This article explains what medicine is and how it came about. What are the directions and areas in it, as well as how traditional medicine differs from non-traditional.
Emergence
From the very beginning, man needed to be cured of ailments and diseases. The word "medicine" has not been used in history for a long time. People believed that a person with health problems was simply attacked by evil spirits. No attempts were made to cure it, because the ancient states did not have the resources to solve such problems.
Over time, theories were replaced one after another. In the end, humanity came to the conclusion that illness is something organic that requires intervention. Of course, then there was still no talk of the use of any medications due to the fact that society had not reached such a level of development as, say, in the 16th or 17th centuries.
Many philosophers and scientists of the early eras wrote works about the body, soul and that, and came to the conclusion that treatment is necessary. People began to appear who called themselves healers and healers who practiced medical methods. In different places of the planet, it was possible to grow more than 10,000 species of herbs, which was what the doctors of that time were doing.
It is worth noting that their methods were so effective that they are still used today, but more on that later. Sometimes people believed that an ordinary person could not heal another, so they attributed magical powers to healers. The era changed one after another, and medicine was formed into a separate science, which is being studied to this day.
Definition
Medicine is the science used by trained professionals to help others combat certain disorders in the human body. For the treatment to be as effective as possible, the doctor must be a professional in his field.
Fields of Medicine
If we talk about the modern world, now this science has dozens of directions. You can stop and consider a few of them.
Oncology
One in 10 people on the planet is at risk of developing cancer. This ailment implies the presence of cells in the body that contribute to the development of oncological tumors. They are neoplasms in a specific organ and have the ability to progress. The reasons for their appearance are very different - from genetic predisposition to the environmental conditions in which a person lives.
In order to normalize the functioning of the body, patients are prescribed chemotherapy, which can reduce the risk of death. According to the World Health Organization, only 10% of the population is cured of cancer. Cancer diseases are different, and the methods of their treatment, respectively, are selected individually for each.
Surgery
Operations are 97% effective when drug treatment does not give any improvement. Surgeons remove certain growths, accumulations of purulent elements, and more. More than 60% of the population addresses them.
Gynecology and urology
Numerous diseases associated with the genitourinary system were the impetus for the development of this field of medicine. Specialist doctors are engaged in preventive measures, diagnostics of diseases of male and female genital organs, monitoring the course of pregnancy, and prevention of dangerous diseases.
Endocrinology
Here the work of the hormonal system is studied, as a result of violations of which diseases of certain organs can arise. An endocrinologist specializes in diagnosing the functions of the endocrine glands. Since the endocrine system is the main human regulatory system, this area is considered one of the most important in medicine.
Dermatology
For a person, one of the most important aspects of life is his appearance, which directly depends on the health of the skin. Dermatologists all over the world say that preventing a certain skin disease means preventing serious consequences for the whole organism.
Differences in approaches in medicine
Traditional medicine is a therapeutic method used by doctors to prevent human disease using previously proven remedies. This can include medicines, special forms of diagnostics, professional equipment. Traditional medicine is an established field. Doctors who adhere to it are skeptical about other treatments.
These are various forms of health maintenance that are not based on official health care. These can include both herbal medicine, acupuncture, homeopathy, and conspiracies.
Traditional and alternative medical methods have their supporters and opponents. Everyone must choose for himself which of them to resort to in case of illness.
Medicine has come a long way since its inception. Today, as before, she stands guard over health, helping people not to lose hope for healing and further recovery!
Medicine is one of the most important sciences in human life and all life on Earth. The first diagnoses were made by observing the first symptoms of the disease. We learn this information from sources, the oldest manuscripts of the great doctors of those times, which were passed down for millennia from generation to generation.
In ancient, primitive times, people could not understand what a disease is, from what it arises and how to overcome it. They suffered from cold, dampness, hunger and died very early, were afraid of sudden death. People did not understand the natural reasons for what was happening and consider it mysticism, the penetration of evil spirits into a person. With the help of magic, witchcraft, primitive people tried:
- eliminate the disease;
- connect with otherworldly forces;
- find answers to your questions.
This was done by the so-called shamans, sorcerers and sorcerers, who, by stupefying, dancing with a tambourine, brought themselves to ecstasy and established a connection with the other world. They tried to drive out evil spirits with the help of noises, dances, chants, and even changed the name of the patient.
The birth of the subject of medicine
Then primitive people began to observe the course and course of the disease, they began to understand after which the ailment arises and what becomes its cause, they began to use random means or techniques and understood that thanks to them pain is eliminated, with the help of vomiting, a person becomes easier, and so on. The first healing developed on this principle.
Dancing with a tambourine was a cure
Modern archaeologists have discovered the remains of the bones of people with lesions such as:
- osteomyelitis;
- rickets;
- tuberculosis;
- fractures;
- curvature;
- deformation.
This suggests that in those days these diseases already existed, but they were not treated, simply not knowing how. In the Middle Ages, medicine did not stand still, and by that time people began to more or less distinguish between diseases and isolated infectious patients. In connection with the Crusades, people began to emigrate, in this way the diseases spread, which contributed to the formation of epidemics. The first hospitals and hospitals at the monasteries were opened.
The first doctors in the history of medicine
The most important contribution to history was made by Hippocrates, who lived in 460-377 BC. NS. His teachings were that diseases are not the influence of evil spirits, but rather the influence of nature on the body, human lifestyle, habits and character, climate. He taught doctors of that time to make diagnoses after careful observation of the patient, examination, collection of anamnesis.
First doctor and healer This is the first scientist who divided humanity into all of us known temperaments, interpreted the meaning of each:
- sanguine;
- choleric;
- melancholic;
- phlegmatic person.
Interesting! In those days, the church was of great importance and influence on science. She forbade the autopsy and examination of corpses, which significantly hindered the development of medicine. But this did not prevent Hippocrates from making great discoveries and achieving the national title: "Father of Medicine".
Hippocrates treated people with sparing, humane methods, thereby giving the body a chance to fight the disease on its own. He diagnosed a huge variety of diseases of varying complexity, thanks to his observations. The methods of its treatment are used to this day. This excellent specialist has every right to be called the First Doctor in the world.
Hippocrates became famous for his oath as well. It dealt with morality, responsibility and the main rules of healing. In the oath, which the Great Physician wrote, he promised to help everyone who asks for help, in no case give a deadly medicine to the patient if he asks for it and in no case will deliberately harm him, which is the main rule of medicine and to this day.
There are a great many theories of its origin, according to some sources it is known that the oath did not belong to the Great Physician, but it is based on many of his commandments, which are popular in our time.
Nurse Florence Nightinglale
Along with the great Hippocrates, you can put the well-known nurse who made a great contribution to the history of medicine - Florence Nightingleil, the so-called "Woman with a lamp". At her own expense, she opened many hospitals and clinics, ranging from Scotland to Australia. Florence drew her knowledge from different parts of the planet, like grains collecting each skill.
She was born in Italy, on May 13, 1820 in the city of Florence, after which she was named. Florence gave all of herself to the profession, even in her old age. She died in 1910 at the age of 90. Later, her birthday was named “Nurse's Day”. In Great Britain, "Woman with a Lamp" is a folk heroine and an icon of kindness, mercy and compassion.
The surgeon who performed the first operation with anesthesia
The well-known physician Nikolai Ivanovich Pirogov made a huge contribution to the development of medicine. Russian natural scientist, military field surgeon, professor and scientist.
The professor became famous for his extraordinary kindness and mercy. He taught poor students absolutely free of charge. He is the first to perform the first operation with ether anesthesia.
During the Crimean War, over 300 patients were operated on. This became one of the great discoveries in world surgery. Before practicing on humans, Nikolai Ivanovich conducted a sufficient number of experiments on animals. In the 14-19 centuries, the church condemned anesthesia as a method of anesthetizing the body. She believed that all the trials that God gives from above, people must endure, including pain. Pain relief was considered a violation of God's laws.
Interesting! In Scotland, the lord's wife was sentenced to death for asking for some kind of sedative during childbirth. This was in 1591. Also in 1521 in Hamburg, a doctor was executed for disguising himself as a midwife and helping a woman in labor. The attitude of the church to pain relief was categorical - it is a sin for which you need to punish.
Therefore, the invention of Nikolai Ivanovich Pirogov was the salvation of mankind from unbearable pain, which was often the cause of death. During the war, the great surgeon made a modern plaster cast. After the end of hostilities, Pirogov opened a hospital where there was no private practice, he treated everyone who needed his help free of charge. Nikolai Ivanovich cured many patients with different diagnoses, but he could not defeat the only disease - his own. The great physician died in 1881 of lung cancer.
You can talk about the history of medicine forever and list the great discoverers such as:
- Wilhelm Konrad Roentgen;
- William Harvey (the first scientist to find out that thanks to the work of the heart, the body works);
- Frederick Hopkins (the value of vitamins in the body, their harm and the consequence of their lack).
All of these great people have a lot to do with the history of general medicine.
Only in recent years has a satisfactory definition of the concept of medicine been given: “Medicine is a system of scientific knowledge and practical measures, united by the purpose of recognizing, treating and preventing diseases, preserving and strengthening the health and working capacity of people, and prolonging life 1. In this phrase, for the sake of accuracy, it seems to us that the word “society” should be added after the word “measures”, since in essence medicine is one of the forms of activity of society in the fight against diseases.
