Egyptian medicineMain article: Ancient Egyptian medicineDuring three thousand years of history, Ancient Egypt developed a large, varied and fruitful medical tradition. Herodotus described the Egyptians as "the healthiest of all men, next to the Libyans",[1] due to the dry climate and the notablepublic health system that they possessed. According to him, "[t]he practice of medicine is so specialized among them that each physician is a healer of one disease and no more." In the Odyssey, Homer describes Egypt as a land where "the earth, the giver of grain, bears greatest store of drugs" and where "every man is a physician."[2] Although Egyptian medicine, to a good extent, dealt with the supernatural,[3] it eventually developed a practical use in the fields of anatomy, public health, and clinical diagnostics.
Medical information in the Edwin Smith Papyrus[4] may date to a time as early as 3000 BC.[5] The earliest knownsurgery in Egypt was performed in Egypt around 2750 BC (see surgery). 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 Smithpapyrus, detailing cures, ailments and anatomical observations. The Edwin Smith papyrus is regarded as a copy of several earlier works and was written circa 1600 BC. 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.[6]
Conversely, the Ebers papyrus[7] (c. 1550 BC) is full of incantations and foul applications meant to turn away disease-causing demons, and other superstition. The Ebers papyrus also provides our earliest possible documentation of ancient awareness of tumors, but ancient medical terminology being badly understood, cases Ebers 546 and 547 for instance may refer to simple swellings.
The Kahun Gynaecological Papyrus[8] treats women's complaints, including problems with conception. Thirty four cases detailing diagnosis and treatment survive, some of them fragmentarily.[9] Dating to 1800 BC, 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 the1st Dynasty.[10] By the time of the 19th Dynasty some workers enjoyed such benefits as medical insurance, pensionsand sick leave.[10]
The earliest known physician is also credited to ancient Egypt: Hesyre, “Chief of Dentists and Physicians” for King Djoser in the 27th century BC.[10] 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.” In addition to her supervisory role, Peseshet graduated midwives at an ancient Egyptian medical school inSais.[10]
[edit]Babylonian medicineFurther information: Babylonia - MedicineThe oldest Babylonian texts on medicine date back to the Old Babylonian period in the first half of the 2nd millennium BC. The most extensive Babylonian medical text, however, is the Diagnostic Handbook written by the physician Esagil-kin-apli of Borsippa,[11] during the reign of theBabylonian king Adad-apla-iddina (1069-1046 BC).[12]
Along with contemporary ancient Egyptian medicine, the Babylonians introduced the concepts of diagnosis, prognosis, physical examination, and prescriptions. In addition, the Diagnostic Handbook introduced the methods of therapy and etiology and the use of empiricism, logic andrationality in diagnosis, prognosis and therapy. 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.[13]
The Diagnostic Handbook was based on a logical set of axioms and assumptions, including the modern view that through the examination andinspection of the symptoms of a patient, it is possible to determine the patient's disease, its aetiology 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, creams andpills.[11]
[edit]Greek and Roman medicineMain articles: Medicine in ancient Greece, Medicine in ancient Rome, Medical community of ancient Rome, Byzantine medicine, andMedieval medicineHippocratic Corpus, is a collection of around seventy early medical works from ancient Greece strongly associated with the ancient Greek physician Hippocrates and his teachings.Medicine in Ancient Greece was influenced by Babylonian and Egyptian medicinal traditions.[citation needed] As was the case elsewhere, the ancient Greeks developed a humoral medicine system where treatment sought to restore the balance of humours within the body. A towering figure in ancient Greek medicine was the physician Hippocrates of Kos, considered the "father of modern medicine."[14][15] The Hippocratic Corpus is a collection of around seventy early medical works from ancient Greece strongly associated with Hippocrates and his students. Most famously, Hippocrates invented the Hippocratic Oath for physicians, which is still relevant and in use today.
