Medicine is the
science
Science is a systematic endeavor that Scientific method, builds and organizes knowledge in the form of Testability, testable explanations and predictions about the universe.
Science may be as old as the human species, and some of the earli ...
and
practice of caring for a patient, managing the
diagnosis
Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines, with variations in the use of logic, analytics, and experience, to determine " cause and effect". In systems engin ...
,
prognosis,
prevention
Prevention may refer to:
Health and medicine
* Preventive healthcare, measures to prevent diseases or injuries rather than curing them or treating their symptoms
General safety
* Crime prevention, the attempt to reduce deter crime and crim ...
,
treatment,
palliation
Palliative care (derived from the Latin root , or 'to cloak') is an interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex, and often terminal illnesses. Wit ...
of their
injury or
disease
A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...
, and
promoting their health. Medicine encompasses a variety of
health care practices evolved to maintain and restore
health
Health, according to the World Health Organization, is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity".World Health Organization. (2006)''Constitution of the World Health Organiza ...
by the
prevention
Prevention may refer to:
Health and medicine
* Preventive healthcare, measures to prevent diseases or injuries rather than curing them or treating their symptoms
General safety
* Crime prevention, the attempt to reduce deter crime and crim ...
and
treatment of
illness
A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...
. Contemporary medicine applies
biomedical sciences,
biomedical research,
genetics
Genetics is the study of genes, genetic variation, and heredity in organisms.Hartl D, Jones E (2005) It is an important branch in biology because heredity is vital to organisms' evolution. Gregor Mendel, a Moravian Augustinian friar wor ...
, and
medical technology to
diagnose
Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines, with variations in the use of logic, analytics, and experience, to determine " cause and effect". In systems engin ...
, treat, and prevent injury and disease, typically through
pharmaceutical
A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy (pharmacotherapy) is an important part of the medical field an ...
s or
surgery, but also through therapies as diverse as
psychotherapy,
external splints and traction,
medical device
A medical device is any device intended to be used for medical purposes. Significant potential for hazards are inherent when using a device for medical purposes and thus medical devices must be proved safe and effective with reasonable assura ...
s,
biologics
A biopharmaceutical, also known as a biological medical product, or biologic, is any pharmaceutical drug product manufactured in, extracted from, or semisynthesized from biological sources. Different from totally synthesized pharmaceuticals, th ...
, and
ionizing radiation, amongst others.
Medicine has been practiced since
prehistoric times
Prehistory, also known as pre-literary history, is the period of human history between the use of the first stone tools by hominins 3.3 million years ago and the beginning of recorded history with the invention of writing systems. The use of ...
, and for most of this time it was an
art
Art is a diverse range of human activity, and resulting product, that involves creative or imaginative talent expressive of technical proficiency, beauty, emotional power, or conceptual ideas.
There is no generally agreed definition of wha ...
(an area of skill and knowledge), frequently having connections to the
religious
Religion is usually defined as a social- cultural system of designated behaviors and practices, morals, beliefs, worldviews, texts, sanctified places, prophecies, ethics, or organizations, that generally relates humanity to supernatur ...
and
philosophical
Philosophy (from , ) is the systematized study of general and fundamental questions, such as those about existence, reason, knowledge, values, mind, and language. Such questions are often posed as problems to be studied or resolved. Some ...
beliefs of local culture. For example, a
medicine man
A medicine man or medicine woman is a traditional healer and spiritual leader who serves a community of Indigenous people of the Americas. Individual cultures have their own names, in their respective languages, for spiritual healers and cerem ...
would apply
herbs and say
prayer
Prayer is an invocation or act that seeks to activate a rapport with an object of worship through deliberate communication. In the narrow sense, the term refers to an act of supplication or intercession directed towards a deity or a deified ...
s for healing, or an ancient
philosopher and
physician
A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
would apply
bloodletting
Bloodletting (or blood-letting) is the withdrawal of blood from a patient to prevent or cure illness and disease. Bloodletting, whether by a physician or by leeches, was based on an ancient system of medicine in which blood and other bodily flu ...
according to the theories of
humorism
Humorism, the humoral theory, or humoralism, was a system of medicine detailing a supposed makeup and workings of the human body, adopted by Ancient Greek and Roman physicians and philosophers.
Humorism began to fall out of favor in the 1850s ...
. In recent centuries, since the
advent of modern science, most medicine has become a combination of
art
Art is a diverse range of human activity, and resulting product, that involves creative or imaginative talent expressive of technical proficiency, beauty, emotional power, or conceptual ideas.
There is no generally agreed definition of wha ...
and
science
Science is a systematic endeavor that Scientific method, builds and organizes knowledge in the form of Testability, testable explanations and predictions about the universe.
Science may be as old as the human species, and some of the earli ...
(both
basic and
applied, under the
umbrella
An umbrella or parasol is a folding canopy supported by wooden or metal ribs that is usually mounted on a wooden, metal, or plastic pole. It is designed to protect a person against rain or sunlight. The term ''umbrella'' is traditionally use ...
of medical science). For example, while stitching technique for
sutures is an art learned through practice, the knowledge of what happens at the
cellular
Cellular may refer to:
*Cellular automaton, a model in discrete mathematics
* Cell biology, the evaluation of cells work and more
* ''Cellular'' (film), a 2004 movie
*Cellular frequencies, assigned to networks operating in cellular RF bands
*Cell ...
and
molecular level in the tissues being stitched arises through science.
Prescientific forms of medicine, now known as
traditional medicine
Traditional medicine (also known as indigenous medicine or folk medicine) comprises medical aspects of traditional knowledge that developed over generations within the folk beliefs of various societies, including indigenous peoples, before the ...
or ''folk medicine'', remain commonly used in the absence of scientific medicine, and are thus called
alternative medicine. Alternative treatments outside of scientific medicine with safety and efficacy concerns are termed
quackery
Quackery, often synonymous with health fraud, is the promotion of fraudulent or ignorant medical practices. A quack is a "fraudulent or ignorant pretender to medical skill" or "a person who pretends, professionally or publicly, to have skill, ...
.
Etymology
Medicine (, ) is the
science
Science is a systematic endeavor that Scientific method, builds and organizes knowledge in the form of Testability, testable explanations and predictions about the universe.
Science may be as old as the human species, and some of the earli ...
and practice of the
diagnosis
Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines, with variations in the use of logic, analytics, and experience, to determine " cause and effect". In systems engin ...
,
prognosis,
treatment, and
prevention
Prevention may refer to:
Health and medicine
* Preventive healthcare, measures to prevent diseases or injuries rather than curing them or treating their symptoms
General safety
* Crime prevention, the attempt to reduce deter crime and crim ...
of
disease
A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...
. The word "medicine" is derived from
Latin
Latin (, or , ) is a classical language belonging to the Italic branch of the Indo-European languages. Latin was originally a dialect spoken in the lower Tiber area (then known as Latium) around present-day Rome, but through the power of the ...
''medicus'', meaning "a physician".
Clinical practice
![Elizabeth Blackwell](https://upload.wikimedia.org/wikipedia/commons/e/e7/Elizabeth_Blackwell.jpg)
Medical availability and clinical practice varies across the world due to regional differences in culture and technology. Modern scientific medicine is highly developed in the
Western world
The Western world, also known as the West, primarily refers to the various nations and states in the regions of Europe, North America, and Oceania. , while in
developing countries
A developing country is a sovereign state with a lesser developed industrial base and a lower Human Development Index (HDI) relative to other countries. However, this definition is not universally agreed upon. There is also no clear agreem ...
such as parts of Africa or Asia, the population may rely more heavily on
traditional medicine
Traditional medicine (also known as indigenous medicine or folk medicine) comprises medical aspects of traditional knowledge that developed over generations within the folk beliefs of various societies, including indigenous peoples, before the ...
with limited evidence and efficacy and no required formal training for practitioners.
In the
developed world
A developed country (or industrialized country, high-income country, more economically developed country (MEDC), advanced country) is a sovereign state that has a high quality of life, developed economy and advanced technological infrastruct ...
,
evidence-based medicine is not universally used in clinical practice; for example, a 2007 survey of literature reviews found that about 49% of the interventions lacked sufficient evidence to support either benefit or harm.
In modern clinical practice,
physicians and
physician assistants
A physician assistant or physician associate (PA) is a type of mid-level health care provider. In North America PAs may diagnose illnesses, develop and manage treatment plans, prescribe medications, and may serve as a principal healthcare prov ...
personally assess patients in order to
diagnose
Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines, with variations in the use of logic, analytics, and experience, to determine " cause and effect". In systems engin ...
,
prognose, treat, and prevent disease using clinical judgment. The
doctor-patient relationship typically begins an interaction with an examination of the patient's
medical history
The medical history, case history, or anamnesis (from Greek: ἀνά, ''aná'', "open", and μνήσις, ''mnesis'', "memory") of a patient is information gained by a physician by asking specific questions, either to the patient or to other peo ...
and
medical record
The terms medical record, health record and medical chart are used somewhat interchangeably to describe the systematic documentation of a single patient's medical history and care across time within one particular health care provider's jurisdic ...
, followed by a medical interview
and a
physical examination
In a physical examination, medical examination, or clinical examination, a medical practitioner examines a patient for any possible medical signs or symptoms of a medical condition. It generally consists of a series of questions about the pati ...
. Basic diagnostic
medical device
A medical device is any device intended to be used for medical purposes. Significant potential for hazards are inherent when using a device for medical purposes and thus medical devices must be proved safe and effective with reasonable assura ...
s (e.g.
stethoscope,
tongue depressor
A tongue depressor (sometimes called spatula) is a tool used in medical practice to depress the tongue to allow for examination of the mouth and throat. The most common modern tongue depressors are flat, thin, wooden blades, smoothed and rounded ...
) are typically used. After examination for
signs and interviewing for
symptoms, the doctor may order
medical test
A medical test is a medical procedure performed to detect, diagnose, or monitor diseases, disease processes, susceptibility, or to determine a course of treatment. Medical tests such as, physical and visual exams, diagnostic imaging, genetic ...
s (e.g.
blood tests), take a
biopsy
A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, or an interventional cardiologist. The process involves extraction of sample cells or tissues for examination to determine the presence or extent of a dise ...
, or prescribe
pharmaceutical drug
A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy (pharmacotherapy) is an important part of the medical field an ...
s or other therapies.
Differential diagnosis methods help to rule out conditions based on the information provided. During the encounter, properly informing the patient of all relevant facts is an important part of the relationship and the development of trust. The medical encounter is then documented in the medical record, which is a legal document in many jurisdictions.
Follow-ups may be shorter but follow the same general procedure, and specialists follow a similar process. The diagnosis and treatment may take only a few minutes or a few weeks depending upon the complexity of the issue.
The components of the medical interview
and encounter are:
* Chief complaint (CC): the reason for the current medical visit. These are the '
symptoms.' They are in the patient's own words and are recorded along with the duration of each one. Also called 'chief concern' or 'presenting complaint'.
* History of present
illness
A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...
(HPI): the chronological order of events of symptoms and further clarification of each symptom. Distinguishable from history of previous illness, often called past medical history (PMH).
Medical history
The medical history, case history, or anamnesis (from Greek: ἀνά, ''aná'', "open", and μνήσις, ''mnesis'', "memory") of a patient is information gained by a physician by asking specific questions, either to the patient or to other peo ...
comprises HPI and PMH.
* Current activity: occupation, hobbies, what the patient actually does.
*
Medication
A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy ( pharmacotherapy) is an important part of the medical field and ...
s (Rx): what drugs the patient takes including
prescribed,
over-the-counter
Over-the-counter (OTC) drugs are medicines sold directly to a consumer without a requirement for a prescription from a healthcare professional, as opposed to prescription drugs, which may be supplied only to consumers possessing a valid prescr ...
, and
home remedies
Traditional medicine (also known as indigenous medicine or folk medicine) comprises medical aspects of traditional knowledge that developed over generations within the folk beliefs of various societies, including indigenous peoples, before the ...
, as well as alternative and
herbal medicines or remedies.
Allergies
Allergies, also known as allergic diseases, refer a number of conditions caused by the hypersensitivity of the immune system to typically harmless substances in the environment. These diseases include hay fever, food allergies, atopic dermat ...
are also recorded.
* Past medical history (PMH/PMHx): concurrent medical problems, past hospitalizations and operations, injuries, past
infectious disease
An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable di ...
s or
vaccination
Vaccination is the administration of a vaccine to help the immune system develop immunity from a disease. Vaccines contain a microorganism or virus in a weakened, live or killed state, or proteins or toxins from the organism. In stimulating ...
s, history of known allergies.
* Social history (SH): birthplace, residences, marital history, social and economic status, habits (including
diet
Diet may refer to:
Food
* Diet (nutrition), the sum of the food consumed by an organism or group
* Dieting, the deliberate selection of food to control body weight or nutrient intake
** Diet food, foods that aid in creating a diet for weight loss ...
, medications,
tobacco
Tobacco is the common name of several plants in the genus '' Nicotiana'' of the family Solanaceae, and the general term for any product prepared from the cured leaves of these plants. More than 70 species of tobacco are known, but the ...
, alcohol).
*
Family history
Genealogy () is the study of families, family history, and the tracing of their lineages. Genealogists use oral interviews, historical records, genetic analysis, and other records to obtain information about a family and to demonstrate kin ...
(FH): listing of diseases in the family that may impact the patient. A
family tree
A family tree, also called a genealogy or a pedigree chart, is a chart representing family relationships in a conventional tree structure. More detailed family trees, used in medicine and social work, are known as genograms.
Representations of ...
is sometimes used.
* Review of systems (ROS) or ''systems inquiry'': a set of additional questions to ask, which may be missed on HPI: a general enquiry (have you noticed any
weight loss
Weight loss, in the context of medicine, health, or physical fitness, refers to a reduction of the total body mass, by a mean loss of fluid, body fat ( adipose tissue), or lean mass (namely bone mineral deposits, muscle, tendon, and other co ...
, change in sleep quality, fevers, lumps and bumps? etc.), followed by questions on the body's main organ systems (
heart
The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide to t ...
,
lungs
The lungs are the primary organs of the respiratory system in humans and most other animals, including some snails and a small number of fish. In mammals and most other vertebrates, two lungs are located near the backbone on either side ...
,
digestive tract
The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans and ...
,
urinary tract
The urinary system, also known as the urinary tract or renal system, consists of the kidneys, ureters, bladder, and the urethra. The purpose of the urinary system is to eliminate waste from the body, regulate blood volume and blood pressure, c ...
, etc.).
The
physical examination
In a physical examination, medical examination, or clinical examination, a medical practitioner examines a patient for any possible medical signs or symptoms of a medical condition. It generally consists of a series of questions about the pati ...
is the examination of the patient for
medical sign
Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showi ...
s of disease, which are objective and observable, in contrast to symptoms that are volunteered by the patient and not necessarily objectively observable. The healthcare provider uses sight, hearing, touch, and sometimes smell (e.g., in infection,
uremia
Uremia is the term for high levels of urea in the blood. Urea is one of the primary components of urine. It can be defined as an excess of amino acid and protein metabolism end products, such as urea and creatinine, in the blood that would be no ...
,
diabetic ketoacidosis
Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion and occasionally loss of ...
). Four actions are the basis of physical examination:
inspection,
palpation
Palpation is the process of using one's hands to check the body, especially while perceiving/diagnosing a disease or illness. Usually performed by a health care practitioner, it is the process of feeling an object in or on the body to determine ...
(feel),
percussion
A percussion instrument is a musical instrument that is sounded by being struck or scraped by a beater including attached or enclosed beaters or rattles struck, scraped or rubbed by hand or struck against another similar instrument. Ex ...
(tap to determine resonance characteristics), and
auscultation (listen), generally in that order although auscultation occurs prior to percussion and palpation for abdominal assessments.
The clinical examination involves the study of:
* Vital signs including height, weight, body temperature,
blood pressure,
pulse
In medicine, a pulse represents the tactile arterial palpation of the cardiac cycle (heartbeat) by trained fingertips. The pulse may be palpated in any place that allows an artery to be compressed near the surface of the body, such as at the n ...
