S1 University Work Environment Course

History of Medicine

Dr Sherko A Omer
Dept. of Microbiology
Objectives

• Identify different chronological periods in history of medicine

• Describe main medical knowledge and practice in each era
• Understanding some old medical treatment and observations
• Know some important historical medical discoveries
• Know some names and their participation to medicine over
time
• Identify some diseases mentioned in past times

2
Timeline

Prehistory Ancient Egypt Roman Empire

Herbs, plants
Trepanation, geophagy Anatomy, mumification
Health advice, dental Galen, Dioscorides, Roman
Evil sprit and shamanism Army surgeon, C section,
treatment, surgery
Very limited practices hospitals

> 10000 BCE 8000-1500 3000 BCE 700 BCE-600 800-474 CE 500 BCE-700 CE
BCE CE

Mesopotamia Greek China & East

Coniform medical writings Hippocrates, humorous Acupuncture, herbal
Code for medical practice theory, human body, medicine, TCM, Kampo
Professional doctor names clinical observation Ayurveda,
Herb, plant, mineral, spells
and surgery

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Timeline

Medieval Renaissances 1900-2000

New age scientists, Invention and discoveries
Hospitals, universities,
pharmacies, anatomy, observation and research
surgery, plague anatomy and physiology

450-1400 CE 800-1200 CE 14-16 Cen. 17-18 Cen. 19-20 Cen. >2000

1700-1800 > 2000

Islamic word Discoveries and inventions
Covid-19
Translation, doctors and
polymaths, hospitals,
herbal remedies and
surgery

Date are approximate and may overlap 4

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Definition of medicine
Medicine (noun)
1. The science or practice of the diagnosis, treatment, and prevention of disease
(in technical use often taken to exclude surgery).
2. A drug or other preparation for the treatment or prevention of disease.
3. (among North American Indians and some other peoples) a spell, charm, or
fetish believed to have healing or magical power.

ORIGIN
Middle English: via Old French from Latin medicina, from medicus
'physician’.

Concise Oxford English Dictionary

5
Medicine
Come with human, come diseases with, then come looking for relief,
for if no relief come, then misery and death is in wait to come.

Our ancient ancestors left us their experience and over centuries

culminated as today’s knowledge which we will pass to our future.

Medicine in one of these knowledge that keep our health and live.

6
Prehistory
Since there is no written records, our knowledge come from cave
drawing, burial sites and some areas. People in prehistoric times
would have believed in a combination of natural and supernatural
causes and treatments for conditions and diseases.

Based om some guesses on limited anthropological evidence

suggest that people knew something about bone structure.
Scientists have found bones that were stripped of the flesh,
bleached, and piled together, according to what part of the body
they came from.

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 the practice of eating the flesh of one's own
species
Prehistory
Some prehistoric communities practiced cannibalism. These people
must have known about the inner organs and where there is most
lean tissue or fat in the human body. Also they believed that spirits
determined their lives.

Live was short, remains of people aged 20 to 40 years were founded

more common than those aged over 40 years. Males lived longer
due to good share of hunt and no childbirth mortality.

Peoples suffered from physical trauma, joint and bone problem

(osteoarthritis), retickets (low vit D and C), infection and its
complications.
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Prehistory
People used herbs and medicinal herbs in prehistoric times.

Other medical practice included geophagy (eating earth and clay),

trepanning (by drilling a hole into the human skull) to allow evil
sprits to leave.

Doctors or shamans, existed in some prehistoric communities. They

were in charge of their tribe’s health and gathered plant-based
medications, mainly herbs and roots, carried out rudimentary
surgery, and cast spells and charms.

9
Prehistory

Cave painting, trepanation, shamanism, and geophagy in birds.

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Mesopotamia
Cuneiform medical manuscripts are found
in large numbers, mostly from 1st -
millennium BCE sites throughout ancient
Mesopotamia.
healing
Included in the therapeutic tradition are
pharmacological glossaries, herbal recipes
with plant, mineral, and animal
ingredients, and healing spells and rituals.

corciform manuscript 11
Mesopotamia
Treatment included identification of the offending supernatural power,
appeasement of the angry gods, for example by offering amulets or
spells, exorcism of evil spirits, as well as a measure of empirical
therapy aimed against certain recognised symptom complexes.

