医学史简论（ 6)

A Brief History of Medicine

浙江大学医学院 余 海Zhejiang University School of Medicine

文艺复兴和医学：解剖学的发展

William Harvey 1578-1657

Harvey announced his discovery of the circulatory system in 1616 and in 1628 published his work Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus (An Anatomical Exercise on the Motion of the Heart and Blood in Animals), and described the pulmonary circulation and systemic circulation

Heart output ： 100-150ml x65=10p

With careful observation and quantitative experiments challenged Galen’s theory on the artery and vein

显微解剖学 Microscopic Anatomy

Early 17th century English man Digges and Dutch spectacle maker Zaccharias and Hans Janssen invented first microscopy

Two convex lenses

显微解剖学的发展 Microscopic Anatomy

1610 Galileo worked our the priciples of lenses and made a better instrument with focusing device enlarging for 70 times

显微解剖学的发展 Microscopic Anatomy

马尔比基 1628-1694

Marcello Malpighi (Italian)

Observed biological tissues with microscope as the pioneer of histology and embryology

显微解剖学的发展 Microscopic Anatomy

Malpighian corpuscle （ Malpighian body ）

Malpighian Tubules

Malpighian alveoli

Capillaries in frog mesentery

The discovery of capillary, microscopic structure of lung and kidney

显微解剖学的发展 Microscopic Anatomy

虎克 1635-1702

Robert Hooke

显微解剖学的发展 Microscopic Anatomy

The discovery of cell and its naming (cork)

Discovery of compound eyes in insects

显微解剖学的发展 Microscopic Anatomy

Antonie van Leeuwenhoek

1632-1723

A Dutch cloth merchant used new method for grinding and polishing tiny lenses of great curvature which gave magnifications up to 270 diameters

显微解剖学的发展 Microscopic Anatomy

Leeuwenhoek was first to see and describe bacteria as animalcules (tiny animals), became the father of microbiology, he was also first to record microscopic observations of muscle fibers, spermatozoa, and blood flow in capillaries.

Origin of Medicine

Egypt Babylon India China

Greece Rome

Medieval Arabic medicine

Renaissance

Pre-modern medicine

Modern medicine TCM

Western

Med

icine

Premodern Medicine: background

1642-1651 English Civil War (revolution) Replacement of English monarchy with the Commonwealth of England, then with a Protectorate under Lord of Protector Olive Cromwell ， James II restoration of monarch （ 1660 ） ， William III (Prince of Orange) and Mary II overthrew James II, “Glorious Revolution”(1688 ） “ The Bill of Rights” was passed and established constitutional monarchy（ 1689 ）

Oliver Cromwell1649.1.30

Trial and execution of Charles I for treason

Premodern Medicine: background

French revolution

 "Liberty leading the people" The tripod

近代医学发展的影响因素：资产阶级革命

French Revolution 1789-1799

Execution of Louis XVIJanuary 21, 1793

Storming of Bastille

1793.1.21

Pre-modern Medicine: Industrial revolution

瓦特 1736-1819

James Watt

Steam power - James Watt improved steam engine provided powerful energy for industrial revolutin

The Industrial Revolution was a period in the late 18th and early 19th centuries when major changes in agriculture, manufacturing, production, mining, and transportation had a profound effect on the socioeconomic and cultural conditions in Britain. The changes subsequently spread throughout Europe, North America, and eventually the world. The onset of the Industrial Revolution marked a major turning point in human society; almost every aspect of daily life was eventually influenced in some way.

Pre-modern Medicine: Industrial revolution

(George Stephenson 1781-1848)

and his locomotive （ 1829 ）

火车

Locomotive

轮船

Steamer boat

近代医学发展的影响因素：工业革命

珍妮纺纱机Spinner Jenny

The starting point-textile industry

Pre-modern Medicine: Scientific revolution

Isaac Newton 1642-1727

Laws of Motion:

1.First law: Law of Inertia

2.Second law F=ma

3.Third law:

Action=Reaction

Universal Gravitation

First law: If there is no net force on an object, then its velocity is constant. The object is either at rest (if its velocity is equal to zero), or it moves with constant speed in a single direction.[

Second law: The acceleration a of a body is parallel and directly proportional to the net force F acting on the body, is in the direction of the net force, and is inversely proportional to the mass m of the body, i.e., F = ma.Third law: When a first body exerts a force F1 on a second body, the second body simultaneously exerts a force F2 = −F1 on the first body. This means that F1 and F2 are equal in magnitude and opposite in direction.

