Prehistoric Medicine: An Overview

• The lecture is about prehistoric medicine.

Global History of Medicine

• Includes medical concepts, pharmaceutical theories and therapeutic practices.
• Includes diseases, health sciences, and their relationships to society.
• Includes practitioners, events, medical professions and systems.

Ancient Wisdom

• Ancient wisdom refers to the body of knowledge and insights accumulated by human civilizations over thousands of years.
• Neanderthals possibly used medicinal herbs, as evidenced by fossilized Neanderthal teeth, 49,000 years ago.
• A successful arm amputation was performed in Buthiers-Boulancourt, France, 7,000 years ago.
• Holes were drilled into skulls (trepanning) to treat medical conditions 20,000 years ago.
• Traditions of shamanism emerged on several continents 10,000 years ago.
• A man in the European Alps, known as Ötzi the Iceman, suffered from gut parasites and painful bone/joint conditions 5,300 years ago.
• Teeth of live patients were drilled in Mehrgarh, Pakistan, perhaps for abscess pain relief, 7,000 years ago.
• The decorated drum of a Mongolian shaman is from 3000 BCE.
• The first reference to diabetes appeared in an Egyptian papyrus, and Egyptian mummies show broken bones, tuberculosis signs and other health problems, 1500 BCE.
• Per-Ankh (Houses of Life) were built in ancient Egypt as places for creation/preservation of knowledge, 2200 BCE.
• The Mesopotamian Gula Hymn (1400 BCE) states "I am a physician, I can heal".
• The Mesopotamian Sakikku diagnostic handbook was completed by physician Esagil-kin-Apli of Borsippa, 1050 BCE.
• Early versions of Susruta Samhita, an Ayurvedic compilation, appeared in India 500 BCE.
• The tomb of Merit-Ptah, one of the earliest known female physicians in ancient Egypt, is inscribed "Chief Physician", 2700 BCE.
• The Code of Hammurabi (Babylon) included pronouncements on medical care, 1755 BCE.
• Imhotep became the leading priest-physician in ancient Egypt and was elevated to godly status, 2650-2600 BCE.
• The Ebers papyrus mentions medical use of willow bark (aspirin source), 1550 BCE.
• The concept of the four humors was taking shape in ancient Greece, 500 BCE.
• Hippocrates died in 370 BCE leaving followers to expand on his teachings.
• Hua Tuo pioneered anaesthesia in China during complex surgery using a cannabis-based concoction (mafeisan), 200 CE.
• Translation of ayurvedic works into Chinese began 400 CE.
• Mayan medical ah'men in Central America used hallucinogenic plant extracts to divine disease causes/treatments, 500 CE.
• Sergius of Reshaina translated about 30 works of Galen into Syriac, which were further translated into Arabic from the 8th century, 530 CE.
• Hippocrates trained at the local asklepieion (healing temple), 440 BCE.
• The Justinian Plague (possibly bubonic plague) killed over 1/3 of the population in Europe/West Asia, 541 CE.
• Huangdi Neijing (Yellow Emperor's Classic of Internal Medicine) established the framework for traditional Chinese medicine, 400 BCE.
• Herophilous and Erasistratus established anatomy and physiology in Alexandria using androtomy (dissecting live/dead human beings), 260 BCE.
• Chinese texts describe acupuncture points and treatments in detail, 100 BCE.
• Soranus of Ephesus wrote Gynaecology, an early text focusing on medicine for women, 130 CE.
• The Antonine Plague (possibly smallpox) devastated populations in Europe, West Asia, and North Africa, 165 CE.
• Claudius Galen returned to Rome and wrote prolifically, dominating European medicine for 1,500 years after 169 CE.
• The Hôtel-Dieu Hospital was founded in Paris, France, and is Europe's possibly world's, oldest hospital still active on original site, 651 CE.
• Paul of Aegina produced the Medical Compendium in Seven Books summarizing Western medical knowledge, 680 CE.
• Chinese scholars came to Nalanda, India, to study Ayurveda and other traditional medicine, 700 CE.

Animal Self-Medication

• Some non-human primates self-medicate, like chimpanzees using Aspilia spp. leaves to expel parasites.
• Chimpanzees also ingest clays with antibacterial properties.

