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57-543: Dresden has had a botanical garden since 1820 when Professor Ludwig Reichenbach created the first on a site now within the forecourt of the Police Headquarters, nearby the famous Brühl's Terrace . By 1822 it contained some 7,800 plant species and varieties. The contemporary garden was created in 1889 by Carl Georg Oscar Drude and officially opened in 1893. However, it was devastated in February 1945 during

114-430: A Selenicereus grandiflorus and various cacti , succulents , orchids , and carnivorous plants . 51°02′36″N 13°45′31″E  /  51.0432°N 13.7586°E  / 51.0432; 13.7586 Ludwig Reichenbach Heinrich Gottlieb Ludwig Reichenbach (8 January 1793 – 17 March 1879) was a German botanist , ornithologist and illustrator. It was he who first requested Leopold Blaschka to make

171-505: A specialist , or watchful observation. A follow-up may be advised. Depending upon the health insurance plan and the managed care system, various forms of " utilization review ", such as prior authorization of tests, may place barriers on accessing expensive services. The medical decision-making (MDM) process includes the analysis and synthesis of all the above data to come up with a list of possible diagnoses (the differential diagnoses), along with an idea of what needs to be done to obtain

228-584: A Societate Florae Germanicae curante . For distributing and exchanging plant specimens he cooperated with many botanists, e.g., Friedrich Wilhelm Noë . Director of the natural history museum in Dresden , Professor Reichenbach was faced with an annoying yet seemingly unsolvable problem of showing invertebrate marine life. Land-based flora and fauna was not an issue, for it was a relatively simple matter to exhibit mounted and stuffed creatures such as gorillas and elephants, their lifelike poses attracting and exciting

285-407: A combination of all three. Most tribal societies provide no guarantee of healthcare for the population as a whole. In such societies, healthcare is available to those who can afford to pay for it, have self-insured it (either directly or as part of an employment contract), or may be covered by care financed directly by the government or tribe. Transparency of information is another factor defining

342-429: A combination of art and science (both basic and applied , under the umbrella of medical science ). For example, while stitching technique for sutures is an art learned through practice, knowledge of what happens at the cellular and molecular level in the tissues being stitched arises through science. Prescientific forms of medicine, now known as traditional medicine or folk medicine , remain commonly used in

399-500: A decade after medical school. Furthermore, surgical training can be very difficult and time-consuming. Surgical subspecialties include those a physician may specialize in after undergoing general surgery residency training as well as several surgical fields with separate residency training. Surgical subspecialties that one may pursue following general surgery residency training: Other surgical specialties within medicine with their own individual residency training: Internal medicine

456-553: A definitive diagnosis that would explain the patient's problem. On subsequent visits, the process may be repeated in an abbreviated manner to obtain any new history, symptoms, physical findings, lab or imaging results, or specialist consultations . Contemporary medicine is, in general, conducted within health care systems . Legal, credentialing , and financing frameworks are established by individual governments, augmented on occasion by international organizations, such as churches. The characteristics of any given health care system have

513-494: A delivery system. Access to information on conditions, treatments, quality, and pricing greatly affects the choice of patients/consumers and, therefore, the incentives of medical professionals. While the US healthcare system has come under fire for its lack of openness, new legislation may encourage greater openness. There is a perceived tension between the need for transparency on the one hand and such issues as patient confidentiality and

570-513: A few minutes or a few weeks, depending on the complexity of the issue. The components of the medical interview and encounter are: The physical examination is the examination of the patient for medical signs of disease that are objective and observable, in contrast to symptoms that are volunteered by the patient and are not necessarily objectively observable. The healthcare provider uses sight, hearing, touch, and sometimes smell (e.g., in infection, uremia , diabetic ketoacidosis ). Four actions are

627-448: A patient to investigate or treat a pathological condition such as disease or injury , to help improve bodily function or appearance or to repair unwanted ruptured areas (for example, a perforated ear drum ). Surgeons must also manage pre-operative, post-operative, and potential surgical candidates on the hospital wards. In some centers, anesthesiology is part of the division of surgery (for historical and logistical reasons), although it

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684-480: A period of supervised practice or internship , or residency . This can be followed by postgraduate vocational training. A variety of teaching methods have been employed in medical education, still itself a focus of active research. In Canada and the United States of America, a Doctor of Medicine degree, often abbreviated M.D., or a Doctor of Osteopathic Medicine degree, often abbreviated as D.O. and unique to

