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112-434: The cave was first mentioned in the records in 1541. In 1686, Gottfried Wilhelm Leibniz visited the cave and wrote a report about it mentioning the local trade with unicorn artefacts. In those days, fossilized bones supposed to be from unicorns were ground and used for making medicine. In the 17th century, Otto von Guericke , the mayor of Magdeburg , wrote a newspaper article about the finding of some ancient animal bones in

224-526: A dissertation Specimen Quaestionum Philosophicarum ex Jure collectarum ( An Essay of Collected Philosophical Problems of Right ), arguing for both a theoretical and a pedagogical relationship between philosophy and law. After one year of legal studies, he was awarded his bachelor's degree in Law on 28 September 1665. His dissertation was titled De conditionibus ( On Conditions ). In early 1666, at age 19, Leibniz wrote his first book, De Arte Combinatoria ( On

336-505: 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

448-407: 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

560-429: 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

672-500: 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

784-553: 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

896-491: 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

1008-700: A fair part of his assigned task: when the material Leibniz had written and collected for his history of the House of Brunswick was finally published in the 19th century, it filled three volumes. Leibniz was appointed Librarian of the Herzog August Library in Wolfenbüttel , Lower Saxony , in 1691. In 1708, John Keill , writing in the journal of the Royal Society and with Newton's presumed blessing, accused Leibniz of having plagiarised Newton's calculus. Thus began

1120-513: 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

1232-511: A geometry book as an example to explain his reasoning. If this book was copied from an infinite chain of copies, there must be some reason for the content of the book. Leibniz concluded that there must be the " monas monadum " or God. The ontological essence of a monad is its irreducible simplicity. Unlike atoms, monads possess no material or spatial character. They also differ from atoms by their complete mutual independence, so that interactions among monads are only apparent. Instead, by virtue of

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1344-594: A journal article titled "New System of the Nature and Communication of Substances". Between 1695 and 1705, he composed his New Essays on Human Understanding , a lengthy commentary on John Locke 's 1690 An Essay Concerning Human Understanding , but upon learning of Locke's 1704 death, lost the desire to publish it, so that the New Essays were not published until 1765. The Monadologie , composed in 1714 and published posthumously, consists of 90 aphorisms. Leibniz also wrote

1456-607: A key role in advancing his mathematical and scientific reputation, which in turn enhanced his eminence in diplomacy, history, theology, and philosophy. The Elector Ernest Augustus commissioned Leibniz to write a history of the House of Brunswick, going back to the time of Charlemagne or earlier, hoping that the resulting book would advance his dynastic ambitions. From 1687 to 1690, Leibniz traveled extensively in Germany, Austria, and Italy, seeking and finding archival materials bearing on this project. Decades went by but no history appeared;

1568-546: A meticulous study (informed by the 1999 additions to the critical edition) of all of Leibniz's philosophical writings up to 1688, Mercer (2001) disagreed with Couturat's reading. Leibniz met Baruch Spinoza in 1676, read some of his unpublished writings, and had since been influenced by some of Spinoza's ideas. While Leibniz befriended him and admired Spinoza's powerful intellect, he was also dismayed by Spinoza's conclusions, especially when these were inconsistent with Christian orthodoxy. Unlike Descartes and Spinoza, Leibniz had

1680-448: 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

1792-473: 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

1904-409: A philosopher, he was a leading representative of 17th-century rationalism and idealism . As a mathematician, his major achievement was the development of the main ideas of differential and integral calculus , independently of Isaac Newton 's contemporaneous developments. Mathematicians have consistently favored Leibniz's notation as the conventional and more exact expression of calculus. In

2016-410: A post he held for the rest of his life. Leibniz served three consecutive rulers of the House of Brunswick as historian, political adviser, and most consequentially, as librarian of the ducal library. He thenceforth employed his pen on all the various political, historical, and theological matters involving the House of Brunswick; the resulting documents form a valuable part of the historical record for

