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History of medicine

Western medicine

Medicine is currently defined as the science of disease prevention,
diagnosis, alleviation and cure. However the Greek pharmakos means both
remedy and poison, indicating a more equivocal attitude in the past.

All human societies have medical beliefs - birth, death, disease and cure
are explained in some manner. Historically, throughout the world illness has
often been attributed to witchcraft and the will of the gods, ideas that
still retain some power, even in 'modern' societies, with faith-healing and
shrines still common.

As socities developed in Europe and Asia belief systems were replaced with a
different natural system. The Greeks, from Hippocrates, developed a humoral
medicine system where treatment was to restore the balance of humours within
the body. Similar views were espoused in China and in India.

From the ideas developed in Greece, through Galen until the Renaissance the
main thrust of medicine was the maintenance of health by control of diet and
hygiene. Anatomical knowledge was limited and there were few surgical or
other cures, doctors relied on a good relation with patients and dealt with
minor ailments and soothing chronic conditions while epidemic diseases grew
out of urbanization and domestication and then raged across the civilized world.

This idea of personalised medicine was challenged in Europe by the rise of
experimental investigation, principally in dissection, examining bodies in a
manner alien to other cultures. The work of individuals like Andreas
Vesalius and William Harvey challenged accepted folklore with scientific
evidence. Understanding and diagnosis improved but with little direct
benefit to health. Few effective drugs existed, beyond opium and quinine,
folklore cures and almost or actually poisonous metal-based compounds were
popular treatments, if useless.

Medicine was aided in the 18th century and beyond by advances in chemistry
and laboratory techniques and equipment, old ideas of infectious disease
epidemiology were replaced with bacteriology (Robert Koch, Louis Pasteur),
and for the first time actual cures were developed for certain endemic
infectious diseases. However the decline in the most lethal diseases was
more due to improvements in public health and nutrition than to medicine. It
was not until the 20th century that there was a true breakthrough in
medicine, with great advances in pharmacology and surgery.

Modern western medicine, despite the hypochondria of western society, is
uniquely effective and widespread compared with all other medical forms. It
is notably secular and material, indifferent to ideas of the supernatural or
the spirit and concentrating on the body to determine causes and cures. The
harsh scientific nature of modern medicine is the pinnacle of a very narrow
concern, a particular aspect of the human condition has been exulted at the
cost of considerable social disquiet, as evinced by anti-vivisectionism,
eugenics, 18th and 19th century concerns about body-snatching and attacks at
doctors for 'playing god' in the 20th century. And the capabilities of
modern medicine have done little to improve the lot of poorer countries.

Ayurveda

?yurveda, the Vedic system of medicine, views health as harmony between
body, mind and spirit. Its two most famous texts belong to the schools of
Charaka and Sushruta. According to Charaka, health and disease are not
predetermined and life may be prolonged by human effort. Sushruta defines
the purpose of medicine to cure the diseases of the sick, protect the
healthy, and to prolong life.

?yurveda speaks of eight branches: k?y?chikits? (internal medicine),
shalyachikits? (surgery including anatomy), sh?l?kyachikits? (eye, ear,
nose, and throat diseases), kaum?rabhritya (pediatrics), bh?tavidy?
(psychiatry, or demonology), and agada tantra (toxicology), ras?yana
(science of rejuvenation), and v?j?karana (the science of fertility).

Apart from learning these, the student of ?yurveda was expected to know ten
arts that were indispensable in the preparation and application of his
medicines: distillation, operative skills, cooking, horticulture,
metallurgy, sugar manufacture, pharmacy, analysis and separation of
minerals, compounding of metals, and preparation of alkalis. The teaching of
various subjects was done during the instruction of relevant clinical
subjects. For example, teaching of anatomy was a part of the teaching of
surgery, embryology was a part of training in pediatrics and obstetrics, and
the knowledge of physiology and pathology was interwoven in the teaching of
all the clinical disciplines.

At the closing of the initiation, the guru gave a solemn address to the
students where the guru directed the students to a life of chastity,
honesty, and vegetarianism. The student was to strive with all his being for
the health of the sick. He was not to betray patients for his own advantage.
He was to dress modestly and avoid strong drink. He was to be collected and
self-controlled, measured in speech at all times. He was to constantly
improve his knowledge and technical skill. In the home of the patient he was
to be courteous and modest, directing all attention to the patient's
welfare. He was not to divulge any knowledge about the patient and his
family. If the patient was incurable, he was to keep this to himself if it
was likely to harm the patient or others.

The normal length of the student's training appears to have been seven
years. Before graduation, the student was to pass a test. But the physician
was to continue to learn through texts, direct observation (pratyaksha), and
through inference (anum?na). In addition, the vaidyas attended meetings
where knowledge was exchanged. The doctors were also enjoined to gain
knowledge of unusual remedies from hillsmen, herdsmen, and forest-dwellers.

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