History of Science 320 Donald deB. Beaver

Spring 2000 117 Bronfman

M[W]F 11 a.m. - 12:15 p.m. 597-2239

"The history of medicine is in essence the history of the doctor-patient relationship." The aim of this course is to understand the many different ways in which medicine has been defined, practiced, and developed throughout history. Understanding the history of medicine helps place the theory and practice of modern medicine in social-historical context.

Three texts and a packet of readings provide the foundation for studying the many changes and developments in medicine up to the early 20th century.

Classes consist of the analysis and discussion of assigned readings, so that active participation is essential. There are many different ways to evaluate and interpret the past; the more their representation, the fuller and more refined one's understanding.

Grading will be based on class participation [20%] 2 short [8+ pages each] papers [25% total], two hour exams [50%], and a final quiz [5%]. The grade for class participation derives from 3 components: attendance, active discussion, and overall quality of contributions.

The following are the three required texts; copies should be on intensive reserve in Sawyer Library:

Lois Magner A History of Medicine

Sherwin B. Nuland Doctors: The Biography of Medicine

Roy Porter The Greatest Benefit to Mankind

[Although it's the best of the most up-to-date histories of medicine, Magner's book is very expensive, priced the same in cloth and paper].

In addition to the texts, a course reading packet may be obtained from Mrs. Alice Seeley in 189 Bronfman. The packet consists of 265 pages [435 pp reading], and will be charged at $ 10.00 to students' term bills.

The usual provisions of the Honor Code apply to papers and examinations in this course.

The following pages give the schedule of classes and reading assignments for the semester.

Note that we meet on Wednesday Feb. 16. It’s possible that we may meet on other Wednesdays, as well.

HISTORY OF MEDICINE History of Science 320

Spring 1999

CLASS SCHEDULE and READING ASSIGNMENTS

Part I

The History of Medicine from Prehistory to 1800

1. Fri 2/4 Introduction. Why History of Medicine?

Outline; Possibly begin Paleopathology, Paleomedicine

Definition of Medicine(s). Reasons for studying History of Medicine.

Chronology or typology [Paleo/Ancient/Greek/Roman/Islam-Arabic/Medieval Latin/European 16th-18th/19th/Modern.]

Dependencies on Anatomy and Physiology; Botany; Chemistry [Cooking].

Theory/Practice. Sources. Nursing, Hospitals, Instruments, Societies, Journals, Pharmaceuticals, Universities, [Research]; Literature.

2. Mon 2/7 Medicine in Antiquity.

Paleomedicine: Evidence [bone, teeth, mummy, soft tissue; painting, artifact]. Disease frequency, type; difficulty of diagnosis]. Remedies. Trepanation. limb/body deformation. Osteomyelitis; mastoiditis.

Ancient Medicine: Mesopotamia; magic; Egypt, rationality of E. Smith Papyrus. Ebers, Berlin papyri. Surgery, Gynecology. [schistosomiasis?] India, Ayurvedic Medicine; China. Conservatism of traditional medicine.

---------------------------Readings--------------------------

70 pp

Magner 1-13 "Paleopathology and Paleomedicine"

17-35 "Medicine in Ancient Civilizations"

Recommended: 37-59 "Medical Traditions of

India and China"

Porter, 135-146 "Indian Medicine"

147-162 "Chinese Medicine"

Recommended: 14-43 "The Roots of Medicine,"

and 44-50 "Antiquity" [Mesopotamia; Egypt]

3. Fri 2/11 Greek Medicine

The Context of PreSocratics and Greek Rationality. Asclepius and the Aesculapians. 4 Humors, relation to Malaria, Psychology. Hippocratic Medicine. Oath, and implications. Tradition. Cooks. Diet.

Regimen. Diagnosis. Urinalysis. Prognosis. Aristotle the biologist; On Reproduction. Classification. 4 Causes. 3 chambered heart

---------------------------Readings--------------------------

90 pp

Magner 63-76(top), "Greco-Roman Medicine"

Nuland, 3-30, "Hippocrates."

