Mesopotamia
Apparently, Mesopotamia is the home of the oldest known civilizations, dating back to 5000 BC. Although Herodotus claims that there were no doctors among the Babylonians, this is not consistent with the abundant archaeological evidence that the Sumero-Akkadian civilization, which preceded the civilizations of Assyria and Babylon in Mesopotamia, had a fairly advanced medicine. The found seal of a Sumerian physician dates back to 3000 BC, so Sumerian medicine probably preceded Egyptian medicine. Sumerian clay tablets report many miracle cures; some of them could make up a “clay book” on obstetrics. Medicine was still mainly magical, doctors were called "asu" ( noise. "a-zu") - "in charge of water", since water played a key role in spells. However, there is no evidence that the activity of the healer coincided with that of the priest.
Numerous data obtained from the excavations of the ruins of the palace of Ashurbanipal (r. 669–626 BC) in Nineveh show that much professional empirical knowledge was accumulated in Assyro-Babylonian medicine, despite its mainly magical character. The tablets mention over 300 different medicines: shoots of plants, wood, herbs, roots, seeds, vegetable juices, minerals, etc. The special purpose of some of them is indicated, for example, “for pain in the heart.” The therapeutic effect of a number of drugs is beyond doubt. So, emollient enemas were used to reduce inflammation, massage - to relieve stomach pain, for some diseases, rest and rest were recommended, and attention was also paid to diet. Poultices, hot and cold compresses were common. Of particular importance was attributed to water, since it was the sacred element of the god Eia, the main among several healing gods.
An important role in the Assyrian-Babylonian civilization was played by astrology, closely related to the prognosis of diseases. The diagnosis was more empirical. In all tablets, before indicating the remedy for the disease, its symptoms are briefly listed. Very well described, for example, signs of tuberculosis. The liver was considered the location of the vital principle. Although not all diseases were attributed to the influence of demons, the treatment was mainly subject to rituals; doctors, for example, were not allowed to visit patients on the 7th, 14th, 21st, or 28th of each month. According to the testimonies that have come down to us, the Assyrians and Babylonians suffered from mental disorders, diseases of the gastrointestinal tract, eyes, gallbladder, heart, and bone diseases.
There is reason to believe that doctors in Assyro-Babylonian society constituted a special social stratum, different not only from priests, but also from veterinarians and surgeons, who occupied a lower position. Medical activity was regulated by law. Dated no later than the 1950s B.C., Hammurabi's code of laws lists rewards for physicians and defines severe penalties for improper treatment. So, if a doctor successfully opens an eye abscess “with a bronze knife”, the “noble” patient must pay him 10 shekels of silver, and the slave - 2 shekels. But if, as a result of the operation, the patient loses his sight, then the doctor should cut off his hands. The punishment was mitigated if the patient was a slave: it was enough to replace the slave.
The beginning of Egyptian medicine is shrouded in legends. The god of wisdom Thoth was considered the author of 32 Hermetic books, 6 of which were devoted to medicine. All of them are lost.
The first physician whose name is recorded in history is the Egyptian Sekhetienanakh (c. 3000 BC). He "healed the king's nostrils" and was honored with a statue inscribed with the event. Much greater fame was achieved by Imhotep (heyday c. 2975 BC), the chief vizier of Pharaoh Djoser and a famous architect, who, according to legend, was also a great physician and was later revered as a demigod and patron of medicine. Little is known about his actual achievements in medicine.
The popular belief that in Egypt physicians were priests is debatable. Physicians were a distinct caste, and the medical schools at Sais and Heliopolis existed independently of the great temples. Modern knowledge of Egyptian medicine is based on the papyri that have come down to us, the most famous of which, the Ebers Papyrus dating from about 1500 BC and the slightly earlier Smith Papyrus, are the oldest surviving medical texts. The Ebers Papyrus, in addition to general medical topics, contains more than 900 prescriptions and prescriptions. The Smith Papyrus is dedicated to the treatment of wounds and bruises. Other papyri contain texts on gynecology and pediatrics. Obviously, in Egypt there was a special reverence for the sacred medical literature. As long as the doctor adhered to the rules laid down in the Hermetic books, no accusation could touch him even in the event of the death of the patient. But with any deviation from these rules, the doctor was punished with death for the death of a patient. The dogmatic nature of Egyptian medicine was also manifested in the fact that despite the practice of autopsies and embalming of the dead, knowledge of anatomy and physiology remained at a low level. This apparent contradiction can be explained by the many taboos associated with the dead, and the fact that embalming was not done by doctors, but by special specialists.
The Egyptians' ideas about diseases were also quite primitive, based on the idea of demons. Spells, chants and magical incantations were an essential part of Egyptian healing. Magical remedies were widespread, with the help of which they apparently tried to make the place being cured disgusting for the spirits of illness. However, not all diseases were attributed to the action of demons: the weather or the ingestion of harmful substances were also attributed to the causes of diseases. Diagnostics differed by rather high level; the pulse was felt in several places, which suggests some idea of the blood circulation. The heart was considered a vital organ, and breathing was considered the most important function for life. The hand served as a thermometer, changes in body temperature were noted. There are even hints of the use of listening (auscultation), as the doctor was said to "use the ear". The initiation of treatment depended on the prognosis: if the head injury seemed fatal, the patient was not treated. Compound fractures were also considered fatal and were not treated.
The Egyptian pharmacopoeia was highly specific: for each disease, its own medicines and their exact doses were prescribed. Some of these remedies, notably castor oil, olive oil, opium, and saffron, are still in use today. The use of surgical operations was limited due to the desire of the Egyptians to preserve the body for the afterlife and resurrection, so amputations were excluded. Wounds were closed with fresh meat, dislocations were set, splints were used for fractures, but the risky surgery of primitive times was already rejected.
Despite their dogmatic pedantry, the Egyptians were known as excellent doctors, and such foreign rulers as Cyrus and Darius needed their services. Egypt was considered the medical center of the ancient world. It was also the birthplace of the first medical specialists; according to Herodotus, “medicine among them is completely divided; each doctor treats only one disease and no other; therefore, there are many doctors in the country, some undertake to treat the eyes, others the head, others the teeth, the fourth the intestines, and some treat general ailments of the whole organism. Interestingly, the medicine of early Egypt was more empirical and less magical than that of the later dynasties.
Palestine
Hebrew medicine probably goes back to the medical practice of Babylon and Egypt, but it also introduces new concepts and new ways of treating. First of all, she refuses the magical approach. Both sickness and health are sent by the one God, sickness is the punishment for sin, and God is the only healer. The roles of doctor and priest are mixed, which did not contribute to the development of medical professionalism and specialization. In the Bible, references to medicine are rare, the methods of treatment indicated there are limited to splinting for fractures, ointments and dressings for wounds. On the other hand, disease prevention and hygiene requirements reach a high level. Daily ablutions, washing hands before eating, obligatory ablutions for women after menstruation and childbirth were included in religious rites. Soldiers had to bury their excrement behind the camp with a special shovel, indicating a high level of sanitation. Special laws were also developed on leprosy (perhaps it meant several different skin diseases). It was ordered to isolate the patient, wash or burn his clothes and, in modern terms, disinfect the home. The story of the plague among the Philistines, the mention of rats, and the description of buboes (1 Sam 5:6, 6:3–11) show that some connection between rats and plague has already been noted.
The ancient Jews were the first people to care about public health, and the Bible can be considered the first sanitation textbook. However, many hygienic prescriptions were part of religious rites, and not special hygienic measures.
Persia and India
In ancient Persia, a dualistic religion dominated, and in the endless struggle between good and evil, the healing gods represented, of course, a bright and good force. Chief among them was Mithra. Medicine originated from the gardens of Amertat, the goddess of longevity, where thousands of medicinal plants grew. The ancient Persians had no anatomical knowledge, and their attitude towards illness was based on religion and magic. Medicine was exclusively practiced by the servants of the god Mazda, the treatment consisted of cleansing ceremonies, prayers and rituals. The Vendidad, the sixth book of the Avesta, establishes penalties for medical errors and rewards for treatment, and describes special tests for those who would like to enter this professional activity.
In India, medicine has developed significantly, but its ancient history cannot be accurately described, since information about it has been preserved only in the form of legends. The earliest Sanskrit source, the Rigveda (c. 1500 BC), contains magical incantations against disease demons. Some information related to medicine is also found in Ayurveda (c. 700 BC). The great medical luminaries of India were Charaka, who lived at the beginning of the Christian era, and Sushruta (flourished c. 500 AD). Sushruta described more than a hundred surgical instruments, compiled a list of 760 medicinal plants. He wrote about malaria, plague, tuberculosis (called the "royal disease" in India), and smallpox. It is believed that he discovered the connection between rats and plague, mosquitoes and malaria.
Medical thought in India was characterized by a desire for detailed classification. In surgery, the type, direction and depth of incisions for each site and organ were strictly prescribed. The general idea of disease was based on the doctrine of juices: it was attributed to an imbalance between the primary elements that make up the body. Among the causes were climate, heredity, accidents, overeating and "karma", i.e. retribution for misdeeds committed in the previous incarnation. So, it was believed that a person who killed a Brahmin would suffer from anemia in the next incarnation.
