medical profession in the 19th century
The first medical school to lead the reform movement was associated with Lind University in Chicago (later Chicago Medical College and presently Northwestern University). The Medical Profession in 19th Century Florida: A Biographical Register [Hammond, E. Ashby] on Amazon.com. Considerable dispute developed between osteopaths and regular practitioners, but over the decades osteopathic physicians so modified the original principles that they became almost indistinguishable in their methods from traditional physicians. Psychiatrists such as Janet, Esquirol, Bayle, and Georget gave France the leadership until the reports of Griesinger and others drew attention to Germany. Alkaloids and antipyretics (fever-lowering compounds) were among the first drugs synthesized. Noté /5. Eventually he did become a physicist and professor of physics in Berlin in 1871, but the thirty years spent in medical practice and investigation were never forgotten. The patient was urged to seek a physician who devoted his time and skill to one type of illness or manipulation. Perhaps the most personally popular of all surgeons was Dominique-Jean Larrey (1766-1842), so highly respected and admired by friend and foe alike that Napoleon called him the most virtuous man he had ever known. Ether was taken up by many other countries shortly after its introduction: notably France, Sweden, Portugal, Spain, Cuba, and South America. In the United States, cholera ravaged the entire country three times in the nineteenth century. But his intensive use of percussion and auscultation, incisive lectures and clinical demonstrations, and emphasis on the newest methods, including examination of the blood and urine, made him a leader in clinical medicine. Therapeutic agents in practice frequently did not keep pace with advances in general science, biology, physiology, and chemistry. The answer to this question lies partly in the medical schools established during the 19th century in colonies of European empires. John Howard in the eighteenth century had shocked the upper classes with his book Hospitals and Lazarettos. Benjamin Brodie (1783-1862), William Fergusson (1808-77), and James Paget (1814-99) were also outstanding surgeons of London. His book, Un Souvenir de Solverino, published three years later, shocked European leaders into action. Her presence and administrative genius during the years 1854 and 1855 saved the hospital from total demoralization. Miss Nightingale’s energies and writings were in large measure responsible for the transformation of nursing from a low, unpopular, almost casual endeavor into a highly respected, essential part of the healing arts. Intent on trying to look inside the eye of a living person, he devised an instrument consisting essentially of a concave mirror with a hole in the center which shone light into the pupil and enabled the viewer to see the reflected image of the retina. Many of these standard listings continued for a long time to include some of the bizarre, ancient substances combined in multi-ingredient formulas. Dunant himself pitched in to try to save as many lives as possible. Doctors struggled to turn these discoveries into cures, but: Our tips from experts and exam survivors will help you through. Physicians, the elite of the profession, offered medical advice to the richest members of the population. Believing Brown’s doctrine that irritation was the basic property of living tissues, he considered changes in tissue heat the fundamental determinant of health and illness. The introduction of anesthesia by dentists was as important to dental procedures as it was to the surgery of other organs. Among other outstanding names of the French school were Armand Trousseau (1801-67), who contributed masterful and perceptive treatises on illness; Jean-Baptiste Bouillaud (1796-1881) (evidently the model for Balzac’s Dr. Bianchon); Pierre-Adolphe Piorry, a pioneer in the use of an instrument for percussion of the chest (the pleximeter); Francois-Olive Rayer, a contributor to clinical and laboratory knowledge who inspired Bernard in physiology, and Davaine and Villemin in their work on infection. In England, many physiologists illuminated the functions of the nervous system in the nineteenth century. Although American medicine throughout the nineteenth century continued to depend upon Western Europe for innovations, individual American physicians demonstrated both intelligence and initiative. Neurology was relatively late in becoming a separate specialty, and then it was often combined with psychiatry. One may say that a strong Scottish thread ran through the fabric of medicine in England, Ireland, and the United States. As late as 1854 in London there were 14,000 cases of cholera with 618 deaths. In 1842 he performed three minor surgical procedures using sulfuric ether. The invention of the water closet by John Harrington (1561-1612) facilitated flushing away human waste and helped to keep some dwellings clean, but the flow from these indoor privies ran into cesspools and ultimately into waterways and wells. III. However, in recent decades, the physiology and surgery of the head, neck, and mouth have brought a greater interdependency among physicians, surgeons, and dentists. By the middle of the nineteenth century, examinations of blood and urine were routine. The older, standard procedures, such as hernia repair, were modified by Bassini and others to obtain better results. In some instances the spur was principally the enormous increase in information (as in pathology), while in others it was the newly devised instruments which required special experience (as in urology and laryngology). The Thomsonians, who emphasized herbal medicines and steam baths, were one of a diverse group of practitioners—prominent especially in the U.S.—who stressed “Nature’s remedies and folk medicine.”