History of medicine

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This article is about the history of human medicine. For the book, see A History of
Medicine. For the history of veterinary medicine, see History of veterinary medicine.

The Hippocratic Corpus
A collection of early medical works may be associated with Hippocrates

The history of medicine shows how societies have changed in their approach to

illness and disease from ancient times to the present. Early medical traditions include
those of Babylon, China, Egypt and India. The Hippocratic Oath was written in ancient
Greece in the 5th century BCE, and is a direct inspiration for oaths of office that
physicians swear upon entry into the profession today. In the Middle Ages, surgical
practices inherited from the ancient masters were improved and then systematized
in Rogerius's The Practice of Surgery. Universities began systematic training of
physicians around 1220 CE in Italy.
Invention of the microscope was a consequence of improved understanding, during the
Renaissance. Prior to the 19th century, humorism (also known as humoralism) was
thought to explain the cause of disease but it was gradually replaced by the germ theory
of disease, leading to effective treatments and even cures for many infectious diseases.
Military doctors advanced the methods of trauma treatment and surgery. Public health
measures were developed especially in the 19th century as the rapid growth of cities
required systematic sanitary measures. Advanced research centers opened in the early
20th century, often connected with major hospitals. The mid-20th century was
characterized by new biological treatments, such as antibiotics. These advancements,
along with developments in chemistry, genetics, and radiography led to modern
medicine. Medicine was heavily professionalized in the 20th century, and new careers
opened to women as nurses (from the 1870s) and as physicians (especially after 1970).
 Contents

 1Prehistoric medicine
 2Early civilizations
o 2.1Mesopotamia
o 2.2Egypt
o 2.3India
o 2.4China
o 2.5Historiography of Chinese Medicine
 3Greece and Roman Empire
o 3.1Hippocrates
o 3.2Herophilus and Erasistratus
o 3.3Galen
o 3.4Roman contributions
 4The Middle Ages, 400 to 1400
o 4.1Byzantine Empire and Sassanid Empire
o 4.2Islamic world
o 4.3Europe
 4.3.1Schools
 4.3.2Humors
 4.3.3Women
 5Renaissance to early modern period 16th–18th century
o 5.1Paracelsus
o 5.2Padua and Bologna
o 5.3Women
o 5.4Age of Enlightenment
o 5.5Britain
o 5.6Spain and Spanish Empire
 5.6.1Spanish Quest for Medicinal Spices
 619th century: rise of modern medicine
o 6.1Germ theory and bacteriology
o 6.2Women
 6.2.1Women as healers
 6.2.2Women as physicians
o 6.3Paris
o 6.4Vienna
o 6.5Berlin
o 6.6U.S. Civil War
o 6.7Statistical methods
o 6.8Worldwide dissemination
 6.8.1United States
 6.8.2Japan
o 6.9Psychiatry
 720th century and beyond
o 7.1Twentieth-century warfare and medicine
o 7.2Public health
 o 7.3Second World War
 7.3.1Nazi and Japanese medical research
o 7.4Malaria
o 7.5Post-World War II
 7.5.1Modern surgery
 8See also
 9Explanatory notes
 10References
 11Further reading
o 11.1Physicians
o 11.2Britain
o 11.3Historiography
o 11.4Primary sources
o 11.5Illustrations
 12External links

Prehistoric medicine[edit]
Main article: Prehistoric medicine
Although there is little record to establish when plants were first used for medicinal
purposes (herbalism), the use of plants as healing agents, as well as clays and soils is
ancient. Over time, through emulation of the behavior of fauna, a medicinal knowledge
base developed and passed between generations. Even earlier, Neanderthals may
have engaged in medical practices.[1] As tribal culture specialized specific
castes, shamans and apothecaries fulfilled the role of healer.[2] The first
known dentistry dates to c. 7000 BCE in Baluchistan where Neolithic dentists used flint-
tipped drills and bowstrings.[3] The first known trepanning operation was carried out c.
5000 BCE in Ensisheim, France.[4] A possible amputation was carried out c. 4,900 BCE
in Buthiers-Bulancourt, France.[5]

