Key Individual in Disease and Infection : Hippocrates

1. Key Individual in Disease and Infection : Hippocrates Key dates: 460 BC –370 BC Who?Greek Doctor – The Father of Medicine Why significant? • Believed and taught that Medicine was natural, not supernatural. • Developed the ideas of clinical observation (watching the patient and recording the symptoms) and the theory of the four humours. • Observation; diagnosis; prognosis; Hippocratic Oath. Factors in their success: COMMUNICATION: Writing – Hippocrates and his followers published the Hippocratic Corpus, which contained his views on medicine and different recorded illnesses. These spread through the Greek world and later through Asia due to Alexander the Great’s success. SCIENCE/TECH: a rigorous approach based on observation and recording to develop diagnosis and prognosis. Problems: Idea of four humours was wrong.

2. Key Individual in Disease and Infection : Aristotle Key dates: 384 BC – 322 BC Who?Greek Philosopher Why significant? • His interest in biology led him to dissect animals and plants • Like Hippocrates he believed that careful, methodical observation was the basis of all learning. This scientific method was copied by others for many centuries, eg William Harvey (in the 1600s) • Although he did not dissect human bodies, Aristotle’s studies led him to suggest that the heart and brain are the most important organs in the body Factors in their success: SKILL: A careful, methodical approach. LUCK/CONNECTIONS: Son of physician to King of Macedon. EDUCATION: Studied at Plato’s academy Problems:Some of his ideas were wrong. Suggested that the heart provides the body’s heat and the brain cools it down, the two working together to control the body. Also believed that the Earth is at the centre of the universe.

3. Key Individual in Disease and Infection : Galen Key dates: 130 AD-200 AD Who?Greek doctor in Ancient Rome Why significant? • Took Hippocrates’ ideas to Rome. • Developed the theory of opposites – his view of medicine was unchallenged for centuries. • Also developed knowledge of anatomy by dissecting animals. Factors in their success: COMMUNICATION/FAME: he became doctor for the Emperor and his ideas spread across the Roman Empire which reached across Europe and into Asia and Africa. RELIGION: Rome became the centre of Christianity and they adopted Galen’s theories which were accepted without question until the Renaissance. Problems:Four Humours and therefore Theory of Opposites was wrong. Also, animals have different anatomies from humans.

4. Key Individual in Disease and Infection : al-Rhazes Key dates: 865AD-925AD Who?Persian physician and pharmacist – leading scholar of the early Islamic world. Why significant? • Influenced by Hippocrates. Wrote many texts on medical and scientific matters which became a standard for Islamic and European medical students for centuries. • Expressed some doubts about Galen’s work • Through careful observation, he recorded the difference in skin inflammations and other physical symptoms of measles and smallpox, and established they were two distinct diseases. • Credited with first use of animal gut for sutures and plaster of Paris for casts • Considered the father of paediatrics for treating it as a distinct area Factors in their success: CONNECTIONS/FAME: became physician to the Royal Court in Baghdad PUBLICATIONS: eg Al-Mansuri; Al-Hawi – encycopaedic reviews of medicine. ‘For One Without Doctor’ – a household manual. Doubts about Galen – noted that Galen’s descriptions did not always agree with his observations, and disputed the superiority of the Greek language. The Diseases of Children – first paediatric manual. SCI/TECH: made extensive use of observation and notes. Experimented widely – eg distilled kerosene. Problems:Criticised for his ignorance and arrogance in questioning Galen. Poor eyesight in later life, and refused to let colleagues operate on him.

5. Key Individual in Disease and Infection : Ibn Sina (Avicenna) Key dates: 980-1037 – a century later than Rhazes Who?Celebrated Islamic philosopher and physician Why significant? • Wrote prolifically (over 450 books) on a wide range of subjects. • His best known text was The Canon. One of the most significant texts in the history of medicine and based on Galen, Ayurvedic principles and his own ideas, it was reprinted at least 60 times between 1516 and 1574 and remained a key medical text well into the 1700s. • Regarded exercise as key to health, and also wrote about the mind. • Agreed with Aristotle and disagreed with Hippocrates that TB was contagious, a fact not universally accepted in Europe for centuries • Pioneered use of early anaesthetics, including cannabis and opium • First to use a cannula inserted into the throat of a choking patient Factors in their success: TECHNOLOGY – printing arrived in Europe in 1454 COMMUNICATIONS – wrote over 450 books EDUCATION – claimed to have memorised the Qur’an by 10 Problems: advocated miasma theory and the four humours, both wrong

6. Key Individual in Disease and Infection : Paracelsus Key dates: 1493 - 1541 Who?Swiss physician and alchemist, Prof of Medicine in Basel Why significant? • Rejected the theory of the Four Humours • In 1527, a year into his professorship, burned books by Galen and Avicenna (Ibn Sina) during a lecture. • Opposed learning from books, and said doctors should learn through experience, at the bedside. • Believed God had created human beings and other creatures using natural substances, and that all the cures for illness would be provided by using herbs, vegetables and minerals (natural cures). • Proposed disease was caused by substances outside the body • Noted that chickens slept after administration of ether, but did not extend this discovery to humans, instead concocting laudanum. Factors in their success: COMMUNICATION/ CONNECTIONS: Some royal doctors including the physician to Emperor Rudolf II of Austria used his methods Problems: Fiercely criticized for his rejection of Galen. Exiled from Basel in 1538.

