Allopathy, also known as the Modern System of Medicine, developed in the West. A system which treats a disease with drugs having opposite effects to existing symptoms, each successive discovery and development in allopathy is the result of extensive research. Each new remedy has helped alleviate pain and suffering and increased the life span of people. Medical research continues at a brisk pace, identifying hitherto unknown diseases and searching for their cures.

How Allopathy Developed

Allopathy has passed through different stages and different lands to come up to the highly advanced level in which we find it today. Its origins can be traced to ancient Egyptian and Mesopotamian medicine. Herodotus, the Greek historian, wrote that the people of different lands, including those of ancient Greece, availed the services of Egyptian physicians and surgeons.

By the fifth century B.C., Greece herself could boast of a flourishing system of medicine. Hippocrates, reverently called the Father of Western or Modern (Allopathy)

Medicine, discarded the influence of the supernatural in determining health and disease, and instead, turned to natural causes for explanations. He evolved the theory of the four humours, maintaining that blood, phlegm, yellow bile, and black bile in the human body promoted health or led to disease.

In the second century, Galen, an eminent Greek physician, physiologist, and researcher, who lived in Rome, investigated the functions of different parts and organs of the body. He is, however, remembered today, not for what he rightly discovered, but for what he wrongly propagated. He propagated that there were small, invisible pores in the wall separating the ventricles (the lower two chambers of the heart), and through these pores, blood flowed from the right side of the heart to the left side. In the Middle Ages, students were taught the theories propounded by Galen.

It was only during the Renaissance period that these theories were questioned. Leonardo da Vinci (1452-1519), a multifaceted genius, wrote a book containing 1,000 sketches on the human anatomy and physiology, after dissections on more than 30 dead bodies. Unfortunately, his work was not published. A systematic study of the human body was picked up earnestly by Andreas Vesalius (1514-1564), a great Belgian anatomist. His book entitled De Humani Corporis Fabrica, published in 1543, refuted Galen’s theory of pores in the inter-ventricular septum. Some staunch Galenists stood their ground even then, claiming that ‘If no pores exist there now, the structure of the heart must have changed since the time of Galen’!

Vesalius maintained that Galen was incorrect about the passage of blood through the wall between the ventricles, but did not suggest any alternative explanation as to how blood passed from the right ventricle to the left in the heart, or, how it flowed from the veins to the arteries. The credit for discovering this and showing that the blood circulates in the body goes to an English physicist, William Harvey (1578-1657).

The main intellectual obstacle to the development of the idea of circulation of the blood was the Aristotelean conception that only heavenly bodies could move naturally in a circular motion, while everything on earth possessed a beginning and an end. By this time, however, both Galen and Aristotle had begun to be questioned.

Harvey estimated that, on an average, the human heart beats 72 times in a minute. Since, with each contraction, the heart ejects about 56.7 grams of blood, at this rate, a quantity of 72 x 60 x 56.7 grams or 24,494 grams or 245 kg of blood is pumped out of the heart in the course of every hour. Accordingly, a man would eject blood equal to three times the weight of his own body, in one hour. If this vast quantity of blood is used up, as Galen had stated, and if it has to be replaced by food, then a man would be eating food, equal to three times his own weight during every hour of the 24 hours of a day!

As this was obviously wrong, Harvey postulated that the blood went out of the heart and then returned to it: that is, it circulated in the body. The construction of the heart — two chambers on either side, connected with a thick inter-ventricular septum containing no pores, coupled with the fact that there are valves at the mouth of the blood vessels coming and going from the heart — suggested to him, the path taken by the blood in its circulation in the body. Harvey demonstrated this phenomenon experimentally as well.

Later after the microscope had been invented, Marcello Malpighi succeeded in identifying the capillaries in the lungs of a frog in 1660. In 1688, Antony Van Leeuwenhock saw the actual circulation of blood through the capillaries in the tail of a tadpole and in the foot of a frog.

