Medicine of Ancient World

(V thousands BC – middle of
1 thousand AD)
 Slave system of Ancient World

Professional medicine, based on achievements of ethnomedicine, is enriched by

new ideas about causes of diseases and facilities of their treatment in accordance
with general progress and changes in the world view of that time. Development
of culture and medicine in the first large slave-holding states had special
features, which were dependent on social terms and geographical features. The
first writing labours of medical maintenance, which gave the best idea about
experience of ancient doctors, appeared in that time.
In this period in addition to the stock-raising agriculture was developing. That assisted
greater enrichment of human association.

There was a division of labor

and its specialization.
Medicine of Ancient
Egypt
 Ancient Egypt civilization included time from
V to II millennium BC and was divided into 4
periods:

- Archaic period (V – IV thousands BC)

- Old reign (IV – III thousands BC)
- Middle reign (III – II thousands BC)
- New reign (from II thousand BC and till birth
of Christ).
Sources for the studying of medicine of
ancient Egyptians were descriptions of
remoteness; architectural sources - pyramids,
tombs and sarcophaguses; archaeological
materials (remains of people and animals,
analysis of mummies), writing sources -
papyrus etc.
 Medical papyrus of Ancient Egypt
Papyrus of medical maintenance, well-known in history of medicine
under the name of Kahun papyrus (from Kahun city), was telling about
treatment of women diseases and diseases of home animals.

Papyrus of Smith had 22 pages. 48 traumatic cases were described in

it, each had a description of physical inspection, surgical procedures,
treatment and prognosis.

Among medical papyruses major is Ebers

papyrus, found in ruins of Thebes in 1873
Volume of Ebers papyrus was 110 pages
and had the name "Book of medications
for all parts of body”. In the papyrus of
Ebers, as in all others, there weren’t any
author names, its content was given as a
gift from higher power.

Ebers papyrus
Ancient Egyptians had a God of sun Rа. Anubis was
considered as a God of Medicine in Ancient Egypt,
Anubis was shown as a man with jackal’s head. Also
there were few more Gods known as patrons of
medicine. Imhotep was known as a founder of
medicine. He lived in the period of the Old reign.
Next generations adored him and considered him as a
leader of all doctors.
Doctors were narrow specialists: one treated eyes,
second - head, third - stomach, fourths - teeth, fifth -
invisible diseases (modern term - general
practitioners).
Goddess Sokhmet Goddess Tauert Imhotep
The first tooth prosthesis, made
exceptionally from of ivory and
fastened gold, appeared in ancient
Egypt. Prosthesises were indexes
of rich people.
One of the first dentists in
Egyptian history was Gesi-rе. It is
considered that he was one of the
most prominent scientists that
time. It is considered that
Egyptians were able to treat all
basic stomatological diseases,
including caries and disease of
paradontium.

Mummy teeth proteses. Ancient Egypt.

2720-2560 yy. BC.
Embalming of bodies of pharaohs was followed
by the sectioning of dead bodies, that’s why
Egyptian doctors had certain anatomic ideas.
They developed the theory of medicine.

The sacred ritual of embalming was conducted

by embalmers. They were rolling dead bodies
with the bandages impregnated in sacred oils and
essences, they were putting amulets inside
muscles and were singing words of gratitude to
the deities.
Head of mummy
 Anatomic data of ancient doctors in Egypt was
ponderable enough for those times. Doctors
considered a brain as a central organ. Except brain
they described heart, kidneys, intestines, and also
distinguished arteries, veins, nerves. Because during
the sections of dead bodies there was no blood in
arteries, they could see blood only in veins, doctors
considered that arteries transfer air - pneuma, which
enters blood through lungs and heart. They believed
that blood flows only in veins, that’s why health is
dependent on a normal exchange between pneuma
and human blood.
As disease is the consequence of bad blood,
rotten pneuma, the basis for the therapy of
ancient egyptian doctors were emetics,
diuretics, diaphoretics and laxatives.
In the Egyptian museums it is possible to see
lancets, pincers, catheters for urine chuting,
fallopian mirrors, sets of tools for cauterization
scarification. Cleating of movable teeth with
healthy teeth with the gold chain was found on
ancient mummies, also broken bones, which
accreted correctly, were found on ancient
mummies. All of it indicates about the high level
of development of surgery in ancient Egypt.
Ancient egyptian surgical instruments.
Medicine of Mesopotamia
• Two thousand years BC in the estuary of the
Tiger and Euphrates rivers Babylonian
kingdom and then Assyrian kingdom appeared.
 Basic sources of study of history of medicine
of Babylonian and Assyrian kingdoms

