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HS Study Cards
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- 1Pre-Historic Health:-Reliance on archaeological records
-Life Expectancy: 30s to 50s
-Limited exposure to pathogens
-Mobility
-No domesticated animals - 2Neolithic Revolution:-10,000 – 3,000 years ago
-Populations grew; No longer enough animals to hunt or plants to gather
-Climate change
( Changes in society: )
-Development of social hierarchies, political states, and civilizations
-People are now living close to animals. Rise in disease - 3Medical Care and Healing:-Two major roles of the sick: (The Child and the Outcast)
-Rise of Medical Specialists: (Medical men, diviners, witch-smellers and shamans, herbalists, birth attendants, bone-setters, healer-priests) - 4Magic and Medicine:-Mystical: illness is an automatic consequence of an act or experience
-Animistic: illness is caused be a personal supernatural being (ancestors, ghosts, spirits or gods)
-Magical: a malicious human being uses secret means to make someone sick - 5Supernatural Medicine in Mesopotamia:-Omen-based framework of disease
-Sickness was a judgement and a punishment
-Code of Hammurabi (1750 BC) - 6Ancient Egypt:-Health meant having a peaceful relationship with the gods and spirits
-Rise of medical profession & some specialization
-Imhotep, polymath & physician (Defied as a god, healing shrines around Egypt) - 7Anatomy:Study of the Body (What)
- 8Physiology:Study of how the body works (How)
- 9Why was dissection banned through most of history?-Cultural/religious reasons.
- 10Egyptian understanding of disease:Supernatural understanding of disease. Learned of the body through the mummification process.
- 11Mummification Process:-70-day process
-Internal organs removed.
-used small incisions in left side of the body to not damage the body
-Hook to pull out brain
-All organs but heart removed. Believed the soul was held in heart.
-Removed moisture, bodies were wrapped - 12Ancient Greek World: 500 BCE-323 BCE:-Moving away from supernatural understanding to observation method.
-Magic was used to diagnose, prevent and treat disease.(spells, worshipping with temples/shrines) - 13Hippocrates, 460-361 BCE:-”Father of Western Medicine”
-Hippocrates Collection: Collection of 50 texts.
-Medicine should be a science.
-Saw value of anatomy. Wasn’t allowed to dissect.
-Hippocratic Oath (how doctors should practice medicine. A promise to follow ethical standards of practice.) - 14Hippocratic Medicine:On Ancient Medicine:
-(Emphasis on patient vs. disease; observation vs theory)
-Balance in the body is key
-To maintain balance: changes in diet, bloodletting, drugs.
On the Sacred Disease (Epilepsy):
-Hippocrates argues that epilepsy is not a supernatural force, but an inbalance of humor of the brain. - 15Eucresia & Dyscresia:Eucresia: Humors are balanced and working together.
Dyscresia: Humors are unbalanced, aggravated. - 164 Humors of Health:-Blood: (Hot and wet. Air and Spring. Crucial for nutrition, health and growth.) Sanguine.
-Phlegm: (Wet and Cold. Winter and Water. Clear fluids: Saliva, tears, urine, mucus. Flushed out impurities.)
Phlegmatic.
-Yellow Bile: (Hot and Dry. Earth In the liver and gall bladder. Fire. Summer. Digestion.) Choleric.
-Black Bile: (Earth and Autumn. Cold and dry. Helped to solidify stool, retentive virtue.) Melancholic. - 17Aristotle 384-322 BCE:-Considered the first anatomist. Studied mammals. Founder of biology.
-Dissected 500 mammals, birds, fish, etc. Only dissected animals.
-Concerned where the soul was. Believed heart was the centre of vascular system.
-Didn’t understand blood circulation in body. Knew blood was in arteries and veins.
-Had a teleological view. Every part of the body has it’s purpose - 18Alexandria:-For a short time, dissection is allowed in Alexandria (city in Egypt,331 BCE-641 CE)
-Represented wealth and stability
-Ptolemy’s capital, wants it to be a cultural hotspot.
-Library of Alexandira is a location of science, medicine, literature. - 19Herophilus & Erasistratus:-Dissected humans, and practiced vivisection.
-Herophilus did public dissections for entertainment.
-Only dissect criminals (death penalty.)
(After 30/40 years, dissection/vicisection stops.) - 20Herophilus 325 -255 BCE:-Noticed Arteries are thicker than veins. Believed arteries contain blood and pneuma.
