A History of Medicine | Top Facts About Western Medicine Through Time - BBC History Magazine

A adjacent tomb reveals the representation of Merit Ptah, the archetypal pistillate doc known by name. She lived successful astir 2,700 BC and hieroglyphs connected the tomb picture her arsenic ‘the Chief Physician’. That's beauteous overmuch each that's known astir her career, but the inscription reveals that it was imaginable for women to clasp high-status aesculapian roles successful Ancient Egypt.

Some 200 years aboriginal different doctor, Peseshet, was immortalised connected a monument successful the tomb of her son, Akhet-Hetep (aka Akhethetep), a precocious priest. Peseshet held the rubric ‘overseer of pistillate physicians’, suggesting that women doctors weren't conscionable occasional one-offs. Peseshet herself was either 1 of them oregon a manager liable for their organisation and training.

Although the barriers of clip and mentation marque it hard to reconstruct the day-to-day signifier of Merit Ptah and Peseshet, pistillate doctors look to person been a respected portion of past Egyptian society.

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One of the oldest known aesculapian textbooks is the Sushruta Samhita, written successful Sanskrit successful India. Its nonstop day is tentative, arsenic nary archetypal mentation survives and it is lone known from aboriginal copies, but the existent statement is that it was written successful astir 600 BC. Sushruta is thought to person been a doc and teacher moving successful the North Indian metropolis of Benares (now Varanasi successful the authorities of Uttar Pradesh). His Samhita – a compilation of cognition – provides elaborate accusation connected medicine, surgery, pharmacology and diligent management.

Sushruta advises his students that nevertheless good work they are, they are not competent to dainty illness until they person applicable experience. Surgical incisions were to beryllium tried retired connected the tegument of fruits, portion cautiously extracting effect seeds enabled the pupil to make the accomplishment of removing overseas bodies from flesh. They besides practised connected dormant animals and connected leather bags filled with water, earlier being fto escaped connected existent patients.

Among its galore surgical descriptions, the Sushruta Samhita documents cataract surgery. The diligent had to look astatine the extremity of his oregon her chemoreceptor portion the surgeon, holding the eyelids isolated with thumb and scale finger, utilized a needle-like instrumentality to pierce the eyeball from the side. It was past sprinkled with bosom beverage and the extracurricular of the oculus bathed with a herbal medication. The surgeon utilized the instrumentality to scrape retired the clouded lens until the oculus “assumed the glossiness of a resplendent cloudless sun”. During betterment it was important for the diligent to avoiding coughing, sneezing, burping oregon thing other that mightiness origin unit successful the eye. If the cognition were a success, the diligent would regain immoderate utile vision, albeit unfocused.

A Roman alleviation portraying an ophthalmologist examining a patient. (Photo By DEA/A DAGLI ORTI/De Agostini/Getty Images)

Trapped successful crystal adjacent Stadacona (the tract of present-day Quebec City) successful 1536, Jacques Cartier's ships weren't going anywhere. The crews, holed up successful a makeshift fort with small entree to caller food, came down with a illness truthful gruesome that “their rima became stincking, their gummes truthful rotten, that each the soma did autumn off, adjacent to the rootes of the teeth, which did besides astir each autumn out.” They had scurvy, present known to effect from a deficiency of vitamin C. Cartier had nary thought what to do.

During his archetypal voyage to Stadacona successful 1534, Cartier had kidnapped 2 young men, Dom Agaya and Taignoagny, taking them backmost to France arsenic impervious that helium had discovered a caller territory. Now that they were home, the men and their assemblage had each crushed not to spot Cartier – an cognition that helium interpreted arsenic “treachery” and “knavery”.

In spite of this tension, Dom Agaya showed Cartier however to marque a decoction from a histrion called Annedda and, though the Frenchmen wondered if it were a crippled to poison them, a mates of them gave it a spell and were cured wrong days. After that, determination was specified a unreserved for the medicine that “they were acceptable to termination 1 another”, and utilized up a full ample tree.

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The individuality of Annedda is not definite but determination are respective candidates including eastbound achromatic cedar and achromatic spruce. Whatever it was, its nutritional benefits resulted successful the sailors' implicit cure.

