Hi, Nick here from Pods with Nick and James. Just a quick one before we get into this podcast.
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Hi, welcome to Pods with Nick and James.
Today's subject is going to be a brief overview of Western medicine with an episode to follow
with some of the modern failings of the medical industrial system, which will be hosted by Nick next time.
Just before we even get going, I've got a bit of a cold here, so if I cough horribly, sorry listeners.
I do not mean to give you that experience. It's just going to be impossible.
I also want to just give a shout out to my sources, the main sources being the videos of Patrick Kelly,
a YouTuber who does a lot of stuff on the history of medicine.
The author of the book, The History of Medicine, a very short introduction by William Bryenesson.
And then a massive shout out to my cousin, Emily, who just through a conversation with her
taught me a lot of points that hadn't been covered in the book, The History of Medicine,
and for just kind of having a conversation with someone makes it so much easier to remember these facts.
So, Emily, thank you very much.
Okay, so I guess we'll jump in.
Medicine is unlike science in that it, although it is scientific,
and we are going to be focusing on the scientific practice of medicine.
Unlike science, it wasn't just a term that was coined in 1836.
There have been doctors, there have been healers since the birth of mankind,
just as there have, I imagine, in all civilizations, always been some form of sickness and infirmity.
I realize, Nick, you're quite a well-versed man, so you may already know this,
but who do historians, do you know who historians see as the father of Western medicine?
I feel like I should know it, but I don't, I'm afraid.
That's absolutely fine. I feel I should be able to quote when the Magna Carta was done.
I couldn't tell you. I should be able to tell you when the Gutenberg printing press was made off the top of my head.
I couldn't tell you. But I can tell you, because I've researched it recently,
that the father of modern medicine was somebody called Hippocrates.
Oh, I did know that.
With, yeah, Hippocrates of Kos.
That's why it's the Hippocratic Oath.
Exactly, exactly, exactly. So, okay, so the Hippocratic Oath also, interesting fact,
Hippocratic Oath has nothing to do with Hippocrates, the person, or Hippocrates' corpus,
which means his body of writings, hence the word corpse.
Well, it's not the cause of the word corpse, I'm just explaining it.
I'm going too far already.
But just as an interesting fact, yeah, Hippocratic is different from Hippocratic or Hippocritical.
Hippocritical comes from the word Hippocritis, which means actor in Greek.
I've probably murdered the pronunciation there.
So it's just unfortunate that this person had a name,
which sounds really, really similar to actor in Greek,
rather than him actually being a Hippocrite or not practicing what he preaches.
Yeah, because the last thing you want to know that your doctor took
before he became a doctor was an oath of hypocrisy, I suppose.
Exactly, it's almost like the traitor's oath from this terrible BBC series,
which has totally, totally just indoctrinated me and it just kind of grabs me every time.
All I can say is it's fantastic garbage. Absolutely love it.
But anyway, moving swiftly on.
Okay, so Hippocrates lived in about 460 BC.
So again, a couple of hundred years after the invention of coins in Lydia.
The island of Kos is just off the coast off of modern-day Turkey
or is part of modern-day Turkey from what I've been told.
He... Yeah, at the time, the ideas of Epiduc... Epidoclus?
Damn it, I've mispronounced that. Epidem... Epidemius? Epid... Damn it.
The person who invented the idea of the four elements,
or at least the Greek Western version of the four elements.
Please note in Indian elementalism, there's five elements
where it is just the four normal ones of fire, earth, water and air,
but they also... the Indians bother to include ether.
Yeah, the spirit.
Which I'll need to... Yeah, the spirit, the void, the unknown,
which I actually think... I just like the fact that it's included, I think.
But anyway, please note also the Chinese had their own elementalism
of fire, water, air, and then they split earth into wood and metal,
which is an interesting take. The two are different.
But moving swiftly on, Hippocrates and his writings had a huge effect
on the origins of medicine in that it stresses the importance of observation
and the importance of looking at the patient as a human being,
as a way of trying to determine what's wrong with them.
We'll go into his oath, and in fact, you know what,
we'll start it off with the oath because I actually read through it,
and it is... you know what, I actually quite like it.
It's quite... I don't know, it's just interesting to read any kind of moral...
There's definitely some points in there which...
Yeah, it's not all that's followed today.
They're very poignant, they're very poignant,
and you can see that it's about the development of knowledge,
the sharing of knowledge, accepting that you don't always know everything
that somebody else will, and using the best knowledge that's available to you,
not necessarily your own, for the betterment of any patient
that comes into your care.
Absolutely. So I guess we'll... I'll talk briefly about...
Okay, so other than the Hippocratic Oath,
which is possibly my favourite part of Hippocrates' legacy,
he also brought humoral medicine.
Humoral medicine is the idea...
It's basically treating disease and deficiencies within the body
through the belief that the body is mostly made up of
a number of liquids or the four humours.
Weirdly enough, this again, humoral medicine,
which also existed in India and China,
and was around in the Islamic world as well,
we'll go into that in a moment though,
as it's not a strict divide between Greek and...
Although there is a divide, but there isn't, if that makes sense,
like there is a divide between Greek and Persian cultures,
but a lot of knowledge was obviously shared,
and a lot of smart people, what I love to see,
seem to be able to get over the early difficulties
of language and cultural barriers and still share knowledge,
which is fantastic.
Right, but anyway, humoral...
I'm mispronouncing everything.
Humoral medicine is the idea.
