modern medicine:In the 19th century, the major European countries successively broke out bourgeois revolution after Britain and France. Britain completed the industrial revolution beginning in the middle of the 18th century in the 19th century. After that, France, Germany, Russia, the United States and other countries also completed the industrial revolution one after another. The bourgeois revolution and industrial revolution destroyed the feudal forces, promoted social development and the reform of production relations, and greatly improved the productivity. This has promoted the development of natural science.
In the 19th century, natural science and technology made great progress. In physics, the laws of energy conservation and transformation, the progress of Optics and the further improvement of microscope, such as compound objective lens (1823), colorless lens (1830), oil immersion device (1886), etc. Due to the progress of electricity, electric heaters and electrical therapy have appeared one after another in the second half.
In chemistry, there are atomic theory, the proposal of element periodicity, and the emergence of synthetic organic compounds. German F. Weiler (1880 ~ 1882) synthesized urea in 1828, breaking the boundary between organic and inorganic substances. In biology, there are cell theory, evolution theory and genetic law. The main advances in European medicine in the 19th century are as follows.
① Cell pathology. In the early 19th century, the cell theory was put forward. By the middle of the 19th century, the German pathologist R. fairshaw advocated cell pathology and deepened the study of diseases to the cell level. The basic principles of his theory include: cells come from cells; The body is the sum of cells; The disease can be explained by cell pathology.
② Establishment of bacteriology. In the mid-19th century, due to the needs of fermentation industry, the progress of physics and chemistry and the improvement of microscope, bacteriology was born. French L. Pasteur (1822 ~ 1895) began to study the role of fermentation, and then studied microorganisms, which proved that fermentation and infectious diseases were caused by microorganisms.
German R. Koch (1843 ~ 1910) discovered Vibrio cholerae, Mycobacterium tuberculosis and Bacillus anthracis, improved the method of bacterial culture and bacterial staining, and put forward Koch’s three laws. Their work laid the foundation of microbiology. The last 30 years of the 19th century was the era of Bacteriology, during which most major pathogenic bacteria were found successively.
Pasteur also studied chicken cholera, cattle and sheep anthrax and rabies, and first studied the vaccine by reducing microbial virulence, thus establishing classical immunology. Later, the Russians working at the Pasteur Institute И.И. Mechnikov (1845 ~ 1916) systematically expounded phagocytosis and immune phenomena of some infectious diseases; In 1880, he published the discussion on the confrontation between microorganisms and their variation; In the early 20th century, it was found that lactic acid bacteria and pathogenic bacteria antagonized each other in human intestine, and lactic acid bacteria were used to treat some intestinal diseases. He made great contributions to early immunology.
③ In the early 19th century, the effective components of some plant drugs were extracted successively. For example, morphine was proposed by opioids in 1806; In 1819, quinine was proposed by Golden Rooster NaPi.
By the middle of the 19th century, urea and chloroform had been synthesized. In 1859, salicylate antipyretic analgesics were successfully synthesized, and aspirin was refined at the end of the 19th century. Since then, the synthesis and refinement of various drugs have been developed continuously. Later, people began to study the properties and effects of drugs. Based on clinical medicine and physiology and by means of animal experiment, experimental pharmacology came into being.
④ Experimental physiology. In the 19th century, people applied physical and chemical theories and experimental methods to study the body, and experimental physiology gradually rose.
magendi of France (1783 ~ 1855), J.P. Maitreya of Germany (1801 ~ 1858) and C. Bernard of France (1813 ~ 1878) have successively carried out a large number of physiological studies on the nervous and digestive systems with animal experiments. Their work has laid a scientific foundation for modern physiological research.
⑤ Advances in diagnostics. Due to the influence of pathological anatomy and cell pathology, clinical medicine at that time paid special attention to the research and diagnosis of pathological changes of internal organs, tried all kinds of methods to find “lesions”, so as to enrich the diagnostic methods and increase the diagnostic means and auxiliary diagnostic tools. By the end of the 19th century, the examination work had more or less changed from direct observation of patients to research the test results of laboratories.
In the mid-18th century, ornbrugg had invented and improved the percussion method. However, the percussion method was despised and ridiculed by conservative doctors at that time and was not applied. It was not until the early 19th century that the French doctor J.N. colvisa (1755 ~ 1821) popularized percussion after 20 years of research that the application of percussion in clinic was promoted.
– T. – H. laenech (1781 ~ 1826) invented auscultation. He was a French pathologist and clinician. He learned from Hippocrates that the heart and lung can be auscultated. At first, he auscultated directly with his ear, and then made a stethoscope, first made of paper, and then made of wood. He examined many patients and studied the smallest phenomena found with a stethoscope. Many autopsies were performed to compare the anatomical results with clinical phenomena, so as to improve the auscultation method. In 1819, he published his paper “indirect auscultation” and diagnosed lung and heart diseases according to this new examination method.
