Download History of Medicine

History of Medicine: Prehistoric Times to the 21st Century
IET 600 – Impact of Technology
By
Joseph Barker
Submitted to:
Dr. Ahmad Zargari
December 12, 2004
Table of Contents
Introduction ......................................................................................................................... 2
Prehistoric Times ................................................................................................................ 3
Ancient Times ..................................................................................................................... 4
The Middle East .......................................................................................................... 4
China and India ........................................................................................................... 4
Greece and Rome ........................................................................................................ 5
The Middle Ages................................................................................................................. 6
The Renaissance.................................................................................................................. 7
Modern Times ..................................................................................................................... 8
The Beginnings of Modern Research ......................................................................... 8
Discovery of the First Anesthetic ............................................................................... 9
The Scientific Study of Diseases ................................................................................ 9
Introduction of Antiseptic Surgery ........................................................................... 10
The Beginnings of Organized Medicine ................................................................... 11
The Medical Revolution of the 1900’s ..................................................................... 12
Timeline of Historical Medical Achievements ................................................................. 13
Highlights in Medical History .................................................................................. 13
Future of Medicine ............................................................................................................ 14
Reference: ......................................................................................................................... 18
1
Introduction
Medicine is the science and art of healing. Medicine is a science because it is
based on knowledge gained through careful study and experimentation. It is an art
because it depends on how skillfully doctors and other medical workers apply this
knowledge when dealing with patients.
Medicine seeks to save lives and relieve suffering. For this reason, it has long
been one of the most respected professions. Many thousands of men and women in the
medical profession spend their lives caring for the sick. When a disaster strikes, hospital
workers rush emergency aid to the injured. When epidemics threaten, doctors and nurses
double their efforts to prevent the spread of disease. Other persons in the medical
profession continually search for better ways of fighting disease.
Human beings have been suffered from disease since they first appeared on the
earth about 2.5 million years ago. Throughout most of this time, they knew little about
how the human body works or what causes disease. Treatment was based largely on
superstition and guesswork. But medicine has made tremendous scientific progress in the
last several hundred years. Today, it is possible to cure, control or prevent hundreds of
diseases, from measles and polio to tuberculosis and yellow fever. New drugs, machines,
and surgical operations add years to the lives of many patients. Partly as a result of
medical progress, people have a longer life expectancy than they had in the past. In
1900, most people in the United States did not live past the age of 50. Today, Americans
live an average of about 74 years (Sameh, 1998).
As medicine has become more scientific, it has also become more complicated.
In the past, doctors cared for patients almost single-handedly. Patients received treatment
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at home for most kinds of illnesses. Very few patients went to hospitals. Today, most
doctors no longer work by themselves. Instead, they head medical teams made up of
nurses, laboratory workers, and many other skilled professionals. The case provided by
such teams cannot generally be given at home. As a result, clinics and hospitals have
become the chief centers for medical care in most countries.
Prehistoric Times
In prehistoric times, people believed that angry gods or evil spirits caused disease.
To cure the sick, the god had to be pacified or the evil spirits driven from the body. In
time, this task became the job of the first “physicians”- the tribal priests who tried to
pacify the gods or drive out the evil spirits.
The first-known surgical instrument was an operation called trephining (Trueman,
2003). Trephining involved the use of a stone instrument to cut a hole in a patient’s
skull. Scientists have found fossils of such skulls that date as far back as 10,000 years.
Early people may have performed the operations to release spirits believed responsible
for headaches, mental illness, or epilepsy. However, trephining could have brought relief
in some cases. Surgeons still practice trephining to relieve certain types of pressure on
the brain.
Prehistoric people probably also discovered that many plants can be used as
drugs. For example, the use of willow bark to relieve pain probably dates back thousands
of years. Today, scientists know that willow bark contains salicin, a substance related to
the salicylates used in making aspirin. Digitalis, morphine, quinine, and ephedrine are all
modern medicines that have been passed down to us from prehistoric practices (Demand,
2000).
