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54 Cards in this Set
- Front
- Back
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Joseph Lister
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• 1827 –1912
• A British surgeon and a pioneer of antiseptic surgery • Promoted the idea of sterile surgery • Introduced carbolic acid (now known as phenol) to sterilise surgical instruments and to clean wounds, which led to a reduction in post-operative infections and made surgery safer for patients. |
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Theodor Billroth
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• The great don of surgery in the late 19th century
• Anastomosis (If one has a stomach cancer, one could cut out the portion of the stomach and put the two back together ) • Cancers can located precisely and scooped from the body • Limbs can be amputated |
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Charles and William Mayo
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• Specializing techniques and environments
• Clinic founded in 1883 (Son of founder Charles Horace Mayo) • Skill as a surgeon, he was also known as a medical administrator whose work was key in the development of group medical practice. |
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William Halstead
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• (1852-1922)
• American surgeon who emphasized strict aseptic technique during surgical procedures, was an early champion of newly discovered anesthetics, and introduced several new operations, including the radical mastectomy for breast cancer. • Radial Mastectomy -Remove the lymphatic tissue and breast to cure breast cancer • Halsted was one of the "Big Four" founding professors at the Johns Hopkins Hospital |
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Louis Pasteur
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• (1822 –1895) was a French chemist and microbiologist who was one of the most important founders of medical microbiology.
• Studies helped support Germ theory • Interested in fermentation : Wine, Why do some wines taste good, whilst other taste like vinegar? • Connected to industries at the time: Wine, Textiles • Epidemic with silk worms • He isolates bacteria that can be associated with diseased silk worm • Developed the swan neck flask |
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Robert Koch
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• (1846-1910)
• Pasteur’s rival • Physician • Works as a surgeon after the war • Wanted to be a researcher • Read Pasteur’s work • Focuses his efforts on TB: Difficult to stain and culture; March 1882 he announces his results in which he found the causative agent of the disease to be the slow-growing Mycobacterium tuberculosis. • In 1883 there’s a cholera outbreak in Egypt – fear there will be another outbreak in Europe: So they send Koch to conduct research in Egypt in the hopes of isolating the causative agent of the disease • Elaborate laboratory protocol that is implemented in any training and hospital |
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Max von Pettenkoffer
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• (1818 –1901), Bavarian chemist and hygienist
• Worked in practical hygiene, as an apostle of good water, fresh air and proper sewage disposal. • He believed that the fermentation of organic matter in the subsoil released the cholera germ into the air which then infected the most susceptible (those with poor diet, constitution, etc.). |
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Paul Ehrlich
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• 1854- 1915
• German physician and scientist who worked in the fields of hematology, immunology, and chemotherapy. • Ehrlich popularized the concept of a “magic bullet”. He also made a decisive contribution to the development of an antiserum to combat diphtheria • Side chain theory! : Develop side chains against syphilis, they could test if you had had syphilis in your blood diptheria antitoxin • Diphteria- upper respiratory tract illness • Patients with severe cases will be put in a hospital intensive care unit and be given a diphtheria antitoxin. • 1897, Paul Ehrlich developed a standardized unit of measure for diphtheria antitoxin. This was first ever standardization of biological product and played an important factor in future developmental work on sera and vaccines. |
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Mary Mallon
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• Early 20th century
• Known as "Typhoid Mary", was an asymptomatic carrier of typhoid fever. • She worked as a cook for several families in New York City at the beginning of the twentieth century. • Several cases of typhoid fever in members of those families were traced to her by the Health Department. • It appeared that she "carried" the infectious agent without becoming sick. • There was at the time no way of eradicating the disease, and an attempt was made to restrict her from continuing to work as a cook to avoid spreading it to others. |
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Carl Ludwig
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• (1816 –1895) was a German physician and physiologist.
