1 Prehistoric Medicine When were prehistoric times Before

1. Prehistoric Medicine

When were “prehistoric” times? Before recorded (written) history.

What was life like? §Nomadic –wandering in small groups, no farming § Most of time spent searching for food & shelter, protecting self § Used “spirits” to explain the unknown § No government (because they wandered) § Limited tools and only oral language

Prehistoric Health Most prehistoric people were relatively healthy! Why? ◦ Lots of exercise ◦ Fresh food ◦ Moved around, didn’t stay near wastes ◦ Living in small groups limited spread of infectious disease

Prehistoric Health Change with the Agricultural Revolution: §When humans settled down to grow crops and raise animals their health began to get worse. §Why do you think this may have been the case? § Less exercise § More people, crowded environments means more germs and waste § Bacteria in food

Prehistoric Medicine §BELIEF in CAUSE of disease: spirits §DOCTORS: medicine men/religious leaders §TREATMENT: ◦ Herbs (limited) ◦ Set bones (move bone back into place) ◦ Trepanning – drill holes in skull (release spirits)

Prehistoric Medicine How do we know? ? §Cave paintings indicate belief in supernatural §Found skulls w/ holes ◦ Some have new bone growth around hole, suggesting survival past surgery

2. Ancient World: Egyptian Medicine

Egyptian Civilization The ancient Egyptians were one of the first people to SETTLE. §They had a farming economy, organized government, laws, and organized religion. §They developed a written language, counting system, and had some of the earliest scholars.

Egyptian Medicine Travel brought herbs used for treatment of disease. The development of a writing and counting system led to the first medical records, medical books, and dosages for drugs.

Ancient Egyptian Hieroglyph "swnw" for "physician".

Disease in Egyptians believed that disease (if not obvious – parasite, wound, etc. ) was caused by evil spirits or poison. Early doctors were also priests. ◦ Imhotep, was given title of God of Medicine after his death. Medicines treated pain or to drive out evil spirits.

Disease in Egypt Believed body was a system of channels ◦ Air ◦ Tears ◦ Blood ◦ Urine ◦ Sperm ◦ Feces If a channel became “clogged”, bloodletting or leeches were used to “open” them

So what did they know? §First aid – § bandaging, stitches, cauterizing wounds §Diagnosis – § was based on observation of the patient (pulse, interview, examination) §Treatment – § because they kept medical records, they were able to track the effectiveness of cures for future reference. §Internal Anatomy – § from removal of organs during mummification process (many other groups at this time burned bodies)

So what did they know? Gynecology – with female doctors! Prosthetics – artificial toes, etc. Dentistry – false teeth NO internal SURGERY! Average life span: 20 years

So what did they know? IMSETY - The human headed god who protected the liver. His cardinal point was South. DUAMUTEF - The jackal headed god who protected the stomach. His cardinal point was East. QEBEHSENUEF - The falcon headed god who protected the intestines. His cardinal point was West. HAPY - The baboon headed god who protected the lungs. His cardinal point was North.

severe skull fractures “carefully lift larger broken pieces of skull off of the brain, and then any small fragments would be brushed away and discarded. The larger pieces would be carefully replaced onto the brain, and a disinfectant made of warm wine and rose oil (they didn’t know it killed germs, because they did not yet understand the germ theory) was put against the outer membrane of the brain. At last, the patient’s head would be wrapped in bandages; eventually, many would heal. ”

2. ANCIENT WORLD: Greece Medicine

Greek Civilization §Group of distinct city-states covering parts of modern Greece, Turkey, Egypt, and Italy §Had many Gods §God of Medicine-Asclepius §Value for logical thinking & observation

Ancient Medicine ". . . But save me. Take me to the ship, cut this arrow out of my leg, wash the blood from it with warm water and put the right things on it - the plants they say you have learned about from Achilles who learned them from Chiron, the best of the Centaurs. "-The Iliad of Homer, Book XI

Greek Medicine Physicians and Priests Medical practice still linked largely to religion. Use of priest at Physicians. Cult of Asclepius Temples/clinics throughout Greece traditional symbol of Hermes and features two snakes winding around an often winged staff. It is often mistakenly used as a symbol of medicine instead of the Rod of Asclepius, especially in the United States

