Title: MEDICINE IN ANTIQUITY
1MEDICINE IN ANTIQUITY
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- Henry A. Azar, MD PhD
- University of North Carolina at Chapel Hill
- Department of Pathology Laboratory Medicine
2Periods 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
3Medicine 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
4The Fertile Crescent
5A Mediterranean World
6Mesopotamian 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)
-
7Babylon
- 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
8Assyrian and Persian Empires
9MESOPOTAMIAN 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
10CODE 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
11Egyptian 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
12EGYPTIAN 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.
13EGYPTIAN 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)
14EGYPTIAN 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)
16Rise of AthensThe Age of Pericles
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-
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- Socrates
- Plato
- Aristotle
- Photo Carolyn Buckler in A History of
Western Civilization
17GREEK 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)
19Alexanders Empire
20SCHOOL 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
21The Roman Empire
22GRECO-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
23IN 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.
24Select 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).
25Medicine 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
26Credits
- 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. -