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Brief history of medicine
- 1. Brief History of Medicine Prof. Dr. Harlina Halizah Siraj Dept of Medical Education Faculty of Medicine UKM
- 2. Learning outcomes At the end of this module, learners would be able to: Explain the importance of history generally and medicine specifically. Illustrate the timelines that composed the history of medicine. Elaborate briefly the significant medical contributions of each civilization to mankind. Appreciate the in-depth values of human achievements throughout history
- 3. Contents Importance of history Timeline for history in medicine Brief review on : Prehistoric medicine Ancient Chinese medicine Ancient Indian medicine Ancient Egyptian medicine Ancient Babylonian medicine Greeks and Romans Middle Ages Islamic medicine The Renaissance 18th and 19th century 20th century 21st century
- 6. Why do we need to learn history? If you would understand anything, observe its beginning and its development. Aristotle The value of history. ..is that it teaches us what man has done and thus what man is. R. G. Collingwood In history, a great volume is unrolled for our instruction, drawing the materials of future wisdom from the past errors and infirmities of mankind. Edmund Burke Not just His-story, but also Her-story………….
- 7. Health & Sickness : Fundamental Questions Why do some man become sick, while others remain healthy? What causes sickness? Where does sickness come from? How do we stop/cure/treat sickness and then prevent death?
- 8. Flow of a `Fragile' Life HEALTHY SICKNESS Gets Better Worsens DEATH
- 11. Timeline of Medical History Prehistoric 8000 BC Ancient Egyptian 2000 BC Greeks & Romans 400 BC – 300 AD Ancient Chinese 3000 BC Ancient Indians 3000 BC Modern Medicine 18th – 21st century Middle Ages (Dark Ages) 500 – 1400 AD Islamic Medicine 700 – 1500 AD) AD Latin : anno domini `In the year of our Lord‘ (Birth of Christ) The Renaissance 1400 – 1700 AD Ancient Babylonian 2000 BC
- 12. Timeline of Medical History Prehistoric 8000 BC AD Latin : anno domini In the year of our Lord (Birth of Christ)
- 13. Prehistoric Medicine Believed in spirits and supernatural forces – good and bad. Sickness – as a result of failure to comply to wishes and likings of spirits and forces. Witch doctors ( Shamans) – mediators between man and the spirits. Dispensed first medications – herbs, animal stuffs, blood, human sacrifices. Archeological findings – primitive brain surgery – trepanning.
- 14. Perak Man : the respected shaman 1991. USM archeological team made a discovery of a burial cave, Gua Gunung Runtuh, Lenggong Perak Tengah. It contained the 11,000-year-old Perak Man, the region’s best-preserved Stone Age skeleton – and the only one found with a genetic skeletal disorder, Brachymesophalangia type A2.
- 16. Perak Man : the respected shaman The skeleton’s foetal position, surrounded by a cornucopia of objects, suggested to archaeologists that his deformity had elevated him to a well- respected shaman.
- 17. Perak Man : The Respected Shaman
- 18. Trepanning: to allow spirits to leave the body of the sick
- 19. Timeline of Medical History Ancient Chinese 3000 BC AD Latin : anno domini In the year of our Lord (Birth of Christ)
- 20. Ancient Chinese Medicine Dated 5,000 years ago, supporting documentation abut 2,000 years. Believed that man became sick if balance between natural elements were not maintained ( Yin & Yang concept) and the `chi’ or life energy was not flowing well. To cure / treat : to retain balance between all five elements (wood, fire, earth, metal and water) and chi to flow. Chinese physicians were also philosophers. Treatment : herbal, acupuncture
- 21. The first written documentation on traditional Chinese medicine is the Hung-Di Nei-Jing (Yellow Emperor's Cannon of Internal Medicine). The oldest medical textbook in the world, 800 BC. Contents : Foundation for theories of Chinese medicine - previous experience and theories of medicine,eg. the meridian theory, physiology, pathology, prevention, diagnosis, treatment, acupuncture.
