The Making of Modern Medicine - (2007) [BBC Radio (MP3 192kbps)] - dearleuk
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The Making of Modern Medicine - (2007) [BBC Radio (MP3 192kbps)] - dearleuk
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The Making of Modern Medicine_dearleuk
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Description
The Making of Modern Medicine
This is a re-seed for anyone who may have missed it, first time around
Andrew Cunningham writes and narrates a major new 30 part narrative history series charting the development of western medicine and healing from the Ancient Greeks to the pioneering organ transplant operations of the 20th century and beyond.
Modern medicine's achievements in countering illness and mortality owe their origins to a scientific revolution in France 200 years ago.
In the very early 1800s, in the wake of the French Revolution, a group of energetic and influential medics based mainly around Paris, became the pioneers of modern medicine.
Their aim was to reform medicine along the lines that physics and chemistry had been developed in the course of the 18th century - to give it a scientific basis.
Medicine was now to be based on experiment and observation, and to rely on the senses rather than the imagination when looking for causes.
In other words, they gave medicine a typically Enlightenment treatment...
The events of the French Revolution triggered a big-bang which completely transformed medicine.
After centuries of near stagnation, medicine embarked on the huge scientific task of classifying human disease.
The foundations laid by Laennec, Corvisart and others opened the door to allow scientists to discover much more about how and why people become ill and what can be done to treat and cure them.
Not my rip, many thanks to Private Walker via alt.binaries.sounds.radio.bbc
Episode 1: Hot cold wet and dry
Andrew Cunningham begins his story with some pithy pieces of advice for the aspiring physician in Ancient Greece. We can trace origins of religious and western learned medicine back to Hippocrates and Galen whose writings remained the basis for medical practice well into the 18th century. Galen's basic understanding of anatomy proved remarkably accurate, yet his ideas of what was going on inside the body were not based on the anatomical facts at all. So why did medical knowledge remain unchallenged for so long?
Episode 2: God's house the hospital
Aside from the medical profession and the universities to educate physicians, the hospital is one of the main innovations made in Christian Medieval times that persist into modern medicine. But where did it come from and why was it thought a good idea to segregate the sick in institutions away from the well? Andrew Cunningham traces the key to their long term success. Our starting point is Christ's description of the Last Judgement whose "works of mercy" could be fulfilled by an institution that would welcome the poor, care for them body and soul - and all for free.
Episode 3: The first sexual epidemic
By 1490 the population of Europe has recovered to the level it had been at when the great Plague had killed up to one in 3 people across the continent. But a mysterious new disease broke out in 1492 terrifying everyone and sparing no one. It was the pox. How did the medical medieval practitioners enact cures and preventions? Andrew Cunningham examines the beliefs behind so called miracle treatments and the extent to which new diseases were inevitable as travel and the new mores of sexual behaviour emerged during the late medieval period.
Episode 4: Paracelcus and the people's medicine
The 16th century witnessed the birth of a new kind of natural philosophy and medicine. Its chief advocate -the Swiss medical reformer Paracelsus, rejected the traditional medicine of the Greeks because of its heathen roots in favour of both a spiritual and alchemical approach. Andrew Cunningham explores how this captivating figure and scourge of the medical establishment clashed with the authorities wherever he went yet became hailed for his innovative use of chemical drugs.
Episode 5: The anatomical renaissance
Noses, ears and lips were often lost during swordfights in defence of honour. Yet thanks to a medical renaissance in anatomy during the 16th century, the art of surgery had been perfected to the extent that artificial but living noses, ears and lips could be supplied in their place. From the rediscovery of Galen's ancient teaching to the new ideas of the young physician Andreas Vesalius this episode explores how the approach to human anatomy, was changed forever.
Episode 6: The Early transfusion experiments
For almost 2000 years in the West, medical men had been taking blood out of their patients to cure them. It wasn't until 1660 that anyone thought of putting blood in! Andrew Cunningham explores how William Harvey's important discoveries of the circulation of the blood and the pumping force of the heart lead to ideas of "extending the circulation of the blood beyond the boundaries prescribed for it by Nature" and pass it from one person to another.
