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History 3D - History of Medicine Week One Lecture Notes

by: Annita Kasabyan

History 3D - History of Medicine Week One Lecture Notes History 3D

Marketplace > University of California - Los Angeles > History > History 3D > History 3D History of Medicine Week One Lecture Notes
Annita Kasabyan
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About this Document

I made sure these notes are understandable and covered everything that Dr. Frank discussed in class this week. I hope they are of great help
History of Medicine
Dr. Robert Frank
Class Notes
history, medicine, History 3D, Robert Frank




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This 4 page Class Notes was uploaded by Annita Kasabyan on Wednesday February 3, 2016. The Class Notes belongs to History 3D at University of California - Los Angeles taught by Dr. Robert Frank in Spring 2016. Since its upload, it has received 592 views. For similar materials see History of Medicine in History at University of California - Los Angeles.


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Date Created: 02/03/16
History of Medicine Week One Lecture Notes 3/28/16 1. World in the 1770s a. Small, dense population b. Agricultural c. Great inequality of wealth i. 70% of wealth owned by 1% of population d. Rural infant mortality rate 200/1000 individuals e. London’s infant mortality rate 450/1000 individuals f. Doctor didn’t see villagers; most didn’t even have medical access g. Many diseases were caused by nutrition deficiencies h. Some caused by environment i. Typhoid fever, tuberculosis, pneumonia i. Some insect­borne j. Epidemics i. Although plague was gone, there was smallpox, measles ii. Yellow fever was a problem in Spain and Italy k. What did the doctor observe? i. Doctor had very strong Hippocratic roots ii. Reliable diagnosis was extremely important iii. Relied on their senses, closely examining the patient, observing their  behavior, etc. 1. Sense of sight, hearing, and smell were most important to the  diagnosis iv. Medical history was also very important to diagnosis 1. Pattern of the spreading of the disease was very important in  identifying it v. Examined excreta (feces, urine, sweat, mucus) to identify disease vi. No use of instruments, measurements a. Described qualitative, not quantitative l. What did the doctor think? i. Thought of disease as a departure from the normal functioning of the body ii. Non­localized, disease was general, didn’t have an origin iii. Transmutation 1. An extreme form of a disease was considered to them as a different disease than the milder form m. What did the doctor do? i. give advice ii. bloodletting 1. open a vein and let them bleed out, using a leech or something  similar iii. purge 1. remove disturbing elements from body iv. medication 1. poly pharmacy 2. opium 3. alcohol 3/30/16 1. Smallpox: A Disease Deterred (eradication in 1981) a. Smallpox: causes, rise, and patterns i. Variola (virus) and transmission 1. Submicroscopic 2. DNA virus, very stable genome 3. Remarkable resistance to environmental agents 4. Main portal of entry is the respiratory tract 5. Not an infective virus ii. Clinical course 1. Lodges and replicates mostly in epithelia 2. As it multiplies, it is protected from immune system 3. Incubates for about 12 days and spreads 4. First symptoms last for 2­4 days; feel lousy, have a fever; person is infective but you don’t know what you have yet 5. After first symptoms, you begin to see a rash; begins at the face,  throat, and then spreads to the arms, trunk, etc. 6. After about 7 days, skin becomes bumpy and the rash forms  papules, becoming vesicles; lasts about 2 weeks 7. Then they become scabs that are very infective iii. Pre­history; before 1500 1. We first see it in the Middle East and then it recedes 2. Came back in about 1100; more popular because Arab writers  wrote about it 3. Relatively mild and not greatly feared 4. In the category of childhood acute diseases 5. Highly immunizing, if you survive attack or get vaccinated iv. New world 1. Highly destructive 2. Brought over by Montezuma into present­day Mexico City in 1520 a. 30 million natives living in the area; went down to 2.5  million after the introduction of smallpox and other  diseases th v. Rise in 17  century vi. Mortality and age 1. Fulminating smallpox is 100% lethal and was mostly found in  children    2. About 20% of people who had disease died from it 3. Very likely to catch smallpox if in an urban area 4. Children most vulnerable vii. Urban prestige b. Prevention: Inoculation (use tissue from an active smallpox case and introduce is  to a nonimmune and hope to get a mild case of smallpox… then you’re immune) i. The East 1. Developed in East and South Asia 2. Practiced widely in the Ottoman Empire ii. Lady Mary 1715­1721 1. Very well known 2. Received smallpox in 1715 3. Saw inoculation in Turkey; had her child inoculated there 4. Came back to London in 1721, when there was a serious outbreak  of smallpox; inoculated the rest of her children iii. Aristocrats 1. Practice of inoculation spread amongst aristocrats, and even the  King 2. King had a physician be sent to a prison to inoculate them to see  the success before inoculating himself 3. Life expectancy: a. 1700­1724: 36.34 years old b. 1725­1749: 36.7 years old c. 1750­1774: 45.7 iv. Resistance 1720­1740s 1. Religious resistance to inoculation 2. Expensive procedure 3. Because it was contagious, many people resisted v. Improvements 1750+ 1. Began taking a sharp instrument, making a little incision in the  skin and place a tiny piece into skin instead of a larger piece 2. This allowed for the person to have a much milder case 3. Inoculation death rate went down to <0.5% 4. Prep time decreased and eventually eliminated 5. Cost reduced 6. Isolated patients when inoculated until they were no longer  infected before allowing them back to their everyday lives vi. Widespread 1770+ 1. Started being advertised 2. Became more of a standard procedure c. Jenner and Vaccination i. Life and Training 1. Edward Jenner, introduced vaccine 2. At age 12, he signed into an apprenticeship 3. At age 17, doctor allowed him to perform inoculations 4. Always on the lookout for cases of smallpox; apparently people  who had cowpox are immune to smallpox; wanted to test the  theory; correct theory 5. People with cowpox were immune to inoculation, therefore  smallpox 6. Called it vaccination  7. Cowpox was not contagious, so it was a more effective form of  inoculation ii. 1790s – why difficult 1. Others thought it was silly so he did more trials iii. 1798+ Rapid Spread 1. Developed a book


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