Moscow Medical Academy named by I. M.

Sechenov
Department of History of Medicine

HISTORY OF MEDICINE
FOR STUDENTS OF FOREIGN DEPARTMENT

Compound by L. E. Gorelova, professor, MD

M. E. Solokhina, senior teacher, PhD;
Editor A. M. Stochik, chief of department of history of medicine,
professor, MD

Moscow
2006
This Guideline of history of medicine for students of Foreign Department. ., 2007.

Compound by L.E.Gorelova, professor, M.D.; M.E.Solokhina, senior teacher, Ph.D. Editor

A.M.Stochik, chief of department of history of medicine, professor, M.D.

Short course of lectures on the history of medicine are included in this Guideline for students of
Foreign Department. All the lectures are supplied by questions for discussion.
The Guideline is written for medical students of Foreign Department with instructions on
English.

-. ., 2007.
.., . .
..

. .

.

A. M. Stochik, L. E. Gorelova, M. E. Solokhina, 2007

. ., . ., . ., 2007

. .., 2007
 Contents

Ancient Egypt........................................................................................ 5

Ancient India....................................................................................... 10

Ancient China ..................................................................................... 22

Ancient Greece................................................................................... 28

Medicine in Roman Times ................................................................. 35

Arabic Medicine.................................................................................. 41

Medicine of Renaissance ................................................................... 45

19 century time of scientific medicine....................................... 47

The history of Russia ......................................................................... 50

Literature ............................................................................................ 55

3
 Directions of medicine

National (popular) medicine: peoples experience, exists

more than two thousand years
Traditional medicine: the base of this medicine is a
religious and philosophic conceptions; exists more than three
thousands years
Scientific medicine

Traditional medicine
Systems of traditional medicine: Chinese (Acupuncture),
Indian (Ajurveda), Tibetan
WHO assesses Ajurvedic medicine as most effective
system of alternative medicine

4
 Ancient Egypt

Ancient Egyptian medicine refers to the common medical practices of

ancient Egypt in the period 3300 BC until the Persian invasion of 525 BC.
The ancient Egyptians had highly advanced medical practices for their time,
including surgery, setting of bones and an extensive set of Pharmacopoeia.
While their remedies were sometimes characterized by magical
incantations and dubious ingredients, they often had a rational basis.
Medical texts specified specific steps of examination, diagnosis, prognosis
and treatments that were often rational and appropriate.

Sources of Information
Until the 19th century, the main sources of information regarding ancient
Egyptian medicine were the writers from a later period of antiquity. Homer,
writing in the Odyssey (c. 800 BC) remarked: In Egypt, the men are more
skilled in medicine than any of human kind. The Greek historian
Herodotus visited Egypt around 440 BC and wrote extensively of his
observations of their medicinal practices. Pliny the Elder also wrote
favorably of them in historical review. Hippocrates (the father of
medicine), Herophilos, Erasistratus and later Galen studied at the temple
of Amenhotep, and acknowledged the contribution of ancient Egyptian
medicine to Greek medicine.
This situation began to change in 1822 with the decipherment of the
Rosetta stone, which finally allowed the translation of ancient Egyptian
hieroglyphic inscriptions and papyri, including many related to medical
matters. The resultant upswing in interest in Egyptology in the 19th century
led to the discovery of several sets of extensive ancient medical
documents, including the Ebers papyrus, the Edwin Smith Papyrus, the
Hearst Papyrus and others dating back as far as 3000 BC.

5
Medical information contained in the Edwin Smith Papyrus dates from as
early as 3000 BC. The earliest known surgery was performed in Egypt
around 2750 BC . Imhotep in the 3rd dynasty is credited as the founder of
ancient Egyptian medicine and as the original author of the Edwin Smith
papyrus, detailing cures, ailments and anatomical observations. The Edwin
Smith papyrus is regarded as a copy of several earlier works and was
written circa 1600 BC. It is an ancient textbook on surgery and describes in
exquisite detail the examination, diagnosis, treatment, and prognosis of
numerous ailments.
The Ebers papyrus (c. 1550 BC) is full of incantations and foul applications
meant to turn away disease-causing demons and other superstition, but in it
there is evidence of a long tradition of empirical practice and observation.
The Ebers papyrus also provides our earliest documentation of an
awareness of tumors.
Other information comes from the images that often adorn the walls of
Egyptian tombs and the translation of the accompanying inscriptions. The
tomb of Ankn-ma-hor of the 6th Dynasty (circa 2200BC) has a detailed
rendering of a ceremonial circumcision.
Advances in modern medical technology also contributed to the
understanding of ancient Egyptian medicine. Paleopathologists were able
to use first X-Rays and later CAT Scans to view the bones and organs of
mummies. Electron microscopes, mass spectrometry and various technical
forensic techniques allowed scientists unique glimpses of the state of health
in Egypt 4000 years ago.

Magic and religion

Magic and religion were part of everyday life in ancient Egypt. Gods and
demons were thought to be responsible for many ailments, so often the
treatments involved some supernatural element. Often the first recourse
would be an appeal to a deity. Often priests and magicians were called on

6
to treat disease instead of, or in addition to a physician. Physicians
themselves often used incantations and magical ingredients as part of their
treatments.
Since the belief in magic and religion was so commonplace in Egypt, it is as
though the use of magic and religion would have contributed to a powerful
placebo effect. Since many medicines appeared to lack active ingredients,
the perceived validity of the cure, including the authoritativeness of the
magical incantations, would have contributed to its effectiveness.
The impact of the emphasis on magic is seen in the selection of remedies,
or the ingredients for those remedies. Ingredients were sometimes selected
seemingly because they were derived from a substance, plant or animal the
had characteristics which in some way corresponded to the symptoms of
the patient. This is known as the principle of simila similibus (similar with
similar) and is found throughout the history of medicine up to the modern
practice of homeopathy. Thus an ostrich egg is included in the treatment of
a broken skull, and an amulet portraying a hedgehog might be used against
baldness.
Amulets in general were enormously popular with ancient Egyptians, being
worn for many magical purposes. Health related amulets are classified as
homopoeic, phylactic and theophoric. Homeopoetic amulets portray an
animal or a part of an animal from which the wearer hopes to assimilate
positive attributes (like strength or speed). Phylactic amulates were
protective, warding off harmful gods and demons. The famous Eye of Horus
was often used on a phylactic amulet. Theophoric amulets represented the
Egyptian gods, such as one representing the girdle of Isis, used to stem the
flow of blood at miscarriage.

Doctors and other healers

The ancient Egyptian word for doctor is swnw. There is a long history of
swnw in ancient Egypt. The earliest recorded physician in the world is also

7
credited to ancient Egypt: Hesyre, Chief of Dentists and Physicians for
King Djoser in the 27th century BC. The lady Peseshet (2400 BC) was
possibly the mother of Akhethotep, and on a stela dedicated to her in his
tomb she is referred to as imy-r swnwt, which has been translated as Lady
Overseer of the Lady Physicians (swnwt is the feminine of swnw). This
may make her the first recorded female doctor.
There were many ranks and specializations in the doctors. Royalty had
their own doctors, even their own specialists. There were inspectors of
doctors, overseers and chief doctors. Known ancient Egyptian specialists
are ophthalmologist, gastroenterologist, proctologist, dentist, doctor who
supervises butchers and an unspecified inspector of liquids. The
ancient Egyptian term for proctologist, neru phuyt, literally translates as
shepherd of the anus.
Medical institutions are known to have been established in ancient Egypt
since as early as the 1st Dynasty. By the time of the 19th Dynasty their
employees enjoyed such benefits as medical insurance, pensions and sick
leave. Employees worked 8 hours per day.

General overview
The Egyptians had a lot of knowledge about the anatomy of the human
body even though they never dissected the body. For example, in the
classic mummification process, they cleanly removed the brain out of the
body via the nose using a long hook.
The Egyptian physicians also knew that the heart pumps blood through the
body and could tell the exact position of the heart from a person's
heartbeats.
Medical knowledge in ancient Egypt was so advanced that other kings and
emperors from different empires would write to the Egyptian pharaoh to
send them their best surgeon to perform operations.