• Trains in Berlin with Muller • Builds his own institute of physiology • Development of machines that can record directly human pulsation o Kymograph • Can record the pulse and pressure (Mechanical objectivity ) Kymograph • a device that gives a graphical representation of spatial position over time in which a spatial axis represents time • Invented by German physiologist Carl Ludwig in the 1840s and found its first use as a means to intrusively monitor blood pressure |
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Hermann von Helmholtz
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• (1821 –1894) was a German physician
• Moves from medicine to physics • Ophthalmoscope o Physics of perception o Body as a system of mechanics that could be measured o Develops system of lenses for looking into the eye • Telestereoscope • High degree of flexibility and imagination in German physics • Had a great deal of resources to create technologies • Invented Ophthalmoscopy o a test that allows a health professional to see inside the fundus of the eye and other structures using an ophthalmoscope |
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Claude Bernard
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• (1813 –1878) was a French physiologist.
• He was one of the first to suggest the use of blind experiments to ensure the objectivity of scientific observations. He was the first to define the term milieu intérieur. • His workshop is not full of specialized machinery o Has access to simple objects and techniques • Experimental but not an observation of science • Experimented on animals o Bernard's scientific discoveries were made through vivisection • Critique of school: o Pathological experimentation on patients could only be correlational • Correlation between clinic studies and anatomy • He wanted determinism and causality • Bed side is such a messy place Individual stories, medicines etc. So how could you get a universal theory from this? • He believed you need to impose control on your work and work only in a laboratory Create hypothesis beforehand, test it on an animal • Wrote about different frames of mind the experimenter must have internal milieu • a phrase coined by Claude Bernard to refer to the extra-cellular fluid environment, and its physiological capacity to ensure protective stability for the tissues and organs ofmulticellular living organisms. |
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Ivan Pavlov
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• (1849-1936)
• A famous Russian physiologist. • The dog as laboratory technology • Animal models: having a normal life o They used to take the dogs out for walks o Given individual names and attention • Classical conditioning- Pavlov’s dog |
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Francis Peabody
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• (1881-1927) Celebrated clinician
• Laboratory and clinic work • Created an environment of scientific inquiry and patient care that gained • Harvard Medical School • The character of a research = the character of the researcher • Human doctor-patient relationship • Animals → Humans – Informed consent wouldn’t get you anywhere • Only way to regulate research was to make sure doctors were of the most high minded of the profession o Elite high moral character |
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Rudolf Virchow
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• (1821 –1902) was a German doctor, anthropologist, pathologist, prehistorian, biologist and politician, known for his advancement of public health.
• Cell as seat of disease • His most widely known scientific contribution is his cell theory cellular pathology • a branch of pathology that studies and diagnoses diseases on the cellular level. The branch of medicine dealing with the essential nature of disease, especially changes in body tissues and organs that cause or are caused by disease. • Founded by Rudolf Virchow in 1858 o He did not discover the cell or the relationship between cells and disease |
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Richard C. Cabot
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• (1868 –1939) was an American physician who advanced clinical hematology, was an innovator in teaching methods, and was a pioneer in social work.
reductionism • A complex system is nothing but the sum of its parts, and that an account of it can be reduced to accounts of individual constituents. • Rituals of Reduction o The clinicopathological conference • A formal discussion of a Pt's clinical, radiologic, and lab data, usually in front of a large group of junior and senior colleagues. o Richard Cabot • The role of being able to see disease microscopically is so important • Ritualized performance |
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James Herrick
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• (1861 -1954) an American physician
• He is credited with the description of sickle-cell disease |
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Linus Pauling
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• (1901 –1994) an American chemist, biochemist, peace activist, author, and educator.
• Molecule as seat of disease molecular disease • any disease in which the pathogenesis can be traced to a single molecule, usually a protein, which is either abnormal in structure or present in reduced amounts. • Linus Pauling o Molecule as seat of disease |
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Wilhelm Roentgen
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• (1845 –1923) was a German physicist, who, on 8 November 1895, produced and detected electromagnetic radiation in a wavelength range today known as X-rays
• images produce as if seeing • Roentgenography o intense enthusiasm for x-ray o could have a reactive screen and watch the body perform o we will still do this o barium swallow • could see the body working in real time • Fluoroscope o see movement o have radiation burns and complications as a result o x-ray goggles sold to naïve boys everywhere • mechanical objectivity o body can write about itself o further objectification of disease |
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Erving Goffman
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• (1922 –1982) was a Canadian-born sociologist and writer.
