Medicine in the 19th Century in Europe

8/9/2019 Medicine in the 19th Century in Europe

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Medicine in the 19th century in Europe

Savu Andrei

Toma Alexandru

Cantoneru Iulian

Voicu Ana


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Cocaine for children?

Cocaine wa le!al" even a late a thi ad #1$$%&"

and wa not conidered harmful in moderate doe' Many

other dru!" now retricted (y law" were alo le!al then"includin! opium" which wa old under city permit on the

treet of Victoria'

In the nineteenth century many u(tance were

ued a medicine" ome of which are now )nown to (e

harmful over the lon! term" uch a mercury and lead'

*+atent medicine*" li)e thee Cocaine Toothache ,rop"

were very popular and re-uired no precription. they

were indeed */or ale (y all dru!!it'*

0y the 1$2" the practice of medicine wa !oin!

throu!h many chan!e' The !erm theory of dieae wa a

controverial idea and not yet widely accepted' The 3rt

of the !eneral anethetic " chloroform and ether" had

recently (ecome availa(le" ma)in! ur!ery potentially lifeavin! rather than life threatenin!" thou!h the routine

ue of antieptic wa till ome year in the future'


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Many medical practitioner till u(cri(ed #at leat

in ome form& to the ancient theory of the *four humor*

developed (y the 4oman phyician 5alen #1617199 A,&'

Accordin! to thi theory" the (ody i made up of four

humor 7 (lood" phle!m" (lac) (ile" and yellow (ile' The

relative amount of each humor in the (ody determined

tate of health and temperament #a peron with more

(lood wa *an!uine*. with more phle!m *phle!matic*.

with (lac) (ile *melancholic*. and if yellow (ile

predominated" *choleric* or *(iliou*&' Too much or too

little of any humor wa aid to caue illne" which could(e cured (y retorin! the (alance' Many nineteenth

century medicine and practice were intended to do thi'


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Cell Theory' 4o(ert 8oo)e aw and named cell in the

early 1th century" when he viewed dead plant cell' Van

:eeuwenhoe) wa the 3rt to ee live cell under a

microcope' In the 19th century the wor) of three5erman cientit" Theodore Schwann #1$127$;&"

Matthia


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5erm Theory' The other

cornertone wa the development of !erm

theory' Even in the heyday of humoral

medicine" there were healer whoreco!nied that ome dieae were

pread (y conta!ion' The earliet

mention of *minute creature* that

caue dieae came in the Veda" the

acred text of 8induim" which were

written (etween 1%22 and %22 0CE'

Avicenna undertood that

tu(erculoi and other dieae were

conta!iou' :ater Mulim cholar

attri(uted the (u(onic pla!ue to

microor!anim' /racatoro" a

noted a(ove" propoed that

dieae wa pread (y

*eed'* In !eneral" however" mot cientit (elieved

that dieae7cauin! !erm aroe from pontaneou

!eneration" @ut a creature uch a ie" worm" and

other mall animal appeared to arie pontaneouly

from decayin! matter' Aritotle (elieved thi" and the

idea perited into the 19th century'

Another theory from the 5ree) continued to hold

way into the 19th century' Thi theory wa (aed on theidea that dieae uch a the pla!ue and cholera were

caued (y foul7mellin! miama" air containin! particle

of rottin! matter' The theory that uch air wa poionou

eemed (elieva(le (ecaue it aociated dieae with


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poor anitation" and the importance of hy!iene wa

reco!nied early' The 0ritih

nurin! pioneer" /lorence Bi!htin!ale #1$;27

1912& who cared for 0ritih oldierdurin! the Crimean ar #1$%671$%&" 3rmly

(elieved that miama caued

dieae'

0y then" however" tudie were well

under way that 3nally put to ret (oth

thee miconception' In 1$%=

the En!lih phyician


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+ateur (elieved paionately that microor!anim

were reponi(le for infectiou dieae in human and

animal and for their tranmiion amon! them' And he

developed eective vaccine a!aint anthrax and ra(ie

(y harvetin! tiue from animal that had died from

thee dieae' 0ut it wa the wor) of a 5erman doctor"

4o(ert Foch #1$=671912&" which 3nally validated the

!erm theory of dieae' 8e identi3ed the peci3c (acteria

that caued anthrax" tu(erculoi" and cholera' 8e

developed a et of rule #FochG potulate& for

determinin! concluively whether a microor!anim i the

ource of a dieae in a peron rather than imply (ein!

preent' The cience of (acteriolo!y wa (orn'


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Hther (ranche of micro(iolo!y oon aroe'

Bumerou tropical dieae were found to (e due to

paraitic micro(e" many of them pread (y mo-uitoe'

