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History of Medicine: History

The study of the development of medical science and the role that medicine has played in society.

Ancient History

Mesopotamia - The cities of the ancient Near East were filled with healers who used spiritual and therapeutic methods to help people. The Code of Hammurabi makes it clear that their practices included numerous surgical techniques.

Egypt - Mummification practices gave Egyptians a better sense of anatomy than any other ancient culture. TheEgyptians believed that the heart sat at the center of a system of channels carrying the various fluids of the body. Many of their sophisticated medical and religious treatments sought to promote the healthy flow of the system.

Greece - Here healing relied heavily on religious experts, but Ancient Greece also developed complex surgical techniques and the Hippocratic school of medical thought. Hippocratic doctors sought to discover natural explanations for disease through close observation and rational analysis. Many of their diagnoses rested on their belief in four humours of the body that needed to be kept in balance through diet, purging, and exercise. This may be the reason why the Greeks seemed to have used fewer herbal treatments than other ancient societies.

China - Though Chinese medicine had its own idea of five elemental humours that interacted in the different systems of the body, a more important focus of medicine was the search for overarching harmony of within the body itself and betweem the body and the environment. Centuries of medical writing led to intricate techniques of diagnosis and treatment to obtain that harmony, such as acupuncture and elaborate herbal preparations. 

Persia -Medicine was divided into three branches: surgery, herbal medicine, and medicine by divine word. The Persian Empire consolidated and expanded the medical knowledge they learned from Indian, Greek, and Chinese healers to create some of the most sophisticated medicine of the ancient world. The Academy of Gundishapur became the first teaching hospital in the sixth century.

India - The ancient Ayurvedic texts taught India's trained physicians the use of surgery and plant drugs to heal the sick, protect the healthy, and prolong life. Though dissection was forbidden, the healers had a deep knowledge of the nature of injuries and illnesses, some of which they could treat effectively. In the Ayurvedic tradition hysical explanations were sought for almost all diseases, though the attempted cures often were meant to restore the body's natural balance through diet, exercise, and religious purification. 

Early Doctors

Hellenistic Greece - Greek medicine made further advancements after the founding of Alexandria in Egypt in the 4th century BCE. The city became a center for intellectual research, including theories of medicine. Several schools of thought developed there that guided physicians throughout the Mediterranean world. These ranged from the Dogmatists, who rigidly acted on the basis of humoural theories, to Empiricists, who focused on treatments that worked and had little concern for understanding the workings of the body or disease. The majority of the Alexandrian thinkers agreed that dissection could do little to improve medical understanding, though others were known to have practiced it.

Rome - For centuries, many of the physicians active in the Roman world were Greeks. Greek medicine had a tremendous influence on the Romans. Most significantly, the Romans continued to believe in the importance of keeping the four humours of blood, phlegm, black bile, and yellow bile in balance in the body. The Romans appear to have used more drugs in their medical treatments than the earlier Greeks, but many of these medicines were intended to balance the humours. Several of the great doctors of the period also had notable surgical skills. Though the Romans sought to understand anatomy, the culture frowned on human dissection which led to significant errors.

Byzantium - The eastern portion of the Roman Empire continued to practice much of the same types of medicine that had been seen in the earlier centuries of the empire. What differed in Byzantium was the many new medical textbooks that compiled earlier knowledge and the spread of hospitals. Modelled on healing facilities in the Roman army, hospitals became centers of medicine when the Christian church built hospitals as part of the charity mission of followers of Christ. Trained doctors staffed the larger Byzantine hospitals.

Islam - With the help of Byzantine texts, the Muslims learned much of their medical theories from the Greeks and Romans. The Islamic world preserved many ancient medical works that had been lost except for the Arabic translation. However, contact with Persia and India meant that those cultures had significant impacts on Muslim medicine as well. Doctors in the various Islamic regions advanced medicine in many fields in the following centuries, most significantly in surgery and pharmacology.


Medieval Care

Monasteries in western Europe joined the tradition of offering healing as part of their mission, but there were limited medical texts and training available in the first centuries of the Middle Ages. This began to change by the 11th century, as more and more texts were brought from the Byzantine and Islamic worlds and translated into Latin. Several universities then started using these books to teach medicine. By the 13th century, several centers of medical study existed in Italy and France. As medicine became more and more sophisticated as a field, trained doctors split completely away from the general surgeons who cared for many of the day to day medical needs of patients. Doctors found more medical texts, started human dissections, developed their own theories on the humours and astrological medicine, found new drugs, and generally tried to improve their medical knowledge, but they had limited success at improving people's health.

Renaissance Developments

One of the developments of the Renaissance period, generally, was the discovery and mastery of unknown ancient texts from the Greeks and Romans. Having trained themselves to understand these works, Europeans then began to do their own sophisticated scholarship and analysis. Against the backdrop of cheap book production through the use of paper and movable type, as well as attacks on the authority of the Catholic Church, people took the next step of beginning to question their understanding of the world around them, especially after new trade routes to Asia and the Americas revealed so much to Europeans that the ancient authors had known nothing about. This pattern of inquiry and scholarship can certainly be seen in the field of medicine during the period roughly from 1400 to 1600.

