MEDICINE IN THE ANCIENT WORLD

Medicine among Primitive Peoples

The first evidence of surgery is skulls from the stone

age. Some adults had holes cut in their skulls. At least
sometimes people survived the 'operation' because the
bone grew back. We do not know the purpose of the
'operation'. Perhaps it was performed on people with
head injuries to release pressure on the brain.
In the 19th and early 20th centuries anthropologists
studied primitive societies. Among them treatment for
injury and sickness was a mixture of common sense and
magic. People knew, of course, that falls cause broken
bones and fire causes burns. Animal bites or human
weapons cause wounds. Primitive people had simple
treatments for these things e.g. Australian Aborigines
covered broken arms in clay, which hardened in the hot
sun. Cuts were covered with fat or clay and bound up
with animal skins or bark. However primitive people had
no idea what caused illness. They assumed it was
caused by evil spirits or magic performed by an enemy.
The 'cure' was magic to drive out the evil spirit or break
the enemies spell.
Ancient Egyptian Medicine

In about 3000 BC the curtain rises on Egyptian

civilization. In a civilized society some people did
specialized jobs. One of these was the doctor.
The first doctor known to history was Sekhet-eanach
who 'healed the pharaoh's nostrils'. (We do not know
what was wrong with them). The second doctor we know
of was Imhotep (c. 2,600 BC) who was vizier or prime
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minister to the pharaoh. He was also a doctor and he
was so famous that after his death he was worshiped as
a god.
Much of Egyptian medicine still relied on magic.
However at least they could keep written records of
which treatments worked and which did not. In this way
medicine could advance.
The earliest known medical book is the Ebers Papyrus,
which was written about 1500 BC.
Egyptian doctors used a huge range of drugs obtained
from herbs and minerals. They were drunk with wine or
beer or sometimes mixed with dough to form a 'pill'.
Egyptian doctors also used ointments for wounds and
they treated chest complaints by getting the patient to
inhale steam.
The Egyptians believed that the human body was full of
passages that acted like irrigation canals. The Egyptians
knew that irrigation canals sometimes became blocked.
They reasoned that if the passages in a human body
became blocked it might cause illness. To open them
Egyptians used laxatives and induced vomiting.
However the Egyptians still believed that spells would
help the sick and they carried amulets to ward off
disease. Nevertheless they were beginning to seek a
physical cause for illness.
The Egyptians did have some knowledge of anatomy
from making mummies. To embalm a dead body they
first removed the principal organs, which would
otherwise rot.

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However Egyptian surgery was limited to such things as
treating wounds and broken bones and dealing with
boils and abscesses. The Egyptians used clamps,
sutures and cauterization. They had surgical instruments
like probes, saws, forceps, scalpels and scissors.
They also knew that honey helped to prevent wounds
becoming infected. (It is a natural antiseptic). They also
dressed wounds with willow bark, which has the same
effect.
Moreover the Egyptians were clean people. They
washed daily and changed their clothes regularly, which
must have helped their health.
There were some women doctors in Ancient Egypt.
Merit Ptah was a famous woman doctor who lived
around 2,700 BC.
Life in Egypt
Ancient Greek Medicine

The roots of modern medicine are in ancient Greece. On

the one hand most Greeks believed in a god of healing
called Asclepius. People who were ill made sacrifices or
offerings to the god. They then slept overnight in his
temple. They believed that the god would visit them in
their sleep (i.e. in their dreams) and when they woke up
they would be healed.
At the same time Greek doctors developed a rational
theory of disease and sought cures. However one did
not replace the other. The cult of Asclepius and Greek
medicine existed side by side.

