1.1 History of Healthcare

• Early beginnings– People believed

illnesses were from evil spirits

• Exorcism

• Trephining

Herbs & plants

• Digitalis: Chewed leaves of foxglove to slow heartbeat

• Quinine: from bark. For fever, muscle spasms, and to prevent malaria

• Beladonna & Atropine: relieve muscle spasms, esp GI

• Morphine from poppies: pain medication

Egyptians

• Earliest people to keep accurate health records

• Priests acted as physicians– Splinted fractures

– Bloodletting with leeches

– Superstitious

Chinese

• Acupuncture

Greeks

• Physicians housed in sacred temples of healing

• First to study disease as natural, not spiritual, process– Kept detailed records– Research helped eliminate superstition– Further developed uses of massage and herbal

therapies

Hippocrates, ca. 469-377 BC

• Greek

• Father of Medicine

• No dissection allowed in ancient times– Based knowledge of anatomy and physiology

by studying external body

• Wrote Oath of Hippocrates– Standard of ethics

Hippocratic Oath

• Original– https://www.youtube.com/watch?v=0ZOWXKt

0TGY

• Modern– https://www.youtube.com/watch?

v=KBDFGSZX8ck

Sanitation

• Greeks discovered some disease from lack of sanitation

• Romans learned from Greeks– Developed sanitation systems

• Aquaducts

• Sewers

• Public baths with filtering systems

Romans

Roman Bath Houses

Roman Sewage

Romans

• Sent medical equipment and physicians with armies

• Physicians kept a room in their houses for the ill– Beginning of hospitals

• Physicians paid by Roman government

Romans

• Physicians wore “death mask”– Had a beak filled with spices– Believed it protected them from infection and

bad odors

Dark Ages and Middle Ages

• Medicine practices only in convents and monasteries– Primary treatment was prayer– Care was custodial– Writings of Greek and Roman physicians

collected and translated by monks

Dark Ages and Middle Ages

• Epidemics caused millions of deaths– Bubonic plague– Smallpox– Diptheria– Syphillis– Tuberculosis

• Today controlled by vaccines

Renaissance

• Rebirth of learning

• Built universities and medical schools for research

• Dissection (autopsy) became accepted

• Development of printing press and publishing of books

16th and 17th Centuries

• Leonardo da Vinci: studied and recorded anatomy of the human body

Leonardo da Vinci

16th and 17th centuries

• William Harvey– Described physiology of the heart

• Gabriele Fallopius– Discovered fallopian tubes

• Bartolommeo Eustachio– Discovered tube leading from ear to throat

• Antonie van Leewenhoek– Invented microscope– Found that bacteria causes tooth decay

16th and 17th centuries

• Quackery

• Mass death from childbed fever

• Disease

• Causes of infection and disease not understood

18th Century

• Elizabeth Blackwell: first female physician• Rene Laennec: invented stethoscope• Joseph Priestly: Discovered element

oxygen, and that plants refresh oxygen for respiration

• Benjamin Franklin: bifocals, transmission of colds

• Edward Jenner: smallpox vaccination

First stethoscope• Made of wood

19th and 20th centuries

• Beginning of organized advancement of medical science

• Ignaz Semmelweis– Identified cause of childbed fever– Women were dying after giving birth

• Women who used midwives instead of physicians had higher survival rates

19th and 20th centuries

• (cont’d)• Difference between physicians and

midwives? HANDWASHING– Physicians conducted dissections on dead

bodies in “dead rooms.” Did not wash hands or change aprons before going in to deliver babies

• Other physicians laughed at Semmelweis• Eventually proven

19th and 20th centuries

• Louis Pasteur: Father of Microbiology– Discovered microorganisms everywhere and

that they caused disease• Before this discovery, doctors thought

microorganisms were created by disease

– Invented process of pasteurization– Created Rabies vaccine

19th and 20th centuries

• Joseph Lister: first doctor to use antiseptic in surgery to prevent infection

• Ernst von Bergmann: developed asepsis (sterility)

• Robert Koch: identified the bacterium that causes tuerculosis

• Wilhelm Roentgen: discovered x-rays• Paul Ehrlich: found treatment for syphillis

19th and 20th centuries

• Anesthesia used for first time in surgery– Nitrous oxide, ether, chloroform

• Before anesthesia– Herbs– Hashish– Alcohol– Choking unconscious

19th and 20th centuries

• Other discoveries included:– Sulfa drugs– Viruses– Psychology/psychiatry (Freud)– Penicillin (Fleming)– Polio Vaccine (dead – Salk; live – Sabin)– Molecular structure of DNA (Crick and

Watson)

21st Century

• Holistic medicine– Treat whole patient

– Alternative/complimentary methods

• Telemedicine• Transplants/reattachments• Use of technology• Noninvasive techniques• Prenatal care/surgery

21st century

• People living longer

• Geriatric medicine, assisted living

Florence Nightingale

• Opened school of nursing• Prior to this time, nursing not a

respectable occupation– “too old, too weak, too drunken, too

dirty, or too bad to do anything else”

• Nightingale cared for soldiers during Crimean War – dying from cholera– In recognition of her services, funding set up for

training of nurses.– Designed a hospital ward to improve environment and

care of patients

Clara Barton

• Volunteer nurse in American Civil War

• After the war, established bureau of records to help find missing soldiers

• Campaigned for Treaty of Geneva – provided relief for sick and wounded soldiers

• Established American Red Cross

Patient care today

• Team approach– Registered nurse (RN), Licensed Vocational

Nurse (LVN) – Certified Nurse Assistant (CNA)– Patient Care Technician (PCT)– Support techs

Review Questions

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