Cartier repaid Dom Agaya by kidnapping him again on with 9 different people. By the clip of Cartier's adjacent voyage – to Canada successful 1541 – astir of the prisoners were dead, but Cartier informed their relatives that they were surviving successful benignant successful France. The scurvy cure did not summation wide designation and the illness continued to assertion the lives of sailors for much than 200 years.

Being a king successful past times was exhaustingly dangerous; determination was ever idiosyncratic plotting to get escaped of you. So, according to legend, Mithradates (aka Mithridates) VI of Pontus (on the shores of the Black Sea successful Turkey) attempted to go resistant to poisons by taking gradually expanding doses. He was besides reputed to person conducted toxicological experiments connected condemned prisoners, culminating successful the instauration of mithridate – a medicine that combined each known antidotes successful 1 potent formula.

It didn't enactment against Roman armies, however, and erstwhile Mithradates was defeated by the subject person Pompey successful 66 BC, the look supposedly arrived successful Rome. Emperor Nero's doc Andromachus developed it into a 64-ingredient composition, which became known arsenic theriac. Most of the ingredients were botanical (including opium), but viper's soma was a notable component.

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In spite of aboriginal scepticism, theriac took disconnected arsenic a prized (and expensive) cure-all. By the 12th period Venice was the starring exporter and the substance had a precocious illustration successful European, Arabic and Chinese medicine alike. Its fortunes waned aft 1745, however, erstwhile William Heberden debunked its alleged efficacy and suggested that enterprising Romans had exaggerated the Mithradates communicative for their ain gain.

Even so, theriac remained successful immoderate European pharmacopoeias until the precocious 19th century.

Tin-glazed Italian pharmacy jar (or albarello) from Rome oregon Deruta, utilized by the Jesuits and intended for storing theriac, 1641. (Photo by SSPL/Getty Images)

Kan Aiya, a 60-year-old woman, had mislaid galore loved ones to bosom cancer. She had seen her sisters dice of the cruel disease, truthful erstwhile a tumour formed successful her near bosom she was good alert of the apt outcome. For her, however, determination was a accidental of endurance – an operation. It was 1804 and she was successful the champion imaginable spot for country – feudal Japan.

Seishu Hanaoka (1760–1835) studied medicine successful Kyoto and acceptable up a signifier successful his hometown of Hirayama. He became funny successful the thought of anaesthesia owing to stories that a third-century Chinese surgeon Houa T'o had developed a compound cause enabling patients to slumber done the pain. Hanaoka experimented with akin formulae and produced Tsusensan, a potent blistery drink. Among different botanical ingredients it contained the plants Datura metel (aka Datura alba oregon ‘devil's trumpet’), monkshood and Angelica decursiva, each of which incorporate immoderate potent physiologically progressive substances.

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Tsusensan had rather a footwear and if you glugged it down willy-nilly you would astir apt die, but successful the close dosage it rendered patients unconscious for betwixt six and 24 hours, allowing ample clip for surgery.

On 13 October 1804, Hanaoka excised Kan Aiya's tumour portion she was nether wide anaesthesia, going connected to run connected astatine slightest 150 much bosom crab patients and radical with different conditions. Sadly, Kan Aiya is thought to person died of her illness the pursuing year, but had been spared the agony that inactive characterised country successful the West.

An illustrated manuscript depicting a drafting of a man's look with a reddish tumour by his mouth, which was to beryllium excised nether wide anaesthesia by Seishu Hanaoka, c1800. Courtesy of the National Library of Medicine. (Photo via Smith Collection/Gado/Getty Images).

The medicinal leech has been successful usage for thousands of years, and is adjacent contiguous considered to beryllium a mode of restoring venous circulation aft reconstructive surgery. But it was successful the aboriginal 19th period that the leech truly soared successful popularity. Led by French doc François-Joseph-Victor Broussais (1772–1838), who postulated that each illness stemmed from section inflammation treatable by bloodletting, the ‘leech craze’ saw barrels of the creatures shipped crossed the globe, chaotic leech populations decimated astir to extinction, and the constitution of prosperous leech farms.

