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Medical historian Richard Barnett joins WIRED to answer the internet’s burning questions about medical history.
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00:00You can essentially stick a spike into the brain, move it back and forth to cut the nerve fibers.
00:05I know, it's awful, isn't it? It gets worse. Just wait till we get to poop transplants.
00:10I'm Richard Barnett, I'm a historian of medicine,
00:13and I'm here today to answer your questions from the internet. This is History of Medicine Support.
00:21BB Horty asks,
00:23So, like surgery before anesthesia, what did you do?
00:26Like, just scream the entire time? Or just get knocked out with a cast iron skillet?
00:29Well, pretty much the former, in fact.
00:31In the 1820s, 1830s, 1840s, various dentists, surgeons start experimenting with things like
00:37laughing gas, nitrous oxide, and ether.
00:39Now, the first widely publicized demonstration of general anesthesia is done in 1846,
00:43and the procedure very, very quickly spreads after that.
00:46But for centuries before then, yeah, you pretty much had to grin and bear it.
00:50But in many cases, surgeons are actually quite keen to keep their patients awake.
00:54This isn't because they're horrible sadists.
00:56It's because the great fear of surgeons in early surgery isn't pain.
00:59Pain won't kill you.
01:00What might kill you is if you start drifting off into unconsciousness and sort of, you know,
01:04gradually kind of falling into death.
01:06So there's a sense that pain at least kind of helps to keep you conscious and helps to kind of
01:10survive this assault on the body, which is basically what early surgery was.
01:14There's a real emphasis on being as quick as possible.
01:17You can't really expect a patient to lie there for hours while you hack away at their leg.
01:21Now, one of the fastest surgeons we know about was a 19th century surgeon working in London,
01:25a man called Robert Liston, who worked at King's College Hospital.
01:28Liston became famous because he could have somebody's leg off in a standing start
01:32in under a minute.
01:33But the price you pay for this sometimes is inaccuracy.
01:36There's a famous story about Liston, which may or may not be apocryphal,
01:40that he was once cutting off a patient's leg.
01:42He accidentally took off the patient's testicles while he was operating.
01:45One of the burly surgical assistants who was holding down the patient,
01:49Liston accidentally cut off his thumb. That man got an infection and died.
01:52There was a woman standing in the balcony watching the procedure,
01:54and she's supposed to have dropped down dead from fright.
01:56The old joke is that this is the only operation in history with a 300% mortality rate.
02:01So this question is from McFapkins, who wants to know,
02:04what in the world is cupping and why is it so popular?
02:07Cupping makes use of little glass cups like this one.
02:10You would take a candle or perhaps a match, burn it inside to create a partial vacuum,
02:14and then you'd apply it to the flesh, perhaps the back.
02:17The vacuum inside would pull up the skin, cause something like a blister,
02:21which could then be left or it could be lacerated to draw out blood or pus.
02:25Now the ideas behind this are very ancient indeed.
02:28The idea that four humours, blood, black bile, yellow bile and phlegm, govern health and disease.
02:34So the idea behind cupping is that you can use this technique to draw out some of these excess humours
02:39and restore balance to the body.
02:40Cupping has seen something of a renaissance in the last few decades with the rise of alternative medicine
02:45and especially the kind of the wellness boom.
02:47Like a lot of techniques in alternative medicine,
02:49you could perhaps argue that there's some sort of placebo effect behind it,
02:51but there's not a great deal of evidence that it has really any kind of clinical effect.
02:56Jeremy Jones says,
02:57Louis Pasteur rolling in his grave right now.
02:59Pasteur might be rolling his grave for several reasons.
03:02Pasteur was a French chemist working in the middle of the 19th century.
03:05He grows up in the French countryside.
03:07So he's very interested in the kind of problems that affect French agriculture.
03:10So in his early research, he's trying to answer the kind of questions that really upset French people.
03:15Like, why does my wine go sour?
03:17So he does a lot of early work on the chemistry of fermentation.
03:20He shows that when grape juice ferments and turns into wine,
03:22or when milk ferments and turns into cheese,
03:24it's actually all caused by microorganisms.
03:27And when things go bad, it's a result of the wrong microorganisms getting involved.
