DOCSLIB.ORG

Department of General Surgery Medical Academy Named After S.I

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Department of General Surgery Medical Academy Named After S.I Department of General Surgery Medical Academy named after S.I. Georgievskiy, The Federal State Autonomous Educational Establishment of Higher Education “Crimean Federal University named after V.I. Vernadsky” Ministry of Education and Science of the Russian Federation For the 3rd year students The text of the lectures and the minimum amount of knowledge necessary for a understanding of the subject material. Topic: Aseptics & Antiseptics in surgery Authors: prof.Mikhailychenko V.Yu, Starykh A.A. 2015 Aseptics & Antiseptics in surgery History of aseptic and antiseptic Empirical asepsis In ancient times, demons and evil spirits were though to be the causes of pestilence and infections. Hippocrates (460-377 BC), the great healer of his time irrigated wounds with wine or boiled water foreshadowing asepsis. Galen (130-200 A.D.), a Greek that practiced medicine in Rome and was the most distinguished physician after Hippocrates boiled his surgical instruments used in the caring of wounded gladiators. The writing of Hippocrates and Galen were the established authority for many centuries. In the early to mid 1800's, people like Ignaz Semmelweis, Louis Pasteur, and Robert Koch introduced us to the world of microorganisms. Since this time, we have witnessed the invention of the first steam sterilizer (1886), the practice of passive and active immunization, and the use of antibiotics. Today, we practice asepsis and sterile technique based on scientific principles. Infection control, asepsis, body substance, and sterile technique should always be a part of patient care at any level. Joseph Lister (5 April 1827 — 10 February 1912) was a Scottish surgeon who picked up the work of Louis Pasteur and used it to change the success rates of surgery. In 1865 Lister read about Pasteur's work on how wine went bad because of microorganisms in the air. Lister was convinced that microorganisms in the air were also the cause of the infections which killed up to half of his patients after they had successfully survived surgery. The open wounds made it easy for the germs to get into the body. Lister had heard that carbolic acid had been used to get rid of a cattle parasite in fields, and to treat sewage. He decided to see if it could also stop wounds becoming infected. He started to clean the wounds of his patients with carbolic acid, and soak the dressings in antiseptic liquid as well. In the years from 1864-66 the death rate for Lister's surgical patients was 45.7%. Between 1867-70, when he introduced his new antiseptic treatment, this fell to 15% Lister in theatre Lister went on to develop an antiseptic spray which was used in operating theatres during surgery to keep the wound clean. This spray was not used for long though, because carbolic acid actually damages the tissues and breathing it in causes many problems. More successful was the special dressings he developed which contained carbolic acid to keep the wound clean but a barrier to keep it away from the flesh so it didn't cause any damage. Lister's work revolutionised surgery once his aseptic techniques were accepted. Although the antiseptics and disinfectants used have changed, aseptic surgery is still the basis of saving millions of lives. Father of Asepsis Gustav Adolf Neuber has been frequently overlooked as the inventor ofasepsis. In 1884 he founded a clinic which used the principles of asepsis to treat each patient. Neuber implemented strict rules and regulations that his apprentices were obligated to follow to ensure the cleanliness of the rooms and instruments. Surgical were required to wash their hands, faces, and arms before entering the operating rooms. The rooms were also isolated from other parts of the building so that no materials could enter or exit the operating rooms. Even the air was sterilized by running through vents that passed the building’s heating system, heating the air and kill bacteria. Furthermore, Neuber used dry, peat aprons when operating on patients which would dry very quickly and would stay sterilized longer than aprons and articles of clothing soaked in antiseptic fluids. In 1886 Neuber published a monograph which described his techniques that kept the environment around the patient sterile. He set the standard for aseptic practice. Neuber’s Followers Ernst von Bergmann of Berlin and his assistant, Curt Schimmelbusch, established their reputations in the field of asepsis in 1890 at tenth International Medical Congress held in Berlin. The congress hosted 7,000 visitors in total from all over the world and Bergmann