History of Clinical Medicine

Abstract

The history of clinical medicine reflects both the complex nature of the relationship between doctors and patients, and the slow evolution of knowledge in natural philosophy and, more recently, the biomedical sciences. This article provides an overview of these issues as they have developed over the last 2500 years, specifically focussing on the application of science and natural philosophy to the control and management of human disease. Despite the expansion of, and remarkable advances in, the biomedical sciences during the past two centuries, the multilayered complexities of disease processes and the ever changing environments of sick people ensure that clinical medicine still remains very much a mix of applied science and the art of healing.

Key Concepts:

  • The history of clinical medicine reflects the slow development of the science and art of medical care set against the background of changes in political, cultural, environmental and economic factors.

  • The Greco‐Roman concept that health reflects the balance of the four humours lasted for two millennia.

  • Disease was believed to reflect an imbalance of the humours.

  • During the Renaissance the humoural concept of disease was discarded and the fields of anatomy, chemistry and surgery began to influence the development of medical practice.

  • During the seventeenth century there were major advances in the understanding of human physiology and the importance of clinical practice at the bedside was emphasised.

  • During the eighteenth and nineteenth centuries the scientific basis of clinical care and the beginnings of statistical approaches to its applications continued to develop.

  • During the twentieth and early years of the twenty‐first centuries there were dramatic advances in every aspect of scientific medicine, culminating in the description of disease at the molecular level, and accompanied by changes in the patterns of provision of health care in many countries.

Keywords: Greco‐Roman medicine; Islamic medicine; communicable disease; public health; epidemiology

Figure 1.

Vesalius (1514–1564) anonymous engraving c. 1600. © Wellcome Library, London.

Figure 2.

William Harvey (1578–1657). © Wellcome Library, London.

Figure 3.

Microscope and lighting apparatus. From Robert Hooke, Micrographia (London: J Martyn and J Allestry, 1665). © Wellcome Library, London.

Figure 4.

Louis Pasteur (1822–1895). © Wellcome Library, London.

Figure 5.

Robert Koch (1843–1910). © Wellcome Library, London.

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References

Bynum WF (2008) The History of Medicine. A Very Short Introduction. Oxford: Oxford University Press.

Bynum WF, Hardy A, Jacyna S, Lawrence C and Tansey EM (2006) The Western Medical Tradition, 1800–2000. Cambridge: Cambridge University Press.

Bynum WF and Porter R (eds) (1993) Companion Encyclopedia of the History of Medicine, vol. 2. London: Routledge.

Further Reading

Conrad LI, Neve M, Nutton V, Porter R and Wear A (eds) (1995) The Western Medical Tradition 800 BC to AD1800. Cambridge: Cambridge University Press.

Cooter R and Pickstone J (eds) (2000) Medicine in the Twentieth Century. The Netherlands: Harwood Academic Publishers.

Grmek MD (ed.) (1998) Western Medical Thought from Antiquity to the Middle Ages. Cambridge, MA: Harvard University Press.

Jackson M (ed.) (2011) The Oxford Handbook of the History of Medicine. Oxford: Oxford University Press.

Judson HF (1979) The Eighth Day of Creation. Makers of the Revolution in Biology. London: Jonathan Cape Ltd. (Published in Penguine Books, London, 1995).

Porter R (1997) The Greatest Benefit to Mankind. A Medical History of Humanity from Antiquity to the Present. London: Harper Collins Publishers.

Porter R (2002) Blood and Guts. A Short History of Medicine. London: Penguin Books.

Weatherall DJ (1995) Science and the Quiet Art. Medical Research and Patient Care. Oxford: Oxford University Press.

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How to Cite close
Weatherall, MW, and Weatherall, DJ(Dec 2014) History of Clinical Medicine. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1002/9780470015902.a0003087.pub2]