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19th-Century
Medicine :
Many
discoveries made in the 19th century led to great advances in diagnosis
and treatment of disease and in surgical methods. Medicine's single
most important diagnostic tool, the stethoscope, an instrument used
to detect sounds in the body such as a heart beat, was invented
in 1819 by French physician René-Théophile-Hyacinthe
Laënnec. A number of brilliant British clinicians studied and
described diseases that today bear their names. British physician
Thomas Addison discovered the disorder of the adrenal glands now
known as Addison's disease; Richard Bright diagnosed the kidney
disorder, Bright's disease; British physician Thomas Hodgkin described
a cancer of lymphatic tissue now known as Hodgkin's disease; British
surgeon and paleontologist James Parkinson described the chronic
nervous system disease called Parkinson disease; and the Irish physician
Robert James Graves diagnosed the thyroid disorder exophthalmic
goiter, sometimes called Graves' disease.
Medicine,
like all other sciences, is subject to influences from other fields
of study. This was particularly true during the 19th century, renowned
for its great scientific innovations. For instance, the evolutionary
theory proposed by Charles Darwin in On the Origin of Species by
Means of Natural Selection (1859) revived interest in the science
of comparative anatomy and physiology. And the plant-breeding experiments
of the Austrian biologist Gregor Johann Mendel in 1866, although
initially overlooked, eventually had a similar effect in stimulating
studies in human genetics.
German
pathologist Rudolf Virchow pioneered development of pathology, the
scientific study of disease. Virchow showed that all diseases result
from disorders in cells, the basic units of body tissue. His doctrine
that the cell is the seat of disease remains the cornerstone of
modern medical science. In France, physiologist Claude Bernard performed
important research on the pancreas, liver, and nervous system. His
scientific studies, which emphasized that an experiment should be
objective and prove or disprove a hypothesis, were the basis for
the scientific method used today. Bernard's work on the interaction
of the digestive system and the vasomotor system, which controls
the size of blood vessels, was developed further by the Russian
physiologist Ivan Petrovich Pavlov, who developed the theory of
the conditioned reflex, the basis of human behaviorism.
A milestone
in medical history occurred in the 1870s when French chemist Louis
Pasteur and German physician Robert Koch separately established
the germ theory of disease. Important in the development of this
theory was the pioneering work of the American physician and author
Oliver Wendell Holmes and of the Hungarian obstetrician Ignaz Philipp
Semmelweis, who showed that the high rate of mortality in women
after childbirth was attributable to infectious agents transmitted
by unwashed hands.
Soon after
the germ theory was recognized, the causes of such age-old scourges
as anthrax, diphtheria, tuberculosis, leprosy, and plague were isolated.
Pasteur developed a way to prevent rabies using a vaccine in 1885.
In the last decade of the 19th century, German physician Emil von
Behring and German bacteriologist Paul Ehrlich developed techniques
for immunizing against diphtheria and tetanus.
New
understanding of infectious diseases made surgery safer. Until the
1800s, surgeons operated in their street clothes, often without
even washing their hands. Operating rooms, like other parts of hospitals,
were filthy. About half of all surgery patients who survived the
actual surgery typically died of infections that developed after
the operation. The era of aseptic surgery, in which physicians used
sterilized instruments and techniques to avoid infecting patients,
was heralded by British surgeon and biologist Joseph Lister. With
his introduction of an effective antiseptic, carbolic acid, Lister
was able to successfully reduce mortality from wound infection.
Rubber gloves were first worn during surgery in 1890, and gauze
masks in 1896.
Another great advance in surgery came with the discovery of anesthesia.
Until the 19th century, doctors used alcohol, opium, and other drugs
to relieve pain during surgery. These medications could sometimes
dull pain but could never completely mask it-patients often suffered
from shock and died during surgery. In the United States, physician
Crawford Long discovered the anesthetic effects of ether in 1842,
and the dentist William Morton used ether in a tooth extraction
in 1846. Ether and other anesthetics reduced surgical mortality
and enabled surgeons to perform longer, more complicated operations.
A new
tool for diagnosing internal diseases became available in 1895 when
German scientist Wilhelm Roentgen discovered X rays. The Danish
physician Niels Ryberg Finsen developed an ultraviolet-ray lamp,
which led to an improved prognosis for some skin diseases. In 1898
in France, Marie and Pierre Curie discovered radium, which was later
used to treat cancer.
In
1898 British physician Ronald Ross proved the role of the mosquito
as a carrier of the malarial parasite, a disease that has been widespread
and sometimes fatal for most of human history. In 1900 United States
Army physician Walter Reed and his colleagues, acting on a suggestion
made by the Cuban biologist Carlos Juan Finlay, demonstrated that
the mosquito is the carrier of yellow fever. This finding lead to
better sanitation and mosquito control, resulting in the virtual
elimination of this disease from Cuba and other areas.
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