Recommended: Porter 50-66 "Antiquity"[Greece, Hippocrates]

Packet: Singer, 1-28, "The Greeks to 50 B.C." [ends w. Aristotle]

Packet: Aristotle, "The Generation of Animals", 79-83

Packet: Hippocrates "The Sacred Disease," 137-144

Source Book of Greek Science:

486-489, on climate; 4 humors;

498-500, on Prognosis

4. Mon 2/14 Greco-Roman Medicine

Alexandria, Museum and Library. Erisistratus and Herophilus, 3 great systems. The 4 chambered heart and the Blood. Methodists, Empiricists, Dogmatists [contrasts between theory and practice.] New Terminology [e.g. duodenum]. Celsus. Galen.

---------------------Readings---------------------------------

100 pp

Magner, 76-96, "Greco-Roman Medicine"

Nuland, 31-60, "Galen"

Recommended: Porter: 66-82 [Alexandrian, Roman,

Galen, practice, insanity]

Packet: Singer, 28-36; [Herophilus and Erisistratus]

37-65, "The Empire and the Dark Ages"

Source Book of Greek Science

480-486, Galen

526-529, Treatment [cataract, aneurysm,

dental]

5. Wed. 2/16 Islamic Medicine

Jundishapur. Transmission. Hospitals, First Aid, Pharmacopeia. New

Terminology. Al Hazen, optics, and eye. Rhazes and measles/smallpox. Avicenna; Ishaq on "the Galenic System," Ibn al Nafis and pulmonary circulation. Current practice of traditional medicine. Crusades

---------------------------Readings--------------------------

83 pp

Magner, 133-149, "Islamic Medicine"

Porter IV: 92 -105. "Medicine and Faith" [Islam, health care]

Packet: Nasr, 184-229, "Medicine"

Source Book of Medieval Science

715-720, "Canon," [Avicenna]

===================Winter Carnival Weekend====================

6. Mon. 2/21 Medieval Medicine

Background to the Middle Ages: Islamic Expansion Ceases. The Western Medieval Technological Revolution: Agriculture, Population, Towns, Universities. Scholasticism. Recovery of Ancient Knowledge. Compass, Gunpowder, Mechanical clock. Crusades. Salerno. Medieval translation and "recovery". Eyeglasses. Brandtwein, and soap. Mondino and his work. Medical astrology. Medical Schools - anatomy, physiology, texts, status. Leprosy. 14th century disaster: bubonic plague, ca. 1344ff.

---------------------------Readings--------------------------

101 pp

Magner 99-128, "The Middle Ages"

Porter 83-92 [Christianity, Galenic legacy]

106-134 "The Medieval West" [hospitals,

plague, women, bodies, leprosy]

Packet: Singer, 66-86, "The Middle Ages and

Renaissance"

Singer, 71-81 [Magic to Science] "The Age of

Arabian Infiltration," and "Translation

from the Arabic"

7. Fri. 2/25 Exemplars of Medieval Medicine

Trotula; Guy de Chauliac; Salerno; Mondino; the Plague

---------------------------Readings--------------------------

39 pp

Packet: Sourcebook of Medieval Science,

724-726,"Anatomical Demonstration at Salerno"

729-739, "Anatomy" [Mondino da Luzzi]

742-745, "General Instructions for the Practitioner"

761-767, "Gynaecology" [Trotula]

775-778, Salernitan Diet and Regimen [poem]

785-787, "How to Make Aqua Vitae," [Aldreotti]

773-774, "Bubonic Plague"

791-795, "History of Surgery" [Chauliac]

PAPER DUE TODAY

8. Mon. 2/28 Renaissance and Reform

Paracelsus and Paré. Alchemy and surgery. Linacre, Caius, and Professionalization. Hygiene. Ergotism, Venereal Disease. Iatrochemistry.