, respiration rate, and hemoglobin
oxygen saturation
Oxygen saturation (symbol SO2) is a relative measure of the concentration of oxygen that is dissolved or carried in a given medium as a proportion of the maximal concentration that can be dissolved in that medium at the given temperature. It ca ...
* General appearance of the patient and specific indicators of disease (nutritional status, presence of jaundice, pallor or
clubbing)
*
Skin
Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation.
Other animal coverings, such as the arthropod exoskeleton, have different de ...
* Head,
eye,
ear
An ear is the organ that enables hearing and, in mammals, body balance using the vestibular system. In mammals, the ear is usually described as having three parts—the outer ear, the middle ear and the inner ear. The outer ear consists of ...
, nose, and throat (
HEENT)
*
Cardiovascular
The blood circulatory system is a system of organs that includes the heart, blood vessels, and blood which is circulated throughout the entire body of a human or other vertebrate. It includes the cardiovascular system, or vascular system, tha ...
(
heart
The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide to t ...
and
blood vessel
The blood vessels are the components of the circulatory system that transport blood throughout the human body. These vessels transport blood cells, nutrients, and oxygen to the tissues of the body. They also take waste and carbon dioxide away ...
s)
*
Respiratory
The respiratory system (also respiratory apparatus, ventilatory system) is a biological system consisting of specific organs and structures used for gas exchange in animals and plants. The anatomy and physiology that make this happen varies gre ...
(large airways and
lungs
The lungs are the primary organs of the respiratory system in humans and most other animals, including some snails and a small number of fish. In mammals and most other vertebrates, two lungs are located near the backbone on either side ...
)
*
Abdomen
The abdomen (colloquially called the belly, tummy, midriff, tucky or stomach) is the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates. The abdomen is the front part of the abdominal segment of the to ...
and
rectum
* Genitalia (and pregnancy if the patient is or could be pregnant)
*
Musculoskeletal
The human musculoskeletal system (also known as the human locomotor system, and previously the activity system) is an organ system that gives humans the ability to move using their muscular and skeletal systems. The musculoskeletal system prov ...
(including spine and extremities)
*
Neurological
Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the brain, the spinal c ...
(consciousness, awareness, brain, vision,
cranial nerves
Cranial nerves are the nerves that emerge directly from the brain (including the brainstem), of which there are conventionally considered twelve pairs. Cranial nerves relay information between the brain and parts of the body, primarily to and f ...
, spinal cord and
peripheral nerves
The peripheral nervous system (PNS) is one of two components that make up the nervous system of bilateral animals, with the other part being the central nervous system (CNS). The PNS consists of nerves and ganglia, which lie outside the brain an ...
)
*
Psychiatric
Psychiatry is the medical specialty devoted to the diagnosis, prevention, and treatment of mental disorders. These include various maladaptations related to mood, behaviour, cognition, and perceptions. See glossary of psychiatry.
Initial psy ...
(orientation,
mental state
A mental state, or a mental property, is a state of mind of a person. Mental states comprise a diverse class, including perception, pain experience, belief, desire, intention, emotion, and memory. There is controversy concerning the exact definiti ...
, mood, evidence of abnormal perception or thought).
It is to likely focus on areas of interest highlighted in the medical history and may not include everything listed above.
The treatment plan may include ordering additional
medical laboratory
A medical laboratory or clinical laboratory is a laboratory where tests are conducted out on clinical specimens to obtain information about the health of a patient to aid in diagnosis, treatment, and prevention of disease. Clinical Medical labor ...
tests and
medical imaging studies, starting therapy, referral to a specialist, or watchful observation. Follow-up may be advised. Depending upon the
health insurance plan and the
managed care system, various forms of "
utilization review
Utilization management (UM) or utilization review is the use of managed care techniques such as prior authorization that allow payers, particularly health insurance companies, to manage the cost of health care benefits by assessing its appropriaten ...
", such as prior authorization of tests, may place barriers on accessing expensive services.
The medical decision-making (MDM) process involves analysis and synthesis of all the above data to come up with a list of possible diagnoses (the
differential diagnoses
In healthcare, a differential diagnosis (abbreviated DDx) is a method of analysis of a patient's history and physical examination to arrive at the correct diagnosis. It involves distinguishing a particular disease or condition from others that p ...
), along with an idea of what needs to be done to obtain a definitive diagnosis that would explain the patient's problem.
On subsequent visits, the process may be repeated in an abbreviated manner to obtain any new history, symptoms, physical findings, and lab or imaging results or specialist consultations.
Institutions
![Pellegrinaio Santa Maria della Scala n5](https://upload.wikimedia.org/wikipedia/commons/1/18/Pellegrinaio_Santa_Maria_della_Scala_n5.jpg)
Contemporary medicine is in general conducted within
health care systems. Legal,
credentialing and financing frameworks are established by individual governments, augmented on occasion by international organizations, such as churches. The characteristics of any given health care system have significant impact on the way medical care is provided.
From ancient times, Christian emphasis on practical charity gave rise to the development of systematic nursing and hospitals and the
Catholic Church
The Catholic Church, also known as the Roman Catholic Church, is the largest Christian church, with 1.3 billion baptized Catholics worldwide . It is among the world's oldest and largest international institutions, and has played a ...
today remains the largest non-government provider of medical services in the world. Advanced industrial countries (with the exception of the
United States
The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territori ...
)
and many
developing countries
A developing country is a sovereign state with a lesser developed industrial base and a lower Human Development Index (HDI) relative to other countries. However, this definition is not universally agreed upon. There is also no clear agreem ...
provide medical services through a system of
universal health care
Universal health care (also called universal health coverage, universal coverage, or universal care) is a health care system in which all residents of a particular country or region are assured access to health care. It is generally organized ar ...
that aims to guarantee care for all through a
single-payer health care system, or compulsory private or co-operative
health insurance. This is intended to ensure that the entire population has access to medical care on the basis of need rather than ability to pay. Delivery may be via private medical practices or by state-owned hospitals and clinics, or by charities, most commonly by a combination of all three.
Most
tribal
The term tribe is used in many different contexts to refer to a category of human social group. The predominant worldwide usage of the term in English is in the discipline of anthropology. This definition is contested, in part due to conflic ...
societies provide no guarantee of healthcare for the population as a whole. In such societies, healthcare is available to those that can afford to pay for it or have self-insured it (either directly or as part of an employment contract) or who may be covered by care financed by the government or tribe directly.
![Drug ampoule JPN](https://upload.wikimedia.org/wikipedia/commons/a/a1/Drug_ampoule_JPN.jpg)
Transparency of information is another factor defining a delivery system. Access to information on conditions, treatments, quality, and pricing greatly affects the choice by patients/consumers and, therefore, the incentives of medical professionals. While the US healthcare system has come under fire for lack of openness, new legislation may encourage greater openness. There is a perceived tension between the need for transparency on the one hand and such issues as patient confidentiality and the possible exploitation of information for commercial gain on the other.
The
health professionals who provide care in medicine comprise multiple
profession
A profession is a field of work that has been successfully ''professionalized''. It can be defined as a disciplined group of individuals, '' professionals'', who adhere to ethical standards and who hold themselves out as, and are accepted by ...
s such as
medics
A medic is a person involved in medicine such as a medical doctor, medical student, paramedic or an emergency medical responder.
Among physicians in the UK, the term "medic" indicates someone who has followed a "medical" career path in postgrad ...
,
nurses
Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health c ...
,
physio therapists, and
psychologists. These professions will have their own
ethical standards
Ethics or moral philosophy is a branch of philosophy that "involves systematizing, defending, and recommending concepts of right and wrong behavior".''Internet Encyclopedia of Philosophy'' The field of ethics, along with aesthetics, concerns ma ...
, professional education, and bodies. The medical profession have been conceptualized from a
sociological perspective.
Delivery
Provision of medical care is classified into primary, secondary, and tertiary care categories.
Primary care
Primary care is the day-to-day healthcare given by a health care provider. Typically this provider acts as the first contact and principal point of continuing care for patients within a healthcare system, and coordinates other specialist care ...
medical services are provided by
physician
A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
s,
physician assistants,
nurse practitioner
A nurse practitioner (NP) is an advanced practice registered nurse and a type of mid-level practitioner. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, formulate and prescribe ...
s, or other health professionals who have first contact with a patient seeking medical treatment or care. These occur in physician offices,
clinic
A clinic (or outpatient clinic or ambulatory care clinic) is a health facility that is primarily focused on the care of outpatients. Clinics can be privately operated or publicly managed and funded. They typically cover the primary care needs ...
s,
nursing home
A nursing home is a facility for the residential care of elderly or disabled people. Nursing homes may also be referred to as skilled nursing facility (SNF) or long-term care facilities. Often, these terms have slightly different meanings to i ...
s, schools, home visits, and other places close to patients. About 90% of medical visits can be treated by the primary care provider. These include treatment of acute and chronic illnesses,
preventive care
Preventive healthcare, or prophylaxis, consists of measures taken for the purposes of disease prevention.Hugh R. Leavell and E. Gurney Clark as "the science and art of preventing disease, prolonging life, and promoting physical and mental hea ...
and
health education
Health education is a profession of educating people about health. Areas within this profession encompass environmental health, physical health, social health, emotional health, intellectual health, and spiritual health, as well as sexual and r ...
for all ages and both sexes.
Secondary care
Health care or healthcare is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health profe ...
medical services are provided by
medical specialist
A medical specialty is a branch of medical practice that is focused on a defined group of patients, diseases, skills, or philosophy. Examples include those branches of medicine that deal exclusively with children (paediatrics), cancer (oncology), ...
s in their offices or clinics or at local community hospitals for a patient referred by a primary care provider who first diagnosed or treated the patient. Referrals are made for those patients who required the expertise or procedures performed by specialists. These include both
ambulatory care
Ambulatory care or outpatient care is medical care provided on an outpatient basis, including diagnosis, observation, consultation, treatment, intervention, and rehabilitation services. This care can include advanced medical technology and proce ...
and
inpatient
A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health car ...
services,
Emergency departments,
intensive care medicine
Intensive care medicine, also called critical care medicine, is a medical specialty that deals with seriously or critically ill patients who have, are at risk of, or are recovering from conditions that may be life-threatening. It includes pro ...
, surgery services,
physical therapy,
labor and delivery
Childbirth, also known as labour and delivery, is the ending of pregnancy where one or more babies exits the internal environment of the mother via vaginal delivery or caesarean section. In 2019, there were about 140.11 million births globall ...
,
endoscopy
An endoscopy is a procedure used in medicine to look inside the body. The endoscopy procedure uses an endoscope to examine the interior of a hollow organ or cavity of the body. Unlike many other medical imaging techniques, endoscopes are inse ...
units, diagnostic
laboratory
A laboratory (; ; colloquially lab) is a facility that provides controlled conditions in which scientific or technological research, experiments, and measurement may be performed. Laboratory services are provided in a variety of settings: physic ...
and
medical imaging services,
hospice centers, etc. Some primary care providers may also take care of hospitalized patients and deliver babies in a secondary care setting.
Tertiary care
Health care or healthcare is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health profess ...
medical services are provided by specialist hospitals or regional centers equipped with diagnostic and treatment facilities not generally available at local hospitals. These include
trauma center
A trauma center (or trauma centre) is a hospital equipped and staffed to provide care for patients suffering from major traumatic injuries such as falls, motor vehicle collisions, or gunshot wounds. A trauma center may also refer to an emergen ...
s,
burn
A burn is an injury to skin, or other tissues, caused by heat, cold, electricity, chemicals, friction, or ultraviolet radiation (like sunburn). Most burns are due to heat from hot liquids (called scalding), solids, or fire. Burns occur ma ...
treatment centers, advanced
neonatology unit services,
organ transplant
Organ transplantation is a medical procedure in which an organ (anatomy), organ is removed from one body and placed in the body of a recipient, to replace a damaged or missing organ. The donor and recipient may be at the same location, or organ ...
s, high-risk pregnancy,
radiation oncology
Oncology is a branch of medicine that deals with the study, treatment, diagnosis and prevention of cancer. A medical professional who practices oncology is an ''oncologist''. The name's etymological origin is the Greek word ὄγκος ('' ...
, etc.
Modern medical care also depends on information – still delivered in many health care settings on paper records, but increasingly nowadays by
electronic means.
In low-income countries, modern healthcare is often too expensive for the average person. International healthcare policy researchers have advocated that "user fees" be removed in these areas to ensure access, although even after removal, significant costs and barriers remain.
Separation of prescribing and dispensing Separation of prescribing and dispensing, also called dispensing separation, is a practice in medicine and pharmacy in which the physician who provides a medical prescription is independent from the pharmacist who provides the prescription drug.
I ...
is a practice in medicine and pharmacy in which the
physician
A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
who provides a
medical prescription
A prescription, often abbreviated or Rx, is a formal communication from a physician or other registered health-care professional to a pharmacist, authorizing them to dispense a specific prescription drug for a specific patient. Historicall ...
is independent from the
pharmacist who provides the
prescription drug. In the
Western world
The Western world, also known as the West, primarily refers to the various nations and states in the regions of Europe, North America, and Oceania. there are centuries of tradition for separating pharmacists from physicians. In Asian countries, it is traditional for physicians to also provide drugs.
Branches
Working together as an
interdisciplinary team
Interdisciplinarity or interdisciplinary studies involves the combination of multiple academic disciplines into one activity (e.g., a research project). It draws knowledge from several other fields like sociology, anthropology, psychology, ec ...
, many highly trained
health profession
The following outline is provided as an overview of and topical guide to health sciences:
Health sciences are those sciences which focus on health, or health care, as core parts of their subject matter. Health sciences relate to multiple aca ...
als besides medical practitioners are involved in the delivery of modern health care. Examples include:
nurse
Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health c ...
s,
emergency medical technician
An emergency medical technician (EMT), also known as an ambulance technician, is a health professional that provides emergency medical services. EMTs are most commonly found working in ambulances. In English-speaking countries, paramedics a ...
s and paramedics, laboratory scientists,
pharmacists
A pharmacist, also known as a chemist ( Commonwealth English) or a druggist (North American and, archaically, Commonwealth English), is a healthcare professional who prepares, controls and distributes medicines and provides advice and instru ...
,
podiatrists
A podiatrist ( ) is a medical professional devoted to the treatment of disorders of the foot, ankle, and related structures of the leg. The term originated in North America but has now become the accepted term in the English-speaking world for ...
,
physiotherapists
Physical therapy (PT), also known as physiotherapy, is one of the allied health professions. It is provided by physical therapists who promote, maintain, or restore health through physical examination, diagnosis, management, prognosis, patient ...
,
respiratory therapists
A respiratory therapist is a specialized healthcare practitioner trained in critical care and cardio-pulmonary medicine in order to work therapeutically with people who have acute critical conditions, cardiac and pulmonary disease. Respirator ...
,
speech therapists,
occupational therapists
Occupational therapists (OTs) are health care professionals specializing in occupational therapy and occupational science. OTs and occupational therapy assistants (OTAs) use scientific bases and a holistic perspective to promote a person's abili ...
, radiographers,
dietitian
A dietitian, medical dietitian, or dietician is an expert in identifying and treating disease-related malnutrition and in conducting medical nutrition therapy, for example designing an enteral tube feeding regimen or mitigating the effects of ca ...
s, and
bioengineers,
medical physicists
Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care pr ...
,
surgeons
In modern medicine, a surgeon is a medical professional who performs surgery. Although there are different traditions in different times and places, a modern surgeon usually is also a licensed physician or received the same medical training as ...
,
surgeon's assistant,
surgical technologist.
The scope and sciences underpinning human medicine overlap many other fields. A patient admitted to the hospital is usually under the care of a specific team based on their main presenting problem, e.g., the cardiology team, who then may interact with other specialties, e.g., surgical, radiology, to help diagnose or treat the main problem or any subsequent complications/developments.
Physicians have many specializations and subspecializations into certain branches of medicine, which are listed below. There are variations from country to country regarding which specialties certain subspecialties are in.
The main branches of medicine are:
* Basic sciences of medicine; this is what every physician is educated in, and some return to in
biomedical research.
