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MEDICINE IN ANTIQUITY

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MEDICINE IN ANTIQUITY Henry A. Azar, MD PhD University of North Carolina at Chapel Hill Department of Pathology & Laboratory Medicine Periods in History Antiquity (ca ... – PowerPoint PPT presentation

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Title: MEDICINE IN ANTIQUITY


1
MEDICINE IN ANTIQUITY
  • Henry A. Azar, MD PhD
  • University of North Carolina at Chapel Hill
  • Department of Pathology Laboratory Medicine

2
Periods in History
  • Antiquity (ca. 4000 BC to 476 AD)
  • Early Near Eastern and Asian civilizations
  • Rise of Greece and Hellenism
  • Rise of Rome Augustus (r. 31 BC-14 AD) first
    emperor
  • Jesus Christ (ca. 1-33)
  • Augustulus deposed in 476 Eastern Empire
    continues
  • Middle Ages (476-1453)
  • Rise of Islam (622 AD, 1st Hegira year)
    Crusades
  • Fall of Constantinople (1453)
  • Modern Age (1453-1945/ 1990)
  • Post-Modern Age

3
Medicine in Antiquity
  • Mesopotamian Medicine
  • Egyptian Medicine
  • Greek and Greco-Roman Medicine
  • School of Alexandria
  • Medicine under the Roman Empire
  • Indian (Ayurvedic) Medical Traditions
  • Chinese Medical Traditions

4
The Fertile Crescent
5
A Mediterranean World
6
Mesopotamian Civilization
  • Flat land between Euphrates and Tigris humid
    climate, clear skies, clay soil (bricks)
    peopled by Semites.
  • Sumer, cuneiform deciphered by Grotefend in
    Perspolis,
  • Epic of Gilgamish
  • Akkad, language akin to Aramean/Phenician
    (Canaanite)
  • Babylonia
  • Assyria
  • Neo-Babylon or Chaldea
  • (Persia)

7
Babylon
  • Babylon succeeded Sumer and Akkad, a great
    metropolis later defeated by Assyria
  • Code of laws promulgated by Hammurabi (ca. 1800
    BC)
  • Sexagesimal and positional system
    (astronomy/astrology)
  • Marduk chief god, also called Bel, successor to
    Sumerian Enlil
  • Magico-religious practices incantation and
    divination zigurat at the horizon, right upper
    corner

8
Assyrian and Persian Empires
9
MESOPOTAMIAN MEDICINE
  • Supernatural powers are
  • involved in afflictions of
  • mankinds
  • Vast number of diseases recognized
  • Collaboration between asipu (priest)
  • and asu (physician)
  • Code of Hammurabi
  • Assurbanipal Library in Nineva
  • some 800 medical texts
  • Rich botanical materia medica

10
CODE OF HAMMURABI
  • 8 stele unearthed at Susa, Persia, in 1902--said
    to have come down from Sun God.
  • Earliest codification of laws monument lists 282
    laws in 16 columns with reverse 28 columns
    several apply to physicians (asu), cow/sheep
    healers, barbers
  • Fees and penalties set according to
  • 3 classes (nobles, commoners and slaves)
  • No penalties for priestly-medical mismanagement

11
Egyptian Civilization
  • A gift of the Nile
  • Ancient Kingdom
  • Pyramids (Imhotep) ca. 2200 BC
  • Middle Kingdom
  • Hyksos invasion ca. 1600 BC
  • New Kingdom
  • Akhneton (d. 1350) and wife Nefertiti
  • Monotheism, Moses
  • Assyrian Persian invasions
  • Alexander (d. 322 BC)
  • Cleopatra (d. 30 BC ), last of Ptolemies

Photo Museum of Fine Arts, Boston
  • Pyramids of Giza
  • Boston Museum. of Fine Arts

12
EGYPTIAN MEDICINE
  • Ebers Papyrus (Leipzig) emphasizes magical
    spells, with large section on diseases of the gut
    and intestinal worms.
  • Metu, a system of vessels and canals
    originating in the heart and carrying air and
    liquids to all parts of the body, and converging
    to the anus.
  • Whedu, concept of decay associated with feces.
  • Large number of drugs of vegetable, botanical
    and mineral origin.

13
EGYPTIAN MEDICINE (cont.)
  • Kahun Gynecological Papyrus (London) almost
    entirely devoted to gynecological organs,
    including test for pregnancy (onion implanted in
    the flesh, positive outcome determined by odor in
    nose).
  • Edwin Smith Surgical Papyrus (ed. J. H. Breasted,
    Univ. of Chicago Press, 1930).
  • Orderly arrangement of cases from head to
    spinal vertebra. Offers brief clinical
    description, diagnosis and treatment
    surprisingly devoid of magico-religious formulae.
  • Case 45 first description of a cancer (male
    breast)

14
EGYPTIAN MEDICINE (cont.)
  • Monuments depiction of circumcision,
    poliomyelitis?, achondroplastic dwarf.
  • Mummies
  • Parasitic infestations (calcified eggs of
    shistosomiasis and preserved tapeworms
  • Evidence of tuberculosis, Potts disease of the
    spine
  • Arthritis, atherosclerosis, gallstones
  • Pneumonia, pleurisy, lung abscesses
  • Splenomegaly
  • Renal atrophy