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Ancient Times
The Middle East
By about 3000 B.C., the Egyptians, who had developed one of the world’s first
great civilizations, began making important medical progress. The world’s first
physician known by name was the Egyptian Imhotep, who lived about 2700 B.C. (Dunn,
1999). The Egyptians later worshiped him as the god of healing. About 2500 B.C.,
Egyptian physicians began to specialize. Some physicians treated only disease of the
eyes or teeth. Others specialized in internal disease. Egyptian surgeons produced a
textbook that told how to treat dislocated or fractured bones and external abscesses,
tumors, ulcers, and wounds (Pahor, 1992).
Other ancient Middle Eastern civilizations also contributed to medical progress.
The ancient Hebrews, for example, made progress in preventive medicine from about
1200 to 600 B.C. The Hebrews required strict isolation of persons with gonorrhea,
leprosy, and other contagious diseases. They also prohibited the contamination of public
wells and the eating of pork and other food that might carry disease.
China and India
The ancient Chinese developed medical practices that have been handed down
almost unchanged to the present day. This traditional medicine is based on the belief that
two life forces, Yin and Yang, flow through the human body. Disease results when two
forces become out of balance. To restore the balance, the Chinese began the practice of
acupuncture—inserting needles into parts of the body thought to control the flow of Yin
and Yang. Chinese doctors still practice acupuncture to this day.
In ancient India, the practice of medicine became known as ayurveda. It stressed
the prevention as well as the treatment of illness. By 600 to 500 B.C., practitioners or
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ayurveda had developed impressive knowledge of drugs and surgery. Indian surgeons
successfully performed many kinds of operations, including amputations and plastic
surgery.
Greece and Rome
The civilization of ancient Greece was at its peak during the 400’s B.C.
Throughout this period, sick people flocked to temples dedicated to the Greek god of
healing, Asclepius, seeking magical cures. But at the same time, the great Greeks
physician Hippocrates began showing that disease has only natural causes. He thus
became the first physician known to consider medicine a science and art separate from
the practice of religion (Frasco, 2003). The Hippocratic Oath, one of the world’s greatest
expressions of medical ethics, reflects Hippocrates high ideals. But the oath was
probably composed from a number of sources rather than by Hippocrates himself.
After 300 B.C., the city of Rome gradually conquered much of the civilized
world, including Egypt and Greece. The Romans got most of their medical knowledge
from Egypt and Greece. Their own medical achievements were largely in public health.
The Romans built aqueducts that carried 300 million gallons of fresh water to Rome each
day (“Ancient Rome Medicine”, 2004). They also built and excellent sewerage system in
Rome.
The Greek physician Galen, who practiced medicine in Rome during the A.D.
100’s, made the most important contributions to medicine in Roman times. Galen
performed experiments on animals and used his findings to develop the first medical
theories based on scientific experiments. For this reason, he is considered the founder of
experimental medicine. But because his knowledge of anatomy was based largely on
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animal experiments, Galen developed many false notions about how the human body
works. Galen wrote numerous books describing his theories. These theories, many of
which were wrong, guided doctors for hundreds of years.
The Middle Ages
During the Middle Ages, which lasted from about 400 to the 1500’s, the Muslim
Empire of Southwest and Central Asia contributed greatly to medicine. Rhazes, a
Persian-born physician of the late 800’s and early 900’s, wrote the first accurate
descriptions of measles and smallpox. Avicenna, an Arab physician of the late 900’s and
early 1000’s, produced a vast medical encyclopedia called Canon of Medicine. It
summed up the medical knowledge of the time and accurately described meningitis,
tetanus, and many other diseases. The work became popular in Europe, where it
influenced medical education for more than 600 years.
A series of epidemics swept across Europe during the Middle Ages. Outbreaks of
leprosy began in the 500’s and reached their peak in the 1200’s. In the mid-1300’s, a
terrible outbreak of bubonic plague called the Black Death killed about a fourth of
Europe’s population. Throughout the medieval period, smallpox and other diseases
attacked hundreds on thousands of people.
The chief medical advances in Europe during the Middle Ages were the founding
of many hospitals and the first university medical schools. Christian religious groups
established hundreds of charitable hospitals for victims of leprosy. In the 900’s, a
medical school was started in Salerno, Italy. It became the chief center of medical
learning in Europe during the 1000’s and 1100’s. Other important medical schools
developed in Europe after 1000. During the 1100’s and 1200’s, many of these schools
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became part of newly founded universities, such as the University of Bologna in Ital and
the University of Paris in France.
