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##Semester I
##Module I: Human and Medicine
##Lesson 3:π©ΊMODERN MEDICINE
Modern medicine developed mainly during the 20th century, shaped by scientific discoveries, social change, and advances in technology. By the end of the 19th century, medicine had clearly divided into two broad streams.
#βοΈ Division of Medicine
By the late 19th century, medicine was divided into:
π Curative Medicine β Diagnosis and treatment of disease in individuals
π Public Health / Preventive Medicine β Prevention of disease and promotion of health at the community level
#π Advances After 1900
Rapid growth of medical specialization
Adoption of a rational and scientific approach
Improved sanitation, hygiene, and vaccination altered disease patterns
#𧬠Changing Disease Patterns
Successful control of acute infectious diseases
(smallpox, cholera, typhoid)Rise of non-communicable diseases (NCDs):
ποΈ Cancer
π Diabetes
β€οΈ Cardiovascular diseases
π§ Mental illnesses
π Accidents
These became the leading causes of death in industrialized countries.
#π¦ Limitations of the Germ Theory
Many modern diseases could not be explained solely by germs
Single βmagic bulletβ treatments were insufficient
Recognition of multiple causes of disease emerged
#π± Emergence of the Multifactorial Concept
Health and disease are influenced by:
π₯ Social factors
π° Economic factors
𧬠Genetic factors
π³ Environmental factors
π Psychological factors
Most are linked to lifestyle and behavior (diet, smoking, stress).
#𧩠Concept of Multifactorial Causation
Disease results from multiple interacting causes
π‘ Max von Pettenkofer (1819β1901) first proposed this idea
Introduced:
β οΈ Multiple causation
π Risk factors as measurable contributors
#π§ Major Developments in Modern Medicine
Modern medicine advanced through:
𧫠Biomedical sciences
π§ββοΈ Public health & preventive medicine
π€ Social & behavioral medicine
π©» Medical technology & specialization
π Epidemiology & evidence-based medicine
#π A. Curative Medicine
#π°οΈ Historical Perspective
Though ancient in origin, modern curative medicine is only ~100 years old
Focuses on individual patient care, not population health
#π§ Objective and Approach
Focuses on diagnosis, treatment, and restoration of health.
Employs multiple modalities and techniques to achieve cure.
Over the years:
π¬ Diagnostic tools have become more refined and sophisticated.
π Therapeutic methods have become more specific and potent.
#π₯ Revolution in Allopathic Medicine
Mid-20th century saw a profound revolution in allopathic medicine.
Allopathy: βTreatment of disease by using a drug which produces a reaction that itself neutralizes the disease.β
The discovery and use of antibacterial and antibiotic agents marked a turning point in modern curative practice.
These breakthroughs transformed medicine into a scientifically organized discipline equipped to:
π©Ί Treat disease effectively
β€οΈ Preserve and prolong life
#𧬠Accumulated Progress
Curative medicine now includes:
π Vast scientific knowledge
π§ͺ Advanced technical skills
π Multiple therapies
βοΈ Sophisticated machinery
#π§ββοΈ B. Specialization in Medicine
#π Rise of Specialization
Driven by:
π Technological advances
π Changing disease patterns
π¨βπ©βπ§βπ¦ Population structure (age, sex)
#π©Ή Types of Specialties
#Based on Technical Skills
πͺ Surgery
π©» Radiology
π¨ Anaesthesiology
#Based on Organs or Systems
π ENT
ποΈ Ophthalmology
β€οΈ Cardiology
π©ββοΈ Gynaecology
#Based on Age / Sex
π§ Paediatrics
π΅ Geriatrics
π€° Obstetrics
#𧩠Subspecialization
Examples (Paediatrics):
πΆ Neonatology
π€° Perinatology
β€οΈ Paediatric cardiology
π§ Paediatric neurology
πͺ Paediatric surgery
β οΈ Raises concerns about over-specialization.
#βοΈ Impact of Specialization
#Advantages
β¬οΈ Better quality care
π§ Deeper scientific knowledge
#Disadvantages
πΈ High costs
π« Limited access
β¬οΈ Decline of general practice
π₯ Isolation of peripheral doctors
#π± B. Preventive Medicine
Preventive medicine focuses on healthy individuals and populations to prevent disease and promote health.
#π°οΈ Historical Milestones
#π Vaccines
Early bacterial vaccines (1900s)
Polio vaccines (1955, 1960)
π’ Smallpox eradicated (1977)
#π₯ Nutrition
Discovery of vitamins & minerals
Prevention of:
ποΈ Vitamin A deficiency
π§ Iodine deficiency disorders
#π¦ Insecticides
DDT, HCH, malathion
Control of malaria, plague, leishmaniasis
Issues: resistance & environmental damage
#π Drugs
Sulpha drugs, antibiotics, anti-TB, anti-leprosy
Enabled chemoprophylaxis & MDA
#π― Eradication Concept
Smallpox success
Targets: measles, tetanus, guinea worm, goiter
#π Screening Era
1930s: syphilis serology, chest X-ray
1950s: multiphasic screening
Focus:
Early detection
Risk factors
High-risk groups
#π₯π Population Explosion
Major issue in developing countries
Solutions include:
π¨βπ©βπ§ Family planning
𧬠Fertility research
π Contraceptive technology
π©Ί Genetic counseling
#π° Levels of Prevention
π‘οΈ Primary
π Secondary
βΏ Tertiary
#πΏ Scope of Preventive Medicine
π± Health promotion
π« Disease prevention
π οΈ Disability limitation
π§ Rehabilitation
#π C. Social Medicine
#π Origins
Europe: Neumann (1847), Virchow (1848)
Medicine viewed as a social science
#π Revival
π¨ββοΈ Alfred Grotjahn (1911) β social pathology
π§πͺ Rene Sand (1912) β social medicine movement
#π Meaning
#Broad Meaning
Humanitarian orientation
Includes care, prevention, administration
#Narrow Meaning
Epidemiology-based
Studies social causes of disease
#𧩠Core Idea
Social medicine is not a new branch, but a new orientation of medicine.
ποΈ Pillars:
π©Ί Medicine + π₯ Sociology
#π¬ Key Contribution
Use of epidemiological methods
Understanding effects of poverty, housing, culture, behavior
#π Changing Concepts in Public Health
#1. π¦ Disease Control Phase (1880β1920)
Clean water, sanitation, sewage
#2. πͺ Health Promotion Phase (1920β1960)
MCH, school health, PHCs
π Winslowβs definition (1920)
#3. 𧩠Social Engineering Phase (1960β1980)
Chronic diseases
Risk-factor approach
Rise of community health
#4. π βHealth for Allβ Phase (1981β2000)
Global inequities
WHO goal: Health for All