We're going to focus on the four,
because that was the most widely accepted,
although again, there was some people, even in ancient Greece,
or ancient Ionia, would say that there were as many as 11 different humours.
The four different humours are each connected with one of the four elements,
yellow bile being fire, black bile being earth,
phlegm being water, and blood being air,
blood being hot and wet, yellow bile being hot and dry for fire,
black bile being dry and cold for earth,
and phlegm just being cold and wet.
The reason why...
I'll tell you what...
OK, so we now know the body is more than this.
And I don't want to just state the questions of,
oh, why do you think these idiots fell for this,
when they were doing the best they flipping could.
Absolutely.
Why do you think...
I don't actually have an answer to this.
I do and I don't, because I don't think my answer to this actually satisfies it.
But why do you think humoral medicine was as popular as it was?
I think it was based on what was clearly visible in and out of the body,
and then knowing that most life itself is satisfied through fluids,
and therefore if you can keep the fluids in balance,
then I suppose the theory was that if the fluids were in balance,
then the body would be in balance.
Well, that's exactly it, yeah.
A lot of ancient natural philosophers realized the importance of fluid.
They noticed that there was a mixture within the world,
and they also...
Yeah, you know what, you hit the nail on the head there, Nick,
when it came to...
Different illnesses would produce different, I don't know, different excretions from the body.
Yeah, I know one therapy that they quite often,
one of the most famous old-timey therapies was the cleansing of the blood,
either through leaching or through bloodletting.
This is one of those practices that was based around humoric medicine,
where it's just trying to bring balance to one of the fluids.
In this case, if there's a fever, a hot blood,
then they would let the blood in order to try and bring balance to that fluid.
That's exactly it, and that's exactly right.
Yeah, the reason why bloodletting was a thing was with fever.
It would be seen as there was too much blood,
so it was just the hopes of removing that bloodletting,
oh, sorry, through bloodletting, removing that type of humor
in the hopes that it would bring the rest of the body into balance,
rather than robbing the body of a needed resource.
Yeah, absolutely right, once again.
Getting a mixture or relieving pressure within the body
does seem to be a thing in old medicine,
drilling holes in people's heads.
Trapanning.
There you go. I'm glad you remembered the name of it, because I'd forgotten.
I remember it from his Dark Materials, their books by Philip Pullman.
One of the characters in that has Trapanning performed on his skull by some shamans.
Does it help him? Honestly.
They don't really go on about how, whether it helps.
Yeah, Trapanning is based around a theory which is exclusive to the books,
so as much as it's a practice that genuinely took place,
and probably still does take place in certain parts of the world,
it wasn't necessarily based around the practices as to why they would use Trapanning.
It was a fictional adaptation.
Okay, that's interesting. Once again, kind of highlighting the importance of education even in fiction.
Well, one of the things that interested me is that Trapanning was picked up briefly in the 1800s
by a French man whose name I can't remember.
Another source would also be the podcast Sawbones with Justin McElroy and his wife,
who's a doctor and is incredibly intelligent, and the fact that I can't remember her name.
That's really going to annoy me now.
We'll call her Dr. McElroy.
Yep, let's go with that.
She goes into this massive, or gives a really good in-depth explanation of this.
A lot of people thought Trapanning, or not a lot of people,
a couple of people who you could argue come under the term quacks,
who believed that Trapanning could release pressure or allow you to achieve enlightenment.
What I do like is that the one guy who came up with this theory,
he did it to other people, but he didn't just do it to other people.
He did it to himself. He Trapanned himself.
He then got institutionalized as a result, but at least he wasn't like,
I'm going to do this to other people, but then secretly...
My question is, did he do it to himself first?
That bit I can't remember.
The reason being is that, there's a couple of points really,
it would make me feel better if his practice run was on himself, morally,
however, it also makes me question the judgment of others
allowing a bloke with a hole in his head to drill a hole in their head.
Well, to be fair, if the person with a hole in their head seemed to be...
I'm going to be honest with you, if there was a bunch of people with holes in their heads
who seemed happier, more collective, more emotionally resilient and resourceful
and genuinely more intelligent, I'd consider it.
I'm not going to say I'd definitely put my hand up and sign me up to the cult,
but I definitely would...
There's definitely something that makes me feel a little bit queasy about it.
It's like the practices that were undertaken by mental health institutions in the US,
like the ice picking, where they aimed an ice pick up the inside of the eye
to try and disconnect a specific part of the brain, I can't remember which part now.
The famous ice pick lobotomy.
Yeah, the frontal lobe, isn't it? They're trying to disconnect the frontal lobe.
Just the thought of that practice makes me close my eyes on the spot.
Sometimes if I'm having one of those lucid moments, I even find myself drilling my hands into my eyes.
It makes me twitch, it makes me cringe, it's horrible.
I worked in a neurological rehab once as a care worker,
and there was a chap that I looked after, no name is named obviously, who was bottled on a train.
Part of his treatment was that he had to have part of his skull cut away by the doctors
to relieve pressure on his brain because his brain swelled up.
So it is still, it's not necessarily trepanning, but it's definitely the release of pressure on the vital organ of the brain.
But obviously it was for a different practice.
So in this case it was to, as I said, relieve pressure on the brain.
Previously it was to allow the demons out and the Holy Spirit in, as it were.
You know, that's, yeah.
Well, that's, it's interesting that it's still done at all.
Bringing back to, I shouldn't have gone into that,
but it's surprising that with medical history it's not just a straight line,
and it's also really surprising that after Hippocrates there's one figure who then brings things forward a little bit,
and then for a long, a huge amount of time just things don't progress.
