medicine, the science and art of treating and preventing disease.

History of Medicine

Ancient Times

Prehistoric skulls found in Europe and South America indicate that Neolithic man was already able to trephine, or remove disks of bone from, the skull successfully, but whether this delicate operation was performed to release evil spirits or as a surgical procedure is not known. Empirical medicine developed in ancient Egypt, and involved the use of many potent drugs still in use today, such as castor oil, senna, opium, colchicine, and mercury. In spite of their skill in embalming, however, the Egyptians had little knowledge of anatomy.

In Sumerian medicine the Laws of Hammurabi Hammurabi (hämrä`bē), fl. 1792–1750 B.C.
..... Click the link for more information. established the first known code of medical ethics, and laid down a fee schedule for specific surgical procedures. In ancient Babylonia, every man considered himself a physician and, according to Herodotus, gave advice freely to the sick man who was willing to exhibit himself to passersby in the public square. The Mosaic Code of the Hebrews indicated concerns with social hygiene and prevention of disease by dietary restrictions and sanitary measures.

Although ancient Chinese medicine was also influenced adversely by the awe felt for the sanctity of the human body, the Nei Ching, attributed to the emperor Huang-Ti (2698–2598 B.C.), contains a reference to a theory of the circulation of the blood and the vital function of the heart that suggests familiarity with anatomy. In addition, accurate location of the proper points for the traditional Chinese practice of acupuncture acupuncture (ăk`y
..... Click the link for more information. implies some familiarity with the nervous and vascular systems. The Chinese pharmacopoeia was the most extensive of all the older civilizations. The Hindus seem to have been familiar with many surgical procedures, demonstrating skill in such techniques as nose reconstruction (rhinoplasty) and cutting for removal of bladder stones.

In Greek medicine the impetus for the rational approach came largely from the speculations of the pre-Socratic philosophers and such philosopher-scientists as Pythagoras, Democritus, and Empedocles. Hippocrates Hippocratic oath cannot be directly credited to him either, it undoubtedly represents his ideals and principles. The oath, which still governs the ethical conduct of physicians today, is often recited at the graduation ceremonies of medical schools.
..... Click the link for more information. , the father of Western medicine, taught the prevention of disease through a regimen of diet and exercise; he emphasized careful observation of the patient, the recuperative powers of nature, and a high standard of ethical conduct, as incorporated in the Hippocratic Oath. By the 4th cent. B.C., Aristotle had already stimulated interest in anatomy by his dissections of animals, and work in the 3d cent. B.C. on human anatomy and physiology was of such high quality that it was not equaled for fifteen hundred years.

The Romans advanced public health and sanitation through the construction of aqueducts, baths, sewers, and hospitals. The encyclopedic writings of Galen Galen (gā`lən), c.130–c.200, physician and writer, b. Pergamum, of Greek parents.
..... Click the link for more information. constitute a final synthesis of the medicine of the ancient world. Revered by Arabic and Western physicians alike, his concepts stood virtually unchallenged until the 16th cent. Unfortunately, his prolific researches on anatomy and physiology were not invariably accurate, and reliance on them impeded subsequent progress in anatomy.

The Middle Ages

With the destruction or neglect of the Roman sanitary facilities, there followed a series of local epidemics that culminated many centuries later in the great plague plague, any contagious, malignant, epidemic disease, in particular the bubonic plague and the black plague (or Black Death), both forms of the same infection.
..... Click the link for more information. of the 14th cent. known as the Black Death. During the Middle Ages certain monastic libraries, notably those at Monte Cassino, Bobbio, and St. Gall, preserved a few ancient medical manuscripts, and Arab and Jewish physicians such as Avicenna Avicenna (ăvĭsĕn`ə), Arabic Ibn Sina, 980–1037, Islamic philosopher and physician, of Persian origin, b.
..... Click the link for more information. and Maimonides Maimonides (mīmŏn`ĭdēz) or Moses ben Maimon
..... Click the link for more information. continued medical investigation.