---------------------------Readings--------------------------

91 pp

Magner, 153-157;165-183, "Medicine and the Renaissance."

Nuland, 94-119, "Ambroise Paré"

Porter, "Renaissance" 163-176; 186-200; [syphilis, Paré, drugs, mind, society]

Porter, "The New Science" 201-211 [Paracelsus; iatrochemistry]

9. Fri. 3/3 Vesalius

The Scientific Revolution in Anatomy. The "Copernicus" of Anatomy?

---------------------------Readings--------------------------

90 pp

Porter 176-186, "Renaissance" [Anatomy]

Magner, 158-164, [Vesalius];

Nuland, 61-93, "Andreas Vesalius"

Packet: Singer, 111-135, "Modern Times to Harvey"

Vesalius' De Fabrica, "Introduction", 54-60

Heseler, "Vesalius' First Public Anatomy", 61-65

Platter, "Journal: Graverobbing for anatomy", 66-67

Recommended: Singer, 187-205, "A Vesalian Atlas"

10. Mon. 3/6 17th Century Medicine; William Harvey

17th century changes in medicine: Sydenham; quinine and malaria; Descartes; microscope[s]; Leeuwenhoek; physicians’ practices; madness. William Harvey and the Circulation of the Blood: Fabricius. Fracastoro, Columbo. Cesalpino. William Harvey, Servetus and Ibn al-Nafis. Malpighi's confirmation of capillaries. New Problems: functions of respiration, circulation. Transfusions. Sanctorio Sanctorio and quantitation. Metabolism. Malpighi's confirmation of capillaries.

---------------------------Readings--------------------------

105 pp

Magner, 189-213, "The Scientific Revolution and the Circulation of the Blood"

Magner, 217-225, "Selected Aspects of Clinical and Preventive Medicine" [17th Century only]

Nuland, 120-144, "William Harvey"

Porter "The New Science" 211-244 [Harvey, Descartes, body, microscope, Leeuwenhoek, practice, Moliere, curing, medicine & people, madness]

Packet:

Singer, 174-185, "The Work of William Harvey"

Recommended: Singer, 140-145, "Vesalius'

Followers"

Recommended: Singer, 153-158, "Fabricius ab

Aquapendente"

11. Fri. 3/10 The Enlightenment

Morgagni. Johann Peter Frank and Medical Police. Lind, scurvy and citric acid, 'limeys'. Mather and smallpox inoculation. Jenner and vaccination. eradication of smallpox. Boerhaave and Leiden; Naturphilosophie. Haller. Medical practice. Auenbruegger. miasma v. contagion. Cullen. therapeutics. insanity. midwifery. surgery. medicine and laypeople. professionalization. education. hospitals. yellow fever.

---------------------------Readings--------------------------

143 pp

Magner, 225-252, " Clinical and Preventive

Medicine"[18th century]

Packet: Jenner on Cowpox, 299-309

Porter "Enlightenment" 245-303

Nuland, 145-170, "Giovanni Morgagni"

171-199, "John Hunter"

12. Mon. 3/13 William Harvey and the Circulation of the Blood

Harvey's experimental method illustrated. Discussion. In class video [Royal College of Physicians]: "William Harvey and the Circulation of the Blood" Review

13. Fri 3/17 Midterm Examination

======================SPRING BREAK=========================

Part II.

The Rise of Modern Medicine: 1800 - 1999

14. Mon. 4/3 Scientific Medicine in the Nineteenth Century

Laennec and the stethoscope. Virchow; medicine in Paris, Bichat, Broussais; German laboratory medicine; pharmacology; education, Bernard; science and practice.

---------------------------Readings--------------------------

100 pp

Porter 304-347, "Scientific Medicine in the 19th

Century"

Magner, 335-341, "Diagnostics and Therapeutics" [Laennec]

Nuland, 200-237, "René Laennec"

408-411, [Halsted - radical mastectomy]

Packet: Laennec on Diseases of the Chest, 310-313

Nuland, 304-342, "Rudolf Virchow"

15. Fri. 4/7 Medical Care in the Nineteenth Century

Institutional changes - education, professinalization, nursing, hospitals, specialization, alternative medicine. Women and/in medicine. The story of Anesthesia.

