Презентация на тему "A short history of the evolution of surgery"

Содержание

• 
  Слайд 1

  A short history of the evolution of surgery

  László Damjanovich Professor of Surgery

• 
  Слайд 2
  

  Evolution of surgery Introduction to modern surgery Short history of the Medical School of Debrecen and the Surgical Institute

• 
  Слайд 3
  

  „The abdomen, the chest and the brain will forever be shut from the intrusion of the wise and humane surgeon.”Sir John Ericksen, Surgeon Extraordinaire to Queen Victoria, 1837

• 
  Слайд 4
  

  „Today our colleagues perform an average of 80.000 operations each day (in the USA), many in the abdomen, chest or brain” Daniel J. Riskin, UCLA, 2006

• 
  Слайд 5

  Epochs of Surgery

  Characteristics of the pre-modern phase: Lack of significant anatomical knowledge Progress was made by the isolated achievement of outstanding personalities Methods were tested during major wars under the pressure of necessity Clerical dogmas prevailed over scientific contributions

• 
  Слайд 6

  Medical heritage of early civilizations

  The earliestwrittenpiece of medicalhistory, 1600-1500 B.C. Edwin Smith Egyptianpapyrus: surgerywaswelldefined, havingimportantroleinmedicine containscasereportsin a logicallyarranged series personalcleanliness, hygiene and correctdiagnosisbeforetreatmentwasimportant

• 
  Слайд 7
  
• 
  Слайд 8

  Scope of surgical activities

  Bandages, dressings Circumcision Opening abscesses Fractures, dislocations Lithotomies (urolith) Hemorrhoides, fistulas Amputations Tooth extractions Herniotomies

• 
  Слайд 9

  Hippocrates(460-375 b.c.)

  „The father of medicine” Medicine and surgerywasonediscipline Great attentiontoobservation, detail, recordkeeping, gatheringknowledgeaboutdiseases, cleanliness, order, practice „Humoralpathology” Corpus Hippocraticum, devotiontothepatient,

• 
  Слайд 10

  Ancient textbooks

  AyurVeda(The book of life) India, China Code of Hammurabi2000 B.C. Mesopotamia)(Surg., Medical, Legal text) Alexandria: Aristotle, Herophilos, Erasistratos Roman empire: Celsus 8 books, Galenus (treatedgladiators, dissectedpigs, manyerrors, greatimpactuntil XV. century, disagreementwasheresy) Arabicperiod, Avicenna(Persian) Xthcentury: The Canon (surgeryas a necessaryevil, Baghdad, Damascus, Cairo: hospital-med. schools)

• 
  Слайд 11

  Medieval medicine (476-1453)

  Religiousmedicine, dogmas Lowsocial status of surgeons Surgerypracticedbybarbersurgeons Clericalbanonautopsies, absense of anatomicalknowledge (dissectiononpigs) Miracles made bysaints Illnes is a retributionfromheaven Hospitalsmaintainedbythechurch The sicktakencare of bynuns

• 
  Слайд 12
  
• 
  Слайд 13
  
• 
  Слайд 14

  The Salerno School

  Firstschool of formaltraining,commencedinthe 12th century, southernItaly The firstsecularmedicalschool Revival of ancientknowledge Dissectiononpigs More emphasisonsurgery Recordingownexperience of surgeons Roger of Salerno: CyrurgiaRigerii 1170- thefirstindependentsurgicalworkinthe West The schoolmovesto Bologna afterhisdeath

• 
  Слайд 15

  Development of medicine in the middle ages

  Lanfranc 1315. France, against „pusbonum et laudabile” keepitclean Pope SixtusIV. (1414-1484) appr. autopsies, stimulation of studies Leonardo da Vinci, Michelangelo, Dürer, Titian… Jacob Sylvius, Paris: Galen’sanatomy Andreas Vesalius, Brussels: atage 23, professor of surgery De Humani Corporisfabrica (atage 28) Paracelsus, Basel: „internalmedicine and surgery must not be separated”

• 
  Слайд 16
  
• 
  Слайд 17

  Ambroise Paré 1510-1590

  Apprentice of Vesalius FieldsurgeonintheFrencharmy Performedautopsies Usedturpentine, instead of burningoiltotreatgunshotwounds, amputatedlimbs Routineligature of vessels Inventednewinstruments, limbprostheses

