Medicine
The medicine (from the Latin ars medicinae, " medical art " the " medicine " ) is the study of the prevention, detection and treatment of disease and injury in humans and animals. It is exercised by physicians, by the members of other recognized health professions, and of other therapists such as naturopaths, registered in Germany with the aim of restoring the health of the patient or to receive. In the area of medicine include not only human medicine, veterinary medicine ( veterinary / animal medicine), in a further understanding of the Phytomedicine ( controlling plant pests and diseases ). In this comprehensive sense medicine is the science of healthy and diseased organisms.
The cultural history knows a large number of different medical teaching buildings, starting with the doctors schools in Europe and Asia antiquity to the modern variety of scientific and alternative offers. The medicine also includes applied research their representatives about the nature and function of the human ( human medicine from the Latin humanus ) and animal body ( veterinary medicine) in healthy and diseased state with which they want to improve their diagnoses and therapies. Scientific medicine makes use of the basics, have worked out the physics, chemistry, biology and psychology.
The doctrine of the healing art is rarely also called the Iatrik (pronounced Iátrik, from the Greek substantivized adjective ἰατρική [ τέχνη ], ancient greek pronunciation iatrikḗ [ techne ], " art of medicine " or " medical craft ", more often " iatrogenic " in compositions such as, " Pediatrics, "" psychiatric ").
Medicine
The medicine is a practical science of experience. Objectives are the prevention ( prophylaxis ) of disease or its complications; the curation ( healing ) of curable diseases, or palliation ( relief ) of symptoms in incurable situations. The rehabilitation ( recovery ) of the physical and mental abilities of the patients is the task of medicine. Create physicians and non-physician therapists for treatment plans and monitor the course of treatment in the patient record. These patient-related documents are the same documents of legal significance. In everyday medical scientific findings with the results of history taking, medical intuition and experience are combined in order to meet the individual patient's needs ideally.
The personal patient - physician relationship is essential that always arises when someone is looking for a health problem help. According to the medical historian, this relationship has changed fundamentally with the advent of modern medicine. The expertise and the authority of uniformly trained doctors has given them a dominant role, the barbers, stone cutters, as well as academic physicians of the old school with their mostly unsuccessful disease theories had not. The medical profession now has the broad power to define what constitutes disease and what medical and medico- political action should be taken against it. On the other hand, the civil society has also repeatedly tried ( in Germany since the late imperial age ) to circumcise the paternalistic discretion of doctors, first published about the 1884 ( Richard Kessler ) legal classification of medical interventions as personal injury, for which the consent of the patient is essential. It is now expected a deliberative power from therapists whose expertise includes the free decision-making power of the patient, not replaced. The obligation related to medical education is also under the influence of the conquered Nazi regime today internationally unchallenged; both internationally valid documents such as the Declaration of Helsinki and the national criminal law and the professional codes of the medical professions.
Both physicians and other health professionals use an analytical concept of disease - the disease as a malfunction of the organism. On the basis of a contract and trust relationship data for medical history (anamnesis) can be collected and a thorough clinical examination should be performed. Technical procedures for medical examination using a laboratory, imaging methods such as x-rays and many other test methods such as the electrocardiogram complement the information collected. For the medical art is to integrate the multitude of facts and observations to diagnose heard. Only a proper diagnosis allows the successful therapy. This analytical disease concept of scientific medicine - also adopted by many alternative therapists - largely replaced the ontological notions of earlier centuries. Controversial limiting cases of the disease definition, disabilities and mental illness, whose definition will always be socially.
Health system
The national legal and financial framework for the practice of medicine is the healthcare system allows a State dar. During the Middle Ages contributed churches and communities with hospitals and physicians employed a rudimentary form of health care. After the advent of powerful nation- states, this first subjected to the control and supervision of the health professional to be adopted approval regulations and fee schedules. Prussia abolished 1852, the outdated separation of the medical profession between surgeons and physicians from surgeons and closed the schools. At the instigation of liberal circles, including Rudolph Virchow belonged, allowed the first commercial order of the German Empire (1871 ) the choice of therapy for nichtapprobierte practitioner who remained with the valid today Naturopaths Act ( 1939).
