The first topic I started to read up on after starting the course was the History of Medicine when I discovered that I would be teaching this (subsequently I discovered I wasn't going to teach it). Ruth recommended "the Greatest Benefit to Mankind" by Porter, which is an excellent book to give a good background. I started by reading about the earliest humans and the really scary point is that the majority of human disease encountered today is a direct result of our development and efforts to domesticate animals. This close proximity with animals, not a feature of the earliest hunter gatherers, allowed bacteria and disease to spread from animals to humans, with cattle and sheep being particular culprits as well as dogs. Man's best friends it seems also introduced us to some particularly unpleasant friends of their own.
The main periods of medical development are the Egyptians, the Greeks, the Romans, the Muslim world, the Renaissance, inoculation and vaccination and the scientific breakthroughs of the 19th and 20th centuries (assisted by the 2 world wars). The Egyptians and Greeks were the first real medical pioneers. The Egyptians, through mummification, began the journey of discovery of human anatomy, a journey frequently delayed and diverted because religious beliefs prohibited it. In reality, mummification was a perfectly logical solution to the problem of heat rotting dead bodies. The body, they believed was made up of channels which carried the air and blood and food around the body and illness ensued when these channels were blocked. The Greeks pushed medical "science" further and Greek ideas held sway for many hundreds of years.The medical symbol of the snake coiled around a staff is of Greek origin. The idea of the body containing four humours, black bile, blood, phlegm and yellow bile (which were linked to the four seasons and the old idea of four elements or fire, air, water and earth) if of Greek origin. Most treatments were based on the idea of keeping the humours in balance, for instance if you were deemed to have too much blood then you would be bled, too much yellow bile and you would be encouraged to vomit. These ideas and treatments held sway for many hundreds of years. Hippocrates was perhaps the greatest Greek doctor and it is from him we still have the Hippocratic oath. The importance of Hippocrates is that he encouraged doctors to look for natural causes and remedies for illness rather than to look to the gods for both cause and cure.
With the Romans the main focus was on public health and surgical procedures (largely as a result of the military requirements of the large Roman Army). Public Health systems such as water wells and fountains and aqueducts, with sewerage systems were hugely important and the fall of the Roman empire led to a great decline in medical standards largely because of the demise of public health systems. Personality wise, Galen is the Roman most remembered for medical science. He was a prolific writer and very good at PR, which gave him great influence. Usually unable to practice on human bodies he used animals to show that we had such things as nerves. In many of his ideas he followed the Greeks, he believed in the four humours, but it was in the field of anatomy that he really pushed the science forward, though his restriction to dissecting animals meant that he made mistakes not discovered for some 1500 years, such as claiming the human lower jaw was made of two bones rather than one. Although Galen advanced medical science and his ideas are hugely important, his very influence meant that his ideas remained unchallenged for some 1500 years even when they were wrong, and the result could be argued that he blocked further medical advancements as a result.
The importance of the Muslim world and scholars like Ibn Sina (Avicenna) lay not some much in their ideas rather in the fact they learned from the peoples and cultures they conquered. Muslim scholars translated many works into Arabic and later Latin so that works from ancient Greece, Rome and Egypt were saved when they might otherwise have been lost to the world in the chaos which reigned after the fall of Rome. But they also added knowledge from other cultures in Africa and India and their faith placed great store in care for the sick, as a result the Muslim world boasted many hospitals where the sick were genuinely cared for rather than just treated well or even turned away (as in medieval Europe).