Pre-modern Medicine: Scientific thinking & methodology (“Enlightenment”) Descartes' rationalism and Bacon's empiricism had to be combined to produce the modern scientific method

培根 Francis Bacon 1561-1626

According to Bacon, scientists should experiment freely and collect facts about everything in the world, until in due time the accumulation of facts would make clear the way nature behaves. From the storehouse of accumulated facts,

scientists would induce the laws of nature. (inductive methodology ) Knowledge itself is power

笛卡儿 Rene Descartes 1596-1650

According to Descartes, scientists should deduce the laws of nature by pure reason, starting from the axioms of mathematics and our knowledge of the existence of God. Experiments needed to be done only to verify that the logical deduction of the laws of

nature was correct. (deductive methodology) His aphorism is I think therefore I am

Pre-modern medicine: chemical school （ Iatrochemie ）

Flemish physician, philosopher, mystic, and chemist

van Helmont demonstrated that acid was the digestive element in the stomach and was neutralized by alkali in the intestine and that blood combined with a “ferment from the air”.

His theory of “ferments” as the agents bringing about physiological processes is a crude precursor of the idea of enzymes

(fermentum). Jan Baptista van Helmont (1580 -1644)

Pre-modern medicine: chemical school （ Iatrochemie ）

Franciscus Sylvius (1614-1672)

He was professor of medicine at the University of Leiden, Holland

He believes that all life and disease processes are based on chemical actions. That school of thought attempted to understand medicine in terms of universal rules of physics and chemistry. Sylvius also introduced the concept of chemical affinity as a way to understand the way the human body uses salts and contributed greatly to the understanding of digestion and of bodily fluids.

Pre-modern medicine: physical school （ Iatrophysics ）

Alfonso Borelli

1608-1679

Italian physiologist, physicist and mathematician father of modern biomechanics

Pre-modern medicine: physical school

Julien Offray de La Mettrie

美特里 1709-1751

。

French physician and philosopher,

materialists of the enlighterment. He is

best known for his work L’homme

machine  (Man a machine published

anonymously 1747), wherein he

claimed that human beings were

machines.

（ Iatrophysics ）

Three major discoveries of 19th century

能量守恒和转化定律 The Law of Energy Conservation 生物进化论 The Evolution 细胞学说的建立 The Cell Theory

能量守恒和转化定律Sanctorius (1561-1636 ） Italian physiologist, professor of Padua

For a period of thirty years Sanctorius weighed himself, everything he ate and drank, as well as his urine and feces. He compared the weight of what he had eaten to that of his waste products, the latter being considerably smaller. He produced his theory of insensible perspiration as an attempt to account for this difference.

Weighing Chair

The Law of Energy ConservationGeman physician and physicist and one of the

founders of thermodynamics.

In 1841 he made the original statements of

the conservation of energy or the first versions

of the first law of thermodynamics: “Energy

can be neither created nor destroyed”

In 1842, Mayer described the vital chemical

process now referred to as oxidation as the

primary source of energy for any living

creature. His achievements were overlooked

and priority for the discovery of the

mechanical equivalent of heat was attributed

to James Joule in the following year.

He also proposed that plants convert light into

chemical energy.

Julius Robert von Mayer (1814-1878)

The Law of Energy Conservation

James Joule （ 1818-1889 ） English physicist and brewer

He studied the nature of heat and discovered its relationship to mechanical work (mechanical heat equivalent) ， confirmed the law of conservation of energy, which led to the development of the first law of thermodynamics

Charles Robert Darwin English naturalist

(1809-1882)

EvolutionAll species of life have evolved over time from common ancestors, through the process he called natural selection.

In modern evolutionary theory, Darwin’s scientific discovery is the unifying theory of the life sciences, providing logical explanation for the diversity of life.

