History of Medicine

Dr. Kıymet Saniç

 Resource Books
 Main Book
 William Bynum.The History of Medicine, A Very Short Introduction-Oxford
University Press, 2008.
 Other books
 Hero Van Urk, Nanncy Duin, Jenny Stcliffe. A History of MEDICINE,
Barnes & Noble Inc.
 Jacalyn Duffin. History of Medicine, A Scandalously Short Introduction
(Second Edition), University of Toronto Press Incorporated 2010
 Lois N. Magner. A History of Medicine (Second Edition), Taylor & Francis
Group, 2005
 Tıp Tarihi ve Tıp Etiği Ders Kitabı. İstanbul Üniversitesi (Cerrahpaşa Tıp
Fakültesi, Yayınları No: 00249), 2007
 Topics

 Why Medical History?

 Paleomedicine (Paleopathology)  
 Medicine at the bedside
  Medicine in the library
  Medicine in the hospital
  Medicine in the community
  Medicine in the laboratory
  Medicine in the modern world
 Summary of Course Topics
 Why Medical History? The most usual reason for studying
medical history is the desire
 to understand medicine itself
 to grasp (hold firmly) its techniques, its organization, and its underlying
ideas.
 Paleomedicine (Paleopathology) is a science which deals with
the methods of diagnosis and treatment of the patients in the
previous period of the invention of writing.
 Bedside medicine, was beginning with the Hippocratics, still
has resonances in modern primary care: the treatment in
patient’s own home.
 Summary of Course Topics
 Library medicine: The library medicine of the
Middle Ages is relevant to the information
explosion that characterizes the modern medical
world (and not, of course, simply the medical
one).
 In the 19th century, hospital medicine was too
bigger than «bedside medicine» with new
diagnostic and therapeutic tools, and the medical
expertise (skill) we expect from the modern
hospital.
 Summary of Course Topics
 Medicine in the community surrounds
the environmental infrastructure of
 clean water, waste disposal, vaccination
programs, health and safety in our chosen
workplaces, along with the analysis of disease
patterns
 their relationships to diet, habits, or exposure to
agents in the environment.
 Summary of Course Topics
 Laboratory medicine
 takes place mostly in the laboratory,
 may be translated (turned) into better
drugs,
 understanding of bodily mechanisms of
disease improved diagnosis or
treatment.
 Summary of Course Topics
 Medicine in the modern and future world
 This chapter deals with the medicine of
the past and next century.
 Medical care has become big business,
and has acquired many of the strategies
of international corporations.
 Processing of the course
Two lessons per a week
 Evaluation 100 %

 40 % midterm
 20 % Attendance and participation of lesson
 80% midterm examination
 60% Final
 10 % Attendance and participation of lesson
 20 % Presentation
 70 % Final examination
 No electronic devices, no phones will be used during the exams.
 Processing of the course
Four lessons per a week
 Evaluation 100 %
 40 % midterm
 20 % Attendance and participation of lesson
 80% midterm examination
 60% Final
 10 % Attendance and participation of lesson
 20 % Presentation
 70 % Final examination
 No electronic devices, no phones will be used during the exams.
 Presentation
 Time: 5-7 minute
 Content
 Preparation
 Presentation
 Easy to understand
 Comment
 Discussion
Why did you chose the medical
school ??
 Why Medical History?

 The most usual reason for studying

medical history is the desire:
 to understand medicine itself
 to grasp (hold firmly, understand) its techniques,
its organization, and its underlying ideas.
 personal concern: Virtually (almost) everyone is
a patient today
 Why Medical History?

 The medical systems of earlier times

are instructive (useful & informative)
both in their similarities and in their
dissimilarities to the medicine of today.
 Why Medical History?

 Reminder-It must always be

remembered:
 that physicians functioned (worked) and that
physicians also fulfilled their task.
 Today, the medical procedures that we have
seen wrongly were accepted right at that time.
 Why Medical History?

 Answers given to problems today

become more understandable when they
are seen as the maintenance
(continuation ) of answers given in
former times.
 Why Medical History?

 One of the great obstacles (barrier) to an

understanding modern medicine is its
complexity, also it has a lot of details.
There is no BETTER WAY than the
study of medical history to bring some
order and coherence into this oppressive
(overwhelming, heavy) mass of details.
 Why Medical History?
 Some historians study in medical
history in order to gain a better
understanding of history in general.
 We can understand much more about a society
when we know how it treated its sick and what
it thought the disease to be.
 Why Medical History?
 A doctor cannot appreciate too early the fact
that his profession is a part and product of
society
 it is always closely connected with
 religion,
 philosophy,
 economics,
 politics, and
 the whole of human culture.
 Words
Paleo: Older and ancient, especially relating to the
geological past.
Paleontology: The study of the forms of life existing in
prehistoric or geologic times, as represented by the fossils
of plants, animals other organism.
Mummy: It is the body of person that has been preserved
after death especially in ancient Egypt.
Supernatural: Something cannot be explain by scientific
understanding or the laws of nature; such as gosth, angels,
gods, souls and spirits anything else considered beyond
nature like magic or miracles.
 Paleopathology and Paleomedicine

 The earliest (first)

documents on
medical history, the
Egyptian papyri,
carry the story back
only about four
thousand years.
 Paleopathology and Paleomedicine

 Nevertheless, there are methods which allow us at least

a notion (idea, belief) of what was going on during the
millions of years before the invention of writing.
 The medical historian can study teeth and bones (often fossilized),
mummies, and prehistoric works of art.
 These methods are, of course, extremely fragmentary (broken,
incomplate).
 Changes in bones will tell us nothing about the numerous diseases
limited to the soft tissues and organs.
 The science dealing with this paleontological and
prehistoric evidence of disease is called paleopathology.
Teeth and Bones
Teeth and Bones
Mummies
Prehistoric Works of Art
 Paleopathology
 These materials all tell the same story.