Besides having offices, beds for patients, and surgical and

pharmacological equipment, Mesopotamian doctors had a
professional names.

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Mesopotamia
Medical practice was rigidly codified, starting with Hammurabi's Code
in the 18th century BC and persisting to the late 1st millennium BC.
1000 years

The so-called Diagnostic Handbook, the Assyrian Herbal and

Prescription Texts describe the rationale of Mesopotamian medicine,
based predominantly on supernatural concepts, although
rudimentary traces of empirical medicine are apparent.

Some practices in this era influence Egypt and later Greek medical
practice.

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Mesopotamia
Among the 282 laws in Hammurabi’s Code, nine
(215-223) pertain to medical practice:
doctor
• If a physician performs eye surgery and saves the
eye, he shall receive ten shekels in money.
• If the patient be a freed man, he receives five
shekels.
• If he be the slave of some one, his owner shall give
the physician two shekels.
• If a physician performs an operation and kills
someone or cuts out his eye, the doctor’s hands shall
be cut off.

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Ancient Egypt
Ancient Egypt was a civilization that lasted from 3300
to 525 B.C.E. This is probably where the concept of
health started. Some of the earliest records of
medical care come from ancient Egypt.

The ancient Egyptians believed in prayer as a solution

-

to health problems, but they also had natural, or

practical, remedies, such as herbs.
reath ent
*

Magic, religion and medical practice were used by

healers.

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Ancient Egypt
It was a structured society with tools such as written language and
mathematics, which enabled them to record and develop ideas,
and it meant that others could learn from them.
dead
The practice of preserving deceased people as mummies meant
that they learned something about how the human curred
body works.
tool
In
one process, the priest-doctor inserted a long, hooked implement
through the nostril and broke the thin bone of the brain case to
remove the brain.
for
searched
Kings and queens from faraway lands sought Egyptian doctors
because of their reputation for excellence.
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Ancient Egypt
A document (Ebers Papyrus) contains over 700 remedies and
magical formulas and incantations for repelling demons that cause
disease or mental problems.

The scroll contains a section on birth control, how to tell if a person

is pregnant, and some other gynecological issues.

People were advised to wash and shave their bodies to prevent

infections, to eat carefully, and to avoid unclean animals and raw
fish.

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 cemin -
incense

Ancient Egypt
->

Caries and tooth decay appear to have been common,

remedies included; cumin, incense, and onion to treat swollen gums,
opium to treat pain and drilling holes into the jaw to drain an water
get the

abscess. out

Egyptian physicians underwent training and could successfully fix

broken bones and dislocated joints.

Basic surgery — meaning procedures close to the surface of the skin

or on the skin — was a common skill, and doctors knew how to stitch
0joc(9)
wounds effectively.
-> opia

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Ancient Egypt

Mumification, dental implant, prosthetic toe and surgical tool.

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Greek
Hippocrates of Kos (c. 460 – c. 370 BC), was a
Greek physician. Called “ the Father of Medicine”,
he is considered one of the most outstanding
figures in the history of medicine.

Beside formulation of humoral theory. He and his

school used medical terms such as; acute and
chronic, endemic and epidemic, convalescence
crisis, exacerbation, paroxysm, peak, relapse,
resolution etc.

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Greek
Greek doctors used rational thinking when dealing
with medicine. For healing, they used practical
and natural solution instead on relying on divine
God
intervention.
involvement

Aristotle and Plato concluded that the human body had no use in
the afterlife. This thinking spread and influenced Greek doctors. It
allowed the Greeks to start finding out about the inside of the
human body in a systematic way.

At Alexandria in Egypt, scholars starting dissecting dead bodies

methodical
seffing
and studying them.
in a

way

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Greek
Greeks would carry out clinical observations.
They would perform a thorough physical
examination. Their books gave guidance on how
to do the examination and which diseases to
consider or rule out.

