History of medicine 1

History of medicineAll human societies have medical beliefs that provide explanations for birth, death, and disease. Throughout history,illness has been attributed to witchcraft, demons, adverse astral influence, or the will of the gods. These ideas stillretain some power, with faith healing and shrines still used in some places, although the rise of scientific medicineover the past millennium has altered or replaced mysticism in most cases.

Prehistoric medicineAlthough there is no record to establish when plants were first used for medicinal purposes (herbalism), the use ofplants as healing agents is an ancient practice. Over time through emulation of the behavior of fauna a medicinalknowledge base developed and was passed between generations. As tribal culture specialized specific castes,Shamans and apothecaries performed the 'niche occupation' of healing.

Antiquity

EgyptAncient Egypt developed a large, varied and fruitful medical tradition. Herodotus described the Egyptians as "thehealthiest of all men, next to the Libyans",[1] due to the dry climate and the notable public health system that theypossessed. According to him, "[t]he practice of medicine is so specialized among them that each physician is a healerof one disease and no more." Although Egyptian medicine, to a good extent, dealt with the supernatural,[2] iteventually developed a practical use in the fields of anatomy, public health, and clinical diagnostics.Medical information in the Edwin Smith Papyrus[3] may date to a time as early as 3000 BC. The earliest knownsurgery in Egypt was performed in Egypt around 2750 BC. Imhotep in the 3rd dynasty is sometimes credited withbeing the founder of ancient Egyptian medicine and with being the original author of the Edwin Smith Papyrus,detailing cures, ailments and anatomical observations. The Edwin Smith Papyrus is regarded as a copy of severalearlier works and was written circa 1600 BC. It is an ancient textbook on surgery almost completely devoid ofmagical thinking and describes in exquisite detail the examination, diagnosis, treatment, and prognosis of numerousailments.[4]

Conversely, the Ebers papyrus[5] (c. 1550 BC) is full of incantations and foul applications meant to turn awaydisease-causing demons, and other superstition. The Ebers papyrus also provides our earliest possible documentationof ancient awareness of tumors, but ancient medical terminology being badly understood, cases Ebers 546 and 547for instance may refer to simple swellings.The Kahun Gynaecological Papyrus[6] treats women's complaints, including problems with conception. Thirty fourcases detailing diagnosis and treatment survive, some of them fragmentarily.[7] Dating to 1800 BC, it is the oldestsurviving medical text of any kind.Medical institutions, referred to as Houses of Life are known to have been established in ancient Egypt as early as the1st Dynasty. By the time of the 19th Dynasty some workers enjoyed such benefits as medical insurance, pensionsand sick leave.The earliest known physician is also credited to ancient Egypt: Hesy-Ra, “Chief of Dentists and Physicians” for KingDjoser in the 27th century BC.[8] Also, the earliest known woman physician, Peseshet, practiced in Ancient Egypt atthe time of the 4th dynasty. Her title was “Lady Overseer of the Lady Physicians.” In addition to her supervisory role,Peseshet trained midwives at an ancient Egyptian medical school in Sais.

History of medicine 2

Mesopotamia and LevantThe oldest Babylonian texts on medicine date back to the Old Babylonian period in the first half of the2nd millennium BC. The most extensive Babylonian medical text, however, is the Diagnostic Handbook written bythe physician Esagil-kin-apli of Borsippa,[9] during the reign of the Babylonian king Adad-apla-iddina(1069-1046 BC).[10]

Along with contemporary ancient Egyptian medicine, the Babylonians introduced the concepts of diagnosis,prognosis, physical examination, and medical prescriptions. In addition, the Diagnostic Handbook introduced themethods of therapy and etiology and the use of empiricism, logic and rationality in diagnosis, prognosis and therapy.The text contains a list of medical symptoms and often detailed empirical observations along with logical rules usedin combining observed symptoms on the body of a patient with its diagnosis and prognosis.[11]

The Diagnostic Handbook was based on a logical set of axioms and assumptions, including the modern view thatthrough the examination and inspection of the symptoms of a patient, it is possible to determine the patient's disease,its aetiology and future development, and the chances of the patient's recovery. The symptoms and diseases of apatient were treated through therapeutic means such as bandages, creams and pills.[9]

Most of our knowledge of ancient Hebrew medicine during the 1st millennium BC comes from the Torah, i.e. theFive Books of Moses, which contain various health related laws and rituals, such as isolating infected people(Leviticus 13:45-46), washing after handling a dead body (Numbers 19:11-19) and burying excrement away fromcamp (Deuteronomy 23:12-13). While the observance of these statutes would have and do lead to several healthbenefits, Jewish belief commands that these rituals and prohibitions be kept purely to fulfill the will of God with noulterior motive. Max Neuberger, writing in his "History of Medicine" says