Hippocrates, regarded as the father of modern medicine,[16][17] and his followers were first to describe many diseases and medical conditions. He 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".[18]Hippocrates was also the first physician to describe Hippocratic face in Prognosis. Shakespearefamously alludes to this description when writing of Falstaff's death in Act II, Scene iii. of Henry V.[19][20]
Hippocrates began to categorize illnesses as acute, chronic, endemic and epidemic, and use terms such as, "exacerbation, relapse, resolution, crisis, paroxysm, peak, and convalescence."[21][22] 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.[23] Hippocrates was the first documented chest surgeon and his findings are still valid.[23]
The Plinthios Brokhos as described by Greek physicianHeraklas, a sling for binding afractured jaw. These writings were preserved in one of Oribasius' collections.[24]The Greek Galen was one of the greatest surgeons of the ancient world and performed many audacious operations—including brain and eye surgeries— that were not tried again for almost two millennia. Later, in medieval Europe, Galen's writings on anatomy became the mainstay of the medieval physician's university curriculum along; but they suffered greatly from stasis and intellectual stagnation. In the 1530s, however, Belgian anatomist and physician Andreas Vesalius took on 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.[25] The works of Galen and Avicenna, especially The Canon of Medicine which incorporated the teachings of both, were translated into Latin, and the Canon remained the most authoritative text on anatomy in European medical education until the 16th century.
The Romans invented numerous surgical instruments, including the first instruments unique to women,[26]as well as the surgical uses of forceps, scalpel, cautery, cross-bladed scissors, surgical needle, sound, and specula.[27][28] Romans were also pioneers in cataract surgery.[29]
Medieval medicine was an evolving mixture of the scientific and the spiritual. In the early Middle Ages, following the fall of the Roman Empire, standard medical knowledge was based chiefly upon surviving Greek and Roman texts, preserved in monasteries and elsewhere. Ideas about the origin and cure of disease were not, however, purely secular, but were also based on a spiritual world view, in which factors such as destiny, sin, and astral influences played as great a part as any physical cause.
Oribasius was the greatest Byzantine compiler of medical knowledge. Several of his works, along with many other Byzantine physicians, were translated into Latin, and eventually, during the Enlightenment and Age of Reason, into English and French. The last great Byzantine Physician was Actuarius, who lived in the early 14th Century in Constantinople.
Medicine was notably not one of the seven classical Artes liberales, and was consequently looked upon more as a handicraft than as a science. Medicine did, nevertheless, establish itself as a faculty, along with law and theology in the first European Universities from the 12th century. Rogerius Salernitanus composed his Chirurgia, laying the foundation for modern Western surgical manuals up to the modern time. The development of modern neurology began in the 16th century with Vesalius, who described the anatomy of the brain and much else; he had little notion of function, thinking that it lay mainly in the ventricles.[30]
[edit]Indian medicineMain article: AyurvedaIn Mehrgarh, Pakistan, archeologists made the discovery that the people of Indus Valley Civilization from the early Harappan periods (c. 3300 BC) had knowledge of medicine and dentistry. The physical anthropologist who carried out the examinations, Professor Andrea Cucina from the University of Missouri-Columbia, made the discovery when he was cleaning the teeth from one of the men. Later research in the same area found evidence of teeth having been drilled, dating back 9,000 years.[31]
The Atharvaveda, a sacred text of Hinduism dating from the 10th to the 12th centuries B.C.E., is the first Indic text dealing with medicine. It identifies the causes of disease as living causative agents such as the yatudhāna, the kimīdin, the krimi or kṛmi and the durṇāma. TheAtharvans seek to kill them with a variety of incantations or plant based drugs in order to counter the disease[32]. This approach to disease is quite different compared to the trihumoral theory of Ayurveda. Remnants of the original atharvanic thought did persist, as can be seen inSushruta's medical treatise and in the Garuda Purana — Garuḍa Purāṇa, karma kāṃḍa, chapter 164. Here following the Atharvan theory, thePurāṇic text suggests the germs as a cause for leprosy. In the same chapter Suśruta also expands on the role of helminths in disease. These two can be directly traced back to the Atharvaveda saṃhitā. The hymn AV I.23-24 describes the disease leprosy and recommends the rajani auṣadhi for its treatment. From the description of the auṣadhi as a black branching entity with dusky patches, it is very likely to have been a lichen with antibiotic properties. Thus the Atharva Veda may be one of the earliest texts to record uses of the antibiotic agents.