*
Medical specialties
A medical specialty is a branch of medical practice that is focused on a defined group of patients, diseases, skills, or philosophy. Examples include those branches of medicine that deal exclusively with children (paediatrics), cancer (oncology), ...
*
Interdisciplinary fields, where different medical specialties are mixed to function in certain occasions.
Basic sciences
* ''
Anatomy
Anatomy () is the branch of biology concerned with the study of the structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old science, having it ...
'' is the study of the physical structure of
organism
In biology, an organism () is any living system that functions as an individual entity. All organisms are composed of cells (cell theory). Organisms are classified by taxonomy into groups such as multicellular animals, plants, and ...
s. In contrast to ''macroscopic'' or ''gross anatomy'', ''cytology'' and ''histology'' are concerned with microscopic structures.
* ''
Biochemistry
Biochemistry or biological chemistry is the study of chemical processes within and relating to living organisms. A sub-discipline of both chemistry and biology, biochemistry may be divided into three fields: structural biology, enzymology and ...
'' is the study of the chemistry taking place in living organisms, especially the structure and function of their chemical components.
* ''
Biomechanics
Biomechanics is the study of the structure, function and motion of the mechanical aspects of biological systems, at any level from whole organisms to organs, cells and cell organelles, using the methods of mechanics. Biomechanics is a branch of ...
'' is the study of the structure and function of biological systems by means of the methods of
Mechanics
Mechanics (from Ancient Greek: μηχανική, ''mēkhanikḗ'', "of machines") is the area of mathematics and physics concerned with the relationships between force, matter, and motion among physical objects. Forces applied to object ...
.
* ''
Biostatistics'' is the application of statistics to biological fields in the broadest sense. A knowledge of biostatistics is essential in the planning, evaluation, and interpretation of medical research. It is also fundamental to
epidemiology
Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and determinants of health and disease conditions in a defined population.
It is a cornerstone of public health, and shapes policy decisions and evide ...
and evidence-based medicine.
* ''
Biophysics
Biophysics is an interdisciplinary science that applies approaches and methods traditionally used in physics to study biological phenomena. Biophysics covers all scales of biological organization, from molecular to organismic and populations. ...
'' is an interdisciplinary science that uses the methods of
physics
Physics is the natural science that studies matter, its fundamental constituents, its motion and behavior through space and time, and the related entities of energy and force. "Physical science is that department of knowledge which r ...
and
physical chemistry
Physical chemistry is the study of macroscopic and microscopic phenomena in chemical systems in terms of the principles, practices, and concepts of physics such as motion, energy, force, time, thermodynamics, quantum chemistry, statistica ...
to study biological systems.
* ''
Cytology
Cell biology (also cellular biology or cytology) is a branch of biology that studies the structure, function, and behavior of cells. All living organisms are made of cells. A cell is the basic unit of life that is responsible for the living an ...
'' is the microscopic study of individual
cells.
![Albert Edelfelt - Louis Pasteur - 1885](https://upload.wikimedia.org/wikipedia/commons/3/3c/Albert_Edelfelt_-_Louis_Pasteur_-_1885.jpg)
* ''
Embryology
Embryology (from Greek ἔμβρυον, ''embryon'', "the unborn, embryo"; and -λογία, ''-logia'') is the branch of animal biology that studies the prenatal development of gametes (sex cells), fertilization, and development of embryos ...
'' is the study of the early development of organisms.
* ''
Endocrinology
Endocrinology (from '' endocrine'' + '' -ology'') is a branch of biology and medicine dealing with the endocrine system, its diseases, and its specific secretions known as hormones. It is also concerned with the integration of developmental event ...
'' is the study of hormones and their effect throughout the body of animals.
* ''
Epidemiology
Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and determinants of health and disease conditions in a defined population.
It is a cornerstone of public health, and shapes policy decisions and evide ...
'' is the study of the demographics of disease processes, and includes, but is not limited to, the study of epidemics.
* ''
Genetics
Genetics is the study of genes, genetic variation, and heredity in organisms.Hartl D, Jones E (2005) It is an important branch in biology because heredity is vital to organisms' evolution. Gregor Mendel, a Moravian Augustinian friar wor ...
'' is the study of genes, and their role in
biological inheritance
Heredity, also called inheritance or biological inheritance, is the passing on of traits from parents to their offspring; either through asexual reproduction or sexual reproduction, the offspring cells or organisms acquire the genetic informa ...
.
* ''
Histology
Histology,
also known as microscopic anatomy or microanatomy, is the branch of biology which studies the microscopic anatomy of biological tissues. Histology is the microscopic counterpart to gross anatomy, which looks at larger structures vi ...
'' is the study of the structures of
biological tissue
In biology, tissue is a biological organizational level between cells and a complete organ. A tissue is an ensemble of similar cells and their extracellular matrix from the same origin that together carry out a specific function. Organs are th ...
s by light
microscopy,
electron microscopy and
immunohistochemistry.
* ''
Immunology
Immunology is a branch of medicineImmunology for Medical Students, Roderick Nairn, Matthew Helbert, Mosby, 2007 and biology that covers the medical study of immune systems in humans, animals, plants and sapient species. In such we can see the ...
'' is the study of the
immune system
The immune system is a network of biological processes that protects an organism from diseases. It detects and responds to a wide variety of pathogens, from viruses to parasitic worms, as well as cancer cells and objects such as wood splint ...
, which includes the innate and adaptive immune system in humans, for example.
* ''
Lifestyle medicine
Lifestyle medicine is a branch of medicine focused on preventive healthcare and self-care dealing with research, prevention, and treatment of disorders caused by lifestyle factors and preventable causes of death such as nutrition, physical inac ...
'' is the study of the
chronic conditions
A chronic condition is a health condition or disease that is persistent or otherwise long-lasting in its effects or a disease that comes with time. The term ''chronic'' is often applied when the course of the disease lasts for more than three mo ...
, and how to prevent, treat and reverse them.
* ''
Medical physics
Medical physics deals with the application of the concepts and methods of physics to the prevention, diagnosis and treatment of human diseases with a specific goal of improving human health and well-being. Since 2008, medical physics has been incl ...
'' is the study of the applications of physics principles in medicine.
* ''
Microbiology'' is the study of
microorganism
A microorganism, or microbe,, ''mikros'', "small") and ''organism'' from the el, ὀργανισμός, ''organismós'', "organism"). It is usually written as a single word but is sometimes hyphenated (''micro-organism''), especially in olde ...
s, including
protozoa,
bacteria
Bacteria (; singular: bacterium) are ubiquitous, mostly free-living organisms often consisting of one Cell (biology), biological cell. They constitute a large domain (biology), domain of prokaryotic microorganisms. Typically a few micrometr ...
,
fungi
A fungus ( : fungi or funguses) is any member of the group of eukaryotic organisms that includes microorganisms such as yeasts and molds, as well as the more familiar mushrooms. These organisms are classified as a kingdom, separately from ...
, and
virus
A virus is a submicroscopic infectious agent that replicates only inside the living cells of an organism. Viruses infect all life forms, from animals and plants to microorganisms, including bacteria and archaea.
Since Dmitri Ivanovsk ...
es.
* ''
Molecular biology
Molecular biology is the branch of biology that seeks to understand the molecular basis of biological activity in and between cells, including biomolecular synthesis, modification, mechanisms, and interactions. The study of chemical and physi ...
'' is the study of molecular underpinnings of the process of
replication,
transcription
Transcription refers to the process of converting sounds (voice, music etc.) into letters or musical notes, or producing a copy of something in another medium, including:
Genetics
* Transcription (biology), the copying of DNA into RNA, the fir ...
and
translation
Translation is the communication of the meaning of a source-language text by means of an equivalent target-language text. The English language draws a terminological distinction (which does not exist in every language) between ''transla ...
of the genetic material.
* ''
Neuroscience
Neuroscience is the scientific study of the nervous system (the brain, spinal cord, and peripheral nervous system), its functions and disorders. It is a multidisciplinary science that combines physiology, anatomy, molecular biology, developme ...
'' includes those disciplines of science that are related to the study of the
nervous system
In biology, the nervous system is the highly complex part of an animal that coordinates its actions and sensory information by transmitting signals to and from different parts of its body. The nervous system detects environmental changes ...
. A main focus of neuroscience is the
biology
Biology is the scientific study of life. It is a natural science with a broad scope but has several unifying themes that tie it together as a single, coherent field. For instance, all organisms are made up of cells that process hereditary i ...
and physiology of the human brain and
spinal cord
The spinal cord is a long, thin, tubular structure made up of nervous tissue, which extends from the medulla oblongata in the brainstem to the lumbar region of the vertebral column (backbone). The backbone encloses the central canal of the sp ...
. Some related clinical specialties include
neurology
Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the brain, the spinal ...
,
neurosurgery
Neurosurgery or neurological surgery, known in common parlance as brain surgery, is the medical specialty concerned with the surgical treatment of disorders which affect any portion of the nervous system including the brain, spinal cord and pe ...
and
psychiatry
Psychiatry is the specialty (medicine), medical specialty devoted to the diagnosis, prevention, and treatment of mental disorders. These include various maladaptations related to mood, behaviour, cognition, and perceptions. See glossary of psych ...
.
* ''
Nutrition science
Nutritional science (also nutrition science, sometimes short ''nutrition'', dated trophology) is the science that studies the physiological process of nutrition (primarily human nutrition), interpreting the nutrients and other substances in food ...
'' (theoretical focus) and ''
dietetics
A dietitian, medical dietitian, or dietician is an expert in identifying and treating disease-related malnutrition and in conducting medical nutrition therapy, for example designing an enteral tube feeding regimen or mitigating the effects of ...
'' (practical focus) is the study of the relationship of food and drink to health and disease, especially in determining an optimal diet. Medical nutrition therapy is done by dietitians and is prescribed for
diabetes
Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level ( hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ...
,
cardiovascular diseases, weight and eating
disorders, allergies,
malnutrition
Malnutrition occurs when an organism gets too few or too many nutrients, resulting in health problems. Specifically, it is "a deficiency, excess, or imbalance of energy, protein and other nutrients" which adversely affects the body's tissues ...
, and
neoplastic
A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...
diseases.
* ''
Pathology as a science
Pathology is the study of the causal, causes and effects of disease or injury. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when us ...
'' is the study of disease—the causes, course, progression and resolution thereof.
* ''
Pharmacology'' is the study of drugs and their actions.
* ''
Gynecology'' is the study of female reproductive system.
* ''
Photobiology Photobiology is the scientific study of the beneficial and harmful interactions of light (technically, non-ionizing radiation) in living organisms. The field includes the study of photophysics, photochemistry, photosynthesis, photomorphogenesis, vis ...
'' is the study of the interactions between
non-ionizing radiation
Non-ionizing (or non-ionising) radiation refers to any type of electromagnetic radiation that does not carry enough energy per quantum (photon energy) to ionize atoms or molecules—that is, to completely remove an electron from an atom or mole ...
and living organisms.
* ''
Physiology
Physiology (; ) is the scientific study of functions and mechanisms in a living system. As a sub-discipline of biology, physiology focuses on how organisms, organ systems, individual organs, cells, and biomolecules carry out the chemical ...
'' is the study of the normal functioning of the body and the underlying regulatory mechanisms.
* ''
Radiobiology
Radiobiology (also known as radiation biology, and uncommonly as actinobiology) is a field of clinical and basic medical sciences that involves the study of the action of ionizing radiation on living things, especially health effects of radiation. ...
'' is the study of the interactions between
ionizing radiation and living organisms.
* ''
Toxicology
Toxicology is a scientific discipline, overlapping with biology, chemistry, pharmacology, and medicine, that involves the study of the adverse effects of chemical substances on living organisms and the practice of diagnosing and treating e ...
'' is the study of hazardous effects of drugs and
poisons.
Specialties
In the broadest meaning of "medicine", there are many different specialties. In the UK, most specialities have their own body or college, which has its own entrance examination. These are collectively known as the Royal Colleges, although not all currently use the term "Royal". The development of a speciality is often driven by new technology (such as the development of effective anaesthetics) or ways of working (such as emergency departments); the new specialty leads to the formation of a unifying body of doctors and the prestige of administering their own examination.
Within medical circles, specialities usually fit into one of two broad categories: "Medicine" and "Surgery". "Medicine" refers to the practice of non-operative medicine, and most of its subspecialties require preliminary training in Internal Medicine. In the UK, this was traditionally evidenced by passing the examination for the Membership of the
Royal College of Physicians
The Royal College of Physicians (RCP) is a British professional membership body dedicated to improving the practice of medicine, chiefly through the accreditation of physicians by examination. Founded by royal charter from King Henry VIII in 1 ...
(MRCP) or the equivalent college in Scotland or Ireland. "Surgery" refers to the practice of operative medicine, and most subspecialties in this area require preliminary training in General Surgery, which in the UK leads to membership of the
Royal College of Surgeons of England
The Royal College of Surgeons of England (RCS England) is an independent professional body and registered charity that promotes and advances standards of surgical care for patients, and regulates surgery and dentistry in England and Wales. T ...
(MRCS). At present, some specialties of medicine do not fit easily into either of these categories, such as radiology, pathology, or anesthesia. Most of these have branched from one or other of the two camps above; for example anaesthesia developed first as a
faculty of the Royal College of Surgeons (for which MRCS/FRCS would have been required) before becoming the
Royal College of Anaesthetists
The Royal College of Anaesthetists (RCoA) is the professional body responsible for the specialty of anaesthesia throughout the United Kingdom. It sets standards in anaesthesia, critical care, pain management, and for the training of anaestheti ...
and membership of the college is attained by sitting for the examination of the Fellowship of the Royal College of Anesthetists (FRCA).
Surgical specialty
![Surgeons at Work](https://upload.wikimedia.org/wikipedia/commons/0/08/Surgeons_at_Work.jpg)
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate or treat a
pathological
Pathology is the study of the causes and effects of disease or injury. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in th ...
condition such as
disease
A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...
or
injury, to help improve bodily function or appearance or to repair unwanted ruptured areas (for example,
a perforated ear drum). Surgeons must also manage pre-operative, post-operative, and potential surgical candidates on the hospital wards. In some centers,
anesthesiology
Anesthesiology, anaesthesiology, or anaesthesia is the medical specialty concerned with the total perioperative care of patients before, during and after surgery. It encompasses anesthesia, intensive care medicine, critical emergency medicine, ...
is part of the division of surgery (for historical and logistical reasons), although it is not a surgical discipline. Other medical specialties may employ surgical procedures, such as
ophthalmology
Ophthalmology ( ) is a surgical subspecialty within medicine that deals with the diagnosis and treatment of eye disorders.
An ophthalmologist is a physician who undergoes subspecialty training in medical and surgical eye care. Following a medic ...
and
dermatology
Dermatology is the branch of medicine dealing with the skin.''Random House Webster's Unabridged Dictionary.'' Random House, Inc. 2001. Page 537. . It is a speciality with both medical and surgical aspects. A dermatologist is a specialist medica ...
, but are not considered surgical sub-specialties per se.
Surgical training in the U.S. requires a minimum of five years of residency after medical school. Sub-specialties of surgery often require seven or more years. In addition, fellowships can last an additional one to three years. Because post-residency fellowships can be competitive, many trainees devote two additional years to research. Thus in some cases surgical training will not finish until more than a decade after medical school. Furthermore, surgical training can be very difficult and time-consuming.
Surgical subspecialties include those a physician may specialize in after undergoing general surgery residency training as well as several surgical fields with separate residency training. Surgical subspecialties that one may pursue following general surgery residency training: ''
''
*
General surgery
*
Bariatric surgery
*
Cardiovascular surgery - may also be pursued through a separate cardiovascular surgery residency track
*
Colorectal surgery
Colorectal surgery is a field in medicine dealing with disorders of the rectum, anus, and colon. The field is also known as proctology, but this term is now used infrequently within medicine and is most often employed to identify practices relati ...
*
Endocrine surgery
Endocrine surgery is a surgical sub-speciality focusing on surgery of the endocrine glands, including the thyroid gland, the parathyroid glands, the adrenal glands, glands of the endocrine pancreas, and some neuroendocrine glands.
Types
Thyro ...