"The commands concern prophylaxis and suppression of epidemics, suppression of venereal disease andprostitution, care of the skin, baths, food, housing and clothing, regulation of labor, sexual life, discipline ofthe people,  etc. Many of these commands, such as Sabbath rest, circumcision, laws concerning food(interdiction of blood and pork), measures concerning menstruating and lying-in women and those sufferingfrom gonorrhea, isolation of lepers, and hygiene of the camp, are, in view of the conditions of the climate,surprisingly rational." (Neuburger: History of Medicine, Oxford University Press, 1910, Vol. I, p. 38).

IndiaThe Atharvaveda, a sacred text of Hinduism dating from the Early Iron Age, is the first Indian text dealing withmedicine, like the medicine of the Ancient Near East based on concepts of the exorcism of demons and magic. TheAtharvaveda also contain prescriptions of herbs for various ailments. The use of herbs to treat ailments would laterform a large part of Ayurveda.In the first millennium BCE, there emerges in post-Vedic India the traditional medicine system known as Ayurveda,meaning the "complete knowledge for long life". Its two most famous texts belong to the schools of Charaka, born c.600 BCE, and Sushruta, born 600 BCE. While these writings display some limited continuities with the earliermedical ideas known from the Vedas, historians have been able to demonstrate direct historical connections betweenearly Ayurveda and the early literature of the Buddhists and Jains. The earliest foundations of Ayurveda were builton a synthesis of traditional herbal practices together with a massive addition of theoretical conceptualizations, newnosologies and new therapies dating from about 400 BCE onwards, and coming out of the communities of thinkerswho included the Buddha and others.[12]

According to the compendium of Charaka, the Charakasamhitā, health and disease are not predetermined and life may be prolonged by human effort. The compendium of Suśruta, the Suśrutasamhitā defines the purpose of medicine to cure the diseases of the sick, protect the healthy, and to prolong life. Both these ancient compendia include details of the examination, diagnosis, treatment, and prognosis of numerous ailments. The Suśrutasamhitā is notable for describing procedures on various forms of surgery, including rhinoplasty, the repair of torn ear lobes, perineal

History of medicine 3

lithotomy, cataract surgery, and several other excisions and other surgical procedures. Most remarkable is Sushruta'spenchant for scientific classification: His medical treatise consists of 184 chapters, 1,120 conditions are listed,including injuries and illnesses relating to ageing and mental illness. The Sushruta Samhita describe 125 surgicalinstrument, 300 surgical procedures and classifies human surgery in 8 categories [13]The Ayurvedic classics mention eight branches of medicine: kāyācikitsā (internal medicine), śalyacikitsā (surgeryincluding anatomy), śālākyacikitsā (eye, ear, nose, and throat diseases), kaumārabhṛtya (pediatrics), bhūtavidyā(spirit medicine), and agada tantra (toxicology), rasāyana (science of rejuvenation), and vājīkaraṇa (aphrodesiacs,mainly for men). Apart from learning these, the student of Āyurveda was expected to know ten arts that wereindispensable in the preparation and application of his medicines: distillation, operative skills, cooking, horticulture,metallurgy, sugar manufacture, pharmacy, analysis and separation of minerals, compounding of metals, andpreparation of alkalis. The teaching of various subjects was done during the instruction of relevant clinical subjects.For example, teaching of anatomy was a part of the teaching of surgery, embryology was a part of training inpediatrics and obstetrics, and the knowledge of physiology and pathology was interwoven in the teaching of all theclinical disciplines. The normal length of the student's training appears to have been seven years. But the physicianwas to continue to learn.[14]

As an alternative form of medicine in India, Unani medicine got deep roots and royal patronage during medievaltimes. It progressed during Indian sultanate and mughal periods. Unani medicine is very close to Ayurveda. Both arebased on theory of the presence of the elements (in Unani, they are considered to be fire, water, earth and air) in thehuman body. According to followers of Unani medicine, these elements are present in different fluids and theirbalance leads to health and their imbalance leads to illness.[15]

