Subdivisions of Medicine as an Art and a Discipline
The medical art (ars medendi) breaks away at once from the unity of the theory of disease. While there is but one body of pathological doctrine for either sex, for every period of life, and for every region and apart of the organism, the practical art divides itself into departments and sub-departments. The most fundamental division is into internal and external medicine, or into medicine proper and surgery. The treatment of wounds, injuries, and deformities, with operative interference in general, is the special department of surgical practice (the corresponding parts of pathology, including inflammation, repair, and removable tumours, are sometimes grouped together as surgical pathology; and where the work of the profession is highly subdivided, surgery becomes the exclusive province of the surgeon, while internal medicine remains to the physician. A third great department of practice is formed by obstetric medicine or midwifery, and with obstetrics there is usually associated gynaecology, or the diseases peculiar to women. Diseases of children are the subject of a voluminous separate literature. Dermatology (diseases of the skin) is an important province of practice which, like the diseases of women and children, pertains as much to medicine as to surgery. The greatest of the so called special departments of practice is ophthalmology (disease and injuries of the eye). Laryngology is a department that owes its existence mainly to the invention of the laryngoscope, its special province being the treatment of the inflammations (ordinary and specific), tumours, and the like, to which the larynx is liable in common with other restricted department of practice, owing to the comparative inaccessibility of the chief part of the organ of hearing. The congenital condition of deaf-mutism may or may not be taken as falling within the province of the last-mentioned subdivision. Dentistry or odontology is extremely limited in the range of its subject-matter; but it affords great opportunities for refinements of technical skill, and it is given up to a distinct branch of the profession.
The care of the weak-minded and the insane (psychological medicine) is an integral part of medical practice, inasmuch as it is concerned with diseases of the nervous system and with numerous correlated states of other organs; but it occupies a unique place by reason of the engrossing interest of the subjective phenomena. Habitual drunkenness is also a subject of special treatment.
A state of war, actual or contingent, gives occasion to special developments of medical and surgical practice (military hygiene and military surgery). Wounds caused by projectiles, sabers, &c., are the special subject of naval and military surgery; while under the head of military hygiene we may include the general subject of ambulances, the sanitary arrangements of camps, and the various forms of epidemic camp sickness.
The administration of the civil and criminal law involves frequent relations with medicine, and the professional subject most likely to arise in that connexion, together with a summary of causes célèbres, are formed into the department of medical jurisprudence. It is the practice in Great Britain to call independent medical evidence on both sides of a cause, whether the proceedings be civil or criminal.
The system of life assurance is based upon the co-operation of the medical profession. Heredity, constitution, and diathesis are here the chief subjects of general consideration, while prognosis is the skilled faculty specially called into play.
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