. By 1900 the major outlines of human physiology were understood, the role of pathogenic organisms and their vectors was explained, and medicine could operate from a reasonably factual basis. Elizabeth Blackwell, who earned a medical degree in 1849, was a pioneer in the struggle to open the medical profession to women. In the Duchy of Nassau, for instance, before it was taken over by Prussia, the physicians and surgeons were in one body under the state, and although strict examinations had to be passed to practice medicine a university degree was not essential. Under the guidance of these two, assisted by William S. Halsted and other outstanding professors, Hopkins drastically reshaped American medical education and set a pattern which persists today. In the United States the organization of the Metropolitan Throat Hospital and The New York Laryngoscopic Society, both in 1873, were due to the efforts of Clinton Wagner. Fauchard also emphasized the need for special training of doctors of the teeth and for the examination of candidates by those experienced in the discipline instead of by surgeons. Encouraged by its effectiveness in his dental practice, he, too, contacted Dr. Warren and in 1846 gave the first public demonstration of surgery without pain. Especially notable were the advances in operative treatment of the reproductive organs of women. His treatment was therefore directed toward the local problem rather than abnormalities in the humors which were still considered the primary causes. Before Laennec, the sounds of the lungs and heart were studied by holding one’s ear against the chest, a technique with numerous disadvantages. In this capacity he was called in to help with a young slave girl who had been in labor for seventy-two hours. Organic chemistry would become merely . Even well into the 1940s many highly reputable hospitals continued to employ nurse-anesthetists rather than physicians specializing in anesthesia. His next step was to construct a wooden cylinder, and he was amazed to discern sounds he had never heard or hardly appreciated before. On the basis of preliminary investigations in France by J. F. Derosne in 1803 and A. Seguin in 1804, F. W. A. Serturner in Germany isolated morphine in 1806. For the first time, medical ethics assumed codified form. Outstanding surgeons everywhere were continually plagued by the dread complications of postoperative purulent infection and gangrene. The school received no support in its fight to raise educational standards until 1871, when Harvard overhauled its medical school and instituted a three-year graded course, a nine-month academic year, and written and oral examinations. James Parkinson (1755-1824), for instance, gained recognition for his description of a neurological disorder now known as “Parkinson’s disease,” but he was also an important writer on paleontology. For about a century, chloroform continued to be the choice agent in Britain until its unmanageable toxicity and delayed damage to the liver was appreciated. Sigmund Freud had earlier studied the anesthetic properties of cocaine but did not pursue the work. At first, physicians and surgeons administered anesthesia in addition to their own specialties. Many physicians continued to use compounds of arsenic for such diverse complaints as intermittent fever, paralysis, epilepsy, edema, rickets, heart disease, cancer, skin ulcerations, parasites, indigestion, and general debility. The certification ordered by Roger II of Sicily in the twelfth century was expanded by Frederic II in the thirteenth century to comprise a nine-year curriculum, an organized system of state licensing examinations, a mechanism for regulating apothecaries, and a sanctioned schedule of fees. In agreeing with the Parisian school on the importance of matching the clinical picture with abnormalities (lesions) in the organs of the body, Broussais vigorously ridiculed attempts to classify diseases according to symptoms. Brown-Sequard taught that the adrenals, thyroid, pancreas, liver, spleen, and kidneys had secretions (later to be called hormones) which entered the bloodstream and could be used in treatment. However, the homeopathic system used such infinitesimal doses that they could hardly have had any effect, and, furthermore, the homeopaths were uncritical in their evaluation of results. The spirit of the Enlightenment of the eighteenth century and Rousseau’s writings were among the incentives to concentrate on the problems of children. Doctors were even considered useless or harmful by large segments of the public conditioned by the failure of bleedings, purgings, and other manipulations to affect illness or stem epidemics and by the extravagant but convincing claims and cures promised by quacks. The professionalization of medicine, starting slowly in the early 19th century, included systematic efforts to minimize the role of untrained uncertified women and keep them out of new institutions such as hospitals and medical schools. In 1904 the A.M.A. The pitiable condition of the tens of thousands of wounded soldiers still lying unattended on the ground so aroused him that he immediately set about persuading the victorious French commanders to free the captured Austrian military surgeons to help care for the injured of all three nations. NINETEENTH CENTURY. Schleiden proposed that the cell and its components formed as a result of a chemical precipitation out of an undifferentiated mass. In that role, he served as a resource on the history and would answer questions from researchers. the chemistry of carbon compounds. Wilhelm Waldeyer (1836-1921) named the chromosome in the nucleus of the cell and put forth in 1891 the theory that the basic unit of the nervous system is the nerve cell, the neurone. After X-rays were introduced by Wilhelm Konrad Roentgen (1845-1923), it took until the 1920s before a feasible technique could be devised