Introduction to physics in modern medicine

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Bland-Altman Analysis for Method Comparisons. End-of-Life Care. What are Clinical Studies? Eosinophilic Pancreatitis with Psoriasis Vulgaris. Content Access Key:. Topics in Neurology Pp. End-of-Life Care Pp. Eosinophilic Pancreatitis with Psoriasis Vulgaris Pp. Related ebooks. The only change observed in the period is in Extraordinary Theoretical Medicine with the replacement of Tegni by Galen with the study of Salernitan questions, which was generated by medical didactic literature based on scholastic learning and structured around questions and answers.

Its greatest representative was Urso da Calabria, a professor from Salerno. The Salernitan questions brought together a collection on science and medicine written by an anonymous English author circa It was probably inspired by Regimen sanitatis , which since its inception had several titles, such as Medicina Salernitana , De conservanda bona valetudine and Flos Medicinae Scholae Salerni , and was the fundamental literary document of the School of Medicine of Salerno. The original nucleus contains almost three hundred verses, collected and commented in the thirteenth century by Arnoldo de Villanova, to which were added other aphorisms attributed indiscriminately to the School of Medicine of Salerno.

From to the inclusion of Aristotle. In , the rotulo records the following courses and readings. In ordinary classes in the first morning hour, the first chapter of Book I of Avicenna was read and reviewed in Theoretical Medicine.


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In the third morning hour in the subject of Ordinary Anatomy Ad anatomen cum ordinarijs anatomical inspection administrabit anatomem was performed. In Practical Medicine in the first hour after lunch, "Specific diseases below the heart" was read. With respect to extraordinary classes, in the first morning hour the Posterior analytics by Aristotle was studied in Logic Ad logica. Meteororum, ac. Parvorum naturalium Arist.

In the second morning hour, "Specific diseases between the head and the heart" was studied in Extraordinary Practical Medicine. In Extraordinary Theoretical Medicine, Tegni was read and discussed in the third morning hour and Ars parva , after lunch, both by Galen. After lunch on public holidays, Aphorisms by Hippocrates was discussed in Theoretical Medicine; also in the second hour on public holidays, the treatise "On fevers" was studied in About Book III by Avicenna.

Over the course of 38 years , several subjects were introduced in the medical curriculum, and these changes mainly reflect the professionalization and the importance of natural philosophy in medical training.

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Anatomy and Surgery were also raised to the status of curricular subjects. The ordinary subject of Botany and Pharmacology was included, in which Book I of Dioscorides about aromatic medicines was read. Although the curriculum of the late seventeenth century shows significant changes in medical theory, the classics including Hippocrates, Galen and Avicenna were retained, thereby showing the commitment of medical education in Padua to the classical tradition. Overriding proof of this commitment is witnessed in the examinations for a doctoral degree, which, according to the bylaws, consisted of a random selection of excerpts from the work of each of these authors.

Innovative aspects were introduced in the program of clinical practice, such as daily visits to hospitals, together with formal discussions of cases and systematic teaching of 'the urines' and 'the pulses. In Botany, the major innovation was the introduction of classes in the botanical garden.

It is important to stress the new Aristotle that was then read by future physicians - new in the sense that the texts introduced prioritized discussions on natural philosophy and method, and the acquisition and demonstration of knowledge, subjects close to the heart of Paduans of the period, such as Abano, Giulio Pace and Zabarella, among others. Between and , in the ordinary classes in Theoretical Medicine, Aphorisms by Hippocrates in the first morning hour; in Anatomy, inspections on the day and time established for the third morning hour; in Practical Medicine, De febribus in the first evening hour; in Philosophy, Books I and II of Physics by Aristotle in the second evening hour.

In almost half a century , the main changes were the introduction of the practical subject known as Demonstrations of Simple Substances, in which De purgantibus was read, and in Humanities, the reintroduction of the poetic form and tragedy of Aristotle, the introduction of Discussion on Book III of Meteororum by Aristotle and The theory of the planets according to ancient and modern hypotheses.

There is, in fact, a simplification of the curriculum content, when compared with that of the previous century, which was recorded in the statutes of Bologna's School of Medicine that included the texts listed below. In the first year in Theoretical Medicine, the Liber canonis by Avicenna; the treatises De differentiis febrium , De complexionibus , De mala complexione , De simplicibus medicinis , De diebus creticis , De interioribus , De regimine sanitatis by Galen; Aphorismata by Hippocrates.

In the second year, Tegni , De accidenti et morbo , De crisi , De diebus criticis , De febribus ad glaucone , De tabe , De utilitate respirationis , De differentiis febrium , De mala complexione , De simplicibus medicinis by Galen; De viribus cordis , Liber canonis by Avicenna; Prognostica , De morbis acutis by Hippocrates.

