The world of Ancient Medicine led to breakthroughs in Modern Medicine. Medical professions aid patients through the work of their predecessors. Due to the discoveries of the past, the present can heal and treat the sick and wounded to the best of their ability.
Compared to today, the gods played a large part in the healing process. Offerings, reading spells, and wearing amulets were common methods to heal.
With time, the profession developed. As it developed, medical professionals could help where the gods could not.
Ancient Medicine in Mesopotamia
The goddess, Gula, had the responsibility for healing and health. She was the “great physician of the black-headed ones”, that being the Sumerians. Her son, Ninazu, associated with serpents, the underworld, and healing. He wielded a rod with two intertwined serpents. He was ‘Lord Healer’. As well, he is linked to health and healing (the continuation of life), and death and dying (life that comes after). Serpents represent regeneration and transformation, hence Ninazu’s association. Together, they helped people pass over or let them recover.
The Gods and Ancient Medicine
People believed deities worked through doctors, maintaining people’s health.
Suffering an illness or disease, essentially, meant an individual sinned. They must submit to proper treatment. Treatments removed the demons sent by the god/s as punishment. Diagnosing an illness always referred to the will and intervention of the gods.
Another cause of illness was when the gods wanted to rectify sins, sending ghosts to cause trouble.
There were two primary doctors: Asu and Asipu.
Asu was a medical doctor who treated illness or injury, practically. Associated with the temple of Gula, they focused on the patient’s accounts of illness.
Asipu were healers who relied on magic. Contradictory to Asu, they focused more on physical examination of the patient.
Additionally, there were two types of healers: Baru and Asipu.
Baru were the diviners. They practiced hepatoscopy (inspecting the liver of animals) and made prognoses (predicting the likely or expected course of disease).
Asipu were not only doctors, but exorcists. They determined what offences to the gods or demons brought on the disease.
Surgeons or vets could be either of Asu or Asipu background, but both types of doctors practiced dentistry. However, it is unclear if they presided over childbirth. Certain sabutu (midwives) delivered children.
Doctors at Work
As well as treating patients in temples, many doctors performed house calls. The city of Isin was the Centre of Gula. A training centre for physicians, though this remains uncertain. Nevertheless, they travelled to temples in various cities when needed. There is no evidence of private practice. Nonetheless, kings did have their own physicians.
Women and men could be doctors. Before the rise of the Akkadian empire and its views on women being inferior, women played a large role in medicine.
Doctors shaved their heads to be easily identified. Although not obligated to do so, it left speculation as to the number of female doctors. Contradicting the speculation, men and women did shave their heads and wore wigs.
With their tools, they travelled through the cities to air the ill. They understood the link between uncleanliness and sickness. However, this was not completely recognized.
Treatments and Prescriptions
Social status was not a factor in receiving healthcare. Fees did depend on social status, where the nobility paid more than ordinary people. The payment would represent the treatment but given in different forms. For example, the nobility paid in gold while ordinary people paid with a bowl of soul or clay cup.
Doctors disregarded social status, with no evidence showing they turned away a patient.
Pharmaceutical prescriptions were prepared in the asu‘s place of business.
Combined materials created treatments. This depended on religious reasoning, as well as trial and error.
Regarding wound treatment, there were three steps:
- Washing the wound
- Applying a plaster
- Binding the wound
With medicine, there were prayers to the god/s and incantations to ward off demons.
The treatments, from translated texts, were effective. Listed over centuries ago, they detailed their efficiency.
Doctors dealt with many areas for many patients. Gastrointestinal problems, urinary tract infections, skin problems, heart diseases, and mental illness were among them.
They were not liable for their practice. Gods were the direct causes and curers of diseases. Nonetheless, they were accountable for what was or was not done during the procedures.
The exception was surgery. Failure resulted in their hand being amputated. Surgery, however, was full of risks. Little was known about human anatomy and physiology. Many procedures were restricted by religious taboos.
Ancient Medicine in Ancient Egypt
Egyptian medicine advanced with time. Their observations, policies, and procedures were not surpassed for centuries. They understood diseases are treatable with pharmaceuticals, and the importance of cleanliness when treating a patient.
Doctors were male and female, specialising in different areas.
Just as with all aspects of Ancient Medicine, doctors had little understanding of how organs worked. Therefore, supernatural forces caused diseases.
Preserved records show how advanced they were in the medical field. Firstly, evidence shows sensible surgical procedures. Secondly, good knowledge was evident in bone structure. Thirdly, they showed awareness of how the brain and liver worked.