Leeches had advantages implicit the communal signifier of bloodletting utilizing a lancet – the nonaccomplishment of humor was much gradual and little of a daze for those of delicate constitution. And due to the fact that Broussais's followers utilized leeches successful spot of each the different medicines astatine the 19th-century physician's disposal, patients were spared immoderate harsh remedies that mightiness different person made them consciousness worse. In 1822, a British surgeon called Rees Price coined the word sangui-suction for leech therapy.

A woodcut from a 1639 treatise by Joannis Mommarti depicting a pistillate applying a medicinal leech to her forearm. In the aboriginal 19th period the medicinal leech soared successful popularity, says Caroline Rance. (Photo by Everett Collection Historical/Alamy Stock Photo)

In 1884, the caesarean conception was not a caller idea. It dated from the clip of the Caesars, for a start, erstwhile Roman instrumentality required the process to beryllium carried retired successful the lawsuit of a woman's decease successful childbirth.

Over the centuries, reports occasionally surfaced of caesarean sections redeeming the lives of some parent and baby, but adjacent aft the instauration of antiseptic methods and anaesthesia, caesareans remained a unsafe past resort. So Edinburgh surgeons were amazed to perceive a lecture by Robert Felkin, a missionary doctor, astir a palmy cognition that helium had witnessed successful the African kingdom of Bunyoro Kitara 5 years earlier.

The operation, Felkin reported, was carried retired with the volition of redeeming some lives. The parent was partially anaesthetised with banana wine. The surgeon besides utilized this vino to lavation the surgical tract and his ain hands, suggesting consciousness of the request for corruption power measures. He past made a vertical incision, going done the abdominal partition and portion of the uterine wall, earlier further dividing the uterine partition capable to instrumentality the babe out. The cognition besides progressive removing the placenta and squeezing the uterus to beforehand contraction.

The archetypal surgical attraction of bosom crab performed nether wide anaesthetic by Seishu Hanaoka (1760-1836) successful 1804 (colour litho), Japanese School (19th century). (Private Collection/Archives Charmet/Bridgeman Images)

The means of dressing the incision was besides highly developed: the surgeon utilized 7 polished robust spikes to bring the edges of the coiled together, tying them successful spot with bark-cloth string. He past applied a heavy furniture of herbal paste and covered this with a lukewarm banana leafage held successful spot with a bandage. According to Felkin's account, the parent and her babe were inactive doing good erstwhile helium near the colony 11 days later.
Although caesarean operations had been performed successful Africa by achromatic surgeons earlier this date, the process appeared to person been developed independently by the Banyoro radical – a somewhat discomfiting realisation for a British assemblage acquainted with assemblage tales of ‘savages’.

In 1865, American archaeologist Ephraim George Squier near Cuzco, Peru, successful possession of an past Mexican skull fixed to him by a collector. The artefact was to ignite statement successful aesculapian circles connected some sides of the Atlantic.

Dating from astir 1400–1530 BC, the skull had a rectangular spread successful its frontal lobe. Squier shared the find with the New York Academy of Medicine and with French neuroscientist Paul Broca, who showed that the spread had been deliberately made portion the idiosyncratic was inactive alive.

Examples of this past signifier – trepanning – person since been recovered worldwide, dating backmost arsenic acold arsenic 10,000 BC. It appears to person developed independently successful galore cultures, and arsenic a effect there's grounds of assorted methods: scraping the skull with a crisp flint; boring a ellipse of holes and prising retired the resulting disc; creating a 'hashtag' signifier of grooves and removing the middle.

But why would radical bash this? Broca speculated that they were trying to fto evil spirits flight from the body. It's a mentation that remains fashionable today, but we should beryllium alert that it alternatively suited 19th-century achromatic anthropologists to presumption indigenous cultures arsenic scientifically inferior.

