It is of extreme importance in medicine to know accurately the anatomical changes that take place in a certain disease for diagnosis and treatment. The man who created this science was Morgagni who taught us to think anatomically in our approach of a disease. Morgagni studied at Bologna under Valsalva and Albertini, who are notable persons themselves in the history of medicine. Morgagni did this in the form of letters to an unknown friend who inquired about Morgagni's thoughts and observations in the diseases he had seen. These included affections of the pericardium, diseases of the valves, ulceration, rupture, dilation and hypertrophy of the aorta which were detailedly described clinically and anatomically. Of all his entires, the section on aneurysm of the aorta is one of the best he had written. A good example of his letter was about angina pectoris.
The aorta was considerably dilated at its curvature; and, in places, through its whole tract, the inner surface was unequal and ossified... The delay of blood in the aorta, in the heart, in the pulmonary vessels, and in the vena cave, would occasion the symptoms of which the woman complained during life; namely, the violent uneasiness, the difficulty of breathing, and the numbness of the arm.."
Morgagni, through this entry, showed also the importance of getting a good history from the patient. His anatomical approach in describing some diseases made it possible for his successors and those who read his wroks to fully understand the value of knowing the anatomy of the diseased organ.
This was followed by Thomas Sydenham, who emphasized the need to write a thorough and accurate history of the illness of the patient. He left these words to reiterate the importance of deriving the correct history in the study of medicine.
In writing therefore, such a natural history of diseases, every merely philosophical hypothesis should be set aside, and the manifest and natural phenomena, however minute, should be noted with the utmost exactness...By these steps and helps it was that the father of physic, the great Hippocrates, came to excel, his theory being no more than an exact description or view of nature. He found that nature alone often terminates diseases, and works a cure with a few simple medicines, and often enough with no medicines at all."
Boerhaave is perhaps the best clinical teacher. He was known to be flocked by students from all over Europe. He taught botany and chemistry and became a chair in the department of Physics after teaching these subjects.
Before the eighteenth century ended, practical medicine had made great leaps. Smallpox was prevalent and considered as one of the deadly diseases that persons who had it seldom reach adulthood it was Edward Jenner who invented the vaccine for smallpox. This made great leaps in the field of medicine that as 1800 began, modern medicine was already taking place.
Modern medicine was marked by a more systematic study of the disease, and specialty clinics were organized. Bichat showed that scientific study of medicine is important. He pointed out the pathological changes in disease were not so much in organs as in tissues, and he laid the foundation of modern histology. He wrote "Anatomic Generale" which was published in 1802 and paved the way for a thorough study of disease processes.
Rene Theophile Laennec, a renowned pupil of Corvisart, laid the foundation of modern clinical medicine through the use of one of the basic but important method in physical diagnosis. If Auenbrugger started percussion, Laennec discovered the art of auscultation, making clinical assessment more accurate than from doing by merely using the sense of touch in documenting observations. With the advent of the use of stethoscope, physical diagnosis was made more accurate and progressive, enabling a more thorough examination of visceral organs such as the lungs, heart and the cavities of the human body. His description of tuberculosis is the most helpful in clinical medicine. This method enabled correlation of the signs and symptoms of diseases with their anatomical changes.
This clinico-pathologic method widened enormously the diagnostic powers of the physician. Bright was able to do this when he studied the relation of disease of the kidney to dropsy and albuminous urine to which he discovered the association of various forms of disease of the kidney with anasarca and albuminous urine. Louis and company were able to distinctly differentiate typhus and typhoid fever. Virchow made researches on cellular pathology. Morgagni's method of "anatomical thinking," Skoda...
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