In the Renaissance, the great ancient writers were finally challenged. Vesalius, Pare and Harvey all advanced medical science, knowledge and practice in anatomy, surgery and physiology respectively. Unfortunately this often brought conflict with the Papacy and Catholic church. Vesalius was repeatedly criticised by the Church, particularly when he proved that men and women both have the same number of ribs (so how could Adam have given a rib to God so he could create Eve?). Pare's use of silk thread instead of hot oil and cauterisation for surgery was revolutionary, but it would not be until the advent of sterilisation a couple of hundred years later that his revolution really paid off. Perhaps the greatest benefit of the Renaissance was that it showed that religious ideas and blind faith in ancient scholars were hindering medical development and the works of people like Vesalius, Pare and Harvey encouraged others. The Medieval Church, which for hundreds of years had hindered medical progress for fear of the contradictions such progress might have for religious teaching, was now finally being overcome.
Jenner is the last area I have read about so far. His curiosity and enquiring mind led to one of the greatest medical discoveries of all - the link between small pox and cow pox and the subsequent development of vaccination as a treatment has led to the virtual disappearance of Small Pox, once one of the most feared and virulent of diseases. Previously, preventative treatments for Small Pox, once they were discovered, consisted of inoculation. This meant injecting/infecting the subject with a small does of Small Pox itself. If this was successful then the subject would suffer a mild does of the disease, recover and then be immune to it on the future, much the same principle which is still employed today with Chicken Pox - as soon as you discover a child has it, all the other children in the neighbourhood come round for a Chicken Pox party so they can catch it too as the disease is much milder for children. This idea was discovered for the West in 1717 by Lady Mary Wortley Montague (her husband was the British Ambassador to Turkey) while she was living in Turkey, but it had been used in the East, particularly China for hundreds of years. Unfortunately, inoculation frequently resulted in the death of the subject. Vaccination, differs from inoculation because it involves injecting/infecting the subject with a similar, less deadly, disease which will give immunity to both diseases. Cow Pox is very similar to Small Pox but is not fatal. The word Vaccination even comes from the Latin Vaccinus meaning from a cow. Jenner discovered "vaccination" as a preventative cure for Small Pox in 1796 after a dairy maid, Sarah Nelmes was infected with Cow Pox. Jenner tested his idea out on James Phipps, a local boy, and it seemed to work so he conducted further tests. Vaccination took a long time to really take off, and it was not until the government made it compulsory in 1852 that it truly became widespread in Britain, but Napoleon Bonaparte had all his soldiers vaccinated. There was much opposition to vaccination in the UK primarily from the powerful lobby who preferred inoculation, and whom had made huge sums of money from it, whilst vaccination was offered free of charge.
In teaching Medicine, much emphasis is placed on sources and source analysis largely because this is a GCSE syllabus. Popular sources for use in teaching are Gillray's The Cow Pock cartoon on vaccination and The Triumph of Death painting on the Black Death.
Teaching Medicine through Time should focus on RIGSWICH - the 7 factors which influence any change through history:
Religion
Individuals (Galen, Jenner, Vesalius etc)
Governments (public health, Romans and Victorians etc)
Science & Technology (better methods of surgery and improved equipment through better use of materials in Roman times)
War (the advances in Surgery in Roman times, Pare in the Renaissance wars in Italy, the advances made during WWI and WWII)
Improved Communications (the huge libraries in Alexandria for example and the Muslim scholars translation of works, the printing press in 1450 coinciding with the medical renaissance)
Chance (luck - Jenner being in the right place at the right time).
In the teaching of Medicine through time it is important to look at factors with periods and across periods. So for example comparing Greek and Roman methods and comparing Medieval Europe to Roman times. But also looking at different factors within, say, Medieval Europe - the positive and negative influence of the church is an example - the fact that religious houses had the best "public" health and looked after people well, but most hospitals did not actually admit the sick and the Church restricted medical research. It is also important to compare supernatural and natural factors and treatments (the idea of the four humours has elements of both). The Black death is a good example - look at beliefs about what caused it and the treatments for it and compare those which centred on it being a punishment from god and the need to pray for deliverance (supernatural) against those treatments which recommended isolating suffers and cleaning up the towns and cities (natural).
OK, that's enough for now. Not sure what my next entry will be about, but it will hopefully be soon.