The discovery of the circulation of blood in the body, and in the lungs, and the fact that air consists mainly of oxygen, nitrogen, and carbon dioxide, verified the fact that blood absorbs oxygen in the lungs from the air that we breathe in. It throws out the carbon dioxide that is produced as a result of energy production and oxygen utilisation in the body for the performance of its functions.

Hippocratic Oath: The Code of Ethics

All medical students upon graduation and before starting practice are required, even today, to take Hippocratic Oath, parts of which are …

‘To hold him who has taught me this art as equal to my parents and to live life in partnership with him; if he is in need of money to give him a share of mine, to regard his offspring as equal to my brothers in male lineage and to teach them this art if they desire to learn it without fee and covenant; to give a share of precepts and oral instruction and all the other learning, to my sons and to the sons of him who has instructed me and to pupils who have signed the covenant and have taken an oath according to medical law, but to no one else.

I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect. Similarly, I will not give to a woman any -abortive remedy.

‘What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about.’

Further knowledge was acquired between the 17th and 20th centuries regarding the anatomy of the body, and the circulation of blood in the body. In England, Thomas Sydenham (1624-1689) studied the natural history of diseases; John Hunter (1728-1793), a Scottish surgeon and anatomist, improved upon the practice of surgery, and in 1796, Edward Jenner discovered vaccination. In France, in 1879, Louis Pasteur discovered the role of bacteria in the causation of different diseases; in Germany, Robert Koch (1843-1910) conducted significant bacteriological studies and discovered the pathogenic bacteria of tuberculosis and cholera. Sigmund Freud (1856-1939) helped in the understanding of the human mind and was the founder of the modern theory of psychoanalysis. In Russia, Pavlov clarified how the nervous reflexes controlled bodily functions; in the United States, Sir William Osier provided new horizons to the practice of medicine. In England, Joseph Lister made use of the discoveries in bacteriology to make surgical operations safe from infection by discovering antiseptics. Paul Ehrlich of Germany discovered the concept of killing germs with chemicals, the culminating process of which was the discovery of penicillin by Alexander Fleming (1881-1955) of England.

The last century has witnessed mammoth strides in understanding the human body and disease — so much has been discovered and so rapidly.

Evolving Concepts

The concept of disease passed through different phases and stages. In ancient Egypt, disease was explained as the work of ‘hidden hands’, demons, the wrath of the gods, magic of the enemy or of the sorcerer.

Concept of Humours. Some of the first attempts to negate the belief of ‘the hidden hands’ with practical explanations were made in the sixth century b.c. by Greek philosophers. They endeavoured to introduce reason in the phenomena they saw around them. On the basis of their observations and experience, around 460 b.c Hippocrates postulated that the human body possessed four humours: blood, phlegm, yellow bile, and black bile. A balance of them in the body meant good health; their imbalance led to disease; the disease depended upon the nature of imbalance of the humours. Hippocrates endeavoured to understand a particular disease in its entirety; before his times, it was the individual symptom, be it fever or cough or diarrhoea, that was considered as a disease and treated accordingly.

The course followed by different diseases in different people and the outcome thereof, led Hippocrates to maintain that the human body possessed a vast potential to heal itself. The duty of a physician was merely to assist nature to increase this power. This could be done through a judicious modification in the diet, as the humours were generated by the food taken. Drugs were prescribed only to bring about a balance of humours.

The concept of humours evolved by Hippocrates and propagated by Galen remained the backbone of medical practice right through the Middle Ages.

Chemical Concept. During the early Renaissance period, Paracelsus (1493-1541) propounded the theory that the human body was essentially a chemical system composed of three principals — mercury, sulphur, and salt. Illness arose from a lack of balance among these three principals.