*
Hand surgery
* Hepatico-Pancreatico-Biliary Surgery
*
Minimally invasive surgery
Minimally invasive procedures (also known as minimally invasive surgeries) encompass surgical techniques that limit the size of incisions needed, thereby reducing wound healing time, associated pain, and risk of infection. Surgery by definition ...
*
Surgical oncology
*
Pediatric surgery
Pediatric surgery is a subspecialty of surgery involving the surgery of fetuses, infants, children, adolescents, and young adults.
History
Pediatric surgery arose in the middle of the 1879 century as the surgical care of birth defects requ ...
*
Plastic surgery
Plastic surgery is a surgical specialty involving the restoration, reconstruction or alteration of the human body. It can be divided into two main categories: reconstructive surgery and cosmetic surgery. Reconstructive surgery includes cranio ...
- may also be pursued through a separate plastic surgery residency track
* Surgical critical care
*
Transplant surgery
Organ transplantation is a medical procedure in which an organ is removed from one body and placed in the body of a recipient, to replace a damaged or missing organ. The donor and recipient may be at the same location, or organs may be transpor ...
*
Trauma surgery
Trauma surgery is a surgical specialty that utilizes both operative and non-operative management to treat traumatic injuries, typically in an acute setting. Trauma surgeons generally complete residency training in general surgery and often fe ...
*
Vascular surgery - may also be pursued through a separate vascular surgery residency track
Other surgical specialties within medicine with their own individual residency training:
*
Dermatology
Dermatology is the branch of medicine dealing with the skin.''Random House Webster's Unabridged Dictionary.'' Random House, Inc. 2001. Page 537. . It is a speciality with both medical and surgical aspects. A dermatologist is a specialist medica ...
*
Neurosurgery
Neurosurgery or neurological surgery, known in common parlance as brain surgery, is the medical specialty concerned with the surgical treatment of disorders which affect any portion of the nervous system including the brain, spinal cord and pe ...
*
Ophthalmology
Ophthalmology ( ) is a surgical subspecialty within medicine that deals with the diagnosis and treatment of eye disorders.
An ophthalmologist is a physician who undergoes subspecialty training in medical and surgical eye care. Following a medic ...
*
Oral and Maxillofacial surgery
*
Orthopedic surgery
Orthopedic surgery or orthopedics ( alternatively spelt orthopaedics), is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal ...
*
Otorhinolaryngology
*
Podiatric surgery
Podiatry () or podiatric medicine () is a branch of medicine devoted to the study, diagnosis, medical and surgical treatment of disorders of the foot, ankle, and leg.
A Doctor of Podiatric Medicine (DPM), or a podiatrist, is a healthcare p ...
- do not undergo medical school training, but rather separate training in podiatry school
*
Urology
Urology (from Greek οὖρον ''ouron'' "urine" and '' -logia'' "study of"), also known as genitourinary surgery, is the branch of medicine that focuses on surgical and medical diseases of the urinary-tract system and the reproductive org ...
Internal medicine specialty
Internal medicine is the
medical specialty
A medical specialty is a branch of medical practice that is focused on a defined group of patients, diseases, skills, or philosophy. Examples include those branches of medicine that deal exclusively with children (paediatrics), cancer (oncology), ...
dealing with the prevention, diagnosis, and treatment of adult diseases. According to some sources, an emphasis on internal structures is implied. In North America, specialists in internal medicine are commonly called "internists". Elsewhere, especially in
Commonwealth nations, such specialists are often called
physician
A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
s.
These terms, ''internist'' or ''physician'' (in the narrow sense, common outside North America), generally exclude practitioners of gynecology and obstetrics, pathology, psychiatry, and especially surgery and its subspecialities.
Because their patients are often seriously ill or require complex investigations, internists do much of their work in hospitals. Formerly, many internists were not subspecialized; such ''general physicians'' would see any complex nonsurgical problem; this style of practice has become much less common. In modern urban practice, most internists are subspecialists: that is, they generally limit their medical practice to problems of one organ system or to one particular area of medical knowledge. For example,
gastroenterologists and
nephrologists specialize respectively in diseases of the gut and the kidneys.
In the
Commonwealth of Nations
The Commonwealth of Nations, simply referred to as the Commonwealth, is a political association of 56 member states, the vast majority of which are former territories of the British Empire. The chief institutions of the organisation are the ...
and some other countries, specialist
pediatricians
Pediatrics ( also spelled ''paediatrics'' or ''pædiatrics'') is the branch of medicine that involves the medical care of infants, children, adolescents, and young adults. In the United Kingdom, paediatrics covers many of their youth until the ...
and
geriatricians are also described as ''specialist physicians'' (or internists) who have subspecialized by age of patient rather than by organ system. Elsewhere, especially in North America, general pediatrics is often a form of
primary care
Primary care is the day-to-day healthcare given by a health care provider. Typically this provider acts as the first contact and principal point of continuing care for patients within a healthcare system, and coordinates other specialist care ...
.
There are many subspecialities (or subdisciplines) of
internal medicine:
:*''
Angiology
Angiology (from Greek , ''angeīon'', "vessel"; and , ''-logia'') is the medical specialty dedicated to studying the circulatory system and of the lymphatic system, i.e., arteries, veins and lymphatic vessels.
In the UK, this field is more oft ...
/Vascular Medicine''
:*''
Bariatrics
Bariatrics is the branch of medicine that deals with the causes, prevention, and treatment of obesity.
Terminology
The term ''bariatrics'' was coined around 1965,Dictionary.com, based on Random House Unabridged Dictionary, Random House (2006 ...
''
:*''
Cardiology
Cardiology () is a branch of medicine that deals with disorders of the heart and the cardiovascular system. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular h ...
''
:*''
Critical care medicine''
:*''
Endocrinology
Endocrinology (from '' endocrine'' + '' -ology'') is a branch of biology and medicine dealing with the endocrine system, its diseases, and its specific secretions known as hormones. It is also concerned with the integration of developmental event ...
''
:*''
Gastroenterology
Gastroenterology (from the Greek gastḗr- “belly”, -énteron “intestine”, and -logía "study of") is the branch of medicine focused on the digestive system and its disorders. The digestive system consists of the gastrointestinal tract ...
''
:*''
Geriatrics
Geriatrics, or geriatric medicine, is a medical specialty focused on providing care for the unique health needs of older adults. The term ''geriatrics'' originates from the Greek γέρων ''geron'' meaning "old man", and ιατρός ''iatros ...
''
:*''
Hematology''
:*''
Hepatology
Hepatology is the branch of medicine that incorporates the study of liver, gallbladder, biliary tree, and pancreas as well as management of their disorders. Although traditionally considered a sub-specialty of gastroenterology, rapid expansion ...
''
:*''
Infectious disease
An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable di ...
''
:*''
Nephrology''
:*''
Neurology
Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the brain, the spinal ...
''
:*''
Oncology
Oncology is a branch of medicine that deals with the study, treatment, diagnosis and prevention of cancer. A medical professional who practices oncology is an ''oncologist''. The name's etymological origin is the Greek word ὄγκος ('' ...
''
:*''
Pediatrics''
:*''
Pulmonology/Pneumology/Respirology/chest medicine''
:*''
Rheumatology
Rheumatology (Greek ''ῥεῦμα'', ''rheûma'', flowing current) is a branch of medicine devoted to the diagnosis and management of disorders whose common feature is inflammation in the bones, muscles, joints, and internal organs. Rheumatolog ...
''
:*''
Sports Medicine
Sports medicine is a branch of medicine that deals with physical fitness and the treatment and prevention of injuries related to sports and exercise. Although most sports teams have employed team physicians for many years, it is only since the ...
''
Training in internal medicine (as opposed to surgical training), varies considerably across the world: see the articles on ''
medical education
Medical education is education related to the practice of being a medical practitioner, including the initial training to become a physician (i.e., medical school and internship) and additional training thereafter (e.g., residency, fellowship, ...
'' and ''
physician
A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
'' for more details. In North America, it requires at least three years of residency training after medical school, which can then be followed by a one- to three-year fellowship in the subspecialties listed above. In general, resident work hours in medicine are less than those in surgery, averaging about 60 hours per week in the US. This difference does not apply in the UK where all doctors are now required by law to work less than 48 hours per week on average.
Diagnostic specialties
* ''
Clinical laboratory
A medical laboratory or clinical laboratory is a laboratory where tests are conducted out on clinical specimens to obtain information about the health of a patient to aid in diagnosis, treatment, and prevention of disease. Clinical Medical labor ...
sciences'' are the clinical diagnostic services that apply laboratory techniques to diagnosis and management of patients. In the United States, these services are supervised by a pathologist. The personnel that work in these
medical laboratory
A medical laboratory or clinical laboratory is a laboratory where tests are conducted out on clinical specimens to obtain information about the health of a patient to aid in diagnosis, treatment, and prevention of disease. Clinical Medical labor ...
departments are technically trained staff who do not hold medical degrees, but who usually hold an undergraduate
medical technology degree, who actually perform the
tests
Test(s), testing, or TEST may refer to:
* Test (assessment), an educational assessment intended to measure the respondents' knowledge or other abilities
Arts and entertainment
* ''Test'' (2013 film), an American film
* ''Test'' (2014 film), ...
,
assays, and procedures needed for providing the specific services. Subspecialties include
transfusion medicine
Transfusion medicine (or transfusiology) is the branch of medicine that encompasses all aspects of the transfusion of blood and blood components including aspects related to hemovigilance. It includes issues of blood donation, immunohematolog ...
,
cellular pathology
Cytopathology (from Greek , ''kytos'', "a hollow"; , ''pathos'', "fate, harm"; and , ''-logia'') is a branch of pathology that studies and diagnoses diseases on the cellular level. The discipline was founded by George Nicolas Papanicolaou in 1 ...
,
clinical chemistry
Clinical chemistry (also known as chemical pathology, clinical biochemistry or medical biochemistry) is the area of chemistry that is generally concerned with analysis of bodily fluids for diagnostic and therapeutic purposes. It is an applied ...
,
hematology,
clinical microbiology
Medical microbiology, the large subset of microbiology that is applied to medicine, is a branch of medical science concerned with the prevention, diagnosis and treatment of infectious diseases. In addition, this field of science studies various ...
and
clinical immunology
Immunology is a branch of medicineImmunology for Medical Students, Roderick Nairn, Matthew Helbert, Mosby, 2007 and biology that covers the medical study of immune systems in humans, animals, plants and sapient species. In such we can see there ...
.
* ''
Pathology as a medical specialty
Pathology is the study of the causes and effects of disease or injury. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in th ...
'' is the branch of medicine that deals with the study of diseases and the morphologic, physiologic changes produced by them. As a diagnostic specialty, pathology can be considered the basis of modern scientific medical knowledge and plays a large role in
evidence-based medicine. Many modern molecular tests such as
flow cytometry,
polymerase chain reaction
The polymerase chain reaction (PCR) is a method widely used to rapidly make millions to billions of copies (complete or partial) of a specific DNA sample, allowing scientists to take a very small sample of DNA and amplify it (or a part of it) ...
(PCR),
immunohistochemistry,
cytogenetics
Cytogenetics is essentially a branch of genetics, but is also a part of cell biology/cytology (a subdivision of human anatomy), that is concerned with how the chromosomes relate to cell behaviour, particularly to their behaviour during mitosis an ...
, gene rearrangements studies and
fluorescent in situ hybridization (FISH) fall within the territory of pathology.
* ''Diagnostic
radiology
Radiology ( ) is the medical discipline that uses medical imaging to diagnose diseases and guide their treatment, within the bodies of humans and other animals. It began with radiography (which is why its name has a root referring to radiat ...
'' is concerned with imaging of the body, e.g. by
x-ray
An X-ray, or, much less commonly, X-radiation, is a penetrating form of high-energy electromagnetic radiation. Most X-rays have a wavelength ranging from 10 picometers to 10 nanometers, corresponding to frequencies in the range 30&nb ...
s, x-ray
computed tomography,
ultrasonography
Ultrasound is sound waves with frequencies higher than the upper audible limit of human hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hear it. This limit varies fr ...
, and
nuclear magnetic resonance
Nuclear magnetic resonance (NMR) is a physical phenomenon in which nuclei in a strong constant magnetic field are perturbed by a weak oscillating magnetic field (in the near field) and respond by producing an electromagnetic signal with a ...
tomography
Tomography is imaging by sections or sectioning that uses any kind of penetrating wave. The method is used in radiology, archaeology, biology, atmospheric science, geophysics, oceanography, plasma physics, materials science, astrophysics, ...
. Interventional radiologists can access areas in the body under imaging for an intervention or diagnostic sampling.
* ''
Nuclear medicine
Nuclear medicine or nucleology is a medical specialty involving the application of radioactive substances in the diagnosis and treatment of disease. Nuclear imaging, in a sense, is " radiology done inside out" because it records radiation emi ...
'' is concerned with studying human organ systems by administering radiolabelled substances (radiopharmaceuticals) to the body, which can then be imaged outside the body by a
gamma camera
A gamma camera (γ-camera), also called a scintillation camera or Anger camera, is a device used to image gamma radiation emitting radioisotopes, a technique known as scintigraphy. The applications of scintigraphy include early drug development ...
or a PET scanner. Each radiopharmaceutical consists of two parts: a tracer that is specific for the function under study (e.g., neurotransmitter pathway, metabolic pathway, blood flow, or other), and a radionuclide (usually either a gamma-emitter or a positron emitter). There is a degree of overlap between nuclear medicine and radiology, as evidenced by the emergence of combined devices such as the PET/CT scanner.
* ''
Clinical neurophysiology
Clinical neurophysiology is a medical specialty that studies the central and peripheral nervous systems through the recording of bioelectrical activity, whether spontaneous or stimulated. It encompasses both research regarding the pathophysiology ...
'' is concerned with testing the physiology or function of the central and peripheral aspects of the nervous system. These kinds of tests can be divided into recordings of: (1) spontaneous or continuously running electrical activity, or (2) stimulus evoked responses. Subspecialties include
electroencephalography,
electromyography,
evoked potential
An evoked potential or evoked response is an electrical potential in a specific pattern recorded from a specific part of the nervous system, especially the brain, of a human or other animals following presentation of a stimulus such as a light f ...
,
nerve conduction study
A nerve conduction study (NCS) is a medical diagnostic test commonly used to evaluate the function, especially the ability of electrical conduction, of the motor and sensory nerves of the human body. These tests may be performed by medical speci ...
and
polysomnography
Polysomnography (PSG), a type of sleep study, is a multi-parameter study of sleep and a diagnostic tool in sleep medicine. The test result is called a polysomnogram, also abbreviated PSG. The name is derived from Greek and Latin roots: the Gre ...
. Sometimes these tests are performed by techs without a medical degree, but the interpretation of these tests is done by a medical professional.
Other major specialties
The following are some major medical specialties that do not directly fit into any of the above-mentioned groups:
* ''
Anesthesiology
Anesthesiology, anaesthesiology, or anaesthesia is the medical specialty concerned with the total perioperative care of patients before, during and after surgery. It encompasses anesthesia, intensive care medicine, critical emergency medicine, ...
'' (also known as ''anaesthetics''): concerned with the perioperative management of the surgical patient. The anesthesiologist's role during surgery is to prevent derangement in the vital organs' (i.e. brain, heart, kidneys) functions and postoperative pain. Outside of the operating room, the anesthesiology physician also serves the same function in the labor and delivery ward, and some are specialized in critical medicine.
* ''
Emergency medicine'' is concerned with the diagnosis and treatment of acute or life-threatening conditions, including
trauma
Trauma most often refers to:
* Major trauma, in physical medicine, severe physical injury caused by an external source
* Psychological trauma, a type of damage to the psyche that occurs as a result of a severely distressing event
*Traumatic i ...
, surgical, medical, pediatric, and psychiatric emergencies.
* ''
Family medicine'', ''
family practice
Family medicine is a medical specialty within primary care that provides continuing and comprehensive health care for the individual and family across all ages, genders, diseases, and parts of the body. The specialist, who is usually a primar ...
'', ''
general practice
General practice is the name given in various nations, such as the United Kingdom, India, Australia, New Zealand and South Africa to the services provided by general practitioners. In some nations, such as the US, similar services may be describe ...