gave a group of visiting surgeons a tour of their clinic. The tour group was impressed with their demonstrations on the effects of unsterilized instruments, utilizing culture plates to show the manifestation of infection. They wanted to show surgeons that practicing asepsis made a very large difference in the outcome of a surgery. Bergmann even went as far to show off his patients and their wounds from recent surgeries to allow visitors to see how quickly their scars and wounds were healing using the aseptic method. Schimmelbusch also made a name for himself starting a few years after the tenth International Medical Congress, when he invented the “Schimmelbusch drum”, which was a machine used to sterilize wound dressing materials and surgical garb. Perfecting Asepsis Although surgeons washing their hands with soap and/or alcohol was common practice by the 1890’s, the advent of surgical gloves even further decreased the rate of infection in hospitals. Starting in 1842, Thomas Watson suggested the use of surgical gloves during operations, but it wasn’t until the late 1890’s when the trend really caught on. William Stewart Halstead, a surgeon from Johns Hopkins University in Baltimore, MD, started this craze when he had two pairs of gloves made for one of his scrub nurses, who was having allergic reactions to the sublimate hand washed being used in the hospital. Eventually, the rest of the surgical team started wearing gloves too, and by 1897, all of the surgeons at Hopkins were wearing rubber gloves. Soon the whole nation was wearing gloves to prevent infection. Modern methods of asepsis and antisepsis includes: thermal sterilization methods (autoclave), ultraviolet and x-ray, Chemical antiseptics, antibiotics, etc. Aseptics & Antiseptics in surgery Topics: Introduction - difference between aseptics and antiseptics. Aseptics - definition, aseptic processes. o Sterilization - . Definitions - sterilization & sterility. Measures of sterilization - physical & chemical. Difference between sterilization of dry heat or moist heat. Methods of sterilization control - physical, chemical, & bacteriological. o Sanitization / Disinfection. o Condition of surgical room. o Surgeon’s hands preparation and protection. o Measures for patient’s protection. Antiseptics - definition, types (mechanical, physical, chemical, biological, & mix), remedies. Introduction: The adjectives, aseptic & antiseptic, are partly synonymous, but something that is antiseptic kills bacteria inside the living organism, while something aseptic is “surgically clean or sterile”. (Sepsis is the state of putrefaction or decay. While asepsis is the absence of contaminants). Asepsis is the state of being free from disease-causing/harmful contaminants (such as bacteria, viruses, fungi, and parasites) or, preventing contact with microorganisms. The term asepsis also often refers to those practices used to promote or induce asepsis in an operative field in surgery or medicine to prevent infection. Ideally, a field is "sterile" — free of all biological contaminants, not just those that can cause disease, putrefaction, or fermentation — but that is a situation that is difficult to attain. However, elimination of infection is the goal of asepsis, not sterility. Antiseptics are antimicrobial substances that are applied to living tissue/skin to reduce the possibility of infection, sepsis, or putrefaction. 2 types / sources of surgical infection are differentiated: 1. Exogenous – source is located in the external medium. 2. Endogenous – source is located in patient’s body. The decisive role (main role) in fighting against endogenous infection is given to antisepsia, for fighting exogenous infestation is used asepsia. Antisepsia ⇒ fighting against Endogenous infection. Asepsia ⇒ fighting against Exogenous infestation / infection (prevention) The main ways of achieving this are: . the washing of hands . adherence to antiseptic and asepsis rituals . aggressive attention to basic surgical principles . compliance with antibiotic guidelines . patiently accepting the measures that are necessary to prevent the spread of resistant organisms . the adoption of universal precautions to prevent diseases due to blood-borne viruses. Aseptics Definition - Aseptic (Greek a – negation + septicas – purulent) – is a complex of prophylactic / preventive measures, which prevent the contamination of wounds, tissues, organs with pathogenic germen’s colonies, from exogenous sources, during surgical interventions and other medical manipulations. (Aiming at the complete exclusion of harmful microorganisms). Aseptic process includes: 1. Instruments’, materials’, and equipment’s’ sterilization. 2. Scrubbing surgeon’s hands. 3. Respecting some rules and processes during the interventions. 4. Effectuation / accomplishment of some special sanitary-hygienic and managerial procedure measures in curative institutions. Sterilization Definitions- Sterilization is a procedure which destroys all the existing forms of microorganisms,