It can be repeated that medical experience, medical science and practice (or art) have a social origin; they cover not only biological knowledge, but also social problems. In human existence, it is easy to see that biological laws give way to social ones.
Discussion of this question is not empty scholasticism. It can be argued that medicine as a whole is not only a science, but also practice (and the most ancient), which existed long before the development of sciences, medicine as a theory is not only a biological, but also a social science; the goals of medicine are practical. B.D. Petrov (1954), arguing that medical practice and medical science, resulting from critical critical generalization, are inextricably linked.
G.V. Plekhanov emphasized that the influence of society on man, his character and habits are infinitely stronger than the direct influence of nature. The fact that medicine and human morbidity are social in nature, it would seem, is beyond doubt. So, N.N. Sirotinin (1957) indicates a close connection of human diseases with social conditions; A.I. Strukov (1971) writes that human disease is a very complex socio-biological phenomenon; and A.I. Germanov (1974) considers it a "socio-biological category."
In a word, the social aspect of human diseases is beyond doubt, although each pathological process taken separately is a biological phenomenon. Let us also cite the statement of S.S. Khalatova (1933): “Animals react to nature as purely biological beings. The influence of nature on man is mediated by social laws. " Nevertheless, attempts to biologize human disease still find defenders: for example, T.E. Vekua (1968) sees the difference between medicine and veterinary medicine in "the qualitative difference between the human body and the animal body."
The cited references to the opinions of many scientists are pertinent, because the relationship between the patient and the doctor can sometimes create the illusion that healing is, as it were, a completely private matter; such an involuntary delusion could have occurred in our country before the Great October Socialist Revolution and now exists in bourgeois states, while the knowledge and skill of a doctor is entirely of social origin, and a person's illness is usually caused by the way of life and the influence of various factors of a particular social environment; the physical environment is also largely socially conditioned.
It is impossible not to recall the importance of the socialist worldview for medical practice and the understanding of illness and understanding of human illness. ON THE. Semashko (1928) wrote that the view of illness as a social phenomenon is important not only as a correct theoretical setting, but also as a fruitful working doctrine. The theory and practice of prevention have their scientific roots from this view. This teaching makes a doctor not an artisan from a hammer and a tube, but a social worker: since a disease is a social phenomenon, then it is necessary to fight it not only with therapeutic, but also with social and preventive measures. The social nature of the disease obliges the doctor to be a social activist.
Socio-hygienic research proves the social conditionality of the state of health of people. Suffice it to recall the well-known work of F. Engels "The Condition of the Working Class in England" (1845) 2. With the help of biomedical analysis, the mechanism of action of environmental factors (climate, nutrition, etc.) on biological processes in the body is established. However, we must not forget about the connection and unity of social and biological conditions of human life. Housing, food, working environment are social factors in origin, but biological in terms of the mechanism of influence on the anatomical and physiological characteristics of a person, i.e. we are talking about the body's mediation of social conditions. The higher the socio-economic level of modern society, the more efficient is the organization of the environment for the conditions of human life (even in space). Therefore, both biologism and abstract sociologism in solving problems of medicine are metaphysical and unscientific. In the listed facts, one can notice the decisive importance in understanding the theory of medicine and health care, the general worldview, the consideration of socio-economic foundations, the class approach.
Description of diseases in ancient times and modern terminology. Practical experience of doctors accumulated over several millennia. It may be recalled that the activity of ancient doctors was carried out on the basis of the great experience of their predecessors. In the 60 books of Hippocrates, in which, apparently, the works of his students were reflected, a significant number names of internal diseases, which were supposed to be fairly familiar to the reader. Hippocrates did not describe their symptomatology, he had only case histories of specific patients and many practical and theoretical remarks. In particular, the following, relatively speaking, nosological units are noted: peripneumonia (pneumonia), pleurisy, purulent pleurisy (empyema), asthma, exhaustion (phthisis), tonsillitis, aphthae, runny nose, scrofula, abscesses of various types (apostems), erysipelas, cephalalgia, phrenitis, lethargy (fever with drowsiness), apoplexy, epilepsy, tetanus, convulsions, mania, melancholy, sciatica, cardialgia (heart or cardia?), jaundice, dysentery, cholera, intestinal obstruction, abdominal suppuration, hemorrhoids, arthritis , stones, stranguria, edema (ascites, edema), leukophlegmasia (anasarca), ulcers, cancers, "large spleen", pallor, fatty disease, fevers - continuous, daily, tertsiana, quartana, burning fever, typhoid, ephemeral fever.
Before the activities of Hippocrates and his school, doctors distinguished at least 50 manifestations of internal pathology. A rather long enumeration of various morbid conditions and, accordingly, different designations is given in order to more specifically represent the great successes of observations, albeit primitive, of doctors of ancient civilizations - more than 2500 years ago. It is useful to realize this and thus be attentive to the hard work of our predecessors.
The position of medicine in society. The concern of people for the treatment of wounds and diseases has always existed and achieved some success in varying degrees in connection with the development of society and culture. In the most ancient civilizations - for 2-3 thousand years BC. - there were already some legislation regulating medical practice, for example, the Hammurabi code, etc.
Quite detailed information about ancient medicine was found in the papyri of Ancient Egypt. The papyri of Eberts and Edwin Smith provided a summary of medical knowledge. A narrow specialization was characteristic of the medicine of Ancient Egypt, there were separate healers for the treatment of lesions of the eyes, teeth, head, stomach, as well as the treatment of invisible diseases (!) (Perhaps they refer to internal pathology?). This extreme specialization is considered one of the reasons that delayed the progress of medicine in Egypt.
In ancient India, along with many empirical advances in medicine, surgery reached a particularly high level (removal of cataracts, removal of stones from the bladder, plastic surgery of the face, etc.); the position of healers seems to have always been honorable. In Ancient Babylon (according to the Hammurabi code) there was a high specialization, and there were also public schools of healers. Ancient China had extensive experience in healing; the Chinese were the first pharmacologists in the world, they paid great attention to disease prevention, believing that a real doctor is not the one who treats the sick person, but the one who prevents the disease; their healers distinguished about 200 types of pulse, 26 of them to determine the prognosis.
Repeated devastating epidemics such as the plague have at times paralyzed the population with fear of "divine punishment." "In ancient times, medicine, apparently, was so high and its benefits are so obvious that the art of medicine was included in the religious cult, was the affiliation of the deity" (Botkin SP, ed. 1912). At the beginning of European civilization, since the ancient period of Ancient Greece, together with the exclusion of religious views on diseases, medicine received the highest praise. This was evidenced by the statement of the playwright Aeschylus (525–456) in the tragedy "Prometheus", in which Prometheus's main feat was in teaching people to provide medical assistance.
In parallel with temple medicine, there were medical schools of fairly high qualifications (Kos, Knids schools), whose help was especially evident in the treatment of injured or wounded people.
The position of medicine and medical care, in particular during the era of Roman rule, was very low. Rome was inundated with many self-appointed healers, often fraudsters, and prominent scholars of the time, such as Pliny the Elder, called doctors the poisoners of the Roman people. We must pay tribute to the state organization of Rome in attempts to improve hygienic conditions (the famous water pipes of Rome, Maximus cesspool, etc.).
The Middle Ages in Europe essentially gave nothing for the theory and practice of medicine. In addition, it should be noted that the preaching of asceticism, contempt for the body, caring mainly for the spirit could not contribute to the development of medical methods, with the exception of the opening of separate nursing homes for the sick and the publication of rare books about medicinal plants, for example, the 11th century book by M. Floridus " On the properties of herbs "3.
The mastery of medical knowledge, like any education, corresponded to the generally accepted scholastic method. Medical students were required to study logic for the first 3 years, then books by canonized authors; medical practice was not in the curriculum. Such a situation, for example, was even officially established in the 13th century and later.
At the beginning of the Renaissance, there were few changes in studies compared with the Middle Ages, classes were almost exclusively book; scholasticism, endless abstract verbal intricacies overwhelmed the heads of students.
However, it should be noted that along with a very heightened interest in the manuscripts of antiquity, intensified scientific research began in general and the study of the structure of the human body in particular. The first researcher in the field of anatomy was Leonardo da Vinci (his research remained hidden for several centuries). One can note the name of François Rabelais - the great satirist and doctor. He publicly performed an autopsy and preached the need to study the anatomy of the dead 150 years before the birth of the "father of pathological anatomy" G. Morgagni.
Little is known about the state organization of education and health care in this era; the transition from the dark Middle Ages to the new medicine was slow.
The state of medical care in the 17th and 18th centuries was rather miserable, the poverty of knowledge was masked by abstruse reasoning, wigs and solemn robes. This position of healing is portrayed quite truthfully in Moliere's comedies. The existing hospitals provided meager assistance to the sick.
Only during the Great French Revolution of 1789 did the state regulation of medical education and help; so, for example, from 1795 by decree a compulsory teaching students at the bedside.
With the emergence and development of capitalist society, medical education and the position of a practical doctor took on definite forms. Medical education is paid, and in some states it is even very expensive. The patient pays the doctor personally, i.e. buys his skills and knowledge to restore his health. It should be noted that most doctors are guided by humane convictions, but in the conditions of bourgeois ideology and everyday life, they must sell their labor to patients (the so-called fee). This practice sometimes acquires the disgusting features of "cash" from doctors due to the desire for more and more profit.
The position of a healer in primitive communities, among the tribe, was honorable.
