01_Evolution_and_trends_of_medicine.pptx

Trends

1. PRESENTATION NAME Evolution and trends of medicine

2. Evolution and trends of medicine All human societies have medical beliefs that provide explanations for  birth, death, and disease Throughout history, illness has been attributed to witchcraft, demons, astral influence, or the will of the gods These ideas still retain some power, with  faith healing and shrines  (holy place/ place of worship) still used in some places, although the rise of scientific medicine over the past millennium has altered or replaced mysticism in most cases.

3. Witchcraft

4. Faith healing

5. Evolution of medicine The ancient Egyptians had a  system of medicine  that was very advanced for its time and influenced later medical traditions The Egyptians and Babylonians both introduced the concepts of diagnosis, prognosis, and medical examination

6. Evolution of medicine The  Hippocratic Oath , still taken by doctors today, was written in Greece in the 5th century BCE In the medieval era , surgical practices inherited from the ancient masters were improved and then systematized in  Rogerius's   The Practice of Surgery

7. Evolution of medicine During the Renaissance , understanding of anatomy improved, and the invention of the microscope would later lead to the ‘‘ germ theory of disease ” These advancements, along with developments in chemistry, genetics, and lab technology (such as the x-ray) led to  modern medicine

8. Prehistoric medicine Herbalism : the use of plants as healing agents is an ancient practice There is no record to establish when plants were first used for medicinal purposes

9. Egypt Ancient Egypt  developed a large, varied and fruitful medical tradition They possessed notable public health system According to them, “the practice of medicine is so specialized among them that each physician is a healer of one disease and no more."

10. Egypt Although Egyptian medicine, to a good extent, dealt with the supernatural , it eventually developed a practical use in the fields of anatomy, public health, and clinical diagnostics

11. Egypt Medical institutions , referred to as  Houses of Life  are known to have been established in ancient Egypt as early as the 1st Dynasty By the time of the  19th Dynasty  some workers enjoyed such benefits as  medical insurance, pensions and sick leave

12. Egypt Imhotep   in the 3rd dynasty is sometimes credited with being the founder of ancient Egyptian medicine and with being the original author of the  Edwin Smith Papyrus , detailing cures, ailments and anatomical observations .

13. Mesopotamia Babylonian Medicine Babylonians introduced the concepts of diagnosis, prognosis, physical examination, and medical prescriptions

14. Mesopotamia Babylonian Medicine The  Diagnostic Handbook  introduced the methods of therapy  and  etiology  and the use of  empiricism ,  logic  and  rationality  in diagnosis, prognosis and therapy The text contains a list of medical  symptoms  and often detailed empirical  observations  along with logical rules used in combining observed symptoms on the body of a  patient  with its diagnosis and prognosis

15. Greek and Roman medicine The ancient Greeks developed a humoral medicine system where treatment sought to restore the balance of  humors  within the body The four humors (of hippocratic medicine ) – metabolic agents of the 4 elements in the human body are Black bile ( melanchole / sadness ) , Yellow bile, Phlegm and Blood

16. The Four Humors The 4 humors and the elements they serve are Blood (red hemoglobin-rich portion)– Air Phlegm(clear plasma portion) – Water Yellow Bile( bilirubin ) – Fire Black Bile( brownish grey sediment with platelets & clotting factors) – Earth Humors or these vital fluids are present in the blood stream in varying quantities. Right balance & purity of them is essential for maintaining health.

17. Greek and Roman medicine Temples dedicated to the healer-god Asclepius , known as  Asclepieia functioned as centers of medical advice, prognosis, and healing (hospitals)

18. Asclepieia

19. Greek and Roman medicine The physician  Hippocrates  (460 BC –370 BC), is considered as the " father of modern medicine “ The Hippocratic Corpus  is a collection of around seventy early medical works from ancient Greece strongly associated with Hippocrates and his students Most famously, Hippocrates invented the  Hippocratic Oath for physicians , which is still relevant and in use today

20. Hippocrates "The Father of Medicine,"

21. The Hippocratic Corpus

22. Greek and Roman medicine The Greek Galen  was one of the greatest surgeons of the ancient world and performed many audacious (risky/brave) operations — including brain and eye surgeries— that were not tried again for almost two millennia Galen's work around 140 AD in Rome ended up being authoritative in Europe until the 16th century!