Diagnosis was made carefully, using probing (palpation), listening, inspection, as well as determining taste and smell. The life-threatening symptoms were carefully numbered, although there was also a touch of mysticism in assessing the prognosis. Treatment was with medicinal plants, bloodletting, cupping, leeches, emetics, laxatives, and enemas. Fat of various origins was also used, both internally and externally. Much attention was paid to diet and adherence to the regimen. Anatomical knowledge was weak; it was believed, for example, that the nerves and blood vessels start from the navel. Despite this, surgery was well developed. Operations for anal fistulas and hernias, lithotomy, removal of tonsils, extraction of the fetus, amputations, removal of tumors were performed. Nose plastic surgery, performed since ancient times by the potter caste, was quite common, since cutting off the nose served as revenge or punishment for adultery. The skin was taken from the cheeks or forehead and fixed at the transplant site with sutures.
Hygiene played an important role. Laws of Manu prescribed a diet, washing, cleansing of secretions. The surgery used ligation of blood vessels, a variety of sutures and various instruments.
China. The origin of Chinese medicine is shrouded in legends. Its founder is considered to be Emperor Shen Nong (c. 2700 BC), who, according to legend, compiled the first herbalist with a description of more than 100 remedies. He is also considered the inventor of the acupuncture technique. The oldest and greatest Chinese medical work is a treatise Neijing (The Canon of Medicine) - attributed to Emperor Huang-di (2698-2599 BC); the true time of its creation is unknown.
Chinese medicine was originally magical; however, empirical knowledge about herbal medicines has since accumulated. The basis of medical theory was the abstract doctrine of the five elements and the opposite forces of yin and yang, i.e. feminine and masculine; in violation of the balance or harmony between them, the main cause of the disease was seen. The Chinese did not practice autopsies, their anatomical and physiological ideas were quite fantastic. However, there is reason to think that they knew about blood circulation. The pulse played a major role in the diagnosis. It was measured at 11 points, each time using three different pressures. Two hundred varieties of pulse were known, 26 of them meant the approach of death.
The therapy was based on the laws of the interaction of yin and yang and used many magical means. The doctrine of “signs” (signatures) was especially popular: yellow flowers were used to treat jaundice, beans resembling the shape of kidneys - for kidney diseases, and so on. At the same time, some of the almost 2,000 traditional Chinese medicine recipes were indeed very valuable and have retained their value to this day. Thus, iron salts were used for anemia, arsenic for skin diseases, mercury for the treatment of syphilis, rhubarb and sodium sulfate as a laxative, and opium as a narcotic. In Chinese pharmacology, the modern use of ephedrine was also anticipated. Smallpox inoculation by inhalation has been practiced since ancient times, but it was probably not a Chinese invention of its own. Surgery, which flourished in ancient China, subsequently ceased to develop. In general, Chinese medicine was characterized by inertia and dogmatism. She avoided direct observation and experiment, and over the centuries has not undergone significant changes.
The heyday of human genius, known as Greek culture, which produced masterpieces of architecture, sculpture, poetry, drama, philosophy and science, also manifested itself in medicine. The spirit of research and reflection broke the shackles of dogma and prompted the direct observation and experiment necessary for the development of medicine. Greek medicine went through three main stages: the pre-Hippocratic period, the classical or Hippocratic period, and the Greco-Roman period. Each has specific features.
The pre-Hippocratic period began with the Minoan civilization that flourished on the island of Crete from the 4th to the 2nd millennium BC. The Egyptians attributed many of their remedies to the Cretans. Among the ruins of the great palace at Knossos, a surprisingly modern plumbing system was discovered, indicating a high level of hygiene. Unfortunately, we do not have any other data on Minoan medicine.
By the time of Homer (c. 1000 BC), the Minoan culture had already disappeared and magic-based medicine was primitive. Apollo was revered as the inventor of the art of healing, Hygiea as the goddess of health, Panacea as the healer of all diseases; other gods and goddesses could also send or prevent death or illness at their will.
The centaur Chiron was considered the founder of medicine and the teacher of Asclepius (Roman Aesculapius), the son of Apollo. The famous cult of Asclepius, which originated in Thessaly, was introduced to Athens in the 5th century. BC. His temples sprang up all over the country. Located in picturesque areas with a healthy climate, near mineral springs, they were in essence sanatoriums. Healing took place during the so-called. incubation. First, the patient had to prepare in a special way: fast, perform ablutions and prayers; after that, he was allowed to spend one or more nights in the temple, at the feet of the statue of the god, in anticipation of a healing dream. The treatment was carried out by priests, who may have resorted to hypnotic suggestion. There are many legends about miraculous healings, some of them are absolutely fantastic.
Effective Greek medicine was not born in the temples of Asclepius. There was no admission of failure, and there was no progress. Temples competed with each other, fees were high, quackery flourished. The glory of Greek medicine comes from another source.
The classical period of Greek medicine began in the 6th century. BC. with the rise of contemplative philosophy. According to tradition, Empedocles (c. 490–430 BC), possibly a Pythagorean, saved the two cities from pestilence by draining the swamps and applying disinfectant fumigations. Anaxagoras (c. 500–430 BC) pioneered the dissection of animals. Alcmaeon of Croton (flourished c. 500 BC) was also engaged in dissection of animals; he described the optic nerve and auditory canals. Alcmaeon considered the brain to be the center of sensations and intellect and considered diseases as disharmony of the primary elements of the body. The contribution of other philosophers of the predecessors of Socrates, among them Thales, Heraclitus and Pythagoras, was rather indirect: the intellectual climate created by the freedom and scope of their theoretical thought made possible the flowering of Hippocratic medicine.
Hippocrates (c. 460-377 BC), rightfully called the "father of medicine", was considered the author of more than 70 treatises of the famous Hippocratic collection, however, according to modern research, no more than 13 of them belong directly to him. These works marked a turning point in the development of medicine. Treatise About airs, waters and places- the first essay on physiotherapy, balneology (the use of baths for medicinal purposes) and the influence of climate on health. IN Forecasting the symptoms of impending death are described, which are still known under the name “Hippocratic mask”. In the treatise Epidemics For the first time, 42 case histories were given, and their presentation is surprisingly modern in method and form. The fact that 60% of the reported cases ended in death is in no way concealed or embellished; the truly scientific impartiality of this treatise allows us to consider it the beginning of clinical medicine. Even more radical was Hippocrates' refusal to recognize epilepsy as a sacred disease.
Actually the Hippocratic concept of the disease, based on the doctrine of juices (humoral theory), was nevertheless erroneous. According to this theory, the juices of the body - blood, phlegm, black and yellow bile - must be balanced in a certain proportion, the violation of which is the cause of the disease. Traces of this theory have survived in today's use of the terms "sanguine", "phlegmatic", "choleric" and "melancholic".
Hippocratic therapy relied on the forces of nature. Hippocrates did not believe in strong remedies and believed that the "healing power of nature" in many cases can lead to a natural recovery. Bloodletting was used infrequently. Diet, rest, fresh air, massages and baths were important components of the treatment. With regard to medicines, the principle “like [is treated] like” dominated, although not exclusively. Mild laxatives were commonly used; hot drink served as a diaphoretic, and vegetable juices as a diuretic. The Hippocratic Pharmacopoeia also included emetics, astringents, and narcotic drugs such as belladonna, mandrake, and opium. Hippocrates had no idea about the pulse, and his knowledge of anatomy and physiology was very approximate. Nevertheless, his principle of direct clinical observation, together with a logical approach to diseases, laid the foundation for the subsequent development of the system of medical knowledge.
A huge contribution of Hippocrates is also the formulation of the principles of medical ethics. Set out in treatises About the doctor, Laws And Aphorisms, as well as in the famous oath Hippocrates, these principles have become in essence the standard of Western medical ethics.
Hippocrates enjoyed great respect during his lifetime, and his posthumous fame and authority survived the centuries. He left numerous disciples. During the Hellenistic period, the center of education and medicine moved from Greece to Alexandria. There, for the first time, Herophilus and Erasistratus began to make public autopsies of the human body; one of them is also credited with the invention of the catheter. Unfortunately, almost all of their works have been lost. Herophilus (heyday c. 300 BC) is considered the "father of anatomy". He distinguished veins and arteries, discovered and named the duodenum and prostate gland, discovered the hyoid bone, described female anatomy, gave names to many parts of the brain, which he considered the location of the intelligent principle, established the difference between motor and sensory nerves, studied the structure of the eye, liver , pancreas and salivary glands. He revealed the meaning of the pulse and used it in the diagnosis. Herophilus was also a famous surgeon who introduced the operation to cut the fetus (embryotomy) and perfected cataract surgery.
Erasistratus (c. 300-260 BC), who is called the “father of physiology”, studied the anatomy and functions of the brain, was interested in the process of breathing, muscle function, nutrition and secretory activity of the body, and left outstanding works on the heart and circulatory system. Erasistratus rejected the humoral theory of Hippocrates and offered his own explanation of diseases, considering them to be the cause of "plethora" - an excess of blood. However, he did not recommend bloodletting, because they reduce the body's resistance, he practiced ligation of bleeding arteries, opposed the excessive use of drugs, prescribed steam baths, rest, diet and exercise.
