China[edit]

Main article: Traditional Chinese medicine

Assorted dried plant and animal parts used in traditional Chinese medicines, clockwise from top left corner:
dried Lingzhi (lit. "spirit mushrooms"), ginseng, Luo Han Guo, turtle shell underbelly (plastron), and dried curled
snakes

China also developed a large body of traditional medicine. Much of the philosophy of traditional
Chinese medicine derived from empirical observations of disease and illness by Taoist physicians
and reflects the classical Chinese belief that individual human experiences express causative
principles effective in the environment at all scales. These causative principles, whether material,
essential, or mystical, correlate as the expression of the natural order of the universe.
The foundational text of Chinese medicine is the Huangdi neijing, (or Yellow Emperor's Inner
Canon), written 5th century to 3rd century BCE.[33] Near the end of the 2nd century CE, during the
Han dynasty, Zhang Zhongjing, wrote a Treatise on Cold Damage, which contains the earliest
known reference to the Neijing Suwen. The Jin Dynasty practitioner and advocate
of acupuncture and moxibustion, Huangfu Mi (215–282), also quotes the Yellow Emperor in his Jiayi
jing, c. 265. During the Tang Dynasty, the Suwen was expanded and revised and is now the best
extant representation of the foundational roots of traditional Chinese medicine. Traditional Chinese
Medicine that is based on the use of herbal medicine, acupuncture, massage and other forms of
therapy has been practiced in China for thousands of years.
In the 18th century, during the Qing dynasty, there was a proliferation of popular books as well as
more advanced encyclopedias on traditional medicine. Jesuit missionaries introduced Western
science and medicine to the royal court, although the Chinese physicians ignored them. [34]
Finally in the 19th century, Western medicine was introduced at the local level by Christian medical
missionaries from the London Missionary Society (Britain), the Methodist Church (Britain) and
the Presbyterian Church (US). Benjamin Hobson (1816–1873) in 1839, set up a highly successful
Wai Ai Clinic in Guangzhou, China. [35] The Hong Kong College of Medicine for Chinese was founded
in 1887 by the London Missionary Society, with its first graduate (in 1892) being Sun Yat-sen, who
later led the Chinese Revolution (1911). The Hong Kong College of Medicine for Chinese was the
forerunner of the School of Medicine of the University of Hong Kong, which started in 1911.
Because of the social custom that men and women should not be near to one another, the women of
China were reluctant to be treated by male doctors. The missionaries sent women doctors such as
Dr. Mary Hannah Fulton (1854–1927). Supported by the Foreign Missions Board of the Presbyterian
Church (US) she in 1902 founded the first medical college for women in China, the Hackett Medical
College for Women, in Guangzhou. [36]

Historiography of Chinese Medicine[edit]

When reading the Chinese classics, it is important for scholars to examine these works from the
Chinese perspective. Historians have noted two key aspects of Chinese medical history:
understanding conceptual differences when translating the term "身, and observing the history from
the perspective of cosmology rather than biology.[37]: 19 
In Chinese classical texts, the term 身 is the closest historical translation to the English word "body"
because it sometimes refers to the physical human body in terms of being weighed or measured, but
the term is to be understood as an “ensemble of functions” encompassing both the human psyche
and emotions.> This concept of the human body is opposed to the European duality of a separate
mind and body.[37]: 19–20  It is critical for scholars to understand the fundamental differences in concepts
of the body in order to connect the medical theory of the classics to the “human organism” it is
explaining.[37]: 20 
Chinese scholars established a correlation between the cosmos and the “human organism.” The
basic components of cosmology, qi, yin yang and the Five Phase theory, were used to explain health
and disease in texts such as Huangdi neijing.[37]: 21  Yin and yang are the changing factors in
cosmology, with qi as the vital force or energy of life. The Five phase theory Wu Xing of the Han
dynasty contains the elements wood, fire, earth, metal, and water. By understanding medicine from
a cosmology perspective, historians better understand Chinese medical and social classifications
such as gender, which was defined by a domination or remission of yang in terms of yin.
These two distinctions are imperative when analyzing the history of traditional Chinese medical
science.
A majority of Chinese medical history written after the classical canons comes in the form of primary
source case studies where academic physicians record the illness of a particular person and the
healing techniques used, as well as their effectiveness.[37]: 225  Historians have noted that Chinese
scholars wrote these studies instead of “books of prescriptions or advice manuals;” in their historical
and environmental understanding, no two illnesses were alike so the healing strategies of the
practitioner was unique every time to the specific diagnosis of the patient. [37]: 226–27  Medical case studies
existed throughout Chinese history, but “individually authored and published case history” was a
prominent creation of the Ming Dynasty.[37]: 225  An example such case studies would be the literati
physician, Cheng Congzhou, collection of 93 cases published in 1644. [37]: 226–27 