For treatment, Greek doctors became expert

herbalists and prescribers of natural remedies Caduceus logo, Ancient
and to correct the four humours imbalance Greek medicine symbol

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Greek
Doctors were skilled experts at setting broken
bones, fixing dislocated limbs, and curing
slipped discs. They remove arrowheads and
other pieces of weaponry. They also carried
out amputations, to stop the spread of
gangrene. - surgically cutting
off a
limb

death of
body tissues

Bloodletting is one of the oldest and most

persistent therapies, and the one most often
held up as evidence of the crude barbarity of
medicine until the modern period.

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Greek
The humoral theory suggested four body
fluids blood, phlegm, yellow bile, and
black bile are responsible for good health
and diseases in their imbalance.

The ancient Greeks later linked each

humour to a season, an organ, a temper, Sanguine: optimistic, positive
Choleric: bad-tempered, irritable
and an element. Melancholic: thinking or feeling sadness
Phlegmatic: self-controlled, calm, cool

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Roman Empire
Roman medical knowledge and practice were
advanced for the time with progress in many
areas.
dead body
With no permission to dissect corpses, they were limited in their
understanding of human anatomy. However, soldiers and gladiators
often had wounds, which could be severe, and doctors had to treat
them. In this way, they learned more about the human body.
sroplying
Romans encouraged the provision of public health facilities
throughout the Empire. Their medicine developed from the needs
of the battlefield and learnings from Egypt and Greek.

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 Roman Empire
Aelius Galenus or Claudius Galenus (129 – c. AD
216), also known as was a Greek physician,
surgeon and philosopher in the Roman Empire.

Galen is considered to be one of the most

accomplished of all medical researchers of
dherent times
antiquity, he influenced the development of
various scientific disciplines, including anatomy
physiology, pathology, pharmacology, and
neurology, as well as philosophy and logic.

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 Roman Empire
Pedanius Dioscorides (c. 40–90 AD) was a Greek
physician, pharmacologist, botanist, and author
of De materia medica— a 5-volume Greek
encyclopedia about herbal medicine and related
medicinal substances (a pharmacopeia), that
was widely read for more than 1,500 years.

He was employed as a physician in the Roman

army.
botanist: an expert in or student of
the scientific study of plants

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Roman Empire
The Romans performed surgical procedures
using opium and scopolamine to relieve pain
and acid vinegar to clean up wounds.
childbirth by
360 surgery
The Romans also had midwives. Cesarean
sections did sometimes take place. The women
would not survive, but the baby might.

In purpose-built hospitals where people could

rest and observed and have a better chance of
recovery. Opium, and Devil's Breath, source
of scopolamine or hyoscine

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Roman Empire
Most Roman surgeons got their practical experience on the
battlefield. They carried a tool kit containing arrow extractors,
catheters, scalpels, and forceps. They used to sterilize their
equipment in boiling water before using it.

They firmly believed in achieving the right balance of the four

humors and restoring the “natural heat” of people with medical
conditions. Galen said that opposites would often cure people. For
a cold, he would give the person hot pepper. If they had a fever, he
advised doctors to use cucumber.

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China and East
Many of practices of ancient China were passed over centuries to
what is called now “Traditional Chinese Medicine” (TCM).

The basic concept of CTM is that a vital force of life, called Qi,
surges through the body. Any imbalance to Qi can cause disease
and illness.

It is believed that to regain balance, you must achieve the balance

between the internal body organs and the external elements of
earth, fire, water, wood, and metal.

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 China and East
Treatment to regain balance
may involve:
I • Acupuncture (need(e)
2- • Moxibustion (the burning of herbal
leaves on or near the body)
3- • Cupping (the use of warmed glass jars
to create suction on certain points of
the body)
4 • Massage
5 •-
Herbal remedies
6- • Movement and concentration exercises
(such as tai chi)

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China and East
Japanese traditional herbal medicine (Kampo medicine) is based
administration of crude herbal drug formulations dates back by more
than 1500 years with practice from CTM.