Ayurveda (the science of living) is the literate, scholarly system of medicine that originated over 2000 years ago in South Asia. Its two most famous texts belong to the schools of Charaka, born c. 300 B.C.E., and Suśruta, the 6th century B.C.E. physician of Varanasi. While these writings display some limited continuities with very ancient medical ideas known from the religious literature called the Vedas, historians have been able to demonstrate direct historical connections between early āyurveda and the early literature of the Buddhists and Jains. The earliest foundations of āyurveda were built on a synthesis of selected ancient herbal practices dating back to the early second millennium BC, together with a massive addition of theoretical conceptualizations, new nosologies and new therapies dating from about 400 B.C.E. onwards, and coming out of the communities of thinkers who included the Buddha and others. [33].
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.
The āyurvedic classics spoke of eight branches of medicine: kāyācikitsā (internal medicine), śalyacikitsā (surgery including anatomy), śālākyacikitsā (eye, ear, nose, and throat diseases), kaumārabhṛtya (pediatrics), bhūtavidyā (spirit medicine), and agada tantra (toxicology), rasāyana (science of rejuvenation), and vājīkaraṇa (aphrodesiacs, mainly for men). 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, 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.
At the closing of the initiation, the guru gave a solemn address to the students where the guru directed the students to a life of chastity, honesty, and vegetarianism. The student was to strive with all his being for the health of the sick. He was not to betray patients for his own advantage. He was to dress modestly and avoid strong drink. He was to be collected and self-controlled, measured in speech at all times. He was to constantly improve his knowledge and technical skill. In the home of the patient he was to be courteous and modest, directing all attention to the patient's welfare. He was not to divulge any knowledge about the patient and his family. If the patient was incurable, he was to keep this to himself if it was likely to harm the patient or others.
The normal length of the student's training appears to have been seven years. Before graduation, the student was to pass a test. But the physician was to continue to learn through texts, direct observation (pratyaksha), and through inference (anumāna). In addition, the doctors(vaidyas) attended meetings where knowledge was exchanged. The physicians were also enjoined to gain knowledge of unusual remedies from hillsmen, herdsmen, and forest-dwellers. [34]
[edit]Persian medicineMain article: Ancient Iranian MedicineFurther information: Islamic medicine and Science and technology in IranThe practice and study of medicine in Persia has a long and prolific history. Persia's position at the crossroads of the East and the West frequently placed it in the midst of developments in both ancient Greek and Indian medicine. Many contributions were added to this body of knowledge in both pre- and post-Islamic Iran as well.
The first generation of Persian physicians was trained at the Academy of Jundishapur, where the teaching hospital has sometimes been claimed to have been invented. Rhazes, for example, became the first physician to systematically use alcohol in his practice as a physician.
The Comprehensive Book of Medicine (Large Comprehensive, Hawi, "al-Hawi" or "The Continence") was written by the Iranian chemist Rhazes(known also as Razi), the "Large Comprehensive" was the most sought after of all his compositions. In it, Rhazes recorded clinical cases of his own experience and provided very useful recordings of various diseases.
The "Kitab fi al-jadari wa-al-hasbah" by Rhazes, with its introduction on measles and smallpox was also very influential in Europe.
The Mutazilite philosopher and physician Ibn Sina and (also known as Avicenna in the western world) was another influential figure. His The Canon of Medicine, sometimes considered the most famous book in the history of medicine, remained a standard text in Europe up until itsAge of Enlightenment.
[edit]Chinese medicineMain article: Traditional Chinese medicineChina 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, which is composed of two books: theSuwen 素問 ("Basic Questions") and the Lingshu 靈樞 ("Divine Pivot"). Although the Neijing has long been attributed to the mythical Yellow Emperor (twenty-seventh century BC), Chinese scholars started doubting this attribution as early as the eleventh century and now usually date the Neijing to the late Warring States period (5th century-221 BC).[35] Because the medical "silk manuscripts" dating from around 200 BC that were excavated in the 1970s from the tomb of a Han-dynasty noble in Mawangdui are undoubtedly ancestors of the received Neijing, scholars like Nathan Sivin now argue that the Neijing was first compiled in the 1st century BC.[36]
In 56 BC, Zhang Liang invented an instrument named "Meng" which is considered to be precursor of modern stethoscope.
