8/8/2019 Whole Document

http://slidepdf.com/reader/full/whole-document 1/18

University of Health Science General English Program

Medicine Department Academic Year 2009- 2010

 

Prehistoricmedicine

Although there is no record to establish when plants were first used for medicinal purposes

(herbalism), the use of plants as healing agents is an ancient practice. Over time through emulation of the

 behavior of fauna a medicinal knowledge base developed and was passed between generations. As tribal

culture specialized specific castes, Shamans and apothecaries performed the 'niche occupation' of healing.

Medicine that predates written records, evolving with the emergence of modern hominids over 2

million years ago. The study of prehistoric medicine is mainly dependent on sources such as skeletons,

artefacts, and cave paintings, and draws heavily on anthropological studies of indigenous cultures in Asia,

Australasia, Africa, and the Americas. Prehistoric people relied on a combination of religious beliefs and

 practical treatments made from local materials to treat their ailments. Their anatomical knowledge

appeared to be very slight, and they believed that illnesses were caused by supernatural media, such as the

gods or curses. Rational treatment was used only on obvious injuries, otherwise spiritual treatment was

carried out by a shaman or medicine man, who received his medical ability through his relationship with

the gods.

Prehistoric medicine incorporated plants (herbalism), animal parts and minerals. In many cases

these materials were used ritually as magical substances by priests, shamans, or medicine men. Well-

known spiritual systems include animism (the notion of inanimate objects having spirits), spiritualism (an

appeal to gods or communion with ancestor spirits); shamanism (the vesting of an individual with mystic

 powers); and divination (magically obtaining the truth). The field of medical anthropology examines the

ways in which culture and society are organized around or impacted by issues of health, health care and

related issues.

 

Research by: Khon Mengyou 1

8/8/2019 Whole Document

http://slidepdf.com/reader/full/whole-document 2/18

University of Health Science General English Program

Medicine Department Academic Year 2009- 2010

 

The ancient Sumerian god Ningishzida, the patron of medicine, accompanied by two gryphons

History of medicine

All human societies have medical beliefs that provide explanations for  birth, death, and disease.

Throughout history, illness has been attributed to witchcraft, demons, adverse astral influence, or the will

of the gods. These ideas still retain some power, with faith healing and shrines still used in some places,

although the rise of scientific medicine over the past millennium has altered or replaced mysticism in

most cases.

Early records on medicine have been discovered from ancient Egyptian medicine, Babylonian

medicine, Ayurvedic medicine (in the Indian subcontinent), classical Chinese medicine (predecessor to

the modern traditional Chinese Medicine), and ancient Greek medicine and Roman medicine. The

Egyptian Imhotep (3rd millennium BC) is the first physician in history known by name. Earliest records

of dedicated hospitals come from Mihintale in Sri Lanka where evidence of dedicated medicinal

treatment facilities for patients are found.

 

Statuette of ancient Egyptian physician Imhotep, the first physician from antiquity known by

name.

Research by: Khon Mengyou 2

8/8/2019 Whole Document

http://slidepdf.com/reader/full/whole-document 3/18

University of Health Science General English Program

Medicine Department Academic Year 2009- 2010

 

Hippocrates

Greece was home to one of the earliest civilisations. Writing, mathematics, philosophy and the

arts all flourished. The Greeks believed in many different gods but they also tried to understand their 

world in a much more scientific way.

Possibly the most famous name in medicine belongs to the Greek philosopher Hippocrates. He is

seen as the father of modern medicine and gives his name to the Hippocratic oath that doctors take.

Hippocrates – famed for the Hippocratic oath

At this time, most people believed that diseases were sent as a punishment from the gods.

Treatments were aimed at pleasing the gods so that the disease would be cured.

Hippocrates went against this conventional thinking and looked on the body as having a balance

 between four humors: blood, phlegm, black bile, and yellow bile. If a person was ill, it meant that there

was an imbalance in their humors and so they would take a treatment to return the balance back to

normal. This often included bleeding or induced vomiting. This radical approach took medicine out of thespiritual world and the four humors formed the basis of medical treatments well into medieval times.

