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The Development of Medicine in the 19th Century

Diseases and illnesses have been present from the very earliest times, and medicine and cures have always been reliefs widely searched for. It was a long time however before man acknowledged the ability to apply the appropriate medical treatment for certain diseases. This was due to the slow increase of knowledge of how the parts of the human body function. Before the great scientific discoveries and breakthroughs of the 19th and 20th centuries, medical procedures were very reliant upon nature. The medical practice involved little more than comfort for the patient until nature took its course. Doctors were not as refined and knowledgeable, operations were not as clean, and hospitals were not as sanitary as the conditions we are accessible to today. Natural instincts and intelligence are what have brought the medical practice to the discoveries and a higher level of success in which we have today.

Early medicine was a mixture of a great deal of magic, charms and superstitions. The modern operation of trepanning for example was mimicked by the prehistoric people using a cure far beyond herbs, berries and chants. Skulls were found with little round pieces cut out of them which were known to be done in order to relieve severe headaches caused by brain tumours. Evidently, these primitive people abided to do this in order to let out and release evil spirits which they thought were lodged in the head. Trepanning was also a remedy for insanity, epilepsy and headaches, yet this procedure killed many people. Those who were practised on by such harsh medical techniques would probably have been more comfortable if the had not been treated at all.

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Unlike these prehistoric methods, techniques today have been discovered in order to assure the patient of a fear-free and painless operation. In this 21st century, a patient will be put unconscious by an anaesthetic gas or injection if they undergo major surgery. The part of the body that is being worked on will be numbed by a local anaesthetic if the surgery is the only minor. Great measures are taken to see that the surgeons and their assistants wear sterile clothing, and use clean, sanitary instruments, bandages and other equipment. These procedures were not yet evident at the start of the 19th century, making surgery very different and difficult.

Patients were extremely hesitant when having to present their doctor with a major problem that could lead to an operation. To proceed with surgery was dreaded for many reasons, and an operating room ordeal was considered “nightmarish”. Anaesthetics were not yet discovered, and patients were left screaming in pain throughout the entire procedure. Even minor surgery was excruciating with nothing except perhaps a little whiskey to dull the agony. Straps and/or husky assistants were the only restraints the patients had as the surgeon proceeded to leave them in pain. Filthy equipment and un-sterile environments left patients with a slim chance of survival. Patients who did survive, however, were taken back to a filthy hospital ward where they were then susceptible to infection.

Doctors too were faced with the challenge of a painful and difficult operation. The only relief the determined doctor could offer the suffering patient was speed. There was a doctor that could cut off, or amputate, a leg in just 32 seconds, leaving him much reason and advantage to brag. The doctors of these times did not have the technology discoveries we are left with today, therefore they did not know what they would find until they cut into the patients body. The doctors were not as concerned with protection from infection, and whether or not the patient was in a clean environment. Surgeons wore a coat of black cloth, stiff with blood and filth of years of operations past.

The more soaked with fluid this garment was, the more forcibly it conveyed evidence of the surgeon’s skill and background. Many surgeon’s of the late 18th and early 19th centuries suggested giving up trying to prevent pain during operations. Although ancient doctors knew of a few plant substances, such as dark sap or “tears” from the opium poppy, that would dull pain, these were not useful due to the high risk of death if the dose was too high. They were ineffective if the dose was too low. Until the 19th century, adequate discoveries were rare, and useful breakthroughs were not obtained.

The discoveries made in the mid 19th century led to great advances in the diagnosis and treatment of different diseases and surgical methods. This earned the 19th century the title of “the golden age of medicine”. The instrument used to detect sounds in the body such as a heartbeat was invented in 1819 by French physician Rene-Theophile-Hyacinthe Laennec-one of medicine’s single most important diagnostic tools, the stethoscope. This man realized and described how the diagnosis of the disease can be helped by understanding the sounds of the heart and lungs.

