Ancient Medicine has always fascinated me, especially the surgical aspect of it. The word surgery is taken from the Greek word Ergon which although means a "unit of work" in this case it just means work and then we have "Chiros" which in effect means hands. So, Ergon Chiros work of the hands.
Celsus described it as 'quae manu curat' or "Cures diseases by means of the hand" The beginnings of medicine cannot be explained simply, because all we have to rely upon are ancient stories and legends.
There are those who seem to be in the majority who believe that humans or Homo Sapiens as they like to call us are millions of years old and we have evolved from a very primitive organism in a primordial soup. I must stress this is not my view, for as a Christian I believe we were created by the one true God. So, when you read this, I do not apologise, you will notice my bias. However, you believe what you will.
In the beginning, according to Western and many Eastern theological traditions the first humans were without any illness or injury, as the earth was paradise or Eden.
The trouble started when Satan persuaded Eve who in turn persuaded Adam to disobey God and sin entered the world. You see, up till that point they were immortal. The apple contained the first poison (sin) and when taken by man, the result was an illness that led to the death of all mankind. It has been getting worse ever since.
Who said an apple a day keeps the doctor away?
It was said by the Greek Poet Hesiod, who along with Homer were known as the first great writers of Greek literature.
"First of all, the deathless gods who dwell on Olympus made a golden race of mortal men who lived in the time of Cronos when he had sovereignty in heaven. And they lived like gods without sorrow of heart, remote and free from toil and grief: miserable age rested not on them; but with legs and arms never failing they made merry with feasting beyond the reach of all evils."
So according to Greek tradition, men lived a life free from illness. The whole book "Works and Days" is worth a read.
There are several stories written from the ancient world of a beginning without suffering, due to magic or religion however, the beginnings of surgery and anaesthesia were like medicine, inextricably linked with ancient magic and ancient religion. Surgery had never been defined as a separate field of medicine and was in ancient times and up until the discovery of Anaesthesia, considered to lowly a task for a trained physician to perform, so was left to lesser-educated assistants.
These early operators were performing what we obviously refer to today as 'Surgery'.
The landscape of the world population was also different in Ancient times, that is, there were fewer large town/city population centres. The bulk of the population was spread out in very small villages and towns where the medicine and surgery were performed by residents, usually town elders. They used flint (sharp stones) to make their incisions, and any remedies and treatments that seemed to be successful were passed down from generation to generation.
During these times, there were remedies given as a result of rumours of miracles stemming from magical wells, streams and ponds. These so called "ponds of purity" was said to have cured the afflicted that had visited before. In all probability, the person was washed by the fresh water, and the drinking of uncontaminated water would eventually aid recovery from the ailment. It would today be classed today as taking simple hygiene precautions, something we do all the time, without really thinking about it; however in those early days because you could not see bacteria or viruses, in the minds of those ancient people they did not exist and there was only one other explanation given, it had to be Supernatural.
The people, even of today's generations head off to a sacred river, or in the Catholic church, to places such as Lourdes for an instant cure, so although at first it sounds quite uncivilised, it is possible to see the people of today mimicking those of history.
There is some suggestion however that the prehistoric peoples used nightshades and other plants to treat certain ailments. Cave drawings in France said to be over 15,000 years old, show tribes doing ritual dances dressed in animal skins and even had heads of animals, these are thought to be to ward illness away.
"So, the Lord God caused the man to fall into a deep sleep; and while he was sleeping, he took one of the man’s ribs and closed up the place with flesh".1
Ancient History is very theoretical, when we go back beyond the Sumerian era the Archaeologist and historians have a licence to say what they like.
They find a bone or a tooth and come up with some theoretical date and build a society out of it based on their guesses.
The truth is nobody is sure of how society was in these pre- writing days, which was about 6 thousand years ago. As regards to medicine, the same applies, not much is known as not much is written.
Pliny the Elder
Gaius Plinius Secundus was a Roman scholar, encyclopedist, and naturalist who was born in Novum Comum in Gallia Cisalpine (today Como, Italy) Around 77 AD. Pliny began the work for which he is best known: the Naturalis Historia. A thirty-seven-chapter book written in ten volumes, this text detailed Pliny's experiences gained through during his travels and the knowledge of his youth to create a compilation of Roman life.
The book dictated astronomy, geography, anthropology, zoology, botany, medicine, magic, and mineralogy, as well as a cornucopia of other topics.2 He mentioned the sacrificial ceremonies of the Druids (Druid means Oak Knowledge) in ancient Britain. These wizards and physicians fuelled the stories of Merlin and the Knights of the Round Table.
Folk lore or as we would say today "Old wives Tales" was the major form of reference for cures.
Physicians were in the main, well-educated men who were articulate and had a very wide knowledge of herbal medicine. Surgeons were seen as uncaring heartless fellows who could work very quickly to remove a limb. It was however not the case as the reason for speed was very simple, to reduce the time the patient was in agony.
There were several other reasons for the low regard for surgery, in general any medical intervention for a surgical or medical condition was looked upon as cruel and against the will of God or Gods.