ChinaChina also developed a large body of traditional medicine. Much of the philosophy of traditional Chinese medicinederived from empirical observations of disease and illness by Taoist physicians and reflects the classical Chinesebelief that individual human experiences express causative principles effective in the environment at all scales.These causative principles, whether material, essential, or mystical, correlate as the expression of the natural order ofthe universe.The foundational text of Chinese medicine is the Huangdi neijing, or Yellow Emperor's Inner Canon, which iscomposed of two books: the Suwen 素問 ("Basic Questions") and the Lingshu 靈樞 ("Divine Pivot"). Although theNeijing has long been attributed to the mythical Yellow Emperor (twenty-7th century BC), Chinese scholars starteddoubting this attribution as early as the 11th century and now usually date the Neijing to the late Warring Statesperiod (5th century-221 BC).[16] Because the medical "silk manuscripts" dating from around 200 BC that wereexcavated in the 1970s from the tomb of a Han-dynasty noble in Mawangdui are undoubtedly ancestors of thereceived Neijing, scholars like Nathan Sivin now argue that the Neijing was first compiled in the 1st century BC.[17]

During the Han dynasty, Zhang Zhongjing, who was mayor of Changsha near the end of the 2nd century AD, wrotea Treatise on Cold Damage, which contains the earliest known reference to the Neijing Suwen. The Jin Dynastypractitioner and advocate of acupuncture and moxibustion, Huangfu Mi (215-282), also quotes the Yellow Emperorin his Jiayi jing, ca. 265. During the Tang Dynasty, Wang Bing claimed to have located a copy of the originals of theSuwen, which he expanded and edited substantially. This work was revisited by an imperial commission during the11th century, and the result is our best extant representation of the foundational roots of traditional Chinesemedicine.

History of medicine 4

Greek and Roman medicine

The Hippocratic Corpus, is a collection of aroundseventy early medical works from ancient Greece

strongly associated with the ancient Greek physicianHippocrates and his teachings.

The first known Greek medical school opened in Cnidus in 700BC. Alcmaeon, author of the first anatomical work, worked at thisschool, and it was here that the practice of observing patients wasestablished. As was the case elsewhere, the ancient Greeksdeveloped a humoral medicine system where treatment sought torestore the balance of humours within the body.

Temples dedicated to the healer-god Asclepius, known asAsclepieia (Greek: Ἀσκληπιεῖα, sing. Ἀσκληπιεῖον, 'Asclepieion),functioned as centers of medical advice, prognosis, and healing.[18]

At these shrines, patients would enter a dream-like state of inducedsleep known as "enkoimesis" (Greek: ενκοίμησις) not unlikeanesthesia, in which they either received guidance from the deityin a dream or were cured by surgery.[19] Asclepeia providedcarefully controlled spaces conducive to healing and fulfilledseveral of the requirements of institutions created for healing.[18]

In the Asclepieion of Epidaurus, three large marble boards dated to350 BC preserve the names, case histories, complaints, and curesof about 70 patients who came to the temple with a problem andshed it there. Some of the surgical cures listed, such as the openingof an abdominal abscess or the removal of traumatic foreignmaterial, are realistic enough to have taken place, but with thepatient in a state of enkoimesis induced with the help of soporificsubstances such as opium.[19]

A towering figure in the history of medicine was the physician Hippocrates of Kos (ca. 460 BC – ca. 370 BC),considered the "father of modern medicine."[20] [21] The Hippocratic Corpus is a collection of around seventy earlymedical works from ancient Greece strongly associated with Hippocrates and his students. Most famously,Hippocrates invented the Hippocratic Oath for physicians, which is still relevant and in use today.

Hippocrates and his followers were first to describe many diseases and medical conditions. He is given credit for thefirst description of clubbing of the fingers, an important diagnostic sign in chronic suppurative lung disease, lungcancer and cyanotic heart disease. For this reason, clubbed fingers are sometimes referred to as "Hippocraticfingers".[22] Hippocrates was also the first physician to describe Hippocratic face in Prognosis. Shakespearefamously alludes to this description when writing of Falstaff's death in Act II, Scene iii. of Henry V.[23] [24]

Hippocrates began to categorize illnesses as acute, chronic, endemic and epidemic, and use terms such as,"exacerbation, relapse, resolution, crisis, paroxysm, peak, and convalescence."[25] [26] Another of Hippocrates'smajor contributions may be found in his descriptions of the symptomatology, physical findings, surgical treatmentand prognosis of thoracic empyema, i.e. suppuration of the lining of the chest cavity. His teachings remain relevantto present-day students of pulmonary medicine and surgery.[27] Hippocrates was the first documented chest surgeonand his findings are still valid.[27]

History of medicine 5

View of the Askleipion of Kos, the best preserved instance of an Asklepieion.

