SCIF Study 2 - David Ellyard

TALK ABOUT: time period, nationality, brief personal details, nature

of issue they dealt with, their response and their impact upon
medical knowledge or practice
James Lind (1716-1794) - Scottish - citrus and scurvy
born into family of merchants
began medical studies as apprentice of George Langlands
in 1739, entered Navy as a surgeons mate
1747 - naval doctor of HMS Salisbury in the Channel Fleet,
conducted an experiment on scurvy whilst patrolling the
English Channel during the War of the Australian Succession
o despite good food and sweet water, 80 out of 350 men
had scurvy (weakness, depression, livid skin spots,
blackened gums) within 10 weeks
o access to fresh food known to clear scurvy within weeks,
and juices of citrus fruits like oranges, lemons and limes
had been long suspected to be an effective remedy
o chose 12 sufferers, groups in pairs, and each pair had a
different addition to their normal rations of gruel,
mutton brother and ships biscuit (cider, vitriol (sulfuric
acid), vinegar, seawater, spicy paste and barley water,
two oranges and a lemon)
o only those drinking cider and eating fruits showed
improvement, more pronounced in the citrus eaters as
one was fit for duty within six days
shortly after Lind retired from the Navy to practice as a private
physician
1753 - A treatise of the scurvy (virtually ignored)
whilst his findings were accepted by the Admiralty, it was 40
years before lemon and lime juices were used by all Royal
Navy ships
1762 - wrote an essay recommending watercress (13 the
Vitamin C of orange juice) to be grown on ships, taken up in
1775 by British Army in North America
however, Lind believed scurvy was the result of putrefying
food in the body, bad water, excessive work and living in a
damp atmosphere, and hence he never advocated for citrus
juice as a single solution; in addition, he weakened the effect
by boiling it which destroyed Vitamin C (but Vitamin Cs
existence he did not know of)
regardless, experience within the navy convinced officers and
surgeons to use citrus juices
also noted typhus didnt occur where patients were baths and
had clean clothes and bedding, and recommended this for
British navy, discovered the steam of heated salt water was
fresh and provided a new method for obtaining freshwater in
the case of scarcity of water that had gone bad (distillation)

SCIF Study 2 - David Ellyard

furthered understanding and interest in realm of nutritional

health
William Withering (1741-1799) - English - active ingredient in
foxglove (for dropsy)
trained as physician (studied medicine) at University of
Edinburgh Medical School (also botanists, geologist, chemist)
member of Lunar Society of Birmingham (1765) - the
lunatics, met full moon (easier to walk home) to link
knowledge and enterprise
physician at Birmingham General Hospital
treating patient with dropsy (atrial fibrillation) - heart failure
due to fluid build-up
o patient improved after taking traditional herbal remedy
from Mother Hutton (old, folk herbalist; contained over
20 ingredients)
o Withering determined there was an active ingredient in
the mixture occurring in foxglove leaves (now known as
digitalis)
slows and strengthens heartbeat, improving
circulation and clearing congestion
o worked on treatment for 10 years, did 156 documented
clinical trials (using various parts of the plant from
several seasons, safest means of employing it) and
observed side-effects and toxicity, all recorded in his
book:
o 1785 - An Account of the Foxglove and Some of its
Medical Uses
led to understanding of active ingredients, for
example the miraculous bark from South
America that cured malaria was found to have the
active ingredient quinine
Edward Jenner (1749-1823) - English - vaccination of smallpox
apprentice for 7 years to surgeon Daniel Ludlow in South
Gloucestershire
1770, apprenticed in surgery and anatomy under John Hunter
and others at St. Georges Hospital, Dont think; try.
1773 - returned to native countryside at Berkeley
MD at University of St. Andrews
smallpox blinded, maimed, disfigured and killed though who
contracted it, particularly amongst indigenous populations in
Africa, America and Oceania
since the start of the century, inoculation had been used in
Europe to confer immunity and prevent spread, and smallpox
sufferers rarely got it twice
pus from a pustule was rubbed into a small incision on the
skin to inoculate, however Jenner improved upon this

SCIF Study 2 - David Ellyard

o the procedure of inducing immunity with cowpox was

done, but it wasnt until 20 years later that it was widely
understood (Jenners work)
o he noted that milkmaids were generally immune to
smallpox, postulating pus in the blisters milkmaids
received from cowpox protected them from smallpox
o 1796 - tested hypothesis by inoculating 8-year-old son of
Jenners gardener using pus from milkmaid, who got a
fever and some uneasiness, and then injected him with
variolous material (the routine method of immunisation
at the time) with no disease following
o 1798 - An Inquiry into the Causes and Effects of the
Variolae Vaccinae
led to global eradication of smallpox 200 years later, led to
work on immunisation/vaccination (further worked on by
Pasteur and Koch), questioned how did the body fight off
infections