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It is important to note that the new and numerous editions of the period attest to the continued interest in these authors, by then accompanied by their interpreters, many of whom were more erudite and essentially critical. The works and their contents: the reception of Hippocratic and Galenic texts.

In the comment below, I focus on the subjects of Theoretical Medicine and Practical Medicine, since it was precisely in this area that the Galenic and Hippocratic texts featured predominantly. In the sixteenth and seventeenth centuries, Theoretical Medicine was the most important subject in the curriculum, using Book I of the Canon by Avicenna; Aphorisms by Hippocrates; and Tegni by Galen. In the other Theoretical Medicine subjects: Ad theoricam extraordinariam medicina and Ad theoricam extraord. The subject Ad lecturam tertio libri Avicennae , although considered the third most important theoretical subject, recorded readings related to practical medicine, such as Book III of the Canon of Avicenna, alternating with notions about fevers, specific diseases between the head and the heart and specific diseases below the heart.

The theoretical training was thus provided by the classics of Hippocrates, Galen and Avicenna, and the theoretical content focused on ideas about the body matter and its behavior in the face of illness and the environment, conceived in the classical and Alexandrian period and later interpreted by the Arab world. Chapter 1 of Book I of the Canon by Avicenna was the first reading on the syllabus of Theoretical Medicine and it introduced notions of the Hippocratic-Galenic physiology of the four elements, four temperaments, four seasons, four humors, the organs, the spirits natural, vital and animal , the forces, the faculties of the soul, the actions, as well as Galen's six non-natural factors air, food and drink, sleep and wakefulness, motion and rest, evacuation and retention, feelings and emotions ; and notions of pathology such as diseases and their causes, concepts of semiology, symptomatology, pulse and urine, the crises and critical days, the plethoras and prognosis.

The material is quite similar to that of the introduction to Tegni , by Galen, and is entitled Isagoge. Avicenna plays little part in the introduction, which is almost fully recovered in his first chapter of Book I of the Canon of medicine.


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The text begins with the presentation of the divisions between theoretical and practical medicine. The first of these was subdivided into three essential parts: natural, non-natural and anti-natural things. There were seven natural things: the elements water, fire, earth and air ; the mixtures wet, dry, hot, cold, and their possible combinations ; the humors blood, phlegm or pituita, black bile and yellow bile ; the body members brain, heart, liver and testes, considered major members, and nerves, veins, arteries and spermatic vessels, deemed secondary members ; the natural faculties the potential of each body part, such as nutrition, growth and attraction ; the functions activity or action of the parties ; the spirits natural, vital and animal ; as well as four additional natural things: the age brackets childhood, adolescence, youth, maturity and old age ; the color of the body parts; the state of the body, and sexual differences.

With respect to non-natural things, all of which are outside the body, there are weather, exercise, bathing and diet, sleep and sexual activity and emotions or accidents of the soul. The anti-natural things, or diseases, are classified according to symptoms, appearance, parts of the body affected and their causes. Practical medicine, on the other hand, dealt with the conservation of health, which was preserved by considering the six natural things air, food, drink, sleep and wakefulness, evacuation and retention, movement and rest and the emotions; with the elimination of disease through dietary prescription; with medicine, taking into account the quality thereof or their effect against to disease, quantity temperament and strength , dosage, time of administration and choice thereof; and, finally, with surgery.

Considered by some historians as the greatest physician of all time, Abu-Ali-Husayn ibn Abdallah ibn-Sina, known in the West as Avicenna, was born in Bukhara in Central Asia in and died in He was the Prime Minister and physician at the court of the ruler of Bukhara and wrote over a hundred books, sixteen of which were about medicine.

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His work Kitab al-Qanun fi al-Tibb , known as the Canon of medicine , was translated into Latin for the first time in , and was prescribed reading in university studia across Christian Europe from the second half of the thirteenth century onwards Ferre, p. The Canon of medicine is considered Avicenna's masterpiece and was a benchmark and the basis for medical studies in East and West for seven centuries, since it was widely taught in the majority schools.

It was the first clear and orderly compendium of the medical knowledge of the time, written in a didactic way, in short paragraphs, comprising a medical encyclopedia of five books now volumes.

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It synthesized the thoughts of Hippocrates and Galen, as well as Aristotle's biological conceptions, enriched with the author's observations. Its introduction in the medical curriculum of studia was linked to the introduction of the 'new Galen' 3 , considered preliminary reading for a clearer understanding of medical thought.

In Book I of the Canon of medicine , as mentioned, Avicenna describes the general principles and theories of medicine, physiology, etiology, symptomatology, dietetics, preventive medicine, psychotherapy and therapeutics. There are also notions of the anatomy and pathology of various organs. In Book II, the therapeutic properties of single drugs are described and listed alphabetically; it also deals with the preparation of medicines as well as pharmacology.

