History of Medicines
From
ancient times, the history of medicine shows how societies have changed in
their approach to illness and disease to the present. Sushruta, from
India, introduced the concepts of medical diagnosis and prognosis. Over time,
medicinal knowledge developed and passed between generations. Earlier, tribal
culture specialized specific castes, healers and pharmacists fulfilled the role
of healer. The first known dentistry dates to c. 7000 BCE in Baluchistan where
Neolithic dentists used flint-tipped drills and bowstrings.
In
India, Ayurvedic herbal medicines were used. The Atharvaveda, a sacred text of
Hinduism dating from the Early Iron Age, is one of the first Indian texts
dealing with medicine. The Atharvaveda also contains prescriptions of herbs for
various ailments. The use of herbs to treat ailments would later form a large
part of Ayurveda.
Ayurveda,
meaning the "complete knowledge for long life" is another medical
system of India. Its two most famous texts belong to the schools of Charaka and
Sushruta. The earliest foundations of Ayurveda were built on a synthesis of
traditional herbal practices. In addition to India other early medical
traditions include those of Babylon, China, and Egypt. Babylonian medicine-The
ancient Mesopotamians had no distinction between "rational science"
and magic. When a person became ill, doctors would prescribe both magical
formulas to be recited as well as medicinal treatments. Along with the Egyptians, the Babylonians
introduced the practice of diagnosis, physical examination, and remedies.
The
symptoms and diseases of a patient were treated through medicinal means such as
bandages, herbs, and creams. In Semitic cultures, the main medicinal authority
was a kind of exorcist-healer known as an āšipu. The profession was generally
passed down from father to son and was held in extremely high regard. Mental illnesses were well known in ancient
Mesopotamia, where diseases and mental disorders were believed to be caused by
specific deities.
When
a caveman got a thorn in his finger, he pulled it out and his finger felt
better. He was practicing medicine-that is, doing something to lessen
discomfort or pain. Sometimes the caveman had a pain for which he could not
find the reason. But even though he did not understand why he had the pain, he
tried to do something about it. His medicine in that case would have been
something that we would call magic. This magic might have been a chant or song,
a figure carved from stone, a picture on a cave wall, or a stew of herbs and
leaves. Since many diseases go away anyway after a period, the caveman probably
thought that his magic worked. Sometimes, by accident, he may have come upon
treatment that really did help him. The warmth of a fire might ease a sprained
shoulder, or an herb drink might help his stomachache.
Among
primitive peoples today, medicine and magic are still mixed. The medicine man
is the one who knows magic. But he also knows some practical things to do to
help the sick and injured. In many primitive tribes the medicine man can set and
splint a broken bone. He knows medicinal plants that are laxatives and plants
that will put people to sleep. The earliest civilizations that we know about
had physicians. The Babylonians left medical writings describing various
diseases so clearly that doctors today can recognize them. Among the ancient
Egyptians it was widely believed that illness was caused by an evil spirit
coming to live in the patient's body. Medical treatments usually included
prayers to drive out the evil spirits. But they also included pills and
ointments containing drugs such as opium and castor oil. And surgical
operations were done on the outer surfaces of the body.
According
to Homer and other sources, the earliest physician in Greek history was
Aesculapius. He was the Greek god of medicine. In Greek mythology he was the
son of Apollo (God of light, truth, and prophecy) and the nymph Coronis. The
legend of his healing powers grew until he was thought of as a god. In his
honor temples were built to which the sick was brought to sleep overnight. In
the morning the patients told their dreams to the priests. The priests
interpreted the dreams as messages from Aesculapius and based the treatment on
what the god had magically ordered.
Staff
of Asclepius (Greek); Aesculapius (Roman)
Homer,
in the Iliad, mentions him only as the skilled or "peerless
physician" and physicians to the Greeks in the Trojan War. In later times,
however, he was honored as a hero and eventually worshipped as a god. The cult
of Asclepius began in Thessaly but spread to many parts of Greece. Since it was
supposed that he effected cures or prescribed remedies to the sick in dreams,
the practice of sleeping in his temples became common.
