Internal medicine

Internal medicine is concerned with the diagnosis and treatment of internal diseases, that is, those that is, those which affect internal organs or the body as a whole. A physician who practices internal medicine is an internist.

It is hard to define the boundaries between internal medicine and several other specialisms. In fact, in some countries all non-surgical specialisms are grouped conveniently with "internal medicine".

In the USA, there is some overlap between internal medicine and primary care (or family medicine), which is often practiced by internists.

In the UK, the specialism is still referred to as general medicine (although the combination general (internal) medicine can be found increasingly), and its practitioners are physicians or hospital physicians.

History

The field on internal medicine came into existence mainly on the European continent. Until the late 18th century, medicine had been a throughly unscientific profession, ignorant of physiology and uninterested in experimental findings. Most medicine that was being practiced was based on the four humors and the writings of Galen and Hippocrates. There was very little interplay between "internal medicine" and surgery, which was being practiced by non-doctors.

A number of changes occurred at the end of the Enlightenment that would change the face of medicine. Perhaps the most vital one was the invention of the stethoscope by René-Theophile-Hyacinthe Laennec (1781-1826) around 1816 [1]. Although doctors had listened to breath sounds before, by putting their ear to the chest of the patient, it became much more comfortable to do so with the stethoscope.

The "internal method" was developed almost completely in the Salpêtrière hospital in Paris, where a large number of very influential doctors practiced the art of diagnosis and prognosis (although they seemed to be much less interested in curing that patient). The method was based on a rigorous history and physical examination (this was before Rudolf Virchow's Pathology and Wilhelm Röntgen's X-rays). Amongst diseases that were originally described by Salpêtrière are Multiple Sclerosis and Haemochromatosis.