EvolutionCharles Robert Darwin

In his five-year (1831-1836)

voyage on HMS Beagle

 established him as an

eminent geologist Puzzled by

the geographical distribution

of wildlife and fossils he

collected on the voyage,

Darwin investigated the

transmutation of species and

conceived his theory of

natural selection in 1838 。

加拉帕戈斯群岛 Galapagos Islands属厄瓜多尔，距南美大陆 1000 公里 由 23 岛屿和组成，称“生物进化活博物馆”

达尔文雀 D

arwin’s F

inches

加拉帕戈斯象龟Galapagos Tortoise共 12 亚种，平塔岛亚种“ Longsome George” 2012.6.24 死亡

Published in 1859

On the Origin of Species

established evolutionary descent with modification as the dominant scientific explanation of diversification in nature

“The struggle for existence, Survival of the fittest” ( 物竞天择，适者生存 )

“I have called this principle, by which each slight variation, if useful, is preserved, by the term Natural Selection.”

He examined human evolution and sexual selection in The Descent of Man, and Selection in Relation to Sex(1871), followed by The Expression of the Emotion in Man and Animals (1872)

Darwin 2009 commemorations

In the United Kingdom a special commemorative issue of the two pound coin shows a portrait of Darwin facing a chimpanzee surrounded by the inscription 1809 DARWIN 2009, with the edge inscription ON THE ORIGIN OF SPECIES 1859

In September 2008, the Church of England issued an article saying that the 200th anniversary of his birth was a fitting time to apologise to Darwin "for misunderstanding you and, by getting our first reaction wrong, encouraging others to misunderstand you still".[

Evolution ： Evidence from embryology

Ernst Haeckel1834-1919 

Recapitulation theory : an

individual organism's

biological development, or

ontogeny, parallels and

summarizes its species'

entire evolutionary

development, or phylogeny ontogeny recapitulates phylogeny fish, amphibians, reptiles, aves, mammalia, primate

The Cell Theory

Robert Hooke

1635-1702

The discovery of plant cell (cork) and

its naming

The Cell Theory

Matthias Schleiden1804-1881

German botanist and co-founder of the cell theory, along with Theodor Schwann and Rudolf Virchow. He wrote Contributions to Phytogenesis (1838), in which he stated that the different parts of the plant organism are composed of cells (inductive)

The Cell Theory In Microscopic Investigations on the

Accordance in the Structure and Growth of Plants and Animals (1839), in which he declared that "All living things are composed of cells and cell products." Thus cell theory was definitely constituted.

Theodor Schwann1810-1882

Schwann cell

Myelin sheath

The Cell Theory

Cells are the unit of structure, function and reproduction in living things.

Anything that is living is composed of cells The chemical reactions of an organism

occur in cells All cells come from preexisting cells

The development of pathology: Organ pathology

Giovanni Battista

Morgagni 1682-1771

Italian anatomist, professor of Padua University, and he is celebrated as the father of the modern anatomical pathology

The development of pathology1761 published De Sedibus et causis morborum per anatomem indagatis (On the seats and causes of diseases investigated by anatomy)

Based on 70 letters containing the records of some 646 dissections, including the symptoms during the course of the malady and the conditions found after death. 

He made pathological anatomy a science, and diverted the course of medicine into new channels of exactness or precision

The development of pathology : Histopathology

Marie François Xavier Bichat 1771-1802

French anatomist and physiologist, is best remembered as the father of modern histology and pathology

He dissected 600 cadavers/year, was the first to introduce the notion of tissue as distinct entities.

He maintained that diseases attacked tissues rather than whole organs.

The development of pathology : cellular pathologyGerman doctor, anthropologist, public health activist, pathologist, prehistorian, biologist and politician, referred to as the “Father of Pathology,” and founded the field of  social medicine. (duel challenged by Bismarck)

Omnis cellula e cellula ("every cell originates from another existing cell like it.") which he published in 1858

First one who discovered leukemia

Rudolf Ludwig Karl Virchow 1812-1902

Virchow's angle — The angle between the nasobasilar line and the nasosubnasal line.Virchow's disease — leontiasis ossium.Virchow's line — a line from the root of the nose to the lambda.Virchow's method of autopsy — A method of autopsy where each organ is taken out one by one. Virchow’s node— the presence of metastatic cancer in a lymph-node in the supraclavicular fossa (root of the neck left of the midline). Also known as Troisier’s sign. Virchow’s triad— factors contributing toward venous thrombus formation.

Medical Terms named after Virchow

Newton’s Apple

Essay writing

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