2128-636: A related mission to the English government in London, early in 1673. There Leibniz came into acquaintance of Henry Oldenburg and John Collins . He met with the Royal Society where he demonstrated a calculating machine that he had designed and had been building since 1670. The machine was able to execute all four basic operations (adding, subtracting, multiplying, and dividing), and the society quickly made him an external member. The mission ended abruptly when news of

2240-658: A role in the initiatives and negotiations leading up to that Act, but not always an effective one. For example, something he published anonymously in England, thinking to promote the Brunswick cause, was formally censured by the British Parliament . The Brunswicks tolerated the enormous effort Leibniz devoted to intellectual pursuits unrelated to his duties as a courtier, pursuits such as perfecting calculus, writing about other mathematics, logic, physics, and philosophy, and keeping up

2352-587: 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

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2464-542: A short paper, "Primae veritates" ("First Truths"), first published by Louis Couturat in 1903 (pp. 518–523) summarizing his views on metaphysics . The paper is undated; that he wrote it while in Vienna in 1689 was determined only in 1999, when the ongoing critical edition finally published Leibniz's philosophical writings for the period 1677–1690. Couturat's reading of this paper influenced much 20th-century thinking about Leibniz, especially among analytic philosophers . After

2576-547: 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

2688-410: 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

2800-663: A two-year residence in Vienna , where he was appointed Imperial Court Councillor to the Habsburgs . On the death of Queen Anne in 1714, Elector George Louis became King George I of Great Britain , under the terms of the 1701 Act of Settlement. Even though Leibniz had done much to bring about this happy event, it was not to be his hour of glory. Despite the intercession of the Princess of Wales, Caroline of Ansbach, George I forbade Leibniz to join him in London until he completed at least one volume of

2912-462: A university education in philosophy. He was influenced by his Leipzig professor Jakob Thomasius , who also supervised his BA thesis in philosophy. Leibniz also read Francisco Suárez , a Spanish Jesuit respected even in Lutheran universities. Leibniz was deeply interested in the new methods and conclusions of Descartes, Huygens, Newton, and Boyle , but the established philosophical ideas in which he

3024-455: A vast correspondence. He began working on calculus in 1674; the earliest evidence of its use in his surviving notebooks is 1675. By 1677 he had a coherent system in hand, but did not publish it until 1684. Leibniz's most important mathematical papers were published between 1682 and 1692, usually in a journal which he and Otto Mencke founded in 1682, the Acta Eruditorum . That journal played

3136-586: A wide variety of advanced philosophical and theological works—ones that he would not have otherwise been able to read until his college years. Access to his father's library, largely written in Latin , also led to his proficiency in the Latin language, which he achieved by the age of 12. At the age of 13 he composed 300 hexameters of Latin verse in a single morning for a special event at school. In April 1661 he enrolled in his father's former university at age 14. There he

3248-450: 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

3360-525: 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

3472-475: Is exercised within natural laws, where choices are merely contingently necessary and to be decided in the event by a "wonderful spontaneity" that provides individuals with an escape from rigorous predestination. For Leibniz, "God is an absolutely perfect being". He describes this perfection later in section VI as the simplest form of something with the most substantial outcome (VI). Along these lines, he declares that every type of perfection "pertains to him (God) in

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3584-410: Is force, while space , matter , and motion are merely phenomenal. He argued, against Newton, that space , time , and motion are completely relative: "As for my own opinion, I have said more than once, that I hold space to be something merely relative, as time is, that I hold it to be an order of coexistences, as time is an order of successions." Einstein, who called himself a "Leibnizian", wrote in

3696-535: Is made of an infinite number of simple substances known as monads. Monads can also be compared to the corpuscles of the mechanical philosophy of René Descartes and others. These simple substances or monads are the "ultimate units of existence in nature". Monads have no parts but still exist by the qualities that they have. These qualities are continuously changing over time, and each monad is unique. They are also not affected by time and are subject to only creation and annihilation. Monads are centers of force ; substance

3808-595: 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

3920-400: 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

4032-456: 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

4144-814: 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

4256-555: The Harz – Brunswick Land – Eastphalia National Geopark . The Unicorn Cave has a checkpoint (no. 101) which is part of the Harzer Wandernadel network of hiking trails. In 2021, the Giant deer bone of Einhornhöhle was found in the cave, the oldest piece of European art ever discovered, and attributed to Neanderthals. According to local folklore, an old and mystical woman lived in a cave in