Episode 7: Fever
In the 17th century fevers were the principal concern of physicians, who believed that nature had a natural way of responding to any disease by eliminating the offensive matter in the body. Andrew Cunningham examines the pioneering work of "The English Hippocrates" the physician Thomas Sydenham who produced accounts of the symptoms and the fevered course of each epidemic disease. Trial and error would lead to some impressive cures.
Episode 8: Learning from the illiterate
By the early 18th century smallpox was taking between 10 and 15% of all lives in Europe and physicians were constantly arguing about how best to cure it. But a new method of treatment was gradually coming to attention -something which peasants and slaves had known for centuries .This episode explores the work of the inoculators which would force learned medics to contradict all that they had learned .To what extent would their work guarantee safe protection from smallpox infection?
Episode 9: The Coming of the GP
This episode begins with a riotous hit satire on the London stage. It offers vital clues to a dramatic siege in 1767 outside the Royal College of Physicians in London between old guard physicians and a new breed of general practitioners from Edinburgh. The individual practices of physicians, surgeons and apothecaries were now under threat. It was to mark a major change in the skills and qualifications of medical men with the coming of the general practitioner and a violent outbreak of class war within medicine.
Episode 10: Anatomy and the invisible hand
Anatomy teaching was big business in the 1700s. Anatomists such as the ambitious William Hunter hoped to profit by supplying anatomical teaching - but in doing so created a huge and unsavoury demand for fresh bodies for use by his students. Amid rivalry and huge public debates every anatomist wanted to make some new discovery build a reputation. So how did this period come to be known as "the perfection of anatomy" and secure one of the few medical disciplines that would survive the political upheaval that was about to engulf Europe?
Episode 11: Little Reading, Much seeing and Much Doing
The French revolution ushered in new ambition and a new scientific clinical medicine that is taught to all medical students today. Andrew Cunningham explores this hugely significant moment in transforming medical thinking training and practise in the early 1800s into an approach we recognise today. Chemist Antoine Forcroy's demand for "Little reading, much seeing and much doing" would have far reaching effects as a new hands-on methods to try to work out what was going on inside a patient's body, began to get taken up.
Episode 12: Making Signs
Systematic post mortems revolutionised the study of disease. It enabled physicians armed with new instruments such as the stethoscope to translate the signs they were reading on the outside of the body into what was going on inside. Andrew Cunningham explores how doctors in the Paris hospitals could now link symptoms with particular diseases .No longer would the doctor take a holistic approach to his patients. But what did this mean for the patient who up until the 1800s had always expected to be seen as special and unique?
Episode 13: A Long And Ghastly Kitchen
Napoleonic France witnessed the second big event that medicine scientific - Dr Magendie's experiments on live animals, which were conducted to find out how the animal and human body works. English observers found this new field of experimental physiology mere self-indulgent cruelty in the pursuit of knowledge despite Magendie and his successor Claude Bernard laid out their position at length. But what did this first generation of researchers discover which was considered to have an important impact on medicine?
Episode 14: Changing disease identity
We assume all diseases are eternal. But a side effect of progress in medical thinking is that diseases often had their identities changed over time. New measuring tools meant that it was impossible to say whether a disease, before and after scientific medicine developed, was in fact the same disease. Additionally the social interpretation of diseases often changed. Andrew Cunningham examines the many changing identities of consumption - soon to become known as tuberculosis - a widespread disease throughout 19th century Europe, affecting people of all ages and from all walks of life.
Episode 15: Sisters of charity
According to the Nursing Record a typical nurse in the 1830s was like Sarah Gamp in Charles Dickens' Martin Chuzzlewit - a domestic servant who was dirty, incompetent and rough with patients. By the 1880's a nurse is young neat and uniformed and has been formally trained. How did this change from old nurse to the new come about? As Andrew Cunningham reveals, the changing religious temper of the time and an enterprising Florence Nightingale gave us a new kind of nurse - offering a vocation that girls "of good character" increasingly felt they were called to undertake.
