MEDICINE Primitive Medicine Early human beings recognized two categories of diseases: those attributed to the influence of evil

demons or spirits and those involving physical disability! Magic played a ma"or part in the treatment but so were cleaning and treating wounds by burning poultices and stitching# resetting and splinting dislocations and fractures# purges diuretics la$atives emetics and enemas! %he use of plant e$tracts as medical treatments was especially important! &s humans formed distinct cultures the two trends in primitive medicine became more institutionalized! 'orcerers and priests too( up the magico)religious approach! %he empirico)rational trend based on e$perience and observation and lac(ing in mystical features was practiced at first by priests but was ta(en up increasingly by nonreligious physicians! Modern medicine arose primarily from the empirico)rational trend as the human body and its functions became better (nown and as science led medical practice away from superstition and the spiritual realm! &ncient Medical Practice In ancient Egypt by the *rd Dynasty the physician emerged as an early form of scientist! %he Egyptians practiced embalming but their anatomical (nowledge remained at a low level and they attempted only minor surgical procedures! In &ssyria and +abylonia the liver was considered the seat of the soul and was studied to determine the intentions of the gods! ,ebrew medicine was influenced by the -ld %estament and emphasized hygienic regulations midwifery feminine hygiene separation of the sic( and disinfection of materials capable of harboring and transmitting germs! &ncient ,indu medicine became .uite sophisticated especially in the field of operative surgery! &ncient Chinese medicine utilized acupuncture and a wide array of drugs including opium! +y the /00s +C 1ree( medicine had become thoroughly nonreligious stressing clinical observation! 1ree( physicians based their doctrine on e$perience gained by trial and error! %he 1ree(s eventually identified the brain as the physiological seat of the senses! 1reece was the home of ,ippocrates the father of 2estern medicine and &ristotle the founder of comparative anatomy! 1ree( medicine influenced con.uering 3ome! 1alen a 1ree( was the most important physician of the 3oman period and influenced medicine well into the Middle &ges! %he 3omans made important contributions in the fields of public health and hygiene with their organization of street sanitation water supply and public hospitals! Medicine in the Middle &ges Medical practice reverted to magic during much of the Middle &ges! -nly a few 1ree( physicians maintained classical learning! %he &rabs who con.uered much of the world in the 4th century &D learned and revived 1ree( medicine and became the (eepers of the tradition through the Middle &ges! In Europe medicine became the realm of religious orders such as the +enedictines and was practiced in monasteries although sometimes shunned in favor of prayer! Eventually nonreligious medicine became acceptable and began to be taught at universities! %he ideas taught there differed little from the ancient 1ree( teachings ta(en from &rab manuscripts! Early medical scientists such as the English philosopher 3oger +acon made valuable contributions based on e$periment and careful observation but did not sway the established traditions! 3enaissance Medicine No abrupt change in medical thought occurred in the 3enaissance but criticism directed against 1alen and the &rabists increased and the doctrines of ,ippocrates were revived! 5eonardo da 6inci and others of his time made ma"or advances in anatomy the practice of chemotherapy was founded and important insights were gained into the nature of contagious diseases!

%he Dawn of Modern Medicine In the 74th century the English physician and anatomist 2illiam ,arvey demonstrated the method of blood circulation and a new medical epoch began! Detailed studies of the organs diseases and processes such as physiology and respiration .uic(ly followed conducted by eminent physicians and scientists! Medical debates focused on minute features of the body how to treat particular diseases and the nature of life itself whether physical or chemical! 6italists believed that the soul is the vital principle but mechanists saw the body as a machine and life as a mechanical process! Important advances were made in the 78th century: the Italian naturalist and biologist 5azzaro 'pallanzani refuted the doctrine of spontaneous generation# the 'wedish botanist and ta$onomist Carolus 5innaeus devised the modern binomial system of biological nomenclature# and the +ritish physician Edward 9enner discovered the principle of vaccination as a preventive measure against smallpo$ and established the science of immunization! 7:th)Century Medicine In the 7:th century great advances occurred in the diagnosis and treatment of disease and in surgical methods! European researchers established the sciences of embryology and histology and the central concept of the cell as the seat of disease! %he +ritish scientist Charles Darwin advanced his theory of evolution! %he &ustrian biologist 1regor 9ohann Mendel laid out the basis of classical genetics! 'tudies of fermentation by the ;rench chemist and microbiologist 5ouis Pasteur revived interest in the contagion theory of disease! Pasteur and the 1erman physician and bacteriologist 3obert <och founded the field of bacteriology considered the greatest single advance in the history of medicine# many bacterial diseases became preventable or controllable! +acteriology allowed important discoveries including the role of white blood cells in destroying microbes the way in which bacteria are carried and the necessity of sterilization to prevent wound infection! -ther advances during this time too( place in physiology =including understanding of various glands and the nervous system> organic chemistry and metabolism optics and ophthalmology and psychology! %he ?)ray was discovered by the 1erman physicist 2ilhelm Conrad 3oentgen# the ;rench physicists Pierre and Marie Curie discovered radium! &merican physicians developed the field of gynecology and identified mos.uitoes as carriers of yellow fever! @0th)Century Medicine %he most important medical finding of the @0th century was the discovery by the &merican biologist 9ames Dewey 2atson and the English biochemist ;rancis ,arry Compton Cric( of the structure of the genetic material deo$yribonucleic acid or DN&! +y 7:40 the first gene had been synthesized# by the mid)7:80s genetic techni.ues were being used medically and genetic engineering was producing large .uantities of pure human substances such as hormones and interferon! 'urgery advanced with the development of operating microscopes and other techni.ues that allow delicate procedures such as reattachment of severed limbs! Medical milestones were reached with the successful transplantation of organs and the development of the artificial heart and (idney! Plastic replacements for "oints relieved some patients from crippling arthritis and lasers were developed for medical use especially in eye surgery! Many infectious diseases have been con.uered in the @0th century by improved sanitation antibiotics and vaccines! Especially important were the developments of the sulfonamide antibiotics and penicillin which immediately saved many lives in 2orld 2ar II =7:*:)7:A/>! 'treptomycin another drug was used to defeat tuberculosis! 6accines are widely used against viral diseases including poliomyelitis diphtheria tetanus yellow fever measles mumps rubella =1erman measles> hepatitis + influenza herpes simple$ and chic(en po$! 6accine production was aided by new techni.ues such as tissue culture production and genetic engineering! In the latter part of the @0th century many microorganisms became resistant to antibiotics and new diseases emerged such as 5egionnairesB disease and ac.uired immune deficiency syndrome =&ID'>! In the @0th century the brain was carefully e$plored! Csing chemical dyes and sophisticated imaging devices scientists discovered the specific parts of the brain that control