Load more

Recommended publications
  • The Agnew Clinic, an 1889 Oil Painting by American Artist Thomas Eakins
    Antisepsis and women in surgery 12 The Gross ClinicThe, byPharos Thomas/Winter Eakins, 2019 1875. Photo by Geoffrey Clements/Corbis/VCG via Getty Images The Agnew Clinic, an 1889 oil painting by American artist Thomas Eakins. Universal History Archive/UIG via Getty images Don K. Nakayama, MD, MBA Dr. Nakayama (AΩA, University of California, San Francisco, Los Angeles, 1986, Alumnus), emeritus professor of history 1977) is Professor, Department of Surgery, University of of medicine at Johns Hopkins, referring to Joseph Lister North Carolina School of Medicine, Chapel Hill, NC. (1827–1912), pioneer in the use of antiseptics in surgery. The interpretation fits so well that each surgeon risks he Gross Clinic (1875) and The Agnew Clinic (1889) being consigned to a period of surgery to which neither by Thomas Eakins (1844–1916) face each other in belongs; Samuel D. Gross (1805–1884), to the dark age of the Philadelphia Museum of Art, in a hall large surgery, patients screaming during operations performed TenoughT to accommodate the immense canvases. The sub- without anesthesia, and suffering slow, agonizing deaths dued lighting in the room emphasizes Eakins’s dramatic use from hospital gangrene, and D. Hayes Agnew (1818–1892), of light. The dark background and black frock coats worn by to the modern era of aseptic surgery. In truth, Gross the doctors in The Gross Clinic emphasize the illuminated was an innovator on the vanguard of surgical practice. head and blood-covered fingers of the surgeon, and a bleed- Agnew, as lead consultant in the care of President James ing gash in pale flesh, barely recognizable as a human thigh.
    [Show full text]
  • Cardiac Surgery
    Gerhard Ziemer Axel Haverich Editors Cardiac Surgery Operations on the Heart and Great Vessels in Adults and Children 123 Cardiac Surgery Gerhard Ziemer Axel Haverich Editors Cardiac Surgery Operations on the Heart and Great Vessels in Adults and Children Editors Gerhard Ziemer Axel Haverich Department of Surgery HTTG - Surgery The University of Chicago Medizinische Hochschule Hannover Chicago, IL Hannover USA Germany ISBN 978-3-662-52670-5 ISBN 978-3-662-52672-9 (eBook) DOI 10.1007/978-3-662-52672-9 Library of Congress Control Number: 2017939170 © Springer-Verlag Berlin Heidelberg 2017 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made.
    [Show full text]
  • Sterilisation
    ZENTRAL D 2596 F 2010 Avril Année/Año 18 RSevue inTternatiEonale RILISATRevisIta inOternacionaNl c oncernant la stérilisation Suppl.1 sobre la esterilización Technique : état des lieux – Concepts pour l’avenir FORUM International Dispositifs Estado de la técnica: Médicaux et Procédures Conceptos para el futuro Vérification des paramè- tres des performances FORUM Internacional de Productos Verificación de los pará- metros de rendimiento Médicos y Procedimientos Qu’est-ce que nous pou- vons à vrai dire certifier ? ¿Qué es lo que se puede realmente certificar? Qu’est-ce qui est néces- saire, qu’est-ce qui est possible ? ¿Qué se necesita? ¿Qué es Le meilleur sur une posible? période de 10 ans Gestion des instruments Gestión del instrumental Lo mejor de los Réglementation des últimos 10 años unités des stérilisation : Prétentions et contra- dictions Sistema de regulación CEYE: Aspiraciones y contradicciones Prévention Prevención Contrôle des processus Controles en proceso Utilisateurs et experts Usuarios y expertos Retraitement – Prière de rester simple ! ¡Reprocesamiento, pero por favor sencillo! 0_Titel_ZT_Suppl1_10.indd 1 21.04.10 19:17 U2_Forumseite 21.04.2010 13:12 Uhr Seite 1 Prof. Dr. Peter Heeg Rédacteur en chef EDITORIAL Redactor jefe FORUM International Dispositifs Médicaux et Procédés : Le meilleur sur une période de 10 ans ! FORO Internacional Productos Médicos y Procedemientos : ¡Lo mejor de los últimos 10 años! es 10 dernières années ont apporté non seulement une nouvelle n estos diez últimos años hemos asistido no sólo a una nueva di- Lfaçon de voir le retraitement des dispositifs médicaux orienté Emensión del reprocesamiento de los productos sanitarios orientada vers les processus de retraitement, mais ont également permis, grâce al proceso, sino también a numerosos pasos para mejorar nuestros à de nombreux petits pas, l’acquisition de nouvelles connaissances, conocimientos, las estructuras y la seguridad de los pacientes.