The Renaissance
A new scientific spirit developed during the Renaissance, the great cultural
movement that swept across Western Europe from about 1300 to the 1600’s. Before this
time, most societies had strictly limited the practice of dissecting human corpse for
scientific study. But laws against dissection were realized during the Renaissance. As a
result, the first truly scientific studies of the human body began.
During the late 1400’s and early 1500’s, the Italian artist Leonardo da Vinci
performed many dissections to learn more about human anatomy. He recorded his
findings in a series of more than 750 drawings. Andreas Vesalius, a physician and
professor of medicine at the University of Padua in Italy, also performed many
dissections. Vesalius used his findings to write the first scientific textbook on human
anatomy, a work called On the Fabric of the Human Body (1543). This book gradually
replaced the texts of Galen and Avicenna.
Other physicians also made outstanding contributions to medical science in the
1500’s. A French army doctor named Ambroise Pare improved surgical techniques to
such an extent that he is considered the father of modern surgery. For example, he
opposed the common practice of cauterizing wounds with boiling oil to prevent infection.
Instead, he developed the much more effective method of applying a mild ointment and
then allowing the wound to heal naturally. Philippus Paracelsus, a Swiss physician,
stressed the importance of chemistry in the preparation of drugs. He pointed out that in
many drugs consisting of several ingredients, one ingredient made another useless.
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Modern Times
The Beginnings of Modern Research
The English physician William Harvey performed many experiments in the early
1600’s to learn how blood circulates through the body. Before Harvey, scientists had
studied only parts of the process and invented theories to fill in the gaps. Harvey studied
the entire problem. He performed dissections on both human beings and animals and
made careful studies of the human pulse beat and heartbeat. Harvey concluded that the
heart pumps blood through the arteries to al parts of the body and that the blood returns to
the heart through the veins.
Harvey described his findings in An Anatomical Treatise on the Motion of the
Heart and Blood in Animals (1628). His discovery of how blood circulates marked a
turning point in medical history. After Harvey, scientists realized that knowledge of how
the body works depends on knowledge of the body’s structure.
In the mid-1600’s, a Dutch amateur scientist named Anton van Leeuwenhoek
began using a microscope to study organisms invisible to the naked eye. Today, such
organisms are called microorganisms, microbes, or germs. In 1676, Leeuwenhoek
discovered certain microbes that later became known as bacteria. Leeuwenhoek did not
understand the role of microbes in nature. But his research paved the way for the
eventual discovery that certain microbes cause disease.
The Development of Immunology
Smallpox was one of the most feared and highly contagious diseases of the
1700’s. It killed many people every year and scarred others for life. Doctors had known
for hundreds of years that a person who recovered from smallpox developed lifelong
immunity to it. To provide this immunity, doctors sometimes inoculated people with
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matter from a smallpox sore, hoping they would develop only a mild case of the disease.
But such inoculations were dangerous. Some people developed a severe case of smallpox
instead of a mild one. Other inoculated persons spread the disease.
In 1796, an English physician named Edward Jenner discovered a safe method of
making people immune to smallpox (Scott, 1999). He inoculated a young boy with
matter from a cowpox sore. The boy developed cowpox, a relatively harmless disease
related to smallpox. But when Jenner later injected the boy with matter from a smallpox
sore, the boy did not come down with the disease. His bout with cowpox had helped his
body build up immunity to smallpox. Jenner’s experiment was the first, officially
recorded vaccination. The success of the experiment led to the science of immunology—
the prevention of disease by building up resistance to it.
Discovery of the First Anesthetic
For thousands of years, physicians tried to dull pain during surgery by
administering alcoholic drinks, opium, and various other drugs. But no drug had proved
really effective in reducing the pain and shock of operations. Then in the 1840’s two
Americans—Crawford Long and William T. G. Morton—discovered that ether gas could
safely be used to put patients to sleep during surgery. Long, a physician, and Morton, a
dentist, made the discovery independently. With the discovery of an effective anesthetic,
doctors could perform operations never possible before.
