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History of medicine

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All human societies have medical beliefs that provide explanations for, and responses to, birth, death, and disease. Throughout the world, illness has often been attributed to witchcraft, demons, averse astral influence, or the will of the gods, ideas that retain some power, with faith healing and shrines still common, although the rise of scientific medicine in the past two centuries has altered or replaced many historic health practices.

General review of the history of medicine

Herbalism

See main article: Herbalism.

There is no actual record of when the use of plants for medicinal purposes first started, although the first generally accepted use of plants as healing agents were depicted in the cave paintings discovered in the Lascaux caves in France, which have been Radiocarbon dated to between 13,000 - 25,000 BCE.

Over time and with trial and error, a small base of knowledge was acquired within early tribal communities. As this knowledge base expanded over the generations, tribal culture developed into specialized areas. These 'specialized jobs' became what are now known as healers or Shaman.

Egyptian medicine

See main article: Ancient Egyptian medicine.

Medical information contained in the Edwin Smith Papyrus date as early as 3000 BC ([1]). The earliest known surgery was performed in Egypt around 2750 BC (see surgery). Imhotep in the 3rd dynasty is credited as the founder of ancient Egyptian medicine and as the original author of the Edwin Smith papyrus, detailing cures, ailments and anatomical observations. The Edwin Smith papyrus is regarded as a copy of several earlier works and was written circa 1600 BC. It is an ancient textbook on surgery and describes in exquisite detail the examination, diagnosis, treatment, and prognosis of numerous ailments ([2]).

Additionally, the Ebers papyrus (c. 1550 BC) is full of incantations and foul applications meant to turn away disease-causing demons and other superstition, in it there is evidence of a long tradition of empirical practice and observation.[citation needed] The Ebers papyrus also provides our earliest documentation of a prehistoric awareness of tumors[citation needed].

Medical institutions are known to have been established in ancient Egypt since as early as the 1st Dynasty[citation needed]. By the time of the 19th Dynasty their employees enjoyed such benefits as medical insurance, pensions and sick leave. Employees worked 8 hours per day [3].

The earliest known physician is also credited to ancient Egypt: Hesyre, “Chief of Dentists and Physicians” for King Djoser in the 27th century BC [4]. Also, the earliest known woman physician, Peseshet, practiced in Ancient Egypt at the time of the 4th dynasty. Her title was “Lady Overseer of the Lady Physicians.” In addition to her supervisory role, Peseshet graduated midwives at an ancient Egyptian medical school in Sais (see Medicine In Ancient Egypt, page 3).

See also the article on ancient Egyptian medicine posted at Indiana University: Medicine in Ancient Egypt.

Indian medicine

Main article: Ayurveda

Ayurveda (the science of living), the Vedic system of medicine originating over 3000 years ago, views health as harmony between body, mind and spirit. Its two most famous texts belong to the schools of Charaka and Sushruta. According to Charaka, health and disease are not predetermined and life may be prolonged by human effort. Sushruta defines the purpose of medicine to cure the diseases of the sick, protect the healthy, and to prolong life.

Āyurveda speaks of eight branches: kāyāchikitsā (internal medicine), shalyachikitsā (surgery including anatomy), shālākyachikitsā (eye, ear, nose, and throat diseases), kaumārabhritya (pediatrics), bhūtavidyā (psychiatry, or demonology), and agada tantra (toxicology), rasāyana (science of rejuvenation), and vājīkarana (the science of fertility).

Apart from learning these, the student of Āyurveda was expected to know ten arts that were indispensable in the preparation and application of his medicines: distillation, operative skills, cooking, horticulture, metallurgy, sugar manufacture, pharmacy, analysis and separation of minerals, compounding of metals, and preparation of alkalis. The teaching of various subjects was done during the instruction of relevant clinical subjects. For example, teaching of anatomy was a part of the teaching of surgery, embryology was a part of training in pediatrics and obstetrics, and the knowledge of physiology and pathology was interwoven in the teaching of all the clinical disciplines.

At the closing of the initiation, the guru gave a solemn address to the students where the guru directed the students to a life of chastity, honesty, and vegetarianism. The student was to strive with all his being for the health of the sick. He was not to betray patients for his own advantage. He was to dress modestly and avoid strong drink. He was to be collected and self-controlled, measured in speech at all times. He was to constantly improve his knowledge and technical skill. In the home of the patient he was to be courteous and modest, directing all attention to the patient's welfare. He was not to divulge any knowledge about the patient and his family. If the patient was incurable, he was to keep this to himself if it was likely to harm the patient or others.

