PLAN

1. Lecture 1History of medicine as a science, its subject of studying. Medicine in primitive society (3 million – 5000 B. C.)

2. PLAN • 1. Introduction to History of Medicine. • 2. Stages in the Development of Medicine • 3. Medicine of Primitive Society.

3. History of medicine is divided into general which studies development of medical knowledges in human society on the whole, and special, development of separate industries of medicine — therapy, surgery and other lights up in which Teaching of the special history of medicine is usually carried out the proper departments of types. As development of medicine depends on the level of development of productive forces and character of relations of productions, in basis of exposition of general history of medicine dividing is fixed by epoches and periods, accepted in general history. Though, clearly, here is not and can not be a complete chronologic coincidence.

4. Stages in the Development of Medicine • Medicine of the Primitive Society • Medicine of the Ancient World • Medicine of the Middle Ages • Renaissance Medicine • Early Modern Medicine • Medicine in the • 20th Century

5. Development of Medicine is influenced by: • Material conditions • Productive forces development • Philosophy and world outlook

6. Sources for Studying History of Medicine: Life of existing prehistoric (aboriginal) societies • Written Evidence (manuscripts, printed sources, papyri, ceramics) • Archaeology and Examination of Artefacts • Multimedia evidence • Ethnographic sources (customs, traditions, songs, etc.)

7. Elements of systems of medicine Magic and Religion Folk remedies Elementary surgery

8. Elements of systems of medicine Magic and Religion Incantations Dancing Magic charms Talismans Various other measures

9. Elements of systems of medicine Folk remedies Potions Herbs Roots Berries Fruits

10. Surgical Procedurespracticed in ancient societies Cleaning and treating wounds by cautery (burning or searing tissue), poultices, and sutures. Trepanation. Resetting dislocations and fractures. Using splints to support or immobilize broken bones. Laxatives and enemas to treat constipation and other digestive ills. Narcotic and stimulating plant extracts (digitalis, a heart stimulant extracted from foxglove).

11. Prehistoric Procedure Setting of Bones, Fractures and Dislocations

12. Prehistoric Procedure Treating Burns

13. Prehistoric Procedure Delivering Babies

14. Prehistoric Procedure Trephining, a remedy for demons, insanity, epilepsy, and headache.

15. Unwritten history is not easy to interpret, and, although muchmay be learned from a study of the drawings, bony remains, and surgical tools of early man, it is difficult to reconstruct his mental attitude toward the problems of disease and death. It seems probable that humans, as soon as they had reached the stage of reasoning, discovered, by the process of trial and error, which plants might be used as foods, which of them werepoisonous, and which of them had some medicinal value. Folk medicine or domestic medicine, consisting largely in the use of vegetable products, or herbs, originated in this fashion and still persists.

16. Archaeologists and anthropologists who study prehistoric man and primitive tribes tell us human societies have always had special individuals, both men and women, who took the job of healer and were responsible for preventing illness and curing the sick and injured. These shaman almost always held multiple roles as healers, magicians, rulers, or priests.

17. Primitive medicine men learned how to splint, but probably not set, bone fractures. They also frequently performed a type of brain surgery that we today call trephination. Trephination was done by using stone instruments to bore or grind holes in the skull. Researchers do not know if the procedure was done to relieve demon spirits, treat skull fractures, or remove bone splinters. It is possible that trephination was done at different times for all of these reasons.

18. Prehistoric Procedure Trephining

20. Trepanation of the skull operation In addition to magic, spells, prayers, and charms, shaman and healers often used signature, or symbolic, items to treat their patients. These signature treatments included things like drinking the blood of a warrior to increase strength or eating leaves shaped like body organs to cure a disease. Sometimes, through chance, these signatures worked. When they did, the medicine men, or shamans, would pass the information to the next generation of priests. Digitalis, morphine, quinine, and ephedrine are all modern medicines that have been passed down to us from prehistoric signature practice.

21. One curious method of providing the disease with means of escape from the body was by making a hole, 2.5 to five centimetres across, in the skull of the victim—the practice of trepanning, or trephining. Trepanned skulls of prehistoric date have been found in Britain, France, and other parts of Europe and in Peru. Many of them show evidence of healing and, presumably, of the patient's survival. The practice still exists among primitive people in parts of Algeria, in Melanesia, and perhaps elsewhere, though it is fast becoming extinct.

