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June '10

  Tuesday 25 May 2010

Changes in Practice of Medicine –

Part 1


Dr. Bert Grapes



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Fifty years ago life expectancy was seventy-five years, it is now 80.5 years.  Prior to 1950 diagnostic tool choice was small and remedial care was meager.  Family doctors were individual entrepreneurs.  Among other things doctors competed against each other, doctors made house calls, fees varied, there were welfare funds for people who couldn’t pay and surgeons were not trained in Canada. 

No antibiotics existed until the 1940’s when Fleming discovered Penicillin. The first vaccine was developed for smallpox causing the disease to be pretty much eliminated and adding iodine to salt caused goiter to virtually disappear.  An explosion of breakthroughs in medical procedures and diagnostics occurred in the late 40’s and early 50’s. 



Two early research projects which really paid off were:

  1. Defining the DNA molecule in 1953.

  2. Discovery of compound F in 1948, from which cortisone was developed and has been a significant help in medical situations.

 


Diagnostic tools have improved significantly.  In the late 40’s, when blood samples were taken, they were analyzed manually with primitive equipment.  Now, 100’s of blood tests are done automatically.

Physicists have also contributed to the development.  Ultrasound was actually developed from sonar process that had been developed in the early 1900’s.  Ultrasound is now used in obstetrics, dealing with blockages in veins and arteries, treating stomach and pancreatic tumors and blasting kidney stones that can’t be passed.  Physicists also helped develop CAT (computerized axial tomography).  This technology is a combination of X-ray and taking pictures of slices of tissue and provides images of the body.  MRI (magnetic resonance imaging) was first developed in 1977.  It provides increased contrast in the soft tissues of the body.  The advantage is that it does no involve radiation.  Basically strong magnetic fields cause water in tissue to vibrate. Finally Angiography puts dye into the veins or arteries to detect blockages.

 Dr. Grapes will continue his presentation next month.



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