Sushruta

Sushruta

History of Medicine (Compiled from Wikipedia, Encyclopedia Britanicca and other E-resources)

All societies had their own faiths & belief regarding birth, death, and disease varying from archaic to scientific. The earliest reference to medication was use of plants & plant material (herbalism). As human race established tribes the art of such herbalism became specialization of specific tribes eg, Shamans and apothecaries. This was followed with development of systems of medical thought which was predominantly specific for each civilization.

Ancient Medical Science

India

Indian medicine is the oldest medical science human history knows based on the sacred writings in the “Vedas”, especially the Atharvaveda, in the 2nd millennium BCE. The system of medicine “Ayurveda” ordained by Dhanvantari deified as the god of medicine. The period of Vedic medicine lasted until 800 BCE . The golden age of Indian medicine, was from 800 BCE until about 1000 CE, with medical treatises  – Charaka-samhita and Sushruta-samhita, attributed respectively to Charaka, a physician, and Sushruta, a surgeon. Both Charaka and Sushruta state the existence of a large number of diseases (Sushruta says 1,120). Rough classifications of diseases are given. In all texts, “fever,” of which numerous types are described, is regarded as important. Phthisis (wasting disease, especially pulmonary tuberculosis) was apparently prevalent, and the Hindu physicians knew the symptoms of cases likely to terminate fatally. Smallpox was common, and it is probable that smallpox inoculation was practiced. Hindu physicians employed all five senses in diagnosis. Hearing was used to distinguish the nature of the breathing, alteration in voice, and the grinding sound produced by the rubbing together of broken ends of bones. They appear to have had a good clinical sense, and their discourses on prognosis contain acute references to symptoms that have grave import. Dietetic treatment was important and preceded any medicinal treatment. Fats were much used, internally and externally. The most important methods of active treatment were referred to as the “five procedures”: the administration of emetics, purgatives, water enemas, oil enemas, and sneezing powders. Inhalations were frequently administered, as were leeching, cupping, and bleeding. The Indian materia medica was extensive and consisted mainly of vegetable drugs, all of which were from indigenous plants. Charaka knew 500 medicinal plants, and Sushruta knew 760. But animal remedies (such as the milk of various animals, bones, gallstones) and minerals (sulfur, arsenic, lead, copper sulfate, gold) were also employed. The physicians collected and prepared their own vegetable drugs. As a result of the strict religious beliefs of the Hindus, hygienic measures were important in treatment. Two meals a day were decreed, with indications of the nature of the diet, the amount of water to be drunk before and after the meal, and the use of condiments. Bathing and care of the skin were carefully prescribed, as were cleansing of the teeth with twigs from named trees, anointing of the body with oil, and the use of eyewashes. In surgery, ancient Hindu medicine reached its zenith. Operations performed by Hindu surgeons included excision of tumours, incision and draining of abscesses, punctures to release fluid in the abdomen, extraction of foreign bodies, repair of anal fistulas, splinting of fractures, amputations, cesarean sections, and stitching of wounds.

China

According to tradition, Huangdi (the “Yellow Emperor”), one of the legendary founders of Chinese civilization, wrote the canon of internal medicine called the Huangdi neijing (Yellow Emperor’s Inner Classic) in the 3rd millennium BCE. Other famous works are the Mojing (known in the West as the “Pulse Classic”), composed about 300 CE, and the Yuzhuan yizong jinjian (“Imperially Commissioned Golden Mirror of the Orthodox Lineage of Medicine,” also known in English as the Golden Mirror), a compilation made in 1742 of medical writings of the Han dynasty (202 BCE–220 CE). Basic to traditional Chinese medicine is the dualistic cosmic theory of yinyang. The yang, the male principle, is active and light and is represented by the heavens. The yin, the female principle, is passive and dark and is represented by the earth. The human body, like matter in general, is made up of five elements: wood, fire, earth, metal, and water. With these are associated other groups of five, such as the five planets, the five conditions of the atmosphere, the five colours, and the five tones. Health, character, and the success of all political and private ventures are determined by the preponderance, at the time, of the yin or the yang, and the great aim of ancient Chinese medicine is to control their proportions in the body.