Prehistoric Medicine

• Study of artifacts and human remains help paint a picture of ancient medical information.
• Fossilized teeth provide key information.
• Self-medication has been practiced for at least 50,000 years.
• Anthropology and the belief systems of native cultures provide context.
• Diseases were believed to be caused by evil spirits.

Artifacts and Human Remains

• In the El Sidrón cave (north Spain), hundreds of fossilized Neanderthal bones and teeth were found.
• The remains belonged to 13 Neanderthals (Homo neanderthalensis), a "sister" species which died out 120,000-35,000 years ago.
• Plant microfossils contained in dental calculus have been tested through gas chromatography mass spectrometry.

Prehistoric Herbalism

• Neanderthals in El Sidrón had a gene enabling them to taste bitter substances.
• Yarrow (tonic/astringent) and chamomile (relaxant/anti-inflammatory) were used for medication.

Evidence from the El Sidrón Area

• Bones, teeth, tools, decorative items, plant seeds, animal fossils, cave paintings, and rock art have provided clues.
• Evidence of possible treatments include "plaster casts" (clay or mud), "splints" (wood, bone, or horn), "poultices" (healing herbs), and "bandage strips" (animal skin).
• Bones with healed fractures have also been studied.

Stomach and Digestive Problems

• Catnip can be used to ease stomach problems.
• Willow bark is a source of acetylsalicylic acid (aspirin), used to relieve pain and reduce swelling.
• Clay or soil (geophagy) can neutralize harmful substances and provide minerals.
• A 20,000-year-old cave painting in Ariège, France, depicts a prehistoric deer doctor driving away evil spirits (healer/therapist).

Prehistoric Dentistry

• Practiced in the ancient Indus Valley Civilization 9,000 years ago.
• Mehrgarh (west central Pakistan) was a farming and herding community.
• Dental techniques have been discovered in approximately 3% of the population, perhaps to relieve abscess pain.

Prehistoric Trepanning

• Trepanning has been performed since 10,000 BCE and is still used as a necessary part of modern neurosurgery.
• Bone growth suggests healing.
• It was used for releasing evil spirits, migraine, epilepsy, depression, bipolar disorder, and intracranial pressure.

Radical Trepanning

• Religious, ritualistic, or therapeutic reasons.
• Hua Tuo (c. 140-208) was a Chinese physician who lived during the late Eastern Han dynasty, and the first person in China to use anaesthesia during surgery.
• Trepanning was common in the 18th century using sharp metal trepanning tools.

Prehistoric Amputation

• Viewed as the earliest evidence of surgical amputation.
• A European Neolithic farmer (7,000 years ago) had the left forearm surgically removed.
• A skeleton of a person from 31,000 years ago has hallmarks of deliberate removal of the lower left leg.

Modern Anthropology

• Indigenous populations and native cultures in the Americas, Africa, Asia, and Australasia.
• Supernatural actions include making offerings/sacrifices to spirits/gods to lift curses.
• Practical treatments include poultices, ointments, and concoctions made from herbs, minerals, and animal body parts.

Shamanism

• Involves shamans reaching into the unseen realm of spirits and souls to help and heal.
• Shamans communicate with the gods and spirits.
• Shamans prepare medicine, administer hands-on treatments, and use objects such as amulets and masks.

Voice of the Voiceless

• Ötzi the Iceman, a 5,300-year-old mummified male, found in the Ötztal Alps in 1991, gives clues about prehistoric health and healing.
• Possessions included fungus (Piptoporus betulinus) with laxative/antibiotic properties to poison intestinal parasites.
• Examination indicated whipworm parasite eggs in his large intestine.
• X-rays revealed degenerative bone/joint conditions.
• 50+ skin tattoos on painful areas correspond to acupuncture points, possibly for pain relief.

Types of Disease and Condition

• Osteoarthritis.
• Micro-fractures of the spine and spondylolysis.
• Hyperextension.
• Infections and complications.
• Rickets.
• Childbirth.

Geophage (Soil-Eating)

• Prehistoric humans consumed soils and clays.
• Reasons include culture, medicinal purposes, religious practices, and iron deficiency anemia.
• Possible benefits include anti-diarrheal effects, alleviation of gastrointestinal upsets, mineral supplementation, relief of excess acidity, and antimicrobial/adsorbent properties.
• Risks include constipation, intestinal obstruction, dental damage, peritonitis, parasitosis, infection, and heavy metal poisoning.