The Scientific Study of Diseases
The scientific study of disease, called pathology, developed during the 1800’s.
Rudolf Virchow, a German physician and scientist, led the development. Virchow
believed that the only way to understand the nature of disease was by close examination
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of the affected body cells. He did important research in such diseases as leukemia,
trichinosis, and tuberculosis. The development of improved microscopes in the early
1800’s helped make his studies possible.
Scientists of the late 1800’s made dramatic progress in learning the causes of
infectious disease. As early as the 1500’s, scholars had suggested that tiny, invisible
“seeds” caused some diseases. The bacteria discovered by Leeuwenhoek in the 1600’s
fitted this description. In the late 1800’s, the research of Louis Pasteur and Robert Koch
firmly established the microbial, or germ, theory of disease.
Pasteur, a brilliant French chemist, proved that microbes are living organisms and
that certain kinds of microbes cause disease. He also proved that killing specific
microbes stops the spread of specific diseases. Koch, a German physician, invented a
method for determining which bacteria cause particular diseases. This method enabled
him to identify the germ that causes anthrax, a severe disease of people and animals. The
anthrax germ thus became the first germ definitely linked to a particular disease. Other
research scientists followed the lead of these two pioneers. By the end of the 1800’s,
researchers had discovered the kinds of bacteria and other microbes responsible for such
infectious diseases as bubonic plague, cholera, diphtheria, dysentery, gonorrhea, malaria,
pneumonia, tetanus, and tuberculosis.
Introduction of Antiseptic Surgery
Hospitals paid little attention to cleanliness before the mid-1800’s. Operating
rooms were often dirty, and surgeons operated in street clothes. Up to half of all surgical
patients died of infections. In 1847, a Hungarian doctor, Ignaz Semmelweis, stressed the
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need for cleanliness in childbirth. But Semmelweis knew little about the germ theory of
disease.
Pasteur’s early work on bacteria convinced an English surgeon named Joseph
Lister that germs caused many of the deaths of surgical patients. In 1865, Lister began
using carbolic acid, a powerful disinfectant, to sterilize surgical wounds. But this method
was later replaced by a more efficient technique known as aseptic surgery. This
technique involved keeping germs away from surgical wounds in the first place instead of
trying to kill germs already there. Surgeons began to wash thoroughly before an
operation and to wear surgical gowns, gloves, and masks.
The Beginnings of Organized Medicine
During the 1800’s and early 1900’s, groups were founded in the United States and
Canada to organize and reform the medical profession in the two countries. In 1847, U.S.
doctors founded the AMA to help raise the nation’s medical standards. Partly as a result
of the AMA’s efforts, the first state licensing boards were set up in the late 1800’s. The
Canadian Medical Association was founded in 1867 for much the same purpose. The
National Medical Association was started in 1895 by black doctors who felt
discriminated against by the AMA.
In 1910, the Carnegie Foundation for the Advancement of Teaching issued a
report called Medical Education in the United States and Canada. The U.S. educator
Abraham Flexner prepared the report for the foundation. Flexner’s report stated that only
1 of the 155 medical schools in the United States and Canada at that time provided an
acceptable medical education. The only school providing an acceptable education was
the Johns Hopkins Medical School, founded in Baltimore in 1893. Flexner’s report and
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the example of Johns Hopkins School helped bring far-reaching reforms in U.S. and
Canadian medical education.
The Medical Revolution of the 1900’s
Advances in many fields of science and engineering have created a medical
revolution in the 1900’s. For example, the discovery of X-rays by the German physicist
Wilhelm Roentgen in 1895 enabled doctors to see inside the human body to diagnose
illnesses and injuries. The discovery of radium by the French physicists Pierre and Marie
Curie in 1898 provided a powerful weapon against cancer.
In the early 1900’s Christian Eijkman of The Netherlands, Frederick G. Hopkins
of England, and a number of other physician-scientists showed the importance of
vitamins. Their achievements helped conquer such nutritional diseases as beriberi,
rickets, and scurvy. About 1910, the German physician and chemist Paul Ehrlich
introduced a new method of attacking infectious disease. Ehrlich’s method, called
chemotherapy, involved searching for chemicals to destroy the microbes responsible for
particular diseases.