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Medical schools were formed in Greece and in Greek
colonies around the Mediterranean. As early as 500 BC
a man named Alcmaeon from Croton in Italy said that a
body was healthy if it had the right balance of hot and
cold, wet and dry. It the balance was upset the body
grew ill.
However the most famous Greek doctor is Hippocrates
(C.460-377 BC). (Although historians now believe that
he was much less famous in his own time that was once
thought. It is believed that many of the medical books
ascribed to him were actually written by other men).
Hippocrates stressed that doctors should carefully
observe the patients symptoms and take note of them.
Hippocrates also rejected all magic and he believed in
herbal remedies.
A number of Greeks speculated that the human body
was made up of elements. If they were properly
balanced the person was healthy. However if they
became unbalanced the person fell ill.
Finally Aristotle (384-322 BC) thought the body was
made up of four humors or liquids. They were phlegm,
blood, yellow bile and black bile. If a person had too
much of one humor they fell ill. For instance if a person
had a fever he must have too much blood. The
treatment was to cut the patient and let him bleed.
The Greeks also knew that diet and exercise and
keeping clean were important for health.
Later Alexander the Great conquered Egypt. In 332 BC
he founded the city of Alexandria and a great medical
school was established there. Doctors in Alexandria
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dissected human bodies and they gained a much better
knowledge of anatomy. However little progress was
made in understanding disease.
Life in Greece
Roman Medicine

The Romans conquered Greece and afterwards doctors

in the Roman Empire were often Greeks. Many of them
were slaves. Doctors had low status in Rome. However
the state paid public doctors to treat they poor. The
Romans also had hospitals called valetudinaria for their
wounded soldiers.
Later in Roman times Galen (130-200 AD) became a
famous doctor. At first he worked treating wounded
gladiators. Then in 169 AD he was made doctor to
Commodus, the Roman Emperor's son. Galen was also
a writer and he wrote many books.
Galen believed the theory of the four humors. He also
believed in treating illness with opposites. So if a patient
had a cold Galen gave him something hot like pepper.
Galen was also interested in anatomy. Unfortunately by
his time dissecting human bodies was forbidden. So
Galen had to dissect animal bodies including apes.
However animal bodies are not the same as human
bodies and so some of Galen's ideas were quite wrong.
Unfortunately Galen was a very influential writer. For
centuries his writings dominated medicine.
In the first century BC a Roman named Varro suggested
that tiny animals caused disease. They were carried
through the air and entered the body through the nose
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or the mouth. Unfortunately with no microscopes there
was no way of testing his theory.
The Romans were also skilled engineers and they
created a system of public health. The Romans noticed
that people who lived near swamps often died of
malaria. They did not know that mosquitoes in the
swamps carried disease but they drained the swamps
anyway.
The Romans also knew that dirt encourages disease
and they appreciated the importance of cleanliness.
They built aqueducts to bring clean water into towns.
They also knew that sewage encourages disease. The
Romans built public lavatories in their towns. Streams
running underneath them carried away sewage.
The Romans also had military hospitals called
Valetudinaria.In the late 4th century The Roman Empire
split in two, east and west. Meanwhile Christians
believed they had a duty to care for the sick and they
founded many hospitals in the Eastern Roman Empire in
the late 4th century. One of the first was built by Basil of
Caesarea (c. 330–379) in what is now Turkey.
Life in Rome
Meanwhile in India surgeons were highly skilled. They
were pioneers of plastic surgery. They performed an
operation to reconstruct the nose (rhinoplasty). There
were hospitals in India and Sri Lanka before 200 BC.