The school of empiricists, which replaced the followers of Herophilus and Erasistratus (i.e., the school of dogmatists), was characterized by adherence to numerous medicines and direct practical experiment, with complete disregard for theory and research. This naturally led to the decline of Alexandrian medicine. Nevertheless, empiricists made great progress in obstetrics and surgery, in particular in the use of dressings, and in the study of poisons and antidotes.
Ancient Rome
In ancient times, Etruscan medicine enjoyed a high reputation, but all that is known about it is that the Etruscans drained swamps to fight malaria and were skilled in treating teeth.
The Romans' own medicine was at first based almost entirely on magic, and they venerated a great many highly specialized healing deities. Among the Romans, the profession of a doctor was not respected, it was considered below the dignity of a Roman citizen. Slaves often practiced medicine. The Greek physicians, who sought to strengthen their position in Rome, were looked upon with suspicion and contempt. Cato the Elder warned his son against them. However, the infiltration of immigrants continued, and finally Julius Caesar gave Greek doctors Roman citizenship. Prejudice gradually dispelled, doctors became popular, rich and famous. Soranus (c. 100 BC), who belonged to the school of methods, can be considered the founder of obstetrics and gynecology; he left extremely valuable advice on child care and made the first attempts at differential diagnosis. Aretheus of Cappadocia, who lived in Alexandria in the 2nd century. AD, was a follower of Hippocrates and compiled excellent descriptions of diseases such as tetanus, epilepsy, hysteria and asthma, as well as the first systematic description of diabetes. For the diagnosis, Areteus used examination, palpation, percussion and listening; he distinguished between acute and chronic diseases, different types of infection.
Although the Romans for a long time regarded the practice of medicine as unworthy, three of them, the so-called. encyclopedists, made a significant contribution to medical science. The first was Mark Terentius Varro (116-27 BC), known only through references to him by other authors. He probably had an idea about the existence of microorganisms and described them as “little creatures invisible to the eye” that fill the air, get inside when breathing and cause dangerous diseases. The origin of this knowledge remains a mystery.
The second great Roman encyclopedist, Aulus Cornelius Celsus, who lived in the 1st century. AD, was the author of eight surviving books About medical business(De re medica); many diseases are still named after him. He coined terms such as heart disease and insanity. His descriptions of inflammation, meningitis, and appendicitis remain relevant today. In addition, he was the first historian of medicine.
The third Roman encyclopedist, Pliny the Elder (23-79 AD), left behind a most valuable encyclopedia of contemporary knowledge or what was considered knowledge in his time. He had an indefatigable curiosity and incredible zeal, but he did not have a critical flair, as a result of which most of his stories are fantastic, and the facts are unreliable. The works of Pliny are valuable in that they preserved descriptions of many superstitions of that time, methods of treatment, remedies, as well as the names of doctors.
Greco-Roman medicine reached its zenith in the work of Galen (130–200 AD). A native of Asia Minor, he practiced in Rome, became the emperor's doctor, and gained great fame and authority. This authority, unfortunately, remained unquestioned for 12 centuries and stood in the way of the development of medicine. Arrogant and self-confident, Galen despised his opponents and rivals, was prone to dogmatic statements. An accomplished clinician, he used diets, massage, and numerous medications. But his most important achievement is a huge written heritage. More than 500 books are attributed to Galen, and 83 of them have survived in many editions and translations. Galen's approach to medicine was based on the philosophy of Aristotle. His authority was recognized by the Christian Church, and until the Renaissance, any departure from Galen was considered heresy. Monotheistic ideas about the world order served as the basis for honoring him by medieval Arab and Jewish doctors. Even after Vesalius, Galen's concept of blood circulation remained canonical.
However, unlike his followers, Galen himself was an experimental scientist; he is considered the founder of experimental physiology. Since at that time the dissection of the human body was already prohibited, he performed dissections of monkeys and pigs, not always rightfully transferring his observations to human anatomy. Galen studied the anatomy of the brain, described seven pairs of cranial nerves, was the first to put forward a hypothesis about the myogenic (depending on muscle contractions) nature of heartbeats, discovered the sympathetic nervous system, and established the important principle of the interdependence of the function of an organ and its lesions. Recognized the movement of blood, but understood it as an ebb and flow, and not as a circulation. He believed that the vital principle, "pneuma", is inhaled by the lungs and mixed with the blood. Galen's therapy, in contrast to the Hippocratic one, was based on the principle of “ the opposite of the opposite". For example, heat cures diseases caused by cold, and vice versa.
Galen was the last great Greek physician of Rome. Rome itself contributed little to the development of medicine, it was only the center of activity of Greek doctors, but in Rome public sanitation reached a high level. Sewerage and water supply protected from the spread of epidemics. Street cleaning was essential. There were many private and public baths.
Roman patients were protected by law from medical abuse. The state provided free consultations and medical care for the poor, and public doctors were attached to individual districts. Thus, Roman medicine, although it did not make original discoveries, reached a high level in the field of public health.
With the fall of Rome, the advent of Christianity and the rise of Islam, powerful new influences completely transformed European civilization. These influences were reflected in the further development of medicine.
Byzantine medicine
Even before the invasion of the barbarians from the north, the center of the Roman Empire moved from Rome to Byzantium. There, despite the decline of ancient civilization, an attempt was made to preserve the medical heritage of the previous centuries.
Galen was the last great ancient medical scientist. Byzantine medicine lacked originality: its contribution was limited to the compilation and preservation of what was achieved. Oribasius (325–403), physician to Emperor Julian, compiled a multi-volume reference book on medicine and surgery. Other famous Byzantine compilers are Aetius (flourished c. 500), Paul of Aegina (607-690) and Alexander of Tralesi (525-605); the latter was the only medical author of this period to show any sort of originality.
The Middle Ages were full of wars and epidemics, social and economic chaos reigned everywhere. The new Christian doctrine, which promised salvation, was accepted with blind fanaticism. The spread of mysticism led to the rise of religious healing. Brothers Cosmas and Damian, martyrs of the era of Diocletian, thanks to miraculous healings, became Christian saints - patrons of medicine. If the pagan Romans endowed various gods and goddesses with special healing powers, now these functions have been distributed among numerous saints. It was believed that St. Roch and St. Sebastian being protected from the plague, St. Job from leprosy, St. Anthony of Fivsky from poisoning.
Even the very concept of disease regressed. They were no longer associated with natural causes, but were considered punishment for sins. Prayers, fasting, repentance became the main remedies. Although Christian charity required the care of the sick, and hospitals were established for this purpose, the methods of treatment were not based on medical knowledge.
The Church Fathers, of course, introduced Christian dogmas into medical teachings. Mysticism, superstition and dogmatism have supplanted scientific knowledge and research. The canonized texts were declared the highest authorities in both religion and science.
Arabic medicine
The decline of science after the fall of the Roman Empire could have led to the complete disappearance and oblivion of the Greco-Roman heritage if the great Arab civilization had not arisen. Muslim conquests in the 7th and 8th centuries put under the rule of the caliphates vast lands of southern Europe, North Africa and a large part of Asia. Surprisingly, this empire, with its fanatical thirst for conquest, showed a high level of tolerance for foreign traditions and knowledge. Precious Greek and Roman manuscripts, which were burned and destroyed if they fell into the hands of the rabble in the first centuries of Christianity, have been carefully preserved, translated, annotated, and accepted as the foundation of science and philosophy.
It should be borne in mind that the Arab civilization was Arabic only in language. Many peoples of East and West contributed to its development, and among its prominent representatives were Persians, Syrians, Spaniards and Jews.
The emergence of Arabic medicine dates back to the time before the birth of Muhammad (570-632). The Christian sect of the Nestorians, founded by the Patriarch of Constantinople, Nestorius, was declared heretical; they were forced to flee in 431 to Edessa, a city in Asia Minor, and there they founded a medical school, which became widely known. Under Emperor Zeno (474–491), the persecution of the Nestorians was renewed, and this time they fled to Gandeshapur (Jandishapur) in Persia. Over the next two centuries, the Nestorians turned this city into a medical center. They translated many Greek and Latin texts into Arabic.
The most prominent among the Nestorian physicians was Hunayn ibn-Ishaq al-Ibadi (809–877), whose treatise Alteration eyes is the earliest known Arabic text on ophthalmology.
Another prominent Arab physician of the 9th c. was Razi (ar-Razi), a Persian by origin, who wrote about 200 works on medicine, including a huge encyclopedia, the so-called. Comprehensive medical book. This vast collection is devoid of systematization; Razi owes his fame rather to a small treatise About smallpox and measles, containing a classic description of the differences between these diseases. Razi followed the Hippocratic method and was a good clinician. He is also known for his merciless exposure of charlatanism.
The creation of medical encyclopedias was continued by Ibn Abbas (Ali ibn al-Abbas), another Persian author of the 10th century, whose royal book, the body of medical knowledge of the time, was much better compiled and systematized than Razi's encyclopedia. But both of these books were overshadowed by the famous Canon Avicenna.
This work, summarizing the achievements of Greco-Arabic medicine, was the main source of medical knowledge for Asia and Europe for the next six centuries. Its author, Avicenna (Abu Ali Ibn Sina, 980-1037), also a Persian by origin, who was often called the “prince of all doctors,” had a bright personality and enterprising character. He was an excellent physician and in his writings tried to reconcile the dogmas of Galen and Aristotle.