'' or ''primary care'' is, in many countries, the first port-of-call for patients with non-emergency medical problems. Family physicians often provide services across a broad range of settings including office based practices, emergency department coverage, inpatient care, and nursing home care.
![Changing lives for girls and women every week (12330467294)](https://upload.wikimedia.org/wikipedia/commons/1/1e/Changing_lives_for_girls_and_women_every_week_%2812330467294%29.jpg)
* ''
Obstetrics and
gynecology'' (often abbreviated as ''
OB/GYN
Obstetrics and Gynaecology (also spelled as Obstetrics and Gynecology; abbreviated as Obs and Gynae, O&G, OB-GYN and OB/GYN) is the medical specialty that encompasses the two subspecialties of obstetrics (covering pregnancy, childbirth, and t ...
'' (American English) or ''Obs & Gynae'' (British English)) are concerned respectively with childbirth and the female reproductive and associated organs.
Reproductive medicine
Reproductive medicine is a branch of medicine concerning the male and female reproductive systems. It encompasses a variety of reproductive conditions, their prevention and assessment, as well as their subsequent treatment and prognosis.
Reprodu ...
and
fertility medicine
Reproductive endocrinology and infertility (REI) is a surgical subspecialty of obstetrics and gynecology that trains physicians in reproductive medicine addressing hormonal functioning as it pertains to reproduction as well as the issue of in ...
are generally practiced by gynecological specialists.
* ''
Medical genetics
Medical genetics is the branch
tics in that human genetics is a field of scientific research that may or may not apply to medicine, while medical genetics refers to the application of genetics to medical care. For example, research on the caus ...
'' is concerned with the diagnosis and management of hereditary disorders.
* ''
Neurology
Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the brain, the spinal ...
'' is concerned with diseases of the nervous system. In the UK, neurology is a subspecialty of general medicine.
* ''
Pediatrics'' (AE) or ''paediatrics'' (BE) is devoted to the care of infants, children, and adolescents. Like internal medicine, there are many pediatric subspecialties for specific age ranges, organ systems, disease classes, and sites of care delivery.
* ''
Pharmaceutical medicine Pharmaceutical medicine is a medical discipline concerned with the discovery, evaluation, registration, monitoring and clinical aspects of pharmaceutical development. All medical specialties overlap to some extent, and likewise the boundaries of pha ...
'' is the medical scientific discipline concerned with the discovery, development, evaluation, registration, monitoring and medical aspects of marketing of medicines for the benefit of patients and public health.
* ''
Physical medicine and rehabilitation
Physical medicine and rehabilitation, also known as physiatry, is a branch of medicine that aims to enhance and restore functional ability and quality of life to people with physical impairments or disabilities. This can include conditions su ...
'' (or ''physiatry'') is concerned with functional improvement after injury, illness, or
congenital disorder
A birth defect, also known as a congenital disorder, is an abnormal condition that is present at birth regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities ca ...
s.
* ''
Podiatric medicine
Podiatry () or podiatric medicine () is a branch of medicine devoted to the study, diagnosis, medical and surgical treatment of disorders of the foot, ankle, and leg.
A Doctor of Podiatric Medicine (DPM), or a podiatrist, is a healthcare p ...
'' is the study of, diagnosis, and medical & surgical treatment of disorders of the foot, ankle, lower limb, hip and lower back.
* ''
Psychiatry
Psychiatry is the specialty (medicine), medical specialty devoted to the diagnosis, prevention, and treatment of mental disorders. These include various maladaptations related to mood, behaviour, cognition, and perceptions. See glossary of psych ...
'' is the branch of medicine concerned with the
bio-psycho-social study of the
etiology, diagnosis, treatment and prevention of
cognitive,
perceptual
Perception () is the organization, identification, and interpretation of sensory information in order to represent and understand the presented information or environment. All perception involves signals that go through the nervous system ...
,
emotional and
behavioral
Behavior (American English) or behaviour (British English) is the range of actions and mannerisms made by individuals, organisms, systems or artificial entities in some environment. These systems can include other systems or organisms as we ...
disorders. Related fields include
psychotherapy and
clinical psychology.
* ''
Preventive medicine
Preventive healthcare, or prophylaxis, consists of measures taken for the purposes of disease prevention.Hugh R. Leavell and E. Gurney Clark as "the science and art of preventing disease, prolonging life, and promoting physical and mental hea ...
'' is the branch of medicine concerned with preventing disease.
** ''
Community health'' or ''
public health
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the det ...
'' is an aspect of health services concerned with threats to the overall health of a community based on
population health
Population health has been defined as "the health outcomes of a group of individuals, including the distribution of such outcomes within the group". It is an approach to health that aims to improve the health of an entire human population. It ha ...
analysis.
Interdisciplinary fields
Some interdisciplinary sub-specialties of medicine include:
* ''
Aerospace medicine
Aviation medicine, also called flight medicine or aerospace medicine, is a preventive or occupational medicine in which the patients/subjects are pilots, aircrews, or astronauts. The specialty strives to treat or prevent conditions to which airc ...
'' deals with medical problems related to flying and
space travel.
* ''
Addiction medicine
Addiction medicine is a medical subspecialty that deals with the diagnosis, prevention, evaluation, treatment, and recovery of persons with addiction, of those with substance-related and addictive disorders, and of people who show unhealthy u ...
'' deals with the treatment of addiction.
* ''
Medical ethics'' deals with
ethic
Ethics or moral philosophy is a branch of philosophy that "involves systematizing, defending, and recommending concepts of right and wrong behavior".''Internet Encyclopedia of Philosophy'' The field of ethics, along with aesthetics, concerns ma ...
al and
moral principles that apply values and judgments to the practice of medicine.
* ''
Biomedical Engineering
Biomedical engineering (BME) or medical engineering is the application of engineering principles and design concepts to medicine and biology for healthcare purposes (e.g., diagnostic or therapeutic). BME is also traditionally logical sciences ...
'' is a field dealing with the application of
engineering
Engineering is the use of scientific principles to design and build machines, structures, and other items, including bridges, tunnels, roads, vehicles, and buildings. The discipline of engineering encompasses a broad range of more speciali ...
principles to medical practice.
* ''
Clinical pharmacology
Clinical pharmacology has been defined as "that discipline that teaches, does research, frames policy, gives information and advice about the actions and proper uses of medicines in humans and implements that knowledge in clinical practice". Clinic ...
'' is concerned with how systems of
therapeutics
A therapy or medical treatment (often abbreviated tx, Tx, or Tx) is the attempted remediation of a health problem, usually following a medical diagnosis.
As a rule, each therapy has indications and contraindications. There are many different ...
interact with patients.
* ''
Conservation medicine
Conservation medicine is an emerging, interdisciplinary field that studies the relationship between human and animal health and environmental conditions. It is also known as ecological medicine, environmental medicine, or medical geology.
The envi ...
'' studies the relationship between human and animal health, and environmental conditions. Also known as ecological medicine,
environmental medicine
Environmental medicine is a multidisciplinary field involving medicine, environmental science, chemistry and others, overlapping with environmental pathology. It can be viewed as the medical branch of the broader field of environmental health. Th ...
, or
medical geology
Medical geology is an emerging interdisciplinary scientific field studying the relationship between natural geology, geological factors and their effects on human and animal health. The Commission on Geological Sciences for Environmental Planning d ...
.
* ''
Disaster medicine
Disaster medicine is the area of medical specialization serving the dual areas of providing health care to disaster survivors and providing medically related disaster preparation, disaster planning, disaster response and disaster recovery lead ...
'' deals with medical aspects of emergency preparedness, disaster mitigation and management.
* ''
Diving medicine
Diving medicine, also called undersea and hyperbaric medicine (UHB), is the diagnosis, treatment and prevention of conditions caused by humans entering the undersea environment. It includes the effects on the body of pressure on gases, the diag ...
'' (or
hyperbaric medicine
Hyperbaric medicine is medical treatment in which an ambient pressure greater than sea level atmospheric pressure is a necessary component. The treatment comprises hyperbaric oxygen therapy (HBOT), the medical use of oxygen at an ambient pressure ...
) is the prevention and treatment of diving-related problems.
* ''
Evolutionary medicine
Evolutionary medicine or Darwinian medicine is the application of modern evolutionary theory to understanding health and disease. Modern biomedical research and practice have focused on the molecular and physiological mechanisms underlying he ...
'' is a perspective on medicine derived through applying
evolutionary theory
Evolution is change in the heritable characteristics of biological populations over successive generations. These characteristics are the expressions of genes, which are passed on from parent to offspring during reproduction. Variation ...
.
* ''
Forensic medicine'' deals with medical questions in
legal
Law is a set of rules that are created and are law enforcement, enforceable by social or governmental institutions to regulate behavior,Robertson, ''Crimes against humanity'', 90. with its precise definition a matter of longstanding debate. ...
context, such as determination of the time and cause of death, type of weapon used to inflict trauma, reconstruction of the facial features using remains of deceased (skull) thus aiding identification.
* ''
Gender-based medicine
Sex differences in medicine include sex-specific diseases or conditions which occur only in people of one sex due to underlying biological factors (for example, prostate cancer in males or uterine cancer in females); sex-related diseases, which ar ...
'' studies the biological and physiological differences between the human sexes and how that affects differences in disease.
* ''
Hospice and Palliative Medicine
In 2006, ''hospice and palliative medicine'' was officially recognized by the American Board of Medical Specialties, and is ''co-sponsored'' by the American Boards of
* Internal Medicine
* Anesthesiology
* Family Medicine
* Physical Medicine ...
'' is a relatively modern branch of clinical medicine that deals with pain and symptom relief and emotional support in patients with
terminal illness
Terminal illness or end-stage disease is a disease that cannot be cured or adequately treated and is expected to result in the death of the patient. This term is more commonly used for progressive diseases such as cancer, dementia or advanced h ...
es including cancer and
heart failure.
* ''
Hospital medicine
Hospital medicine is a medical specialty that exists in some countries as a branch of family medicine or internal medicine, dealing with the care of acutely ill hospitalized patients. Physicians whose primary professional focus is caring for ...
'' is the general medical care of hospitalized patients. Physicians whose primary professional focus is hospital medicine are called
hospitalist
Hospital medicine is a medical specialty that exists in some countries as a branch of family medicine or internal medicine, dealing with the care of acutely ill hospitalized patients. Physicians whose primary professional focus is caring for ho ...
s in the United States and
Canada
Canada is a country in North America. Its ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, covering over , making it the world's second-largest country by tot ...
. The term Most Responsible Physician (MRP) or attending physician is also used interchangeably to describe this role.
* ''
Laser medicine
Laser medicine consists in the use of lasers in medical diagnosis, treatments, or therapies, such as laser photodynamic therapy, photorejuvenation, and laser surgery.
Lasers
Lasers used in medicine include in principle any type of laser, bu ...
'' involves the use of lasers in the diagnostics or treatment of various conditions.
* ''
Medical humanities
''Medical Humanities'' is a quarterly peer-reviewed academic journal covering the field of medical humanities. The journal presents the international conversation around medicine and its engagement with the humanities and arts, social sciences, h ...
'' includes the
humanities
Humanities are academic disciplines that study aspects of human society and culture. In the Renaissance, the term contrasted with divinity and referred to what is now called classics, the main area of secular study in universities at the t ...
(
literature
Literature is any collection of written work, but it is also used more narrowly for writings specifically considered to be an art form, especially prose fiction, drama, and poetry. In recent centuries, the definition has expanded to include ...
,
philosophy,
ethics
Ethics or moral philosophy is a branch of philosophy that "involves systematizing, defending, and recommending concepts of right and wrong behavior".''Internet Encyclopedia of Philosophy'' The field of ethics, along with aesthetics, concer ...
, history and religion),
social science
Social science is one of the branches of science, devoted to the study of societies and the relationships among individuals within those societies. The term was formerly used to refer to the field of sociology, the original "science of so ...
(
anthropology
Anthropology is the scientific study of humanity, concerned with human behavior, human biology, cultures, societies, and linguistics, in both the present and past, including past human species. Social anthropology studies patterns of be ...
,
cultural studies,
psychology
Psychology is the scientific study of mind and behavior. Psychology includes the study of conscious and unconscious phenomena, including feelings and thoughts. It is an academic discipline of immense scope, crossing the boundaries between ...
,
sociology
Sociology is a social science that focuses on society, human social behavior, patterns of social relationships, social interaction, and aspects of culture associated with everyday life. It uses various methods of empirical investigation an ...
), and the arts (
literature
Literature is any collection of written work, but it is also used more narrowly for writings specifically considered to be an art form, especially prose fiction, drama, and poetry. In recent centuries, the definition has expanded to include ...
, theater, film, and
visual arts
The visual arts are art forms such as painting, drawing, printmaking, sculpture, ceramics, photography, video, filmmaking, design, crafts and architecture. Many artistic disciplines such as performing arts, conceptual art, and textile art ...
) and their application to
medical education
Medical education is education related to the practice of being a medical practitioner, including the initial training to become a physician (i.e., medical school and internship) and additional training thereafter (e.g., residency, fellowship, ...
and practice.
* ''
Health informatics'' is a relatively recent field that deal with the application of computers and
information technology
Information technology (IT) is the use of computers to create, process, store, retrieve, and exchange all kinds of Data (computing), data . and information. IT forms part of information and communications technology (ICT). An information te ...
to medicine.
* ''
Nosology'' is the classification of diseases for various purposes.
* ''
Nosokinetics Nosokinetics is the science/subject of measuring and modelling the process of care in health and social care systems.'' Nosokinetics'' brings together the Greek words for ''noso'': disease and ''kinetics'': movement.
Black box models are currently ...
'' is the science/subject of measuring and modelling the process of care in health and social care systems.
* ''
Occupational medicine
Occupational medicine, until 1960 called industrial medicine, is the branch of medicine which is concerned with the maintenance of health in the workplace, including prevention and treatment of diseases and injuries, with secondary objectives ...
'' is the provision of health advice to organizations and individuals to ensure that the highest standards of health and safety at work can be achieved and maintained.
* ''
Pain management
Pain management is an aspect of medicine and health care involving relief of pain (pain relief, analgesia, pain control) in various dimensions, from acute and simple to chronic and challenging. Most physicians and other health professionals pr ...
'' (also called ''
pain medicine
Pain management is an aspect of medicine and health care involving relief of pain (pain relief, analgesia, pain control) in various dimensions, from acute and simple to chronic and challenging. Most physicians and other health professional ...
'', or ''algiatry'') is the medical discipline concerned with the relief of pain.
* ''
Pharmacogenomics
Pharmacogenomics is the study of the role of the genome in drug response. Its name ('' pharmaco-'' + ''genomics'') reflects its combining of pharmacology and genomics. Pharmacogenomics analyzes how the genetic makeup of an individual affects the ...
'' is a form of ''individualized medicine''.
* ''
Podiatric medicine
Podiatry () or podiatric medicine () is a branch of medicine devoted to the study, diagnosis, medical and surgical treatment of disorders of the foot, ankle, and leg.
A Doctor of Podiatric Medicine (DPM), or a podiatrist, is a healthcare p ...
'' is the study of, diagnosis, and medical treatment of disorders of the foot, ankle, lower limb, hip and lower back.
* ''
Sexual medicine
Sexual medicine or Psychosexual medicine as defined by Masters and Johnsons in their classic Textbook of Sexual Medicine, is “that branch of medicine that focuses on the evaluation and treatment of sexual disorders, which have a high prevalence ...
'' is concerned with diagnosing, assessing and treating all disorders related to sexuality.
* ''
Sports medicine
Sports medicine is a branch of medicine that deals with physical fitness and the treatment and prevention of injuries related to sports and exercise. Although most sports teams have employed team physicians for many years, it is only since the ...
'' deals with the treatment and prevention and rehabilitation of sports/exercise injuries such as
muscle spasm
A spasm is a sudden involuntary contraction of a muscle, a group of muscles, or a hollow organ such as the bladder.