During the Han dynasty, Zhang Zhongjing, who was mayor of Changsha near the end of the second century A.D., wrote a Treatise on Cold Damage, which contains the earliest known reference to the Neijing Suwen. The Jin Dynasty practitioner and advocate of acupuncture andmoxibustion, Huangfu Mi (215-282 A.D), also quotes the Yellow Emperor in his Jiayi jing, ca. 265 A.D. During the Tang Dynasty, Wang Bing claimed to have located a copy of the originals of the Suwen, which he expanded and edited substantially. This work was revisited by an imperial commission during the eleventh century A.D., and the result is our best extant representation of the foundational roots of traditional Chinese medicine.
[edit]Hebrew medicineMost of our knowledge of ancient Hebrew medicine during the 1st millennium BCE comes from the Torah, i.e. the Five Books of Moses, which contain various health related laws and rituals, such as isolating infected people (Leviticus 13:45-46), washing after handling a dead body (Numbers 19:11-19) and burying excrement away from camp (Deuteronomy 23:12-13). While the observance of these statutes would have and do lead to several health benefits, Jewish belief commands that these rituals and prohibitions be kept purely to fulfill the will of God with no ulterior motive. Max Neuberger, writing in his "History of Medicine" says
"The commands concern prophylaxis and suppression of epidemics, suppression of venereal disease and prostitution, care of the skin, baths , food, housing and clothing, regulation of labor , sexual life , discipline of the people , etc. Many of these commands, such as Sabbath rest, circumcision, laws concerning food (interdiction of blood and pork), measures concerning menstruating and lying-in women and those suffering from gonorrhea, isolation of lepers, and hygiene of the camp, are, in view of the conditions of the climate, surprisingly rational."(Neuburger: History of Medicine, Oxford University Press, 1910, Vol. I, p. 38).[edit]Islamic medicineAn Arabic manuscript, dated 1200 CE, titled Anatomy of the Eye, authored by al-Mutadibih.Main article: Islamic medicineFurther information: Ophthalmology in medieval Islam, Bimaristan, Unani, and Ancient Iranian MedicineThe Islamic civilization rose to primacy in medical science as Muslim physicians contributed significantly to the field of medicine, including anatomy, ophthalmology, pharmacology, pharmacy, physiology, surgery, and the pharmaceutical sciences. The Arabs further developed Greek and Roman medical practices. Galenand Hippocrates were pre-eminent authorities.[37] The translation c.830-870 of 129 works of ancient Greekphysician Galen into Arabic by 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. Muslim physicians set up some of the earliest dedicated hospitals, which later spread to Europe during the Crusades, inspired by the hospitals in the Middle East.[38]
Al-Kindi wrote De Gradibus, in which he demonstrated the application of mathematics to medicine, particularly in the field of pharmacology. This includes the development of a mathematical scale to quantify the strength of drugs, and a system that would allow a doctor to determine in advance the most critical days of a patient's illness.[39] Razi (Rhazes) (865-925) recorded clinical cases of his own experience and provided very useful recordings of various diseases. His Comprehensive Book of Medicine, which introducedmeasles and smallpox, was very influential in Europe. In his Doubts about Galen, Razi was also the first to prove the theory of humorism false using an experimental method.[40]
Abu al-Qasim (Abulcasis), regarded as the father of modern surgery,[41] wrote the Kitab al-Tasrif (1000), a 30-volume medical encyclopediawhich was taught at Muslim and European medical schools until the 17th century. He used numerous surgical instruments, including the instruments unique to women,[42][26] as well as the surgical uses of catgut and forceps, the ligature, surgical needle, scalpel, curette, retractor, surgical spoon, sound, surgical hook, surgical rod, and specula,[43] bone saw,[44] and plaster.[45]
Avicenna, considered the father of modern medicine[46] and one of the greatest thinkers and medical scholars in history,[38] wrote The Canon of Medicine (1020) and The Book of Healing (11th century), which remained standard textbooks in both Muslim and European universities until the 17th century. Avicenna's contributions include the introduction of systematic experimentation and quantification into the study of
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Medical information in the Edwin Smith Papyrus[4] may date to a time as early as 3000 BC.[5] The earliest knownsurgery in Egypt was performed in Egypt around 2750 BC (see surgery). 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 Smithpapyrus, detailing cures, ailments and anatomical observations. The Edwin Smith papyrus is regarded as a copy of several earlier works and was written circa 1600 BC. 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.[6]
Conversely, the Ebers papyrus[7] (c. 1550 BC) is full of incantations and foul applications meant to turn away disease-causing demons, and other superstition. The Ebers papyrus also provides our earliest possible documentation of ancient awareness of tumors, but ancient medical terminology being badly understood, cases Ebers 546 and 547 for instance may refer to simple swellings.
