19th Century Foundations of Scientific Medicine:
Diagnosis of disease

Historical Setting

French and Industrial Revolutions
Changes in 19th century

-wealth
-nationalism & growth of government
-new technology
-continuing scientific revolution
- education (universities)
-social changes

Paris School of Medicine

Hospitals (Hôtel Dieu)
Xavier Bichat (1771-1802)

Revolution in diagnosis

René Laennec, A Treatise on the Diseases of the Chest (orig. publ. 1821)

Pierre Louis (1787-1872) "numerical method"

Influence of Paris

Britain

Guy’s Hospital, London

Stethoscope introduced in 1825 by Thomas Hodgkin (disease 1832), cancer of lymph

Richard Bright (disease 1827), kidney disorder

Thomas Addison (disease 1855), pernicious anemia

Robert Graves (Ireland) hyperthyroidism, 1834

U.S.

Germany

Microscopes and laboratory

Justus Liebig (1803-1873)

Schleiden, Schwann and the cell

Rudolf Virchow (1821-1902)

Cellular pathology
"omnis cellula a cellula"

Pharmacology

Impact of chemical and industrial revolution
Refinement of substances in plants strychnine, quinine, caffeine, nicotine
commercial sale
Entry into universities came later (1850)

Physiology: France and Claude Bernard

William Beaumont (1785-1853), U.S.
Claude Bernard (1813-78), France

Liver and secretions
Internal environment
Experimental Medicine (1865)

Later diagnosis and instrumentation

Stethoscope
Microscope (1877 white, red blood cells)
Thermometer (1841 linked to disease)
Spirometer (1846 lungs)
Sphymomanometer (1835 blood pressure)
Chemical tests (1841 urinalysis)

X-ray (1895)
Wilhelm Conrad Roentgen (1845-1923)