Ancient and Prehistoric Medicine

It is difficult to imagine anything other than modern medical treatments. Medicine today is so advanced. Researches are finding new and better things for every kind of illness known. The study and practice of medicine seems like a modern day fixation. The truth is

that for thousands of years humans have become ill and for the same amount of time people have tried to cure them.

If you had to be ill in ancient times, one of the best places to do so would be in Egypt. The Egyptians were advanced medical practitioners of there time. They were masters of human anatomy and healing mostly due to the extensive mummification ceremonies which also led them to have a basic knowledge of organ functions within the human body. The Egyptians believed that most illnesses, other than the ones caused by an obvious accident, were mysterious.

The Egyptians explained them as the work of the gods, caused by the presence of evil spirits or their poisons, and cleansing the body was the way to rid the body of their influence. Incantations, prayers to the gods – above all to Sekhmet the goddess of healing, curses, and threats, often accompanied by the injection of nasty smelling and tasting medicines into the various bodily orifices, were hoped to prove effective. (Nefertiti)

There was not the separation of Physician, Priest, and Magician in Egypt. Some of the preventive measures included prayers and various kinds of magic, and even the wearing of amulets. An example of this could be the Egyptians cure for cataracts. In order to cure cataracts the Egyptians believed you had to:
mix brain-of-tortoise with honey. Place on the eye and say: There is shouting in the southern sky in darkness, There is an uproar in the northern sky, The Hall of Pillars falls into the waters. The crew of the sun god bent their oars so that the heads at his side fall into the water, Who leads hither what he finds? I lead forth what I find. I lead forth your heads. I lift up your necks. I fasten what has been cut from you in its place. I led you forth to drive away the god of Fevers and all possible deadly arts. (Brier)

The Egyptian priest-physician had a number of important functions. They first had to discover the nature of the particular entity that possessed the person and then drive it out or destroy it. This was done through some sort of powerful magic or sometimes wearing a certain amulet. “Though Egyptian medical practices by no means could rival that of the present day physicians, Egyptian healers engaged in surgery, prescriptive, and many other healing practices still found today” (Brier). The Egyptians used many types of plants, animals, and mineral compounds for curatives. The use of these compounds led to curative recipes, some even available today. “The prescription for a healthy life, which was almost always given by a member of the priestly caste meant that an individual undertook the stringent and regular purification rituals, which included: much bathing, and often times shaving one’s head and body hair, and maintaining their dietary restrictions against raw fish and other animals considered unclean to eat” (Crystalinks A).

Egyptians are credited as being the first to use and record advanced medical practices. The Egyptians recorded some of there techniques on papyri. Some of the most famous are: the Edwin Smith Papyri, the Ebers Papyrus, Kahun Papyrus, Berlin Papyrus, London Papyrus, and Hearst Papyrus. The treatments of the text are often organized into groups. For instance, the Edwin Smith Papyrus begins with eight texts concerning head wounds, followed by nineteen treatments of wounds to the face, six descriptions of how to deal with injuries to the throat and neck, five dealing with collar-bones and arms, and seven with chest complaints.

Surgery was believed to come to the Egyptians through the care of traumatic wounds and autopsy. The use of autopsy is believed to come from the long and extensive embalming and funerary practices. Surgery was considerably advanced when considering the technology available to the Egyptians. “The Edwin Smith Papyrus deals extensively with the setting of bones, traumatic injury such as dislocation of the jaw, arm or shoulders, bruises, various fractures which include those of the limbs, ribs, nose, and skull” (Showcase).

The Egyptians were also very mindful that they could not treat every injury or disease that they faced. If such a case was to happen then usually they would write, “An affliction for which nothing can be done”. An Egyptian medical kit consisted of: knives, drill, saw, forceps or pincers, censer, hooks, bags tied with string, beaked vessel, vase with burning incense, Horus eyes, scales, pot with flowers, shears, and spoons. The Egyptians often would heat the blades of their knives before cutting so that the knife would cut as well as seal the blood vessels. Prostheses were generally of a cosmetic character or added as a preparation for the afterlife. There were mummies found with artificial arms, artificial forearms, artificial toes, artificial feet, and some even had an artificial penis. Even things like a glass eye has been found, which was more likely used to fill an empty eye socket of a mummy rather than used by a living person. “Physicians performed other cosmetics as well. Apart from prescribing lotions, salves and unguents for skin care, they also produced remedies against the loss of hair and graying, which was combated by an ointment made with blood from the horn of a black bull. Hair loss was hoped to be stopped by a mixture of honey and fats from crocodiles, lions, hippos, cats, snakes, and ibex” (Nefertiti).

