The practice of modern medicine

: 11/21

In some primitive elements of the societies of developing countries, and of some developed countries, there exists the belief that illness comes from the displeasure of ancestral gods and evil spirits, from the malign influence of evil disposed persons, or from natural phenomena that can neither he forecast nor controlled. To deal with such causes there are many varieties of indigenous healers who practice elaborate rituals on behalf of both the physically ill and the mentally afflicled. If it is understood that such beliefs, and other forms of shamanism, may provide a basis upon which health care can be based, then primary health care may he said to exist almost everywhere. It is not only easily available but also readily acceptable, and often preferred, to more rational methods of diagnosis and treatment. Although such methods may sometimes be harmful, they may often be effective, especially where the cause is psychosomatic. Other patients, however, may suffer from a disease for which there is a cure in modern medicine.

In order to improve the coverage of primary health-care services and lo spread more widely some of the benefits of Wesiern medicine, attempts have sometimes been made to tun.) a means of cooperation, or even integration, between traditional and modern medicine (see above India). In Aluca, for example, some such attempts are officially sponsored by ministries of health, state governments, universities, and the like, and they have the approval of WHO, which often lakes the lead in this activity. In view, however, of the historical relationships between these two systems of medicine, their different basic concepts, and the fuel that their methods cannot readily be combined, successful merging has been limited.

ALTERNATIVE OR COMPLEMENTARY MEDICINE

Persons dissatisfied with the methods of modern medicine or with its results sometimes seek help from those professing expertise in other, less conventional, and sometimes controversial, forms of health care. Such practitioners are not medically qualified unless they are combining such treatments with a regular (allopathic) practice, which includes osteopathy. In many countries the use of some forms, such as chiropractic, requires licensing and a degree from an approved college. The treatments afforded in these various practices are not always subjected to objective assessment, yet they provide services that are alternative, and sometimes complementary, to conventional practice. This group includes practitioners of homeopathy, naturopathy, acupuncture, hypnotism, and various meditative and quasi-religious forms. Numerous persons also seek out some form of faith healing to cure their ills, sometimes as a means of last resort. Religions commonly include some advents of miraculous curing within their scriptures. The belief in such curative powers has been in part responsible for the increasing popularity of the television, or "electronic," preacher in the United States, a phenomenon that involves millions of viewers. Millions of others annually visit religious shrines, such as the one at Lourdes in France, with the hope of being miraculously healed.

SPECIAL PRACTICES AND FIELDS OF MEDICINE

Specialties in medicine. At the beginning of World War II it was possible to recognize a number of major medical specialties, including internal medicine, obstetrics and gynecology, pediatrics, pathology, anesthesiology, ophthalmology, surgery, orthopedic surgery, plastic surgery, psychiatry and neurology, radiology, and urology. Hematology was also an important field of study, and microbiology and biochemistry were important medically allied specialties. Since World War II, however, there has been an almost explosive increase of knowledge in the medical sciences as well as enormous advances in technology as applicable to medicine. These developments have led to more and more specialization. The knowledge of pathology has been greatly extended, mainly by the use of the electron microscope; similarly microbiology, which includes bacteriology, expanded with the growth of such other subfields as virology (the study of viruses) and mycology (the study of yeasts and fungi in medicine). Biochemistry, sometimes called clinical chemistry or chemical pathology, has contributed to the knowledge of disease, especially in the field of genetics where genetic engineering has become a key to curing some of the most difficult diseases. Hematology also expanded after World War II with the development of electron microscopy. Contributions to medicine have come from such fields as psychology and sociology especially in such areas as mental disorders and mental handicaps. Clinical pharmacology has led to the development of more effective drugs and to the identification of adverse reactions. More recently established medical specialties are those of preventive medicine, physical medicine and rehabilitation, family practice, and nuclear medicine. In the United States every medical specialist must be certified by a board composed of members of the specialty in which certification is sought. Some type of peer certification is required in most countries.

: 11/11/2009