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MEDICINE IN THE MIDDLE AGES
After the fall of Rome in the 5th century the eastern half
of the Roman Empire continued (we know it as The
Byzantine Empire) and later Muslims took their
knowledge of medicine from there. In the 9th century a
man named Hunain Ibn Ishaq traveled to Greece
collecting Greek books. He then returned to Baghdad
and translated them into Arabic. Later the same works
were translated into Latin and passed back to western
Europe.
In the Middle Ages learning flourished in Europe. Greek
and Roman books, which had been translated into
Arabic were now translated into Latin. In the late 11th
century a school of medicine was founded in Salerno in
Italy. (Women were allowed to study there as well as
men). In the 12th century another was founded at
Montpellier. In the 13th century more were founded at
Bologna, Padua and Paris. Furthermore many students
studied medicine in European universities. Medicine
became a profession again.
However ordinary people could not afford doctors fees.
Instead they saw 'wise men' or 'wise women', whose folk
remedies were probably, at least sometimes, better than
medicine!
In the Middle Ages medicine was dominated by the
ideas of Galen and the theory of the four humors.
Medieval doctors were great believers in blood letting. Ill
people were cut and allowed to bleed into a bowl.
People believed that regular bleeding would keep you
healthy. So monks were given regular blood letting
sessions.
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Medieval doctors also prescribed laxatives for purging.
Enemas were given with a greased tube attached to a
pigs bladder.
Doctors also prescribed baths in scented water. They
also used salves and ointments and not just for skin
complaints. Doctors believed it was important when
treating many illnesses to prevent heat or moisture
escaping from the affected part of the body and they
believed that ointments would do that.
Medieval doctors also examined a patient's urine. The
color, smell and even taste of urine were important.
Astrology was also an important part of Medieval
medicine. Doctors believed that people born under
certain zodiac signs were more susceptible to certain
ailments.
In the 13th century a new type of craftsman emerged in
towns. He (or she because not all were male) was the
barber-surgeon. They cut hair, they pulled teeth and
they performed simple operations such as amputations
and setting broken bones.
In the Middle Ages the church operated hospitals. In 542
a hospital called the Hotel-Dieu was founded in Lyon,
France. Another hospital called the Hotel-Dieu was
founded in Paris in 1660. The number of hospitals in
western Europe greatly increased from the 12th century.
In them monks or nuns cared for the sick as best they
could. Meanwhile, during the Middle Ages there were
many hospitals in the Byzantine Empire and the Islamic
world.

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In the Middle Ages monasteries had sanitation. Streams
provided clean water. Dirty water was used to clear
toilets, which were in a separate room. Monks also had
a room called a laver where they washed their hands
before meals.
However for most people sanitation was non-existent. In
castles the toilet was simply a long passage built into the
thickness of the walls. Often it emptied into the castle
moat. Despite the lack of public health many towns had
public bath-houses were you could pay to have a bath.
From the mid-14th century the church allowed some
dissections of human bodies at medical schools.
However Galen's ideas continued to dominate medicine
and surgery.
MEDICINE IN THE 16th CENTURY
During the 16th century there were some improvements
in medicine. However it remained basically the same as
in the Middle Ages. Medicine was still dominated by the
theory of the four humors. In 1546 a man Girolamo
Fracastoro published a book called On Contagion. He
suggested that infectious diseases were caused by
'disease seeds', which were carried by the wind or
transmitted by touch. Unfortunately there was no way of
testing his theory.
In 1478 a book by the Roman doctor Celsus was
printed. (The printing press made all books including
medical ones much cheaper). The book by Celsus
quickly became a standard textbook. However in the
early 16th century a man named Theophrastus von
Hohenheim (1493-1541) called himself Paracelsus
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(meaning beyond or surpassing Celsus). He denounced
all medical teaching not based on experiment and
experience. However traditional ideas on medicine held
sway for long afterwards.
However surgery did become a little more advanced in
the 16th century. Leonardo Da Vinci (1452-1519)
dissected some human bodies and made accurate
drawings of what he saw.
However the greatest surgeon of the age was Andreas
Vesalius (1514-1564). He did many dissections and
realized that many of Galen's ideas were wrong. In 1543
he published a book called The Fabric of the Human
Body. It contained accurate diagrams of a human body.
Vesalius's great contribution was to base anatomy on
observation not on the authority of writers like Galen.
Another great surgeon was Ambroise Pare. In the 16th
century surgeons put oil on wounds. However in 1536
during the siege of Turin Pare ran out of oil. He made a
mixture of egg whites, rose oil and turpentine and
discovered it worked better than oil. Pare also designed
artificial limbs.
In 1513 a man named Eucharius Roslin published a
book about childbirth called Rosengarten. In 1540 an
English translation called The Birth of Mankind was
published. It became a standard text although midwives
were women.
Syphilis was common in the 16th century. The standard
treatment was mercury administered with a urethral
syringe. In the 16th century syringes were also used to
irrigate wounds with wine.
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MEDICINE IN THE 17TH CENTURY
In the 17th century medicine continued to advance. In
the early 17th century an Italian called Santorio invented
the medical thermometer.
In 1628 William Harvey published his discovery of how
blood circulates around the body. Harvey realized that
the heart is a pump. Each time it contracts it pumps out
blood. The blood circulates around the body. Harvey
then estimated how much blood was being pumped
each time.
Unfortunately in the 17th century medicine was still
handicapped by wrong ideas about the human body.
Most doctors still thought that there were four fluids or
'humors' in the body, blood, phlegm, yellow bile and
black bile. Illness resulted when you had too much of
one humor. Nevertheless during the 17th century a more
scientific approach to medicine emerged and some
doctors began to question traditional ideas.
Apart from Harvey the most famous English doctor of
the 17th century was Thomas Sydenham (1624-1689).
He is sometimes called the English Hippocrates
because he emphasized the importance of carefully
observing patients and their symptoms.
In the 17th century medicine was helped by the
microscope (invented at the end of the 16th century).
Then in 1665 Robert Hooke was the first person to
describe cells in his book Micrographia.
Finally in 1683 Antonie van Leeuwenhoek observed
microorganisms. However he did not realise they

