History of Medicine As written by its founders Edited by Luis H. Toledo-Pereyra Included in this preview: • Table of Contents • Preface • Introduction For additional information on adopting this book for your class, please contact us at 800.200.3908 x501 or via e-mail at [email protected] History of Medicine, As Written By Its Founders Volume 1 From the Hammurabi Code to the Canon of Medicine Edited by Luis Horacio Toledo-Pereyra Michigan State University, Kalamazoo Center for Medical Studies Western Michigan University, Kalamazoo Bassim Hamadeh, CEO and Publisher Christopher Foster, General Vice President Michael Simpson, Vice President of Acquisitions Jessica Knott, Managing Editor Kevin Fahey, Cognella Marketing Manager Jess Busch, Senior Graphic Designer Jamie Giganti, Project Editor Brian Fahey, Licensing Associate Copyright © 2013 by Cognella, Inc. All rights reserved. No part of this publication may be reprinted, reproduced, transmitted, or utilized in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information retrieval system without the written permission of Cognella, Inc. First published in the United States of America in 2013 by Cognella, Inc. Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Printed in the United States of America ISBN: 978-1-60927-253-1 (pbk) Contents Preface 1 By Luis Horacio Toledo-Pereyra Introduction 3 By Luis Horacio Toledo-Pereyra Chapter 1 Mesopotamian Medicine and The Code of Hammurabi (c. 1772–1750 B.C.E.) 6 Hammurabi's Code of Laws 7 By Mesopotamian Doctors, Priests, Law Experts, and Scribes of the Hammurabi Court Translated by L.W. King Chapter 2 Surgery and Medicine in Egyptian Times: The Edwin Smith Papyrus (c. 1600 B.C.E.) 24 The Edwin Smith Surgical Papyrus 25 By Egyptian Surgeons and Scribes of the Old Kingdom Special introduction and translation by James Henry Breasted Chapter 3 Hippocrates of Cos (c. 460–370 B.C.E.) 54 Hippocratic Writings 55 By Hippocrates and his associates Translated by Francis Adams Chapter 4 Aulus Cornelius Celsus of Roman Origin (c. 25 B.C.E.–50 C.E.) 116 De Medicina 117 By Celsus Translated by W.G. Spencer Chapter 5 Galen of Pergamon (129–200 C.E.) 144 Galen on Bloodletting: A Study of the Origins, Development and Validity of His Opinions, 145 Excerpts by Galen Written and translated by Peter Brain On Anatomical Procedures 169 By Galen Translated by Charles Singer Chapter 6 Albucaisis of Cordova (936–1013 C.E.) 202 On Surgery and Instruments 203 By Albucaisis Introduction and translation by M.S. Spink and G.L. Lewis Chapter 7 Avicenna of Afshana (980–1037 C.E.) 234 The Canon of Medicine 235 By Avicenna Translated by O.C. Gruner Conclusion By Luis Horacio Toledo-Pereyra 295 Preface By Luis Horacio Toledo-Pereyra T his book, History of Medicine as Written by its Founders, Volume 1: From the Hammurabi Code to the Canon of Medicine, represents an attempt to publish some of the original works written by the extraordinary physicians or writers who articulated observations and concepts important to the development of the practice of medicine (1–5). The principle behind this book is that nothing can speak better for medicine than the writings of those directly involved in the history of the discipline since they were the creators of it. Even though our initial intention was to include all of the Founder’s writings, we immediately realized that it would have been difficult and impractical to do that. Therefore, we decided to select their most representative works or those that conveyed many of their unique contributions to this field of human knowledge. The selection was not necessarily systematic but it followed a chronological order that was aimed at introducing the works that were considered important by the editor. In this regard, the possibility of bias was not absent. We reviewed many times the writings of the Medical Founders from the Hammurabi Code to The Canon of Medicine and selected the works considered inside. It is unfortunate that because of the extensive number of published books in this era of medicine, several notable physician authors from the Byzantine and Monastic Medicine Period (starting in 476 C.E.) such as Oribasus, Aetius, Alexander of Tralles, Paul of Aegina and Johannes were not included in this publication. Furthermore, writings of Eastern masters of medicine from China (Hua To and others) and India (Sushrupta, Charaka and Vagbhata) who legitimately could be considered in the ranks of the Founders are not represented in this work. The magnitude of the actual writings of the Founders of Medicine included in this volume precluded us from having all the works and authors from antiquity to modernity. This publication will be Volume 1 and will