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