The Egyptians diet was consisted of much abrasive materials which caused them to have teeth which were in a very poor state. Destruction of the enamel caused some to lose teeth at an early age and even sometimes was the cause of death. “ Mutnodjmed, pharaoh Horemheb’s second wife and sister of Nefertiti, had lost all her teeth when she died in her forties. Djedmaatesankh, a Theban musician who lived around 850 BCE suffered from thirteen abscesses, extensive dental disease and a huge infected cyst, which probably killed her, aged thirty-five” (Nefertiti).

People that were of more stature in society were more likely to have caries as opposed to the people that were of less stature. A person of the people was limited to what they could eat and thanks to the lack of sugar in their diet were more likely to have a clean slate of teeth. The Egyptians referred to caries as “a worm gnawing a tooth”. They sometimes treated the tooth with fillings made of resin and chrysocolla. “Swollen gums were treated with a concoction of cumin, incense and onion. Opium, the toxicity of which was well known, might be given against severe pain. At times holes were drilled into the jawbone in order to drain abscesses. But extraction of teeth, which might have saved the lives of many patients, was rarely if ever practiced” (Nefertiti). They also would sometimes use gold wire as a means to bind a loose tooth to a neighboring tooth that was sound.

Fertility was important to Egyptians and they had many tests listed in the Kahun Gynaecological Papyrus. There was an existence of need of planning pregnancies also. Some Egyptian women would soak cotton in a paste of dates and acacia bark which was a spermicidal effect. They also devised the first known pregnancy test:
Means for a knowing if a woman will give birth: Put some barley and some wheat into two bags of clot which the woman will moisten with her urine every day, equally barley and grain in the two bags. If both the barley and the wheat sprout she will give birth. If only the barley germinates it will be a boy, if it is the wheat which alone germinates it will be a girl. If neither germinates she will not give birth. (Nefertiti)

Some of the upper-class women would give birth in birth houses. The houses were attached to temples that had pictures of Hather, the goddess of healing, and Bes, the god of pregnant women. In one temple there is a picture of a pregnant woman sitting in a birthing chair, in which the baby would drop through a hole in the seat and was caught by a midwife. “Birth itself was dangerous both to the mother and the baby. Infant mortality was high, probably around thirty percent, and complications and childbed fever killed many women” (Nefertiti). So one must admire the ingenuity of the Egyptians, which undoubtedly has its place within human medical history. “Although many of the treatments used had a little or no value from our modern vantage point, Egyptian medicine had a well deserved reputation throughout the Ancient World, with, for instance, Hippocrates and Galen acknowledging that part of their information came from Egyptian works which they had studied at the temple of Imhotep at Memphis” (Crystalinks A).

Ancient Greece was much different from the Greece of today. In Ancient Times Greece was a collection of City States. Although each was independent from the others they all still shared a similar culture and religious beliefs. By 1200 B.C., Ancient Greece was developing in all areas: trade, farming, warfare, sailing, craftsmanship etc. Their knowledge of medicine developed accordingly. Greek Medicine, like the Egyptians, was advanced for its time. The early works of people like Hippocrates, Aristotle, and Alcaemon and many others show an advanced knowledge of physiology, surgical, and medicinal practices. Greek ideas influenced ideas in the Western medicine for times to come. The Greeks had an influence in the progress and changes in ideas on cures and diseases, and also influenced the attitudes towards doctors and healthy living and even medicine in general.

According to mythology, the Greek god Ascelpius was a trained doctor. Along with his daughters Hygieia and Panacea, he was worshipped in a type of healing temple called asclepeia. Asclepeias was:

built for those in poor health. These were like temples and here people came to bathe, sleep and meditate. The poor were also allowed to beg for money in these buildings. Those who went to asclepeias were expected to leave offerings to Asclepios. The asclepeias were run by priests. Patients to asclepeias were encouraged to sleep as it was believed that during sleep they would be visited by Asclepios and his two daughters, Panacea and Hygeia. A visit by these three was expected to cure all ailments. Those who were not cured could stay at the asclepeia where they were. (Trueman)

There have been some written accounts of those who have supposedly been cured; “Hermodicus of Lampsacus was paralyzed in the body. When he slept in the temple the god healed him and ordered him to bring to the temple as large a stone as he could. The man brought the stone which now lies before the abaton where people slept” (Trueman).