The works of Avicenna mark the highest point in the development of Arabic medicine, especially in the East. In the 10th century the center of Arab civilization moved to Spain. There, in the Caliphate of Cordoba, the only known Arab surgeon worked - Albukasis (Abu-l-Qasim, 936-1013).
Surgery remained for a very long time lower in status than medicine, which was characteristic of both Arab and Christian civilizations. Albucasis, however, tried to raise the prestige of this neglected profession. His treatise is one of the oldest illustrated books on surgery; among the surgical devices depicted there are not only tweezers, but also a wide variety of dental instruments. Albucasis was also the first to describe hemophilia.
To another Arab surgeon, Avenzoar (Ibn Zuhr) of Seville (c. 1072–1162), medieval medicine owes a popular fetish known as bezoar stone (a dense deposit formed from food debris and inedible particles in the stomach of certain ruminants, especially goats; he was credited with the greatest healing properties). Despite this superstition, Avenzoar was a good clinician, the first physician to use a nutritional enema, and was able to diagnose stomach cancer. His student Averroes (Ibn Rushd, 1126-1198) mastered not only medicine, but also many other disciplines. He wrote extensively on medical subjects, but it was mainly philosophical works that brought him fame. The interpenetration of medicine and philosophy marked the work of his outstanding student Maimonides (1135-1204), whose biography marks the end of the era of tolerance and glory of the Arab civilization. Maimonides refused to convert from Judaism to Islam and was expelled from Spain. He became the physician of Caliph Saladin (Salah ad-din) and had an extensive practice in Cairo. Like Averroes, he was better known to posterity as a philosopher than as a physician.
The art of healing has come a long way to achieve a high level of development. People were always sick, and healers, healers, healers began their existence almost with the birth of the human race.
prehistoric medicine
In prehistoric times, there were many different diseases. Primitive people did not care about the hygiene of their homes and bodies, did not process food and did not seek to isolate their dead tribesmen. Such a way of life is the best environment for the growth and development of a variety of infections and diseases, and ancient medicine could not cope with them. The lack of basic hygiene gave rise to skin diseases. Poor processing of food, its primitiveness and rigidity led to abrasion, damage to the teeth and jaws, diseases of the digestive system. During battles and hunting, primitive people received dangerous injuries, the lack of treatment of which often led to death.
A huge number of diseases and injuries provoked the emergence of primitive medicine. The most ancient people believed that any disease is caused by the entry of an alien soul into the body of a person, and for healing it is necessary to expel this soul. The primitive doctor, and part-time priest, was engaged in exorcism with the help of spells and various rituals.
Primitive healing was not limited to this. Over time, people learned to notice and use the medicinal properties of plants and other fruits of nature. Clay served as a kind of "gypsum" of that time - healers fixed fractures with it. Primitive operations were carried out, for example, skulls with traces of successful trepanation were found.
Ancient Egypt
Ancient Egypt can be considered the cradle of medicine as a science. The knowledge and writings of the ancient Egyptian physicians provided the basis for many more modern medical practices and teachings. Considered the oldest documented system of medicine. A feature of ancient Egyptian medicine is that a large part of the discoveries were attributed to the gods. Such as Thoth, Isis, Osiris, Horus, Bastet. The best healers were also priests. They attributed all their discoveries and observations to the gods. Unlike prehistoric times, the Egyptians placed great importance on hygiene. They clearly prescribed what to eat, when to sleep, when to do preventive procedures (emetics and laxatives to cleanse the body). They were the first to consider that the health of the body must be maintained by special games and physical activity. The Egyptians were the first to know about the existence of the pulse. They did not have an accurate idea of the vessels, various nerves, tendons and how they differ. They represented the entire circulatory system as the Nile River.
The priests showed themselves as surgeons, they could amputate a limb, surgically remove skin growths, perform circumcision - both male and female. Many methods were ineffective and useless, but they were the first steps for further development. For example, as drugs based on mold and fermentation processes, ancient medicine in Egypt was quite advanced for its time.
ancient india
According to Indian beliefs, the gods who invented medicine were Shiva and Dhanvantari. Initially, as in Egypt, only brahmins (priests) could practice medicine. Further, healing passed into a separate caste. Which, unlike the Brahmins, received a reward for their labors. In addition to the reward, a person who became a doctor had to dress cleanly, take care of himself, behave gently, culturedly, come at the first request of the patient, treat the priests for free.
In India, they took great care of their hygiene: in addition to simple washing, Indians brushed their teeth. There was a separate list of foods that help digestion. Separately, surgery was taken out of medicine, calling it “shalia”. Surgeons could both extract the cataract and remove the stones. Surgery to restore the ears and nose was very popular.
It was the ancient medicine of India that described the beneficial properties of more than 760 plants and studied the effect of metals on the body.
They paid special attention to obstetrics. The doctor was supposed to have four experienced women to help. Medicine in India was more advanced than in Egypt or Greece.
Ancient Asia
Chinese medicine served as the basis of Asian medicine. They strictly observed the observance of hygiene. Chinese medicine is based on nine laws, categories of conformity.
Based on the nine laws, they chose the methods of treatment. But in addition to this, surgical operations were carried out in China, anesthesia and asepsis were used. The first smallpox inoculations were made in China 1000 B.C.
Japanese medicine cannot be singled out separately; it was based on traditional Chinese medicine. At the same time, the ancient medicine of Tibet was based on the medical traditions of India.
Ancient Greece and Rome
In Greek medicine, the practice of observing the patient was first adopted. Studying the ancient medicine of Greece, it is hard not to notice the influence of ancient Egyptian medicine on it. Most of the medicines used have long been described in the papyri of Egyptian healers. In ancient Greece, there were two schools - in Kirina and Rhodes. The first school emphasized that disease was a general pathology. Accordingly, she was treated, focusing on the characteristics of the patient, for example, on the physique. The school from Rhodes worked immediately with the focus of the disease. On the other hand, philosophers were involved in medicine, they spread their knowledge among the public. It was they who studied medicine from a scientific point of view. Separately from all medicine, gymnastics was singled out as a way to treat dislocations and develop your body.
The deeper the knowledge of ancient Egyptian medicine penetrated, the more experienced doctors appeared with new methods. One of these fathers of medicine was Hippocrates. He has more deeply developed surgical practices. He could carry out trepanation of the skull, removal of pus, puncture of the chest, abdominal cavity. The only problem was operations with a large amount of blood - not knowing how to work with blood vessels, Hippocrates refused such patients.
All medicine of ancient Rome was based on achievements previously borrowed from Greek doctors. The situation repeats itself - how Japanese medicine was built on the basis of Chinese medicine. Initially, all medicine in Rome was based on pleasant and pleasurable methods: walks, baths. Further, based on the teachings of Hippocrates, the methodical school, the school of pneumatics, tried to improve them, but already in a scientific way. The best physician in Rome was Galen. He studied anatomy in detail, wrote more than 500 treatises on medicine. More carefully studied the work of muscles.
It's so easy to think of all our prehistoric ancestors as savages and underdeveloped creatures. When someone talks about the era known as the Stone Age, most of us immediately imagine wild ancestors overgrown with hair who sit in caves, hewing large cobblestones against each other.
However, this is not quite true. Or rather, not at all. Before mankind evolved to create large cities and invented writing, it was capable of actions that simply do not fit in the head of modern man.
Alas, prehistoric cavemen are not able to tell us about their lives, occupations, plans, dreams, ways of development. Almost everything that we know about our ancestors who have long sunk into oblivion, we were able to get by studying the objects left by them in their graves.
And even if they did not leave us records of their existence - this is not at all necessary, since the remains of their bodies eloquently tell about the life of ancient people. Some of them are quite capable of telling about ancient medicine. A number of facts that we managed to find out look simply incredible.
History of Medicine in the Stone Age
Amputation under the influence of an anesthetic
This happened about seventy kilometers from the borders of the southern part of Paris (at least in its modern borders). The man's arm was amputated there. His doctor first gave the patient an anesthetic, and only then performed a surgical operation to amputate the limb.
Bone scarring shows that the patient's forearm was severed with the painstaking precision of a skilled surgeon, despite the fact that the operation was apparently performed with a flint instrument.
A deeper study of other tissues allowed scientists to conclude that the patient was most likely exposed to a hallucinogenic substance (most likely it was some kind of plant, like Datura). This made it possible to somewhat reduce pain during the operation.
The absence of some markers that would indicate the development of an infection after the operation led to the assumption that the patient's wound was treated with some kind of plant that has an antiseptic effect. Perhaps it was sage or some other herb.
And the fact that the wound looks completely healed indicates that the patient has fully recovered from the operation, living for at least a few more years. Of course, it is difficult to imagine that a man in the Stone Age managed to complete all of the above steps. However, this is a fact, and not the only one.
Archaeologists have found numerous evidence of successful amputations of various parts of the bodies, which were produced by our distant ancestors in the Stone Age. And the nature of the wounds indicates that patients managed to survive after such operations. Moreover, all these operations were performed with the help of pointed silicon and medicinal herbs.
Using ants to suture wounds
If doctors in the Neolithic era were able to perform surgical operations, then they must also have been able to suture wounds. There is some pretty convincing evidence that stone age healers actually knew how to seal the edges of an open wound in some way.