03:31So as part of this, Pasteur develops a technique of heating grape juice or wine or beer or milk
03:36to a certain temperature for a certain period to kill off the microorganisms.
03:39And as we now say to sterilize it, this is pasteurization.
03:42And this not only becomes very widespread and does great work to improve the health of many foods,
03:48it also makes Pasteur a great deal of money because he very sensibly patents it.
03:52But in later life, he becomes very well known for his work on vaccines.
03:55He begins his work trying to understand the kind of diseases that affect farm animals.
04:00Pasteur works out that if you identify the bacterium or the spore that's causing the disease,
04:05you can actually use it to make a vaccine. You can, as he says, attenuate it.
04:09And then you can use those weakened, killed germs as a kind of vaccine.
04:13So in 1881, Pasteur carries out a very large, very public, very well-publicized trial of his vaccines
04:18involving dozens of farm animals. But his most famous work is done on a human disease, rabies.
04:24Rabies is a much feared disease in the 19th century. Not only is there no effective treatment for it,
04:29but it's a really, really horrible way to die. Pasteur starts to, again, apply this technique
04:34of attenuation to making a vaccine for rabies. In 1885, a young French boy called Joseph Meister
04:40is savaged by a rabied dog. His parents bring him to Pasteur. Pasteur tries out this experimental
04:46vaccine. And it's a very difficult vaccine. It involves, I think, 13 injections into the abdominal
04:51cavity over about 11 days. So poor Joseph Meister goes through Croiser trial. But he remains healthy.
04:57And he, as a result of this, Pasteur really does become a French national hero.
05:00He gets his own medical institution. The Institut Pasteur still works in France.
05:04He gets just about every honor that the French state can throw at him.
05:09So, example is here, asks, you all ever heard of Radithor? Radithor was an American patent medicine,
05:15sold in about the decade after the end of the First World War. And it was immensely popular.
05:19It sold hundreds of thousands of bottles every year. You were drinking distilled water,
05:23mixed with traces of radioactive isotopes, mostly radium. Now, why on earth were people doing this?
05:29Now, this goes back to an episode that historians have called the radium craze. At the end of the 19th
05:35into the early 20th century is a great deal of public fascination with new work that's being done
05:40in physics, especially around the idea of radiation. Now, Pierre and Marie Curie discover radium in 1898.
05:46Marie Curie gets the Nobel Prize in Chemistry in 1911 for her discovery. There's a lot of medical
05:51interest in radiation as well, not only through x-rays, but also through the idea that radioactive
05:56substances might be used to treat diseases, especially cancer. Probably the most famous
06:00victim of Radithor was an American golfer, a man called Eben Byers. He seems to have been absolutely
06:05addicted to the stuff. It's thought that he drank more than a thousand bottles of it during his lifetime.
06:10In the late 1920s, he developed cancer of the mouth, which in its very late stages led to the loss
06:14of his entire
06:15lower jaw. And it's as a result, largely of the publicity around this case, that Radithor was
06:20eventually banned in 1932. R.N. Morris asks, when you think about it, the expression blowing smoke
06:26up your ass is very strange. Where did it come from? How is the smoke blown? Through a tube? And
06:31what does
06:32the smokey get out of it? If you think about 18th century Britain, a seafaring nation, there's a great
06:36deal of concern about how to revive sailors who've been washed overboard. One idea is to use tobacco smoke.
06:42Tobacco smoke is seen as a kind of irritant. If you think about breathing it in, it can make you
06:46cough.
06:47So some physicians start to experiment with specially designed bellows that have a sort of little
06:52tobacco pipe built into them. You can inflate the bellows, fill it with tobacco smoke, and essentially
06:56push it up the bottom of some poor drowned person and blow it in. And the idea is, as I
07:00say, that if
07:01there's even a little bit of life left inside this person, this will bring them back to life. And I
07:05think
07:05it's probably fair to say that it would. A user on the To Western Europe For You subreddit says,
07:10share your most controversial Nobel Prize winner. I'll start. Agas Monis, inventor of the lobotomy.
07:16I think I'd agree with that. Antonio Agas Monis was a Portuguese neurologist. In the 1930s,
07:21he developed this new procedure, lobotomy. Lobotomy literally means lobe cutting or brain cutting.
