Ancient Medicine started from time immemorial man has been interested in trying to control disease. herbalist and the magician, all undertook in various ways to cure man’s disease and/or to bring relief to the sick.In an almost complete absence of scientific medical knowledge, it would not be fair to say that the early practitioners of medicine contributed nothing to the alleviation of man’s suffering from disease. Medical knowledge in fact has been derived, to a very great degree, from the intuitive and observational propositions and cumulative experiences gleaned from others. A history of medicine thus contributes a review of accomplishments and errors, false theories and misinformation and mistaken interpretations.In Ancient Medicine It is also a study of the evolution of man and of human knowledge down the ages; of the biographies of eminent individuals who developed medicine; of the discoveries and inventions in different historical periods; and of the ever-changing concepts, goals and objectives of medicine.
In the course of its evolution, which proceeded by stages, with advances and halts, medicine has drawn richly from the traditional cultures of which it is a part, and later from biological and natural sciences and more recently from social and behavioural sciences. Medicine is thus built on the best of the past.
In the crucible of time, medicine has evolved itself into a social system heavily bureaucratized “explosion” of knowledge during the 20th century has made medicine more complex, and treatment more costly, but the benefits of modern medicine have not yet penetrated the social periphery in many countries.
The glaring contrasts in the state of health between the developed and developing countries, between the rural and urban areas, and between the rich and poor have attracted worldwide criticism as “social injustice”. The commitment of all countries, under the banner of the World Health Organization, is to wipe out the inequalities in the distribution of health resources and services, and attain the Millenium Development Goals. The goal of modern medicine is no longer merely treatment of sickness.
The other and more important goals which have emerged are prevention of disease, promotion of health and improvement of the quality of life of individuals and groups or communities. In other words, the scope of medicine has considerably broadened during recent years. It is also regarded as an essential development. The medicine man, the priest, the and politicized. The components of socio-economic development.
Medicine In Antiquity
In ancient times, health and illness were interpreted in a cosmological and anthropological perspective. Medicine was dominated by magical and religious beliefs which were an integral part of ancient cultures and civilizations. Henry Siegerist, the medical historian has stated that every culture had developed a system of medicine, and medical history is O but one aspect of the history of culture.
Dubos goes one step further and says that ancient medicine was the mother of sciences and played a large role in the integration of early cultures. Since there is an organic relationship between medicine and human advancement, any account of medicine at a given period should be viewed against the civilization and human advancement at that time, i.e. U philosophy, religion, economic conditions, government, education, science and aspirations of the people.
It has been truly said that medicine was conceived in sympathy and born out of necessity; and that the first doctor was the first man, and the first woman, the irst nurse, The prehistoric man, motivated by leelings of sympathy and kindness, was always at the behest of his kindred, trying to provide relief, in times of sickness and suffering. Since his knowledge was limited, the primitive man attributed disease, and in fact all human suffering and other calamities, to the wrath of gods, the invasion of body by “evil spirits” and the malevolent influence of stars and planets.
The concept of disease in which the ancient man believed is known as the “supernatural theory of disease” As a logical sequence, the medicine he practised consisted in appeasing gods by prayers, rituals and sacrifices, driving out “evil spirits” from the human body by witchcraft and other crude means and using charms and amulets to protect himself against administration of certain herbs or drugs whose effect is doubtful or nil, but hopefully harmless, may also be likened to a kind of magic ritual associated with the need to “do something”.
There is also evidence that prehistoric man improvised stone and flint instruments with which he performed skulls. It is thus obvious that medicine in the prehistoric times (about 5000 B.C. ) was intermingled with superstition, religion, magic and witchcraft. the influence of evil spirits. The circumcisions, amputations and trephining of
Primitive medicine is timeless. If we look around the world, we find that the rudiments of primitive medicine still persist in many parts of the world – in Asia, Africa, South America, Australia and the Pacific islands. The super natural theory of disease in which the primitive man believed is as new as today. For example, in India, one may still hear the talk of curing snake bites by “mantras”. Diseases such as leprosy are interpreted as being punishment for one’s past sins in some cultures. All through primitive man may be extinct, his progeny –the-so-called “traditional healers” are found everywhere.
