H ISTORY OF M EDICINE

I NTRODUCTION
Medicine is the science and art of cure of disease.
Medicine is a science of uncertainty and an art of
probability
-SirWilliam Osler
Ancient medicine was dominated by religious and
magical beliefs.
Ancient medical system is one aspect of the
history of culture of a particular people.
 P RIMITIVE MEDICINE
(5000BC)
Primitive man attributed disease, human suffering
and other calamities to the wrath of gods, the
invasion of the body by evil spirits & malevolent
influence of stars and planets- The Supernatural
Theory of Disease.
He practiced medicine in the form of rituals, sacrifices
and witchcraft.
Examples:
-snake bites/ scorpion stings are still considered to
be cured by mantras.
-Chicken pox is attributed to the wrath of Devi ma.
 T REPHINING
Primitive man improvised stone and flint
instruments with which he performed
circumcisions, amputations and trephining of skulls.
He believed that head pain was the work of evil
spirits who invaded the body of unfortunate
individuals.
If headache was caused by the invasion of evil
spirits, then letting the spirits out of the skull should
bring relief.
Thus was born the surgical procedure known as
trepanning which dates back ten thousand years or
more.
Such procedures were found in the South Pacific,
Europe, North America and South America.
 I NDIAN MEDICINE

Ancient medicine practiced was Ayurveda &

Siddha.
Dhanvantari was considered the god of medicine.
Ayurveda, the knowledge of life, is a derivative of
one of the Vedas, The Atharwaveda.
Atreya (800 BC) is considered the great Indian
physician and teacher.
King Ashoka (226 BC) patronised Ayurveda as state
medicine and established schools of medicine and
public hospitals.
 I NDIAN MEDICINE

Charaka penned his famous treatise Charaka

Samhita based on the teachings of Atreya & it
consisted of about 500 drugs.
Susruta the Father of Indian Surgery compiled
Susruta Samhita which deals with a variety of
surgical procedures.
Early Indians performed amputations, excised
tumours, repaired hernias and excelled in cataract
surgeries and plastic surgery.
Even the British surgeons learned the art of
Rhinoplasty from their Indian counterparts.
 I NDIAN MEDICINE

Tridosha theory of disease: Disease occurrence was

explained as a disturbance in equilibrium of 3
humors/ doshas viz: vata (wind), pita (gall) and
kapha (mucus).
The samhitas of Charaka & Susruta was translated
into Persian and Arabic during 800 AD.
The Laws of Manu were a code of personal hygiene.
The Indus valley civilization revealed advanced
knowledge of sanitation, water supply and
engineering.
ATREYA
C HARAKA
S USRUTA
 C HINESE MEDICINE
(2700BC)
Based on two principles Yin (feminine principle) and
Yang (masculine principle).
Balance of these two opposing forces meant health.
Chinese were early pioneers of immunization. They
practiced variolation to prevent small pox.
To a Chinese a great doctor is one who treats not
who is ill but someone not yet ill.
They introduced the concept of Bare foot doctors
and acupuncture.
 E GYPTIAN MEDICINE
(2000BC)
They believed disease was due to absorption of
harmful substances from the intestine which gave
rise to putrefaction of blood and formation of pus.
They practised enema, bloodletting and used
cathartics to treat disease.
They built planned cities, public bath and
underground drains and excelled in public health.
Horus was their god of health.
The best known Egyptian medical manuscripts were
the Edwin Smith papyrus and the Ebers papyrus.
 I MHOTEP
O NE W HO WALKED IN P EACE
Vizier of a Pharaoh, lived about 2900 BC;
Imhotep, the greatest of Egyptian physician, was
considered both a doctor and a divinity.
He is credited with many accomplishments in many
fields and one of his activities seems to have been
that of a successful physician.
He is one of the first medical men whose name is
on record and rose from the role of medical hero to
become God of Medicine.
He began using simple surgery instead of just
magic.
Imhotep
E DWIN S MITH PAPYRUS
E BERS PAPYRUS
 M ESOPOTAMIAN MEDICINE
(2100 BC)
Their civilization was called the cradle of civilization.
They had 3 types of doctors, the herb doctors, knife
doctors and spell doctors who parallel our interns,
surgeons and psychiatrists.
Babylonian code of Hammurabi, the very first
codification of medical practice was introduced at
their time and it governed the conduct of
physicians.
C ODE OF HAMMURABI
 G REEK MEDICINE
(460- 136 BC)
They were the civilizers of ancient world.
Hygeia was their goddess of health and
Panacea the goddess of medicine.
H YGEIA & PANACEA
 H IPPOCRATES
THE FATHER OF MEDICINE
The Corpus Hippocraticum is a collection of around
seventy early medical works from ancient Greece
strongly associated with Hippocrates and his
students. Hippocrates invented the Hippocratic
Oath for physicians.
He first described clubbing of the fingers. For this
reason, clubbed fingers are sometimes referred to
as "Hippocratic fingers".
Hippocrates was also an epidemiologist. His treatise
on Airs, Water and Places stressed the relation
between man and his environment.
 T HE H IPPOCRATIC O ATH
Hippocrates also made changes in how physicians
looked upon their profession.
During his time, a doctor was sometimes bribed to
see that a patient died, or asked to prepare poison
to kill an enemy. If a ruler wanted to rid himself of a
rival, he could hire a court physician who would see
that the rival became sick and died.
Hippocrates taught against such improper conduct.
He told his students to treat everyone the same.
Sometimes give your services for nothingfor
where there is love of man, there is also love of
medicine.
 H IPPOCRATES R EFUSING G IFT FROM
A LEXANDER BY A NNE -L OUIS G IRODET (1816)
 R OMAN MEDICINE

