1. Dr Samuel taiwo alawode samueltaiwo@windsor.edu
HISTORY OF MEDICINE
Dr Samuel taiwo alawode

2. On the Marble
If no use were to be made of labors of the past ages, the world must remain in the infancy of Knowledge.
- CICIRO

3. Prehistoric Medicine

4. Prehistory: Timeline
Prehistory is a term used to describe the period before recorded history.
The term "prehistory" can be used to refer to all time since the beginning of the universe, although it is more often used in referring to the period of time since life appeared on Earth, or even more specifically to the time since human-like beings appeared.
The date marking the end of prehistory, that is the date when written historical records become a useful academic resource, varies from region to region. For example, in Egypt it is generally accepted that prehistory ended around 3200 BC.

5. Knowledge about Prehistoric era
Anthropology
Artifacts
Cave engraving

6. Causes of disease
Magico-religious or supernatural ideas dominated as the cause of disease in primitive society.
Diseases were believed to be due to:
- Supernatural power like evil spirit, demons & god
- Rational cause like injury etc.
- Unknown terror (thunderstorm, fire, water, rain, sun, moon, animals, etc.)

7. Diseases of prehistoric era
Physically men were affected primarily by degenerative joint disease, fractures, respiratory diseases like sinusitis, bronchitis, digestive disturbances, skin disease.
Various cancers are identifiable in the skeleton. Primary bone cancer is rare, but the skeleton is a common site for the secondary spread of cancerous growth from other tissues.
Specific traces in the skeleton system suggests certain infection like tuberculosis (traces on the ribs and tends to destroy the bodies of the lumbar vertebrae), congenital syphillis (Hutchison’sincisor), leprosy (damage to the bones of the face, fingers, and toes)
Life expectancy was years.

8. Shamans: the healers
Shamans or Sorcerers, were considered as intermediate between human world & spiritual world.
He use to wore monstrous animal mask to frighten the evil spirits causing illness.
Shamans were considered to be able to contact supernatural powers and to remove the evil spirits to cure the patients.

9. Trephining
Trephining was the process in which shamans use to make a perforation in the skull to expel the demon or evil spirit.
This was practiced to cure headache, epilepsy or tumours.
For triphining they used sharpened edges of stones and flints.

10. Healing art in Prehistoric era
Treatment for Fracture
They were able to set broken or fractured bones using clay material.
Clay used to set hard so that the bone could heal properly.
Healing of open wound
They used pincers of certain ant species to heal an open wound.
They allowed the ant to stand above the wound until it bit, then its head was removed allowing the pincers to remain and hold close the wound.

11. Prehistoric era and Naturopathy
They use to eat clay and earth as well as they used to apply it externally.
Also, early humans could have learned about the use of various healing clays by observing animal behavior.
Such clay is used both internally and externally, such as for treating wounds, and after surgery.
The reflection of same is seen in Naturopathic process of mud therapy.

12. Ancient Egyptian Medicine
Egyptian Medicine 3000–500 BC

13. Egypt
The Egyptian Empire existed over 5,000 years ago, and lasted until 500 BC B C A D F E

14. Egyptian society
The Egyptian Empire was very wealthy because of its fertile soil, and had strong rulers who took over other lands. They built large cities and traded with distant countries such as China.
The wealthier people were educated, and could afford doctors to treat their illnesses. They believed in cleanliness and followed a structured religion which dictated that they needed their bodies in an afterlife.
An important library was built at Alexandria.
The library contained reference books which allowed people to study and learn about medicine.

15. Egyptian society
Religion: Egyptians believed that they would need their bodies in the afterlife, and so preserved them by embalming them. This meant removing most internal organs and wrapping the body in bandages.
Egyptians believed that their bodies were required for the afterlife, and so they practised mummification to preserve the bodies of the dead.
This involved removing all the internal organs, except the heart, treating the body with spices (embalming) and then wrapping it in bandages as a mummy.
Education: Egypt’s wealth enabled some people to study medicine and to become physicians (doctors). Others became skilled craftsmen who could make medical instruments.
Communications: Their widespread trading brought them new medicinal plants and introduced them to new medial ideas from different countries.
Technology: The new discoveries that were made could be written down on papyrus, a type of paper made from reeds. This meant their discoveries could be passed on to other physicians.

16. Religion Very Important Temples Priests Charms
Alternative medical care from master physicians
Charms
Still used extensively

17. The Afterlife? Elaborate death ritual Embalming Procedure
Directed by Priests
Uses sophisticated tools and techniques
HOWEVER
It is not a medical procedure
He is already dead!

