医学史简论.ppt

医学史简论（6) A Brief History of Medicine,浙江大学医学院 余 海 Zhejiang University School of Medicine,Origin of Medicine Egypt Babylon India China Greece Rome Medieval Islamic medicine Renaissance Pre-modern medicine Modern medicine TCM,Western Medicine,Premodern Medicine: background,1642-1651 English Civil War (revolution) Replacement of English monarchy with the Commonwealth of England, then with a Protectorate under Lord of Protector Olive Cromwell，Charles II （1630-1685） James II restoration of monarch（1660） ，William III (Prince of Orange) and Mary II overthrew James II, “Glorious Revolution”(1688） “The Bill of Rights” was passed and established constitutional monarchy（1689）,Oliver Cromwell 15991658,1649.1.30,Trial and execution of Charles I for treason,Premodern Medicine: background,French revolution,“Liberty leading the people“,The tripod,近代医学发展的影响因素：资产阶级革命,French Revolution 1789-1799 Liberty， Equality，Fraternity,Execution of Louis XVI with the guillotine January 21, 1793,Storming of Bastille,1793.1.21,Pre-modern Medicine: Industrial revolution,瓦特 1736-1819 James Watt,Steam power - James Watt improved steam engine provided powerful energy for industrial revolutin,The Industrial Revolution was a period in the late 18th and early 19th centuries when major changes in agriculture, manufacturing, production, mining, and transportation had a profound effect on the socioeconomic and cultural conditions in Britain. The changes subsequently spread throughout Europe, North America, and eventually the world. The onset of the Industrial Revolution marked a major turning point in human society; almost every aspect of daily life was eventually influenced in some way.,Pre-modern Medicine: Industrial revolution,(George Stephenson 1781-1848) and his locomotive（1829）,火车 Locomotive 轮船 Steamer boat,近代医学发展的影响因素：工业革命,珍妮纺纱机Spinner Jenny,The starting point-textile industry,Pre-modern Medicine: Scientific revolution,Isaac Newton 1642-1727 天不生牛顿， 万古如长夜 Nature and natures law lay hid in light, God said, let Newton be! And all was light.,Laws of Motion: First law: Law of Inertia Second law F=ma Third law: Action=Reaction Universal Gravitation,First law: If there is no net force on an object, then its velocity is constant. The object is either at rest (if its velocity is equal to zero), or it moves with constant speed in a single direction. Second law: The acceleration a of a body is parallel and directly proportional to the net force F acting on the body, is in the direction of the net force, and is inversely proportional to the mass m of the body, i.e., F = ma. Third law: When a first body exerts a force F1 on a second body, the second body simultaneously exerts a force F2 = F1 on the first body. This means that F1 and F2 are equal in magnitude and opposite in direction.,Philosophi Naturalis Principia Mathematica ( Mathematical Principles of Natural Philosophy）1897,Pre-modern Medicine: Scientific thinking methodology (“Enlightenment”) Descartes rationalism and Bacons empiricism had to be combined to produce the modern scientific method,培根 Francis Bacon 1561-1626 According to Bacon, scientists should experiment freely and collect facts about everything in the world, until in due time the accumulation of facts would make clear the way nature behaves. From the storehouse of accumulated facts, scientists would induce the laws of nature. (inductive methodology ) Knowledge itself is power,笛卡儿 Rene Descartes 1596-1650 According to Descartes, scientists should deduce the laws of nature by pure reason, starting from the axioms of mathematics and our knowledge of the existence of God. Experiments needed to be done only to verify that the logical deduction of the laws of nature was correct. (deductive methodology) His aphorism is I think therefore I am,Pre-modern medicine: chemical school （Iatrochemie）,Flemish physician, philosopher, mystic, and chemist van Helmont demonstrated that acid was the digestive element in the stomach and was neutralized by alkali in the intestine and that blood combined with a “ferment from the air”. His theory of “ferments” as the agents bringing about physiological processes is a crude precursor of the idea of enzymes (fermentum).,Jan Baptista van Helmont (1580 -1644),Pre-modern medicine: chemical school （Iatrochemie）,Franciscus Sylvius (1614-1672),He was professor of medicine at the University of Leiden, Holland He believes that all life and disease processes are based on chemical actions. That school of thought attempted to understand medicine in terms of universal rules of physics and chemistry. Sylvius also introduced the concept of chemical affinity as a way to understand the way the human body uses salts and contributed greatly to the understanding of digestion and of bodily fluids.,Pre-modern medicine: physical school （Iatrophysics）,Alfonso Borelli 1608-1679,Italian physiologist, physicist and mathematician father of modern biomechanics,Pre-modern medicine: physical school,Julien Offray de La Mettrie 美特里 1709-1751,。