Greece and Roman Empire[edit]

Main article: Medicine in ancient Greece
Around 800 BCE Homer in The Iliad gives descriptions of wound treatment by the two sons
of Asklepios, the admirable physicians Podaleirius and Machaon and one acting doctor, Patroclus.
Because Machaon is wounded and Podaleirius is in combat Eurypylus asks Patroclus to cut out this
arrow from my thigh, wash off the blood with warm water and spread soothing ointment on the
wound.[38] Asklepios, like Imhotep, became to be associated as a god of healing over time.

View of the Askleipion of Kos, the best preserved instance of an Asklepieion.

Temples dedicated to the healer-god Asclepius, known as Asclepieia (Ancient Greek: Ἀσκληπιεῖα,
sing. Ἀσκληπιεῖον, Asclepieion), functioned as centers of medical advice, prognosis, and healing.
[39]
 At these shrines, patients would enter a dream-like state of induced sleep known
as enkoimesis (ἐγκοίμησις) not unlike anesthesia, in which they either received guidance from the
deity in a dream or were cured by surgery.[40] Asclepeia provided carefully controlled spaces
conducive to healing and fulfilled several of the requirements of institutions created for healing. [39] In
the Asclepeion of Epidaurus, three large marble boards dated to 350 BCE preserve the names, case
histories, complaints, and cures of about 70 patients who came to the temple with a problem and
shed it there. Some of the surgical cures listed, such as the opening of an abdominal abscess or the
removal of traumatic foreign material, are realistic enough to have taken place, but with the patient in
a state of enkoimesis induced with the help of soporific substances such as opium. [40] Alcmaeon of
Croton wrote on medicine between 500 and 450 BCE. He argued that channels linked the sensory
organs to the brain, and it is possible that he discovered one type of channel, the optic nerves, by
dissection.[41]

Hippocrates[edit]
A towering figure in the history of medicine was the physician Hippocrates of Kos (c. 460 – c. 370
BCE), considered the "father of modern medicine."[42][43] The Hippocratic Corpus is a collection of
around seventy early medical works from ancient Greece strongly associated with Hippocrates and
his students. Most famously, the Hippocratics invented the Hippocratic Oath for physicians.
Contemporary physicians swear an oath of office which includes aspects found in early editions of
the Hippocratic Oath.
Hippocrates and his followers were first to describe many diseases and medical conditions.
Though humorism (humoralism) as a medical system predates 5th-century Greek medicine,
Hippocrates and his students systematized the thinking that illness can be explained by an
imbalance of blood, phlegm, black bile, and yellow bile. [44] Hippocrates is given credit for the first
description of clubbing of the fingers, an important diagnostic sign in chronic suppurative lung
disease, lung cancer and cyanotic heart disease. For this reason, clubbed fingers are sometimes
referred to as "Hippocratic fingers". [45] Hippocrates was also the first physician to describe
the Hippocratic face in Prognosis. Shakespeare famously alludes to this description when writing
of Falstaff's death in Act II, Scene iii. of Henry V.[46]
Hippocrates began to categorize illnesses as acute, chronic, endemic and epidemic, and use terms
such as, "exacerbation, relapse, resolution, crisis, paroxysm, peak, and convalescence."[47][48][49]
Another of Hippocrates's major contributions may be found in his descriptions of the
symptomatology, physical findings, surgical treatment and prognosis of thoracic empyema,
i.e. suppuration of the lining of the chest cavity. His teachings remain relevant to present-day
students of pulmonary medicine and surgery. Hippocrates was the first documented person to
practise cardiothoracic surgery, and his findings are still valid.
Some of the techniques and theories developed by Hippocrates are now put into practice by the
fields of Environmental and Integrative Medicine. These include recognizing the importance of taking
a complete history which includes environmental exposures as well as foods eaten by the patient
which might play a role in his or her illness.