7. Key Individual in Disease and Infection : Edward Jenner Key dates:1749 - 1823 Who? English country doctor in Berkeley, Gloucestershire Why significant? • Had long known the story that milkmaids who caught cowpox never seemed to get the far more severe smallpox • In the 1790s, Jenner carried out experiments to test the theory, publishing his evidence from 23 different cases in 1798. Factors in their success: EDUCATION/CONNECTIONS: Aged 21, studied with John Hunter in London, the greatest surgeon of the time. SCIENCE/TECHNOLOGY: Hunter told his students to observe patients carefully and experiment to test their ideas PUBLICATIONS: An enquiry into the Causes and Effects of Variola Vaccinae, known by the Name of Cowpox (1798) Problems: Many people opposed vaccination. Governments could not force people to be healthier (though from 1871 people were fined for not having their children vaccinated). Jenner did not know that germs cause disease or therefore how vaccination worked.

8. Key Individual in Disease and Infection : Mary Seacole Key dates:1805 - 1881 Who?Jamaican-born nurse, daughter of a local healer and a Scottish soldier Why significant? • In 1854, heard about the Crimean War and travelled to Britain to volunteer her services for the army, but no one would see her (she was turned down by Florence Nightingale). • She then paid her own way to the Crimea. • In the Crimea, set up her ‘British Hotel’, providing food and drinks to the soldiers and tending the wounded on the battlefield. Factors in their success: • PUBLICATION: Her memoirs Wonderful Adventures of Mrs Seacole in Many Lands (1857), a bestseller • DETERMINATION: She was known for her bravery Problems:Seacole was half black and a woman in a male-dominated world. Florence Nightingale made it clear she disapproved of a single woman running a boarding house and selling alcohol. When Seacole arrived back in London in 1856, she was bankrupt from debts run up by the hotel, though a fund set up by The Times newspaper helped her.

9. Key Individual in Disease and Infection : Florence Nightingale Key dates: 1820-1910 Who? The Lady with the Lamp Why significant? • Trained in Germany as a nurse, after many arguments with her family • When the Crimean War broke out in 1854, she heard reports of the terrible conditions, so talked to family friend and Minister for War Sidney Herbert. He arranged for her to take 38 nurses to the Crimea. • She supervised cleaning of the wards, repair of the wards and ‘stirring up of the whole organisation generally’. The death rate at the hospital at Scutari fell from 40% to 2%. • She pioneered certain statistical methods, including pie charts • Returned to Britain a national heroine and set up nursing schools. Factors in their success: LUCK/CONNECTIONS: Wealthy, well-connected family PUBLICATIONS:Notes on Nursing (1859); Notes on Hospitals (1863) Problems: Paid little attention to Pasteur’s germ theory when it appeared in the decade after the Crimean War. Like Chadwick, she had been brought up in the early 1800s, and believed miasma theory.

10. Key Individual in Disease and Infection : Louis Pasteur Key dates: 1822 - 1895 Who?French Scientist (a microbiologist, not a doctor) Why significant? • As part of his work on wine, discovered that heating wine to 50°C killed the yeast which caused the fermentation, and stopped it going sour. This became known as ‘pasteurisation’. • During 1870s, worked to establish that microbes were the cause of disease Factors in their success: DETERMINATION: suffered a stroke in 1868 and was paralysed down the left side of his body but kept working and went on to make some of his greatest discoveries CONNECTIONS/GOVERNMENT: Had support of the Emperor of France and the government, who believed his success was making France respected abroad. CHANCE: His colleague Charles Chamberland forgot to inoculate a batch of chickens with cholera germs, leaving the germs in the lab over the summer. When he came back and used it, they realised they had found a cholera vaccination Problems:Ongoing rivalry with Koch (a German doctor)

11. Key Individual in Disease and Infection : Robert Koch Key dates: 1843 – 1910. Nobel Prize in 1905. Who?German doctor who became interested in Pasteur’s work and began to study bacteria too Why significant? • Discovered the specific bacterium that causes anthrax, which also was the final proof of Pasteur’s germ theory. • Laid down the methodology of how researchers should discover the germ that caused a specific infectious disease, enabling others to find bacteria for, eg, typhoid, tetanus, meningitis, dysentery, cholera, plague Factors in their success: SCI/TECH: Developed ways of staining and studying bacteria so they could be photographed using a new high-quality photographic lens and studied in detail. TEAMWORK: His assistant Julius Petri discovered how to grow cultures of bacteria on a substance made from potatoes and gelatine (much easier to study than a liquid) Problems:Ongoing rivalry with Pasteur (a French scientist)

