procedures
 Intrauterine device IUD
 Liver transplant
 Iron lung (Respirators)
 Lung transplantMagic
bullets
 Kampo (Japanese
medicine)
 Massage
 Kidney dialysis
 Meat inspection
 Kidney transplant
 Mechanical ventilators
 Laser in medicine
 Medical education
 Leech tharapy
 Miasma theory
Techniques & Procedures
 Microscope
 Oral contraceptive pill
 Military hospitals
 Ophthalmoscope
 MRI
 Orthopedic surgery
 Neurosurgery
 Osteopathy
 Nuremburg code and trials
 Pacemaker
 Nursing
 Palpation
 Ophthalmoscope
 Patients' records
Techniques & Procedures
 PCR
 Pulse measurement
 Percussion and palpation
 Randomized controlled
trials
 Plaster of Paris
 Penicillin
 PET scan
 Physiotherapy
 Pregnancy tests
 Radio-isotope scan
 Renal Dialysis
 Rhinoplasty
 Robotic surgery
 Sterilization
Techniques & Procedures
 Speculum
 Tissue culture
 Stem cells
 Traditional medicine
 Stethoscope
 Trephination
 Surgical instruments
 Triage
 Surgery
 Ultrasound
 Thermometer
 Scurvy
 Thermal ablation
 Syphilis
Techniques & Procedures
 Vaccination
 Yin and Yang
 Vivisection
 ‫التجبير العربي‬
 War surgery
 ‫الطب الشعبي‬
 Wet-nursing and milk banks
 wheelchair
 Wu Xing
 X-rays
History of Diseases
 Allergy
 Brain surgery
 Alzheimer’s disease
 Carcinogens
 Appendectomy
 Cholera
 ARDS
 Cochlear implant
 Asthma
 Cataract
 Bladder stone Beriberi
 Cholera
 Botulism
 Diabetes
History of Diseases
 Diphtheria
 Gout
 DVT
 Hearing aid
 Epilepsy
 Heart valve replacement
 Food poisoning
 Heart failure
 Gallstones
 Heat stroke
 Gangrene
 Hepatitis
 Goiter
 Hernia
History of Diseases
 Herpes
 Malaria
 Hypertension
 MERS (Corona)
 Internal fixation of
fractures
 Meningitis
 Jaundice
 Joint replacement
 Kyphosis
 Leprosy
 MRSA
 Open heart surgery
 Plague
 Pleurisy
History of Diseases
 Poliomyelitis
 Thyroid disease
 Puerperal fever
 Tonsillectomy
 Rabies
 Trachoma
 Rickets
 Tuberculosis
 Surgery
 Thalidomide
 Swine flue (H1N1)
 Typhus
 Tetanus
 Urethral stones and
strictures
http://thequeenstable.blogspot.com/
Medical Students 140 yrs ago
 No one worried about admissions
 entrance requirements were lower than they are for a
good high school student
 Instruction was superficial and brief
 The terms lasted only 16 weeks, and after the
second term the M.D. was automatically
given, regardless of a student’s academic
performance
Medical Milestones
MEDICAL MILESTONES | BMJ | jANUARY 2007 | volume334
Medical Milestones
MEDICAL MILESTONES | BMJ | jANUARY 2007 | volume334