18. Mummification
Excessive respect for the Dead body
Will hinder medical developments for many years
Sacred Body does not allow for exploration or experimentation.
Dissection Forbidden
(A) ANUBIS The priest in charge of the mummification wore the mask of Anubis (the god of the dead). (B) INCENSE A priest stands by, holding sweet-smelling incense. (C) WRAPPING THE BODY The body, or mummy, was wrapped in layers of linen before being placed in the coffin. (D) NATRON Natron, a kind of soda, was placed in the body to dry it out before it was wrapped in linen. (E) SOAKING THE BANDAGES Sometimes, linen strips were soaked in plaster so they would harden when dry.

19. Hieroglyphics Development of Writing Papyrus Pictographs
Allows ideas to be transferred
Can spread throughout Egypt
Can be passed down through generations

20. Who were the Medical Care Givers?
“It is seven days from yesterday since I saw my love,
And Sickness has crept over me,
My limbs have become heavy,
I cannot feel my own body.
If the Master-Physicians come to me
I gain no comfort from their remedies.
And the priest-magicians have no cures,
My sickness is not diagnosed.
My love is better by far for me than any remedies.
She is more important than all the books of medicine.”
Egyptian Love Poem c1500 BC

21. Imphotep – god of medicine
Master Physicians
can be afforded by the very wealthy
Pharoah Zozer’s Physician
Adviser
Architect on some Pyramids
Healer
c2600 BC
Becomes God of Medicine
For Greeks and Egyptians
c500 BC
Imhotep was a personal doctor to the Pharaoh c BC. He was made a god and worshipped as the founder of Egyptian medicine. People believed that leaving gifts before his statue in temples would ensure a cure for their illness.

22. Egyptian’s medical knowledge and beliefs
Egyptians had a reasonable knkowledge about the vital organs, such as the brain, liver, lungs and heart – but they did not know their functions.
They knew about the pulse and that blood carried air and water. They believed, however, that the blood flowed from the heart to all parts of the body through more than 40 channels.
They believed that illness was caused by food rotting in the bowel, which produced bad gases. These then travelled along the channels.
They though these bad gases blocked the channels, stoppiing the flow of blood and causing disease. For example, a red, swollen knee told them a channel in the leg was blocked just above the knee.
Consequently, they applied their knowledge about removing blockaged in irrigation channels to medicine, performing somple surgery like removing cysts.

23. The Nile Theory
Attempt to Explain how the Body works and why people get sick
Related to their Natural Environment and their understanding of how the world works
River Nile
Channels (River)
Mixture of Blood and Air
Flows from the centre to extremeties
Disease
Caused by blockages of the channels
Caused by rotting food
Letting off gases
Prevents normal flow
A Rational Explanation

24. Hieroglyphic writing
Hieroglyphic method of writing contained a combination of logographic and alphabetic elements.
Papyrus are written mostly in hieroglyphic writing.

25. Papyrus
Papyrus is a thick paper-like material produced from the pith of the papyrus plant, Cyperus papyrus.
These papyri were used to record documents related to medicine, religion, philosophy, mathematics, magic etc.
Egyptians wrote there inscription on papyri mostly in Hieroglyphic language.
There were several papyri related to medical texts but Edwin Smith Papyrus and Ebers Papyrus were the most interesting and well known.

26. Ebers and Smith Papyri Smith Papyrus Ebers Papyrus
C1700 BC (but refers to Imphotep’s era)
Surgical treatments for wounds
Ebers Papyrus
C1500 BC
110 Pages
Treatments for diseases
Herbal Remedies
Remedies used by Gods
Incantation and foul application meant for disease causing demons

27. List of Medical Papyrus
Hearst Papyrus (20th century BC): Medical text relating to urinary bladder, blood, hair and piles. It also included treatment for cancer.
Ramesseum Medical Papyrus (18th century BC): Related to ophthalmology, Gynaecology, muscles & tendon, and Paediatrics
Chester Beatty Papyrus (12th century BC): For headache and anorectal ailments
Brooklyn Papyrus (4th century BC): Ailments for poison
Carlsberg Papyrus (2nd century BC): Deals with eye disease and Pregnancy

28. Egyptian treatments
Personal cleanliness was part of the Egyptian religion. The Greek historian, Herodotus, wrote in the 5th century BC:
“…[the Egyptians] purge themselves … for they think that all diseases stem from the foods they eat … They wear newly washed linen clothing. They practise circumcision for the sake of cleanliness. Twice a day and every night they wash in cold water.”