Herophilus and Erasistratus[edit]

The plinthios brochos as described by Greek physician Heraklas, a sling for binding a fractured jaw. These
writings were preserved in one of Oribasius' collections.[50]

Two great Alexandrians laid the foundations for the scientific study of anatomy and
physiology, Herophilus of Chalcedon and Erasistratus of Ceos.[51] Other Alexandrian surgeons gave
us ligature (hemostasis), lithotomy, hernia operations, ophthalmic surgery, plastic surgery, methods
of reduction of dislocations and fractures, tracheotomy, and mandrake as an anaesthetic. Some of
what we know of them comes from Celsus and Galen of Pergamum.[52]
Herophilus of Chalcedon, the renowned Alexandrian physician, was one of the pioneers of human
anatomy. Though his knowledge of the anatomical structure of the human body was vast, he
specialized in the aspects of neural anatomy.[53] Thus, his experimentation was centered around the
anatomical composition of the blood-vascular system and the pulsations that can be analyzed from
the system.[53] Furthermore, the surgical experimentation he administered caused him to become
very prominent throughout the field of medicine, as he was one of the first physicians to initiate the
exploration and dissection of the human body.[54]
The banned practice of human dissection was lifted during his time within the scholastic community.
This brief moment in the history of Greek medicine allowed him to further study the brain, which he
believed was the core of the nervous system.[54] He also distinguished between veins and arteries,
noting that the latter pulse and the former do not. Thus, while working at the medical school
of Alexandria, Herophilus placed intelligence in the brain based on his surgical exploration of the
body, and he connected the nervous system to motion and sensation. In addition, he and his
contemporary, Erasistratus of Chios, continued to research the role of veins and nerves. After
conducting extensive research, the two Alexandrians mapped out the course of the veins and nerves
across the human body. Erasistratus connected the increased complexity of the surface of the
human brain compared to other animals to its superior intelligence. He sometimes
employed experiments to further his research, at one time repeatedly weighing a caged bird, and
noting its weight loss between feeding times. [55] In Erasistratus' physiology, air enters the body, is
then drawn by the lungs into the heart, where it is transformed into vital spirit, and is then pumped by
the arteries throughout the body. Some of this vital spirit reaches the brain, where it is transformed
into animal spirit, which is then distributed by the nerves.[55]