• Goffman published Asylums: Essays on the Social Situation of Mental Patients and Other Inmates in 1961.[7][8] It was one of the first sociological examinations of the social situation of mental patients i.e. psychiatric hospitals • Goffman introduced his idea of 'total institutions' total institution • a place of work and residence where a great number of similarly situated people, cut off from the wider community for a considerable time, together lead an enclosed, formally administered round of life • The term was coined and defined by American sociologist Erving Goffman in his paper "On the Characteristics of Total Institutions" |
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Abraham Flexner
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• whether or not the Hopkins model would be come the standard model hinged on this man
• what is the size and training of the faculty • published in 1910, Flexner Report o two parts o essay on the principles of medical education • partial to modern science • standardization the laboratory o teachings by lectures are pointless according to Flexner, lab and teaching hospitals were most important • second part o Flexner’s report • visits all the medical schools • only wants proper schools with proper labs • involve recommendations to shut down certain schools • why do the schools open doors to Flexner Carnegie wanted to do site visits and they thought this would allow for more money • Suggests reducing from 150 to 30 • huge part of the country left without hospitals o already have to many doctors per capita o beneficial thing to cut down the number of training opportunities o suggests that they take on Hopkins model |
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Charles Eliot
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• March 20, 1834 – August 22, 1926) was an American academic who was selected as Harvard's president in 1869. He transformed the provincial college into the preeminent American research university.
• Under Eliot, Harvard became a worldwide university, accepting its students around America using standardized entrance examinations and hiring well-known scholars from home and abroad. • Eliot was an administrative reformer, reorganizing the university's faculty into schools and departments and replacing recitations with lectures andseminars. • During his forty-year presidency, the university vastly expanded its facilities, with laboratories, libraries, classrooms, and athletic facilities replacing simple colonial structures. |
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Henry Bigelow
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• (1818 –1890) was an American surgeon and Professor of Surgery at Harvard University. He was a vocal opponent of vivisection
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William Osler
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• (1849 –1919) was a Canadian physician. He was one of the "Big Four" founding professors at the Johns Hopkins Hospital as the first Professor of Medicine and founder of the Medical Service there.
• He is considered the "Father of Modern Medicine." • Insist that students learn from seeing and talking to patients and the establishment of the medical residency. |
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W. H. Welch
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• (1850 –1934) was an American physician, pathologist, bacteriologist, and medical school administrator.
• He was one of the "Big Four" founding professors at the Johns Hopkins Hospital. • 1916, he established and led the Johns Hopkins School of Hygiene and Public Health, the first school of public health in the country |
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Jonas Salk
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• polio was one of the most frightening public health problems, got worst over the course of the 20th century
• most of the victims were children • Salk develops the first effective polio vaccine • experiments on own children, then feeble minded, animals, people • takes preliminary evidence and takes to march of dimes, his sponsor, and tells them to go test • March of Dimes does a randomized controlled trial o Salk says that the worst way o fetish of orthodox o do historical controls • compare statistics between years • those arguing against randomized control times weren’t behind the times • what happens o Salk loses the trial o 1.6 million o 1 million controls o trial lasts a year o dramatic proof of efficacy o very important moment in biomedical therapeutics o minus that Salk had predicted, many people in the control arm get polio and die or are paralyzed |
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Eunice Rivers
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• Nurse Eunice Rivers, an African-American trained at Tuskegee Institute who worked at its affiliated John Andrew Hospital, was recruited at the start of the study