- 22. QUOTES A good healer cannot depend on skill alone. A quote from the Yellow Emperor’s Classics of Medicine The superior doctor should first adjust the patient’s diet and life style. Only if that does not eliminate disease should the doctor go on to administer acupuncture and herbs. Sun Si Maio,the greatest doctor of the Tang Dynasty (618-907)
- 23. Timeline of Medical History Ancient Indians 3000 BC AD Latin : anno domini In the year of our Lord (Birth of Christ)
- 24. Ancient Indian Medicine Basis : Physical health is part of spiritual health. Ayurveda ( the science of living): a form of ancient Indian science of medicine, with eight disciplines : Internal medicine Surgery & anatomy ENT Paediatrics Toxicology Spirit medicine Science of rejuvenation Aphrodisiacs
- 25. Ancient Indian Medicine Famous ayurvedic practitioner : Chakara Concept : health and disease are not predetermined and life may be prolonged by human effort and attention to lifestyle. A physician who fails to enter the body of a patient with the lamp of knowledge and understanding can never treat diseases. He should first study all the factors, including environment, which influence a patient's disease, and then prescribe treatment. It is more important to prevent the occurrence of disease than to seek a cure. Chakara ( born 300BC)
- 27. Timeline of Medical History Ancient Egyptian 2000 BC AD Latin : anno domini In the year of our Lord (Birth of Christ)
- 28. Ancient Egyptian Medicine Concept : Illness was due to evil spirits or poisons and removing these from the body with prayers to the gods would cure the disease. Documentation & prescription of medicine Medical procedures & process of mummification
- 29. Eber Papyrus 1550 BC A 110-page scroll, which is about 20 meters long. The scroll contains some 700 magical formulas and remedies.
- 31. Timeline of Medical History Ancient Babylonian 2000 BC AD Latin : anno domini In the year of our Lord (Birth of Christ)
- 32. Ancient Babylonian (Mesopotamian) Medicine Revolved heavily around magic and supernaturalism. Documentation was included in the Assyrian copies of Babylonian texts, originated in the first half of the 2nd millennium BC. https://healthandfitnesshistory.com/ancient-medicine/babylonian-medicine/
- 33. Ancient Babylonian (Mesopotamian) Medicine Babylonian healthcare system - fairly well standardized, subject to some level of legal code. The Hammurabi Code (c. 2000 BC), inscribed on an 8-foot tall block of black diorite, covers doctor payment and malpractice. https://healthandfitnesshistory.com/ancient-medicine/babylonian-medicine/
- 34. Hammurabi Code (2000BC) - Lines 218 to 221 If the doctor has treated a man for a severe wound with lances of bronze and has caused the man to die, or has opened an abscess of the eye for a man and has caused the loss of the man’s eye, one shall cut off his hands. If a doctor has treated the severe wound of a slave of a poor man with a bronze lances and has caused his death, he shall render slave for slave. If he has opened his abscess with a bronze lances and has made him lose his eye, he shall pay money, half his price. If a doctor has cured the shattered limb of a gentleman, or has cured the diseased bowel, the patient shall give five shekels of silver to the doctor. https://healthandfitnesshistory.com/ancient-medicine/babylonian-medicine/
- 35. Timeline of Medical History Greeks & Romans 400 BC – 300 AD AD Latin : anno domini In the year of our Lord (Birth of Christ)
- 36. The Greeks Believed diseases were sent as a punishment from the gods. Treatments were aimed at pleasing the gods. Important figures : Hippocrates ( Father of Medicine – Hippocrates Oath ) Four humors – choleric, melancholic, sanguine & phlegmatic. Galen - One of the first physicians to use dissections to understand how the body works
- 37. Hippocrates Oath