By the beginning of the seventeenth century, a remarkable growth had occurred in the realm of the science of chemistry, and this branch of knowledge was increasingly used to explain health and disease.
Mechanical Concept. Before the Renaissance, scientists and medical men looked only at the qualitative aspects of things. Galileo shepherded in the age of measurement, and quantitative aspects of things began to be considered. Instruments such as pendulum clocks, telescopic lenses, thermoscopes and others made this change possible.

Concepts — humoural, chemical, mechanical and a host of others — prevailed among medical men as means of explaining health and disease, but they were of little use to the patient. Though recent work had revolutionised classical concepts of the working of the human body, and anatomy and physiology had contributed to an understanding of the human body, they still played no part in the art of healing. Disillusioned, some physicians wandered into natural sciences.

In this atmosphere of cynicism, emerged a change for the better. This was brought about by an English physician named Thomas Sydenham (1624-1689). He was more of a practical man than a theorist. On the basis of his vast experience, he postulated that illness was a struggle between the body of the sick person and the noxious influences that produced the illness, and the symptoms were the expression of this struggle. The body reacted against these noxious influences, tried to overcome their evil effects through its own healing power, and endeavoured to make good the disturbance. The doctor’s business was to assist nature in its struggle, to guide, and to intensify the healing power of the body.

Concept of Organ Involvement. When physicians began to do post-mortems, a systematic examination of dead bodies led to the realisation that in the initial stages, the disease affects only one organ or area of the. body and, sometimes, remains localised there for long periods. This view was postulated by Giovanni Battista Morgagni (1682-1771), professor of anatomy at Padua, Italy.

Concept of Tissue Involvement. While Morgagni stated that disease usually gained a foothold in one or more specific organs, Bichat (1771-1802), practising in France, went a step further. After having conducted dissections and post-mortems (as many as 600 post-mortems in a year), he concluded that structural changes in various diseases were localised in different tissues of which- the organs were made. In other words, the seat of a disease was not the organ as a whole but a part of it, namely, the tissue. Any tissue in an organ could become diseased, apart from the other tissues of which the organ was made up. In this way, Bichat pushed localisation of disease a stage further — from the organ to the tissues.

Concept of Cell Involvement. Availability of the compound microscope made it possible for scientists to study the structure of the body minutely. The body and its different organs were found to be made up of individual cells. In 1855, Rudolf Virchow, a German, put forward the concept that body cells were the basic units of life. Disease resulted primarily from changes in the cells due to external influences.

Thus we see a gradual evolution in the concept of the seat of the disease in the body. Morgagni regarded the organ as the seat of disease; Bichat, the tissues; for Virchow, it was the cell. The cell was the sustainer of life, and diseases also occurred in the cell. Disease, Virchow maintained, was the reaction of the cell to abnormal stimuli.

The structure and function of different cells of the body in health and disease, and the particular stimuli which lead to structural changes in the cells, have since formed the basis of all research and investigations.

Etiological Concept. What were the stimuli that initiated changes in the cells? This was the next step in research. The credit for discovering that bacteria cause diseases, goes to Pasteur, a French national. In 1879, he showed to the Paris Academy of Medicine that the cause of puerperal fever* in women was a microbe which was transmitted by the unclean and infected hands of doctors to delivering mothers. He saw and demonstrated this phenomenon in the discharges of delivering women.

Thereafter, looking for germs that cause different diseases became a matter of labour and study. The work of Pasteur was furthered by the German scientist Robert Koch (1843-1910), whose main contribution was identifying the tubercle bacillus as the cause of tuberculosis.

More and more medical scientists devoted their time and energies to isolating germs (micro-organisms) that caused different diseases in human beings, animals, and even plants. As a result of their efforts , micro-organisms, came to be isolated and recognised as causing diseases.