concentrate as indicated before on the works written from Babylonian times to the era of Avicenna of the Golden Era of Arabic Medicine. A subsequent Volume 2 will cover the original works from the Middle Ages to Renaissance times. The introduction of further works (e.g. Volume 3 and others) will depend on the interest of our audience and the requirements of the History of Healthcare class that I currently teach at Western Michigan University. Each chapter starts with a list of the specific pages of the work utilized. It will indicate any significant highlights for the better understanding of the writing used. Important additions will be clarified whenever necessary. Finally, if the students of the history of medicine or healthcare can validate their knowledge by reading and evaluating the original works of the fathers of the discipline, our goals will be more than well served. In historical terms, a great deal of enlightening will come by analyzing the initial works on which medicine was established. Preface 1 2 History of Medicine, As Written by Its Founders We hope that this book will stimulate both students of the history of medicine and also those physicians who have a committed desire to enhance their opportunities to learn from those who wrote the works leading to medical breakthroughs. By carefully examining those early works, physicians and scholars together will advance the medicine of today. By considering how the Fathers of Medicine thought and wrote their ideas, the field of the physicians’ and scholars’ expertise will be widened. By characterizing those initial discoveries medicine will be more alive when applying it directly to the patients we currently serve. The support of Martha Faketty and Lee Ann Johnson on the location and acquisition of the original writings of the Fathers of Medicine was highly appreciated. Frequent discussions oriented at excelling in the selection of the best works were also welcomed. References 1. Temkin, O., and Temkin, C. L. Ancient Medicine. Selected Papers of Ludwig Edelstein. The Johns Hopkins Press. Baltimore. 1967. 2. Dawson, W. R. The Beginnings of Egypt and Assyria. Hafner Publishing Company. New York. 1964. 3. Sigerist, H. E. A History of Medicine. Volumes I and II. Oxford University Press. New York. 1967, 1987. 4. Nutton, V. Ancient Medicine. Routledge. London. 2004 5. Toledo-Pereyra, L. H. Vignettes on Surgery, History and Humanities. Landes Bioscience. Georgetown, Texas. 2005. Introduction By Luis Horacio Toledo-Pereyra M edicine is a profession that began many centuries ago. It is possible that it constitutes one of the oldest professions of mankind since the necessity and desire to cure or help somebody have been one of the most coveted and earliest responses of the human race. The evolution of medicine, however, has been slow and unexpectedly overcome by long periods of stagnation at various points in history. The Founders of the discipline have been firm nevertheless in advancing their ideas and presenting better ways to portray the medical profession where the patient, the disease and the physician have been the most important triad under consideration. Who are the Founders then? How did they advance the progression of medicine? How did they improve the recognition of the disease and the care of patients? How did they represent the best medicine of the times? How do we recognize a Founder and maintain his/her efforts all throughout history? The Founders of Medicine are those individuals that alone or in group were able to recognize the existent problems and introduce new avenues of discovery or innovation. A Founder sees the necessity and provides an answer for it. An associated risk was not part of the equation. The Founders enabled medicine to progress because they saw the field with different eyes and responded with well-defined ideas and principles applied to the discipline.(1-7) They were risk-takers and gave appropriate solutions to the problems seen. Let’s take into study, for instance, the role of the first Founders, the Babylonians. Initially, the Sumerians practiced non-naturalistic medicine associated with magic and religious background. As their regime began to flounder, Babylonians began to transform medicine from its magico-religious orientation to a more lay-oriented medicine with an added empirical basis. This direction of their medical approach to disease in conjunction with their interest in human and animal anatomy and the professional responsibility of the physician (Hammurabi Code) were the Babylonians' critical advances to medicine; this makes them as Founders of Medicine. The Founders of Medicine improved the recognition of disease and the care of