India’s earliest school of medicine known is Ayurveda. It was

strengthered
consolidated by Charaka nearly 2500 years ago. In his book “Charak
Samhita,” has described the medicinal qualities and functions of
100,000 herbal plants.

He also has emphasized the influence of our diet and physical

activities over our mind, which is even practiced by our today’s
generation.
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China and East
Sushruta, father of surgery, used to
conducted complicated surgical procedures
advanced
2600 years ago, without the sophisticated
instruments of today.

He performed surgeries like like artificial

limbs, cesareans, cataract, rhinoplasty,
urinary stones, dislocations, fractures,
plastic surgery, and even brain surgery.

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Medieval (middle ase)
In Medieval era the practice of medicine in the was rooted in the
Greek tradition. Hippocrate’s body as made up of four humours was
still believed firmly. Galenic theories was prominent until 16th while
Dioscorides writings was still used in treatment.

By the 12th century, there were medical schools throughout Europe.

The most famous was the school of Salerno in southern Italy, where
women permitted to study.

34
Medieval
formous
Dissection for medical purposes became more prominent around
1299. During this time the Italians were practicing anatomical
dissection and the first record of an autopsy
↓
dates from 1286.
a postmortem examination to discover the cause of death or the extent of
disease

Dissection was first introduced in the educational setting at the

university of Bologna, to study and teach anatomy

Although plants were the main source of medieval remedies, around

the sixteenth century medical chemistry became more prominent.
Medical chemistry began with the adaptation of chemical processes
to the preparation of medicine O if

35
 Medieval
I Among Medieval medical achievements were hospitals, pharmacies
(apothecary, originally from Baghdad), eyeglasses, anatomy and
dissection (In the year 1315 the Italian physician Mondino de Luzzi
even conducted a public dissection for his students and spectators),
universities, cleaning wounds, C section, quarantines and dental
I

amalgams.3

Surgery such as amputations, cauterization, removal of cataracts,

dental extractions, and even trepanning were practiced using opiates
for anesthesia and doused wounds with wine as a form of antiseptic.
poured preventing growth
of the world

36
Medieval
Among pandemics, were the Justinian Plague (541)
started in central Africa and spread to Egypt and the
Mediterranean and the Black Death of 1347 originated
in Asia and spread to the Crimea then Europe and
Russia.

Plague is an infection caused by Gram-negative bacteria Yersinia

pestis. It occur after being bitten by a rodent flea that is carrying
the plague bacterium or by handling an animal infected with
plague. The infection results in swollen lymph nodes (buboes),
septicaemia and if not treated, death is eventual.
blood poisoning

37
Medieval
It was thought that plague was a punishment
from God. They used prayers, self flogging, herbal
remedies but without any results. Plague death
was wiping entire areas.

In the 15th and 16th centuries doctors wore a

peculiar costume to protect themselves from the
plague when they attended infected patients.

Venice instituted various public health controls such as isolating

victims from healthy people and preventing ships with disease
from landing at port.
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Islamic world
5,
Islamic medicine built upon the legacies of Galen, Hippocrates,
and the Greek scholars of Alexandria and Egypt.

Scholars translated medical literature from Greek and Roman into

Arabic and Hebrew and then elaborated upon it, adding their
findings, developing new conclusions, and contributing new
perspectives.
favors
Consequently, Arabs and Jews were renowned for the practice of
medicine, and Arabic and Jewish doctors were often employed by
kings.

39
Islamic world
Islamic scholars expertly gathered data and ordered it so that
people could easily understand and reference information
through various texts.

Al-Razi was a Persian physician, chemist, alchemist, philosopher,

and schola,r he lived from 865 to 925 C.E. He was the first to
distinguish measles from smallpox, and he discovered the
chemical kerosene and several other compounds. He is known as
the “father of pediatrics,”, he wrote more than 200 scientific
books and articles. He also believed in experimental medicine.