Early civilizations[edit]
Mesopotamia[edit]
Medical recipe concerning poisoning. Terracotta tablet, from Nippur, Iraq, 18th century BCE. Ancient Orient
Museum, Istanbul
Monumental stone relief of a fish-garbed figure from the Temple of Ninurta in the Assyrian city of Kalhu,
believed by some experts to be a representation of an āšipu, or exorcist-priest,[6]: 83  who functioned as a kind of
healer and primitive doctor[7]

Further information: Babylonian medicine

The ancient Mesopotamians had no distinction between "rational science" and magic.[8][9]
[10]
 When a person became ill, doctors would prescribe both magical formulas to be
recited as well as medicinal treatments.[8][9][10][7] The earliest medical prescriptions appear
in Sumerian during the Third Dynasty of Ur (c. 2112 BCE – c. 2004 BCE).[11] The oldest
Babylonian texts on medicine date back to the Old Babylonian period in the first half of
the 2nd millennium BCE.[12] The most extensive Babylonian medical text, however, is
the Diagnostic Handbook written by the ummânū, or chief scholar, Esagil-kin-
apli of Borsippa,[13][14] during the reign of the Babylonian king Adad-apla-iddina (1069–
1046 BCE).[15] Along with the Egyptians, the Babylonians introduced the practice of
diagnosis, prognosis, physical examination, and remedies. In addition, the Diagnostic
Handbook introduced the methods of therapy and cause. The text contains a list of
medical symptoms and often detailed empirical observations along with logical rules
used in combining observed symptoms on the body of a patient with its diagnosis and
prognosis.[16] The Diagnostic Handbook was based on a logical set of axioms and
assumptions, including the modern view that through the examination and inspection of
the symptoms of a patient, it is possible to determine the patient's disease, its cause
and future development, and the chances of the patient's recovery. The symptoms and
diseases of a patient were treated through therapeutic means such as bandages, herbs
and creams.[13]
In East Semitic cultures, the main medicinal authority was a kind of exorcist-healer
known as an āšipu.[8][9][10] The profession was generally passed down from father to
son[8] and was held in extremely high regard.[8] Of less frequent recourse was another
kind of healer known as an asu, who corresponds more closely to a modern
physician[7] and treated physical symptoms using primarily folk remedies composed of
various herbs, animal products, and minerals, as well as potions, enemas, and
ointments or poultices.[7] These physicians, who could be either male or female, also
dressed wounds, set limbs, and performed simple surgeries. [7] The ancient
Mesopotamians also practiced prophylaxis[7] and took measures to prevent the spread of
disease.[7]
Mental illnesses were well known in ancient Mesopotamia,[17] where diseases and mental
disorders were believed to be caused by specific deities. [6] Because hands symbolized
control over a person, mental illnesses were known as "hands" of certain deities. [6] One
psychological illness was known as Qāt Ištar, meaning "Hand of Ishtar".[6] Others were
known as "Hand of Shamash", "Hand of the Ghost", and "Hand of the God".
[6]
 Descriptions of these illnesses, however, are so vague that it is usually impossible to
determine which illnesses they correspond to in modern terminology. [6] Mesopotamian
doctors kept detailed record of their patients' hallucinations and assigned spiritual
meanings to them.[17] A patient who hallucinated that he was seeing a dog was predicted
to die;[17] whereas, if he saw a gazelle, he would recover.[17] The royal family of Elam was
notorious for its members frequently suffering from insanity. [17] Erectile dysfunction was
recognized as being rooted in psychological problems. [17]
Egypt[edit]
Main article: Ancient Egyptian medicine

The Edwin Smith Surgical Papyrus, written in the 17th century BCE, contains the earliest recorded reference to
the brain. New York Academy of Medicine.