A spasmodic muscle contraction may be caused by many medical conditions, including dystonia. Most commonly, it is a muscl ...
s,
muscle tear
A strain is an acute or chronic soft tissue injury that occurs to a muscle, tendon, or both. The equivalent injury to a ligament is a sprain. Generally, the muscle or tendon overstretches and partially tears, under more physical stress than ...
s, injuries to ligaments (ligament tears or ruptures) and their repair in
athletes,
amateur and
professional
A professional is a member of a profession or any person who works in a specified professional activity. The term also describes the standards of education and training that prepare members of the profession with the particular knowledge and ski ...
.
* ''
Therapeutics
A therapy or medical treatment (often abbreviated tx, Tx, or Tx) is the attempted remediation of a health problem, usually following a medical diagnosis.
As a rule, each therapy has indications and contraindications. There are many different ...
'' is the field, more commonly referenced in earlier periods of history, of the various remedies that can be used to treat disease and promote health.
* ''
Travel medicine
Travel medicine or emporiatrics is the branch of medicine that deals with the prevention and management of health problems of international travelers.
Globalization and travel
Globalization facilitates the spread of disease and increases the num ...
'' or ''emporiatrics'' deals with health problems of international travelers or travelers across highly different environments.
* ''
Tropical medicine'' deals with the prevention and treatment of tropical diseases. It is studied separately in temperate climates where those diseases are quite unfamiliar to medical practitioners and their local clinical needs.
* ''
Urgent care An urgent care center (UCC), also known as an urgent treatment centre in the United Kingdom, is a type of walk-in clinic focused on the delivery of urgent ambulatory care in a dedicated medical facility outside of a traditional emergency departme ...
'' focuses on delivery of unscheduled, walk-in care outside of the hospital emergency department for injuries and illnesses that are not severe enough to require care in an emergency department. In some jurisdictions this function is combined with the emergency department.
*
Veterinary medicine
Veterinary medicine is the branch of medicine that deals with the prevention, management, diagnosis, and treatment of disease, disorder, and injury in animals. Along with this, it deals with animal rearing, husbandry, breeding, research on nutri ...
;
veterinarians
A veterinarian (vet), also known as a veterinary surgeon or veterinary physician, is a medical professional who practices veterinary medicine. They manage a wide range of health conditions and injuries in non-human animals. Along with this, vet ...
apply similar techniques as physicians to the care of animals.
* ''
Wilderness medicine
Wilderness medicine is a rapidly evolving field and is of increasing importance as more people engage in hiking, climbing, kayaking, and other potentially hazardous activities in the backcountry. The modern definition of wilderness medicine is "m ...
'' entails the practice of medicine in the wild, where conventional medical facilities may not be available.
* Many other
health science fields, e.g.
dietetics
A dietitian, medical dietitian, or dietician is an expert in identifying and treating disease-related malnutrition and in conducting medical nutrition therapy, for example designing an enteral tube feeding regimen or mitigating the effects of ...
Education and legal controls
![Medical students learning about stitches (2760577402)](https://upload.wikimedia.org/wikipedia/commons/f/f7/Medical_students_learning_about_stitches_%282760577402%29.jpg)
Medical education and training varies around the world. It typically involves entry level education at a university
medical school, followed by a period of supervised practice or
internship
An internship is a period of work experience offered by an organization for a limited period of time. Once confined to medical graduates, internship is used practice for a wide range of placements in businesses, non-profit organizations and gover ...
, or
residency
Residency may refer to:
* Domicile (law), the act of establishing or maintaining a residence in a given place
** Permanent residency, indefinite residence within a country despite not having citizenship
* Residency (medicine), a stage of postgra ...
. This can be followed by postgraduate vocational training. A variety of teaching methods have been employed in medical education, still itself a focus of active research. In Canada and the United States of America, a
Doctor of Medicine
Doctor of Medicine (abbreviated M.D., from the Latin ''Medicinae Doctor'') is a medical degree, the meaning of which varies between different jurisdictions. In the United States, and some other countries, the M.D. denotes a professional degree. T ...
degree, often abbreviated M.D., or a
Doctor of Osteopathic Medicine
Doctor of Osteopathic Medicine (DO or D.O., or in Australia DO USA) is a medical degree conferred by the 38 osteopathic medical schools in the United States. DO and Doctor of Medicine (MD) degrees are equivalent: a DO graduate may become lice ...
degree, often abbreviated as D.O. and unique to the United States, must be completed in and delivered from a recognized university.
Since knowledge, techniques, and medical technology continue to evolve at a rapid rate, many regulatory authorities require
continuing medical education. Medical practitioners upgrade their knowledge in various ways, including
medical journals, seminars, conferences, and online programs. A database of objectives covering medical knowledge, as suggested by national societies across the United States, can be searched at http://data.medobjectives.marian.edu/.
In most countries, it is a legal requirement for a medical doctor to be licensed or registered. In general, this entails a medical degree from a university and accreditation by a medical board or an equivalent national organization, which may ask the applicant to pass exams. This restricts the considerable legal authority of the medical profession to physicians that are trained and qualified by national standards. It is also intended as an assurance to patients and as a safeguard against
charlatan
A charlatan (also called a swindler or mountebank) is a person practicing quackery or a similar confidence trick in order to obtain money, power, fame, or other advantages through pretense or deception. Synonyms for ''charlatan'' include '' ...
s that practice inadequate medicine for personal gain. While the laws generally require medical doctors to be trained in "evidence based", Western, or
Hippocratic
Hippocrates of Kos (; grc-gre, Ἱπποκράτης ὁ Κῷος, Hippokrátēs ho Kôios; ), also known as Hippocrates II, was a Greek physician of the classical period who is considered one of the most outstanding figures in the history of ...
Medicine, they are not intended to discourage different paradigms of health.
In the European Union, the profession of doctor of medicine is regulated. A profession is said to be regulated when access and exercise is subject to the possession of a specific professional qualification.
The regulated professions database contains a list of regulated professions for doctor of medicine in the EU member states, EEA countries and Switzerland. This list is covered by the Directive 2005/36/EC.
Doctors who are negligent or intentionally harmful in their care of patients can face charges of
medical malpractice
Medical malpractice is a legal cause of action that occurs when a medical or health care professional, through a negligent act or omission, deviates from standards in their profession, thereby causing injury or death to a patient. The neglige ...
and be subject to civil, criminal, or professional sanctions.
Medical ethics
![HippocraticOath](https://upload.wikimedia.org/wikipedia/commons/1/1a/HippocraticOath.jpg)
Medical ethics is a system of moral principles that apply values and judgments to the practice of medicine. As a scholarly discipline, medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, and sociology. Six of the values that commonly apply to medical ethics discussions are:
*
autonomy – the patient has the right to refuse or choose their treatment. (''Voluntas aegroti suprema lex''.)
*
beneficence – a practitioner should act in the best interest of the patient. (''Salus aegroti suprema lex''.)
*
justice
Justice, in its broadest sense, is the principle that people receive that which they deserve, with the interpretation of what then constitutes "deserving" being impacted upon by numerous fields, with many differing viewpoints and perspective ...
– concerns the distribution of scarce health resources, and the decision of who gets what treatment (fairness and equality).
*
non-maleficence – "first, do no harm" (''primum non-nocere'').
*
respect for persons
Respect for persons is the concept that all people deserve the right to fully exercise their autonomy. Showing respect for persons is a system for interaction in which one entity ensures that another has agency to be able to make a choice.
This ...
– the patient (and the person treating the patient) have the right to be treated with dignity.
*
truth
Truth is the property of being in accord with fact or reality.Merriam-Webster's Online Dictionarytruth 2005 In everyday language, truth is typically ascribed to things that aim to represent reality or otherwise correspond to it, such as belie ...
fulness and
honesty
Honesty or truthfulness is a facet of moral character that connotes positive and virtuous attributes such as integrity, truthfulness, straightforwardness, including straightforwardness of conduct, along with the absence of lying, cheating, theft ...
– the concept of
informed consent has increased in importance since the historical events of the
Doctors' Trial
The Doctors' Trial (officially ''United States of America v. Karl Brandt, et al.'') was the first of 12 trials for war crimes of high-ranking German officials and industrialists that the United States authorities held in their occupation zone ...
of the Nuremberg trials,
Tuskegee syphilis experiment
The Tuskegee Study of Untreated Syphilis in the Negro Male (informally referred to as the Tuskegee Experiment or Tuskegee Syphilis Study) was a study conducted between 1932 and 1972 by the United States Public Health Service (PHS) and the Cente ...
, and others.
Values such as these do not give answers as to how to handle a particular situation, but provide a useful framework for understanding conflicts. When moral values are in conflict, the result may be an ethical
dilemma
A dilemma ( grc-gre, δίλημμα "double proposition") is a problem offering two possibilities, neither of which is unambiguously acceptable or preferable. The possibilities are termed the ''horns'' of the dilemma, a clichéd usage, but dist ...
or crisis. Sometimes, no good solution to a dilemma in medical ethics exists, and occasionally, the values of the medical community (i.e., the hospital and its staff) conflict with the values of the individual patient, family, or larger non-medical community. Conflicts can also arise between health care providers, or among family members. For example, some argue that the principles of autonomy and beneficence clash when patients refuse
blood transfusions
Blood transfusion is the process of transferring blood products into a person's circulation intravenously. Transfusions are used for various medical conditions to replace lost components of the blood. Early transfusions used whole blood, but mod ...
, considering them life-saving; and truth-telling was not emphasized to a large extent before the HIV era.
History
Ancient world
Prehistoric medicine
Prehistoric medicine is any use of medicine from before the invention of writing and the documented history of medicine. Because the timing of the invention of writing per culture and region, the term "prehistoric medicine" encompasses a wide r ...
incorporated plants (
herbalism
Herbal medicine (also herbalism) is the study of pharmacognosy and the use of medicinal plants, which are a basis of traditional medicine. With worldwide research into pharmacology, some herbal medicines have been translated into modern reme ...
), animal parts, and minerals. In many cases these materials were used ritually as magical substances by priests,
shamans
Shamanism is a religious practice that involves a practitioner (shaman) interacting with what they believe to be a spirit world through altered states of consciousness, such as trance. The goal of this is usually to direct spirits or spiritu ...
, or
medicine men
A medicine man is a traditional healer and spiritual leader among the indigenous people of the Americas.
Medicine Man or The Medicine Man may also refer to:
Films
* ''The Medicine Man'' (1917 film), an American silent film directed by Clifford S ...
. Well-known spiritual systems include
animism
Animism (from Latin: ' meaning ' breath, spirit, life') is the belief that objects, places, and creatures all possess a distinct spiritual essence. Potentially, animism perceives all things— animals, plants, rocks, rivers, weather syst ...
(the notion of inanimate objects having spirits),
spiritualism
Spiritualism is the metaphysical school of thought opposing physicalism and also is the category of all spiritual beliefs/views (in monism and Mind-body dualism, dualism) from ancient to modern. In the long nineteenth century, Spiritualism (w ...
(an appeal to gods or communion with ancestor spirits);
shamanism (the vesting of an individual with mystic powers); and
divination (magically obtaining the truth). The field of
medical anthropology
Medical anthropology studies "human health and disease, health care systems, and biocultural adaptation". It views humans from multidimensional and ecological perspectives. It is one of the most highly developed areas of anthropology and applie ...
examines the ways in which culture and society are organized around or impacted by issues of health, health care and related issues.
Early records on medicine have been discovered from
ancient Egyptian medicine,
Babylonian Medicine
Babylonia (; Akkadian: , ''māt Akkadī'') was an ancient Akkadian-speaking state and cultural area based in the city of Babylon in central-southern Mesopotamia (present-day Iraq and parts of Syria). It emerged as an Amorite-ruled state ...
,
Ayurvedic medicine (in the
Indian subcontinent
The Indian subcontinent is a list of the physiographic regions of the world, physiographical region in United Nations geoscheme for Asia#Southern Asia, Southern Asia. It is situated on the Indian Plate, projecting southwards into the Indian O ...
),
classical Chinese medicine
Traditional Chinese medicine (TCM) is an alternative medical practice drawn from traditional medicine in China. It has been described as "fraught with pseudoscience", with the majority of its treatments having no logical mechanism of action ...
(predecessor to the modern
traditional Chinese medicine
Traditional Chinese medicine (TCM) is an alternative medical practice drawn from traditional medicine in China. It has been described as "fraught with pseudoscience", with the majority of its treatments having no logical mechanism of acti ...
), and
ancient Greek medicine and
Roman medicine.
In Egypt,
Imhotep (3rd millennium BCE) is the first physician in history known by name. The oldest
Egyptian medical text is the ''
Kahun Gynaecological Papyrus
The Kahun Gynaecological Papyrus (also Petrie Medical Papyrus, Kahun Medical Papyrus, Lahun Medical Papyrus, or UC32057) is the oldest known medical text in Egypt, although not the oldest in the world as in Philadelphia museum a Sumerian medical c ...
'' from around 2000 BCE, which describes gynaecological diseases. The ''
Edwin Smith Papyrus'' dating back to 1600 BCE is an early work on surgery, while the ''
Ebers Papyrus'' dating back to 1500 BCE is akin to a textbook on medicine.
In China, archaeological evidence of medicine in Chinese dates back to the
Bronze Age
The Bronze Age is a historic period, lasting approximately from 3300 BC to 1200 BC, characterized by the use of bronze, the presence of writing in some areas, and other early features of urban civilization. The Bronze Age is the second prin ...
Shang Dynasty
The Shang dynasty (), also known as the Yin dynasty (), was a Chinese royal dynasty founded by Tang of Shang (Cheng Tang) that ruled in the Yellow River valley in the second millennium BC, traditionally succeeding the Xia dynasty and ...
, based on seeds for herbalism and tools presumed to have been used for surgery. The ''
Huangdi Neijing
''Huangdi Neijing'' (), literally the ''Inner Canon of the Yellow Emperor'' or ''Esoteric Scripture of the Yellow Emperor'', is an ancient Chinese medical text or group of texts that has been treated as a fundamental doctrinal source for Chines ...
'', the progenitor of Chinese medicine, is a medical text written beginning in the 2nd century BCE and compiled in the 3rd century.
In India, the surgeon
Sushruta described numerous surgical operations, including the earliest forms of
plastic surgery
Plastic surgery is a surgical specialty involving the restoration, reconstruction or alteration of the human body. It can be divided into two main categories: reconstructive surgery and cosmetic surgery. Reconstructive surgery includes cranio ...
.
Earliest records of dedicated hospitals come from Mihintale in
Sri Lanka where evidence of dedicated medicinal treatment facilities for patients are found.
![HSAsclepiusKos retouched](https://upload.wikimedia.org/wikipedia/commons/1/1c/HSAsclepiusKos_retouched.jpg)
In Greece, the
Greek physician Hippocrates
Hippocrates of Kos (; grc-gre, Ἱπποκράτης ὁ Κῷος, Hippokrátēs ho Kôios; ), also known as Hippocrates II, was a Greek physician of the classical period who is considered one of the most outstanding figures in the history o ...
, the "father of modern medicine",
[The father of modern medicine: the first research of the physical factor of tetanus](_blank)
, European Society of Clinical Microbiology and Infectious Diseases laid the foundation for a rational approach to medicine. Hippocrates introduced the
Hippocratic Oath for physicians, which is still relevant and in use today, and was the first to categorize illnesses as
acute
Acute may refer to:
Science and technology
* Acute angle
** Acute triangle
** Acute, a leaf shape in the glossary of leaf morphology
* Acute (medicine), a disease that it is of short duration and of recent onset.
** Acute toxicity, the adverse eff ...
,
chronic,
endemic
Endemism is the state of a species being found in a single defined geographic location, such as an island, state, nation, country or other defined zone; organisms that are indigenous to a place are not endemic to it if they are also found else ...
and epidemic, and use terms such as, "exacerbation,
relapse
In internal medicine, relapse or recidivism is a recurrence of a past (typically medical) condition. For example, multiple sclerosis and malaria often exhibit peaks of activity and sometimes very long periods of dormancy, followed by relapse or ...
, resolution, crisis,
paroxysm
Paroxysmal attacks or paroxysms (from Greek παροξυσμός) are a sudden recurrence or intensification of symptoms, such as a spasm or seizure. These short, frequent symptoms can be observed in various clinical conditions. They are usually ...