Many clinical diagnostic aids, such as blood pressure measurement, body temperature measurement and coelometry, were applied in the 19th century. Using new lighting devices and optical instruments, a series of optical instruments have been invented and used one after another. The ophthalmoscope of German h. Helmholtz (1821 ~ 1894) was invented earlier, followed by laryngoscope, cystoscope, esophagoscope, gastroscope and bronchoscope, which enriched the means of clinical medical diagnosis and made it possible to treat in the body cavity later.
Due to the development of chemistry, clinical medicine has greatly improved the diagnostic method by using chemical analysis and test methods to check the contents of blood. With the continuous progress of microscopy, morphological diagnostics has gradually achieved an important position in clinic. It studies the tissue structure and tangible components of body fluids and solid parts, and the structural components of normal and abnormal excreta. By the end of the 19th century and the beginning of the 20th century, doctors had more abundant diagnostic methods due to the achievements of Microbiology and immunology.
⑥ Advances in surgery. Before the 19th century, surgery was very backward. The main basic problems such as pain, infection and bleeding have not been solved, which limits the number and scope of surgery. In the middle of the 19th century, the development of anatomy and the application of anesthesia, antisepsis and aseptic methods played a decisive role in the development of surgery in the late 19th century and the early 20th century.
The first is the invention of anesthesia. In the mid-19th century, nitrous oxide, ether and chloroform were successively used as general anesthetics. Surgery can be performed without pain, which is a great progress in surgery and the premise for the development of surgery. At the end of the 19th century, the method of local anesthesia was invented to overcome the shortcomings of complex procedures and many side effects of general anesthesia.
Suppurative complications after trauma surgery are the most troublesome thing. Before L. Pasteur discovered pathogenic microorganisms, Samuel Weiss (1818 ~ 1865), an obstetrician in Vienna, proved in 1847 that the real cause of puerperal fever was the infectious factors brought into hands and obstetric instruments, and advocated washing hands with lime water.
According to Pasteur’s discovery, the British surgeon Joseph Liszt (1827 ~ 1912) believed that the decay and decomposition process in the wound was caused by microorganisms. In 1865, he successfully performed complex fracture surgery with carbolic acid disinfection method. He also disinfected the operating room, operating table, operating site and wound with carbolic acid. The wound was wrapped with a complex dressing method.
The antiseptic method greatly reduces wound suppuration and postoperative mortality. However, the problem of wound infection has not been completely solved. In 1886, e. Bergman (1836 ~ 1907) used a hot press sterilizer for disinfection, and surgery really entered the era of aseptic surgery. There are also some initial advances in hemostasis, such as the application of hemostatic forceps, tourniquets and vascular ligation.
These important achievements pave the way for the development of surgery. Since then, surgery began to develop rapidly. At the end of the 19th century, body cavity surgery was generally developed, so in many clinical specialties (such as Gynecology, Urology, ophthalmology, etc.), in addition to medical treatment, surgical methods also gained an important position.
⑦ Preventive medicine. There were some improvements in preventive medicine in the 18th century, but most of them were the result of personal efforts and the scope of implementation was very limited. By the 19th century, preventive medicine and medical countermeasures to ensure health had gradually become a legislative and administrative problem.
Britain established the Ministry of health and general affairs in 1848 to stipulate some laws and regulations on disease prevention. Shortly after that, a cholera pandemic occurred in Britain, killing about 60000 people. Statistics show that the infectious vector of the disease is drinking water, so appropriate preventive measures have been taken to gradually curb the epidemic.
The person who made hygiene an accurate science should be M.J. pettenkover (1818 ~ 1901) of Germany. He applied the research methods of physics and chemistry to hygiene and studied the effects of air, water and soil on human body; The significance of carbon dioxide in the atmosphere to respiration was determined, and a method for determining the content of carbon dioxide in the air was invented; He studied the ventilation and heating equipment of houses, and published the guide to hygiene in 1882.
After him, labor hygiene for studying occupational diseases and nutrition and food hygiene for food industry came into being one after another. Since the second half of the 19th century, some more developed capitalist countries have also begun to pay attention to school health. At the end of the 19th century and the beginning of the 20th century, social hygiene appeared. Its purpose is to study people’s health, the causes of illness and death, and the methods to fight them.
⑧ Nursing. Nursing has a long history, but the people engaged in nursing have a low status for a long time. Before the 19th century, the working conditions have been very poor, the quality of personnel is poor and the treatment is low. F. Nightingale (1820 ~ 1910) of Britain studied nursing knowledge in Germany and led nurses to carry out field rescue in the Crimean war with remarkable results. In 1860, she founded a nursing school to spread her nursing thought, improve the status of nursing, and make nursing a science.