dHippocratic Writings


Although Hippocrates of Cos (c.460-380 BCE) is considered to be the "Father of Medicine" little is known about him. It is generally accepted that he was roughly a contemporary of Socrates and was a practicing physician. It also seems likely that Hippocrates would have been an Asclepiad. The Asclepiads were members of a guild of physicians which traced its origins to Asclepius, the god of healing. Tradition also tells us that Hippocrates was the most famous physician and teacher of medicine of his time. Over 60 medical treatises that have traditionally been attributed to him. These treatises are collectively referred to as the Hippocratic Corpus. Most of these treatises, however, were not written by Hippocrates himself. In fact, several of the existent treatises were written well after the life of Hippocrates. The treatises themselves were written over about a two hundred year period and range in date from c.510-c.300 BCE, so clearly one man could not have authored all of them. Although It is likely that Hippocrates did compose some of the treatises, none of the 60 treatises can positively be attributed to Hippocrates. Therefor at times they contain conflicting materials and different ideas. In the main, however, they are similar in looking for natural explanations and treatments of illness and rejecting sorcery and magic

 

dMEDICINE IN ANCIENT MESOPOTAMIA

 

The name Mesopotamia (meaning "the land between the rivers") refers to the geographic region which lies near the Tigris and Euphrates Rivers and not to any particular civilization. In fact, over the course of several millennia, many civilizations developed, collapsed, and were replaced in this fertile region

 

Most of the information available to modern scholars comes from cuneiform tablets. There are no useful pictorial representations that have survived in ancient Mesopotamian art, nor has a significant amount of skeletal material yet been analyzed The vast majority of these tablets are prescriptions, but there are a few series of tablets that contained entries that were directly related to one another, and these have been labeled "treatises." The largest surviving such medical treatise from ancient Mesopotamia is known as "Treatise of Medical Diagnosis and Prognoses." . In fact, as recent research is showing, the descriptions of diseases contained in the diagnostic treatise demonstrate a keen ability to observe and are usually astute. Virtually all expected diseases can be found described in parts of the diagnostic treatise, when those parts are fully preserved, as they are for neurology, fevers, worms and flukes, VD and skin lesions. The medical texts are, moreover, essentially rational, and some of the treatments, as for example those designed for excessive bleeding (where all the plants mentioned can be easily identified), are essentially the same as modern treatments for the same condition

 

 By examining the surviving medical tablets it is clear that there were two distinct types of professional medical practitioners in ancient Mesopotamia. The first type of practitioner was the ashipu, in older accounts of Mesopotamian medicine often called a "sorcerer." One of the most important roles of the ashipu was to diagnose the ailment. In the case of internal diseases, this most often meant that the ashipu determined which god or demon was causing the illness. The ashipu could also refer the patient to a different type of healer called an asu. He was a specialist in herbal remedies, and in older treatments of Mesopotamian medicine was frequently called "physician" because he dealt in what were often classifiable as empirical applications of medication. For example, when treating wounds the asu generally relied on three fundamental techniques: washing, bandaging, and making plasters. All three of these techniques of the asu appear in the world's oldest known medical document (c. 2100 BCE).

Another textual source of evidence concerning the skills of Mesopotamian physicians comes from the Law Code of Hammurabi. This collection was not found written on a tablet, but was discovered on a large block of polished diorite. It was not a code of law in the modern sense, but probably a collection of legal decisions made by Hammurabi (c. 1700 BCE) in the course of his activities as a judge and published to advertise his justice. Among Hammurabi's laws were several that pertained to the liability of physicians who performed surgery. These laws state that a doctor was to be held responsible for surgical errors and failures. Since the laws only mention liability in connection with "the use of a knife," it can be assumed that doctors in Hammurabi's kingdom were not liable for any non-surgical mistakes or failed attempts to cure an ailment. It is also interesting to note that according to these laws, both the successful surgeon's compensation and the failed surgeon's liability were determined by the status of his patient. Therefore, if a surgeon operated and saved the life of a person of high status, the patient was to pay ten shekels of silver. If the surgeon saved the life of a slave, he only received two shekels. However, if a person of high status died as a result of surgery, the surgeon risked having his hand cut off. While if a slave died from receiving surgical treatment, the surgeon only had to pay to replace the slave. This use of status to evaluate misdeeds does not seem to appear in other, similar "codes" however.    