In semi-wild conditions, not so long ago, unsuccessful treatment led to the death of the doctor. For example, during the reign of Tsar Ivan IV, two foreign doctors were executed in connection with the death of the princes they treated, they were slaughtered "like a sheep."
Later, during the period of serfdom, the remnants of feudalism, the attitude towards the doctor was often disdainful. Back at the end of the 19th century V. Snegirev wrote: "Who does not remember how the doctors stood at the lintel, not daring to sit down ..." Zakharyin has the honor of fighting against the humiliation of doctors.
The position of "purchase and sale" in medical practice was in pre-revolutionary Russia. The deviation of the doctor's activity from the rules of humanity (sometimes from elementary honesty) was noted in the works of D.I. Pisareva, A.P. Chekhov and others. However, doctors and the general public know the life and ideal behavior of most doctors (for example, F.P. Haas and others), as well as the actions of physicians-scientists who subjected themselves to life-threatening experiments for the development of science, the names of numerous doctors in Russia are familiar who worked conscientiously in the countryside. However, the practice of bourgeois relations prevailed everywhere, especially in the cities.
The Great October Socialist Revolution created new, most humane rules for medical practice. All relations between doctor and patient, distorted by bourgeois ideology and practice, have changed dramatically. Creation of a public health care system that provides free medical care, established new relationship between doctor and patient.
Caring for the health of the population in our country is one of the most important tasks of the state, and the doctor has become the executor of this serious task. In the USSR, doctors are not people of the so-called free profession, but public figures, working in a specific social area. The relationship between doctor and patient has changed accordingly.
In conclusion, referring to the high value of the medical profession, one should remind novice doctors or students that this activity is difficult both in terms of the possibilities of success and the environment in which a doctor will have to live. Hippocrates (published in 1936) eloquently wrote about some of the difficulties of our labor: “There are some of the arts that are difficult for those who possess them, but for those who use them they are beneficial and for ordinary people - a blessing that brings help, and for those who practice them - sorrow. Among these arts is that which the Hellenes call medicine. After all, the doctor sees the terrible, touches that which is disgusting, and out of the misfortunes of others he reaps sorrow for himself; the sick, thanks to art, are freed from the greatest evils, diseases, suffering, from sorrow, from death, for against all this medicine is a healer. But the weaknesses of this art are difficult to recognize, and the strengths are easy, and these weaknesses are known to some doctors ... "
Almost everything that Hippocrates said is worthy of attention, careful thought, although this speech, apparently, is more addressed to fellow citizens than to doctors. Nevertheless, the future doctor must weigh his possibilities - the natural movement of helping the suffering, the inevitable atmosphere of difficult spectacles and experiences.
The difficulties of the medical profession were vividly described by A.P. Chekhov, V.V. Veresaev, M.A. Bulgakov; their experiences are useful for every doctor to think over - they complement the dry exposition of textbooks. Familiarity with artistic descriptions of medical topics is essential for enhancing the culture of the doctor; E.I. Liechtenstein (1978) has provided a good summary of what writers say about this side of our lives.
Fortunately, in the Soviet Union, a doctor is not a “lone handicraftsman” dependent on the police or Russian tyrants, but is a worker, a rather respected member of the state health care system.
1 TSB, 3rd ed. - T. 15.- 1974.- P. 562.
2 F. Engels The Situation of the Working Class in England // K. Marx, F. Engels Works - 2-ed. - T. 2.- P. 231–517.
3 Odo from Mena / Ed. V.N. Ternovsky .- M .: Medicine, 1976.
Source of information: Aleksandrovsky Yu.A. Frontier psychiatry. M .: RLS-2006. & Nbsp— 1280 s.
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History of medicine in brief
Project of the Department of the History of Medicine, Moscow State University of Medicine and Dentistry. A.I. Evdokimova
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Medicine in Western Europe
The feudal system was established in different countries of the world at different historical times. This process of transition from slavery to feudalism took place in specific forms for each country. So, in China it happened around the III-II century BC. e., in India - in the first centuries of our era, in Transcaucasia and Central Asia in the IV-VI centuries, in the countries of Western Europe - in the V-VI centuries, in Russia - in the IX century.
Fall of the Western Roman Empire in AD 476 NS. represents for Western Europe the historical borderline between the slave formation and the new formation that came to replace it - the feudal one, between the so-called antiquity and the Middle Ages. The Middle Ages, the era of feudal, or serfdom, relations spanned the 12-13 centuries.
Under feudalism, there were two main classes: feudal lords and dependent serfs. Subsequently, with the growth of cities, the layer of urban artisans and merchants increased - the future third estate, the bourgeoisie. Throughout the Middle Ages, there was an incessant struggle between the two main classes of feudal society.
The feudal system of France, Germany, England went through three stages. The first stage of feudalism (from V to X-XI centuries) - the early Middle Ages followed immediately after the fall of the slave system in Rome as a result of the uprising of slaves and the invasion of "barbarians".
The progressive features of the feudal system did not show themselves soon. New forms of social life took shape slowly. The Celtic and Germanic tribes, who defeated the slave-owning states, brought with them the remnants of the clan system with its economic and cultural features, primarily with natural forms of economy. The transition from the ancient world to the Middle Ages in Western Europe was associated at first with a deep economic and cultural decline. In the early Middle Ages, subsistence farming prevailed. In the countries of Western Europe, the decline of science has been noted for a number of centuries.
In the second stage of feudalism in Western Europe (approximately from the 11th to the 15th centuries) - in the developed Middle Ages - with the growth of productive forces, cities grew - centers of crafts and trade. Artisans in the cities united in workshops, the development of which is characteristic of this stage. Along with subsistence farming, an exchange economy developed. Commodity-money relations were getting stronger. Trade within the country and between countries developed and grew.
The entire spiritual culture of the Middle Ages was under the yoke of church ideology, which asserted the divine immutability of existence.
The gatekeeper of the medieval city does not allow "lepers" to enter.
class order and oppression. "The worldview of the Middle Ages was predominantly geological ... the church was the highest generalization and sanction of the existing feudal system." Blessed Augustine in the IV century put forward a characteristic position in this respect: "The authority of sacred scripture is higher than all the abilities of the human mind." The official church fought against heresies - attempts to critically relate to the scriptures and church authorities. These heresies reflected the social protest of peasants and townspeople. To suppress heresies at the end of this period in the Catholic countries of Western Europe, a special body was created - the Inquisition. The clergy were also the only educated class. From this it naturally followed that church dogma was the starting point and basis of all thinking. Jurisprudence, natural science, philosophy - all the content of these sciences was brought in accordance with the teachings of the church. In the Middle Ages, science was considered a servant of the church, and it was not allowed to go beyond the limits established by faith.
In the X-XII centuries, scholasticism became the dominant form of philosophy in Western Europe. In the XIII century, scholasticism reached its peak. The meaning of scholasticism was to substantiate, systematize and defend the official church ideology through artificial formalistic logical tricks. The class meaning of scholasticism was to justify the feudal hierarchy and religious ideology with the aim of the cruel exploitation of the working people and the stifling of progressive thought.
Scholasticism proceeded from the position that all possible knowledge had already been given either in the Holy Scriptures or in the creations of the church fathers ..
The philosophical basis of medieval science was primarily the teachings of Aristotle, largely distorted and placed at the service of theology. In the Middle Ages, Aristotle was canonized by “scholastic science, he was called“ the forerunner of Christ in explaining! Nature. ”Cosmogony and physics of Aristotle turned out to be extremely convenient for the teachings of theologians. VI Lenin said about Aristotle that.
Universities were the centers of medieval medicine. The prototypes of Western European universities were the schools that existed in the Arab Caliphate and the school in Salerio. A university-type higher school existed in Byzantium already in the middle of the 9th century. In Western Europe, universities initially represented private associations of teachers and students, to a certain extent analogous to craft guilds, in accordance with the general guild structure of the Middle Ages. In the XI century, a university arose in Salerno, transformed from the Salerno medical school near Naples, in the XII-XIII centuries, universities appeared in Bologna, Moipelje, Paris, Padua, Oxford, in the XIV century - in Prague and Vienna. The number of students in universities did not exceed several dozen in all faculties. The statutes and curricula of medieval universities were controlled by the Catholic Church. The whole system of university life was copied from the system of church institutions. Many doctors belonged to monastic orders. Secular doctors, when entering medical positions, took an oath similar to that of priests. Some ancient writers were also allowed to study in universities. In the field of medicine, such an officially recognized ancient author was primarily Galen. Medieval medicine took Galen's conclusions tinged with idealism, but completely discarded his research method (experiments, autopsies), which was his main merit. From works
Hippocrates accepted those where his materialistic views in medicine were reflected with the least force. The task of scientists was, first of all, to confirm the correctness of the teachings of recognized authorities in the relevant field and to comment on it. Commentaries on the works of one or another authoritative writer were the main type of medieval scientific literature. Natural science and medicine were fed not by experiments, but by the study of the texts of Galen and Hippocrates. Galileo spoke about a scholastic who, having seen at an anatomist that the nerves converge in the brain and not in the heart, as Aristotle taught, said: “You showed me all this so clearly and tangibly that if the text of Aristotle did not say the opposite (and it directly says that the nerves originate in the heart), then it would be necessary to recognize this as the truth. "
The teaching methods and the very nature of science were purely scholastic. The students memorized what the professors said. The works of Hippocrates, Galen, Ibyasina (Avicenna) were considered dogmatic in medicine. The glory and brilliance of the medieval professor consisted primarily in his erudition and in the ability to confirm his every position with a quote taken from some authority and brought to memory. The disputes presented the most convenient opportunity to express all their knowledge and art. Truth and science meant only what was written, and medieval research became simply an interpretation of the known. Galen's comments on Hippocrates were widely used, many commented on Galen.