Under the chancellorship of Otto von Bismarck, Germany was the world's first general social security system, with the inclusion of a statutory health insurance for all employees and their dependents, which now comprises 90 % of the population. Medical practitioners organized themselves against the initially overwhelming Administration ( Hartmannbund, 1900) and translated into doctors' strikes today's self-administration by, after which the panel doctors for ensuring the ambulatory patient care are solely responsible and ensure total remuneration received ( Emergency Ordinance, 1931). After the reunification of the usual outpatient clinics in the GDR were dissolved or converted into offices. The health authorities play no role in patient care outside of disasters. Inpatient medicine in hospitals, however, remained in a predominantly state-owned. German hospitals include supply contracts with health insurance companies and also receive investment subsidies from tax revenues, so have a dual financing that is completely separated from the physicians' rail. Numerous reforms of the health legislation have tried to prevent the resulting threat of a double supply of expensive infrastructure (such as major medical equipment ). Other industrialized countries have developed other solutions. So there are developed nations with national, tax-funded health systems ( as the National Health Service in the UK) or with largely unregulated provider markets ( so the health care system of the United States). In other European countries there are regulated markets with strong public sector; For example, bears in the German health system, the public sector over the statutory health insurance and the state hospital grants about 80 percent of the total expenditure for medical treatment.
With the increase of doctors and hospitals, improved technical capabilities, and demographic change was accompanied by a continuous increase in the cost of health care, were used against the numerous health reforms. They established not only scope of work and payment, but regulated, increasingly, the actual performance and quality control. About the thus introduced rationalization (efficiency gains ), implicit and explicit rationing ( power limitation ), and the achieved distributive justice debate society intense.
A common classification of medical care are three sectors:
- Primary health care (English primary care, " family medicine " ) is supported by doctors' offices, clinics and other public general hospital outpatient facilities. About 90 percent of acute and chronic health problems should be dealt with at this cost, nationwide level.
- The secondary supply (English secondary care, specialist care, " Medical Specialist " ) form established and salaried specialists all directions as well as other specialists who are working to transfer the primary physicians. The specialist treatment is outpatient or inpatient (after admission to a hospital ) instead. Within this sector, emergency rooms, intensive care units, operating rooms, laboratory and x-ray diagnostics, physical therapy are maintained.
- The tertiary care ( tertiary care, maximum care ) is based on specialized clinics and centers that serve larger regions or more cities with more expensive and complex services, such as accident and combustion hospitals, cancer centers, transplantation centers, hospitals and neonatal.
Spectrum of medicine
The variety of teaching and the increase in knowledge have led to a breakdown of the medicine in a large number of disciplines and sub-specialties.
The basis of scientific medicine, the natural sciences (biology, chemistry, physics ), especially human biology, anatomy, biochemistry, physiology, supplemented by psychology and social sciences (see, medical sociology, epidemiology, health monitoring and health economics ). In the German study medicine, these subjects are summarized as pre-clinical in the first section. Clinical sciences are concerned with the health treatment itself They include the traditional subjects of internal medicine and surgery, gynecology and obstetrics, and since about 1800 of Pediatrics. Younger specializations include ophthalmology, ear, nose and throat medicine, pulmonology, social medicine and psychiatry. In the 20th century, technology-oriented subjects such as radiology and radiotherapy, and subjects with integrative claim as geriatrics and palliative care formed. These medical specialties include subspecialties such as pediatric, neuroradiology, addiction medicine, and many others, the contents of which are codified, for example, in Germany in the pattern further education regulations of the German Medical Association.
Added to this are the areas of responsibility of other health professions, such as physiotherapy, speech therapy, medical- technical assistant, medical assistant, who, like the medical profession attained a high degree of specialization and professionalization. In particular, the nursing has developed from purely charitable assistance to an academic science and self- support of health care.
Besides this, state-sanctioned and controlled medicine, a variety of alternative or complementary medical services, which are by definition not taught in medical schools. Depending on their social status, some of these teachings and methods can still allow for some standardization and more academic subject ( by means of private associations and schools) and be included in the national health financing; in Germany, for example, the specific remedies homeopathy, herbal medicine, anthroposophic medicine and acupuncture. In the U.S., osteopathy is anchored similarly broad. Many complementary methods ( dietetics, order therapy, naturopathy ) are recognized by much of the medical profession practicing; other (traditional systems of medicine, folk medicine ), at least by many doctors. Countless unsecured methods and procedures are at the edge of the spectrum and only be used by individual clinicians; some are regarded as dangerous for the patient (eg, Clark therapy, Germanic New Medicine ). In the U.S. and in Germany attempts university medicine and complementary medicine are to combine, also with the slogan Integrative Medicine.