4368-513: The Leibniz wheel , later used in the arithmometer , the first mass-produced mechanical calculator. In philosophy and theology , Leibniz is most noted for his optimism , i.e. his conclusion that our world is, in a qualified sense, the best possible world that God could have created , a view sometimes lampooned by other thinkers, such as Voltaire in his satirical novella Candide . Leibniz, along with René Descartes and Baruch Spinoza ,

4480-574: The Thirty Years' War had left German-speaking Europe exhausted, fragmented, and economically backward. Leibniz proposed to protect German-speaking Europe by distracting Louis as follows: France would be invited to take Egypt as a stepping stone towards an eventual conquest of the Dutch East Indies . In return, France would agree to leave Germany and the Netherlands undisturbed. This plan obtained

4592-547: The Théodicée of 1710 was published in his lifetime. Leibniz dated his beginning as a philosopher to his Discourse on Metaphysics , which he composed in 1686 as a commentary on a running dispute between Nicolas Malebranche and Antoine Arnauld . This led to an extensive correspondence with Arnauld; it and the Discourse were not published until the 19th century. In 1695, Leibniz made his public entrée into European philosophy with

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4704-454: The calculus priority dispute which darkened the remainder of Leibniz's life. A formal investigation by the Royal Society (in which Newton was an unacknowledged participant), undertaken in response to Leibniz's demand for a retraction, upheld Keill's charge. Historians of mathematics writing since 1900 or so have tended to acquit Leibniz, pointing to important differences between Leibniz's and Newton's versions of calculus. In 1712, Leibniz began

4816-517: 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

4928-450: The history of philosophy and the history of mathematics . He wrote works on philosophy , theology , ethics , politics , law , history , philology , games , music , and other studies. Leibniz also made major contributions to physics and technology , and anticipated notions that surfaced much later in probability theory , biology , medicine , geology , psychology , linguistics and computer science . Leibniz contributed to

5040-913: 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

5152-410: The principle of sufficient reason . Using the principle of reasoning, Leibniz concluded that the first reason of all things is God. All that we see and experience is subject to change, and the fact that this world is contingent can be explained by the possibility of the world being arranged differently in space and time. The contingent world must have some necessary reason for its existence. Leibniz uses

5264-410: The 20th century, Leibniz's notions of the law of continuity and transcendental law of homogeneity found a consistent mathematical formulation by means of non-standard analysis . He was also a pioneer in the field of mechanical calculators . While working on adding automatic multiplication and division to Pascal's calculator , he was the first to describe a pinwheel calculator in 1685 and invented

5376-521: The British. Thus Leibniz went to Paris in 1672. Soon after arriving, he met Dutch physicist and mathematician Christiaan Huygens and realised that his own knowledge of mathematics and physics was patchy. With Huygens as his mentor, he began a program of self-study that soon pushed him to making major contributions to both subjects, including discovering his version of the differential and integral calculus . He met Nicolas Malebranche and Antoine Arnauld ,

5488-596: The Combinatorial Art ), the first part of which was also his habilitation thesis in Philosophy, which he defended in March 1666. De Arte Combinatoria was inspired by Ramon Llull 's Ars Magna and contained a proof of the existence of God , cast in geometrical form, and based on the argument from motion . His next goal was to earn his license and Doctorate in Law, which normally required three years of study. In 1666,

5600-569: The Elector in the hope of obtaining employment. The stratagem worked; the Elector asked Leibniz to assist with the redrafting of the legal code for the Electorate. In 1669, Leibniz was appointed assessor in the Court of Appeal. Although von Boyneburg died late in 1672, Leibniz remained under the employment of his widow until she dismissed him in 1674. Von Boyneburg did much to promote Leibniz's reputation, and

5712-664: The Elector's cautious support. In 1672, the French government invited Leibniz to Paris for discussion, but the plan was soon overtaken by the outbreak of the Franco-Dutch War and became irrelevant. Napoleon's failed invasion of Egypt in 1798 can be seen as an unwitting, late implementation of Leibniz's plan, after the Eastern hemisphere colonial supremacy in Europe had already passed from the Dutch to