Ren Laennec (1781-1826) - French - stethoscope

mother died of tuberculosis, had tuberculosis himself
began medical studies under uncle Guillaime-Franois
Laennec, then later in Paris where he was trained to use sound
(percussion) as a diagnostic aid by Corvisart
1819 - De l'Auscultation Mdiate (On Mediate Auscultation)
o invented stethoscope to allow auscultation (listening to
internal sounds) without issues of age, sex and degree
of fatness of the patient
o used the idea that scratching on wood with a pin would
amplify the sound if you put your ear next to it
o rolled paper into cylinder to listen to their heart, found it
amplified the sound action
o then made wooden cylinder version, advanced hearing
allowed him to classify sounds in terms of rales, rhonchi,
crepitance and egophony (terms still used today) to
diagnose by sound
o also developed understanding of peritonitis and cirrhosis
James Simpson (1811-1870) - Scottish - anaesthetics
completed education at 18 (obstetrician), had to wait 2 years
for medical licence
developed Air Tractor (earliest childbirth-assisting vacuum
extractor), improved design of obstetric forceps, fought
infection during childbirth, early advocate of midwives,
introduced anaesthesia to childbirth
at 28, appointed Chair of Medicine and Midwifery at University
of Edinburgh
1799 - Simpson first used anaesthetic (nitrous oxide or
laughing gas)

SCIF Study 2 - David Ellyard

1847 - discovered chloroform during experiment with friends

(trying new chemicals, they all woke up the following morning)
o significant as many had died from the shock/pains of
surgery, and now not only could surgery be done with
relative ease, it could also be done over a longer period
of time allowing more thorough investigations

John Snow (1813-1858) - English

born into poor neighbourhood
at 14, apprenticed as a surgeon to William Hardcastle, when
he first encountered cholera
enrolled in Hunterian School of Medicine in 1836
1837 - worked at Westminster Hospital
20 years later, first paper linking illegal food additives in bread
and distortion of bones
one of the first to study and calculate dosages of ether and
chloroform as surgical anaesthetics, designed apparatus to
administer and mask for physician
o personally administered chloroform to Queen Victoria for
her last two children, leading to wider public acceptance
of obstetric anaesthesia
sceptic of miasma theory, marked houses with cholera
outbreak in area around him, and after talking to local
residents, linked it to a public water pump on Broad Street,
which convinced the local council to disable it (even though
microscopically he could not identify anything) which ended
the outbreak (although Snow believes it was already declining
so too hard to say), however officials didnt want to believe his
theory as it accepted oral-fecal contact (as the water was
infected by sewage-runoff) and reinstalled a pump, however
eventually later supporters won over
o further supported Germ Theory of disease, showed that
disease could be transmitted by water
Ignaz Semmelweis (1818-1865) - Hungarian - washing hands
son of prosperous grocer
studied medicine (after switching from law) at University of
Vienna, specialised in obstetrics
assistant in the First Obstetrical Clinic (maternity institution
where underprivileged women would have children cared for;
they were subjects of doctor and midwifery training) of Vienna
General Hospital, Austria
o well known that more died of puerperal (or childbed)
fever here than 2nd Obsterical Clinic (only midwives) and
even on the street
o 1847 - determined it was because doctors had been in
contact with cadaverous particles

SCIF Study 2 - David Ellyard

o found calcium hypochlorite removed smell of infected

autopsy tissue, so instructed doctors to wash hands with
this between autopsies and patient examination
o reduced mortality rate to comparable with others
o his idea that diseases had set causes (not that each
case of disease was unique) and cleanliness was the
most important factor was ridiculed and rejected as it
did not conform to current paradigms (unexplainable no understanding of germ theory of disease, they
believed in miasma theory and dyscrasia - much like 4
humours) and many doctors were offended that their
hands could be unclean as they were gentlmen
o 1848 - widened washing protocol to all instruments
whilst the British argued they had already concluded this and
he had to point out the differences, Semmelweis influenced
many people that led to the slow uptake of better hygiene not
only for obstetricians, but all doctors and midwives

