History of Medicine
As written by its founders
Edited by Luis H. Toledo-Pereyra
Included in this preview:
• Table of Contents
• Preface
• Introduction
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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,
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First published in the United States of America in 2013 by Cognella, Inc.
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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.