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Introduction to episode 6 Continuing development 60 of public health care. Ihad their day and there was room for medicine based on 1819), the laryngoscope (Bozzini, 1807), the ophthalmoscopeDoctors wanted to be able to look inside. All sorts of technicalinstruments were developed, like the stethoscope (Laennec,n the nineteenth century medicine was given a newscientific foundation. Hippocrates and Galenus had finally 144 empirical research and statistics. The hospital gained a central (Von Helmholtz, 1850) and the endoscope (second half of the position and physical examination became an important activity. nineteenth century). The microscope, which had been around Examining patients was not limited to the outside of the body. since the seventeenth century (Van Leeuwenhoek) was improved and also used in examining the body. The breakthrough came when achromatic lens systems could be constructed (Beeldsnyder, 1791). This made it possible to visualise the cellular level of diseases (Rudolf Virchow, 1858), and for Robert Koch (1882) to see acid-resistant rods in the sputum of tuberculosis patients. Instruments were developed to measure physiological processes, like the pulse (Hérisson, 1835), lung function (Hutchinson, 1846), temperature (von Bärensprung and Traube, 1850) and blood pressure (Riva-Rocci, 1896). Laboratory medicine developed after 1880 when chemical tests became available to examine blood and urine, and radiology entered on the scene with the discovery of X-rays by Conrad Röntgen in 1895. However, these developments were restricted to diagnostics, there were as yet no developments in treatments and cure. New possibilities in this area emerged after the discovery of ether anaesthesia (Morton, 1846), which made surgical procedures less burdensome to patients and enabled surgeons to explore new areas of surgery. As a consequence, however, the number of wound infections increased rapidly and in 1867, Lister, having read Pasteur’s publications, assumed that infections might be caused by something in the air. He successfully sprayed the operative area with carbolic acid, thereby introducing antisepsis into surgery.


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