Articles

HISTORY OF MEDICINE

Dr. V.A.A. LAKSHMI, M.D., D.G.IO.,

Asst. Professor of Gynaecology & Obsterics

Guntur Medical College,Guntur.

            Throughout history people have tried to cure illness and restore health. The development of modern medicine not only is linked with old magical rites and religious creeds with primitive Opotherapy and classical Hippocrratism with dognatic doctrines and revoluionary discoveries but is also intimately associatred with the econocmi, intellectual and political conditions at different times. Medicine is one of the mightiest of all the individual and the society constantlyu facing new threats and menancws, but also offering new promises opening unexpected horizons for the future.

            The beginnings :- Although the origins of medicine are lost in the mists of time, archelogical evidence reveals that stone age people were ffamilliar with healing herbs and other plants n could also set fractured or broken bones. By 2000 B.C. Ehyptian Medicine had three main branches. Physicians used drugs and ointments surgeions treated fractures, priests dealt with evgil spirits. The first known physcian was an Egyptian lmhotep (2686-2613 B.C). In Mesopotamia, the Sumerians in turn developed their medicine.

            Spirits and healing :- In some forms of trraditional medicine, the main healing powers lie not with remedies such as herbs or surgery, but in people’s belief in the supernatural powers of the shaman or with-doctor. The witch doctor communicates with spirit world often while in trance or possessed state and calls upon the spirit to leave the patient’s body.

Herbal heling is probably the oldest form of medicine. The earliest Medicine text books from Egypt, Babylonia and China list hundreds of plant remedies. Some plants are seasonal, only certain parts were effective such as laves. They could be cooked, eaten fresh, drunk as a tea or inhaled as a vapor. Modern analysis shows that many ancient plant remedies contain medically active substances.

Ancient Medicine :- India’s medical system Ayurveda meaning knowledge of life began about 2400 year ago and  reached its basic present form by AD 500. It is mainly based on the Charaka Samhita and Sushruta Samhita texts, traditionally ascribed to the Physician Charaka (1000 B.c.) and the Surgeon Susruta (Ad 50 or 450). In Ayurvedic medicine, illness is seen as an imbalance of the body’s three main powers-bile, phlegm and wind. They are treated with herb minerals, operations, ritual chants, and offerings. In China, Medicine was mixed with religion Until A.D. 500, when professional doctors took over. China’s key text, the Huang Ti Nei Ching, is traditionally ascribed to the mythical Emperor Huang Ti.

In Ancient Greece History tells how the God Apollo invented healing and how Chiron the Centaur passed the knowledge to Asclepius God of medicine, and his daughters Hygeia, Goddess of health, and Panacea, Goddess of heeling. The cult of Asclepius, God of medicine, and his daughters hygeia, Goddess of health, and panacea, Goddess of healing. The cult of Asclepius arose in the 5^th century BC., alongside the work of Hippocrates of Kos (460-377B.C) Greece’s most famous physician. He and his followers left over 50 written works, which have guided doctors ever since. They described how doctors shold examine patients, look for causes of diseases in the diet or surroundings, advise simple remendieslike exercise and good food, and respect the body’s natural powers of healing. They also described how doctors should act and behave. Doctors still follow many of Hippcratic principles such as confidentiality.

Roman Medicine :- In 293 BC Plague swept through Rome and the turned to the Greek god ascleuius for help. Gradually Greek doctors moved to Rome bringing Greek ideas with them. The  first  physician to arive was Asclepiades (124-60BC). Two popular Roman encyclopedic works were De Re Medicina by Cornelius celsus (20BC-AD 45) Mmainly based on Hippocratic texts and Historia Naturalis by caius Plony the Elder (AD 23-69) which included surgery herbs magic and folklore.  But Claudius Galen (AD 130-200) anatomist, physician and theorists was  Rome’s  Greatest medical figure. He gollowed Hippocrates’ concept of the four humours, but also believed in a life spirit or Pneuma taken with each breath.

The Isalmic trradition:- By about the 5^th century AD. The Roman empire had declined and Europe was descending into the dark ages. Much of Greek and roman Medical Knowledge ws lost as physicians turned to superstition and religion. But Greco-Roman traditions were maintained further. In AD. 431 the biship Nestorius of Constantinople was accused of heresy by the Christian church. As a result he and his followers fled east as far as Persia. As they travelled they set up medical shools in Greece, Mescopotamia and persia, translated Greek and Roman medical works into Arabic. The Byzanthene empire centred on Constantinople condemned the followers of Nestorius but its rulers followed their example and set up medical centres and hospitals for the poor. From the 7^th century the followers of the prolphet Mohammad the Arrabic founder of the islamic religion invaded Persia, the Middle East, noth Africa and parts of spain. They adopted the translationof the Greek and Roman Medical works and set up medical schools and Hospitals in Baghdad, Cairo in Eqypt and Cordoba in Spain.