• Fire-place of times of Hammurabi king (1792-1750

BC), on which 282 laws were written.
• The library of king Assurbanipal (669-663 BC) was
found in Nineve. It consisted of clay tables on which
the life of Assyrian kingdom was represented in
cuneiform. There were found around thousand
medical aspirations on those tables.
A clay table with text of medical character about treatment of
stomach disorders. VII century BC
 The development of treatment in Shumer
First data about the development of medical knowledge in Schumer was
received in the end of a 19th century. In 1889 in Iraq during archaeological
excavations of the oldest Schumer city Nipur numerous tables with medical text
in cuneiform, dated by the end of 3th thousand BC, were found. There were 15
recipes written in Schumer language. They were separated into 3 divisions:
poultices, internal and external medicinal facilities.
The analysis of recipes showed that doctors in Schumer were using medicinal
facilities of phytogenous origin (mustard, silver fir, pine-tree, thyme, garden-
stuffs of fig etc), facilities of mineral origin (oil, common salt, resin), and also
facilities of animal origin (milk, armour of tortoise, internal organs). In a table
there weren’t any words about Gods or demons. Thus, treatment in Schumer
developed not in connection with magic and religion (they arose up later), but
was based on practical experience. In Schumer strict hygienical rules were
produced:
1) not to drink water from dirty tableware;
2) not to pray to Gods with unwashed hands;
3) to limit yourself at certain sort of meal etc
• Medicare was rendered by doctors-priests and doctors
that ended state medical schools. Priests were
respected as mediators in intermingling of people
with the world of Gods and spirits. Priests were the
predecessors of scientists.
• Theoretical presentations of medicine in Babylon and
Assyria were such: a man was created from earth,
God inserted a soul in a man - pneuma. Disease was a
punishment for sins. Disease was caused by
penetration of bad fairies into the body.
One of Mesopotamian tables saved the imprint of printing of Schumer
doctor Ur-Lugal-Eddine, who lived in Lagash in XXIV cent. BC. The
name of proprietor of printing, figure of doctor or him divine patron,
instruments for treatment and tableware for medications were written on
that table.

Free people had stamps in ancient

Schumer. It looked like little fretted
cylinder from a stone with opening on
longitudinal wasp, through which a
lace was put. People carried it on their
necks. At the stowage of important
documents this stamp was rolled on a
moist clay table and executed the
functions of signature, which appeared
later in ancient Schumer.
Amulet with demon of storm Pazuzu (left) and demon of fever
Lamashtu (right).
The goddess of treatment in Schumer
mythology was Gula. Gula was a
goddess of treatment and death (an
attribute is a dog). Gula is translated as
”Great” from Shumer language. Under
this name she appeared in texts of
Mesopotamia from XXII cent. BC. She
was also called the "Large healer" or
"Reviving dead Gula". She returned the
dead to life by the touch of her hand.
People believed that Gula can send
incurable diseases. Gula’s cult animal
was a dog, which was frequently
represented near her.
• Treatment was begun with banishment of
spirits by invocations, incineration of figures
of demons.
• They were also studying a star sky. From these
observations doctors were interested in
position of stars on sky during treatment,
folded horoscopes for the determination of
lucky and unlucky days.
• Patients were brought to the populous places,
where passers-by could give recommendations
in relation to their treatment.
 Clay model of sheep’s liver, which was used for fortunetelling. First
Babylonian dynasty (XIX – XVI centuries BC.). London. British museum
Trepanation of skull, cataract removal, superficial
tumours, amputation of extremities, treatment of
breaks and dislocations were used.

