Ancient Medicine Overview

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Prehistoric

Prehistoric means 'before writing'. We know about prehistoric medicine due to: archaeological evidence from skeletons, which tell us about simple surgery and life expectancy; and tribes of people who have continued to live the same ways as their ancestors (e.g. Australian aboriginals).

Natural:

Made from herbs, plants, minerals, animal parts, etc. A common remedy is honey and herbs for sore throats.

Gashes were covered with mud and bound with bark.

Cuts were smeared with healing herbs.

Medicine men (shaman) would give herbal remedies.

Women would also care for the sick.

Tribes would not stay in one place for long, which distanced them from polluted water supplies and piles of excrement which attracted disease.

Natural injures and illness were caused by: accidents; hunting wounds; hunger; ailments such as fevers; polluted water supplies.

Supernatural:

Shaman were also trained to communicate with spirits, and would provide amulets, chants, and prayer to treat illness.

Prehistoric tribes believed that evil spirits could get into the body through cuts.

Trephining (drilling a hole in the skull) was done to release evil spirits from a person's skull.

Supernatural causes of illness were believed to be from gods, witches, curses from enemies, and the spirits of the dead.

They had achieved simple surgery in prehistoric times - they set bones with splints, and carried out the process of trephining (which some people survived). There was likely no pain relief (except perhaps some herbs).

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Egyptians

Egyptian medicine progressed significantly due to a number of factors.

War:

The Egyptians' metal-works improved as they made weapons for war - this meant they were able to create sharper surgical tools (thus, they were able to remove minor tumors from the surface of the skin).

Communications:

Egyptians developed hieroglyphics and papyrus paper. Doctors were able to record any medical ideas they had, and more effectively share ideas between themselves.

The Library of Alexandria was also a great source of knowledge, where medical papyri would be stored.

Trade from abroad was also made possible by the invention of boats. This meant Egyptians had access to more herbs and mineral ions, which could be used in treatment - e.g. malachite, which Egyptians crushed and wore as eye make-up, is effective against eye infections.

Religion:

Religion encouraged cleanliness, and the Egyptians washed several times throughout the day.

Embalmers had great anatomical knowledge, as their job was to preserve the organs after death.

Swnw were specially trained as both doctors and priests.

Way of life:

The rich could afford their own doctors, which meant doctors were wealthy enough to spend time studying and became specialist doctors.

Irrigation channels from the Nile in farming inspired the Channel Theory - people believed that illness was caused by blockages in the body. This lead belief away from purely supernatural causes of illness, which promoted further research into natural treatments.

Egyptians still used natural remedies, passed down through generations, to treat illness.

However, the progress of medicine was also hindered in Egyptian times.

Religion:

Dissection was condemned in religion, so embalmers were distanced from the rest of society. This meant that those with great anatomical knowledge were not able to share it.

Illness was still believed to be caused by gods and evil spirits, and so swnws still provided and recommended supernatural treatments (e.g. prayer, amulets).

Way of life:

There was no public health system and the government did not help to protect from illness.

The Channel Theory was incorrect, and methods like blood-letting and purging were used to treat illness.

Triphining was still commonly used.

Public health was poor - for example, people had to empty their toilets by hand.

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Ancient Greece

The Greeks developed lots of new ideas about medicine because they had lots of wealthy classes, whom were able to spend time being educated - many of them became rich through farming and trade, and the hard work in fields was done by slaves.

The Greeks used iron and steel, so doctors had stronger and sharper surgical instruments; they also had good techniques for setting broken bones; there is even evidence of some amputations. Internal operations did not take place, and there was limited pain relief.

A number of Greeks were also interested in finding logical, natural explanations of the world:

Aristotle developed the Theory of the Four Humours. The humours had to be balanced or we became sick, and our body would attempt to rid the excess humours. The humours were: blood (wet, warm - spring); phlegm (wet, cold - winter); black bile (dry, cold - autumn); and yellow bile (dry, warm - summer).

Hippocrates supported this theory, and also had his own major impact upon medicine. He developed:

The Hippocratic Oath - this gave people confidence in their doctors, and meant they felt able to trust them. It established that doctors had to keep high standards of treatment and behaviour, and to keep things confidential. It made a huge impact as it is still used to this day.

Hippocratic Collection - this was a number of books collected by Hippocrates, written by a number of Greek physicians. It was the first detailed list of symptoms and treatments, as well as theories and methods of treatment which were used for many centuries following its creation.