Also imaginable is that trepanning was a applicable mode to dainty fractures (the past Greeks surely utilized it this way). With caput wounds a acquainted effect of struggle oregon accident, practitioners mightiness person observed the people of corruption and realised that dormant bony would yet disintegrate (if the diligent didn't dice successful the meantime). Removing these fragments manually would person been worthy a try. We can't inquire past communities wherefore they made holes successful heads, but their rationale could person been little barbaric than it astatine archetypal appears.

Magic, religion and rational subject mingled without contradiction successful past Egyptian healing. A sick idiosyncratic could consult a doc (called a swnw), a magician oregon a laic clergyman – oregon each 3 if they felt similar it. One practitioner mightiness beryllium some clergyman and doctor, curing via a operation of medicines, incantations and prayers.

Egypt's strategy of medicine was the archetypal to beryllium acceptable down successful writing, but its past remained obscure until hieroglyphs started being decoded successful the aboriginal 19th century. Since then, papyri and depictions successful tombs person shown that doctors had an extended cognition of illness and a affluent pharmacopoeia of herbs, carnal products and minerals. Prescriptions were prepared according to precise recipes that included agelong lists of ingredients and their measurements, and took galore forms including pills, ointments, inhalations and enemas.

One doc peculiarly skilled successful administering these enemas was Irenakhty, who lived successful astir 2150 BC. He was doc to the royal palace and (among respective different titles) held the presumption of neru pehut – herdsman of the anus. His proctological expertise was not a one-off: his predecessor Khuy was different anal guardian, who combined the relation with his skills arsenic a dentist to guarantee some ends of the pharaoh's alimentary canal remained successful tip-top condition.

Reconstruction of an past Egyptian alleviation from the Temple of Kom Ombo, showing a postulation of surgical instruments. (Photo by DeAgostini/Getty Images)

The nonaccomplishment of a chemoreceptor – whether the effect of punishment, unluckiness successful sword-fighting, oregon illness – has historically led surgeons to effort to reconstruct the patient's features and dignity.

The Indian surgeon Sushruta (c600 BC) utilized a plant-leaf template to dissect a flap of tegument from the patient's cheek, leaving it attached by a portion called a pedicle. Twisting it truthful the coiled aboveground remained downwards, Sushruta would suture it into the spot of the missing chemoreceptor and affix tiny reed tubes to enactment arsenic nostrils.

Similar procedures re-emerged successful Renaissance Italy, erstwhile surgical families the Brancas and the Vianeos developed methods of creating a caller chemoreceptor from the tegument of a patient's arm. It was worthy these practitioners' while, however, to support the details concealed to ward disconnected competition. In 1597, Gaspare Tagliacozzi, prof of anatomy astatine Bologna, brought nasal reconstruction retired into the unfastened by publishing De Curtorum Chirurgia per Insitionem, which aimed to picture rhinoplasty scientifically and amended different surgeons astir it.

Tagliacozzi's cognition progressive making parallel incisions successful the tegument of the precocious limb and drafting a linen dressing underneath the flesh. After astir 14 days, helium chopped the flap astatine 1 end; different 14 days allowed the flap to mature and helium past engrafted it to the patient's nasal cavity, utilizing a strategy of bandages to support the limb and look together. After different fortnight, helium separated the limb from the chemoreceptor (much to the patient's relief) and shaped the graft accordingly. But aft Tagliacozzi's decease successful 1599, the cognition failed to go mainstream. It was not until the precocious 18th period that European surgeons realised caller noses were inactive being created successful India.

A missive to the Gentleman's Magazine successful 1794 told of an Indian service bullock-driver called Cowasjee, who was captured by the sultan and punished arsenic a traitor by having his chemoreceptor and 1 manus severed. An unnamed Mahratta surgeon skilfully moulded a caller chemoreceptor from the tegument of Cowasjee's forehead. British surgeon Joseph Constantine Carpue drew upon these reports to statesman nasal reconstructions successful 1814; his enactment revived involvement successful rhinoplasty and helped occidental surgeons drawback up with their Indian counterparts.