8
Mostly the Egyptian physician's advice for staying healthy was to wash and
shave the body, including under the arms. This would have worked
because cleaning would prevent microbes and viruses. The physicians
would also advise their patients to look after their diet, and avoid foods such
as raw fish or other animals which would not be clean.

General overview
1) Medical papyruses: The Edwin Smith papyrus, te George Ebers
paryrus
2) Mummies
3) Gods: Osiris, Anubis, Isis, Amen, Pthah
4) Book of Dead
5) Pyramids
6) Diseases: diseases of eyes, diseases from water and food, syphilitic
infection, leprosa, tuberculosis

Questions
1) What can you tell about resources of Egyptian medicine?
2) Tell about papyruses.
3) Tell about mummification.
4) Tell about Egyptian doctors.

9
 Ancient India

Historical periods of Ancient India:

Civilization of Indus Valley (23-18 century BC)
Vedic period (13-8 century BC.)
Buddhist period (5-3 century BC.)
Classic period (2 century BC 5 century)

Civilization of Indus Valley (23-18 century BC): Mane resources of

history of medicine are archaeological. Unique pools for ritual washing,
wells and drainage town systems were found in Ancient towns Harrapah,
Mohenjo-Daro.

Vedic period (13-8 century BC): mane resources of history of medicine

found in Vedas: (Rigveda, Samaveda, Yajurveda,
Atharvaveda). Description of bleeding, tuberculosis, leprosy was found in
Rigveda. The treatment of diseases were magic rituals.
Vedic pantheon
Indra (god of weather and war
Varuma (all-seeing god of justice and cosmic order)
Agni (god of fire)
Kali goddess of disease and destruction
Shiva god of destruction and regeneration
Brahma creator
Vishnu sustainer

Buddhist period (5-3 century BC)

Religion: Buddhism
Religious and philosophical conceptions were concern of human
being. It was concerned that all functions and structure in human

10
 body are the same as process in the nature. There are five elements (
soil, air, water, fire, ether) of the worlds structure and the cooperation
of the three elements ( air, water and fire ) produces all functions of
the nature.
Ayurveda or Ayurvedic medicine system of knowledge about
healthy life

Ayurveda (Sanskrit: ayu life; veda knowledge of) or ayurvedic

medicine is a more than 6,000 year old comprehensive system of medicine
based on a holistic approach rooted in Vedic culture. Its conspicuous use of
the word veda, or knowledge, reveals its role in early Hinduism and
describes its hallowed place in India. Ayurveda also had a tradition of
surgery. Two early texts (from centuries BCE) of Ayurveda are the Charaka
Samhita and the Sushruta Samhita.
Charaka (perhaps 6th century BC) is one of the founders of Ayurveda.
According to Charaka, health and disease are not predetermined and life
may be prolonged by human effort.
According to the Charaka tradition, there existed six schools of medicine,
founded by the disciples of the sage Punarvasu treya. Each of his
disciples, Agnivesha, Bhela, Jatkarna, Parshara, Hrta, and Kshrapni,
composed a Samhit. Of these, the one composed by Agnivesha was
supposed to be the best. The Agnivesha Samhit was later revised by
Charaka and it came to be known as Charaka Samhit. The Charaka
Samhit was revised by Dridhbala.
yurveda is traditionally divided into eight branches which, in Charaka's
scheme, are: 1. stra-sthna, general principles; 2. nidna-sthna,
pathology; 3. vimna-sthna, diagnostics; 4. sharra-sthna, physiology and
anatomy; 5. indriya-sthna, prognosis; 6. chikits-sthna, therapeutics; 7.
kalpa-sthna, pharmaceutics; and 8. siddhi-sthna, successful treatment.

11
Ayurveda
Knowledge on anatomy :
It was described 500 muscles,900 ligaments,300 bones,107
conjunctions, 40 general blood vessels, 24 nerves in Ayurveda.
Ancient doctors study anatomy of the human body by method of
maceration
Knowledge of energy points and channels in human body: seven
chakras system of psychic centers in human body, in which energy
of life circulates and clears mind and brings pacification.

Doshas
The 3 main doshas (organizing qualities of intelligence) are Vata
(resembles the classical elements ether and air), Pitta (fire), and Kapha
(water and earth).
All bodily processes are believed to be governed by a balance of the 3
doshas. Whichever dosha appears to dominate a person's behavior and
physique is called his constitution type. Each constitution type has
particular strengths and susceptibilities.

Vata
Vata, composed of space and air, governs all movement in the mind and
body and must be kept in good balance. Too much vata leads to, worries,
insomnia, cramps and constipation. Vata controls blood flow, elimination of
wastes, breathing and the movement of thoughts across the mind. Vata
activates the nervous system, hearing and speech; and expresses as
enthusiasm and creativity. Vata also controls the other two principles (Pitta
and Kapha) and is usually the first cause of disease. Another word for Vata
is Vayu it is the more traditional Sanskrit word for air.
Those who are classified as Vata tend to have lighter frames, and are either
short or tall and thin. Their skin tends to be dry and cold with dark, thin hair.

12
They have dark brown or grey eyes. Movements and speech is quick and
sleep is light, interrupted, and fitful. Mentally, they are restless and have
lots of ideas. They are creative and imaginative, but are fearful, anxious,
and insecure.
Vata doshas' corresponding colors are warm and gentle, such as yellow,
ochre, or brown. Amethyst is the stone associated with Vata.

Pitta
Pitta is said to be composed of fire; it governs, all heat, metabolism and
transformation in the mind and body. It controls how we digest food, how
we metabolize our sensory perceptions, and how we discriminate between
right and wrong. Pitta must be kept in balance, too. Too much Pitta can
lead to anger, criticism, acidity, ulcers, rashes and thinning hair.. A
balanced Pitta mind makes one a good leader with a warm personality.
Pitta types are generally average physically. They tend to have fine, soft,
red or fair hair (though Pittas have been known to have dark hair.) Eyes
tend to be blue, grey, or hazel. Their moods change slowly and they are
busy people, usually achieving much in their lives. They are more
intellectual and speech is clear, sharp, and precise. They are fiery, angry
and judgemental.
The Pitta doshas' corresponding color are cool, calming colors such as
blue, green, or purple. Their stone is Moonstone.

Kapha
Kapha is the watery humour, consisting of the water and earth elements.
Kapha cements the elements in the body, providing the material for
physical structure. This dosha maintains body resistance....Kapha
lubricates the joints; provides moisture to the skin; helps to heal wounds;
fills the spaces in the body; gives biological strength, vigor and stability;

13
supports memory retention; gives energy to the heart and lungs and
maintains immunity...Kapha is responsible for emotions of attachment,
greed and long-standing envy; it is also expressed in tendencies toward
calmness, forgiveness and love. Too much Kapha leads to lethargy and
weight gain, as well as congestion and allergies.
Kaphas' body types are sturdier and thicker than the other body types. Hair
is thick and lustrous and eyes are blue or brown. They have the best
strength and endurance and have a slow, steady pace. Mentally they are
calm, steady, and stable. They can be greedy and possessive but are
caring and not easily irritated.

Knowledge on etiology of diseases:

Influence of nature
Gods damnation (leprosy)

Knowledge on pathological mechanisms of diseases:

Disease is result of misbalance between Kapha, Vata, Pitta, bodys
secretion, sense organs and mind.

Diagnostic methods:
to interview patients
to hear noises of breathing and sounds of voice
examination of color of the skin and tongue
examination the taste of urine

Methods of treatment:
Herbs
Surgery
Massage
Cleaning of the body
14
 Cauterization (moxibustion)
Meditation
Yoga

Prophylactic measures: ayurveda used inoculation for protection against

smallpox

Doctors and other healers

At the closing of the initiates' training, the guru gave a solemn address
where he directed the students to a life of chastity, honesty, and
vegetarianism. The student was to strive with all his being for the health of
the sick. He was not to betray patients for his own advantage. He was to
dress modestly and avoid strong drink. He was to be collected and self-
controlled, measured in speech at all times. He was to constantly improve
his knowledge and technical skill. In the home of the patient he was to be
courteous and modest, directing all attention to the patient's welfare. He
was not to divulge any knowledge about the patient and his family. If the
patient was incurable, he was to keep this to himself if it was likely to harm
the patient or others.
The normal length of the student's training appears to have been seven
years. Before graduation, the student was to pass a test. But the physician
was to continue to learn through texts, direct observation (pratyaksha), and
through inference (anumna). In addition, the vaidyas attended meetings
where knowledge was exchanged. The doctors were also enjoined to gain
knowledge of unusual remedies from hillsmen, herdsmen, and forest-
dwellers.

