Biomedical Theory: Improving Patient Outcomes

Health Models An Overview Before the advent of microscopes and the technology to see the very small, many people thought that illness was caused by divine intervention, lack of faith, or random and unexplained "vapors" or smells. For the most part, there was no understanding that certain organisms caused anything; in fact, while it seems ridiculous to us now, we must remember that for hundreds of years, even many historical figures believed in using leeches or draining blood to help heal the body (Kennedy, 2004, pp. 3-11). After the discovery of bacteria and the use of the microscope, the "Bio-Medical Model" (BMM) moved into prominence, believing that specific illness were linked to specific bacteria, viruses, or pathogens. Many of the more common diseases that killed so many in history were mitigated by using the BMM: measles, chicken pox, tuberculosis, etc. Still, many questions even into the 20th century seemed to not really fit with this pathogen-based model (Porter, 1999). For most of the West, the idea of categorizing everything came out of the Enlightenment and was expressed as a "germ" model. The European mind could then find, define, analyze and kill the germ therefore healing the person. In fact, the whole idea of vaccination came out of this model, and changed the health of society (James, 1992).

The germ theory was proposed by Robert Koch and Louis Pasteur in the 1870s, on the basis that microorganisms were the cause of many diseases.

Disease is regarded as a failure within the body that changes it from its usual healthy self. In keeping with the germ theory the disease can be identified as a micro-organism and the cause of the disease isolated then treated to restore the body to full health. This technological imperative places great emphasis on surgical procedures and pharmacological

“In the light of the germ theory…[d]jseases are to be considered as a struggle between the organism and the parasites invading it.” The aforementioned quote, by Henry Gandle, a professor of physiology at Chicago Medical College, characterizes the germ theory through the collective human struggle against disease inducing microorganisms. In a period of discovery, where the nature of various germs and diseases were brought to light, the common conception encompassed a war between humans and diseases; this analogy to a war implicates a united effort on the part of the human race in battling these dangerous microorganisms. Tomes writes in The Gospel of Germs not only of the different scientific discoveries associated with the emergent germ

136). The germ theory can be defined as “microorganisms, which are too small to be seen without the aid of a microscope, can invade the body and cause certain diseases” (Kusinitz).

It was Robert Koch who linked the germ theory and disease with actual proof in 1878, a few years after the Second Public Health Act had been passed, but many people believed that he was right before he proved it. One of the most important reasons was that in 1867, the vote was given to all male householders. Before, it had just been the rich that had voted. The rich lived in the towns, owned houses where disease was kept to a minimum and lived, on average, twenty-five years longer than the urban working class. The Public Health Act was extremely successful and by the end of the century almost all towns had hygienic sewers and water systems.

(Starr.) Germ theory or “filth theory”, as coined by Charles V. Chaplin, was established in order to help define how environmental health impacts infection was transmitted. Personal hygiene and modern sanitary science became radically popular outlook in the early 19th century that helped aid and control diseases like tuberculosis and veneral disease, improving the health of infant, and other health problems. This growing emphasis created the need for individual health

-The germ theory led to the creation of vaccines, anti-toxins, antibiotics, and the development of laboratory-based pharmacology to help patients to get healthy.

Although most disease struck the poorest, the upper class was not fully immune. Because people wanted to move to cities to make their lives better, they were forced to live around these diseases without proper means for prevention, protection, and recovery. Once contracting the disease, they would either die within hours or suffer from uncontrollable diarrhea and pain. In addition, scientific knowledge on disease was not as developed as it fortunately is today. Doctors had not yet learned the concept of a germ theory and instead associated the disease with the “bad air” that surrounded toxic, polluted cities. This “bad air” was known as miasa and was incorrectly used to explain the spread of cholera in major cities during the mid 1800s. After studies and research, doctors noticed that there was a heavy concentration of miasmata near certain rivers, but they still connected it to a lack of air quality in bustling cities such as Manchester, London, and Paris. Although air pollution and coal emissions did play a role in certain illnesses, they were not the main cause for diseases such as cholera. Poor ventilation, dirty homes, malnourishment, and no access to clean water made people easily susceptible to a ruthless disease like cholera. Moreover, causes of cholera were investigated more thoroughly after John Snow’s theory claimed that cholera was spread through the water John Snow was an English physician who is today considered one of the fathers of modern epidemiology, the branch of medicine that deals with the distribution and control of diseases relating to health. Finally, doctors could see cholera in a new light and were able to find better means of protection and prevention for its victims. Today, doctors recognize the germ theory of disease which states that some diseases are caused by microorganisms, and not just by “bad

One of the prominent men behind the germ theory was Robert Koch, a German physician, who laid the foundation for the theory. Koch experimented on animals because he noticed what most people saw as a mystery. He used a microscope to look at blood that belonged to cows that died of anthrax. Koch discovered that there were tiny bacteria shaped like a rod and supposed that it was a disease called anthrax. Out of curiosity, he transported the bacteria to mice, which also acquired anthrax. His observation of the transportation of anthrax led Koch to create the four standards that determines that a certain germ can cause a specific disease. Koch’s criterion famously known as Koch’s Postulates and are still commonly used. His third postulate is, “the disease must be reproduced when a pure culture is inoculated into a healthy, susceptible host.” In other words, a disease is able to multiply when a clean group of germs introduces itself to a vulnerable animal to house the germs. Robert Koch launched the germ theory for other great minds to enhance by discovering a disease and creating a set of principles.

Today, billions of germs live on Earth, and some families of germs on Earth have been around for billions of years which is far longer than any plants, humans or animals. Although some germs can cause diseases, the good thing is that 95% of germs are harmless. Some types of germs are actually helpful like the bacteria that help us to digest food, and the ones that curdle milk into yogurt.

Throughout history until the 19th century, infectious diseases, epidemics, and pandemics were thought to be the manifestation of supernatural forces and little to nothing was truly effective in preventing or treating these devastating threats to society. It was only during the Age of Reason and the Enlightenment that the long-accepted realities of society were questioned and research was conducted based on science and reason that would forever change the world we live in (Kumar, 2007). The science of epidemiology was founded by John Snow’s identification of polluted public water well as the source of an 1854 cholera outbreak in London. Shortly thereafter germ theory began to emerge and science took off.

Diagnosis and treatment; Even diagnosis of the disease causing microbe is taught so as to give right drug and combat infection effectively. The identification of

Robert Koch was a German physician who is most known for his development of rules, or postulates that identify the causative agent of a particular disease. The four postulates includes, (1) the infected tissue must be present in all cases of the disease; (2) the microorganism must be isolated and grown in a pure culture; (3) microorganism from a pure culture , when injected into a healthy animal must produce the disease, and (4) this “second generation” microorganism should then be isolated and shown to be identical with the microorganism found in 1. Koch’s postulates have been important to microbiology and medicine because they are used to prove that specific microorganisms cause specific diseases which can

Health care professionals within conventional medicine believe that diseases are caused by microorganisms such as bacteria and viruses.