They live close to the people and their treatment are based on various combinations of religion, magic and empiricism.
The Indian Medicine
The medical systems that are truly Indian in origin and development are the Ayurveda and the Siddha systems Ayurveda is practised throughout India, but the Siddha system is practised in the Tamil-speaking areas of South India These systems differ very little both in theory and practice (Ayurveda by definition implies the “knowledge of life” or the knowledge by which lile may be prolonged ts, During this period, medical history was associated with mythological iqures, sages and seers.
Dhanvantari, the of the churning of the oceans during a Tug of war between gods and demons According to some authorities, the medical knowledge in the Atharvaveda (one of the four Vedas) gradually developed into the science of Ayurveda In ancient India, the celebrated authorities in Ayurvedic medicine were Atreya, Charaka, Susruta and Vaghbhatt Atreya (about 800 B.C.) is acknowledged as the first great Indian physician and teacher. He lived in the ancient university of Takshashila, about 20 miles west of modern Rawalpindi (5). Ayurveda witnessed tremendous growth and development during the Buddhist times (226 King Ashoka B.C. ) and the other Buddhist kings patronized Ayurveda as State medicine and established schools of medicine and public hospitals.
Charaka (200 A.D.), the most popular name in Ayurvedic medicine, was a court physician to the Buddhist king Kanishka. Based on the teachings of Atreya, Charaka compiled his famous treatise on medicine, the “Charaka Samhita”. Charaka mentions some 500 drugs The Indian centuries by the Indian physicians, before reserpine was extracted from the root and found spectacularly effective in the treatment of hypertension.Among the medicine, that of Susruta, the “father of Indian surgery”
stands out in prominence. He compiled the surgical knowledge of his time in his classic “Susruta Samhita”. It is believed that this classic was compiled between 800 B.Cand 400 A.D. Though this work is mainly devoted to Surgery, it also includes medicine,midwifery, ophthalmology, hygiene and bedside manners. The early Indians set fractures, performed amputations, excised tumours, repaired hernias and excelled in cataract operations and plastic surgery. It is stated that the British physicians learned the art of rhinoplasty from surgeons in the days of East India Company. However, during Buddhist times, Indian surgery because of the doctrine of ahimsa (non-violence). Of significance in Ayurveda is the “tridosha theory of disease”.
The doshas or humors are: vata (wind), pitta (gall) and kapha (mucus). Disease was explained as a disturbance in the equilibrium of the three humors; when these were is snakeroot (rauwolfia) was employed for many distinguished names pathology, anatomy, Indian buffered a setback, This theory of disease is strikingly similar to the “thep of four humors” in Greek medicine Medical historians admit that there was free exchange ol thought and experience between the Hindu, Arab, Persian, Greek and Jewish scholars translated into Persian and Arabic in about 800 AD The Samhitas of Charaka and Susruta were translated into persian and arabic in about 800 AD.
Hygiene was given an important place in ancient Indian medicine. The laws of Manu were a code of personal hygiene. Archaeological excavations at Mohenjo-daro and Harappa in the Indus valley uncovered cities of over two thousand years old which revealed rather knowledge of sanitation, water supply and engineering. The golden age of Indian medicine was between 800 B.C. and 600 A.D. During the Moghul period and subsequent years, Ayurveda declined due to lack of State support. Advanced Medical historians admit that Indian medicine has played in Asia the same role as the Greek medicine in the west, for it has spread in Indochina, Indonesia, Tibet, Central Asia, and as far as Japan, exactly as the Greek medicine has done in Europe and Arab countries . Mention must be made of the other indigenous systems of medicine namely Unani-Tibb and Homoeopathy, which are not of Indian origin. The Unani-Tibb system of medicine, whose origin is traced to the ancient Greek medicine, was introduced into India by the Muslim rulers about the 10th century A.D. By the 13th century, the Unani system of medicine was firmly entrenched in certain towns and cities notably Delhi, Aligarh, Lucknow and Hyderabad . It enjoyed State support under successive Muslim rulers in India, till the advent of the British in the 18th century. Homoeopathy, which was Hahnemann (1755-1843) of Germany gained foothold in India during 1810 and 1839. It is a system of pharmaco- dynamics based on “treatment of disease by the use of small amounts of a drug that, in healthy persons, produces symptoms similar to those of the disease being treated”. Homoeopathy is practised in several countries, but India claims to have the largest number of practitioners of this system in the world (9). The Indian systems of medicine including Unani-Tibb and Homoeopathy are very much alive in India even today. In fact, they have become part of Indian culture, and they continue to be an important source of medical relief to the rural population.
