Medicine through Ages

Part I: Prehistoric, Ancient Egyptian and Ancient Greek

By

Dr. Alok Mishra

Post graduate Trainee, National Institute of Homoeopathy

Under Guidance of

Prof. LM Khan
HOD, Organon of Medicine, National Institute of Medicne
31st August 2010 1
 If no use were to be made of labors of the
past ages, the world must remain in the
infancy of Knowledge.

- CICIRO

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 Prehistoric Medicine

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 Prehistory: Timeline
• Prehistory is a term used to describe the
period before recorded history.

• The term "prehistory" can be used to refer to

all time since the beginning of the
universe, although it is more often used in
referring to the period of time since life
appeared on Earth, or even more
specifically to the time since human-like
beings appeared.

• The date marking the end of prehistory,

that is the date when written historical
records become a useful academic
resource, varies from region to region. For
example, in Egypt it is generally accepted
that prehistory ended around 3200 BC.

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 Knowledge about Prehistoric era

Anthropology

31st August 2010 Artifacts 5

Cave engraving
 Causes of disease
• Magico-religious or supernatural
ideas dominated as the cause of
disease in primitive society.

• Diseases were believed to be due to:

- Supernatural power like evil spirit,

demons & god

- Rational cause like injury etc.

• Diseases were due to fright, fear and

unknown terror (thunderstorm, fire,
water, rain, sun, moon, animals, etc.)

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 Diseases of prehistoric era
• Physically men were affected primarily by degenerative joint
disease, fractures, respiratory diseases like sinusitis,
bronchitis, digestive disturbances, skin disease.

• Various cancers are identifiable in the skeleton. Primary bone

cancer is rare, but the skeleton is a common site for the
secondary spread of cancerous growth from other tissues.

• Specific traces in the skeleton system suggests certain infection

like tuberculosis (traces on the ribs and tends to destroy the
bodies of the lumbar vertebrae), congenital syphillis
(Hutchison’sincisor), leprosy (damage to the bones of the face,
fingers, and toes)

• Life expectancy was 25-40 years.

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 Shamans: the healers
• Shamans or Sorcerers, were
considered as intermediate
between human world &
spiritual world.

• He use to wore monstrous

animal mask to frighten the evil
spirits causing illness.

• Shamans were considered to be

able to contact supernatural
powers and to remove the evil
spirits to cure the patients.
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 Trephining
• Trephining was the process
in which shamans use to
make a perforation in the skull
to expel the demon or evil
spirit.

• This was practiced to cure

headache, epilepsy or
tumours.

• For triphining they used

sharpened edges of stones
and flints.
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 Healing art in Prehistoric era
Treatment for Fracture

• They were able to set broken or

fractured bones using clay material.

• Clay used to set hard so that the bone

could heal properly.

Healing of open wound

• They used pincers of certain ant

species to heal an open wound.

• They allowed the ant to stand above

the wound until it bit, then its head
was removed allowing the pincers to
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remain and hold close the wound. 10
 Prehistoric era and Naturopathy
• They use to eat clay and earth as
well as they used to apply it
externally.

• Also, early humans could have

learned about the use of various
healing clays by observing animal
behavior.

• Such clay is used both internally and

externally, such as for treating
wounds, and after surgery.

• The reflection of same is seen in

Naturopathic process of mud
therapy.
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 Knowledge of anatomy
• Occasionally one finds, in wall painting made by pre-historic man, the
spears or arrows plunged exactly into the vital organs of the
animals, showing that in terms of their animal victims, if not
themselves, pre-historic hunters had a precise knowledge of
anatomy.

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 Ancient Egyptian Medicine

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 Importance of Egyptian Medicine
• The oldest historic phase of medicine known to us is
that of ancient Medicine.

• All future development of medicine had some glimpses of

Egyptian medicine.

• Egyptian medicine enjoyed great fame in antiquity.