, peak, and
convalescence
Convalescence is the gradual recovery of health and strength after illness or injury. It refers to the later stage of an infectious disease or illness when the patient recovers and returns to previous health, but may continue to be a source of ...
".
The Greek physician
Galen
Aelius Galenus or Claudius Galenus ( el, Κλαύδιος Γαληνός; September 129 – c. AD 216), often Anglicized as Galen () or Galen of Pergamon, was a Greek physician, surgeon and philosopher in the Roman Empire. Considered to be one ...
was also one of the greatest surgeons of the ancient world and performed many audacious operations, including brain and eye surgeries. After the fall of the
Western Roman Empire
The Western Roman Empire comprised the western provinces of the Roman Empire at any time during which they were administered by a separate independent Imperial court; in particular, this term is used in historiography to describe the period ...
and the onset of the
Early Middle Ages
The Early Middle Ages (or early medieval period), sometimes controversially referred to as the Dark Ages, is typically regarded by historians as lasting from the late 5th or early 6th century to the 10th century. They marked the start of the Mi ...
, the Greek tradition of medicine went into decline in Western Europe, although it continued uninterrupted in the
Eastern Roman (Byzantine) Empire.
Most of our knowledge of ancient
Hebrew medicine Jewish medicine is medical practice of the Jewish people, including writing in the languages of both Hebrew and Arabic. 28% of Nobel Prize winners in medicine have been Jewish, although Jews comprise less than 0.2% of the world's population.
Hist ...
during the
1st millennium BC comes from the
Torah
The Torah (; hbo, ''Tōrā'', "Instruction", "Teaching" or "Law") is the compilation of the first five books of the Hebrew Bible, namely the books of Genesis, Exodus, Leviticus, Numbers and Deuteronomy. In that sense, Torah means the ...
, i.e. the Five Books of
Moses, which contain various health related laws and rituals. The Hebrew contribution to the development of modern medicine started in the
Byzantine Era
The Byzantine calendar, also called the Roman calendar, the Creation Era of Constantinople or the Era of the World ( grc, Ἔτη Γενέσεως Κόσμου κατὰ Ῥωμαίους, also or , abbreviated as ε.Κ.; literal translation of ...
, with the physician
Asaph the Jew Asaph the Jew ( ''Assaf HaYehudi''), also known as Asaph ben Berechiah and Asaph the Physician ( ''Asaph HaRofe'') is a figure mentioned in the ancient Jewish medical text the ''Sefer Refuot'' (lit. “Book of Medicines”). Thought by some to have ...
.
Middle Ages
![Al-Risalah al-Dhahabiah](https://upload.wikimedia.org/wikipedia/commons/b/b3/Al-Risalah_al-Dhahabiah.JPG)
The concept of hospital as institution to offer medical care and possibility of a cure for the patients due to the ideals of Christian charity, rather than just merely a place to die, appeared in the
Byzantine Empire
The Byzantine Empire, also referred to as the Eastern Roman Empire or Byzantium, was the continuation of the Roman Empire primarily in its eastern provinces during Late Antiquity and the Middle Ages, when its capital city was Constantinopl ...
.
Although the concept of
uroscopy
Uroscopy is the historical medical practice of visually examining a patient's urine for pus, blood, or other symptoms of disease.
The first records of uroscopy as a method for determining symptoms of an illness date back to the 4th millennium BC, ...
was known to Galen, he did not see the importance of using it to localize the disease. It was under the Byzantines with physicians such of
Theophilus Protospatharius
Theophilus Protospatharius ( el, Θεόφιλος Πρωτοσπαθάριος; ca. 7th century) was the author of several extant Greek medical works of uncertain status, either from Philaretus or Philotheus. Nothing is known of his life or the ti ...
that they realized the potential in uroscopy to determine disease in a time when no microscope or stethoscope existed. That practice eventually spread to the rest of Europe.
After 750 CE, the Muslim world had the works of Hippocrates, Galen and Sushruta translated into
Arabic
Arabic (, ' ; , ' or ) is a Semitic language spoken primarily across the Arab world.Semitic languages: an international handbook / edited by Stefan Weninger; in collaboration with Geoffrey Khan, Michael P. Streck, Janet C. E.Watson; Walter ...
, and
Islamic physicians engaged in some significant medical research. Notable Islamic medical pioneers include the
Persian
Persian may refer to:
* People and things from Iran, historically called ''Persia'' in the English language
** Persians, the majority ethnic group in Iran, not to be conflated with the Iranic peoples
** Persian language, an Iranian language of the ...
polymath
A polymath ( el, πολυμαθής, , "having learned much"; la, homo universalis, "universal human") is an individual whose knowledge spans a substantial number of subjects, known to draw on complex bodies of knowledge to solve specific pro ...
,
Avicenna, who, along with Imhotep and Hippocrates, has also been called the "father of medicine". He wrote ''
The Canon of Medicine
''The Canon of Medicine'' ( ar, القانون في الطب, italic=yes ''al-Qānūn fī al-Ṭibb''; fa, قانون در طب, italic=yes, ''Qanun-e dâr Tâb'') is an encyclopedia of medicine in five books compiled by Persian physician-phi ...
'' which became a standard medical text at many medieval European
universities
A university () is an institution of higher (or tertiary) education and research which awards academic degrees in several academic disciplines. Universities typically offer both undergraduate and postgraduate programs. In the United States, ...
, considered one of the most famous books in the history of medicine. Others include
Abulcasis
Abū al-Qāsim Khalaf ibn al-'Abbās al-Zahrāwī al-Ansari ( ar, أبو القاسم خلف بن العباس الزهراوي; 936–1013), popularly known as al-Zahrawi (), Latinised as Albucasis (from Arabic ''Abū al-Qāsim''), was ...
,
Avenzoar,
Ibn al-Nafis, and
Averroes
Ibn Rushd ( ar, ; full name in ; 14 April 112611 December 1198), often Latinized as Averroes ( ), was an
Andalusian polymath and jurist who wrote about many subjects, including philosophy, theology, medicine, astronomy, physics, psy ...
. Persian physician
Rhazes
Abū Bakr al-Rāzī (full name: ar, أبو بکر محمد بن زکریاء الرازي, translit=Abū Bakr Muḥammad ibn Zakariyyāʾ al-Rāzī, label=none), () rather than ar, زکریاء, label=none (), as for example in , or in . In m ...
[copy]
was one of the first to question the Greek theory of
humorism
Humorism, the humoral theory, or humoralism, was a system of medicine detailing a supposed makeup and workings of the human body, adopted by Ancient Greek and Roman physicians and philosophers.
Humorism began to fall out of favor in the 1850s ...
, which nevertheless remained influential in both medieval Western and medieval
Islamic medicine
In the history of medicine, "Islamic medicine" is the science of medicine developed in the Middle East, and usually written in Arabic, the ''lingua franca'' of Islamic civilization.
Islamic medicine adopted, systematized and developed the medi ...
. Some volumes of
Rhazes
Abū Bakr al-Rāzī (full name: ar, أبو بکر محمد بن زکریاء الرازي, translit=Abū Bakr Muḥammad ibn Zakariyyāʾ al-Rāzī, label=none), () rather than ar, زکریاء, label=none (), as for example in , or in . In m ...
's work ''Al-Mansuri'', namely "On Surgery" and "A General Book on Therapy", became part of the medical curriculum in European universities. Additionally, he has been described as a doctor's doctor, the father of
pediatrics,
and a pioneer of
ophthalmology
Ophthalmology ( ) is a surgical subspecialty within medicine that deals with the diagnosis and treatment of eye disorders.
An ophthalmologist is a physician who undergoes subspecialty training in medical and surgical eye care. Following a medic ...
. For example, he was the first to recognize the reaction of the eye's pupil to light.
The Persian
Bimaristan hospitals were an early example of
public hospital
A public hospital, or government hospital, is a hospital which is government owned and is fully funded by the government and operates solely off the money that is collected from taxpayers to fund healthcare initiatives. In some countries, this typ ...
s.
In Europe,
Charlemagne
Charlemagne ( , ) or Charles the Great ( la, Carolus Magnus; german: Karl der Große; 2 April 747 – 28 January 814), a member of the Carolingian dynasty, was King of the Franks from 768, King of the Lombards from 774, and the first ...
decreed that a hospital should be attached to each cathedral and monastery and the historian
Geoffrey Blainey
Geoffrey Norman Blainey (born 11 March 1930) is an Australian historian, academic, best selling author and commentator. He is noted for having written authoritative texts on the economic and social history of Australia, including '' The Tyranny ...
likened the
activities of the Catholic Church in health care during the Middle Ages to an early version of a welfare state: "It conducted hospitals for the old and orphanages for the young; hospices for the sick of all ages; places for the lepers; and hostels or inns where pilgrims could buy a cheap bed and meal". It supplied food to the population during famine and distributed food to the poor. This welfare system the church funded through collecting taxes on a large scale and possessing large farmlands and estates. The
Benedictine
, image = Medalla San Benito.PNG
, caption = Design on the obverse side of the Saint Benedict Medal
, abbreviation = OSB
, formation =
, motto = (English: 'Pray and Work')
, foun ...
order was noted for setting up hospitals and infirmaries in their monasteries, growing medical herbs and becoming the chief medical care givers of their districts, as at the great
Abbey of Cluny
Cluny Abbey (; , formerly also ''Cluni'' or ''Clugny''; ) is a former Benedictine monastery in Cluny, Saône-et-Loire, France. It was dedicated to Saint Peter.
The abbey was constructed in the Romanesque architectural style, with three churche ...
. The Church also established a network of
cathedral schools
Cathedral schools began in the Early Middle Ages as centers of advanced education, some of them ultimately evolving into medieval universities. Throughout the Middle Ages and beyond, they were complemented by the monastic schools. Some of these ...
and universities where medicine was studied. The
Schola Medica Salernitana
The Schola Medica Salernitana ( it, Scuola Medica Salernitana) was a Medieval medical school, the first and most important of its kind. Situated on the Tyrrhenian Sea in the south Italian city of Salerno, it was founded in the 9th century and rose ...
in Salerno, looking to the learning of
Greek
Greek may refer to:
Greece
Anything of, from, or related to Greece, a country in Southern Europe:
*Greeks, an ethnic group.
*Greek language, a branch of the Indo-European language family.
**Proto-Greek language, the assumed last common ancestor ...
and
Arab
The Arabs (singular: Arab; singular ar, عَرَبِيٌّ, DIN 31635: , , plural ar, عَرَب, DIN 31635: , Arabic pronunciation: ), also known as the Arab people, are an ethnic group mainly inhabiting the Arab world in Western Asia, ...
physicians, grew to be the finest medical school in Medieval Europe.
![SantaMariaDellaScalaSienaBack](https://upload.wikimedia.org/wikipedia/commons/f/f3/SantaMariaDellaScalaSienaBack.JPG)
However, the fourteenth and fifteenth century
Black Death devastated both the Middle East and Europe, and it has even been argued that Western Europe was generally more effective in recovering from the pandemic than the Middle East. In the early modern period, important early figures in medicine and anatomy emerged in Europe, including
Gabriele Falloppio
Gabriele Falloppio (also Gabrielle Falloppia) (1522/23 – 9 October 1562) was an Italian anatomist often known by his Latin name Fallopius. He was one of the most important anatomists and physicians of the sixteenth century, giving his name ...
and
William Harvey
William Harvey (1 April 1578 – 3 June 1657) was an English physician who made influential contributions in anatomy and physiology. He was the first known physician to describe completely, and in detail, the systemic circulation and propert ...
.
The major shift in medical thinking was the gradual rejection, especially during the
Black Death in the 14th and 15th centuries, of what may be called the "traditional authority" approach to science and medicine. This was the notion that because some prominent person in the past said something must be so, then that was the way it was, and anything one observed to the contrary was an anomaly (which was paralleled by a similar shift in European society in general – see
Copernicus
Nicolaus Copernicus (; pl, Mikołaj Kopernik; gml, Niklas Koppernigk, german: Nikolaus Kopernikus; 19 February 1473 – 24 May 1543) was a Renaissance polymath, active as a mathematician, astronomer, and Catholic canon, who formulated ...
's rejection of
Ptolemy
Claudius Ptolemy (; grc-gre, Πτολεμαῖος, ; la, Claudius Ptolemaeus; AD) was a mathematician, astronomer, astrologer, geographer, and music theorist, who wrote about a dozen scientific treatises, three of which were of importance ...
's theories on astronomy). Physicians like
Vesalius
Andreas Vesalius (Latinized from Andries van Wezel) () was a 16th-century anatomist, physician, and author of one of the most influential books on human anatomy, ''De Humani Corporis Fabrica Libri Septem'' (''On the fabric of the human body'' '' ...
improved upon or disproved some of the theories from the past. The main tomes used both by medicine students and expert physicians were
Materia Medica and
Pharmacopoeia
A pharmacopoeia, pharmacopeia, or pharmacopoea (from the obsolete typography ''pharmacopœia'', meaning "drug-making"), in its modern technical sense, is a book containing directions for the identification of compound medicines, and published by ...
.
Andreas Vesalius
Andreas Vesalius (Latinized from Andries van Wezel) () was a 16th-century anatomist, physician, and author of one of the most influential books on human anatomy, ''De Humani Corporis Fabrica Libri Septem'' (''On the fabric of the human body'' ' ...
was the author of ''
De humani corporis fabrica
''De Humani Corporis Fabrica Libri Septem'' (Latin, lit. "On the fabric of the human body in seven books") is a set of books on human anatomy written by Andreas Vesalius (1514–1564) and published in 1543. It was a major advance in the history ...
'', an important book on
human anatomy. Bacteria and microorganisms were first observed with a microscope by
Antonie van Leeuwenhoek in 1676, initiating the scientific field
microbiology.
Independently from
Ibn al-Nafis,
Michael Servetus
Michael Servetus (; es, Miguel Serveto as real name; french: Michel Servet; also known as ''Miguel Servet'', ''Miguel de Villanueva'', ''Revés'', or ''Michel de Villeneuve''; 29 September 1509 or 1511 – 27 October 1553) was a Spanish th ...
rediscovered the
pulmonary circulation
The pulmonary circulation is a division of the circulatory system in all vertebrates. The circuit begins with deoxygenated blood returned from the body to the right atrium of the heart where it is pumped out from the right ventricle to the lungs ...
, but this discovery did not reach the public because it was written down for the first time in the "Manuscript of Paris" in 1546, and later published in the theological work for which he paid with his life in 1553. Later this was described by
Renaldus Columbus and
Andrea Cesalpino
Andrea Cesalpino ( Latinized as Andreas Cæsalpinus) (6 June 1524 – 23 February 1603) was a Florentine physician, philosopher and botanist.
In his works he classified plants according to their fruits and seeds, rather than alphabetically ...
.
Herman Boerhaave
Herman Boerhaave (, 31 December 1668 – 23 September 1738Underwood, E. Ashworth. "Boerhaave After Three Hundred Years." ''The British Medical Journal'' 4, no. 5634 (1968): 820–25. https://www.jstor.org/stable/20395297.) was a Dutch botanist, ...
is sometimes referred to as a "father of physiology" due to his exemplary teaching in Leiden and textbook 'Institutiones medicae' (1708).
Pierre Fauchard
Pierre Fauchard (January 2, 1679 – March 21, 1761) was a French physician, credited as being the "father of modern dentistry". He is widely known for writing the first complete scientific description of dentistry, ''Le Chirurgien Dentiste'' (''" ...
has been called "the father of modern dentistry".
Modern
![Paul-Louis Simond injecting plague vaccine June 4th 1898 Karachi](https://upload.wikimedia.org/wikipedia/commons/f/ff/Paul-Louis_Simond_injecting_plague_vaccine_June_4th_1898_Karachi.jpg)
Veterinary medicine was, for the first time, truly separated from human medicine in 1761, when the French veterinarian
Claude Bourgelat
Claude Bourgelat (27 March 1712 – 3 January 1779) was a French veterinary surgeon. He was a founder of scientifically informed veterinary medicine, and he created one of the earliest schools for training professional veterinarians.
Life a ...
founded the world's first veterinary school in Lyon, France. Before this, medical doctors treated both humans and other animals.