In the XIII-XIV centuries scholastic medicine with its abstract constructions, speculative conclusions and disputes developed in the universities of Western Europe. Therefore, in Western European drug science, along with the means obtained by medical practice, there were also those whose application was based on a distant comparison, on the indications of alchemy, astrology, which acted on the imagination or satisfied the whims of the wealthy classes.
Medieval medicine is characterized by complex medicinal recipes. Pharmacy was directly related to alchemy. The number of parts in one recipe often reached several dozen. A special place among medicines was occupied by antidotes: the so-called teriak, which included 70 or more components (the main component is snake meat), as well as mitridate (opal). Teriak was also considered a remedy against all internal diseases, including "pestilence" fevers. These funds were highly valued. In some cities, especially famous for their teriacs and mitridates and selling them to other countries (Venice, Nuremberg), the manufacture of these funds was carried out publicly, with great solemnity, in the presence of the authorities and invited persons.
Autopsies during pestilences were carried out as early as the 6th century AD. e., but they did not contribute much to the development of medicine. The first autopsies, traces of which have come down to us, were carried out from the 13th century. In 1231, Emperor Frederick II allowed an autopsy to be performed on a human corpse once every 5 years, but in 1300 the Pope imposed severe punishment on anyone who dared to dismember a human corpse or boil it down to make a skeleton. From time to time, some universities were allowed to perform autopsies. The medical faculty at Montpellier in 1376 received permission to open the bodies of those executed; in Venice in 1368, it was allowed to perform one autopsy per year. "In Prague, regular autopsies began only in 1400, that is, 52 years after the opening of the university. The University of Vienna received such permission in 1403, but for 94 Only 9 autopsies were performed there (from 1404 to 1498). At the University of Greifswald, the first human corpse was opened 200 years after the university was established. The autopsy was usually limited to the abdominal and thoracic cavities.
In 1316 Mondino de Lucci compiled a textbook on anatomy, trying to replace the part of the first book of IbnSina's Canon of Medicine, which was devoted to anatomy. Mondino himself had the ability to open only two corpses, and his textbook was a compilation. Mondino drew his main anatomical knowledge from a poor translation of an Arabic compilation of Galen's works full of errors. For more than two centuries, Mondino's book remained an anatomy textbook.
Only in Italy at the end of the 15th and 16th centuries did the dissection of human corpses for the purpose of teaching anatomy become more frequent.
Among the medieval universities of Western Europe, Salerno and Padua played a progressive role and were less influenced by scholasticism.
Already in antiquity, the Roman colony of Salerno, lying south of Naples, was known for its healing climate. The influx of patients, naturally, led to the concentration of doctors here. At the beginning of the 6th century, meetings were held in Salerno for reading the works of Hippocrates, and later, in the 9th century, a medical school was created in Salerno, the prototype of the university that arose in the 11th century. The teachers at the Salerno school were people of different nationalities. Teaching consisted of reading the works of Greek and Roman, and later Arabic writers and interpreting what was read. The "Salerno Sanitary Regulations", a popular collection of personal hygiene rules, which was compiled in the 11th century in poetic form in Latin and was published several times, was widely known in Western Europe in the Middle Ages in Western Europe.
Unlike most medieval universities, the University of Padua in the domain of Venice began to play a role later, by the end of the Middle Ages, during the Renaissance. It was founded in the 13th century by scholars who fled from the papal regions and from Spain from the persecution of the Catholic church reaction. In the 16th century, it became the center of advanced medicine.
The Middle Ages in the West and in the East are characterized by a new phenomenon not known to the ancient world in such proportions - large epidemics. Among the numerous epidemics of the Middle Ages, the "black death" in the middle of the XIV century - the plague with the addition of other diseases to it - left a particularly difficult memory of itself. Historians, based on data from chronicles, church records of burials, city chronicles and other documents, argue that many large cities have been deserted. These devastating epidemics were accompanied by devastation in all areas of economic and social life. The development of epidemics was facilitated by a number of conditions: the emergence and growth of cities, characterized by overcrowding, cramped and muddy, massive movements of a huge number of people. the so-called great migration of peoples from East to West, later a great military-colonization movement in the opposite direction - the so-called crusades (eight campaigns from 1096 to "291.) Epidemics of the Middle Ages, like infectious diseases of antiquity, are usually described under a general name “Pestilence” loimos (literally “plague.”) But, judging by the surviving descriptions, various diseases were called plague (pestilence): plague, typhus (primarily typhus), smallpox, dysentery, etc., often mixed epidemics.
The widespread spread of leprosy (under this name also hid a number of other skin lesions, in particular syphilis) during the Crusades led to the formation of the Order of St. Lazarus for the charity of the lepers. Hence, the asylums for lepers were called infirmaries. Along with the infirmaries, shelters for other infectious patients arose.
In large port cities of Europe, where epidemics were brought in by merchant ships (Venice, Genoa, etc.), special anti-epidemic institutions and measures arose: in direct connection with the interests of trade, quarantines were created (literally "forty days" - the period of isolation and observation of the crew of arrivals ships); there were special port overseers - “health caretakers”. Later, also in connection with the economic interests of medieval cities, there appeared "city doctors", or "urban physicists", as they were called in a number of European countries; these doctors performed mainly anti-epidemic functions. In a number of large cities, special rules were published - regulations aimed at preventing the introduction and spread of infectious diseases; known London, Paris, Nuremberg rules of this kind.
To combat the widespread "leprosy" in the Middle Ages, special measures were developed, such as: isolation of the "lepers" in a number of countries in the so-called infirmaries, supplying the "lepers" with a horn, rattle or bell for signaling from afar in order to avoid contact of healthy people with them. At the city gates, the gatekeepers examined those who entered and detained those suspected of "leprosy."
The fight against infectious diseases also contributed to the implementation of some general sanitary measures - primarily to provide cities with good-quality drinking water. Among the oldest sanitary facilities in medieval Europe are the water pipes of ancient Russian cities.
Following the first hospitals in the East-Caesarea and others, hospitals appeared in Western Europe. Among the first hospitals, more precisely, almshouses, in the West belonged to the Lyons and Paris "Hôtel die" - the house of God (they were founded: the first - in the 6th century, the second - in the 7th century), then Bartholomew's Hospital in London (XII century) and others. Most often, hospitals arranged poi in monasteries.
Monastic medicine in Western Europe was entirely subordinated to religious ideology. Its main task was to promote the spread of Catholicism. Medical assistance to the population, along with the missionary and military activities of the monks, was an integral part of the complex of measures carried out by the Catholic Church during the conquest of new territories and peoples by the feudal lords. Medicinal herbs were used as a tool of Catholic expansion along with a cross and a sword. The monks were ordered to provide medical assistance to the population. Most of the monks, naturally, lacked deep medical knowledge and medical "specialization, although among them there were undoubtedly skilled healers. The monastic hospitals served as practical schools for monks' doctors, they accumulated experience in the treatment of diseases, the manufacture of medicines. But, linking medicine with the church, observance of rituals, prayers, repentance, and healing with "miracles of the saints", etc., they hindered the development of scientific medicine.
From the branches of practical medicine in the Middle Ages, in connection with numerous wars, surgery developed. Surgery in the Middle Ages was not so much practiced by doctors who graduated from medical faculties, as practitioners - chiropractors and barbers. The most complete generalization of the experience of medieval surgery was given in the 16th century by the founder of surgery.
The third stage of feudalism (XVI-XVII centuries) in Western Europe was a period of its decline and decomposition, the relatively rapid development of the commodity-money economy and then the emergence of capitalist relations and bourgeois society in the bowels of feudalism, representing the transition to the next socio-economic formation - capitalism.
essay
on the topic:
History development of medicine
1.History of medicine
1.1 History of medicine: first steps.
1 2 History of Medicine: the Middle Ages
1 3 Medicine in the XVI-XIX centuries.
1 4 Development of medicine in the XX century.
2. Hippocrates
3. Hippocrates collection
4. Michelle Nostradamus
Conclusion
List of used literature
1. History of medicine
1.1 History of medicine: first steps
The rudiments of healing appeared at the earliest stages of human existence: “Medical activity is the same age as the first person,” wrote IP Pavlov. The sources of our knowledge about diseases and their treatment in those distant times are, for example, the results of excavations of settlements and burials of primitive people, the study of individual ethnic groups, which, due to the special conditions of their history, are still at a primitive level of development. Scientific data indicate with certainty that a person did not have any "perfect" health at that time. On the contrary, primitive man, completely at the mercy of the surrounding nature, constantly suffered from cold, dampness, hunger, was ill and died early. Skeletons of people preserved from prehistoric periods bear traces of rickets, dental caries, accrete fractures, joint lesions, etc. Some infectious diseases, for example. malaria, were "inherited" by man from his ancestors - great apes. Tibetan medicine teaches that "the mouth is the gateway to all diseases" and that "the first disease was stomach disease."
