Medicine through time

Key ideas:
. They had both superstitious and practical ideas.
. They developed the first rational ideas about disease.
. They were the first to get an idea of human anatomy
KEY POINTS -
. God of healing = IMHOTEP , Goddess of disease = SEKHMET.
. They carried charms to keep away any bad spirits.
. Their rational idea was '' disease is caused by blocked channels and gases in body''
. They got this idea from irrigation channels and what they found in bodies.
. They got knowledge of anatomy from preparing bodies for mummification.
. They were clean people, washed regularly and wore linen. Priests shaved all hair.
. They had a number of different healers, priests, majicians, physicians, spiritualists and women.
.They carried out simple surgery including eye operations and trephining.
. Their instruments were made of bronze.
. They found that certain minerals like malachite prevented eye infections.

Key ideas:
. They improved on Egyptian medicine, better surgical instruments and more advanced surgery - including amputations.
. Like the egyptians, they had superstition alongside rational medicine.
KEY POINTS:
. They believe in a god of healing, ASCLEPIOS: he ''healed'' in dreams with the d of his two daughters, HYGEIA and PANACEA. Priests of asclepios used snakes in the rituals.
. There were collections of buildings at the ASCLEPIAA - temples stadia, gymnasiums, baths and the ABATON ( like a hospital where priests came). The most famous asclepiaa was at EPIDAURUS. cured patients left offerings.
. The greek idea of natural medicine came from HIPPOCRATES.

His ideas:
THE FOUR HUMOURS:
. The body has four humours which must be kept '' in balance'' for good health.
. The four humours are blood, phlegm, black bile and yellow bile.
. Illness is explained as the humours being out of balance( too much of one humour, and too little of another, etc).
. Treatments included blood letting, purging.
. The humours were associated with the seasons.
. He stressed the use of opposites.
THE HIPPOCRATIC OATH:
. Always treat the patient with your best skill, never give poisons or abortions.
. Keep confidential everything you learn about the patient.
. never seduce a patient.
CLINICAL PROCEDURE: - observe and examine, record symptoms, make a diognosis, make a prognosis and give treatments ( STILL BASIS OF MEDICINE TODAY)...

THE HIPPOCRATIC COLLECTION : - written by himself, 600 books.

Key ideas:
. Their main idea was public health.
PUBLIC HEALTH:
WATER SUPPLY - Fresh water was brought into towns and cities by latrines, conduits, pipes and syphons. The water was filtered into settling tanks before being used for public baths, drinking fountains, PUBLIC LATRINES, army forts and emporers own use.
SEWERS - Wase water from latrines, baths and rainwater collected in gutters ran down pipes and flushed the sewers. In rome was the CLOACA MAXIMA the ''great sewer''' flushed by seven underground rivers. Slaves were sent down manholes to clean out blocked sewers.
THE BATHS - Built by the emperors in rome itself - but found in every roman town and city and every roman fort. Baths were cheap enough for common citizens to use. The baths for the rich were lined with marble silver and gold. HYPOCAUSTS - were underfloor heating systems for the hot plunge pools.

HOSPITALS - usually military - kept clean, dry , and airy with water supplies and seperate wards.

Key points:
. He was greek by birth and becam the most famous doctor in Rome in the 2nd century AD. He had experience treating GLADIATORS and worked for 2 emperors.
WHY IS HE IMPORTANT?...
. He did lots of work on anatomy ( Carryin our dissections ( mainly on animals) But possible human dissection as well at Alexandria)
. He proved that the brain controlled speech and that arteries carried blood.
. He was a great teacher, he told his students to dissect humans if possible or animals close to humans.
. He made mistakes - as vesalius is to show centuries later.
. He added to Hippocrates' work on the four humours and developed the idea of opposites.
.He wrote 60 books on anatomy, the four humours, opposites and his own observations. These books were used, virtually unchallenged for 1500 years.
. He stressed how well designed the human body was and that a divine creator must have been behind it. so he was favoured by the christians at that time.

. They associated filthy conditions with disease( though they knew nothing of germs, one roman write called PLINY actually did write about invisible things in the air that caused illness)
. They knew that poor water caused illness. They never used local water supplies if local people had looked unhealthy.
.They lived in big cities ( rome itself had 1 million inhabitants) . Such large numbers of people would be wiped out by a disease without decent water and sewage systems.
. They, like the greeks, associated cleanliness with good health.
. They were able to do this because they were great engineers. They invented cement. The emperors were ALL powerful, so they got what they wanted. They had enourmous wealth. There was a vast supply of slave labour.

