Objectives:
At the end of this presentation, students shall have learned:
• Cultural Heritage in Medicine
• Medical Specialists in History
• History of Medical Educations
• History of Attitudes Towards Medicine
• Historical Medical Treatments
• Significant Contributions To Medicine
• History of the Health and Human Services in the US
•
Insurance in the United States
Cultural Heritage in Medicine
The informed and caring
health professional will
recognize that a person’s
_________________
and
_____________
heritage
play an enormous role in
any kind of health care.
Cultural Heritage in Medicine
Mesopotamian cultures believed that illness was a ______________by the gods for violation of a moral code. Ancient Egyptians believed the body was a system of channels for air, tears, blood, urine, sperm, and feces.
• Embalming (Mummies had Arthritis, Kidney stones and atherosclerosis)
• Done by special priests (NOT the doctor priests)
• Advanced knowledge of anatomy
• Strong antiseptics used to prevent decay
• Gauze similar to today’s surgical gauze
Cultural Heritage in Medicine
The ancient Chinese cultures examined and carefully monitored the pulse in each wrist. It was believed that the ___________ had hundreds of characteristics important in medical treatment. There were _______methods of treatment to bring a person to the right track. Chinese Herbal Medicine
Cultural Heritage in Medicine
They were:
1. Cure the spirit
2. Nourish the body
3. Give medications
4. Treat the whole body
5. Use acupuncture and moxibustion
Chinese Herbal Medicine
Greek Medicine
Aesculapius
• Developed the staff and serpent symbol of medicine
• temples built in his honor they became the first true clinics and hospitals
• First culture to study cause of disease
§ Hippocrates in the physician frequently recalled from the Greek culture. § His writings have contributed much to today’s culture. § He is remembered for his well known Hippocratic Oath, which establishes guidelines for a physician’s practice.
§ Because of this he is referred to as the “Father of Modern Medicine
Medicine’s history gives early evidence of many “specialists” in the healing arts. They were known by various names:
•
•
•
•
These healers were more than ancestors of the modern physician, however, for they performed many functions that involved the welfare of the entire community or village. By today’s standards, they were considered to be equivalent to ______________________, social workers, counselors and ____________________.
Whereas women were accepted as healers in primitive societies, later cultures reduced their status to that of being allowed to: ________________________________________
________________________________________ In any culture that granted women only secondary status, women were also considered unqualified to become __________________. In Muslim society, the reluctance of Arabic physicians to violate social taboo and touch the genitals of female strangers further encouraged relegating the practice of obstetrics and gynecology to __________________.
Women were not accepted in Western culture until the nineteenth and twentieth century.
In the United States, the first female physician was Elizabeth Blackwell, who was awarded her degree in _______________.
Although she was snubbed by the public, she soon earned the respect of her colleagues. When she refused to be absent from class when the male reproductive system was discussed, her fellow male students supported her actions.
During the rise of Christianity, emphasis was placed on the _________ rather than on the body;; therefore, early Christian monks held great control over medicine. This is evidenced by St. Benedict of Nursia (480-­554), who forbade the study of medicine. The care of the sick was encouraged, but only through _____________ and divine intervention.
Much of the medical knowledge in Europe was lost during this time.
St. Benedict of Nursia
At the same time, ____________ moved to preserve the classical learning that had been achieved in medicine, and practitioners were not only able to return to the same methods as those earlier practiced by Greeks and Roman cultures, but ____________________________________________.
During the European “crusades” (1095 – 1291) into the Holy land (Islamic held territory), Europeans learned much from the Muslims and brought back with them a wealth of mathematical and medical knowledge.
One result of the “crusades” was the sparking of a renaissance period. During the 9th century, medical universities emerged. By the time the renaissance was at its height in mid-­fifteenth century, the physician had become licensed, was receiving great status.
Three medical advancements that took place during the renaissance were:
1. Medical schools were established
2. Dissections lead to the publication of medical books
3. Physicians were required to become licensed.
____________ and _______________ were more likely related during the Renaissance than any other period.
Michelangelo spent years on careful human dissection, the details of which are evidenced in his paintings at the Sistine Chapel.
Leonardo Da Vinci made anatomical preparations from which he produced drawings representing the skeletal, muscular, nervous and vascular systems. § Isolation and Abandonment A sick person might be excluded from daily activity, but was likely to be shunned if the disease was believed to be a punishment by the gods for mortal sin. This forced isolation may well have been beneficial to the community.
