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Theme 7. Medicine of the Modern Times: the biomedical direction (XVIII - beginning of the XX century)

(4 hours)

Session 1.

Plan:

1. The formation of scientific anatomy

2. The development of the theory of general pathology

3. Stages of the evolution of histology

Session 2.

Plan:

1. Empirical and Experimental Microbiology

2. Advances in physiology and experimental medicine

3. Domestic medicine of the New time

In anatomy and physiology both centuries have left an indelible mark. One of the most important acquisitions of physiology was the discovery of blood circulation, which accounted for the glory of Harvey. He expounded his theory in lectures as early as 1613, but he published a book on this subject in 1628; only after 25 years of controversy did the teachings of Harvey finally triumph. Borelli, Haller and Humberger studied the phenomena of respiration in detail and found out the role of the lungs. Lymphatic vessels are described by Azelli, Peke, Rüdlek, Mascagni and others; they also proved or established the connection of the lymphatic system with the circulatory system. Van Helmont made many experiments to explain the digestion and nutrition, and anatomical data were presented by Stenon and Wharton. In the XVII century. anatomy of tissues (histology). Malpighi, using a microscope, studies the development of the chicken, blood circulation in the smallest vessels, the structure of the tongue, glands, liver, kidneys, and skin. Ruysh was famous for his excellent filling (injections) of vessels, which allowed him to see vessels where they had never been suspected. For 50 years, Leeuwenhoek found a lot of new facts in the study of all tissues and parts of the human body; discovered blood cells and seminal filaments (spermatozoa). Many autopsies provided rich material for pathological anatomy. For the first time, such observations were collected by Bone, but Margany was the true creator of the new science. It is difficult in a few words to convey the profound changes that took place in the 2nd c. survived in her systems M. Following one doctrine, quite often the opposite occurred; each challenged the right to explain all medical phenomena. Van Helmont in some respects close to Paracelsus, but higher than the latter in depth of thought and erudition. His system is a mixture of mysticism, vitalism, and chemism. According to his teaching, special vital principles, archaea, control the body through enzymes; each part of the body has its own archaea, and these minor archaea depend on the main one; above the archaea is the sensual soul; the minor archaea act through the aid of special weightless liquids — blas, sensing, moving, and changing. As long as an archaea is in its natural state, a part of the body or the whole body is healthy, but if an archaea is frightened, a disease is detected. To cure the disease - it is necessary to calm the Archaea, strengthen it, prescribing various medications: mercury, antimony, opium, wine; penetrators are given with caution; bloodlettings are completely expelled, for they weaken the patient. Silvius le Bohe, anatomist and chemist, is a representative of a numerous school of yatrochemists. He accepts Van Helmont's teachings about archaea and enzymes, but does not change it at all in order to make it clearer: administration is caused by chemicals — alkalis and acids, although controlled by spirits. The alkaline or acidic properties of liquids constitute the causes of disorders that may develop in dense parts, liquids, perfumes, or the soul. Medications were prescribed to change the acidic or alkaline characteristics of liquids. This teaching quickly spread to Europe, especially in England and Germany. Thomas Willis gave a slightly different form to yatrohimiya. According to his teaching, the body consists of spirits, water, sulfur, salt, and earth; spirits serve as sources of movement and life; life is caused and sustained by fermentation, all administrations are the essence of fermentation, and special enzymes are found in all organs. Diseases occur during improper fermentation; frustration is found mainly in spirits and in blood, into which harmful wanders outside or from tissues fall; it is necessary to purify the body and the spirits, reduce the volatile properties of the blood, strengthen the sulfur content in the latter; bloodletting is beneficial because abnormal fermentation soothes. Borelli is rightly considered the founder of the school of mechanics. The latter, in order to explain the phenomena occurring in the body, called for help information about the then known physical forces (elasticity, attraction); besides, much was explained by chemical interactions (fermentation, evaporation, crystallization, coagulation, precipitation, etc.). Borelli taught that muscle contraction depends on cell swelling due to the penetration of blood and perfume; the latter go on nerves arbitrarily or involuntarily; as soon as the spirits met with blood, an explosion occurs and a reduction appears. Blood restores the organs, and the nerve spirit supports their vital properties. A large number of diseases come from nerve juice disorder, which is due to irritation or clogging of nerve ramifications in organs and glands. Ballyvi, not satisfied with any system, proved the advantages of inheriting truth through experience, discovered the spirit of hippocratic M. and its useful features, rebelled against the opinions of Galen and Yatrochemists, and advised not to get involved in theories at the bedside. In general, Balviwi explored the techniques of thinking in M. and pointed out the right ways to discover the truth. According to Hoffmann, life consists in the circulation of blood and the movement of other liquids; it is supported by blood and perfume, and by means of branches and excretions balances the administration and protects the body from rotting and deterioration. Circulation is the cause of heat, all strength, muscle tension, propensities, qualities, character, mind and insanity; the cause of blood circulation should be considered narrowing and expansion of solid particles, resulting from the very complex composition of the blood. Contractions of the heart due to the influence of the nervous fluid that develops in the brain. In general, all departures are explained mechanically. Diseases occur as a result of disturbances in the movements of solid parts, which leads to disorders of fluids. Medicines should reduce stress (sedative, anti-inflammatory) or increase it (strengthen), or change the composition of fluids (altering); the funds act depending on the patient's condition, age, etc. Another representative of the Yatrome Khanizm - Burgav - enjoyed particular fame. The body, in his opinion, consists of dense parts, which are placed in the form of levers, ropes and various devices; liquids are treated solely according to the laws of physics; the activity of the nerves is filled with perfume or nervous fluid; the variety of items is due to the blood circulation rate, the temperature of the air contained in the organs, and so on. Diseases occur from the breakdown of solid parts and liquids; in the first case, there is a strong tension or relaxation in the region of the vessels, intestinal membranes and other parts; irregularities in the composition of liquids depend on alkalinity, acidity, abundance and uneven distribution of blood. Steel, an eminent physician and chemist, is recognized as the founder of systematic animism, which is the opposite of the yatro-mechanism. There is a higher engine, there is the basis of all life, namely the soul, and it acts on the body through the medium of the driving force, which is not archaea, not sensitivity, not attraction, but something higher, not susceptible to research and definition. The soul has the highest properties - consciousness and reason - and the lower ones, which are intended for organs and tissues. During an illness, it is necessary to distinguish the consequences of the influence of the pathogens from the effects of the soul’s efforts to cure the disease, although it often does not achieve this goal.