• Egyptians are credited with being the first to use and

record advanced medical practices.

• Egyptian medicine played a dominant role in the history

of ancient medicine for about 2500 years and then it
was replaced by Greek medicine

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 Papyrus
• Papyrus is a thick paper-like
material produced from the pith of the
papyrus plant, Cyperus papyrus.

• These papyri were used to record

documents related to medicine,
religion, philosophy, mathematics,
magic etc.

• Egyptians wrote there inscription on

papyri mostly in Hieroglyphic
language.

• There were several papyri related to

medical texts but Edwin Smith
Papyrus and Ebers Papyrus were
the most interesting and well known.

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 List of Medical Papyrus
• Hearst Papyrus (20th century BC): Medical text relating to urinary bladder,
blood, hair and piles. It also included treatment for cancer.

• Ramesseum Medical Papyrus (18th century BC): Related to ophthalmology,

Gynaecology, muscles & tendon, and Paediatrics

• Edwin Smith Papyrus (16th century BC): Textbook of Surgery

• Ebers Papyrus (16th century BC): Incantation and foul application meant for
disease causing demons

• Chester Beatty Papyrus (12th century BC): For headache and anorectal
ailments

• Brooklyn Papyrus (4th century BC): Ailments for poison

• Carlsberg Papyrus (2nd century BC): Deals with eye disease and
Pregnancy

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 Hieroglyphic writing
• Hieroglyphic method
of writing contained a
combination of
logographic and
alphabetic elements.

• Papyrus are written

mostly in hieroglyphic
writing.

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 Knowledge of Anatomy
• Egyptian had some knowledge of
Anatomy can be gathered from the way
they mummified the dead body.

• Mummifiers use to pierce the nasal

bone to remove the brain.

• They also must have had a general idea

of the location in the body cavity of the
inner organs, which they removed
through a small incision in the left groin.

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 Knowledge of Physiology
• They had good knowledge of physiology which they
derived from embalming the dead body.

• They were able to cure night blindness by feeding with

liver.

• They supposed that the disease to which men are

subjected proceed from the food they use.

• Egyptian physicians were aware of the existence of the

pulse and of a connection between pulse and heart.

• They could not discriminate between blood vessels,

nerves and tendon.

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 Concept of disease

• The Egyptians believed that disease and death

were caused by a god, a spirit, or some other
supernatural force.

• The healers often used incantations and magic

as part of treatment.

• In Egyptian time priest, doing magic &

incantations, and physicians were the one and
same.

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 Theory of Channels
• They developed their theory of
"channels" that carried air, water
and blood to the body by
analogies with the River Nile.

• In analogy to river Nile they said

as crops became unhealthy when
it is blocked in the same way they
said that body becomes sick
when these channels are
blocked.

• If a person was unwell, they would

use laxatives to unblock the
"channels".
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 Similia in Egyptian time
• They Similia principle in very crude form.

• They used similia principle in the form of

doctrine of signature eg they used ostrich
egg for the treatment of broken skull.

• However, Hahnemann in § 110 refuted the

use of similia principle on the basis of
doctrine of signature.

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 Common diseases of their time
• They suffered from the injuries and deformities caused by hard
labor.

• They suffered from insect born diseases such as malaria and

trachoma, an eye disease, small pox, measles, tuberculosis, and
cholera.

• It is believed that there were occasional outbreaks of the bubonic

plague.

• Leprosy, which had originated in Egypt, was relatively rare.

• Silicosis of the lungs, caused by breathing in sand particles was a

common cause of pneumonia for the ancient Egyptians.

• Eye diseases due to injuries from sandy wind from desert.

• The ancient Egyptians also suffered from diet-related ailments such

as malnutrition, vitamin and mineral deficiencies, dental abrasion, and
ailments normal to all humans such as arthritis.
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 Knowledge of Surgery
• The use of surgery evolved from a knowledge of the basic
anatomy and embalming practices of the Egyptians.

