Текст 1. Primitive medicine

Unwritten history is not easy to interpret, and, although much may be learned from a study of the drawings, bony remnants, and surgical tools of the early man, it is difficult to reconstruct his mental attitude toward the problems of disease and death. It seems probable that humans, as soon as they had reached the stage of reasoning, discovered, by the process of trial and error, which plants might be used as foods, which of them were poisonous, and which of them had some medicinal value.

However, the man did not at first regard death and disease as natural phenomena. Common maladies, such as colds, were accepted as part of existence, but serious and disabling diseases were placed in a very different category and were considered to be of supernatural origin.

One curious method of providing the disease with means of escape from the body was by making a hole, 2.5 to five centimetres across, in the skull of the victim - the practice of trepanning. Trepanned skulls of prehistoric date have been found in Britain, France and other parts of Europe and in Peru. The practice still exists among primitive people in parts of Algeria, in Melanesia, and perhaps elsewhere, though it is fast becoming extinct.

Magic and religion played a large part in the medicine of the prehistoric or primitive man. Administration of a vegetable drug or remedy by mouth was accompanied by incantations, dancing, grimaces, and all the tricks of the magician. Therefore, the first doctors, or "medicine men," were witch doctors. The use of charms and talismans, still prevalent in modem times, is of ancient origin. Apart from the treatment of wounds and broken bones, primitive physicians showed their wisdom by treating the whole person, soul as well as body. Treatments and medicines that produced no physical effects on the body could nevertheless make a patient feel better when both the medicine man and the patient believed in their efficacy. This so-called placebo effect is applicable even in modem clinical medicine.

Текст 2. More specialties in medicine

Since World War II there has been an almost explosive increase of knowledge in the medical science as well as enormous advances in technology as applicable to medicine. These developments have led to more and more specialization. Expansion of knowledge both in depth and in range has encouraged the development of new forms of treatment that require high degrees of specialization, such as organ transplantation and exchange transfusion. The field of anesthesiology has grown increasingly as equipment and anesthetics have improved.

New technologies have introduced microsurgery, laser beam surgery, and lens implantation (for cataract patients), all requiring the specialist’s skill. Precision in diagnosis has markedly improved; advances in radiology, the use of ultrasound, computerized axial tomography (CAT scan), and nuclear magnetic resonance imaging are examples of the technology extension requiring expertise in the field of medicine.

To provide more efficient service it is not uncommon for a surgeon and a physician to form a team working together in the field of, for example, heart disease. An advantage of this arrangement is that they can attract a highly trained group of nurses, technologists, operating room technicians, and so on, thus greatly improving the efficiency of the service to the patient.

Such specialization is expensive, however, and has required an increasingly large proportion of the health budget of institutions, a situation that eventually has its financial effect on the individual citizen. The question therefore arises as to their cost-effectiveness. Governments of developing countries have usually found, for instance, that it is more cost-efficient to provide more people with basic care.