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caused disease. Meanwhile in 1661 Robert Boyle
published the Skeptical Chemist, which laid the
foundations of modern chemistry.
In the early 17th century doctors also discovered how to
treat malaria with bark from the cinchona tree (it
contains quinine).
The Chinese invented the toothbrush. (It was first
mentioned in 1498). Toothbrushes arrived in Europe in
the 17th century. In the late 17th century they became
popular with the wealthy in England.
MEDICINE IN THE 18TH CENTURY
During the 18th century medicine made slow progress.
Doctors still did not know what caused disease. Some
continued to believe in the four humors (although this
theory declined during the 18th century). Other doctors
thought disease was caused by 'miasmas' (odorless
gases in the air).
However surgery did make some progress. The famous
18th century surgeon John Hunter (1728-1793) is
sometimes called the Father of Modern Surgery. He
invented new procedures such as tracheotomy.
Furthermore during the 18th century a number of
hospitals were founded. In 1724 Guys Hospital was
founded with a bequest from a merchant named
Thomas Guy. St Georges was founded in 1733 and
Middlesex Hospital in 1745. Hospitals were also founded
in Bristol in 1733, York in 1740, Exeter in 1741 and
Liverpool in 1745. The first civilian hospital in America
opened in Philadelphia in 1751.

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In the late 18th century and early 19th century
dispensaries were founded in many towns. They were
charities were the poor could obtain free medicines.
In the 18th century many sailors suffered from scurvy
(vitamin c deficiency). However a Scottish surgeon
named James Lind discovered that fresh fruit or lemon
juice could cure or prevent scurvy. He published his
findings in 1753 as A Treatise on the Scurvy.
In 1792 Luigi Galvani discovered that frogs legs twitch if
given an electric shock, showing that electricity plays a
part in the nervous system.
A major scourge of the 18th century was smallpox.
However in the 18th century people realized that
milkmaids who caught cowpox were immune to
smallpox. In 1796 Edward Jenner introduced
vaccination. (Its name is derived from the Latin word for
cow, Vacca). The patient was cut then matter from a
cowpox pustule was introduced. The patient gained
immunity to smallpox. (Jenner was not the first person to
think of this but it was due to his work that it became a
common practice). Unfortunately nobody knew how
vaccination worked.
During the 18th century superstition declined. In 1700
many people believed that scrofula (a form of tubercular
infection) could be healed by a monarch's touch.
(Scrofula was called the kings evil). Queen Anne
(reigned 1702-1714) was the last British monarch to
touch for scrofula. Despite the decline of superstition
there were still many quacks in the 18th century. Limited
medical knowledge meant many people were desperate
for a cure. One of the most common treatments, for the
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wealthy, was bathing in or drinking spa water, which
they believed could cure all kinds of illness.
During the 18th century the mentally ill were not
regarded as 'truly' human. It was thought that they did
not have human feelings. They were therefore confined
in chains. People paid to visit asylums and see the
insane as if they were animals in a zoo.
However in 1793 a doctor called Philippe Pinel argued
that the insane should be released and treated
humanely. As an experiment he was allowed to release
some patients. The experiment worked and attitudes to
the insane began to change.
In 1792 a Frenchman named Dominique-Jean Larrey
created an ambulance service for wounded men.
Life in the 18th Century
MEDICINE IN THE 19TH CENTURY
During the 19th century medicine made rapid progress.
In 1816 a man named Rene Laennec invented the
stethoscope. At first he used a tube of paper. Later he
used a wooden version.
In 1822 a trapper named Alexis St Martin was shot in
the stomach. The wound healed leaving a hole into his
stomach. A doctor named William Beaumont found out
how a stomach works by looking through the hole.
During the 19th century there were several outbreaks of
cholera in Britain. It struck in 1832, 1848, 1854 and
1866. During the 1854 epidemic John Snow (1813-