Pain in ancient times was considered and accepted as an inevitable occurrence in life.
There was no resentment to pain in the minds of most people. Pain gives you a warning of something that is wrong with you, if you received no sensation from ailments or injury as pain provides, your ailment would become incurable before you recognised a problem exists, and example is the detection of breast or other cancers they are not painful till its latter stages, if pain was felt when it first started to develop, most would be completely curable.
It was the case however that most would be so petrified that they would rather risk death rather than trusting their condition to the knife of the surgeon There was also the theory that the attempt to control pain, would interfere with the will of the almighty, who instigated it in the first place. This attitude of mind was still the case well into the 20th century when some obstetricians believed it necessary for women to suffer labour pains as that is what the Almighty said would have to happen in the book of Genesis. The feelings from the religious establishments about pain has always been that it was a trial from God to test the faith of those that were suffering, in very much the same way as the biblical Job suffered to test his faith.
In effect if Jesus had to suffer cruel scourging and crucifixion, we should be willing to suffer as well. This would also be to remind the unfortunate person that the suffering on earth was nothing in comparison to the suffering your soul would have to endure if you did not turn to God, the suffering of the soul would take place in the domain that we know as Hell, for all eternity.
Pliny the Younger, (nephew of the Elder) in Letters 10:96, recorded early Christian worship practices including the fact that Christians worshipped Jesus as God and were very ethical, and he includes a reference to something that is interesting to us today, the love feast and Lord’s Supper.
Pliny the Elder died in 79 AD when he went to investigate the eruption of Vesuvius, it is believed of an asthma attack. A passage from the book A Sight of Hell" is a typical pre 20th century picture of the non-believers.
“The sinner lies chained down on a bed of red-hot blazing fire. All the body is salted with fire. The fire burns through every bone and every muscle. Every nerve is trembling and quivering with the sharp fire. The fire rages inside the skull, it shoots out through the eyes, it drops out through the ears, it roars in the throat as it roars in the chimney"3
In the scriptures it is written that hell is a real place, you might say a remand centre for those who defy God. Is it true? Well as a Christian I believe so, as a Christian I believe that Christ will keep me from this dreaded place.
Pain and Suffering
Pain and suffering was a way of life in ancient times. The rich and powerful could afford the services of a physician who could sometimes find a remedy for the illness or affliction. The poor were not so lucky, they would suffer the full effects of the illness and were more likely to die.
When an unfortunate individual agreed to undergo an operation to save his/her life, it would mean that person being strapped to the table or held down or both. They would be given time to gather their thoughts, to pray or to have a drug of some kind to enable them to go through with it. After the operation, they would always suffer post traumatic shock or long-term depression. Some would even end up even committing suicide because of the post-operative shock and depression.
Time ingrained into people that patients could suffer very high levels of pain. Today we would find this very difficult to accept as we have been conditioned to take a paracetamol even if we get a headache.
My role involves looking after post-operative patients who come out of surgery suffering different degrees of pain. Those who were in great pain prior to going into surgery, often are very uncomplaining post op, even if their pain score is quite high, why, because it was higher prior to the surgery; the surgery and the operative pain medication has reduced their normal levels of pain significantly.
Then there are those who come in for a routine operation like for instance a Laparoscopic Sterilization who rate their pain levels as severe even though we assess it visually as very mild. (i.e. they are sleeping most of the time.)
It is a fact, pain is nature’s way of protecting the individual; it gives warning of disease, injury or a condition that was disabling. So, suffering was an acceptable, (although not wished for), occurrence of life in ancient times.
Christian religious orders (Rome) throughout time have encouraged pain through the scourging of the body with whips and other implements of self-torture. These orders were trying to emulate the suffering that Christ had to go through before his crucifixion.
All this was done to shorten the time in what the then Catholic church regarded as Purgatory (which may be seen as remand prison for those awaiting judgement), although there is no proof in scripture that this is so as Christ’s sacrifice was enough.
Remedial measures during this period were simplistic, and nature itself was the most important healer. As regards to pain control, man’s knowledge of certain herbs like Helenium are examples that did provide some relief from the pain experienced from the surgeon’s knife and saw.
Helenium was described by Pliny, who suggested it was one of Homers Nepenthes (that is a substance that people took in ancient times to forget their sadness or troubles, or the plant that produced the substance.) Both surgeon and holy man performed much of the early day surgery and pain relief, the surgeon with the aid of a holy man, treated wounds to heal the patient.
Haemorrhage was arrested using crude cauterisation techniques with a hot iron or knife. The oldest surgery for which we had evidence is Burr Holes.
Pre-Inca, Inca and Neolithic European skulls have been found trepanned (From the Greek word meaning Borer).
Forensic examination of these skulls found that some patients survived for long periods after the procedure, this would clearly be evidence suggesting that the operation was successful; however the main reason that Skulls were trepanned, was to drive out the demons (As opposed to releasing the inter-cranial pressure).
There is also evidence to suggest that the Aztec reset broken bones and splinted them.
The crude form of internal fixation that they used was constructed of wood.