Galen[edit]
The Greek Galen (c. 129–216 CE) was one of the greatest physicians of the ancient world, as his
theories dominated all medical studies for nearly 1500 years.[56] His theories and experimentation laid
the foundation for modern medicine surrounding the heart and blood. Galen's influence and
innovations in medicine can be attributed to the experiments he conducted, which were unlike any
other medical experiments of his time. Galen strongly believed that medical dissection was one of
the essential procedures in truly understanding medicine. He began to dissect different animals that
were anatomically similar to humans, which allowed him to learn more about the internal organs and
extrapolate the surgical studies to the human body.[56] In addition, he performed many audacious
operations—including brain and eye surgeries—that were not tried again for almost two millennia.
Through the dissections and surgical procedures, Galen concluded that blood is able to circulate
throughout the human body, and the heart is most similar to the human soul. [56][57] In Ars medica ("Arts
of Medicine"), he further explains the mental properties in terms of specific mixtures of the bodily
organs.[58][59] While much of his work surrounded the physical anatomy, he also worked heavily in
humoural physiology.
Galen's medical work was regarded as authoritative until well into the Middle Ages. He left a
physiological model of the human body that became the mainstay of the medieval physician's
university anatomy curriculum. Although he attempted to extrapolate the animal dissections towards
the model of the human body, some of Galen's theories were incorrect. This caused his model to
suffer greatly from stasis and intellectual stagnation. [60] Greek and Roman taboos caused dissection
of the human body to usually be banned in ancient times, but in the Middle Ages it changed. [61][62]
In 1523 Galen's On the Natural Faculties was published in London. In the 1530s Belgian anatomist
and physician Andreas Vesalius launched a project to translate many of Galen's Greek texts into
Latin. Vesalius's most famous work, De humani corporis fabrica was greatly influenced by Galenic
writing and form.[63]

Mandrake (written 'ΜΑΝΔΡΑΓΟΡΑ' in Greek capitals). Naples Dioscurides, 7th century

Roman contributions[edit]
Main articles: Medicine in ancient Rome and Medical community of ancient Rome
The Romans invented numerous surgical instruments, including the first instruments unique to
women,[64] as well as the surgical uses of forceps, scalpels, cautery, cross-bladed scissors,
the surgical needle, the sound, and speculas.[65][66] Romans also performed cataract surgery.[67]
The Roman army physician Dioscorides (c. 40–90 CE), was a Greek botanist and pharmacologist.
He wrote the encyclopedia De Materia Medica describing over 600 herbal cures, forming an
influential pharmacopoeia which was used extensively for the following 1,500 years. [68]
Early Christians in the Roman Empire incorporated medicine into their theology, ritual practices, and
metaphors.[69]

The Middle Ages, 400 to 1400[edit]

Byzantine Empire and Sassanid Empire[edit]
Main articles: Byzantine medicine and Medicine in the medieval Islamic world
Byzantine medicine encompasses the common medical practices of the Byzantine Empire from
about 400 CE to 1453 CE. Byzantine medicine was notable for building upon the knowledge base
developed by its Greco-Roman predecessors. In preserving medical practices from antiquity,
Byzantine medicine influenced Islamic medicine as well as fostering the Western rebirth of medicine
during the Renaissance.
Byzantine physicians often compiled and standardized medical knowledge into textbooks. Their
records tended to include both diagnostic explanations and technical drawings. The Medical
Compendium in Seven Books, written by the leading physician Paul of Aegina, survived as a
particularly thorough source of medical knowledge. This compendium, written in the late seventh
century, remained in use as a standard textbook for the following 800 years.
Late antiquity ushered in a revolution in medical science, and historical records often mention civilian
hospitals (although battlefield medicine and wartime triage were recorded well before Imperial
Rome). Constantinople stood out as a center of medicine during the Middle Ages, which was aided
by its crossroads location, wealth, and accumulated knowledge.
The first ever known example of separating conjoined twins occurred in the Byzantine Empire in the
10th century. The next example of separating conjoined twins will be first recorded many centuries
later in Germany in 1689.[70][71]
The Byzantine Empire's neighbors, the Persian Sassanid Empire, also made their noteworthy
contributions mainly with the establishment of the Academy of Gondeshapur, which was "the most
important medical center of the ancient world during the 6th and 7th centuries." [72] In addition, Cyril
Elgood, British physician and a historian of medicine in Persia, commented that thanks to medical
centers like the Academy of Gondeshapur, "to a very large extent, the credit for the whole hospital
system must be given to Persia."[73]