Asclepius
was frequently represented standing, dressed in a long cloak, with bare breast;
his usual attribute was the staff with a serpent coiled around it. The staff is
the only true symbol of medicine. In 293 B.C. because of the plague, the Romans
adopted the cult of Asclepius.
Both
Greeks and Romans had temples to Aesculapius in which this kind of magical
medicine was practiced. But at the same time, nonmagical medicine was beginning
in Greece. About 460 B.C. on the small Greek island of Cos, Hippocrates
was born. Cos seems to have been a kind of center for men interested in
medicine. Hippocrates' father was a physician. Hippocrates himself did so much
to rescue medicine from magic and superstition that he is called the Father of
Medicine.
Hippocrates
did not have the scientific knowledge on which medicine is based today. He did
not know about bacteria or chemistry or what the various organs of the body do.
Therefore, he could not explain the causes of diseases. But he did have the
kind of mind and spirit that make a good physician.
In
his writings he taught that the physician should observe the patient closely
and accurately. Gentle treatment should be used to try to encourage the natural
healing process. The physician should never risk harming the patient. The
patient's secrets should be kept, and the physician should be in every way worthy
of the sick person's trust.
Hippocrates
recognized and described many diseases. Some of the medical facts he observed
are as true today as they were over 2,000 years ago. For example, he said,
"Those naturally very fat is more liable to sudden death than the
thin." And he wrote, "Tuberculosis occurs most commonly between the
ages of eighteen and thirty-five years."
This
nonmagical kind of medicine was advanced further by Aristotle, the great
Greek scientist. He studied the bodies of animals closely and described their
development. He was not a physician, but he helped establish the science of
biology, on which nonmagical medicine is based.
After
Alexander the Great conquered most of the known world, the city of Alexandria
in Egypt became the center of learning. There was a famous library in
Alexandria, and there were many schools, including a medical school. Erasistratus
(310? -250? B.C.) was one of the greatest teachers in the school. If a patient
died, Erasistratus and his students would operate on the body to try to find
out the cause of the fatal illness.
The
Romans were a very practical people. They did not care as much about study and
discovery of new knowledge as the Greeks had. They cared more about putting
knowledge to work. They made the world a more healthful place to live in, even
though they did little scientific research.
The
city of Rome was large and crowded. People could not live so close together
without spreading disease from person-to-person unless they were careful about
sanitation. The Romans built huge sewers under the city to carry away the
waste. The main sewer of Rome, called the Cloaca Maxima, is still in use today.
The Romans also had a supply of pure water for their city. Fourteen great
aqueducts brought 300,000,000 gallons of water into Rome every day. There were
special Roman officials to inspect the markets and make sure that no spoiled
food was sold.
The
Romans were also the first to try to organize medical care so that all sick
people could have help. They began by sending physicians and medical equipment
with the Roman armies so that the wounded soldiers would be cared for. Often in
the towns the physician's house had extra rooms, where his patients might stay
if they were very ill. This was the beginning of hospitals. The Romans also
built public buildings for the care of the sick, especially the slaves and the
poor, who might not be able to pay a doctor. The Roman government paid doctors
to work in the public hospitals.
The
earliest scientific medical book in Latin was written by Celsus (1st century
A.D.). He brought together in a kind of encyclopedia most of the Greek learning
about medicine.
Galen (c.130 AD - c.210 AD)
Claudius Galen was born in Pergamum
(modern-day Turkey). Born of Greek parents, he was the
greatest physician in Rome. He
studied in Greece, in Alexandria and other parts of Asia Minor and returned
home to become chief physician to the gladiator school in Pergamum, gaining
much experience of treating wounds. His writings do not show
the gentleness and kindliness that Hippocrates' works show. Galen gave
explanation of every organ in the body. Modern scientists know that many of his
explanations were completely wrong, but Galen seldom admitted that there was
anything he did not know.