Research by: Khon Mengyou 3

8/8/2019 Whole Document

http://slidepdf.com/reader/full/whole-document 4/18

University of Health Science General English Program

Medicine Department Academic Year 2009- 2010

 

Tradition knows seven physicians named Hippocrates, of whom the second is regarded as the

most famous. Of his life we know but little. He was born at Cos in 460 or 459 B.C., and died at Larissa 

about 379. How great his fame was during his lifetime is shown by the fact that Plato compares him with

the artists Polycletus and Phidias. Later he was called "the Great" or "the Divine". The historical kernel is probably as follows: a famous physician of this name from Cos flourished in the days of Pericles, and

subsequently many things, which his ancestors or his descendants or his school accomplished, were

attributed to him as the hero of medical science. The same was true of his writings. What is now known

under the title of "Hippocratis Opera" represents the work, not of an individual, but of several persons of 

different periods and of different schools. It has thus become customary to designate the writings ascribed

to Hippocrates by the general title of the "Hippocratic Collection" (Corpus Hippocraticum), and to divide

them according to their origin into the works of the schools of Cnidus and of Cos, and of the Sophists.

How difficult it is, however, to determine their genuineness is shown that even in the third century beforeChrist the Alexandrian librarians, who for the first time collected the anonymous scrolls scattered through

Hellas, could not reach a definite conclusion. For the development of medical science it is of little

consequence who composed the works of the school of Cos for they are more or less permeated by the

spirit of one great master. The secret of his immortality rests on the fact that he pointed out the means

whereby medicine became a science. His first rule was the observation of individual patients,

individualizing in contradistinction to the schematizing of the school of Cnidus. By the observation of all

the principles were gradually derived from experience, and these, uniformly arranged, led by induction to

a knowledge of the nature of the disease, its course, and its treatment. This is the origin of the famous

"Aphorismi", short rules which contain at times principles derived from experience and at times

conclusions drawn from the same source. They form the valuable part of the collection. The school of 

Cos and its adherents, the Hippocratics, looked upon medical science from a purely practical standpoint;

they regarded it as the art of healing the sick, and therefore laid most stress on prognosis and treatment by

aiding the powers of nature through dietetic means, while the whole school of Cnidus prided itself upon

its scientific diagnosis and, in harmony with money with the East, adopted a varied medicinal treatment.

The method which the school of Cos established more than 2000 years ago has proved to be the

only one, and thus Hippocratic medial science celebrated its renascence in the eighteenth century with

Boerhaave at Leyden and subsequently with Gerhard van Swieten at Vienna. In his endeavour to the truth 

the earnest investigation often reaches an impassable barrier. There is nothing more tempting than to seek an outlet by means of reflection and deduction. Such a delusive course may easily become fatal to the

 physicist; but a medical system, erected upon the results of speculative investigation, carries the germ of 

death within itself.

Hippocrates made such an impression on medical history that his name is still very much

associated with medicine today. All newly qualified doctors take what is called the ‘Hippocratic Oath’

and some see Hippocrates as the father of modern medicine even though he did most of his work some

430 years before the birth of Christ.

Greek doctors had started to look at the issue of poor health and disease by using a process of 

reasoning and observation. The most famous of these was Hippocrates. He is thought to have been born in

Cos in 460 BC. In fact, we know very little about Hippocrates as a person but his fame was such that

Research by: Khon Mengyou 4

8/8/2019 Whole Document

http://slidepdf.com/reader/full/whole-document 5/18

University of Health Science General English Program

Medicine Department Academic Year 2009- 2010

 

Plato and Aristotle wrote about him. While Hippocrates has found fame in medical history, there were

other Ancient Greek doctors who were not so lucky.

Ancient Greek medical knowledge is demonstrated in what is known as the Hippocratic

Collection. This is a collection of sixty medical books of which Hippocrates wrote just some. We do not

know who wrote most of them but they cover a time span of 150 years so they could not have all beenwritten by Hippocrates.

Hippocrates and other Greek doctors believed that the work done by a doctor should be kept

separate from the work done by a priest. They believed that observation of a patient was a vital aspect of 

medical care. Ancient Greek doctors did examine their patients but Hippocrates wanted a more systematic

 period of observation and the recording of what was observed. Today, we would call this ‘clinical

observation’. Such ideas have lead to Hippocrates being called the ‘Father of Medicine’.

