Cardiology
Cardiovascular disease became an important issue for modern medicine at the
beginning of the Twentieth century. By the late 80’s coronary disease became
the number one source of deaths in the United States. Every two people died
from heart attacks, while three others suffered from them.
Many people and their studies throughout history, dating all the way back to
the 16th century up until today, have gathered the information needed to become
more aware of this disease. Refined diagnostic techniques led physicians to a
greater understanding of how to monitor the heart. New literatures on
difficult, troublesome abnormalities help researchers detect early signs of
heart failure. With not only concerns of heart attacks worrying doctors and
patients alike, the new trend of high blood pressure or hypertension became
even more than a treat. The hardening and thickening of heart’s arteries meant
that more work was expected out of the heart. This over exhilaration caused
skipping, lack of breath, pains that were preamps for fatal heart attacks.
Arteriosclerosis was caused and by ‘a build up of fatty deposits in arterial
wall’, and made worse by stress, smoking, and excessive drinking. Due to
multiple complications of the heart, cardiology stepped up its efforts in the
mid-twentieth century. Computerized axial tomography(CAT-scan) and nuclear
magnetic resonance (NMR-scanning) provided new methods of understanding
pathology and physiology of individual heart problems. Surgical procedures that
performed effective bypasses and open-heart surgeries before; are now being
replaced by even more up to date advances, making recovery minimal. New drugs
that dissolve blood clots and reduce cholesterol have reduced drastically the
death rate in heart attacks victims. Besides the pharmacological and surgical
approaches to curing heart problems, developments with the management of
abnormal heart rhythms have improved. Pace makers along with other electrodes
are used to help regulate heart rates.
In the United State between 1970-1990 coronary heart disease drop by half,
leading to 300,000 less deaths a year. This amazingly data can be credited to
the health kick that has caught on so rapidly. Instead of worrying about new
and improved treatments, there has been a general concern with prevention.
Understanding the risk factors has help greatly. Knowing the dangers of
cholesterol and the importance of a good diet and a lot of exercise has not
only prevented heart problems for the United States, but has set a higher
standard of health for the rest of the world.
Teaching/practice of Med.
In the beginning of the 19th century basic primary health care began to be
available to everyone in need. It was nothing fancy. Sick patients were treated
to the best of the doctors’ ability. They not only saw physically ill patients,
but people with a variety of ‘psychological, social, conventional, and
ritualistic problems.’ Doctors found themselves trying to solve theses issues
only to please their patients. Looking pass the social aspect of seeing a
doctor, physicians were challenged to cure deadly diseases that were not going
away through the tradition conservative (bed-rest, tonics, care and hope) and
not so conservative (calomel, blood letting, chloral mixtures and morphia)
methods of the time.
With the 20th century on the brink, doctors decided to use more science in
their treatments. Diagnostic equipment, chemical tests, physical examinations
and break through medication were used as reference instead of the good ol’
fashion style of doing things. ‘New diagnostic jargon and fancy prescriptions’
set the evolving standard that physicians were quite professional. This new
form of general practice that was slowly changing into ‘professionalism’ was
founded on new diagnostic principles. This new way of doing things was created
in medical schools across the United States. The medical universities taught
the link between scientific understanding and the symptoms’ of the ill through
the use of more advanced diagnosis, thermometers, sphygmomanometers,
laboratories, microscopes, and detailed physical examinations. Patients very
well received the new procedures’ of the early 20th century physicians. They
felt secure that their general welfare was being better taken of through the
way doctors diagnosed them.
As time went on, physician became concerned into their diagnostic procedures
that they soon began to forget about their patients. They saw them as nothing
more than diseases needing to be cured. Doctors were required to be retrained
in how to react with patients. Medical education began to teach the importance
of empathizing with the sick. It was ironic that what science had forced them
away from was now once again a main priority in the medical field. Doctors were
instructed in sociological, psychological, and clinical medicine.
Now days the practice of medicine has become more specialized than anything. In
1989, merely one out of eight physicians were in general and family medicine.
The public has been attracted to progress of health care due to the
specialization of medicine. No longer do physicians make house calls, but many
types of doctors group themselves in the same office building for convenience.