741-587: A secondary care setting. Tertiary care medical services are provided by specialist hospitals or regional centers equipped with diagnostic and treatment facilities not generally available at local hospitals. These include trauma centers , burn treatment centers, advanced neonatology unit services, organ transplants , high-risk pregnancy, radiation oncology , etc. Modern medical care also depends on information – still delivered in many health care settings on paper records, but increasingly nowadays by electronic means . In low-income countries, modern healthcare

798-545: A set of glass marine invertebrate models for scientific education and museum showcasing, the successful commission giving rise to the creation of the Blaschkas' Glass sea creatures and, subsequently and indirectly, the more famous Glass Flowers . Born in Leipzig and the son of Johann Friedrich Jakob Reichenbach (the author in 1818 of the first Greek-German dictionary) Reichenbach studied medicine and natural science at

855-561: A significant impact on the way medical care is provided. From ancient times, Christian emphasis on practical charity gave rise to the development of systematic nursing and hospitals, and the Catholic Church today remains the largest non-government provider of medical services in the world. Advanced industrial countries (with the exception of the United States ) and many developing countries provide medical services through

912-410: A system of universal health care that aims to guarantee care for all through a single-payer health care system or compulsory private or cooperative health insurance. This is intended to ensure that the entire population has access to medical care on the basis of need rather than ability to pay. Delivery may be via private medical practices, state-owned hospitals and clinics, or charities, most commonly

969-450: Is classified into primary, secondary, and tertiary care categories. Primary care medical services are provided by physicians , physician assistants , nurse practitioners , or other health professionals who have first contact with a patient seeking medical treatment or care. These occur in physician offices, clinics , nursing homes , schools, home visits, and other places close to patients. About 90% of medical visits can be treated by

1026-530: Is derived from Latin medicus , meaning "a physician". Medical availability and clinical practice vary across the world due to regional differences in culture and technology . Modern scientific medicine is highly developed in the Western world , while in developing countries such as parts of Africa or Asia, the population may rely more heavily on traditional medicine with limited evidence and efficacy and no required formal training for practitioners. In

1083-595: Is not a surgical discipline. Other medical specialties may employ surgical procedures, such as ophthalmology and dermatology , but are not considered surgical sub-specialties per se. Surgical training in the U.S. requires a minimum of five years of residency after medical school. Sub-specialties of surgery often require seven or more years. In addition, fellowships can last an additional one to three years. Because post-residency fellowships can be competitive, many trainees devote two additional years to research. Thus in some cases surgical training will not finish until more than

1140-400: Is often too expensive for the average person. International healthcare policy researchers have advocated that "user fees" be removed in these areas to ensure access, although even after removal, significant costs and barriers remain. Separation of prescribing and dispensing is a practice in medicine and pharmacy in which the physician who provides a medical prescription is independent from

1197-462: Is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. According to some sources, an emphasis on internal structures is implied. In North America, specialists in internal medicine are commonly called "internists". Elsewhere, especially in Commonwealth nations, such specialists are often called physicians . These terms, internist or physician (in

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1254-814: Is the science and practice of caring for patients, managing the diagnosis , prognosis , prevention , treatment , palliation of their injury or disease , and promoting their health . Medicine encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness . Contemporary medicine applies biomedical sciences , biomedical research , genetics , and medical technology to diagnose , treat, and prevent injury and disease, typically through pharmaceuticals or surgery , but also through therapies as diverse as psychotherapy , external splints and traction , medical devices , biologics , and ionizing radiation , amongst others. Medicine has been practiced since prehistoric times , and for most of this time it

1311-1122: The University of Leipzig in 1810 and, eight years later in 1818, he the now Professor became an instructor before, in 1820, he was appointed the director of the Dresden natural history museum and a professor at the Surgical-Medical Academy in Dresden, where he remained for many years. Together with Carl Friedrich Heinrich Schubert he started in 1822 to edit and distribute his first exsiccata work Lichenes exsiccati collecti atque descripti auctoribus L. Reichenbach et C. Schubert. Die Flechten in getrockneten Exemplaren, gesammelt und beschrieben von L. Reichenbach und C. Schubert . Later on he published several other exsiccatae, an example being Flora Germanica exsiccata sive Herbarium normale plantarum selectarum criticarumve, in Germania propria vel in adjacente Borussia, Austria et Hungaria, Tyroli, Helvetia Belgiaque nascentim, concinnatum editumque