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5824-437: The Elector's death (12 February 1673) reached them. Leibniz promptly returned to Paris and not, as had been planned, to Mainz. The sudden deaths of his two patrons in the same winter meant that Leibniz had to find a new basis for his career. In this regard, a 1669 invitation from Duke John Frederick of Brunswick to visit Hanover proved to have been fateful. Leibniz had declined the invitation, but had begun corresponding with

5936-665: The Russian Tsar Peter the Great stopped in Bad Pyrmont and met Leibniz, who took interest in Russian matters since 1708 and was appointed advisor in 1711. Leibniz died in Hanover in 1716. At the time, he was so out of favor that neither George I (who happened to be near Hanover at that time) nor any fellow courtier other than his personal secretary attended the funeral. Even though Leibniz

6048-467: 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

6160-478: The Unicorn Cave. 51°38′06″N 10°24′15″E  /  51.63501°N 10.40403°E  / 51.63501; 10.40403 Gottfried Wilhelm Leibniz Gottfried Wilhelm Leibniz or Leibnitz (1 July 1646 [ O.S. 21 June] – 14 November 1716) was a German polymath active as a mathematician , philosopher , scientist and diplomat who is credited, alongside Sir Isaac Newton , with

6272-480: 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

6384-473: 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

6496-827: The University of Leipzig turned down Leibniz's doctoral application and refused to grant him a Doctorate in Law, most likely due to his relative youth. Leibniz subsequently left Leipzig. Leibniz then enrolled in the University of Altdorf and quickly submitted a thesis, which he had probably been working on earlier in Leipzig. The title of his thesis was Disputatio Inauguralis de Casibus Perplexis in Jure ( Inaugural Disputation on Ambiguous Legal Cases ). Leibniz earned his license to practice law and his Doctorate in Law in November 1666. He next declined

6608-522: The Zeunickenberg, a Harz mountain near Quedlinburg . Based on Guericke’s writings, Leibniz drew a fictional reconstruction of the unicorn's skeleton using the bones that had been found in the cave and published the drawing in his book Protogaea . In 1872, Rudolf Virchow carried out an excavation there and determined that the unknown bones actually stem from extinct animals like mammoths and cave bears. Over 70 species of animal have been identified from

6720-446: 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"

6832-589: 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

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6944-416: The best of all masters" and he will know when his good succeeds, so we, therefore, must act in conformity to his good will—or as much of it as we understand (IV). In our view of God, Leibniz declares that we cannot admire the work solely because of the maker, lest we mar the glory and love God in doing so. Instead, we must admire the maker for the work he has done (II). Effectively, Leibniz states that if we say

7056-502: 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);

7168-459: 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

7280-401: The consort of her grandson, the future George II . To each of these women he was correspondent, adviser, and friend. In turn, they all approved of Leibniz more than did their spouses and the future king George I of Great Britain . The population of Hanover was only about 10,000, and its provinciality eventually grated on Leibniz. Nevertheless, to be a major courtier to the House of Brunswick

7392-557: The duke in 1671. In 1673, the duke offered Leibniz the post of counsellor. Leibniz very reluctantly accepted the position two years later, only after it became clear that no employment was forthcoming in Paris, whose intellectual stimulation he relished, or with the Habsburg imperial court. In 1675 he tried to get admitted to the French Academy of Sciences as a foreign honorary member, but it

7504-435: The earth is good because of the will of God, and not good according to some standards of goodness, then how can we praise God for what he has done if contrary actions are also praiseworthy by this definition (II). Leibniz then asserts that different principles and geometry cannot simply be from the will of God, but must follow from his understanding. Medicine This is an accepted version of this page Medicine

7616-763: 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

7728-579: The exercise of their free will . God does not arbitrarily inflict pain and suffering on humans; rather he permits both moral evil (sin) and physical evil (pain and suffering) as the necessary consequences of metaphysical evil (imperfection), as a means by which humans can identify and correct their erroneous decisions, and as a contrast to true good. Further, although human actions flow from prior causes that ultimately arise in God and therefore are known to God as metaphysical certainties, an individual's free will