Yoga
Yoga, meaning union in Sanskrit, is a family of ancient spiritual practices,
and also a school of spiritual thought that originated in India, where it

15
remains a vibrant living tradition and is seen as a means to enlightenment.
Karma Yoga, Bhakti Yoga, Jnana Yoga, and Raja Yoga are considered the
four main yogas, but there are many other types. In other parts of the world
where yoga is popular, notably the West, Yoga has become associated with
the asanas (postures) of Hatha Yoga, which are popularly considered there
as fitness exercises and also form the basis of an expanding business.

Yoga as a means to enlightenment is central to Hinduism, Buddhism, and

Jainism, and has influenced other religious and spiritual practices
throughout the world. Ancient Hindu texts establishing the basis for yoga
include the Upanishads, Yoga Sutras of Patanjali, the Bhagavad Gita, the
Hatha Yoga Pradipika and many others, which specify the criteria of having
successfully mastered a particular yoga technique.

Yoga practice and Intentions

Modern yoga practice often includes traditional elements inherent in
eastern religion, such as moral and ethical principles, postures designed to
keep the body fit, spiritual philosophy, instruction by a guru, chanting of
mantras (sacred syllables), pranayama (breathing exercises), and stilling
the mind through meditation. These elements are sometimes adapted to
meet the needs of non-Hindu practitioners, who may be attracted to yoga
by its utility as a relaxation technique or as a way to keep fit.

History of Yoga
Images of a meditating yogi from the Indus Valley Civilization are thought to
be 6 to 7 thousand years old. The earliest written accounts of yoga appear
in the Rig Veda, which began to be codified between 1500 and 1200 BC. It
is difficult to establish the date of yoga from this as the Rig Veda was orally
transmitted for at least a millennium. The first Yoga text dates to around the
2nd century BC by Patanjali, and prescribes adherence to eight limbs

16
(the sum of which constitute7 Ashtanga Yoga) to quiet one's mind and
merge with the infinite.

The first quasi-rational full description of the principles and goals of yoga
are found in the Upanisads, thought to have been composed between the
eighth and fourth centuries BC. The Upanisads are also called Vedanta
since they constitute the end or conclusion of the Vedas (the traditional
body of spiritual wisdom). In the Upanisads, the older practices of offering
sacrifices and ceremonies to appease external gods gives way instead to a
new understanding that man can, by means of an inner sacrifice, become
one with the Supreme Being (referred to as Brhman or Mhtman) --
through moral culture, restraint and training of the mind

Proponents of yoga is leading to improved health, emotional well-being,

mental clarity, and joy in living. Yoga advocates progress toward the
experience of samadhi, an advanced state of meditation where there is
absorption in inner ecstasy, Ananda.

The goals of yoga are expressed differently in different traditions. In

Hinduism, yoga may be seen as a set of practices intended to bring people
closer to God to help them achieve union with God. In Buddhism, which
does not postulate a creator-type god, yoga may help people deepen their
wisdom, compassion, and insight. In Western nations, where there is a
strong emphasis on individualism, yoga practice may be an extension of the
search for meaning in self, and integration of the different aspects of being.
The terms Self-Realization and god-Realization are used interchangeably in
Hindu yoga, with the underlying belief that the true nature of self, revealed
through the practice of yoga, is of the same nature as God.

The ultimate goal of yoga is the attainment of liberation (Moksha) from

worldly suffering and the cycle of birth and death (Samsara). Yoga entails

17
mastery over the body, mind, and emotional self, and transcendence of
desire. It is said to lead gradually to knowledge of the true nature of reality.

The word yoga

The word yoga derives from the Sanskrit root yuj (to yoke); which is
cognate to modern English yoke, jugal and jugum in Latin. All derive
from the Proto-Indo-European root *yeug- meaning to join or unite.

It is generally translated as union of the individual atma (loosely translated

to mean soul) with Paramatma, the universal soul. This may be
understood as union with the Divine by integration of body, mind, and spirit.
Thus, in essence, one who attempts yoga may loosely be referred to as a
yogi or in Sanskrit, a yogin (masculine) or yogini (feminine). These
designations are actually intended for advanced practitioners, who have
already made considerable progress along the path towards yoga.

In the west the word has often been taken to mean union between the mind
and body, justifying the practice of some forms of Yoga solely for physical
and mental benefits. In addition to physical and mental benefits of yoga , it
also provides a union with oneself. Day by day, more people are turning to
yoga to find solutions for stress relief and peaceful life.

Diversity of yoga
Over the long history of yoga, different schools have emerged, and there
are numerous examples of subdivisions and synthesis. It is common to
speak of each form of yoga as a path to enlightenment. Thus, yoga may
include components of love and devotion (as in Bhakti Yoga), selfless work
(as in Karma Yoga), knowledge and discernment (as in Jnana Yoga), or an
eight-limbed system of disciplines emphasizing meditation (as in Raja
Yoga). These practices occupy a continuum from the religious to the
scientific.They need not be mutually exclusive. (A person who follows the
path of selfless work might also cultivate some knowledge and devotion.)
18
Some people (particularly in Western cultures) pursue Hatha yoga as
exercise divorced from spiritual practice.

Other types of yoga include Mantra Yoga, Kundalini Yoga, Iyengar Yoga,
Kriya Yoga, Integral Yoga, Nitya Yoga, Maha Yoga, Purna Yoga, Prasara
Yoga, Natya Yoga, Anahata Yoga, Tantra Yoga, Tibetan Yoga, Sahaja
Yoga etc. It is often helpful to check the teacher and lineage to be sure how
these terms are being used. Another name for Raja Yoga (royal yoga) is
Ashtanga Yoga (eight-limbed yoga), but this should not be confused with
the Ashtanga Vinyasa Yoga developed by Sri K. Pattabhi Jois, which is a
specific style of Hatha Yoga practice.

Yoga and religion

In the Hindu, Buddhist and Jain traditions, the spiritual goals of yoga are
seen as inseparable from the religions of which yoga forms a part. Some
yogis make a subtle distinction between religion and yoga, seeing religion
as more concerned with outward culture, values, beliefs and rituals; and
yoga as more concerned with inner Self-Realization, i.e., direct perception
of the ultimate truth. In this sense, religion and yoga are complementary. Sri
Ramakrishna likened religion to the husk, and direct experience to the
kernel. Both are needed, but if one wants to get at the kernel itself, he
must remove the husk of the grain.

Common themes

Common to most forms of yoga is the practice of concentration (dharana)

and meditation (dhyana). Dharana, according to Patanjali's definition, is
the binding of consciousness to a single point. The awareness is
concentrated on a fine point of sensation (such as that of the breath
entering and leaving the nostrils). Sustained single-pointed concentration
gradually leads to meditation (dhyana), in which the inner faculties are able

19
to expand and merge with something vast. Meditators sometimes report
feelings of peace, joy, and oneness.

The focus of meditation may differ from school to school, e.g. meditation on
one of the chakras, such as the heart center (anahata) or the 'third eye'
(ajna); or meditation on a particular deity, such as Krishna; or on a quality
like peace. Non-dualist schools such as Advaita Vedanta may stress
meditation on the Supreme with no form or qualities (Nirguna Brahman).
This resembles Buddhist meditation on the Void.

Another common element is the spiritual teacher (guru in Sanskrit; lama in

Tibetan). While emphasized to varying degrees by all schools of yoga, in
some the guru is seen as an embodiment of the Divine. The guru guides
the student (shishya or chela) through yogic discipline from the beginning.
Thus, the novice yoga student traditionally devotes himself to a satguru
(true teacher). Traditionally, knowledge of yoga as well as permission to
practice it or teach it--has been passed down through initiatory chains of
gurus and their students. This is called guruparampara.