Public health was born in Rome with the

development of baths, sewers and aqueducts. they
made fine roads throughout their empire, brought
pure water to all their cities through aqueducts,
drained marshes to combat malaria, built sewerage
systems and established hospitals for the sick.
Galen, an outstanding figure made important
contributions in the field of comparative anatomy
and experimental physiology. About health he
stated, since both in importance and in time
health precedes disease, so we ought to consider
first how health may be preserved, and then how
GALEN
 T HE F OUR H UMORS
Developed out of the humoral theory of
Empedocles(500 to 430B.C.), the Scilian philosopher.
Developed by Hippocrates and consolidated by
Galen.
From the 4 elements: earth, air, fire and water
derived the idea of the 4 humours(or fluids) of black
bile, yellow bile, blood and phlegm with their
associated meancholic, choleric, sanguine and
phlegmatic temperments.
It was believed that the balance of these humours in
the body determined physical states of health.
 M IDDLE AGES / M EDIEVAL
PERIOD : (500- 1500 AD)
Dark ages of medicine started. People considered it
is immoral to see ones own body and they seldom
bathed. The practice of medicine was dominated by
superstition and dogma.
2 important features stand out during this decline:
A) Preeminence of do-it-yourself handbooks,
primarily of dietetic medicine.
B) The ecclesiastical takeover of medical learning
and learning in general. For few could read outside
the ecclesiastical community.
 A RAB MEDICINE
(800- 1300 AD)
During the dark ages the arabs improved their
medical knowledge. They translated the greek-
roman literature into arab and developed their own
system of medicine the Unani system of medicine.
Avicenna and Abu Becr was two of the most
renowned in Arab medicine. Avicennas 21 volume
encyclopaedia titled the Canon of medicine was
his greatest. Arabs were pioneers in
pharmacology.the word drug, sugar, alcohol and
syrup are all Arabian in origin.
 AVICENNA (980-1037 A.D.)
AND THE C ANON OF M EDICINE
 D AWN OF SCIENTIFIC MEDICINE
(1500AD)
Paracelsus labelled as genius by some and quack by
others publicly burnt the works Galen and Avicenna
and attacked superstition and dogma and helped
turn medicine towards rational research.
Fracastorius enunciated the theory of contagion.
He explained the transfer of infection through
minute invisible particles and explained the cause
of epidemics.
He became the founder of Epidemiology.
 D AWN OF SCIENTIFIC MEDICINE
(1500AD)
Andreas Versalius(1514-1564). Was the first master
of human anatomy.
Versalius kept a copy of Galens books on hand and
made changes in them. He found over 200 mistakes
in the ancient books. His great work Fabrica became
a classic text in medical education.
Versalius learned human anatomy by looking at
humans not just animals.
He made detailed drawings of his findings so others
could also learn.
 T HE FABRIC
It was published in 1543, contained 663 pages and
300 beautiful illustrations.
Versalius spent his personal fortune and all his
enthusiasm on it.
 D AWN OF SCIENTIFIC MEDICINE
(1500AD)
Professors in medical schools seldom performed
surgery.
They did not think that it was proper for a
professional man to do such work.
Surgeon is from a French word meaning one who
works with his hands.
In the Europe of the 1500s, barbers, not doctors,
performed minor operations, pulled teeth, and
treated cuts.
 D AWN OF SCIENTIFIC MEDICINE
(1500AD)
Barbers who gained skill in closing wounds were
called barber-surgeons.
In 1540 the united company of Barber Surgeons
was established in England, which later became the
Royal College of Surgeons
 D AWN OF SCIENTIFIC MEDICINE
(1500AD)
Thomas Sydenham the English Hippocrates set the
example of true clinical methods. He is regarded as
the first distinguished epidemiologist.
Morgagni ( 1682- 1771) started pathologic anatomy.
Ambroise Pare(1510-1590)- Pare used ointments
and silk thread to repair injuries in place of burning
oil and hot pokers.
Pare discovered new techniques that made surgery
practical.
 A MBROISE PARE
(1510-1590)
He published his book in French with useful
information that all doctors could use.
Pare did not have a formal education. He never
earned a medical degree. Yet he became Frances
most skilled surgeon. In 1562, he was given the
dignified title, First Surgeon of the King.