• They were very much skilled in healing physical injuries, these

physician were able to do amputation and for the first time
Egyptian used prosthetics.

• They were skilled in performing eye surgery.

• They knew how to suture wound. They used honey as an

antiseptic and moldy bread as antibiotic.

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Prosthetic foot
 Therapeutic knowledge
• The prescription for a healthy life, meant that an individual
undertook the stringent and regular purification rituals
(which included much bathing, and often times shaving
one's head and body hair), and maintained their dietary
restrictions against raw fish and other animals considered
unclean to eat.

• Among the curatives used by the Egyptians were all types

of plant (herbs and other plants), animal (all parts nearly)
and mineral compounds.

• Yeast's were also taken internally for digestive disorders

and were an effective cure for ulcers.

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 Specialization
• In Egyptian time the art of medicine was divided
so that each physician applies himself to one
disease only and not more.

• Some were physicians of eyes, other for the

head, others for the teeth. Others for the intestines
and others for internal disorders.

• This clearly shows that today’s era of

specialization and super-specialization has
come en route from Egyptian medicine.

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 Imhotep: Egyptian Demigod (2655 -2600 B.C.):
• Imhotep was the Egyptian demigod
of medicine.

• He was earliest known physician.

• He was founder of medicine in Egypt

and his writings were devoid of
magical thinking.

• He was the original author of Edwin

Smith Papyrus.

• He was also considered as the first

architect engineer. He designed the
step pyramid at Saqqara.
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 Thoth
• Thoth was considered one of the
more important deities of the
Egyptian pantheon.

• In art, he was often depicted as a

man with the head of an ibis or a
baboon; these animals were sacred
to him.

• His feminine counterpart was

Seshat.

• The Egyptians credited him as the

author of all works of science,
religion, philosophy, and magic.

• Mythology also credits him with the

creation of the 365 day calendar.
Seshat
31
st Thoth
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 Ancient Greek Medicine

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 Aegean Civilization
• Ancient Aegean civilization began around 3000 B.C.

• Greek Medicine developed with philosophy, disciplined by

strict criticism, and healing for the first time became a
science as well as an art, practiced not by priestly caste
but by laymen who replaced magic by enquiry.

• From the writings of Homer (c. 850 B.C.), a great poet, we

get the earliest glimpse of Greek medicine.

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 Aesculapius

Greek God

of

Medicine & Healing

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 Aesculapius: Birth Mythology
• He was son of Apollo and
Coronis.

• A mythological story is attached

to his birth that his mother was
killed for being unfaithful to
Apollo but the unborn child
was rescued from the womb
of his dead mother.

• He was called as Aesculapius

which means “to cut open”.
Apollo Snatching the Unborn Asclepius
• Apollo took the baby to
from the Flaming Womb of Coronis
Centaur Chiron, son of Saturn,
who brought him up and taught
him art of medicine.
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 Daughters of Aesculapius
• Aesculapius had five daughter, each reflecting a specific
feature of medical art:

Hygieia : Hygiene

Panacea: Universal remedy

Laso: Medicine

Aceso: Healing

Aglæa: healthy glow

Hygieia

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Panacea Laso
 Staff of Aesculapius: Askelepian
• Aesculapius carried with him a Staff
round which twists the serpent,
this was the symbol of ancient
medicine and is still the symbol of
medicine in modern world.

• This staff of Aesculapius was called

as Askelepian.

• The snake symbolizes the shedding

of skin as a sign of rejuvenation or
alternatively it signifies dual nature
of physician as dealing with life and
death, health and sickness, medicine
and poison etc.

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 Temple of Aesculapius: Asclepieia
• The temples of his cult, dedicated to healer
God Aesculapius, were known as
Asclepieia. Most celebrated Asclepieia were
in Cos, Epidaurus, Cnidus and Pergamus.