- 38. Hippocrates Oath I swear by Apollo the physician, and Asclepius, and Hygieia and Panacea and all the gods and goddesses as my witnesses, that, according to my ability and judgement, I will keep this Oath and this contract: To hold him who taught me this art equally dear to me as my parents, to be a partner in life with him, and to fulfill his needs when required; to look upon his offspring as equals to my own siblings, and to teach them this art, if they shall wish to learn it, without fee or contract; and that by the set rules, lectures, and every other mode of instruction, I will impart a knowledge of the art to my own sons, and those of my teachers, and to students bound by this contract and having sworn this Oath to the law of medicine, but to no others. I will use those dietary regimens which will benefit my patients according to my greatest ability and judgement, and I will do no harm or injustice to them. I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly I will not give a woman a pessary to cause an abortion. In purity and according to divine law will I carry out my life and my art. I will not use the knife, even upon those suffering from stones, but I will leave this to those who are trained in this craft. Into whatever homes I go, I will enter them for the benefit of the sick, avoiding any voluntary act of impropriety or corruption, including the seduction of women or men, whether they are free men or slaves. Whatever I see or hear in the lives of my patients, whether in connection with my professional practice or not, which ought not to be spoken of outside, I will keep secret, as considering all such things to be private. So long as I maintain this Oath faithfully and without corruption, may it be granted to me to partake of life fully and the practice of my art, gaining the respect of all men for all time. However, should I transgress this Oath and violate it, may the opposite be my fate. Translated by Michael North, U.S. National Library of Medicine, 2002
- 40. The Romans – Public health hygiene The Romans realized that there was a link between dirt and disease. To improve public health, they built aqueducts to supply clean drinking water and sewers to remove wastes safely. Improved personal hygiene helped to reduce disease and Roman baths were places to socialise as well as stay clean
- 42. Timeline of Medical History Middle Ages (Dark Ages) 500 – 1400 AD AD Latin : anno domini In the year of our Lord (Birth of Christ)
- 43. Middle (Dark) Ages The fall of the Roman Empire – lack of public hygiene practices. People in Europe – lack of access to clean drinking water, regular bathing or a sewage system. Starvation and disease were common. Medicine in the middle ages was dominated by religion. Sickness - a punishment from God for sins Only way to cure someone was to pray for their forgiveness.
- 44. Middle (Dark) Ages Doctors were usually priests or other religious scholars. Hospitals were set up in monasteries and other religious establishments. The patients were given food and comforted by religious nursing staff but little else was done to cure their illness.
- 45. Middle (Dark) Ages Traditional cures, using herbal remedies and potions were seen as witchcraft and outlawed by the church. Laws stated that only trained and registered people could practice medicine.
- 46. Middle (Dark) Ages Biggest challenge : Black death, or Bubonic Plague. In 1347, an outbreak of bubonic plague broke out in Istanbul. Traders soon carried the disease throughout Europe and records show that in some areas it killed up to 90% of the population. (49 million people killed) Poor public hygiene, congested living condition
- 48. Timeline of Medical History Islamic Medicine 700 – 1500 AD) AD Latin : anno domini In the year of our Lord (Birth of Christ)
- 49. Islamic Medicine After the fall of the Roman Empire, the Arabic world was the centre of scientific and medical knowledge. Texts from Greece and Rome were translated into Arabic and studied by Islamic scholars. They developed and refined Hippocrate's theories and Islamic physicians began to use the regulation of diet, exercise and the prescription of medicinal herbs in the treatment of their patients.
- 50. Islamic Medicine Arabic pharmacists became skilled in the formulation of medicines from plants and minerals. Even though they did not know about microbes, they used alcohol to clean wounds which healed better and did not become infected.
- 51. Islamic Medicine Muslim practiced universal healthcare : Hospitals were not just for the wealthy and treated rich and poor alike. Large hospitals were involved in the training and licensing of doctors and pharmacists. Officials tested medicines to certify that they were safe and visited pharmacists to make sure that prescriptions were being made correctly.
- 52. Islamic Medicine Records show that Muslim doctors performed many different surgical operations including the removal of varicose veins, kidney stones and the replacement of dislocated limbs. They used sponges soaked in narcotic drugs which were placed over the patient's nose as early anaesthetics.