23. Galen is using the technique of "cupping," creating small vacuums in heated cups to "draw the poisons out." This technique continued in folk culture through the early 20th century. 

24. Greek and Roman medicine The Romans  invented numerous surgical instruments , including the first instruments unique to women as well as the surgical uses of forceps, scalpels,  cautery , cross-bladed scissors, the surgical needle, the sound, and  speculas Romans also performed cataract surgery

25. CHINA China developed a large body of traditional medicine of which much of the philosophy derived from empirical observations of disease and illness by Taoist physicians It reflects the classical Chinese belief that individual human experiences express causative principles effective in the environment at all scales These causative principles , whether material, essential, or mystical, correlate as the expression of the natural order of the universe .

26. CHINA Traditional Chinese Medicine  that is based on the use of herbal medicine, acupuncture, massage and other forms of therapy has been practiced in China for thousands of years However, Western Medicine was introduced to China in the 19th Century , mainly by medical missionaries sent from various Christian mission organizations

27. India The  Atharvaveda , a sacred text of Hinduism dating from the  Early Iron Age , is the first Indian text dealing with medicine , like the medicine of the Ancient Near East based on concepts of the exorcism of demons and magic The Atharvaveda also contain prescriptions of herbs for various ailments The use of herbs to treat ailments would later form a large part of  Ayurveda .

28. India In the first millennium BCE, there emerges in post-Vedic India the traditional medicine system known as  Ayurveda , meaning the " complete knowledge for long life“ Its two most famous texts belong to the schools of  Charaka , born 600 BCE, and  Sushruta , born 600 BCE

29. India According to the compendium (concise, yet comprehensive compilation of a body of knowledge) of  Charaka , the  Charakasamhitā , health and disease are not predetermined and life may be prolonged by human effort The compendium of  Suśruta , the  Suśrutasamhitā  defines the purpose of medicine to cure the diseases of the sick, protect the healthy, and to prolong life Both these ancient compendia include details of the examination, diagnosis, treatment, and prognosis of numerous ailments

30. A noted physician in India, Shushutra , was known for a range of writings

31.   India: Healing a wound .

32. India The Ayurvedic classics mention eight branches of medicine: kāyācikitsā (internal medicine) śalyacikitsā (surgery including anatomy) śālākyacikitsā (eye, ear, nose, and throat diseases) kaumārabhṛtya ( pediatrics ) bhūtavidyā (spirit medicine) agada tantra (toxicology) rasāyana (science of rejuvenation) and vājīkaraṇa (aphrodisiacs, mainly for men)

33. India Apart from learning these, the student of Āyurveda was expected to know ten arts that were indispensable in the preparation and application of his medicines : distillation, operative skills, cooking, horticulture, metallurgy, sugar manufacture, pharmacy, analysis and separation of minerals, compounding of metals, and preparation of alkalis

34. India As an alternative form of medicine in India,  Unani medicine got deep roots and royal patronage during medieval times It progressed during Indian Sultanate and  Mughal  periods Unani medicine is very close to Ayurveda

35. India Both are based on theory of the presence of the elements (in Unani , they are considered to be fire, water, earth and air ) in the human body According to followers of Unani medicine, these elements are present in different fluids and their balance leads to health and their imbalance leads to illness

36. Middle Ages

37. Medieval medicine was an evolving mixture of the  scientific and the spiritual like  Unani . In the early Middle Ages , following the fall of the Roman Empire, standard medical knowledge was based chiefly upon surviving Greek and Roman texts , preserved in monasteries and elsewhere Ideas about the origin and cure of disease  were not, however, purely secular, but were also based on a  spiritual world view , in which factors such as destiny, sin, and astral influences played as great a part as any physical cause.