dMEDICINE IN ANCIENT EGYPT

 The first is the study of medical Papyri. Early on it was recognized that the textual material of the Dynastic Period pertaining to the recognition and treatment of disease was extremely important for understanding both the state of health as well as the concept of disease in ancient Egypt. The second is the study of the artistic representation of disease in the Nile Valley. The Egyptian's predilection to portrayl life in a relatively realistic manner offers an excellent opportunity for the study of disease. The third, and perhaps most obvious, is the study of human remains, both skeletal and soft tissue, of ancient Egyptians. With the advent of increasingly sophisticated medical techniques at the beginning of the 20th century, as well as those complex medical techniques in use today, the analysis of Egypt's veritable wealth of human remains provided a tremendous boost to the study of the state of disease and health in the ancient Nile Valley.

dMedical Papyri

The Edwin Smith Papyrus

The Edwin Smith Surgical Papyrus is, without a doubt, one if the most important documents pertaining to medicine in the ancient Nile Valley In 1930, James Henry Breasted, director of the Oriental Institute at the University of Chicago, published the papyri with facsimile, transcription, English translation, commentary, and introduction. The volume was accompanied by medical notes prepared by Dr. Arno B. Luckhardt. To date, the Breasted translation is the only one if its kind

 The Ebers Papyrus

The Ebers Papyrus comprises 110 pages, and is by far the most lengthy of the medical papyri the Ebers Papyrus consists of a collection of a myriad of different medical texts in a rather haphazard order

 Paragraphs 1-3 contain magical spells designed to protect from supernatural intervention on diagnosis and treatment. They are immediately followed by a large section on diseases of the stomach (khet), with a concentration on intestinal parasites in paragraphs 50-85.(Bryan 1930:50) Skin diseases, with the remedies prescribed placed in the three categories of irritative, exfoliative, and ulcerative, are featured in paragraphs 90-95 and 104-118. Diseases of the anus, included in a section of the digestive section, are covered in paragraphs 132-164.(Ibid. 50) Up to paragraph 187, the papyrus follows a relatively standardized format of listing prescriptions which are to relieve medical ailments.

 Kahun Gynecological Papyrus

The papyrus is dated to this period by a note on the recto which states the date as being the 29th year of the reign of Amenenhat III (c. 1825 B.C.E.). The text was published in facsimile, with hieroglyphic transcription and translation into English, by Griffith in 1898, and is now housed in the University College London. .

The gynecological text can be divided into thirty-four paragraphs, of which the first seventeen have a common format.(Nunn 1996: 34) The second section begins on the third page, and comprises eight paragraphs which, because of both the state of the extant copy and the language, are almost unintelligible. Paragraph 19 is concerned with the recognition of who will give birth; paragraph 20 is concerned with the fumigation procedure which causes conception to occur; and paragraphs 20-22 are concerned with contraception. Among those materials prescribed for contraception are crocodile dung, 45ml of honey, and sour milk.(Ibid:35) The third section (paragraphs 26-32) is concerned with the testing for pregnancy. Other methods include the placing of an onion bulb deep in the patients flesh, with the positive outcome being determined by the odor appearing to the patients nose.