The Plinthios Brokhos as described by Greekphysician Heraklas, a sling for binding a fractured

jaw. These writings were preserved in one ofOribasius' collections.[28]

Herophilus of Chalcedon, working at themedical school of Alexandria placedintelligence in the brain, and connected thenervous system to motion and sensation.Herophilus also distinguished between veinsand arteries, noting that the latter pulsewhile the former do not. He and hiscontemporary, Erasistratus of Chios,researched the role of veins and nerves,mapping their courses across the body.Erasistratus connected the increasedcomplexity of the surface of the humanbrain compared to other animals to itssuperior intelligence. He sometimesemployed experiments to further hisresearch, at one time repeatedly weighing acaged bird, and noting its weight lossbetween feeding times. In Erasistratus'physiology, air enters the body, is thendrawn by the lungs into the heart, where it istransformed into vital spirit, and is thenpumped by the arteries throughout the body.Some of this vital spirit reaches the brain,where it is transformed into animal spirit,which is then distributed by the nerves.[29]

The Greek Galen was one of the greatestsurgeons of the ancient world and performed many audacious operations—including brain and eye surgeries— thatwere not tried again for almost two millennia. Later, in medieval Europe, Galen's writings on anatomy became themainstay of the medieval physician's university curriculum along; but they suffered greatly from stasis andintellectual stagnation. In the 1530s, however, Belgian anatomist and physician Andreas Vesalius took on a projectto translate many of Galen's Greek texts into Latin. Vesalius's most famous work, De humani corporis fabrica, wasgreatly influenced by Galenic writing and form.[30] The works of Galen and Avicenna, especially The Canon ofMedicine which incorporated the teachings of both, were translated into Latin, and the Canon remained the mostauthoritative text on anatomy in European medical education until the 16th century.

The Romans invented numerous surgical instruments, including the first instruments unique to women,[31] as well asthe surgical uses of forceps, scalpels, cautery, cross-bladed scissors, the surgical needle, the sound, and speculas.[32]

[33] Romans also performed cataract surgery.[34]

Medieval medicine was an evolving mixture of the scientific and the spiritual like Unani. In the early Middle Ages,following the fall of the Roman Empire, standard medical knowledge was based chiefly upon surviving Greek andRoman texts, preserved in monasteries and elsewhere. Ideas about the origin and cure of disease were not, however,purely secular, but were also based on a spiritual world view, in which factors such as destiny, sin, and astralinfluences played as great a part as any physical cause.Oribasius was the greatest Byzantine compiler of medical knowledge. Several of his works, along with many other Byzantine physicians, were translated into Latin, and eventually, during the Enlightenment and Age of Reason, into English and French. The last great Byzantine Physician was John Actuarius, who lived in the early 14th century in

History of medicine 6

Constantinople.

Middle Ages

Islamic Middle Ages

An Arabic manuscript, dated 1200 CE, titledAnatomy of the Eye, authored by al-Mutadibih.

Persia's position at the crossroads of the East and the West frequentlyplaced it in the midst of developments in both ancient Greek andIndian medicine. The first generation of Persian physicians was trainedat the Academy of Jundishapur. This evolved into the medieval IslamicBimaristan hospitals.[35] [36]

The Islamic civilization rose to primacy in medical science as Muslimphysicians contributed significantly to the field of medicine, includinganatomy, ophthalmology, pharmacology, pharmacy, physiology,surgery, and the pharmaceutical sciences. The Arabs were influencedby, and further developed Greek, Roman and Indian medical practices.Galen, Hippocrates, Sushruta and Charaka were pre-eminentauthorities.[37] The translation of 129 works of ancient Greek physicianGalen into Arabic by Hunayn ibn Ishaq and his assistants, and inparticular Galen's insistence on a rational systematic approach tomedicine, set the template for Islamic medicine, which rapidly spreadthroughout the Arab Empire. Muslim physicians set up some of theearliest dedicated hospitals, which later spread to Europe during theCrusades, inspired by the hospitals in the Middle East.[38]

Muhammad ibn Zakariya al-Razi became the first physician to systematically use alcohol in his practice as aphysician. The Comprehensive Book of Medicine (Large Comprehensive, Hawi, "al-Hawi" or "The Continence") waswritten by the Iranian chemist Muhammad ibn Zakariya al-Razi, the "Large Comprehensive" was the most soughtafter of all his compositions. In it, Muhammad ibn Zakariya al-Razi recorded clinical cases of his own experienceand provided very useful recordings of various diseases. The "Kitab fi al-jadari wa-al-hasbah" by Muhammad ibnZakariya al-Razi, with its introduction on measles and smallpox was also very influential in Europe.

