Medicine

C

Palestinian

Hebrew medicine was mostly influenced by contact with Mesopotamian medicine during the Assyrian and Babylonian captivities. Disease was considered evidence of the wrath of God. The priesthood acquired the responsibility for compiling hygienic regulations, and the status of the midwife as an assistant in childbirth was clearly defined. Although the Old Testament contains a few references to diseases caused by the intrusion of spirits, the tone of biblical medicine is modern in its marked emphasis on preventing disease. The Book of Leviticus includes precise instructions on such varied subjects as feminine hygiene, segregation of the sick, and cleaning of materials capable of harboring and transmitting disease. Although circumcision, the surgical removal of the foreskin on the male’s penis, is the only surgical procedure clearly described in the Bible, common medical practices include wounds dressed with oil, wine, and balsam. The leprosy so frequently mentioned in the Bible is now believed to have embraced many skin diseases, including psoriasis.

D

Indian

The practices of ancient Hindu, or Vedantic, medicine (1500-1000 bc) are described in the works of two later physicians, Charaka (lived about 2nd century ad) and Susruta (lived about 4th century ad). Susruta gave recognizable descriptions of malaria, tuberculosis, and diabetes. He also wrote about Indian hemp, or Cannabis, and henbane for inducing anesthesia, and included specific antidotes and highly skilled treatments for bites of venomous snakes. An ancient Hindu drug derived from the root of the Indian plant Rauwolfia serpentina was the source of the first modern tranquilizer. In the field of surgery, the Hindus are acknowledged to have attained the highest skill in all antiquity. They were probably the first to perform successful skin grafting and plastic surgery for the nose.

With the rise of Buddhism the study of anatomy was prohibited, and with the Muslim conquest of India, beginning around AD 1000, the field of medicine further declined and ultimately stagnated. Nevertheless, much valuable knowledge concerning hygiene, diet, and surgery was passed to the West through the writings of Indian physicians.

E

Chinese

Chinese physicians believed that diseases result from imbalances in two life forces, Yin and Yang, that flow through the body. Drugs and other treatments were intended to restore this balance. Hundreds of ancient herbal medicines, including iron for anemia, mercury for syphilis, arsenic for skin diseases, and opium, are still used in traditional Chinese medicine. Other Chinese medicines and techniques, including acupuncture, are now commonly used in Western medicine. Most Chinese medicine was based on a famous textbook, the Nei Ching, written by Emperor Huang Ti between 479 and 300 bc. Chinese physicians specialized in treating wounds, fractured bones, allergies, and other diseases. They diagnosed patients by asking questions about symptoms, diet, and previous illnesses, and by checking the patient’s pulse.

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F

Greek

Greek culture, renowned for its masterpieces of art, poetry, drama, and philosophy, also made great advances in medicine. The earliest Greek medicine still depended on magic and spells. Homer considered Apollo the god of healing. Homer's Iliad, however, reveals a considerable knowledge of the treatment of wounds and other injuries by surgery, already recognized as a specialty distinct from internal medicine.

By the 6th century bc, Greek medicine had left the magic and religious realm, instead stressing clinical observation and experience. In the Greek colony of Crotona the biologist Alcmaeon (lived about 6th century bc) identified the brain as the physiological seat of the senses. The Greek philosopher Empedocles elaborated the concept that disease is primarily an expression of a disturbance in the perfect harmony of the four elements—fire, air, water, and earth—and formulated a rudimentary theory of evolution.

Kos and Cnidus are the most famous of the Greek medical schools that flourished in the 5th century bc. Students of both schools probably contributed to the Corpus Hippocraticum (Hippocratic Collection), an anthology of the writings of several authors, although popularly attributed to Hippocrates, who is known as the father of medicine. Hippocrates was the greatest physician in antiquity. He convinced physicians that disease had identifiable causes and was not due to the supernatural. His writings were used in medical textbooks well into the 19th century. Greek physicians introduced such modern ideas as prognosis, or outcome of disease, and the use of case histories of actual patients to teach students. The highest ethical standards were imposed on physicians, who took the celebrated oath usually attributed to Hippocrates and still used in modified form today (see Hippocratic Oath).

Although not a practicing physician, the Greek philosopher Aristotle contributed greatly to the development of medicine by his dissections of numerous animals. He is known as the founder of comparative anatomy. Further progress in understanding anatomy flourished by the 3rd century bc in Alexandria, Egypt, which was firmly established as the center of Greek medical science. In Alexandria the anatomist Herophilus performed the first recorded public dissection, and the physiologist Erasistratus did important work on the anatomy of the brain, nerves, veins, and arteries. The followers of these men divided into many contending sects. The most notable were the empiricists who based their doctrine on experience gained by trial and error. The empiricists excelled in surgery and pharmacology; a royal student of empiricism, Mithridates VI Eupator, king of Pontus, developed the concept of inducing tolerance of poisons by the administration of gradually increased dosages.

G

Greco-Roman

Alexandrian Greek medicine influenced conquering Rome despite initial resistance from the Romans. Asclepiades of Bithynia was important in establishing Greek medicine in Rome in the 1st century bc. Asclepiades taught that the body was composed of disconnected particles, or atoms, separated by pores. Disease was caused by restriction of the orderly motion of the atoms or by the blocking of the pores, which he attempted to cure by exercise, bathing, and variations in diet, rather than by drugs. This theory was revived periodically and in various forms as late as the 18th century.

Galen of Pergamum, also a Greek, was the most important physician of this period and is second only to Hippocrates in the medical history of antiquity. His view of medicine remained undisputed into the Middle Ages ( 5th century to 15th century). Galen described the four classic symptoms of inflammation and added much to the knowledge of infectious disease and pharmacology. His most important work, however, was in the field of the form and function of muscles and the function of the areas of the spinal cord. He also excelled in diagnosis and prognosis. Some of Galen's teachings tended to hold back medical progress, however, such as his theory that the blood carried the pneuma, or life spirit, which gave it its red color. This theory, coupled with the erroneous notion that the blood passed through a porous wall between the ventricles of the heart, delayed the understanding of circulation and did much to discourage research in physiology. The importance of Galen's work cannot be overestimated, however, for through his writings knowledge of Greek medicine was subsequently passed to the Western world by the Arabs.

While the Romans learned most of their medical knowledge from Egypt, Greece, and other countries that they conquered, their own contributions involved sanitation and public health. Roman engineers built aqueducts to carry pure water to residents of Rome, a sewage system to dispose of human wastes, and public baths. These measures helped to prevent infectious diseases transmitted by contaminated water.

The gradual infiltration of the Roman world by a succession of barbarian tribes was followed by a period of stagnation in the sciences. These invasions destroyed the great medical library in Alexandria (Alexandria, Library of) and many of its books and medical manuscripts were lost. Western medicine in the Middle Ages consisted of tribal folklore mingled with poorly understood remnants of classical learning. Even in sophisticated Constantinople (now İstanbul), a series of epidemics served only to initiate a revival of magical practices, superstition, and intellectual stagnation.