The first real light on modern medicine in Europe came with the translation of many writings from the Arabic at Salerno, Italy, and through a continuing trade and cultural exchange with Byzantium. By the 13th cent. there were flourishing medical schools at Montpellier, Paris, Bologna and Padua, the latter being the site of production of the first accurate books on human anatomy. At Padua, Vesalius Vesalius, Andreas (vĭsā`lēəs), 1514–64, Flemish anatomist.
..... Click the link for more information. proved that Galen had made anatomical mistakes. Prominent among those who pursued the new interest in experimental medicine were Paracelsus Paracelsus, Philippus Aureolus (fĭlĭp`əs ôrēō`ləs părəsĕl`səs)
..... Click the link for more information. , Ambroise Paré Paré, Ambroise (äNbrwäz` pärā`), c.1510–1590, French surgeon.
..... Click the link for more information. , and Fabricius Fabricius (Caius Fabricius Luscinus) (fəbrĭsh`əs fäbrēä`nō), d. 250 B.C.
..... Click the link for more information. , who discovered the valves of the veins.

The Birth of Modern Medicine

In the 17th cent. William Harvey Harvey, William, 1578–1657, English physician considered by many to have laid the foundation of modern medicine, b. Folkestone, studied at Cambridge, M.D. Univ. of Padua, 1602. Returning to London, he became a physician of St.
..... Click the link for more information. , using careful experimental methods, demonstrated the circulation of the blood, a concept that met with considerable early resistance. The introduction of quinine marked a triumph over malaria, one of the oldest plagues of mankind. The invention of the compound microscope led to the discovery of minute forms of life, and the discovery of the capillary system of the blood filled the final gap in Harvey's explanation of blood circulation.

In the 18th cent. the heart drug digitalis was introduced, scurvy was controlled, surgery surgery, branch of medicine concerned with the diagnosis and treatment of injuries and the excision and repair of pathological conditions by means of operative procedures (see also anesthesia ; medicine ; radiology ).
..... Click the link for more information. was transformed into an experimental science, and reforms were instituted in mental institutions. In addition, Edward Jenner Jenner, Edward, 1749–1823, English physician; pupil of John Hunter. His invaluable experiments beginning in 1796 with the vaccination of eight-year-old James Phipps proved that cowpox provided immunity against smallpox.
..... Click the link for more information. introduced vaccination vaccination, means of producing immunity against pathogens, such as viruses and bacteria, by the introduction of live, killed, or altered antigens that stimulate the body to produce antibodies against more dangerous forms.
..... Click the link for more information. to prevent smallpox, laying the groundwork for the science of immunization.

The 19th cent. saw the beginnings of modern medicine when Pasteur Pasteur, Louis (păstŭr`, Fr. lwē pästör`), 1822–95, French chemist.
..... Click the link for more information. , Koch Koch, Robert (rō`bĕrt kôkh), 1843–1910, German bacteriologist. He studied at Göttingen under Jacob Henle .
..... Click the link for more information. , Ehrlich Ehrlich, Paul (poul ār`lĭkh), 1854–1915, German bacteriologist.
..... Click the link for more information. and Semmelweis Semmelweis, Ignaz Philipp (ĭg`näts fē`lĭp zĕm`əlvīs), 1818–65, Hungarian physician.
..... Click the link for more information. proved the relationships between germs and disease disease, impairment of the normal state or functioning of the body as a whole or of any of its parts. Some diseases are acute, producing severe symptoms that terminate after a short time, e.g., pneumonia; others are chronic disorders, e.g.
..... Click the link for more information. . Other invaluable developments included the use of disinfection and the consequent improvement in medical, particularly obstetrical, care; the use of inoculation; the introduction of anesthetics in surgery (see anesthesia anesthesia (ănĭsthē`zhə) [Gr.
..... Click the link for more information. ); and a revival of better public health public health, field of medicine and hygiene dealing with the prevention of disease and the promotion of health by government agencies. In the United States, public health authorities are engaged in many activities, including inspection of persons and goods entering
..... Click the link for more information. and sanitary measures. A significant decline in maternal and infant mortality followed.