- 53. Islamic Medicine Most important medical books of its time was written by the physician Ali al-Husayn Abd Allah Ibn Sina (also known as Avicenna). His massive manuscript, called the Laws of Medicine, was completed around 1030 AD and translated into Latin in the 12th Century. This encyclopaedia of medicine contained five books detailing the formulation of medicines, diagnosis of disorders, general medicine and detailed therapies.
- 55. Az Zahrawi : Father of Modern Medicine
- 56. Timeline of Medical History The Renaissance 1400 – 1700 AD AD Latin : anno domini In the year of our Lord (Birth of Christ)
- 57. The Renaissance The Renaissance was a period in European history during which there was a revival in the ideas of ancient Rome and Greece. Culture, art, science and medicine were studied by aristocrats and scholars who prized themselves on their education.
- 58. The Renaissance Ideas flourished and the newly invented printing press allowed books to be produced quickly. (The printing press was a revolution in information technology and resulted in ideas spreading around)
- 59. The Renaissance Medical research was intensified during this period. Medicine remained dominated by the teachings of the church but physicians began to learn more about the human body. They read books translated from Arabic medical texts and began to study anatomy in a scientific and systematic way.
- 60. The Renaissance Andreas Vesalius and Leonardo Da Vinci dissected human bodies and made the first anatomical drawings. The church did not permit the dissection of 'God fearing bodies' so it was often the bodies of criminals or 'sinners' that were used. Doctors learned about anatomy from watching these dissections.
- 61. Renaissance : Da Vinci’s medical paintings
- 64. Timeline of Medical History Modern Medicine 18th – 21st century AD Latin : anno domini In the year of our Lord (Birth of Christ)
- 65. Modern Medicine : 18th - 19th century Two of the big medical advances of this time were: Vaccinations X-rays The study of microbes, or microbiology, was born and the increased knowledge of pathogenic microbes led to the development of new medicines to tackle infectious diseases. The pharmaceutical industry was born Surgery – discovery of anaesthesia & antiseptic
- 66. The Visit of The Doctor : 1867
- 68. Marie Curie (1867 – 1934) Nothing in life is to be feared, it only to be understood. Now is the time to understand more that we may fear less.
- 69. PBL 12
- 71. Manchester Medical School : 1904
- 74. Modern Medicine : 20th century Major advances in healthcare which include development of: Antibiotics : Penicillin - the discovery and development of antibiotics by Fleming, Florey and Chain. Insulin: Banting and Best's work to show that insulin can be used to treat diabetes. Other medicines: pharmaceutical laboratories around the world are constantly producing new treatments for diseases. Imaging techniques DNA & human diseases
- 75. Father of Modern Medical Education
- 78. 1891 - 1941
- 79. Modern Medicine : 21st century Human genome project It started in 1990 and completed in 2003. Genetic & medicine Genetic engineering Genetic manipulation & enhancement Ethic & medicine Dealing with the controversial issues
- 81. Dr. Francis S. Collins Head of Human Genome Project I started this journey of intellectual exploration to confirm my atheism. That now lay in ruins as the argument from the Moral Law ( and many other issues) forces me to admit the plausibility of the God hypothesis. Faith in God now seemed more rational than disbelief. Harlinasiraj2010©
- 83. What’s next? Personalized medicine is an emerging practice of medicine that uses an individual's genetic profile to guide decisions made in regard to the prevention, diagnosis, and treatment of disease.
- 84. Feb 1st 2016
- 85. CONGENITAL ZIKA VIRUS INFECTION Severe microcephaly
- 89. Artificial Intelligence in Healthcare
- 92. Conclusion Medicine continues to progress Main duty of medical healthcare providers are to preserve the nobility of the profession Be a part of history…leave a legacy behind….
- 93. Prof Dr. Mahmoud Fathalla (FIGO President – 1994 – 1997) What I fear most for the future is a world which is too technologically advanced, but too morally backward’