The yoga tradition is one of practical experience, but also incorporates texts
which explain the techniques and philosophy of yoga. Many gurus write on
the subject, either providing modern translations and elucidations of
classical texts, or explaining how their particular teachings should be
followed. A guru may also found an ashram or order of monks; these
comprise the institutions of yoga. The yoga tradition has also been a fertile
source of inspiration for poetry, music, dance, and art.

When students associate with a particular teacher, school, ashram or order,

this naturally creates yoga communities where there are shared practices.
Chanting of mantras such as Aum, singing of spiritual songs, and studying
sacred texts are all common themes. The importance of any one element
may differ from school to school, or student to student. Differences do not
20
always reflect disagreement, but rather a multitude of approaches meant to
serve students of differing needs, background and temperament.

The yogi is sometimes portrayed as going beyond rules-based morality.

This does not mean that a yogi will act in an immoral fashion, but rather that
he or she will act with direct knowledge of the supreme Reality. In some
legends, a yogi having amassed merit through spiritual practice, may
then cause mischief even to the gods. Some yogis in history have been
naked ascetics, such as Swami Trailanga, who greatly vexed the occupying
British in 19th century Benares by wandering about naked.

Questions
What does it mean yoga ?
Tell about history of yoga.
Tell about goals of yoga.
What schools of yoga do you know?
Tell about of periods of history of Ancient India.
What kind of knowledge does Ayurveda consists of?
Tell about methods of diagnosis in Ayurveda.
Tell about treatment in Ayurveda

21
 Ancient China

Periods of History (the name of ruling dynasty gave the name for historical
periods of Ancient China)
Shang-Yin 17-11 century B.C.
Chjou 11-3 century B.C. country was separated in many regions
Chin 221-207 years B.C. country was united in Empire
Han 206 year B.C. 3 century Time of prosperity of Empire

Religion and philosophy

Taoism (Tao-te Ching, by Lao-tzu) 6 century B.C.
Confucianism ( Kung Fu-tzu, 550-479 B.C.)
Buddhism

Philosophic and medical treatises

Fu His- Philosophic treatise about yang and yin (Si ji juang) 4-3 B.C.
Huan Ti The Yellow Emperors Internal Classic (Nei Ching)
3 B.C.)
Shen- Nung Medical herbal (2 century B.C.)
Huanfu Mes Acupuncture and moxibustion Classic 265 year
Van Shukhe Pulse treatis (280 year)

Religious and philosophical aspects: principle of duality of nature

Primary substance separated in two yang and yin
Cooperation and struggle between yang and yin gave five elements : water,
fire, wood, metal and soil

22
 Principle of duality of nature
Yang Yin

The active, light, dry, The passive, dark

warm, positive, masculine cold, moist, negative, feminine

Yang-organs Yin-organs
Heart
Gallbladder
Liver
Stomach
Spleen
Small and large intestine
Lungs
Urinary bladder
Kidneys

Ancient Chinese described the 12 mane channels and 2 accessories in

body. In healthy body energy Chi permanently goes through the channels.
These channels dont coincide with anatomical ways. Chi makes harmony
and balance in body, also disturbed Chi is a reason of disease in body.
Health is a balance between the Yang, Yin, fife elements and energy- Chi.
Disease is a misbalance between the Yang and Yin and fife elements.
Syndromes were divided in two gropes: Yang-syndromes and Yin-
syndromes. For example, Yang-syndromes are those with abundance,
plenty and Yin-syndromes are those with lack, shortage, deficiency. But the
knowledge about anatomy was very poor, because religious ethic forbid to
deform body after death .

Methods of diagnoses
Examination of the skin, eyes and tongue (wang)
Hearing the noises of the body and determination smells (when)
Interviewing of the patient (wen)
Palpation of the different points of the body, including pulse (she)

23
These methods were introduced by Bian Chue in 6-5 century B.C.
Ivory female diagnostic statuette, which, for reasons of modesty, upper-
class ladies made use of to indicate to doctors the location of their ailments
(picture)

Most important diagnostic technique was examination of the pulse.

Physicians determine symptoms, diagnosis, prognosis and proper
treatment by palpation of the pulse. Ancient doctors examined the pulse in
9 points of the body. They described 28 sorts of the pulse. The circulation
of the blood in vessels were described in treatise Nei Jing.

Puls chart from a 1693 edition of Secrets of the Pulse, originally written by
Pien Chiao in the 6th of 5 th century B.C. The work describes multitudinous
readings of the pulse, each of which reflects the condition of a particular
internal organ.

Traditional Chinese Medicine consists of

Zhen-jiu ( acupuncture and moxibustion)
Ji-gun (system of aerobic (breathing )exercises )
Ang-mo (point massage)
Traditional medications
Diet
Traditional gymnastic

Traditional medications
Therapeutic minerals and metals included compounds of mercury ( for
venereal diseases)
Animal-derived remedies included whole part, segments of organs, urine,
dung

24
Herbs most important: ephedra and ginseng for stimulation and many
disease
Seaweed for thyroid disease (contained iodine), willow plant (contains
salicylic acid) for rheumatism

Acupuncture and moxibustion

The aim of these treatments was to drain off excess yang and yin and thus
establish a proper balance.
In moxibustion a powdered plant substance fashioned into a small mound
on the patients skin and burned

In acupuncture the skin is pierced by long needles. Needles are inserted

into any of 365 points along 12 meridians and transmit an active life force
called chi. Each of these points is related to a particular organ.

Physiology of acupuncture and moxibution

Surgery
Hua To one of the few names mentioned in connection with surgery. He
operated on the skull, abdomen and thorax, spleen. He also used
mandragore and acupuncture for anesthesia

Ancient healers

Pien Chiao (Bian Que) also named Tai Yueren from (today) Renqiu in
Hebei province. The most ancient of the physicians from the historical
period (ca. 500 B.C.). He was reputed to be an excellent diagnostician,
excelling in pulse taking and acupuncture therapy. He is ascribed the

25
authorship of Bian Que Neijing (Internal Classic of Bian Que). Han Dynasty
physicians claimed to have studied his works, which have since been lost.
One day Bian Que heard the queen of Hu state (in today's Shaanxi
province) had died. He felt very sad and decided to go to the palace. He
found the queen inner thighs were not yet very cold and diagnosed her as
fake death. Under his care the queen has recovered fully. Thus Bian Que
received the title The doctor who brings back from the dead. From that
day on Bian Que became a doctor at a level of a god. At the same time the
imperial doctor dispatched agents to kill Bian Que (at that time still named
Tai Yueren) for fear of Bian Que high level of medicine. After his death and
because of his abnormal skill of medicine, people have named him as the
spiritual doctor Bian Que.
Hua Tuo also named Yuan Hua of Hao county in Anwei province was the
first famous Chinese surgeon. He is the first in the world to developed the
use of anesthesia, and furthered the limited Chinese knowledge of
anatomy. When using acupuncture and herbs, he preferred simple
methods, using a small number of acupuncture points and formulas
comprised of only a few herbs. He practiced Chi-kung (Qi Gong) and taught
the frolics of the five animals, a practice still used today. The five animals
are Tiger, Deer, Bear, Ape and Crane.
One day a patient came to see Hua Tuo. Hua Tuo diagnosed the patient
with ulcerative colitis (bleeding ulcer in the large intestine). He thus decided
that surgery was needed. He gave the patient Anesthetic powder, as the
patient lost feeling he performed the operation. He cut the abdomen open
and located the ulcer in the intestines. Clearing the infected area he sawed
it back and applied Spirits Lotion. In one month the patient recovered
completely. Later on a famous general named Zao Cao contracted illness
called Tou Feng. The general came to see Hua Tuo and was advised to
have an operation. The general suspected Hua Tuo wanted to harm him

26
and thus ordered the death of Hua Tuo. A very loved and revered physician
was lost to the world.

Huang-fu (Huangfu Mi; 214-282 A.D.) Huangfu lived to see the end of the
latter Han Dynasty. He is famous for his skills in acupuncture therapy; he
Huang Fumi, also named Huang Shian, composed many literary works
during his life time and was very influential during his time. At his middle
age while contracting a severe disease he decided that the study of
medicine is of utmost importance. He assiduously studied Chinese
medicine and by his life end he compiled one of the prominent acupuncture
works in history: Huang Di Zhenjiu Jia Yi Jing. The classic Jia Yi Jing
totally has 12 scrolls with 128 chapters. This work summarized the entire
knowledge of acupuncture at the time, and in addition added sizeable
amount of new information. Later generations of acupuncturist needed only
to learn this book as to understand the secrets of the art. This classic not
only influenced the acupuncture art in China but around the world, in
countries as Japan, Korea and France.