Amon! thee were two !reat )illermalaria and yellowfever' Jellow fever" thou!h" li)e mallpox and ra(ie"

could not (e aociated with any (acterium' 0uildin! on

the tudie of a 4uian patholo!it" ,mitry Ivanov)y

#1$=719;2&" the American ur!eon alter 4eed #1$%17

192;& dicovered in 1921 that yellow fever wa caued (y

a viru" omethin! even maller than a (acterium'

Virue were thou!ht to (e invii(le until theinvention of the electron microcope in the 19=2" (ut

they were eventually identi3ed a the caue of a hot of

dieae' Thee include not only mallpox" (ut alo

inuena" the common cold" chic)enpox" polio" and more

recently" AI,S' They are alo thou!ht to play a ma@or role

in cancer'

Anetheia and Antieptic' In the middle of the 19th

century other dicoverie 3nally made extenive ur!ery

practical' >ntil then ur!ical option had (een limited (y

the pain of operatin! on a peron who wa awa)e" and

the dan!er of infection after the operation' In the 1$=2

everal American dentit pioneered the ue 3rt of

nitrou oxide and then ether a anethetic' The latter

wa oon adopted in Europe for ur!ical purpoe" 3nally

allowin! ur!eon time to perform lon! and delicate

ur!erie'


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It wa a(out the ame time that 8un!arian phyician

I!na Semmelwei eta(lihed that infection followin!

child(irth were pro(a(ly due the unwahed hand of

phyician in hopital' In the late 1$2 the 0ritihur!eon


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A !rowin! medical indutry

:i)e

otherlearned

profeion" medicine !rew in ie and re!ulation' In the

early Victorian era it wa dominated (y the !entlemen

phyician of the 4oyal Colle!e #founded 1%1$&" with

ur!eon and apothecarie occupyin! lower poition'

The 0ritih Medical Aociation wa eta(lihed in 1$%

and from 1$%$ the 5eneral Medical Council #5MC&

controlled entry throu!h central re!itration' In the ame

pirit" the profeion alo reited the admiion of

women" who tru!!led to have their -uali3cation

reco!nied' +artly in repone to population !rowth"

however" num(er roe. for example" from a total of

1="=1% phyician and ur!eon in En!land and ale in

1$1" to ;;"9$ #of whom ;1; were female& in 1921' At

the turn of the century the 5MC re!iter held 6%"%2

name alto!ether" includin! %$2 in military and imperial


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ervice' The num(er of dentit roe from 1%$= in 1$1

to %629 #includin! 1=2 women& in 1921' A !rowin!

proportion of -uali3ed peronnel wor)ed in pu(lic

intitution" and a new hierarchy aroe" headed (yhopital conultant' Thi reected the rie in hopital7

(aed practice" for thi wa alo the era of heroic hopital

(uildin! in the ma@or citie" accompanied (y municipal

and +oor :aw in3rmarie elewhere' Thee were for

wor)in!7cla patient. thoe in hi!her economic !roup

received treatment at home'

A econdary apect of !rowth and re!ulation wa the

teady medicaliation of child(irth" o that over thi

period traditional female

midwive were upereded (y

male o(tetrician" with all

their KmodernK idea and

intrument' >nder prevailin!

condition" however"

intervention throu!h the

ue of forcep" for example"

often caued puerperal

fever and the hi!h

maternal mortality" which

wa a mid7centuryconcern'


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:ar!ely throu!h the endeavour and

ener!y of /lorence Bi!htin!ale" whoe

nurin! team at Scutari captured the

pu(lic ima!ination amid militaryde3ciencie in the Crimean ar" hopital

and home nurin! wa reformed" chiey

alon! anitary line' 4i!orou

nure trainin! alo raied the

ocial tatu of the profeion

and created a

career tructure

lar!ely occupied

(y women'

,epite thee and other improvement" death rate

remained relatively teady' 4ou!hly one -uarter of all

children died in the 3rt year at the end of VictoriaK rei!n


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a at the (e!innin!" and maternal mortality howed no

decline' In ome 3eld" however" urvival rate improved

and mortality tatitic lowly declined' Thu crude death

rate fell from ;1' per thouand in 1$=1 to 1=' in 1921'8ere" the main factor were pu(lic hy!iene and (etter

nutrition than) to hi!her earnin! 7 that i" prevention

rather than cure' Althou!h doctor made much of their

medicine with :atin name and meaured doe"

eective remedie were few" and chemical pharmacolo!y

a it i )nown in ;221 only (e!an at the end of the

Victorian era' /rom the 1$2 #animal& thyroid extract

wa ued for variou complaint includin! contipation

and depreion" while from 1$$9 animal teticular

extract were deployed in puruit of re@uvenation and

miracle cure' At the ame date apirin wa developed to

replace traditional opiate pain)iller'

