The most important and influential discovery was the practice of surgery. With this invention, human life became more sophisticated, humans lived longer, and we obtained a knowledge of ourselves sufficient enough to break the boundaries built by ignorance. Lacking prescription drugs, accurate tools, computer technology, and any background experience to build from, our ancestors struggled to learn how to repair the human body. They did an suprisingly competent job of treating the sick and injured. Some of the medical technology developed in ancient times surpassed anything available in the modern world until the 18th century or 19th century.
In eras wherein religious views took precedence over medicine and logic, surgical advancement was difficult. The knowledge we have now was obtained from these peoples exploits.
The first known medical procedure is called trephination. Trephination is the cutting of a hole through ones skull to relive excess pressure. This dates back to as early as the Stone Age, around 3,000 BC.
Unearthed remains of successful brain operations, as well as surgical instruments, were found in France at one of Europe's noted archeological digs. The success rate was remarkable, even around 7,000 BC. Skulls have been found from about 8,000 BC with these telltale holes, most of which are exact and show growth, meaning that patients often lived for weeks, even months, afterwards . Pre-historic evidence of brain surgery was not limited to Europe.
Early Incan civilization used brain surgery as an extensive practice as early as 2,000 BC. In Paracas, Peru, archeological evidence indicates that brain surgery was used frequently. Here, too, an inordinate success rate was noted as patients were restored to health. The treatment was used to treat mental illnesses they blamed on evil spirits, epilepsy, headaches, and osteomylitis, as well as head injuries.
Brain surgery was also used for both spiritual and magical reasons; often, the practice was limited to kings, priests and the nobility. Surgical tools in South America were made of both bronze and carved obsidian. The Akkadians used trephination thousands of years later for the same purposes, and the practice was improved until it reached the state of today.
The Akkadians learned from experience with surgery.
There were no books or documentations of previous procedures, so the trade was passed down through hands on, personal training. The Code of Hamurabi states that surgeons of the Akkadian era were well paid, but a failure was expensive. Surgeons who did not cure or even killed their patients, if only by accident, paid the patients family with money or their lives, depending on the social class involved. Laws 215 through 223 provide information on physicians duties and payments. These laws were often strict and binding. Law number 218 is as follows: 218.
If a physician makes a large incision with the operating knife, and kills him, or opens a tumor with the operating knife, and cuts out the eye, his hands shall be cut off. The Code of Hamurabi is also the first documentation of surgery. It describes delicate work with bronze lancets and knives and steps for setting bones. The Akkadians use primarily the same manner to set bones as we do in the 21st century.
The earliest written reference to cataract surgery is found in Sanskrit manuscripts dating from the 5th century BC. They are thought to have been written by the Hindu surgeon Sushruta.
He practiced a type of cataract surgery known as couching, in which the cataractous lens was removed from the pupil to lie in the vitreous cavity in the back of the eye. This displacement of the lens enabled the patient to see better. Vision, however, was still blurred because of the unavailability of corrective lenses. A typical operation performed by Sushruta for removing cataracts is described below. "It was a bright morning.
The surgeon sat on a bench which was as high as his knees. The patient sat opposite on the ground so that the doctor was at a comfortable height for doing the operation on the patient's eye. After having taken bath and food, that patient had been tied so that he could not move during the operation. The doctor warmed the patient's eye with the breath of his mouth. He rubbed the closed eye of the patient with his thumb and then asked the patient to look at his knees. The patient's head was held firmly.
The doctor held the lancet between his fore-finger, middle-finger and thumb and introduced it into the patient's eye towards the pupil, half a finger's breadth from the black of the eye and a quarter of a finger's breadth from the outer corner of the eye. He moved the lancet gracefully back and forth and upward. There was a small sound and a drop of water came out. The doctor spoke a few words to comfort the patient and moistened the eye with milk. He scratched the pupil with the tip or the lancet, without hurting, and then drove the 'slime' towards the nose. The patient got rid of the 'slime' by drawing it into his nose.
It was a matter of joy for the patient that the could see objects through his operated eye and the doctor drew the lancet out slowly. He then laid cotton soaked in fat on the wound and the patient lay still with the operated eye bandaged. It was the patient's left eye and the doctor used his right hand for the operation." The first written description of the cataract and its treatment in the West appears in 29 AD in On Medicine, the work of the Latin encyclopedist Cornelius Celsus . Physicians used his book for 1,700 years.
In the Western world, recent excavations in Babylonia, Greece, and Egypt have uncovered bronze instruments that would have been appropriate for cataract surgery. As recently as the middle of this century, couching was still practiced in Egypt, India, and Tibet.
Although modern plastic surgery began in the 1700s, its roots go as early as 3400 BC when the Egyptians first attempted facial reconstruction. It was not until the 6th century BC that the skill evolved .
Sushruta Samhita invented this improved form of facial surgery. He devised what came to be known as the pedicle flap method of plastic surgery as a solution for the punishment for adultery - the cutting off of the nose. In the procedure, tissue from one part of the body was sewed onto another to repair defects. Skin transplanted to the nose area was kept alive by remaining attached to healthy tissue. As the Susruta Samhita explained: "When a man's nose has been cut off or destroyed, the physician takes the leaf of a plant which is the size of the destroyed parts. He places it on the patient's cheek and cuts out of this cheek a piece of skin of the same size (but in such a manner that the skin at one end remains attached to the cheek).
