prehistoric times ◦ angry god or evil spirits caused illness ◦ the gods needed to be pacified to...
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PathologyConcepts of Health and Disease
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Health and Society Prehistoric Times
◦ Angry god or evil spirits caused illness◦ The gods needed to be pacified to obtain a cure◦ Evil spirits driven out
Communities helped to secure health of its members◦ Health practices were based on belief systems
Modern Western Thinking◦ Originating with the Greeks
No supernatural powers affecting health
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Health and Society Western Beliefs
◦ Everything that can be known can be found through studying and observing science
◦ Cortez conquering the Aztecs changed a culture’s belief in polytheism to monotheism
Diseases were thought to have been caused by emotional turmoil or grief (nervous condition)◦ Certain illnesses had a stigma attached
Leprosy, AIDS
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Hippocrates◦460-377BC◦The foundation of cl inical principles and ethics for modern medicine
◦Four Humors Blood (red) from the heart = sanguine
Yel low bi le from the l iver = choleric Black bi le from the spleen = melanchol ic
Phlegm from the brain = phlegmatic
Early Scholars
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384-322BC Dissection of small
animals Heart was the most
important organ◦ Center of the body ◦ Seat of emotions
Aristotle
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Galen 129-199AD Physician to the Emperor of Rome
Continued to do more dissections
Started experimentations on live animals◦ Severed a pig’s spinal cord to cause paralysis
The body carried 3 kinds of blood
◦ Natural spirit from the liver◦ Vital spirit from the lungs◦ Animal spirit from the nerves
His work was considered infallible for 1400 years
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Professor of Anatomy from Padua, Italy
1514-1564 Dissection of
Humans (considered horrible!)
Made much more accurate drawings and diagrams
Andreas Vesalius
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1578-1657 English physician
and physiologist Established blood
circulates in a closed system impelled by a pump-like heart
William Harvey
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Anton van Leeuwenhoek
1632-1723Refined the microscope lens
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Robert Hooke Published Micrographia
◦ Described the plant cells in cork◦ First to describe what a cell was
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Antoine Lavoisier
1743-1794 Was actually a lawyer but devoted his life to
scientific pursuits He studied Chemistry
◦ Came up with new ideas that allowed for the beginning of Biochemistry
He was beheaded during the French Revolution.
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Edward Jenner
1749-1823 Conducted the first vaccination of
cowpox on a jerseymaid◦ Saved a child’s life with smallpox
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1827-1912Concluded that
microbes caused wound infections
Used Carbolic acid on wounds to kill microbes
Listerine
Joseph Lister
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1820-1910 Leading proponent of
sanitation Crimean War with
Napoleon◦ Had 38 nurses with her to
treat 2000 wounded and sick soldiers
◦ She and her nurses cleaned up the hospital tents
◦ Used hygiene on the soldiers and
◦ Slashed the death rate of soldiers from from 40% to 2%!!!!!!
Florence Nightingale
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1822-1895 First real
Bacteriologist Studied fermentation
processes◦ Learned how to prevent
the souring of wine◦ “Pasteurization”
Dispelled the idea the “Miasma” or fumes was the cause of diseases
Louis Pasteur
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Robert Koch
1843-1910 Claimed microorganisms are the cause of illnesses
Identified the organism for tuberculosis◦Discovered TB skin testing method
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1845-1923 Discovered X rays
Wilhelm Rontgen
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1845-1915 Bacteriologist
◦ “magic bullets” could attack diseases and leave the rest of the body undamaged
He used arsenic compound (Salvarsan) as a weapon again syphilis
Paul Ehrlich
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Sir Alexander Fleming
1881-1955 In 1928 he studied the relationship between
bacteria and the mold Penicillium ◦ Penicillium had the ability to kill Staphylocci
Not until 1940 were researchers able to use the microorganism as an antibiotic Penicillin
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Sir Frederick Banting and Charles Best
1921 Discovered Insulin
◦ Isolated insulin from the pancreas of a dog 1922
◦ Successfully treated a little boy with diabetes
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1914-1995 Vaccine for
Poliomyelitis ◦Used inactivated
virus vs the vaccine already in use with activated virus
Jonas Salk
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Watson and Crick DNA structure
DNA Molecule
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Pathophysology Pathology
From the Greek for Pathos meaning Disease◦ Deals with the study of the structural and
functional changes in cells, tissues and organs of the body that cause or are caused by disease
Physiology◦ Function of the Body in the healthy state
Pathophysiology◦ Focuses on the mechanisms of the underlying
disease and provides the background for preventive as well as therapeutic health care measures and practices
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Disease Any deviation from or interruption of the
normal structure or function of a part, organ, or system of the body that is manifested by a characteristic set of symptoms or signs
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Etiology The causes of disease = etiologic factors
◦ Biological Agents Bacteria, viruses
◦ Physical Forces Trauma, burns, radiation
◦ Chemical Agents Poisons, alcohol
◦ Nutritional Excesses of Deficits Most diseases are multifactorial in origins
◦ Risk Factors For example, heart disease or cancer
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Pathogenesis The sequence of cellular and tissue events
that takes place from the time of initial contact with an etiologic agent until the ultimate expression of a disease.
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Morphology Fundamental structure or form of cells or
tissues◦ Histology
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Clinical Manifestations Signs v. Symptoms
Symptom◦ A subjective complaint that is noted by the person
with a disorder Sign
◦ A manifestation that is noted by an observer
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Diagnosis The designation as the the nature or cause
of a health problem Requires history and physical examination Differential Diagnosis
◦ A systematic method used to identify unknowns. This method, essentially a process of elimination
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Diagnosis
Normality◦ An important factor when interpreting diagnostic test results is the
determination of whether they are normal or abnormal
Reliability◦ The extent to which an observation is repeatable
Validity◦ The extent to which a measurement tool measures what is intended to
measure
Sensitivity◦ The proportion of people with a disease who are positive for that disease
on a given test or observation
Specificity◦ The proportion of people without the disease who are negative on a
given test or observation 95% accurate v. 100%
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Morbidity and Mortality Mortality
◦ Death statistics
Morbidity◦ The effects of an illness has on a person’s life
Concerned not only with the occurrence and incidence of the diseases but also the long-term impact of the disease
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Risk Factors
Conditions suspected of contributing to the development of a disease
Studies to determine risk factors◦ Cross-sectional studies
Simultaneous collection of information for classification of exposure and outcome
◦ Case-control studies Compares persons known to have the outcome of
interest and those known not to have the outcome of interest
◦ Cohort studies Group of persons who were born at approximately the
same time or share some characteristics of interest◦ Longitudinal studies
A cohort is studies over a period of time
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Framingham Study Framingham Massachusetts
◦ In 1948, the Framingham Heart Study embarked on an ambitious project in health research to identify the common factors that contribute to cardiovascular disease by following its development over a long period of time in a large group of participants.
5000 people between 30 and 59 years of age
Followed for 20 years Looking at coronary artery disease
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Prognosis Probable outcome and prospect of recovery
from a disease
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Levels of Prevention Primary
◦ Keeping disease from occurring by removing risk factors
Secondary◦ Detect disease early when it is still asymptomatic
Pap smears Tertiary
◦ Clinical interventions that prevent further deterioration or reduces the complication of a disease once it is diagnosed