History of medicine

The history of medicine shows how societies have changed in their approach to illness and disease from ancient times to the present. Early medical traditions include those of Babylon, China, Egypt and India. The Indians introduced the concepts of medical diagnosis, prognosis, and advanced medical ethics. The Hippocratic Oath was written in ancient Greece in the 5th century BCE, and is a direct inspiration for oaths of office that physicians swear upon entry into the profession today. In the Middle Ages, surgical practices inherited from the ancient masters were improved and then systematized in Rogerius's The Practice of Surgery. Universities began systematic training of physicians around 1220 CE in Italy. The history of medicine shows how societies have changed in their approach to illness and disease from ancient times to the present. Early medical traditions include those of Babylon, China, Egypt and India. The Indians introduced the concepts of medical diagnosis, prognosis, and advanced medical ethics. The Hippocratic Oath was written in ancient Greece in the 5th century BCE, and is a direct inspiration for oaths of office that physicians swear upon entry into the profession today. In the Middle Ages, surgical practices inherited from the ancient masters were improved and then systematized in Rogerius's The Practice of Surgery. Universities began systematic training of physicians around 1220 CE in Italy. Invention of the microscope was a consequence of improved understanding, during the Renaissance. Prior to the 19th century, humorism (also known as humoralism) was thought to explain the cause of disease but it was gradually replaced by the germ theory of disease, leading to effective treatments and even cures for many infectious diseases. Military doctors advanced the methods of trauma treatment and surgery. Public health measures were developed especially in the 19th century as the rapid growth of cities required systematic sanitary measures. Advanced research centers 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 radiography led to modern medicine. Medicine was heavily professionalized in the 20th century, and new careers opened to women as nurses (from the 1870s) and as physicians (especially after 1970). Although there is little record to establish when plants were first used for medicinal purposes (herbalism), the use of plants as healing agents, as well as clays and soils is ancient. Over time, through emulation of the behavior of fauna, a medicinal knowledge base developed and passed between generations. Even earlier, Neanderthals may have engaged in medical practices.As tribal culture specialized specific castes, shamans and apothecaries fulfilled the role of healer.The first known dentistry dates to c. 7000 BC in Baluchistan where Neolithic dentists used flint-tipped drills and bowstrings. The first known trepanning operation was carried out c. 5000 BC in Ensisheim, France. A possible amputation was carried out c. 4,900 BC in Buthiers-Bulancourt, France. 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. The earliest medical prescriptions appear in Sumerian during the Third Dynasty of Ur (c. 2112 BC – c. 2004 BC). The oldest Babylonian texts on medicine date back to the Old Babylonian period in the first half of the 2nd millennium BCE. The most extensive Babylonian medical text, however, is the Diagnostic Handbook written by the ummânū, or chief scholar, Esagil-kin-apli of Borsippa, during the reign of the Babylonian king Adad-apla-iddina (1069–1046 BCE). Along with the Egyptians, the Babylonians introduced the practice of diagnosis, prognosis, physical examination, and remedies. In addition, the Diagnostic Handbook introduced the methods of therapy and cause. The text contains a list of medical symptoms and often detailed empirical observations along with logical rules used in combining observed symptoms on the body of a patient with its diagnosis and prognosis. The Diagnostic Handbook was based on a logical set of axioms and assumptions, including the modern view that through the examination and inspection of the symptoms of a patient, it is possible to determine the patient's disease, its cause and future development, and the chances of the patient's recovery. The symptoms and diseases of a patient were treated through therapeutic means such as bandages, herbs and creams. In East 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. Of less frequent recourse was another kind of healer known as an asu, who corresponds more closely to a modern physician and treated physical symptoms using primarily folk remedies composed of various herbs, animal products, and minerals, as well as potions, enemas, and ointments or poultices. These physicians, who could be either male or female, also dressed wounds, set limbs, and performed simple surgeries. The ancient Mesopotamians also practiced prophylaxis and took measures to prevent the spread of disease. Mental illnesses were well known in ancient Mesopotamia, where diseases and mental disorders were believed to be caused by specific deities. Because hands symbolized control over a person, mental illnesses were known as 'hands' of certain deities. One psychological illness was known as Qāt Ištar, meaning 'Hand of Ishtar'. Others were known as 'Hand of Shamash', 'Hand of the Ghost', and 'Hand of the God'. Descriptions of these illnesses, however, are so vague that it is usually impossible to determine which illnesses they correspond to in modern terminology. Mesopotamian doctors kept detailed record of their patients' hallucinations and assigned spiritual meanings to them. A patient who hallucinated that he was seeing a dog was predicted to die; whereas, if he saw a gazelle, he would recover. The royal family of Elam was notorious for its members frequently suffering from insanity. Erectile dysfunction was recognized as being rooted in psychological problems. Ancient Egypt developed a large, varied and fruitful medical tradition. Herodotus described the Egyptians as 'the healthiest of all men, next to the Libyans', because of the dry climate and the notable public health system that they possessed. According to him, 'the practice of medicine is so specialized among them that each physician is a healer of one disease and no more.' Although Egyptian medicine, to a considerable extent, dealt with the supernatural, it eventually developed a practical use in the fields of anatomy, public health, and clinical diagnostics. Medical information in the Edwin Smith Papyrus may date to a time as early as 3000 BC. Imhotep in the 3rd dynasty is sometimes credited with being the founder of ancient Egyptian medicine and with being the original author of the Edwin Smith Papyrus, detailing cures, ailments and anatomical observations. The Edwin Smith Papyrus is regarded as a copy of several earlier works and was written c. 1600 BC. It is an ancient textbook on surgery almost completely devoid of magical thinking and describes in exquisite detail the examination, diagnosis, treatment, and prognosis of numerous ailments. The Kahun Gynaecological Papyrus treats women's complaints, including problems with conception. Thirty four cases detailing diagnosis and treatment survive, some of them fragmentarily. Dating to 1800 BCE, it is the oldest surviving medical text of any kind.