Introduction to the�History of Medicine
Brian Regal, PhD
Professor for the History of Science, Department of History
Kean University
HIST 3321
Simon Forman (1552-1611)
Elizabethan astrologer, physician, occultist
Tens of thousands of astrological
consultations performed between
1596 to 1611
Use of sympathetic magic
Teratology = study of birth defects�Tera (Greek) = monster�Monster (Latin, Monstrum) = prodigy or portent
Monstrous Births
Monstrous Births
disabilities
Monstrous Births
Monstrous Births
Monstrous birth, France 1808
Monstrous birth, Italy 1585
London edition (first published in 1680)
New England edition (1821)
Hairy child (New England ed)
Hairy child – Hypertrichosis ? (London ed)
Two headed boy of Bengal
Two headed boy of Bengal, 21st century version
Conjoined twins, Chang & Eng and the Hilton Sisters
The Biddenden Maids
Gynecology tools
Gynecology tools
Gynecology tools
What is this?
Scarification (Bleeding) equipment
Medicine in India
Atharva Veda: (The book of magical formulas) book of medicine, written around 1000 – 900 BCE.
Fractures: “Let marrow be put together with marrow, and joint together with joint, together what of the flesh fallen apart, together sinew and together your bone. Let marrow come together with marrow, let bone grow over together with bone. We put together your sinew with sinew, let skin grow with skin.”
Atharvaveda 4.15, Paippalada Edition
Use healing herbs to stop decay and infection.
Also contains spells to charm a lover
or acquire a wife.
The magical aspects begin to go into decline in favor of more medically based remedies around the first century CE.
Body snatching
1541 – Royal Company of Barbers and Surgeons (UK) may dissect four executed criminals a year
Dissection a horrible and degrading thing reserved for the lowest classes
1644 – a cadaver is not property
1752 – Murder Act = murder now gets you execution and dissection
18th century – anatomy being taught widely in the UK at both state sponsored and private medical schools
Competition between schools and professors leads to fights over bodies and school sponsored grave robbing
Free lance grave robbers
Body snatching
Edinburgh Scotland 1827-1828
Burke and Hare sold 16 bodies to
Dr. Robert Knox
Hare turned state’s evidence and was
Jailed briefly then released.
Burke was executed then dissected
Dr. Knox was disgraced
Anatomy act of 1832
William Burke and William Hare
Burke’s end
Propaganda about Witches
Witches
Gervase Markham, The English Housewife (1615)
Albertus Magnus, Bishop of Regensburg,
De secretis mulierum libellus (1601)
Popular writings originally published
in the 1470s dealing with astrological
influences on pregnancy and women's
health; magic properties of plants, stones,
and animals; and wonders of nature.
This edition also contains
De secretis naturae, a treatise on
generation and physiognomy.
Nicholas Culpeper (1616-1653) Herbalist, astrologer, physician
Medicine as science
William Harvey (1578-1657) English anatomist, blood circulates by being pumped by the heart
Herman Boerhaave (1668-1738) Dutch anatomist, the body is a complex plumbing system
Rene Descartes - Ghost in the Machine concept, Machina Carnis
The human body is a machine with a driving force
Morphine – 1806
Hypodermic needle – 1853
Heroin – 1898 (Bayer Aspirin company)
Dr. William Harvey, Exercitatio Anatomica (1628)
Wright of Derby: Robert Boyle, Experiment with an Air pump
Birth of the ‘New Experimental Philosophy’
Anton Van Leeuwenhoek (1632-1723)
Sees little living things he calls animalcules
Robert Hooke
Robert Hooke (1635-1703) Micrographia (1665)
Early microscopes
Early microscope with Clyster
Boyle and Hooke’s lab, High Street, Oxford, UK
Luigi Galvani’s frog experiments
Allesandro Volta’s experiments
Static electricity generator – 1700s
�First invented by Rene Laennec in 1816�
1870
1860
1865
Variolation
Variolation, the precursor to vaccination, had a long history in China and India. It likely spread from there along the Silk Road into the Middle East and Africa.
One technique had you cut the surface of the skin then smear in Small Pox pus from a victim. This had a tendency to prevent full blown infections in the individual variolated.
In China Pus was dried into a powder and blown up the nose to get it into the blood stream.
Variolation
Variolation / inoculation are terms meaning the general introduction of a disease in a limited way into a patient in order to render them immune to the effects of the disease (Vaccination is a specific technique).
