1. The History of Medicine
in America
HIST 3323
Brian Regal, PhD
Assistant Professor for the History of Science, Department of History
Kean University
Union, New Jersey USA
2. • Medicalization vs. Demedicalization
Medicalization: doctors want to be central and
important players in society, to gain respect
and authority—scientific and technical
medicine
Demedicalization: dissenters not wanting to be
under control of mainstream medical
profession: faith healers, folk remedies, do it
yourself-alternative medicine
3. • Heroic Narrative of the history of
medicine
History shows the progressive—ever improving—
nature of western medicine: great doctors
overcoming great odds to create great cures
and discoveries. Medicine is important to the
growth of western civilization.
Support the supremacy of
academically/mainstream trained physicians
against non-medical, alternative, folk
practitioners
4. Chinese medicine and the origins of medical ethics and physician practice
Kung Fu-tse (Master Kung)
Known as
Confucius (551-476 BC)
Five classical Confucian
elements applied to medical practice:
Ren ( 仁 , Humanity)
Yi ( 義 , Righteousness)
Li ( 禮 , Ritual)
Zhi ( 智 , Knowledge)
Xin ( 信 , Integrity)
7. Hippocratic Oath
I swear by Apollo, the healer, Asclepius, Hygieia, and Panacea, and I take
to witness all the gods, all the goddesses, to keep according to my ability and
my judgment, the following Oath and agreement: To consider dear to me, as
my parents, him who taught me this art; to live in common with him and, if
necessary, to share my goods with him; To look upon his children as my own
brothers, to teach them this art.
I will prescribe regimens for the good of my patients according to my ability
and my judgment and never do harm to anyone.
I will not give a lethal drug to anyone if I am asked, nor will I advise such a
plan; and similarly I will not give a woman a pessary to cause an abortion.
But I will preserve the purity of my life and my arts.
I will not cut for stone, even for patients in whom the disease is manifest;
I will leave this operation to be performed by practitioners, specialists in this art.
In every house where I come I will enter only for the good of my patients,
keeping myself far from all intentional ill-doing and all seduction and
especially from the pleasures of love with women or with men, be they free or
slaves. All that may come to my knowledge in the exercise of my profession or
in daily commerce with men, which ought not to be spread abroad, I will keep secret
and will never reveal.
If I keep this oath faithfully, may I enjoy my life and practice my art, respected by
all men and in all times; but if I swerve from it or violate it, may the reverse be my lot.
14. ‘The Irregulars,-Homeopathic unorthodox practitioners
• Samuel Hahnemann (1755-1843), regular
MD, German
• similia similibus curantur -- “like cures like”
• later discovered same beneficial effects with
minute doses --> law of infinitesimals, ritual
dilutions
• drugs acted on some spiritual level, vital forc
• popular among German immigrant doctors,
educated patients
• many homeopaths also regular physicians
16. ‘The Irregulars,-Homeopathic unorthodox practitioners
James Still (1812-1882)
Black Doctor of the Pines
• Self-taught
• Herbalist
• Sold medicines and saw patients
• Thomsonian influences
25. Mary Baker Eddy (1821-1910) and Christian Science
Eddy built her work on a Boston doctor named
PHINEAS PARKHURST QUIMBY (1802-1866) founder of New Thought
She called her book Science and Health – became the ‘bible’ of Christian
Science
26. Mary Baker Eddy (1821-1910) and Christian Science
Eddy built her work on a Boston doctor named
PHINEAS PARKHURST QUIMBY (1802-1866) founder of New Thought
She called her book Science and Health – became the ‘bible’ of Christian
Science
27. African American Doctors
James McCune Smith (1813-1865) first African American to receive a medical
degree. Travelled to University of Glasgow, Scotland, graduated in 1837
28. African American Doctors
Rebecca Crumply (1831-1895) first African American woman awarded a medical
degree in the United States. New England Female Medical College (now the
medical school of Boston University) 1864
Fisrt Black owned hospital, Chicago, 1890s. Opened by Dr. Daniel Hale Williams
who also did the first open heart surgery on an emergency patient who had
been stabbed
30. History of Psychology and Brian function
Phrenology: Franz Joseph Gall, Austrian argued language localised in the
brain not global.