From the observations and experience of millennia, passed down from generation to generation, rational healing was born. The fact that any accidentally applied means or techniques were beneficial, eliminating pain, stopping bleeding, alleviating the condition by inducing vomiting, etc., made it possible to resort to their help in the future if similar circumstances arose. The empirically found methods of treatment and protection against diseases were fixed in the customs of primitive man and gradually made up folk medicine and hygiene. Among these therapeutic and preventive measures were the use of medicinal plants, the use of natural factors (water, air, sun), some surgical techniques (extraction of foreign bodies, bloodletting), etc.
Primitive man did not know the natural causes of many of the phenomena he observed. So, illness and death seemed to him unexpected, due to the intervention of mysterious forces (witchcraft, the influence of spirits). Misunderstanding of the surrounding world, helplessness before the forces of nature forced to resort to spells, conspiracies and other magical techniques in order to establish contact with otherworldly forces and find salvation. This "treatment" was carried out by healers, shamans, sorcerers, who by fasting, intoxication, dancing brought themselves to a state of ecstasy, as if being transported into the world of spirits.
Ancient medicine inherited both the magical forms of healing, and rational methods, and the healing remedies of folk medicine. Great importance was attached to dietetics, massage, water procedures, and gymnastics. Surgical methods were used, for example, in cases of difficult childbirth - cesarean section and operations of destruction of the fetus (embryotomy), etc. An important place was given to the prevention of diseases ("Rip out the disease before it touches you"), from which many prescriptions of a hygienic nature followed , including on the diet, family life, on the attitude towards pregnant women and nursing mothers, on the prohibition to drink intoxicating drinks, etc.
In the early stages of the slave-owning system, medicine emerged as an independent profession. The so-called temple medicine was widely developed: medical functions were performed by priests (for example, in Egypt, Assyria, India). The medicine of Ancient Greece, which reached a high flowering, was reflected in the cults of the deified doctor Asclepius and his daughters: Hygieia, the protector of health (hence hygiene) and Panakia, the patroness of the medical business (hence the panacea).
The medical art of this period reached its pinnacle in the activities of the great ancient Greek physician Hippocrates (460-377 BC), who turned observation at the patient's bedside into an actual medical research method, described the external signs of many diseases, pointed out the importance of lifestyle and the role of the environment, especially climate, in the origin of diseases, and by the doctrine of the main types of physique and temperament in humans, he substantiated an individual approach to the diagnosis and treatment of a patient. He is rightly called the father of medicine. Of course, treatment in that era did not have a scientific basis, it was based not on clear physiological ideas about the functions of certain organs, but on the doctrine of the four liquid principles of life (mucus, blood, yellow and black bile), changes that supposedly lead to illness.
The first attempt to establish the relationship between the structure and functions of the human body belongs to the famous Alexandrian doctors Herophilus and Erasistratus (III century BC), who performed autopsies and experiments on animals.
The Roman physician Galen had an exceptionally great influence on the development of medicine: he summarized information on anatomy, physiology, pathology, therapy, obstetrics, hygiene, medicine, introduced many new things into each of these medical branches and tried to build a scientific system of medicine.
1.2 History of Medicine: the Middle Ages
In the Middle Ages, M. in Western Europe received almost no further scientific development. The Christian Church, which proclaimed the primacy of faith over knowledge, canonized the teachings of Galen, turning it into an indisputable dogma. As a result, many naive and speculative ideas of Galen (Galen believed that blood is formed in the liver, spreads throughout the body and is completely absorbed there, that the heart serves to form in it a "vital pneuma" that maintains the warmth of the body; “Forces”: the forces of pulsation, due to which the arteries pulsate, etc.) have become the anatomical and physiological basis of medicine. In the atmosphere of the Middle Ages, when prayers and holy relics were considered more effective means of treatment than medicines, when the autopsy and the study of its anatomy were recognized as a mortal sin, and an attempt on the authorities was viewed as heresy, the method of Galen, an inquisitive researcher and experimenter, was forgotten; only the “system” invented by him remained as the final “scientific” basis of medicine, and the “scientists” physicians-scholastics studied, quoted and commented on Galen.
The accumulation of practical medical observations, of course, continued into the Middle Ages. In response to time requests, specials arose. institutions for the treatment of sick and wounded, identification and isolation of infectious patients were carried out. The Crusades, accompanied by the migration of huge masses of people, contributed to devastating epidemics and caused quarantines in Europe; monastery hospitals and infirmaries were opened. Even earlier (7th century), large hospitals for the civilian population arose in the Byzantine Empire.
In the IX-XI centuries. center of scientific honey. thoughts moved to the countries of the Arab Caliphate. We owe the Byzantine and Arab medicine the preservation of the valuable heritage of M. of the Ancient World, which they enriched with the description of new symptoms, diseases, and medicines. An important role in the development of M. was played by a native of Central Asia, a versatile scientist and thinker Ibn Sina (Avicenna, 980-1037): his "Canon of Medicine" was an encyclopedic collection of medical knowledge.
In the ancient Russian feudal state, along with monastic medicine, folk medicine continued to develop. Widespread medical books contained a number of rational instructions on the treatment of diseases and household hygiene, herbalists (zelniks) described medicinal plants.
1.3 Medicine in Xvi-XIX cc
The slow but steady development of honey. knowledge begins in Western Europe in the XII-XIII centuries. (which was reflected, for example, in the activities of the University of Salerno). But it was only in the Renaissance that the Swiss-born physician Paracelsus came out with a vigorous criticism of Galenism and the propaganda of a new medicine, based not on authorities, but on experience and knowledge. Considering the disorder of chemical transformations during digestion and absorption as the cause of chronic diseases, Paracelsus introduced various chemicals and mineral waters into medical practice.
At the same time, the founder of modern anatomy, A. Vesalius, rebelled against the authority of Galen; on the basis of the systematic anatomy of corpses, he described the structure and functions of the human body. The transition from the scholastic to the mechanical-mathematical consideration of nature had a great influence on the development of medicine, the English physician W. Harvey created the doctrine of blood circulation (1628), having laid down the so-called. foundations of modern physiology. W. Harvey's method was already not only descriptive, but also experimental, using mathematical calculation. A striking example of the influence of physics on medicine is the invention of magnifying devices (microscope) and the development of microscopy.
In the field of practical medicine, the most important events of the 16th century. were the creation by the Italian physician G. Fracastoro of the doctrine of contagious (infectious) diseases and the development of the first scientific foundations of surgery, French. doctor A. Pare. Until that time, surgery was the stepdaughter of European medicine and was carried out by deeply educated barbers who were looked down on by certified doctors. The growth of industrial production drew attention to the study of prof. diseases. At the turn of the XVI-XVIII centuries. the Italian physician B. Ramazzini (1633-1714) initiated the study of industrial pathology and occupational health. In the second half of the 18th century. - the first half of the 19th century. the foundations of military and naval hygiene were laid. The works of the Russian doctor D. Samoilovich on the plague, published in the second half of the 18th century, allow us to consider him one of the founders of epidemiology.
The conditions for theoretical generalizations in the field of medicine were created by the progress of physics, chemistry and biology at the turn of the 18th-19th centuries: the discovery of the role of oxygen in combustion and respiration, the law of conservation and transformation of energy, the beginning of the synthesis of organic substances (1st half of the 19th century) , the development of the doctrine of good nutrition, the study of chemical processes in a living organism, which led to the emergence of biochemistry ”, etc.
The development of clinical medicine was facilitated by the development in the 2nd half of the 18th - 1st half of the 19th centuries. methods of objective examination of the patient: percussion (L. Auenbrugger, J. Corvisard, etc.) "listening (R. Laennek and others), palpation, laboratory diagnostics. The method of comparing clinical observations with the results of postmortem autopsies used in the 18th century. J. Morgagni, and then M. F. K. Bisha, R. Virkhov, K. Rokitansky, N. I. Pirogov and many others, as well as the development of the cellular theory of the structure of organisms gave rise to new disciplines - histology and pathological anatomy, which made it possible to establish localization (place) of the disease and the material substrate of many diseases.
An exceptional influence on the development of medicine was exerted by the use in many countries of the method of vivisection - an experiment on animals - to study normal and impaired functions. F. Magendy (1783-1855) opened the era of consistent application of the experiment as a natural-scientific method of cognizing the laws of the activity of a healthy and sick organism. K. Bernard (1813-1878) in the middle of the 19th century. continued this line and indicated the ways in which experimental medicine successfully advanced a century later. By studying the effect of drugs and poisons on the body, K. Bernard laid the foundations of experimental pharmacology and toxicology. To appreciate the importance of the development of the science of medicines, it is enough to recall what crude empiricism prevailed here at that time. Both in the 16th and 18th centuries. The arsenal of remedies, regardless of what views the doctor adhered to, was limited to bloodletting, klystyra, laxatives, emetics and a few more, but quite effective drugs. The famous French physician F. Brousset (1772-1838), a supporter of endless bloodletting, was said to have shed more blood than the Napoleonic wars combined.
In Russia, the fundamental contribution to the development of experimental pharmacology was made by the works of N.P. Kravkov.
Physiology and its experimental method, together with pathological anatomy, have transformed various fields of clinical medicine on a scientific basis. The German scientist G. Helmholtz (1821-1894) showed by brilliant experiments the importance of physicochemical methods as the basis of physiology; his work on the physiology of the eye and his invention of the eye mirror, along with the previous physiological studies of the Czech biologist J. Purkinje, contributed to the rapid progress of ophthalmology (the study of eye diseases) and its separation from surgery as an independent branch of medicine.