Clinical Observation - he showed that it was important to observe and record symptoms, development, and treatment of diseases. Doctors were more likely to use the correct cure if they took care to find the cause, and the notes made could be used to diagnose and treat later patients. This is also used to this day. At the time, clinical observation allowed the Greeks to develop a way to successfully drain the lungs

Natural treatments - Hippocrates' encouraged natural treatments that interfered minimally with the body (he was not an advocate of bloodletting and purging), and steered treatment away from the supernatural.

Asclepia were also developed in Greece. They were temples of healing, dedicated to the god Asclepius. The sick would go these temples, as it was believed that if they slept there, they would be visited and healed by Asclepius (and his daughters) in the night. By 200BC, there was an Asclepion in every town; each had its own priest, who would be a skilled healer.

Asclepia helped progress medicine because it enabled good public health. People would often feel better after visiting an Asclepion because the priests encouraged exercise, cleaning in baths, and a good diet. Some larger Asclepia had gyms, baths, stadiums, a theater, etc.

The priests would also treat patients in the night with natural remedies (e.g. garlic, which kills infections, and vinegar, which cleans wounds) and simple surgeries (e.g. removal of fragments of a spearhead from the cheek).

Some factors in Ancient Greece hindered the progression of medicine.

Some Geeks believed Gods caused and cure illness; these beliefs were encouraged through Asclepia.

Dissection was not permitted in Greece, so there was poor anatomical knowledge.

There was no public health system, so poor people were not able to get sufficient medical care.

Charms and prayers were still used by many.

The Theory of the Four Humours was incorrect, but people used it as the basis of medicine for the next 1500 years.

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The Roman Empire

There was a significant period of overlap between the Greek and Roman empires. As such, many of their ideas seem to have come from the Greeks: many Greek doctors travelled to Rome to make a good living; the Romans took over the Library of Alexandria; many Roman medical books were written by Hippocrates and his followers.

However, the Romans were also skilled engineers and builders, and the Empire was organised with good communication throughout. They were a practical people, who liked practical solutions to illness (whereas the Greeks were famous for their philosophers and theories). They also needed to ensure the well-being of their army, as the Roman army were the builders and defenders of the Empire - thus, the government provided the best medical care, which allowed for developments. The increased wealth of the Roman people also allowed for medical development.

Roman doctors had lots of surgical practice, as they had lots of soldiers and gladiators to practice on - they also had good surgical instruments, and amputations took place. Opium and alcohol were commonly used as pain relief. However, very few operations inside the body took place.

The Romans believed public health was important because:

a healthy body = a health mind

if fit, people would be more likely to be able to fight off illness

it was better to spend money on keeping fit, than on a doctor

'prevention better than cure'

The Roman Empire had: public baths, which were cheap to enter, had clean water, and were used by both the rich and poor; water pipes, which were made of lead; toilets; sewers, which carried waste from houses, baths, and lavatories; aqueducts, through which 1000 million litres of clean water was delivered through daily; public fountains, street pumps, and rain barrels, which provided water for the poor; public lavatories, which were flushed by public bath water and drained into sewers. They also built cities and towns away from marshland and polluted water.

However, the Romans were not able to prevent the spread of plagues, despite their good public health (e.g. Galen's plague, which killed 5 million). There were other problems, such as: some sewers being too large, so water didn't flow quickly enough to clear the bottom, and rough stone sewers trapped bacteria; the towns were still dirty, as people would throw dirty water into the streets; sewers emptied into rivers, which people would use to wash clothes, drink, and bathe; bath water was only changed once a week; and lead water pipes may have to lead poisoning.

Claudius Galen was a Greek doctor who moved to Rome, bringing Greek ideas of the Four Humours with him. Galen is credited with many fundamental medical developments during the Roman Empire:

he developed the Theory of Opposites to balance the humours (e.g. peppers to cure illness caused by cold).

encouraged clinical observation, such as taking the pulse and noting symptoms

made detailed notes on a plague in AD 167 (later named Galen's Plague)

he used treatments such as bloodletting to balance the humours

encouraged a holistic approach to health (diet and exercise)

encouraged dissection of apes, as human dissection was frowned upon - but he believed it was fundamental for physicians to understand the body

he studied human bones and dissected many animals, trying to work out how the body worked together

proved the brain, not the heart, controlled speech by dissecting a pig in front of a large crowd

proved the arteries carried blood

had his own collection of books, Galen's Collection, all written by himself

However, since Galen only dissected animals, he made many mistakes (such as the jaw having two bones, when it only has one) - these mistakes would hinder medical development for the next 1500 years. He also believed in the Four Humours, which was wrong.