History of Medicine Through the Ages and Continents PDF

# HISTOIRE DE LA MÉDECINE ET DES IDÉES MÉDICALES A TRAVERS LES AGES ET LES CONTINENTS ## Pr. BOUGUERMOUIH. ### 1- Introduction - It is difficult to evoke the term of science without situating it in its social, political and historical context. It is also difficult to separate it from its links wit...

# HISTOIRE DE LA MÉDECINE ET DES IDÉES MÉDICALES A TRAVERS LES AGES ET LES CONTINENTS ## Pr. BOUGUERMOUIH. ### 1- Introduction - It is difficult to evoke the term of science without situating it in its social, political and historical context. It is also difficult to separate it from its links with the past. - History is a human science par excellence. It teaches us to position ourselves along the timeline of the evolution of medicine and helps us better understand where it came from and how it progressed. Understanding the past and the present would make it difficult to move forward into the future. As the philosophers said, "Those who cannot know the past are condemned to repeat it with its mistakes." ### 2- Antiquity of medicine - The practice of medicine has existed since time immemorial, although we have few traces of the medical knowledge of prehistoric men. Medicine began to appear towards the end of prehistory, during the Bronze Age. It was born in countries where agriculture and writing originated, in the Middle East. - The most ancient medical texts were found in the great civilizations of Antiquity, such as Mesopotamia, Pharaonic Egypt, China, and India. ### 3- Primitive or magical medicine - The mentality of primitive man is not limited to the rational world. His area of thinking is the supernatural (good and evil spirits, demons, ghosts...). - The primitive period of the history of medicine is obscure, to them, illness came from the supernatural world, the realm of the hereafter. - If he falls ill, primitive man will believe he is being attacked by an evil spirit that wants to harm him or take revenge. In terms of treatment, healers come into contact with malevolent forces to learn what happened and what to do. ### 4- Archaic medicine - Prehistory is followed by the time of great civilizations, who saw a new form of medicine succeed primitive and magical medicine, archaic medicine, which appeared 3000 BC. - With the development of trade, men gradually created calculation and then writing, which would allow them to transmit knowledge from one generation to another. - Archaic physicians have misconceptions about anatomy and physiology. ### 5- Medicine in Pre-Columbian America - People believed that there was a harmony and a balance between man, nature and the gods, and were concerned with eating healthy and varied food. - Mayan culture: medicine was practiced by the religious elite. - Mayans knew how to suture wounds using human hair and reduce fractures. They concocted remedies that could be ingested, smoked, or applied to the skin. - Incas had a very good knowledge of anatomy thanks to human sacrifices. - They practiced amputation using an obsidian blade after anesthetizing the muscle with coca leaves and other plants. ### 6- Medicine in Mesopotamia - Dates back to 2250 BC. Tablets from this period are the first known medical documents in humanity. - Most diseases were the effect of hostile forces and were treated by magic. - From the 1st millennium BC, natural and more rational treatments replaced magic: plant, mineral materials, maceration in oil. ### 7- Ancient Egyptian medicine - Medicine was the most popular of all the disciplines of ancient Egypt; its practice lasted for over 5000 years. - Imhotep: priests of training, was considered the founder of Egyptian medicine and the author of a medical treatise, the Ebers Papyrus. - These priest physicians had noted in their treatises the papyrus many descriptions of diseases such as anemia, diarrhea, hemorrhoids, certain tumors, urinary incontinence. - The physicians applied dressings, opened tumors, performed circumcision. They also dealt with hygiene and dietetics. - The idea that illnesses are the consequence of the malfunctioning of organs can be found in the treatises of Ywti, who was the physician of Ramses I and Sethi II. ### 8- Indian medicine - It is an ancient medicine based on the Vedas, a collection of sacred texts from ancient India. - It assumes that the human being is made up of 7 main elements (blood, flesh, fat, bone, marrow, chyle and sperm) and the 5 elements (earth, water, fire, air and space). - The main remedies are preparations with sometimes very complex formulas. - The best tribute paid to the Indian system comes from Avicenna. - Like the Greeks, Indians have localized thought not in the brain, but in the cardiac cavities. ### 9- Traditional Chinese medicine - It is one of the oldest medicines in the world (over 4000 years old), based on the use of medicinal plants and acupuncture. - It is also a preventive medicine. It is composed of 5 disciplines: pharmacopeia, massage, dietetics, acupuncture, and moxibustion. ### 10- Hippocratic medicine - Appeared in the 5th century BC, at the time of the first schools, the most famous of which was the Hippocratic School. - The most influential physician and philosopher of this era was Hippocrates (450-377 BC). - He is considered, in the Western world, as the 'father of medicine', the founder of medical knowledge. - Galen and Galenic