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 with wide maga
& Person
knowledge
Islamic world
and
· I learning

↑
Ibn Sina, (Avicenna), was Persian polymath. He had many
skills and professions, and he wrote approximately 450
books and articles. Forty of these focus on medicine such
as “The Canon of Medicine,” which became essential
reading at several medical schools around the world
which was studied in Europe.

Discovery and description of pulmonary blood circulation

is attributed to ibn al-Nafis, Damascus. He contradicted
Galen writing about human circulatory system and
proposed closed circulatory system before William
Harvey.
41
Islamic world
Hasan ibn al-Haytham, from Iraqi explained that the eye is an
optical instrument and provided a detailed description of the
eye’s anatomy. Later, he developed theories about the formation
of images. Scholars in Europe referred to his “Book of Optics”
until the 17th century.

Ibn al-Quff al-Karaki was an Arab physician and surgeon from

Jordon
D and author of the earliest and largest medieval Arabic

treatise intended solely for surgeons.

42
Islamic world
Medieval Islamic medications were usually plant-based, as had
been those of Ancient Greece, Rome, and Egypt. Doctors used
poppies, the seeds of which contain codeine and morphine, to
relieve: eye pain, pain from gallbladder stones, fevers,
toothaches, pleurisy and headaches.
uflon rection
↑

· f plevia

There were also hospitals, including teaching hospitals, where

students could learn how to treat patients.

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 in Europe Antiquity ->medieval -> renaissance -> modern
lege
& ancient
age
I Iriddesal

Renaissances
Before the Renaissance, medicine in Europe was largely built
upon theories, with little research into what actually worked.
Knowledge filtering from the Islamic world improved the
situation somewhat, but even their contribution hailed back to
the incorrect assumptions made by Aristotle and Pliny the Elder.

From the 1450s onwards great medical personalities and scholar

humanists made unique advances to medicine and surgery.

• Girolamo Fracastoro, an Italian doctor and scholar, suggested that

S epidemics may come from pathogens outside the body. He proposed that
these might pass from human-to-human by direct or indirect contact.
44
 Belgion
Renaissance R
• Andreas Vesalius, a Flemish anatomist and physician, wrote on the structure

I
of the human body.
• William Harvey, an English doctor, he properly describe the systemic
circulation and properties of blood, and how the heart pumps it around the
body.
& iscovered

• Paracelsus, a German-Swiss doctor, scholar, and occultist, pioneered the useI

of minerals and chemicals in the body. aalchemy,

person who believes in or practices occult arts, such as magic, astrology,
seances, or other activity claiming the use of secret knowledge or
supernatural powers or agencies:
• Leonardo Da Vinci was expert in anatomy and made studies of tendons,
muscles, bones, and other features of the human body.
• Ambroise Paré , from France, helped lay the foundations for modern forensic
Set
pathology and surgery.

45
 Renaissance
• Herman Boerhaave , a Dutch botanist, chemist is regarded as the founder of

2
clinical teaching and of the modern academic hospital. He is sometimes
referred to as “the father of physiology.”
• Bacteria and protists were first observed with a microscope by Antonie van
Leeuwenhoek in 1676, initiating the scientific field of microbiology.

46
 is not important
years

1700-1800
During the 18th and 19 centuries more and more
discoveries and invention were chieved
achieved
-
ununization &

• 1701 Giacomo Pylarini gives the first smallpox inoculations

• 1747 James Lind publishes his Treatise of the Scurvy stating
that citrus fruits prevent scurvy -> a
disease due to
lack of Vitamin C

• 1763 Claudius Aymand performs the first successful

appendectomy - T
• 1796 Edward Jenner develops the process of- vaccination for
smallpox, the first vaccines for any disease
& • 1800 Humphry Davy discovers the anesthetics properties of
nitrous oxide

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 1700-1800
• 1816 Rene Laennec invents the stethoscope
• 1818 James Blundell performs the first successful transfusion
of human blood ther
2