Due to the lack of theorizing the medicine can only be constrained referred to as science. The approach of evidence-based medicine seeks to remedy this situation by clinical decision-making is aligned with scientific knowledge, that is, forms of therapy will only be accepted if their effectiveness has been proven by clinical studies. At the basic trial- and-error approach of basic medical research, this progress so far nothing changed. However, the medicine, together with the natural sciences in today's scientific landscape, particularly in universities, a cornerstone of research and funding, which also her high reputation in the general public can be partially justified. This was clear in the last part of the Excellence Initiative.
History
In ancient times, different medical systems were formed in the cultures of China, India, and the Mediterranean out that in many cases changed and not mixed in the Western alternative medicine play a major role. Traditional Chinese medicine was about the second millennium BC from simple demons and ancestral healing cults; in the post-Confucian time they differentiated to the still existing natural-philosophical system of dual and elemental correspondences. The practical medicine dates from around 300 BC, the pharmacology was based on the work of Tao Hongjing acupuncture with the anonymous work Huangdi Neijing ( Inner Classic of the Yellow Prince ). In modern times, under the influence of the communist government and the increasing Western reception, the techniques have been perfected and standardized, abandoned the original magic demonology against it.
The Ayurvedic medicine of India has also been defined in 500 BC from the older, magical - theistic beliefs. It is based on a theoretical temperaments connected with an equilibrium physiology of the elements of air, bile and phlegm, practically on diet and meditation exercises. First written evidence to be found already in the Arthashastra; detailed textbooks come from Sushruta, and Chakara Vagbhata. Also, yoga is used for healing.
In medicine, the Egyptian, Greek and Roman antiquity rooted today used worldwide, Western medicine. Historians divide the ancient medicine into four phases. The first, theurgical - magical medicine treated the sick in temples and tried to elicit divine healing miracle. Your end is associated with the life time of Hippocrates of Kos. Hippocrates was named after, but certainly not the only source of a new natural philosophy of teaching elements and quality pathology that made medical action of the direct influence of the deities independent. The Hippocratic practice of diagnosis, therapy and prognosis is common today; the Hippocratic case descriptions are provided as the origin of modern scientific medicine. In the following Hellenistic phase formed next to the Hippocratic physicians more schools, such as the empiricists, the methodologists, or pneumatics. Finally, the Greco-Roman phase followed, characterized by outstanding writers such as Celsus, Galen and Dioscorus. Their anatomical, pharmacological and surgical certain plants next to the Hippocratic to the Enlightenment medical thinking in the West.
In the Byzantine era, the ancient idols were handed down and complemented by teaching pulse and urine inspection. After the fall of Constantinople took over the medical traditions and Islamic scholars developed schools of Botany, dietetics and surgery, including the outstanding work of Avicenna. The classical authors, mostly in Islamic translation and compilation, the core part of Western medicine remained until the 16th century. The most influential school of medicine existed in Salerno. New posts monastic medicine in the Middle Ages were astrological and theological components as well as the doctrine of signatures, after the medicinal plants by their external characteristics are visible - an idea that was picked up much later in a similar form of homeopathy again.
The term medicine originates from the Medicini who had dissected in 1302 in Bologna for the first time a corpse and this regularly conducted from 1306. After centuries of standstill, the doctors broke in the Renaissance of the antique models. The anatomist Andreas Vesalius was meaning and role model of a new type of scholars who wrote and endured contradictions to Hippocrates and Galen due to his own experience. At the same time revolutionized Ambroise Paré surgery, and Paracelsus rejected in its Iatrochemistry the Hippocratic theory of humors. In the 17th century began with the experiments of Francis Bacon, the age of scientific medicine, which continues to this day. The disease theories were not, as now established; only in the 19th century, the pathology sat against competing doctrines as the humoral or the Hufelandsche vitality through final.
The 20th century was finally marked by an enormous increase in knowledge and hence differentiation of numerous medical disciplines, such as bacteriology, hygiene, anesthesiology, social medicine or psychiatry. At the same time, industrialized countries increasingly gained the regulation of the health sector and it established itself in part a national health care system such as the NHS in England. Zerr and Schandbild of government supervision was the medicine under National Socialism. The current endpoint of the development is the evidence-based medicine and the widespread introduction of quality management systems in all areas of patient care.