A HISTORY OF MEDICINE IN THE ANCIENT WORLD
By Tim Lambert
Medicine among Primitive Peoples
The first evidence of surgery is skulls from the stone age. Some adults had holes cut in their skulls. At least sometimes people survived the 'operation' because the bone grew back. We do not know the purpose of the 'operation'. Perhaps it was performed on people with head injuries to release pressure on the brain.
In the 19th and early 20th centuries anthropologists studied primitive societies. Among them, treatment for injury and sickness was a mixture of common sense and magic. People knew, of course, that falls cause broken bones and fire cause burns. Animal bites or human weapons cause wounds. Primitive people had simple treatments for these things e.g. Indigenous Australians covered broken arms in clay, which hardened in the hot sun. Cuts were covered with fat or clay and bound up with animal skins or bark. However primitive people had no idea what caused illness. They assumed it was caused by evil spirits or magic performed by an enemy. The 'cure' was magic to drive out the evil spirit or break the enemies spell.
Ancient Egyptian Medicine
In about 3000 BC the curtain rises on Egyptian civilization. In a civilized society, some people did specialized jobs. One of these was the doctor. The first doctor known to history was Sekhet-eanach who 'healed the pharaoh's nostrils'. (We do not know what was wrong with them). The second doctor we know of was Imhotep (c. 2,600 BC) who was vizier or prime minister to the pharaoh. He was also a doctor and he was so famous that after his death he was worshiped as a god.
Much of Egyptian medicine still relied on magic. However, at least they could keep written records of which treatments worked and which did not. In this way, medicine could advance. The earliest known medical book is the Ebers Papyrus, which was written about 1500 BC. Egyptian doctors used a huge range of drugs obtained from herbs and minerals. They were drunk with wine or beer or sometimes mixed with dough to form a 'pill'. Egyptian doctors also used ointments for wounds and they treated chest complaints by getting the patient to inhale steam.
The Egyptians believed that the human body was full of passages that acted like irrigation canals. The Egyptians knew that irrigation canals sometimes became blocked. They reasoned that if the passages in a human body became blocked it might cause illness. To open them Egyptians used laxatives and induced vomiting.
However the Egyptians still believed that spells would help the sick and they carried amulets to ward off disease. Nevertheless, they were beginning to seek a physical cause for illness. The Egyptians did have some knowledge of anatomy from making mummies. To embalm a dead body they first removed the principal organs, which would otherwise rot.
However Egyptian surgery was limited to such things as treating wounds and broken bones and dealing with boils and abscesses. The Egyptians used clamps, sutures, and cauterization. They had surgical instruments like probes, saws, forceps, scalpels, and scissors. They also knew that honey helped to prevent wounds from becoming infected. (It is a natural antiseptic). They also dressed wounds with willow bark, which has the same effect. The Egyptians were clean people. They washed daily and changed their clothes regularly, which must have helped their health. There were some women doctors in Ancient Egypt. Merit Ptah was a famous woman doctor who lived around 2,700 BC.
Life in Egypt
Ancient Greek Medicine
The roots of modern medicine are in ancient Greece. On the one hand, most Greeks believed in a god of healing called Asclepius. People who were ill-made sacrifices or offerings to the god. They then slept overnight in his temple. They believed that the god would visit them in their sleep (i.e. in their dreams) and when they woke up they would be healed.
At the same time Greek doctors developed a rational theory of disease and sought cures. However one did not replace the other. The cult of Asclepius and Greek medicine existed side by side. Medical schools were formed in Greece and in Greek colonies around the Mediterranean. As early as 500 BC a man named Alcmaeon from Croton in Italy said that a body was healthy if it had the right balance of hot and cold, wet and dry. It the balance was upset the body grew ill.
However the most famous Greek doctor is Hippocrates (C.460-377 BC). (Although historians now believe that he was much less famous in his own time that was once thought. It is believed that many of the medical books ascribed to him were actually written by other men). Hippocrates stressed that doctors should carefully observe the patient's symptoms and take note of them. Hippocrates also rejected all magic and he believed in herbal remedies.
A number of Greeks speculated that the human body was made up of elements. If they were properly balanced the person was healthy. However, if they became unbalanced the person fell ill.
Finally Aristotle (384-322 BC) thought the body was made up of four humors or liquids. They were phlegm, blood, yellow bile, and black bile. If a person had too much of one humor they fell ill. For instance, if a person had a fever he must have too much blood. The treatment was to cut the patient and let him bleed. The Greeks knew that diet and exercise and keeping clean were important for health.
Later Alexander the Great conquered Egypt. In 332 BC he founded the city of Alexandria and a great medical school was established there. Doctors in Alexandria dissected human bodies and they gained a much better knowledge of anatomy. However little progress was made in understanding disease.
Life in Greece
The Romans conquered Greece and afterwards doctors in the Roman Empire were often Greeks. Many of them were slaves. Doctors had low status in Rome. However, the state paid public doctors to treat the poor. The Romans also had hospitals called valetudinaria for their wounded soldiers.
Later in Roman times Galen (130-200 AD) became a famous doctor. At first, he worked treating wounded gladiators. Then in 169 AD, he was made the doctor to Commodus, the Roman Emperor's son. Galen was also a writer and he wrote many books. Galen believed the theory of the four humors. He also believed in treating illness with opposites. So if a patient had a cold Galen gave him something hot like pepper.
Galen was also interested in anatomy. Unfortunately by his time dissecting human bodies was forbidden. So Galen had to dissect animal bodies including apes. However, animal bodies are not the same as human bodies and so some of Galen's ideas were quite wrong. Unfortunately, Galen was a very influential writer. For centuries his writings dominated medicine.
In the first century BC a Roman named Varro suggested that tiny animals caused disease. They were carried through the air and entered the body through the nose or the mouth. Unfortunately, with no microscopes, there was no way of testing his theory.
The Romans were also skilled engineers and they created a system of public health. The Romans noticed that people who lived near swamps often died of malaria. They did not know that mosquitoes in the swamps carried disease but they drained the swamps anyway.
The Romans also knew that dirt encourages disease and they appreciated the importance of cleanliness. They built aqueducts to bring clean water into towns. They also knew that sewage encourages disease. The Romans built public lavatories in their towns. Streams running underneath them carried away sewage.
The Romans also had military hospitals called Valetudinaria.In the late 4th century The Roman Empire split in two, east and west. Meanwhile, Christians believed they had a duty to care for the sick and they founded many hospitals in the Eastern Roman Empire in the late 4th century. One of the first was built by Basil of Caesarea (c. 330 - 379) in what is now Turkey.
A Timeline of Medicine
A Brief History of Dentistry
A Brief History of Life Expectancy
A Brief History of Surgery
A Brief History of Washing
A Brief History of Public Health