Some claim this can be traced back to 10th Century China and the Song Dynasty. It was used to combat smallpox. There is, however, little textural evidence for this.
Inoculation was first described by Zhang Lu in his book Yuyi cao, or Notes on My Judgment (1695).
Small Pox = 天花 tian hua
Inoculation = 接種 jie zhong
Variolation
It was popularized in the West via the work of Lady Mary Wortley Montagu, an early feminist, author and freethinker. She originally saw it being done in the Islamic world when she travelled to Constantinople where her husband was ambassador to the UK (Variolation had already been used sporadically in England and Wales but few believed it actually worked).
In 1721--after they returned to home—England
had a Small Pox outbreak and so she had a
doctor variolate her children for protection.
The British Royal Family found out and had
their kids vatiolated as well.
Sir Hans Sloane (later founder of the
British Museum) organized
“The Royal Experiment” in 1721, in which six
condemned prisoners were variolated. They
survived and were then pardoned.
Variolation in America
Smallpox Epidemic of the American Revolution (1775-1782)
ravaged American colonial forces as well as the Native population.
George Washington, fearing the epidemic would kill the Revolution, had troops and entire cities quarantined and used variolation to stop the spread of the disease, under threat of violence.
It worked.
Zephaniah Swift. The Laws of the United States of America (Philadelphia, 1796).
Variolation
Sloane began to realize that you could give someone a small dose of Small Pox and it would protect them.
There was an outcry against this as some patients died anyway and you could start a pandemic which would run out of control and kill many.
A better way was needed.
Smallpox
Smallpox
Edward Jenner – vaccination mss 1789
Hypodermic Syringe
The hypodermic needle, at least the concept of injection under the skin (subcutaneous) has its origins in the ancient world.
Galen mentions syringes made out of reeds being used to apply salves and ointments to the surface of the body.
900CE Islamic doctors used glass tubes to suck out puss and blood from wounds, and even in cataract surgery.
Mid-1600s European doctors used reeds to inject dogs then humans under the skin in the use of opioids (Poppy sap). They used crow quills. Not knowing about sterilization and dosage they mostly killed their patients.
Injection goes out of favor.
Pandemics and Plagues
165 - 185CE The Antonine Plague: probably Smallpox and Measles - 5 million dead (Contributed to the fall of the Roman Empire)
541 - 542CE The Plague of Justinian: 30-50 million dead, first Bubonic Plague
1347 - 1352CE The Black Death: 75-200 million dead, also Bubonic Plague
1520 - ? New World Smallpox: 25-55 million dead, Smallpox and Measles, part of the genocide of Native people in the Americas
1665CE The Great Plague of London: 75-100,000 dead, Bubonic Plague
1817-1923 The Cholera Pandemics: 1 million dead worldwide
Pandemics and Plagues
Late 1800s Yellow Fever: 150,000 dead across America
1918-1920 Influenza: 50 million dead, H1N1 strain
1957-1958 Spanish Flu: 1 million dead, H2N2 strain (In America a vaccine hastily prepared kept the death rate there to 70,000 instead of half a million)
2009 Swine Flu: 200,000 dead, H1N1
2020 - ? Covid 19: 2.5 million dead worldwide, 500,000 and counting in America
Hypodermic Syringe
1844 Dublin, Ireland doctor Francis Rynd makes a syringe needle out of metal. By 1851 Alexander Wood designs the glass vial so you could see how much you were injecting.
1858 the term ‘Hypodermic’ is coined 1950s, plastic introduced for disposability.
Francis Rynd
Alexander Wood
Hypodermic Syringe
Hypodermic Syringe
Louis Pasteur (1822-1895)
Medicine as science
Giovanni Morgagni (1682-1771) pioneers the autopsy - Find the cause of death
Biology = term coined in 1800
Histology = study tissues with a microscope
Physiology = reduce the workings of the body
to a series of chemical actions which can be
Detected, measured and studied
Medicine moves out of the physicians office
and into the laboratory
Examine the body and its constituent parts
Directly
Koch’s postulate
For determining Communicable diseases
the animal to develop the disease
4. You must be able to get the disease from
the test animal
History of Surgery-Wound Man�German manuscript illumination, 1420
History of Surgery
5000 BC Trepanning – cutting a hole in the head
History of Surgery
Renaissance Trepanning
History of Surgery
Early Trepanning instructions in a medical book
19th century Trepanning kit
Amboise Paré – French surgical pioneer
Amboise Paré – surgical tool set and first traction/splint apparatus
Amboise Paré – artificial limbs
Surgery/Amputation
Surgery/Amputation kits
Surgery/Amputation
Surgery/Amputation kits
19th century compound fracture which led to amputation
Amputation of the big toe!