Questions
Tell about methods of diagnosis in China.
Tell about traditional Chinese therapy.

27
 Ancient Greece

Periods of history
Cretan-Mycenaean Civilization 2000-3000 B.C.
Greek Dark Ages 1200-800 B.C.
Ancient Greece 776-323 B.C.
Hellenistic Greece 323-146 B.C.
Roman Greece 146- 330 A.D.
Byzantine Empire 330- 1453 A.D.
Ottoman Greece1453- 1832
Modern Greece from 1832

The history of medicine in ancient Greece covers the period from about
776 BCE to 323 BCE. Medical practice in Hellenistic civilization and the
Greco-Roman era was also strongly influenced by medicine of ancient
Greece and is sometimes studied as part of ancient Greek medicine. Greek
ideas on medicine were very important, and ultimately influenced ideas on
medicine for millenia to come. The influence of Hippocrates and Aristotle
meant that not only did ideas on cures for diseases prgress and change,
but so did attitudes towards doctors, healthy living and medicine in general.
Many people believe Greece was the home of the beginnings of true
medical science in the west, when doctors stopped relying on superstition
and divine cures, and replaced it with rational curiosity about the causes of
illness (the ancient Greeks were practically unique in being a largely
secular country). According to tradition, the pioneer of this attitude of
observation was Hippocrates (c.460 377 BC). According to his traditional
biography, Hippocrates based his medical practices on careful observation
and keeping records of case histories. He is therefore often regarded as the
father of Western medicine, as it was his ideas and interest in the whole
patient that was the basis of further medicine for hundreds of years.

28
In its early phases, western medicine (we are not concerned here with
Oriental medicine) was a theurgic medicine, in which the disease was
considered to be divine castigation, a concept which is found in a great
many Greek texts such as the Iliad, and is still connaturalised by man
today.
The symbol adopted for medicine was the serpent, thought of as a sacred
creature because it was erroneously believed to be immune from illness
and disease. However, according to another version the symbol is not the
representation of the serpent, but the extirpation of Filaria or the serpent of
Medicine. Moreover, the serpent had an important practical function in
ancient medicine: every temple had a type of underground passage with
serpents. In fact, the temple was not only a place of devotion, but also site
where the ill and sick were brought. The purpose of the serpent pit was to
frighten the patient, who probably received potions to help him, or her, in
order to induce a state of shock and make the God appear in front of them
who would thus heal them.
With the passage of time, medicine moved further and further away from
religion until the rational medicine of Hippocrates arrived, signalling the
boundary between rationality and magic.
The first schools to develop were in Greece and in Magna Grecia, that is to
say, in Sicily and Calabria in Italy. Among these, the most important was
the Pythagorean school.
The great mathematician Pythagoras originally operated from the island of
Samos, but moved to Crotone when the tyrant Policrates took power in this
city. He brought his theory of numbers to natural science, as yet not
definable as medicine: according to Pythagoreans, some numbers had
precise meanings and, among these, the most important were 4 and 7.
Seven always had a significant meaning. For example, in the Bible the
number of infinity is indicated by 70 times 7. Among other things, 7
multiplied by 4 is 28, that is to say, the duration of lunar month ad of

29
menstrual period; seven multiplied by 40 is 280, that is to say, the duration
of gravidity in days. Furthermore, the magic seven meant that it was better
for a baby to be born in the seventh month rather than the eighth. The
period of quarantine, too, the forty days that served to avoid contagion from
diseases, is derived from the concept of the number 40 being sacred.
Taletes elaborated an important system according to which the universe
was composed of four fundamental elements: air, water, earth and fire. In
this period great relevance was also given to the qualities of dryness and
humidity, hot and cold, sweet and bitter, etc.
Healing was family tradition. A family-school accepted more members from
another families. There were 6 main medical schools in that time: Cos-
school, Rodosian- school, Kirenian-school, Crotonian-school, Sicilian-
school and Cnidian-school
In the VI-VII centuries B.C. a great student of Pythagoras, Alcmaeon of
Crotone, was first to have the idea that man might be a microcosm
constituted of Talete's four individual elements. According to him, a
person's state of health derives from the equilibrium of these elements,
which he called isonomy or democracy, whereas disease derived from
monarchy, or rather from the prevalence of one element over and above
the others. Alcmaeon also was the first to identify the brain as the most
important organ in the body. Until then, very little importance had been
given to the brain: in Greek times the body was sacred and so dissection
was not practised, but even during animals sacrifices, brain was seen only
as a cold and gelatinous mass of little interest. Alcmaeon, instead, asserted
that it was the very organ that controlled the whole organism. He also may
have deduced, a fact that was then denied by others, that the nerves might
serve to conduct nervous impulses, but this idea made no headway in
science at that time.

30
Cnidian-school:
Doctor: Eurifon
Explained mechanism of illness in term of four basic humors: blood,
phlegm, bile yellow and black. Treatise about symptoms of disease and
methods of diagnosis
Sicilian-school
Doctor: Empedokles
The teaching:
four basic elements (water, air, fire and earth) with specific quality (moist,
dry, hot and cold)
heart is mane organ of living
Cos-school
Doctors: Hippocrates and Praxagoras (picture)
Teaching:
four humors
physis- internal human nature
healing has to assist the nature

Hippocrates of Cos (c. 460 BC 377 BC) was an Ancient Greek

physician, is commonly regarded as one of the most outstanding figures in
medicine of all time and has been called 'the father of medicine'. He was
the leader of the medical school of Kos. Writings attibuted to him rejected
the superstition and magic of primitive medicine and laid the foundations
of medicine as a branch of science.
Hippocrates associated personality traits with the relative abundance of the
four humours in the body: phlegm, yellow bile, black bile, and blood, and
was a major influence on Galen.
The Hippocratic Corpus, a collection of about sixty treatises, most written
between 430 BC and 330 BC, is actually a group of texts written by several
different people holding several different viewpoints erroneously grouped

31
under the name of Hippocrates at the Library of Alexandria. Most texts
included in the Corpus are not considered to have been written by
Hippocrates himself, and in fact many were written by his son-in-law
Polybus. The best known of the Hippocratic writings is the Hippocratic
Oath, however this text was most likely not written by Hippocrates himself.
A famous, time-honoured medical rule ascribed to Hippocrates is Primum
non nocere (First, do no harm).

Works
Aphorisms
Instruments of Reduction
Of The Epidemics
On Airs, Waters, And Places
On Ancient Medicine
On Fistulae
On Fractures
On Hemorrhoids
On Injuries Of The Head
On Regimen In Acute Diseases
On The Articulations
On The Sacred Disease
On The Surgery
On Ulcers
The Book Of Prognostics
The Law
The Oath

Hippocratic Corpus:
Physiology: the four humors corresponding to the four elements are
physiological base of body function

32
General pathology: causes of illness internal and from outside. Disease has
three stages: degeneration of humors, cooking process and crisis
Therapy: Doctor must assists nature in doing the cure
Prognosis after examination the patient
Surgery: described wounds of skull and its treatment; hemorrhage is
controlled by compression; tumors, fistulas, ulcers and hemorrhoids are
among the diseases treated by surgery
The Hippocratic method:
- observe all
- study the patient rather than disease
- evaluate honestly
- assist nature

Ethics and the Oath. The Hippocratic Oath. Original Version

I SWEAR by Apollo the physician, Aesculapius, and Health, and All-heal,
and all the gods and goddesses, that, according to my ability and judgment,
I will keep this Oath and this stipulation.
TO RECHON him who taught me this Art equally dear to me as my parents,
to share my substance with him, and relieve his necessities if required; to
look up his offspring in the same footing as my own brothers, and to teach
them this art, if they shall wish to learn it, without fee or stipulation; and that
by precept, lecture, 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
disciples bound by a stipulation and oath according the law of medicine, but
to none others.
I WILL FOLLOW that system of regimen which, according to my ability and
judgment, I consider for the benefit of my patients, and abstain from
whatever is deleterious and mischievous. I will give no deadly medicine to
any one if asked, nor suggest any such counsel; and in like manner I will
not give a woman a pessary to produce abortion.

