History of medicine
From WikiMD Wellnesspedia & World Directory
History of Medicine
- Realdo Colombo, anatomist and surgeon who contributed to understanding of lesser circulation
- William Harvey describes blood circulation
- John Hunter, surgeon
- Percivall Pott, surgeon
- Sir Thomas Browne physician and scientific neologist (medical-pathology-hallucination-electricity etc.)
- Edward Jenner, the pioneer of vaccination
- Louis Pasteur, microbiologist
- Abraham Colles, surgeon and anatomist
Medicine is currently defined as the science of disease prevention, diagnosis, alleviation and cure. However the Greek pharmakos means both remedy and poison, indicating a more equivocal attitude in the past.
All human societies have medical beliefs - birth, death, disease and cure are explained in some manner. Historically, throughout the world illness has often been attributed to witchcraft and the will of the gods, ideas that still retain some power, even in 'modern' societies, with faith-healing and shrines still common.
As socities developed in Europe and Asia belief systems were replaced with a different natural system. The Greeks, from Hippocrates, developed a humoral medicine system where treatment was to restore the balance of humours within the body. Similar views were espoused in China and in India.
From the ideas developed in Greece, through Galen until the Renaissance the main thrust of medicine was the maintenance of health by control of diet and hygiene. Anatomical knowledge was limited and there were few surgical or other cures, doctors relied on a good relation with patients and dealt with minor ailments and soothing chronic conditions while epidemic diseases grew out of urbanization and domestication and then raged across the civilized world.
This idea of personalised medicine was challenged in Europe by the rise of experimental investigation, principally in dissection, examining bodies in a manner alien to other cultures. The work of individuals like Andreas Vesalius and William Harvey challenged accepted folklore with scientific evidence. Understanding and diagnosis improved but with little direct benefit to health. Few effective drugs existed, beyond opium and quinine, folklore cures and almost or actually poisonous metal-based compounds were popular treatments, if useless.
Medicine was aided in the 18th century and beyond by advances in chemistry and laboratory techniques and equipment, old ideas of infectious disease epidemiology were replaced with bacteriology (Robert Koch, Louis Pasteur), and for the first time actual cures were developed for certain endemic infectious diseases. However the decline in the most lethal diseases was more due to improvements in public health and nutrition than to medicine. It was not until the 20th century that there was a true breakthrough in medicine, with great advances in pharmacology and surgery.
From 20th century we have witnessed a shift from a master-apprentice paradigm of teaching of clinical medicine to a more "democratic" system of medical schools. With the advent of the evidence-based medicine and great advances of information technology the process of change is likely to evolve further.
The evidence-based medicine has had a great impact on practice of medicine throughout the world of modern medicine.
Modern western medicine, despite the hypochondria of western society, is uniquely effective and widespread compared with all other medical forms. It is notably secular and material, indifferent to ideas of the supernatural or the spirit and concentrating on the body to determine causes and cures. The harsh scientific nature of modern medicine is the pinnacle of a very narrow concern, a particular aspect of the human condition has been exulted at the cost of considerable social disquiet, as evinced by anti-vivisectionism, eugenics, 18th and 19th century concerns about body-snatching and attacks at doctors for 'playing god' in the 20th century. And the capabilities of modern medicine have done little to improve the lot of poorer countries.
Āyurveda, the Vedic system of medicine, views health as harmony between body, mind and spirit. Its two most famous texts belong to the schools of Charaka and Sushruta. According to Charaka, health and disease are not predetermined and life may be prolonged by human effort. Sushruta defines the purpose of medicine to cure the diseases of the sick, protect the healthy, and to prolong life.
Āyurveda speaks of eight branches: kāyāchikitsā (internal medicine), shalyachikitsā (surgery including anatomy), shālākyachikitsā (eye, ear, nose, and throat diseases), kaumārabhritya (pediatrics), bhūtavidyā (psychiatry, or demonology), and agada tantra (toxicology), rasāyana (science of rejuvenation), and vājīkarana (the science of fertility).
Apart from learning these, the student of Āyurveda was expected to know ten arts that were indispensable in the preparation and application of his medicines: distillation, operative skills, cooking, horticulture, metallurgy, sugar manufacture, pharmacy, analysis and separation of minerals, compounding of metals, and preparation of alkalis. The teaching of various subjects was done during the instruction of relevant clinical subjects. For example, teaching of anatomy was a part of the teaching of surgery, embryology was a part of training in pediatrics and obstetrics, and the knowledge of physiology and pathology was interwoven in the teaching of all the clinical disciplines.
At the closing of the initiation, the guru gave a solemn address to the students where the guru directed the students to a life of chastity, honesty, and vegetarianism. The student was to strive with all his being for the health of the sick. He was not to betray patients for his own advantage. He was to dress modestly and avoid strong drink. He was to be collected and self-controlled, measured in speech at all times. He was to constantly improve his knowledge and technical skill. In the home of the patient he was to be courteous and modest, directing all attention to the patient's welfare. He was not to divulge any knowledge about the patient and his family. If the patient was incurable, he was to keep this to himself if it was likely to harm the patient or others.
The normal length of the student's training appears to have been seven years. Before graduation, the student was to pass a test. But the physician was to continue to learn through texts, direct observation (pratyaksha), and through inference (anumāna). In addition, the vaidyas attended meetings where knowledge was exchanged. The doctors were also enjoined to gain knowledge of unusual remedies from hillsmen, herdsmen, and forest-dwellers.