Psychology begins 1870s
1879 Wilhelm Wundt opens first psychology school at Leipzig, Germany
Wundt inspires William James and Ivan Pavlov as well as B.F. Skinner’s
behaviorism
Neuroscience: Paul Broca argues different parts of the brain do
different things
Use of the microscope helps show brain function 1860s/70s while Camillo
Golgi invents techniques for staining brain tissue to show individual
neurons (1890s)
31. Phrenology
Franz Joseph Gall (1758 – 1828) pioneering German neurologist. His work was
hijacked and turned into Phrenology
35. Phineas Gage - after
Phineas Gage (1823-1860)
September 13, 1848, Cavendish,
VT.
36. Lobotomy
Manipulate the frontal lobe of the brain, this area controls emotion
1890: Friederich Gouz does work on dog brains, found them much tamer
after manipulating them
1892: Gottlieb Burkhardt did the first such limited operations on a human
at the Swiss Insane Asylum
1935: Yale University, Carlyle Jacobson lobotomizes chimps to calm them
down
Antonio Moniz, Lisbon Medical School, first modern operations on humans
and lectures on the subject
Later, a former patient, outraged at what had been done to him shot Moniz
to death.
1936: American Walter Freeman starts the lobotomy craze in the US
39. Early antiseptic work
1500s a ‘miasma’ (poison air) causes infection
19th century – British surgical pioneer John Hunter showed how subcutaneous
wounds – under the skin– did not get infected while surface wounds open to
the air did
You must cover wounds immediately!
Collodion wraps: a syrupy and explosive material seals wounds and protects
them
George Tichnor (US civil war) used alcohol to clean wounds and found less
infection
Ignaz Semmelwies (Hungarian doctor) used chlorine to was hands of doctors
in 1860s and found dramatic drop in death of post birth mothers
40. Joseph Lister (1827-1912)
British surgeon, Glasgow Infirmary
-clean wounds
-Sterilize equipment
-Remove germs
-Suggested Carbolic Acid (which had been used
de-stinkify the sewer system
Spray it on everyone as you work
41. Oliver Wendell Holmes Sr. (1809-1894)
American (Boston) medical reformer and poet
- academically trained but critical of the mainstream profession
- must improve hygiene at hospitals
Anti-quack, anti-homeopathy
Early proponent of the belief that doctors unconsciously infected their
patients with their dirty hands
1846: Holmes coins the term ‘antiseptic’ (against putrification) in a letter to
Boston dentist William Morton
44. Thomas Bartholin. De nivis usu medico observationes variae (1661)
Earliest discussion of anesthesia.
Chapter XXII of this historically important
book makes the first known mention of the
use of mixtures of ice and snow for freezing
to produce surgical anesthesia . . .
The treatise on snow crystals, by
Bartholin's younger brother, Erasmus, is the
earliest publication on crystallography,
and preceded Boyle on gems (1672)
by eleven years.
47. William Morton (1853)
A compendium of testimonies, hearings,
investigations, etc., both favorable and unfavorable
to Morton's claim, including reprints of the 1852
Majority and Minority Committee Reports, the latter
supplemented by adverse marginal notes. The
appendix contains testimony relating to the
competing claim by Horace Wells.
48. Horace Wells (1815-1848)
1844: Wells had been a partner
briefly with Morton and had
showed Morton nitrous oxide
(which he had already
experimented with). 1845 his demo
at Mass General Hospital was a
disaster. He left dentistry and the
country. Returned and became
addicted, ended up committing
suicide in1848.
49. Crawford Long (1815-1878)
Used nitrous oxide (laughing gas)
to remove a tumor from a friend’s
neck on March 30, 1842
56. Eugenics
Eugenics: from the Greek for good breeding
First developed by Francis Galton in the UK then picked up on by Americans
Blood is all – biological relations dictate
Behavior, future development and nothing
Can change it, therefore medical/social
amelioration programs are a waste of money
Madison Grant (1865-1937)
Johnson Act 1925
57. Public health
Sanitary reform comes in three phases
3.1840-1890 clean up the environment
4.1890-1910 Bacteriology – go after germs
5.1910-present clean up people
Conservative response: keep poor and working class people down, they spread
Disease – employ eugenics
Giving the poor and working class health benefits only renders them dependent
and leeches upon the state and the healthy (well off) body politic
Liberal Response: health care makes the country a better, stronger, and more
Economically viable place
97. Abortion
First anti-abortion laws in America – after 4 months – 1820s
Many doctors and the AMA pushed for completely outlawing abortion by 1900
1873: Comstock Law outlawed sale of birth control devices including
prophylactics and ‘pornography’
Susan B. Anthony was an anti-abortion advocate
1938: government case against Margaret Sanger overturned the Comstock
Law
1973: Roe versus Wade makes abortion legal