Engraving from Tagliacozzi’s ‘De Curtorum Chirurgia per Insitionem’, showing rhinoplasty country successful which the patient's chemoreceptor was attached to a flap of tegument connected his precocious arm. (Photo by DeAgostini/Getty Images)

The words 'cigarettes' and 'health' are present improbable bedfellows. Nineteenth-century aesculapian cigarettes for asthma, however, were portion of a agelong past of inhalation therapy that continues successful the inhalers of today.

Ideas astir the causes of asthma changed implicit the centuries, truthful the inhalation of herbal fume fell successful and retired of favour depending connected the prevailing theory. By the extremity of the 18th century, however, asthma was being interpreted arsenic a 'nervous' illness caused by spasms of the bronchi. Into this receptive aesculapian situation came the works datura stramonium, oregon thorn-apple. Already known successful the US, radical successful Britain began smoking it betwixt 1802 and 1810, aft a akin remedy, datura ferox, was brought backmost by an East India Company physician. Joseph Toulmin, a surgeon from Hackney, substituted the much easy obtainable datura stramonium, gaining alleviation from his ain asthma. Word rapidly dispersed astir the caller remedy.

At first, stramonium was smoked successful mean baccy pipes. It was imaginable to turn it oneself and adust the roots and stalks (although not the leaves, which person a unsafe narcotic effect). By the mediate of the 19th century, smoking was socially acceptable and ever easier with the instauration of cigars, past cigarettes (and matches). Commercial brands of stramonium cigarettes fitted nicely into this discourse and were not seen arsenic a quack remedy – doctors recommended them arsenic a convenient mode of inhaling the drug.

In the aboriginal 20th period the spasmodic exemplary of asthma gave mode to the conception of allergic inflammation, and this made smoking look little appropriate. At the aforesaid time, caller drugs specified arsenic ephedrine provided an alternate to the perchance hallucinogenic stramonium. As the dangers of baccy smoking became much apparent, medicated cigarettes fell retired of favour – but, for a while, stramonium had played an important relation successful bringing alleviation to those struggling to breathe.

^{Kellogg’s ‘asthma cigarettes’. (Reg Innell/Toronto Star via Getty Images)}

In May 1869, a doc addressed the yearly gathering of the New England Anti-Slavery Society. Slavery had been abolished successful 1865, and the doc expressed beardown hopes for the aboriginal for achromatic people. She besides gave a prescient warning: it would “take earnest labour connected the portion of their friends to unafraid them each their rights.” The talker was Rebecca Crumpler, the archetypal African-American pistillate to postgraduate arsenic a physician. She devoted her vocation to improving the wellness presumption of achromatic radical surviving successful poverty, particularly women and children.

Crumpler was calved Rebecca Davis successful Christiana, Delaware, successful 1831. She joined Wyatt Lee successful 1852, settling astatine Charlestown, Massachusetts. There, she worked arsenic a caregiver for section physicians, and these employers supported her palmy exertion to the New England Female Medical College. Her hubby died of tuberculosis successful 1863 but she persisted with her studies and graduated the pursuing twelvemonth arsenic 'doctress of medicine.' She concisely practised successful Boston earlier travelling to St John successful New Brunswick, Canada, wherever she joined Arthur Crumpler successful May 1865. She is present remembered arsenic Rebecca Lee Crumpler, though she does not look to person continued utilizing the sanction Lee aft her 2nd marriage. Sadly, nary identifiable photos of her person survived.

With the American Civil War over, Crumpler went to Richmond, Virginia, to enactment for the Freedmen's Bureau, a authorities bureau assisting freed slaves and impoverished achromatic radical successful the erstwhile Confederate states. Despite her degree, she is listed successful the records arsenic 'nurse', receiving $10 per month. As she aboriginal explained, however, this portion of her vocation was the 'real missionary work' to which she felt called. Serving a colonisation of 30,000 achromatic radical emancipated from slavery yet inactive experiencing convulsive discrimination, she focused connected assisting the poorest families.

Her A Book of Medical Discourses (1883), was 1 of the earliest aesculapian publications by an African-American writer, and specifically spoke to a pistillate readership. Crumpler realised that cognition is powerfulness and that encouraging women to beryllium progressive successful protecting their ain and their children's wellness would amended their lives wrong a hard context.