Modern scientific
biomedical research (where results are testable and
reproducible
Reproducibility, also known as replicability and repeatability, is a major principle underpinning the scientific method. For the findings of a study to be reproducible means that results obtained by an experiment or an observational study or in a ...
) began to replace early Western traditions based on herbalism, the Greek "
four humours
Humorism, the humoral theory, or humoralism, was a system of medicine detailing a supposed makeup and workings of the human body, adopted by Ancient Greek and Roman physicians and philosophers.
Humorism began to fall out of favor in the 1850s ...
" and other such pre-modern notions. The modern era really began with
Edward Jenner
Edward Jenner, (17 May 1749 – 26 January 1823) was a British physician and scientist who pioneered the concept of vaccines, and created the smallpox vaccine, the world's first vaccine. The terms ''vaccine'' and ''vaccination'' are derived f ...
's discovery of the
smallpox vaccine
The smallpox vaccine is the first vaccine to be developed against a contagious disease. In 1796, British physician Edward Jenner demonstrated that an infection with the relatively mild cowpox virus conferred immunity against the deadly smallpox ...
at the end of the 18th century (inspired by the method of
inoculation earlier practiced in Asia),
Robert Koch
Heinrich Hermann Robert Koch ( , ; 11 December 1843 – 27 May 1910) was a German physician and microbiologist. As the discoverer of the specific causative agents of deadly infectious diseases including tuberculosis, cholera (though the bacteri ...
's discoveries around 1880 of the transmission of disease by bacteria, and then the discovery of
antibiotics around 1900.
The post-18th century
modernity
Modernity, a topic in the humanities and social sciences, is both a historical period (the modern era) and the ensemble of particular socio-cultural norms, attitudes and practices that arose in the wake of the Renaissancein the "Age of Reas ...
period brought more groundbreaking researchers from Europe. From
Germany
Germany,, officially the Federal Republic of Germany, is a country in Central Europe. It is the second most populous country in Europe after Russia, and the most populous member state of the European Union. Germany is situated betwe ...
and Austria, doctors
Rudolf Virchow
Rudolf Ludwig Carl Virchow (; or ; 13 October 18215 September 1902) was a German physician, anthropologist, pathologist, prehistorian, biologist, writer, editor, and politician. He is known as "the father of modern pathology" and as the founder ...
,
Wilhelm Conrad Röntgen
Wilhelm may refer to:
People and fictional characters
* William Charles John Pitcher, costume designer known professionally as "Wilhelm"
* Wilhelm (name), a list of people and fictional characters with the given name or surname
Other uses
* Mount ...
,
Karl Landsteiner
Karl Landsteiner (; 14 June 1868 – 26 June 1943) was an Austrian-born American biologist, physician, and immunologist. He distinguished the main blood groups in 1900, having developed the modern system of classification of blood groups from ...
and
Otto Loewi
Otto Loewi (; 3 June 1873 – 25 December 1961) was a German-born pharmacologist and psychobiologist who discovered the role of acetylcholine as an endogenous neurotransmitter. For his discovery he was awarded the Nobel Prize in Physiology or M ...
made notable contributions. In the
United Kingdom
The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Europe, off the north-western coast of the European mainland, continental mainland. It comprises England, Scotlan ...
,
Alexander Fleming,
Joseph Lister
Joseph Lister, 1st Baron Lister, (5 April 182710 February 1912) was a British surgeon, medical scientist, experimental pathologist and a pioneer of antiseptic surgery and preventative medicine. Joseph Lister revolutionised the craft of ...
,
Francis Crick and
Florence Nightingale
Florence Nightingale (; 12 May 1820 – 13 August 1910) was an English social reformer, statistician and the founder of modern nursing. Nightingale came to prominence while serving as a manager and trainer of nurses during the Crimean War, i ...
are considered important.
Spanish
Spanish might refer to:
* Items from or related to Spain:
**Spaniards are a nation and ethnic group indigenous to Spain
**Spanish language, spoken in Spain and many Latin American countries
**Spanish cuisine
Other places
* Spanish, Ontario, Can ...
doctor
Santiago Ramón y Cajal
Santiago Ramón y Cajal (; 1 May 1852 – 17 October 1934) was a Spanish neuroscientist, pathologist, and histologist specializing in neuroanatomy and the central nervous system. He and Camillo Golgi received the Nobel Prize in Physiology or Me ...
is considered the father of modern
neuroscience
Neuroscience is the scientific study of the nervous system (the brain, spinal cord, and peripheral nervous system), its functions and disorders. It is a multidisciplinary science that combines physiology, anatomy, molecular biology, developme ...
.
From New Zealand and Australia came
Maurice Wilkins,
Howard Florey, and
Frank Macfarlane Burnet
Sir Frank Macfarlane Burnet, (3 September 1899 – 31 August 1985), usually known as Macfarlane or Mac Burnet, was an Australian virologist known for his contributions to immunology. He won a Nobel Prize in 1960 for predicting acquired immune ...
.
Others that did significant work include
William Williams Keen
William Williams Keen Jr. (January 19, 1837June 7, 1932) was an American physician and the first brain surgeon in the United States. During his lifetime, Keen worked with six American presidents.
Early life and education
Keen was born in Phila ...
,
William Coley
William Bradley Coley (January 12, 1862 – April 16, 1936) was an American bone surgeon and cancer researcher best known for his early contributions to the study of cancer immunotherapy. Although his work was not proven effective in his lifetime ...
,
James D. Watson
James Dewey Watson (born April 6, 1928) is an American molecular biologist, geneticist, and zoologist. In 1953, he co-authored with Francis Crick the academic paper proposing the double helix structure of the DNA molecule. Watson, Crick and ...
(United States);
Salvador Luria
Salvador Edward Luria (August 13, 1912 – February 6, 1991) was an Italian microbiologist, later a Naturalized citizen of the United States#Naturalization, naturalized U.S. citizen. He won the Nobel Prize in Physiology or Medicine in 1969, with ...
(Italy);
Alexandre Yersin
Alexandre Emile Jean Yersin (22 September 1863 – 1 March 1943) was a Swiss- French physician and bacteriologist. He is remembered as the co-discoverer of the bacillus responsible for the bubonic plague or pest, which was later named in hi ...
(Switzerland);
Kitasato Shibasaburō
Baron was a Japanese physician and bacteriologist. He is remembered as the co-discoverer of the infectious agent of bubonic plague in Hong Kong during an outbreak in 1894, almost simultaneously with Alexandre Yersin.
Kitasato was nominate ...
(Japan);
Jean-Martin Charcot,
Claude Bernard
Claude Bernard (; 12 July 1813 – 10 February 1878) was a French physiologist. Historian I. Bernard Cohen of Harvard University called Bernard "one of the greatest of all men of science". He originated the term '' milieu intérieur'', and the ...
,
Paul Broca
Pierre Paul Broca (, also , , ; 28 June 1824 – 9 July 1880) was a French physician, anatomist and anthropologist. He is best known for his research on Broca's area, a region of the frontal lobe that is named after him. Broca's area is involve ...
(France);
Adolfo Lutz
Adolfo Lutz (6 October 1855 – 18 December 1940) was a Brazilian physician, father of tropical medicine and medical zoology in Brazil, and a pioneer epidemiologist and researcher in infectious diseases.
Life
Lutz was born in Rio de Janeiro, on ...
(Brazil);
Nikolai Korotkov
Nikolai Sergeyevich Korotkov (also romanized Korotkoff; russian: Никола́й Серге́евич Коротко́в) ( – 14 March 1920) was a Russian Empire surgeon, a pioneer of 20th-century vascular surgery, and the inventor of auscul ...
(Russia);
Sir William Osler
Sir William Osler, 1st Baronet, (; July 12, 1849 – December 29, 1919) was a Canadian physician and one of the "Big Four" founding professors of Johns Hopkins Hospital. Osler created the first residency program for specialty training of phys ...
(Canada); and
Harvey Cushing
Harvey Williams Cushing (April 8, 1869 – October 7, 1939) was an American neurosurgeon, pathologist, writer, and draftsman. A pioneer of brain surgery, he was the first exclusive neurosurgeon and the first person to describe Cushing's disease. ...
(United States).
As science and technology developed, medicine became more reliant upon
medication
A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy ( pharmacotherapy) is an important part of the medical field and ...
s. Throughout history and in Europe right until the late 18th century, not only animal and plant products were used as medicine, but also human body parts and fluids.
Pharmacology developed in part from
herbalism
Herbal medicine (also herbalism) is the study of pharmacognosy and the use of medicinal plants, which are a basis of traditional medicine. With worldwide research into pharmacology, some herbal medicines have been translated into modern reme ...
and some drugs are still derived from plants (
atropine,
ephedrine
Ephedrine is a central nervous system (CNS) stimulant that is often used to prevent low blood pressure during anesthesia. It has also been used for asthma, narcolepsy, and obesity but is not the preferred treatment. It is of unclear benefit in ...
,
warfarin
Warfarin, sold under the brand name Coumadin among others, is a medication that is used as an anticoagulant (blood thinner). It is commonly used to prevent blood clots such as deep vein thrombosis and pulmonary embolism, and to prevent st ...
,
aspirin
Aspirin, also known as acetylsalicylic acid (ASA), is a nonsteroidal anti-inflammatory drug (NSAID) used to reduce pain, fever, and/or inflammation, and as an antithrombotic. Specific inflammatory conditions which aspirin is used to treat inc ...
,
digoxin,
''vinca'' alkaloids,
taxo
Banana passionfruit (''Passiflora'' supersect. ''Tacsonia''), also known as taxo and curuba, is a group of around 64 ''Passiflora'' species found in South America. Most species in this section are found in high elevation cloud forest habitats. Flo ...
l,
hyoscine
Scopolamine, also known as hyoscine, or Devil's Breath, is a natural or synthetically produced tropane alkaloid and anticholinergic drug that is formally used as a medication for treating motion sickness and postoperative nausea and vomiti ...
, etc.).
Vaccine
A vaccine is a biological preparation that provides active acquired immunity to a particular infectious or malignant disease. The safety and effectiveness of vaccines has been widely studied and verified. s were discovered by
Edward Jenner
Edward Jenner, (17 May 1749 – 26 January 1823) was a British physician and scientist who pioneered the concept of vaccines, and created the smallpox vaccine, the world's first vaccine. The terms ''vaccine'' and ''vaccination'' are derived f ...
and
Louis Pasteur.
The first antibiotic was
arsphenamine
Arsphenamine, also known as Salvarsan or compound 606, is a drug that was introduced at the beginning of the 1910s as the first effective treatment for syphilis, relapsing fever, and African trypanosomiasis.
This organoarsenic compound was the f ...
(Salvarsan) discovered by
Paul Ehrlich
Paul Ehrlich (; 14 March 1854 – 20 August 1915) was a Nobel Prize-winning German physician and scientist who worked in the fields of hematology, immunology, and antimicrobial chemotherapy. Among his foremost achievements were finding a cure ...
in 1908 after he observed that bacteria took up toxic dyes that human cells did not. The first major class of
antibiotics was the
sulfa drugs, derived by German chemists originally from
azo dyes.
Pharmacology has become increasingly sophisticated; modern
biotechnology
Biotechnology is the integration of natural sciences and engineering sciences in order to achieve the application of organisms, cells, parts thereof and molecular analogues for products and services. The term ''biotechnology'' was first used ...
allows drugs targeted towards specific physiological processes to be developed, sometimes designed for compatibility with the body to reduce
side-effects
In medicine, a side effect is an effect, whether therapeutic or adverse, that is secondary to the one intended; although the term is predominantly employed to describe adverse effects, it can also apply to beneficial, but unintended, consequence ...
.
Genomics and knowledge of
human genetics
Human genetics is the study of inheritance as it occurs in human beings. Human genetics encompasses a variety of overlapping fields including: classical genetics, cytogenetics, molecular genetics, biochemical genetics, genomics, population gene ...
and
human evolution
Human evolution is the evolutionary process within the history of primates that led to the emergence of '' Homo sapiens'' as a distinct species of the hominid family, which includes the great apes. This process involved the gradual development o ...
is having increasingly significant influence on medicine, as the causative
gene
In biology, the word gene (from , ; "... Wilhelm Johannsen coined the word gene to describe the Mendelian units of heredity..." meaning ''generation'' or ''birth'' or ''gender'') can have several different meanings. The Mendelian gene is a b ...
s of most monogenic
genetic disorder
A genetic disorder is a health problem caused by one or more abnormalities in the genome. It can be caused by a mutation in a single gene (monogenic) or multiple genes (polygenic) or by a chromosomal abnormality. Although polygenic disorders ...
s have now been identified, and the development of techniques in
molecular biology
Molecular biology is the branch of biology that seeks to understand the molecular basis of biological activity in and between cells, including biomolecular synthesis, modification, mechanisms, and interactions. The study of chemical and physi ...
,
evolution
Evolution is change in the heritable characteristics of biological populations over successive generations. These characteristics are the expressions of genes, which are passed on from parent to offspring during reproduction. Variation ...
, and
genetics
Genetics is the study of genes, genetic variation, and heredity in organisms.Hartl D, Jones E (2005) It is an important branch in biology because heredity is vital to organisms' evolution. Gregor Mendel, a Moravian Augustinian friar wor ...
are influencing medical technology, practice and decision-making.
Evidence-based medicine is a contemporary movement to establish the most effective
algorithms
In mathematics and computer science, an algorithm () is a finite sequence of rigorous instructions, typically used to solve a class of specific problems or to perform a computation. Algorithms are used as specifications for performing ...
of practice (ways of doing things) through the use of
systematic reviews and
meta-analysis
A meta-analysis is a statistical analysis that combines the results of multiple scientific studies. Meta-analyses can be performed when there are multiple scientific studies addressing the same question, with each individual study reporting me ...
. The movement is facilitated by modern global
information science
Information science (also known as information studies) is an academic field which is primarily concerned with analysis, collection, classification, manipulation, storage, retrieval, movement, dissemination, and protection of informatio ...
, which allows as much of the available evidence as possible to be collected and analyzed according to standard protocols that are then disseminated to healthcare providers. The
Cochrane Collaboration
Cochrane (previously known as the Cochrane Collaboration) is a British international charitable organisation formed to organise medical research findings to facilitate evidence-based choices about health interventions involving health profess ...
leads this movement. A 2001 review of 160 Cochrane systematic reviews revealed that, according to two readers, 21.3% of the reviews concluded insufficient evidence, 20% concluded evidence of no effect, and 22.5% concluded positive effect.
Quality, efficiency, and access
Evidence-based medicine, prevention of
medical error
A medical error is a preventable adverse effect of care (" iatrogenesis"), whether or not it is evident or harmful to the patient. This might include an inaccurate or incomplete diagnosis or treatment of a disease, injury, syndrome, behavior ...
(and other "
iatrogenesis
Iatrogenesis is the causation of a disease, a harmful complication, or other ill effect by any medical activity, including diagnosis, intervention, error, or negligence. "Iatrogenic", ''Merriam-Webster.com'', Merriam-Webster, Inc., accessed 2 ...
"), and avoidance of
unnecessary health care
Unnecessary health care (overutilization, overuse, or overtreatment) is health care provided with a higher volume or cost than is appropriate.
In the United States, where health care costs are the highest as a percentage of GDP, overuse was the ...
are a priority in modern medical systems. These topics generate significant political and public policy attention, particularly in the United States where healthcare is regarded as excessively costly but
population health
Population health has been defined as "the health outcomes of a group of individuals, including the distribution of such outcomes within the group". It is an approach to health that aims to improve the health of an entire human population. It ha ...
metrics lag similar nations.
Globally, many
developing countries
A developing country is a sovereign state with a lesser developed industrial base and a lower Human Development Index (HDI) relative to other countries. However, this definition is not universally agreed upon. There is also no clear agreem ...
lack access to care and
access to medicines Access to medicines refers to the reasonable ability for people to get needed medicines required to achieve health. Such access is deemed to be part of the right to health as supported by international law since 1946.
The World Health Organization ...
. As of 2015, most wealthy developed countries provide
health care to all citizens, with a few exceptions such as the United States where lack of
health insurance coverage may limit access.
See also
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References
{{Authority control
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