The Development of Scientific Medicine

The Development of Scientific Medicine

A. EARLY HUMANS: (before 3000 B.C.) 1. Supernatural Belief Systems: magical-religious or supernatural explanations of disease. Causes of disease: by direct intervention of a god or spirit, or through a sorcerer/magician or through the intrusion of some foreign object into the body. Cures: religious rituals (prayer, magic spells, exorcism, dancing, sacrifices) or physical means (sucking out, vomiting, bloodletting, skull trephination) 2. The first physicians were known as the shaman (or the witch doctor or medicine man).

ANCIENT CIVILIZATIONS: EGYPT AND MESOPOTAMIA (3000 B.C.) 1. Egyptian physicians were specialists and religious leaders. Each was devoted to a different god. Diseases were associated with their deity. 2. In Mesopotamia, medicine and religion were intertwined; disease was considered a punishment for sin, and the intervention of a medical-religious agent was necessary for cure.

GREEK AND ROMAN SOCIETIES: (2000 B.C.) Apollo, the sun god, was also god of health and medicine. 2. Aesculapius, son of Apollo, was the Greek god of health. 3. Temples called "asklepieia" were created where priest-physicians could practice. 4. Hippocrates: The Father of Medicine. (460-377 B.C.)

Hippocrates: The Father of Medicine. (460-377 B.C.) Contributions: The principle of natural, rather than supernatural explanations for disease (the natural elements such as air, earth, fire, and water balance with the element in the body such as blood (hot), phlegm (cold), yellow bile (dry), and black bile (wet)). His teaching of human compassion and ethical standards: Hippocratic Oath. The regular physicians adopted the Hippocratic oath and code of ethics as their standard. Among other things, this oath forbids abortion.

Asclepiades (a Greek physician) Causes of disease: health and illness were determined by the condition of the pores - either too open or too closed. Cure: massage, diet (wine) and baths.

Roman contributions to medicine public health (pure water, public baths, street cleanliness, and hospitals). Galen: The Father of Experimental Physiology

THE MEDIEVAL ERA: (A.D. 500-1500) 1. Monastic Medicine: church controlled the medical practice. Disease and illness are beneficial in that they test one's faith and commitment to God and the church. Causes of disease: due to the punishment by God, possession by the devil, or the result of witchcraft.

THE MEDIEVAL ERA: (A.D. 500-1500) (II) think of the body as a machine, of disease as a breakdown of the machine, and of the doctor s task as repair of the machine (Engel, 1977) 2. Arabic Medicine: built hospitals and bestowed high prestige on private physicians. 3. Scholastic Medicine: medicine practice became the province of the secular clergy, and universities began to plan a prominent role in the education of physicians.

MEDICINE IN THE RENAISSANCE: (15C - 16C) 1. Focuses on humanism: dignity of the individual, the importance of this life, and spiritual freedom. 2. Medical specialization: physicians, surgeons, barber surgeons and apothecaries (today s term pharmacist).

MEDICINE FROM 1600 TO 1900 1. William Harvey's confirmation of the circulation of blood. 2. In the 17C, scientific medicines were met with skepticism, medicine superstitions were common, some physicians focused on the physician-patient relationship and on the body's self-healing capacity. 3. In the 18C: Development of a modern concept of pathology: Morgagni's anatomical concept of disease - diseases could be traced to a particular pathology or disturbance in individual organs. The emergence of public health and preventive medicine. Alternative paths of medicine.

MEDICINE FROM 1600 TO 1900 (II) 4. In the 19C: industrialization accompanied with migration and urbanization: Hospital medicine and laboratory medicine. Discovery of the cell by Rudolf Virchow, who emphasized on the importance of environmental influences on health and illness. The germ theory of disease by Louis Pasteur (the Father of Modern Medicine) Progress in surgery: an understanding of the localized nature of disease, an ability to control patient's pain in the surgical process, and an ability to prevent wound infection.

The germ theory of disease Each disease is caused by a specific bacterium or agent (the basis of scientific medicine) and human body is the medium for disease. Implicitly denied a role to social and economic factors in disease causation. In the absence of a verifiable clinical entity, the patient was by definition (health is the absence of disease) pronounced healthy. His/her protestations of feeling ill became a matter for the psychiatrist.

THE ASCENDANCY OF MEDICAL AUTHORITY IN AMERICA 1. Native Americans relied mostly on supernatural explanations for disease and illness. 2. Early medical care was provided by colonists (often clergy) who had some formal education. 3. The first comprehensive hospital was built in 1751, the first efforts to license medicine came in 1760 the first formalized medical school was established in 1765, and the first state medical society was organized in 1766. 4. Domestic medicine was prevailing. 5. The revolution to the mid-1800s: progress, but medicine remained a very downgraded occupation. Physicians were poorly paid due to different reasons.

THE ASCENDANCY OF MEDICAL AUTHORITY IN AMERICA (II) 6. Alternative healing philosophies: Thomsonianism (botanical healing) and homeopathy (a system of medical practice that treats a disease especially by the administration of minute doses of a remedy that would in healthy persons produce symptoms similar to those of the disease). 7. Professional nursing and the ambulance corps were begun during the civil war. 8. Medical advancements especially between 1920s and 1940s. 9. American Medical Association was formed in 1847. 10. Forces stimulating professionalization: the discovery of the germ theory of disease; medical licensure requirements; control of medical education.

PERSPECTIVES ON THE ASCENDANCY OF MEDICAL AUTHORITY 1. Paul Starr: the professions develop authority in order to maintain their position - social authority and cultural authority 2. Vicente Navarro: the ascendancy of medical authority occurred because it served the interests of powerful societal groups (government, the wealthy, the corporate sector).

The effects of global stratification on health care Global stratification -- Three Worlds of Development 1. The simple model of First, Second, and Third Worlds is outmoded. 2. Both this model and its alternative, using developed, developing, and undeveloped nations, are judgmental. 3. Henslin: -- most Industrialized, Industrializing, and Least Industrialized Nations (basing on global levels of property, power, and prestige)

The effects of global stratification on health care (II) International stratification of medical care (consequence of global domination by the most industrialized nations) The least industrialized nations cannot afford the technology that affects all aspects of health, from life expectancy to the prevention of specific diseases.