hearing speech and movement of the limbs# they showed that the right and left halves of the brain were functionally different! %he discovery of the chemicalDelectrical method of nerve impulse transmission was an important finding as were the comple$ way in which the brain regulates body function by hormones and the comple$ connection between emotions and biochemistry! %reatments became available for neurological diseases such as epilepsy and Par(insonBs disease! 'cientific insight into the wor(ings of the immune system and the structure of antibody molecules has allowed better treatment of immune disorders even temporary disabling of the immune system to prevent re"ection of transplanted organs! -ne form of antibody molecule proved to be associated with allergy now viewed as an immune system disorder! %he typing of blood by immune specificity has made transfusion safe and widely applicable! In recent years new and better methods of seeing inside the human body have revolutionized medical diagnosis! %he computerized a$ial tomography =C&%> scanner is a computer)assisted ?)ray device! Nuclear magnetic resonance imaging employs radio waves to identify molecular structure! Cltrasound produces images from sound waves and positron emission tomography scans the body with antimatter! %he treatment of mental disorders first became scientific and successful in the @0th century! %he &ustrian physician and neurologist 'igmund ;reud pioneered the methods of psychoanalysis! %reatment of psychosis by lobotomy and electroconvulsive therapy began in the 7:*0s although these are now seldom used! Drug therapy for mental illness became possible in the 7:/0s! %he first drugs widely used to treat schizophrenia the phenothiazines have since been "oined by lithium for manic depressive disease and tricyclic antidepressants for depression! Despite these successes physicians now realize that some patients are not helped by drugs and that supportive psychological therapy must be provided as well! ,eart disease the number one (iller in 2estern countries has declined dramatically because of recent medical advances such as cardiac catheterization angiography nerve) bloc(ing drugs heart valve replacement arterial bypass surgery and heart transplants! Increased awareness of the ris(s of smo(ing stress obesity high blood pressure and elevated blood cholesterol have also helped reduce heart disease! Cancer has become more prevalent in the @0th century! 3esearch has lin(ed some cancers with e$posure to certain chemicals# smo(ing is (nown to cause lung cancer and other cancers! 'urgery and radiation were primary means of treatment until the 7:E0s when drug therapy also became effective against cancer! %he discovery of vitamins and their importance to the body produced important advances in nutritional medicine! &n e$ample is the discovery of vitamin + 7@ and its use to treat pernicious anemia! 'imilarly improved understanding of the hormones led to better control of conditions such as hypothyroidism or cretinism treated with thyroid e$tract diabetes mellitus treated with insulin and various reproductive disorders treated with synthetic testosterone and estrogen! &dvances have been made in birth control with the improvement of intrauterine devices and the development of oral contraceptives! 'olutions to some fertility problems have been provided by in vitro fertilization =Ftest)tubeG babies> and transplantation of fertilized ova from one womb to another! Diagnosis of some birth defects can now be made through amniocentesis! Comple$ medical ethics problems have gained increasing attention especially the .uestion of abortion and the decision whether to remove life support systems from terminally ill patients! Medical treatments became increasingly e$pensive in the @0th century and many people came to distrust the orthodo$ medical establishment! %his situation led in the Cnited 'tates to the consumer medical movement in which people attempted to ta(e control of their own health largely through preventive medical practices and to understand more about normal and diseased bodily function! -utgrowths of the movement included many popular medical reference boo(s and development of the field of holistic medicine which promotes good nutrition physical e$ercise and Fself)regulationG techni.ues such as biofeedbac( and rela$ation!