Episode 16: Science has no sex
The only way a woman could become a doctor in the early 19th century was by pretending to be a man - as famously demonstrated by Dr "James" Barry, Inspector General of the Army Medical Dept. By the mid 1800s the situation began to change - in 1881 25 women doctors were practising in England and Wales with numbers rising rapidly. Andrew Cunningham traces the influence and legacy of the pioneer women doctors and in particular Marie Zakrzewska one of 4 women among 200 men admitted to Cleveland Medical College who overcame hostility and many closed doors to create the first true women's hospital.
Episode 17: The dark side of obstetrics
By the mid 19th century all across Europe, maternity hospitals had become a scene of carnage. Scientific measures intended to improve care in the birthing room had all gone wrong and instead of being helped, hundreds of poor mothers and their new born infants were being killed each year. Doctors and medical students were unwittingly spreading child-bed fever in the lying in hospitals But as Andrew Cunningham reveals it was the work of Ignaz Semmelweis in Vienna who would pinpoint the cause. But would Semmelweis succeed in persuading his colleagues to adopt essential cleanliness to stop the spread of disease?
Episode 18: Anaesthesia "A Yankee Dodge"
So great was the pain suffered by patients during operations, patients would only undergo them if there was no alternative. In 1846, the acclaimed surgeon Robert Liston's operation to amputate a patient's leg using what he described as "a yankee dodge": after trials with ether - a clever contrivance from America, marked the beginning of anaesthesia in Europe. But to what extent would this transform surgery in the long term? Andrew Cunningham looks back to the origins of pain relief and how chloroform with its rapid action and few side effects would come to be favoured amongst surgeons - transforming the operating theatre from a place of panic and screaming to a place of calm and silence.
Episode 19: The disease is its own preventative
July 1885 - and the life of 9 year old Joseph Meister, bitten by a rabid dog was about to be saved by Louis Pasteur's new anti rabies vaccine. This episode tells the story of how, with the rise of laboratory medicine, Pasteur was able to give the newly developed germ theory of disease new impetus by identifying the disease-causing germs of many infectious diseases. Soon invisible microbes could be manipulated in the lab that would succeed in preventing the disease they caused!
Episode 20: Stopping the Rot
The surgeon Joseph Lister during the late 1800s had built upon Pasteur's germ theory and introduced anti sepsis into surgery. Lister's success with carbolic acid is what we now think of as having made internal surgery safe. But was this really the case? Andrew Cunningham examines the less than enthusiastic welcome for Lister's antisepsis, as surgeons - who were more concerned with general cleanliness of their operating environment - were experiencing greater success with their patients than ever before.
Episode 21: Culturing the germ theory
Our story continues with Louis Pasteur's great European rival, Robert Koch- a country doctor from Prussia- who succeeds in doing what has eluded all bacteriologists up until now. He has traced the entire life cycle of a bacillus . And he's been able to do this by culturing it outside the body. Andrew Cunningham traces how this revolutionary insight would lead to proof that particular micro organisms would cause a particular disease. But why was there still resistance to the germ theory amongst some medical professionals?
Episode 22: Transforming Plague
Most people flee from plague but bacteriologists rush to it. When bubonic plague breaks out in Hong Kong in 1894, European rivalry between France and Germany continues to be played out between two students of Pasteur and Koch who head straight to East Asia in a race to discover the causative micro organism of plague. No longer will plague be defined by its symptoms and course, but by its cause - thanks to a new series of rigorous laboratory tests. But how easy would it be for the micro biologists to get everyone to agree to this new approach?
