19th-Century Medicine
/ purchase medical books
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.
|