The Kahun Gynaecological Papyrus[8] treats women's complaints, including problems with conception. Thirty four cases detailing diagnosis and treatment survive, some of them fragmentarily.[9] Dating to 1800 BC, 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 the1st Dynasty.[10] By the time of the 19th Dynasty some workers enjoyed such benefits as medical insurance, pensionsand sick leave.[10]
The earliest known physician is also credited to ancient Egypt: Hesyre, “Chief of Dentists and Physicians” for King Djoser in the 27th century BC.[10] 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.” In addition to her supervisory role, Peseshet graduated midwives at an ancient Egyptian medical school inSais.[10]
[edit]Babylonian medicineFurther information: Babylonia - MedicineThe oldest Babylonian texts on medicine date back to the Old Babylonian period in the first half of the 2nd millennium BC. The most extensive Babylonian medical text, however, is the Diagnostic Handbook written by the physician Esagil-kin-apli of Borsippa,[11] during the reign of theBabylonian king Adad-apla-iddina (1069-1046 BC).[12]
Along with contemporary ancient Egyptian medicine, the Babylonians introduced the concepts of diagnosis, prognosis, physical examination, and prescriptions. In addition, the Diagnostic Handbook introduced the methods of therapy and etiology and the use of empiricism, logic andrationality in diagnosis, prognosis and therapy. 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.[13]
The Diagnostic Handbook was based on a logical set of axioms and assumptions, including the modern view that through the examination andinspection of the symptoms of a patient, it is possible to determine the patient's disease, its aetiology 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, creams andpills.[11]
[edit]Greek and Roman medicineMain articles: Medicine in ancient Greece, Medicine in ancient Rome, Medical community of ancient Rome, Byzantine medicine, andMedieval medicineHippocratic Corpus, is a collection of around seventy early medical works from ancient Greece strongly associated with the ancient Greek physician Hippocrates and his teachings.Medicine in Ancient Greece was influenced by Babylonian and Egyptian medicinal traditions.[citation needed] As was the case elsewhere, the ancient Greeks developed a humoral medicine system where treatment sought to restore the balance of humours within the body. A towering figure in ancient Greek medicine was the physician Hippocrates of Kos, considered the "father of modern medicine."[14][15] The Hippocratic Corpus is a collection of around seventy early medical works from ancient Greece strongly associated with Hippocrates and his students. Most famously, Hippocrates invented the Hippocratic Oath for physicians, which is still relevant and in use today.