Injury and Disease
Injuries were among the easiest to understand.
Diseases were difficult. Their causes were less clear and, therefore, led to problems with diagnoses.
As with the Sumerians, Egyptian doctors believed the causes of diseases were sin or demonic attack. A demonic attack meant a plague by an angry ghost. Another reason was a god’s own way of rectifying. This is treated through a doctor’s recitation of magic spells.
Additionally, doctors used amulets, offerings, aromas, tattoos, and statuary. They drove away ghosts, appeased the gods, and involved protection from a higher power.
Incantations and spells on papyrus rolls served as medical texts. This relied on sympathetic magic and practical techniques. The science of medicine was a “necessary art”.
For treatable injuries, doctors intervened immediately.
Curable injuries meant the person did not require medical intervention. If they survived, the doctors would decide whether to intervene.
For untreatable ailments, doctors would not intervene.
Obvious injuries were handled with practical remedies. Toothaches or gum disease (like all diseases at the time) were from supernatural causes. Magic, ingrained in Egyptian culture, was part of their way of life. The God of Magic and Medicine, Heka, carried a staff intertwined with two snakes.
Per-Ankh, “Home of Life”, was a library and school attached to a temple. Doctors were priests of Per-Ankh. The concept of this building included the healing knowledge of individual doctors.
Doctors needed to be of pure spirit and body, as well as literate. Each had their own speciality. There were also swnu, a general practitioner, and sau, whose speciality was magic.
Midwives, masseurs, nurses, attendants, and seers assisted doctors. However, regarding childbirth, delivery was the responsibility of midwives and women of the house. There was no evidence of medical training as a midwife. It was not a medical profession.
A highly respected profession, males and females could be nurses, assisting in procedures. There is no evidence of school or professional training either.
Wet nurses were essential. In Ancient Egypt, women generally died after childbirth. Then came a legal agreement. Should the mother pass, the child is raised by the family and the wet nurse.
Dentistry never developed widely, though it was a well-known profession. There was an abundance of medical problems, making it unclear as to why there were not as many dentists.
Both doctors and dentists used herbs and spices for medicinal purposes.
The importance of diets, especially a change in diet, was recognized. Doctors advised people to shave their bodies, preventing infection, and avoid unclean animals and raw fish.
The ‘channel theory’ was discovered by observing farmers digging out irrigation channels for their crops. Doctors believed channels provided the body with routes for good health. Blockage meant taking laxatives. Though this was the case, they did not understand that the channels had different functions.
Many discovered surgical instruments are still in use today, only modified.
Every doctor knew the basics of surgery. It was a common skill, along with knowing how to effectively stitch wounds. Bandages were bound with certain plant products to treat inflammation. As there were no anesthetics or antiseptics, it was highly unlikely that procedures deeper into the body were performed.
Through mummies, it is evident that the surgeries were successful. People survived amputations and brain surgery years before passing. Wooden prosthetics were even found.
By preserving the deceased as mummies, they learnt how the body worked.
Ancient Medicine in Ancient Greece
Just like in Mesopotamia and Ancient Egypt, illness was a divine punishment and healing was a gift from the gods.
There were two crucial factors that led the Greeks to heal and promote health: the military and sport.
Due to battles in war, practitioners needed to heal wounds, remove foreign objects, and look after the soldiers’ general health.
The Olympic Games, originating in Ancient Greece, promoted sport. Practitioners raised the need for people to keep healthy. Combined with sport, this promoted fitness and prevented injury.
Practitioners took an interest in the body. They explored the connection between cause and effect, the relation between symptoms and illness, and success and failure of treatments.
There is a blur between the physical and spiritual worlds of medicine. Patients called the God Asclepius, the dispenser of healing and a highly skilled practical doctor, to his sanctuaries. Through the patient’s dreams, he gave advice that the doctors would act upon.
Important factors have been discovered, from lifestyle to traumatic events.
Firstly, they discovered ways to ease or worsen symptoms of an illness. Secondly, physical structure affects the seriousness or vulnerability of an illness. Thirdly, there was a growing understanding of the causes that could help fight it. Fourthly, there was greater knowledge of the body through the balance of fluids (humours).
Four humours, further linked to a season, organ, temper, and element:
- Black bile – season: cold; organ: spleen; temper: melancholy; element: dry earth.
- Yellow bile – season: cold and wet; organ: lungs; temper: phlegmatic; element: water.
- Phlegm – season: warm and wet; organ: the head; temper: sanguine; element: air.
