Friday, September 23, 2016

1849: Great inventors at the dawn of modern medicine

The man who would become the father of modern medicine was born in Canada on July 12, 1849.  His parents would name him William Henry Osler. He was born into an era where medicine was changing for the better, and he would grow to become a significant part of it.

Yet a post about the life and times of the infamous Dr. Osler won't come on this blog for another few months.  First we must consider medical significance of the era to which he was born into.

It was an era, they say, where physicians were just starting to adapt to new equipment, such as the stethoscope, laryngoscope, thermometer and microscope.  Students were just starting to learn about them, and physicians just starting to adapt them into their daily practice.

The incorporation and use of these devices would allow physicians to learn what went on inside the body that affected what went on outside the body.  It was by knowledge obtained by their investigations with these tools that antiquated medical theories about medicine were being reviewed.  Those proven true were further substantiated, and those proven false were cast away.  

The following are some of the significant contributions that affected the medical community at this time:

Oliver Wendell Holmes (1809-1894)
was among the first to realize
fevers may spread by unclean hands.
 (4, page 457)
1843:  Oliver Wendell Holmes announced to the medical community that women in child bed should not be attended by physicians who had been studying the victims of perpetual fever. He was concerned the causative agent might be spread to the mothers and their babies. He recommended that physicians and medical caregivers wash their hands and change their clothing after leaving patients infected with perpetual fever. He received harsh criticism from his fellow physicians who were in harsh opposition to change. (4, page 457)

Ignaz Semmelweis (1818-1865)
proved hand washing between patients
 reduced the spread of sickness.
He was mocked and ignored.
(4, page 458)
1846:    Ignaz Philipp Semmelweis became an assistant in an obstetric ward in Vienna where there was such a high death rate from child bed fever that women feared to go there. Semmelweis observed the death rate was higher in the 1st ward where he and his fellow male physicians worked compared to the 2nd ward where female mid wives worked. Upon investigation he learned the women were much cleaner in appearance than the physicians, who often walked proudly around with blood stained hands and aprons. The physicians also were more likely to perform postmortem investigations just prior to checking the vagina. The women, on the other hand, did not have blood stained clothes and washed their hands in calcium chloride solution between patients. When he insisted his physicians likewise wash their hands and put on clean clothes prior to checking women in child bed, the death rate fell from 9.92% to 3.8%. The following year it was down to 1.27%. The proud physicians were unhappy, and eventually rejected Semmelweis. After they went back to their old poor habits, the death rare once again duly rose. (4, pages 457-8)
Charles Darwin (1809-1882)
His theory of evolution
may have been controversial,
yet it helped transform medicine.

1859:  Charles Darwin, the grandson of Erasmus Darwin, published his "Origin of Species" in which he introduced his theory of evolution. Surely it resulted in much scrutiny and controversy, but this may have been one of the key publications that helped to spark the scientific revolution, of which the medical profession was one of the main beneficiaries. However, and to be expected, many proud and stubborn medical professors and physicians refused to let go of old theories. Yet the few who did continued investigating, and scientific evidence would ultimately force change, and change for the better.
Louis Pasteur (1882-1895)
His Germ theory of Medicine
Revolutionized medicine 

1865:  Louis Pasteur discovered that microbes were the cause of diseases. He invented vaccinations for anthrax, cholera, consumption and smallpox." (3)
Joseph Lister (1827-1912)
invented a rinse to disinfect wounds.
It was also useful for cleaning mouths.

1870s:  Joseph Lister discovered that antiseptic use reduced post surgical infections.  He was a British scientist and physician who observed that about 50 percent of amputation patients survived the surgery but died later of septic fevers, or what was known as "ward fevers."   With knowledge of the works of men like Pasteur and Semmelweiz, Lister surmised microbes in the air were infecting wounds, and so he used phenol as an antimicrobial to reduce the death rate by 15 percent. (4)  He recommended the antimicrobial carbolic acid to be placed on bandages to keep the wounds clean, and he invented a machine to pump carbolic acid into the air in the rooms where surgeries were being performed.  Post operative mortality rates plummeted. (5)

Listerine bottle from the 1920s
1879:  While working with Jordan Wheat Lambert (1851-1889), Lister invented an antiseptic to use during surgeries.  In honor of Lister's discovery, Lambert insisted the product be named "Listerine," introducing it to surgeons in 1879.  The product was so successful that it was ultimately marketed to dentists as an oral rinse in 1895, and to the public as a mouthwash in 1914.  The product is still available on the market to this day (although the taste has been improved).

A young William Osler must have been inspired by all this wisdom, becoming so rapt that he cast aside his father's dream that he go into the ministry, and instead studied medicine.

  1. "Sir William Osler At Seventy -- A Retrospect," The Journal of the American medical Association," 1919, Saturday, July 12, pages 106-108
  2. Osler, William, "The Principles and Practice of Medicine," 1892, New York, pages 497-501
  3. Bliss, Micheal, "William Osler:  A Life in Medicine," 1999, New York
  4. Garrison, Fielding Hudson, "An introduction to the history of medicine," 1921, London and Philadelphia, 
Further readings:
  1. Jackson, Mark, "Asthma: The Biography," 2009, New York, pages 211-12
  2. Brenner, Barry E, ed., "Emergency Asthma," 1998, New York, pages 212-14
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