07:27So it's a matter of opening up the skull and severing some of the connections that connect the frontal
07:31lobes with the rest of the brain. Now, Monis, in doing this, was trying to come up with a new
07:36treatment for some of the most severe kinds of mental illness. He very quickly found that people
07:41who went through this procedure were indeed quieter and calmer, but the procedure caused tremendous
07:46problems for those who went through it. They very often suffered changes in character. Very often they
07:51suffered physical symptoms, physical disabilities as well. So the question really is, why did lobotomy become
07:55so popular, so widely used, if it had such terrible consequences for patients? Well, the answer really
08:01goes back to the 19th century. All sorts of new institutions, especially medical institutions,
08:05are established. And one response to what's seen as a growing problem of insanity is institutionalising
08:10the mat, putting them away in asylums. But by the early 20th century, it's becoming clear that asylums
08:15really don't work as a kind of therapy for mental illness. Unlike the great transformations in medicine
08:20and surgery, psychiatrists don't really have much to show by the end of the 19th century in terms of really
08:24effective techniques for treating madness. So historians have talked about a kind of age of heroic
08:29therapy in the early 20th century. All kinds of new therapies being tried, using insulin to put
08:35patients into something like a diabetic coma for several days, with again the idea that this might
08:39in some ways almost sort of reset their minds. This is also the period in which electroshock therapy
08:45starts to be used for certain kinds of conditions. But lobotomy has become the most notorious of these
08:49heroic therapies. Now part of the reason it becomes so popular is the work of an American doctor,
08:54Walter Friedman. He simplifies the procedure, which is called the transorbital lobotomy.
08:59So essentially, you take something like an ice pick, you make an incision just above the eyelids,
09:04so in the orbital bone, and through that you can get directly into the brain. Now for more than 30
09:09years, Friedman traveled across the United States, moving from asylum to asylum, carrying out thousands
09:13of these procedures in waiting rooms or in doctors' offices. Now Friedman eventually became notorious for
09:19his work, and in 1967 he was banned from medical practice. But lobotomy became a symbol of a kind of
09:25oppressive, restrictive kind of psychiatry. If you've ever seen the film One Flow Over the Cuckoo's Nest,
09:30you'll know that the lobotomy in that film is really used as a kind of punishment, it's not really
09:34a kind of therapy at all. 121212 asks, were maggots ever purposely cultivated for field medicine?
09:41Fascinating and rather gruesome fact, maggots, which are the larva of certain kinds of flies,
09:46if they get into a wound, they will eat dead tissue, but they won't eat live tissue. So many doctors
09:51have noticed that this is a technique you can use for what's called debridement,
09:55getting rid of dead or infected tissue within a wound. Now this is a rather kind of counterintuitive
09:59idea. You might think if a wound is infected with maggots and flies, this would be a very,
10:03very bad thing. But we can actually find evidence of the use of maggots in this way in many traditional
10:08medical cultures around the world. And from about the Renaissance onwards, military surgeons working in
10:14Europe start to notice that even if a soldier's been lying on a battlefield for days, even if their wound
10:19has got infected with maggots, very often that wound will actually stay uninfected and will heal
10:24quite well. And this is a technique that's often been used in situations where no other kinds of
10:29treatment are available. Maggot therapy is still occasionally used today. Of course, the most
10:32important thing is that you have sterile, disinfected maggots. So Wowiful asks, explain like I'm five,
10:39what is the iron lung and how does it work? So picture in your head a metal tube. Looks a
10:45little bit like a
10:45railway carriage, but imagine it's about the size of a coffin. Now imagine you lie inside that tube and
10:50it's got a seal around your neck so that you're sealed inside it. And there's a pump at the far
10:55end
10:56of the tube that's pumping air into the tube and out of the tube. Now why on earth would you
11:01do this?