Modern Concept. Advancing research, however, also revealed that a large percentage of diseases were not caused by micro-organisms or viruses alone, but had other causes. These other causes, as biochemical studies proved, were nutritional deficiencies, deficiencies of vitamins and minerals, and increased or decreased functioning of different endocrine glands in the body, such as in cases of myxodema and hyperthyroidism. There were also diseases in which there is narrowing of the smaller blood vessels, leading, in some cases, to narrowing of the coronary arteries of the heart — causing heart attacks; there were diseases like rheumatoid arthritis and others which, for want of a better term, came to be termed as degenerative diseases. There were still other diseases with which one was born, that is, congenital and hereditary diseases about which we are now beginning to understand, 
 *Fever following childbirth.

thanks to the science of molecular biology and the study of the nucleus, its chromosomes, genes, and parts of the genes.

Isolation of germs causing a disease did not explain the entire concept of the disease. During epidemics, and in experiments on animals, it was seen that introduction of germs in living beings did not lead to the production of disease in all those living beings; even in those in which it did, the disease was mild in some, and severe, in others. This clearly showed that there was more to disease production than merely the introduction of germs into the body. The body itself or the ’soil’ on which these germs grew and flourished, was of vital importance. In this connection, many factors that resisted the germs getting a foothold in the body, were recognised. Latest research indicates that the mind has the greatest control on the body, both in health and disease.

Diagnosing a Problem

The sixteenth and seventeenth centuries were unable to present an informed method of diagnosis, in spite of fundamental discoveries of the structure and functions of the body. Auenbrugger, a Viennese physician, discovered percussion of the chest*, and Laennec of France listened to breath and heartbeats by means of the stethoscope. Both these diagnostic procedures helped in localising the disease in the patient while he lived, in the same manner as Morgagni’s anatomical localising did when the patient died.
Major discoveries in the field of diagnosis are the product of the second half of the nineteenth and the twentieth centuries. These include detection and isolation

“”Tapping a part of the body gently with an instrument;

part of a diagnosis.of germs and viruses in different disease states; discovery of X-rays by Wilhelm Konrad Roentgen of Germany and the use of this technique in diverse ways; examination of diseased tissues taken from the patient and looking at their structure under the microscope; study of biochemical materials in the body, such as the level of different enzymes, hormones, and other substances; and the innumerable surgical techniques used as diagnostic agents.

With the help of the techniques available to us now, we can study not only the cell, its nucleus, its chromosomes, but also the genes — the very basis of life.

Selecting the Right Treatment

Before the discovery of germs as causative agents of different diseases, treatment in the majority of the diseases was based on the principle of increasing the vitality of the body so as to put up adequate resistance to the disease. Proper diet, rest, blood-letting, and medicines derived from vegetable, animal, and mineral sources were used where indicated.

A study of the phenomenon of entry of the germs into the body revealed that the intruding germs released a poison into the bloodstream of the patient; in turn, the body produced an excess of counter-poison so as to kill the intruding germs. When the counter-poison was able to kill the germs, the patient was saved from the disease. This counter-poison was named an antitoxin. Efforts were made to artificially produce antitoxins against various diseases and to inject them in patients suffering from these diseases so as to facilitate their recovery. The first success in this direction was achieved in cases of diphtheria.

Another approach to killing the bacteria which entered the body and caused disease was by administration of such chemicals or drugs which killed these germs without affecting the normal body cells. This work was initiated by Paul Ehrlich of Germany. He succeeded in his efforts by producing a salt of arsenic which came to be known as compound 606, because this was the 606th drug produced and tested by him which killed the germs that caused syphilis. This approach of killing the disease-producing germs in the body initiated an era which led to the production of chemotherapeutic drugs and antibiotics through which a large number of bacterial diseases can be cured now.

The second major approach to treating diseases was the surgical approach. It owed its development to the discovery of bacterias as causes of different diseases. Application of this concept, by first using antiseptics and then by developing aseptic techniques, availability of effective and efficient anaesthetic agents, and above all, the availability of antibiotics to check infection during and after surgical operations, provided encouragement to surgeons to go ahead and operate on cases where surgery had been considered impossible earlier. The ensuing result today is that surgery has entered a stage where it can perform miraculous operations such as transplantation of organs.

