1 WHAT IS MEDICINE?
should be able to give the gist. Remind students that they are only going to hear the next part of each lecture once. Play each extract in turn, pausing if necessary to allow students to make notes, but not replaying any section. Tell students to choose an appropriate type of notes for this part of the lecture – it could be a continuation of the type they chose for the introduction, or it could be a different type.
Transcript ≤1.6 Lecture 1
So, what exactly is a laser? Well, a laser is a light of very high intensity which can be focused in an extremely precise way. Because of its intensity, it can burn whatever it is focused on. This means that it is particularly suited for cancers which occur on the surface of the body or the lining of internal organs. In contrast to using a scalpel, where the surrounding tissue is cut away to get to the tumour, a laser can be used through an endoscope. An endoscope is a flexible tube inserted into an opening in the body, which is manipulated so that it gets close to the location of the tumour without the need for additional cutting.
So, let’s look at the advantages of laser surgery.
Because lasers are more precise, they cause less bleeding and damage to normal tissue than standard surgical tools. As a result, patients tend to bleed less, to have less pain and swelling and there are lower levels of scarring. In addition, operations using a laser are usually shorter than traditional operations and can sometimes be done on an outpatient basis. All of these factors mean that there is a much lower risk of infection for the patient.
However, laser therapy has some limitations.
Firstly, surgeons who use this technique must have extra specialized training before they are allowed to use the equipment, and much stricter precautions must be followed. Secondly, the equipment required to carry out the operation is expensive and bulky. Thirdly, additional technical assistance may also be required for the maintenance of the equipment. A final limitation is that as the surgery may need to be repeated.
Transcript ≤1.7 Lecture 2
Following on from the Greeks, the Romans were responsible for many new developments in medicine. The work of Galen, born around 120 AD, is of particular significance, as he developed models of the body and how it functions. These were accepted for over twelve hundred years.
The publication of a book by William Harvey
in 1628, describing the circulation of blood in the body, could be seen as the next landmark stage of development, essentially marking the basis of modern physiology. Along with the developments in chemistry, which took place around the same time, this meant that the body could be studied rationally as a functioning system for the first time.
Another significant development was the discovery
of vaccination. This was in use in England from the 1730s. Children were deliberately infected with small amounts of smallpox so that they would develop a resistance to the disease. Unfortunately, this could sometimes be fatal. The process was refined in 1796, when Edward Jenner discovered that cowpox (a non-fatal disease) could provide immunity to smallpox (which was fatal). Further developments came in the 1870s when Louis Pasteur was able to produce weak strains of viruses in the laboratory and develop vaccines for anthrax.
The introduction of antiseptics by Joseph Lister
in 1865 gave medicine another tool with which to fight infection. Maintenance of good levels of hygiene had long been recognized as important in preventing illness, but Lister outlined the mechanisms by which infection could spread in a clinical setting and introduced carbolic acid as an effective way of preventing this. His work led to the widespread acceptance of the theory that micro- organisms caused disease.
Finally, I’d like to mention the significant
development in the fight against micro-organisms with the discovery of penicillin, which is usually attributed to Alexander Fleming. While the action of penicillin on bacteria was known about from 1928 onward, it was not until 1942 that it was first used successfully on a patient. Its success in treating a very wide range of diseases meant that, for perhaps the first time, doctors had a tool which was easy to use and which could quickly bring about enormous improvements in a patient’s condition. The modern era of medicine had dawned.
Transcript ≤1.8 Lecture 3
In stage one of the disease, the changes are very similar to those which occur with the onset of old age. For example, short memory lapses, mild word aphasia – I mean, not being able to think of the correct word – not being able to find everyday items such as glasses and keys. Even though the individual notices some decline in cognition, it is not noticed by those around them. At this stage, Alzheimer’s is very rarely diagnosed.
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