1368-660: The bombing of Dresden in World War II . In 1949 it became a part of the Dresden University of Technology, and in 1950 reopened with partially restored outdoor gardens. In subsequent years administrative buildings and greenhouses have been rebuilt. Today the garden contains approximately 10,000 plant species, including unusual collections of annual plants (about 800 species) and wild plants from Saxony and Thuringia . It contains geographically arranged sections of plants from Asia , North America , etc., including

1425-517: The developed world , evidence-based medicine is not universally used in clinical practice; for example, a 2007 survey of literature reviews found that about 49% of the interventions lacked sufficient evidence to support either benefit or harm. In modern clinical practice, physicians and physician assistants personally assess patients to diagnose , prognose, treat, and prevent disease using clinical judgment. The doctor-patient relationship typically begins with an interaction with an examination of

1482-918: The pharmacist who provides the prescription drug . In the Western world there are centuries of tradition for separating pharmacists from physicians. In Asian countries, it is traditional for physicians to also provide drugs. Working together as an interdisciplinary team , many highly trained health professionals besides medical practitioners are involved in the delivery of modern health care. Examples include: nurses , emergency medical technicians and paramedics , laboratory scientists, pharmacists , podiatrists , physiotherapists , respiratory therapists , speech therapists , occupational therapists , radiographers, dietitians , and bioengineers , medical physicists , surgeons , surgeon's assistant , surgical technologist . The scope and sciences underpinning human medicine overlap many other fields. A patient admitted to

1539-421: The Dresden natural history museum director suggested. A decision which swiftly sparked the Blaschkas' highly lucrative mail-order business of selling Glass sea creatures to interested parties across the globe. Poetically, though Reichenbach did not know it, many years later his showcasing problem and manner of finding the Blaschkas would be repeated by Harvard Professor George Lincoln Goodale - Goodale getting

1596-643: The Trinity Cemetery in Dresden Johannstadt. The tomb, however, was cleared after abandoning the right to use. However, the cemetery administration had not awarded the grave site, so that at the initiative of the Senckenberg Natural History Collections in Dresden, a stele was erected, which was unveiled on September 11, 2011. Medicine This is an accepted version of this page Medicine

1653-470: The UK where all doctors are now required by law to work less than 48 hours per week on average. The following are some major medical specialties that do not directly fit into any of the above-mentioned groups: Some interdisciplinary sub-specialties of medicine include: Medical education and training varies around the world. It typically involves entry level education at a university medical school , followed by

1710-487: The United States, can be searched at http://data.medobjectives.marian.edu/ Archived 4 October 2018 at the Wayback Machine . In most countries, it is a legal requirement for a medical doctor to be licensed or registered. In general, this entails a medical degree from a university and accreditation by a medical board or an equivalent national organization, which may ask the applicant to pass exams. This restricts

1767-473: The United States, must be completed in and delivered from a recognized university. Since knowledge, techniques, and medical technology continue to evolve at a rapid rate, many regulatory authorities require continuing medical education . Medical practitioners upgrade their knowledge in various ways, including medical journals , seminars, conferences, and online programs. A database of objectives covering medical knowledge, as suggested by national societies across

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1824-446: The absence of scientific medicine and are thus called alternative medicine . Alternative treatments outside of scientific medicine with ethical, safety and efficacy concerns are termed quackery . Medicine ( UK : / ˈ m ɛ d s ɪ n / , US : / ˈ m ɛ d ɪ s ɪ n / ) is the science and practice of the diagnosis , prognosis , treatment , and prevention of disease . The word "medicine"

1881-589: The basis of physical examination: inspection , palpation (feel), percussion (tap to determine resonance characteristics), and auscultation (listen), generally in that order, although auscultation occurs prior to percussion and palpation for abdominal assessments. The clinical examination involves the study of: It is to likely focus on areas of interest highlighted in the medical history and may not include everything listed above. The treatment plan may include ordering additional medical laboratory tests and medical imaging studies, starting therapy, referral to

1938-509: The broadest meaning of "medicine", there are many different specialties. In the UK, most specialities have their own body or college, which has its own entrance examination. These are collectively known as the Royal Colleges, although not all currently use the term "Royal". The development of a speciality is often driven by new technology (such as the development of effective anaesthetics) or ways of working (such as emergency departments);

1995-459: The considerable legal authority of the medical profession to physicians that are trained and qualified by national standards. It is also intended as an assurance to patients and as a safeguard against charlatans that practice inadequate medicine for personal gain. While the laws generally require medical doctors to be trained in "evidence based", Western, or Hippocratic Medicine, they are not intended to discourage different paradigms of health. In