Hippocrates, regarded as the father of modern medicine,[16][17] and his followers were first to describe many diseases and medical conditions. He 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".[18]Hippocrates was also the first physician to describe Hippocratic face in Prognosis. Shakespearefamously alludes to this description when writing of Falstaff's death in Act II, Scene iii. of Henry V.[19][20]
Hippocrates began to categorize illnesses as acute, chronic, endemic and epidemic, and use terms such as, "exacerbation, relapse, resolution, crisis, paroxysm, peak, and convalescence."[21][22] 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.[23] Hippocrates was the first documented chest surgeon and his findings are still valid.[23]
The Plinthios Brokhos as described by Greek physicianHeraklas, a sling for binding afractured jaw. These writings were preserved in one of Oribasius' collections.[24]The Greek Galen was one of the greatest surgeons of the ancient world and performed many audacious operations—including brain and eye surgeries— that were not tried again for almost two millennia. Later, in medieval Europe, Galen's writings on anatomy became the mainstay of the medieval physician's university curriculum along; but they suffered greatly from stasis and intellectual stagnation. In the 1530s, however, Belgian anatomist and physician Andreas Vesalius took on 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.[25] The works of Galen and Avicenna, especially The Canon of Medicine which incorporated the teachings of both, were translated into Latin, and the Canon remained the most authoritative text on anatomy in European medical education until the 16th century.
The Romans invented numerous surgical instruments, including the first instruments unique to women,[26]as well as the surgical uses of forceps, scalpel, cautery, cross-bladed scissors, surgical needle, sound, and specula.[27][28] Romans were also pioneers in cataract surgery.[29]
Medieval medicine was an evolving mixture of the scientific and the spiritual. In the early Middle Ages, following the fall of the Roman Empire, standard medical knowledge was based chiefly upon surviving Greek and Roman texts, preserved in monasteries and elsewhere. Ideas about the origin and cure of disease were not, however, purely secular, but were also based on a spiritual world view, in which factors such as destiny, sin, and astral influences played as great a part as any physical cause.
Oribasius was the greatest Byzantine compiler of medical knowledge. Several of his works, along with many other Byzantine physicians, were translated into Latin, and eventually, during the Enlightenment and Age of Reason, into English and French. The last great Byzantine Physician was Actuarius, who lived in the early 14th Century in Constantinople.
Medicine was notably not one of the seven classical Artes liberales, and was consequently looked upon more as a handicraft than as a science. Medicine did, nevertheless, establish itself as a faculty, along with law and theology in the first European Universities from the 12th century. Rogerius Salernitanus composed his Chirurgia, laying the foundation for modern Western surgical manuals up to the modern time. The development of modern neurology began in the 16th century with Vesalius, who described the anatomy of the brain and much else; he had little notion of function, thinking that it lay mainly in the ventricles.[30]
[edit]Indian medicineMain article: AyurvedaIn Mehrgarh, Pakistan, archeologists made the discovery that the people of Indus Valley Civilization from the early Harappan periods (c. 3300 BC) had knowledge of medicine and dentistry. The physical anthropologist who carried out the examinations, Professor Andrea Cucina from the University of Missouri-Columbia, made the discovery when he was cleaning the teeth from one of the men. Later research in the same area found evidence of teeth having been drilled, dating back 9,000 years.[31]
The Atharvaveda, a sacred text of Hinduism dating from the 10th to the 12th centuries B.C.E., is the first Indic text dealing with medicine. It identifies the causes of disease as living causative agents such as the yatudhāna, the kimīdin, the krimi or kṛmi and the durṇāma. TheAtharvans seek to kill them with a variety of incantations or plant based drugs in order to counter the disease[32]. This approach to disease is quite different compared to the trihumoral theory of Ayurveda. Remnants of the original atharvanic thought did persist, as can be seen inSushruta's medical treatise and in the Garuda Purana — Garuḍa Purāṇa, karma kāṃḍa, chapter 164. Here following the Atharvan theory, thePurāṇic text suggests the germs as a cause for leprosy. In the same chapter Suśruta also expands on the role of helminths in disease. These two can be directly traced back to the Atharvaveda saṃhitā. The hymn AV I.23-24 describes the disease leprosy and recommends the rajani auṣadhi for its treatment. From the description of the auṣadhi as a black branching entity with dusky patches, it is very likely to have been a lichen with antibiotic properties. Thus the Atharva Veda may be one of the earliest texts to record uses of the antibiotic agents.