    [Show full text]
  • FORUM Panamericano Dispositos Medicos Procesos Relacionados
    Fifth edition ● Quinta edición FORUM PanAmericano 5 Dispositivos Médicos y Procesos Relacionados – desde 2016 International FORUM Medical Devices & Processes since 1999 ¿Estéril, pero no limpio? Sterile, but not clean? www.mhp-medien.de Investigation & Application Investigación & Aplicación VISUALLY INSPECT WITH REMARKABLE CLARITY The FIS includes a distal �p composed of a light source and camera lens at the end of a 110cm flexible sha�, which features gradua�on marks. The Flexible Inspec�on Scope is a perfect tool to get a visualiza�on of any poten�ally soiled device. So�ware is included and allows viewing and recording. FIS-005SK 110CM LONG 2.0MM DIAMETER FIS-006SK 110CM LONG 1.3MM DIAMETER HEALTHMARK OFFERS MANY OPTICAL INSPECTION TOOLS TO SUIT YOUR NEEDS MAGIC TOUCH HANDHELD MADE IN AMERICA 4X LED MAGNIFIER MULTI-MAGNIFIER MAGNIFIER MAGNIFIER HEALTHMARK INDUSTRIES CO. | HMARK.COM | 800.521.6224 | [email protected] FORUM PanAmericano 1/2020 1 Editorial Sterile but not clean: Florence Nightingale searched for evidence Estéril, pero no limpio: Florence Nightingale buscada la «evidencia» a esterilización se remonta a la obra de Louis Pasteur y también a la terilization is attributed to the discoveries of Louis Pasteur but credit Lde Florence Nightingale, una mujer británica nacida en la Toscana y Sfor this is also often given to the British nurse, Florence Nightingale, formada en un hospital alemán cerca de Düsseldorf (Kaiserswerth who was born in Tuscany, trained among other places at a German 1850/51) que trabajó para el imperio colonial británico en el siglo XIX. A hospital in Düsseldorf (Kaiserswerth 1850/51), and worked in the service través de sus viajes y de su experiencia posterior en la Guerra de Crimea of the British Empire during the 19th century.
    [Show full text]
  • UNIVERSITÄTSKLINIKUM HAMBURG-EPPENDORF Die Darstellung Der
    UNIVERSITÄTSKLINIKUM HAMBURG-EPPENDORF Zentrum für Anästhesiologie und Intensivmedizin Prof. Dr. med. Alwin E. Goetz Klinik und Poliklinik für Anästhesiologie Prof. Dr. med. Christian Zöllner Die Darstellung der Anästhesie in gängigen Lehrbüchern der Chirurgie in Deutschland von 1846 bis in die 1950er Jahre Dissertation zur Erlangung des Grades eines Doktors der Medizin an der Medizinischen Fakultät der Universität Hamburg. vorgelegt von: Anna Hofmann aus Coburg Hamburg 2017 Angenommen von der Medizinischen Fakultät der Universität Hamburg am: 28.03.2018 Veröffentlicht mit Genehmigung der Medizinischen Fakultät der Universität Hamburg. Prüfungsausschuss, der/die Vorsitzende: Prof. Dr. Michael Goerig Prüfungsausschuss, zweite/r Gutachter/in: PD Dr. Rebecca Schwoch 2 Inhaltsverzeichnis 1 Einleitung .............................................................................................................. 7 1.1 Stand der Forschung und Fragestellung ....................................................... 8 1.2 Methoden ...................................................................................................... 9 2 Die ersten 100 Jahre der modernen Anästhesie - ein historischer Abriss ......... 12 2.1 Von Äther und Lachgas - Der Beginn der modernen Anästhesie ............... 12 2.2 Das Aufkommen des vermeintlich gefahrlosen Chloroforms und wieder zurück zum sicheren Äther .................................................................................... 14 2.3 Alternativen zur inhalativen Narkose werden entwickelt ............................