Ehrlich’s work greatly advanced drug research. In 1935, a German doctor,
Gerhard Domagk, discovered the ability of sulfa drugs to cure infections in animals. His
discovery led to the development of sulfa drugs to treat diseases in human beings. In
1928, the English bacteriologist Sir Alexander Fleming discovered the germ-killing
power of a mold called Penicillium. In the early 1940’s, a group of English scientists
headed by Howard Florey isolated penicillin, a product of this mold. Penicillin thus
became the first antibiotic.
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Since Domagk’s and Fleming’s discoveries, scientists have developed many other
sulfa drugs and antibiotics. These drugs have helped control most infectious diseases.
Other drugs have been developed to fight such disorders as diabetes and high blood
pressure. The development of new vaccines has helped control the spread of such
infectious diseases as polio and measles. During the 1960’s and 1970’s, the World
Health Organization conducted a vaccination program aimed at eliminating smallpox
from the world.
Another major advance in modern medicine has been the discovery of the
placebo. First published in 1955 by HK Beecher, placebos are inert substances, such as
sugar pills, that are used as controls in clinical trials with the intent of mimicking some
experimental intervention. The placebo effect is a term used to describe an unexplained
occurrence as the inert placebo actually changes a patient’s condition, sometimes curing
the patient completely. A landmark study conducted in 1955 showed that 35% of 1000
participants had their conditions improved by administering placebos (Beecher, 1955).
Timeline of Historical Medical Achievements
Highlights in Medical History
8000 B.C. Prehistoric people practiced trephining
2500 B.C. Egyptian physicians developed the first systematic methods of
treating diseases
400’s B.C. Hippocrates showed that diseases have only natural, not
supernatural, causes.
A.D. 100’s Galen formulated the first medical theories based on scientific
experimentation
1100’s The first university medical schools developed in Europe
1543 Vesalius published the first scientific study of human anatomy
Mid-1500’s Pare, the “father of modern surgery,” introduced advanced surgical
techniques
1628 Harvey started modern physiology with his book on blood
circulation
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1676 Leeuwenhoek discovered bacteria, which helped lead to the germ
theory of disease
1796 Jenner gave the first officially recognized vaccination, against
smallpox
1842-1846 Long and Martin introduced the use of ether, the first practical
anesthetic
Mid-1800’s Nightingale founded the modern nursing profession
1850’s Virchow pioneered in pathology, the scientific study of disease
Late-1800’s Lister introduced antiseptic methods to surgery
1895 Roentgen discovered X rays, used in diagnosing diseases and
treating cancer
1898 The curies discovered radium, used in treating cancer
1900 Freud developed the psychoanalytic method of treating mental
illness
Early 1900’s Eijkman and Hopkins demonstrated the existence of vitamins
1928 Fleming discovered penicillin, the first antibiotic drug
1950’s The development of new techniques and devices revolutionized
heart surgery. Salk developed the first successful polio vaccine
1954 American surgeons transplanted a kidney—the first successful
organ transplant
Future of Medicine
Within the next few years it is likely that scientists will be able to grow organs to
replace worn out or diseased organs. These will be grown from a single cell taken from
the person. This will enable us to extend the lives of people. It is this new emerging
technology that will come to define medicine of the next 20 years. This new research is
called stem cell treatments.
Diabetes, cancer, heart disease, Alzheimer's--all are deadly and often incurable,
until now. In the near future, stem cell treatments could relegate them to history. Those
aren't the only conditions that may end up being cured by the groundbreaking research-there also are kidney disease, Parkinson's, spinal paralysis, amyotrophic lateral sclerosis
(Lou Gehrig's disease), and severe burns (Herold, 2003). Then there are a slew of
debilitating and often fatal autoimmune disorders like lupus, multiple sclerosis, and
Crohn's disease. The list of cell-based diseases that could be eradicated through stem cell
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treatments encompasses almost anything you can think of, including age-related
conditions and the process of aging itself. In fact, if and when stem cell treatments
become available to Americans, they could end up extending people's life spans well
beyond anything one could have dreamed possible a mere 10 years ago (Finkel, 2003).