Episode 23: The ministry of healing
Could the "feel" for a good diagnosis really be reduced to instruments and rule following? The new idea that doctors now needed to consult laboratory workers about the identity of a disease before they could make a final diagnosis was seen by many physicians as a threat to their authority over a patient. One who did more than anyone to successfully unite the two worlds of the bedside and the laboratory was the Canadian William Osler. Andrew Cunningham examines how by putting a small laboratory in the ward for the clinician to pursue his diagnosis, Osler ensured that "the lab would become indispensable in the everyday work of the practitioner"
Episode 24: Flinging the tropics open to civilisation
In the 1870's the so called "scramble for Africa" saw many countries all competing for a slice of the continent. But what role did European medicine play in spreading European culture across Empire? Andrew Cunningham traces the work of Patrick Mason - a colonial doctor who's credited with "flinging the tropics open to civilisation" and creating the then new discipline of "tropical medicine". We see how enthusiastic a colonial doctor could be to join in the research activities of this great period in scientific medicine however isolated and ill equipped he was.
Episode 25: Near Pavilions
By 1900 hospitals were clean environments, not overcrowded, and with tall windows open as much of the time as possible to fresh air. No longer were they "more fatal than the battlefield" as Florence Nightingale had described them 50 years earlier. Andrew Cunningham traces the influence of Nightingale and the sanitarians in creating isolated pavilion style buildings designed on the basis of a current theory of disease. They would become not only the place to care for the poor, but also for the first time where the middle classes would receive the services of a physician or surgeon rather than at home. At the beginning of the 20th century the hospital is now for everyone.
Episode 26: You are what you eat
Doctors had long recognised that one of the crucial elements of health was a correct diet. Frederick Gowland Hopkins in 1911 conducted early animal experiments to show that aside from fat, carbohydrate and protein another ingredient was essential in nutrition. But what should it or they, be called to enable everyone to relate to them? Casimir Funk came up with the term vitamins (vital for life) in 1912. Meanwhile, as Andrew Cunningham reveals, it was the disease of beri-beri in the Dutch East Indies that would inspire medics that the absence of something, rather than the presence of a microbe could be the cause of some particular disease conditions.
Episode 27: It looks like a miracle
By 1940 we'd had quinine for malaria, the magic bullet Salvarsan for syphilis -each a very specific drug. But there was one greater than these - penicillin, active against a whole range of infections. This first antibiotic appeared to be a miracle medicine. Alexander Fleming was treated as the great hero discoverer, but how could have Fleming failed to realise the medical significance of what he had discovered - leaving Howard Florey and Ernst Chain to develop its potential in the fight against staphylococcal infections?
Episode 28: Free at the point of need
Aneurin Bevan called it "the biggest single experiment in social service that the world has ever seen" .The National Health Service was set up in July 1948 to provide health care for everyone, and free at the point of need. Andrew Cunningham examines the health care which the NHS would replace and how the ministry of health had to coax or force the hospitals and medics into the service against the clock if the NHS was to come into existence. How did doctors react to the new system they would be working within?
Episode 29: The crippler
America prided itself on being the cleanest nation on earth - but polio was no respecter of cleanliness. In the early 1900s mass epidemics in the US occurred annually. Public concern for this debilitating disease marked a watershed in American attitudes to public disease and health research: preventatives and funding for polio would be all American. And the fact that Franklin Roosevelt in 1921 had lost the use of his legs from polio was crucial to all these developments. But producing a vaccine to immunise children took the best part of 40 years. Andrew Cunningham traces the impact of the great polio epidemics and the ethical dilemmas after the 2nd World War that predominated in the progress towards a safe effective vaccine in 1955.
Episode 30: Transplant
Andrew Cunningham's story draws to close with what's been called the greatest therapeutic advance of the second half of the 20th century - organ transplantation. It gained its greatest public awareness with Christian Barnard's first heart transplant operation in 1967. Competition between pioneering teams of transplant surgeons would push the limits as to what was possible in scientific medicine assisted by new rapid advances in technology. This has continued to be a hallmark of all future medical development. And in looking back at the making of modern medicine, Andrew Cunningham reflects on what scientific medicine has given us and what we have lost.
Type : mpeg 1 layer III
Bitrate : 192
Mode : stereo
Frequency : 48000 Hz
Length : 07:30:00
Encoder : Lame 3.97
Source : Freeview
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