And I'm going to talk about that in a little bit,
but for now let's take a look at the modern version of the Hippocratic Oath.
I'm going with the modern version because the old one speaks,
well you know what, I'm going to be honest with you, it's very very Greek.
I think anybody who's not of ancient Greece would struggle with it simply because it starts by praising Apollo the physician.
And it mentions a number of the other gods from the Greek pantheon.
The version we're looking at would be the revised version, which was revised, believe it or not, as late as the 1960s.
And there's still debate about whether this document or this oath is relevant,
but a number of physicians still see it as a rite of passage.
And as you've said it's got a number of poignant points in it, so we're going to go through it.
Just so it's not... I'm going to be honest with you mate, how would you feel,
because I sent this to you and it's on the chat that we're sharing,
and I've spent too much time speaking already, how would you feel about reading it out?
Would you be okay with that?
Yeah, absolutely.
Great. So I'll read it out now.
It says, I swear to fulfill to the best of my ability and judgment this covenant.
I will respect the hard-won scientific gains of those physicians in whose steps I walk,
and gladly share such knowledge as is mine with those who are to follow.
I will apply for the benefit of the sick all measures that are required,
avoiding those twin traps of overtreatment and therapeutic nihilism.
I will remember that there is art to medicine as well as science,
and that warmth, sympathy and understanding may outweigh the surgeon's knife or the chemist's drug.
I will not be ashamed to say I know not, nor will I fail to call in my colleagues
when the skills of another are needed for a patient's recovery.
I will respect the privacy of my patients, for their problems are not disclosed to me that the world might know.
Most especially must I tread with care in matters of life and death,
if it is given me to save a life, all thanks, but it may also be within my power to take a life.
This awesome responsibility must be faced with great humbleness and awareness of my own frailty.
Above all, I must not play at God.
I will remember that I do not treat a fever chart, a cancerous growth,
but a sick human being, whose illness may affect the person's family and economic stability.
My responsibility includes these related problems if I am to care adequately for the sick.
I will prevent disease wherever I can, for prevention is preferable to cure.
I will remember that I remain a member of society with special obligations to all my fellow human beings,
those sound of mind and body as well as the infirm.
If I do not violate this oath, may I enjoy life and art, respected while I live, and remembered with affection thereafter.
May I also act so as to preserve the finest traditions of my calling,
and may I long experience the joy of healing those who seek my help.
Okay. All right, so ladies and gentlemen, that is the revised and slightly altered Hippocratic Oath.
Please note that although the first bit of the praising Apollo has been removed,
the main body of the text is still, for the most part, the same,
and a number of the points that are made, although they sound incredibly modern,
are just translations. Translations of things that were said even at the time.
Yeah, one thing that blows me away is just, again,
like holistic medicine quite often sounds almost like alternative medicine,
but it's about looking at the whole person, and the Hippocratic Oath really, in my mind, seems to stress that,
and I'm sure there are problems in there, and I'm sure if I looked at it with a fine-toothed chrome,
I could find a couple of bits to debate on, but for the most part,
I find it very difficult to disagree with what seems to be a wholeheartedly best attempt at,
I will do my best to be humble, to cure people, to consider all the outcomes, and not to be a dick.
It's really hard to disagree with that stuff. What are your feelings on it?
I think there's a lot of responsibility throughout that oath.
I think it's strange to think that every doctor is expected to take the Hippocratic Oath,
and yet I have had doctors which, this isn't exclusive to all doctors, please note,
but there are doctors out there that are almost arrogant in their demeanor,
which is almost contradictory to the oath in its own entirety.
It clearly says you are a member of society, yes, you have special obligations,
but you are still a human being, you are just one with knowledge that can help others,
and as such have responsibility to do so.
It doesn't say in there you are better than other people because you have the ability to save lives,
but I like the points about obviously respecting privacy of patients,
that's something that has obviously been in there since the day dot.
I thought it was quite a new thing with the Confidentiality Act and what not else,
but it's obviously been in there a lot longer for doctors.
The looking for knowledge in other people, as I said earlier in the podcast,
when you don't necessarily know something yourself, accepting that and saying,
you know what, I don't know, I will ask somebody for help.
I think everybody can take a little bit from the Hippocratic oath in their own right.
Absolutely, I love the balance of I will apply for the benefit of the sick all measures that are required,
avoiding the twin traps of over treatment and therapeutic nihilism.
I'm not going to treat for the sake of treating.
Also just the really basic thing, I will not be ashamed to say I don't know, I know not,
nor will I fail to call in my colleagues when it's needed for a patient's recovery.
I think I see a lot of the development of knowledge and the acceptance that knowledge is going to change over time
and accepting that knowledge is going to change over time and develop over time is part and parcel of being a doctor.
The way you treat today may well change in 10, 15 years.
Don't get stuck on old ways if there are better methods and more holistic methods that are implemented as time goes by.
That's it.
Okay, so unfortunately, I think this is a certain thing that I could go through for a while, but I am just going to get moving on.
Okay, so this is the oath that Hippocrates, his corpus or his body of work put down.
There is a lot of problems with the textual criticism of Hippocrates because the dates on all of the documents within the corpus
spread over a time scale, which seems unrealistic for a person to have lived.
There's some, yeah, some people, yeah, some people say that a number of documents in the corpus were added or altered by members of the Hippocratic movement
who weren't Hippocrates himself, but were the students of the people who took stuff from his writing.
