UERM

COLLEGE OF MEDICINE CLASS 2021B

1.02 Early Ancient Civilizations
Dr. Arcangel M. Diamante, MD, FPOGS, FPCS | August 14, 2017
LE 1 TRANS 2
HISTORY AND PERSPECTIVES IN MEDICINE

OUTLINE
I. MESOPOTAMIA
A. History
B. Diseases Recognized
C. Beliefs on Causes of Disease
D. Class of Healers or Priests
E. Class of Patients
F. Modes of Treatment
II. ANCIENT EGYPT
A. Contribution to Civilization
B. Beliefs on Life, Health, and Illness
C. Egyptian Healing Figure 1. Ancient World Map
D. Diagnosis
E. Diseases Recognized
F. Treatment
III. ANCIENT HEBREW CIVILIZATION (BIBLICAL
TIMES)
A. History
B. Concepts on Life, Health, and Disease
C. Biblical Medicine
D. Healing Methods
IV. ANCIENT INDIA
A. History
B. Ayurvedic Medicine
C. Beliefs on Health and Illness
D. Drugs and Medicaments Figure 2. Ancient River Valley Civilizations
V. ANCIENT CHINA
A. History
B. Philosophy regarding Health and Disease I. MESOPOTAMIA
C. Diagnosis
D. Treatment • Fertile Crescent
• Mesopotamia’s Original People
LEGEND • Mesopotamia
Remember Lecturer Book Previous Presentation • Currently Iraq
Trans

EARLY ANCIENT CIVILIZATIONS

• 3,500BC-220AD:
▪ Mesopotamia (Iraq) (3500-559 BC)
▪ Egypt (3000 BC-900 AD)
▪ Hebrew (2nd Century AD-700 AD)
▪ India (2500 BC-1500 BC)
▪ China (2600 BC-220 AD)
▪ Fall of Empires 500AD: Figure 3. Map of Ancient Civilization
- Roman Empire-(Mediterranean) A. HISTORY
- Han Dynasty- China
- Gupta Dynasty- India • Land between 2 rivers: Tigris & Euphrates
• Six Continents in Ancient Time: • Cradle of civilization:
▪ North America ▪ 1st known civilization: Sumer
▪ South America • Following civilizations: Babylon, Assyria, Chaldean
▪ Europe
• Pictograms – Symbol as word or phrases
▪ Africa
▪ Earliest known form of writing
▪ Asia
▪ Examples discovered in Egypt & Mesopotamia from
▪ Antartica
before 3000 BC
• Modern Times: 6 Ancient Time Continents + Australia
• Cuneiform writing (wedge shape symbols): ‘pencil’ written in
• All ancient civilizations started where there is water clay; the clay was hardened, made into tablets
• Ancient River Valley Civilizations: • Famous: King Hammurabi (1792-1750 BC)
▪ Mesopotamia – Tigris & Euphrates River
• Code of Hammurabi: Sumerian rule of law
▪ Egypt – Nile River
▪ “eye for an eye, a tooth for a tooth”
▪ India – Indus River
▪ China – Huang/Yellow River
B. DISEASES RECOGNIZED

• Dysentery
• Schistosomiasis
• Pneumonia
• Small pox

C. BELIEFS AND CAUSES OF DISEASE

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1.02 Early Ancient Civilizations LE 1
TRANS 1 ▪ Smith (1822 BC): Case histories with anatomical &
• Supernatural: Illness caused by a curse or punishment by physiological information, surgical diagnosis &
the god treatment
• Omens: ▪ Kahun (1889 BC): OB-GYN, contraception,
▪ Howling of dogs – Upcoming earthquake pregnancy (diagnosis, sex determination) veterinary
▪ Migration of birds – Winter is coming medicine
▪ Wine colored urine - Onion is placed in vagina - Woman is
▪ Flickering flame in water – Bright flame (good); dull flame fertile if breath smells like onion
(bad) - Sex determination of fetus:
▪ Natural Causes: Trauma, accidents • Growth in barley – planted soil
• Centers of Healthcare: Home & temples after urination – BOY
▪ Gula (feline – looking god) – Tents constructed near rivers • Growth in wheat – planted soil
so that bad spirits flow with it after urination – GIRL
- Contraception:
D. METHODS OF TREATMENT • Putting dried crocodile
manure inside the vagina
• Spiritual: ▪ Egyptian pessary is inserted in the vagina
▪ Religious: Confession, chants, rituals, sacrifices • Embalming/mummification technique (70 days):
▪ Diseases caused by demons: Noxious remedies 1. “Autopsy tent” – Ebu
• Physical: 2. Wash the body with palm oil and water from the Nile
▪ Drugs: Herbal, mineral, animal substances 3. Removing the viscera (excluding the heart) because
- Method of Administration: oral (catharsis), salves, they believed in life after death and thus dissection is
fumigation, herbs inserted via enema prohibited
▪ Surgery (copper knives): Wounds, abscesses, fractures - Metal pierces the nostrils---brain
▪ Techniques: Washing, bandaging, plasters - Cut thru sides of the body---body cavities
• Babylonian Clay Model of Sheep Liver - Wash w/ palm wine & aromatics
▪ Reference tool in divination &prognosis of an illness when 4. Drying the cadaver (natron) Na Carbonate, NaCl and
examining liver of a sacrificed animal (Hepatoscopy) NaSO4
5. Wrapping the desiccated corpse
6. Preservation of viscera (canopic jars) with vinegar
and salt
- Body is placed in wooden case shaped
like a human