A successful operation of cataract removal costed

10 silver sekels for the free citizen, unsuccessful -
costed a hand for a doctor. If operative
intervention to the slave ended with his death, a
doctor compensated the cost of slave to the
owner.
Medicine of Ancient
India
Ancient India gets development, starting from III millennium
BC. The territory of old India includes modern states, which
are: India, Nepal, Pakistan, Bangladesh and Butan.
Hinduism and buddhism religions influenced the
development of medicine of Ancient India.
The features of Indian culture were: building of cities, high
level of their sanitary equipment, development of artificial
irrigation, handicrafts (ceramics, materials made from metal
and stone) and foreign trade.
Buddhist relief from Bharhuta: a tooth of a giant is deleted by
an elephant. II century BC.
 Sources for studying of Indian
medicine (written sources)
• Ayurveda (studies about long lifespan) - system of
traditional treatment of ancient India. Large attention in
studies is spared to the diets and correct food, pulse
diagnostics, natural treatment approaches were
exceptionally used : herbs, spices, minerals, oils and
other;
• the laws of Manu presented hygienical aspects;
• religiously-philosophical works "Vedas"
• tractates of ”Ayurveda of Charaka" (contains information
about treatment of internal illnesses) and ”Ayurveda of
Sushruta".
• Sectioning of dead bodies got wide distribution in
ancient India.
• Theoretical presentations of the Indian physicians
were such: the body of man consists of bile, mucus
and air, and also from five space elements: earth,
water, fire, air, ether. Seven organic products appear
from these elementary particles, namely: chyle,
blood, meat, fatty cellulose, bones, brain, family.
Every next product appears from previous. So there is
a physiology cycle, which runs for a month and
creates a life power, which can be excited by food
and curative remedies.
Old American Indians had a broad scope of
surgical work. Surgical methods of treatments
included caesarian section, the removal of
urinary bladder stones, the removal of
cataracts, skull trepanation, amputation of
extremities, stop of bleeding by ligatures.
Ancient surgical instruments, which were found during archaeological
excavations in Taxila
• In ancient India slaves were punished by
cuttings-off ears and nose. It fastened the
development of plastic surgery with
application of special surgical instruments.
Rhinoplasty
Illustration of the ‘Indian method’ of cataract removal
Medicine of Ancient
China
• History of medicine of Ancient China begins from IV
thousand BC.
• The main sources of studying were written
documents. Among written sources of conventional
Chinese medicine special place belongs to the tractate
of ”Huangdi Neijing”.
• According to legend, Huangdi was the legendary
"Yellow ancestor" of Chinese people – and he was
considered as the founder of Chinese medicine. He
wrote the first medical codex of ”Nuzi-king" dated
2657 BC.
Old Chinese considered that in human body there is a
balance between five staples: fire, earth, water, tree and
metal. Forces of these processes are concentrated in two
opposite beginning – poles. One of these opposite
beginning was descrobed as masculine (Yang) and it was
considered active and light, second - as a feminine (Yin)
– passive and dark.
Over 700 types of medical plants of China were
described in "Book of medical plants of Sheng-nung".
One of large achievements of doctors of Ancient China was an idea
about circular blood movement. In ”The Pulse Classics” it is written
that a heart continuously drives blood in a circulatory mode, and
according to the blood movement doctor could judge about pulse. A
"pulse is internal essence of one hundred parts of body and thinnest
expression of internal spirit". The Chinese doctors distinguished
more than 20 types of pulse. They came to the conclusion, that
every organ and every process in an organism have its expression in
a pulse, and on the change of pulse in a few points it is possible not
only to define illness of man but also predict the outcome. These
studies were described in ”The Pulse Classics" (III cent. AD) of
Wang Shuhe.
For a fight against a pox in ancient Chinese doctors started to apply
the so-called variolation (inoculation of the pox papule contents into
a human body). Variolation played an important role in the
vaccination development.

Conventional Chinese medicine included important medical and

preventive approaches: medications, diet, massage, curative and
respiratory gymnastics.
Especially treatments of Zhen Jiu (by pricks is
acupuncture) and treatment by cauterizations became
traditional Chinese methods. In the book of prominent
Chinese doctor Biang-Jiu "Tractate about a disease" (VI -
V cent. BC) were described around 600, which could be
used for the disease treatment. Pricks normalized
circulation of ”Yang" and ”Yin".
Information about acupuncture was written in the various
tractates of famous Chinese doctors.
Scheme of kidney channel with traditional acupuncture
points. Period of Mines dynasty (XIV - XVII centuries)
Empty bronze figure of man with channels for acupuncture practical skills
assimilation. XIV century, Riga, Museum of History of Medicine
Modern Chinese needles: six threadlike for deepening into the
tissuess and one for of vein puncture
 Procedure of cauterization

Modern cigars for cauterization

Medicine of Ancient Greece
 A bloom of medicine in ancient Greece was during
the first millennium BC. Main sources for studying of
medicine of ancient Greece were: Homer’s "Iliad",
”Odyssey" and ”Hippocratic Collection".
Ancient Greeks did not
make sectioning of human
bodies. Medical
nomenclature of "Iliad"
and ”Odyssey" made basis
for terminology of Greek
doctors.
Asclepius was god of medicine (he was a grandchild
of Zeus and son of Apollo). He had two sons -
Machaon and Podalirius and two daughters - Hygieia
and Panacea. Asclepius was painted with a stick,
twisted with a snake. A snake is an old symbol of
wisdom. The connoisseurs of curative herbs were
goddesses Artemis and Athena.
Later new well-known medical terms appeared from
the names of Panacea and Hygieia: a panacea is
universal approach from all diseases; a hygiene is
science about disease prevention.
Asclepius and Hygieia. Ancient sculpture. Rome. Vatican
Panacea is a patron of medical treatment
 Medical emblems

ХVI cent. ХIХ cent.