    [Show full text]
  • People Teaching Research People Teaching Research
    PEOPLE TEACHING RESEARCH PEOPLE TEACHING RESEARCH Charité — excellence in health care CHARITÉ OFFERS OUTSTANDING HEALTH CARE. CHARITÉ’S STAFF MEMBERS DELIVER CLINICAL CARE, RESEARCH, AND TEACHING TO THE HIGH­ EST INTERNATIONAL STANDARD. ALL OF THEIR EFFORTS COMBINE EXCEPTIONAL EXPERTISE WITH SOCIAL RESPONSIBILITY. 1 Foreword 6 2 From ‘pest house’ to Europe‘s largest university hospital 8 More than 300 years of making people our purpose — insights into the history of Charité 9 Charité today — a leading health care organization with a social conscience 16 3 Medicine in all its facets — Charité‘s pillars of excellence 24 Highest standards of medical care 25 Nursing competence 28 Excellence in research 30 Cutting-edge concepts in teaching and learning 33 4 Health care priorities and research foci with international recognition 36 Neuroscience 37 Oncology 40 Regenerative therapies 42 Cardiology 45 Immunology 48 Genetics 50 5 Charité‘s strategic networks 52 Cooperative projects with industrial partners — from research innovation to practical application 53 Truly international 55 Charité Foundation — promoting innovation 57 World Health Summit — bringing experts together 59 Berlin Institute of Health — a model facility for translational research 62 6 Charité in numbers 64 Organogram 66 Content 5 1 Foreword Charité — Universitätsmedizin Berlin, which recently marked its 300-year anniversary, Welcome to Charité. For over 300 years, within the social care arena. Aside from is now the largest university hospital in Europe. Throughout its history, Charité has been we have been attracting people and interest, being responsible for the well-being of its dedicated to research, teaching, and medical care. We hope that our brochure ’People — not simply from within the Berlin area and patients, Charité is also actively involved in the rest of Germany, but also from all over supporting victims of violence.
    [Show full text]
  • Asepsis and Bacteriology: a Realignment of Surgery and Laboratory Science
    Med. Hist. (2012), vol. 56(3), pp. 308–334. c The Author 2012. Published by Cambridge University Press 2012 doi:10.1017/mdh.2012.22 Asepsis and Bacteriology: A Realignment of Surgery and Laboratory Science THOMAS SCHLICH∗ Department of Social Studies of Medicine, McGill University, 3647 Peel Street, Montreal, Quebec, H3A 1X1, Canada Abstract: This paper examines the origins of aseptic surgery in the German-speaking countries. It interprets asepsis as the outcome of a mutual realignment of surgery and laboratory science. In that process, phenomena of surgical reality were being modelled and simplified in the bacteriological laboratory so that they could be subjected to control by the researcher’s hands and eyes. Once control was achieved, it was being extended to surgical practice by recreating the relevant features of the controlled laboratory environment in the surgical work place. This strategy can be seen in the adoption of Robert Koch’s bacteriology by German-speaking surgeons, and the resulting technical changes of surgery, leading to a set of beliefs and practices, which eventually came to be called ‘asepsis’. Keywords: Asepsis, Antisepsis, Surgery, Bacteriology If he were a surgeon, the laboratory scientists Louis Pasteur wrote in 1878, he would not only clean his instruments thoroughly, ‘but after having cleaned my hands with the greatest of care, I would subject them to rapid flaming’. Pasteur did this in his laboratory with all objects that came into contact with his microbial cultures, in order to avoid contamination. Furthermore, he ‘would use only lint, bandages and sponges previously exposed to air temperatures of 130–150 ◦C and use water that had been heated to temperatures of 1 110–120 ◦C’.