patients. In order to do this, they had to advance the knowledge of disease and the means by which the patients were taken care of. In this regard, let’s introduce at this point the Egyptians of pharaonic times and see how they should be considered Founders of Medicine as well. Egyptian ancient medicine was both magical and rational. They produced, however, a great number of rational methods applicable to wound treatment and other traumatic injuries. Systematic approach to diagnosis and treatment was the rule when analyzing the cases introduced on the Edwin Smith Papyrus. In this unique body of surgical literature, Egyptian physicians clearly outlined new ways by which the evaluation of disease and the care of patients were greatly improved. Other noted papyri such as the Ebers, Hearst, Berlin and Kahun(1-7) further advanced medicine to levels not seen before.(1,4) Continuing with the characterization of the Founders of Medicine, we need to respond to the question of their representation on the medicine of the times. In this regard we can utilize the contributions Introduction 3 4 History of Medicine, As Written by Its Founders and works made by the advanced medicine of Hippocrates of Cos and his Greek contemporaries. Rational medicine as the main positive development of Hippocratic physicians represented the essence of the Golden Age of Greek Medicine.(2,5) The incorporation of the four humors—black bile, yellow bile, phlegm and blood—was another important contribution of the Hippocratics as well. The Corpus Hippocratum, a comprehensive analysis of the medicine of the day, integrated approximately 70 books and written by Hippocrates and his followers. Many diseases were described in these writings such as pneumonia, pleurisy, cancer, epilepsy, tetanus, apoplexy and others.(2,3,5) Infectious diseases were frequently reported also. All this work was the basis for considering Hippocrates and his school of healing as belonging to the Founders of Medicine. Next, we recognize the Founders represented by the medical Roman writer, Celsus, followed by the surgeon of the gladiators Galen of Pergamon, then Albucaisis of Cordoba and finally Avicenna of Afshana. All of them, because of their special contributions and for maintaining their advanced efforts throughout their lives, certainly belong to those unique professionals who form part of the Founders of Medicine. The list of Founders of Medicine is clearly selective and represented by those pillars of Western Medicine that have made advances well-accepted throughout the medical literature. Ultimately, our main objective was to learn from the Founders of Medicine as represented in this volume and as they wrote their experiences during their professional careers. In short, we are learning from the written words of the Founders of Medicine. References 1. Ghalioungui, P. The House of Life. Magic and Medical Science in Ancient Egypt. B.M. Israel. Amsterdam. 1973. 2. Phillips, E. D. Greek medicine. Thames and Hudson. London. 1973. 3. Brothwell, D. L., and Sandisom, A. T. Diseases in Antiquity. Charles C. Thomas Publisher. Springfield, Illinois. 1967. 4. Dawson, W. R. The Beginnings, Egypt and Assyria. Hafner Publ. Co. New York. 1964. 5. Adams, F. The Genuine Works of Hippocrates. William and Wilkins Co. Baltimore. 1939. 6. Bynum, W., and Bynum, H. Great Discoveries in Medicine. Thames and Hudson. London. 2011. 7. Toledo-Pereyra, L. H. Origins of the Knife: Early Encounters with the History of Surgery. Landes Bioscience. Georgetown, Texas. 2006. Mesopotamian Medicine and The Code of Hammurabi (c. 1772–1750 B.C.E.) Historical Highlights • • • • • • • • • • Approximately 1780 B.C.E. Babylon Code of Laws Babylon ruins are today near the city of Al Hillah, 50 miles south of Baghdad in Iraq Hammurabi’s reign (1792–1750 B.C.E.) The Code of Laws is written on a black stone—diorite stele-structure The Code structure is eight feet high with 282 laws It was discovered in 1901 at Shush, now in Iran Currently located at the Louvre, Paris Paragraphs 215–223 deal with surgical ethics Earliest known code of ethics and surgery Writings representative of the Mesopotamian practice of Medicine and suggested for reading are as follows: 1. The Babylonian Laws. Edited with Translation and Commentary by G.R. Driver and John C. Miles. Volume I. Legal Commentary. Oxford: Clarendon Press. First edition, 1952. Reprinted 1956, 1960, 1968. 2. The Babylonian Laws. Edited with Translation and Commentary by G.R. Driver and John C. Miles. Volume II. Transliterated Text, Translation, Philological Notes, Glossary. Oxford: Clarendon Press. First published 1955. Reprinted 1960, 1968.
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