How Modern Medicine was Developed

The Development of Modern Medicine How did Greek and Galenic notions of health and disease differ from the work of Morgagni and the practitioners of French Clinical medicine? The Greek and Galenic notions of health and disease differed from the Morgagni in that they viewed disease as being caused by an imbalance in the body.

Galenic notions were intertwined with philosophy, which was aimed at answering the Socratic question "How should a person live a good life?" Therefore, the Galenic physicians were required to have mastered philosophy and this meant that they employed more of philosophy on their diagnosis, prognosis, and therapy. It is for this reason that most of the physicians believed that a disease was caused by an excess or deficiency in the body. The main goals for treatment were to restore the proper balance of the patient's body.

The physicians were not meant to treat an ailment or a disease, they were merely meant to help nature. This meant that nature played a vital role in the physician's art because it was the source and also the limit. During those times, a physician who was deeply steeped in the study of philosophy was considered to be performing true medicine and the others were just quacks. Having mastered natural philosophy, the physician had insight into both the nature of the universe and human nature.

This is what informed the Galenic view of the body as being fluid mainly because it was composed of four humors namely blood, black bile, yellow bile, and phlegm. It was believed that the four humors were formed by the same elements that constituted the cosmos (fire, water, air, and earth). The imbalance that caused an illness needed to be cleansed and the cleansing was done by using specific diets and bloodletting. In those Greek times, people had for a long time believed in the supernatural causes of disease.

However, the Galenic view it became more important because it offered an alternative that was grounded in philosophy. With the Hippocrates' idea of disease was given a more natural suggestion. People now began to seek natural remedies instead of supernatural remedies. The galenic influence was stemmed in using medicine that was derived from vegetable and animal ingredients and this can still be seen to date. There are people who still practice Galenism and they only use drugs and medicines that are derived from vegetable or animals.

Treatment for diseases was aimed at readjusting the perceived imbalances of the humors. Siphoning off a humor that was believed to have overgrown or has been corrupted. Other methods used were bleeding, vomiting, or purging. Physicians were never worried about a loose stool or diarrhea. They believed that this was the body's own way of cleansing its system and there was no need for worry or concern. If the cleansing was not discharged, it could lead to some distemper. Prevention was vital in humoral medicine.

The best method for preventing a disease was for an individual to practice moderation in all things. By modifying their lifestyle, a person could be able to preserve their health and regain it. People were advised to avoid overdoing certain things like overeating, strong drinks, exhaustion, and sedentary lifestyles. The disease was seen as an abuse of nature and every abuse of nature had to be required. Every condition was associated with some form of natural imbalance.

This association of the disease with an imbalance of the four humors meant that physicians were more concerned with readjusting the imbalance and not focused on identifying the cause of the disease. Morgagni was the pioneer of the modern pathological anatomy. He challenged the notion that disease was caused by imbalances in the body that was caused by the four humors. By demonstrating the need for basing diagnosis, prognosis, and treatment on a comprehensive knowledge of the anatomical condition.

This allowed for the disease to be viewed as being caused by external factors or organisms. By closely analyzing body fluids and tissues one is able to properly diagnose a disease. This differed completely with the Galenic view of disease and offered a different perspective that could be answered using evidence and not just philosophical underlying’s. Separating medicine from philosophy was also vital to ensure that physicians were allowed to focus on the anatomy of the human body without employing philosophy in order to diagnose a disease.

Treatments are based on the processing, examination, and diagnosing of surgical specimens. Morgagni had a desire to understand the underlying anatomical lesions of the disease than any of his patients had suffered from. This is what led him to autopsies on bodies of patients. This was never done during the Galenic period because it was outlawed in the Greek law. However, Galen had made some attempts at dissecting animals especially pigs, which he believed had the same anatomical structure as that of humans (Bynum).

Having dissected and inspected numerous bodies, the physicians now began to doubt. This doubt is what has led to the modern technology of anatomical pathology. Assumptions were no longer the order of the day and physicians now had doubt. By doubting one was forced to investigate further and this investigation is what led to the discovery of the root causes of the disease.

Symptoms were no longer been seen as due to imbalances in the body, but there was a need to investigate and uncover the underlying cause of the symptoms. This investigation also allowed for the discovery of other bodily functions that had not been discovered in the past. The working of organs was also modified and it was now better understood how fluids moved into the body.

Dissecting a body allowed the physicians to better analyze the working of organs and it was no longer believed that blood was produced and used up within the body. Physicians were now better informed and they could offer medications that would assist in fighting off the disease. In the past, due to religious restrictions, it was not possible for a physician to conduct an autopsy.