Galen was a physician, writer and
philosopher who became the most famous doctor in the Roman Empire and whose
theories dominated European medicine for 1,500 years.
Galen was the originator of the
experimental method in medical investigation, and throughout his life dissected
animals in his quest to understand how the body functions. Some of his
anatomical and physiological observations were accurate - for example, he
proved that urine was formed in the kidney (as opposed to the bladder which was
common belief). His most important discovery was that arteries carry blood
although he did not discover circulation. Galen was prolific, with hundreds of
treatises to his name. He compiled all significant Greek and Roman medical
thought to date and added his own discoveries and theories. His influence
reigned supreme over medicine for 15 centuries after his death. It was not
until the Renaissance that many of his theories were refuted.
Beginning
about the year 200, the Western world went through a time of much trouble.
Barbarian tribes from the North overran the cities of the Roman Empire. There
were wars, earthquakes, and plagues of disease in which thousands of people
died. The Church taught that people should be kind to the sick and try to help
them. Early Christians risked their lives to nurse the dying during the
plagues. But the deeply religious people felt that getting well dying was in
God's hands. They did not try to or understand the body and what happened to it
in the course of a disease. They were not scientists at all.
During
the Middle Ages interest in scientific medicine continued. From the 9th century
to the 14th century one city in southern Italy, Salerno, was a medical center.
Monks from western Europe, Jews, Arabs, and Greeks met at Salerno. Many of them
brought with them the valuable books of their own languages. The writings of
Hippocrates and other earlier doctors were preserved and studied.
During
the 13th century all of Europe became interested again in Greek learning and in
science. By the 1400's the rebirth of learning was well under way. Leonardo
da Vinci, who was a scientist as well as an artist, was the first to
question some of Galen's explanations of the body. Leonardo's notebooks, full
of detailed drawings of the heart, the blood vessels, and the muscles, are
beautiful examples of his keen observation.
One
of the great men of medicine was Andreas Vesalius. He was born in
December 1514, at Brussels [Belgium]—and died in June 1564, Venice [Greece]).
Vesalius was from a family of physicians and pharmacists. He studied at the
medical school of the University of Paris, where he learned to dissect animals.
He also had the opportunity to dissect human corpses, and he devoted much of
his time to a study of human bones, at that time easily available in the Paris
cemeteries. He revolutionized the study of biology and the practice of medicine
by his careful description of the anatomy of the human body. Basing his
observations on dissections he made himself, he wrote and illustrated the first
comprehensive textbook of anatomy, the science of the body's structure.
At
first, Vesalius had no reason to question the theories of Galen, the Greek
physician who had served the emperor Marcus Aurelius in Rome and whose books on
anatomy were still considered as authoritative in medical education in
Vesalius’s time. In January 1540, breaking with this tradition of relying on
Galen, Vesalius openly demonstrated his own method—doing dissections himself,
learning anatomy from dead bodies, and critically evaluating ancient texts. He
did so while visiting the University of Bologna (Italy).
Such
methods soon convinced him that Galenic anatomy had not been based on the
dissection of the human body, which had been strictly forbidden by the Roman
religion. Galenic anatomy, he maintained, was an application to the human form
of conclusions drawn from the dissections of animals, mostly dogs, monkeys, or
pigs. It was this conclusion that he had the courage to declare in his teaching
as he hurriedly prepared his complete textbook of human anatomy for
publication. Early in 1542 he traveled to Venice to supervise the preparation
of drawings to illustrate his text. The drawings of his dissections were
engraved on wood blocks, which he took, together with his manuscript, to Basel,
Switzerland, where his major work “The Seven Books on the Structure of the
Human Body” commonly known as the Fabrica, was printed in 1543.
Vesalius
was too much a scientist to rely on Galen and Aristotle. The drawings in his
printed on the work of ancients like books were drawn from actual human bodies.