Doctors were trained in asclepions and private domestic
schools. The art of treatment was transfered from one
generation to another.
Treatment in asclepions combined empiric and magic
approaches. The fixed treatment approaches were: drug
treatment, hydropathy, physical exercises. Next to them there
was a ritual, when patients were put in the state of dream - the
hypnosis, which was achieved by application of drugs or
methods of psychological influence. A ritual was accompanied
by theatrical performances, prayers, God phenomenon or his
sacred snake and even by presentation of surgical operations
(the enormous amount of surgical instruments was found in
Epidaurus and other asclepions).
 Hippocratus (450-370 BC)
Most famous doctor of ancient
Greece, he was a doctor in 17th
generation. Representative of Kos
medical school.
Hippocrates works about medical
etiquette were collected in
”Hippocratic Collection”, which
included: ”The Oath", ”The Law",
”On the Physician", ”On Honourable
Conduct”, ”Precepts”. Other famous
works of Hippocrates were: ”On Air,
Waters and Surroundings",
”Ptognostics", "Aphorisms”,
”Epidemics".
Well-known expression of
Hippocrates: a "Doctor-philosopher is
Hippocratus
similar to God".
 Allopathy is principle of medicine of
Hippocrates
Therapy of diseases of Hippocrates was based on
such principle: opposite to treat opposite (сontraria
contrariis) – fullfillment by emptying, labour - by
rest, calmness - by movement. During the treatment
it was recommended to prescribe remedies, which
would strengthen healthful forces of nature: Vis of
medicatrix naturae. It was considered that doctor
must not make harm to the patient - Primum of non
nocere.
Any disease, according to the Hippocrates
idea, is the consequence of fight between
health forces of the body and harmful natural
reasons - soil waters placement, state of air,
climate, diet, way of life. Main task of doctor -
to promote maximal health properties of the
body.
A theory of pathology of Hippocrates is a humoral
theory
In accordance with the studies of Hippocrates, a
human body contains 4 juices: blood, mucus,
black and yellow bile. The predominance of one
kind of juice determines temperament of a
person: sanguine (blood), phlegmatic (mucus),
choleric (yellow bile), melancholy (black bile).
Favourable mixing of juices provides eucracia,
unfavorable - dyscracia.
 Achievements of Hippocrates
Enormous successes were achieved in diagnostics of illnesses.
Such illnesses and pathological states were described: pleurisy,
pneumonia, empyema, hepatitis, nephrite, diarrhea, dysentery,
ophthalmia, exanthema, phlyctena, tetanus, opisthotonos,
paraplegia, epilepsy. Hippocrates is considered as the father of
clinical medicine.
Thus, main achievements of Hippocrates were:
- principle ‘do not "harm";
- ”The Oath of Hippocrates";
- principle of allopathy;
- Studies about four juices and four temperaments.
Hippocrates surgery (dislocation correction by extursion method).
Apparatus for shoulder extursion constructed by Hippocrates
Hippocrates. Byzantium miniature of XIV century.
Hippocrates, famous doctor of Ancient Greece
Alcmaeon of Croton was a founder of the medical school of
Croton. He was the author of the first ancient Greek medical
tractate. In a tractate "About nature" Alcmaeon examined the
problems of embryology, physiology, theory of feeling,
psychology. The works of Alcmaeon about health made a
considerable influence on ancient medical opinion.
Herophilus and Eristratus were the most well-known
representatives of Alexandria school, which became an
interlink between Greek and Roman medicine. They opened
new ideas in anatomy and physiology and had substantial
influence on the development of medicine in Ancient Rome.
Herophilus was one of the first doctors who started to
section human corps. Investigating the structure of eye, he
gave description of vitreous body and choroid.
Medical instruments of hellenistic period
Instruments of Kos school
Medicine of Ancient Rome
Medicine of Rome absorbed the achievements of previous
epochs and at the same time complemented the unique
deposit. Main writing sources of that time were: "Laws of
XII tables", works of Asclepiadus, Celsus, Titus Lucretius
Carus ”On the Nature of Things" and, especially, Galen.
God of treatment in Ancient Rome
Building of aqueducts (from lat. аqua is water, ductus is
realization), which started in Ancient Rome, could not
provide all habitants of city with clean drinking water, and
water of the river of Tiber was so muddy, that using it as
drinking water was forbidden by law.
In III cent. BC Roman builders built first thermaes (грец.
thermae are hot bath-houses, from thermos - warm), which
were free to use for city population. For providing of their
maintenance he distinguished the special estates, and for a
supply a new aqueduct conducted a thermal water to them.
Thus, Roman thermaes were hygienic, medical, social and
cultural centres.
 Asclepiades (128-56 BC) was a Roman
doctor, founder of methodical school. Greek,
studied in Alexandria and Athens, in 90 BC
arrived to Rome. His ideas about nature of
human body and its diseases had a great
influence on the Greek doctors-thinkers.