33
WITH PURITY AND WITH HOLINESS I will pass my life and practice my
Art. I will not cut persons laboring under the stone, but will leave this to be
done by men who are practitioners of this work . Into whatever houses I
enter, I will go into them for the benefit of the sick, and will abstain from
every voluntary act of mischief and corruption; and, further from the
seduction of females or males, of freemen and sleves.
WHATEVER, IN CONNECTION with my professional practice or not, in
connection with it, I see or hear, in the life of men, which ought not to be
spoken of abroad, I will not divulge, as reckoning that all such should be
kept secret. WHILE I CONTINUE to keep this Oath unviolated, may it be
granted to me to enjoy life and the practice of the art, respected by all men,
in all times! But should I trespass and violate this Oath, may the reverse be
my lot.

Questions
Tell about main medical schools in Ancient Greece.
Tell about principals of Hippocratic medicine

34
 Medicine in Roman Times

Aqueducts grate technical constructions. Lead pipe, which brought water

into the dwelling Interior courtyard of the Hose of Faun, one of the richly
decorated houses in Pompeii Reconstruction of the Baths of Caracalla

Galeni (129-200) was a grates doctor of ancient medicine. He made

theoretical explanations for each functions of the body.Anatomy,
physiology, pharmacology, pathology, therapy, hygiene, dietetics and
philosophy were subjects of his work. Galen was born in Pergamum
(modern-day Bergama, Turkey), the son of Nicon, a wealthy architect. His
interests were eclectic agriculture, architecture, astronomy, astrology,
philosophyuntil he concentrated on medicine.
By the age of twenty he had become a therapeutes (attendant or
associate) of the god Asclepius in the local temple for four years. After
his father's death in 148 or 149 he left to study abroad. He studied in
Smyrna and Corinth and at Alexandria. He studied medicine for a total of
twelve years. When he returned to Pergamum in 157, he worked as a
physician in a gladiator school for three or four years. During this time he
gained experience of trauma and wound treatment. He later regarded
wounds as windows into the body.
Galen performed many audacious opererations on people that were not
used again for almost 2 millenia. Included in these were brain surgeries and
eye surgeries. To preform cateract surgeries, Galen would insert a long
needle-like instrument into the eye behind the lens. He would then pull it
back slightly and remove the cateract. The slightest slip could cause
permanent blindness. Galen had set the standard for modern medicine in
many different ways.
From 162 he lived in Rome where he wrote extensively, lectured and
publicly demonstrated his knowledge of anatomy. He gained a reputation

35
as an experienced physician and his practice had widespread clientele.
One of them was the consul Flavius Boethius who introduced him to the
court where he became a court physician to Emperor Marcus Aurelius.
Later he also treated Lucius Verus, Commodus and Septimius Severus.
Reputedly he spoke mostly Greek, which was a more respected language
of medicine than Latin at the time. He briefly returned to Pergamum during
166-169.
Galen spent the rest of his life in the Imperial court, writing and
experimenting. He performed vivisections of numerous animals to study the
function of the kidneys and the spinal cord. His favorite subject was the
barbary ape. Reportedly he employed twenty scribes to write down his
words. In 191, fire in the Temple of Peace destroyed some of his records.
His exact date of death has traditionally been placed around the year 200,
based on a reference from the 10th century Suda Lexicon. Some, however,
have argued for dates as late as 216,on the basis that his last writings
seem to be as late as 207.
Work and impact
Galen transmitted Hippocratic medicine all the way to the Renaissance. His
On the Elements According to Hippocrates describes the philosopher's
system of four bodily humours, blood, yellow bile, black bile and phlegm,
which were identified with the four classical elements, and in turn with the
seasons. He created his own theories from those principles, and much of
Galen's work can be seen as building on the Hippocratice theories of the
body, rather than being purely innovative. In turn, he mainly ignored Latin
writings of Celsus, but accepted that the ancient works of Asclepiades had
sound theory.
Amongst Galen's own major works is a seventeen-volume On the
Usefulness of the Parts of the Human Body. He also wrote about
philosophy and philology, as well as extensively writing on anatomy. His

36
collected works total twenty-two volumes, and he wrote a line a day for
most of his life.
Galen's own theories, in accord with Plato's, emphasized purposeful
creation by a single Creator (Nature Greek phusis) a major reason
why later Christian and Muslim scholars could accept his views. His
fundamental principle of life was pneuma (air, breath) that later writers
connected with the soul. These writings on philosophy were a product of
Galen's well rounded education, and throughout his life Galen was keen to
emphasise the philosohical element to medicine. Pneuma physicon (animal
spirit) in the brain took care of movement, perception, and senses. Pneuma
zoticon (vital spirit) in the heart controlled blood and body temperature.
Natural spirit in the liver handled nutrition and metabolism.however, he
did not agree with the Pneumatist theory that air passed through the veins
rather than blood.
Galen expanded his knowledge partly by experimenting with live animals.
One of his methods was to publicly dissect a living pig and cut its nerve
bundles one at a time. Eventually he cut a laryngeal nerve (now also known
as Galen's Nerve) and the pig stopped squealing. He tied the ureters of
living animals to show that urine comes from the kidneys. He severed
spinal cords to demonstrate paralysis. As well as working with pigs he also
experimented with barbary apes and goats, and emphasised that he
practised on pigs because of their similarities in some ways to the human
anatomy. Crucially, he never dissected animals in public, as this
Alexandrian tradition had not reached Rome, and Galen was always keen
to distance himself from the more manual, artisan element to medicine.
Public dissections were also highly valuable ways of disputing and
disproving others theories, and was one of the main methods of academic
medical learning at Rome, as many medical students would often attend
these public gatherings, which could turn into debates.

37
From the modern viewpoint, Galen's theories were partially correct, partially
flawed. He demonstrated that arteries carry blood, not air and made first
studies about nerve functions, and the brain and heart. He also argued that
the mind was in the brain, not in the heart as Aristotle had claimed.
However, much of Galen's understanding is flawed from the modern point
of view. He did not recognize blood circulation and thought that venous and
arterial systems were separate. This view did not change until William
Harvey's work in the 17th century. Since most of his knowledge of anatomy
was based on dissection of pigs, dogs, and Barbary apes, he also assumed
that rete mirabile, a blood vessel plexus of ungulates, also existed in the
human body. He also resisted the idea of tourniquets to stop bleeding and
vigorously propagated blood letting as a treatment.
Galen's authority dominated medicine all the way to the 16th century.
Experimenters' disciples did not bother to experiment and studies of
physiology and anatomy stopped Galen had already written about
everything. Blood letting became a standard medical procedure. Vesalius
presented the first serious challenge to his hegemony.
Much of medieval Islamic medicine drew on the works of the ancient
Greeks, especially those elucidated by Galen, such as his expanded
humoral theory. Most of Galen's Greek writings were first translated to the
Syriac language by Nestorian monks in the university of Gundishapur,
Persia. Muslim scholars primarily in Baghdad translated the Syriac
manuscripts into Arabic, along with many other Greek classics. They
became some of the main sources for Arabian scholars such as Avicenna,
Rhazes, and Maimonides. Galen was known in Arabic as Jalinos, and
many people with that name today are considered to be descended from
him

38
Medicine in Byzantine
In 395 A.D. Roman Empire split in two parts: Western and Eastern
Western Roman Empire after 476 A.D. no more existed
Eastern Roman Empire existed from 395 to 1453, when in was occupied
by Turkish army

Aqueducts
The length of the most grate Aqueducts is 625 km
Special place for saving water Cistern
Roman bath

Religion
Byzantine was a Multinational state
It accepted culture of many nations (ancient Greece, Roman, Egyptian
culture)
In that time ( 4 15 cent.) Constantinople became the centre of
Christianity

Medical knowledge
Encyclopedias:
By Oribasios (325-403)
By Aecios (502-572)
By Alexander (525-605)
By Paulus (625-690)

