Last: Ancient Medicine.

Some General Characteristics:

functional, holistic, emphais on prevention [public health] more than cure

supernatural but also empirical/rational elements

Systems with theory in India and China

Health: balance, harmony of humors; hence all in moderation

Disease: imbalance: excess/deficiency

Causes: Gods, spirits, demons, ancestors, sorcerers, stars, bad environment, witches, sin, self behavior: largely supernatural

Diagnosis:

5 senses, history; auscultation, succussion; sphygmology [pulse]; urine - color, smell, taste, clarity, texture.

divination, confessio, haruspicy, hepatoscopy

Treatment:

• Diet
• Regimen (exercise, bathing, massage, sex, sleep)
• Drugs [herbal>>mineral]

  ethical to refuse treatment

  cleanliness important

  psychological, important:

  • ritual, confessio,

  purgatives, emetics, enemas, cathartics; masticatories, fumigants,

  bleeding [not China], cupping, cautery, pessary, speculum,

  inoculation [India]

  moxibustion, acupuncture [China]

  Rx: ephedra, opium, coca [cocaine]; hypnosis, quinine, cod-liver oil,

  • tea; mercury,

Surgery: trepanation, C-section, lithotomy, rhinoplasty (India), plastic surgery,

couching the cataract, tonsillectomy,

Metaphysics: Yin-Yang with Qi, 5 "elements" [China]

5 phases [elements] [India];

channels [Egypt]

Eminents: Imhotep; Women practitioners, professors, and Empresses in Egypt;

Iri, Keeper of the Royal Rectum;

Ayurvedic Canon: Susruta, Caraka, Vaghbata;

Chinese canon: Fu Hsi [YellowEmperor?], Shen Nung?, Huang Ti

Evidence: Texts: cuneiform [1000s],

papyri [8], [esp. Ebers (comprehensive); Edwin Smith (rational)]

books [e.g. 4 Vedas; Imperial College 12,000 volume medical library China];

pottery, art,monuments

Instruments: mortars, mills, sieves, balances, amulets, talismans, splints,

fire drill, bandages, poultices, rectal speculum, forceps, knives, saws,

Pharmacopeia: extensive from 100s, to 1000s of herbal preparations;

Hospitals: after 600 B.C. India [Aztec predate by 1000+ years]

Medical Schools: Egypt; China.

Profession/Status: Hierarchical social structure develops elite priestly -scribal class;

physicians caste-free profession in India; popular medical practitioners highly varied.

Some laws governing malpractice [cf. Hammurabi]

Indian surgical prowess

Chinese belief in circulation of blood

"freeze" after ca. 600 A.D. in India, China.

Agricultural Revolution and Urban Revolution

ushered in the Era of Epidemics.

Pathogens multiply. Diseases become endemic in cities.

Neolithic skeletons are shorter than Paleolithic!

Major diseases: malaria, typhus, measles, tuberculosis, rickets, arthritis