Figure 4. Babylonian Clay Model of Sheep Liver

E. CLASS OF HEALERS AND PRIESTS

• Baru (diviner): Diagnosis & prognosis

• Ashipu (exorcist): Incantations Figure 5. Hieroglyphics (Alphabet)
• Asu (physicians/priest): Drugs & minor operations, also
incantations that were believed to increase healing powers
• Unlucky days: 7,14,19,21,28 B. BELIEFS ON LIFE, HEALTH, AND ILLNESS

F. CLASSIFICATION OF PATIENTS • Emphasis on the supernatural.

• Life is a “preparation for after life” .
• kills servants to serve them after death
• Upper class (gentlemen & seigniors): Seen by regular • There is life after death (dissection forbidden).
physicians • Disease – caused by disturbed function of the body.
• Lower class (commoners & slaves): Seen by barber- • Life is a balance between man’s experience & his relationship with
surgeons the universe.
• Failures of Treatment – Punished according to the Code of • Spells and magic to drive out spirits.
Hammurabi
Imhotep (2600 BC)
• Code of Hammurabi: * the great god of medicine
▪ “eye for an eye” * vizier to the pharoah
▪ “tooth for a tooth” * architect (pyramid builder - Sakkara)
▪ “judicial mutilation”
▪ Fees: shekel (wt= 11grams) Sekhmet: goddess of healing, curses and threats
Peseshet: 1st recorded woman doctor
II. ANCIENT EGYPT Cleopatra(60-30BC): Egyptian queen well-versed in Medicine
Imhotep Temples: Medical knowledge training
A. CONTRIBUTION TO CIVILIZATION Text: Sacred Secret Medical Writings
• Writing Tools: C. EGYPTIAN HEALING
▪ Reed Pen
▪ Papyri
• Medical Papyri (Ebers, Smith & Kahun):
▪ Priest-Healer: Highest healer, incantations
▪ Ebers (1500 BC): Complete collection of ▪ Lay Physician: Medicine & Surgery
prescriptions, incantations & diseases (encyclopedia) ▪ Magician: charms; etc.