38. Islamic Middle Ages The Arabs were influenced by, and further developed Greek, Roman and Indian medical practices Galen,Hippocrates ,  Sushruta  and  Charaka  were pre-eminent authorities

39. Islamic Middle Ages The Islamic civilization rose to primacy in medical science as Muslim physicians  contributed significantly to the field of medicine, including  anatomy, ophthalmology, pharmacology, pharmacy, physiology, surgery, and the pharmaceutical sciences

40. An Arabic manuscript titled  Anatomy of the Eye

41. Christian Middle Ages In Western Europe , with the collapse of Roman imperial authority, medicine became localised; folk-medicine supplemented what remained of the medical knowledge of antiquity Medical knowledge was preserved and practised in many  monastic institutions , which often had a hospital attached

42. Christian Middle Ages Organised professional medicine re-emerged , with the foundation of the medical college ( Schola Medica Salernitana ) of Salerno in Italy in the 11th century, which in co-operation with the monastery of Monte Cassino , translated many Byzantine and Arabic works In the 12th century universities were founded in Italy and elsewhere, which soon developed schools of medicine.

43. Christian Middle Ages Gradually the reliance on the masters of the ancient world was augmented by the results of individual observation and experience Surgical practice improved greatly during the medieval period Rogerius Salernitanus  composed his  Chirurgia ,  which became the foundation for modern Western surgical manuals up to the modern time.

44. Physician setting a dislocated arm (1450)

45. Renaissance to Early Modern period With the Renaissance came an increase in experimental investigation , principally in the field of dissection and body examination, thus advancing our knowledge of human anatomy The development of modern neurology began in the 16th century with Vesalius , who described the anatomy of the brain and other organs; he had little knowledge of the brain's function, thinking that it resided mainly in the ventricles

46. " Anatomy Lesson of Dr. Nicolaes Tulp " by Rembrandt van Rijn, 1632.

47. Renaissance to Early Modern period Over his lifetime he corrected over 200 of Galen's mistakes Understanding of medical sciences and diagnosis improved, but with little direct benefit to health care Few effective drugs existed, beyond  opium and quinine Folklore cures and potentially poisonous metal-based compounds were popular treatments.

48. Thomas Syndenham , @1665

49. Anton van Leeuwenhoek,  simple (but surprisingly powerful) microscope, 1674

50. Anton Lavoisier was a major pioneer of chemistry in France around the 1770s, especially in identifying oxygen as the key component in both combustion and human and animal respiration. 

51. Phillipe Pinel was a supervisor of mental hospitals in the regions around Paris and had the patients' chains removed.

52. John Hunter, anatomist. @ 1765

53. 19th century: Rise of modern medicine Medicine was revolutionized in the 19th century and beyond by advances in chemistry and laboratory techniques and equipment, old ideas of infectious disease epidemiology were replaced with bacteriology and virology

54. 19th century: Rise of modern medicine Bacteria and microorganisms were first observed with a microscope by  Antonie van Leeuwenhoek in 1674 , initiating the scientific field microbiology

55. Claude Bernard in the mid-1800s made significant contributions to physiology, such as the way the liver processes the metabolism of sugars

56. 19th century: Rise of modern medicine Gregor Mendel  (1822–1884) published in 1865 his books on pea plants, which would be later known as Mendel's laws Re-discovered at the turn of the 20th century, they would form the basis of  classical genetics The 1953 discovery of the structure of DNA by  Watson and Crick  would open the door to molecular biology and modern genetics

57. 19th century: Rise of modern medicine   Louis Pasteur :Linking microorganisms with disease, Pasteur brought about a revolution in medicine His experiments confirmed the germ theory He also invented with  Claude Bernard  (1813–1878) the process of pasteurization  still in use today

58. 19th century: Rise of modern medicine  Pasteur, along with  Robert Koch  (who was awarded the  Nobel Prize  in 1905), founded bacteriology Koch was also famous for the discovery of the tubercle bacillus (1882) and the cholera bacillus(1883) and for his development of Koch's postulates.

59. 19th century: Rise of modern medicine The participation of women in medical care (beyond serving as midwives, sitters and cleaning women) was brought about by  Florence Nightingale Nightingale showed a previously male dominated profession the elemental role of nursing in order to lessen the aggravation of patient mortality which resulted from lack of hygiene and nutrition .

