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The origins of ancient medicine

Updated Saturday, 1st January 2005

Eleanor Betts explores how the craft of medicine began to develop in the ancient world in the Mediterranean and Near East.

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The term ‘technology’ is based on the ancient Greek techné (‘art’, ‘skill’, ‘craft’) (logos means ‘study’). Greek medical texts describe medicine as a techné, suggesting that it was a skill to know why and how to treat a condition. For us, ‘medicine’ is “the science or practice of the diagnosis, treatment, and prevention of disease” (Oxford English Dictionary).

 

Bodies from the Stone Age show signs of medical treatment: broken limbs that have been set and healed, dislocations replaced and wounds treated successfully. Bone needles from the Upper Palaeolithic (c.30,000 years ago) may indicate that wounds were stitched (sutured) at this time. A widespread practice from the late Palaeolithic, which flourished in Neolithic Europe (c.7,000 years ago), was trepanation (making a hole through the frontal or parietal bones of the skull). Whilst the reasons for this practice are unknown, the high survival rate of patients, indicated by the healing and remodelling of bone, proves great technical skill. Major blood vessels in the skull had to be avoided, haemorrhage was minimised by turning back the flaps of skull created by the incision and the operation site had to be kept free from infection.

The transition from hunter-gatherer to settled agricultural societies brought new diseases, but also allowed people to develop wound healing and bone-setting skills and medicines. The development of cuneiform (wedge-shaped) writing in Mesopotamia and hieroglyphs in Egypt allowed preservation and dissemination of medical knowledge and created the first technical medical language.

The earliest references to medical care and surgical procedures are found in Babylonian texts like the laws of Hammurabi (1792-1750/43 BCE) describing the surgeon’s responsibilities and how much he should be paid. Pay was good, but penalties for mistakes harsh: “If a physician performs a major operation on a lord… and causes his death…. they shall cut off his hand”. Only wounds, fractures and abscesses were treated surgically. A Sumerian clay tablet (2150 BCE) describes wounds being washed in beer and hot water, poultices made from pine, prunes, wine dregs and lizard dung, and use of bandages (for a nose-bleed!). Other texts describe the symptoms and prognosis of epilepsy, bronchitis and scurvy. A list of 230 medicines using plant, animal and mineral ingredients was found in an Assyrian pharmacy and records of distillation of cedar oil proves that this was an earlier invention than we thought.

The three branches of Egyptian medicine included use of internal and external medicines, using ingredients like onions, hippopotamus fat and fried mice. The Ebers Papyrus and others list treatments of the eye, skin and abdomen, also 21 cough treatments. Egyptian surgeons never opened the abdomen, but performed external operations such as lancing boils, cutting out cysts and circumcision, as well as dealing with wounds and fractures. Their surgical equipment included scalpels, knives, forceps and probes, as well as red-hot irons to cauterize wounds. The Edwin Smith Papyrus (1600 BCE) makes detailed observations of the head, nose, face, ears, neck, chest and spine, describing 42 examinations leading to surgery. Sorcerers used incantations and amulets to combat evil spirits.

Mummified bodies provide direct evidence for ailments and their treatments. They have shown us that ancient Egyptians suffered from eye diseases, rheumatoid arthritis, bladder, kidney and gallstones, bilharzia, arterial disease, gout and appendicitis. The tree-bark splints on a 5,000 year old mummified arm show that fractures were splinted. Most bone fractures found archaeologically are healed, further proof of good medical care.

The Greek historian Herodotus describes Egypt as “a country filled with doctors”, because there were so many specialists. Their skills of diagnosis and surgery won them a good reputation and many came to live in Greece and Rome as those Empires evolved.

 

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