11:01Well, this is a kind of respirator. So for patients who've lost the ability to breathe, this is a machine
11:06that can be used to inflate and deflate their lungs and keep them alive. It was developed in the US
11:11in
11:11the late 1920s, initially for treating victims of coal gas poisoning. But the iron lung really came
11:17into its own during the polio pandemic of the early mid 20th century. Polio is an infectious disease
11:22that largely affects the nervous system. It can leave patients physically paralyzed, but it can also
11:27leave them in a situation where they can't breathe for themselves. So iron lungs became a way of keeping
11:32many polio patients alive through this epidemic at a great cost to their kind of mobility and quality of
11:38life. You do have cases of people being infected with polio at quite a young age and living decades
11:43inside an iron lung. The use of the iron lung declined with the decline of polio. Effective
11:49vaccines come along in the 1950s and 1960s. There's a very successful public drive for vaccination to try
11:55and eliminate this disease. So iron lungs now are hardly ever used. Sleepy Mount Everest asks,
12:01WTF is bloodletting? This was a very widespread procedure, especially in medieval and classical medicine.
12:07Again, based on the idea that health is a matter of balance. So if you have too much blood inside
12:12your system, blood is seen to be a very hot, fiery, kind of overstimulating humour. It's the humour of
12:17spring. It's the humour of youth. So it can kind of make you overexcited and feverish. So there's a
12:23very long standing idea that if you let a few pints of blood out of your body, it'll calm you
12:27down.
12:27And it certainly does. There are some very famous cases of bloodletting carried to kind of
12:31extraordinary excesses. One of the most famous is in the last few days of the life of the first American
12:36president, George Washington. Washington's physicians kept bleeding him over and over again,
12:40eventually letting several pints of blood out. And there's an argument that actually his death
12:44in the end was the result of the action of his physicians, not of the disease he was suffering from.
12:49Stop That Girl 7 asks, Hey Siri, who was Typhoid Mary? Typhoid Mary was Mary Mallon. She came to the
12:55US
12:55to work as a cook. In the early 20th century, several outbreaks of typhoid were associated with the
13:01households in which Mary had worked. Now, the New York Public Health Department investigated this case
13:07and they discovered that Mary was what's called an asymptomatic carrier of the disease. In other words,
13:12she carried the bacterium responsible for typhoid, but she didn't suffer from the disease herself.
13:16Like many asymptomatic carriers in this period, she was forcibly quarantined for a while. She was released
13:21in 1910. But in 1915, a further series of outbreaks at a maternity hospital in New York
13:26were linked to her. And sadly enough, she spent the rest of her life incarcerated. She died in quarantine
13:31in 1938. Now, Typhoid Mary has become almost a figure of sort of gothic folklore. But in many ways,
13:37her case raises issues that are very familiar to us in the last 10 years. The questions we all face
13:41during the COVID lockdown of how do we balance individual freedom with the question of sort of
13:46larger public health and social good. There's also a question about why Mary was treated so harshly.
13:51She was far from the only asymptomatic carrier of typhoid identified in this period, but she was
13:56the only one who was incarcerated for so long. And historians have suggested that this may be
14:01connected with the fact that she was working class, the fact that she was Irish, and the fact that she
14:06was a woman who tried to stand up for herself. So a Quarry user asks, is trepanning still used today?
14:12Well, trepanning is a very ancient technique. It's the idea of cutting or drilling a hole in the skull.
14:18Now, this sounds like rather a radical intervention, but it's actually one of the oldest
14:21techniques that we have evidence for. Archaeologists working as far back as the Neolithic have found
14:25skulls to which this has been done. Holes have been cut or chipped, presumably with quite sort
14:30of simple flint tools. And the most extraordinary thing is that many of these skulls show some
14:34evidence of healing. Now, because texts don't really survive from these ancient societies,
14:38we don't really know why it was done. It might have been some sort of surgical intervention,
14:43perhaps to relieve the symptoms of mental illness or to treat some kind of head injury,
14:47but it's perfectly possible that it was perhaps some kind of initiation rite.
14:52One thing it almost certainly wasn't was a kind of punishment, simply because there are easier ways
14:57of inflicting more suffering. The technique is still used. Modern surgeons will use it sometimes
15:01if a patient has suffered a serious head injury to try and relieve pressure on the brain,
15:05or in some other kinds of diseases like brain cancer.
15:093k Carlo asks, yo, how did surgeons learn that stuff? Like there had to be a psychopath who was
15:14cutting people's bodies open and exploring. If you're going to learn surgery, if you're going
15:18to learn about the human body, the best way to do it is not learning through texts, but rather through
15:23practice. Well into the 18th century, the way that you learn surgery was really through apprenticeship.