Al-Kindi wrote De Gradibus, in which he demonstrated the application of mathematics to medicine, particularly inthe field of pharmacology. This includes the development of a mathematical scale to quantify the strength of drugs,and a system that would allow a doctor to determine in advance the most critical days of a patient's illness.[39] Razi(Rhazes) (865-925) recorded clinical cases of his own experience and provided very useful recordings of variousdiseases. His Comprehensive Book of Medicine, which introduced measles and smallpox, was very influential inEurope.Abu al-Qasim (Abulcasis), who some have called the father of modern surgery,[40] wrote the Kitab al-Tasrif (1000),a 30-volume medical encyclopedia which was taught at Muslim and European medical schools until the 17thcentury. He used numerous surgical instruments, including some that are unique to women.[31] [41]

Avicenna, considered among the most influential medical scholars in history,[38] wrote The Canon of Medicine (1025) and The Book of Healing (1027), which remained standard textbooks in both Muslim and European universities until the 17th century. Avicenna's contributions include the discovery of the contagious nature of infectious diseases, the introduction of quarantine to limit the spread of contagious diseases, the introduction of experimental medicine and clinical trials,[42] the distinction of mediastinitis from pleurisy, the contagious nature of phthisis and tuberculosis, the distribution of diseases by water and soil, and the first careful descriptions of skin troubles, sexually transmitted diseases, and nervous ailments,[38] as well the use of ice to treat fevers, and the

History of medicine 7

separation of medicine from pharmacology, which was important to the development of the pharmaceuticalsciences.[41]

In 1242, Ibn al-Nafis was the first to describe pulmonary circulation and coronary circulation,[43] He also describedthe earliest concept of metabolism,[44] and developed new systems of physiology to replace the Avicennian andGalenic systems, while discrediting many of their erroneous theories on the four humours, pulsation,[45] bones,muscles, intestines, sensory organs, bilious canals, esophagus, stomach, etc.[46]

The Tashrih al-badan (Anatomy of the body) of Mansur ibn Ilyas (c. 1390) contained comprehensive diagrams of thebody's structural, nervous and circulatory systems.[47] During the Black Death, or bubonic plague in 14th centuryal-Andalus, Ibn Khatima and Ibn al-Khatib discovered that infecious diseases are caused by microorganisms whichenter the human body.[48] Other medical innovations first introduced by Muslim physicians include the discovery ofthe immune system, the introduction of microbiology, the use of animal testing, and the combination of medicinewith other sciences (including agriculture, botany, chemistry, and pharmacology),[41] , the first drugstores inBaghdad (754), the distinction between medicine and pharmacy by the 12th century, and the discovery of at least2,000 medicinal and chemical substances.[49]

Christian Middle Ages

Physician setting a dislocated arm (1450)

In western Europe, with the collapse of Romanimperial authority, medicine became localised;folk-medicine supplemented what remained of themedical knowledge of antiquity. Medical knowledgewas preserved and practised in many monasticinstitutions, which often had a hospital attached.Organised professional medicine re-emerged, with thefoundation of the medical college (Schola MedicaSalernitana) of Salerno in Italy in the 11th century,which in co-operation with the monastery of MonteCassino, translated many Byzantine and Arabic works.In the 12th century universities were founded in Italyand elsewhere, which soon developed schools ofmedicine.

Gradually the reliance on the masters of the ancientworld was augmented by the results of individualobservation and experience. Surgical practice improvedgreatly during the medieval period. RogeriusSalernitanus composed his Chirurgia, which becamethe foundation for modern Western surgical manuals upto the modern time.

Renaissance to Early Modern period

With the Renaissance came an increase in experimental investigation, principally in the field of dissection and bodyexamination, thus advancing our knowledge of human anatomy. The development of modern

History of medicine 8

"Anatomy Lesson of Dr. Nicolaes Tulp" by Rembrandt van Rijn,1632.

neurology began in the 17th century with Vesalius,who described the anatomy of the brain and otherorgans; he had little knowledge of the brain's function,thinking that it resided mainly in the ventricles.Understanding of medical sciences and diagnosisimproved, but with little direct benefit to health care.Few effective drugs existed, beyond opium andquinine. Folklore cures and potentially poisonousmetal-based compounds were popular treatments.