And then they've just applied his name to their stuff as their stuff was inspired by his stuff.
See, I find that quite frustrating.
It's quite subjective to implement that as a negative point on his works based on hypothetical knowledge of, there's no way that he could have existed for that long or at that time or whatever.
This was two and a half thousand years ago. You don't know, and I use the proverbial you, of course.
And one thing that it reminds me of quite heavily is the King's List in ancient Egypt.
Pre dynastic kings listed to have lived for thousands of years and people now are like, oh, it's just it's mythological. It's it's completely hypothetical. I'm not saying it existed.
What I am saying is that you have no place to say it didn't because this is thousands and thousands of years ago.
There's no way that you can know how things have changed and how time is maybe maybe perceived differently or or there's any hypothetical scenario that could change the way that they were recording Kings on the King's List or even what enabled may or may have enabled Hippocrates to
live beyond his his fellow peers years, you know.
Yeah, that's absolutely that's absolutely fair.
Although you can prop up a lot of bad theories with that argument that argument that you've made in and of itself is entirely true.
I think we don't know when it comes to second and information. It's it's very difficult to judge at all.
Perhaps I shouldn't have said anything but I was just going you're right.
You're right. You're right to
go both sides. All I was doing was offering my my perspective on that. I think it's quite important to hear both sides but not necessarily to offer an objective opinion for or against.
I think it's important to listen.
The important part, I think that the people seem to miss because of X and Y hypothetical fact is is actually the writings and the teachings which is more than anything, the bit that we should be listening to not the hows and whys and whens.
Look at what was written. That's the bit that was was. That's the bit that's primary like the how the hows and whens is secondary and can perhaps give you further insight.
But in order to have a further insight you first must have basic understanding. Yeah, is that what you're saying. Yeah.
Okay, cool. All right. Well, moving forward about 500 years or so.
We come to a person who is.
Yeah, although Hippocrates is like the
father of medicine. This individual had a huge influence on all scientific.
Well, I say all scientific scientific humorous or humoral medicine, at least.
This guy's name was weird enough he was a Roman and he seems to be one of the
most famous people in the world.
You know what I've poo pooed Rome, a little bit in the past because it turns out a lot of the pre Socrates came up with a lot of their stuff, and then, yeah Socrates Plato and Aristotle were all from the Greek city states, rather than, rather than Roman.
It's a whole empire, but you're going to assimilate knowledge, and then try to take the trotter they claim to it, wherever possible, just to validate your existence and your reign as a global empire.
But I don't think it's a reason to to disregard or go against Romans in general.
I will say though that this is what kind of like this is what really surprised me, because although Rome assimilated knowledge and took several parts of several other cultures, like although they're the administrative and
the unconquerable achievements are incredible. When it comes to what what stuff they made, they didn't really invent or make much.
They reproduced I guess is what I was going, whereas what's really surprising is that with Claudius Galen, he was a Roman.
He made a shit ton of stuff. Like he was a he was a physician. He, I don't know how he lived, but he never charged a fee.
He healed people from all walks of life.
He was both a physician and and a surgeon and an apothecary, which is weirdly enough where you get the term general practitioner from, because those three professions up until recent times were seen as entirely separate.
Well, no, you suppose even now you still I know you get GPs, which are your general doctors, but you get specialists and they tend to specialize in those three areas. You get chemists and you get you get surgeons and you get like physicists.
I can't even think of the right word. Physicians. Physicians. Yeah. Yeah. Yeah. Physicians were seen as kind of like the high and mighty doctors.
Surgeons were seen almost as butchers and apothecaries were quite often seen as mystics. Yeah.
But it's interesting that you do. This guy was all of those. He healed lots and lots of people. But the thing that sets him apart is that he wrote over 600 treatises over the course of his life. And unlike Hippocrates, Galen's writings.
You know what I can't even quote the numbers. I don't know the numbers. I just know all of the subtext from what I've read seems to be that they are all more clearly directly associated with him and are believed or are believed with less dispute or discernment.
Like they all just people go. Yeah, this is this. This is all him. He wrote he so he wrote 600 treatises. The the amount that he wrote was over double the Harry Potter franchise, which although that doesn't necessarily sound particularly impressive nowadays at a time when
every single page costs you money. Ink was expensive. And all of this was scientific observation of different types of disease and different types of human medicine. It's an incredible achievement.
Yeah, absolutely. Absolutely.
The reason why, though, and this is something which this is something which bothered me, and it's I feel I've got to be honest about it, but it's something that I don't don't necessarily like is that what we have of ancient history and ancient science and ancient
everything is solely what's been preserved and what's been preserved has been it's been very selective.
Like I don't know if there were better philosophers than the seven sages of ancient Greece and I don't know if there were better doctors than Galen.
What I don't know is that this is what has survived. The reason why Galen.
The reason why Galen's knowledge was kind of unchallenged and was adopted for well over 1000 years.
It lasted for 1000 years. And, and people didn't advanced further for a couple of different reasons. But unfortunately part of it is the fact that his writings were very popular in amongst the Catholic Church.
His, because he, because Galen when looking at the human body, realizing how all the systems work together. He was a humorous humoral doctor but he also dissected animals, because human dissection was seen as a parent to the Greeks and to later the to
appoint the Roman and then to the to Christendom with dissection only being legalized in 1480s by Pope at the time can't remember which, which one it was though but until 1480s in most Christian Roman Greek countries dissection in and of itself was illegal so if
somebody caught you doing an autopsy, autopsy, they'd almost treat you.