The Greek physician Hippocrates, considered the "father of medicine", laid the foundation for a

rational approach to medicine. Hippocrates introduced the Hippocratic Oath for physicians, which is still

relevant and in use today, and was the first to categorize illnesses as acute, chronic, endemic and

epidemic, and use terms such as, "exacerbation, relapse, resolution, crisis, paroxysm, peak, and

convalescence". The Indian surgeon Sushruta is considered the father of surgery, having described

numerous surgical operations, including the earliest forms of plastic surgery. The Greek physician Galen 

was also one of the greatest surgeons of the ancient world and performed many audacious operations,including brain and eye surgeries. After the fall of the Western Roman Empire and the onset of the Dark 

Ages, the Greek tradition of medicine went into decline in Western Europe, although it continued

uninterrupted in the Eastern Roman (Byzantine) Empire.

 

The Greek physician Hippocrates (ca. 460 BCE – ca. 370 BCE), considered the father of Western

medicine.

Research by: Khon Mengyou 5

8/8/2019 Whole Document

http://slidepdf.com/reader/full/whole-document 6/18

University of Health Science General English Program

Medicine Department Academic Year 2009- 2010

 

GalenDeparture from the Hippocratic observation of nature led physicians to form numerous mutually

opposing sects. A man of great industry and comprehensive knowledge, Galen of Pergamum (about A.D.

130-201), tried to rescue medical science from this labyrinth. He chose the path of eclecticism, on which

he built his (as he thought) infallible system. Whatever sense-perception and clinical observation left

obscure, he tried to explain in a speculative manner. That this system of teaching could hold medicine in

 bondage until modern times shows the genius of the master, who understood how to cover up the gaps by

 brilliancy of style. Galen took the entire anatomical knowledge of his time, and out of it produced a work 

the substance of which was for centuries regarded as inviolable. His anatomy was to a large extent based

upon the dissection of mammals, especially of monkeys, and, like his physiology, was under teleological 

influence. His presentation of things lacks dispassionateness. Instead of explaining the functions of organs

on the basis of their structure, Galen chose this reverse method. His anatomy and physiology were the

most vulnerable part of his system, and an earnest re-examination of these fields must necessarily have

shaken his entire scheme of teaching. Galen expressed the greatest respect for Hippocrates, published his

most important works with explanatory notes, but never entered into the spirit of the school of Cos,

although he adopted many of its doctrines. Galen is the culminating point and end of ancient Greek 

medical science. In his vanity he thought he had completed all investigation, and that his successors had

only to accept without effort what he had discovered. As will be shown in the following paragraph, hisadvice was, unfortunately for science, followed literally.

The Romans conquered the Greeks and this brought a lot of their ideas about healthcare into use

across the Roman empire. Galen was a Greek physician who emigrated to Rome and became the

 principal doctor for many of the professional gladiators. At that time, it was illegal to dissect human

 bodies and so he dissected animals to find out how their bodies worked. This knowledge helped Roman

doctors to improve their techniques in surgery. They developed new instruments and much of their 

knowledge was gained treating casualties in the many wars of conquest that the Romans fought. Military

settlements had hospitals to treat soldiers and army surgeons became proficient in removing arrows and

they could stitch wounds. Records also show that they were able to treat bladder stones, hernias, and

cataracts.

Research by: Khon Mengyou 6

8/8/2019 Whole Document

http://slidepdf.com/reader/full/whole-document 7/18

University of Health Science General English Program

Medicine Department Academic Year 2009- 2010

 

Galen. One of the first physicians to use dissections to understand how the body works.

Courtesy of the Blocker History of Medicine Collections, University of Texas, USA.

After 750 CE, the Muslim Arab world had the works of Hippocrates, Galen and Sushruta

translated into Arabic, and Islamic physicians engaged in some significant medical research. Notable

Islamic medical pioneers include the polymath, Avicenna, who, along with Imhotep and Hippocrates, has

also been called the "father of medicine". He wrote The Canon of Medicine, considered one of the most

famous books in the history of medicine. Others include Abulcasis, Avenzoar, Ibn al-Nafis, and Averroes. 

Rhazes was one of first to question the Greek theory of humorism, which nevertheless remained

influential in both medieval Western and medieval Islamic medicine. The Islamic Bimaristan hospitals

were an early example of  public hospitals. However, the fourteenth and fifteenth century Black Death was

 just as devastating to the Middle East as to Europe, and it has even been argued that Western Europe was

generally more effective in recovering from the pandemic than the Middle East. In the early modern

 period, important early figures in medicine and anatomy emerged in Europe, including Gabriele Falloppio

and William Harvey.