    [Show full text]
  • Geschichte Der Pharmazie
    ISSN 0939 - 334X | 69. Jahrgang | November 2017 | 4 Geschichte der Pharmazie DAZ Beilage | Redaktion Prof. Dr. Wolf-Dieter Müller-Jahncke | Prof. Dr. Christoph Friedrich EDITORIAL Xyla et Lineamenta Im Frühjahr 2018 veranstaltet die Deut- sche Gesellschaft für Geschichte der Phar- mazie e. V. ihre pharmaziehistorische Bi- ennale vom 6. bis 8. April in der über tau- medicamentosa send Jahre alten, geschichtsträchtigen, einstigen Reichsstadt Lindau (Bodensee). Imprägnierte oder präparierte Verbandstoffe Aus einem Frauenkloster auf der „Insel der Linden“ hervorgegangen, fügt sich Lindau mit der Klosterinsel Reichenau und dem Kloster Sankt Gallen in den Ka- Ursula Lang | Die neunte Auflage der 1870er-Jahren richtungsweisend non der Formierung europäischer Kultur Vorschriftensammlung Hagers zur Entwicklung, Herstellung, Prü- und akademischer Bildung im mittelalter- Pharmazeutisch-technisches Manu- fung und dem Vertrieb antisepti- lichen Bodenseeraum. Lindau bietet damit aus dem Jahr 1931 bietet Ein- scher Verbandstoffe bei, bearbeite- den idealen Ort, um sich der Entwicklung ale der Pharmazie vom Handwerk zur Wis- blick in die heute überholte Herstel- ten chemische, technologische und senschaft zu widmen, gleichsam flankiert lung von Verbandstoffpräparaten in analytische Fragenstellungen und von Zeugnissen abendländischer Pharma- öffentlichen und klinischen Apothe- setzten sich dafür ein, Patienten mit zie wie dem rekonstruierten Gärtlein des Walahfried Strabo (um 808–849), des ken. Der Abschnitt „Verbandstoffe“ qualitativ hochwertigen Verband-
    [Show full text]
  • Disinfectants Used in Stomatology and SARS-Cov-2 Infection
    Published online: 2021-03-10 THIEME 388 Review Disinfectants Article against SARS-CoV-2 Stawarz-Janeczek et al. Disinfectants Used in Stomatology and SARS-CoV-2 Infection Magdalena Stawarz-Janeczek1 Agata Kryczyk-Poprawa2 Bożena Muszyńska3 Włodzimierz Opoka2 Jolanta Pytko-Polończyk1 1Department of Integrated Dentistry, Faculty of Medicine, Address for correspondence Agata Kryczyk-Poprawa, PhD, Department Jagiellonian University Medical College, Kraków, Poland of Inorganic and Analytical Chemistry, Faculty of Pharmacy, Jagiellonian 2Department of Inorganic and Analytical Chemistry, Faculty of University Medical College, Medyczna 9 Street, 30-688 Kraków, Poland Pharmacy, Jagiellonian University Medical College, Kraków, Poland (e-mail: [email protected]). 3Department of Pharmaceutical Botany, Faculty of Pharmacy, Jagiellonian University Medical College, Kraków, Poland Eur J Dent 2021;15:388–400 Abstract Effective disinfection is a basic procedure in medical facilities, including those conduct- ing dental surgeries, where treatments for tissue discontinuity are also performed, as it is an important element of infection prevention. Disinfectants used in dentistry and dental and maxillofacial surgery include both inorganic (hydrogen peroxide, sodium chlorite-hypochlorite) and organic compounds (ethanol, isopropanol, peracetic acid, chlorhexidine, eugenol). Various mechanisms of action of disinfectants have been reported, which include destruction of the structure of bacterial and fungal cell mem- branes; damage of nucleic acids; denaturation of proteins, which in turn causes inhi- bition of enzyme activity; loss of cell membrane integrity; and decomposition of cell components. This article discusses the most important examples of substances used as disinfectants in dentistry and presents the mechanisms of their action with par- ticular focus on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