A higher standard of living, along with technology, not only with equipment but
also with newer drugs, has changed the diseases fought today. In these ways the
teaching and practice of medicine in the 20th and 21st centuries have provided
services that help the human race live longer and fuller lives.
Doubt/skepticism/open mind
One of the basic concepts of the experimental method is doubt. Bernard says it
is expressed when an open mind is used towards a conclusion that started
uncertain. It is important the experimenters always doubt their beginning
points. This gives them a level mind frame towards any form of contradiction
that might come about during their experiment. Men of science are able to doubt
because of their flexibility gives them a great source of confidence. Through
doubt they gain knowledge by accepting that there is always more understanding
to achieve. Finding absolute truth is not important, just as long as there is
an understanding of the connection that leads you between the different ideas.
A true doubter only disbelieves himself, but promotes experimentation and
trusts in science. He can never fall into skepticism. The true skeptic
distrusts in the nature of science and only finds truth in his own abilities to
reason. He has no groundwork on which to create his principles. After time he will
never have the chance to discover what he is truly looking for.
A main condition of the experimental method is having a free and opened mind
that is founded on doubt. Having a free mind towards ideas is fighting against
skepticism. Men of science need to confide in their concepts after only after
verification. They also need to accept the link between all things, but never
to the point of not being open to their opposite. As a man of science keeps an
open mind, he is able to discover the freedom needed to make the right choices
in the experimental method.
Inductive/deductive
Bernard first describes that induction and deduction are two different forms of
reasoning. The induction side is an ‘interrogative form’ performed by people
who do not know, but wish to find something out. They search from the
particular to the general. The deduction side is a ‘demonstrating form’
occupied by people who know, but yet wish to teach others. They look from the
general to the particular. Along with the reasoning side there is a scientific
method part also, which explains inductive method as experimental physical
sciences and deductive method as the mathematical sciences.
Then Bernard proceeds to debunk his first assumptions by stating that it is not
correct to say that induction forms the physical sciences and deduction relates
only to mathematics, but they contribute to all the sciences. This is due to
the fact that we think we do not understand the sciences, but in reality, we
do. He further more discusses that induction and deduction are not really
methods of reasoning, but all humans think logically only one way, which is the
general to the particular. This basically states that all people naturally
reason from the deductive side and that the inductive form only depends on an
ability to view the general in the particular.
I personally think that Bernard is contradicting rat bastard. He should make up
his mind on what he wants to write at the first of the chapter, rather than
waiting until the last page to explain what he really wants to say.
Higher organisms that are objects of the experimental method have an advantage
over their outer environment because of their ‘spontaneity’. Their
characteristics are full of life, activity, and freedom. This independent force
within them brings out the true meaning of creation. These more developed,
higher animals with their endless movement never seem to become manipulated by
their outer surroundings. These bodies find themselves free from restraining
physico-chemical influences, which can include changes in conditions of
temperature, moisture, light etc. in the outer atmosphere. Although these
living beings need the outer circumstances as their environment the live, they
will continue to exist without being effected by them. These traits demonstrate
that experimentation may be awkward and nearly impossible.
The less dominant living beings, whether vegetable or animal, are not so
independent or isolated to their surroundings. They are directly affected by
the conditions of their outer environment. These lower organisms are at mercy
to the physico-chemical ‘manifestations’ of life. Their conditions are
seasonally altered due to the changes of the harsh environment. Under these
circumstances, these characteristics suggest that lower organisms are perfect
specimens for experimentation.
Bernard explains that the nature of living beings, as subjects of
experimentation, is a product of determinism, which connects both the internal
and external conditions together. In all living organisms (higher and lower)
the internal environment maintains the necessary ties that form equilibrium
with the external environment. This will fluctuate as long as there is
development and independence from these physico-chemical elements. In higher
forms of life their ability to isolate themselves from external influences can
be contributed to their well-organized internal makeup. This is completely
opposite in how the lower organisms’ independence is effected. These different
specifications do not state the variance of nature in these living beings, but
are only ‘improvements’ or advantages in protecting themselves from the
external conditions of the environment. The true nature of all living organisms
in the experimental method is identical, varying only to the physico-chemical
conditions that influence the living beings’ internal environment.