15:28You'd be apprenticed to a master surgeon, you'd follow them around, you'd watch them doing
15:32their procedures, so you'd learn very much in practice. One of the things this gives early
15:36surgeons is a really good sense of the kind of materiality of the body. So a lot of what we've
15:40come to learn about, yeah, the fine detail of movement or circulation of the blood or things
15:46like that really come from dissection, come from getting to grips with the kind of rather bloody,
15:50messy materiality of the body.
15:52This is from the AskHistorian subreddit.
15:55What is the oldest example of a plastic surgery or plastic surgery-like procedure?
15:58What was the procedure like? So we may think of plastic surgery as a very modern phenomenon,
16:03but in fact it's a very old idea indeed. Wherever we find ancient medical texts,
16:08we find interventions that are intended not only to restore the function of the damaged body part,
16:13but also its appearance. Now probably the most famous of these early procedures is called
16:16rhinoplasty. The earliest records of this come from ancient Sanskrit medical texts of the Ayurvedic
16:22tradition. Now imagine you've lost your nose, it's been cut off as a punishment, or you've suffered some
16:27awful disfiguring disease. One thing you can do, or a surgeon can do, to try and at least recreate
16:32the appearance of a nose, is to cut a triangle of skin from your forehead, leaving a little strip
16:37so that the skin is still getting blood supply, still stays alive, and kind of fold it down and
16:42then attach it on either side to form something like a nose. And the idea is that the tissue will
16:47heal and you'll have not a kind of properly functioning nose, but at least something that looks like a nose.
16:54Alex8762 asks, why did it take so long for surgeons to recognise the need for sterilisation of equipment
17:00and washing their hands? It's a very simple question that opens up a very rich historical subject.
17:05Now in some ways there's a paradox here. Microscopes are developed in Europe in about
17:09sort of the middle of the 17th century. People start using them to look at all sorts of objects
17:13and substances. One thing they find very quickly is that the world is full of these previously unsuspected,
17:18tiny little dots and squiggles and blobs that seem to be alive. But it's not until the 19th century
17:24that ideas like germ theory, and with it the idea that cleanliness and disinfection are kind of central
17:29to effective surgery, start to become very prevalent. So why did it take two and a half centuries for
17:34these ideas to arise? Well the first thing to say, I suppose, is that it's not at all clear to
17:39the first
17:40observers that germs actually cause disease. These germs cover every surface that early microscopists
17:47look at, and they seem to be all over every bit of the body that they look at. So many
17:51people say,
17:51well if these germs are everywhere, how can they possibly cause disease? Why don't we just
17:56sort of all die immediately of this overwhelming infection? There's also not really a sense that
18:00there are different kinds of germs. That really only kind of comes out of laboratory medicine
18:04in the 19th century. There's also a question about the kind of the nature of what we'd now call
18:09scientific evidence itself. It can be very hard in practice actually to identify the cause of a disease.
18:14So a working surgeon might say, well sometimes wounds get infected, sometimes they don't.
18:18Perhaps it's a consequence of the body trying to heal surgical wounds. So there are lots of reasons
18:24that it's quite hard for early surgeons to draw this connection between cleanliness of surgical
18:29instruments and the rates of wound infection. J.D. Nelson asks, well barber surgeons were a thing,
18:35time for a comeback. Well it probably isn't time for a comeback, but barber surgeons certainly were a thing.
18:39It's rather strange to the modern mind to think that the kind of people who cut your hair might
18:43also have been the sort of people who cut your leg off. But the connection going back three or four
18:48hundred years is that both barbers and surgeons are working on the outside of your body with sharp
18:53implements. You can imagine a barber perhaps accidentally cutting you while he was shaving,
18:57kind of dressing the wound. It's maybe not an enormous step from that to think about barbers
19:02carrying out basic kinds of surgical procedures. So although it's very counterintuitive today,
19:06historically there was a very close connection between barbers and surgeons. And this is embodied most
19:11famously in the old blood and bandages, the red and white striped pole that you still see outside
19:15many modern barbershops. The Pixel Paint asks, was the discovery of penicillin really an accident?