7840-417: 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

7952-571: The fair sum he left to his sole heir, his sister's stepson, proved that the Brunswicks had paid him fairly well. In his diplomatic endeavors, he at times verged on the unscrupulous, as was often the case with professional diplomats of his day. On several occasions, Leibniz backdated and altered personal manuscripts, actions which put him in a bad light during the calculus controversy . He was charming, well-mannered, and not without humor and imagination. He had many friends and admirers all over Europe. He

8064-436: The field of library science by developing a cataloguing system while working at the Herzog August Library in Wolfenbüttel , Germany, that served as a model for many of Europe's largest libraries. His contributions to a wide range of subjects were scattered in various learned journals , in tens of thousands of letters and in unpublished manuscripts. He wrote in several languages, primarily in Latin, French and German. As

8176-640: 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

8288-422: The highest degree" (I). Even though his types of perfections are not specifically drawn out, Leibniz highlights the one thing that, to him, does certify imperfections and proves that God is perfect: "that one acts imperfectly if he acts with less perfection than he is capable of", and since God is a perfect being, he cannot act imperfectly (III). Because God cannot act imperfectly, the decisions he makes pertaining to

8400-521: The history of the Brunswick family his father had commissioned nearly 30 years earlier. Moreover, for George I to include Leibniz in his London court would have been deemed insulting to Newton, who was seen as having won the calculus priority dispute and whose standing in British official circles could not have been higher. Finally, his dear friend and defender, the Dowager Electress Sophia, died in 1714. In 1716, while traveling in northern Europe,

8512-553: 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

8624-434: 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

8736-482: The introduction to Max Jammer 's book Concepts of Space that Leibnizianism was superior to Newtonianism, and his ideas would have dominated over Newton's had it not been for the poor technological tools of the time; Joseph Agassi argues that Leibniz paved the way for Einstein's theory of relativity . Leibniz's proof of God can be summarized in the Théodicée . Reason is governed by the principle of contradiction and

8848-476: The invention of calculus in addition to many other branches of mathematics , such as binary arithmetic, and statistics . Leibniz has been called the "last universal genius" due to his knowledge and skills in different fields and because such people became much less common after his lifetime with the coming of the Industrial Revolution and the spread of specialized labor. He is a prominent figure in both

8960-499: The journey from London to Hanover, Leibniz stopped in The Hague where he met van Leeuwenhoek , the discoverer of microorganisms. He also spent several days in intense discussion with Spinoza , who had just completed, but had not published, his masterwork, the Ethics . Spinoza died very shortly after Leibniz's visit. In 1677, he was promoted, at his request, to Privy Counselor of Justice,

9072-611: The latter's memoranda and letters began to attract favorable notice. After Leibniz's service to the Elector there soon followed a diplomatic role. He published an essay, under the pseudonym of a fictitious Polish nobleman, arguing (unsuccessfully) for the German candidate for the Polish crown. The main force in European geopolitics during Leibniz's adult life was the ambition of Louis XIV of France , backed by French military and economic might. Meanwhile,

9184-400: The leading French philosophers of the day, and studied the writings of Descartes and Pascal , unpublished as well as published. He befriended a German mathematician, Ehrenfried Walther von Tschirnhaus ; they corresponded for the rest of their lives. When it became clear that France would not implement its part of Leibniz's Egyptian plan, the Elector sent his nephew, escorted by Leibniz, on

9296-400: The many bones that have been found, including 60 species of mammal; amongst them the cave lion and the wolf . In 1905, the Unicorn Cave was made accessible to visitors by the construction of an entrance gallery. Since then, 270 metres (890 ft) of the total length of 610 metres (2,000 ft) have been opened up as a show cave. The Unicorn Cave is one of the three information centres of