60. 19th century: Rise of Modern medicine Florence Nightingale set up the  St Thomas Hospital , Post-Crimea, in 1852 Elizabeth Blackwell  (1821–1910) became the first woman to formally study , and subsequently practice, medicine in the United States

61. Florence Nightingale (1820-1910)

62.  Jean Charcot, Medicine, studies in hysteria, Paris, @1890s

63. Ramon y Cajal , staining and microscopy 1890s. Finer structures. 

64. 19th century: Rise of Modern medicine Actual cures were developed for certain endemic infectious diseases The decline in many of the most lethal diseases was more due to improvements in public health and nutrition than to medicine It was not until the 20th century that the application of the  scientific method to medical research began to produce multiple important developments in medicine, with great advances in pharmacology and surgery.

65. 20th century Major wars have stressed the need for qualified medical treatment and hygiene

66. American combat surgery during the Pacific War, 1943.

67. 20th century During the  First World War , Alexis Carrel and Henry Dakin developed the  Carrel-Dakin method  of treating wounds with an irrigation, Dakin's solution, a germicide which helped prevent gangrene The Great War spurred the usage of  Roentgen 's  X-ray , and the electrocardiograph, for the monitoring of internal bodily functions

68. 20th century This was followed in the inter-war period by the development of the first anti-bacterial agents such as the  sulpha antibiotics . The Second World War saw the introduction of widespread and effective antimicrobial therapy with the development and mass production of  penicillin antibiotics , made possible by the pressures of the war and the collaboration of British scientists with the American pharmaceutical industry

69. Paul Erlich & Hata, Drug Synthesis, 1910  (Salvarsan against syphilis) 

70. Banting & Best isolate Insulin, 1921

71. 20th century Human subject research  was at its height during the mid-20th century, with Nazi human experimentation during the Holocaust as the most significant example. Principles of  Medical ethics, such as the Nuremberg Code, have been introduced to prevent atrocities (violence/ murder). During and just after World War II, DDT was used as insecticide to combat insect vectors carrying malaria and typhus.

72. Smallpox vaccination

73. Post-World War II Smallpox  vaccination in Niger, 1969 A decade later, this was the first infectious disease to be eradicated Most countries have seen a tremendous increase in life expectancy since 1945 However, in southern Africa, the HIV epidemic beginning around 1990 has eroded national health.

74. Post-World War II The  World Health Organization  was founded in 1948 as a United Nations agency to improve global health As infectious diseases have become less lethal , and the most common causes of death in developed countries are now  tumors  and cardiovascular diseases , these conditions have received increased attention in medical research

75. Post-World War II Tobacco smoking as a cause of lung cancer  was first researched in the 1920s, but was not widely supported by publications until the 1950s Cancer treatment  has been developed with  radiotherapy and chemotherapy Oral rehydration therapy  has been extensively used since the 1970s to treat  cholera and other diarrhea -inducing infections

76. Post-World War II Hormonal contraception  was introduced in the 1950s, and was associated with the sexual revolution, with normalization of abortion and homosexuality Family planning  has been applied around the world, and has promoted a  demographic transition  in most of the world

77. Post-World War II With threatening sexually transmitted infections , not least HIV, use of barrier contraception has become imperative The struggle against HIV has provided no cure , but improved antiretroviral treatments

78. Post-World War II MR scanning  and other imaging methods became available. Genetics  have advanced with the discovery of the DNA molecule, genetic mapping and gene therapy Stem cell research took off in the 2000s, with stem cell therapy as a promising method.

79. Post-World War II Evidence-based medicine  is a modern concept, not introduced to literature until the 1990s. Prosthetics  have improved In 1958, Arne Larsson in Sweden became the first patient to depend on an artificial cardiac pacemaker Lightweight materials as well as neural prosthetics emerged in the end of the 20th century.

80. PRESENTATION NAME Current Trends in Medicine

81. Current Trends in Medicine Increased Specialization Individualized care Sophisticated Equipments for patient care Advanced Investigations: point of care testing Various Treatment Modalities Evidence based practice

82. CONCLUSION

83. PRESENTATION NAME Thanks