Islamic world[edit]
Main article: Medicine in the medieval Islamic world

Sketch representing Muslim physician Muhammad ibn Zakariya al-Razi

The Islamic civilization rose to primacy in medical science as its physicians contributed significantly

to the field of medicine, including anatomy, ophthalmology, pharmacology, pharmacy, physiology,
and surgery. Islamic civilization's contribution to these fields within medicine was a gradual process
that took hundreds of years. Dating back to the time of the first great Muslim dynasty, the Umayyad
Caliphate (661-750 CE), there was not an abundance of medical understanding in these fields that
were in their very early stages of development. [74]  A factor why that there was not a strong push for
medical advancements is because of how the population handled diseases and illnesses. This was
influenced by the direction, energy, and resources that the early Umayyad caliphs directed after the
death of Prophet Muhammad (632 CE) towards spreading Islam to the nations that they invaded and
the expansion of their caliphate.[75] Because of this effort from the growing dynasty towards the
expansion of Islam, there was not nearly as much effort that was given towards medicine. Rather,
the Umayyad Caliphate after taking over the Caliphate wanted to foremost establish control over the
new empire. The priority on these factors led a dense amount of the population to believe that God
will provide cures for their illnesses and diseases because of the attention on spirituality. [75] There
were also many other areas of interest during that time before there was a rising interest in the field
of medicine. Abd al-Malik ibn Marwan, the fifth caliph of the Umayyad, developed governmental
administration, adopted Arabic as the main language, and focused on many other areas. [76] However,
this rising interest in Islamic medicine grew significantly when the Abbasid Caliphate (750-1258 CE)
overthrew the Umayyad Caliphate in 750 CE.[77] This change in dynasty from the Umayyad Caliphate
to the Abbasid Caliphate served as a turning point towards scientific and medical developments. A
big contributor to this is because, under Abbasid rule, there was a great part of the Greek legacy that
was transmitted into Arabic which by then, was the main language of Islamic nations. [75] Because of
this, many Islamic physicians were heavily influenced by the works of Greek scholars of Alexandria
and Egypt and were able to further expand on those texts to produce new medical pieces of
knowledge.[78] This period of time is also known as the Islamic Golden Age where there was a period
of development for development and flourishments of technology, commerce, and sciences including
medicine. Additionally, during this time the creation of the first Islamic Hospital in 805 CE by the
Abbasid caliph Harun al-Rashid in Baghdad was recounted as a glorious event of the Golden Age.
[74]
 This hospital in Baghdad contributed immensely to Baghdad's success and also provided
educational opportunities for Islamic physicians. During the Islamic Golden Age, there were many
infamous Islamic physicians that paved the way for medical advancements and
understandings. Muhammad ibn Zakariya al-Razi (965-1040 CE), sometimes referred to as the
father of modern optics, is the author of the monumental Book of Optics and also was known for his
work in differentiating smallpox from measles.[79] However, this would not be possible without the
influence from many different areas of the world that influenced the Arabs.