Different tribes and peoples in different places of our planet did it in different ways. For example, in Egypt, a linen rope was used for this purpose. In the European part, the seams were applied using a special thread made from the intestines of cattle. To do this, the intestines of small ruminants were dried and twisted into a thread called catgut.
However, the most interesting technique for "closing up" open wounds involves the use of ants. In India and some regions of Africa, ancient tribes fastened the edges of the wounds of patients or injured people by planting ants on the cuts, which grabbed them with their mandibles.
As soon as the insect "snapped" the ends of the wound of a patient with its mandibles, the ancient healer separated his body, leaving the ant's head on the wound. The ant, of course, was dying, and its jaw tightly grasped the ends of the cut or wound.
Scientists believe that this technique of suturing wounds was widespread in the Neolithic era. Now it is almost impossible to say exactly when people learned to treat wounds in this way. However, it is known that by the time writing appeared in India (third century BC), local healers were already using ants for similar purposes.
Dental treatment by drilling
The oldest dental drill that archaeologists have ever found was constructed much earlier than you might imagine. It was made of silicon and was found in what is now Pakistan. According to scientists, this drill was used for dental treatment nine thousand years ago!
It was there that the remains of a whole tribe were discovered, which clearly indicated that its representatives knew firsthand about dentistry and dental treatment. Apparently, ancient dentists often used a flint drill to drill into the teeth of their fellow tribesmen who complained of dental problems.
Findings of teeth with traces of dental treatment have raised speculation about whether this is a natural deformation. However, molars (teeth that are deep in the mouth) were often found. The molars were processed in such a way that there is no need to talk about any random nature of the deformation - they were clearly drilled.
Numerous beads were found in the same area, which indicates the prevalence of this craft (bead making) in that period. It is assumed that it was the development of this craft that became the impetus for the appearance of the first experimenters in the field of dentistry among ancient people.
In fact, local craftsmen simply used their knowledge of the ability to drill holes in beads in order to try to save their fellow tribesmen from the excruciating pain associated with tooth decay. When they saw that drilling could relieve pain, it enabled them to create their own dental treatment.
Teeth have been treated in this way for a long historical period of time. Logic also dictates that there was more than one dentist in the tribe. In that era, writing was out of the question, so knowledge about the method of dental treatment had to be passed on from generation to generation for at least one and a half thousand years.
The development of stone age medicine
The tribes that lived in the territory of modern Europe in the Stone Age began to use acupuncture in unimaginably distant times. To understand what period we are talking about, it is enough to say that our European ancestors used acupuncture two thousand years before the Chinese.
Scientists came to this conclusion by examining specific marks on mummified remains found in the Ötztal Alps between Italy and Austria. These remains are at least 5300 years old. The ice mummy, which is the oldest human mummy discovered in Europe, was named Ötzi.
After acupuncture procedures, which could only be performed for the purpose of pain relief, the ancient healer treated the incisions by applying charcoal to them. Perhaps this is how the doctor wanted to disinfect them.
This find speaks to the incredibly deep knowledge of the people of the Stone Age about such a medical technique as acupuncture. However, as history shows, the descendants of the ancient healer Ötzi lost this knowledge - Europeans did not resort to treatment with acupuncture for about five thousand years.
The process of having children in the Stone Age was very dangerous. The birth of a child in that era, without all that modern medicine offers us, could lead to fatal consequences. In some regions, according to researchers, female mortality during childbirth exceeded thirty percent.
However, this was not the case everywhere. Some tribes clearly learned the basic rules for caring for a woman who was about to give birth to a child. According to many archaeologists, there were tribes in the Stone Age who followed a certain plan and procedures aimed at facilitating childbirth.
Moreover, these rules and procedures had the character of instructions in the literal sense of the word, as they were applied in the form of drawings on the walls of the caves. As a result of archaeological excavations, cave drawings were discovered, which can be called instructions from the Stone Age, used as a kind of guide by ancient obstetricians.
According to these drawings, it was possible to judge the position that ancient people considered the most optimal for a woman in labor: a woman was recommended to start giving birth standing up. At the same time, her hands were on her waist. It was this position that was the best for the birth of a child - the least painful in terms of the opportunities that people of the Stone Age then had.
Then, judging by the drawings, the woman in labor was advised to lean forward a little, bending her legs in high haunches for the second stage of labor. Archaeologists believe that the caves where these drawings were discovered were not the residence of Stone Age people. In their opinion, these were sort of primitive maternity wards.
Neither the death of animals, nor the death of fellow tribesmen as a result of operations could stop the inquisitive mind of an ancient man. This can be judged at least by the fact that Stone Age doctors even tried to carry out such an operation as craniotomy - the earliest form of brain surgery.
It may be hard to believe, but in the Stone Age this operation was quite common throughout the world - some scientists believe that it is already more than ten thousand years old. The first physicians of mankind drilled a hole in the skull of the patient with a sharp tool made of silicon.
If it was a traumatic brain injury, then after trepanation, the doctor had to pull out pieces of bone from the patient's brain and remove the blood accumulated at the site of the operation. And, no matter how surprising it may sound, such a procedure, carried out by ancient physicians, bore fruit.
In other words, due to craniotomy, patients with severe head injuries had a better chance of surviving. Studying the rock paintings, scientists came to the conclusion that Stone Age people who suffered from epilepsy, headaches, and even mental illness could have been subjected to the trepanation procedure.
Most likely, in those days it was believed that such people were possessed by evil spirits. And the only way to release them is to drill a hole in the skull. And let the ancient healers incorrectly assessed the causes of diseases. Findings show that many patients survived and continued to live with a hole in their head.
Man everywhere and always sought to maintain health. Medicine - a science designed to take care of human health, originated in ancient times.For the first time targeted research in the field of medicine began to be carried out in ancient Egypt. It is no coincidence that the Greeks called the Egyptians the inventors of medicine, especially preventive medicine. According to the Egyptians, all healing work is under the auspices of the god Thoth, who was depicted as a man with the head of an ibis or a baboon.
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The mummification or embalming of bodies in ancient Egypt was carried out by specialists whom the Greeks called tariheuts. The embalming procedure was described in detail by Herodotus in the middle of the 5th century. BC. During this procedure, the structure, condition and functions of the organs were studied. In the same way - dissecting corpses - students of modern medical universities study the structure of the body.
Of course, doctors in ancient Egypt misunderstood a lot about the functioning of the human body. For example, they believed that the heart is connected not only to veins and arteries, but also to nerves and muscles, and that thought processes and emotions are born and flow not in the brain, but in the heart. The purpose of the circulatory system was not fully understood then.
Healing in ancient Egypt
The art of healing in ancient Egypt was widely developed, and arose from practical experience accumulated over the centuries. Medicine was taught in scribal schools, where they taught complex hieroglyphic writing. There were such schools at the temples. The most authoritative, higher schools of scribes, which were called the Houses of Life, were located in large cities - Sais and Heliopolis. Along with medicine, schools taught mathematics, architecture, sculpture, and astronomy. A doctor in Egypt was also a priest, since medicine was part of a religious cult. Medical students were attached to a temple, so that they at the same time comprehended religious sacraments and rites. Students practiced under the guidance of experienced healers.
The secrets of healing were often kept secret and passed down from father to son, whole medical dynasties were formed that owned the art of healing. Very little written evidence of the activities of doctors has come down to us. Basically, these were court doctors who used the pharaohs and the nobility. The personal physicians of the kings occupied a high position at court. The fact that narrow specializations already existed at that time is evidenced by the titles of doctors: “court healer of the stomach”, “healer of the eyes at the court of the pharaoh”, “keeper of the royal entrails”.
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Mechen was a famous healer, as evidenced by the inscription on the wall of his tomb. He had the title of nomarch - a dignitary of the pharaoh of the 4th dynasty of Snorfu (XXVIII century BC). At the same time, the famous healer of teeth Khasi-Ra also lived.
The healers of ancient Egypt not only treated, but also conducted medical research, the results of which were recorded. An extensive archive of scientific works has come down to us. Case histories of patients, prescriptions and prescriptions, anatomical and medical reference books and treatises were compiled by ancient Egyptian doctors on papyrus scrolls.
The oldest mention of medical papyri from the period of the Old Kingdom was found on the wall of the tomb of Uash-Ptah, the chief architect of the 5th dynasty king Neferirik-Ra (XXV century BC). The priest and historian Manetho reports that the second king of the 1st dynasty Djer (XXVIII century BC) was a skilled healer and compiled a treatise on the structure of the human body on a papyrus scroll. The treatise itself, however, has not been preserved, but there is a reference to it in the famous Ebers Papyrus, dedicated to the art of healing. In total, more than 10 papyrus scrolls were found, which are to some extent devoted to the art of healing. All of them are lists (copies) of earlier treatises.
The Ebers and Smith Papyri
One of the most famous and most extensive medical treatises of antiquity is the Ebers Papyrus. It was discovered in 1872 by the German Egyptologist Georg Ebers in Thebes, taken out of Egypt and today is kept at the University of Leipzig. The treatise is called The Book of Preparing Medicines for All Parts of the Body, and it contains more than a hundred pages. The time of its writing is also known - the 17th century. BC e. The papyrus, which is 3,600 years old, is 20.5 meters long and contains a total of 2,289 lines written in hieroglyphs. This scroll is a copy of an even older document. The scribe who created this copy reports that part of the scroll contains even older texts relating to the 1st, 6th and 12th dynasties of the pharaohs.