Then he freshens with his scalpel the edges of the stump of the nose and wraps the piece of skin from the cheek carefully all around it, and sews it at the edges. Then he places two thin pipes in the nose where the nostrils should go, to facilitate breathing and to prevent the sewn skin from collapsing. There after he strews powder of sapan wood, licorice-root and barberry on it and covers with cotton. As soon as the skin has grown together with the nose, he cuts through the connection with the cheek. Modern surgeons have never found better substitutes for Sushrutas techniques. The modern plastic surgery we use today was learned by the British while they worked for the East India Company.
Although the pedicle flap was developed over 2,000 years ago, it is the same procedure that the British learned.
The practice of medicine was fairly advanced in Ancient Egypt, with Egyptian physicians having a widespread and excellent reputation. The Egyptians thought that most illnesses - at least those caused by no obvious accident - were the work of divine powers, and it was for this reason that magicians, as well as physicians, were concerned with medicine. Much documentation exists that in addition to magicians, useful in the villages and countryside, there existed a much less primitive form of medicine. Texts of the time frequently mention doctors, oculists, dentists and other specialists, including veterinarians. The practices of Egyptian physicians ranged from embalming, to faith healing, to surgery, to autopsy.
The use of autopsy came about due to the extensive embalming practices of the Egyptians. It was not unlikely for an embalmer to examine the body for a cause of the illness which killed it. The use of surgery evolved from a knowledge of the basic anatomy and embalming practices of the Egyptians. Doctors and other medical personnel kept detailed notes on papyrus describing the conditions they encountered, and the treatment applied in all areas of medicine, including gynecology, bone surgery and eye complaints, the latter of which was very frequent in the dry, dusty Egyptian climate. The only medical schools of this time were the Houses of Life, centers devoted to medicine. Young doctors learned from their elders through watching their surgeries and reading medical manuscripts the scribes copied.
These scribes compiled all the medical papyri of Egypt. All Egyptian surgeons were employees of the state. They worked free of charge during battles and were paid by the state after working. The medical society of Egypt had a hierarchy with the head physicians on the top, followed by the physicians in chief, then the medical supervisors, and finally the head physicians of Northern and Southern Egypt. The Pharaoh had a royal court of doctors.
Each was a specialist in a different procedure or disease. The specialists expanded knowledge on their personal subjects and passed it through generations to come.
Early Chinese treatments were based on natures four elements-fire, water, earth, and air. The four elements were said to correspond to the four humours, the four most important bodily fluids to the Chinese- phlegm, bile, atrabile, and blood. Before surgery, a patients correct humour was drained to cleanse the body. Through the study of the humours, the Chinese found the first link to high blood pressure, an excess of salt in the diet.
They also began to use acupuncture to target certain areas of the body without dealing with them directly or using surgery. Surgery, as well as dissections, was discouraged by the rise of Confucianism, which stressed the importance of keeping the human body whole and intact. Acupuncture stayed within the boundaries of Confuciuss views. It was recently rediscovered by western medicine in the 1970s and only years ago was given an endorsement by the National Institutes of Health. During the Chinese Warring States period, the idea of Chhih, or breath, became popular.
Diseases were believed to be the result of too much chhih. There were six types of breath- cold and heat, wind and rain, and light and darkness. Diseases were blamed on various compounds of chhih. In this era of illogical thought in terms of medicine, surgery still was able to advance.
Hua Tho was a surgeon who is famous for prescribing hydrotherapy and physical exercise to his patients. He produced anesthesia through a special wine, thus revolutionizing surgery. Patients no longer had to suffer through drawn out procedures, wide awake.
Ancient civilization thrived on religion.
It was the driving force behind the soul of each civilizations beliefs. Because religion was so influential, it is easy to see why medical advancements were so difficult when most of the population blamed diseases on heavenly powers. In the biblical view, diseases were gods scourges. The penitent man was free of ill health because he was also free of sin. Mesopotamians held exorcisms for particularly evasive diseases instead of surgery or medicine.
Surgery fell into a decline in China because Confucianism urged the preservation of the living body. Celestial phenomena were said to cause epidemics. The heart was governed by the sun, the brain by the moons orbit, the bile by Saturn, and the bodies of women by the moon itself. Experimentation was the greatest method of learning for the ancients. All of our current procedures and knowledge come from someones discovery. However, along with the successful finds, there are at least twice as many failures.
These are treatments based on thinking, not fact or logic. Ancient cures for the plague were quarantine, proper hygiene, and air purification through fires. They all cut down on the spread of the plague, but these remedies were also developed to cure the same ailment. Album graecum, the faces of dogs fed on bones, were a common pharmaceutical prescription. Sarsaparilla, china root, sassafras, sacred wood, and fumigated herbs all were prescribed to the sick.
Diseases were treated with remedies containing the opposite quality in many cases. For example, Saint Anthonys Fire, a great plague of swollen blisters which consumed the people by a loathsome rot so that their limbs were loosened and fell off before death" ravaged the people with gangrene and burning pain in the extremities, as well as convulsions, hallucinations, severe psychosis, and death. It was treated with cold herbs placed on boils. Unicorns horns, if located, were said to cure any disease or injury.
In the midst of incompetent medicinal logic, surgery advanced, mainly through dissections, and eventually became widely accepted as a highly foolproof cure.
Although shadowed by ignorance and lack of resources, doctors managed to educate themselves on ailments of the body and their treatments. Today, a persons heart can fail to beat and start once more after a quick surgery. One can completely remodel their entire appearance under the blade of a plastic surgeon. Doctors can open up the chest cavity of one patient, place an organ belonging to another, and have that person completing their daily activities in a matters of days.
People who did plastic surgery in India, cataract extractions in Rome 2,000 years ago, and brain surgery 10,000 years ago helped build the foundations of our modern health-care system and raise the quality of life we know today. Most amazing is how much they accomplished with so little.
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