You know, like a murderer like you were doing a crime. So because of that everybody had very limited knowledge.
They missed a trick.
You think of the, the conquest of the Roman Empire.
How many wars they must have had the physicians should have just been with the generals up on the, up on the hill, waiting for the end of the battle and they just go down and see what was left.
It's interesting that you say that you know what I'm going to, you know, I'm going to do this all in the wrong order but you, the fact that you've said that brings up a really interesting fact.
Right. You're absolutely right. It wasn't until the hospital, the large number of hospitals in France opened that this use of observation and large numbers of dead was used as a form of scientific
way of mass gathering of knowledge and of autopsies through the, through the hospitals in Paris.
In the 1800s, medical professionals would do their best to treat patients with whatever they had at the time which was very very limited.
If they died, they'd cut them open and find out what was wrong afterwards. But you're right, they could have done it so much earlier.
Like so much earlier considering the huge amount of death that the, the Romans dealt out.
Well not just the Romans, the Greeks were guilty of it too.
Well they were warring against each other. Exactly. There was, there was the opportunities there for accidental observations of the internals of the human body.
No, you're absolutely right. I wonder if soldiers knew more about the inside of the human body than surgeons did.
Well surgeons cut, did cut people open. So but I would argue that surgeons would know more about the internals of a body than a physician or a apothecary for sure.
You know.
Just another interesting fact which kind of got me. Plato figured out that the brain is where thoughts and feelings happened.
Aristotle debunked him by, because he was a bit of a, well this is possibly unfair, a bit of a sensationalist and he pointed out that when you're truly frightened or when you're truly in love, it's the heart which changes.
Like the beating of the heart physically changes. So he thought that feelings must come from the heart which is why he got that.
But it was, it goes back to Galen who then, through dissection and a few weird, few more of his weirder experiments, proved that, I can't remember how, but he proved that it was the brain again.
And yet, probably through the discovery of the nervous system if I'm honest, you see that interconnection of like cables running from the brain to everything else in the body.
You kind of left with at least a hypothesis that it's the computer of the body as it were.
Well you can understand both as well really, if you think like the physiological reaction to like the adrenal gland kicking in.
Like that, and the flutter in of the heart when you see something that you fancy. You can understand the idea that it came from that end, but likewise you see, think, taste and smell all from the top of your body.
And maybe you can also understand Plato's mentality of like the brain being the hub, the central hub.
Yeah, no that's, yeah, that's fair enough isn't it.
Weirdly enough, just to once again kind of, okay so you had Galen in, Galen died in about 216 AD.
Things got a little bit more chaotic, the Roman Empire broke down, it went massively into decline and the Byzantine Empire was also kind of almost, there were a couple of times when it was reclaimed and stuff but it was mostly declined, things became chaotic.
And then, based on our other discussions and our other discussions throughout like history and stuff. Can you guess where a lot of the, a lot of Hippocrates' and Galen's writings where they ended up going when they became more, when they became rare during the dark ages.
When the old books started just falling apart, the knowledge was lost, the money wasn't there to make new books. Where do you think they went?
I would assume that it went to the Vatican City.
Okay, there was some stuff in the Vatican for sure, for sure.
But funny enough, you're along the right lines, but think about what other monotheistic religion or, in this case, both religion and government kind of rivaled that of Catholicism.
So like, Mecca, that kind of, I can't think of the right place.
You're thinking along the right lines, it's Islam, man.
Islam, yeah.
Yeah, like Islam and once again, like it's really weird when you think about it today.
When you think about Baghdad, you just think of, well, this is really bad, but I'll just say what I think of. I think of war, I think of Saddam Hussein, I think of just kind of, I know this is really bad, but the only images I've seen of it are during wartime.
Yeah, you see the propaganda that is portrayed to give that feeling of desolation and destruction, but Baghdad is probably one of the fewest nations of the old human history that still exists.
Absolutely.
The archaeological sites have been destroyed over the years and their history itself has been destroyed. So all that is left is the sandy desolation that you see portrayed on the news now, but yeah, it's absolutely amazing, or it would have been pre-wartime.
Well, this is it. Like Medina and Baghdad were the places where Islamic scholars who had their own medical traditions and their own ways of doing things.
Like in Western medicine, you have the laboratory and you've got the hospital and the two are often separate. There were a number of hospitals which also acted as centers of learning all throughout the Islamic Golden Age.
Additionally, in Baghdad there was one place, I'm not even going to, I know this is really bad, I'm not going to try, no I'll try.
The House Al-Halmaka, which translates as House of Wisdom, was a library in Baghdad which had just had, it was weird that they translated, they got hold of books from their own conquests, they translated them into Arabic, and then several hundred years later they translated them back into
Latin and yeah, and like it's so it's kind of really interesting that
yeah, the Islamic nation
kind of safe safeguarded a lot of scientific knowledge when it was just kind of being lost.
The Dark Ages were exactly that, they were dark, so much was burned and destroyed. I think one of the safest places it possibly could be is within the Islamic faiths.
Absolutely.
Okay, well moving quickly on. Okay, so one thing I will say is Galen's work was challenged by a number of both Western and Islamic physicians, but nothing ever changed simply because of his popularity, and because of, you know, his work didn't always
his cures didn't always work, but they were the best they had at the time and it was difficult to go against it, there was a kind of it. His work was good but it also had snowballed into popularity and that popularity had almost become a fanaticism within,
yeah, within even intellectual people.