Magic and superstition :- Between the 5^th  and 15^th centuries in Europe, there was little progress in the sciences particularlu in Medicine. A few Medical schools flourished, influenced by lslamic practice, notably at Salermo in ltaly, Montepellier in France and Bologna in Italy, but every day medicine regressed into mixtures of herbalism magic and religious beliefs. In this early period the thoughts of Galen ruled medical field and were gradually adopted into the Christian view of disease as God’s punishment for people’s sins.

Renaissance and revolution :-  From 14^th century, renaissance or rebirth of Medicine spread from Italy across Europe. Galileo Galilei ( 1564-1642) who invented telescope pressed the argument that the earth is not the centre of the Universe. Inspired by him Leonardo da Vinci and Andress Vesalius began to dissect human corposes to discover the structures and functions of the body. Realdo Colombo Andrea Cesalpino and the English physician  William Harvey showed that blood circulates around the body, pumped by the heart. In Europe in the 17t^h century traditional treatments such as blood letting by blade or leech and cautery were still popular for all ailments. The English Hippocrates Thomas Sydenham (1624-1689) reminded doctors that their frist priority should be to treat their patients nottest theories or prescribe increasingly complex surgery or drugs. Sydenham’s ideas were admired by Hermann Boerhaave (1668-1738) a dutch Physician and Professor at Leiden University. Boerhaave was responsible for many of today’s teaching methods, such as involving students in Post-Mortems to show cause of death.

Advance in Diagnosis : Doctors started to belive that diseases were caused by malformation or malfunction of the body’s organs or systems. They invented a whole new range of techniques and devices for clinical diagnosis. In 1612 the ltalian sanctorius had experimented with taking body temperature, but not widely practised until 1880s. English Physician John Floyer in 1707 devised one minute watch and used for timing the pulse rate. In 1781 in Vienna, Leopold Auenbrugger devised percussion-tapping to the resonant quality of the sounds. The French doctor Reni Laennec (1781-1826) devised the stethoscope and carried out clinical research linking sounds to diseases.

Beyound the Human eye :- From the Mid 17^th century the Microscope revealed a whole New World of tissues and cells. In Bologna, Marcello Malpighi (1628-1694) studied micro-anatomy in animals and humans. He described the tiny blood vessels called capillaries. Johannes Muller (1801-1858) a German pioneered the Microssopic studay of diseased tissues and cells which is called cellular pathology. His pupil Theodar Schwann (1810-1882) developed the concept the cell as the basic’Unit’ of  life. Jokob Henle (1809-1885) wrote the frist text book of anatomy to describe cells and tissues as well as larger parts. Rudolf Virchow, student of Muller the first Professor of Pathology at Berlin is recognized as the founder of cellular pathology.

Germs and Disease :- The French bacteriologist louis Pasteur (1822-1895) helped to develop the ‘ Germ theory’ of disease. In 1876 Robert Koch a German doctor studied anthrax, the first disease to be identified that Mircobe is causative agent. In 1888 Pasteur’s Assistant Email Roux studied the Diptherial bacteria and its toxins. Earlier the English doctor Edward Jenner (1749-1823) had begun to introduce Cowpox fluid into the people to project them from small pox. of Muller the first Professor of Pathology at Berlin is recognized as the founder of cellular pathology.

Germs and Disease :- The French bacteriologist louis Pasteur (1822-1895) helped to develop the ‘ Germ theory’ of disease. In 1876 Robert Koch a German doctor studied anthrax, the first disease to be identified that Mircobe is causative agent. In 1888 Pasteur’s Assistant Email Roux studied the Diptherial bacteria and its toxins. Earlier the English doctor Edward Jenner (1749-1823) had begun to introduce Cowpox fluid into the people to project them from small pox.

Seeing into the Body was made possible by the Discovery of X – rays by German Physicist Wilhelm Rontgen in 1895.

Revolutionary century of Medicine : 20 th century has revolutionized the field of Medicine, chemotherpay was pioneered by German Paul Ehrlich (1854- 1915), who synthesized “Salvarsan” the first drug in the laboratory and used it for syphilis. In 1928 Alexander Flemming  A Scottish Researcher discovered Pencilin. Psycho analusis probing the unconscious by Viennese doctor sigmund Freud ( 1856-1939) developed the field of Psychairty.

It was not until Joseph Lister ( 1827-1912) the safe surgery began to develop after introducing the antiseptics to prevent infections. An American dentist Holace Wells (1815-1948) used Nitrous Oxide. Thomas Morton in 1846 tried Ether, thus began the modern era of anesthesia and Blood transfusions after the discovery of Blood Groups by Karl Land Steiner (1868-1943) facilitated safe surgery.

There are many indigenous or complimentary medical systems lkie Homeopathy, Accupuncture, Unani etc., in various parts of the world, which are beyond the scope of this topic.

Since then rapid changes in technology, modern Pharmocology, Micro invasive surgery, artificial devices, improved Nursing Cae, Emergency treatment facilities, immunology, public health etc., have completely revolutionized the History of Medicine. However the progress of Medicine involves complex questions of priorities, morals, ethics and resources.