    [Show full text]
  • A Luta Contra a Dor E O Sofrimento Uma Perspetiva Histórica Da Humanidade Joaquim J
    Dor História Evolução A LUTA CONTRA A DOR E O SOFRIMENTO Uma perspetiva histórica da Humanidade Joaquim J. Figueiredo Lima Apoio DEDICATÓRIA Esta obra é dedicada à Associação Portuguesa para o Estudo da Dor (APED), a José Luís Portela, João Santos Pereira e a Beatriz Pereira Gomes pelo contributo para a evolução da Medicina da Dor em Portugal e pela Amizade. AGRADECIMENTO A Maria Glória Santos pelo incentivo e colaboração. 1 2 Amputação em Gettysburg. Julho de 1863. National Archives Records Adm. US. en.wikipedia.org. “No disCOVERY EVER MADE IN MEDICINE HAS PROVEN MORE BENEFICIAL TO THE HUMAN RACE THAN THE DISCOVERY OF ANAESTHESIA, NOT ONLY BECAUSE IT HAS ALLEVIATED THE FEARFUL PAINS OF SURGERY, BUT ALSO BECAUSE THE WHOLE STRUCTURE OF MODERN MEDICINE HAS DRAWN STRENGTH FROM ITS SUCCESS AND SURGERY IT SELF HAS BEEN ABLE TO ACCOMPLISH, WITH ITS AID, A GREATER ADVANCE IN THE LAST CENTURY THAN IN ALL PRECEDING MILLENia!” Armstrong Davidson, 1959 3 INTRODUÇÃO “HUMAN BEINGS AND THEIR SOCIETIES RUN ON GOOD STORIES, NOT SCIENTIFIC REPORTs!” Steven B. Harris, 1992 As primeiras tentativas para aliviar o sofrimento e a dor perdem-se nos confins dos tempos da humanidade! Recuperar e catalogar procedimentos, invenções, desco- bertas, tradições e atitudes, significa remexer na poeira da noite dos séculos, referenciando-as, por vezes, sem grande rigor científico e, ainda, rotular personalidades, que contri- buíram para a construção de um caminho, de forma exage- rada ou, quiçá, injusta. 4 Meditar sobre esta evolução temporal, que levou ao estado em que hoje nos encontramos (alívio do sofrimento, res- peito pela dignidade e pelos valores éticos, legais e morais do ser humano, diferenciação tecnológica, imunologia, clo- nagem e manipulação genética, medicina de urgência, de emergência e de catástrofe, etc.), permite-nos assumir um grande respeito por aqueles que, nas suas épocas, foram pioneiros na busca das miragens que acreditaram poder, efetivamente, existir.
    [Show full text]
  • Aus Der Fakultät Für Medizin Der Universität Regensburg Professor Dr
    AUS DER FAKULTÄT FÜR MEDIZIN DER UNIVERSITÄT REGENSBURG PROFESSOR DR. MED. HABIL. DR. PHIL. WERNER E. GERABEK GESCHICHTE DER MEDIZIN DER GYNÄKOLOGE ALFRED HEGAR (1830-1914) LEBEN UND WERK Inaugural – Dissertation zur Erlangung des Doktorgrades der Zahnmedizin der Fakultät für Medizin der Universität Regensburg vorgelegt von Gianna Köper 2017 AUS DER FAKULTÄT FÜR MEDIZIN DER UNIVERSITÄT REGENSBURG PROFESSOR DR. MED. HABIL. DR. PHIL. WERNER E. GERABEK GESCHICHTE DER MEDIZIN DER GYNÄKOLOGE ALFRED HEGAR (1830-1914) LEBEN UND WERK Inaugural – Dissertation zur Erlangung des Doktorgrades der Zahnmedizin der Fakultät für Medizin der Universität Regensburg vorgelegt von Gianna Köper 2017 Dekan: Prof. Dr. Dr. Torsten E. Reichert 1. Berichterstatter: Prof. Dr. Dr. Werner E. Gerabek 2. Berichterstatter: Prof. Dr. Dr. Peter Proff Tag der mündlichen Prüfung: 24.01.2018 Inhaltsverzeichnis 1. Einleitung 8 1.1 Über diese Arbeit 8 1.2 Methodik 9 1.2.1 Quellensuche 9 1.2.2 Forschungsstand 10 1.2.3 Spurensuche in Freiburg 13 1.3 Ziel dieser Arbeit 15 2. Der Lebenslauf Hegars 15 2.1 Die Familie von Alfred Hegar 15 2.2 Ausbildung zum Mediziner 16 2.3 Arbeit und Leben in Freiburg 17 2.3.1 Hegar als Arzt und Lehrer 17 2.3.2 Hegar als Mensch 21 2.4 Korrespondenz zwischen Alfred Hegar und Wilhelm Alexander Freund 21 3. Gynäkologie zu Hegars Zeit 28 3.1 Medizinische Entwicklung 28 3.2 Oberrheinische Gesellschaft für Gynäkologie und Geburtshilfe 35 4. Medizinische Werke Hegars 36 4.1 Operative Gynäkologe mit R. Kaltenbach, 1874 37 4.1.1 Inhalt und Aufbau 37 4.1.2
    [Show full text]
  • Hygiene Und Infektionsschutz Auf Schiffen Der Kaiserlichen Marine
    Aus dem Institut für Geschichte, Theorie und Ethik der Medizin der Heinrich-Heine-Universität Düsseldorf Direktor: Univ.-Prof. Dr. med. Heiner Fangerau Hygiene und Infektionsschutz auf Schiffen der Kaiserlichen Marine Dissertation zur Erlangung des Grades eines Doktors der Medizin der Medizinischen Fakultät der Heinrich-Heine-Universität Düsseldorf vorgelegt von Sarah Barbara Sander geb. Kavajin 2016 Als Inauguraldissertation gedruckt mit Genehmigung der Medizinischen Fakultät der Heinrich-Heine-Universität Düsseldorf Gez.: Dekan: Univ.-Prof. Dr. med. Joachim Windolf Erstgutachter: Univ.-Prof. Dr. med. Dr. phil. Alfons Labisch M.A. Zweitgutachter: PD Dr. med. Roland Schulze-Röbbecke ~ Für meine Familie ~ Barbara Kavajin Dr. med. Zoran Kavajin Dominik Kavajin ~ In memoriam ~ Flottenarzt a.D. Prof. Dr. med. Dr. h.c. Hans Schadewaldt Teile dieser Arbeit wurden veröffentlicht: Kavajin, Sarah B. (2013): Hygiene auf Fahrzeugen der Kaiserlichen Marine. In: Jahrbuch 2013 der Deutschen Gesellschaft für Schiffahrts- und Marinegeschichte, Berlin, 60-67. Zusammenfassung Der historische Rahmen dieser Arbeit wird durch das deutsche Kaiserreich (1871-1918) und die aufgrund von Flotten- und Kolonialpolitik aufstrebende Kaiserliche Marine gebildet. In wenigen Jahrzehnten erfolgte der Wandel von der hölzernen Segelfregatte zum Panzerschiff. Die Heimatgewässer wurden, besonders mit Einrichtung der Kolonien, immer häufiger verlassen. Vor diesem Hintergrund sollen die vier wichtigsten gesundheitlich-hygienischen Versorgungsfaktoren, Belüftung, Trinkwasserversorgung, Reinigung, Prävention und Behandlung von Infektionskrankheiten auf einem (Kriegs-)Schiff jener Zeit untersucht werden. Ziel ist eine Darstellung der sanitätsdienstlichen und versorgungstechnischen Verhältnisse und Maßnahmen an Bord. Parallel zum technischen und medizinischen Fortschritt wandelten sich auch die Gegebenheiten auf den Schiffen. Richtlinien und Vorgehensweisen im sanitätsdienstlichen Alltag an Bord wurden deshalb laufend überarbeitet und neu angepasst.
    [Show full text]