The normal length of the student's training appears to have been seven years. Before graduation, the student was to pass a test. But the physician was to continue to learn through texts, direct observation (pratyaksha), and through inference (anumāna). In addition, the vaidyas attended meetings where knowledge was exchanged. The doctors were also enjoined to gain knowledge of unusual remedies from hillsmen, herdsmen, and forest-dwellers.

In 2001, archaeologists studying the remains of two men from Mehrgarh, Pakistan, made the discovery that the people of Indus Valley Civilization, even from the early Harappan periods (circa 3300 BC), had knowledge of medicine and dentistry. The physical anthropologist who carried out the examinations, Professor Andrea Cucina from the University of Missouri-Columbia, made the discovery when he was cleaning the teeth from one of the men. (See Indus Valley Civilization: Science)

Chinese medicine

See main article: History of traditional Chinese medicine.

China also developed a large body of traditional medicine. Much of the philosophy of traditional Chinese medicine derived from empirical observations of disease and illness by Taoist physicians and reflects the classical Chinese belief that individual human experiences express causative principles effective in the environment at all scales. These causative principles, whether material, essential, or mystical, correlate as the expression of the natural order of the universe.

During the golden age of his reign from 2696 to 2598 B.C, as a result of a dialogue with his minister Ch'i Pai, the Yellow Emperor is supposed by Chinese tradition to have composed his Neijing (內經) Suwen (素問) or Basic Questions of Internal Medicine.

During the Han dynasty, Chang Chung-Ching, who was mayor of Chang-sha near the end of the second century A.D., wrote a Treatise on Typhoid Fever, which contains the earliest known reference to Neijing Suwen. The Chin dynasty practitioner and advocate of acupuncture and moxibustion, Huang-fu Mi (215-282 A.D), also quotes the Yellow Emperor in his Chia I Ching, ca. 265 A.D. During the Tang dynasty, Wang Ping claimed to have located a copy of the originals of the Neijing Suwen, which he expanded and edited substantially. This work was revisited by an imperial commission during the eleventh century A.D., and the result is our best extant representation of the foundational roots of traditional Chinese medicine.

Hebrew medicine

Most of our knowledge of ancient Hebrew medicine during the 1st millennium BC comes from the Old Testament of the Bible which contain various health related laws and rituals, such as isolating infected people (Leviticus 13:45-46), washing after handling a dead body (Numbers 19:11-19) and burying excrement away from camp (Deuteronomy 23:12-13). Max Neuberger, writing in his "History of Medicine" says"

"The commands concern prophylaxis and suppression of epidemics, suppression of venereal disease and prostitution, care of the skin, baths , food, housing and clothing, regulation of labour , sexual life , discipline of the people , etc. Many of these commands, such as Sabbath rest, circumcision, laws concerning food (interdiction of blood and pork), measures concerning menstruating and lying-in women and those suffering from gonorrhoea, isolation of lepers, and hygiene of the camp, are, in view of the conditions of the climate, surprisingly rational."(Neuburger: History of Medicine, Oxford University Press, 1910, Vol. I, p. 38).

Early European medicine

See also Medieval medicine.

File:Medical Astro-Man.jpg
Astrology played a very important part in early Western medicine; most university-educated physicians were trained in at least the basics of astrology to use in their practice

As societies developed in Europe and Asia, belief systems were replaced with a different natural system. The Greeks, from Hippocrates, developed a humoral medicine system where treatment was to restore the balance of humours within the body. Ancient Medicine is a treatise on medicine, written roughly 400 BC by Hippocrates. Similar views were espoused in China and in India. See Medicine in Ancient Greece for more. In Greece, through Galen until the Renaissance the main thrust of medicine was the maintenance of health by control of diet and hygiene. Anatomical knowledge was limited and there were few surgical or other cures, doctors relied on a good relation with patients and dealt with minor ailments and soothing chronic conditions and could do little when epidemic diseases, growing out of urbanization and the domestication of animals, then raged across the world.

Medieval medicine was an evolving mixture of the scientific and the spiritual. In the early middle ages, following the fall of the Roman Empire, standard medical knowledge was based chiefly upon surviving Greek and Roman texts, preserved in monasteries and elsewhere. Ideas about the origin and cure of disease were not, however, purely secular, but were also based on a spiritual world view, in which factors such as destiny, sin, and astral influences played as great a part as any physical cause.