According to the studies of Asclepiades, the body consists of

atoms, which are taken from air and are being desintegrated on
atoms in lungs. Atoms are transferred within the body through a
blood flow. If this process takes place without disruption, the
body is healthy, if the movement of atoms is disrupted, the disease
occurs.
His treatment motto treatment was: to treat safely, quickly and
pleasantly.
 Celsus (30 BC - 45 AD) wrote a tractate with 8th
books, related to the medicine, ”About
Medicine". This work is valuable because it
recreated history of medicine of previous
periods.

He was describing the diseases of gums, related to the teeth

loosening, in his works.
Celsus followed a nihilistic attitude towards medicine, which was
expressed in his credo: Illness itself – medicine itself. Celsus
preached an idea about absurdity of application of medications.
A prominent place in the history of medicine
is occupied by work of Titus Lucretius
Carus (98-55 BC) ”On the Nature of
Things", in which he hypothesized for the
first time that illnesses are spread by
invisible seed.
Speaking about ”destructive mixed air" ,
which: carries the seed of "illness and death"
in the human body, Lucretius gave an idea
about miasmatic conception of the disease
origin (the further opening of microbes will
decline this hypothesis).
Galen (131-210 AD) was the most famous doctor of Ancient
Rome.
He wrote a work ”Functions of parts of human body",
”Anatomical studies". According to theoretical ideas of Galen
basis of human organism was made by soul, which is a part of
the world soul - pneuma. This pneuma enters the lungs with
air, then enters the heart, from where is spread by arteries
through the body. There is ”soul pneuma" – in therain, "vital
pneuma" – in the heart and "natural pneuma" – in the liver.
Blood appears in liver and can easily go across from a right
heart to the left passing by peripheral vessels.
Nerves carry ”soul force”, liver gives "natural force" to the
blood, a pulse arises up under the action of "pulsating force".
Galen. Picture of Rubens. Vienna. National library
Galen started making the experiments on animals
(vivisection) - pigs and monkeys, so he was able to
classify bones (flat and long), he discovered and
described sensory and motor nerves, opened seven
craniocerebral nerves, described muscles, tendons,
structure of arterial walls, intestines, uterus. For the
health maintenance and disease treatment Galen
followed Hippocrates principles.
Galen was also engaged in teeth treatment. He
thought that gum inflammation was the result of diet,
which leads to the weakening of teeth fixation.
Galen made and applied such curative forms: powders, pills,
ointments, plaster, mustard plasters, infusions, decoctions,
solutions, mixtures, vegetable juices, vegetable and aethereal
oils, wines, vinegar, compresses, washes, poultices.

Galen developed curative assortment due to mixtures and

difficult recipes. One of his recipes consisted of 23
ingredients.

He applied gravimetric and volume correlations during the

preparation of infusions, extracts, decoctions from plants,
which were called ‘galenicals’ (a term introduced by
Paracelsus (1493-1541).
Main religious study (fortunetelling), which was popular in Ancient
Rome was inherited from the Etruscans and was performed on the
internal animal organs. The fortunetelling on the liver of sacrificial
animals was very popular at that time.

Model of liver, that was used for fortunetelling in ancient Rome.

Dentures of etruscans. VII cent. BC
Dentures of the Etruscans. VII – VI cent. BC
 Conclusions:
General lines of the development of treatment in the countries
of Ancient world were:
- invention of the written language (from 4-3th millenniums BC)
and creation of the first texts of medical contents (from the end of
3rd millennium BC);
- formation of two directions of curative activity: empiric treatment,
based on practical experience of people, and cult treatment, based
on religiously-mystic beliefs,;
- development of ideas about the origin of diseases (related to
nature, moral and ethical, religiously-mystic);
- training of doctors (domestic tradition, studying at general schools
at temples).
Thank you for your
attention!