D. DIAGNOSIS

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1.02 Early Ancient Civilizations LE 1
TRANS 1 ▪ coital belief/ practices – no sex during menstruation
▪ History (interrogation) ▪ marriage – against marrying to people with mental
illnesses, genital problems and physical disability
▪ Physical examination (inspection, palpation)
▪ Symptoms : cough, fever, swelling, rashes, etc.
• Observance of rest day (Sabbath)
▪ Laboratory: exam of blood, urine, stool, sputum • Diseases (textbook of TALMUD) – collection of writings
regarding medical knowledge and religious traditions
E. RECOGNIZED DISEASES ▪ Phthsis – wasting disease-chronic lung disease
• TB • Trachoma ▪ Icterus – jaundice - liver problem
• Leprosy •Schistosomaiasis ▪ Gonorrhea – leukorrhea – STD
• Malaria •Elephantiasis ▪ Lumbago – lower back pains
• Small pox •Typhoid/dysentery ▪ Paralysis – spinal cord injuries
F. TREATMENT D. HEALING METHODS
▪ With the exception of the incurable serpent bite, biblical
• Performed by priest-physician: incantations, therapeutic
remedies are rational and do not involve incantations or
dreams, holy water, baths, etc.
magic rites. (conservative method of healing)
• Integration of physical, psychic and spiritual factors • Exercise
• 2 Trends: • Massage
- magico- religious • Washing, bathing, sunrays
- empirico- rational • Use of oils, balsams, powder herbs
ex. eye and skin diseases • Medicated Drinks: myrrh, cinnamon, cassia (constipation),
• Less accessible disorders (treated by spells/incantations) galbanum (expectorant), mandrake (narcotic, aphrodisiac)
• Drugs: physician compounded remedies w/ exact quantities • Resuscitation – mouth to mouth respiration
• Surgical operations
• Sources: vegetable, animals , mineral substances ▪ wounds - stitches bandages
• Plants: heart problems (digitalis), pain reliever (belladona), ▪ fractures - splint, immobilization
fever (camphor), rheumatism (colchicum), flatulence (garlic), ▪ castration, circumcision, imperforate anus
diuretic (onion), laxative (tamarind), burns (acacia) ▪ cesarean section (only for dead fetuses)
• Animal: milk, fats(ointment), Liver (anemia) • Healings in Temple Halls, synagogues, and house visits
• Minerals: alum, sulfide, sodium bicarbonate • Physician receives compensation
• Physician’s Role in the Holy Scripture:
• Surgical • Sirach 38: 1-8
▪ Minor Operations: superficial tumor (excision),
• “Hold the physician in honor for he is essential to
abscess (drainage), Mandible dislocation, Cataract
you, and God it was whoe established his
removal, Circumcision (male and female)
profession. From God the doctor has his wisdom
▪ Major Operations: Fractures (splint and plaster
and the King provides for his sustenance. God
cast), Dentistry (gold as teeth binder)
makes the earth yield healing herbs which the
• Psychotherapy- suggestion prudent man should not neglect. Through which
• Compensation: paid in goods, no monetary payment the doctor eases pain and the druggist prepares
his medicines.”
III. ANCIENT HEBREW CIVILIZATION
IV. ANCIENT INDIA
A. HISTORY
• Biblical Times A. HISTORY
• Settled in the area between Mesopotamia (Southern
Mesopotamia) and Egypt (now modern Israel and Palestine) • Aryan invasion from Persia -- 1500 B.C. provided basis for
• Greatest contribution: the Jewish religion, Judaism, firmly religion & cultural development
believing in one GOD (Monotheism) • Sanskrit: Hindu or Vedic language and ancient writing (2000-
• Marked contrast to the many gods (Polytheism) 500BC)
• Founded by Abraham of Ur, an ancient city of Sumer, where • Hinduism: religion, polytheistic (gods responsible for health
the roots of the two religions Christianity and Islam began and disease)
• Brahma: supreme power creator, author of Ayurveda
B. CONCEPTS ON LIFE, HEALTH, AND DISEASE • Shiva: goddess of destruction and regeneration
• Health and disease comes from a divine source, Jehovah • Kali (consort of Shiva): god of disease & death
• Sickness is regarded as a divine retribution • Bronze statue of Shiva, god of destruction and regeneration
• The heart is the seat of emotion and intellect • Kali (Parvati, consort of Shiva), goddess of disease, death,
• Medicine and religion are closely connected and destruction
• Taboo against pigs (because pigs are dirty and tend to
compete with the water source of the people) B. AYURVEDIC MEDICINE

C. BIBLICAL MEDICINE • Ayurvedic Medicine (ayur: life, veda: body of knowledge):

Science of Life
• Traditional art of healing and rejuvenation
• Physicians (priest/rabbi) are instruments of god to effect cure • Oldest Holistic Organized system of medicine
• Sole contribution made by the Jews to medicine: hygiene & • Objective: maintenance of health
prophylaxis (preventive medicine & community health), • Harmony of the mind, body and spirit
• Body cleanliness leads to spiritual cleanliness: • Contributors: Charaka, Susruta, Vagbhata
▪ frequent washing (wash before and after sex) • TRIAD OF ANCIENTS
▪ prevention of epidemics ▪ Charaka (1,000-800 BC)
▪ quarantine - 1st great treaties of Indian Medicine
▪ kissing practices – mouth to mouth kisses were - describes drugs & classification of diseases
discouraged except for emergency situation - concepts of digestion, metabolism, immunology
(resuscitation) ▪ Sushruta (600 BC)