15
Hellenic CivilizationHomer (fl. ca. 850
BC), Iliad Herodotus, Persian Wars (492 BC- 479
BC) Thucydides, Peloponnesian War (431 BC-404 BC)
16
Rise of AthensThe Age of Pericles

  • Socrates
  • Plato
  • Aristotle
  • Photo Carolyn Buckler in A History of
    Western Civilization

17
GREEK and GRECO-ROMAN MEDICINE
  • Asclepius, originally a skilled physician,
    subsequently deified usually depicted with staff
    and serpent.
  • Hippocrates of Cos (d. about 370 BC) ), father
    of
  • medicineand Hippocratic Corpus (including
    writings of Hippocrates) gathered in Alexandria
    two centuries later.
  • School of Alexandria, includes two important
    anatomists (Herophilus and Erasistratus).
  • Medicine under the Roman Empire Celsus, a Roman,
  • dominance of Galen and Galenism for over 1000
    years. Botany of Dioscorides.
  • .

18
DOMINANT TENETS OF GREEK MEDICINE
  • Dissociation between medicine and religion
  • Four humors phlegm, yellow bile, black bile,
    blood (corresponding to 4 elements, 4 qualities,
    4
  • temperaments, etc.) a crude anatomy and
    physiology
  • Health is the result of proper balance between
    the four humors disease results from an
    imbalance emphasis on proper rules of health
  • Treatment rests on evacuation of undesired or
    excessive humor (purgation, emetics, phlebotomy)
  • Professionalism and a code of behavior
    (Hippocratic Oath)

19
Alexanders Empire
20
SCHOOL OF ALEXANDRIA
  • Alexandrian Library and Museum founded by
    Ptolemy (r. 382-282)
  • Autopsies, vivisection?
  • Herophilus arteries filled with blood,
    delineated nerves
  • Erasistratus brain seat of intelligence motor
    and sensory nerves.
  • Archimedes, Euclid, Ptolemy

21
The Roman Empire
22
GRECO-ROMAN Materia Medica
  • Dioscorides (40-90 AD)
  • of Anazarba, botanist and
  • army surgeon under Nero,
  • described and illustrated some 600 plants
  • Galen incorporated much
  • of Dioscoridess Materia medica in his writings
  • Both had great influence on Arabic medicine

23
IN CONCLUSION
  • MESOPOTOMIA AND EGYPTDiseases are caused mainly
    by supernatural influences. There is a blending
    of magico-religious practices with pragmatism. An
    evolution from magician-priest-physician to
    physician and surgeon is noticeable.
  • GREECE, ROME and ALEXANDRIA Natural causes
    explain disease. Greek philosophers dissociate
    science and medicine from magic and religion.
    Hippocrates establishes a strong tradition of
    pragmatism and professional behavior. Greek
    medicine flourishes in Alexandria with Herophilus
    and Erasistratus. Galen remains the dominant
    physician during the late Roman empire and up to
    modern times.

24
Select General References
  • L. I. Conrad, Michael Neve, Vivian Nutton, Roy
    Porter and Andrew Wear, The Western Medical
    Tradition 800 BC to AD 1800 (Cambridge, UK
    Cambridge Univesity Press, 1995), pp. 11-91 (by
    Vivian Nutton). Warren D. Dawson, The Beginnings
    Egypt Assyria (New York Paul B. Hoeber, 1930.
  • Guido Majno, The Healing Hand Man and Wound in
    the Ancient World (Cambridge, MA Harvard
    Univeristy Press, 1991, paperback edition).
  • Roy Potter, The Greated Benefit to Mankind A
    Medical History of Humanity (New York/London W.
    W. Norton, 1997), Ch. II.
  • Plinio Prioreschi. A History of Medicine, v. I.
    Primitive and Ancient Medicine (Omaha Horatio
    Press, 1996).
  • Henry E. Sigerist, A History of Medicine, v. I.
    Primitive and Archaic Medicine (New York/Oxford
    Oxford University Press, reissued 1987).

25
Medicine in Antiquity Websites
  • www.med.unc.edu/wrkunits/syllabus/yr4/gen/medhist
    /publish
  • Microsoft PowerPoint presentations
  • Eric Ball, The Code of Hammurabi
  • Richard Baecher, Smith Surgical Papyrus
  • Elizabeth Griffiths, Evolution of the Hippocratic
    Oath
  • Denis Hadjiliades, Present Vestiges of Greek
    Medicine
  • Also,
  • www.indiana.edu/ancmed/concepts.htm
  • Egypt Mesopotomia Greece

26
Credits
  • Photos of the Pyramids and of the Parthenon as
    well as all maps are from
  • John. P. McKay, Bennett D. Hill and John
    Buckler, A History of Western Civilization
    (Boston Houghton Mifflin Co., 1979)
  • The following illustrations are from Ralph
    Majors A History of Medicine, v. 1 (Springfield,
    Charles C. Thomas, 1954)
  • Babylon of Nebuchadrezzar, Oriental Institute,
    Univ. of Chicago
  • Stele of Hammurabi, Louvre Museum, Paris
  • Divination Liver and Rosetta Stone, British
    Museum, London.
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