GREAT DISCOVERIES

INTRODUCTION

Unable to provide effective treatment (drugs), 19th-century

medicine focused on disease prevention through vaccines and
medical and public hygiene (hygienist movement, prevention
policies). Nevertheless, the 19th century was a century of
discoveries and revolutions, and the sciences benefited
greatly from this effervescence, with spectacular advances in
medicine and therapeutics, more significant than in any
previous century.
 HYGIENE
The main principles of hygiene have been known since ancient
times. Bathing was practiced by the Egyptians, Hebrews, Assyrians,
Persians and Chinese. It was often performed during religious
ceremonies as a symbolic gesture of purification.

Hammams developed in Arab-Muslim cities

after the advent of Islam in the 7th century, as
religious precepts recommended meticulous
hygiene. The practice of hammam, associated
with the geographical expansion of Islam,
continued over the centuries.
By the end of the 15th century, public baths in
Europe had acquired a bad reputation and were
gradually closing down. They were accused of being
hotbeds of disease transmission (plague, syphilis).

From the 19th century , knowledge of the human body and disease
transmission became more precise. Water was no longer feared. On
the contrary, it became the basic element of good hygiene. Scientists
and doctors formulated recommendations such as hand washing and
daily cleansing with soap and water.
French physician Villermé and the Englishman Chadwick,
using medical statistics, were the first to note the
precarious health of working-class and poor populations
and to encourage legislation, giving the hygiene movement
a political foundation.

The end of the century saw the development of bathrooms

and toilets in housing, with the development of water in
homes.
 Asepsis
Ignace Philippe Semmelweis, a Hungarian
physician (1818-1865), advocated asepsis
in obstetrics. Before Pasteur, he
recognized the infectious nature of
puerperal fever. Ignace Philippe
Semmelweis observed that students
moved from cadaveric dissection rooms
to delivery rooms without taking any
particular precautions.
 Asepsis

He noticed that cadaveric odors were

being exhaled from the hands of
professors, assistants and students
performing dissections on cadavers, and
concluded that there must be an
"INVISIBLE AGENT" causing death, and
that transferring this agent from the
autopsy room to the delivery room
should be avoided.
In 1847, he prohibits medical students from leaving
dissection rooms without having washed their hands, which
immediately leads to a significant drop in mortality rates,
from 12% to 3%. He extended his disinfection formalities to
anyone who had come into contact with a patient, surgical
instruments or dressings, and ordered the isolation of sick
women: mortality fell to 1%.

Semmelweis reported his observation to his mentor Klin,

who was also instructed to wash his hands systematically.
Klin considered this ridiculous and dismissed Semmelweis in
March 1849.
 Puerperal fever:An infectious disease (caused by
streptococcus) that occurs after childbirth.Antibiotics have
practically eliminated this disease.
After Pasteur's discoveries, compliance with hygiene rules,
in the bacteriological sense of the term, becomes an urgent
necessity.

Hospitals were equipped with sterilization equipment. The

entire chain of contamination was addressed, starting with
waste. Washing rooms became widespread.
Ovens for disinfection were developed: the Poupinel and
the autoclave. Dr. Poupinel develops the first dry-heat
sterilizer (170°C). Terrillon and Terrier introduce the
autoclave in 1888.
 Antiseptic treatment

Joseph Lister (1827-1912)He

used phenic acid as a compress
and spray. This technique
enabled him to reduce mortality
from 60% to 15% for exposed
fractures. But it took 15 years
for the technique to gain
widespread acceptance.
 Vaccination

Edward Jenner 1796

It all began at the end of the 18th century, when it was
discovered that farmers who came into contact with bovines
infected with "vaccinia" (cowpox) and who had contracted
the disease, never caught "human variola".
It seemed that vaccinia, which is benign for both animals
and humans, protected against this much more serious and
highly contagious disease.
 Vaccination
In 1796, Edward Jenner, an English rural
physician, was inspired by this simple
observation to take some pus from the
pustule of a peasant woman suffering
from vaccinia and inoculate an 8-year-old
child, James Phipps. The child was only
slightly affected. The process was called
variolization. It wasn't until Louis
Pasteur's experiments a hundred years
later that vaccination was really used.
 Louis Pasteur, 1822-1895.Professor at the
Lille Faculty of Science. He made a crucial
discovery: yeasts are the living organisms
responsible for fermentation.He suggested
heating wine to 57°C to kill the germs, thus
solving the problem of preserving wine:
pasteurization.
By 1879, he had succeeded in isolating and
cultivating the microbe that caused the disease.
When he injected a very small quantity of these
preparations under the skin of a chicken, the
animal died within a few hours.

