The purpose of this chapter is to understand the problems in health care today, and the need to trace the history of medicine to its roots. Methods of evolution of medical practice have a lot to say about how training of medical professionals must be carried out. The history of medicine is both fascinating in scope yet elementary in application. In other words, medicine has always been about the patient and no one but the patient.
TopKey Points
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to observe how the science and art of medicine has evolved over the centuries
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to study the extraordinary lengths and breadths of medical knowledge
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to appreciate the traditional or alternative practices of medicine and health care
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to understand the contribution that technology has made in the progress of medicine
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to understand the evolution of medical education and residency training
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Figure 1. NRMP= National Resident Matching ProgramEWTR= European Working Time Regulations TopIntroduction
The meaning of the word medicine is “the science or practice of diagnosis, treatment and prevention of disease” and a substance to provide remedy for the same.
Medicine, as a subject, aims to treat illness and make a sick person well again. It is easy to understand how this has been achieved throughout the history of mankind, and through the different parts of the globe. Herbs, pills, magic potions and magical powers, talismans, mantras and prayers, all have in one way or the other been used to cure the maladies of man, and beast too!
One of the elementary tenets of medicine is the identification and acknowledgement of the way the human body works, and the nature of sickness and healing. All living things undergo periods of damage and repair from their point of creation to the moment of death. While nature ensures that all this happens in a pre-ordained and seamless manner, the superior intelligence of man has gone a step further and attempted to intervene at particular instances to promote the period of repair, and thus health, while countering the damage and subsequent destruction. Man’s knowledge has unraveled and controlled, to a great extent, the laws of nature in order to improve the way living beings exist in the world today. The contrary is also true, that by conflicting with nature in innumerable ways, some living beings, both human and animal, enjoy a position of advantage over others of their kin.
Medicine as a science and art is believed to have been born out of the essence of sympathy of man for man, as described by Sir William Osler (Osler, 1913). The renowned Canadian physician, one of the founding fathers of Johns Hopkins Hospital and probably the best loved medical teacher of all time, gave a series of lectures on the history of medicine, which is immensely rich and interesting. At the turn of the last century, he had heard the late Dr J F Payne- medical historian and librarian of the Royal College of Physicians, whose collection was procured by the Wellcome Trust in 1911- remark that medicine is the outcome of man’s desire to do good for others, and this desire and sympathy for another in distress is what ultimately resulted in softening or refinement of the primitive and hard human race- “tum genus humanum primum mollescere coepit ”, leading to the beginning of the human “civilization”.
Man’s earliest understanding of the human being arose from the observation of the natural kingdom, the ways in which plants grew and renewed themselves, and the many instances of animals looking after and taking care of the sick in their own communities. Early man, by careful observation of the human and animal kingdom, repetition of the usual practices, and experimentation with newer methods laid the foundation of medical science.