A Latin copy of The Canon of Medicine, written by Avicenna, who is also considered the father of 

medicine.

The major shift in medical thinking was the gradual rejection, especially during the Black Death 

in the 14th and 15th centuries, of what may be called the 'traditional authority' approach to science and

medicine. This was the notion that because some prominent person in the past said something must be so,

then that was the way it was, and anything one observed to the contrary was an anomaly (which was

 paralleled by a similar shift in European society in general - see Copernicus's rejection of Ptolemy's

theories on astronomy). Physicians like Ibn al-Nafis and Vesalius improved upon or disproved some of 

the theories from the past.

Research by: Khon Mengyou 7

8/8/2019 Whole Document

http://slidepdf.com/reader/full/whole-document 8/18

University of Health Science General English Program

Medicine Department Academic Year 2009- 2010

 

An ancient Greek patient gets medical treatment: this aryballos (circa 480-470 BCE, now in Paris's

Louvre Museum) probably contained healing oil

First universities in the west

Having voluntarily undertaken the education of the young in all branches of learning, the

monasteries were aided in their endeavours by both Church and State. The foundation of state schools is

the work of Charlemagne (768-814), whose activity, especially in the Germanic countries, was stimulated

 by the decree of the Synod of Aachen (789), that each monastery and each cathedral chapter should

institute a school. According to the Capitulary of Charlemagne at Diedenhofen (Thionville) in 806,

medicine was commonly taught in these schools. At the diocesan school in Reims, we find Gerbert

d'Aurillac, later Pope Sylvester II (999-1003), long active as a teacher of medicine. Simultaneously with

the rise of the cities there sprang up higher municipal schools, as for instance the Burgerschule at St.

Stephan's in Vienna (about 1237). Out of the secular and religious schools, the curriculum of which

institutions comprised the entire learning of the times, the first universities developed themselves partly

under imperial and partly under  papal protection, according as they sprang from the lay and the cathedral or monastic schools.

Research by: Khon Mengyou 8

8/8/2019 Whole Document

http://slidepdf.com/reader/full/whole-document 9/18

University of Health Science General English Program

Medicine Department Academic Year 2009- 2010

 

From the pre-historic times through the Egyptian, Greek and Roman civilizations, as well as

elsewhere. Things picked up beginning in around the 1400s CE as we approach what later historians came

to call the Renaissance—a word meaning “re-birth,” because other forms of knowledge from ancient

times and the Islamic world—i.e., knowledge that didn’t come through the monasteries—became more

recognized; and the first principles of science were articulated, dealing with questioning authority and

experimenting.

For thousands of years people have sought to help in healing, and this process involved not just

treatment, and more accurate diagnosis, but the word, diagnosis, means gnosis–knowing, and dia, as in

diaphanous, semi-trasparent, see-through— means understanding. It's not just a matter of slapping a

clever-sounding label on something. To understand involves in turn a continuous process of research,

which in turn implies various forms of inductive and deductive reasoning, theory building, and

experimentation. This last, the practice of experiment, became a mainstream with the emergence of 

science as a way of dealing with knowledge, instead of blindly accepting authority. I’ll note here that this

new way of thinking by no means has become established, and traditional modes of learning still prevailin many fields and regions.

Consider, for example, the emerging field of anatomy. It became conceivable at least to a few

daring people to think that what was in the books that had guided the world for what seemed like forever 

 —maybe a thousand years or more—might be (gulp) mistaken! Anatomy involves what is inside, and that

requires cutting open the human body to look—which was not just kinda icky, but religiously taboo. So it

wasn’t done. People speculated. Some people back in the Roman era dissected animals and just guessed

that humans were also built something like that. That’s true in a very rough way, but there are lots of 

differences in the specifics, and knowing the right anatomy then leads to the construction of more

accurate theories of disease, which then can lead oh so gradually to the search for appropriate treatments.

Research by: Khon Mengyou 9

8/8/2019 Whole Document

http://slidepdf.com/reader/full/whole-document 10/18

University of Health Science General English Program

Medicine Department Academic Year 2009- 2010

 

Consider this picture:

 There are in fact many inaccuracies, such as the location of the womb, the uterus, off to the left

side rather than in the center.

Around the same time, in Italy, there were a few people who dared to look for themselves, and one

of these was the polymath—one who is brilliant in many ways—, Leonardo da Vinci. He did the next two

 pictures around 1501 and 1508, and they were based on observations made of actual dissections.

