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 major part in the treatment, but so were cleaning and treating wounds by
burning, poultices, and stitching; resetting and splinting dislocations and fractures; purges,
diuretics, laxatives, emetics, and enemas. The use of plant extracts as medical treatments was
especially important.
As humans formed distinct cultures, the two trends in primitive medicine became
more institutionalized. Sorcerers and priests took up the magico-religious approach. The
empirico-rational trend, based on experience and observation and lacking in mystical features,
was practiced at first by priests but was taken up increasingly by nonreligious physicians.
Modern medicine arose primarily from the empirico-rational trend, as the human body and its
functions became better known and as science led medical practice away from superstition
and the spiritual realm.

Ancient Medical Practice In ancient Egypt, by the 3rd Dynasty, the physician
emerged as an early form of scientist. The Egyptians practiced embalming but their
anatomical knowledge remained at a low level, and they attempted only minor surgical
procedures. In Assyria and Babylonia, the liver was considered the seat of the soul and was
studied to determine the intentions of the gods. Hebrew medicine was influenced by the Old
Testament and emphasized hygienic regulations, midwifery, feminine hygiene, separation of
the sick, and disinfection of materials capable of harboring and transmitting germs. Ancient
Hindu medicine became quite sophisticated, especially in the field of operative surgery.
Ancient Chinese medicine utilized acupuncture and a wide array of drugs, including opium.
By the 500s BC, Greek medicine had become thoroughly nonreligious, stressing
clinical observation. Greek physicians based their doctrine on experience gained by trial and
error. The Greeks eventually identified the brain as the physiological seat of the senses.
Greece was the home of Hippocrates, the father of Western medicine, and Aristotle, the
founder of comparative anatomy.
Greek medicine influenced conquering Rome. Galen, a Greek, was the most
important physician of the Roman period and influenced medicine well into the Middle Ages.
The Romans 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 Ages Medical practice reverted to magic during much of the
Middle Ages. Only a few Greek physicians maintained classical learning. The Arabs, who
conquered much of the world in the 7th century AD, learned and revived Greek medicine and
became the keepers of the tradition through the Middle Ages. In Europe, medicine became the
realm of religious orders such as the Benedictines and was practiced in monasteries, although
sometimes shunned in favor of prayer. Eventually, nonreligious medicine became acceptable
and began to be taught at universities. The ideas taught there differed little from the ancient
Greek teachings taken from Arab manuscripts. Early medical scientists such as the English
philosopher Roger Bacon made valuable contributions based on experiment and careful
observation but did not sway the established traditions.

Renaissance Medicine No abrupt change in medical thought occurred in the

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 The Dawn of Modern Medicine In the 17th century, the English physician and
anatomist William Harvey 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 quickly 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. Vitalists 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 18th century: the Italian naturalist and biologist Lazzaro
Spallanzani refuted the doctrine of spontaneous generation; the Swedish botanist and
taxonomist Carolus Linnaeus devised the modern binomial system of biological
nomenclature; and the British physician Edward Jenner discovered the principle of
vaccination as a preventive measure against smallpox and established the science of
immunization.

19th-Century Medicine In the 19th 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.
The British scientist Charles Darwin advanced his theory of evolution. The Austrian biologist
Gregor Johann Mendel laid out the basis of classical genetics. Studies of fermentation by the
French chemist and microbiologist Louis Pasteur revived interest in the contagion theory of
disease. Pasteur and the German physician and bacteriologist Robert Koch founded the field
of bacteriology, considered the greatest single advance in the history of medicine; many
bacterial diseases became preventable or controllable.
Bacteriology 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. Other advances during this time took place in physiology
(including understanding of various glands and the nervous system), organic chemistry and
metabolism, optics and ophthalmology, and psychology. The X-ray was discovered by the
German physicist Wilhelm Conrad Roentgen; the French physicists Pierre and Marie Curie
discovered radium. American physicians developed the field of gynecology and identified
mosquitoes as carriers of yellow fever.