He corrected many errors that no one else had found in all the hundreds of
years that the work of the ancient masters had been copied and recopied.
Another
famous doctor of the same period Ambroise Paré (1517 -90), who became
surgeon in chief to the kings of France. In Europe surgery was often done by
barbers and others with little training. Paré, a student of the new anatomy,
helped to make surgery as highly respected as other forms of treatment.
When
Paré was a surgeon with the French Army, everyone believed that gunshot wounds
contained a poison. Some doctors poured boiling oil on the wounds to drive out
the poison. Young Paré ran out of oil and treated some men without it. He was
surprised to discover that these patients did better without the treatment. He
wrote about his discovery, saying, "Then I resolved within myself never so
cruelly to burn poor wounded men." At about the same time, the Swiss
physician Paracelsus (1493 -1541) was bringing back the Greek idea that experience
is the key to treating sick people correctly. He angered the other professors
at the University of Basel, where he taught, by attacking their belief in the
ideas of Galen and by teaching in German instead of Latin. He taught by taking
students to the bedsides of the sick instead of lecturing in the classroom. He
was one of the first to bring a knowledge of chemistry to medicine and to
suggest new kinds of drugs, prepared by rules of science rather than by
superstition. For instance, he introduced laudanum, sulfur, and mercury, three
substances still used today. However, some of his beliefs would now be called
superstitions.
Galileo,
the man who first looked at the sky through a telescope, brought a new outlook
to the study of nature. He believed that each thing in nature should be
examined carefully and, if possible, measured exactly. Galileo stressed
mathematics because it is a science that tries to give exact answers. His
approach brought changes to all sciences.
At
the time of Galileo another Italian, named Fabricius of Acquapendente (1537
1619), was improving surgery and making discoveries about the structure of the
human body. He noticed, for example, that the veins have valves, which he
described as little doors. One of Fabricius' most famous students was William
Harvey, who became physician to James I and Charles I of England. Harvey holds
a unique place in medical history. For about 20 years he did experiments and
studied the way the blood moves through the body. When he had found an answer,
he published his discovery on the circulation of the blood. Since the time of
Aristotle and Galen, doctors had believed that the liver created an unending
supply of blood, which ran through the blood vessels and was used up by the
body tissues that it reached. But Harvey showed that the same blood goes around
and around through the body, passing through the lungs on each trip. This
constant movement in a circle, he noted, “is brought about by the beat of the
heart." Thus, for the first time in history, the heart was seen as what it
is: a living pump.
Marcello
Malpighi (1628-95), a professor of anatomy at Bologna, Italy,
completed the study of how blood circulates by showing that arteries and veins
are connected through a network of tiny channels called capillaries. Malpighi
made this discovery with the help of an invention, the microscope, which
enabled him to see details not visible to Harvey's unaided eyes.
Invention
of the microscope improved understanding medicines. The germ theory of disease, lead to effective
treatments and even cures for many infectious diseases. Military doctors
advanced the methods of treatment for pain and trauma. The microscope first
became a useful tool for medicine in the hands of a skilled Dutch lens maker,
Anton van Leeuwenhoek. Al though he had no formal training as a
scientist, Leeuwenhoek was a scientific observer. He drew the first pictures of
the one-celled animals called protozoa, which can be seen only under a
microscope.
Meanwhile,
Thomas Sydenham (1624 89), a famous London doctor, was bringing a new
approach to treating the sick. Or, rather, he was returning to the idea of
Hippocrates': study of the patient. This idea had been neglected for hundreds
of years by all but a few people, such as Paracelsus. Most doctors preferred to
look in books and read complicated theories about disease. Sydenham felt that
the surest way to understand a disease was to study people affected with it.
In
Holland, Hermann Boerhaave (1668 1738) carried Sydenham's ideas even
further. Skilled in chemistry, anatomy, and botany as well as in practical
medicine, Boerhaave tried to bring together the knowledge of these different
sciences to help the sick. Like Sydenham, he began at the bedside, by studying
the patient.