Ayurveda (the science of living) is the literate, scholarly system of medicine that originated over 2000 years ago in South Asia. Its two most famous texts belong to the schools of Charaka, born c. 300 B.C.E., and Suśruta, the 6th century B.C.E. physician of Varanasi. While these writings display some limited continuities with very ancient medical ideas known from the religious literature called the Vedas, historians have been able to demonstrate direct historical connections between early āyurveda and the early literature of the Buddhists and Jains. The earliest foundations of āyurveda were built on a synthesis of selected ancient herbal practices dating back to the early second millennium BC, together with a massive addition of theoretical conceptualizations, new nosologies and new therapies dating from about 400 B.C.E. onwards, and coming out of the communities of thinkers who included the Buddha and others. [33].
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.
The āyurvedic classics spoke of eight branches of medicine: kāyācikitsā (internal medicine), śalyacikitsā (surgery including anatomy), śālākyacikitsā (eye, ear, nose, and throat diseases), kaumārabhṛtya (pediatrics), bhūtavidyā (spirit medicine), and agada tantra (toxicology), rasāyana (science of rejuvenation), and vājīkaraṇa (aphrodesiacs, mainly for men). 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, 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.
At the closing of the initiation, the guru gave a solemn address to the students where the guru directed the students to a life of chastity, honesty, and vegetarianism. The student was to strive with all his being for the health of the sick. He was not to betray patients for his own advantage. He was to dress modestly and avoid strong drink. He was to be collected and self-controlled, measured in speech at all times. He was to constantly improve his knowledge and technical skill. In the home of the patient he was to be courteous and modest, directing all attention to the patient's welfare. He was not to divulge any knowledge about the patient and his family. If the patient was incurable, he was to keep this to himself if it was likely to harm the patient or others.
The normal length of the student's training appears to have been seven years. Before graduation, the student was to pass a test. But the physician was to continue to learn through texts, direct observation (pratyaksha), and through inference (anumāna). In addition, the doctors(vaidyas) attended meetings where knowledge was exchanged. The physicians were also enjoined to gain knowledge of unusual remedies from hillsmen, herdsmen, and forest-dwellers. [34]
[edit]Persian medicineMain article: Ancient Iranian MedicineFurther information: Islamic medicine and Science and technology in IranThe practice and study of medicine in Persia has a long and prolific history. Persia's position at the crossroads of the East and the West frequently placed it in the midst of developments in both ancient Greek and Indian medicine. Many contributions were added to this body of knowledge in both pre- and post-Islamic Iran as well.
The first generation of Persian physicians was trained at the Academy of Jundishapur, where the teaching hospital has sometimes been claimed to have been invented. Rhazes, for example, became the first physician to systematically use alcohol in his practice as a physician.
The Comprehensive Book of Medicine (Large Comprehensive, Hawi, "al-Hawi" or "The Continence") was written by the Iranian chemist Rhazes(known also as Razi), the "Large Comprehensive" was the most sought after of all his compositions. In it, Rhazes recorded clinical cases of his own experience and provided very useful recordings of various diseases.
The "Kitab fi al-jadari wa-al-hasbah" by Rhazes, with its introduction on measles and smallpox was also very influential in Europe.
The Mutazilite philosopher and physician Ibn Sina and (also known as Avicenna in the western world) was another influential figure. His The Canon of Medicine, sometimes considered the most famous book in the history of medicine, remained a standard text in Europe up until itsAge of Enlightenment.
[edit]Chinese medicineMain article: Traditional Chinese medicineChina 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, which is composed of two books: theSuwen 素問 ("Basic Questions") and the Lingshu 靈樞 ("Divine Pivot"). Although the Neijing has long been attributed to the mythical Yellow Emperor (twenty-seventh century BC), Chinese scholars started doubting this attribution as early as the eleventh century and now usually date the Neijing to the late Warring States period (5th century-221 BC).[35] Because the medical "silk manuscripts" dating from around 200 BC that were excavated in the 1970s from the tomb of a Han-dynasty noble in Mawangdui are undoubtedly ancestors of the received Neijing, scholars like Nathan Sivin now argue that the Neijing was first compiled in the 1st century BC.[36]
In 56 BC, Zhang Liang invented an instrument named "Meng" which is considered to be precursor of modern stethoscope.