Chinese medicine claims to be the world’s first organized body of medical knowledge dating back to 2700 B.C. . It is based on two principles is believed to be an active masculine principle and the vin negative feminine principle.) The balance of these two opposing forces meant good health. Hygiene, dietetics hydrotherapy, massage, drugs were all used by the Chinese physicians.
The Chinese were early pioneers of immunization. They practised variolation to prevent smallpox. To a Chinese, “the great doctor is one who treats not someone who is already ill but someone not yet ill”.
The Chinese have great faith in their traditional medicine, which is fully integrated with modern medicine. The Chinese system of “barefoot doctors” and accupuncture have attracted worldwide attention in recent years . the yang and the yin. The yang Egyptian medicine Egypt had one of the oldest civilizations in about 2000 B.C. A lot is known about ancient Egypt because they invented picture writing and recorded their doings on papyrus.
In Egyptian times, the art of medicine was mingled with religion. Egyptian physicians were co-equals of priests, trained in schools within the temples. They often helped priests care for the sick who were brought to the temples for treatment. There were no practical demonstrations in anatomy, for Egyptian religion enjoined strict preservation of the human body.
Egyptian medicine reached its peak in the days of Imhotep (2800 B.C.) who was famous as a statesman, architect, builder of the step pyramid at Saggarah and physician. The Egyptians worshipped many gods. Imhotep was considered both a Specialization prevailed doctors, head doctors and tooth doctors. All these doctors were officials paid by the State. Homer speaking of the doctors of the ancient world considered the Egyptians to be the “the best of all” doctor and divinity. Egyptian times. There were eye Egyptian medicine was far from primitive. They believed that disease was due to absorption from the intestine of harmful substances which gave rise to putrefaction of blood and formation of pus. They believed that the pulse was “the
speech of the heart”. Diseases were treated with cathartics, enema, blood-letting and a wide range of drugs. The best known medical manuscripts belonging to the Egyptian times are the Edwin Smith papyrus (3000-2500 B.C. ), and the Ebers papyrus (1150 B.C.). The Edwin Smith papyrus, the oldest treatise on surgery, accurately describes partial paralysis following cerebral lesions in skull fractures. The Ebers papyrus which was found with a mummy on the banks of the Nile, is a unique record of some 800 prescriptions based on some 700 drugs. Castor oil, tannic acid, opium, turpentine,
gentian, senna, minerals and root drugs were all used by the Egyptian physicians. A great number of diseases are reported in the papyri such as worms, eye diseases, diabetes, rheumatism, polio and schistosomiasis. Unfortunately, these ailments are still present in modern Egypt (7) In the realm of public health also, the Egyptians excelled. They built planned cities, drains which even the modern might envy. They had also some knowledge of inoculation against smallpox, the value of mosquito nets and the association of plague with rats. Their god of health was Horus. Egyptian medicine occupied a dominant place in the ancient world for about 2,500 yearswhen it was replaced by Greek medicine.
Contemporary with ancient Egyptian civilization, there existed another civilization in the land which lies between the Euphrates and Tigris rivers, Mesopotamia (now part of Iraq), often called the “Cradle of Civilization”, as long as 6,000 years ago. In ancient Mesopotamia, the basic concepts of medicine were religious, and taught and practised by herb doctors, knife doctors and spell doctors a classification that roughly parallels our own internists, surgeons and psychiatrists.
Mesopotamia was the cradle of magic and necromancy. Medical students were busy in classifying “demons”, the causes of diseases. Geomancy, the interpretation of dreams, and hepatoscopic divination (the liver was considered the seat of life) are characteristic of their medical lore. Sumerians, Babylonians and Assyrians were the authors of a medical astrology which flourished in the whole of Eurasia. Prescriptions were written on tablets, in cuneiform writing. The oldest medical prescription Mesopotamia, dating back to 2100 B.C.comes us from Hammurabi, 2000 B.C. formulated a set of drastic laws known as the Code of Hammurabi that governed the conduct of physicians and provided for health practices . Doctors whose great king of Babylon who lived around proposed therapy proved wrong, ran the risk of being killed.