Hydrotherapy is probably of Chinese origin, since cold baths were used for fevers as early as 180 BCE. Acupuncture consists of the insertion into the skin and underlying tissues of a metal needle, either hot or cold.

Egypt

The Edwin Smith Papyrus dates as early as 3000 BC. The earliest known surgery in Egypt was performed in Egypt around 2750 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. Conversely, the Ebers papyrus (c. 1550 BC) is full of incantations and foul applications meant to turn away disease-causing superstition. The Kahun Gynaecological Papyrus treats women’s complaints, including problems with conception. The earliest known physician in ancient Egypt was Hesy-Ra, “Chief of Dentists and Physicians” for King Djoser in the 27th century BC. Also, the earliest known woman physician, Peseshet, practiced in Ancient Egypt at the time of the 4th dynasty.

Mesopotamia and Levant

History of Medicine

History of Medicine

The oldest Babylonian texts on medicine date back to the first half of the 2nd millennium BC. The most extensive Babylonian medical text, however, is the Diagnostic Handbook written by the physician Esagil-kin-apli of Borsippa, during the reign of the Babylonian king Adad-apla-iddina (1069-1046 BC). The Babylonians introduced the concepts of diagnosis, prognosis, physical examination, and medical prescriptions. They introduced the methods of therapy and etiology and the use of empiricism, logic and rationality in diagnosis, prognosis and therapy.

Greek and Roman

The first known Greek medical school opened in Cnidus in 700 BC. Alcmaeon, author of the first anatomical work, worked at this school. Temples dedicated to the healer-god Asclepius, known as Asclepieia functioned as centers of medical advice, prognosis, and healing. At these shrines, patients would enter a dream-like state of induced sleep known as “enkoimesis” not unlike anesthesia, in which they either received guidance from the deity in a dream or were cured by surgery. Some of the surgical cures listed, such as the opening of an abdominal abscess or the removal of traumatic foreign material, are realistic enough to have taken place. A towering figure in the history of medicine was the physician Hippocrates of Kos (ca. 460 BC – ca. 370 BC), is considered the “father of modern medicine. Most famously, Hippocrates invented the Hippocratic Oath for physicians, which is still relevant and in use today. Hippocrates began to categorize illnesses as acute, chronic, endemic and epidemic, and use terms such as, “exacerbation, relapse, resolution, crisis, paroxysm, peak, and convalescence”. Another of Hippocrates’s major contributions may be found in his descriptions of the symptomatology, physical findings, surgical treatment and prognosis of thoracic empyema. Hippocrates was the first documented chest surgeon and his findings are still valid. Herophilus of Chalcedon, working at the medical school of Alexandria placed intelligence in the brain, and connected the nervous system to motion and sensation. Erasistratus of Chios, connected the increased complexity of the surface of the human brain compared to other animals to its superior intelligence. The Greek Galen was one of the greatest surgeons of the ancient world and performed many audacious operations—including brain and eye surgeries.

Medieval Medical Science

Persian:

Roentgen

Roentgen

Virchow

Virchow

An Arabic manuscript, dated 1200 CE, titled Anatomy of the Eye, authored by al-Mutadibih. The translation of 129 works of ancient Greek physician Galen into Arabic by Hunayn ibn Ishaq and his assistants, and in particular Galen’s insistence on a rational systematic approach to medicine, set the template for Islamic medicine, which rapidly spread throughout the Arab Empire. Muslim physicians set up some of the earliest dedicated hospitals. Muhammad ibn Zakariya al-Razi (865-925) became the first physician to systematically use alcohol in his practice as a physician. His Comprehensive Book of Medicine, which introduced measles and smallpox, was very influential in Europe. Abu al-Qasim (Abulcasis), who some have called the father of modern surgery, wrote the Kitab al-Tasrif (1000), a 30-volume medical encyclopedia which was taught at Muslim and European medical schools until the 17th century. He used numerous surgical instruments, including some that are unique to women.In 1242 Ibn al-Nafis gave the first description of pulmonary circulation and coronary circulation. He also described the earliest concept of metabolism. Tashrih al-badan (Anatomy of the body) of Mansur ibn Ilyas (c.1390) contained comprehensive diagrams of the body’s structural, nervous and circulatory systems.