22. Magic and religion played a large part in the medicine of prehistoric or primitive man. Administration of a vegetable drug or remedy by mouth was accompanied by incantations, dancing, grimaces, and all the tricks of the magician. Therefore, the first doctors, or “medicine men,” were witch doctors or sorcerers. The use of charms and talismans, still prevalent in modern times, is of ancient origin.

23. Apart from the treatment of wounds and broken bones, the folklore of medicine is probably the most ancient aspect of the art of healing, for primitive physicians showed their wisdom by treating the whole person, soul as well as body. Treatments and medicines that produced no physical effects on the body could nevertheless make a patient feel better when both medicine man and patient believed in their efficacy. This so-called placebo effect is applicable even in modern clinical medicine.

24. Trepanation of the skull operation

25. Bronze knife for trepanation of the skull decorated with images of trepanation, found in Hamburg

26. Skulls of ancient people who went through trepanation of the skull (regeneration of edges of trepanation openings). Copenhagen

27. Skull of ancient man who died during trepanation of the skull (openings without regeneration signs)

28. A scarred skull demonstrates evidence of trephination, a surgical technique in which holes were drilled in the patient’s skull to relieve intracranial pressure caused by head trauma. (Israel Antiquities Authority)

31. Herbalism There is no actual record of when the use of plants for medicinal purposes first started, although the first generally accepted use of plants as healing agents were depicted in the cave paintings discovered in the Lascaux caves in France, which have been Radiocarbon dated to between 13,000 - 25,000 BCE. Over time and with trial and error, a small base of knowledge was acquired within early tribal communities. As this knowledge base expanded over the generations, tribal culture developed into specialized areas. These 'specialized jobs' became what are now known as healers or shamans.

33. Shamanism refers to a range of traditional beliefs and practices similar to animism that claim the ability to diagnose and cure human suffering and, in some societies, the ability to cause suffering. This is believed to be accomplished by traversing the axis mundi and forming a special relationship with, or gaining control over, spirits. Shamans have been credited with the ability to control the weather, divination, the interpretation of dreams,astral projection, and traveling to upper and lower worlds. Shamanistic traditions have existed throughout the world since prehistoric times.

34. Some anthropologists and religion scholars define a shaman as an intermediary between the natural and spiritual world, who travels between worlds in a state of trance. Once in the spirit world, the shaman would commune with the spirits for assistance in healing, hunting or weather management. Ripinsky-Naxon describes shamans as, “People who have a strong interest in their surrounding environment and the society of which they are a part.”

35. Other anthropologists critique the term "shamanism", arguing that it is a culturally specific word and institution and that by expanding it to fit any healer from any traditional society it produces a false unity between these cultures and creates a false idea of an initial human religion predating all others. However, others say that these anthropologists simply fail to recognize the commonalities between otherwise diverse traditional societies.

36. Archaeology and Artefacts Cave Drawing

37. Medical Equipment used by Aboriginal People

38. Thighosteosis of primitive man from Java island. Oldest example of human pathology.

39. Sacral mask used in ceremony of “banishing ancestors’ spirits”. Sri Lanka

40. Burial ceremony in a “flower tribe”

41. Paleolithic Venus

42. Totem of tribe

43. Sacred animals of tribes

44. Sacred animals of tribes

45. This gilded bronze ear was presented to the Asklepion at Pergamum by a woman named Fabia Secunda, who had in made “for the god Asklepios because the ear was healed in a dream.”

46. This first-century A.D. relief of a leg was dedicated by a man named Tycheas as “a thank-offering to Asklepios and Hygeia” at the Asklepion on the island of Melos, Greece. Bridgeman Art Library

48. A 2.5 millimeter bronze wire (indicated by an arrow) in this tooth’s canal is evidence of early dentistry. Discovered in a mass grave at Horvat En Ziq, a small Nabatean fortress in the northern Negev desert in Israel, the incisor contains one of the earliest known fillings, dating to about 200 B.C.E. (Israel Antiquities Authority)

49. This array of bronze surgical instruments, from a private collection in Jerusalem, dates from 40 B.C.E. to 400 C.E. and includes spoons used to scrape out wounds (lower right), a forked probe (among the spoons), knife and scalpel handles (center, their iron blades have disintegrated), spatula probes for working in wounds (lower left), forceps (upper left), hooks used to hold the skin back (left of center), and cyathisconele, cupped tools used to clean wounds (top center).(Zev Radovan)