MEDS 280: The History of Medicine: A Doctor’s Perspective
FALL 2015
Weekday TBA 1 hour 50 minutes
2 units
INSTRUCTORS:
 Peter Crookes, M.D., Professor of Surgery, Keck School of Medicine of USC
 Guest Faculty from the Keck School of Medicine and Dornsife College of Letters, Arts and
Science
 Office Address: 1510 San Pablo Street Suite 514, Los Angeles, CA 90033
 Office Phone: (323) 442 5831
 Office hours by appointment: please contact:
Shelley Staudenmeir
ADMINISTRATIVE ASSISTANT:
Shelley Staudenmeir (323) 442 5831
Introduction and Purpose
The history of medicine has lessons for the future of medicine. This course will explore the role of
medicine and surgery in society, whose ideas about health and disease have undergone enormous
changes from antiquity to the present day.
Understanding where we have come from is an important aspect in directing where we are going in
healthcare. Healthcare in this country is no longer the sole province of physicians, but has come to
occupy a central position in the nation’s culture and priorities, and is of great relevance not just to
medical, nursing and allied healthcare professionals, but also to public policy, the corporate world,
economists and educators. Insights into how modern healthcare has developed will give much needed
perspective into what it takes to promote change in the nation’s health, and will have a humanizing
effect on healthcare practitioners such as physicians and nurses.
Course Requirements and Grades





The principal textbook which outlines many of the key areas in the course is “The Greatest Benefit
to Mankind” by Roy Porter (WW Norton & Co., 1999)
Periodic quizzes will be held throughout the course. These quizzes will form part of the
assessment and will be included in the assessment of “Class attendance and participation.”
Course materials will include a selection of articles from the peer-reviewed medical literature.
These required readings will be distributed one week before each relevant session.
The course will consist of one 110 minute meeting each week, which will involve a dynamic
combination of lecture, videos, class discussion and special guests.
Prior to each class meeting, students will receive communication with material to read, listen to,
and/or watch in preparation for the session. Students will be expected to be able to discuss the
material during class.
1


After each meeting, students will receive an email with questions involving material from the
session. These questions will not be graded, but will instead act as practice questions for the final
examination.
Grading breakdown: Letter Grade
10% of the grade will be for attendance and participation
35% of the grade will be for the mid-term examination
55% of the grade will be for the final exam
Grading Scale:
A
AB+
B
BC+
C
CD+
D
DF
94-100
90-93
87-89
83-86
80-82
77-79
75-76
74-70
69-67
66-64
63-60
59-0
Examinations:
Exams will be multiple choice and/or short answer questions or short essays as appropriate and
will cover didactic information provided within the class discussions and readings.
Class Sessions: 1 hour 50 minutes
Week 1
Medicine in antiquity and the classical age
Hippocrates, Galen, the 4 humors theory, philosophical concepts in the Ancient world
and medieval times which precluded empirical observation (e.g. anatomy dissections).
Influence of anatomists like Vesalius.
Week 2
Concepts of disease: the major causes of premature death and disability
Insight into infections, trauma (war) Malnutrition, and awareness of vitamins and other
vital nutrients: concepts of life expectancy, risk of perinatal, maternal and infant
mortality, and the evolution of health from concerns about premature mortality to the
current awareness of the burden of chronic disease
Week 3
The fight against infections
2
Vaccination: Edward Jenner and the fight against smallpox, the elucidation of control
over malaria and yellow fever. Discovery of microbiology and antisepsis. Discovery
of Antibiotics. Application to the world's biggest killers (TB, Malaria, HIV)
Week 4
Extending human unaided observation: Microscope, X rays, endoscopy
Leeuwenhoek and the microscope, Virchow and the concept of cells and tissues,
development of X rays (Wilhelm Conrad Roentgen), contrast radiology (WB Cannon)
and CT Scanning. Development of endoscopy from Mikulicz in Austria to Basil
Herschowitz in Michigan
Week 5
Surgery before and after anesthesia
Development of anesthesia (Humphrey Davy, Wells, Morton, Crawford Long).