Back in the 1st half of the 19th century. the works of E.O. Mukhin, I.E.Dyadkovsky, A.M. Filomafitsky and others laid the theoretical and experimental foundations for the development of the physiological direction in domestic medicine, but it flourished especially in the second half of the 19th and 20th centuries. IM Sechenov's book "Reflexes of the Brain" (1863) had a decisive influence on the formation of the materialistic views of doctors and physiologists. The physiological approach and the ideas of nervousism were most fully and consistently used in clinical medicine by S.P.Botkin, the founder of the scientific direction of domestic internal medicine, and A.A.Ostroumov. Along with them, the clinical school of G.A.Zakharyin brought world fame to Russian therapy, which perfected the method of questioning the patient. In turn, the views of S.P. Botkin had a deep influence on I.P. Pavlov, whose works on the physiology of digestion were awarded the Nobel Prize, and the doctrine of higher nervous activity created by him determined the ways of solving many problems of both theoretical and clinical medicine. ...
Numerous students and ideological successors of I.M.Sechenov (N.E. Vvedensky, I.R. Tarkhanov, V.V. Pashutin, M.N. various biomedical disciplines.
In the middle and especially in the 2nd half of the 19th century. from therapy (or internal medicine, which originally encompassed all medicine except surgery and obstetrics), new scientific and practical branches are spun off. For example, pediatrics, which existed before as a branch of practical medicine, is being formed into an independent scientific discipline, represented by departments, clinics, societies; its outstanding representative in Russia was N.F. Filatov. Neuropathology and psychiatry are turning into scientific disciplines on the basis of successes in the study of the anatomy and physiology of the nervous system and clinical activity by F. Pinel, J. M. Charcot (France), A. Ya. Kozhevnikov, S. S. Korsakov, V. M. Bekhterev and many other scientists in different countries.
Along with curative medicine, preventive medicine is developing. The search for not only an effective, but also a safe method of preventing smallpox disease led the English physician E. Jenner to the discovery of a smallpox vaccine (1796), the use of which made it possible to radically prevent this disease in the future by means of smallpox vaccination. In the XIX century. the Viennese physician I. Semmelweis (1818-1865) established that the cause of childbirth fever lies in the transfer of an infectious principle with the instruments and hands of physicians, introduced disinfection and achieved a sharp reduction in the mortality rate of women in childbirth.
The works of L. Pasteur (1822-1895), who established the microbial nature of infectious diseases, marked the beginning of the “bacteriological era”. Based on his research, the English surgeon J. Lister (1827-1912) proposed an antiseptic method (see antiseptics, asepsis) for treating wounds, the use of which made it possible to dramatically reduce the number of complications in wounds and surgical interventions. The discoveries of the German doctor R. Koch (1843-1910) and his students led to the spread of the so-called etiological trend in medicine: doctors began to look for the microbial cause of diseases. Microbiology and epidemiology developed in many countries, pathogens and vectors of various infectious diseases were discovered. The method of sterilization with flowing steam developed by R. Koch was transferred from the laboratory to the surgical clinic and contributed to the development of asepsis. The description by the domestic scientist DI Ivanovsky of “tobacco mosaic disease” (1892) laid the foundation for virology. The shadow side of the general enthusiasm for the successes of bacteriology was the undoubted overestimation of the role of the pathogen microbe as the cause of human diseases. With the activity of I.I. Most of the prominent microbiologists and epidemiologists of Russia in the late 19th - early 20th centuries. (D. K. Zabolotny, N. F. Gamaleya, L. A. Tarasovich, G. N. Gabrichevsky, A. M. Bezredka and others) worked together with I. I. Mechnikov. German scientists E. Bering and P. Ehrlich developed the chemical theory of immunity and laid the foundations of serology — the doctrine of the properties of blood serum (see Immunity, Serums).
The successes of natural science determined the use of experimental research methods in the field of hygiene, the organization in the 2nd half of the 19th century. hygiene departments and laboratories. The works of M. Pettenkofer (1818-1901) in Germany, A.P. Dobroslavin and F.F.Erisman in Russia developed a scientific basis for hygiene.
Industrial revolution, urban growth, bourgeois revolutions at the end of the 17th century - the first half of the 19th century. conditioned the development of social problems of medicine and the development of public hygiene. In the middle and 2nd half of the 19th century. materials began to accumulate testifying to the dependence of workers' health on working and living conditions.
1.4 The development of medicine in Xx in.
Decisive steps to transform from craft, art into science were made by medicine at the turn of the 19th - 20th centuries. influenced by the achievements of natural sciences and technological progress. The discovery of X-rays (VK Roentgen, 1895-1897) marked the beginning of X-ray diagnostics, without which it is now impossible to imagine an in-depth examination of the patient. The discovery of natural radioactivity and the subsequent research in the field of nuclear physics led to the development of radiobiology, which studies the effect of ionizing radiation on living organisms, led to the emergence of radiation hygiene, the use of radioactive isotopes, which in turn made it possible to develop a research method using the so-called labeled atoms; radium and radioactive drugs have been successfully used not only for diagnostic, but also for medicinal purposes (see Radiation therapy).
Another research method that fundamentally enriched the possibilities of recognizing cardiac arrhythmias, myocardial infarction and a number of other diseases was electrocardiography, which entered clinical practice after the work of Goll. physiologist V. Einthoven, Russian physiologist A. F. Samoilov, and others.
Electronics played a huge role in the technical revolution that seriously changed the face of medicine in the second half of the 20th century. Fundamentally new methods have appeared for registering the functions of organs and systems using various perceiving, transmitting and recording devices (for example, the transmission of data on the work of the heart and other functions is carried out even at a cosmic distance);
controlled devices in the form of an artificial kidney, heart, lungs replace the work of these organs, for example, during surgical operations; electrical stimulation allows you to control the rhythm of a diseased heart, the function of the bladder. Electron microscopy has made it possible to magnify tens of thousands of times, which makes it possible to study the smallest details of the structure of the cell and their changes. Honey is actively developing. cybernetics (see. Medical cybernetics). The problem of attracting electronic computers for diagnosis has acquired particular importance. An automatic system for regulating anesthesia, respiration and blood pressure level during operations, active guided prostheses, etc. have been created.
The influence of technological progress also affected the emergence of new branches of medicine. So, with the development of aviation in the early 20th century. aviation medicine was born. Human flights on spaceships led to the emergence of space medicine (see Aviation and Space Medicine).
The rapid development of medicine was due not only to discoveries in the field of physics and technical progress, but also to the achievements of chemistry and biology. New chemical and physicochemical research methods have entered clinical practice, the understanding of the chemical foundations of life, including disease processes, has deepened.
Genetics, the foundations of which were laid by G. Mendel, established the laws and mechanisms of heredity and variability of organisms. An outstanding contribution to the development of genetics was made by Soviet scientists NK Koltsov, NI Vavilov, AS Serebrovsky, NP Dubinin and others. The discovery of the so-called. the genetic code contributed to the deciphering of the causes of hereditary diseases and the rapid development of medical genetics. The successes of this scientific discipline made it possible to establish that environmental conditions can contribute to the development or suppression of hereditary predisposition to the disease. Methods for express diagnostics, prevention and treatment of a number of hereditary diseases have been developed, and medical and genetic counseling for the population has been organized (see. Medical and genetic counseling).
Immunology XX century. has outgrown the framework of the classical doctrine of immunity to infectious diseases and gradually covered the problems of pathology, genetics, embryology, transplantation, oncology, etc. The discovery by K. Landsteiner and J. Jansky of human blood groups (1900-1907) led to the use of transfusion in practical medicine blood. In close connection with the study of immunological processes, the study of various forms of the perverted reaction of the body to foreign substances was carried out, begun by the discovery of the phenomenon of anaphylaxis by the French scientist J. Richet (1902). Austrian pediatrician K. Pirke introduced the term allergy and proposed (1907) an allergic skin reaction to tuberculin as a diagnostic test for tuberculosis. In the 2nd half of the XX century. the doctrine of allergy - allergology - has grown into an independent section of theoretical and clinical medicine.
At the beginning of the XX century. German doctor P. Ehrlich proved the possibility of synthesis according to a given plan of drugs capable of affecting pathogens; he laid the foundations for chemotherapy. The era of antimicrobial chemotherapy practically began after the introduction of streptocide into medical practice. Since 1938, dozens of sulfa drugs have been created that have saved the lives of millions of patients. Earlier, in 1929, in England, A. Fleming established that one of the types of molds secretes an antibacterial substance - penicillin. In 1939-1941. H. Flory and E. Chain developed a method for obtaining resistant penicillin, learned how to concentrate it and set up the production of the drug on an industrial scale, marking the beginning of a new era in the fight against microorganisms - the era of antibiotics. In 1942, in the laboratory of Z. V. Ermolyeva, domestic penicillin was obtained. In 1943 S. Waxman obtained streptomycin in the USA. Later, many antibiotics were isolated with different spectrum of antimicrobial action.
