Medicine

I

Introduction

Medicine (Latin, medicus, “physician”), science and art concerned with curing and preventing disease and preserving health.

II

Early Medicine

The understanding of prehistoric medical practice is derived from palaeopathology, the study of pictographs showing medical procedures, of skulls and skeletons, and of the surgical tools of ancient and contemporary nontechnological societies. Although such study is properly the concern of anthropology, some of the practices have survived into modern times, justifying their consideration in the history of medicine.

Serious diseases were of primary interest to early humans although they did not function effectively in treating them. They divided the genesis of such disease into two categories, each involving a variety of mutually exclusive therapies. First and most numerous were diseases attributed to the influence of malevolent demons, who were believed to project an alien spirit, a stone, or a worm into the body of the unsuspecting patient. Such disabilities were to be warded off by incantation, dancing, magic effects, charms and talismans, and various other measures. If the demon managed to enter the body of its victim, either in the absence of such precautions or despite them, efforts were made to make the body uninhabitable to the demon by beating, torturing, and starving the patient. The alien spirit could also be expelled by potions that caused violent vomiting, or could be driven out through a hole bored in the skull. This last procedure, called trepanning, was also a remedy for insanity, epilepsy, and headache.

However, therapy mounted directly against a disability was usually most successful. Operative procedures practised in ancient societies included cleaning and treating wounds by cautery, poultices, and sutures, resetting dislocations and fractures, and using splints. Additional therapy included the use of purges, diuretics, laxatives, emetics, and enemas. Perhaps the greatest success was achieved by the use of plant extracts, the opiate and stimulating properties of which were slowly discovered. So successful were these that 50 or more continue to be used today. Digitalis, a heart stimulant extracted from foxglove, is perhaps the best known.

III

Ancient Medical Practice

Several prescientific systems of medicine, based primarily on magic, folk remedies, and elementary surgery, existed in various diverse societies before the coming of the more advanced Greek medicine in about the 6th century bc.

A

Egyptian Medicine

Two distinct trends are discernible in Egyptian medicine, the magico-religious, embodying very early elements, and the empirico-rational, based on experience and observation, and lacking in mystical features. Common diseases of the eyes and skin were usually treated rationally by the physician because of their favourable location; less accessible disorders continued to be treated by the spells and incantations of the priest-magician. In the 3rd Dynasty the physician emerged as an early form of scientist, a type distinct from the sorcerer and priest. The earliest physician whose name has survived is Imhotep (lived around 2725 bc), renowned equally as vizier (high official) to the pharaoh, a pyramid builder, and an astrologer.

The physician normally spent years of arduous training at temple schools in the arts of interrogation, inspection, and palpation (examining the body by touch). Prescriptions contained some drugs that have continued in use through the centuries. Favourite laxatives were figs, dates, and castor oil. Tannic acid, derived principally from the acacia nut, was valued in the treatment of burns.

Although Egyptians practised embalming, their anatomical knowledge remained at a low level; as a result, they attempted only minor surgical procedures. An exception was the practice of trepanning. According to reports of the Greek historian Herodotus, the ancient Egyptians recognized dentistry as an important surgical speciality. Some evidence suggests that Egyptian studies of physiology and pathology, based on the work of the physician Imhotep, and the later vivisection of criminals by the Greek anatomist and surgeon Herophilus may have influenced the Greek philosopher Thales of Miletus, who is known to have travelled in Egypt in the 7th century bc.