Surgery/Amputation kits – US Civil War
London Operating Theater
Operating Table with Blood Box
John Keats as a surgery student at Guy’s Hospital, London, 1816
"My last operation was the opening of a man's temporal artery. I did it with the utmost nicety, but reflecting on what passed through my mind at the time, my dexterity seemed a miracle, and I never took up the lancet again.“ – John Keats
Surgery without anesthetic - Horrified by the experience, Keats left medical school and became a poet hoping he could heal with words where he failed to heal with medicine.
London Operating Theater with former patient
London Operating Theater
London Operating Theater
Medieval/Renaissance health care
St. Roch ceramic figurine (1520). Venerated as
the protector against the plague. Look closely
at the figure. The Saint’s left hand points to a
dripping and bloody ‘bobos’ and his thigh. These
sores are what give the disease its name:
Bubonic Plague.
Such a figurine—about two feet tall—would
Have been positioned at the entrance to a shrine so
that illiterate but needy pilgrims would have
known which shrine to pray at.
Good hospital
Medieval hospital
St. Leonard’s, UK
Early Modern era Bad hospital
Bad hospital
19th century hospital, Mass General, 1847
Fanny Burney (1752-1840)
English Author, playwright: her most famous work is Evelina (1778)
In 1810 while in France, she developed breast cancer. In 1811 doctors decided to give her a mastectomy (surgical removal of the breast) – without anesthetic. She later wrote a harrowing description of her ordeal, which she survived.
Fanny Burney (1752-1840)
“I mounted, therefore, unbidden, the Bed stead – & M. Dubois placed me upon the Mattress, & spread a cambric handkerchief upon my face. It was transparent, however, & I saw, through it, that the Bed stead was instantly surrounded by the 7 men & my nurse. I refused to be held; but when, Bright through the cambric, I saw the glitter of polished Steel – I closed my Eyes. I would not trust to convulsive fear the sight of the terrible incision. Yet – when the dreadful steel was plunged into the breast – cutting through veins – arteries – flesh – nerves – I needed no injunctions not to restrain my cries. I began a scream that lasted unintermittingly during the whole time of the incision – & I almost marvel that it rings not in my Ears still? so excruciating was the agony. When the wound was made, & the instrument was withdrawn, the pain seemed undiminished, for the air that suddenly rushed into those delicate parts felt like a mass of minute but sharp & forked poniards, that were tearing the edges of the wound. I concluded the operation was over – Oh no! presently the terrible cutting was renewed – & worse than ever, to separate the bottom, the foundation of this dreadful gland from the parts to which it adhered – Again all description would be baffled – yet again all was not over, – Dr. Larry rested but his own hand, & – Oh heaven! – I then felt the knife (rack)ling against the breast bone – scraping it!”
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
Bartholin's younger brother, Erasmus, is the
earliest publication on crystallography,
and preceded Boyle on gems (1672)
by eleven years.
Crawford Long (1815-1878)
Used nitrous oxide (laughing gas) to remove a tumor from a friend’s neck on March 30, 1842
Did it in private but did not really understand what he had done
William Morton, dentist in Boston,
removed a tooth under anesthetic of
September 1846
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.
William Morton, First use of ether/anesthetic for surgery, 1846�Dr. Warren did the actual surgery to remove the tumor
William Morton, First use of ether/anesthetic for surgery, 1846
Morton used Ether rather than Nitrous Oxide.
Wells had used Nitrous Oxide, but his disastrous exhibition at Mass General in
1845 made it fall out of use as dangerous
Not used again until 1862 when re-popularized by G.Q. Colton
Anesthetic
Anesthetic, ether and nitrous oxide
Joseph Lister (1827-1912)
British surgeon, Glasgow Infirmary
-clean wounds
de-stinkify the sewer system
Spray it on everyone as you work
Antiseptic, carbolic acid
Antiseptic, carbolic acid
Leeches
Enema jug
X-Rays
Wilhelm Rontgen (1845-1923) discovers x-rays by accident in November 1895.�
X-Rays
X-Ray of the wrist 2021.�
X-Rays
Danger of X-Rays to equipment operators.