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1.02 Early Ancient Civilizations LE 1
TRANS- 1 emphasis on the art of surgery ▪ Rauwolfia serpentina: tranquilizers, antihypertensives
-pharmacology ▪ Terminalia arjuna: angina pectoris,heart failure
-Father of Cosmetic Surgery (Rhinoplasty) ▪ Sesame,Sunflower oil: antineoplastic
▪ Vaghbata (6 BC) ▪ Senna from cassia: laxative
- ob-gyn, pediatrics ▪ Sap from guggul tree: anticholesterol
- pulse diagnosis • Animal products: milk, fat, liver, bones, excrements,
• 4 Pillars of Ayurvedic Medicine • Minerals: sulfur, arsenic, copper, gold
▪ Physician - exercise good judgment • Therapeutics
▪ Medicines - drugs ▪ Aroma Therapy
▪ Gem Therapy: healing energy vibrations
▪ Attendant - prepare medicines & nursing duties - Amethyst (fast healing)
▪ Patient - gives history & follows physician’s - Diamond (rejuvenating)
instructions - Opal (protection against anger)
• Primary Qualifications of Physicians - Pearl (strength, vitality)
▪ Theoretical Knowledge - Topaz (passion and relieves fear)
▪ Color Therapy
▪ Clarity of Reasoning - Red (healing properties)
▪ Practical Experience - Yellow (understanding and intelligence)
▪ Personal Skills - Green (calming effect)
• 8 Components of Ayurveda - Blue (cool)
▪ General Medicine • Yoga – complex system of postures, meditation & breath control to
calm the mind & establish harmony between mind & body
▪ Pediatrics
• Surgical:
▪ Surgery ▪ Major: amputation cataract extraction, C-section, lithotomy
▪ Ophthalmology ▪ Minor: stitching of wounds, release of fluids (body cavities),
▪ Demonology (not included in the present times) cauterization
▪ Toxicology ▪ Cosmetic: repair of ear lobe and nose reconstruction by
using skin flap from the forehead (based on writings of
▪ Anti-aging Sushruta)
▪ Aphrodisiac
• PHYSICIAN V. ANCIENT CHINA
▪ Apprenticeship with an established physician
▪ Recommended by his trainer to a group who issue A. HISTORY
license
▪ Certificate of good moral and ethical character • 3 Celestial Chinese Emperors (founder of Chinese
▪ Expected to conform to the highest ideals of civilization)Tribal leaders
professional and personal life ▪ Shen Nong (2,600 BC)
- Veterinarian and Agriculturist, founder of herbal
C. BELIEFS ON HEALTH AND ILLNESS medicine
• Health is a balance of 3 humors (5 Elements) - Self medicated to analyze plants with nutritional/
▪ vata (air and space – “wind”) medicinal/ toxic properties
▪ pitta (fire and water – “bile”)
- Died after unsuccessful experiments
▪ kapha (water and earth – “phlegm”)
• Punishment by the gods
▪ Fu Hsi (2,000 BC)
• Karma – you are responsible for what you’ve done
- Founder of China’s 1st Dynasty
• Body, mind and spirit must be in unison (Yoga) - Book of Changes
• DIAGNOSIS: Intensive history and examination of the patient - Yin Yang concept
including body discharges
• Symptoms of Imbalances ▪ Huang Di or Ti (800-200 BC)
• 3 DOSHAS - Yellow emperor
▪ Vata: over exertion, nervousness, easy fatigue, - Canon of Internal Medicine
excessive worrying, underweight, constipated - Patron of Acupuncture(365 acupoints, 12
▪ Pitta: demanding, critical, easily frustrated, meridians)
inpatient, intolerant to hot weather, sensitive skin - Acupuncture/ Moxibustion restores free flow of
▪ Kapha: feeling complacent, lethargic, dull, over cosmic energy
sleeping, slow digestion, over weight, oily skin - Yin Yang – disharmony between cosmological
• Prevention or Correction notions
▪ Vata: be calm, get enough sleep, drink warm • 3,000 BC -Traditional Chinese Medicine & Healing
liquids, avoid stimulants, eat regular meals, herbal (ginger, Techniques
cinnamon) • Primary goal of Chinese Medicine: enhance body’s ability to
▪ Pitta: practice moderation, avoid excessive heat, regulate itself
alcohol & smoking, spicy, sour & salty foods ▪ Moxibustion – burned dry and ground leaves of
▪ Kapha: keep awake, favor spicy, bitter, astringent mugwort are placed over specific parts of the body to ward
foods, exercise, keep warm off evils.
• Holistic healing (Conservative Method of Healing) ▪ Cupping - an ancient Chinese practice in which a
▪ Healthy metabolic system cup is applied to the skin and the pressure in the cup is
▪ Good digestion reduced (by using change in heat or by suctioning out air),
▪ Proper excretion so that the skin and superficial muscle layer is drawn into
▪ Exercise and held in the cup.
▪ Massage • 1st written documentation of Traditional Chinese Medicine
▪ Meditation (Yellow Emperors Cannon of Internal Medicine)
▪ Hygiene • Meridian Theory – channels in the body through which qi
(cosmetic energy that powers the universe) flows
D. DRUGS AND MEDICAMENTS rhythmically. Each channel is directed to a specific
area/organs.
• Herbals • Sensation: Warmth, numbness

