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From the solar system to the Milky Way Vivienne Parry v@vparry.co.uk. History of Medicine. Ancient methods of diagnosis. Astronomy & Astrology If the patient was a Pisces, doctors were told to avoid cutting the feet. Sacrifice Looking at the shape and position of a sheep’s liver .
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From the solar system to the Milky Way Vivienne Parry v@vparry.co.uk
Ancient methods of diagnosis • Astronomy & Astrology • If the patient was a Pisces, doctors were told to avoid cutting the feet • Sacrifice • Looking at the shape and position of a sheep’s liver
Ancient Greeks Gods as healers Hippocrates 400 B.C
Galen 150 AD Galen • A Greek in the Roman empire • No dissection of human bodies • Knowledge based on animals • Often wrong • Promoted the idea of humors • Blood letting as a cure
Andreas Vesalius 1514 - 1564 • Founder of modern human anatomy • “De humanicorporisfabrica” • Printed descriptions and illustrations of human dissections • Openly challenged Galen
16th– 19th Centuries • Harvey, Fallopio, Colombo • Anatomical knowledge • Symptom observation but no understanding of cause • Treatment of symptoms not cause • Carving out of territory based on organs and body systems
Symptoms vs Causes • Koch, Theory of Disease • Bacteria - not evil spirits or miasmas - cause disease • Cholera, Anthrax and TB
The beginning – 1897:Archibald Garrod • obsessed with urine • alkaptonuria • The first to recognise inborn errors of metabolism • Linked it with work of Mendel • Ignored • Identification of specific genes with specific disorders post Second World War – progress halted by eugenics movement
Evolution of Medicine Genomic medicine
Genome Environment Modified from Loscalzo et al Mol Sys Bio 20007;3:124
Genome Environment Transcriptome Proteome Metabolome Immune response Cell proliferation Thrombosis Hemorrhage Apoptosis Necrosis Inflammation Fibrosis Abnormal organ function Disease with different phenotypes Modified from Loscalzo et al Mol Sys Bio 20007;3:124
Rare diseases • Search for a diagnosis time consuming, expensive heartsink process • Only 25% have molecular definition • Where do you start looking? • The same cause may have many different phenotypes • No longer looking for single genes • May be control and regulation that is the problem • Whole Genome Sequencing
Today Birth of modern genetics • Genomic healthcare • Refining diagnosis from not just observation and biochemical tests • Understanding basis of disease • Predicting drug effects • Developing new therapies