Developed successfully in the XX century. the doctrine of vitamins discovered by the Russian scientist N.I. Lunin, the mechanisms of development of many avitaminosis were deciphered and ways to prevent them were found. Created at the end of the 19th century. By the French scientist S. Brown-Se-Kar and others, the doctrine of the endocrine glands turned into an independent medical discipline - endocrinology, a circle of problems, which, along with endocrine diseases, includes hormonal regulation of functions in a healthy and diseased organism, chemical synthesis of hormones. The discovery of insulin in 1921 by the Canadian physiologists Banting and Best revolutionized the treatment of diabetes mellitus. The isolation in 1936 of a hormonal substance from the adrenal glands, which was later called cortisone, as well as the synthesis (1954) of more effective prednisolone and other synthetic analogs of corticosteroids led to the therapeutic use of these drugs in diseases of the connective tissue of the blood, lungs, skin, etc. etc., that is, to the widespread use of hormone therapy for non-endocrine diseases. The development of endocrinology and hormone therapy was facilitated by the work of the Canadian scientist G. Selye, who put forward the theory of stress and general adaptation syndrome.
Chemotherapy, hormone therapy, radiation therapy, the development and use of psychotropic drugs that selectively affect the central nervous system, the possibility of surgical intervention on the so-called open heart, deep in the brain and on other organs of the human body that were not previously accessible to the surgeon's scalpel, have changed the face of medicine, allowed the doctor to actively intervene during the course of the disease.
2. HIPPOCRATES
The earliest biographers of Hippocrates wrote no earlier than 200 years after his death and, of course, it is difficult to count on the reliability of their messages. We could get much more valuable information from the testimony of contemporaries and from the works of Hippocrates themselves.
The testimony of contemporaries is very scarce. This includes, first of all, two passages from Plato's dialogues "Protagoras" and "Phaedrus". In the first of them, the story is told on behalf of Socrates, transmitting his conversation with the young man Hippocrates (this name - literally translated "horse tamer" - was quite common at that time, especially among the equestrian class). According to this place, at the time of Plato, who was approximately 32 years younger than Hippocrates, the latter was widely known and Plato places him alongside such famous sculptors as Polycletus and Phidias.
Even more interesting is the mention of Hippocrates in Plato's dialogue "Phaedrus". There, Hippocrates is spoken of as a physician with a broad philosophical bias; it is shown that in the era of Plato, the works of Hippocrates were known in Athens and attracted the attention of wide circles for their philosophical dialectical approach.
Of course, over the course of 24 centuries, not only praise and surprise fell to the lot of the famous doctor: he experienced both criticism, reaching the point of complete denial, and backbiting. A sharp opponent of the Hippocratic approach to diseases was the famous doctor of the methodological school of Asclepiades (1st century BC), who said, among other things, a sharp word about "Epidemics": Hippocrates, they say, shows well how people die, but does not show how to cure them. Among the doctors of the 4th century, the younger contemporaries of Hippocrates, some mention his name in connection with criticism of his views. Galen, in his commentary on the book of Hippocrates "On the joints", writes: "Hippocrates was reprimanded for the way of repositioning the hip joint, indicating that it falls out again ...".
Other evidence with direct mention of the name of Hippocrates comes from Diocles, a famous physician of the middle of the 4th century, who was even called the second Hippocrates. Criticizing one of the aphorisms of Hippocrates, where, it is argued that diseases corresponding to the season are less dangerous, Diocles exclaims: "What are you saying, Hippocrates! Fever, which, due to the qualities of matter, is accompanied by fever, intolerable thirst, insomnia and all that is observed in summer , will be more easily tolerated due to the correspondence of the season, when all suffering is aggravated, than in winter, when the strength of movements is moderate, the severity decreases and the whole disease becomes milder. "
Thus, from the testimony of the writers of the IV century, the closest in time to Hippocrates, one can glean confidence that he really existed, was a famous doctor, teacher of medicine, writer; that his writings are distinguished by a broad dialectical approach to man and that some of his purely medical positions were already criticized at that time.
It remains to consider what materials for biography can be extracted from the works that have come down to us under the name of Hippocrates. They can be divided into two unequal groups.
The first includes essays of a business nature that have one or another relation to medicine: they are the majority. The second includes the correspondence of Hippocrates, the speeches of him and his son Thessal, decrees. There is very little biographical material in the works of the first group; in the second, on the contrary. There is a lot of it, but, unfortunately, the correspondence is recognized as entirely fake and not trustworthy.
First of all, it should be noted that none of the books of the "Hippocratic Collection" contains the author's name, and it is very difficult to determine what was written by Hippocrates himself, what his relatives, that outside doctors. However, it is possible to single out several books bearing the stamp of the personality of Hippocrates, as they used to imagine it, and from them one can get an idea of the places where he worked and where he visited in his travels. Hippocrates was undoubtedly the physician Periodeut, i.e. he did not practice in his city, where, due to the excess of doctors from a certain school, there was nothing to do, but traveled around different cities and islands, sometimes holding the post of a public doctor for several years. In the books "Epidemics" 1 and 3, which are recognized by the vast majority as authentic, the author describes the state of the weather at different times of the year and the appearance of certain diseases on the island of Thasos for 3, and maybe 4 years. Among the case histories appended to these books, in addition to the sick in Thasos, there are patients from Abdera and a number of cities in Thessaly and Propontis. In the book: "On Air, Water and Localities" the author advises, having come to an unfamiliar city, to familiarize yourself in detail with the location, water, winds and generally the climate in order to understand the nature of emerging diseases and their treatment. This directly points to the doctor - Periodeut. From the same book it is clear that Hippocrates, from his own experience, knows Asia Minor, Scythia, the Eastern coast of the Black Sea near the Phasis River, as well as Libya.
The Epidemics mentions the names of Alevads, Disseris, Sim, Hippolochus, known from other sources as noble people and princes. If a doctor was called to treat a groom, a slave or a maid, it only meant that the owners treasured them. This, in essence, is all that can be learned from the medical books of Hippocrates in terms of his biography.
It remains to consider the last source of the biography of Hippocrates: his correspondence, speeches, letters, invitations, decrees - a variety of historical material, placed at the end of his works and included in the "Hippocrates Collection" as an integral part of it.
In the old days, all these letters and speeches were believed, but the historical criticism of the 19th century deprived them of all confidence, recognizing them as fake and composed, like most other letters that have come down to us from the ancient world, for example, Plato. German philologists suggest that the letters and speeches were composed in the rhetorical school of the island of Kos in the 3rd and subsequent centuries, perhaps in the form of exercises or essays on given topics, as was the practice at that time. That the letters of Hippocrates were planted, this is proved by some anachronisms, historical inconsistencies and in general the whole style of letters, so it is difficult to object to this. But, on the other hand, it is also impossible to deny any historical value of these writings: such an attitude is the result of hypercriticism, which flourished especially in the 19th century among scholarly historians and philologists. It should not be forgotten - and this is the most important thing - that in fact the data cited, for example, in Thessal's speech, are chronologically the earliest, in comparison with which biographies written many hundreds of years after the death of Hippocrates cannot be counted. That huge amount of details and small details concerning persons, places and dates, which lend credence to the story, could hardly be just fictional: in any case, they have some kind of historical background.
The most interesting historical materials are contained in the speech of Thessalus, the son of Hippocrates, delivered in the Athenian people's assembly, where he acted as an ambassador for his hometown of Kos, and, listing the merits that his ancestors and he himself rendered to the Athenians and the citywide cause, tried to ward off the impending war and the defeat of the island of Kos. From this speech we learn that the ancestors of Hippocrates, by the father of Asclepiades, by the mother were Heraclides, i.e. the descendants of Hercules, as a result of which they were in kinship with the Macedonian court and the Thessalian feudal rulers, which makes the stay of Hippocrates, his sons and grandchildren in these countries quite understandable.
In addition to this speech, there are also stories of no less interest about the merits of Hippocrates himself.
It is also necessary to dwell on the correspondence of Hippocrates, which occupies most of the appendices to the "Collection". It has already undoubtedly been planted and composed, but it contains a large number of details, both everyday and psychological, giving letters an imprint of some freshness, naivety and such a flavor of the era, which after several centuries it is difficult to invent. The main place is occupied by the correspondence about Democritus and with Democritus himself.
Such are biographical materials of a heterogeneous nature, which depict the life and personality of Hippocrates; this is how he appeared to the ancient world and passed into history.
He lived in the era of the cultural flourishing of Greece, was a contemporary of Sophocles and Euripides, Phidias and Polycletus, the famous sophists, Socrates and Plato, and embodied the ideal of the Greek doctor of that era. This physician must not only be fluent in the art of medicine, but also be a physician-philosopher and a physician-citizen. And if Schulze, a medical historian of the 18th century, in search of historical truth, wrote: "So, the only thing we have about Hippocrates of Kos is the following: he lived during the Peloponnesian war and wrote books about medicine in Greek in the Ionian dialect", then to this it can be noted that there were many such doctors, since many doctors wrote in the Ionian dialect at that time, and it is completely incomprehensible why it was precisely history that brought Hippocrates to the first place, consigning the rest to oblivion.
If for his contemporaries Hippocrates was, first of all, a doctor-healer, then for posterity he was a doctor-writer, "the father of medicine." The fact that Hippocrates was not the "father of medicine" hardly needs to be proved. And to whom it seems certain that all the "works of Hippocrates" were really written by him, he with a certain right can assert that the true paths of medicine have been paved by him, especially since the works of his predecessors have not reached us. But in reality, the "works of Hippocrates" are a conglomerate of works by various authors, of various directions, and it is possible to single out the true Hippocrates from them only with difficulty. To single out the "true Hippocrates" from many books is a very difficult task and can be solved only with a greater or lesser degree of probability. Hippocrates entered the medical field when Greek medicine had already reached significant development; as the head of the Kosovo school, he introduced a big revolution into it, and can rightfully be called a reformer of medicine, but he does not extend beyond his meaning. To find out this meaning, it is necessary to dwell a little on the development of Greek medicine.