Such admiration for doctors and healing was not restricted to the gods. “Many people believe Greece was the home of the first Western medical science, when doctors stopped relying on superstition and diving cures, and replaced them with rational curiosity about the causes of illness” (Wikipedia). The ancient Greeks also greatly admired Ancient Egyptian medicine as well. The Greeks had respect for Egyptian medicine and imported some of the Egyptian substances into their own pharmacopoeia. The Greeks had an extensive knowledge of herbs and were aware of many herbal properties. They did perform scientific observations, but did not perform scientific experiments. Some of the herbs used by the Ancient Greeks were: anise, black hellebore, cassia, root of cucumber, cumin, root of cyclamen, frankincense, germander, honey, wild lettuce, myrrh, olive oil, opium poppy, parsnip, and seseli. “The first known medical school opened in Cnido in 700 BC. Alcmaeon, author of the first anatomical work, worked at the school, and it was here that the practice of observing patients was established” (Wikipedia).

Although births that were depicted in art mostly involved men; in most cases of childbirth in Ancient Greece a woman was the deliverer. Midwifes became popular when women were no longer able to become doctors. The majority of the deliveries were taken care by the lady of the house and her servants. Women did use an obstetric chair for the process. Two women would hold the mother in the chair while a third kneeled in front to receive the baby. The equipment that a midwife normally must have for labor were:

olive oil (clean, not previously used in cooking), warm water, warm fomentations (ointments applied to the body), soft sea sponges, pieces of wool, bandages (to swaddle the infant), things to smell (pennyroyal, dirt, barley groats, apples, quinces, lemons, melons, cucumbers; these were used as people today use spirits of ammonia to revive someone who has fainted), a midwife’s stool or chair (this was the property of the midwife; she brought it with her to the home where the delivery was to take place), two beds (a hard one for use during labor and a soft one for rest after delivery), and a proper room (of medium size and moderate temperature). (French)

At the onset of labor all this equipment was made ready and the midwife summoned. In order to ease labor pains, the midwife would give a gentle massage with a cloth soaked in warm olive oil laid over abdomen and genital area. Once the cervix began to dilate, the midwife would gently rub the opening with her left forefinger that is smeared with olive oil in order to encourage the process of dilation. After the cervix is dilated to the size of an egg the patient is moved to the midwife’s stool. The baby would safely be delivered and then the midwife would carefully inspect it for any congenital deformities. The midwife would make the initial recommendation about whether the newborn was healthy and fit. In order for the midwife to make this decision the baby would engage in several tests. “First, when placed on the ground, it should cry lustily; babies that do not cry, or cry only weakly, are suspect. Second, its body should be normal; the openings for the nose, ears, urethra, and anus should be clear; its arms and legs should bend and stretch readily. Finally, by pressing her fingers against the skin of the newborn, the midwife should be able to elicit a reaction, indicating that the infant is sensitive to such sensations” (French).

Not all congenital defects were regarded as unfit. The midwife would make a determination about the infant’s survival and likely recommend that any infant with a severe congenital problem would be left outside to die.
Perhaps one of the most important Ancient Greeks when dealing with medicine is Hippocrates. He lived 400 years before the birth of Christ and is known as the father of medicine because of the many things he discovered is still practiced today.