Development of Local Anesthesia: dramatic effect on practice of clinical and
experimental surgery
Week 6
Major surgical figures
John Hunter: father of scientific Surgery. Theodor Billroth and his disciples. Halsted,
Cushing and the development of surgical specialties. Harnessing technology, from
Bovie to Laparoscopy
Week 7
Dramatic Milestones in Surgery and Medicine
Heart Surgery (Heart Lung Machine), Dialysis, The first Kidney Transplant, the first
Heart Transplant, and the development of laparoscopic surgery. Analysis of why these
advances were resisted (eg how the early laparoscopic surgery almost landed Dr Muhe
in jail).
Week 8
Women's Health
Childbirth and its risks. Midwifery and Obstetrician in primitive and advanced
societies. History of Obstetric Forceps (Chamberlen family), vacuum and Caesarean
Section. How cultural norms impeded the treatment of women.
Week 9
Women in Medicine
Florence Nightingale and the power of statistical observation and rigorous training.
Elizabeth Blackwell in USA and Elizabeth Garrett Anderson in England as pioneering
women physicians. The transformation of Western medical practice brought about by
the contribution of women.
Week 10
Cancer: understanding of what cancer is and how it leads to ill health and death.
3
Cancer development, environmental risk factors (Smoking, H Pylori, HCV, UV light,
GE Reflux, HPV).
Week 11
Cancer Treatment
Radiation therapy (Marie Curie etc) and the develoment of chemotherapy from
Nitrogen Mustard, Judah Folkman and anti-angiogenesis.
Week 12
Medicine and international politics.
Where medicine changed international relations: Sir Morrell Mackenzie and the crown
prince of Germany, Anthony Eden negotiating Suez Canal treaty). How illness affected
the function of influential politicians and rulers.
Week 13
The education of Physicians
Transformation from haphazard apprenticeship to structured and regulated training.
Effect of the Flexner Report and its consequences for reformation medical schools.
The development of Residency Training, From Billroth to Halsted and beyond.
Week 14
The force of personality.
Major figures whose forceful personality, drive, ambition and passion created major
change despite ridicule and opposition: Semmelweiss, Christiaan Barnard, Sir William
Osler, Thomas Starzl. Analysis of what it takes to introduce reform and how resistance
can be overcome.
Week 15
Field trip TBA (notable historical archival collections in Huntington Library and old
LAC USC .
FINAL
FINAL EXAM 1 hours 50 minutes
Statement for Students with Disabilities
Any student requesting academic accommodations based on a disability is required to register with
Disability Services and Programs (DSP) each semester. A letter of verification for approved
accommodations can be obtained from DSP. Please be sure the letter is delivered to me as early in the
semester as possible. DSP is located in STU 301 and is open 8:30 a.m.–5:00 p.m., Monday through
Friday. The phone number for DSP is (213) 740-0776.
Statement on Academic Integrity
USC seeks to maintain an optimal learning environment. General principles of academic honesty
include the concept of respect for the intellectual property of others, the expectation that individual
work will be submitted unless otherwise allowed by an instructor, and the obligations both to protect
one’s own academic work from misuse by others as well as to avoid using another’s work as one’s
4
own. All students are expected to understand and abide by these principles. Scampus, the Student
Guidebook, contains the Student Conduct Code in Section 11.00, while the recommended sanctions
are located in Appendix A: http://www.usc.edu/dept/publications/SCAMPUS/gov/. Students will be
referred to the Office of Student Judicial Affairs and Community Standards for further review, should
there be any suspicion of academic dishonesty. The Review process can be found at:
http://www.usc.edu/student-affairs/SJACS/..
Emergency Preparedness/Course Continuity:
In case of emergency, and travel to campus is difficult, USC executive leadership will announce an
electronic way for instructors to teach students in their residence halls or homes using a combination
of Blackboard, teleconferencing, and other technologies. Instructors should be prepared to assign
students a "Plan B" project that can be completed at a distance. For additional information about
maintaining your classes in an emergency please access:
http://cst.usc.edu/services/emergencyprep.html
5