29. Herbal, animal and mineral treatments
The Egyptians recorded on papyrus thousands of remedies made from plants, animals, minerals and other ingredients. These examples are from medical documents dated from around 1500 BC:
To drive away inflammation of the eyes, grind the stems of the juniper of Byblos, steep them in water, apply to the eyes of the sick person and he will be quickly cured.
For diseases of the bladder: Bread in a rotten condition. The doctor must use it to fight the sickness…
Quotes from the Ebers' Papyrus, c. 1550

30. Mix brain-of-tortoise with honey. Place on the eye and say:
Cure for cataracts:
Mix brain-of-tortoise with honey. Place on the eye and say:
There is a shouting in the southern sky in darkness, There is an uproar in the northern sky, The Hall of Pillars falls into the waters. The crew of the sun god bent their oars so that the heads at his side fall into the water, Who leads hither what he finds? I lead forth what I find. I lead forth your heads. I lift up your necks. I fasten what has been cut from you in its place. I lead you forth to drive away the god of Fevers and all possible deadly arts.
Quote from the Ebers' Papyrus, c. 1550

31. Egyptian surgical treatments
Egyptian surgery included mending broken bones and removing cysts, but no major surgery was done.
Egyptian religion required that the body stayed intact, meaning that embalmers extracted organs through small incisions and no dissections happened.
Treatment for a broken nose from the Papyrus, 1550 BC:
“…clean his nose with two plugs of linen and then insert two plugs soaked in grease into his nostrils. You should make him rest until the swelling has gone down, you should bandage his nose with stiff rolls of linen and treat him with lint every day until he recovers.”

32. Medical Kit knives drill saw forceps or pincers censer hooks
bags tied with string
beaked vessel
vase with burning incense
Horus eyes
scales
pot with flowers of Upper and Lower Egypt
pot on pedestal
graduated cubit or papyrus scroll without side knot (or a case holding reed scalpels)
shears
spoons.

33. Medical Kit

34. Importance of Egyptian Medicine
The oldest historic phase of medicine known to us is that of ancient Medicine.
All future development of medicine had some glimpses of Egyptian medicine.
Egyptian medicine enjoyed great fame in antiquity.
Egyptians are credited with being the first to use and record advanced medical practices.
Egyptian medicine played a dominant role in the history of ancient medicine for about 2500 years and then it was replaced by Greek medicine

35. Knowledge of Physiology
They had good knowledge of physiology which they derived from embalming the dead body.
They were able to cure night blindness by feeding with liver.
They supposed that the disease to which men are subjected proceed from the food they use.
Egyptian physicians were aware of the existence of the pulse and of a connection between pulse and heart.
They could not discriminate between blood vessels, nerves and tendon.

36. Concept of disease
The Egyptians believed that disease and death were caused by a god, a spirit, or some other supernatural force.
The healers often used incantations and magic as part of treatment.
In Egyptian time priest, doing magic & incantations, and physicians were the one and same.

37. Common diseases of their time
They suffered from the injuries and deformities caused by hard labor.
They suffered from insect born diseases such as malaria and trachoma, an eye disease, small pox, measles, tuberculosis, and cholera.
It is believed that there were occasional outbreaks of the bubonic plague.
Leprosy, which had originated in Egypt, was relatively rare.
Silicosis of the lungs, caused by breathing in sand particles was a common cause of pneumonia for the ancient Egyptians.
Eye diseases due to injuries from sandy wind from desert.
The ancient Egyptians also suffered from diet-related ailments such as malnutrition, vitamin and mineral deficiencies, dental abrasion, and ailments normal to all humans such as arthritis.

38. Knowledge of Surgery
The use of surgery evolved from a knowledge of the basic anatomy and embalming practices of the Egyptians.
They were very much skilled in healing physical injuries, these physician were able to do amputation and for the first time Egyptian used prosthetics.
They were skilled in performing eye surgery.
They knew how to suture wound. They used honey as an antiseptic and moldy bread as antibiotic.
Prosthetic foot

39. Therapeutic knowledge
The prescription for a healthy life, meant that an individual undertook the stringent and regular purification rituals (which included much bathing, and often times shaving one's head and body hair), and maintained their dietary restrictions against raw fish and other animals considered unclean to eat.
Among the curatives used by the Egyptians were all types of plant (herbs and other plants), animal (all parts nearly) and mineral compounds.
Yeast's were also taken internally for digestive disorders and were an effective cure for ulcers.

40. Specialization
In Egyptian time the art of medicine was divided so that each physician applies himself to one disease only and not more.
Some were physicians of eyes, other for the head, others for the teeth. Others for the intestines and others for internal disorders.
This clearly shows that today’s era of specialization and super-specialization has come en route from Egyptian medicine.