• 
  Слайд 18
  
• 
  Слайд 19

  XVIII. Enlightenment

  Revival of ancientmedicalknowledge William and John Hunter Anatomy of thegraviduterus (William) Ligature of theaneurysmofthesuperficialfem. art. (instead of amputation) infourcasessuccesfully Angina pectorisinhisowncase (John)

• 
  Слайд 20
  
• 
  Слайд 21

  Beginning of modern surgery

  Phase I: introduction of anaesthesia (Morton) anesthetic – theagent 1842. January: William E. Clarke toothextractionunderethernarcosisRochester, NY 1846. October: Dr.John C. Warren (NEJM, AMA, 1stdean of Harvard)jaw tumor removalunderethernarcosisperformedby William T.G. Morton

• 
  Слайд 22
  

  Warren and Morton

• 
  Слайд 23

  Early development of biomedical sciences

  Edward Jenner (surgeon): 1749-1823 Vaccination, pox Theodor Schwann: 1810-1882, cells Rudolf Virchow 1821-1902, cellularpathology Francois Magendie 1783-1855, nervoussystemanatomy Claude Bernard 1813-1878, experimentalphysiologyhomeostasis

• 
  Слайд 24

  Antisepsis-asepsis, II. phase

  Louis Pasteur: correlationbetweenrotting and oxygencontent of the air, discovery of bacteria Joseph Lister: carbolicacidusedforsanitationinCarlisle, woundtoilette, and operatinginstruments, deathratedroppedto 1/3, lead and zincplatestocoverwounds Semmelweis Ignácz: hypochloricacidfordecontamination of thehandafterautopsies R.Koch: TB, anthrax, steemforsterilization Trendelenburg, Schimmelbusch: steamsterilization Steril rubbergloves: Halsted 1891. Facemask: Hunter 1900.

• 
  Слайд 25

  The first(surgical) Nobel Prizeinmedicine

  Theodor Kocher1841-1917. Bern 1909: „…forhisworkinphysiology, pathology and surgeryonthethyroidgland…”

• 
  Слайд 26

  Features of modern surgery

  Highdegree of specialization (heart, vascular, chest, pediatric, colorectal…) Maximum use of relatedsciences (rtg, US, CT, MRI, laboratorytests, endoscopy…) Fast and wideshare of information Research orienteddevelopment of surgeryguidedbytherules of science and law and grants!

• 
  Слайд 27

  Independent disciplines sprouting from general surgery

  Urology Orthopedics Radiology Traumatology Chest surgery Heart surgery Pediatric surgery Hand surgery Vascular s. Transplantation s. Neurosurgery Head and neck s. Ophtalmic s. Plastic s.

• 
  Слайд 28

  Cooperation between disciplines

  „ClinicalSciences” Anesthesiology, ICU Imaging: US, CT, MR, PET, nuclearmedicine Laboratorydiagnostics, microbiologylab Internalmedicine (gastroent., endocrin., cardiol., nephrol…) Surgery TheoreticalSciences” Anatomy, physiol., chemistry, physics Pharmacology Engineering (sterilization, lighting, laparoscopy, endoscopy, US cuttingdevices, staplers, implants Immunology (transfusion, transplantation…) Genetics (FAP, HNPCC…)

• 
  Слайд 29
  

  Science Art, Personalchallenge Handicraft Surgery

• 
  Слайд 30

  Historical moments of the University of Debrecen

  Calvinist Coll. 1541 University XVII th century 1750- István Hatvani: naturalsciencesinthecurricula 1906. Gyula Kenézy, theol., law, science and medicalfaculties 1914-1918. University of Arts and Sciences, FlorisKorb 1921: Inauguration of theMedicalFaculty Four out of 15 professorsstayin Debrecen duringWWII 1951: Med. Fac. becomes and independentuniversity: DOTE 1977: DentistryFac. founded 1987: English Program initiated 1998: University Assoc. of Debrecen DATE, DOTE, KLTE, KFRTF, LFZFDK, ATOMKI, DRHE 2000: UDMHSC

• 
  Слайд 31
  
• 
  Слайд 32
  

  Prof. Tivadar Hüttl

• 
  Слайд 33
  
• 
  Слайд 34
  
• 
  Слайд 35