-Interested in pulses, nerves & brain. Begins to figure out how brain operates. Believes brain is most important. - 21Erasistratus 304-250BCE:-Doesn’t believe in the humors, believes in mechanistic principles.
-Compared heart to smiths bellows (pumping capacity).
-Believes arteries held pneuma, and veins held blood.
-Food is taken from intestines to liver via the portal vein. Food is then transformed into blood and taken to vena cava. (Some blood is diverted to right ventricle, nourishing the lungs.
-No evidence of believing in circulatory system. - 22Galen 129-216 CE:-Responsible for spreading humoral theory. 1400 year influence.
-Argued ideal physician should be familiar with greek philosophy. Agreed with Hippocrates’ view of medical caretakers.
-Dissection is forbidden during his time.
-Published hundreds of texts on the human body. Picks and chooses from older ideas of physiology. - 23Galenic Anatomy & Physiology:-Hippocratic Medicine & Humoral Theory. (Believed these were the perfect understanding of the body.)
-Aristotle → heart is location of the soul
-Herophilus → arteries and veins are different
-Erasistratus → heart is the source of veins and arteries.
Rete Mirable: network of veins and blood vessels found in animals. Not found in human body. - 24Divided human body into 3 systems:1: Brain, spinal chord, nerves (motor & sensory)
2.Heart + arteries (vital source)
3. Liver + veins (nutrition of body) - 25Galen’s Cardiopulmanary System:1) Food is consumed, absorbed + transformed in liver into blood with natural spirit
2) Blood flows from liver, throughout body like water in an irrigation ditch (non-circulating)
3) Blood passes through pores in heart, where vital spirit is added, lungs cool the heart
4) Blood flows outward from left ventricle to all parts of body
Has a Teleological view, like Aristotle. - 26Galen’s Heart:-acknowledged that heart pulsates. Used heart like a sponge (sucking up blood and pushing out.)
-Interventricular Septum: (believes it transfers blood through pores in the interventricular Septum) - 27Why did Galenism persist?-The roman empire divides into two sections:
- 28Rise of Christianity:-Emperor Constantine makes Christianity the religion of the empire.
-Religious learning > medical learning
-Focus on the soul, not body. Believed that the body must be whole or you wouldn’t get into heaven.
-Galen’s views and teachings = evidence that soul exists. - 29Q: What prevented people from dissection (before)? A: 3 Cultural Ideas: Corpse, Skin, Cutting.Q: What prevented people from dissection (before)? A: 3 Cultural Ideas: Corpse, Skin, Cutting.
Corpse: A corpse pollutes the area, you, and everything around it. So they had to “purify” the body through rituals and ceremonies. Religious practice. Doctors didn’t want to be seen as “polluted.”
Skin: Seen as sacred in Greek culture bc. It’s seen as a “natural bounary to not be crossed” and the idea of wholeness (no cutting).
Cutting: Cutting or harming the body was associated with violence. You are doing someone harm, - 30Q: Why did dissection happen?A: The king at the time (Ptolemy) allowed it. No democracy to vote against it. Patronage (financial, donation of bodies). Ptolemy wants to create cultural centre. Frontier in hellonistic empire. Aristotle’s ideas (stoics, epicureans. The body is nothing but matter, therefore not sacred.)
- 31Q: Why did dissection stop?A: When H & E died, dissection/vivisection died out. Rulers withdrew support. Empricism (anti-dissection. Believe dissection alters the body, is unecessary. Only results, the ability to cure, matters.) Ratjonalists. (Pro-dissection.) Dogmatists. (Pro.)
- 32Collapse of Roman Empire:Not a lot of medicine/treatment happening in Europe due to the fall of the Roman empire.
- 33Islamic Medicine:Galean continues to influence medicine. Galeanism is medical dogma in Eastern Roman empire. Those in this area follow Galean and Hippocrates.
- 34al-Razi:-Believed reason should be foundation of medical practice.
-Wrote 200 texts, including Comprehensive Book of Medicine is the most famous (holds case studies. Distinguishes between smallpox and measles). - 35Ibn Sina:Wrote “Canon of Mecicine” (1020 CE): (Medical Encyclopedia. Wrote about anatomy + diseases associated with certain parts).
- 36Rise of Medical Schools:Salerno School (During 9th Century, first medical school). More organized medical training, model for other medical schools.
** Dissection wasn’t allowed until 12th century. Mondino brought it to medical schools (still criminals). Only allowed to dissect 1-2 bodies per year. - 37Mondino (Professor)-University of Blogna. Created expectations for dissection. Wrote: Anatomia
Believed in dissecting according to 3 bellies, in order.