Research by: Khon Mengyou 10

8/8/2019 Whole Document

http://slidepdf.com/reader/full/whole-document 11/18

University of Health Science General English Program

Medicine Department Academic Year 2009- 2010

 

It was a characteristic of the Renaissance that in a few places people were pushing the edges of 

what had been taboo in most of Europe—and dissections were one of these frontiers. Interestingly, in

spite of creating far more accurate pictures than what others had done previously, to some extent

Leonardo still saw what he was told he would see by recognized authorities, and in certain crucial details

that we’ll note later, he was wrong. For example, note the thin lines or vaguely perceived ducts between

the top of the uterus—in spite of the male looking chest, this is a woman’s body— and the breast area?

We now know they don’t exist, but they were said to back then, so he put them in. It’s kinda messy in

there in real action of dissection, so you’re not always sure what you’re looking at. The belief that thesechannels existed were part and parcel of the mistaken theories of why women sometimes got fatal

infections after having babies, and we’ll talk about that more in the next lecture.

 

About 50 years later another pioneer, Andreas Vesalius, did the first real anatomical research. He

really looked, and looked carefully, refusing to rely on the traditional textbooks that had remained

authoritative for a thousand years!

Research by: Khon Mengyou 11

8/8/2019 Whole Document

http://slidepdf.com/reader/full/whole-document 12/18

University of Health Science General English Program

Medicine Department Academic Year 2009- 2010

 

Gross anatomy emerged as a science rather than as an encrusted academic tradition—as something

in which people looked for themselves, did experiments—anatomy in this sense was new. Even then,

small errors have continued to be corrected by other anatomists over the last several hundred years.

 

Part of the last few slides are instructive, because this process of moving towards science was not

clear-cut. One could be progressive in this way and in another realm, still mired in traditional modes of 

thought. For example, the person who is considered the epitome of science and modernity, Isaac Newton,

was certainly a pioneer in a number of ways, but he was also immersed deeply in alchemy (see below,

and compare with notes about alchemy on another webpage on this site, about 1/3 way down)... , and

indeed, may have spend more time researching and writing in notebooks about that than all the time he

spent on the things he’s more widely known for today—calculus, optics, gravity, and so forth.

Research by: Khon Mengyou 12

8/8/2019 Whole Document

http://slidepdf.com/reader/full/whole-document 13/18

University of Health Science General English Program

Medicine Department Academic Year 2009- 2010

 

So, in the century following Columbus’ discovery of what he called a “new world”—it wasn’t

new to the folks who lived here—there were many discoveries, of worlds out there in the heavens and a

new view of worlds inside the human body. We’ll talk soon about another world within that world, the

world that is revealed as folks began to examine the tissues microscopically! Most of the events of these

talks, though, emerged mainly between around 1790 through 1880—that is, mainly in the 19th century.

That’s when your great-great-grandparents were alive, so it’s not all that very long ago!

 

History is a vast field, but I enjoy focusing on one aspect at a time. In other lecture series I’ve

spoken about the history of writing, the history of psychotherapy, and so forth. Being a physician, an

M.D., I’m especially interested in the history of medicine, because for me it offers lessons for today about

the complexity of events, how knowledge comes to be disseminated and used in culture.

Modern medicine 

Medicine was revolutionized in the 19th century and beyond by advances in chemistry and

laboratory techniques and equipment, old ideas of infectious disease epidemiology were replaced with

 bacteriology and virology.

Bacteria and microorganisms were first observed with a microscope by Antonie van Leeuwenhoek in

1676, initiating the scientific field microbiology.

Research by: Khon Mengyou 13

8/8/2019 Whole Document

http://slidepdf.com/reader/full/whole-document 14/18

University of Health Science General English Program

Medicine Department Academic Year 2009- 2010

 

Ignaz Semmelweis (1818–1865) in 1847 dramatically reduced the death rate of new mothers from

childbed fever by the simple expedient of requiring physicians to clean their hands before attending to

women in childbirth. His discovery pre-dated the germ theory of disease. However, his discoveries were

not appreciated by his contemporaries and came into general use only with discoveries of British surgeonJoseph Lister , who in 1865 proved the principles of antisepsis in the treatment of wounds; However,

medical conservatism on new breakthroughs in pre-existing science prevented them from being generally

well received during the 19th century.