I treated him. God healed him.

 M EDICINE IN THE 17 TH
C ENTURY
The greatest physiological advance of the 17th
century was the discovery of the circulation of
blood.
Credit goes to the Englishman William Harvey(1578-
1657).
In 1628, Harveys De Motu Cordis which concerned
with the mechanical process of circulation.
 A NTONI VAN L EEUWENHOEK
(1632-1723)
Developed the most
powerful microscopes
of his day.
He discovered one-
celled protozoans and
bacteria.
His work eventually led
to the discovery of the
causes of diseases,
such as the Black
Death.
 E DWARD J ENNER (1749-
1823)
Jenner discovered that
having cowpox
protected a person
against smallpox.
Jenners cowpox
serum saved many
lives, and almost
eliminated the disease
of smallpox.
 T HE B IRTH OF A NESTHESIA

A nineteenth-century physician administering chloroform prior to

surgery. Ether was one of the earliest anesthetics to be used but it was
difficult to administer as it usually made the patient choke.
 J AMES L IND (1716-1794)
In James Linds
experiment, those that
ate citrus fruit stayed
healthier.
The British Navy finally
ordered sailors to drink
lime juice.
Lind had found the
cure for scurvy
vitamin C.
 C HRISTIAN E IJKMAN
(1858-1930)
Found that bacteria
did not cause beriberi.
He found that brown
rice was a cure for
beriberi because of a
vitamin (now know to
be thiamine) in the
husks.
 J OHN S NOW (1813-1858)
THE FATHER OF P UBLIC H EALTH
Effectively brought
an end to the 1854
epidemic in Soho,
London by
demonstrating only
those who drank
from the infected
Broad Street pump
contracted the
disease.
 R OBERT K OCH
Robert Koch
discovered that
anthrax was caused by
bacteria.
He proved that most
diseases are caused by
a particular bacteria.
He discovered the
tubercle bacillus in
1882.
 L OUIS PASTEUR
Louis Pasteur
discovered that
chickens could survive
cholera when given a
weakened form of the
disease.
He found that an
anthrax vaccine could
be made by heating
the bacteria.
He discovered rabies
was caused by a virus
and then developed a
vaccine for humans.
A NDREW W. D OC
F LEISCHER
In 1921, the above
developed the mercurial
sphygmomanometer and
spent his career refining
medical instruments,
including the modern
stethoscope.
T HE GREAT SANITARY AWAKENING
( MID NINETEENTH CENTURY )
Industrial revolution of the 18th century resulted in
creation of slums, overcrowding with all its ill
effects, accumulation of filth in cities and towns and
high sickness and death rates.
Edwin Chadwicks report the sanitary conditions
of the laboring population of the people of Great
Britain focused the attention to the urgent need to
improve public health & led to the enactment of
the Public Health Act of 1848 in England.
E DWIN C HADWICK
 E VOLUTION OF COMMUNITY
MEDICINE
The discovery that the cause of disease is
multifactorial and the notion that most of them can
be controlled by mass measures led to the concept
of community medicine.
It is the discipline which is applied to healthy
people with the objective of prevention of disease
and promotion of health rather than treating
patients individually.
It includes care of patients prevention of disease,
administration of medical services with the
objective of changing the needs of a man and
society.
 COMMUNITY MEDICINE

It is a specialty dealing with population and

comprises of doctors who try to measure the needs
of population both sick and well, who plan
administer services and are engaged in research
and teaching.
The public health administration in India started in
1869 with the appointment of sanitary commission.
The first municipal act was passed in year 1884 in
Bengal.
The Bhore committee laid the foundation of
modern public health care in India.
 COMMUNITY MEDICINE

In the year 1955, the department of preventive and

social medicine were established in medical
colleges all over the countries.
These departments have teaching, training, service
and research components.
After 1975 these departments were enriched with
the field experiences in training, monitoring and
evolution with active participation in various
national health programmes.
 COMMUNITY MEDICINE

From 1977 under the reorientation of medical

education scheme they are directly involved in health
care delivery system by accepting the total
responsibilty for promotive, preventive and curative
health care at the block level extending to the whole
district.
 D EPARTMENT OF C OMMUNITY
MEDICINE ,CSMMU,L UCKNOW.
THANKS