2052-788: The examination for the Membership of the Royal College of Physicians (MRCP) or the equivalent college in Scotland or Ireland. "Surgery" refers to the practice of operative medicine, and most subspecialties in this area require preliminary training in General Surgery, which in the UK leads to membership of the Royal College of Surgeons of England (MRCS). At present, some specialties of medicine do not fit easily into either of these categories, such as radiology, pathology, or anesthesia. Most of these have branched from one or other of

2109-417: The expertise or procedures performed by specialists. These include both ambulatory care and inpatient services, emergency departments , intensive care medicine , surgery services, physical therapy , labor and delivery , endoscopy units, diagnostic laboratory and medical imaging services, hospice centers, etc. Some primary care providers may also take care of hospitalized patients and deliver babies in

2166-426: The field of science and a scientific marvel in the field of art," were exactly what Prof. Reichenbach needed and, at last, provided an outlet for the wonder Leopold had felt all those years ago when observing the phosphorescent ocean life. The key fact, though, was that these glass marine models were, as would soon be acknowledged, "perfectly true to nature," and as such represented an extraordinary opportunity both for

2223-653: The gut and the kidneys. In the Commonwealth of Nations and some other countries, specialist pediatricians and geriatricians are also described as specialist physicians (or internists) who have subspecialized by age of patient rather than by organ system. Elsewhere, especially in North America, general pediatrics is often a form of primary care . There are many subspecialities (or subdisciplines) of internal medicine : Training in internal medicine (as opposed to surgical training), varies considerably across

2280-553: The hospital is usually under the care of a specific team based on their main presenting problem, e.g., the cardiology team, who then may interact with other specialties, e.g., surgical, radiology, to help diagnose or treat the main problem or any subsequent complications/developments. Physicians have many specializations and subspecializations into certain branches of medicine, which are listed below. There are variations from country to country regarding which specialties certain subspecialties are in. The main branches of medicine are: In

2337-550: The idea for the creation of the Glass Flowers from Harvard's own collection of Glass sea creatures. Sadly, however, the original six glass sea anemones purchased by Ludwig Reichenbach in 1863 as well as the rest of that first collection was destroyed in the Bombing of Dresden in World War II . He was later the founder of the Dresden botanical gardens and joint founder of Dresden Zoo . The museum's zoological collection

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2394-434: The information provided. During the encounter, properly informing the patient of all relevant facts is an important part of the relationship and the development of trust. The medical encounter is then documented in the medical record, which is a legal document in many jurisdictions. Follow-ups may be shorter but follow the same general procedure, and specialists follow a similar process. The diagnosis and treatment may take only

2451-571: The museums' visitors. Invertebrates, however, by their very nature, posed a problem. In the 19th century the only method practised for showcasing them was to take a live specimen and place it in a sealed jar of alcohol. This killed it but, more importantly, time and a lack of hard parts eventually rendered the specimen little more than a colorless floating blob of jelly, making it neither pretty nor an effective teaching tool. Prof. Reichenbach wanted something more, specifically 3D colored models of marine invertebrates that were both lifelike and able to stand

2508-773: The narrow sense, common outside North America), generally exclude practitioners of gynecology and obstetrics, pathology, psychiatry, and especially surgery and its subspecialities. Because their patients are often seriously ill or require complex investigations, internists do much of their work in hospitals. Formerly, many internists were not subspecialized; such general physicians would see any complex nonsurgical problem; this style of practice has become much less common. In modern urban practice, most internists are subspecialists: that is, they generally limit their medical practice to problems of one organ system or to one particular area of medical knowledge. For example, gastroenterologists and nephrologists specialize respectively in diseases of

2565-504: The new specialty leads to the formation of a unifying body of doctors and the prestige of administering their own examination. Within medical circles, specialities usually fit into one of two broad categories: "Medicine" and "Surgery". "Medicine" refers to the practice of non-operative medicine, and most of its subspecialties require preliminary training in Internal Medicine. In the UK, this was traditionally evidenced by passing

2622-477: The patient's medical history and medical record , followed by a medical interview and a physical examination . Basic diagnostic medical devices (e.g., stethoscope , tongue depressor ) are typically used. After examining for signs and interviewing for symptoms , the doctor may order medical tests (e.g., blood tests ), take a biopsy , or prescribe pharmaceutical drugs or other therapies. Differential diagnosis methods help to rule out conditions based on

2679-440: The possible exploitation of information for commercial gain on the other. The health professionals who provide care in medicine comprise multiple professions , such as medics , nurses , physiotherapists , and psychologists . These professions will have their own ethical standards , professional education, and bodies. The medical profession has been conceptualized from a sociological perspective . Provision of medical care