• Vonderlehr was a strong advocate for Nurse Rivers' participation, as she was the direct link to the community. During the Great Depression of the 1930s, the Tuskegee Study began by offering lower class African Americans, who often could not afford health care, the chance to join "Miss Rivers' Lodge". Patients were to receive free physical examinations at Tuskegee University, free rides to and from the clinic, hot meals on examination days, and free treatment for minor ailments. • Based on the available health care resources, Nurse Rivers believed that the benefits of the study to the men outweighed the risks. • As the study became long term, Nurse Rivers became the chief person with continuity. Unlike the changing state of national, regional and on-site PHS administrators, doctors, and researchers, Rivers stayed at Tuskegee University. She was the only study staff person to work with participants for the full 40 years. By the 1950s, Nurse Rivers had become pivotal to the study—her personal knowledge of the subjects enabled maintenance of long-term follow up. • Historians found evidence that most of the African American staff that assisted the Tuskegee Experiments were under the belief that they were part of a medical experiment that gave them the opportunity to act in the best interests of poor Black residents of Tuskegee. |
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A. Bradford Hill
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• (8 July 1897 – 18 April 1991)
• a physician, had TB as a medical student and had to drop out of school • develops a randomized control trial using streptomycin as a treatment for TB • pioneered the randomized clinical trial and was the first to demonstrate the connection between cigarette smoking and lung cancer. Hill is widely known for pioneering the "Bradford Hill" criteria for determining a causal association o Brandford- group of minimal conditions necessary to provide adequate evidence of a causal relationship between an incidence and a consequence |
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Ronald Aylmer Fischer
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• randomized trials in agricultural biology
• there are so many variables in how life forms o seed, soil, weather, etc issues • if you could randomize allotments and the tinker with variables he could eliminate objective bias • eliminate confounding variables, things that could get in between problems and results • 17 February 1890 – 29 July 1962 |
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Louis Dublin
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• (November 1, 1882 – March 7, 1969) was a Jewish American statistician.
• Dublin promoted progressive and socially useful insurance underwriting policies. o the process that a large financial service provider (bank, insurer, investment house) uses to assess the eligibility of a customer to receive their products |
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Talcott Parsons
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• Early famous North American sociologist
• (December 13, 1902 – May 8, 1979) • Sociology of the sick role o new social script of the sick role • the book The Social System o concept of the sick role is very powerful o important figure in medical sociology o isolates the sick from one another o the sick role channels deviance o people who are deviant in their sickness do so separately o can not be political about being sick |
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Rose Kushner
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• (June 22, 1929 - January 7, 1990) was an American journalist and pioneering advocate for breast cancer patients.
• cannon of health feminism • health journalist • notes a lump in her breast • saw her doctor, went to library and found a book for patients in general, radical notion of a patients bill of rights, should know about their diagnosis and treatment options • she becomes involved in the concept of the one step procedure • women in 1974 are structurally not given the opportunity to gather info and make decisions • becomes a powerful figure • other forms of activism that follow later |
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Tomes
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• Private side of public health
o Move into the mess of public health o The role of individuals within a family to maintain the health of a home o Domestic public health o The way individuals adopted/incorporated germ theory into domestic practices to regulate their own health o Continuity of home practices with bot filth and germ theory |
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Chapin
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• New public health
o Responsibility o Germ theory – the responsibility now lies within the individual o No longer the fault of the authorities to clean up the environment |
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Howell
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• Secondary Source
o Looking back on the period • What changes does Howell identify? o Technologies • X-rays • ECG o Role of the hospital • “acute intervention” – getting people in and out of the hospital • No longer just treat the chronically ill o Information collection • Hospital records o Physicians become head of the hospital • Used to be administrators/trustees in control o Middle class paying patients o Need for education in specific technologies/specialization o Quantitative analysis of patients • Visual information – graphical • What were some of the results of these changes for medical practice? o Patients become less of individuals – standardizes the patients as well • He uses forms and statistics to describe patients • Large volumes of patient records o Patients story (of illness) does not matter so much • In early 19th century, patients used to be participants whereas no they are almost passive • What is this article mainly about? o Technology o Existence of technology does not automatically improve the diagnostic of the patient o They had to change their ideologies and know how to use them for technologies to be useful o Technological determinism – if technology is better, we will adopt it |