Arabic manuscript, Anatomy of the Eye, by al-Mutadibih, 1200 CE

The Arabs were influenced by ancient Indian, Persian, Greek, Roman and Byzantine medical
practices, and helped them develop further.[80] Galen & Hippocrates were pre-eminent authorities.
The translation of 129 of Galen's works into Arabic by the Nestorian Christian Hunayn ibn Ishaq and
his assistants, and in particular Galen's insistence on a rational systematic approach to medicine, set
the template for Islamic medicine, which rapidly spread throughout the Arab Empire.[81] Its most
famous physicians included the Persian polymaths Muhammad ibn Zakarīya al-Rāzi and Avicenna,
who wrote more than 40 works on health, medicine, and well-being. Taking leads from Greece and
Rome, Islamic scholars kept both the art and science of medicine alive and moving forward.
[82]
 Persian polymath Avicenna has also been called the "father of medicine". [83] He wrote The Canon
of Medicine which became a standard medical text at many medieval European universities,
[84]
 considered one of the most famous books in the history of medicine. [85] The Canon of
Medicine presents an overview of the contemporary medical knowledge of the medieval Islamic
world, which had been influenced by earlier traditions including Greco-Roman
medicine (particularly Galen),[86] Persian medicine, Chinese medicine and Indian medicine. Persian
physician al-Rāzi[87] was one of the first to question the Greek theory of humorism, which
nevertheless remained influential in both medieval Western and medieval Islamic medicine.[88] Some
volumes of al-Rāzi's work Al-Mansuri, namely "On Surgery" and "A General Book on Therapy",
became part of the medical curriculum in European universities. [89] Additionally, he has been
described as a doctor's doctor,[90] the father of pediatrics,[91][92] and a pioneer of ophthalmology. For
example, he was the first to recognize the reaction of the eye's pupil to light. [92]
In addition to contributions to mankind’s understanding of human anatomy, Islamicate scientists and
scholars, physicians specifically, played an invaluable role in the development of the modern
hospital system, creating the foundations on which more contemporary medical professionals would
build models of public health systems in Europe and elsewhere. [93] During the time of the Safavid
empire (16th–18th centuries) in Iran and the Mughal empire (16th–19th centuries) in India, Muslim
scholars radically transformed the institution of the hospital, creating an environment in which rapidly
developing medical knowledge of the time could be passed among students and teachers from a
wide range of cultures.[94] There were two main schools of thought with patient care at the time.
These included humoural physiology from the Persians and Ayurvedic practice. After these theories
were translated from Sanskrit to Persian and vice-versa, hospitals could have a mix of culture and
techniques. This allowed for a sense of collaborative medicine. Hospitals became increasingly
common during this period as wealthy patrons commonly founded them. Many features that are still
in use today, such as an emphasis on hygiene, a staff fully dedicated to the care of patients, and
separation of individual patients from each other were developed in Islamicate hospitals long before
they came into practice in Europe.[95] At the time, the patient care aspects of hospitals in Europe had
not taken effect. European hospitals were places of religion rather than institutions of science. As
was the case with much of the scientific work done by Islamicate scholars, many of these novel
developments in medical practice were transmitted to European cultures hundreds of years after
they had long been utilized throughout the Islamicate world. Although Islamicate scientists were
responsible for discovering much of the knowledge that allows the hospital system to function safely
today, European scholars who built on this work still receive the majority of the credit historically [96]
Before the development of scientific medical practices in the Islamicate empires, medical care was
mainly performed by religious figures such as priests.[93] Without a profound understanding of how
infectious diseases worked and why sickness spread from person to person, these early attempts at
caring for the ill and injured often did more harm than good. Contrarily, with the development of new
and safer practices by Islamicate scholars and physicians in Arabian hospitals, ideas vital for the
effective care of patients were developed, learned, and transmitted widely. Hospitals served as a
way to spread these novel and necessary practices, some of which included separation of men and
women patients, use of pharmacies for storing and keeping track of medications, keeping of patient
records, and personal and institutional sanitation and hygiene. [93] Much of this knowledge was
recorded and passed on through Islamicate medical texts, many of which were carried to Europe
and translated for the use of European medical workers. The Tasrif, written by surgeon Abu Al-
Qasim Al-Zahrawi, was translated into Latin; it became one of the most important medical texts in
European universities during the Middle Ages and contained useful information on surgical
techniques and spread of bacterial infection.[93]
The hospital was a typical institution included in the majority of Muslim cities, and although they were
often physically attached to religious institutions, they were not themselves places of religious
practice.[94] Rather, they served as facilities in which education and scientific innovation could
flourish. If they had places of worship, they were secondary to the medical side of the hospital.
Islamicate hospitals, along with observatories used for astronomical science, were some of the most
important points of exchange for the spread of scientific knowledge. Undoubtedly, the hospital
system developed in the Islamicate world played an invaluable role in the creation and evolution of
the hospitals we as a society know and depend on today.