Modern Medicine

Medicine in the 20th cent. received its impetus from Gerhard Domagk Domagk, Gerhard (gĕr`härt dō`mäk), 1895–1964, German chemist and pathologist.
..... Click the link for more information. who discovered the first antibiotic, sulfanilamide, and the groundbreaking advancements in the use of penicillin penicillin, any of a group of chemically similar substances obtained from molds of the genus Penicillium that were the first antibiotic agents to be used successfully in the treatment of bacterial infections in humans.
..... Click the link for more information. . Further progress has been characterized by the rise of chemotherapy chemotherapy (kē'mōthĕr`əpē), treatment of disease with chemicals or drugs .
..... Click the link for more information. , especially the use of new antibiotics antibiotic, any of a variety of substances, usually obtained from microorganisms, that inhibit the growth of or destroy certain other microorganisms.

Types of Antibiotics

..... Click the link for more information. ; increased understanding of the mechanisms of the immune system (see immunology immunology, branch of medicine that studies the response of organisms to foreign substances, e.g., viruses , bacteria , and bacterial toxins (see immunity ).
..... Click the link for more information. ) and the increased prophylactic use of vaccination; utilization of knowledge of the endocrine system to treat diseases resulting from hormone imbalance, such as the use of insulin to treat diabetes; and increased understanding of nutrition and the role of vitamins vitamin, group of organic substances that are required in the diet of humans and animals for normal growth, maintenance of life, and normal reproduction. Vitamins act as catalysts; very often either the vitamins themselves are coenzymes , or they form integral parts
..... Click the link for more information. in health.

In Mar., 1953, at Cambridge Univ., England, Francis Crick Crick, Francis Harry Compton, 1916–2004, English scientist, grad. University College, London, and Caius College, Cambridge. Crick was trained as a physicist, and from 1940 to 1947 he served as a scientist in the admiralty, where he designed circuitry for naval
..... Click the link for more information. , age 35, and James Watson Watson, James Dewey, 1928–, American biologist and educator, b. Chicago, Ill., grad. Univ. of Chicago, 1947, Ph.D. Univ. of Indiana, 1950. With F. H. C.
..... Click the link for more information. , age 24, announced "We have discovered the secret of life." Indeed, they had unraveled the chemical structure of the fundamental molecule of heredity, deoxyribonucleic acid (DNA), giving science and medicine the basis for molecular genetics and leading to a continuing revolution in modern medicine.

Much medical research is now directed toward such problems as cancer cancer, in medicine, common term for neoplasms, or tumors, that are malignant. Like benign tumors, malignant tumors do not respond to body mechanisms that limit cell growth.
..... Click the link for more information. , heart disease, AIDS AIDS or acquired immunodeficiency syndrome, fatal disease caused by a rapidly mutating retrovirus that attacks the immune system and leaves the victim vulnerable to infections, malignancies, and neurological disorders.
..... Click the link for more information. , reemerging infectious diseases such as tuberculosis tuberculosis (TB), contagious, wasting disease caused by any of several mycobacteria. The most common form of the disease is tuberculosis of the lungs (pulmonary consumption, or phthisis), but the intestines, bones and joints, the skin, and the genitourinary,
..... Click the link for more information. and dengue fever Dengue hemorrhagic fever, a severe form of the disease, can cause hemorrhage, shock, and encephalitis. It occurs when a person who has acquired immunity to one of the viruses that cause dengue fever is infected by a different dengue virus.
..... Click the link for more information. , and organ transplantation transplantation, medical, surgical procedure by which a tissue or organ is removed and replaced by a corresponding part, either from another part of the body or from another individual.
..... Click the link for more information. . Currently, the largest worldwide study is the Human Genome Project Human Genome Project, international scientific effort to map all of the genes on the 23 pairs of human chromosomes and, to sequence the 3.1 billion DNA base pairs that make up the chromosomes (see nucleic acid ).
..... Click the link for more information. , which will identify all hereditary traits and body functions controlled by specific areas on the chromosomes chromosome (krō`məsōm')
..... Click the link for more information. . Gene therapy gene therapy, the use of genes and the techniques of genetic engineering in the treatment of a genetic disorder or chronic disease. There are many techniques of gene therapy, all of them still in experimental stages.
..... Click the link for more information. , the replacement of faulty genes, offers possible abatement of hereditary diseases. Genetic engineering genetic engineering, the use of various methods to manipulate the DNA (genetic material) of cells to change hereditary traits or produce biological products.
..... Click the link for more information. has led to the development of important pharmaceutical products and the use of monoclonal antibodies monoclonal antibody, an antibody that is mass produced in the laboratory from a single clone and that recognizes only one antigen. Monoclonal antibodies are typically made by fusing a normally short-lived, antibody-producing B cell (see immunity ) to a fast-growing
..... Click the link for more information. , offering promising new approaches to cancer treatment. The discovery of growth factors has opened up the possibility of growth and regeneration of nerve tissues.