As with many of the advancements of the Renaissance, the first developments occurred in nothern Italy which had a long tradition of medical study at the universities. After training at these centers, medical writers like Linacre first sought to perfect their understanding of the classical canon from figures such as Hippocates and Galen. Other Renaissance figures such as Paracelsus, who also apparently had some medical training in Italy, had harsh criticism for the failings of the ancient medical thought. The need for a new understanding of medicine became ever more clear as scholars continued to find ways that classical authors had been mistaken. Vesalius and other anatomists found that even Galen had misunderstood the basic structure of the human body.

Renaissance doctors and surgeons began to have confidence in their own research and to publicize them for othe experts with the new printing technology. Medical expertise advanced among the growing medical class of physicians and professors that arose amidst Europe's increasing wealth. Methods of surgery, theories on the spread of epidemics, and anatomy all advanced significantly during the period even doctors still could not see what was going on at the cellular level and debates continued over the need to balance the body's humors.

Rational Medicine

By the 17th century, the natural philosophers of Europe were using the new developments in mathematics and experimentation to understand their observations of the world around them and thereby advance human knowledge. In medicine, researchers turned away from the old theories of Galen and began to consider the body as a mechanism that was affected by the surrounding environment. They applied contemporary knowledge in chemistry and physics to the question of how that mechanism functioned.

Early in the century, William Harvey solved one of the greatest medical puzzles with his observations on circulation when he showed that heart pumped the same blood around in the body and back to itself. He could not see all the details of how the exchange took place or its purpose, but he knew that the heart was part of a circulatory system. Throughout the century, microscopes would continue to improve until scientist could describe the capillaries and their role in circulation. Microscopic observations also created new questions with the descriptions of cells and life forms that could not be seen with the naked eye.

Though many aspects of disease and physiology could still not be explained, and there were few discoveries that immediately brought improvements to human health, doctors began to feel that medical science was on the road to progress, and that it was possible for them to understand its mysteries. This helped to spur the work that brought about better surgical techniques, precise anatomical studies, and some effective new treatments.

Medical Theories

Medicine in the 18th century was slow to live up to the promise of the knowledge that doctors possessed at the beginning of the century. When old ideas had been put to rest, numerous competing theories arose as explanations for the functions of the organs and the processes of disease. Still, through the hard work of observation, experimentation, and argument medical understanding increased. Pharmacology and medical treatment came to replace notions such as mesmerism and vitalism.

Anatomy and pathology were described in minute detail over the course of the 18th century, allowing medical scientists a firm base from which to investigate more complicated problems, including issues of physiology. Doctors came to understand much more about respiration, digestion, and even muscle movement. With new confidence, doctors addressed the problems of public health through campaigns for cleanliness and complete diets. Clinical practices became more logical and effective, while there was a revolution in the surgical and bandaging techniques of the day that required extensive knowledge from trained surgeons. Innoculation and later vaccination became well known, helping to save many lives.

The Age of Medical Science

Medical discoveries in the 19th century completely changed the understanding of how the body worked and helped usher in a new era of human health. Laboratory work by figures such as Claude Bernard clarified the chemistry of organ function. This made clear to medical scientists the need to understand what was going on at the cellular level, which encouraged them to conduct extensive investigations. Researchers in organic chemistry created a whole new level of pharmacology that was the source of many effective treatments. Experiments with various drugs led to the development of anesthesia which allowed for methodical surgery on almost every organ of the body. The new focus on the microscopic that had become such a large part of medical science also helped researchers to understand the role of bacteria in disease, leading to safer operating rooms and methods for stopping the spread of deadly diseases.

The amount of information contained in the new medical science and the complexities of treatments brought on more specialization among doctors in the 19th center. That coupled with the rising wealth of national states meant that many countries around the world witnessed a growing number of clinics, hospitals, and research institutes to provide the best level of care possible. And for many people, medicine achieved exactly that, helping to keep the general population healthier than it had ever been for longer lifespans.

Laboratory Investigations

With the beginning of the 20th century, medical science had reached the point where monumental advances were occurring in almost every branch of knowledge. Germ theory was followed by cellular pathology and immunology. Advances in microscopic techniques and the development of radiography allowed scientists to see more, and their knowledge helped them to study even things that were still invisible, such as viruses and their patterns of replication.  Acquiring ever increasing funding through charity and government organizations, researchers created large projects to track epidemics and to search for cures to specific diseases and to develop specific surgical treatments.

Having developed antibiotics, painkillers, and insuline, as well as ways to prevent many of the diseases that killed huge numbers of people in the past, doctors of the 20th century had great confidence that medicine would continue to make great strides. And it did, but the second half of the century also showed how research into issues such as genetics, cancer, and neurology brought to light new questions that required tremendous effort and time to answer. Among those questions would be the greater complications involved in old issues of medicine such as how to train doctors for all of these skills and information and how to make health care available to everyone who needed it.

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