A number of diseases bear the names of the people who studied and described them. Some acknowledgeable diseases today that were discovered during the 1800s include Addison’s disease, discovered by British physician Thomas Addison who ascertained the disorder of the adrenal glands; Richard Bright diagnosed the kidney disorder, Bright’s disease; Hodgkin’s disease, a cancer of lymphatic tissue, was first described by Thomas Hodgkin; British palaeontologist and surgeon James Parkinson described the chronic nervous system disease called Parkinson’s disease; and the thyroid disorder exophthalmic goitre, sometimes called graves disease was diagnosed by the Irish physician Robert James Graves.

The development of pathology was pioneered by a German pathologist named Rudolf Virchow. It was this man that delineated that all diseases result from disorders in the cells, the basic units of body tissue. His conclusion that the cell is the initiator of the disease remains the cornerstone of modern medical science. In France, physiologist Claude Bernard showed that his scientific studies emphasized that an experiment should be objective and prove or disprove a theory or hypothesis. After performing important research on the pancreas, liver, and nervous system Claude Bernard discovered the basis of the scientific method used today. Russian physiologist Ivan Petrovich Pavlov developed further Bernard’s work on the interaction of the digestive system and the vasomotor system (which controls the size of blood vessels). It was Pavlov who developed the theory of the conditioned reflex, the basis of human behaviourism.

An extremely significant milestone in medical history occurred in the 1870s when the germ theory of disease was promulgated. French chemist Louis Pasteur and German physician Robert Koch separately established this theory which led to many medical breakthroughs. The American physician and author Oliver Wendell Holmes and of the Hungarian obstetrician Ignaz Philipp Semmelweis showed that the high rate of mortality in women after childbirth was attributable to infectious agents transmitted by unwashed hands. Some causes of age-old illnesses such as anthrax, diphtheria, tuberculosis, leprosy, and plague were soon isolated after the germ theory was acknowledged.

In 1885, Pasteur developed a way to prevent rabies from using a vaccine. Techniques for immunizing against diphtheria, which is a highly infectious disease affecting children particularly, characterized by the disposition of a false membrane in the passages of the upper respiratory system was developed by a German physician Emil von Behring and German bacteriologist Paul Ehrlich. In the last decade of the 19th century, these men also developed methods for immunizing against tetanus, which is when a bacterial toxin causes severe muscle spasms leaving a serious infectious disease of the nervous system, also called lockjaw.

Surgery was made much safer by these new understandings of infectious diseases. The late 19th century was the end of doctors operating in filthy clothes, using unsterilized instruments, and patients dying of infections developing after the operation. The era of aseptic surgery was heralded by British surgeon and biologist Joseph Lister, in which physicians used sterilized instruments and techniques to avoid preventable deaths. Mortality from wound infection was successfully reduced by Lister’s introduction of an effective antiseptic, carbolic acid. New and improved measures were taken in order to protect the patients well being. Rubber gloves were first worn during surgery in 1890, and gauze masks in 1896.

Another great advance in 19th-century medicine originated from doctors and medical students inhaling laughing gas and/or ether at parties. It was Crawford Williamson Long who discovered the anaesthetic effects of ether in 1842. He observed that during these parties, those who inhaled these gases were not effected by pain when they happen to fall, cut themselves, or bump into things. This led to the first painless operation done by Crawford on his friend James Venable. Crawford insisted his friend inhale ether before the small operation, therefore pain would not be felt. It was a successful removal of a small tumour on the back of Venable’s neck, and when the surgery was complete, Venable refused to believe that the operation had taken place until Crawford showed Long the tumour.

This was the first operation in which ether or any other gas was used to deaden the pain. This was the beginning of a new era for doctors, patients and medicine. It was a dentist named William Thomas Green Morton who used ether in tooth extraction in 1846 and soon patented the idea of using a special “preparation” for a painless operation. This breakthrough reduced surgical mortality and allowed surgeons to perform lengthy, more complex operations while being much more careful.

At the very end of the 19th century, in 1895, a new tool for diagnosing internal diseases became available. German scientist William Roentgen had discovered X rays. An ultraviolet-ray lamp, discovered by the Danish physician Niels Ryberg Finsen , led to an improved prognosis for some skin diseases. Marie and Pierre Curie later discovered radium in 1898 in France, which was later used to treat cancer. All of these discoveries have been used for many years, and have improved patients health all over the world.

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