With the surge of general and specialized medical knowledge, the educational requirements of the medical profession have increased. In addition to the four-year medical course and the general hospital internship required almost everywhere, additional years of study in a specialized field are usually required. Similar progress and increased requirements in education are reflected in ancillary professions such as nursing.

Modern Health Care Management

Modern medicine, characterized by growing specialization and a complex diagnostic and therapeutic technology, faces problems in the allocation of capital and personnel resources. Some authorities advocate an increase in the use of paramedical personnel to supervise the care of individuals with common, chronic, or terminal illnesses, leaving the physician in charge of treating curable disease. Others emphasize the physician's responsibility to help patients and families in the overall management of their health problems, many of which are thought to reflect the social ills of living in an urban, industrialized society.

In some countries, such as Great Britain, medical care is under government control and is available virtually without charge to all. In the United States, medical practice is characterized by a patchwork mixture of government and private control. The Kefauver-Harris amendments to the federal Food, Drug, and Cosmetic Act of 1962 empower the Food and Drug Administration to require stricter testing and licensing of new drugs. There have also been federal, state, and local programs for mass vaccination and other public health programs. The Medicare Medicare, national health insurance program in the United States for persons aged 65 and over and the disabled. It was established in 1965 with passage of the Social Security Amendments and is now run by the Centers for Medicare and Medicaid Services.
..... Click the link for more information. program, enacted in 1965, provides subsidized hospital and nursing-home care for persons over 65 and, with the Hill-Burton Act, provides funds for state aid to the medically indigent (Medicaid Medicaid, national health insurance program in the United States for low-income persons; established in 1965 with passage of the Social Security Amendments and now run by the Centers for Medicare and Medicaid Services.
..... Click the link for more information. ).

A wide variety of private medical insurance plans are also available to those who can afford them, and many employers pay all or part of their employees' health insurance premiums. In addition, health maintenance organizations health maintenance organization (HMO), type of prepaid medical service in which members pay a monthly or yearly fee for all health care, including hospitalization. The term "health maintenance organization" was coined by a health policy analyst, Dr.
..... Click the link for more information. (HMOs), or group practice plans, are designed to promote disease prevention and reduce medical expenditures.

Bibliography

See J. Walton et al., ed., The Oxford Companion to Medicine (2 vol., 1986); historical study by H. E. Sigerist (2 vol., 1951–61); studies by R. Hudson (1983), P. Starr (1983), D. Dutton (1988), and E. Shorter (1991).

medicine

Set of scientific fields related to prevention, diagnosis, and treatment of disease and maintenance of health, practiced in doctors' offices, health maintenance organization facilities, hospitals, and clinics. In addition to family practice, internal medicine, and specialties for specific body systems, it includes research, public health, epidemiology, and pharmacology. Each country sets its own requirements for medical degrees (M.D.'s) and licenses. Medical boards and councils set standards and oversee medical education. Boards of certification have stringent requirements for physicians seeking to practice a specialty and stress continuing education. Advances in therapy (see therapeutics) and diagnosis have raised complex legal and moral issues in areas such as abortion, euthanasia, and patients' rights. Recent changes include treating patients as partners in their own care and taking cultural factors into consideration.

Medicine