In
the 18th century, Giovanni Batista Morgagni (1682-1771), an anatomist
working at Padua early in the 18th century, made another step forward in
relating the effects of disease to its causes. Examining the bodies of people
who had died of various diseases, he showed that damage to organs, such as the
liver or kidneys, had a direct connection with the signs and symptoms of the
disease. Study of organs affected by disease is called pathological anatomy. By
introducing it as part of what a practicing physician should consider, Morgagni
added greatly to medical progress.
The
18th-century Italian Luigi Galvani (1737-98) was interested in the
nervous system. In experiments made with the muscles of a frog, Galvani showed
that electric current, then a mystery, affects the nerves and causes muscles to
act.
Meanwhile,
other men were studying various parts of the body and how they act. In France, Antoine
Lavoisier (1743-94) worked on the chemistry of breathing. He made
experiments to find out whether the human body uses the same amount of oxygen
when it is at rest as when the muscles are working. His experiments proved that
more oxygen is needed when the muscles are working.
Another
Frenchman, Philippe Pinel (1745 1826), who was a doctor at a Paris
hospital, was horrified by the fact that many mentally ill patients were kept
in chains. He convinced his government to make reforms in the treatment of the
mentally ill. As Pinel had fore seen, the patients improved with kinder
treatment. Pinel was the first famous reformer in the field of psychiatry, the
branch of medicine that tries to apply science to mental illness.
Not
long after Pinel's important reform, René Laennec (1781-1826) brought a
different kind of progress to medicine with the invention of the stethoscope.
By applying t new tool to the patient’s chest and listening through the
earpiece, a doctor could clearly hear breathing sounds and heart sounds. Thus,
Laennec made it possible for doctors to find out whether people show signs of
heart or lung disease.
While
Laennec worked on the problems of chest diseases, a United States Army surgeon,
William Beaumont, was learning much about how the stomach digests food.
One of Beaumont's patients had been shot in the stomach, and the wound healed
leaving an opening like a buttonhole. Through this opening Beaumont could
observe the action of the stomach. He found that the stomach gives off certain
juices that change food into material that the body can use.
A
little later, Claude Bernard (1813-78) of France studied the functions
of the liver. Through experiments he found that a dog's liver produces sugar
even if the dog has no sugar in its diet. His finding proved the idea that
animals, like plants, make sugar inside their bodies. Bernard also studied
another organ, the pancreas, and pointed the way to a later explanation of
diabetes disease.
During
19th-century despite all the new medical knowledge, diseases like smallpox that
spread rapidly from person to person still caused many deaths. To the English
country doctor Edward Jenner goes credit for introducing a way to
protect people against smallpox. Jenner learned that people who had had a mild
disease called cowpox, which they got from cows, did not catch smallpox. He
tried injecting a boy with liquid taken from a cowpox infection on a
dairymaid's finger. Later he injected the same boy with liquid from a smallpox
infection, and the boy remained well. Working from this discovery, Jenner
developed vaccination. People who are vaccinated are immune that is, they will
not catch a disease even though they are exposed to it. Jenner's method has
saved many thousands of lives. Today vaccinations have been developed to
protect people against many other diseases. Although scientists were
discovering more and more about how the body works, they still did not
understand much about the causes of disease. Throughout history, countries and
even whole continents had been swept by infectious diseases. In an epidemic, a
period when huge numbers of people got a disease, sometimes half the people in
a city would die. Yet no one knew how the disease spread from person to person.
There
were some dim ideas that the spread of disease had something to do with lack of
cleanliness. Finally, contagion, or the catching of disease, came to be linked
to the little one-celled organisms seen under the microscope. Once people
understood that bacteria or germs caused disease, they began to think of ways
to stop contagion.