9408-773: 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

9520-497: The nearby village of Scharzfeld . As she was a pagan, she was forced to flee from a group of Frankish warriors, led by a monk in a black habit. A unicorn is said to have appeared and protected her from the pursuers, allowing her to escape and join the witches' community on the Brocken Mountain . The unicorn then chased away the warriors and black monk, causing him to disappear into a deep hole while running. This hole then led to

9632-496: 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

9744-496: The next Elector became quite annoyed at Leibniz's apparent dilatoriness. Leibniz never finished the project, in part because of his huge output on many other fronts, but also because he insisted on writing a meticulously researched and erudite book based on archival sources, when his patrons would have been quite happy with a short popular book, one perhaps little more than a genealogy with commentary, to be completed in three years or less. They never knew that he had in fact carried out

9856-483: The offer of an academic appointment at Altdorf, saying that "my thoughts were turned in an entirely different direction". As an adult, Leibniz often introduced himself as "Gottfried von Leibniz". Many posthumously published editions of his writings presented his name on the title page as " Freiherr G. W. von Leibniz." However, no document has ever been found from any contemporary government that stated his appointment to any form of nobility . Leibniz's first position

9968-510: The only way we can truly love God is by being content "with all that comes to us according to his will" (IV). Because God is "an absolutely perfect being" (I), Leibniz argues that God would be acting imperfectly if he acted with any less perfection than what he is able of (III). His syllogism then ends with the statement that God has made the world perfectly in all ways. This also affects how we should view God and his will. Leibniz states that, in lieu of God's will, we have to understand that God "is

10080-477: 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

10192-625: The period. Leibniz began promoting a project to use windmills to improve the mining operations in the Harz Mountains. This project did little to improve mining operations and was shut down by Duke Ernst August in 1685. Among the few people in north Germany to accept Leibniz were the Electress Sophia of Hanover (1630–1714), her daughter Sophia Charlotte of Hanover (1668–1705), the Queen of Prussia and his avowed disciple, and Caroline of Ansbach ,

10304-440: 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

10416-432: 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

10528-426: The principle of pre-established harmony , each monad follows a pre-programmed set of "instructions" peculiar to itself, so that a monad "knows" what to do at each moment. By virtue of these intrinsic instructions, each monad is like a little mirror of the universe. Monads need not be "small"; e.g., each human being constitutes a monad, in which case free will is problematic. Monads are purported to have gotten rid of

10640-531: The problematic: The Theodicy tries to justify the apparent imperfections of the world by claiming that it is optimal among all possible worlds . It must be the best possible and most balanced world, because it was created by an all powerful and all knowing God, who would not choose to create an imperfect world if a better world could be known to him or possible to exist. In effect, apparent flaws that can be identified in this world must exist in every possible world, because otherwise God would have chosen to create

10752-518: The term " possible world " to define modal notions. Gottfried Leibniz was born on July 1 [ OS : June 21], 1646, in Leipzig , Saxony, to Friedrich Leibniz (1597–1652) and Catharina Schmuck (1621–1664). He was baptized two days later at St. Nicholas Church, Leipzig ; his godfather was the Lutheran theologian Martin Geier  [ de ] . His father died when he was six years old, and Leibniz

10864-555: 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

10976-602: The view of Leibniz, because reason and faith must be entirely reconciled, any tenet of faith which could not be defended by reason must be rejected. Leibniz then approached one of the central criticisms of Christian theism: if God is all good , all wise , and all powerful , then how did evil come into the world ? The answer (according to Leibniz) is that, while God is indeed unlimited in wisdom and power, his human creations, as creations, are limited both in their wisdom and in their will (power to act). This predisposes humans to false beliefs, wrong decisions, and ineffective actions in

11088-423: The world must be perfect. Leibniz also comforts readers, stating that because he has done everything to the most perfect degree; those who love him cannot be injured. However, to love God is a subject of difficulty as Leibniz believes that we are "not disposed to wish for that which God desires" because we have the ability to alter our disposition (IV). In accordance with this, many act as rebels, but Leibniz says that

11200-406: The world that excluded those flaws. Leibniz asserted that the truths of theology (religion) and philosophy cannot contradict each other, since reason and faith are both "gifts of God" so that their conflict would imply God contending against himself. The Theodicy is Leibniz's attempt to reconcile his personal philosophical system with his interpretation of the tenets of Christianity. This project