2736-432: The primary care provider. These include treatment of acute and chronic illnesses, preventive care and health education for all ages and both sexes. Secondary care medical services are provided by medical specialists in their offices or clinics or at local community hospitals for a patient referred by a primary care provider who first diagnosed or treated the patient. Referrals are made for those patients who required

2793-458: The scientific community and the Blaschkas themselves. Knowing this and thrilled with his newly acquired set of glass sea creatures, Reichenbach advised Leopold to drop his current and generations long family business of glass fancy goods and the like in favor of selling glass marine invertebrates to museums, aquaria, universities, and private collectors. Advice which would prove wise and fateful both economically and scientifically, for Leopold did as

2850-413: The south-central U.S. and northern Mexico was named in his honor. Reichenbach's sunbird ( Anabathmis reichenbachii ) is also named after him. This botanist is denoted by the author abbreviation Rchb. when citing a botanical name . Finally, he was also the father of Heinrich Gustav Reichenbach , equally a botanist and an eminent orchid specialist. Reichenbach died in 1879 and was interred in

2907-599: The test of time. In 1863, he "saw an exhibition of highly detailed, realistic glass flowers created by a Bohemian Lampworker , Leopold Blaschka, at an exhibition hosted by Prince Camille de Rohan ;" and it was the Prince who first introduced Reichenbach to Leopold Blaschka. Enchanted by the botanical models and positive that Leopold held the key to ending his own showcasing issue, in 1863 Reichenbach convinced and commissioned Leopold to produce twelve model sea anemones . These marine models, hailed as "an artistic marvel in

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2964-568: The two camps above; for example anaesthesia developed first as a faculty of the Royal College of Surgeons (for which MRCS/FRCS would have been required) before becoming the Royal College of Anaesthetists and membership of the college is attained by sitting for the examination of the Fellowship of the Royal College of Anesthetists (FRCA). Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on

3021-1137: The unusual Quercus phellos as well as Corydalis nobilis , Hamamelis , rhododendrons , magnolias , and so forth; a systematic section; an alpine garden collecting a variety of European high mountain plants, including gentian ( Gentiana ), species of saxifrage ( Saxifraga ), Dianthus caryophyllus , numerous cruciferous plants and primroses ; and a garden that contains poisonous, curative, and medicinal plants. The garden also contains five greenhouses of about 1,000 m total area, containing some 3,000 species, as well as an aquatic greenhouse for Victoria cruziana and plants from tropical America including Ananas comosus , Tillandsia usneoides , Theobroma cacao , epiphytic bromeliads, etc. The Great Tropical House (Paläotropis) contains tropical flora of Asia and Africa, including Cinnamomum verum , Coffea arabica , Elaeis guineensis , Ficus religiosa , Gossypium arboreum , Hibiscus rosa-sinensis , Musa acuminata , Pandanus , Piper nigrum , Platycerium , Saccharum officinarum , and Streptocarpus sect. Saintpaulia . The succulent house contains

3078-418: The world: see the articles on medical education for more details. In North America, it requires at least three years of residency training after medical school, which can then be followed by a one- to three-year fellowship in the subspecialties listed above. In general, resident work hours in medicine are less than those in surgery, averaging about 60 hours per week in the US. This difference does not apply in

3135-500: Was almost completely destroyed by the fire in the Zwinger palace during the constitutional crisis of 1849, but Reichenbach was able to replace it within only a few years. This collection is the basis of that seen in the museum today. Reichenbach was a prolific author and able botanical artist. His works included Iconographia Botanica seu Plantae criticae (1823–32, 10 vols.) and Handbuch der speciellen Ornithologie (1851–54). He

3192-419: Was an art (an area of creativity and skill), frequently having connections to the religious and philosophical beliefs of local culture. For example, a medicine man would apply herbs and say prayers for healing, or an ancient philosopher and physician would apply bloodletting according to the theories of humorism . In recent centuries, since the advent of modern science , most medicine has become

3249-407: Was honoured by having several plants and animals named after him including Iris reichenbachii Heuff., Viola reichenbachiana Jord. ex Bor. (syn. V. sylvatica (Hartm.) Fr. ex Hartm. and V. sylvestris Lam. p.p.) (the slender wood violet). Dr. Reichenbach oversaw a world-famous botanical garden in Dresden with a great collection of cacti, and Echinocactus reichenbachii a beautiful cactus of

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