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1.02 Early Ancient Civilizations LE 1

• TRANS 1 in pregnancy (may induce contractions)

Forbidden
6external factors + 7 emotions = disease
• Zhou Dynasty: Yin-Yang Principle (bright and dark side of a
person) better understanding of the meridian theory used C. HISTORY
metal needles in acupuncture
• Ming Dynasty: 1368-1644 • Diagnosis (based on latent phenomena)
• Compendium of Materna Medica - best known Chinese o Interrogation History taking
contribution to pharmacology recognized worldwide o Observation and inspection: voice, eyes, skin,
• Li-Shih-Chen compiled 1,800 kinds of medicines tongue and excrements
• Bian Que- First to use pulse for diagnosis (sphygmology) o Auscultation and Olfaction
o Palpation: pulse and affected parts
B. PHILOSOPHY REGARDING HEALTH AND DISEASE
E. TREATMENT
▪ Health and disease is man’s relationship with heavens,
earth, weather and seasons • Prevention: healthy diet, psychological peacefulness,
• The body is composed of 2 opposing aspects -Yin-Yang in meditation, exercise
harmony • Medications:
- herbal (rhubarb, aconite, opium)
• The body is vulnerable to interference by ancestors, demons - minerals (sulfur, arsenic)
and spirits - animals (concoction of animal organs, excretions)
• Man’s well-being is a balance of physical, mental and social • Whole body treatment: acupuncture, cupping, exercise
factors (qigong) massage (Tuina)
• Cure the spirit: rituals

SUMMARY

• Mesopotamia: cradle of civilization, cuneiform writings, code

of Hammurabi, healers
• Egypt: embalming, mummification, papyrus, herbs
• Hebrew: monotheism, hygiene & preventive medicine
• India: Hindu, Ayurvedic Medicine, humors, herbals, yoga
• Chinese: 5 element theory, yin-yang concept, meridian
theory, acupuncture, moxibustion, sphygmology

REVIEW QUESTIONS
___1. Temple of Gula
• Theory of 5 Elements: wood,fire,earth,metal and water ___2. Code of Hammurabi
Major Organs ___3. Kahun Papyrus
___4. Mummification
Storage Elimination ___5. Belladonna “Pretty Lady”
___6. Biblical Medicine
Liver Gallbladder ___7. Ayurvedic Medicine
___8. Susruta
Heart Small Intestine ___9. Bian Que
___10. Huang Di
Spleen Stomach
OPTIONS:
A. Na Carbonate, NaCl, Na Sulfide
Lungs Large Intestine B. Pregnancy and Contraception
C. Sumerian rule of Law
Kidney Urinary Blader D. Antispasmodic
E. Mesopotamia Health Care Center
• Latent Phenomena F. Galbanum
▪ 5 centers in the body that maintains function G. Sphgmology
- Heart -mind, consciousness & intelligence H. Father of Indian Cosmetic Surgery
I. Oldest Holistic Organize System of Healing
- Lungs - regulates intrinsic functions of the body J. Prevention of Disease and Community Health Care
- Liver - emotional response to external environment K. Yellow Emperor
- Spleen - regulates the distribution of nutrition L. Preservation of Viscera
- Kidneys - regulates storage of nutrition
Answers: E, C, B, A, D, J, I, H, G, K
• 6 External Factors Causing Disease
1. Wind REFERENCES
2. Cold Lecture and Powerpoint Slides of Dr.Diamante,
3. Heat
4. Moisture
5. Dryness
6. Internal Heat
• 7 Emotions Causing Mood Changes
1. Happiness
2. Anger
3. Worry
4. Grief
5. Fear
6. Surprise
7. Pensiveness

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