Ancient Egypt developed a large, varied and fruitful medical

tradition. Herodotus described the Egyptians as "the healthiest of all men, next to the
Libyans",[18] because of the dry climate and the notable public health system that they
possessed. According to him, "the practice of medicine is so specialized among them
that each physician is a healer of one disease and no more." Although Egyptian
medicine, to a considerable extent, dealt with the supernatural, [19] it eventually developed
a practical use in the fields of anatomy, public health, and clinical diagnostics.
Medical information in the Edwin Smith Papyrus may date to a time as early as
3000 BCE.[20] Imhotep in the 3rd dynasty is sometimes credited with being the founder of
ancient Egyptian medicine and with being 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 c. 1600 BCE. It
is an ancient textbook on surgery almost completely devoid of magical thinking and
describes in exquisite detail the examination, diagnosis, treatment, and prognosis of
numerous ailments.[21]
The Kahun Gynaecological Papyrus[22] treats women's complaints, including problems
with conception. Thirty four cases detailing diagnosis and [23] treatment survive, some of
them fragmentarily.[24] Dating to 1800 BCE, it is the oldest surviving medical text of any
kind.
Medical institutions, referred to as Houses of Life are known to have been established in
ancient Egypt as early as 2200 BCE. [25]
The Ebers Papyrus is the oldest written text mentioning enemas. Many medications
were administered by enemas and one of the many types of medical specialists was an
Iri, the Shepherd of the Anus.[26]
The earliest known physician is also credited to ancient Egypt: Hesy-Ra, "Chief of
Dentists and Physicians" for King Djoser in the 27th century BCE.[27] 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." [28]
India[edit]
Main articles: Ayurveda, Unani, and Siddha medicine

Ayurvedic herbal medicines

The Atharvaveda, a sacred text of Hinduism dating from the Early Iron Age, is one of

the first Indian texts dealing with medicine. The Atharvaveda also contains prescriptions
of herbs for various ailments. The use of herbs to treat ailments would later form a large
part of Ayurveda.
Ayurveda, meaning the "complete knowledge for long life" is another medical system of
India. Its two most famous texts belong to the schools of Charaka and Sushruta. The
earliest foundations of Ayurveda were built on a synthesis of traditional herbal practices
together with a massive addition of theoretical conceptualizations, new nosologies and
new therapies dating from about 600 BCE onwards, and coming out of the communities
of thinkers which included the Buddha and others.[29]
According to the compendium of Charaka, the Charakasamhitā, health and disease are
not predetermined and life may be prolonged by human effort. The compendium
of Suśruta, the Suśrutasamhitā defines the purpose of medicine to cure the diseases of
the sick, protect the healthy, and to prolong life. Both these ancient compendia include
details of the examination, diagnosis, treatment, and prognosis of numerous ailments.
The Suśrutasamhitā is notable for describing procedures on various forms of surgery,
including rhinoplasty, the repair of torn ear lobes, perineal lithotomy, cataract surgery,
and several other excisions and other surgical procedures. Most remarkable was
Susruta's surgery specially the rhinoplasty for which he is called father of modern plastic
surgery. Susruta also described more than 125 surgical instruments in detail. Also
remarkable is Sushruta's penchant for scientific classification: His medical treatise
consists of 184 chapters, 1,120 conditions are listed, including injuries and illnesses
relating to aging and mental illness.
The Ayurvedic classics mention eight branches of medicine: kāyācikitsā (internal
medicine), śalyacikitsā (surgery including anatomy), śālākyacikitsā (eye, ear, nose, and
throat diseases), kaumārabhṛtya (pediatrics with obstetrics and gynaecology),
bhūtavidyā (spirit and psychiatric medicine), agada tantra (toxicology with treatments of
stings and bites), rasāyana (science of rejuvenation), and vājīkaraṇa (aphrodisiac and
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, the 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. The normal length of the student's training appears to have been
seven years. But the physician was to continue to learn. [30]
As an alternative form of medicine in India, Unani medicine found deep roots and royal
patronage during medieval times. It progressed during the Indian sultanate
and mughal periods. Unani medicine is very close to Ayurveda. Both are based on the
theory of the presence of the elements (in Unani, they are considered to be fire, water,
earth, and air) in the human body. According to followers of Unani medicine, these
elements are present in different fluids and their balance leads to health and their
imbalance leads to illness.[31]
By the 18th century CE, Sanskrit medical wisdom still dominated. Muslim rulers built
large hospitals in 1595 in Hyderabad, and in Delhi in 1719, and numerous
commentaries on ancient texts were written. [32]