So it's weird that it was the person who disproved
humoral medicine was a gentleman called William Harvey.
You may recognize that name as the hospital in our local area.
Being named after him. Yeah, he was a gentleman who he dissected a lot of animals.
I'm not sure what he, what he did for humans but he dissected a lot of animals looked at the different organs and then actually started doing mathematical equations.
I was believed in humoral medicine that the way digestion worked is that food was transferred into a particular chemical which was then turned directly into blood.
So William Harvey did the maths for it and he found out that our blood vessel would literally rupture, if that was the case. And it's really interesting that he used maths in order to kind of, in order to prove his point, which is why he was able, well, that's one of the small things he did.
He also discovered the circulatory system and did a number of things to do with the heart.
Moving quickly on, after William Harvey, things started to,
yeah, things started to progress in medicine.
Weirdly enough, it wasn't England where a lot, although, no, okay, I'm actually skipping ahead. Okay.
Right, can you, can you tell me when was the first
vaccine?
Oh God.
I thought that the first vaccination would have taken place
18th century.
You're close, is that 1800s or 1700s?
1700s.
18th century is the 1700s.
Yeah.
Okay, you're actually right, you got the right century.
I think it was towards the end of that century though. It's 1796 was the first vaccine.
Was it the same, do you know if it was the same like structure of vaccine now where they obviously vaccinate you with essentially a dead part of the virus?
Similar.
Yeah.
Okay, so this is the weird thing and this is where I'm going to get into it because although I'm going to be honest with you, it was a rivalry between two doctors, two medical, well, two amazing scientists and doctors, one from France, one from Germany who brought about germ theory and brought about
the mainstead of vaccines but the first one was done by an English gentleman called, I think, have I written Edward? So many of my notes are badly written here.
Edward Jenner, who noticed, so at the time, smallpox was the most deadly disease,
ravaging Europe. In Europe alone it was killing 400,000 people a year.
This disease reached even the nobility with five notable monarchs, I haven't remembered their names, succumbing to it over the course of 100 years.
It was just ravaging everywhere.
And then there was a set of people who, and so this is the thing, this was just basic observation, the one set of people who never seem to die from smallpox and never seem to get smallpox, was the milkmaids.
Such a weird observation.
Yeah.
But that's what was going on.
And then, and then Jenner noticed, although the milkmaids didn't ever seem to die of smallpox or ever seem to get smallpox, a number of them did have blisters on their hands with sores which looked slightly similar to smallpox.
And from that, from that one observation, he started thinking that, okay, well, the things they've got on their hands are cowpox.
So if everyone who gets cowpox doesn't seem to die from smallpox, what, you know, what is the worst thing to get? And if I, if I inject somebody with cowpox, will that make them immune to smallpox?
Now the bloke, he didn't have, he had some resources, but he didn't have all the resources in the world. And it was a fairly solid theory because he'd seen, he'd noticed this for a number of years and it had been noticed by the mainstead of society, although, you know, it wasn't a conclusion.
It was just, yeah, yeah, just, you know, it was an oddity.
It was a, huh, that's weird. Move on.
So he did something which has produced incredibly good results, but in and of itself, if it had have gone badly, would have been an evil act.
But there's, there's, there's risk everywhere.
What he did is he took the child of his gardener and injected them with cowpox.
Geez.
Yeah, and this is not like the lot take the bull by the horns.
Yeah, well he took the bull by the horns. It's also annoying. I know this is really bad. But just like just like yourself when we were talking about trepanning.
He didn't do it to himself. He didn't do it to a member of his family. He did it to an indebted servant of his family, which is just a little bit of a right. But you know what?
One more. I don't have time to go into the more immorality of that.
Yeah, I'll test it on somebody who's expendable kind of mentality.
Exactly. Exactly. That's the bit that I really struggle with. But I can't. This is the thing that I can't deny.
I can't deny the results of it. I can't deny that.
You can't justify the end by the means.
Yeah, no. Okay, you know what? That in itself is another podcast.
Yeah, yeah.
Right. Okay, so just really quickly. The kid's name was James fibs. And he.
So this is when he was injected with cowpox. So he's already injected the kid with a disease once several months later.
He injects him with smallpox.
The disease, which is ravaging just to test whether or not he was right or not, just to test whether he was right or not.
Yeah, not not ideal, not very. You know what?
If it wasn't for the result, I would call it a dick move.
I will remember that I do not treat a fever chart or a cancerous growth, but a sick human being.
Exactly. It goes against the Hippocratic Oath massively.
This is the this is the thing, though. It worked.
By injecting people with a small amount of cowpox, it made them immune to smallpox.
And so he did. And so and so he did it with other people.
And he did it with people who weren't children. And he did it with people who weren't this, weren't that, weren't that.
And then my question is, my question is, did the kid get autism?
That's not recorded. Maybe, maybe.
I don't know. I don't think so.
It's it's you know, it's not recorded and he probably would have been apprenticed and been a gardener.
I reckon he would have been fine.
Just to clarify for anybody that was offended there, I'm also autistic.
So don't think for a minute that I actually believe that.
Yeah. But that was the first one.
And that was the first vaccine or the first successful vaccine in 1796.
Yeah, I do find it somewhat hypocritical that
Jenner knowingly injected a child with two diseases and locked out and, you know, is acclaimed with awards.
Yet Typhoid Mary just went around her business working as working as a servant.
And yet, because she was a carrier of a disease, was sentenced to prison.
