HIST 249 Lecture Notes - Lecture 22: Degenerative Disease, Gonorrhea, Sexually Transmitted Infection
Medicine in the 20th Century - Part 1
• Reading:
o
On-line e-book chapters:
o E.M. Tansey, “From the Germ Theory to 1945”, in
Western Medicine: An Illustrated
History
- 102-122
o Stephen Lock, “Medicine in the Second Half of the Twentieth Century”, in
Western
Medicine: An Illustrated History
- 123-144
• Modern medicine vs. traditional western medicine
• Patient is lying down
• Radiation therapy
• Entry of machines
• Hospital medicine is not abolished
• Laboratory medicine with its experimental approach
• 20th approach - a new layer is added (technology)
• Shift of authority away from patient and away from the doctor
• Involves machines
• New place of research
• Knowledge being produced - knowledge that could be applied directly to care
• Endocrine diseases (hormones)
• Infectious diseases
• Using genetics as a case study
• Context - institutionalized research --> found discoveries
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2
• Universities no longer the main breeding grounds of discoveries
• Germany - Ehrlich & Hoechst
• France - Pasteur Institutes
• Self funded research
• UK - Lister Institute to Medical Research Council
• Funded by public subscription
• US - Rockefeller Institute
• Scientific break through
• Data as hereditary
• Cell biology
• 23 Nobel prizes
• Research now is a much bigger enterprise
• Not something the ordinary doctor can always understand & participate in
• Measuring Body Functions
• De-personal medicine
• Made it more expensive
• Doctors often couldn’t afford these expensive machines
• Technological innovations of research in the early 20th century
• Impact on doctor & the patient
• Physical measurement
• Kymograph (records this in a curve)
• Measures physiological phenomenon, 19th century physiology
• Un-bloody measurement for blood pressure - don’t need to cut into body
• EEG
• Vital functions become measurable physical phenomenon
• Disease retreats even further from patient's - and even MD's - experience
• Machines can do things with more credibility and easier than humans
• Mechanical objectivity - no human observer
• Goes automatically
• Produces a new kind of reliability
• Shift
• Produces new signs
• (EX) The doctor listening to the patient through tools - looking for signs
• Barrier between observer and the patient
• Therefore technology opens up opportunities but it also makes the physician in-
superior to machines
• A new kind of ray
• X-rays discovered by physicist Wilhelm Konrad Rontgen in 1895
• Used for diagnostic services
• 1897 - Walter Cannon discoveries research application through x-rays
• Where is the radio topic food?
• Make digestive tract visible in an x-ray
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3
• X-rays are also being used as therapies
• X-rays can burn the tissue off - used in cancer
• Used for proliferative diseases
• Breast cancer
• Stop cells from growing
• 1904 - Marie Curie discovers radium - and radiation burns
• Took awhile for side effects of long term damage of radiation to be discovered
(radiologists dying of cancer at high rates due to high exposure of radiation/x-
ray)
• X-ray - diagnostic
• Endocrine diseases
• Insulin (endocrine diseases)
• Edward Schafer & George Oliver - adrenalin
• Isolate active principle in the adrenal gland
• Important for lab research
• Given to animals
• Ernest Starling & William Bayliss - hormone
• Gave a name to this category of substances
• Idea of hormones - messenger substance for internal
communication (like nerves)
• C Bernard - internal secretion
• Organs that secret substances into the blood stream
• Liver --> secreting glucose
• Other organs were identified that have internal secretion
• Pancreas
• All go through the thyroid gland
• Edouard Brown-Sequard -
organotherapy
• Influential
• Used internal secretion therapeutically
• Extract from testicles for rejuvenation of elderly men
• Rejuvenation therapy
• Extracts from particular organs
• Could see effects
• Elderly men being able to walk properly again etc.
• Substances isolated from specific organs
• Tried in animal therapy
• Frederick Banting & Charles Best - insulin
• Most therapeutic hormone
• 1921 - found insulin
• 1869 - take out pancreas from a dog, this dog became diabetic
• Well known disease - diabetes
• Islets of Langerhans - cell groups in the pancreas, different than the
other cells in the pancreas…
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Document Summary
Medicine in the 20th century - part 1: reading, on-line e-book chapters, e. m. tansey, from the germ theory to 1945 , in western medicine: an illustrated. History - 102-122: stephen lock, medicine in the second half of the twentieth century , in western. Medicine: an illustrated history - 123-144: modern medicine vs. traditional western medicine. Important for lab research: given to animals, ernest starling & william bayliss - hormone, gave a name to this category of substances. Idea of hormones - messenger substance for internal communication (like nerves: c bernard - internal secretion. Liver --> secreting glucose: organs that secret substances into the blood stream, other organs were identified that have internal secretion, pancreas, all go through the thyroid gland, edouard brown-sequard - organotherapy. Islets of langerhans - cell groups in the pancreas, different than the other cells in the pancreas .