The fourth and final section contains two paragraphs which do not fall into any of the previous categories. The first prescribes treatment for toothaches during pregnancy. The second describes what appears to be a fistula between bladder and vagina with incontinence of urine "in an irksome place."(Ibid. 35)

Parasitic Diseases

Schistosomiasis (bilharziasis)

Of the three main species of the platyhelminth worm Schistosoma, the most important for Egypt are S. mansoni and S. haematobium. There is a complex life cycle alternating between two hosts, humans and the fresh water snail of the genus Bulinus

One of the finest archaeological examples for the existence of schistosomiasis in ancient Egypt was the discovery of calcified ova in the unembalmed 21st Dynasty mummy of Nakht. Upon medical examination, the mummy not only exhibited a preserved tapeworm, but also ova of the Schistosoma haematobium and displayed changes in the liver resulting from a schistosomal infection.(Millat et al. 1980:79)

Tuberculosis (Mycobacterium tuberculosis)

Ruffer (1910) reported the presence of tuberculosis of the spine in Nesparehan, a priest of Amun of the 21st Dynasty. This shows the typical features of Pott's disease with collapse of thoracic vertebra, producing the angular kyphosis (hump-back

Poliomyelitis

A viral infection of the anterior horn cells of the spinal chord, the presence of poliomyelitis can only be detected in those who survive its acute stage. Mitchell (Sandison 1980:32) noted the shortening of the left leg, which he interpreted as poliomyelitis, in the an early Egyptian mummy from Deshasheh. The club foot of the Pharaoh Siptah as well as deformities in the 12th Dynasty mummy of Khnumu-Nekht are probably the most attributable cases of poliomyelitis  

 Ayurveda originated in India long back in pre-vedic period. Rigveda and Atharva-veda ( 5000 years B.C.), the earliest documented ancient Indian knowledge have references on health and diseases. Ayurved texts like Charak Samhita and Sushruta Samhita were documented about 1000 years B.C. The term Ayurveda means ‘Science of Life'. It deals elaborately with measures for healthful living during the entire span of life and its various phases. Besides, dealing with principles for maintenance of health, it has also developed a wide range of therapeutic measures to combat illness. These principles of positive health and therapeutic measures relate to physical, mental, social and spiritual welfare of human beings. Āyurveda, the Vedic system of medicine, views health as harmony between body, mind and spirit. Its two most famous texts belong to the schools of Charaka and Sushruta. According to Charaka, health and disease are not predetermined and life may be prolonged by human effort.  defines the purpose of medicine to cure the diseases of the sick, protect the healthy, and to prolong life.  

Thus Ayurveda becomes one of the oldest systems of health care dealing with both the preventive and curative aspects of life in a most comprehensive way A perusal of its several classical treatises indicate presence of two schools of Physicians and Surgeons and eight specialities. These eight disciplines are generally called "Ashtanga Ayurveda" and are :-

  • Internal Medicine(Kaya Chikitsa)
  • Paediatrics(Kaumar Bhritya)
  • Psychiatry( Bhoot Vidya)
  • Otorhinolaryngology and Ophthalmology(Shalakya)
  • Surgery( Shalya)
  • Toxicology( Agad Tantra)
  • Geriatrics(Rasayana)
  • Eugenics and aphrodisiacs(Vajikarana)

Compendia on these subjects like Charak Samihta, Sushruta Samhita etc. were written by the ancient scholars during B.C. period. These were used for teaching of Ayurveda 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 (anumāna). 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 

The word ‘Homoeopathy' is derived from two Greek words, Homois meaning similar and pathos meaning suffering. Homoeopathy simply means treating diseases with remedies, prescribed in minute doses, which are capable of producing symptoms similar to the disease when taken by healthy people. It is based on the natural law of healing- "Similia Similibus Curantur" which means "likes are cured by likes". Dr. Samuel Hahnemann (1755-1843) gave it a scientific basis in the early 19th century. It has been serving suffering humanity for over two centuries and has withstood the upheavals of time and has emerged as a time-tested therapy.

