A Hundred Years of Medicine

A fascinating account of medical advances over the centuries, with particular emphasis on surgical innovations and the prevalent diseases of the period 1840-1940.

Categories: Healthcare | History

This title is part of the Healthcare Administration list.

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This fascinating account provides a history of medical advances over the centuries. The focus, however, is on medical science from the middle of the nineteenth century to the middle of the twentieth century, particularly surgery and the prevalent diseases of the time. The historical approach, which sometimes has a detective story flavor, will rivet the attention of the layman as well as medical practitioners and students.

A Hundred Years of Medicine is presented in four parts. Part I discusses the historical background of modern medicine, which is considered to have begun in England around the middle of the 1700s. About half of the chapters in Part II on the history of infectious disease remain, for the most part, as Lloyd wrote them. The other half of Lloyd's chapters in Part II and all of Part III, "Surgery During the Last Hundred Years," and Part IV, "New Social Aspects of Medicine," have been entirely rewritten by Haagensen. Haagensen's extensive 2000 update of Lloyd's original 1943 work is in keeping with that author's original intention that his "historical essay may prove to be of value not only to the layman [its primary audience]...but also to those medical practitioners and students who have not found time for any specialized study of the history of medicine."

This book is not presumed nor intended to be comprehensive. Lloyd remarks in the preface to the original edition that his intent is to present the subject matter in a manner that is not "too technical [for] the non-medical reader." However, A Hundred Years of Medicine does provide a thorough discussion of medical issues, including advances in surgery during this time, that the reader is certain to find fascinating.

Part I, a general history of medicine titled "Medicine Up to a Hundred Years Ago," demonstrates the progress that has been made in the medical field, including the contributions of its primary professionals (doctors) and institutions (hospitals). Hospitals, which became prevalent in the eighteenth century, were not only centers for the treatment of medical problems, but also served as places for conducting scientific and research studies that would further the field of medicine. Part I also contains a broad historical section that sets the context for the advances in understanding and treatment of disease and the major improvements in surgical procedures during the nineteenth and early twentieth centuries.

In the second and third parts, on diseases and surgery respectively, the reader learns that "important medical advances are not made in a single day but are generally the result of a laborious series of steps made by a number of different workers over long periods of years." It is here that the book moves from a historical treatise to a discussion of particular medical conditions and their treatments. Lloyd and Haagensen illuminate the developments in chronological order so the reader can appreciate the challenges, breakthroughs, and notable junctures in medical and surgical achievements. The authors also follow, however, parallel developments in other areas of medicine that, taken together, portray the forward movement of the entire medical field. In line with this approach, the general subject of disease in Part II is delineated into chapters on the three main areas of developments of germ theory: ineffective organisms, germs outside the body, and germs inside the body. Also found in this part are separate chapters on the introduction of chemotherapy; the campaigns to combat tuberculosis, diabetes, and anemia; and the role of vitamins in preventive medicine.

The nineteenth century was notable for the large strides made in the recognition, diagnosis, and treatment of disease. At the core of this advancement was the discovery of the animal cell. This, in turn, led to the conception of the living body as a vast organization consisting of millions of tiny individual cells. This view, which came to be known as Cell Theory, quickly spread throughout the medical field because it answered centuries-old medical mysteries and gave doctors scientifically-based guidance for identifying and treating diseases. Eventually it led to developments in disease prevention and public sanitation for individuals and governments. First posited little more than one hundred years ago, Cell Theory remains the basic principal of today's medical field by which doctors are educated and trained and diseases are treated.

In recent decades, Cell Theory has led to remarkable progress in the treatment of cancer and one day may result in a cure for it, as tuberculosis and polio were cured in earlier times.

The authors similarly cover the historical turning point in the field of surgery. Surgery is considered the "opening of the great cavities of the body, the abdomen and chest...to operate upon the viscera." Before the early 1800s, medical treatment had been limited to dealing with wounds and diseases on the "surface of the body and in the extremities." There were no doctors called surgeons as such. But in 1809 in his home in Danville, Kentucky, where he had begun his practice in 1795, thirty-eight-year old Ephraim McDowell removed a twenty-two and a half-pound ovarian tumor from a woman in what was the first surgery lasting twenty-five minutes without anesthesia. It was seven years before McDowell performed another ovariotomy, and not until the 1820s before other doctors performed the operation. With the introduction of anesthesia in the early 1840s, surgery quickly moved into new areas and developed rapidly.

With such engaging, sometimes dramatic material and portrayals of the pioneers of medicine, A Hundred Years of Medicine offers a readable and memorable history of medicine.

Dr. Cushman Haagensen practiced as a surgeon at Columbia Presbyterian Medical Center in NYC for fifty years specializing in the area of breast diseases. He wrote three editions of his classic textbook Diseases of the Breast, the last edition being published in 1986. He was one of the first physicians to develop a clinical classification system for breast cancer. He showed that the use of Halstedian surgical technique for mastectomy resulted in long term cures, and that the chance of long term cures in the treatment of breast cancer related to the stage at which the disease could be detected.