What is clinical medicine? Clinical medicine is a science to study the etiology, diagnosis, treatment and prognosis of diseases, improve the level of clinical treatment and promote human health. Clinic means “visiting the hospital bed in person”. It studies the etiology, pathogenesis and pathological process of the disease as a whole according to the patient’s clinical performance, and then determines the diagnosis.
Through prevention and treatment, it can weaken the disease, reduce the patient’s pain, restore the patient’s health and protect the labor force to the greatest extent. Clinical medicine is a science that directly faces diseases and patients and directly treats patients.
During the Renaissance of the 16th century, medical stereotypes were broken and human anatomy came into being. In the 17th century, physiology was established. In the 18th century, pathological anatomy was established. In the 19th century, cytology and bacteriology made great progress. Basic medicine and clinical medicine have gradually become two independent disciplines. The great progress in mathematics, biology, physics and chemistry has laid a solid foundation for the emergence of modern clinical medicine.
As early as prehistoric times, human beings began to accumulate experience in treating diseases and formed the rudiment of clinical medicine. Ancient China has formed a unique clinical system of traditional medicine in its long history. See traditional Chinese medicine for details. The EBS Papyrus of ancient Egypt recorded 205 kinds of diseases, including abscess incision, superficial mass resection, circumcision and other operations in surgery, sweating, vomiting, catharsis, diuresis and enema in internal medicine. The production of mummies also involves superb surgical knowledge.
Ancient India’s ashurveda recorded quite a lot of medicine and treatment experience. Medicine was divided into eight branches for the first time. The collection of jaraga and the collection of wonderful news are the famous works of internal medicine and surgery of ashurvedic medicine respectively.
The ancient Greek Anthology of Hippocrates recorded the surgical treatment of fractures, dislocations and head injuries. Galen of ancient Rome also made achievements in drug treatment. In ancient times, the distinction between basic medicine and clinical medicine was not clear. Limited by objective conditions, most of them focused on experience accumulation and lacked scientific and systematic sorting.
Sydenham T., 1624-1689, a 17th century doctor, proposed: “What is most directly related to doctors is neither anatomy practice nor physiology experiment, but patients suffering from diseases. Therefore, the task of doctors should first correctly explore the essence of pain, that is, they should observe the situation of patients, and then study anatomy, physiology and other knowledge, so as to derive the explanation and treatment of diseases.” Sidenham’s appeal received people’s support, and doctors began to return to patients to engage in clinical observation and research. Sidenham is also known as the “father of clinical medicine”.
In the 18th century, clinical teaching rose. Leiden University set up a special hospital bed for clinical teaching in the hospital. Boerhave H (1668-1738), a clinician, made full use of the teaching hospital bed to carry out bedside teaching and initiated the clinical pathology Seminar (CPC) In the first mock exam, the biomedical model gradually formed in this period. This mode regards health as the balance between the three hosts, the environment and the cause of disease. Every disease can find measurable morphological and / or chemical changes from organs, cells and biological macromolecules, and determine the biological and / or physical causes, so as to treat them.
Under the influence of the third scientific and technological revolution, three revolutions have taken place in medicine in the 20th century, resulting in modern clinical medicine. The first revolution took place from the 1930s to the 1950s, marked by the discovery of sulfonamides, antibiotics and large-scale production of penicillin. The second revolution took place in the 1970s, marked by computer X-ray tomography (CT) And the invention and application of magnetic resonance imaging (MRI). The third revolution occurred in the late 70s, marking the use of genetic engineering to produce biological products (such as somatostatin, insulin, growth hormone, interferon, hepatitis B vaccine).
With the development of pharmacology, therapeutics, molecular biology, immunology, medical genetics, organ transplantation technology, infectious diseases, medical imaging and other disciplines, the biomedical model gradually transitioned to the bio psycho social medical model in the 1970s, looked at health and disease comprehensively from the three factors of biology, psychology and society, and implemented comprehensive treatment from many aspects. Modern clinical medicine has formed distinct characteristics, such as division and specialization, internationalization of development, technological modernization, mutual penetration and intersection of disciplines. It has an increasingly close relationship with social medicine and general medicine, and has become the most important weapon for human beings to fight against diseases.
As a science that directly confronts diseases, clinical medicine will play a more important role in the future. There are four specific development trends: the application of molecular biology to transform clinical medicine, the cross integration of clinical medicine and various disciplines, the combination of clinical medicine and preventive medicine, and geriatrics has become an important research topic of clinical medicine