The principle of Homoeopathy has been known since the time of Hippocrates from Greece, the founder of medicine, around 450 BC More than a thousand years later the Swiss alchemist Paracelsus employed the same system of healing based upon the principle that "like cures like". But it was not until the late 18th century that Homoeopathy as it is practiced today was evolved by the great German physician, Dr. Samuel Hahnemann. He was appalled by the medical practices of that time and set about to develop a method of healing which would be safe, gentle, and effective. He believed that human beings have a capacity for healing themselves and that the symptoms of disease reflect the individuals struggle to overcome his illness

Hahnemann continued to experiment, noting that every substance he took, whether a herb, a mineral, an animal product or a chemical compound, produced definite distinct symptoms in him. He further noted that no two substances produced exactly the same set of symptoms. Each provoked its own unique pattern of symptoms. Furthermore the symptoms were not just confined to the physical plane. Every substance tested also affected the mind and the emotions apart from the body.

Eventually, Hahnemann began to treat the sick on the principle ‘let likes be treated by likes'. From the outset he achieved outstanding clinical success

Homoeopathy is the system of treatment based on demonstrable laws and principles, which are -

a) The Law of Similars - It is also called the Law of Cure. This law demonstrates that the selected remedy is able to produce a range of symptoms in a healthy person similar to that observed in the patient, thus leading to the principle of Similia Similibus Curentur i.e. let likes be treated by likes. To give a simple example the effects of peeling an onion are very similar to the symptoms of acute cold. The remedy prepared from the red onion, Allium cepa, is used to treat the type of cold in which the symptoms resemble those we get from peeling onion. The principle has been verified by millions of Homoeopaths all over the world.

b) The Law of Single Remedy - This law directs to choose and administer such a single remedy, which is most similar to the symptom complex of the sick person at a time.

c) The Law of Minimum Dose - The similar remedy selected for a sick should be prescribed in minimum dose, so that when administered there is no toxic effects on the body. It just acts as a triggering and catalytic agent to stimulate and strengthen the existing defense mechanism of the body. It does not need to be repeated frequently 

 

Nature Cure movement started in Germany & other western countries with "Water cure" (Hydrotherapy). Water cure was synonymous with Nature Cure in those early days. The credit of making Water cure world famous goes to Vincent Priessnitz1799-1851) who was a farmer. Dr. Henry Lindlahr and others go to the extent of crediting him as "Father of Naturopathy". The word ("Naturopathy" has been coined by Dr. John Scheel in the year 1895 and was propagated and popularised in the western world by Dr. Benedict Lust. A number of Doctors of modern medicine and others became Nature Cure enthusiasts and gradually added a number of modalities within the fold of Naturopathy and scientifically developed them. Nature Cure movement gained momentum in India as Mahatma Gandhi, "Father of the Nation" became much interested in this system and included it in his programmes. He has also established a Nature Cure Hospital in Uruli Kanchan, Distt. Poona, Maharashtra which is still functioning  

 

Nature Cure believes that all the diseases arise due to accumulation of morbid matter in the body and if scope is given for its removal, it provides cure or relief. It also believes that the human body possesses inherent self constructing and self healing powers. The fundamental difference in Nature Cure with other systems is that its theory and practice are based on holistic view point whereas the later's approach is specific. Nature Cure does not believe in the specific cause of disease and its specific treatment but takes into account the totality of factors responsible for diseases such as one's un-natural habits in living, thinking, working, sleeping, relaxation, sexual indulgence etc, and also considers the environmental factors involved which on the whole disturbs the normal functioning of the body and lead it to a morbid, weak and toxic state Naturopathy provides not only a simple practical approach to the management of diseases, but a firm theoretical basis which is applicable to all the holistic medical care and by giving attention to the foundations of health; also offers a more economical frame work for the medicine of future generation.