• In the state of induced sleep, called as

enkoimesis, the priest presented himself
before the patient to administer medical
advice, if he happened to be awake.

• If he slept, as was usually the case, the

advice came in a dream, which was
interpreted afterwards by the priests, who
Temple of Aesculapius
then prescribed catharsis, emesis, blood-
letting or whatever remedy seemed
appropriate.

• Before these patients left the temple a

tablets were hung on the wall of the temple
engraving there name, brief history and
treatment offered.
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 Death of Aesculapius
• Aesculapius became so
proficient in the healing
art that Pluto accused
him of diminishing the
number of shades in
Hades. He was then
destroyed by a
thunderbolt of Zeus,
and so became and
Zeus
objects of worship.

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 EMPEDOCLES (c. 493-c. 433 B.C.)
• The theory of the Four Elements is
generally attributed to Empedocles.

• According to this theory, everything in the

universe, including the human body, is
composed of the Four Elements in
varying proportions viz.:

- Fire, - Air, - Earth - Water.

• Empedocles had a theory of building up,

or synthesis (anabolism) versus breaking
down, or analysis (catabolism).

• The physician's job was to assess the

patient to see which aspect of metabolism
predominated, and then bring them back
into balance.

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 THALES (640-546 B.C.)
• Thales was the first true scientist-
philosopher of the Greeks.

• Thales believed that the basic element

in all animal and plant life was water,
from which came earth and air.

• Although he accepted the idea of a

God, he did not use religious means
to seek or establish the natural
processes of the universe or of
humans.

• He has been called as the "Father of

Science".

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 ALCMAEON OF CROTONA (c. 500 B.C.)

• Alcmaeon of Crotona gave a theory of isonomia, which

means the perfect harmony of all substances in the
metabolism.

• The body is healthy as long as this metabolic harmony was

maintained; disease resulted from its disruption.

• Disease was cured by restoring metabolic balance and

harmony to the organism.

• Modern nutritionists and physiologists see in isonomia the

precursor of all modern metabolic theory.

• But he also believed that investigation (including dissection),

not just philosophy, was needed in order to understand the
body. His combination of direct observation and
experimental testing stands out as unique in his time.

• Although many remarkable facts emerged from his

dissections (probably on animals)
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 Hippocrates
(c 460-377 B.C.)

FATHER OF MEDICINE

VIS-MEDICATRIX NATURAE

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 Vis medica trix naturae
• Hippocrates based his principles and
practice on the theory of the existence
of a spiritual restoring essence or
principle, the vis medicatrix naturae.

• In therapeutics, he believed in simply

assisting nature, his scheme of
treatment was usually confined to such
plain expedients as fresh air, good
diet, purgatives, blood-letting,
barley water, honey & water, honey
& vinegar, massage, and
hydrotherapy.

• To this end, Hippocrates believed

"rest and immobilization were of
capital importance".

• Here Hahnemann differed slightly

from Hippocrates.
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 Humoral Pathology
• Hippocrates gave idea of four Humours:
• blood,

• yellow bile,

• phlegm and

• black bile.

• He said that balance between these humours is

the state of health and any imbalance is illness.

• His therapy was also directed in restoring the

balance between these humours.
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 Survey of Diseases
• He divided diseases into four classes
• acute,

• chronic,

• endemic and

• epidemic.

• His book on Epidemic Diseases gave vivid description of

these diseases.

• Hahnemann in §72 to §81 made similar survey of disease.

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 Man and environment
• Hippocrates 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 the disease.

• His book Airs, waters, and places stressed the relation

between man and his environment. This book contains the
first enunciation of the principles of public health.

• Same concept reflects in Hahnemann’s work in § 4, § 5,

§77 of Organon of Medicine and also at many places in
Chronic Disease.

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 Law of simple
• Hippocrates chose the simplest out of a
class of diseases; these he watched
closely and described minutely.

• In these simplest maladies he gave single

simple remedies out of the store of existing
drugs which was then small.

