TOPIC-9_p18 &19_How medicine changed from a “healing art” to a “modern medical science” early in the 20th century and the financial problems that created for hospitals
{A} As a medical doctor and Dean of a very prestigious medical school, Dr. JWW found himself living and working in one of the most extraordinary times in the history of medicine. Dr JWW and his contemporaries all played an important part in the most profound change in the practice of medicine in human history. For a variety of reasons, very few Americans know about this important period of history – the ‘birth’ of modern medicine as a science and the end of the pre-scientific “healing arts”.
From Hippocrates to Heart Transplants ~ the birth of medical science
Medical science was preceded by 2,000 years during which the practice of medicine in Western cultures was known as “the healing arts”. These traditional healing methods started with the famous Greek physician, Hippocrates, (460 — 375 BCE) and his theory of “four humors”. The standard treatment for disease was based on “balancing” the four humors, which consisted of repeatedly bleeding patients until they lost consciousness and purging them with strong laxatives.
Over many centuries, more accurate knowledge of human anatomy and biology greatly improved the ability of doctors to diagnose and treat their patients. But without our modern diagnostics testing and effective drug therapies, the practice of medicine continued to primarily be an intuitive “art”. These thousands of years old practices defined medical care until the mid 19th century, when a rapid series of world-changing scientific discoveries in Europe and America gave us “modern medical science” and slowly displaced the “healing arts” over the course of the next century.
Medical science jumped into high-gear in 1850 with the use of ether by Dr. Morton, a Boston dentist, as the first relatively safe anesthesia. This was followed in the 1860s by Pasteur’s many important discoveries that resulted in the new science of bacteriology. Pasteur showed that microbes were omnipresent – in water, in air, on objects, and on the skin, and that a type of microbe called “bacteria” is what causes infectious diseases. Pasteur first published the finding of his study in 1861 and a 2nd paper on contagion and infectious diseases titled “The Germ Theory” in 1879.
In 1881 Pasteur delivered an address to a group of physicians at the Paris’ Institute of Medicine. Standing at a blackboard, he picked up a piece of chalk and drew a picture of what looked like railroad tanker cars lined up in a row. Then he turned to his audience and pointing to his rendition of the pathogenic bacteria streptococcus pyogenes said:
“This gentlemen is what causes puerperal sepsis and the death of newly-delivered mothers”.
Understanding that certain bacteria caused fermentation and disease allowed Pasteur to develop vaccines against anthrax and rabies. Prevention of disease though public sanitation systems and aseptic principles of personal cleanness, in combination with vaccinations and immunizations, continues to be a cornerstone of our science-based healthcare system.
{ref a ~ https://www.pasteur.fr/en/institut-pasteur/history}.
In 1865, Sir Joseph Lister, royal surgeon to Queen Victoria and “Father of modern surgery”, used the principles set out in Pasteur’s bacteriological science to develop antiseptic medicine and sterile surgical technique. The principles asepsis and sterility continue to be one of the pillars of modern medical practice.
In 1895, the discovery of radiation led to the manufacture of the first x-rays machines. This was quickly followed by blood-typing in 1901 and the first pharmaceutical drug in 1909. At this point, the practice of medicine had become a modern science, one that would change the lives of millions of people for the better.
However, the scientific advances in late 19th and early 20th century were not restricted to diseases and their treatments. This particularly fertile period included the invention of electric lights, telephones, the x-ray machine (1895), aspirin and understanding blood types (1901), first manned plane flight (1903), Model T Ford (1908), the Hoover vacuum cleaner, an early version of an automatic dishwasher, and in 1909, the first pharmaceutical drug to treat African sleeping sickness.
The great “leap forward” even more important than landing on the moon
For the very first time in human history, the combining of scientific knowledge with technical abilities and human ingenuity allowed medical doctors to consistently cure formerly fatal diseases and successfully treat injuries that used to be deadly. All of this stands on the shoulders of the dedicated physician-scientists who brought the “miracles of modern science” into being in the late 19th and early 20th century.
Over the next century, medical science expanded exponentially to included antibiotic drugs, chemotherapy, organ transplants, reattachment of limps, laser surgery to restore sight, DNA-designed drugs and genetic engineering.
This change also dramatically impacted hospitals who suddenly had to figure out how to bring the scientific practice of medicine to their hospital without breaking the bank. The best guess by historians is that US had about 8,000 small, doctor-owned 2 to 10 bed hospitals in the early 1900s. Relative to the modern practice of medical science, these small private hospitals they were still on 19th century time.