Oribasios (325-403) encyclopedia

Hippocratic and Galen treatises
Treatises of many philosophers
Different Drugs

39
Alexanders (525-605) encyclopedia
Treatment of internal diseases
His work was translated in 12 languages
He criticized Galen
His opinion was that prophylactic was the mane part of medicine

Paulus (625-690)
His work devoted to gynecology and surgery
His book of surgery was popular in 14-16 century
It described treatment of fractures, abdominal surgery, military and
plastic surgery

Hospitals
Christian hospitals in Monastery
Public hospitals

Medical education
Medicine was a theoretical subject in school
Doctors study medicine by reading by heart of medical books and
treatises
Doctors didnt study anatomy on dead body, for religion forbid to make
anatomical dissection on cadavers

Questions
Tell about Galenis work (philosophy, physiology, anatomy, surgery,
experimental work)

40
 Arabic Medicine
Arabic civilization has two main periods of history:
Period before Islam
Period after Muhammad founding Islam in 610
After the next hundred years Islam spread through near and Middle East,
Africa, Spain and France
Caliphates and capitals: Abbasids in Persian Baghdad (750-1258),
Umayyads in Cordova in Spanish West (756-1031), Fatimids in Cairo,
Egypt ( 909-1171)

Arabic culture
Islam (only one God; Muhammad is a founder of Islam; Muslim has to pray
5 times a day; religious trip to Mecca; charity and others)
Arab translated Greek and Roman writings (Aristotle, Hippocrates, Galen)
and save it for European civilization
Most famous Muslim writers and philosophers al- Farabi ( 870-950) al-
Biruni (973-1048), Rhazes (850-932), Avicinna (980-1037)
Researchers invented alcohol, many acids, methods for chemistry and
astronomy.

Muhammad's medicine (Islamic medicine)

There many hygienic recommendations on Koran ( religious cleaning of the
body, special diet, forbidden wine, pork)
The cases of diseases were: Gods punishment, overeating, rage and bad
emotions
Treatment: reading of Koran, honey, moxibustion, diet, surgical operation
were forbidden.

41
Public health and hospitals

First hospital was organized in 8 century

The best- known of great hospitals were at Baghdad (981 year) , Damascus
(1154) and Cairo (1282 )
There were hospitals for the rich, poor and military
Hospitals has wards for different diseases: fever, eye conditions, diarrhea,
wounds and female disorders. Convalescents had separate sections.
Hospitals has big libraries and medical schools
First chemist-shop was opened in 754 in Baghdad

Famous Healers
Rhazes, Avicenna, Haly, Abbas and Isaak Judaeus, Abul Qasim, Avenzoar

Rhazes
Clinical descriptions of many diseases
He followed Galen humoral pathology
Practiced bloodletting
He gave the first accurate description of smallpox and measles
Advised proper food in preference to drugs in treatment

Avicenna (980-1037)

Avicennas writing the Canon It includes five books; of which the first and
second treat of physiology, pathology and hygiene, the third and fourth deal
with the methods of treating disease, and the fifth describes the
composition and preparation of remedies. This last part contains some
contingent of personal observation. Up to the year 1650, or thereabouts,
the Canon was still used as a text-hook in the universities of Louvain and
Montpellier.

42
It included: theoretical medicine, methods of treatment, rugs
He described 4 periods of disease, 15 different types of pain
Methods of diagnosis: percussion, examined pulse and urine, differentiated
ascites and meteorism
Made clinical descriptions of rabies and meningitis
Surgery: amputation of tongue, operation on trachea
He made a test of drugs on animals

Albucasis (936-1013)

His book Al-Tasrif contained section on surgery (described surgical

treatment of wounds, fractures, operations on blood vessels)
He first used catgut
Made operations on cataract
Method of cauterization

Famous Healers

Ibn al- Nafis described circulation of the blood in lungs

Ibn Nafis (d. 1288) was the first person to accurately describe the process
of blood circulation in the human body. Contemporary drawings of this
process have survived.
In 1628 this was again 'discovered' by William Harvey. It was not
uncommon for early Muslim medicine to be re-invented in Western Europe,
or for ambitious Europeans to discover Muslim ideas and publish them as
their own. It was also not uncommon for Europeans to simply not know of,
or to disbelieve, Muslim discoveries, despite the fact that Rhazes,
Avicenna, Al-Zahra and Al-Ibadi were well known.
This particular theory contradicted one of Galen, as Harvey discovered, to
his chagrin. It may have been suppressed in Europe because it was a clear

43
case where Muslim discoveries had contradicted classical discoveries,
which Europeans sought to elevate as their own.

Ibn al- Haitham studies anatomy of eye, described eye-diseases

Questions
Tell about Avicenna and Rhazes

44
 Medicine of Renaissance

Renaissance. In Italy 14-16 centuries; In Germany, France, England

and others 16-17 centuries.
The grate geographical discoveries acquainted the peoples of Europe with
new medical advances and brought new herbs ( quinine, ipecacuanha)
The philosophy of Renaissance was created in 14 century. The ideas of
philosophers depended on the science discoveries (N. Copernicus, J.
Bruno, N. Kuzansky)

Philosophers changed the principle of theocentrism to the principle of

anthropocentrism; as a result there was a new trend in philosophy
humanism

It was a time of progress of pharmaceutics

The experiments of alchemist had developed a type of laboratory which
was use for the pharmacist (picture)
The appearance of the apothecaries shop also changed.
In early times, medicine has been sold in shops opening onto the street.
Now the workshop (the officina) became the place where medicaments
were handed out and the room behind it turned into laboratory
Anatomy before Andreas Vesalius (pict)

Anatomy
Andreas Vesalius (1514-1564) dissected dead bodies, described 12 pairs
of cranial nerves, found more than 200 mistakes of Galeni
Miguel Serveto ( 1511-1553) discovered pulmonary circulation
William Harvey (1578-1657) in 1616 explained blood circulation

Surgery

45
Ambroise Pare (1506-1590)
He proved that bullet wounds should be treated in different way from
poisoned ones
He stopped the cauterization of wound, reintroduced ligature of veins into
practice
He invented artificial limbs
He reintroduced method of external turn a child into proper position in
abnormal presentation in womb

Iatrochemistry
A. T. Paracelsus (1493-1541)
New theory of pathology: human body consists of sulfur, salt and mercury.
Sulfur is ether, salt material parts of the body and mercury humor.
Disease is a result of deficiency or plenty of one- three elements.
Causes of diseases: 1) poisons external and internal, 2) psychological
facts (desire, vises) 3) Karma 4) influence of the Cosmos 5) Over work or
disturbance of the organs functioning
He developed astrology, chemistry, iatrochemistry. He began to study
professional diseases

Epidemic diseases
Girolamo Fracastoro (1478-1553)
He invented teaching about contagio:
1) Contagio living substance, specific for each diseases, can multiply.
2) There 3 method of transmission of disease: through the air, objects and
through contact with ill human
3) He also proposed tern disinfection.

Questions
Tell about Ambroise Pare and Girolamo Fracastoro

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 19 century time of scientific medicine

Base of scientific medicine

Inventions in chemistry, physics and biology
Methods: experiment, observation, systematization
Theory is proved by practice
Three directions: theoretical, clinical and prophylactic

Scientific societies, conferences and publications

First numbers of the Lancet was started to publish in 1823
First international conference was held in Brussels in 1852. Twelve
international doctors conference was held in Moscow in 1897

Forms of medical care

State
Private
Peoples medicine
Insurance (new form)

Hospitals
Treatment only for : emergency cases and very severe diseases
Conditions were very bad in hospitals in
19 century (pict)

Theoretical medicine
Pathologic anatomy
Experimental physiology
Bacteriology

Pathologic anatomy

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 German scientist Rudolf Virchow (1821-1902) achieved results in
pathology. His teaching (1858) was about that centre of pathology
was a cell.