19:22Well, pretty much yes. So this was the work of a Scottish physician and bacteriologist, Alexander
19:26Fleming. Fleming in the 1920s has already done some work on the body's natural defenses against bacteria.
19:33He's discovered an enzyme called lysozyme, which the body secretes in things like snot and mucus,
19:38that attacks bacteria and viruses that try to get into the body. So Fleming is very interested in
19:43this idea of simple chemicals that might kill bacteria. But the discovery of penicillin itself
19:47really was a kind of lucky accident. In the summer of 1928, Fleming leaves his laboratory in St. Mary's
19:54Hospital, goes on holiday, comes back about a month later and finds that some of the petri dishes of
19:59bacterial cultures that he's been using have become contaminated with mold. Now he's about to throw
20:04these away, but he takes a look at one of them and makes a fortuitous and fantastic discovery.
20:09He notices that the mold growing on this petri dish is clearly secreting or releasing something,
20:15some chemical that is killing the bacteria that were growing on the petri dish. Fleming cultures
20:21this mold separately. He tries to extract a drug, a kind of simple chemical from it, and he calls this
20:26drug penicillin. If you were trying to grow certain kinds of bacteria and your cultures kept getting
20:30infested with others, you could perhaps use penicillin to kind of clear out these cultures
20:35and make sure that only the bacteria you wanted were growing. But in the 1930s, two things happened.
20:40The first really successful antibacterial drug called Promptosil is developed in Germany. Second,
20:46the outbreak of the Second World War. Military surgeons, allied governments are very well aware
20:51that they're going to need effective treatments for battlefield injuries. So a research project is
20:55started in Oxford which essentially kind of combs the literature looking for techniques that might
21:00lead to effective drugs. This project led by Howard Florey and Ernst Chain come across Fleming's paper.
21:06They start work on developing penicillin as a kind of mass market pharmaceutical. It becomes the world's
21:13first successful antibiotic and Florey, Chain and Fleming share the 1945 Nobel Prize for their discovery.
21:20And this extract of the penicillium mold, penicillin, turns out to be the world's first effective antibiotic.
21:27Runnerlovejewel asks, how is Mad Hatter's disease a real thing? Like, what do you mean? You had
21:31continuous exposure to mercury and only got a little silly? Well, Mad Hatter's disease certainly
21:35was a real thing. Alice in Wonderland, we all know the Mad Hatter behaving and talking
21:39in the strange way that he does. What Carol is alluding to with this character is the characteristic
21:44trade disease of hatters in the 18th and 19th centuries. Mercury was used in the preparation of the
21:50animal pelts that we use to make things like beaver hats. So, hatters in the course of their work were
21:55often exposed to mercury and by the end of their lives they'd often suffered quite severe neurological
22:00damage, in some cases even forms of madness, from this long exposure to mercury.
22:05So, Queen Hasada asks, why wasn't measles eradicated like smallpox? Now, as the question suggests,
22:11it would be perfectly possible for measles to be eradicated. We have very effective vaccines and there
22:15many global programmes associated with the World Health Organisation that are working towards this
22:20aim. But since 2017, the disease has seen a resurgence and this was made much worse by the
22:26Covid pandemic. As you can imagine, medical attention, medical resources were diverted elsewhere,
22:31vaccination programmes in many parts of the world were paused. After the end of the pandemic,
22:35the incidence of the disease has started to rise again in many countries where it had been declining
22:39for decades. Now, it's rather useful here to compare measles with another infectious disease like
22:44smallpox. Smallpox historically was widely feared. It was a very serious, disfiguring,
22:49often fatal disease. It became the subject of the world's first vaccination. The English doctor Edward
22:54Jenner in 1796 develops a fairly effective vaccination technique against smallpox. And in the 20th century,
23:01even at the height of the Cold War, the disease was the subject of one of the first kind of
23:05global
23:05attempts to eradicate a disease and this was finally successful. Now, compare smallpox to measles.
