The Transition of Knowledge from the Patient to the Doctor

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The Transition of Knowledge from the Patient to the Doctor

By Daniel Griffin

Over the past several hundred years, medicine has undergone a radical transformation. The field of medicine has moved from period of where the patient was once the most qualified person to help diagnose their own health complaints, to the period now where qualified doctors have the knowledge and medical expertise to diagnose and refer treatment for an extraordinary range of medical complications. These improvements in medicine have come thanks to years of anatomical research and huge advancements in science and technology. Medical technology has now worked alongside scientific technology for years and each and every stage of all illnesses around the world are now recorded and researched by medical professionals, helping to further improve medical technology for the future. It is the aim of this essay to identify what the most significant influences are to have helped to move medicine from the domain of the patient to the domain of the doctor.

Up until the 1800’s, the human body was still understood in terms of the four humours and fluids. There were very few medical Institutions and governments took almost no part in providing medical services.  A wide range of unqualified individuals provided medical care and offered dubious treatments such as herbal remedies and bloodletting.  Throughout this period, patients were usually diagnosed by doctors whose opinions were formed through Ancient Greek (Hippocratic) and Galen-era theories. These approaches largely consisted of the doctor listening to the patients story and then using their five senses to examine the general appearance, secretions, and excretions of the patient. These early practices of medicine were, needless to say, completely untested and largely based the superstitions and assumptions of a small number of historic physicians.  Therefore, due to the mystery and absence of understanding surrounding disease, infection, and human anatomy, the potential for diagnosis and treatment was bleak and largely dependent on the patients thoughts on their own health complaints; hence the general consensus at the time 'the patient knew best'.

However, some of the mystery regarding human the body was gradually alleviated largely thanks to dissections carried out by Vesalius, William Harvey, Leonardo Da Vinci, and others. Although their findings were not fully embraced for hundreds of years, these few were some of the first figures in history to perform dissections on the human body and publish their work (with the exception of Leonardo Da Vinci whose works remained private for a prolonged period of time). Books such as Vesalius’ ‘On the fabric of the human body’ in 1543, got the ball rolling for countless other anatomical discoveries and is widely recognised as one of the main contributors to the commencement of the ‘scientific revolution’. Up until this point all of our knowledge on human anatomy was drawn from superstition, religious philosophy, and animal dissections carried out by Greek physician Galen. Therefore, this progressive practice helped to eradicate uncertainty and superstition surrounding the human body, and from the 18th century onwards the study of anatomy was eventually accepted and taught by educational institutions worldwide. From then on students of medicine began to view the body as something that could be explained in terms of mechanics, biology, and chemistry, and practices such as bloodletting were gradually proven to be counterproductive and phased out.

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Even with these advancements in the understanding of the human body, there was still absolutely no awareness of germs and that poor hygiene, pollution from sewage, filthy water, and physical contact were responsible for the cause of many fatal infectious diseases. Up until the mid-nineteenth century, many people believed that diseases were punishment for a person's immoral or sinful behaviour, and when huge numbers of people became ill the disease was often blamed on foul odours from sewage. Many educated individuals believed that epidemics were also caused by poisonous vapours created by planetary movements causing disturbances within the Earth.

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