The above systems forced us to study the same phenomena from different points of view, led to a revision of treatment methods, and finally, the consequence was the introduction of some general concepts about the properties of tissues and organs. Especially beneficial was the acceptance of irritability, as a general quality of life. Glisson in all parts of the animal took the property of living parts to shrink or relax under the influence of stimuli and called this property irritability.
The disciple of Burgava, Gorter, found this feature in all living beings, even animals, and distinguished it from the soul and the nervous fluid or spirits. More accurately studied the laws of irritability and its relationship with other forces of the body Albert Galler. His bibliographic works present real miracles of reading; in them he expounds the works of his predecessors and contemporaries with remarkable accuracy and impartiality. Haller distributed tissues and organs according to the degree of sensitivity and irritability, recognized the independence of both properties; sensitivity attributed to the differences of nerves, and irritability separated from elasticity. His experiments were repeated, and the doctrine of irritability became the starting point for new views. Gauby laid the basis for all pathology irritability, which he explained various diseases. Cullen tries to combine the teachings of Hoffman with the views of Haller: the majority of diseases depend on nervous disorders that cause spasm or relaxation; but nervous activity is caused by blood circulation, which irritates the nerves. His student, Brown, simplified all pathology and treatment to the extreme. His highly one-sided theory was met at first sympathetically in Germany and America, but in reality turned out to be harmful and was soon abandoned. Along with the desire for broad generalizations, theories and systems in the XVII and especially in the XVIII century. we meet a purely practical direction. Many researchers scattered in different countries collect thousands of observations, discover new signs of disease, and study the effects of new and old means. Such a movement of medical thought contributed device clinics. Straten in Utrecht and Otto Gurn in Leiden introduced clinical teaching, which was especially developed in the hands of Selvia le Bohe. Forty years later, Burgav gave his lectures a practical character, perfectly arranged a hospital. Following the example of Burgawa, other professors began to establish clinics in Rome and others. Ital. cities, Vienna, Würzburg, Copenhagen, etc. Of the practical doctors who were hostile to all sorts of theories, it should first be called Sydengam. His ability to accurately observe is found in describing epidemics during which he tried to discover a known legitimacy and consistency. Stoll kept the same direction, giving accurate descriptions of chronic diseases and epidemics. Of the other epidemiologists who have presented more or less remarkable works, let's call: Dimerbrook, Rivin, Morley, Shakhty, Shrek, Kanodda, Lange, Valcarengi, and others. A lot of people studied the diseases characteristic of well-known places. Bontius described the diseases of India, Kempfer - Persia, Japan and Siam, Piso - Brazil, etc. Separate descriptions of the distribution of diseases inspired the idea to present an image of pain depending on the climate. The first such attempt was made by Falconer; Later similar works were presented by Finke, Wilson, Karteizer. Collections of observations that were published in separate editions or published in journals are very instructive. Such works became famous: Tsakut Lusitan, Tulpy, Bartholin, Vepfer and others. According to the description of certain diseases are given out: Guxgem, Pringle, Geberden, Fordyce, Van Sweeten, de Gaen, Stark, Vic-d'Azir, Lepec de la Clotteur, Loetho, Lafuente, Torres, and more. etc. In order to recognize diseases, many techniques have been proposed. The types of pulse and its significance were noted by Solano, Niggel, and especially Bordeaux and Fuke; later this recognition industry fell into disrepair. Avenbrugger tapped to identify chest diseases, and Lennek listened. In the XVIII century. we meet the desire to distribute all diseases by categories, classes and species, just as it was done for animals and plants. Sovazh, in his "Nosografiya", tried to solve this problem; he divided all sufferings into 10 classes, 44 species, 315 genera. Linnae, Vogel, Cullen, Maabride, Vite, Selle worked a lot on improving the nozography. Pinel's writing survived 6 editions, but his division of diseases was still not accepted. In the treatment of diseases, doctors of both centuries have made progress. Syphilis was treated more correctly; the use of quinine for fevers has spread; against smallpox, proposed opeprivating; studied the properties of belladonna, dope, aconite; against pain offered opium. Many other means were tested on animals and then found use in human diseases. Authors op. on hygiene, observations were made on the influence of external conditions on humans. Cheyne found out the importance of milk and plant food for health and suggested reasonable rules for people who want to reach old age. Doctors, administrators, and private individuals joined forces to improve public health. In Marseille, then in other cities, quarantines are arranged to protect against infectious diseases. Thanks to Howard, improvements have been made in hospitals and prisons. Pinel changed the treatment of the mentally ill and drove out of use all barbaric methods: chains, corporal punishment, etc. Captain Cook, through experience, saw how painfulness among seafarers drastically reduced when applying sanitary measures. Fortunate Fidelis first collected observations related to the judicial M. Important collection was published later by Tsaksky. Many works in the XVIII century. developed individual issues just mentioned science. On the success of surgery, see Surgery. Since the XVIII century. Compositions on ucmopuu M. begin to appear, namely, Leclerc, Goedicke, Freund, Schulze, Ackermann. Some developed the history of individual branches of M. (Gebenshtreyt, Gruner, Thriller, Grimm, Kokki, etc.), others - biographies (Baldinger), and others - bibliographies (Haller). Historical works have become more numerous in our century: Kurt Sprengel published his great essay on the pragmatic history of M., Gezer, Baas, Wunderlich, Pumman; Daramberg, Renzar, Guardia, de Renzi, Richter and many others. others have published very important works.