Its beginnings are lost in antiquity and are associated with the medicine of the ancient cultures of the East - Babylonian and Egyptian. In the laws of the Babylonian king Hammurabi (about 2 thousand years BC), there are paragraphs relating to doctors performing eye surgery, with the definition of a large fee and at the same time a great responsibility for an unsuccessful outcome. Bronze eye instruments were found during excavations in Mesopotamia. The famous Egyptian papyrus of Ebers (mid-twentieth century BC) gives a huge number of recipes for various diseases and rules for the study of the patient. The specialization of Egyptian doctors took place in time immemorial, and we now know that the Cretan - Mycenaean culture developed in close contact with Egypt. During the Trojan War (dating back to this culture), the Greeks had doctors who bandaged wounds and treated other diseases; they were respected, for "an experienced doctor is more precious than many other people" (Iliad, XI). It should be noted that medicine in Greece was from time immemorial in nature, while in Babylon and Egypt, doctors belonged to the class of priests: it was based on empiricism and in its the basis was free of theurgy, i.e. invocations of gods, spells, magic techniques, etc.
Of course, in each region there were, in addition, special objects and places associated with the cult of various gods (trees, springs, caves), to which unfortunate patients flocked to seek healing - a phenomenon common to all countries and eras. Healing cases were recorded on special tables that were hung in churches, and, in addition, the sick brought offerings to the temple - images of the affected parts of the body, found in abundance during excavations of these records in churches, had previously attached great importance in the education of doctors; they supposedly formed the basis of the "Kos forecasts", and from there, according to the testimony of the geographer Strabo, Hippocrates drew his medical wisdom.
In the fifth century, by the time of Hippocrates, there were doctors of various categories in Greece: military doctors, specialists in the treatment of wounds, as described in the book: "About the doctor", court doctors - life-doctors who existed at the court of the kings: Persian, or Macedonian.
Public doctors in most democratic republics, and, finally, doctors of the period, who were bound by certain places: they moved from city to city, practicing at their own risk, but sometimes transferred to the service of the city. Public doctors were elected by the national assembly after a preliminary examination, and their merits were increased by a golden wreath, the right of citizenship and other insignia, as evidenced by the inscriptions found during excavations.
Where did all these doctors come from? "Hippocrates collection" gives complete information on this issue: along with doctors - healers and charlatans, doctors of late scientists ", real doctors are people who have received education from a young age in the depths of a certain school and bound by a certain oath. From other sources, starting with Herodotus and ending with Galen, we know that in the 6th and 5th centuries in Greece there were famous schools: Croton (southern Italy), Cyrene in Africa, Cnidus in Asia Minor in the Asia Minor city of Knidos, Rhodes on the island of Rados, and Kos. The collection "the schools of Cnidus, Kos and Italian were reflected. The Cyrene and Rhodes schools disappeared early, leaving no noticeable trace.
The venerable Cnidus school, continuing the tradition of Babylonian and Egyptian doctors, distinguished complexes of painful symptoms and described them as separate diseases.
In this respect, the Cnidan doctors have achieved great results: they distinguished, according to Galen, 7 types of bile diseases, 12 - bladder diseases, 3 - consumption, 4 - kidney diseases, etc .; they also developed methods of physical research (auscultation). The therapy was very varied, with many complex recipes, face-to-face dietary guidance, and extensive use of local remedies such as moxibustion. In short, they developed private pathology and therapy in connection with medical diagnosis. They have done a lot in the field of female diseases.
But with regard to the pathophysiology and pathogenesis of the Cnidian school, the merit of a distinct formulation of humoral pathology in the form of the doctrine of 4 basic body fluids (blood, mucus, black and yellow bile) belongs to the Cnidus school: the predominance of one of them causes a certain disease.
The history of the Kosovo school is inextricably linked with the name of Hippocrates; he is credited with the main direction of the school, since we did not have sufficient data on the activities of his ancestors of doctors, and his numerous descendants, apparently, only followed in his footsteps. Hippocrates, first of all, acts as a critic of the Cnidus school: its desire to break up diseases and make accurate diagnoses, and its therapy. It is not the name of the disease that is important, but the general condition of the patient. As for therapy, diet and the general regime, they should be strictly individualizing: you need to take everything into account, weigh and discuss - then only you can make appointments. If the Cnidus school, in search of places of disease, can be characterized as a school of private pathology that catches painful local processes, the Kosovo school laid the foundations of clinical medicine, in the center of which is an attentive and careful attitude towards the patient. The foregoing determines the role of Hippocrates as a representative of the Kosovo school - in the development of medicine: he was not the "father of medicine", but he can rightfully be called the founder of clinical medicine. Along with this, the Kosovo school is fighting all kinds of charlatans of the medical profession, demands from the doctor in accordance with his dignity of behavior, i.e. the establishment of a certain medical ethics and, finally, a broad philosophical view. All this taken together makes it clear the significance of the Kosovo school and its main representative Hippocrates in the history of healing and medical life.
It should be added that surgery played an important role in the activities of Hippocrates: wounds, fractures, dislocations, as evidenced by his surgical works, perhaps the best of all, where, along with rational methods of reduction, mechanical methods and machines, the latest achievements of that time, are widely used.
Another specialty of Hippocrates, and, apparently, of the entire Kosovo school, was acute febrile diseases such as tropical fevers, and to this day it is extremely widespread in Greece, claiming many victims. A lot of attention is paid to these "epidemics", "acute diseases" in the works of Hippocrates and his descendants. But this is not enough: Hippocrates and the School of Kos made an attempt to put these acute and epidemic diseases into the general course of natural phenomena, to present them as a result of location, water, winds, precipitation, i.e. climatic conditions, to associate them with the seasons and the constitution of the inhabitants, which again is determined by environmental conditions, is a grandiose attempt, not fully resolved to this day, which, in all likelihood, gave the philosopher Plato a reason to highly value the doctor Hippocrates.
It remains to say a few words about the Italian and Sicilian schools. What was their practical activity, no information has been preserved about this: their doctors are better known as theorists of medicine. The Italian school passed into history as a school of theoretical speculative constructions, as an anticipation of the future, but in terms of its historical significance it can in no way be placed alongside the purely medical schools - the Cnidus and Kos.
3. HIPPOCRATES COLLECTION
The total number of books in the Collection is determined differently. Depending on whether some books are considered independent or a continuation of others; Littre, for example, has 53 works in 72 books, Ermerins 67, Diels 72. Several books appear to have been lost; others have been planted. They arrange these books in editions, translations and histories of medicine in a very different order - in general, following two principles: or according to their origin, i.e. alleged authorship - such is, for example, the location of Littre in his edition and Fuchs in the "History of Greek Medicine" - or according to their content.
The works of Hippocrates probably would not have reached posterity if they had not ended up in the Alexandrian library founded by the successors of Alexander the Great, the Egyptian kings, the Polomei, in the newly founded city of Alexandria, which was destined to be a cultural center for a long time after the fall of Greek independence. This library consisted of scholars: librarians, grammarians, critics, who assessed the merits and authenticity of works and entered them into catalogs. Scientists from different countries came to this library to study certain works, and many centuries later, Galen considered the lists of the works of Hippocrates kept in it.
Herophilus of Alexandria, a famous physician at the time, who lived around 300 BC, compiled the first commentary on Hippocrates' Forecast; his student Bakhiy from Tanagra continued the work of his teacher - this proves that in the III century. The collection of Hippocrates was part of the Alexandrian library. From Herophilus begins a long series of commentators on the Hippocratic collection, culminating in Galen (2nd century AD). We owe the latter the main information about them, since their compositions have not reached us. Apparently, these comments were of a grammatical nature, i.e. explained words and phrases, the meaning of which was unclear or had been lost by that time. These comments then referred to one or more books. Galen points out that only two commentators fully covered all the works of Hippocrates, these are Zevkis and Heraclides of Theran (the latter is the famous physician himself), both belonging to the school of empiricists. From the whole mass, the commentary of Apollo of Kitty, the Alexandrian surgeon (1st century BC), on the book "On the reduction of joints". This commentary was supplied with figures in the manuscript.
Galen, who, according to the generally accepted opinion, gave a synthesis of all ancient medicine, a great practitioner and at the same time an anatomist theorist, an experimental physiologist and, in addition, a philosopher, whose name has passed through the centuries along with the name of Hippocrates, paid much attention to the writings of his famous predecessor ... In addition to 2 books: "On the Dogmas of Hippocrates and Plato", he gave, in his own words, comments on 17 books of Hippocrates, of which 11 have come down to us in full, in parts of 2 books, 4 have not come down to us. Hippocrates "; did not reach the book "On the Anatomy" of Hippocrates, about his dialect and (which can be more regretted) about his original works.
Galen, who was a great scholar and read most of the ancient commentators, pronounces a devastating sentence on them mainly for the fact that, disregarding the medical point of view, they focused on grammatical explanations: they pretend to understand mysterious passages that no one understands, and that concerns provisions , which are clear to everyone, they do not understand them. The reason is that they themselves do not have medical experience and are ignorant in medicine, and this forces them not to explain the text, but to adjust it to a fictitious explanation.