Experimental physiology
French scientist Claude Bernard (1813-1878) made experiment:
injection in fourth brain ventricle after that he found high glucose level
in blood and urine.
Charles Broun-Sequar in 1889 injected himself a extract of testicles.
That extract had a rejuvenation effect.
Ivan Pavlow studied physiology of digestion (Nobels prize in 1904).
(pict)
Pavlovs lab (pict)

Bacteriology
French scientist Louis Paster (1822-1895) studied disease of vine
and beer and found microscopic living organism, their pathogenic
effect. He made vaccine against rabies and plague (Siberian).
Robert Koch determined etiology of plague, cholera, tuberculosis. Hi
made diagnostic liquid tuberculin. Robert Koch was rewarded by
Nobels prize in 1905

Clinical medicine
New methods of diagnostic
Rene Laennec (1781-1826) in 1816 invented stethoscope and
introduced symptomatic classification of lung (pneumonia, plevritis,
asthma, tuberculosis) and heart diseases. (pict)
Improvement of stethoscope (pict)

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 French doctor Jean Nicolas Corvisart (1755-1821) retranslated in
1818 a neglected work on percussion, by the Austria Leopold
Auenbrugger (1722-1809) and added material on his own experience

Studying anatomy (pict)

Aseptic and antiseptic

Ignac Semmelweis (Hungary) (1818-1865) discovered the causes of
puerperal fever and showing how it could be prevented : by washing hands
and after each examination and forbid for students to examine women after
anatomy classes (pict)

Chloroform narcosis (pict)

Methods of narcosis (pict)

1846 American dentist William Morton (1819-1868) and surgeon

John Warren (1778-1856) applied ether for narcosis
1847 F. Inozemcev was the first in Russia to apply ethereal
narcosis English obstetrician James Simpson (1811-1870) introduced
chloroform for anesthesia

Questions
Who invented stethoscope, who applied ether for narcosis?

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 The history of Russia

The peculiarities of Russian civilization

There are four civilization peculiarities of Russia. The first one is the
geographic factor, the second the community, the third the Orthodox
religion, the fourth very strong state power.
The geographic factor includes: climate and the territory. Russia is one of
the northern agricultural countries in the world. The period of agricultural
work is very short in Russia (only 5 months a year). The territory scale of
Russia is unique. Russians lived and live the very large country. One of the
results of it is the extensive economy till now days, because our country is
thinly populated. The intensive development of economy begins, when
there is no opportunity for the extensive way, and the first condition for it is
when the whole territory of the country is populated. The next result of our
large territory is the aspiration to absoluteness, the endlessness. The
territory of Europe is small and the Europeans began to develop intensively
since the 15th century, when they populated their territory.
The next civilization peculiarity of Russia is the peasant community. The
peasant community was formed before the 6th century and was destroyed
in the end of the 19th and the beginning of the 20th century.
The third peculiarity of Russian civilization is an Orthodox religion. Russians
got it from Byzantine at the 10th century. An Orthodox religion became the
dominating idea of the Russian civilization and influenced its development,
its culture, its policy and so on. The main idea of the Orthodox Christianity
is the God is the Love; so the main aim of Russians was the search of the
spiritual perfection, to reach the transfiguration of the soul.
The 4th peculiarity of the Russian civilization is very strong state system.
There 5 functions of the state:
The state is the instrument of the political rule
It is the personification of the national roots, the justice

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The state is the keeper of the security and the territorial integrity
It is the arbiter in any argument between the public and individual interests
It has the civilization all function (it create the form in which the civilization is
developing).

Medical Faculty, Imperial Moscow University (IMU-MSU)

The MMA forefather was the medical faculty of Imperial Moscow
University opened by the efforts of count I.I. Shuvalov and the grate
Russian scientist M.V. Lomonosov during the reign of Empress Elizaveta
Petrovna. (3 pict)

n 1755 Inauguration of imperial Moscow University

n 1758 Firs lectures at the IMU medical faculty

The first six students their studied at the faculty in 1758. By the early 19 th
century, the medical faculty had three departments. The teaching staff was
foreigners. However, they were soon replaced with Russian professors who
had been perfectly trained abroad. Poor village clergy by birth, all of them
were highly moral and humane persons. Further generations of teachers
inherited their better features.
n 1764 Beginning of continuous lecturing at the medical faculty
n 1768 G. Zybelin and P. Veniaminov, first Russian professors at
the medical faculty
n 1791 Imperial Moscow University was granted the right of
conferring the Doctor of Medicine degree
n 1794 F.Barsuk-Moiseev was the first to be conferred with the
Doctor of Medicine degree after defending the thesis entitled On
breathing
In the first half of the 19th century the faculty was enlarged. The University
Charter of 1804 provisioned six independent departments and three

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instituted, the Charter of 1835 ten departments and many additional
courses
n 1805 Opening of the first clinics at Nikitskaya street
n 1806 Publication of the first issue of the Medico-Physical
Journal
n 1812 Professors, lectures and students of the IMU medical
faculty took part in the Patriotic War of 1812. Destruction of the
medical faculty buildings, books and manuals.
n 1820 Completion of the Medical Faculty building restoration
after fire 1812. Opening of the Clinic Institute.
n 1826 Beginning of the students practical studies at the old
Ekaterinian Hospital
n 1842 V. A. Basov was the first to perform an operation for
artificial fistula in animals
n 1847 F. I. Inozemtsev was the first in Russia to apply ethereal
narcosis A. Pol was the first to apply chloroform narcosis

n Of primary importance in the reform of higher medical education

in Russia was the Government Supplementary Resolution of the
madical faculty of Moscow University that recieved the Royal assent
on December 7, 1845. This resolution provisioned opening of hospital
clinics and the extention of the term of study to five years.
Acknowledged in 1863, the new Charter confirmed this and increased
the number of department to 17.

A lecture delivered at a hall of the propedeutic-therapeutic clinic (end

of the 19th century)
n The second half of the 19thcentury saw flourishing of clinic
medicine in Russia caused by an advance of large clinic schools at

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Moscow University, diversification of medical knowledge, and
formation of scientific hygiene as a branch of scientific knowledge .
n 1851 A. I. Polunin started to publish the Moscow Medical
Journal
n 1858 F.I. Inisemtsev initiated publication of the Moscow Medical
Newspaper.
n 1861 he organized the Society of Russian Physicians in
Moscow
n Unique combination of scientific with educational, scientific
with practical and practical with educational was the educations
strong point. This was supplemented with public activity, wide and
close contacts with other regions of Russia and abroad. All this
formed the tradition, enhanced the prestige of the faculty and allowed
it to reach a high status among the medical institutions of Russia and
in the system of international medical relations.
n S.G. Zybelin, M.Ya. Mudrov, E.O. Mukhin, then, F.I.
Inozemtsev, A.I. Polunin, then G.A. Zakharyin, A.A. Ostroumov, N.V.
Slifosovskii, A. Ya. Kozhevnikov, S.S. Korsakov, A.I.Babukhin, I.M.
Sechenov, N.F. Filatov, V.F. Snegirev, F.F. Erisman and many other
prominent workers of the national madicine studied, worked, founded,
the scientific schools, andtrained physicians and scientists at the
faculty.
n A grate son of our country, Nikolai Ivanovich Pirogov was
educated within the precincts of the faculty.
n In the late 1890s, a unique, world best complex was opened at
Devichye Polye, Moscow.
n 1887-1897 Construction of the Clinic Town at Devichye Pole,
building of 15 clinics and institutes.
n 1891 I.M. Sechenov was elected professor of the Physiology
Department

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n 1897 Inauguration of the N.I. Pirogov memorial. The 12th
international Congress of Physicians was held on the base of the
medical faculty.
n The 12th International Congress of Physicians (1897) held in
Moscow was the triumph of the Russion medicine. It was then that
the great German pathologist Rudolf Virhow exclaimed, Learn from
the Russians!.
n 1930 Reorganization of the medical faculty of Moscow State
University into 1st Medical Institute
n 1990 On the resolution of the USSR Council of Ministers, the
1st Medical Institute was raised to the I.M. Sechenov Moscow
Medical Academy
n 1997 The centenary of the I.M. Sechenov MMA clinic town.

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 Literature

1. Bettman O.T., Hench P.S. A pictorial history of medicine.

Charles of Thomas publisher: Illinois, 1962. 318 p.
2. Lyons A.S., Petruchelli R.J. Medicine an illustrated history.
Harry N. Abrams, Inc., publisher: New York, 1978. 616 p.
3. Internet: Wikipedia the free encyclopedia.

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