Modern medicine

Medicine was revolutionized in the 19th century andbeyond by advances in chemistry and laboratorytechniques and equipment, old ideas of infectiousdisease epidemiology were replaced with bacteriology and virology. Bacteria and microorganisms were firstobserved with a microscope by Antonie van Leeuwenhoek in 1676, initiating the scientific field microbiology.[50]

Ignaz Semmelweis (1818–1865) in 1847 dramatically reduced the death rate of new mothers from child bed fever bythe simple expedient of requiring physicians to clean their hands before attending to women in childbirth. Hisdiscovery pre-dated the germ theory of disease. However, his discoveries were not appreciated by his contemporariesand came into general use only with discoveries of British surgeon Joseph Lister, who in 1865 proved the principlesof antisepsis in the treatment of wounds; However, medical conservatism on new breakthroughs in pre-existingscience prevented them from being generally well received during the 19th century.After Charles Darwin's 1859 publication of The Origin of Species, Gregor Mendel (1822–1884) published in 1865his books on pea plants, which would be later known as Mendel's laws. Re-discovered at the turn of the 20th century,they would form the basis of classical genetics. The 1953 discovery of the structure of DNA by Watson and Crickwould open the door to molecular biology and modern genetics. During the late 19th century and the first part of the20th century, several physicians, such as Nobel prize winner Alexis Carrel, supported eugenics, a theory firstformulated in 1865 by Francis Galton. Eugenics was discredited as a science after the Nazis' experiments in WorldWar II became known; however, compulsory sterilization programs continued to be used in modern countries(including the US, Sweden and Peru) until much later.Semmelweis's work was supported by the discoveries made by Louis Pasteur. Linking microorganisms with disease,Pasteur brought about a revolution in medicine. He also invented with Claude Bernard (1813–1878) the process ofpasteurization still in use today. His experiments confirmed the germ theory. Claude Bernard aimed at establishingscientific method in medicine; he published An Introduction to the Study of Experimental Medicine in 1865. Besidethis, Pasteur, along with Robert Koch (who was awarded the Nobel Prize in 1905), founded bacteriology. Koch wasalso famous for the discovery of the tubercle bacillus (1882) and the cholera bacillus (1883) and for his developmentof Koch's postulates.The participation of women in medical care (beyond serving as midwives, sitters and cleaning women) was broughtabout by Florence Nightingale. Nightingale showed a previously male dominated profession the elemental role ofnursing in order to lessen the aggravation of patient mortality which resulted from lack of hygiene and nutrition.Nightingale set up the St Thomas hospital, post-Crimea, in 1852. Elizabeth Blackwell (1821–1910) became the firstwoman to formally study, and subsequently practice, medicine in the United States.It was in this era that actual cures were developed for certain endemic infectious diseases. However the decline in many of the most lethal diseases was more due to improvements in public health and nutrition than to medicine. It was not until the 20th century that the application of the scientific method to medical research began to produce

History of medicine 9

multiple important developments in medicine, with great advances in pharmacology and surgery.During the First World War, Alexis Carrel and Henry Dakin developed the Carrel-Dakin method of treating woundswith an irrigation, Dakin's solution, a germicide which helped prevent gangrene.The Great War spurred the usage of Roentgen's X-ray, and the electrocardiograph, for the monitoring of internalbodily functions. This was followed in the inter-war period by the development of the first anti-bacterial agents suchas the sulpha antibiotics. The Second World War saw the introduction of widespread and effective antimicrobialtherapy with the development and mass production of penicillin antibiotics, made possible by the pressures of thewar and the collaboration of British scientists with the American pharmaceutical industry.Lunatic asylums began to appear in the Industrial Era. Emil Kraepelin (1856–1926) introduced new medicalcategories of mental illness, which eventually came into psychiatric usage despite their basis in behavior rather thanpathology or etiology. In the 1920s surrealist opposition to psychiatry was expressed in a number of surrealistpublications. In the 1930s several controversial medical practices were introduced including inducing seizures (byelectroshock, insulin or other drugs) or cutting parts of the brain apart (leucotomy or lobotomy). Both came intowidespread use by psychiatry, but there were grave concerns and much opposition on grounds of basic morality,harmful effects, or misuse. In the 1950s new psychiatric drugs, notably the antipsychotic chlorpromazine, weredesigned in laboratories and slowly came into preferred use. Although often accepted as an advance in some ways,there was some opposition, due to serious adverse effects such as tardive dyskinesia. Patients often opposedpsychiatry and refused or stopped taking the drugs when not subject to psychiatric control. There was also increasingopposition to the use of psychiatric hospitals, and attempts to move people back into the community on acollaborative user-led group approach ("therapeutic communities") not controlled by psychiatry. Campaigns againstmasturbation were done in the Victorian era and elsewhere. Lobotomy was used until the 1970s to treatschizophrenia. This was denounced by the anti-psychiatric movement in the 1960s and later.The 20th century witnessed a shift from a master-apprentice paradigm of teaching of clinical medicine to a more"democratic" system of medical schools. With the advent of the evidence-based medicine and great advances ofinformation technology the process of change is likely to evolve further, with greater development of internationalprojects such as the Human genome project.In 1954 Joseph Murray, J. Hartwell Harrison, M.D. and others accomplished the first kidney transplantation.