Louis Pasteur (1822-1895) - French - supported Germ Theory,

artificial vaccines
three children that died of typhoid, led him to cure infectious
diseases (previously had been researching crystallography
and molecular asymmetry)
1854 - dean of faculty of sciences at Lille University
1856 - local wine manufacturer (M. Bigot, the father of a
student) wanted to avoid souring alcohol after long storage,
and the following year he developed his ideas, demonstrating
that the yeast produced alcohol and lactic acid (due to
bacterial contamination), which soured the wine
following experiments on fermentation, he boiled broths in
swan-necked flasks, then exposed one to air where dust
particles could pass through, finding only that one fermented
o definitively disproved the Theory of Spontaneous
Regeneration (as Francesco Redi had suggested,
supported his Germ Theory)
he also found when working on chicken cholera, infecting with
a spoiled culture failed to induce the disease in some
chickens, and upon infecting them with the proper culture
they were not diseased; in 1870s applied this immunisation
method to anthrax in sheep, comparing 25 pre-inoculated to
25 un-inoculated; he also found anthrax did not infect
chickens unless their body temperature was cooled
(43o37oC), at which point they could gain the disease; also
made vaccine for rabies
o unlike Jenner, the vaccine was generated artificially, so
a weak strain need to be found

SCIF Study 2 - David Ellyard

Joseph Lister (1827-1912) - English - antiseptics

a prosperous Quaker who attended University College,
London, initially for a BA in botany, then a Bachelor of
Medicine
became professor of surgery at University of Glasgow,
Scotland
1867 - promoted carbolic acid (phenol) as an antiseptic as it
eased the stench of sewage waste in irrigated fields
o prior to this many assumed infections or wounds
resulted from chemical damage, and surgeons were not
required to wash hands before seeing a patient as it
wasnt considered necessary (stains were like a warriors
war wounds)
o tested by spraying surgical instruments, incisions and
dressings, and found it remarkably reduced the
incidence of gangrene
o published his findings in The Lancet over 6 articles
(1867)
o instructed surgeons to wear clean gloves and wash their
hands with 5% carbolic acid before and after operations
father of modern surgery - changed surgery forever,
drastically reduced chances of infection, further confirmed
Pasteurs theories
Marie Curie (1867-1934) - Polish (naturalised-French) - radiation
parents respected teachers, although became poorer after
losing Polish national uprisings to restore independence
first studied in Floating University, Warsaw
1891 - moved to France, studied physics, chem and maths
University of Paris
explained Becquerels observation of radiation in uranium,
related amount of radiation to amount of uranium, discovered
the radioactive elements radium and polonium
o first used medically in WWI, where she used X-ray
equipment to produce mobile radiography units (petites
Curies or Little Curies). used hollow needles containing
radium emanation (later identified as radon) to sterilise
infected tissue
o her work has been vital in understanding and utilising
PET, X-ray and CT scans
Willem Kolf (1911-2009) - Dutch (Netherlands) - haemodialysis,
artificial organs
studied medicine at Leiden University in his hometown
one of first patients was 22yo man dying of renal failure,
prompted him to perform research on artificial renal function

SCIF Study 2 - David Ellyard

replacement, treated his first patient in 1943, and first saved a

patient with haemodialysis in 1945
o sent machines to London, Amsterdam, Poland and US
1940 - organised first blood bank in Europe
later involved in development of heart-lung machines to
maintain heart and pulmonary function for heart surgery, and
the development of the artificial heart (first implanted 1982,
patients heart functioned until death)
o father of artificial organs - saved millions through
haemodialysis and permanent artificial organs, which
are
procedures
being
performed
and
further
investigated today

Christiaan Barnard (1922-2001) - South African - heart transplant

father was a minister
one brother (Abraham) died from a heart problem aged 5
studied at University of Cape Town Medical School
trained as cardiothoracic surgeon at University of Minnesota,
US, where he became acquainted with Norman Shumway who
did much of the research leading to the first successful human
heart transplant
1967 - completed second successful kidney transplant in
South Africa (one year after the first)
experimented for several years with animal heart transplants
(on over 50 dogs)
two months after the kidney transplant, he performed the first
successful heart transplant by paralysing the donated heart
with potassium, and continued to do so even without as good
immunosuppressants that we have today
o also performed first heterotopic heart transplant, where
the original heart is not removed but a double heart is
formed
also first surgeon to attempt xenograft (cells from another
animal)
his work ploughed through what was believed to be the
capabilities of a surgeon, extending it beyond our previous
reaches and saving many lives through practice and
inspiration