• 1842 Crawford W. Long uses either as a general anesthetic

-
-
-

& • 1844 Dr. Horace Wells uses nitrous oxide as an anesthetic

& • 1846 William Morton, a dentist, is the first to publish the
process of using anesthetic properties of nitrous oxide
• 1847 Ignaz Semmelweis discovers how to prevent the
transmission of puerperal fever
• 1853 Charles Gabriel Pravaz and Alexander Wood develop the
syringe

48
1700-1800 areto se
• 1857 Louis Pasteur identifies germs as clause of disease
• 1867 Joseph Lister develops the use of antiseptic surgical
methods
• 1870 Robert Koch and Louis Pasteur establish the germ theory
of disease
• 1879 First vaccine developed for cholera, 1881 for anthrax by
Pasteur and 1882 vaccine for rabies by Pasteur
• Koch discovers the TB bacillus
• 1895 Wilhelm Conrad Roentgen discovers X-rays
• 1899 Felix Hoffman develops aspirin

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1900-2000
• 1901 Karl Landsteiner introduces the system to classify blood
into A, B, AB, and O groups
• 1913 Dr. Paul Dudley White pioneers the use of the
electrocardiograph - ECG
• 1922 Insulin first used to treat diabetes
• 1927 First vaccine developed for tuberculosis (BCG)
• 1928 Alexander Fleming discovers penicillin
• 1945 First vaccine developed for influenza
• Jonas Salk develops the first polio vaccine, then oral polio
vaccine by Sabin.

50
1900-2000
• 1953 James Watson and Francis Crick work on the structure of
the DNA molecule
• Dr. Joseph E. Murray performs the first kidney transplant
• Dr. Christian Bernard performs the first human heart transplant
• 1975 Robert S. Ledley invents CAT-Scans
• 1978 First test-tube baby is born
• 1980 Smallpox is eradicated
• 1981 First vaccine developed for hepatitis B
• 1983 HIV, the virus that causes AIDS, is identified
• PCR was invented in 1983 by the Kary Mullis
• 1996 Dolly the sheep becomes the first clone

51
2001
• 2000 Cracking human genome
• 2003 first SARS epidemic
• 2006 First vaccine to target a cause of cancer
• 2019 Covid-19 epidemic, RNA vaccines

52
Death report
George Washington (1732-1799) the first president
of the United States.

On December 14, 1799, George Washington died at

his home after a brief illness.

That night, Washington woke his wife Martha to say

he was feeling very sick, and that he could hardly
breathe or talk on his own.

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Death report
Washington asked his overseer, Albin Rawlins to bleed him. Doctors
then arrived and bled him four more times over the next eight hours,
with a total blood loss of 40 percent.

Washington also gargled with a mixture of molasses, vinegar and

butter; he inhaled a steam of vinegar and hot water; and his throat
also was swabbed with a salve and a preparation of dried beetles. An
enema was also used.
By late afternoon, Washington knew he was dying and asked for his
will.

54
Death report
Since Washington death, several retrospective diagnoses have been
offered ranging from croup, quinsy, Ludwig’s angina, Vincent’s
angina, diphtheria, and streptococcal throat infection to acute
pneumonia. There is also suggestion of acute bacterial epiglottitis.

Debate has centered on the massive bloodletting and the ignored

suggestion of a tracheotomy as possible main contributors to
Washington’s death. Both unlikely be the cause!

55
References
Prehistoric medicine: Research, disease prevention, and medications (medicalnewstoday.com)
Medicine, Mesopotamia | Oxford Classical Dictionary (oxfordre.com)
Mesopotamian medicine - PubMed (nih.gov)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5472722/
https://asopahospital.in/history-of-indian-medicine-and-surgery/
Medicine in the Middle Ages | Essay | The Metropolitan Museum of Art | Heilbrunn Timeline of Art
History (metmuseum.org)
Medieval Islamic medicine: Influences, thinkers, and anatomy (medicalnewstoday.com)
https://www.medicalnewstoday.com/articles/323612
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4379645/
https://en.wikipedia.org/wiki/Humorism

History of Medicine. Digital Edition 6th . Amy Best

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Thanks for attendance

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