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Carhart
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• Primary Source
• He is a Physician • From Texas • 1895 – late 19th century o A lot of the standards and consolidation get fully accepted in the 20th century, so this is still early • What changes does he see? o Speculative to demonstrative o New technologies • Physicians were too reliant • Why are the technologies valued? o They are more accurate measurements • What might be the dangers? o Over dependence on them o Might prompt doctors to forget the importance of all the aspects of the patient o Detrimental to the patient • Should take a holistic view – danger of just focusing on temperature rather than the actual reason for illness |
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Osler (Text)
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• Pros and cons of specialization
• Pros o More exact knowledge o Help the general practitioner • If they work together they can cover more ground o Understand rare occurrences • Cons o Become too focused on one specific thing and lose sight of wider problems o Could lead to misinformation |
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Vandervall
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• She is a female black physician
• She got through medical school and did well • More gatekeeping o When she was not allowed to intern because she was a black female • There were all these changes in institutions but individuals in society were not adapting at the same rate o They considered it a joke when she went to intern |
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Livingston
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• Context really matters
• Anthropological |
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Brandt
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• Push back from the states, so they went to other places
• Going to die anyway, might as well smoke our cigarettes • Issues of globalization • How cigarette companies used science to promote their product • Using science in the public interest |
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Wailoo
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• Intersection between politics and health/medicine
• Context o Disease of sickle cell anemia affecting African American population in Memphis in the 1960s o During civil rights movement • Desegregation o Inequality of health care o More funding for research in hospitals o Popularity of genetics • Why are African Americans sicker? o Poverty → can’t pay → get sick (economic) o Social inequality • What research? o Population genetics • Sickle cell is passed down o Traced back to Africa • Sickle cell is linked to the African American identity o Use it to exact change within the city o Overcome struggles • Later in the 60s o Push for desegregation • Shift from research to research and patient care • Pain management o Treatment • Similar to Culpeper’s piece on breast cancer patients |
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Brant(biomedicine and its subjects)
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• Syphilis study
• Issues of research ethics • Critique of ATW report • ATW critiqued study for lack of informed consent • Grant is saying that is not the issue – they missed underlying issues o Racial assumptions that study was based on o Moral component of African Americans o This is science at the time • Accepted • Context of research is important in understanding issues • Primary sources o Claims of African Americans wouldn’t continue treatments and wouldn’t help themselves o Grant – they lied to the patients saying they would treat them, but they didn’t so they could study the course of syphilis o Power issues between researcher and subject |
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Harry Marx
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• Overview of randomized clinical trials
• Questioning its inherent usefulness |
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Ignaz Semmelweis
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• (1818 – August 13, 1865) a Hungarian physician now known as an early pioneer of antiseptic procedures. Described as the "savior of mothers", Semmelweis discovered that the incidence of puerperal fever could be drastically cut by the use of hand disinfection in obstetrical clinics.
• Hand washing and iatrogenic infection o infection caused by accidental medical actions |
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Fanny Burney
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• Account of mastectomy, 1811
o Steel cutting through the breast – cutting through veins, arteries, flesh, nerves o Cries o Scream |
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Emil du Bois-Reymond (German)
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• (1818 –1896) was a German physician and physiologist, the discoverer of nerve action potential, and the father of experimental electrophysiology.