Cult of Ascelpius • After exercise, rest, eat, and taking potions. Patients slept at the temple (Asclepion)… hoping to be healed • The temple-clinics developed into health spas with a gym, baths, and stadium

Ruins of Asclepion Healthy lifestyle… Bathe Eat right Clean teeth Walk Keep fit Moderation

Hippocrates – Greek philosopher ◦ Lived from 460 – 377 BC ◦ Magic doesn’t cause or cure disease. ◦ First examples of what Greek medical thought was based upon. Hippocratic Oath ◦ Swear to help patient, keep info confidential, never to poison! ◦ Beginning of true medical profession as medicine and religion split

Health Regiment-Hippocrates 'The care of health begins the moment a man wakes up… every day, he should wash his face and eyes using pure water. He should rub his teeth using some fine peppermint powder and taking away any leftover bits of food. He should rub and anoint his head every day. ' 'After this, people who have to or wish to work will do so, but people of leisure will first take a walk. Long walks before meals clear out the body, prepare it for food and give it more power for digesting. ' Hippocrates, 'Regimen' (c. 500 BC)

Theory of the Four Humors §Theory of Four Humors ◦ 4 liquids of the body need to be in balance §Phlegm, yellow bile (vomit), black bile (diarrhea), & blood ◦ Causes and cures linked to these four. ◦ This theory lasts for about 2, 000 years!

Medical Research Common Herbs: • anise • black helebore • Late in the period… • cassia • Dissection allowed on Criminals • cucumber, wild, root v. Even on condemned criminals who were ALIVE v. Found out brain controlled body v. Knew blood circulated, didn’t know why it did (ie. Transport oxygen and nutrients) • cumin • cyclamen, root of • frankincense • germander • honey • myrrh • olive oil • opium poppy

Diagnosis & Treatment First to look at the CAUSE of the disease, rather than treating just the symptoms. ◦ Detailed examination of patient ◦ Looked for natural causes, not supernatural • Looked for natural cures ◦ Vinegar, garlic, honey ◦ Bleeding and purging to balance blood and black bile • Tried to balance temperature ◦ Cure cold by warming ◦ Treat fever by chilling • Simple Surgery as last resort

The fall of Greece When Greece fell, much of its academic progress was lost (particularly since the Romans didn’t value it) Much was rediscovered during the Crusades as Europeans traveled and found it in Egypt, Spain, Constantinople, etc.

2. ANCIENT WORLD: Roman Medicine

The Roman Empire §Conquered Greece 47 BC, Lasted over 1000 years §Advanced government to provide safe and comfortable life to all citizens… ◦ Life revolved around trade and war ◦ Wealthy empire, money spent on public works like roads and hospitals…

Religion and Medicine §Strong beliefs in many gods and their power §Early in Roman rule, people still thought disease was caused by gods and spells/rituals would cure them. Mars-- God of War

Beliefs of Health and Disease They valued reasoning, like the Greeks ◦ So, searched for the CAUSE of disease, then ways to minimize risk and exposure (better chance of success than trying to cure the ill) ◦ Ex. Higher death rates around swamps…. Drained swamps to build temples, kept army and leaders away from swamps ◦ Also linked poor health to: living bad air or water, sewage, lack of cleanliness

Solutions to Public Health Problems � Provide clean water through aqueducts � Develop sewer system to remove wastes � Encourage personal hygiene by building public baths � Cemeteries

Doctors §Early in empire, most doctors are Greek slaves ◦ Devalued, not trusted §Doctors had NO licensing, so anyone could call themselves a doctor. ◦ Continues distrust

Health and the Military Need for a fit army, made medicine a priority ◦ Particularly since lands they invaded (ex. England) often lacked the public works of Rome ◦ As a result of later civil war there was an increased status of doctors, followed by development of Army Medical School.

Roman Knowledge of the Body §Didn’t allow dissection of humans… so the Romans learned from dissection of animals and treatment of gladiators and military. Few new ideas developed. One was that tiny creatures caused disease.

Roman Medicine Caesarean – to remove baby from mother who dies during childbirth Boiled tools before reuse, washed wounds with antiseptic

Galen § 130 -200 AD §Studied in Greece and Egypt §Doctor to Gladiators §Surgeon §Studied apes and dissected human remains §Experimented with pigs. Cut nerves to study how information travels the body. §Study of animals lead to errors