Another papyrus introduces us to the state of medical science in ancient Egypt. Scientists consider it the oldest treatise on medicine that has come down to us. It is named after the Egyptologist Edwin Smith, who acquired this papyrus scroll in 1862 in Luxor from a local villager for his collection of antiquities. The Smith Papyrus is 4.5 meters long and about 33 centimeters wide and contains 400 lines of hieroglyphic text. Based on the font and handwriting, the manuscript is dated to 1600 BC. Later, after examining the language and numerous errors in transcription, scientists found that this treatise is a copy of a text written about three centuries earlier.
The Smith Papyrus describes 48 cases of injuries (of the bones of the skull, brain, cervical vertebrae, collarbones, forearm, chest and spinal column) received in war or construction, as well as ways to treat them. Interestingly, the author of the papyrus describes three categories of damage. Egyptian medical ethics demanded that the healer, after examining the patient, openly inform him about the expected outcome of the treatment with one of three phrases: “This is a disease that I can cure”, “This is a disease that I may be able to cure and with which I will fight "," This is a disease with which nothing can be done.
It is clear from the papyrus that ancient physicians knew that blood flows through the veins because it is pumped by the heart. In the same place we meet the first description of the brain and brain injuries that have come down to us. The appearance of the brain in an open wound, writes an ancient doctor, is like boiling copper. Thus, the ancient Egyptians laid the foundation for natural science ideas about the brain.
The papyrus also gives advice on the use of natural antiseptics: honey (for open wounds) and linden bark tincture, which contains substances chemically similar to aspirin.
magical medicine
If the drug did not help, the doctor gave the patient further prescriptions, from which it is clear that the healers knew a whole range of medicinal preparations from herbs and other plants. For example, onion in ancient Egypt was revered as a sacred plant, it was dedicated to the goddess Isis. Bunches of onions were often found in sarcophagi along with mummies. Poppy was used as a sleeping pill. Aloe has been used in embalming formulations.
How were diagnoses made in ancient Egypt?
The medical papyri contain advice on how to make a diagnosis, and this advice is not much different from modern diagnostic techniques. Identification of diseases was based on a patient interview, personal examination and analysis.
Ancient Egyptian healers also paid attention to such indicators of the patient's condition as the color of the skin (pallor, yellowing, redness), fever, temperature, trembling in the hands, etc. Urine, feces and saliva were studied. With fractures, enlarged tonsils, or a tumor on the body, the doctor palpated the sore spot in the same way as it is done today, and recorded the results of the examination.
Egyptian healers also practiced simple surgical operations. In the treatment of fractures, wooden splints (“tires”) and tight bandaging of the injured limb with a linen cloth soaked in resin were used. On the wall of one of the tombs, a surgeon is depicted adjusting a dislocated shoulder to a patient. Surgeons applied bandages to protect the wound from contamination, put a cold compress on bruises and fractures.
Craniotomy and dentistry
The most commonly used surgical operation in the ancient world was trepanation of the skull. Many skulls with square holes have been found. Only in Israel, 28 such skulls were found. Scientists encountered similar finds during the excavations of the city of Jericho in the archaeological cultural layer, which belongs to the earliest settlements in this area. It follows from this that neurosurgery existed already at the dawn of civilization. Trepanned skulls were found with overgrown holes, which indicates a successful surgical intervention and that the patient survived after the operation.Since time immemorial, people have suffered from toothache. The profession of a dentist was extremely popular in ancient Egypt. The study of mummies showed the widespread occurrence of severe inflammatory diseases of the periosteum, gums and teeth among the Egyptians. Even the pharaohs, who were treated by the best dentists of their time, were found to have jaw lesions and tooth loss. Then they did not yet know the filling of carious cavities and the prosthetics of teeth with gold or other metals. The only evidence of the use of gold in ancient Egyptian dental practice is the overlay of the two lower chewing teeth, connected to each other by a thin wire along the line of their necks. Single archaeological finds: teeth connected by wire (attempts at prosthetics), jaws with round holes drilled in the area of the roots of the teeth to ensure the outflow of pus and relieve inflammation of the periosteum, indicate that dentistry in Egypt was at a high level.
In ancient Judea, healthy teeth were valued, and anyone who was missing at least one tooth was considered defective. The ancient Jews considered a fight with damage to the teeth a serious offense, so if the master knocked out the tooth of his slave, then in return he was obliged to give him freedom.
Health and hygiene
The ancient priests-healers solved not only issues related to diseases and accidents. They also tried to find means to stop the aging process, as recorded in magical papyri.
Hospitals and sanatoriums
One of the most interesting areas of ancient Egyptian medicine is sanatorium treatment. Sanatoriums were organized at temples. This tradition was later adopted by the ancient Greeks. In hospitals, as well as in modern health and spa institutions, patients could rest from several days to several weeks, receiving the necessary treatment and offering prayers to the gods for their healing. Treatment was paid for by offering to the temple images of healed organs made of marble, silver, and gold. Excavations at Epidaurus (Epidaurus (Epidauros) - an ancient city in Greece in the northeast of the Peloponnese (preserved in ruins).) many such offerings were found in the form of marble feet, hands, silver hearts, golden eyes and ears.In the Egyptian temples there were grandiose archives and libraries, where thousands of papyri, including medical ones, were stored. Famous ancient Greek doctors in a later period used the methods of ancient Egyptian healers,
read about in the medical treatises stored in these libraries.Today, the remains of ancient Egyptian hospitals have been found. Fragments of similar health resorts have been preserved in Greece. Here they were called Asklepion (in honor of the god of healing Asclepius). One of the two main sanctuaries of the god Asclepius in antiquity (the second is in Epidaurus) has been preserved on the island of Kos, where the father of Greek medicine Hippocrates (about 460 BC - about 377 BC) was born. Archaeologists have found small rooms, like cells, for resting, baths for washing, rooms for medical examination. Thousands of patients from all over the Mediterranean were treated here, who were treated in accordance with the methods developed by Hippocrates.
Much of the Sanctuary of Asclepius in Epidaurus is still under archaeological excavation. Unfortunately, now only ruins remain of this once famous hospital. During excavations at the site of the ancient city of Pergamon (Pergamum (Greek PErgamos) is an ancient city in Asia Minor (modern Bergama). Founded in the 12th century BC by immigrants from mainland Greece. In 283-133 BC, the capital of the Kingdom of Pergamon.) several ancient sanatoriums have also been found.Medicine in Ancient Greece
At present, science does not have written information about medicine in ancient Greece. The only references are found in the first Greek literary monuments of the 12th-6th centuries. BC e. - Homer's poems "Iliad" and "Odyssey".
The Hippocratic Collection, an outstanding monument of medical literature, compiled around the 3rd century BC, gives an idea of the medicine of the classical period in the history of Greece. BC e. from the writings of ancient Greek physicians. It is named after the great physician of the ancient world, Hippocrates. Some information about the medicine of the archaic and classical periods of the history of Greece is also contained in Herodotus in his History in Nine Books.
The medicine of the Hellenistic era is narrated by the medical treatises of scientists from Alexandria as presented by Galen and Aulus Cornelius Celsus. The original treatises, alas, have not been preserved,
The ancient Greeks respected ancient Egyptian medicine. In The Odyssey, Homer remarked: "The medical knowledge of ancient Egypt left the rest of the world far behind."After Alexander the Great conquered Egypt, and his commanders began to rule this country, the Greeks joined the knowledge of the Egyptians in the field of medicine and borrowed a lot from the ancient Egyptian healers. In the library at the temple of the god Ptah in Memphis, the ancient Greeks diligently studied prescriptions for the sick, prescriptions, diagnostic methods, as well as the use of sleeping pills and painkillers by Egyptian healers.
Having reached a high flourishing, the medicine of Ancient Greece was reflected in the cults of the deified physician Asclepius and his daughters - Hygiea, the guardian of health (hence the word hygiene) and Panakia, the patroness of the medical business (hence the term panacea came to us).
The medical art of this period reached its peak in the activities of the ancient Greek physician Hippocrates, who is rightly called the father of medicine. The heritage of Hippocrates and other doctors of Ancient Greece is summarized in the Hippocratic Collection, which is an encyclopedia of ancient Greek medicine. It was compiled in the 3rd century. BC. for the Library of Alexandria, founded by the Ptolemaic dynasty (successors of Alexander the Great), who ruled Egypt during the Hellenistic era.There were several medical schools in Ancient Greece, each with its own philosophy and methods of diagnosis and treatment.
medical ethics
At all times, there have been written or unwritten laws regarding the relationship between a doctor and a patient. Despite the high position in society and the respect that people of this profession enjoyed in the ancient world, the doctor had to act with extreme caution. The activity of healers was subject to strict rules, including moral ones. Violation of these rules was punishable up to the death penalty.
Here are some excerpts from the law code of Hamurappi, the Babylonian king who ruled from 1792-1750. BC..
218. If a doctor performs a complex operation on someone with a copper knife and kills him, removes someone's thorn and deprives him of his eye, he should cut off his hands.