Hippocrates stated that:
Medicine is not philosophy, and therefore must be practiced on a case-by-case basis rather than from first principles. In The Sacred Disease, he stated that epilepsy (and disease in general) does not have divine causes. He advocated clinical observations, diagnosis, and prognosis, and argued that specific diseases come from specific causes. Hippocrates’s methodology relied on physical examination of the patient and proceeded in what was, for the most part, a highly rational deductive framework of understanding through observation. (Jouanna)

He told his students to carefully observe their patients and learn from the things that they observed. He said that the human body could heal itself and could return itself back to good health. Some more things Hippocrates said would be things such as telling his patients to eat in moderation. A moderate amount of exercise was recommended. Doctors were told to make sure that when they treated patients their hands were clean. He said that the operating rooms should be well lit and seem cheerful. He believed that patients in good spirits would heal faster. He encouraged his physicians to be men of honor that worked as hard as possible for the good of sick. The Hippocratic Oath was named after him. The existence of the Hippocratic Oath implies:

That this “Hippocratic” medicine was practiced by a group of professional physicians bound (at least among themselves) by a strict ethical code. Aspiring students normally paid a fee for training (a provision is made for exceptions) and entered into a virtual family relationship with his teacher. This training included some oral instruction and probably hands-on experience as the teacher’s assistant, since the Oath assumes that the student will be interacting with patients. The Oath also places limits on what the physician may or may not do (“To please no one will I prescribe a deadly drug”) and intriguingly hints at the existence of another class of professional specialists, perhaps akin to surgeons (“I will leave this operation to be performed by practitioners, specialists in this art”). (Wikipedia)

The Hippocratic knowledge was widely distributed, highly influential, and marked as the rise of rationality in both medicine and the physical sciences. The Ancient Greeks themselves did not have a concept of germ theory; rather their view of human physiology was predominated by the ideas of essentialism. Essentialism was the belief that every living organism alive contained certain mixtures of the four elements. The Hippocratics and many other Greeks also believed in the theory of the four humours.

This theory had its roots in the belief in four elements which, Empedocles argued, made up everything in the world: earth, air, fire, and water with their associated qualities of dryness, coldness, heat, and wetness respectively. These, in turn, were linked to the four seasons; dry autumn, cold winter, hot summer, and wet spring (it followed that you were more likely to suffer from a particular humour in the corresponding season). Among other corollaries, this theory meant that for some diseases, remedies to purge excess humours, such as bloodletting or vomiting, seemed advisable. (Wikipedia)

These ideas influenced Western medicine for over 1500 years. As the exact relationship between the illness and humours, beliefs were varied. “The Hippocratics taught that an imbalance of the humours, or dyscrasia, was symptomatic of an illness. Aristotle (384-322BC), however, suggested that it was the cause of illness. It was believed that one could only be in perfect health when the humours were in balance, known as crasis or eucrasia. The natural tendency towards balance, or recovery, was called pepsis or coction” (Wikipedia).
There was a major impact on Greek medical ideas and practices when Alexander the Great founded Alexandria, Egypt in 332 B.C. It was here that the Library of Alexandria was soon established, and its collections of important scientific and philosophical texts became famous throughout the Hellenistic world. “Alexandria was also the only city in Ancient Greece where dissection and maybe even vivisection of criminals sentenced to death was legal, which meant that doctors could gain a far more detailed knowledge of the workings of the human anatomy” (Wikipedia).
Early Romans had a religious, yet fundamental understanding of medicine. “Deriving knowledge from the Medical Treaties and Methods of the Greeks, the Etruscans, the Egyptians, the Persians and other conquered peoples, the Romans came up with one of the best and most sophisticated Medical Systems of the Ancient World. The science of medicine and the human body was evolving” (Crystalinks B). The Romans started by learning what the Greeks thought about medicine, and in fact most Roman doctors were from Greece, or of Greek origin. Like the Greeks the Romans believed in the four humours.

One of Rome’s most important doctors was Galen. He lived in the 100’s and wrote a book about medicine.
Galen repeated a lot of Hippocrates’ work on the four humours, but also added a lot of observations about how the human body worked, which he learned from looking at the insides of human bodies. He saw the insides of people by looking at wounded soldiers and gladiators, and he cut open a lot of animals to see how they worked. Galen certainly knew more about anatomy than Hippocrates did. Galen understood that the blood was pushed around the body be the heart, for instance. And he knew that nerves controlled the movement of the body, and that people thought with their brains. He did not make any real advances in treating people. He still thought that blood-letting was a good idea. (Jungman)
Ancient Roman medicine was a combination of physical techniques using various tools and holistic medicine using rituals and religious beliefs. The Ancient Romans, like the Ancient Egyptians, believed that diseases were brought on by the disfavor of the gods. They believed that superstition, rituals, and spells would rid them of the disease. Religious cures were rare, but magical treatments were common. “The practice of reading livers was common in the Roman world. After an animal was sacrificed its liver was examined by a priest who would interpret the liver. Looking at the liver, the priest would reveal good or bad omens from it. It was thought that the gods responses were communicated through the liver and other internal organs of sacrificed animal” (Crystalinks B). Ancient Romans had hospitals that were originally built for the military. Soon the influence of superstitious quackery begin to die and Ancient Roman medicine begin to take on a more practical and logical approach. It was still a trial and error, patient by patient thing, but the medics were more observant and carefully noted down anything that worked or was effective. The knowledge from the notes could be passed on and could be used by the next doctor.