Though the basic Nature Cure deals only with Pancha Mahabhoota's, the recent developments advocates the practice of drugless therapies like Massage, Electrotherapy, Physiotherapy Acupuncture and Acupressure, Magnetotherapy etc., Diet plays a major role, above all.,  

 

 Siddha system is one of the oldest systems of medicine in India. The term ‘Siddha' means achievement and the ‘Siddhars' were saintly figures who achieved results in medicine through the practice of Yoga. Eighteen ‘Siddhars' seem to have contributed towards the development of this medical system. Siddha system's literature is in Tamil and it is practiced in Tamil speaking parts of India. The system is also called Agasthyar system in the name of its famous exponent sage Agasthya. A number of medical works of this system are ascribed to him. This system of medicine developed within the Dravidian culture, which is of the pre-vedic period. The Siddha system is largely therapeutic in nature.

The original Home allotted to mankind by the Creator was in the temparate and fertile region of the East and pointedly in India.  It is from here that the human race began its culture and career.  India may, therefore, be safely stated as that the first country from which human culture and civilization originated and spread.  According to Indian history prior to Aryans migration, the Dravidian was the first inhabitant of India of whom the Tamilians were the most prominent.  The Tamilians were not only the earliest civilized but also those who may more considerable progress in civilization than any other early people.  The languages of India were divided into two great classes, the northern with Sanskrit as the pre-pondering element and the southern with Dravidian language as independent bases.  The science of medicine is of fundamental importance to man's well being be and his survival and so it must have originated with man and developed as civilization.  It is, therefore rather pointless to try to determine the exact point of time to which the beginning of these systems could be traced  They are eternal, they began with man and may end with him.  The Siddha was flouriest in south and Ayurveda prevalent in the north.  Instead of giving the name of any of individual as the founder of these systems our ancestors attributed their origin to the creator.  According to the tradition it was Shiva who unfolded the knowledge of Siddha system of medicine to his concert Parvati who handed it down to Nandi Deva and he the Siddhars. According to tradition, the origin of Siddha system of medicine is attributed to the great Siddha Ayastiyar.  Some of his works are still standard books of medicine and surgery in daily use among the Siddha Medical practitioners  

 

Unani Medicine is based on the Greece philosophy. According to Basic Principals of Unani the body is made up of the four Basic elements i.e. Earth, Air, Water, Fire which have different Temperaments i.e. Cold, Hot, Wet, Dry. After mixing and interaction of four elements a new compound having new temperament comes into existence i.e. Hot Wet, Hot Dry, Cold Wet, Cold Dry. The body have the Simple and Compound Organs which got their nourishment through four Humours i.e. Blood, Phlegm, Yellow Bile, Black Bile. The humour also assigned temperament as blood is hot and wet, Phlegm is cold and hot, yellow bile is hot and dry and black bile is cold and dry.

Development and its Status

Unani system of medicine is one of the oldest system of medicine in the world it is still popular & practiced in Indian sub continent & other parts of the world.

The scientists and experts of different countries have contributed in development of Unani system in different periods as under.

The development of Unani Medicine can be divided into following periods

1. Greek Period

Unani medicine was originated in Greece and its founder was great philospher & Physician ,Hippocrates ( Buqrat 460-377 BC).He was the first Unani Physician who opened the education of Medicine to all communities, so he is known as the father of medicine in Allopathic also because modern medical science was developed on the foundation of Hippocratic philosophy  of  health and disease. Before Hippocrates it was restricted to the Aesclabius family only. After Buqrat, Galen(Jalinoos130-201 BC) contributed a lot to the Unani Medicine. Aristotle (Arastoo384-322 BC) laid down foundation of Anatomy & physiology.

Dioscorides was the famous physician in the Ist Century AD. He was famous for his book on Ilmuladviya(Pharmacology) named as Kitabulhashayash.

2. Arabic-Persian Era

(a) In Egyptian period the pharmacy was very much developed and they prepared the medicine in different dosage forms like alcohol, oils, powder and ointment etc.

(b) Persia  encouraged and developed physicians and philosophers by the Iranian .They further developed this medicine into a complete science and it got deep roots in the masses. Eminent Physician of this period are:-

1. Ibne Raban Tabari (810-895AD) was famous physician and wrote a book Firdous ul Hikmat and introduced concept of official formulary,

2. Abu Bakar Zarakariya Razi or Rhazes (865-925 AD) etc. He wrote the book "Alhawi fit tibb". He was first scholar who described the concept of Acquired Immunity by his experiments in the article "Maqala fi Judri wa Hasba".