219. If a doctor performs a complex operation on a slave with a copper knife and kills him, then he must deliver another to the owner for the dead slave.
220. If a doctor removes a thorn from a slave with a copper knife and deprives him of his eye, then he must pay half the cost of the slave in money.
Ancient Greek doctors were guided by the rules of the "Holy Book", and if the doctor did not deviate from them, then any outcome of the treatment was considered acceptable. A similar position existed in Roman law. For example, a doctor was forbidden to sell poison for the purpose of poisoning, to perform abortion and castration operations.
Under Christianity, a norm appeared about responsibility for not providing assistance to the sick. In Palestine, this crime was punishable by death with confiscation of property in favor of the state.
Health laws in ancient Israel
The author of the first five books of the Bible, the prophet Moses, was born in Egypt at a time when Israel was in bondage there. The book of Exodus tells that the princess, the daughter of the Egyptian pharaoh, found the baby Moses in a reed basket and, since she was childless, adopted him and made him heir to the Egyptian throne. Moses received an excellent education at the court of the pharaoh. That was the heyday of Egyptian culture, and the young man must have been well acquainted with the principles of healing, possessed knowledge in the field of medicine. “And Moses was learned in all the wisdom of the Egyptians, and was mighty in word and deed” (Acts 7:22).
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The book of Exodus outlines not only the laws of health transmitted by God through Moses, but also the consequences of breaking these laws: statutes, I will not bring on you any of the diseases that I brought on Egypt, for I am the Lord your healer” (Ex. 15:26).
The principles of health given by God to the prophet Moses are described in detail, they trace the relationship between obedience to the will of God and human health, between the idea of holiness and personal hygiene, which has always been of great importance in Israel. Before appearing to the people of Israel at Mount Sinai, the Lord gives the following command through Moses: “And the Lord said to Moses: go to the people, and sanctify them today and tomorrow; let them wash their clothes, that they may be ready for the third day: for on the third day the Lord will descend before the eyes of all the people on Mount Sinai” (Ex. 19:10, 11). Compliance with the rules of personal hygiene established by God was not only the duty of every Israelite in relation to fellow tribesmen and God, but also protected from many diseases and epidemics.
Nowadays, few people doubt how important proper nutrition is for the body. Today, everyone knows that eating fatty foods leads to obesity and excess cholesterol in the blood. But after all, God told the people of Israel about this in the wilderness: “This is an everlasting ordinance throughout your generations, in all your dwellings; eat no fat and no blood” (Lev. 3:17).
Prevention of infectious diseases
Today, the norm is the isolation of infectious patients, the use of respirators to prevent viral and bacterial infections transmitted by airborne droplets. But this principle was also known to the people of Israel. God's ordinance regarding the upkeep of infected patients says: "The leper who has this ulcer must have his clothes torn, and his head must be uncovered, and he must be covered to the mouth, and shout: "Unclean! Unclean!" (Lev. 13:45). The people of Israel were well aware of the danger of contracting infectious diseases. Patients with leprosy were isolated from society so that the disease would not spread further. “As long as the plague is on him, he must be unclean, he is unclean; he must dwell alone, outside the camp of his dwelling” (Lev. 13:46). The word "leper" as used in Scripture could include other infectious skin diseases. In Israel, infectious patients were isolated, and their clothes were burned, since microbes and bacteria die at high temperatures. This once again suggests that the Israelis were well aware of the need for disinfection. “He must burn the garment, or the warp, or the weft of woolen or linen, or any leather thing that has a sore, for it is caustic leprosy: it must be burned with fire” (Lev. 13:52).However, the criticism and rejection of the Bible during the Enlightenment deprived the nations of this precious knowledge. The Middle Ages in Europe were marked by terrible epidemics that broke out as a result of the neglect of the rules of hygiene and sanitation. Until the 19th century, European physicians did not realize the danger of infection from touching a human corpse. The doctor could, teaching students, conduct an autopsy, and then, without even washing his hands, immediately go to the ward to examine the patient. As a result, a large number of hospital patients died of unknown causes. As it turned out later, patients died from various infections. But even in ancient times, the following command was given to Moses: “And the Lord spoke to Moses, saying: Command the children of Israel to send out of the camp all the lepers, and all that have a discharge, and all that are defiled by the dead” (Numbers 5:1,2 ).
The relationship between obedience to the laws of God and health is indicated in the book of Deuteronomy: “And keep His ordinances and His commandments, which I command you today, so that it will be good for you and your sons after you, and that you spend a long time in the land that the Lord, your God gives you forever” (Deut. 4:40). Life confirms the validity of these requirements. Therefore, it is also useful for us today to get acquainted with the Biblical principles regarding a healthy lifestyle.
Alcohol and health
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To understand how valid these references are, let's find out in what sense the word "wine" is used in the Bible. The New Testament, which is written in ancient Greek, does not use separate words for such different concepts as fermented wine and pure grape juice. The same word is used - "oinos". In the Old Testament, the word wine is mainly rendered by the Hebrew word "yain". To determine the meaning of “yain” and “oinos”, it is necessary in each specific case to refer to the literary and historical context.
In one of his epistles, the Apostle Paul says: "And do not get drunk with wine, in which there is debauchery" (Eph. 5:18). In this case, of course, he means alcoholic wine. Now let's turn to the prophet Isaiah: “Thus says the Lord: when there is juice in a bunch of grapes (the word “yain” or “new wine” is used in the original text), then they say: “do not harm it, for there is a blessing in it” (Is 65:8). In this case, it is quite obvious that we are talking about fresh grape juice, which is good for health. In the Jewish Encyclopedia, freshly squeezed juice before fermentation is called "yain-migat", that is, new wine from a vat, or from a press. Thus, freshly squeezed juice was called “new wine”. This was the wine that Jesus used at the supper and recommended to Timothy for medicinal purposes by the Apostle Paul.
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Some people argue that drinking alcohol in moderation is harmless and even beneficial. However, no one can be sure that they will be saved from the severe alcohol addiction that many of those who started with that “low dose” fell into. Many drink "for the company" or on the occasion of the holiday. Unfortunately, many people who follow this path become hopeless alcoholics. The Bible tells us that in regard to alcohol, total abstinence is to be observed.
Addictions
Another equally harmful habit is smoking. Tobacco addiction poses serious health problems. Smoking causes many diseases that have reached epidemic proportions. It has become one of the main health problems in many countries of the world. Medical organizations around the world are sounding the alarm, warning the public of impending danger. Smoking is a bad habit that is detrimental to health and life-threatening. Responsible attitude to one's health is a religious duty of a person, our duty to the Creator Himself. The apostle Paul wrote: “Do you not know that you are the temple of God, and that the Spirit of God dwells in you? If anyone destroys the temple of God, God will punish him: for the temple of God is holy; and this temple is you” (1 Cor. 3:16, 17).
This principle also applies to other bad habits that lead a person to addictions. The most popular addictive habit is the consumption of caffeinated drinks: coffee, tea, cola. The aroma and stimulating effect of coffee and tea are preached all over the world. Many people drink caffeinated drinks, believing that they are energized and increase their performance. However, the caffeine found in these drinks has an artificial stimulating effect on the body, especially on the nervous system. In fact, caffeine is a type of drug, it has a harmful effect on the physical and mental health of a person. Yes, at first, under the influence of caffeine, our mood improves, fatigue disappears, but this effect is short-lived. Caffeine does not solve the problem of fatigue. It plays the role of a whip for the body, which actually needs rest. When you drink coffee or tea, you really stimulate the body's performance, but since you have already exhausted your energy resource, in the end, you will have to pay dearly for "coffee vivacity". Such "doping" threatens to deplete the nervous system and individual organs. Drugs are not a cure for fatigue. A healthy lifestyle, proper nutrition and proper rest will help you much better.
Proper nutrition and health
Photo 18.
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But even allowing us to eat the meat of animals, the Lord teaches us to distinguish between "clean" and "unclean" animals. After the exodus of Israel from Egypt, the Lord gives clear instructions on the meat of which animals can be eaten. “Every livestock that has cloven hooves and a deep cut in its hooves, and that chews the cud, eat” (Lev. 11:3). Among the animals, the meat of which was strictly forbidden to be eaten, was a pig, “because its hooves are cloven and the cut on the hooves is deep, but it does not chew the cud, it is unclean for you; do not eat their meat and do not touch their corpses; they are unclean to you” (Lev. 11:7, 8).
The ban also extended to certain fish products. “Of all the animals that are in the water, eat these: those that have feathers and scales (whether in the water, whether in the seas or rivers), eat those; but all those who do not have feathers and scales (whether in the seas or rivers, from all that swim in the waters, and from all that live in the waters), are filthy for you ”(Lev. 11: 9, 10). This category of aquatic inhabitants included eels, crabs, shrimps and oysters. All of the listed species, which are forbidden by God for eating, are harmful to human health.
health reform
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Modern research carried out at the borders of the natural and human sciences makes it possible to find out what people of past eras were sick with and understand how diseases influenced the course of world history.