The Ancient Romans were led to significant medical innovations after the fifteen-year civil war that began after the assassination of Julius Caesar. This war was fought by the best armies of the world that resulted in so many injuries that the new emperor, Augustus, formed a professional military medical corps. Before this event doctors had a very low status in society.
Augustus, realizing that they were the key in an empire and especially an army gave all physicians that joined his new army medical corps dignified titles, land grants, and special retirement benefits. For the next five hundred years, fueled by the motivations and opportunity for medical advancement supplied by the many battles, and supported by the powers that be, this serious group advanced the study and practice of medicine to a level not seen again until late in the nineteenth century. (Crystalinks B)

After Emperor Augustus formed the first Roman Medical Corps and gave land grants, dignified titles out, and special retirement gifts to the doctors, the profession changed from being low in society to being a respectable occupation. They increased their success rates in treatments by making the medical professionals train at the Army Medical School and could not practice until they passed. Like the modern medical practice, Ancient Roman medicine was split among different specialties, such as internists, ophthalmologists, and urologists; so all the surgical tasks would be performed by the specialist of the injury. Some of the same tools the surgeons would use are the same ones that doctors used only just 100 years ago. Some of the tools in an Ancient Roman tool kit would include: forceps, scalpels, catheters, and even arrow-extractors.
The Ancient Romans had a large variety of painkillers and sedatives to help in surgery, including extracts of opium poppies which is morphine, and extracts of henbane seeds which is scopolamine. “There is little doubt that the many folk remedies used throughout the Roman Empire were tested in battle by Roman physicians on wounded and ailing soldiers, who sifted through and found the treatments and methods with the most useful effects. Further, the bureaucracy of Rome ensured that the treatments were recorded and taught in medical school” (Crystalinks B). Although the Romans never really understood how germs were related to disease, they used many of the techniques that killed germs. Some examples of this would be before the Romans used a tool on a patient they would boil it; and they would not ever reuse the same tool on another patient until they reboiled it. The Romans also washed wounds with acetum which was a great antiseptic.

The fact that arteries and veins carry blood was common knowledge to the Ancient Romans. “All surgeons knew how to use tourniquets, arterial clamps, and ligatures to stem blood flow. They also used amputation to prevent gangrene” (Crystalinks B). Not only did they have knowledge of all this, but the Roman war doctors also learned how to prevent many battlefield epidemics. They would do so by placing their forts away from insect infested swamps and they also installed drains and sewers to transport the sewage away from the men. The Ancient Romans would build sophisticated permanent hospitals that had heating and good ventilation to help the patients; the also had certain rooms for certain tasks and separated patients from others in order to prevent the spreading of disease.

In the case of the Roman army it is clear that it was the wartime doctors that created most of the innovations because they were organized, they were distributed throughout the Empire, they were careful about capturing and spreading any new information or technique that worked, and they were highly motivated by the great loss of life suffered by their soldiers during the many battles. (Crystalinks B)

The Romans obtained some of the most important techniques that our modern civilization uses today.
Ancient people sometimes called upon supernatural spirits to heal their sick while modern medicine relies on science. DNA and research has replaced spirits. The history of medicine shows how ideas have developed over the centuries. Medieval barbers were the fore-runners of today’s skilled surgeons. Today’s medicine has evolved over thousands of years as each generation built on the knowledge of earlier times. This will continue to happen. Our understanding of the human genome will lead to fresh treatments and new discoveries may open the door to unimagined advances in medicine. The Ancient people may have had a very broad understanding of medicine, but they set the pathways to today’s knowledge.