After Charles Darwin's 1859 publication of  The Origin of Species, Gregor Mendel (1822–1884)

 published in 1865 his books on pea plants, which would be later known as Mendel's laws. Re-discovered

at the turn of the century, they would form the basis of classical genetics. The 1953 discovery of the

structure of DNA by Watson and Crick would open the door to molecular biology and modern genetics.

During the late 19th century and the first part of the 20th century, several physicians, such as Nobel prize

winner Alexis Carrel, supported eugenics, a theory first formulated in 1865 by Francis Galton. Eugenics

was discredited as a science after the Nazis' experiments in World War II became known; however,compulsory sterilization programs continued to be used in modern countries (including the US, Sweden

and Peru) until much later.

Semmelweis's work was supported by the discoveries made by Louis Pasteur . Linking

microorganisms with disease, Pasteur brought about a revolution in medicine. He also invented with

Claude Bernard (1813–1878) the process of  pasteurization still in use today. His experiments confirmed

the germ theory. Claude Bernard aimed at establishing scientific method in medicine; he published An

 Introduction to the Study of Experimental Medicine in 1865. Beside this, Pasteur, along with Robert Koch

(who was awarded the Nobel Prize in 1905), founded bacteriology. Koch was also famous for the

discovery of the tubercle bacillus (1882) and the cholera bacillus (1883) and for his development of Koch's postulates.

The participation of women in medical care (beyond serving as midwives, sitters and cleaning

women) was brought about by the likes of Florence Nightingale. These women showed a previously male

dominated profession the elemental role of nursing in order to lessen the aggravation of patient mortality

which resulted from lack of hygiene and nutrition. Nightingale set up the St Thomas hospital, post-

Crimea, in 1852. Elizabeth Blackwell (1821–1910) became the first woman to formally study, and

subsequently practice, medicine in the United States.

It was in this era that actual cures were developed for certain endemic infectious diseases.

However the decline in many of 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 the application of the scientific

method to medical research began to produce multiple important developments in medicine, with great

advances in pharmacology and surgery.

Research by: Khon Mengyou 14

8/8/2019 Whole Document

http://slidepdf.com/reader/full/whole-document 15/18

University of Health Science General English Program

Medicine Department Academic Year 2009- 2010

 

“Anatomy lesson of Dr. Nicolaes Tulp,” by Rembrandt van Rijin, 1632.

Modern scientific  biomedical research (where results are testable and reproducible) began to

replace early Western traditions based on herbalism, the Greek "four humours" and other such pre-

modern notions. The modern era really began with Edward Jenner's discovery of the smallpox vaccine at

the end of the 18th century (inspired by the method of  inoculation earlier practiced in Asia), Robert 

Koch's discoveries around 1880 of the transmission of disease by bacteria, and then the discovery of 

antibiotics around 1900. The post-18th century modernity period brought more groundbreaking

researchers from Europe. From Germany and Austrian doctors (such as Rudolf Virchow, Wilhelm 

Conrad Röntgen, Karl Landsteiner , and Otto Loewi) made contributions. In the United Kingdom

Alexander Fleming, Joseph Lister , Francis Crick , and Florence Nightingale are considered important.From New Zealand and Australia came Maurice Wilkins, Howard Florey, and Frank Macfarlane Burnet).

In the United States William Williams Keen, Harvey Cushing, William Coley, James D. Watson, Italy

(Salvador Luria), Switzerland (Alexandre Yersin), Japan (Kitasato Shibasaburo), and France (Jean-Martin 

Charcot, Claude Bernard, Paul Broca and others did significant work). Russian Nikolai Korotkov also did

significant work, as did Sir William Osler and Harvey Cushing.

As science and technology developed, medicine became more reliant upon medications. 

Throughout history and in Europe right until the late 18th century not only animal and plant products

were used as medicine, but also human body parts and fluids.[25] Pharmacology developed from herbalism

and many drugs are still derived from plants (atropine, ephedrine, warfarin, aspirin, digoxin, vinca

alkaloids, taxol, hyoscine, etc.). The first of these was arsphenamine / Salvarsan discovered by PaulEhrlich in 1908 after he observed that bacteria took up toxic dyes that human cells did not. Vaccines were

discovered by Edward Jenner and Louis Pasteur . The first major class of antibiotics was the sulfa drugs,

derived by French chemists originally from azo dyes. This has become increasingly sophisticated; modern

 biotechnology allows drugs targeted towards specific physiological processes to be developed, sometimes

designed for compatibility with the body to reduce side-effects. Genomics and knowledge of human

genetics is having some influence on medicine, as the causative genes of most monogenic genetic

disorders have now been identified, and the development of techniques in molecular biology and genetics

are influencing medical technology, practice and decision-making.