§ Good Samaritans
The New Testament Parable of the Good Samaritan helped establish a nexus between the early Church and a concern for the sick. It was believed that though the body might be waste and foul with disease, the purity of the soul guaranteed life everlasting..
§ Native Americans
Native Americans had various feelings about illness. The ill were treated with kindness among the Navajo and Cherokee, and some who recovered from serious illness was considered to have extraordinary powers.
§ Eskimos
If a tribe was faced with famine, suicide by the aged and infirm was considered the highest form of bravery. The Eskimos put their adults unprotected onto ice floes. § Roman and Greek Attitudes toward illness.
Neither the Romans nor the Greeks treated the hopelessly ill or deformed, and unwanted infants were disposed of quickly or left to die.
§ Today’s right to choose life or death.
The Western medical community and the consumers it serves are heatedly debating the right to choose life or death and the legality of physician-­assisted suicide, which is acceptable in many other cultures.
§ Fear of disease such as AIDS.
Many individuals are still fearful of any illness they do not understand or that they perceive as threatening their health. AIDS is a good example. The fear is often accompanied by public ill treatment of the individuals suffering from certain diseases.
The writings of Ancient Egypt reveal that when a woman suspected she was pregnant, she __________________over a mixture of wheat and barley seeds combined with dates and sands. If any of the grains sprouted, she was surely pregnant. If the wheat grew, she should have a boy. If the barley grew, it would be a girl.
Today, urine is still used in modern tests to determine pregnancy. Early medical treatments were crude. Malaria, diphtheria, tuberculosis, typhoid and dysentery were commonplace. Leprosy was prevalent, and venereal disease was rife.
Death toll from small pox was high particularly among children. Ancient Times
§ Herbs and plants were used as medicine
examples:
– Digitalis from foxglove plants
• Then, leaves were chewed to strengthen & slow heart
• Now, administered by pills, IV, or injections
•
Quinine from bark of cinchona tree • Controls fever and muscle spasms
• Used to treat malaria
•
Belladonna and atropine from poisonous nightshade plant
• relieves muscle spasms especially in the Gastrointestinal tract
• Morphine from opium poppy relieves severe pain
In the 18th century, Edward Jenner made a great contribution to the prevention of disease by discovering a method of vaccination against ________________. Louis Pasteur was sometimes referred to as the father of preventive medicine as a result of his work in recognizing the relationship between ________________ and ______________________________________. He was also the first to develop a vaccine for ___________.
Joseph Lister revolutionized surgery because of his belief in Pasteur’s use of carbolic acid as an antiseptic spray. He insisted that all instruments and physicians’ hands be washed with the solution (thus introducing the use of _____________________ during surgery).
Robert Koch used the culture plate method for isolating bacteria and demonstrated how cholera was transmitted by food and water (thus demonstrating how ____________________________________). His discovery changed the way health departments cared for persons with infectious disease. U.S Department of Health and Human Services
The Department of Health and Human Services (HHS) is the United States government’s principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves.
• HHS works state and local governments
• provided at the local level by state or county Sylvia Mathews Burwell
Secretary of Health agencies, or through private sector grantees. and Human Services
• Administered by 11 operating divisions
• Department includes more than 300 programs, covering a wide spectrum of activities. • the HHS programs provide for equitable treatment of beneficiaries nationwide, and they enable the collection of national health and other data.
Operating Divisons of the HHS
§
Administration for Children and Families (ACF)/Administration on Children, Youth and Families (ACYF)/
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§
Centers for Disease Control and Prevention (CDC)
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§
Monitors disease and outbreaks and guides all immunizations
Food and Drug Administration (FDA)
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The Administration for Children & Families (ACF) is a division of the Department of Health & Human Services. ACF promotes the economic and social well-­being of families, children, individuals and communities.
Leads a functionally unified FDA Foods Program that addresses food and feed safety, nutrition, and other critical areas to achieve public health goals
Provides leadership for FDA's domestic and international product quality and safety efforts.
Provides advice and counsel to the Commissioner on all medical product and tobacco-­related programs and issues.
National Institutes of Health (NIH)
• NIH is the nation’s medical research agency—supporting scientific studies that turn discovery into health.