It is hard to believe that a single field in science could produce such a quantum
leap, but stem cell therapies promise to overcome one of the central limitations of
biological life--the fact that, over a lifetime, the body has at its disposal a finite number of
cells. Sooner or later, we no longer are able to repair and replace these cells with anything
like the rate of their loss through disease or injury. Once we lose that race, disease and
the assaults of aging take their toll. Too few beating cardiac cells and the heart enlarges
and grows weak, too few functioning neurons in the hippocampus and the brain declines
into dementia. Cancer can wipe out normal cells much faster than the body can replace
them at any age, possibly resulting in organ failure and death.
The genetic revolution will completely redefine the meaning of health, transform
disease management and totally wipe out many diseases. It will also create huge resource
problems and urgent ethical dilemmas. The same tools to destroy cancer and cure
diabetes could also permanently alter the human race
Chips and genes will combine to produce bionic people by 2030, with the first
digitally enhanced human beings by 2020 (Dixon, 2004). We are already able to link
computer chips to human cells such as nerves to help those who are paralyzed. The next
step will be to implant biochips which control blood sugar levels, helping diabetics.
Beyond that, biochips will be implanted directly onto the surface of the brain, to restore
sight, hearing, and movement or enhance memory and intelligence. Early work has
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already been completed in animals, fusing living nerve tissue with the surface of a chip,
allowing nerve impulses to activate a computer pathway, and a computer to activate brain
cells directly.
Other extraordinary possibilities facing tomorrow's adults will be the ability to
transplant human heads onto new bodies - already achieved in quadriplegic monkeys and
one US scientist ready to start in humans, cloning for spare parts, humanised animals as
organ factories, "magic bullets" for cancers, entire drug factories contained in the cell of a
single microbe, viruses built to correct gene defects in people, new genetically modified
foods such as bananas containing vaccines and other medical ingredients, continuous biomonitoring of human body functions such as blood glucose by implanted electrical
devices that need no batteries and last a lifetime (Dixon, 2004).
Doctors will be forced to consult computers for advice before making any
important decisions about treatment, with the risk of being sued for mismanagement if
they don't. These diagnostic robots will draw on global research to offer expert opinion,
which few doctors will dare to ignore. Medical training will shift from what people know,
to getting accurate data on which robots can make decisions, and providing "high-touch"
emotional support.
A new generation of smart drugs will change society by 2025, improving sex
lives, intelligence and slowing down the ageing process. The anti-impotence pill Viagra
is the model smart drug, and is a fore-runner of hundreds of others. Within 14 weeks, two
million men in America alone had taken Viagra, the vast majority using it purely for
recreational reasons (Dixon, 2004). Drug companies woke up to a vast new market for
performance-enhancers, as people strive for the ultimate in physical perfection and
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personal enjoyment. There will be a shift in emphasis by researchers from treating
disease or preventing it, to enhancing normal life.
A new branch of "designer" medicine will develop, which is neither treating nor
preventing disease, but merely satisfying an insatiable appetite for human pleasure and
achievement. It will be highly controversial and its practitioners will be shunned by the
rest of the medical profession. For example, students will be able to add the equivalent of
20 points to their IQ in exams by using memory enhancing, and other stimulatory drugs
developed for Alzheimer’s, while drugs will also be available to let people eat as much as
they like without ever growing fat. Others will slow down the process of ageing beyond
anything we dream possible today. These smart drugs will raise huge moral dilemmas
because they will be widely used in wealthy nations at a time when millions are still
living in terrible poverty in most of the rest of the world. And of course, addiction to a
variety of substances will continue to be a major problem, in the medical profession as
well as the rest of the population.
It is inevitable that the field of medical technology will continue to grow at
unimaginable rates. Since the 1950’s, medical technology has went through quantum
leaps in both applicatory and diagnostic trends, and there is no reason to believe that this
will not continue in the next 20 years. Gene therapy and stem cells will replace
established medical treatments and usher the medical field into a moral debates that may
never be concluded, while computers will become the leading diagnostic tool and replace
some of the guesswork in the diagnosing of ailments. By the year 2025, the medical field
will barely resemble that of the late 20th century. But whether or not this improvement
will be a positive or negative change can only be seen through time.
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