11312-418: 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

11424-750: Was a life member of the Royal Society and the Berlin Academy of Sciences , neither organization saw fit to honor his death. His grave went unmarked for more than 50 years. He was, however, eulogized by Fontenelle , before the French Academy of Sciences in Paris, which had admitted him as a foreign member in 1700. The eulogy was composed at the behest of the Duchess of Orleans , a niece of the Electress Sophia. Leibniz never married. He proposed to an unknown woman at age 50, but changed his mind when she took too long to decide. He complained on occasion about money, but

11536-419: 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

11648-583: Was as a salaried secretary to an alchemical society in Nuremberg . He knew fairly little about the subject at that time but presented himself as deeply learned. He soon met Johann Christian von Boyneburg (1622–1672), the dismissed chief minister of the Elector of Mainz , Johann Philipp von Schönborn . Von Boyneburg hired Leibniz as an assistant, and shortly thereafter reconciled with the Elector and introduced Leibniz to him. Leibniz then dedicated an essay on law to

11760-548: Was considered that there were already enough foreigners there and so no invitation came. He left Paris in October 1676. Leibniz managed to delay his arrival in Hanover until the end of 1676 after making one more short journey to London, where Newton accused him of having seen his unpublished work on calculus in advance. This was alleged to be evidence supporting the accusation, made decades later, that he had stolen calculus from Newton. On

11872-460: Was educated influenced his view of their work. Leibniz variously invoked one or another of seven fundamental philosophical Principles: Leibniz would on occasion give a rational defense of a specific principle, but more often took them for granted. Leibniz's best known contribution to metaphysics is his theory of monads , as exposited in Monadologie . He proposes his theory that the universe

11984-651: Was guided, among others, by Jakob Thomasius , previously a student of Friedrich. Leibniz completed his bachelor's degree in Philosophy in December 1662. He defended his Disputatio Metaphysica de Principio Individui ( Metaphysical Disputation on the Principle of Individuation ), which addressed the principle of individuation , on 9 June 1663 [ O.S. 30 May], presenting an early version of monadic substance theory. Leibniz earned his master's degree in Philosophy on 7 February 1664. In December 1664 he published and defended

12096-438: Was identified as a Protestant and a philosophical theist . Leibniz remained committed to Trinitarian Christianity throughout his life. Leibniz's philosophical thinking appears fragmented because his philosophical writings consist mainly of a multitude of short pieces: journal articles, manuscripts published long after his death, and letters to correspondents. He wrote two book-length philosophical treatises, of which only

12208-656: Was motivated in part by Leibniz's belief, shared by many philosophers and theologians during the Enlightenment , in the rational and enlightened nature of the Christian religion. It was also shaped by Leibniz's belief in the perfectibility of human nature (if humanity relied on correct philosophy and religion as a guide), and by his belief that metaphysical necessity must have a rational or logical foundation, even if this metaphysical causality seemed inexplicable in terms of physical necessity (the natural laws identified by science). In

12320-403: Was one of the three influential early modern rationalists . His philosophy also assimilates elements of the scholastic tradition, notably the assumption that some substantive knowledge of reality can be achieved by reasoning from first principles or prior definitions. The work of Leibniz anticipated modern logic and still influences contemporary analytic philosophy , such as its adopted use of

12432-544: Was quite an honor, especially in light of the meteoric rise in the prestige of that House during Leibniz's association with it. In 1692, the Duke of Brunswick became a hereditary Elector of the Holy Roman Empire . The British Act of Settlement 1701 designated the Electress Sophia and her descent as the royal family of England, once both King William III and his sister-in-law and successor, Queen Anne , were dead. Leibniz played

12544-437: Was raised by his mother. Leibniz's father had been a Professor of Moral Philosophy at the University of Leipzig , where he also served as dean of philosophy. The boy inherited his father's personal library. He was given free access to it from the age of seven, shortly after his father's death. While Leibniz's schoolwork was largely confined to the study of a small canon of authorities, his father's library enabled him to study

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