Research by: Khon Mengyou 15

8/8/2019 Whole Document

http://slidepdf.com/reader/full/whole-document 16/18

University of Health Science General English Program

Medicine Department Academic Year 2009- 2010

 

Evidence-based medicine is a contemporary movement to establish the most effective algorithms 

of practice (ways of doing things) through the use of systematic reviews and meta-analysis. The

movement is facilitated by modern global information science, which allows as much of the available

evidence as possible to be collected and analyzed according to standard protocols which are then

disseminated to healthcare providers. One problem with this 'best practice' approach is that it could be

seen to stifle novel approaches to treatment[citation needed ]. The Cochrane Collaboration leads this movement.A 2001 review of 160 Cochrane systematic reviews revealed that, according to two readers, 21.3% of the

reviews concluded insufficient evidence, 20% concluded evidence of no effect, and 22.5% concluded

 positive effect.[26]

During the 1910s, medicine was closely related to church in most of Europe including the United

Kingdom. Most doctors took permission of the church before prescribing any medicine to patients.[53]

Before surgeries, permission of the church was mandatory.[53] During the First World War, Alexis Carrel and Henry Dakin developed the Carrel-Dakin method of treating wounds with an irrigation, Dakin's

solution, a germicide which helped prevent gangrene.

The Great War spurred the usage of Roentgen's X-ray, and the electrocardiograph, for the

monitoring of internal bodily functions. This was followed in the inter-war period by the development of 

the first anti-bacterial agents such as the sulpha antibiotics. The Second World War saw the introduction

of widespread and effective antimicrobial therapy with the development and mass production of  penicillin

antibiotics, made possible by the pressures of the war and the collaboration of British scientists with theAmerican pharmaceutical industry.

Lunatic asylums began to appear in the Industrial Era. Emil Kraepelin (1856–1926) introduced

new medical categories of mental illness, which eventually came into psychiatric usage despite their basis

in behavior rather than pathology or etiology. In the 1920s surrealist opposition to psychiatry was

expressed in a number of surrealist publications. In the 1930s several controversial medical practices were

introduced including inducing seizures (by electroshock , insulin or other drugs) or cutting parts of the

 brain apart (leucotomy or lobotomy). Both came into widespread use by psychiatry, but there were grave

concerns and much opposition on grounds of basic morality, harmful effects, or misuse. In the 1950s new psychiatric drugs, notably the antipsychotic chlorpromazine, were designed in laboratories and slowly

came into preferred use. Although often accepted as an advance in some ways, there was some

opposition, due to serious adverse effects such as tardive dyskinesia. Patients often opposed psychiatry

and refused or stopped taking the drugs when not subject to psychiatric control. There was also increasing

opposition to the use of psychiatric hospitals, and attempts to move people back into the community on a

collaborative user-led group approach ("therapeutic communities") not controlled by psychiatry.

Campaigns against masturbation were done in the Victorian era and elsewhere. Lobotomy was used until

the 1970s to treat schizophrenia. This was denounced by the anti-psychiatric movement in the 1960s andlater.

Research by: Khon Mengyou 16

8/8/2019 Whole Document

http://slidepdf.com/reader/full/whole-document 17/18

University of Health Science General English Program

Medicine Department Academic Year 2009- 2010

 

The 20th century 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,

with greater development of international projects such as the Human genome project.

Reference

Research by: Khon Mengyou 17

8/8/2019 Whole Document

http://slidepdf.com/reader/full/whole-document 18/18

University of Health Science General English Program

Medicine Department Academic Year 2009- 2010

 

1 http://www.talktalk.co.uk 

2 http://www.blatner.com/adam/consctransf/historyofmedicine

3 http://en.wikipedia.org/wiki/History_of_medicine

4 http://healthsciencetechnology.wikispaces.com/The History of Modern Medicine

5 http://www.answersingenesis.org/creation/v17/i1/medicine.asp

6 http://en.wikipedia.org/wiki/History_of_medicine#cite_note-Brock-51