You know, I just but anyway, that's again, that's another thing.
Right. But did you did you know that although that became a vaccine,
can you guess the amount of time it took for another vaccine to be discovered?
Oh, at least 100 years.
Mate, you are on it today. Well done.
All right. Yeah, not quite, but pretty flipping close.
I would have expected like five years.
You know, I've been spoiled by them by the speed of modern progression.
Eighty nine years. Yeah.
Eighty nine years of we've got a cure for we've got a cure for smallpox.
We inject you with a bit of cowpox.
All right. Can you guess the can you guess the disease that was was next cured by vaccination?
I'm going to go with the flu.
It's not quite. No, not quite.
It was rabies. Oh, oh, yeah.
They came out with a vaccination for rabies.
Next on the list, it was then and it's weird.
You had you had smallpox and then it was eighty nine years.
And then you've got the two the two medical giants, which is Louis Pasteur
and Robert Kroc and their their rivalry produced germ theory
and produced a number of vaccines and a number of just and pasteurized milk,
which Louis Pasteur milk in the world.
Well, you can make it you can make or just kind of showed that
because of microbes, things go wrong.
So if you pasteurize, if you eat something and pasteurize it, then it lasts longer,
which apparently saved the French economy at the time.
But anyway, it was those two who then started
working kind of again, working not side by side, but as rivals against each other,
making all kinds of discoveries, discoveries, the Tesla and Edison of medicine.
That's exactly it. Yeah, they didn't like each other,
but they their work was at the same time they did address each other.
It was cordial and awkward at times.
Yeah, it was it's just interesting that you had you had smallpox,
then nothing happened, then you had rabies, followed by cholera,
followed by
hyphoid.
And then they then they then they then they created a vaccine for the plague.
So those were the first five things to be cured.
Those were the first things which were or the first vaccines that were invented.
But there was an 89 years gap between the first and the second.
Oh, dear. Right. OK.
Running out of time now, but we'll just go through
those. Yeah, those two things.
So I also found it interesting that you had Louis Pasteur and Robert
Koch literally
researching going against each other. You had a number of other
theories, whereas people thought that diseases created microbes
and germs rather than germs causing diseases.
People had loads of ideas for, you know, like it was known that if somebody's
sick, isolation sometimes is a good idea,
which you get from
just a number like things like leprosy, where people would be ostracized from the
community simply to stop the disease spreading.
Yeah, Louis Pasteur was an amazing scientist
and did a lot of did a lot of good things.
But his methods, he would ignore evidence
which didn't support his theories,
which isn't great. Whereas Robert, Robert Koch,
his scientific theories and the way that he did things
was better, but the experiments that he did
were also somewhat, well, you know what, like maybe it's wrong to just look at things
through this way, but he literally took Amfrax and injected it into rats.
Yeah, I mean, there's a means. Yeah.
There's a way of doing things, I suppose.
Yeah, like that's it. It pays the rats back for the black death, doesn't it?
You know, you know what? I hadn't thought about it that way.
Maybe, maybe. OK, but you had.
So with Jenner, the first vaccine being 1796, then you had germ theory kind of really being worked on.
But you had it being created in 1880 or you had it really being cemented in 1885.
You had carbolic disinfectant or carbolic soap being mass produced in 1859.
This might not seem like a massive thing, but before that time,
a lot of surgeons wouldn't bother washing their hands.
In fact, if anything, they wouldn't bother washing their tools because they thought that the more blood
that was stained on their things, it showed to the uninitiated that they knew what they were doing
because they'd cut people open before.
Oh, the naivety of arrogance.
Yeah. Yeah. So like, you know, oh, well, look, you can see that surgeon over there with the rusty saw.
He's far more experienced and knows what he's doing so much more.
I mean, much safer, better hands.
Yeah, he knows exactly how to pass tetanus on to the next person.
Exactly. Exactly. So you had carbolic soap and just a hygiene revolution in the 1800s
or 19th century that saved a huge number of lives.
Yeah, just going quickly through a couple of other dates here.
The first X-ray was in 1897.
Weirdly enough, that wasn't by Mary Curie, who I thought was the first person to use X-rays,
but she was the first person to organize and distribute X-rays to the French troops during the First World War.
And she also discovered palladium, which was later.
You know what? I'm not even going to go into how it was used because it's disgusting how it was used,
but she did a lot of stuff, but it wasn't her who originally did the first X-ray.
After that, during this time, things started to move far more drastically as modern medicine was kind of really came into its fruition.
The first insulin shot was in 1922 and a kid who had type 1 diabetes, who normally only would live for months,
lived an additional 13 years as a result of that.
I think they covered that, didn't they? In Call the Midwife. My partner, my wife watches Call the Midwife,
and I believe they covered the first insulin shot in Call the Midwife.
That's interesting because I thought it was set in the sixth.
You know what? Call the Midwife has actually stretched over generations at this point, so that is quite possible.
Penicillin was discovered and made in 1942.
Yeah, he locked himself in a room for I think it was a month until he made a discovery, the bloke that came up with Penicillin,
by which time mould had started to grow on his plates and food and he started to investigate that.
I mean, you know what? Dedication, I guess.
He was like, I am going to make a discovery. I don't care how long it takes. I will be in this room until I make a discovery.
Well, what can I say? He did it.
He did it. That's fair enough.
The NHS was also founded in 1948, which is where I am going to stop the kind of just veil of successes.