,French physician and philosopher, materialists of the enlighterment. He is best known for his work Lhomme machine (Man a machine published anonymously 1747), wherein he claimed that human beings were machines.,（Iatrophysics）,Wheel gear spring lever bearing,Three major discoveries of 19th century,能量守恒和转化定律 The Law of Energy Conservation 生物进化论 The Evolution 细胞学说的建立 The Cell Theory,能量守恒和转化定律,Sanctorius (1561-1636）Italian physiologist, professor of Padua For a period of thirty years Sanctorius weighed himself, everything he ate and drank, as well as his urine and feces. He compared the weight of what he had eaten to that of his waste products, the latter being considerably smaller. He produced his theory of insensible perspiration as an attempt to account for this difference.,Weighing Chair,The Law of Energy Conservation,Geman physician and physicist and one of the founders of thermodynamics. In 1841 he made the original statements of the conservation of energy or the first versions of the first law of thermodynamics: “Energy can be neither created nor destroyed” In 1842, Mayer described the vital chemical process now referred to as oxidation as the primary source of energy for any living creature. His achievements were overlooked and priority for the discovery of the mechanical equivalent of heat was attributed to James Joule in the following year. He also proposed that plants convert light into chemical energy.,Julius Robert von Mayer (1814-1878),The Law of Energy Conservation,James Joule （1818-1889） English physicist and brewer He studied the nature of heat and discovered its relationship to mechanical work (mechanical heat equivalent)，confirmed the law of conservation of energy, which led to the development of the first law of thermodynamics,Charles Robert Darwin English naturalist (1809-1882),Evolution All species of life have evolved over time from common ancestors, through the process he called natural selection. In modern evolutionary theory, Darwins scientific discovery is the unifying theory of the life sciences, providing logical explanation for the diversity of life.,Evolution Charles Robert Darwin In his five-year (1831-1836) voyage on HMS Beagle established him as a natural historian. Puzzled by the geographical distribution of wildlife and fossils he collected on the voyage, Darwin investigated the transmutation of species and conceived his theory of natural selection in 1838。,加拉帕戈斯群岛 Galapagos Islands 属厄瓜多尔，距南美大陆1000公里 由23岛屿和组成，称“生物进化活博物馆”,达尔文雀 Darwins Finches,加拉帕戈斯象龟 Galapagos Tortoise 共12亚种，平塔岛亚种“Longsome George” 2012.6.24 死亡,beak,Eating cactuses (cacti),Published in 1859,On the Origin of Species established evolutionary descent with modification as the dominant scientific explanation of diversification in nature “The struggle for existence, Survival of the fittest” (物竞天择，适者生存) “I have called this principle, by which each slight variation, if useful, is preserved, by the term Natural Selection.”,He examined human evolution and sexual selection in The Descent of Man, and Selection in Relation to Sex(1871), followed by The Expression of the Emotion in Man and Animals (1872),Domain-kingdom-phylum-class-order-family-genus-species,Evolution：Evidence from embryology,Ernst Haeckel1834-1919 Recapitulation theory : an individual organisms biological development, or ontogeny, parallels and summarizes its species entire evolutionary development, or phylogeny,ontogeny recapitulates phylogeny fish, amphibians, reptiles, aves, mammalia, primate,Darwin 2009 commemorations,In the United Kingdom a special commemorative issue of the two pound coin shows a portrait of Darwin facing a chimpanzee surrounded by the inscription 1809 DARWIN 2009, with the edge inscription ON THE ORIGIN OF SPECIES 1859 In September 2008, the Church of England issued an article saying that the 200th anniversary of his birth was a fitting time to apologise to Darwin “for misunderstanding you and, by getting our first reaction wrong, encouraging others to misunderstand you still“.,The Cell Theory,Robert Hooke 1635-1702,The discovery of plant cell (cork) and its naming,The Cell Theory,Matthias Schleiden 1804-1881,German botanist and co-founder of the cell theory, along with Theodor Schwann and Rudolf Virchow. He wrote Contributions to Phytogenesis (1838), in which he stated that the different parts of the plant organism are composed of cells (inductive),The Cell Theory,In Microscopic Investigations on the Accordance in the Structure and Growth of Plants and Animals (1839), in which he declared that “All living things are composed of cells and cell products.“ Thus cell theory was definitely constituted.,Theodor Schwann 1810-1882,Schwann cell,Myelin sheath: insulating layer,The Cell Theory,Cells are the unit of structure, function and reproduction in living things. Anything that is living is composed of cells The chemical reactions of an organism occur in cells All cells come from preexisting cells,The development of pathology: Organ pathology,Giovanni Battista Morgagni 1682-1771 Italian anatomist, professor of Padua University, and he is celebrated as the father of the modern anatomical pathology,The development of pathology,1761 published De Sedibus et causis morborum per anatomem indagatis (On the seats and causes of diseases investigated by anatomy) Based on 70 letters containing the records of some 646 dissections, including the symptoms during the course of the malady and the conditions found after death. He made pathological anatomy a science, and diverted the course of medicine into new channels of exactness or precision,The development of pathology : Histopathology,Marie Franois Xavier Bichat 1771-1802,French anatomist and physiologist, is best remembered as the father of modern histology and pathology He dissected 600 cadavers/year, was the first to introduce the notion of tissue as distinct entities. He maintained that diseases attacked tissues rather than whole organs.,The development of pathology : cellular pathology,German doctor, anthropologist, public health activist, pathologist, prehistorian, biologist and politician, referred to as the “Father of Pathology,” and founded the field of social medicine. (duel challenged by Bismarck) Omnis cellula e cellula (“every cell originates