. They used gods like SALUS and ASCLEPIOS ( stolen from the greeks) - ASCLEPIOUS was credited for ending a plague in Rome.
. The most common romans visited the GODS first and the DOCTORS next.
. They had doctors - the bests were greek like GALEN
.Most romans relied on family members for cures.
. They used herbal remedies
. THey were good at surgery

RELIGION
In the past - religion had both encouraged and hindered the medical progress. Heres some things that:
. HINDERED PROGRESS:

• Reliance on healing Gods like IMHOTEP or ASCLEPIOS to bring healing.
• The belief that gods and evil spirits were the cause of disease.
• Religious laws that forbade tampering with dead bodies for medical investigation.

.HELPED PROGRESS:

• Egyptian priests were also skilled at medicine
• Mummification of bodies gave the egyptians a good idea of the anatomy of humans.

--RELIGION--

GOOD POINTS
. Hospitals were run by Christian monks and nuns.

BAD POINTS
. Even in hospitals there was more emphasis on prayer than treatment
. Superstition came back with vengeance. The devil was the cause of anything unexplainable.
. Even something like black death was thought o be gods punishment on sinful man.
. ''wise women'' - those who had practical knowledge of herbal remedies were often persecuted as witches.
. the church forbade the dissection of bodies.
. Medical schools were thought to be a waste of time and were shut down for centureis.
. They took their cue from the bible - Christ drove demons out and brought miracle cures, so why did you need doctors?...

. Much better than Christian medicines for a few reasons...
. The Koran teaches that it is the duty of Muslims to look after the sick.
. The Muslims built really good hospitals. There were 50 in Baghdad alone.
. Muslims were far less ''hung up'' on superstition. They were much more practical - had a good knowlege of herbal remedies etc.
. They had better medical training for their physicians.
. Baghdad - the centre of Islamic world, was very well place to accumuilate the medical knowledge of the west and east.
. One great Islamic physician AVICENNA produced the CANON OF MEDICINE - The sum total of all medical knowledge.
. There were other great Islamic physicians like Rhazes who discovered the symptoms of small pox.

DID ISLAMIC IDEAS SPREAD TO THE CHRISTIAN PARTS OF EUROPE?...
-Eventually, the church discouraged '' Heathen medicine'' at first, but crusaders returning from the wars brough back good ideas - especiall treatment of war wounds.

Town conditions were dreadful because Roman engineering was destroyed and no - one had the engineering skills and the men to rebuild. Also towns grew up overcrowded because towns were bounded by walls for defence.

WHAT WAS SO BAD IN THE TOWNS?...
. They were overcrowded.
. Houses were built close together - they were made, generally speaking, of wood, mud and plaster. The houses were damp and infested with pests, people shared dwellings with animals.
. People changed their cloths and bathed infrequently.
. There were no underground sewers - instead there were open gutters in the streets.
. Rubbish and excretement accumulated in the houses and streets which rats lived in and they of course spread the BLACK DEATH.
.The water supplies were from streams and rivers and wells - Possibly built too close to cess pits.
. Only CASTLE DWELLERS and MONKS lived differently with good water supplies .

THEY HAD VARIOUS EXPLANATIONS -
. Most commonly a ''punishment from God''
. Some blamed bad airs - poisonous clouds arising from fissures in the earth.
. The alignment of planets.
. Poison - spread by the rich, the poor, the jews.
. Imbalance of the humours.

THEY DEALT WITH IT IN VARIOUS WAYS -
. FLagellants - whipping themselves to relieve bad sin.
. Protecting themselves from bad airs with candles and incense.
. Isolating themselves.
. Persecuting minority groups like jews.
. Bleeding, purging, herbal remedies.
. Carrying charms.
. Some people just gave up .

. Teaching was inadequate and repetitious.
. There was little chance for new ideas to be discovered.
. The ''master'' would sit in a high chair and read from books of GALEN whilst a demonstrator pointed to the parts of the anatomy.

. Later on in the middle ages, medical schools re-opened.
. The works of Galen and Hippocrates were given more importance.
. Towns and conditions showed some improvements thanks to various rules and regulations.