One day, wanting to repeat his experiment, he used an old culture

that had been left out in the air for a whole week. To his great
surprise, he found that the chickens only became slightly affected and
then recovered.
Pasteur then inoculated other cultures which killed all the
inoculated chickens except those who had already recovered
from the injection of the old forgotten preparations.

Pasteur realized that chickens infected with

cultures of "attenuated" microbes
developed defenses that enabled them to
combat these same microbes when they
were still in full virulence. He named his
process "vaccination" in homage to Jenner's
discoveries.
He then applied it to other diseases: rabies. He
began his rabies research in 1880, and found
that infected, desiccated spinal cord protects
dogs from the disease.

On June 6, 1885, Pasteur received a visit from a lady whose son

"Joseph" had been bitten by a dog suspected to have rabies. He began
injections and 3 months later, the child was saved. Pasteur presented
his work to the Académie des Sciences.In 1888, the Academy
proposed the creation of a facility to treat rabies after bites: the
Institut Pasteur.
1894: creation of the Institut Pasteur d'Algérie.
 PAIN MEDICATIONS

Morphinics Somniferous opium (Papaver

somniferum L, Papaveraceae) induces
sleep and has narcotic and analgesic
properties.
It is considered a narcotic.Source of
alkaloids: morphine, codeine, thebaine,
papaverine...
 PAIN MEDICATIONS

Morphine

The first efforts to isolate morphine were made by Jean-François

Derosne, who in 1803 succeeded in isolating a salt, Derosne's salt, a
mixture of narcotine and morphine. In 1806, another French chemist,
Armand Seguin, succeeded in separating morphine, but did not publish
his discovery.

The German pharmacist Friedrich Wilhelm Sertürner showed that

morphine was combined with opium in the form of the meconic acid
salt, and gave it the name morphium referring to the ancient Greek
dream god Morpheus.
 Aspirin
The first synthetic medicine, it was named "Aspirin": "A"
for "Acetil", and "Spir" for Spirsaüre, the German botanical
name for Meadowsweet.
The synthesis of acetylsalicylic acid was taken up again by
Félix Hoffman, a pharmacist at the Bayer laboratories. He
obtained chemically pure and stable acetylsalicylic acid on
October 10, 1897.

Initially marketed as a powder, aspirin was finally

introduced in 1904 in the form of small tablets in a glass
bottle.
 Paracetamol (Acetaminophen)
The best-selling drug, since the
1990s.Synthesized by Harmon Northrop Morse at
the University of Baltimore.

It was abandoned in favor of phenacetin because

of its nephrotoxicity (scientific error due to the
absence of clinical trials).
Bernard Brodie and Julius Axelrod demonstrated that
acetanilide degrades in the body to paracetamol, but also
to phenyl hydroxylamine, which is toxic.

They therefore suggested replacing acetanilide with

paracetamol.Paracetamol is marketed by Mc Neil
Laboratories as Tylenol Children's syrup (1955 fever and
pain syrup for children).
ANTIBIOTICS
The use of fungi to treat infections has been known since
ancient times.

For example, in ancient China, moldy fruit were used to

treat panaritium

The effectiveness of this treatment is due to the fact that

certain molds, including Penicillium, produce antibiotics.
At the time, however, it was impossible to distinguish,
isolate and produce the active substance.
ANTIBIOTICS
Arabs working in stables used molds to treat horses.In
Serbia & Greece, bread molds were used to treat injuries
and infections.

The idea of using molds as a treatment was formulated

by apothecaries such as John Parkington (England), who
mentioned the subject in his "Book on pharmacology" in
1640.
 Penicillin

Penicillin is the first antibiotic discovered.

The discovery of penicillin was made by Sir

Alexander Fleming in 1928. He was the first to
demonstrate that the mold Penicillium
notatum synthesized an antibacterial
substance.
 Penicillin
On September 3, 1928, in London, Alexander Fleming noticed a
halo of inhibition around a blue-green mold that had
contaminated a staphylococcus culture.

He concluded that the mold produced a substance that diffused

into the agar and inhibited bacterial growth. With the help of a
chemist, he concentrates the antibacterial substance he calls
"penicillin".

In 1929, he published the first report on the effect of this

substance in the British Journal of Experimental Pathology.