During the Han dynasty, Zhang Zhongjing, who was mayor of Changsha near the end of the second century A.D., wrote a Treatise on Cold Damage, which contains the earliest known reference to the Neijing Suwen. The Jin Dynasty practitioner and advocate of acupuncture andmoxibustion, Huangfu Mi (215-282 A.D), also quotes the Yellow Emperor in his Jiayi jing, ca. 265 A.D. During the Tang Dynasty, Wang Bing claimed to have located a copy of the originals of the Suwen, which he expanded and edited substantially. This work was revisited by an imperial commission during the eleventh century A.D., and the result is our best extant representation of the foundational roots of traditional Chinese medicine.
[edit]Hebrew medicineMost of our knowledge of ancient Hebrew medicine during the 1st millennium BCE comes from the Torah, i.e. the Five Books of Moses, which contain various health related laws and rituals, such as isolating infected people (Leviticus 13:45-46), washing after handling a dead body (Numbers 19:11-19) and burying excrement away from camp (Deuteronomy 23:12-13). While the observance of these statutes would have and do lead to several health benefits, Jewish belief commands that these rituals and prohibitions be kept purely to fulfill the will of God with no ulterior motive. Max Neuberger, writing in his "History of Medicine" says
"The commands concern prophylaxis and suppression of epidemics, suppression of venereal disease and prostitution, care of the skin, baths , food, housing and clothing, regulation of labor , sexual life , discipline of the people , etc. Many of these commands, such as Sabbath rest, circumcision, laws concerning food (interdiction of blood and pork), measures concerning menstruating and lying-in women and those suffering from gonorrhea, isolation of lepers, and hygiene of the camp, are, in view of the conditions of the climate, surprisingly rational."(Neuburger: History of Medicine, Oxford University Press, 1910, Vol. I, p. 38).[edit]Islamic medicineAn Arabic manuscript, dated 1200 CE, titled Anatomy of the Eye, authored by al-Mutadibih.Main article: Islamic medicineFurther information: Ophthalmology in medieval Islam, Bimaristan, Unani, and Ancient Iranian MedicineThe Islamic civilization rose to primacy in medical science as Muslim physicians contributed significantly to the field of medicine, including anatomy, ophthalmology, pharmacology, pharmacy, physiology, surgery, and the pharmaceutical sciences. The Arabs further developed Greek and Roman medical practices. Galenand Hippocrates were pre-eminent authorities.[37] The translation c.830-870 of 129 works of ancient Greekphysician Galen into Arabic by 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. Muslim physicians set up some of the earliest dedicated hospitals, which later spread to Europe during the Crusades, inspired by the hospitals in the Middle East.[38]
Al-Kindi wrote De Gradibus, in which he demonstrated the application of mathematics to medicine, particularly in the field of pharmacology. This includes the development of a mathematical scale to quantify the strength of drugs, and a system that would allow a doctor to determine in advance the most critical days of a patient's illness.[39] Razi (Rhazes) (865-925) recorded clinical cases of his own experience and provided very useful recordings of various diseases. His Comprehensive Book of Medicine, which introducedmeasles and smallpox, was very influential in Europe. In his Doubts about Galen, Razi was also the first to prove the theory of humorism false using an experimental method.[40]
Abu al-Qasim (Abulcasis), regarded as the father of modern surgery,[41] wrote the Kitab al-Tasrif (1000), a 30-volume medical encyclopediawhich was taught at Muslim and European medical schools until the 17th century. He used numerous surgical instruments, including the instruments unique to women,[42][26] as well as the surgical uses of catgut and forceps, the ligature, surgical needle, scalpel, curette, retractor, surgical spoon, sound, surgical hook, surgical rod, and specula,[43] bone saw,[44] and plaster.[45]
Avicenna, considered the father of modern medicine[46] and one of the greatest thinkers and medical scholars in history,[38] wrote The Canon of Medicine (1020) and The Book of Healing (11th century), which remained standard textbooks in both Muslim and European universities until the 17th century. Avicenna's contributions include the introduction of systematic experimentation and quantification into the study of