for adequately visualizing the urological tract. However, Rokitansky’s reliance on humoral theories (he tried to reconcile the ancient concepts with modern anatomical knowledge) led to devastating criticisms by the young Virchow which shook his standing, but he remained an honored pathologic anatomist throughout his life. In addition to the breathing abnormality which linked his name with Cheyne’s, there is a type of dysfunction of the heartbeat first described by Robert Adams in the same century called “Stokes-Adams” heart block. In his quest for a more pleasant and more controllable agent than ether, he had tried a drug suggested to him by a Liverpool chemist which had just been named “chloroform” by J. At the time, this nihilism was probably more beneficial than the bleedings, emetics, and purgings that were still part of medical treatment. We use cookies to give you the best online experience in accordance with our Privacy Policy. Gradually both sides evolved effective ambulance systems and hospitals, procured adequate medical supplies, and developed well-trained surgeons. The priority of this accomplishment was challenged by Charles Bell, among others, and the principle is now called the “Bell-Magendie law.” Magendie’s analyses of the actions of drugs also made him a founder of the discipline of pharmacology. The priority of his experiments proving the motor function of the anterior nerve roots emerging from the spinal canal and the sensory characteristics of the posterior roots has been challenged by scholars who suggest that Magendie in Paris gave the first definitive proofs. Lembert contributed to intestinal surgery, Meniere to the medical and surgical aspects of ear diseases. Abel became head of materia medica and therapeutics at the University of Michigan in 1891, and later, at Johns Hopkins, he occupied the first chair in the United States in the new discipline of pharmacology. In 1859 Lind raised its entrance requirements and lengthened its academic year to five months. For instance, theriac was still in the pharmacopoeia of London in the eighteenth century. Pernicious anemia and adrenal insufficiency are both still referred to as “Addison’s anemia” and “Addison’s disease of the adrenals.”. William Beaumont (1785-1853), an obscure army surgeon who had learned medicine through an apprenticeship, took advantage of a rare opportunity to pave the way for the present understanding of the gastric process. The “open” method of dripping the anesthetic on a gauze mask was replaced by “closed” systems in which an airtight mask could deliver a precisely measured amount of vapor and remove the exhaled carbon dioxide through absorption by a calcium compound. Lists of drugs to guide therapeutics have existed since ancient times, but the word pharmacopoeia (which means the making of medical substances) was first applied to such a listing in the sixteenth century. Famous 19th Century American Physicians. Antimony, which had its heyday in a previous century, was also still much in use, possibly sometimes aiding patients with parasitic infestations. Johann Friedrich Dieffenbach (1795-1847), a pioneer in plastic surgery, wrote, “The wonderful dream that pain has been taken away from us has become reality. Specialization in the nineteenth century was at first vehemently opposed by many in the profession who felt that it would be detrimental to the patient. Surgery in Paris was comparatively well-developed, especially in the first half of the century, with much of the advance due to the bloody events of the Revolution and Napoleonic wars. The very introduction of numerical analysis of bloodletting results by Pierre-Charles-Alexandre Louis (1787-1872) was not only a fatal blow to venesection but a major force leading to the scientific evaluation of all therapies. Pierre-Francois Percy (1754-1825), a surgical colleague, called him “the first of surgeons and the least of men.”. Although Larrey was famous as a surgeon (he is said to have performed over two hundred amputations during a twenty-four-hour period in the Russian campaign) and also as a clinician (he wrote vivid descriptions of “trench foot,” scurvy, contagious eye infections, and a method of feeding through a stomach tube), perhaps his most influential contribution was the creation of “flying ambulances,” wagons for stretcher use during battle. Miraculously, after a lengthy convalescence, Alexis St. Martin, the patient, survived, but he was left with a permanent gastric fistula giving direct access to his stomach. In the second of two international conferences, the Geneva Convention of 1864, sixteen nations signed a treaty establishing the International Red Cross and specifying the regulations that should apply to the treatment of wounded soldiers, which included the recognition that all hospitals, military and civilian, were to be neutral territory; that medical personnel of any country, and their equipment, were to be free from seizure or molestation. Things were improving by the 19th century. The man largely responsible for reforming the Union Medical Corps was Surgeon General William A. Hammond, a bright, energetic individual whose much-needed reforms irritated enough regular army officers and politicians to lead to his dismissal in November, 1863, and his subsequent court-martial. The approaches to tumors of the brain and spinal cord by Victor Horsley (1857-1916) in England gave impetus to neurological surgery. Learn how your comment data is processed. Pierre Robiquet was another of the many pharmacist-chemists in France and Germany who discovered and isolated the new plant alkaloids so important to medicine—among them atropine, colchicine, and cocaine. The remarkable numbers of intestinal lesions which he saw, especially of typhoid fever, led him to conclude that the gastrointestinal tract was the primary source of most illnesses, especially those with fever.