“The undergraduate student of medicine will for the most part acquire the methods, standards, and habits of science by working over territory which has been traversed before, in an atmosphere freshened by the search for truth.”
– Abraham Flexner –
Biological behaviour is simply the way a disease behaves. By the time you have written a ‘biological behaviour’ section of a card, your level of understanding should be such that you are almost able to predict the clinical manifestations. There are a number of possible ways to organise information on disease behaviour. Useful categories include pathogenesis, pathophysiology, natural history, pathology, prognosis and complications.
An important principle in medicine is that a change in structure leads to a change in function. The discipline of pathology studies these changes and their relationship. Pathogenesis relates to the events occurring in the development of disease, and pathophysiology relates to the physiology of disordered function.
You may choose to use the categories above as subheadings to keep your cards well organised. You should keep in mind that each subheading is simply a guide: tools which you may or may not need for a specific disease. When writing a card, choose the tools you need, or employ other headings of your own design as the need arises – just remember to keep things well structured!
Andreas Vesalius (1514-1568) Vesalius was born into a medical family and showed his enthusiasm at a young age, dissecting the bodies of stray dogs, rats and cats from the streets of Brussels. He entered formal medical education which, at that time, generally involved simply listening to 1500 year old recitals of the works of Galen. Sometimes a non-medical assistant would dissect while a Professor read Galen’s writings, but no effort was made to verify them – they were considered beyond reproach and too perfect for improvement. Sylvius, Vesalius’ teacher, for example, once remarked that any structure found in contemporary man which differed from the Galenic description, could be due only to a later decadence and degeneration of mankind.
Vesalius, however, was of a different character. His declared that teachers “prattled arrogantly from the pulpit about things they had never seen”, and adopted the motto ‘per ocules, non per aures’ (learn by seeing, not through hearing). The day after graduation from Padua University, in Italy, he was appointed as professor and proceeded to spend long hours examining the inside of corpses for medical truth. His thirst for anatomy (‘furor anatomicus’) was such that he took great risks to acquire ever more specimens, famously procuring a dead body of a criminal for a complete skeleton, by stealing into the gallows late at night. His work capacity was equally enormous, and with the publication of his monumental text De Humanis Corporis Fabricus (The Fabric of the Human Body), which contained detailed anatomical drawings of all body parts, Vesalius single-handedly proved that much of Galen’s work was wrong or based on animals. In doing so, he truly brought medicine into the age of rational enquiry. His work represents the watershed between medieval and modern medicine. Desired all over Europe for his skills as a physician, Vesalius chose to go into service for Emperor Charles V of Spain. He had many adventures in this capacity, including as an army physician in a war against the French, for whom Ambrose Pare was making his discoveries aided by Vesalius’ book. Vesalius died in a shipwreck returning from a journey to the Holy Land.