• Classical figure who is hooked up to a galvanometer (n instrument for detecting electric current.) • Could record electrical impulses coming through a body • Multiplikator o Healing as an electrical process |
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Giambattista Morgagni
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• 1682 -1771
• An Italian anatomist, celebrated as the father of modern anatomical pathology • Anatomical pathology - the diagnosis of disease through the laboratory analysis of bodily fluids and/or tissues • Organ as a seat of disease |
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Francois Xavier Bichat
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• 1771 –1802
• French anatomist and physiologist who is best remembered as the father of modern histology and descriptive anatomy. • Despite working without a microscope, he was the first to introduce the notion of tissues as distinct entities, and maintained that diseases attacked tissues rather than whole organs. • Tissue as a seat of disease |
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Chadwick:
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o The filth that collected in the city, attracted filthy people, then healthy people would get sick, then disease would sick
o No sympathy for the poor o Filthy conditions bred poverty Cholera |
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Tuskegee Syphilis Study
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• An infamous clinical study conducted between 1932 and 1972 by the U.S. Public Health Service to study the natural progression of untreated syphilis in rural African American men who thought they were receiving free health care from the U.S. government
• Investigators enrolled in the study a total of 600 impoverished sharecroppers from Macon County, Alabama; 399 who had previously contracted syphilis before the study began, and 201 without the disease. For participating in the study, the men were given free medical care, meals, and free burial insurance. They were never told they had syphilis, nor were they ever treated for it. According to the Centers for Disease Control, the men were told they were being treated for "bad blood", a local term for various illnesses that include syphilis, anemia, and fatigue. • The 40-year study was controversial for reasons related to ethical standards; primarily because researchers knowingly failed to treat patients appropriately after the 1940s validation of penicillin as an effective cure for the disease they were studying • Now studies require informed consent |
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Nuremberg Code
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• a set of research ethics principles for human experimentation set as a result of the Subsequent Nuremberg Trials at the end of the Second World War.
o Voluntary consent, good of the community, avoid suffering etc. • The Subsequent Nuremberg Trials formally the Trials of War Criminals before the Nuremberg Military Tribunals were a series of twelve U.S. military tribunals for war crimes against surviving members of the leadership of Nazi Germany • 1947 |
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Helsinki Report
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• 1975
• a set of ethical principles regarding human experimentation developed for the medical community by the World Medical Association(WMA). It is widely regarded as the cornerstone document of human research ethics. • The fundamental principle is respect for the individual (Article 8), their right to self determination and the right to make informed decisions (Articles 20, 21 and 22) regarding participation in research, both initially and during the course of the research. The investigator's duty is solely to the patient (Articles 2, 3 and 10) or volunteer (Articles 16, 18), and while there is always a need for research (Article 6), the subject's welfare must always take precedence over the interests of science and society (Article 5), and ethical considerations must always take precedence over laws and regulations (Article 9). • The recognition of the increased vulnerability of individuals and groups calls for special vigilance (Article 8). It is recognised that when the research participant is incompetent, physically or mentally incapable of giving consent, or is a minor (Articles 23, 24), then allowance should be considered for surrogate consent by an individual acting in the subject's best interest. In which case their consent should still be obtained if at all possible (Article 25). |
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Belmont Report
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• The Belmont Report [1] summarizes ethical principles and guidelines for research involving human subjects. Three core principles are identified: respect for persons, beneficence, and justice. Three primary areas of application are also stated. They are informed consent, assessment of risks and benefits, and selection of subjects. According to Vollmer and Howard, the Belmont Report allows for a positive solution, which at times may be difficult to find, to future subjects who are not capable to make independent decisions.[2]
• Prompted in part by problems arising from the Tuskegee Syphilis Study (1932–1972) |
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1964 Surgeon General’s Report
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• a landmark report published on January 11, 1964 by the Surgeon General's Advisory Committee on Smoking and Health, chaired by then-Surgeon General of the United States Luther Terry regarding the negative health effects of smoking.[1] Although it was not the first such declaration, or the first declaration by an official of the United States of America, it is notable for being arguably the most famous, and certainly had lasting and widespread effects on the tobacco industry and on the worldwide perception of smoking.
• The report's publication had wide effects across the United States and the world. It was deliberately published on a Saturday to minimize the negative effect on the American stock markets, while maximizing the coverage in Sunday newspapers. It led to policy and public opinion changes such as warning labels and restrictions on advertising, large scale anti-smoking campaigns, and questioning from the tobacco industry. |