A a reult" many condition remained chronic or

incura(le' Thee limitation" to!ether with the relatively

hi!h cot of medical attendance" led to the rie #or

extenion& of alternative therapie includin! homeopathy"

naturopathy #Kher(al remedieK&" hydropathy #water

cure&" memerim #hypnotim& and !alvanim #electric

therapy& a well a (latant fraudulence throu!h the

promotion of uele pill" powder and coloured li-uid'/rom 1$ notion that dieae wa caued and cured (y

mental or piritual power alone were circulated (y the

Chritian Science movement'


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Treatin! mental illne

Another hi!hly popular fahion wa

that of phrenolo!y" which claimed to

identify temperamental

characteritic uch a a!!reion or lut #KamativeneK&

(y mean of lump and (ump on the individual )ull" and

facial phyio!nomy' +ycholo!y itelf retained lar!ely

traditional concept uch KmelancholicK and KcholericKtendencie" (ut in 1$= the term KpychiatryK wa coined

to denote medical treatment of dia(lin! mental

condition" which were !enerally held to have hereditary

caue'


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The Victorian period witneed

an impreive !rowth in the

clai3cation andiolation #or trictly the

concentration& of the inane

and mentally impaired in

lar!e" trictly re!ulated

lunatic aylum

outide ma@or citie"

where women andmen were le!ally

incarcerated" uually

for life' Hpened in 1$%1" the

Colney 8atch Aylum in

Middleex houed 1;%2

patient' ealthier familie made ue of private care" in

maller eta(lihment'


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Two ma@or 3!ure in the Victorian mental health

3eld were


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theorie of inanity were teadily impoed on mad

women" in way that were unmita)a(ly manipulative'

Toward the end of the 19th century" the term

KneuratheniaK came into ue to decri(e milder ortemporary nervou condition" epecially amon! the

educated clae'

Throu!hout the era" ince diorder of (oth (ody and

mind were (elieved to (e herita(le condition" the chronic

ic)" the mentally impaired and the deran!ed were

vi!orouly ur!ed a!aint marria!e and parenthood'

niverity of Suex and

i wor)in! on Victorian repreentationof ethnicity'


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Scienti3c Medicine" Alternative Medicine" and Luac)ery

It i worth notin! that" durin! the 19th century thetheoretical ide of medicine wa termed cienti3c

medicineN while the daily practice of medicine within

ociety could (e more accurately decri(ed a the le

cienti3c and more non7traditional alternative medicineN

uch a homeopathy or" in evere cae of malpractice

and fraud" a -uac)ery'N Suppoed medical practice of

the 19th century included Thomonianim" phrenolo!y

#)ull morpholo!y&" memerim" electropathy" and

hydropathy' hile ome were readily accepted while

other were not" over time the dierent practice adopted

each otherG trait in order to reduce confuion and !ain

overall acceptance of the !eneral pu(lic'

Scienti3c 4evolution v' 4omanticim in America


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The

cienti3c revolution" althou!h rapid in term of the entire

hitory of humanity" wa low to unfold' Thi lowne

wa due to (oth the medical conervatim in Europe at

the time" in which new (rea)throu!h in pre7exitin!

cience were reited with upicion" a well a the

American 4omanticim philoophical movement' In revoltto the A!e of 4eaon" 4omanticim arrived in America

from Europe (etween 1$1; and 1$1' 4omanticim

emphaied enitivity" feelin!" and the upernatural

over the rational empirical thou!ht' In America"

4omanticim mixed with the


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licene were now open to all to practice' Thi view" when

com(ined with the removal of profeional tandard of

practice" led the people of the >'S' to alternative

medicine and even -uac)ery' The correpondin! (irth ofthe patent of medicineN in the >nited State alo too)

place durin! thi time' Many of thee medicineN were in

reality nothin! more than alcohol laced with other dru!

and (otanical'

Improved ,ru!" 4eearch" and Techni-ue


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At the (e!innin! of thi

century" cienti3c medicine

conited of heroic medicineD

all dieae were (elieved to(e the reult of uid exce"

with the cure of pur!in!"

vomitin!" (leedin!" and

(literin! precri(ed in order

to retore the natural (alance

of a !iven individual' ,urin!

thi time" ur!ery wa alway

a lat reort" a it wa

extremely painful and often

deadlyD the only availa(le

early anethetic were opium

and alcohol' 0y the 1$=2" dru! uch a chloroform"

nitrou oxide" and ether (e!an to (e ued (y hi!h ociety

a ocial dru! O dru! that were eventually ued in

ur!ery' ith the introduction of anethetic" the often

extremely intene pain of ur!ery wa removed' Thi

pain7free tate allowed for lon!er and more complex

operation'