12. Key Individual in Disease and Infection : Elizabeth Blackwell Key dates: 1821-1910. Qualified as a doctor in 1849. Who?First female doctor to graduate in the US Why significant? • Born into a Quaker family in Bristol, 1821, then moved to US in 1832. Studied medicine in New York, graduating top of her class in 1849. Went to Paris and London to ‘walk the wards’. • Unable to get a job in a US hospital, she, her sister and another female doctor started their own hospital in New York. • Returned to the UK in 1869 to set up a nursing school with Florence Nightingale and helped Elizabeth Garrett Anderson set up the London School of Medicine for Women. Factors in their success: CHANCE/LUCK: Her father believed in female education and was an active campaigner against slavery. CHANCE/LUCK: She was let into medical school when her application was put to the vote and the students, thinking it a joke, voted her in. Problems:Constant opposition in a sexist and male-dominated world.

13. Key Individual in Disease and Infection : Elizabeth Garrett Anderson Key dates: 1836-1917. Qualified as a doctor in 1865. Who? First woman doctor in Britain Why significant? • First woman to qualify as a doctor in Britain (1865). She faced continued male opposition to her career. • Started the New Hospital for Women in London. Women allowed in Medicine from 1876. • Very active in the women’s suffrage movement Factors in their success: DETERMINATION: She qualified through the Society of Apothecaries, was inspired by first American female doctor Elizabeth Blackwell. She learned French so she could study in Paris where women were allowed. GOVERNMENT: The Government eventually (1876) passed a law to allow women to study Medicine. Problems:She was a woman in a very sexist male dominated world.

14. Key Individual in Disease and Infection : Paul Ehrlich Key dates: 1854-1915. Key discovery 1909. Nobel Prize in Medicine, 1908. Who? German physician and scientist Why significant? • Developed staining techniques making it possible to distinguish different blood cells. • In 1909, developed the first chemical cure for a disease – Salvarsan 606 • He called it a ‘magic bullet’ because it homed in on and destroyed the harmful bacteria that caused syphilis. Factors in their success: EDUCATION/CONNECTIONS/LUCK: Had been part of Robert Koch’s research team Problems:It wasn’t until the 1930s that Gerhard Dromagk developed Prontosil, the second ‘magic bullet’, to cure blood poisoning. Scientists then discovered that the important chemical in these cures was sulphonamide and drug companies then developed more sulphonamide cures for diseases such as pneumonia.

15. Key Individual in Disease and Infection : Alexander Fleming Key dates: 1881 – 1955. Nobel Prize 1945 Who? Doctor and research scientist Why significant? • He identified and published the discovery of penicillin, an anti-biotic mould that killed bacteria (1928). Factors in their success: LUCK: He was studying bacteria and returned from holiday to find mould in one dish that was killing it. SKILL/SCIENCE/TECH: He was able to see the importance of this and then conducted experiments to show it killed other types of bacteria. COMMUNICATION: He published his findings in scientific journals. Problems:In 1929, his findings were mainly ignored as he had not used penicillin on animals to heal infections so had no evidence of it being useful. It was difficult for him to produce penicillin in enough quantity. Fleming also cautioned against using too little penicillin or for too short a period, due to the possibility of developing resistance.

16. Key Individual in Disease and Infection : Ernst Chain and Howard Florey Key dates: Florey (1898-1968) and Ernst Chain (1906- 79) Shared Nobel prize with Fleming in 1945 Who? Medical Scientists Why significant? They developed the way to mass produce penicillin which has since saved thousands of lives and made many other better more quickly. Factors in their success: COMMUNICATION: Fleming’s research. WAR: WW2 and especially the US involvement provided the funding to develop penicillin in large quantities. US drug companies provided facilities. SCIENCE/TECH: They were researchers from Oxford University who worked together. Problems:In the early days they also found production difficult and one patient improved then died when they ran out.

17. Key Individual in Disease and Infection : Francis Crick and James Watson; Rosalind Franklin and Maurice Wilkins. Key dates: Discovery of the structure of DNA, 1953. Crick, Watson and Wilkins got the Nobel Prize in 1962 Who?Research scientists based in Cambridge (Crick and Watson) and King’s College London. Why significant? • Discovered the structure of DNA. • Proved it is present in every human cell and showed how it passed on information from parents to children. Factors in their success: TEAMWORK: Maurice Wilkins was an expert in X-ray photography. Rosalind Franklin developed a technique to photograph a single strand of DNA and was the first person to take X-ray photographs of DNA. SCIENCE/TECH: They used the latest equipment and techniques Problems:Their research was very expensive because of the cost of the complex equipment and the number of highly skilled people involved.