23:11Part of the problem with measles is that we still don't take it very seriously. We tend to think of
23:15it as a kind of childhood disease, the sort of thing you get and then get over. But it's a
23:20very,
23:20very serious disease. It can cause serious disfigurement like blindness. It can also leave your immune
23:25system compromised and leave you susceptible to other diseases. And of course, a big problem in the West
23:30in the last 20 or 30 years has been the rise of vaccine scepticism. The English doctor Andrew Wakefield,
23:35in 1998, published a paper which claimed to show an association between the MMR vaccine and the
23:41development of childhood autism. Now, this paper has been comprehensively discredited and The Lancet,
23:45to its great credit where it was first published, has now withdrawn the paper. But unfortunately,
23:49it has very much contributed to the rise of vaccine scepticism. Now, I don't want to get on my high
23:54horse here, but if you're lucky enough to live in a country that has vaccination programs against
23:58measles, for heaven's sake, get vaccinated. Torley 42 asks, why is it called an X-ray? Well,
24:05if you think back to algebra that you learned in school, X is the term that we use in mathematics
24:09and science for the unknown quantity. So X-rays are called X-rays because when they were first
24:13discovered in 1895 by William Roentgen, who was a German physicist, they were unknown. Now,
24:19Roentgen is working in his laboratory using new scientific equipment, vacuum tubes, cathode ray tubes,
24:24that seem to emit certain kinds of radioactivity. He discovers very quickly that
24:28these rays have very strange qualities, that they can pass through the human body, but they cast
24:33shadows of the bones which you can capture on a fluorescent screen or even on photographic paper.
24:38There's a famous story of Roentgen bringing his wife in to take an X-ray of her hand,
24:42and when he shows her the X-ray that she's supposed to have exclaimed,
24:45I see my death, as if she'd seen her own skeleton, her own mortality for the first time.
24:50Good one for you asks, some surgeons still pull cataracts out of the eye with a fish hook,
24:54but when did that start? Well, you might think that
24:57operations on the eye, such a delicate, sensitive part of the body, would be a very modern phenomenon.
25:02But actually, operations for cataracts are some of the oldest surgical procedures that we know about.
25:06Now, cataracts arise when the lens that sits in the front of the eye and is responsible for
25:10focusing light onto the retina and go cloudy, and that can cause blindness.
25:14Now, the earliest procedure for dealing with cataracts was called couching.
25:17We find this described in many ancient medical texts from many different traditions.
25:22Essentially, you take a little tool, perhaps something like a fish hook,
25:25and you just insert it into the eye and you just push the cloudy lens out of the way.
25:29Now, this restores vision. It does leave you without a lens,
25:32so you get something like very, very blurred vision.
25:35But it's better than blindness.
25:36Now, it's in the middle of the 18th century that European physicians start removing the lens
25:40instead of just pushing it to one side.
25:42In 1884, an Austrian neurologist, a colleague of Sigmund Freud called Karl Koller,
25:46starts to use cocaine as a local anesthetic to help keep the eye still during eye surgery.
25:52And this makes cataract surgery a great deal easier and a great deal more precise.
25:56And the roots of modern cataract surgery, where instead of just removing a lens,
26:00we try and insert an artificial lens, that goes back to 1949.
26:03An English surgeon called Harold Ridley had been working during the Second World War with fighter pilots.
26:09Many of them had been in bad crashes and the acrylic windscreens of their planes had shattered
26:14and bits of acrylic had got into their eyes.
26:16Now, Ridley noticed that unlike most substances, a piece of acrylic in the eye isn't rejected by the body.
26:21So, Ridley starts experimenting with replacement lenses made out of acrylic.
26:25And this is really the kind of the origin of modern cataract surgery.
26:29So, Allwrong74 asks, did leeching actually do anything?
26:33Leeches are little invertebrates that swim around in pools
26:36and they live by sucking blood from other creatures.
26:38So, leeches were, as it were, kind of nature's way of doing bloodletting.
26:41And it really had all of the kind of negative sides that bloodletting had.
26:44If you were unlucky enough to get a leech that was infected with a disease,
26:47you could catch the disease.
26:49And, as with bloodletting, it could be done to excess.
26:52You could find yourself kind of seriously weakened and compromised
26:54by losing too much blood to a leech.
26:57So, that's everything for today.
26:58I hope you enjoyed it and I hope you had fun.
27:00Thanks so much for watching History of Medicine Support.
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