In addition" >'S' phyician were alo expandin! their

medical )nowled!e durin! thi time period" trein! thetudy and determination of a dia!noi over the

indicriminate procedure involved with heroic' Three

>'S' doctor encoura!ed thi hift in medical thou!ht and

practice early on' The 3rt doctor" ,r' ,aniel ,ra)e"


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attempted to tandardie medical practice in 1$19 when

he founded the Medical Colle!e of Hhio in Cincinnati' The

econd doctor" a >'S' Army doctor (y the name of ,r'

illiam 0eaumont" too) advanta!e of a tra!ic ituation totudy the tructure and function of the di!etive ytemD

he tudied the tomach wound of a military patient' Thi

wound would not heal" o 0eaumont tudied the wor)in!

of the tomach throu!h thi openin! and in 1$66 wa

a(le to pu(lih a wor) on the chemitry of di!etion

entitled Experiment and H(ervation on the 5atric


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peer until nearly twenty year later" with the dicoverie

of 'S'

ur!eon ,r' illiam Mayo (e!an practicin! antieptic

ur!ery' Alo in thi century wa the development of

cure for ome endemic infectiou dieae (e!an to ta)e

place" for the mot part" a decline in the mot lethal of

the dieae wa due more to improvement in

anitation" pu(lic health" and nutrition than to actual

medicine'

Scienti3c Method" ,ieae Identi3cation" P 5enetic

It wa Claude 0ernard who et the foundation for the

eta(lihment of the cienti3c method in medicine' In

1$% he pu(lihed An Introduction to the Study of

Experimental Medicine' 8owever" it would not (e until the


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followin! century that the application of the cienti3c

method to medical reearch would produce numerou )ey

development in medicine" includin! !reat advance in

pharmacolo!y and ur!ery'

In term of dieae identi3cation" +ateur and +ruian

phyician 4o(ert Foch #1$=671912& O the latter of whom

wa awarded the Bo(el +rie in 192% O to!ether founded

the cience of (acteriolo!y" which later on would (e

!rouped with other cienti3c (ranche uch a mycolo!y"

paraitolo!y" and virolo!y under the more (road cience

cate!oriation of micro(iolo!y' Foch wa alo famou for

the dicovery of the tu(ercle (acillu in 1$$; a well a

the dicovery of the cholera (acillu one year later' In

1$$=" with 5erman (acteriolo!it /riedrich :oeQer #1$%;7

191%&" Foch developed the four criteria dei!ned to

eta(lih a caual lin) (etween a !iven cauative micro(e

and a dieae" which came to (e called FochG potulate'

The econd half of the 19th century wa alo a time for

!enetic dicoverie' In 1$%9 En!lih naturalit Charle

,arwin #1$2971$$;& pu(lihed The Hri!in of Specie'


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omen and Medicine

The 19th century leader of women in medicine wa

0ritih nure" writer" and tatitician /lorence Bi!htin!ale

#1$;271912&' Bi!htin!ale" who (ecame )nown a the

:ady with the :ampN for her ni!ht viit to her patient"

howed the then male dominated profeion that hy!iene

and nutrition were the critical )ey to the reduction of

patient mortality' In 1$%9" Bi!htin!ale pu(lihed Bote onBurin!" which (ecame re-uired readin! for all nurin!

tudent' In 1$2" Bi!htin!ale et up the St ThomaG

8opital" the 3rt ecular nurin! chool" with En!lih

phyician Elia(eth 0lac)well #1$;1O1912& and (ecame

the 3rt woman to formally tudy" and u(e-uently

practice" medicine in the >nited State" durin! a time

when the a mater7apprentice model of intruction wacommon' 0y 1$1" a profeional nurin! chool wa

eta(lihed within the >nited State in Bew Jor) City and

other oon followed throu!hout the nation" (oth durin!

and after the American Civil ar" when the need for

hopital )yroc)eted'

The 4ole of the Church" Science" and +ychiatry

,urin! the 19th century and early ;2th century" medicine

wa cloely related to the church" (oth within the >nited


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State and throu!hout Europe' 8owever" technolo!y and

cience oon replaced any reli!iou authority' Mental

health reearch (e!an with the mentally ill in the lunatic

aylum of the 1$th and 19th centurie" which led to thereco!nition of the cience of pychiatry' 5erman

pychiatrit Emil Fraepelin #1$%719;& i deemed to (e

the founder of modern cienti3c pychiatry' In the >nited

State" it wa not until after the Civil ar and really not

until the end of the 19th century that cienti3c medical

advance (e!an to catch up with the need of ociety' /or

example" the caualtie of the American Civil ar" it

hopital" and the new (acteriolo!y theorie !radually

reulted in critical chan!e in the medical practice and

profeion" which eventually led to todayG cuttin!7ed!e

>'S' medical and pharmaceutical indutrie'


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Medicine in the 19th Century in Europe

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Transcript of Medicine in the 19th Century in Europe