Notes[1] Herodotus. "Chapter 77, Book II" (in English translation (http:/ / www. perseus. tufts. edu/ cgi-bin/ ptext?doc=Perseus:text:1999. 01. 0126&

layout=& loc=2. 77. 3)). The Histories.[2] Nunn, John F. (2002). Ancient Egyptian Medicine. University of Oklahoma Press.[3] J. H. Breasted, The Edwin Smith Surgical Papyrus, University of Chicago Press, 1930[4] Edwin Smith papyrus - Britannica Online Encyclopedia (http:/ / www. britannica. com/ eb/ article?tocId=9032043& query=Edwin Smith

papyrus& ct=)[5] P. W. Bryan, The Papyrus Ebers, Geoffrey Bles: London, 1930[6] Griffith, F. Ll. The Petrie Papyri: Hieratic Papyri from Kahun and Gurob[7] The Kahun Gynaecological Papyrus (http:/ / www. reshafim. org. il/ ad/ egypt/ timelines/ topics/ kahunpapyrus. htm)[8] Helaine Selin, Hugh Shapiro, Medicine Across Cultures: History and Practice of Medicine in Non-Western Cultures, Springer 2003, p.35[9] H. F. J. Horstmanshoff, Marten Stol, Cornelis Tilburg (2004), Magic and Rationality in Ancient Near Eastern and Graeco-Roman Medicine,

p. 99, Brill Publishers, ISBN 90-04-13666-5.[10] Marten Stol (1993), Epilepsy in Babylonia, p. 55, Brill Publishers, ISBN 90-72371-63-1.[11] H. F. J. Horstmanshoff, Marten Stol, Cornelis Tilburg (2004), Magic and Rationality in Ancient Near Eastern and Graeco-Roman Medicine,

p. 97-98, Brill Publishers, ISBN 90-04-13666-5.[12] Kenneth G. Zysk, Asceticism and Healing in Ancient India: Medicine in the Buddhist Monastery, Oxford University Press, rev. ed. (1998)

ISBN 0-19-505956-5[13] http:/ / www. ispub. com/ ostia/ index. php?xmlFilePath=journals/ ijps/ vol4n2/ sushruta. xml[14] Dominik Wujastyk, ed., The Roots of Ayurveda, Penguin (2003) ISBN 0-14-044824-1[15] Arab Medicine during the Ages by Hakim Syed Zillur Rahman, Studies in History of Medicine and Science, IHMMR, New Delhi, Vol.

XIV, No. 1-2, 1996, p. 1-39

History of medicine 10

[16] Unschuld (2003), 1.[17] Sivin (1993).[18] Risse, G.B. Mending bodies, saving souls: a history of hospitals. Oxford University Press, 1990. p. 56 (http:/ / books. google. com/

books?id=htLTvdz5HDEC& pg=PA56& dq=History+ of+ Hospital+ Asclepieion& lr=lang_en& as_brr=0& cd=2#v=onepage& q=History ofHospital+ Asclepieion& f=false)

[19] Askitopoulou, H., Konsolaki, E., Ramoutsaki, I., Anastassaki, E. Surgical cures by sleep induction as the Asclepieion of Epidaurus. Thehistory of anesthesia: proceedings of the Fifth International Symposium, by José Carlos Diz, Avelino Franco, Douglas R. Bacon, J. Rupreht,Julián Alvarez. Elsevier Science B.V., International Congress Series 1242(2002), p.11-17. (http:/ / books. google. com/books?id=TM-8NIDPowoC& pg=PA11& dq=History+ of+ Hospital+ Asclepieion& lr=lang_en& as_brr=0& cd=1#v=onepage& q=History ofHospital+ Asclepieion& f=false)

