Medicine

Medicine is one of the branches of the health sciences. It deals with restoring and maintaining health, but is also used in determining the causes of death. It is a practical science that applies knowledge from biology, chemistry, and physics to treat diseases. Biological knowledge is derived from anatomy, biochemistry, physiology, histology, epidemiology, microbiology, genetics, toxicology, pathology, and many other disciplines. Biology forms the basis for understanding how the human body works and interacts with its environment. An understanding of chemistry is required to determine the interactions between different drugs, to detect chemicals in the body, and design drugs for treatment. Physics has an impact on understanding how the body works and on understanding how the various instruments and equipment are used in diagnosis and treatment. The need to understand interactions between all of these areas makes medicine one of the most complex scientific disciplines.

In its early days medicine was not based on science. Many aspects of it were considered forms of magic, encompassing everything from disease causes to treatments. This was because the disease process was not understood. There was no knowledge of infectious agents (such as bacteria and viruses). Therefore, unless the cause of a disease was obvious and visible, sickness was considered a punishment from gods or an interference of an evil spirit. As a result, some treatments were logical, while others were irrational and often involved magic incantations and spells.

The practice of medicine goes back to at least 3000 B.C., when the first written medical records appeared in Mesopotamia. Babylonian medical texts provided the first anatomical descriptions and an early code of conduct for doctors. Their understanding of diseases was very basic; they recognized trauma and food poisoning, but a lot of the illnesses were still a mystery. Despite advances in anatomy and surgery, ancient Egyptians, as the Babylonians before them, still believed in supernatural causes for many illnesses.

The scientific basis of medicine was laid down by Hippocrates, who rejected magical causes of diseases. He believed in medical examination and keeping detailed records of a disease history. His influence on medicine is present even today, in form of the "Hippocratic Oath," which all new doctors have to take. It sets out ethical guidelines for doctors.

The importance of clinical examination of the patient was made even more important by Claudius Galen, another Greek physician. He worked extensively on anatomy and experimented with live animals.

Great advances in all areas of medicine, especially in epidemiology and hygiene, took place in the middle ages. Avicenna, a Persian physician, was the first to recognize the contagious nature of tuberculosis. In his many works, he gave important advice to surgeons, especially on cancer treatment and advanced use of oral anesthetics (painkillers). Another great advancement of the times was the use of silk thread for stitching wounds, developed by Abul Qasim al-Zahrawi.

A number of scientific discoveries, starting from the late 1800s with the work of E. Jenner, L. Pasteur, R. Koch, A. Flemming and others, established that microbes are the cause of infectious disease; these diseases can be prevented by vaccinations; and there are drugs that can kill the infectious agents (microbes). These findings shaped modern western medicine.

Furthermore, discoveries in physics, such as x rays, ultrasounds, magnetic resonance, and lasers, led to the development of equipment that allows quicker and better diagnosis, as well as easier and safer surgical procedures.

As a result of these scientific and technological changes, the knowledge that medical students have to acquire is immense. Therefore, all doctors learn the same basics but later they have to specialize in narrower areas in order to be highly skilled and able to effectively treat all of the diseases of a particular organ or tissue.

There are doctors specializing in various areas of medicine, such as emergency medicine, intensive care medicine, internal medicine, pediatrics, surgery, neurology, obstetrics, and others. While obstetrics is a relatively narrow area, dealing with childbirth and female health, surgery or internal medicine is further subdivided into sub specializations. Some of those subspecialties are hematology (blood and its diseases), cardiology (heart and cardiovascular system), oncology (cancer), ophthalmology (eyes), orthopedic surgery (mostly skeletal system), or neurosurgery (brain). On the other hand, pediatrics deals with childhood diseases and most of the specialties and subspecialties have their pediatric equivalent. Some doctors specialize in narrow medical fields, while others specialize in areas requiring wide medical knowledge such as sport, aerospace, or forensic medicine.

The most important doctor for the majority of the population is the family doctor (or general practitioner, GP). It is the GP who makes the first examination and keeps a record of the medical history of the patient. He or she also makes an assessment if more tests are required before a diagnosis can be made or if a referral to a specialist is required.