In Book III there are detailed descriptions of the diseases located in the body "between the head and the heart" , all accompanied by a therapeutic proposition. Book IV is devoted to general diseases, signs and symptoms, diagnostics, prognostics, fevers, tumors, wounds, fractures, bites, poisoning, minor surgery and cosmetic care. Lastly, Book V is drafted in list form and describes medical prescriptions and medicinal preparations, listing medical compounds. Books II and V, devoted to pharmacology, were omitted by Dioscorides, possible due to the difficulties in terminology and identification of the plants indicated.

On the other hand, Books III and IV, organized in a didactic and pedagogic manner, served as valuable reference material in clinical practice, being widely used in universities and elsewhere. For its part, the compendium known as Aphorisms had been the most widely known Hippocratic treatise since antiquity.

Credited to Hippocrates, the compendium synthesizes the medical knowledge of ancient Greek physicians and was designed for memorization and practice. The seven books or sections particole that compose it are made up of 'aphorisms,' a term coined by Rabelais when translating the work into the French language. The first book or section deals with diets and purgation; the second with sleep and health; the third with the influence of climate and temperature on health and infirmity in different age groups; the fourth returns to the theme of purgation in the context of diagnostics, especially by examining the urine; the fifth deals with spasms, epilepsy, diseases of the breast and cure thereof and ailments in women, a theme that brought together the greatest number of gynecological aphorisms of the treatise; the sixth, diagnostics, prognostics and therapies; and the seventh addresses symptoms and the identification of infirmities.

The introduction describes the different modes of exposition suitable for the art of medicine: that which derives the notion of an end, by means of analysis decomposition ; bringing together the analytical findings composition ; and the dialysis of a definition separation , that Galen claimed to be a type of explanation or simplification Galen, , passage , p.

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For Galen, dialysis permitted affirmations derived from conclusions based on practical demonstrations, making possible the creation of a set of true principles, including the definition of medical art as knowledge of health, disease and "what is neither one thing nor the other" Galen, , passage , p. Galen identified three categories to which this definition applied - the body, the causes and the signs - and divided the text into three parts. In the first, he considered the body in a state of health, morbidity and neutrality; in the second, he presented the Galenic doctrine of signs and symptoms; and in the third, he presented the theory of the Galenic causes in relation to morbid ailments.

The order of exposition followed the logical order of clinical practice, because, according to Galen, diagnosis was only possible from observation of the signs, after consideration of which one could seek for the causes of states of health passage , pp. The health of the body was conceived as a good blend of simple substances, namely the primary parts elements and qualities and a good proportion of the organs that they comprised position, size, shape and numbers of parts. Illness was the result of a poor blend of elements, attributes and parts of the body.

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The signs enabled the diagnosis of the current condition, the prognosis of future states and mnemonic investigation of the past. The observation of the signs was performed on the basis of the principles of Galenic physiology: the brain, the heart, the liver and the testicles as well as their subservient parts - the nerves and spinal cord, the arteries, the veins and spermatic duct, respectively.

After considering the three possible states health, disease and neutrality for each of the main parts, Galen presented his famous theory of necessary causes of disease, immortalized by medieval medicine as the theory of the six non-naturals: the air and the environment, movement and rest, sleep and wakefulness, drinks and food, evacuation and repletion, and "what happens to the soul" feelings and emotions. The text concludes with the presentation of other works by Galen and the order in which they should be read. In general terms, Tegni reflects the Galenic interpretation of certain Hippocratic treaties such as his comments on On airs, waters, and places , Prognostics , On regimen in acute diseases and topics about humors, among others.

If we consider that the three studies Tegni , chapter 1 of Book I of the Canon and Aphorisms repeated the same theoretical notions, we can deduce that theoretical teaching was a type of memorization of inherited notions that were to be reproduced without significant changes. Avicenna's theory of fevers and his description of specific diseases were also based on Galenic treatises 4 , which were in turn based on Hippocratic 5 treatises.

The advantage of Avicenna's text was its succinct and systematic character, ideally suited to teaching and memorization. Liber ad Almansorem or Nonus Almansoris , by Rhazes, is one of the most important examples of the transmission of classical medical thinking. The sources of the first book on the purchase of slaves, and the third on dietetics, were Hippocrates, Galen, Oribasius, Aetius and Paul of Aegina; the fourth book contains the hygiene of Galen; the fifth focuses on dermatology; the sixth is also derived from the Greek authors, and addresses the diet of workers; the seventh is devoted to surgery, being almost exclusively derived from the surgical treatises of Corpus hipocraticum by Paul of Aegina, Synopsis of Galen by Oribasius, and the works of Aetius; the eighth deals with toxicology; and the ninth considers the diseases that affect the body between the head and the heart.

This last chapter was featured the most in the curricula of the period addressed here.

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