Medical evidence also tells us that disease

forms have remained essentially the same
throughout the millions of years.
 Paleomedicine Age
 The supernatural forces bring about disease
by shooting foreign matter into the body of
the patient or by introducing (insert or bring
into sth) spirits (soul) into it.
 Consequently, It is only logical that diseases caused by
supernatural agencies can be diagnosed and treatment
only by supernatural techniques.
 Paleomedicine Age
 Consequently, It is only logical that diseases caused by
supernatural agencies can be diagnosed and treated only by
supernatural techniques.
 Invisible disease-producing foreign bodies have to be
removed
 The abducted (taken away by force, miss) soul has to be
hunted (chase, pursue and kill) by the soul of the
medicine man, who has the power to separate(allocate,
set apart) himself from his own soul in a state of trance.
Trances
Religious Rites
Magician
 Demon,devil, satan, gin, evil spirit

 People believe that diseases and illness

were caused by demons (devil, satan,
gin) and evil spirits.
 Paleomedicine
 One of the most surprising results of modern
anthropological (the study of human)
research is the discovery that
 a biological phenomenon (fact, event)
which is considered normal in one culture
may be regarded as abnormal and
pathological in another (Because there is
no/little scientific basis).
 Paleomedicine
 People do not in general make a
distinction (difference, seperation)
between organic, functional, and mental
diseases.
 For them there were only disease and
its treatment.
 Elements of Paleomedical Systems
Many findings of paleomedicine
have been shown to have little
medical significance.

 Magic and Religion

 Folk remedies (cure,
solution)
 Elementary surgery
 Elements of Paleomedical Systems
 Magic and Religion
 Incantations (spell, magic wods) and
amulets
 Dancing
 Magic charms (charisma, attraction, against
evil eye- nazarlik)
 Talismans (good-luck piece,
ugur,tilsim,muska)
 Various other measures (precoution)
 Sacral mask used in ceremony of “banishing
(fire, dismiss) ancestors’ spirits”. Sri Lanka
 Magic charms: An object that you keep or
wear because you believe that is lucky
Talismans: an object that people think
will make them lucky
 Elements of Paleomedical Systems

 Folk remedies
 Potions (Elixir)
 Concoction (creation, mixture) prepared for
mental or physical effect
 Herbs (plants, greenery)
 Roots
 Berries (small fruit)
 Fruits
Elixir
Herbalism
 Folk Remedies
Foxglove (heart failure)
 Folk Remedies
 Laxatives (purgative) and enemas (lavman- for
clean of bowel ) to treat constipation and other
digestive ills.
 Narcotic
 Stimulating plant extracts (Digitalis): A heart
stimulant extracted from foxglove (yüksükotu).

Laxative :A substance that makes it easier for the waste from someone's
bowels to come out
Enema: A treatment for cleaning the bowels by filling them with a
liquid through the anus
Herbs and plants were used as a
medicine.

Do you now which ones are still

used today?
Morphine for pain &

Digitals for the heart.

 Surgical Procedures
practiced in ancient societies
 Cleaning and treating wounds by
cautery (burning) or searing (hot,
baking) tissue.
Cauterisation
 Surgical Procedures
practiced in ancient societies
 Bandage and sutures.
Bandage and Sutures.
 Surgical Procedures
practiced in ancient societies

 Resetting
dislocations and
fractures.
 Surgical Procedures
practiced in ancient societies
 Resetting
dislocations and
fractures.
 Using splints
(atels) to support
or immobilize
broken bones.
 The supernaturalistic approach goes far toward
explaining the strange contradictions of
primitive surgery. Tribes that in other respects
have developed no surgical techniques more
complicated than their neighbors are often able
to perform a few very complicated operations,
such as
 trephining,
 cesarean section, and
 subincision of the penis.
 Trepanation (a hole in the skull
produced surgically)

 Trephined skulls are found all over Europe

in Neolithic deposits.

 Skulls of ancient people who
went through trepanation of the
skull (regeneration of edges of
trepanation openings).
Copenhagen - Denmark
Skull of ancient man who died
during trepanation of the skull
(openings without regeneration
signs)
 Trepanation
 It seemed hard to believe that primitive
man had been able to carry through
successfully, with simple stone knives, an
operation then greatly dreaded (anticipate
with horror) by contemporary (modern)
surgeons.
Bronze knife for trepanation of the
skull decorated with images of
trepanation, found in Hamburg-
Germany
 Trepanation
 He felt that primitive man had made these
holes in the skull in order to liberate evil
spirits who might be causing headaches or
epilepsy.
 He felt that the operation was
introduced in order to remove bone
fragments and relieve intracranial
pressure in the case of head wounds.
 Trepanation was the treatment for
insanity, epilepsy and headache.
 That means boring
(drill) hole in the
skull.
 Prehistoric Procedure

Trephining, a remedy (cure) for evil, mental illness, epilepsy,

and headache.
Cesarean Section
C-Section
Subincision of The Penis(Circumcise)
 Hippocrates (Medicine at the
bedside)
 Hippocrates has became the favored
Father for healers.
 He lived on the island of Cos, off the coast of
present-day Turkey, from about 460 BC to 370
BC.
 This makes him a bit older than Plato, Aristotle,
and the other cosmopolitan creators of classical
Greek culture, centered in Athens.
Hippocrate
Cos