Step-by-Step Approach: Allopathy follows a methodical approach in diagnosis and treatment today. Let us take the hypothetical case of a nine-year-old child suffering from breathlessness due to exertion for the last five years.

When he arrives at a hospital, the doctor first asks him and his parent to describe the symptoms. He listens carefully, translating them in his mind into medical language. He then asks a few questions to elicit information. His questions may be along these lines: Did the child’s mother suffer from any disease while she was carrying the child? Was it a normal delivery? What diseases did the child suffer up to the age of five years? What other symptoms besides breathlessness due to exertion, does the child get? Has he ever become blue while crying? Is breathlessness a continuous complaint, or is the child free from breathlessness during some months or in a particular season? How much exertion brings on the breathlessness? How many brothers and sisters has the child got? Does any other member of the family suffer from similar complaints? Where does the family live? How hygienic is the environment?

On the basis of the information volunteered by the patient or his relative, coupled with that elicited by the doctor in response to leading questions, the doctor now has before him the complete medical history of the patient. He is familiar with the present complaint of the patient, the diseases he has suffered from in the past, his family, and social background. If the doctor makes a detailed note of the history of the patient, chances are that he will come to a tentative conclusion about the nature of the disease the patient is suffering from.

The next step is to examine the patient carefully. First comes the general physical examination. The doctor assesses whether the child’s growth has been normal or stunted. He looks for any other obvious abnormality such as whether the child is comfortable or breathless while lying down, whether he is pale or bluish, whether there is swelling over the feet or in any other part of the body.

Having inspected the patient, the doctor examines his pulse rate, its regularity or any other characteristic of the pulse; he notes the rate of respiration; he takes the blood pressure; examines the tongue and nails for any evidence of anaemia or bluishness; palpates his abdomen to detect any tenderness in the liver, spleen, and kidneys.

After the general examination, the doctor turns to the chest, that is, the heart and lungs, because these are the organs primarily concerned with breathing. He inspects and then palpates the heartbeat of the patient, tries to localise it and figure out from this whether the heart is enlarged or not. Then he uses his stethoscope to hear the heart beat to know whether it is normal or not, or whether there are any extra sounds in the form of murmurs. Similarly, he examines the lungs to assess the type of breath sounds or the accompanying extra breath sounds.

After this stage, the doctor, most probably, comes to a conclusion about the diagnosis, and is able to identify the disease that the patient is suffering from.

If he has any doubts or wants to confirm his findings, he may also conduct some laboratory investigations. These may include examination of the blood for any evidence of anaemia; urine, for any abnormality such as the presence of albumin in it which may indicate whether the kidneys have been affected; stool examination, and so on. He may also deem it necessary to carry out some special investigations such as taking an electrocardiogram of the patient and echocardiography.

Let us presume that, in this patient, the history of the patient, physical examination, and the laboratory investigations reveal that the patient is suffering from a defect in the structure of the heart. There is a hole between the two chambers of the heart, with the result that some of the pure (oxygenated) blood from the left side of the heart flows to the right side of the heart. The efforts of the lungs to oxygenate this blood will be wasted as also the effort of the heart to pump it. Furthermore, as a result of this structural defect in the heart, the quantity of blood that goes through the aorta to the body, can meet the body’s demand of oxygen only when the patient is resting. Any exertion puts an extra load on the lungs and the heart, and it is this extra strain which the patient experiences in the form of breathlessness.