[20] Hippocrates: The "Greek Miracle" in Medicine (http:/ / www. medicinaantiqua. org. uk/ sa_hippint. html)[21] The Father of Modern Medicine: Hippocrates (http:/ / web. archive. org/ web/ 20080228084033/ http:/ / www. geocities. com/ trepanationz/

hippocrates/ )[22] Schwartz, Richards & Goyal 2006[23] Singer & Underwood 1962, p. 40[24] Margotta 1968, p. 70[25] Garrison 1966, p. 97[26] Martí-Ibáñez 1961, p. 90[27] Major 1965[28] Day, Cyrus L. (1967). Quipus and Witches' Knots. Lawrence, Kansas: University of Kansas Press. pp. 86–89, 124–126.[29] Mason, A History of the Sciences, p 57[30] Dear, Peter. Revolutionizing the Sciences: European Knowledge and Its Ambitions, 1500-1700. Princeton, NJ: Princeton University Press

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Group, ISBN 056708969X.[37] Amber Haque (2004), "Psychology from Islamic Perspective: Contributions of Early Muslim Scholars and Challenges to Contemporary

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[39] Felix Klein-Frank (2001), Al-Kindi, in Oliver Leaman and Hossein Nasr, History of Islamic Philosophy, p. 172. Routledge, London.[40] A. Martin-Araguz, C. Bustamante-Martinez, Ajo V. Fernandez-Armayor, J. M. Moreno-Martinez (2002). "Neuroscience in al-Andalus and

its influence on medieval scholastic medicine", Revista de neurología 34 (9), p. 877-892.[41] Bashar Saad, Hassan Azaizeh, Omar Said (October 2005). " Tradition and Perspectives of Arab Herbal Medicine: A Review (http:/ / ecam.

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[46] Dr. Sulaiman Oataya (1982), "Ibn ul Nafis has dissected the human body", Symposium on Ibn al-Nafis, Second International Conference onIslamic Medicine: Islamic Medical Organization, Kuwait (cf. Ibn ul-Nafis has Dissected the Human Body (http:/ / www. islamset. com/ isc/nafis/ index. html), Encyclopedia of Islamic World).

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History of medicine 11

[50] Madigan M, Martinko J (editors) (2006). Brock Biology of Microorganisms (11th ed.). Prentice Hall. ISBN 0-13-144329-1.

References• Murray, Joseph E., "The First Successful Organ Transplants in Man", Nobel Lect., 1990, Nobelprize.org., Web,

July 7, 2010

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Harper Collins. ISBN 0-00-215173-1.• Rousseau, George S. (2003). Framing and Imagining Disease in Cultural History (Basingstoke: Palgrave

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External links• American Association for the History of Medicine (http:/ / www. histmed. org/ ),• Science Museum's History of Medicine Website (http:/ / www. sciencemuseum. org. uk/ broughttolife)•  "History of Medicine". Catholic Encyclopedia. New York: Robert Appleton Company. 1913.•  "Anatomy". Catholic Encyclopedia. New York: Robert Appleton Company. 1913.• History of Medicine (http:/ / www. nlm. nih. gov/ hmd/ ), United States National Library of Medicine• Directory of History of Medicine Collections (http:/ / wwwcf. nlm. nih. gov/ hmddirectory/ index. cfm/ )• The history of medicine and surgery as portrayed by various artists (http:/ / www. imageofsurgery. com/

Surgery_history_art. htm)• Medicine @ JewishEncyclopedia.com (http:/ / www. jewishencyclopedia. com/ view. jsp?artid=325& letter=M&

search=medicine)• Exhibition of the Vatican Library's Medical Holdings @ The Library of Congress (http:/ / www. loc. gov/

exhibits/ vatican/ medicine. html)• Info Britain - History of medicine in the UK (http:/ / www. infobritain. co. uk/ History_Of_Medicine. htm)• Wellcome Library History of Medicine (http:/ / library. wellcome. ac. uk/ index. html)• Digital Clendening Library at the University of Kansas Medical Center (http:/ / clendening. kumc. edu/ dc/ index.

html)• "MacKinney Collection of Medieval Medical Illustrations" (http:/ / www. lib. unc. edu/ dc/ mackinney/ index.

html)• The Center for the History of Medicine, Countway Library, Harvard Medical School (includes the Warren

Anatomical Museum) (http:/ / www. countway. harvard. edu/ menuNavigation/ historicalResources. html)• Medical Heritage Library (http:/ / www. medicalheritage. org/ ) digital curation collaborative

Article Sources and Contributors 12

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