- Blood – season: warm and dry; organ: gallbladder; temper: choleric; element: fire.
All humours balanced meant perfect health.
If the individual has an illness, there was either too little or too much of one of the humours.
Doctors and Practitioners
There were no professional qualifications for medical practitioners. Anyone could be a doctor and travel to look for patients, practicing the technique of medicine.
Magic and incantations were a way to search for natural causes. As that went on, people started looking for natural cures. Greek doctors were expert herbalists, as well as prescribers of natural remedies. They preferred nature over superstition, seeing nature as the better healer.
If treatments did not work, doctors appealed to the gods. After treating the patient, the doctor would take them to a temple to sleep. The daughters of Asclepius, Hygeia and Panacea, would arrive in their dreams with two holy snakes to cure the patients.
Surgery was avoided. It was too risky. Minor operations were carried out, particularly on wounded soldiers.
One way doctors learnt their trade and expanded their knowledge was through wounded soldiers. If something went wrong, there was less risk of a soldier causing problems.
Doctors dealt with wounds made by swords, javelins, arrows, and sling projectiles. They knew the importance of removing foreign objects (e.g. arrowheads) and cleaning the wound. In addition to treating wounds, they knew the importance of stopping excessive blood loss.
Opium was often an anesthetic. However, opium was rare. Soldiers were held down during the operation.
Post-operation, flax or linen thread closed the wounds. Then, linen bandages dressed the wound. Leaves also dressed wounds, sealed using egg-whites or honey.
As for treatment, a proper diet was important and using plants with anti-inflammatory properties.
The basic knowledge of human anatomy was through observation of wounded soldiers and animal dissection. However, certain beliefs and restrictions appeared. The belief was that the human body changed when in contact with air and light. Moreover, some protested against the use of animals for such purposes, deeming it cruel.
In Alexandria, Egypt, Greek scholars dissected bodies and studied them. On criminals, they performed vivisection. It led to two discoveries:
- The brain controls the movement of limbs, not the heart, and
- Blood moves through the veins.
With a lack of practical knowledge, there were fundamental errors in learning the inner body.
There was an attempt to balance the natural temperature of the body. With a cold, an individual kept warm. Sweaty and feverish patients were kept dry and cool. To restore blood pressure, patients bled. To restore bile balance, patients cleansed their inner bodies.
All in all, Greek practitioners started the medical profession in the right direction.
Ancient Medicine in Byzantine
Located in the Eastern Roman Empire, also known as Byzantium, it is now Istanbul.
Just like all ancient eras, they relied on prayer, churches, and priests to heal diseases, plagues, and perform medical marvels.
Priests maintained hospitals. To be near God, hospitals were near churches. Therefore, when medicine failed, patients turned to prayer.
The rulers of Constantinopple (the Byzantine capital city) surrounded themselves with the best physicians.
Physicians were in high regard in society, but their practice questioned daily. Certain physicians oversaw all physicians in an area. Each physician was responsible for 300 citizens.
The hospitals were the first to offer care to the sick. They gained support from powerful groups in society, especially since the majority of hospitals were in large cities.
This is where the modern hospital concept originated, from early Byzantine hospitals.
Anargyroi means ‘without money’.
The practice of practical, supernatural ancient medicine was within healing institutions. They did not charge any fee and were open to all individuals.
To receive treatment, the individuals had to spend the night at a church or shrine. During their sleep, one of two saints, Comas or Damian, visits them. They would suggest a particular treatment, the patient passing it on to the physician. The next day, after treatment, the patient would leave.
Many of the recommendations by the saints were odd, and at times, sexual.
There was no ‘conventional’ medicine.
There was no tradition of scientific medicine. It was largely from ancient Greek and Roman medicine.
There was tension between the church and folk medicine, with folk medicine seen as magical. The combination of herbs and remedies created spells and incantations. Spells were separated from physical remedies. Often, these spells replaced Christian prayers and devotions.
As with all ancient eras, God punished people by giving them an illness. Only repentance can lead to a full recovery. This soon became a way of curing illnesses.
The Church did not consider medicine a suitable profession for Christians.
The similarities of ancient medicine led to the ones the medical community shares today. The hard work and dedication of the past led to modern medicine and procedures. The doctors and physicians of the ancient era passed down their knowledge for future generations to improve. It is because of the past that we have medical advances, such as the ones we currently have.
“Early to bed and early to rise, makes a man healthy, wealthy, and wise.”
-Benjamin Franklin, Poor Richards’ Almanac.