medicine: Galen (129-210), a Greek born in Pergamum, became a physician and went to Rome. - He was the spiritual heir of Hippocrates. He practiced dissection on large animals (pigs, monkeys) and treated gladiators (anatomy). ### 11- Medieval medicine - Byzantine medicine (330-1453) is largely based on the knowledge of Greece and ancient Rome. - With the advent of Christianity, there were changes in the way of life of men. - Introduction of nursing care in hospitals, public health measures, and the production of manuals. ### 12- Arab-Islamic medicine - Began to develop in the 8th century in the eastern part of the Arab-Islamic world (Iraq, Syria, Palestine, Iran, Egypt). - The 3 main phases of Arab-Islamic medicine: - **1st phase**: Translation (7th & 8th centuries): all of Hippocratic, Galenic, and Byzantine medicine was available in Arabic by the end of the 9th century thanks to the paper revolution. - **2nd phase**: Innovation (9th-12th centuries): - Written medicine: this was the peak of Arab science, marked by the emergence of the first great Arab-speaking physicians. - Teaching medicine: young doctors were trained in public lectures held in hospital wards and amphitheaters. - The awarding of degrees: the authorization to practice 'Al Ijaz' was only granted to future physicians in major cities (Baghdad, Damascus, Cairo, Kairouan...) after passing a formal exam. This medicine has been illustrated by famous practitioners: IBN ISHAQ (806-87), AL-RAZI (854-935), IBN SINA (980-1037), IBN AN NAFIS (1213-1288), AL KAIRAOUANI (925-1000), IBN RUSHD (1126-1198), IBN BAYTAR (1197-1248), Abderezak Ibn Hamadouch Al Djazairi (1695-1791). - **3rd phase**: Beginning of a decline in scientific activity, which began in the 13th century. ### 13- Medieval Europe - During this period (5th-11th centuries), knowledge and the practice of medicine were largely the responsibility of monks. - In the 12th century, the translation of Avicenna's Canon also influenced hygiene: diet, exercise, air, meditation. ### 14- The Renaissance (16th, 17th, 18th centuries in Europe) - This period, dubbed the "Renaissance," was marked by an enthusiasm for knowledge and learning. The invention of printing would lead to a revolution in the dissemination of knowledge. - In 1543, Andreas Vesalius (1514-1564), the first true anatomist, performed a public dissection. He challenged 200 errors of Galen. Teaching medicine directly at the bedside of the sick was one of the great pedagogical innovations of the 18th century. - The first microscopes were developed in the Netherlands at the end of the 16th century. The discovery of vaccination took place at the end of the 18th century. ### 15- The pre-modern medicine of the 19th century - The emergence of anatomical-clinical theory, which purports to explain all pathological manifestations by at least one organic lesion. - René Laënnec (1781-1826) invented the stethoscope. - Robert Koch (1843-1910) discovered the bacillus of tuberculosis (1882) and cholera (1883). - Louis Pasteur (1822-1895) demonstrated the role of microorganisms as infectious agents. At the end of the 19th century: biological, technical, pharmaceutical discoveries, X-rays, electrocardiogram, antibiotics, transplants, organ transplants, chemotherapy. ### 16- Medicine in the 20th century - Rational and effective medicine. Antibiotics have transformed the fate of men; syphilis, tuberculosis, septicemia are no longer fatal diseases. It is progress in heart, lung, and brain surgery. Treatment of cancers. The discovery in 1900 by Karl Landsteiner of the ABO blood group system, allowing blood transfusions. - Jean Dausset discovered the HLA tissue group system in 1955, which allows organ transplants. ### 17- What medicine for the 21st century? - Reflection on medicine for the future will be based on the growth of genetics, care, the production of medications, vaccines, and technologies. - As well as new technologies such as robot-assisted surgery, a technique that can replace the human hand and act from a distance from the patient during hundreds of diagnostic or therapeutic interventions. - Stem cell based treatment is one of the major advances in 21st-century medicine. ### 18- Conclusion - We have seen that, over time, medicine has progressed and become more effective, especially after the devastating epidemics and major conflicts worldwide. Despite the advent of antibiotics, there is reason to be concerned about the harmful effects of these treatments, such as birth defects. - Each advance in research on technologies and genetics brings us closer to population selection with all the attendant risks and consequences, hence the need to coordinate all researchers and actors of different disciplines to channel these advances and bring them meaning, ethics, and logic. ### 19- Bibliography 1. BELANET René, "Les musées d'anatomie pathologique de Paris. Le musée Dupuytren", pp. 259-263. In La médecine à Paris du XIIIème au XXème siècle, sous la direction d'André Pecker. Paris, Hervas, 1984 et 1990. 2. ARO N Emile, Bretonneau, le médecin de Tours. Chambray-les-Tours, C.L.D., 1979, 295 pages. 3. ARO N Emile (en collaboration), Histoire culturelle de la maladie. Toulouse, Privât, 1980, 453 pages. 4. AUZÉP Y Philippe, L'hôpital de Bicêtre au XXème siècle, histoire médicale et scientifique, Paris, Arnette, 1998, un volume (en collaboration multiple), 96 pages.