(c) The Islamic rulers of the Arabian countries further developed and adopted the Unani Medicine at government level and here at first they recognised the importance of the official formulary (Qarabadeen). They made many additions /deletions on the basis of their experiments, advance knowledge of Medicine in Greek and  Persian literature. They developed the chemistry, pharmacy and pharmaceutical procedures. In this period they invented the process of distillation, sublimation, calcination and fermentation to promote the efficacy of the medicine and to remove the impurities and toxic effects of the drugs.

1.Jabir bin Hayyan(717-813AD) who was settled in the Arab as Royal physician was a famous physician and Chemist. He was the first who had described Chemistry.

2.The very eminent scholar of this period was Bu Ali Sina ( Avicenna 980-1037AD) He was the great philosopher, physician of the Arab. He gave a final shape to the Unani medicine & redefined many concepts based on his clinical experiences. His book Alqanoon or (The canon of medicine) was an internationally accepted book on medicine, which was taught in European countries till the 17th century.

3. Spanish Period

The Arabs have introduced Unani medicine in the Spain in the patronage of Spanish Ruler, many scholars contributed a lot to Unani Medicine for instance 1. Abul Qasim Zohravi ( Abulcasus 946 -1036AD) was the famous surgeon was attached to Royal Hospital of Cordoba. He wrote a famous book on surgery "Al Tasreef"

2.Ibn-e-Haisham (965-1039AD)was a renowned scientist and Unani physician from Syria laid down the foundation of optics in his famous book"Kitabul Manazir"

3.Ibn-e-Zohar ( Avenzor1091-1162AD) was a renowned physician and Scholar. He was known for his famous book "Kitabul Tasreef".

4.Ibn Rushd (1126-1198AD) was famous for his book on Basic Principals of Unani Medicine known as Kitabul Kulliyat

5.Ibne Baitar (1197-1248AD) was Pharmacognosist and Botanist. His famous book on extensive survey and experiments on Single Drugs of Plant origin Kitabul jameul Mufradat. Was widely acclaimed.

6.Ibn-e-Nafees (1210-1288 AD) was the first scientist who described the blood pulmonary circulation and prescribed anatomy as a separate chapters.

 Unani medicine in India was introduced in 1351AD by Arabs. The first known Hakim was Zia Mohd Masood Rasheed zangi. Unani Medicine soon got acceptance by the masses due to its efficacy and nontoxicity of the drugs. Following eminent scholars of that period are:

1. Akbar. Mohd. Akbar Arzani (1721 AD death.). He was known for his book Qarabadin Qadri and Tibbe Akbar,based on his own lifelong clinical experience.

2.Hakim M. Shareef Khan (1725-1807) A famous Hakim of Delhi in Mughal Period. He was famous for his book Ilaj ul Amraz.

3. Hakim Ajmal Khan (1864-1927) Hkm Ajmal Khan. was renowned Hakim,scientist,politician and freedom fighter and a great patriot. He was established Unani and Ayurvedic College at Karol Bagh Delhi. He is remembered as Masihul Mulk Hkm Ajmal Khan.He was the first person who opened the door of research in Indian Systems of medicine and under his supervision Asarol (Rauwolfia serpentina) was analysed and isolated various alkaloids i.e. Ajmaloon, Reserpine etc and most effective drug for Hypertension was introduced in world.

4. Hakim kabeeruddin (April 1894-9th January 1976) was very dedicated scholar of Unani Medicine . He was translated 88 Unani books of Arabic and Persian languages into Urdu. Which was the greatest achievement. Due to this achievements today, the Unani colleges in India are in existence. The first institution of Unani medicine was established in 1872 as Oriental College at Lahore. Thereafter many institution came into existence.