In this era, there was no clear tradition of scientific medicine, and accurate observations went hand-in-hand with spiritual beliefs as part of the practice of medicine.

Islamic medicine

Main article: Islamic medicine

The Islamic World rose to primacy in medical science with such thinkers as Ibn Sina (Avicenna), Ibn Nafis, and Rhazes.

The first generation of Persian superb physicians were trained at the Academy of Gundishapur, where the teaching hospital was first invented. Rhazes, for example, became the first physician to systematically use alcohol in his practice as a physician.

The Comprehensive Book of Medicine (Large Comprehensive, Hawi or "al-Hawi" or "The Continence") was written by the Iranian chemist Rhazes (known also as Razi), the "Large Comprehensive" was the most sought after of all his compositions. In it, Rhazes recorded clinical cases of his own experience and provided very useful recordings of various diseases.

The "Kitab fi al-jadari wa-al-hasbah" by Rhazes, with its introduction on measles and smallpox was also very influential in Europe.

The Mutazilite philosopher and doctor Ibn Sina (also known as Avicenna in the western world) was another influential figure. His The Canon of Medicine, sometimes considered the most famous book in the history of medicine, remained a standard text in Europe up until its Age of Enlightenment and the renewal of the Islamic tradition of scientific medicine.

Maimonides, although a Jew himself, made various contributions to Arabic medicine in the 12th century.

Ibn Nafis (d. 1288) described human blood circulation. This discovery would be rediscovered, or perhaps merely demonstrated, by William Harvey in 1628, who generally receives the credit in Western history. There was a persistent pattern of Europeans repeating Arabian research in medicine and astronomy, and some say physics, and claiming credit for it.

European Renaissance and Enlightenment medicine

This idea of personalised medicine was challenged in Europe by the rise of experimental investigation, principally in dissection, examining bodies in a manner alien to other cultures. The work of individuals like Andreas Vesalius and William Harvey challenged accepted folklore with scientific evidence. Understanding and diagnosis improved but with little direct benefit to health. Few effective drugs existed, beyond opium and quinine, folklore cures and almost or actually poisonous metal-based compounds were popular, if useless, treatments.

Important figures:

Modern medicine

Medicine was revolutionized in the 18th century and beyond by advances in chemistry and laboratory techniques and equipment, old ideas of infectious disease epidemiology were replaced with bacteriology.

Ignaz Semmelweis in 1847 dramatically reduced the death rate of new mothers from childbed fever by the simple experiment of requiring physicians to wash their hands before attending to women in childbirth. His discovery predated the germ theory of disease. However, his discoveries were not appreciated by his contemporaries and came into use only with discoveries of British surgeon Joseph Lister, who in 1865 proved the principles of antisepsis.

His work is based on the very important discoveries made by French biologist Louis Pasteur. Pasteur was able to link some microorganisms with disease. This brought a revolution in medicine. He also devised one of the most important methods in preventive medicine, when in 1880 he produced the vaccine against rabies. Pasteur also invented the process of pasteurization to help prevent the spread of disease through milk and other foods.

Robert Koch is considered one of the founders of bacteriology. He is famous for the discovery of the tubercle bacillus (1882) and the cholera bacillus (1883) and for his development of Koch's postulates.

For the first time actual cures were developed for certain endemic infectious diseases. However the decline in the most lethal diseases was more due to improvements in public health and nutrition than to medicine. It was not until the 20th century that there was a true breakthrough in medicine, with great advances in pharmacology and surgery.

The 20th century witnessed a shift from a master-apprentice paradigm of teaching of clinical medicine to a more "democratic" system of medical schools. With the advent of the evidence-based medicine and great advances of information technology the process of change is likely to evolve further.

Evidence-based medicine, the application of modern scientific method to ask and answer clinical questions, has had a great impact on practice of medicine throughout the world of modern medicine.

Modern, western medicine has proven uniquely effective and widespread compared with all other medical forms, but has fallen far short of what once seemed a realistic goal of conquering all disease and bringing health to even the poorest of nations. It is notably secular and material, indifferent to ideas of the supernatural or the spirit, and concentrating on the body to determine causes and cures - an emphasis that has provoked something of a backlash in recent years.

Medical inventions

Source
Running Press Cyclopedia, second edition

Special history of medicine

Museums and collections of health and medicine

See also

External links

Bibliography

  • Porter, R. (1997). The Greatest Benefit to Mankind: A Medical History of Humanity from Antiquity to the Present. Harper Collins. ISBN 0002151731.
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