Laws relating to medical practice, including fees payable to physicians for satisfactory services and penalties for harmful therapy are contained in the Babylonian Code of Hammurabi, the very first codification of medical practice While the code of Hammurabi reflected a high degree of social organization, the medicine of his time was devoid of any scientific foundation.
Greek medicine The classic period of Greek medicine was the year 460-136 B.C. The Greeks enjoyed the reputation of the ancient world. They taught men to think in terms of why’ and ‘how’. An early leader in Greek medicine was Aesculapius (1200 B.C. ) . Aesculapius bore two daughters Hygiea and Panacea. The medical historian, Guthrie has reminded us of the legend that Hygiea was worshipped goddess of medicine. Panacea and Hygiea gave rise to dynasties of healers (curative medicine) and hygienists (preventive medicine) with different philosophies.
Thus the dichotomy between curative medicine began early and we know it remains true today. Hygiea (prevention) is at present fashionable among the intellectuals; but Panacea (cure) gets the cash. Aesculapius is still cherished in medical circles serpent, continues to be the symbol of medicine.
The civilizers Douglas as the goddess of health, and Panacea as the medicine and preventive his staff, entwined by a By far the greatest physician in Greek medicine was Hippocrates (460-370 B.C.) who is often called the “Father of Medicine”. He was born on the little island of Cos, in the Aegean sea, diseases based on observation and reasoning. He challenged the tradition of magic in medicine, and initiated a radically new approach to medicine i.e., application of clinical methods in medicine. Hippocrate’s lectures and writings, as
compiled later by Alexandrian scholars into the “Corpus Hippocraticum”, encompassed all branches of medicine. This 72 volume work contains the first scientific clinical case histories. Some of the sayings of Hippocrates later became favourites with physicians, such as “Life is short, the art (of medicine) long, opportunity fleeting, experience treacherous and judgement difficult”, and mankind, there is love for the art of healing”. His famous oath, the “Hippocratic oath” has become the keystone of medical ethics. It sets a high moral standard for the medical profession and demands absolute integrity of doctors Hippocrates will always be regarded as one of the masters of the medical art.
Hippocrates was also an epidemiologist. Since he distinguished between diseases which were epidemic and those which were endemic, he was, in fact, the first true epidemiologist. He was constantly seeking the causes of disease. He studied such things as climate, water, clothing. diet, habits of eating and drinking and the effect they had in
producing disease. His book “Airs, Water and Places” js considered a treatise on social medicine and hygiene, The Hippocratic concept of health and disease stressed the relation between man and his environment. In short, the Greeks gave a new direction to medical thought. They rejected the supernatural theory of disease and looked upon disease as a natural process, not a god of immolation. The Greeks believed earth, air, fire visitation from a that matter was made up of four elements and water. These elements had the corresponding qualities of being cold, dry, hot and moist and were the body by the four humors represented in phlegm, yellow bile, blood and black bile Ayurveda. The Greeks postulated that health prevailed when the four humors were in equilibrium and when the balance was disturbed, disease was the result. The human body was assumed to have powers of restoration of humoral equilibrium, and it was the physician’s primary role to assist in this healing process. While the humoral theory of Hippocrates was based on incorrect foundations, the concept of the innate capacity of the body of responding to disturbances in the equilibrium that constitutes health is highly relevant to modern medicine.similar to the “tridosha theory” in Outstanding amongst post-Hippocratic medical centres was Alexandria’s huge museum, the first University in the world which sheltered a library containing over 70,000 books. To this house of learning came eminent men.
Between 300 B.C. and 30 B.C., thousands of pupils matriculated in the school of Alexandria, which replaced Athens as the world’s centre of learning. In short, the Hippocratic school inspired in turn the Alexandria school, and the Arabo-Persian medicine. The Hippocratic school changed the destiny of medicine by separating it from magic and raising it to the status of a science. They had scientific method, although not scientific knowledge. The glorious Greek civilization fell into decay and was succeeded by the Roman civilization.