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1858) showed that cholera was transmitted by water.
However doctors were not certain how.
Later Louis Pasteur (1822-1895) proved that
microscopic organisms caused disease. In the early
19th century many scientists believed in spontaneous
generation i.e. that some living things spontaneously
grew from non-living matter. In a series of experiments
between 1857 and 1863 Pasteur proved this was not so.
Once doctors knew what caused disease they made
rapid headway in finding cures or prevention.
In 1880 Pasteur and a team of coworkers searched for a
cure for chicken cholera. Pasteur and his team grew
germs in a sterile broth. Pasteur told a coworker to inject
chickens with the germ culture. However the man forgot
and went on holiday. The germs were left exposed to
the air. Finally, when he returned the man injected
chickens with the broth. However they did not die. So
they were injected with a fresh culture. Still they did not
die.
Pasteur realized the germs that had been left exposed
to the air had been weakened. When the chickens were
injected with the weakened germs they had developed
immunity to the disease.
Pasteur and his team went on to create a vaccine for
anthrax by keeping anthrax germs heated to 42-43
degrees centigrade for 8 days.
In 1882 they created a vaccine for rabies. A co-worker
dried the spines of rabbits that had contracted the
disease in glass jars. Pasteur tried giving a series of
injections made from the dried spines to animals to test
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the remedy. Then, in 1885, Pasteur successfully used
the vaccine on a boy who had been bitten by a rabid
dog. Pasteur also invented a way of sterilizing liquids by
heating them (called pasteurization). It was first used for
wine (in 1864) and later for milk.
Meanwhile In 1875 Robert Koch (1843-1910) isolated
the germ that causes anthrax. In 1882 he isolated the
germ that causes tuberculosis and in 1883 he isolated
the germ that causes cholera in humans.
Meanwhile the organism that causes leprosy was
discovered in 1879. The germ that causes typhoid was
isolated in 1880. The germ that causes diphtheria was
discovered in 1882 by Edwin Klebs. In 1884 the germs
that cause tetanus and pneumonia were both
discovered. Immunization against diphtheria was
invented in 1890. A vaccine for typhoid was invented in
1896.
Surgery was greatly improved by the discovery of
Anesthetics. As early as 1799 the inventor Humphry
Davy (1778-1829) realized that inhaling ether relieved
pain. Unfortunately decades passed before it was
actually used by a man named Crawford Long in an
operation in 1842.
James Simpson (1811-1870), who was Professor of
Midwifery at Edinburgh University, began using
chloroform for operations in 1847. In 1884 cocaine was
used as a local anesthetic. From 1905 Novocain was
used.
In 1865 Joseph Lister (1827-1912) discovered antiseptic
surgery, which enabled surgeons to perform many more
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complicated operations. Lister prevented infection by
spraying carbolic acid over the patient during surgery.
German surgeons developed a better method. The
surgeons hands and clothes were sterilized before the
operation and surgical instruments were sterilized with
superheated steam.
Rubber gloves were first used in surgery in 1890.
Anesthetics and antiseptics made surgery much safer.
They allowed far more complicated operations.
In 1851 Herman von Helmholtz invented the
ophthalmoscope. In 1853 two men, Alexander Wood
and Charles Pravaz invented hypodermic needles. Then
in 1866 Clifford Allbut invented the clinical thermometer.
In 1895 x-rays were discovered by Wilhelm Roentgen.
The same year aspirin was invented.
Nursing was greatly improved by two nurses, Florence
Nightingale (1820-1910) and Mary Seacole (1805-1881)
who both nursed soldiers during the Crimean War 1853-
56. In the USA Clara Barton founded the American Red
Cross in 1881.
Meanwhile in the 19th century several more hospitals
were founded in London including Great Ormond Street
Children's Hospital (1852). In 1864 Jean Henri Dunant
founded the international Red Cross.
Life in the 19th Century
MEDICINE IN THE 20TH CENTURY
Medicine made huge advances in the 20th century. The
first non-direct blood transfusion was made in 1914.