The process of determining the cause of a disease and prescribing treatment is quite complex. It consists of clinical examination, diagnosis, and treatment.

Clinical examination can consist of a number of different aspects, including visual, pathological, toxicological, and genetic analysis. Visual examination addresses the general symptoms: a patient's appearance, heart rate etc. Pathological analysis is often required to identify any non-obvious cause of disease. The tests can include blood or urine analysis, electrocardiogram (ECG), ultrasound, computed tomography (CT) scan, biopsy, histology of removed tissues, or bacteriological analysis of body fluids. Most people have blood and urine tests during their lives. Toxicological analysis is usually carried out on blood, but can be done on tissue samples (bones or hair) and can detect alcohol, certain drugs, toxic metals, and other compounds (for example dioxins). Genetic testing is not usually required for the majority of patients, but in cases of inherited diseases, or genetic predisposition, they can be carried out. Often it is not just the adults that undergo this procedure. Amniotic fluid surrounding the embryo can be tested to determine if a child will develop a life-threatening disease.

Diagnosis is based on the combination of all of the examinations that have been performed and the accumulated knowledge of the doctor. Depending on the illness, it can be quick and simple or time consuming and difficult.

Treatment is the ultimate result of a visit to the doctor. It can include prescription of drugs, surgery, or special diet. Any treatment can be simple or complex depending on the illness.

Not all doctors treat patients. Pathologists study disease processes. They analyze clinical tests and base their diagnosis on the results. They can work with isolated tissues and samples, or, in the case of forensic pathologists, the deceased. Pathological analysis is very important in the diagnosis of an illness in the case of regular pathology and in determining a cause of death in forensic pathology. Forensic pathology is a part of a forensic medicine, a branch of medicine answering questions important to the law.

Forensic medicine is important in determining the cause of death, time of death, and identification of the remains. This allows doctors to determine the cause of death as accident, suicide, or murder. A forensic pathologist describes the state of the body (decomposition if any), and subsequently examines the body for a cause of death, but also notes any abnormalities found on the surface or in the tissues. The surface of the body is initially checked for the presence of trauma injuries (bruises, broken bones), cuts or stab wounds, thermal injuries (burns), firearm injuries (gunshot wounds), or defensive wounds. An internal examination of the body is carried out on organs or isolated tissues (histology). It might reveal presence of water in lungs (drowning), or asphyxia (lack of oxygen).

The analysis of a corpse is often carried out in the same way as for normal patients using x rays, toxicology, and genetics. Forensic medicine requires great attention to detail and a wide medical knowledge, especially in the areas of anatomy and physiology.

Modern western medicine is not the only existing medical system. There is also traditional medicine and complementary or alternative medicine. Traditional medicine includes folk and indigenous practices. The best known and most widely accepted areas are Chinese medicine and western herbal medicine. Complementary medicine uses non-invasive and non-pharmaceutical methods. Examples of alternative treatments include yoga, chiropractic or osteopathic manipulation, or various massage methods, as well as many others.

The first written evidence of Chinese medicine comes from 1766 B.C. The philosophy of medicine and methods used by Chinese doctors differed widely from those of the ancient Mediterranean and current modern medicine. The Chinese have based their medicine on a philosophy of yin and yang, and on The Five Elements (metal, wood, water, fire, and earth). A healthy person would have a harmonious mix of these elements. Among the practices developed in Chinese medicine are acupuncture, moxibustion (a technique that involves the use of heat, through burning specific herbs, to facilitate healing), and traditional herbal medicines. A physical examination with a doctor can include detailed interview, pulse taking, breath analysis, and tongue inspection. Some of the traditional Chinese treatments are quite widely accepted by modern western medicine, for example acupuncture.

A new approach to practicing medicine is the development of integrative medicine. It combines the modern western practices with alternative treatments. It only accepts methods for which there is scientific evidence for safety and effectiveness. Acupuncture, herbal treatment, music, and massage therapy are just some of the accepted treatments. The aim of this approach is not to just treat the illness, but to provide support to patients and induce their general well-being.