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 Similia vs Contraria
• Hippocrates gave two ways of applying
medicines:
• On the basis of similia

• On the basis of contraria

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 Clinical Knowledge
• He devised a method of diagnostic investigation based on
observation and on reason which is even valid today.

• He laid much stress on prognosis.

• He & his followers evaluate an illness and induce likely progression of

disease based on the data collected and detailed case histories.

• To this end Hippocrates and his follower instituted for the first time
through going examination of patient’s condition including facial
appearance, pulse, temperature, respiration, excreta, sputum,
localized pains and movements of the body.

• They gave several clinical signs which still hold its importance in
modern medicine few important among them were
– Hippocratic facies, - Clubbing of fingers,

– Cheyne-stokes breathing. - Crisis etc.

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 Surgery
• In Greek atheletes and sports was very prevalent.

• History reports that Olympoid games started in Greece in

776 B.C. and was very prevalent in ancient time and even
today.

• Atheletes and sports had great impact in the development

of medicine in Greek time.

• Many fractures and wounds described by Hippocrates

are common only in atheletes.

• Hippocratic Bench was one of his innovative techniques

for giving traction to the fractured limb.

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 HIPPOCRATIC CORPUS
• The Hippocratic Corpus (Latin: Corpus
Hippocratum) is a collection of around
seventy early medical works from
ancient Greece strongly associated with
Hippocrates and his teachings.

• The Hippocratic Corpus contains

textbooks, lectures, research, notes
and even philosophical essays on
various subjects in medicine, in no
particular order.

• There are a number of case-histories

in the Hippocratic Corpus, 42 to be
exact.

• Two books in corpus hippocraticum

contain description about similia
principle
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 BOOKS AUTHORED BY HIPPOCRATES
• Aphorisms
• Instruments of Reduction
• Of the Epidemics
• On Airs, Waters, and Places
• On Ancient Medicine
• On Fistulae
• On Fractures
• On Hemorrhoids
• On Injuries of The Head
• On Regimen in Acute
Diseases
• On the Articulations
• On the Sacred Disease
• On the Surgery
• st August
31 On Ulcers
2010 50
 Aristotle (384 – 322 B.C.)

Father of Biology

Student of Plato

Teacher of Alexander
the Great
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 Father of Biology
• He was the man who gave medicine the beginning
of
• botany,

• zoology,

• comparative anatomy,

• embryology,

• Teratology,

• physiology,

• and the use of formal logic as an instrument of precision.

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 Embryology
• He studied development of the chick day by day,
noted the salient features of the development of
the chick embryo.

• He noted the
• beat of foetal heart,

• the vitelline and allontoic veins,

• the enveloping membrane, and

• the possibility of superfetation.

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 Cardiocentric
• In contrast to his predecessor philospers, but in much
accordance to the Egyptian belief, placed the rational soul
in the heart rather than brain.

• He gave the doctrine of primacy of the heart, as the source

of ‘innate heat,’ the seat of sensation and thought.

• Contrary to the view of Alamaeon, that the brain feels and

thinks, Aristotle regarded it as a gland secreting cold
humours to prevent overheating of the body by the fiery
heart (via the lungs).

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 Classification of animals
• He divided animals into
• Enaima or sanguineous (vertebrates) and

• Anaima or bloodless (invertebrates),

• Then he also divided them as to their reproductive

status
• viviparous,

• oviparous,

• gemmulous,

• spontaneous generation.

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 Aristotle: Organon
• It was the book of Aristotle titled “Organon” which was
standard collection of his six works on logic.

• These works are

– Categories,

– On Interpretation,

– Prior Analytics,

– Posterior Analytics,

– Topics, and
– Sophistical Refutations.

• Later Francis Bacon (1561 -1626) gave the Novum Organum.

• Hahnemann was influenced by both these works and gave a

title to his book as Organon of Medicine.
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