Ignaz
Semmelweis (1818-65) and Joseph Lister were two of the first
physicians who tried to control the spread of infections. In a Vienna hospital
Semmelweis found that many women developed a fatal fever after giving birth. He
believed that the fever might be connected with the fact that medical students
treated the women after doing work in anatomy. The hands of these students,
Semmelweis thought, probably carried infection. So, he insisted that the
students clean their hands very thoroughly before attending the women giving
birth. As a result, the fever practically disappeared from the hospital. Other
doctors were insulted when Semmelweis told them they were not clean enough, and
they would not believe him.
Like
Semmelweis, Lister believed that many patients died because of infection by
germs. He insisted on cleanliness when he did operations, and he also used a
spray that killed germs in the air. But he realized that it would be even
better to avoid the danger of infection by keeping germs out of the operating
room. He began using the technique of sterilizing everything that would touch
the patient during an operation that is, he made the instruments completely
germfree.
Semmelweis
and Lister believed that infections are caused by bacteria, first seen by Leeuwenhoek
through his microscope. It was Louis Pasteur who discovered more about
the action of bacteria. Pasteur, a chemist, tried to find out what causes
fermentation, the process that sours milk and changes wine to vinegar. He
decided that bacteria cause these changes.
Then
he found that heating wine kills the bacteria and keeps the wine from turning
to vinegar. The term "pasteurization," taken from his name, means the
process of heating a liquid such as milk until the bacteria are killed. Pasteur
also introduced a vaccination to prevent anthrax, a disease then killing cattle
by the thousands. And he discovered a treatment for rabies, often a fatal
disease. This remarkable man earned all the honor that he received.
As
Pasteur worked in his laboratory to find out more about infection, Edwin
Chadwick (1800-90) carried on the same fight in another way. He saw that
dirty, crowded living conditions were bad for people's health. When typhoid
fever broke out in England, he noticed that the poor died in large numbers, and
he began a campaign to improve their way of living. Chadwick wanted better
sewers, regular garbage disposal, cleaner streets, and a pure water supply. He
led the way to a new attitude by the government toward public health.
In
Germany, Robert Koch shared Pasteur's interest in bacteria, and he found
new ways to study them through a microscope. His work established bacteriology
as a special field of science. Koch proved what doctors since Hippocrates had
thought to be true: that tuberculosis is contagious.
In
the 20th century, as medical detectives tried to trace disease to its source,
another German supplied medicine with a new tool. Wilhelm Conrad Roentgen
(1845-1923) discovered X rays and quickly understood their value to doctors.
The newly found rays could go through skin and muscle to make pictures of bones
and organs. At first used to see broken bones, X rays soon proved just as
useful to find stomach and lung ailments.
A
whole concept of mental illness came into being with the work of Sigmund
Freud, a Viennese doctor. The branch of medicine in which he worked is
called psychoanalysis. Freud was the first to explore the ways in which the
unconscious mind works. He found that a patient's dreams and earliest childhood
memories often give clues to explain his mental illness.
Devices
called pacemakers began to keep the heart beating steadily. They can even
operate directly on the heart, during a procedure called open-heart surgery, by
using a mechanical pump to keep the blood circulating while they work.
Another
advance is microsurgery. This is surgery performed under a microscope. Tiny
scalpels and other tools are used to operate on blood vessels, nerves, and
other small structures. Microsurgery makes it possible to reconnect limbs and
do difficult brain and eye operations. Measuring blood pressure and giving safe
blood transfusions are other medical techniques developed in the 1900's.
Scientists have also developed laboratory tests for many diseases. A small
sample of blood or a tiny piece of tissue can reveal a wealth of information
about the patient's health. Surgeons have recently made vast progress in
replacing parts of human body.
Advanced
research centers were opened in the early 20th century, often connected with
major hospitals. The mid-20th century was characterized by new biological treatments,
such as antibiotics. These advancements, along with developments in chemistry,
genetics, and x-rays led to modern medicine. In the 20th century, new careers
opened to women as nurses.
Ref:
https://www.britannica.com/biography/Andreas-Vesalius
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