Greece:
Organised professional medicine re-emerged, with the foundation of the medical college (Schola Medica Salernitana) of Salerno in Italy in the 11th century. Rogerius Salernitanus composed his Chirurgia, which became the foundation for modern Western surgical manuals up to the modern time.

Renaissance Period
The development of modern neurology began in the 17th century with Vesalius, who described the anatomy of the brain and other organs; he had little knowledge of the brain’s function, thinking that it resided mainly in the ventricles. Understanding of medical sciences and diagnosis improved, but with little direct benefit to health care. Few effective drugs existed, beyond [opium] and quinine. Folklore cures and potentially poisonous metal-based compounds were popular treatments.

Modern Medical Science

Nightingale

Nightingale

nightingal2Medicine was revolutionized in the 19th century and beyond by advances in chemistry and laboratory techniques and equipment, old ideas of infectious disease epidemiology were replaced with bacteriology and virology. Bacteria and microorganisms were first observed with a microscope by Antonie van Leeuwenhoek in 1676, initiating the scientific field microbiology. Ignaz Semmelweis (1818–1865) in 1847 dramatically reduced the death rate of new mothers from child bed fever by the simple expedient of requiring physicians to clean their hands before attending to women in childbirth. His discovery pre-dated the germ theory of disease. Joseph Lister, in 1865 proved the principles of antisepsis in the treatment of wounds. Charles Darwin’s 1859 publication of The Origin of Species, Gregor Mendel (1822–1884) published in 1865 his books on pea plants, which would be later known as Mendel’s laws. The 1953 discovery of the structure of DNA by Watson and Crick opened the door to molecular biology and modern genetics. Louis Pasteur linked microorganisms with disease. Claude Bernard (1813–1878) published An Introduction to the Study of Experimental Medicine in 1865. Robert Koch (Nobel Prize1905), founded bacteriology, tubercle bacillus (1882) and the cholera bacillus (1883) and Koch’s postulates. The participation of women in medical care was brought about by Florence Nightingale. Nightingale set up the St Thomas hospital, post-Crimea, in 1852. Elizabeth Blackwell (1821–1910) became the first woman to formally study, and subsequently practice, medicine in the United States. Alexis Carrel and Henry Dakin developed the Carrel-Dakin method of treating wounds with an irrigation, Dakin’s solution, a germicide which helped prevent gangrene. Emil Kraepelin (1856–1926) introduced new medical categories of mental illness, which eventually came into psychiatric usage despite their basis in behavior rather than pathology or etiology. In the 1930s several controversial medical practices were introduced including inducing seizures (by electroshock, insulin or other drugs) or cutting parts of the brain apart (leucotomy or lobotomy). In 1954 Joseph Murray, J. Hartwell Harrison, M.D. and others accomplished the first kidney transplantation.

Bibliography

  • Porter, R. (1997). The Greatest Benefit to Mankind: A Medical History of Humanity from Antiquity to the Present. Harper Collins. ISBN 0-00-215173-1.
  • Rousseau, George S. (2003). Framing and Imagining Disease in Cultural History (Basingstoke: Palgrave Macmillan). [with Miranda Gill, David Haycock and Malte Herwig]. ISBN 1 – 4039 -1292 – 0
  • Sivin, Nathan (1993). “Huang-ti nei-ching 黃帝內經.” In Early Chinese Texts: A Bibliographical Guide, ed. by Michael Loewe: 196-215. Institute for East Asian Studies, University of California, Berkeley.
  • Unschuld, Paul U. (2003). Huang Di Nei Jing Su Wen: Nature, Knowledge, Imagery in an Ancient Chinese Medical Text. Berkeley and Los Angeles: University of California Press.
  • Walsh, James J. (1908, reprinted 2003). The Popes and Science; the History of the Papal Relations to Science During the Middle Ages and Down to Our Own Time. Kessinger Publishing. ISBN 0-7661-3646-9. from WorldCat [5] Review excerpts: