Hello. I'm Olena. In this lecture, we will track the historical processes and learn about great discoveries that led to the professionalization of medicine in the 19th, 20th century. The whole history of medicine is basically the history of human being on earth. The biology of our body requires care and assistance from the first days of life through the period of growth and especially in sickness. Caregivers existed all the time. We know them under the names of priests, shamans, magicians, healers, sorcerers, et cetera. It doesn't matter what was the name, the purpose of their work was to help people be healthier and live longer and better life. Due to the limited knowledge in all fields, not only medical, for a very long time, healing process was mostly empirical and was as completely based on observations and the experience of caregiver. They didn't know the reason for most diseases. They didn't have tools powerful enough to conquer the disease. However, they had of wisdom of centuries and centuries of observations. We can say now that they were absolutely wrong in their approaches to the diagnostic and treatment. For example, in ancient China, they tried already to provide vaccination to their children to protect them from smallpox. For this purpose, they were blowing the dry crust of the altar taken from a sick person into the noses of children using, for example, this tool, causing the mild form of the disease and long life immunity after that, without knowing, of course, what immunity is. Another example is high esteem of healthy lifestyle and hygiene in ancient Greece and Rome as a predictor of a good health. Despite periodically discovered great advancements in medicine, generally, all doctor felt the lack of knowledge. They couldn't explain a lot of processes that are happening in the human body, reasons of diseases especially infectious one, how to treat them, and how to relieve people from suffering. The reason of that is not only a slow development of medicine. Medicine, as a science, based it's knowledge on the basis of a lot of other sciences: biology, chemistry, physics, mechanics, mathematics, microbiology, et cetera. Above mentioned sciences based their own complicated period of the development with their own failures and successes. Political, geographical, and especially religion reasons postponed the breakthrough in science until the end of the 18th, beginning of the 19th century. During that period, the most important factor that pushed forward the development of sciences was introduced. It was experiment. Since that time, all new knowledge that was introduced in any field of science should have had an experimental proof. This rule was particularly introduced because young and progressive scientists had to fight. Not literally, of course, for the truth that not only authorities in respectful fields, but as well with the power of church and their confidence that all knowledge was given to us a long time ago, and this is the absolute truth which cannot be doubted. Due to the numerous experiments and a thorough search for the truly great discoveries, such as microscope and bacteria with their role in causing the diseases, chemicals and antiseptics, drugs for anesthesia, tools for surgeries, equipment for diagnostics were made because of rapid development of all sciences in general at that time. It gave to doctors numerous ideas and chances for discoveries, advancements, and developing new ways of diagnostic treatment improving quality of patient's life and prolongation of their lives. The baggage of knowledge that medicine had accumulated at the time let scientists draw the line between a mature doctor and doctor professional. That allows us to call the development of medicine in the 19th century the Era of Professionalization of Medicine. Discovery of first bacteria and proving their role in causing of the infection diseases started the new stage of the development of the science. Doctors became able to explain not only what is the causative agent of dangerous diseases that cause epidemics such as cholera, Black, and tracks tuberculosis, but as well search for effective treatment and prevention. The first vaccine was introduced a century before that. Discovery of the vaccine against the smallpox made Edward Jenner, a rural doctor from Britain, had the effect that we can compare with the invention of Internet or MRI. It gave an effective tool to prevent a deadly disease that killed thousands, probably millions of people before. However, the discovery was made half because of luck and half because of smart observation. The causative agent of smallpox is virus, and viruses were discovered only two centuries ago. The scientific approach to vaccination was developed after the discovery of bacteria. Great example of these are works of French scientist, not a doctor by the way, Louis Pasteur, and Father of Modern Microbiology, Robert Koch, the great German doctor. The big medical challenge for a very long time, it was performing safe, painless, and effective surgeries. Development of the anatomy as a science helped doctors to understand the structure of human body and localization of pathological processes that could be fixed during the life of the patient, not only started after death during the autopsy. From the other hand, surgeries for a very long time was not part of medical profession. It were barbers who were performing surgeries, and they didn't have proper education for that, and could perform some procedures only mechanically like amputations, fixing of limb dislocation, tooth extraction. That was not a pleasant time spending for patients as well because there were no known and effective anesthetics at that time. How is that to survive and to feel ever since with the process of the amputation without anesthesia? This wise introduction of the first anesthetic drugs that helped patients to be as senseless during the surgery and do not feel pain is another revolution in medicine. The first anesthetic that became famous worldwide and was implemented all over the world were the Ether discovered as a remedy by American surgeon, John Warren and William Morton in 1846. Of course, only this discovery didn't relieve patients from all their sufferings. Those who survived the pain in the era before anesthesia and those who were unconscious during the surgery could easily die after, and they did from complications like inflammations or gangrene. Again, because of there were no understanding how to prevent or treat an infection. After the discovery of Staphylococcus and Streptococcus bacteria and proving their role in complications after surgeries, this discovery was made by Louis Pasteur. Scientists firstly started to look for a reason why they are in the wound, and secondly, they were looking for the way how to eliminate them or to prevent inflammation of the wound. The solution was aseptics and antiseptics. One more revolution in medicine in the 19th century, and one more step in professionalization of medicine. Introduction of the carbolic acid made by Joseph Lister into surgical practice made a great difference in prevalence of the complications after surgery and mortality after surgery, and as a medical mystery was solved. There were a lot of another less famous, but yet no less significant for the future development of medical discoveries, at the end of the 19th century and the beginning of the 20th century. Among them, numerous drugs, for example, acetylsalicylic acid, antibiotics, method of diagnostics like blood test, urine test, ECG, X-ray, methods of treatment like plaster bandage, surgical tools and techniques, and prevention, introduction of public health as a science with all its benefits for the population.