Bibliography

1. Borodulin F.G. History of Medicine. Selected lectures. - M .: Medicine, 1961. - 252 p.

2. Gritsak E.N. The popular history of medicine. - M .: Veche, 2003. - 464 p.

3. Zabludovsky P, E. History of Russian medicine: Materials for the course of the history of medicine: H 1. The period up to 1917 - Moscow: Izd. COLIUV, 1969. - 400 p.

4. Zabludovsky P.E. History of Russian medicine: Textbook. allowance: Part 2. Medicine in the USSR. - M .: Izd. COLIUV, 1971. - 90 p.

5. Zabludovsky P.E., Kryuchok R.R., Kuzmin M.K. History of Medicine. - M .: Medicine, 1981.

6. History of Medicine: Materials for the course of the history of medicine / Ed. B.D. Petrova. - M .: Medicine, 1954. - 282 p.

7. Kuzmin M.K. History of Medicine: Essays. - M., 1978. - 197 p.

8. Lisitsyn Yu.P. History of Medicine: Textbook. - M .: GEOTAR-MED, 2004. - 400 p.

9. Medicine // Great Medical Encyclopedia. V. 17. - 2nd ed. - M .: Medical encyclopedia, 1960. - STB. 47 - 512.

10. Medicine // Big Medical Encyclopedia. T. 14. - 3rd ed. - M., 1980. - p. 7 - 322. Stb. 1 - 947.

11. Medical encyclopedic dictionary / Ed. IN AND. Borodulin. - M .: Onyx XXI century, 2002. - 704 p.

11. Mirsky B.M. The history of medicine in Russia in the XVI-XIX centuries. - M .: ROS-SPAN, 1996. - 400 p.

12. Multanovsky M.P. History of Medicine: Textbook. - M .: Medicine, 1967. - 348 p.

13. Semenchenko V.F. Pharmacy history. - M .: ICC "Mart", 2003.

14. Sorokina TS History of Medicine: Textbook. In 2 tons. - M .: Izd-vo RUDN, 1992. - 386 p.

15. Sorokina TS History of Medicine: Textbook. - 4th ed. - M .: "Akademiya", 2005. - 560 p.

16. Readings on the history of medicine / Sost, E.D. Gribanov. Ed. and with notes. P.E. Zabludovskogo. - M .: Medicine, 1968. - 359 p.
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Theme 7. Medicine of the Modern Times: the biomedical direction (XVIII - beginning of the XX century)

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