---------------------------Readings--------------------------

106 pp

Porter 348-359; "19th Century Medical Care"

[Education and professionalization];

375-396 [nursing, specialization, alternatives]

Packet: Blackwell, Women and Medicine, 282-287

Porter 360-368 [surgery and anesthesia]

Magner 279-294 "The Art and Science of Surgery"

Nuland, 263-303, "Surgery without Pain"

16. Mon. 4/10 Infection and Asepsis

Semmelweiss; Lister.

---------------------------Readings--------------------------

114 pp

Magner, 259-275, "Childbed Fever, Midwifery, and Obstetrics"

Nuland 238-262 Semmelweis

Packet: Semmelweis on Puerperal Fever, 240-246

Magner 294-302 [Lister]

Porter 368-374 [Lister]

Nuland 343-385 "Joseph Lister"

Packet: Lister on Antisepsis, 247-252

17. Fri. 4/14 Public Health

Industrialization and public health. disease statistics; legislation; cholera; clean water. sanitation and hygiene.

---------------------------Readings--------------------------

85 pp

Porter 397-427, "Public Medicine"

Packet: Chadwick's Report, 217-239

"Snow on Cholera", 25-55

18. Mon. 4/17 From Pasteur to immunology

Pasteur; The Germ Theory of Disease. Koch. Bacteriology. chemotherapy. antibiotics. immunology.

---------------------------Readings--------------------------

102 pp

Porter 428-461, "From Pasteur to Penicillin"

Magner, 305-331, "The Germ Theory of Disease:

Medical Microbiology"

341-365 [serum therapy, chemotherapy,

antibiotics, and immunology]

Packet: 253-257 Pasteur on Germ Theory

319-329 Koch on Tuberculosis

19. Fri. 4/21 1. Tropical Medicine. 2. Psychiatry.

Colonialism and Imperialism. ‘new’ dangers. Medicine becomes international. Reforms in mental treatment. Sanitarium. Moral Treatment. Psychoanalysis. new technologies.

---------------------------Readings--------------------------

83 pp

Porter 462-492, "Tropical Medicine, World Diseases"

Porter 493-524, "Psychiatry"

Packet: Pinel on Insanity, 166-177

Dix on Treatment of the Insane, 352-359

20. Mon. 4/24 Medical Research

Institutionalization and Specialization. Neurology; Neuropathology; Biochemistry and nutrition; Endocrinology; Neurochemistry; Cancer; Cardiology; Genetics, Immunology.

---------------------------Readings--------------------------

72 pp

Porter, 525-596 "Medical Research" and "Clinical Science"

21. Fri. 4/28 Second Hour Exam

22. Mon. 5/1 Surgery after Lister

New operations and instruments. Heart; Transplants; Reproductive technology. Halsted; Taussig.

---------------------------Readings--------------------------

135 pp

Porter 597-627, "Surgery"

Nuland, 386-421, "William Stewart Halsted"

Nuland, 422-456, Helen Taussig

457-489, "The Story of Transplantation"

23. Fri. 5/5 Medicine: social, political, and personal context

Social policies. Insurance. Changes in doctor-patient relationships.

---------------------------Readings--------------------------

82 pp

Porter 628-709, "Medicine, State and Society," and

"Medicine and the People"

24. Mon. 5/8 Retrospect QUIZ

Quiz. Reflections, Review, Prospects. SCS.

---------------------------Readings--------------------------

18 pp

Porter 710-718 "The Past, the Present, and the

Future"

Packet: Porter, "The Rise and Fall of the Age of

Miracles," 1-9

25. Fri. 5/12 Choosing a Lifetime in Medicine

[or Wed., 5/10?]

Dr. Michael Payne, M.D.