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Insulin was first used to treat a patient in 1922. The EEG
machine was first used in 1929. Meanwhile many new
drugs were developed. In 1910 the discovered
salvarsan, a drug used to treat syphilis was discovered.
In 1935 prontosil was used to treat blood poisoning
Later it was discovered that the active ingredient of the
dye was a chemical called sulphonamide, which was
derived from coal tar. As a result in the late 1930s a
range of drugs derived from sulphonamide were
developed.
Antibiotics were discovered too. Penicillin was
discovered in 1928 by Alexander Fleming but it was not
widely used till after 1940. Another antibiotic,
streptomycin was isolated in 1944. It was used to treat
tuberculosis. They were followed by many others.
Meanwhile the iron lung was invented in 1928 and in
1943 Willem Kolff built the first artificial kidney machine.
(The first kidney transplant was performed in 1950 by
Richard Lawler).
In Britain the health of ordinary people greatly improved
when the National Health Service was founded in 1948.
In 1953 Jonas Salk announced he had a vaccine for
poliomyelitis. A vaccine for measles was discovered in
1963.
Meanwhile surgery made great advances. The most
difficult surgery was on the brain and the heart. Both of
these developed rapidly in the 20th century. A Swede
named Rune Elmqvist invented the first implantable
pacemaker in 1958. The first heart transplant was

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performed in 1967 by Christiaan Barnard. The first
artificial heart was installed in 1982. The first heart and
lung transplant was performed in 1987.
The laser was invented in 1960. In 1964 it was used in
eye surgery for the first time. Meanwhile the invention of
fiber optics in the 1950s made possible the development
of endoscopes in the 1960s.
Treatment for infertility also improved in the late 20th
century. The first test tube baby was born in 1978.
In the late 20th century medicine continued to develop
rapidly. In 1980 the World Health Organisation
announced that smallpox had been eradicated. However
in 1981 a terrible new disease called AIDS was isolated.
Meanwhile in 1975 Computerized Axial Scanning or
CAT was introduced. In 1983 Magnetic Resonance
Imaging or MRI was introduced. Synthetic skin was
developed in 1986 and gene therapy was introduced in
1990.
MEDICINE IN THE 21ST CENTURY

In the early 21st century new types of transplant were

performed. In 2005 the first face transplant took place.
Then in 2011 the first leg transplant was carried out.
Finally in 2012 the first womb transplant was carried out.
A Timeline of Medicine
A Brief History of Dentistry
A Brief History of Life Expectancy
A Brief History of Surgery
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A Brief History of Washing
A Brief History of Public Health
Home
Last revised 2017

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