The casting out of demons or evil spirits were not just confined the Neolithic or bronze age as Priests and monks believed that with self-flagellation, sinful thoughts would be cast out.
It was then quite normal in ancient times and dare I say up until the middle ages for the physician and holy man to treat simultaneously the sick and injured.
This collaboration of the doctor and holy man can still be seen in some countries throughout the world. Even today, the witch doctors of India and Nepal will carry out minor surgery and give potions to remove the evil spirits at the same time. It is a sad fact that even today in remote areas of Nepal and other countries not blessed by local hospitals, that people will have adapted their way of treating certain conditions, that could mean bringing in a holy man or the acceptance of certain ailments, an example of this is: In the past, women who had developed goitres in Nepal were proud of the enlarged thyroid as it was seen as a status symbol.
It was a fact though that several people have died of conditions because there were no doctors.
It was at this time the holy man acted as a comforter to the patient, very much in the same way as you would see a pastor or priest visit the sick in this country.
It is hard to imagine that these Witch doctors still exist, however even now in the 21st century they exist in many countries and in numerous quantities.
North American Indians used cautery to arrest bleeding, whilst there is evidence to suggest that East African tribes ligated severed blood vessels following battles during tribal conflicts. The examples from above confirm that primitive man understood the need for surgical intervention, albeit in a very crude way.
Native American medicine historically included many sophisticated interventions that have been lost in whole or in part, such as various forms of bodywork, bone setting, midwifery, naturopathy, hydrotherapy, and botanical and nutritional medicine.
Ceremonial and ritual medicine is the largest surviving piece of Native American medicine but is still only a small part of what was available 500 years ago.
It is well documented that the armies of the ancient civilizations used to treat the wounded following the vicious battles that were fought during these periods. The seriously wounded were terminated by fracturing the cervical spine. This was done to reduce the suffering of the unfortunate individual who would have indeed died anyway, in agony. A high proportion of those cases today would have a high chance of survival.
"They are a doomed Race. Wars, smallpox, gross immorality, a change from old ways their fate is the common fate of the American, whether he sails the sea in the North, gallops over the plain in the west, or sleeps in his hammock in the forests of Brazil." 4
The American Indians are the genuine Americans in the sense that they did not hail from Europe or Africa, they were always there. However, it is interesting to note that according to the bible the world was divided in the days of Peleg, and the nations were confused at Babel. There are Babel like buildings in Mexico and other Central and South American countries.
My point is, if you go back far enough we all meet our ancestors in the same place
It was during these ancient times that religion was seen as a help, faith was in most cases, all the people had, they believed in a life that was in the hands of a divine power and it was the will of God if something nasty befell you. This is still the case in the minds of many religious people today.
This attitude I have actually experienced when I worked in a Hospital in Nepal for 20 months, was that if the patient died the family were grieved, but also, they had comfort with their belief that the person was going to a better place. It also leads them to put their faith in local healers of priests, like some tribal societies that are seen today in the African Continent the whole village relies on this.
It just so happens in this world today even with institutions like the NHS there are still treatments that can cure you or relieve your suffering that are unavailable to the average human being as the cost is too much.
In times gone by, it was a comfort to know that when man could not heal you, you have done your duty, fought the good fight (on the right side), and you were now going to a better place, Heaven, or Valhalla. This way of thinking was a comfort to a majority of people who watched their loved ones suffer.
It was a fact then, that superstition and religion helped the poor fellow who was wounded in battle or the women who died giving birth to her child, for it gave genuine comfort to the individual concerned and those around who were affected by the loss.
Even today many people will revert to spiritual comfort during their final days or hours. It has a lot going for it, if they believe there is a place that you can go after your suffering is over and that choice is between heaven and hell, why not take comfort from that, is that not a treatment? If given the choice, where would you like to be carried too?
If the scientists and Humanists are wrong, then no one needs to worry as on the other side of death is complete annihilation or non-existence as a human or spirit or soul.
If on the other hand however those who have no faith are wrong, and there is a Heaven and more horribly, a Hell, then I will be honest, I know what I would rather choose.
In the sub Asian continent, I have met with ordinary individuals who are in the mind-set that although their loved one is dead they have gone to a better place, and suffers no longer, it works for them.
Archaeological evidence confirms that the origins of medicine started with the appearance of modern man.
"He who has an ear, let him hear what the Spirit says to the churches. To him who overcomes, I will give the right to eat from the tree of life, which is in the Paradise of God." 5
Heaven has been described as Indescribable, this because there are no words that can make us understand how marvellous it is.
There are religions that believe it is a place for bodily pleasures. This concept suits those who are easily tempted, who are weak in faith, it is a carrot they can understand. Christ said that we would be like the Angels in heaven where we will not need a sexual relationship, we will have a spiritual relationship which goes far beyond the pleasures of the body.
1 Genesis 2:21 King James Version
3 Furness Rev J, (1870) The Sight Of Hell
4 George A. Dorsey As reported in the Chicago Tribune from a lecture on the Haida Indian Nation (Nov 1897
5 Revelation 2:7 KJV