20th-Century Medicine The most important medical finding of the 20th century was
the discovery, by the American biologist James Dewey Watson and the English biochemist
Francis Harry Compton Crick, of the structure of the genetic material, deoxyribonucleic acid,
or DNA. By 1970 the first gene had been synthesized; by the mid-1980s genetic techniques
were being used medically, and genetic engineering was producing large quantities of pure
human substances such as hormones and interferon. Surgery advanced with the development
of operating microscopes and other techniques 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 kidney. Plastic
replacements for joints relieved some patients from crippling arthritis, and lasers were
developed for medical use, especially in eye surgery.
Many infectious diseases have been conquered in the 20th century by improved
sanitation, antibiotics, and vaccines. Especially important were the developments of the
sulfonamide antibiotics and penicillin, which immediately saved many lives in World War II
(1939-1945). Streptomycin, another drug, was used to defeat tuberculosis. Vaccines are
widely used against viral diseases, including poliomyelitis, diphtheria, tetanus, yellow fever,
measles, mumps, rubella (German measles), hepatitis B, influenza, herpes simplex, and
chicken pox. Vaccine production was aided by new techniques such as tissue culture
production and genetic engineering. In the latter part of the 20th century many
microorganisms became resistant to antibiotics, and new diseases emerged, such as
Legionnaires' disease and acquired immune deficiency syndrome (AIDS).
In the 20th century the brain was carefully explored. Using chemical dyes and
sophisticated imaging devices, scientists discovered the specific parts of the brain that control

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hearing, speech, and movement of the limbs; they showed that the right and left halves of the
brain were functionally different. The discovery of the chemical/electrical method of nerve
impulse transmission was an important finding, as were the complex way in which the brain
regulates body function by hormones and the complex connection between emotions and
biochemistry. Treatments became available for neurological diseases such as epilepsy and
Parkinson's disease.
Scientific insight into the workings 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 rejection of transplanted organs. One form of
antibody molecule proved to be associated with allergy, now viewed as an immune system
disorder. The 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. The computerized axial tomography (CAT) scanner is a
computer-assisted X-ray device. Nuclear magnetic resonance imaging (MRI) employs radio
waves to identify molecular structure. Ultrasound produces images from sound waves, and
positron emission tomography (PET) scans the body with antimatter.
The treatment of mental disorders first became scientific and successful in the 20th
century. The Austrian physician and neurologist Sigmund Freud pioneered the methods of
psychoanalysis. Treatment of psychosis by lobotomy and electroconvulsive therapy began in
the 1930s, although these are now seldom used. Drug therapy for mental illness became
possible in the 1950s. The first drugs widely used to treat schizophrenia, the phenothiazines,
have since been joined 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.
Heart disease, the number one killer in Western countries, has declined dramatically
because of recent medical advances such as cardiac catheterization, angiography, nerve-
blocking drugs, heart valve replacement, arterial bypass surgery, and heart transplants.
Increased awareness of the risks of smoking, stress, obesity, high blood pressure, and elevated
blood cholesterol have also helped reduce heart disease. Cancer has become more prevalent
in the 20th century. Research has linked some cancers with exposure to certain chemicals;
smoking is known to cause lung cancer and other cancers. Surgery and radiation were primary
means of treatment until the 1960s, when drug therapy also became effective against cancer.
The discovery of vitamins and their importance to the body produced important
advances in nutritional medicine. An example is the discovery of vitamin B 12 and its use to
treat pernicious anemia. Similarly, improved understanding of the hormones led to better
control of conditions such as hypothyroidism or cretinism, treated with thyroid extract,
diabetes mellitus, treated with insulin, and various reproductive disorders, treated with
synthetic testosterone and estrogen.
Advances have been made in birth control with the improvement of intrauterine
devices and the development of oral contraceptives. Solutions to some fertility problems have
been provided by in vitro fertilization (“test-tube” babies) and transplantation of fertilized ova
from one womb to another. Diagnosis of some birth defects can now be made through
amniocentesis.
Complex medical ethics problems have gained increasing attention, especially the
question of abortion and the decision whether to remove life support systems from terminally
ill patients. Medical treatments became increasingly expensive in the 20th century, and many
people came to distrust the orthodox medical establishment. This situation led in the United
States to the consumer medical movement, in which people attempted to take control of their
own health, largely through preventive medical practices, and to understand more about
normal and diseased bodily function. Outgrowths of the movement included many popular
medical reference books and development of the field of holistic medicine, which promotes
good nutrition, physical exercise, and “self-regulation” techniques, such as biofeedback and
relaxation.

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