The beef tapeworm, taenia saginata, tin turn to implicit 20 metres agelong successful the quality intestines. As is besides the lawsuit with its shorter but meaner cousin, the pork tapeworm, it absorbs nutrients from the contents of the digestive strategy and tin past peacefully for years – unless, that is, its big decides to evict it.

1812 copperplate engraving of a parasitic tapeworm. (Photo by Florilegius/SSPL/Getty Images)

In precocious 19th and aboriginal 20th-century America, the tapeworm provided a profitable vocation for itinerant practitioners, who travelled from municipality to town, parting radical from their intestinal inhabitants. Such 'tapeworm specialists' are not precisely a much-fêted portion of the past of medicine, but their activities springiness an penetration into the healthcare options disposable to agrarian communities.

When treated by a worm doctor, you would person to accelerated for a time to get the worm hungry, past instrumentality a spoon of the indispensable lipid of antheral fern successful a cupful of lukewarm milk. After this, you laic down for a fewer hours earlier taking a draught of castor oil, turpentine and croton lipid – the second being toxic and a drastic laxative. The spectacular effects of this substance tin readily beryllium imagined.

Some tapeworm specialists were showmen, impressing the punters by displaying preserved 'worms' of tremendous length. These were much apt to beryllium fakes made from carnal entrails than the existent thing, truthful the tapeworm doc became a reasonably disreputable character. He's improbable to beryllium commemorated with a statue extracurricular a infirmary oregon a reverent biography detailing his selfless quest for aesculapian progress, but helium was portion of the colourful assortment of healthcare providers to whom the mean idiosyncratic could crook erstwhile incapable to spend a physician.

The connection 'plague' sounds inherently medieval, but the Third Plague Pandemic finished wrong surviving memory. Previous pandemics had wiped radical retired indiscriminately, but this 1 disproportionately affected those surviving successful poverty, highlighting the planetary wellness inequality that has been worsening ever since.

The Third Pandemic emerged successful China successful the 1850s and crossed planetary borders during the 1890s. From Hong Kong successful 1894, rats infested with plague-carrying fleas starting travelling the satellite connected assemblage proviso ships, taking their lethal bacteria to each inhabited continent.

The bacterium – yersinia pestis – was isolated the aforesaid twelvemonth (1894) by Alexandre Yersin and Kitasato Shibasaburō, who independently recovered it wrong days of each other. In 1898 Paul-Louis Simond established rat fleas arsenic the vector, oregon transmitter. As the illness dispersed to planetary ports, however, nationalist wellness officials responded with quarantine programmes that isolated suspected sufferers connected the presumption that the illness could walk from 1 quality to another.

Draconian measures by the British authorities successful India led to governmental unrest; successful the United States, existing anti-Asian prejudice fed connected the disease's Chinese origin. When plague reached Cape Town via Argentina successful 1901, its archetypal victims were achromatic dockworkers. South Africa's assemblage authorities utilized this arsenic a pretext to region the African colonisation of District Six, forcing them nether equipped defender to a determination extracurricular the metropolis astatine Uitvlugt (Ndabeni). Segregation, which had been regularly mooted connected ostensible wellness grounds for the erstwhile 2 decades, began successful earnest.

The Third Pandemic killed astir 15 cardinal people, the bulk successful India and Africa. The disease's pandemic presumption officially ended successful 1959, but plague has ne'er been eradicated, and though yersinia pestis remains susceptible to the antibiotic streptomycin, multi-drug resistant strains occasionally surface. Let's anticipation aboriginal historians bash not person to analyse a Fourth Plague Pandemic.

Caroline Rance blogs astatine www.thequackdoctor.com astir the past of aesculapian advertizing and wellness fraud. Her publication The History of Medicine successful 100 Facts (Amberley Publishing, 2015) explores medicine's past successful bite-sized topics, from prehistoric parasites to the menace of antibiotic resistance. You tin travel Caroline connected Twitter @quackwriter and connected Facebook astatine www.facebook.com/quackdoctor

This nonfiction was archetypal published by HistoryExtra successful 2015