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In 1899-1905, in a cave near the city of Krapina (Croatia), anthropologist Karl Goryanovich-Kramberger unearthed more than 900 bones of Neanderthals who lived 120-100 thousand years ago. Not a single complete skeleton or evidence of intentional burial has survived here. This suggested that the Krapina Neanderthals practiced cannibalism. And the presence of gracile and massive individuals among the Krapina Neanderthals gave rise in the first half of the 20th century to the hypothesis that they were an independent species of fossil man. Currently, the site is attributed to the Mousterian Neanderthals. Some bones from the Krapina cave were marked with traces of bone pathology. Currently, they are stored in a specialized museum.
While studying these skeletons, anthropologist David Fryer (University of Kansas) discovered the world's oldest bone tumor. Previously, such tumors older than the Bronze Age were not known in paleopathology. The tumor was discovered in the costal bones belonging to an incomplete skeleton, which did not make it possible to determine whether it was fatal for this person and whether it was secondary or primary. The uniqueness of the discovery is also determined by the fact that in both primates and humans, such tumors are very rare. Macroscopic analysis determined that the bones belonged to an adult male. The radiograph showed the process of destruction of bone tissue with significant damage to the periosteum, trabeculae, filled in healthy people with collagen tissue and bone marrow, were destroyed. X-ray microtomography determined the size of the tumor (24 by 16 mm) and ruled out other pathological causes such as traumatic tumor or osteomyelitis.
The discovery of David Fryer allows us to understand the mechanism of carcinogenesis. Several theories coexist in modern oncology. One of them assigns a leading role in the appearance of malignant neoplasms to carcinogens and substantiates the growth of oncological diseases with environmental factors. The discovery of cancer in Neanderthals living in an ecologically clean environment suggests that this cause is not the main reason for the occurrence of oncology. An explanation may be the genetic theory, which describes cancer as the result of genetic abnormalities that cause cell regeneration. The Neanderthal populations of Europe, and especially those of the periglacial zone, genetically represented rather small number of isolates. Under such conditions, they quickly accumulated lethal anomalies, including oncological ones. A cancer patient from Krapina may indicate the beginning of such a process. At the same time, scientists believe that the disappearance of the Neanderthal as a biological species was the result of the summing effect of many factors and none of them (demographic, biological, genetic, social, food) can be absolutized.
Bone pathology caused by tuberculosis
Muriel Masson of the University of Edinburgh and her colleagues at the University of Szeged published an osteological and biomolecular study of skeletons from the necropolis of the Neolithic site Hódmezővásárhely-Gorzsa (Tisza culture, 4970-4550 BC). Currently, there are quite a few publications that fix the presence of tuberculosis in prehistoric people who lived in various regions of the Earth, but most of these works are based on macroscopic, rather than biomolecular studies. A rare exception is the study of skeletons from Atlit-Yam. Masson's article largely fills the existing gap. Based on studies of living people and skeletons of people who died in the 19th-20th centuries, it is known that pulmonary pathology caused by tuberculosis manifests itself in the form of symmetrical neoplasms on the bones (Marie-Bamberger syndrome). Such neoplasms were noted on all 70 examined skeletons discovered at the Hódmezővásárhely-Gorzsa settlement, which means that the entire village was ill with tuberculosis. To check whether these neoplasms were caused by tuberculosis, a comprehensive examination of the skeleton with the most striking macroscopic signs of tuberculosis was carried out. It was the skeleton of a man 19-20 years old and about 165 cm tall. Such a height can serve as an indirect indication of early or intrauterine infection. In macroscopic analysis, pathology was observed in his skull, chest, spine, upper and lower extremities. Samples weighing about 55 mg of bone tissue were taken from his lower leg, ribs and spine. After identifying the DNA of the mycobacterium of the causative agent of tuberculosis, an analysis was carried out that revealed the presence of traces of mycocerous and mycolipenic acids in the bone, as well as the lipid biomarker HGO-53.
Muriel Masson's research reveals the negative side of the Neolithic revolution in Europe, which consisted in the long-term residence of the same community of people in a limited area. The oldest evidence of tuberculosis is the skeletons of a 25-year-old woman and her one-year-old child, found in the now flooded settlement of Atlit-Yam (Israel, VII millennium BC). They revealed characteristic elements of mycobacteria DNA and mycoline biomarkers of the cell wall. Tuberculosis was also found in the mummies of pre-dynastic Egypt (4th millennium BC). However, most often it was diagnosed in the early medieval period, for example, in the Merovingian villages of Le Ruth de Vigne (Northern France, 500-700 AD) and Czarna Wielka (Poland, ca. 600 AD). The presence of tuberculosis in pre-Columbian America, for example, in the classical Maya (300-900 AD) and in the Tikoman culture, formative period (II-I millennium BC), suggests that infection occurred in the Paleolithic. Large ungulates served as a source of tuberculosis, and recent studies have identified tuberculosis in bison killed by Paleolithic hunters who lived 17,000 years ago in Wyoming. Before the Neolithic revolution, tuberculosis did not have the character of an epidemic. Infection with tuberculosis in the Paleolithic or Mesolithic led to the extinction of a clan or a large family, respectively, but with the advent of large settlements, the entire village could eventually die out from one patient.
Skeletons with lesions of tuberculosis
Paleomedicine data allow us to say that tuberculosis has become a significant problem for Europe in the Neolithic-Bronze Age. It was revealed during a macroscopic examination in women 15 and 30 years old from the Arena Candide cave (Liguria, ca. 3750 BC), in a man from Mierzanowice (Poland, ca. 3000 BC), as well as in Germany and Hungary (Alsónyék-Bátaszék, 5th millennium BC and Vésztő-Mágor, 4th millennium BC). Among the unfavorable factors that contributed to the development of tuberculosis in Europe are the damper and colder climate of the Balkan-Danube region compared to the Middle East and the poor adaptability of the Neolithic population that came to Europe from Asia Minor. We also note that the transition to a productive economy was associated with significant genetic changes in populations, such as the emergence of the ability to digest milk and dairy products, which led to a significant decrease in immunity. All these factors held back the spread of the Neolithic revolution to the west and north. The northwestern wave of migrations of the Balkan-Danubian Neolithic (linear-band ceramic culture) was mainly represented by individual farms, consisting of one (rarely several) large-family farms. The settlements of the northeastern wave of the Balkan-Danubian Neolithic (Tripolye-Kukuteni culture) in the first phase of its development were rather insignificant. The emergence of large proto-cities, such as the Maidanets settlement, was due to the need for defense against Indo-European migration. None of these settlements contained more than one archaeological layer (that is, they did not last more than 40-50 years) and were always covered by fire. It is possible that extinction from tuberculosis was the reason for the termination of life in the settlement, and the ritual burning of the settlement was a preventive measure aimed at stopping the spread of the disease. Since tuberculosis is tenacious and cumulative, it is likely that the movement of the Neolithic "frontier" in Europe was caused not only by overpopulation, but also by the desire to leave the infected settlements for new, healthier lands, but the settlers also carried tuberculosis with them.
Leprosy (leprosy) is considered one of the oldest diseases. In Medieval Europe, it caused damage comparable to plague epidemics. And, unlike the plague, leprosy has not yet been defeated - every year 200 thousand people fall ill with it in the world. The first reliable mention of leprosy occurs in the Vedas, written around 600 BC, although some scholars suggest that it was known to both the Egyptians (Ebers papyrus, 1550 BC) and the authors of the Old Testament (VII -VI century BC). A study of the oldest skeleton with traces of leprosy was published in 2009 by a group of scientists led by anthropologist Gwen Robbins from the University of Appalachia (North Carolina). The skeleton was found during the excavations of the Balathal settlement (3700-1200 BC), which was either a former Harappan colony or was under significant Harappan influence (ceramics, copper implements, crafts, architecture, weapons). The burial dates back to 2000 BC. The difference between this burial and other burials of the settlement is that it was made in a mountain of ash left from the burning of dry manure. Ethnographic data show that those who died of leprosy in some regions of India were not cremated after death, but were buried in similar heaps, which were burned much later than the burial. Such burials are known in Northwest India and the Southern Deccan from the Neolithic to the early Iron Age (800-500 BC). In the Iron Age they are synchronous with the megalithic monuments. Thus, we are talking about the continuity of the cultural tradition of attitude towards the corpses of lepers, which suggests that leprosy appeared earlier than the end of the 3rd millennium BC.
This is also supported by comparative genomics, which revealed two areas of leprosy (East Africa and South Asia), each of which corresponds to a specific pathogen genotype: the Asian strain (type I) differs significantly from the African strain (type II). At the same time, the African strain is much more variable, and this suggests that the causative agent of the disease originated in East Africa about 40 thousand years ago, penetrated from there to South Asia, and further to Europe (type III). From Europe, type III came to West Africa (where it mutated into type IV) and America. The timing of leprosy migration to Asia is debatable. Some scientists suggest that it occurred during the late Pleistocene settlement of the Cro-Magnon, others tend to date the migration of leprosy to Asia to the Eneolithic time, when trade routes were formed between Egypt, Mesopotamia, Central Asia (Turan), Arabia (Dilmun and Magan) and India (Meluhha).
The time of the existence of this common ancestor was dated to the border of the III and II millennium BC, that is, approximately the time that the burial of the leper from Balathal is dated. Comparison of East Asian strains of leprosy with American strains showed significant differences: East Asian strains are type II, while American strains were introduced by European colonists (type III) and slaves from West Africa (type IV). This means that leprosy did not participate in the Paleolithic settlement of the Americas.
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