Lower belly: below diaphragm.
Middle Belly (chest area: heart, lungs)
Highest belly (brain and sensory organs) - 38Medieval Dissection:-Professor/Physician: Reads from a book (usually Galen or Mondino), sits up high, has authority.
-Barber Surgeon: Actually dissects the body.
-Observator: Pointed to body parts as they came into view.
(Demonstration not exploration. Not why. If a body did not align with what Galen wrote, it was deemed “imperfect:.) - 39The Plague:13th and 14th century, known as the “great dying”. 25% of European population dies. Many attribute the plague to “Miasmas” (clouds of polluted air that descend upon cities and make people sick). Bc of the plague, people begin to question medical “experts” (ex. Galen).
- 40Renaissance:-Period of rebirth after middle ages. Rebirth of interest in Galen.)
-Invention of Gutenberg Press (1450): Efficient transcription.
-Greek becomes taught once more. - 41Leonardo Da Vinci (1452):-Interested in link between form and action in body.
-Dissected pigs, horses, monkeys (and humans)
-Private research. Dissected for a year, studied for 6 years.
*Work on anatomy is never finished, university professor who gave Leo access to corpses, dies. None of his work is published.
-First to discover Atria.
-First to make an accurate drawing of heart. - 42Andreas Vesalius (Important Turning Point)(Changes how we think about anatomy & practice dissection in medical schools)
-Attended university of Paris Medical School (Taught by Jacobus Sylvius-big Galen supporter.)
-Attended University of Padua (Performed solo Anatomical dissections while teaching)
Versalius’s Fabrica:
-De Humani Corporis Fabrica: On the Fabric of Human Body (Published in 1543): 649 Pages Long. Divided into seven sections. - 43Seven Sections of Fabrica: (How-to guide for Dissection:-Skeletal System
-Muscles and Ligaments
-Circulatory System
-Cerebral and peripheral nerves
-Abdominal organs
-Thoracic organs
-Brains and sensory organs
-Vivisection and experiments - 44Vesalius' Beliefs and Discoveries:-Believes the body is a set of inter-locking systems, rather than humors
-Argues Galen did not follow his own project.
-Vena Cava does not originate from liver.
-Questioned existence of pores in interventricular septum.
-Believed brain was center of the mind.
-Disproved that men had less ribs and more teeth than women.
-”The body is the text.” (the body is where the truth about anatomy is) - 45Vesalis’s Legacy:-Dissection of human body is key
-Most detailed account of human body in history (at his time)
-Limitations: Access to bodies - 46Ibn al-Nafis:-Published: Commentary on Anatomy in Avicenna’s Canon.
-States interventricular septum is not porous.
-Output of right ventricle can only reach the left via pulmonary circulation.
-Communication between pulmonary artery and pulmonary vein - 47Colombo: (R Physiology)-Wrote: De re Anatomica (published after his death)
-Seperates heart from lungs.
-Heart is not a sponge! - 48Fabricius: (R Physiology)-Wrote: De Venarum Ostiolis:
-Concerned with Valves in the veins (covers in De Venarum)
-Discovers vales are arranged at different intervals towards the heart. - 49William Harvey: (R Physiology)-Studied at Padua
-Practiced scientific method.
-Published Anatomical Exercises on the Motion of the Heart and Blood in Animals (1628)
-Believes the heart is a muscle, functions as a pump, pushing blood around body.
-Questions how much blood is in the body? How does blood circulate? (Physiology) - 50Harvey’s Legacy:-Destruction of Galenism. (!!!!)
-Bloodletting (method of disease treatment, but loses its favour).
-What did Galen get wrong? (doctors began to question him more). - 51Reading NotesWhy is dissection a ritual? There is a particular sequence it always follows. Everybody participating has a role. Public is also invited. It is a calendar event. Although it is meant to be a teaching moment, it is more of a spectacle.
What type of ritual is dissection? A sacred ritual, has religious importance.
What is the author saying/arguing? Anatomy/dissection was a failed attempt at researching the body, it was important bc it was an important ritual. - 52Reading Notes Pt. 2Why does this sacred ritual end? The demise of natural philosophy. The rise of laboratories (science is now behind closed doors). The end of the public event (end of public dissections). Rather see public executions.
We have viewed dissections as entertainment for centuries.
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- Fichas sobre HS Study Cards, creado por Hannah Howard el 27/09/2022.
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