– • National Cancer Institute (NCI)
Other Divisons of the HHS
§
Substance Abuse and Mental Health Services Administration (SAMHSA)
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Agency for Healthcare Research and Quality (AHRQ)
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Administration for Community Living (ACL)
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Centers for Medicare & Medicaid Services
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Health Resources and Services Administration (HRSA)
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Indian Health Service (IHS)
History Of HHS
1798
Passage of an act for the relief of sick and disabled seamen, which established a federal network of hospitals for the care of merchant seamen, forerunner of today's U.S. Public Health Service
1862
President Lincoln appointed a chemist, Charles M. Wetherill, to serve in the new Department of Agriculture. This was the beginning of the Bureau of Chemistry, forerunner to the Food and Drug Administration.
1887
The federal government opened a one-­room laboratory on Staten Island for research on disease, thereby planting the seed that was to grow into the National Institutes of Health.
1891
Immigration legislation was passed, assigning the Marine Hospital Service the responsibility for medical examination of arriving immigrants.
1902
Conversion of the Marine Hospital Service into the Public Health and Marine Hospital Service in recognition of its expanding activities in the field of public health. In 1912, the name was shortened to the Public Health Service.
1906
The Pure Food and Drugs Act was passed, authorizing the government to monitor the purity of foods and the safety of medicines, now a responsibility of the FDA.
1912
President Theodore Roosevelt's first White House Conference urged creation of the Children's Bureau to combat exploitation of children.
1921
The Bureau of Indian Affairs Health Division was created, forerunner to the Indian Health Service.
1930
The National Institute (late Institutes) of Health was created out of the Public Health Service's Hygienic Laboratory.
1935
The Social Security Act was passed.
1938
The Federal Food, Drug and Cosmetic Act was passed. (replaced the 1906 version)
1939
The Federal Security Agency was created, bringing together related federal activities in the fields of health, education and social insurance.
1946
Communicable Disease Center was established, forerunner of the Centers for Disease Control and Prevention
1953
The Cabinet-­level Department of Health, Education and Welfare was created under President Eisenhower, officially coming into existence April 11, 1953. In 1979, the Department of Education Organization Act was signed into law, providing for a separate Department of Education. HEW became the Department of Health and Human Services, officially arriving on May 4, 1980. Some highlight dates in HEW and HHS history:
1955
Licensing of the Salk polio vaccine.
Indian Health Service was transferred to HHS from the Department of Interior.
1961
First White House Conference on Aging.
1964
Release of the first Surgeon General's Report on Smoking and Health.
1965
Medicare and Medicaid programs were created, making comprehensive health care available to millions of Americans.
Older Americans Act created the nutritional and social programs administered by HHS’ Administration on Aging.
Head Start program was created.
1977
The Health Care Financing Administration was created to manage Medicare and Medicaid separately from the Social Security Administration.
Worldwide eradication of smallpox, led by the U.S. Public Health Service.
1981
Identification of AIDS. In 1984, the HIV virus was identified by PHS and French scientists. In 1985, a blood test to detect HIV was licensed.
1984
National Organ Transplantation Act was signed into law.
1988
The McKinney Act was passed to provide health care to the homeless.
1990
The Human Genome Project was established.
The Nutrition Labeling and Education Act was passed, authorizing the food label.
The Ryan White Comprehensive AIDS Resource Emergency (CARE) Act began providing support for people with AIDS.
1995
The Social Security Administration became an independent agency.
1996
Welfare reform under the Personal Responsibility and Work Opportunity Reconciliation Act was enacted.
The Health Insurance Portability and Accountability Act (HIPAA) was enacted.
1997
The State Children's Health Insurance Program (SCHIP) was created, enabling states to extend health coverage to more uninsured children.
2000
Publication of human genome sequencing.
2001
The Centers for Medicare & Medicaid was created, replacing the Health Care Financing Administration.
HHS responds to the nation’s first bioterrorism attack -­-­ delivery of anthrax through the mail.
2002
Office of Public Health Emergency Preparedness was created to coordinate efforts against bioterrorism and other emergency health threats.
2003
The Medicare Prescription Drug Improvement and Modernization Act of 2003 was enacted;; the most significant expansion of Medicare since its enactment, including a prescription drug benefit.
Completion of human genome project
2010
The Affordable Care Act was signed into law, putting in place comprehensive U.S. health insurance reforms.
Health Care and Insurance in the United States
§ http://www.staysmartstayhealthy.com/watc
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