Important Men of Allopathy

William Harvey (1578-1657): Discovered blood circulation.
Edward Jenner (1749-1823): Discovered vaccination (for smallpox) in 1798.
Louis Pasteur (1822-1895): Discovered the germ theory of disease.
Joseph Lister (1827-1912): Founder of antiseptic surgery.
Wilhelm Konrad Roentgen (1845-1923): Discovered X-rays in 1895; awarded Nobel Prize for Physics in 1901.
Karl Lansteiner (1868-1943): Discovered blood groups in 1900.
Sir Alexander Fleming (1881-1955): Discovered Penicillin in 1928; awarded the Nobel Prize for Medicine and Physiology in 1945.
Jonas Edward Salk (born in 1914): Discovered the polio vaccine in 1955.
Dr Har Gobind Khurana (born in 1922): Worked out the genetic code; awarded the Nobel Prize for Medicine and Physiology in 1968.
Christian Barnard (born in 1922): Performed the first successful heart transplant on December 3, 1967.

This structural defect in the patient’s heart has been there since birth, but because the heart has a lot of reserve power, it has so far been coping with the extra workload. It has tried to do its best to serve the patient, till it has, finally, been overstrained.

In this patient, the doctor has to find answers to two questions as far as the treatment is concerned: In the process of coping with the workload over the years, how much has the heart been enlarged or strained itself? How big is the hole between the two chambers of the heart since it must be closed if the child is to survive?

In order to assess the size of the hole in the heart, a procedure called cardiac catheterization is done. A plastic tube (cardiac catheter) is passed from a vein in the arm, up the arm and neck, and then down into the right chamber of the heart. Through this catheter is measured the quality of blood, that is, how much oxygen the blood in each chamber has, by which is calculated the size of the hole through which mixing of the blood occurs. It also measures the pressure of blood in these chambers, confirming, at the same time, their normal or abnormal size.

Equipped with this quantitative data, and boosting up the patient’s condition with some preliminary treatment, the doctor is ready to perform the operation on the patient’s heart to close down the hole. The latest technique of open-heart surgery, in which the blood passing through the heart is bypassed through a heart-lung machine, has facilitated surgical operation on such patients.

As a result of all the investigations and treatments, it is probable now that this child will be cured of his disease and live to enjoy a normal span of life.

During the past four decades, many new drugs have become available for treating different diseases. These include antibiotics, steroids, painkillers, tranquillizers, and a host of others. Judicious use of these drugs should naturally lessen suffering. However, currently, a situation has arisen in which drugs are often prescribed too freely, unmindful of their actual necessity or side-effects.

There was a time — and this still prevails to an extent in the Ayurvedic and Unani systems — when the physician prepared and compounded medicines himself for his patients. But during the last three decades or so, huge international pharmaceutical companies have sprung up. They manufacture and propagate scores and scores of drugs each year. While the motive of the physician who prepared the medicines for his patients, was to cure the patient, many physicians today prescribe drugs loosely. Perhaps due to lack of proper knowledge, or merely not to be considered old-timers or ill-informed about new medications, they also fall prey to the sophisticated advertising and marketing strategies employed by pharmaceutical companies.

It is no exaggeration to say that the knowledge of many doctors prescribing newer drugs is limited only to  what the sales representatives of the companies tell them or what the companies state in their pamphlets.
Overuse of costly drugs and misuse of many of them are, unfortunately, two major drawbacks which the use of allopathy is faced with today.

Latest developments and researches in allopathy are based upon a greater and deeper understanding of the life processes in men, animals, and plants. Discoveries of the last few decades have already lessened the suffering of man from disease and cut short mortality due to different diseases in infants, adults, and older people. However, much remains to be done to battle degenerative diseases and cancer, as also, new diseases which will surely keep cropping up due to changing lifestyles and environments.

————————Now You Know…

Based on scientifically verifiable concepts, allopathy is able to diagnose and treat more health disorders than any other system today. In fact it is the only answer for life-threatening situations and acute conditions. It is the only system offering surgical remedies. The past century has witnessed near miraculous surgical innovations such as organ transplantation, open heart surgery, and micro­surgery, to name a few.

The drugs prescribed are standardised. However attention has to be paid to side-effects in some cases. Treatment can also be prohibitively expensive.

Stressing both prevention and cure of disease, ongoing and well-documented research in allopathy ensures continuous feedback and improvement.