But the NHS was produced mostly out, well, before, OK, so before the NHS, there was the National Insurance Act,
which covered working men for their health care.
If you were a man, if you worked and if you were providing for a family, you would get free health care.
If you were a woman, you wouldn't. If you were a child, you wouldn't.
If you were elderly and no longer working, you wouldn't. You might see the problem with that.
Yeah. Yeah. Yeah.
I mean, it's not quite Inuit. When the elderly are deemed beyond their use in the old Inuit ways, they would just move them outside.
Yeah. Terrible to. Yeah, it's terrible to think, isn't it?
But like with, yeah, well, the National Insurance Act was incomplete.
So the NHS was founded as troops returned from the Second World War, who they felt they had a sense of entitlement,
which to be fair, they should have. They fought for a country and for a government.
They fought. They fought hard. They saw a lot of horrible things and they came back and they expected to be looked after by the England that they had fought for.
Likewise, a lot of people who, well, sorry, a lot of women who had fought or who had like worked in the munitions factories
and done a lot of the jobs that needed to be done whilst the blokes were away at war,
likewise had contributed to the war effort and therefore felt there was this growing sense of entitlement
in amongst the people of England that health care should be covered by the government.
And so even within a Conservative government, there was a scheme that was produced.
And then within a coalition government, the NHS was put forward.
Unfortunately, the NHS covered England and Wales and not yet Scotland, but later kind of rose to do this.
I'm, yeah, before we get into the problems with the modern pharmaceutical companies and with the NHS in its present time,
I am at least for all its problems, I am at least glad that the NHS exists.
Yeah, yeah, I'm definitely with you on that.
Yeah, just the fact that it doesn't, although with the forms, you know what, I won't even go down that one.
No matter who you are, you can seek medical aid and advice.
Like there's a really good video that I started watching, didn't get to the end to before this.
And it was an address from the Conservative Health Minister laying out what the NHS would be.
And I'm going to be honest with you, it was a huge promise.
It was a massive promise. And I also was surprised by, despite the fact that the film was from the 1940s and it was a Conservative Health Minister,
it was completely legible and completely down to earth and frank.
It was a, this will be available. You don't have to use it if you don't want to.
No one's going to force you to, but this is available now.
You will be able to see a doctor for care. There will be no charge for any of this, any consultations.
There will be, and it was just, it was actually kind of really inspiring to see.
Yeah, it was a good speech is all I can say on that.
All right, finally, before we stop, do you have any favourite stories of medical mishaps or medical breakthroughs?
No, I think my favourite story, as I said earlier in the podcast, is how Panacillin was found in, like stumbled across.
And it was the determination of the chap, I can't even remember his name now, who?
Alexander Fleming. Yeah, Fleming, who, it was his grim determination he set out to make a discovery.
He wasn't even sure what discovery he would make.
And yet he locked himself away until he found Panacillin, which I thought was incredible and hilarious at the same time.
Could you imagine somebody going, I'm going to make a discovery and then locking themselves away?
Like a thought is preposterous.
It is, but like the annoying thing is geniuses often are preposterous, you know.
But the problem is the only difference between someone who's, well, often the only difference between someone who's recognised as a genius
and somebody who looks like a crazy person is just that proven usefulness or that proven, markable achievement.
Up until they have that, every genius is just passed aside as weird.
So I don't know, maybe. Yeah, but it is. I definitely I don't think I would discover anything quite as useful as Panacillin if I locked myself in a room.
I, yeah, I don't know. Maybe I'm not.
Yeah, I just I don't think I just don't think I could do it.
No, and I think the fact that he had the belief in himself to to do it and then executed it, it's just incredible.
I one of my favourite medical things is that
as although although although modern medicine was moving forwards, there were several magazine zines out there which would warn people against
because you had a lot of fake medicine mixed in with the real and it wasn't just fake medicine as in
shamanistic rituals or faith healing or anything like necessary along those lines, although I do believe there are I do believe there are
documentations where faith healing has worked, but that is another conversation for another time.
Like there were lots of fake medicines out there. Yeah, but there were placeboic tablets that were distributed under the guises.
Yes, yes, that's exactly it. And charms and things like that that were sold that were supposed to ward off.
The placebo tablets are the ones that I'm going after here.
The first emperor of China took
it was either zinc or lead tablets in order to try and gain immortality.
And die. Yeah, well, it died of lead poisoning.
It was it was either lead or zinc poisoning. The thing that really surprised me is that as late as the 1800s, there were tablets for
Yeah, there were tablets which were these. I can't even remember the exact name of it. There were these there were these blue tech tablets which were being sold as
both an amphrodisiac sorry, aphrodisiac and as a contraceptive.
And as you know, these things were like an all in one thing and these were being sold in England.
And they were lead and zinc tablets. Is that why Viagra is blue?
You know what? I hadn't thought of that. I had not thought of that. But you know what? That would be interesting.
But it just surprises me that like as late as the 1800s,
poison was legitimately being sold on a mass produced scale as medicine.
Yeah, it doesn't surprise me so much. But no, I get I get the I mean everybody wants their own piece, don't they?
Their own bit of the puzzle.
That's it.
Well, on that depressing note, looking forward to the next podcast listeners, if you're still listening, well done for getting through that.
I hope you've learned a thing or two. Hope you've learned a couple of interesting facts from this and had some fun listening along.
Yeah, thanks again to my cousin Emily for a lot of this information.
And yeah, have have good weeks, everybody. Speak to you all again soon. Goodbye from me and goodbye from me.
Thank you.