However, there was a gradual relaxation in the late Middle Ages that allowed for autopsies to be carried out in order to determine the cause of death. This was the basis of pathology. Conducting autopsies allowed for the discovery of diseases in individual organs. This discovery is what led to the abandonment of the notion that disease is caused by an imbalance in the four humors. Investigations now became part of the diagnosing process and the practices of bloodletting or cleansing were abandoned.

Anatomists further studied the human body and discovered that in a diseased organ only some of its tissues might be affected. Localization of a disease and identifying the actual tissues that were affected allowed the physicians to come up with better methods for treating the disease and this resulted in reduced mortality rates. Studying the body structures and observing the functioning of the structures allowed physicians to better understand how organs functions and how they can easily treat diseases or infections.

Clinical medicine was based on analyzing the fluids of the body and identifying if there is any defect or disease. Laboratory work also gained prominence in that physicians were now more interested in the working of the organs and the flow of fluids (Bynum). understanding the different fluids within the body and their functions led to the further discovery of what causes diseases. New discoveries were now being made and this improved the treatment of disease.

Having understood that diseases are caused by external bacteria that infect an individual's organs allowed the physicians to develop treatments that could ensure the body is able to fight off the bacteria. Prevention was now not focused on maintaining a proper balance, but rather on how best an individual can ensure that they do not get infected by particular bacteria.

French Clinical medicine required that the doctor or physician diagnoses a patient using tests and investigations and in case the patient died, the physician would follow them to the morgue and perform an autopsy. This allowed them to compare their diagnosis to the lesions they find in the dead body. With this kind of investigation, it was now easier for physicians to determine the best course of treatment for other patients who would present with the same symptoms. The relationship between inquiry resulted in great discoveries.

Theories were abundant and doctors were trying to prove or disapprove the theories. There was also optimism amongst the population and the doctors. The physical diagnoses that a doctor performed on a patient assisted them to find the lesion and the autopsy enabled them to interpret their earlier diagnoses in order to modify or reinforce them. The clinician had to follow the patient in death as in life.

Discussing the findings in the light of the final observations on the corpse also allowed the clinicians to make other discoveries that were beneficial to the practice of medicine. Post-mortems were conducted in order to objectify the phenomena of disease. This allowed for the replacement of speculation of 2,000 years by having hard, palpable, weighable, visible, materials evidence of pathology (Bynum). The French doctors brought about the notion of complete medical history examination and can only be performed in a hospital or diagnostic clinic.

Describe the changing social and economic fortunes of antebellum American physicians. What factors do you see as responsible for these changes? Before the American Civil War, physicians were not concerned much about infections. The physicians would visit his patients at home and midwives were still charged with the birthing of babies. The status a physician was honorary in that they were held in high esteem within the society even though they were performing unorthodox medical interventions (Warner and Tighe).

During this period there was no restriction and since most physicians had learned by observing or by being apprentices of other physicians they could only practice what they had learned. This meant that they had to compete with the other well-trained physicians and people were unaware of the consequences of their treatment methods. American physicians were well off economically since a well-known physician could be able to have a couple of students under their wing.

These students had to pay for tuition during the apprenticeship period, which was beneficial to the physicians. There is no legally mandated body for observing and training physicians, the field was left to self-regulate and this was beneficial to the physicians. Social status improved and physicians who were well renown were able to attract more apprentice students. Others established medical schools that were not associated with any hospital. The schools had two terms of four months each and they were mainly conducted through didactic lecture.

Medical schools were able to attract more students than the informal apprenticeship system. This meant that more students could attend the school and there were more physicians being churned out. However, these fresh medical students had to practice before they could become proficient. The penalties for practicing without a medical license had been removed and this eliminated the restriction that had been placed on doctors. This increased the number of doctors and competition between orthodox and unorthodox physicians intensified.

When the civil war came, there were numerous changes that took place. Key amongst them was that since the soldiers were passing through towns that had less population they were infecting more and more people and this was increasing the diseases that were being suffered by the townspeople (Warner and Tighe). With the increase in disease transmission, there was a need for the establishment of public health boards, new research projects aimed at uncovering the infectious diseases, and clinical teaching.

The need for the development of better medical practices also resulted in physicians having to undergo further training. Prewar physicians were not trained on the French clinical method for disease investigation and they found it hard to treat diseases. This led to them losing patients’ and without the knowledge for conducting autopsies they could not learn more regarding the ailment the patient was suffering. Physicians were now required to offer.