The history of medicine


How did we come from drilling holes in our skulls to complex procedures such as organ transplants and keyhole surgery? Ekaterina Tikhoniouk explains

Advancements in nutrition and technology as well as a rise in living standards have greatly increased our overall life expectancy. During the Middle Ages, an average adult had a life expectancy of only about 30 years, while in ancient Rome the average person was only expected to make it to 20.

In 1901 an average male born in the UK was expected to live to 45, while now, a century later, he is expected to live to 77. But the main factor that is allowing people to live longer and better lives are the dramatic advancements in medicine that happened the world over and continue improving to this day.

Human beings have been practising medicine for a very long time. Medicine is termed as the science of diagnosing, treating or preventing disease and other damage to the body and mind. It has been around for millennia, as ancient and even prehistoric civilisations had their own beliefs about what caused death and illness. Throughout history, illness has been attributed to witchcraft, demons, adverse astral influences or the will of the gods.

It is believed that the earliest forms of medicine were practised as early as the Stone Age, but these were often misguided attempts to alleviate symptoms of illnesses, often through superstitious practises. A lot of this early medicine consisted of wild guesses at what caused the various diseases that afflicted the population. Ancient medicine was a crude system of trial and error, predominantly based on appeasing the gods or spirits through ritual or sacrifice, or expelling the evil spirit troubling the sick person.

Throughout the long process of discovering which plants were edible, the Stone Age man did occasionally stumble upon plants with natural properties that alleviated certain symptoms or reduced pain when ingested. Herbal medicine was the earliest medical practise with a scientific basis. Some of their discoveries have been disproven, while others play an integral part in our modern medicinal practises. Curare, made from poisonous bark by South American tribes in the Amazonian jungle, was smeared on the tips of their arrows to paralyse their prey. Nowadays a modern variant of curare is used as an important muscle relaxant during surgery.

It is hard to tell how long mankind has known about the medicinal properties of certain herbs, but the oldest medical procedure known to man is the trepanation of skulls, which, according to archaeological evidence, dates back to roughly 2,000BC.

Trepanation is an age-old medical intervention in which a hole is drilled or scraped into the human skull. Stone Age societies believed that this relieved migraines by releasing the evil spirits trapped within the sufferer’s head, as well as curing epilepsy and mental disorders. It is only by fluke that this sometimes worked by relieving inter-cranial pressure.

Well-preserved mummies survive in Peru with this hole in their skull, many of which show signs of healing in the bone around the wound, suggesting that as many as half of these so-called patients survived the crude and most likely gruesome operation. Gradually, a growing base of medical knowledge began to build up, mainly through chance observation.

The ancient Egyptians developed the beginnings of a primitive medical tradition, with their earliest known surgery carried out almost 5,000 years ago. The earliest physician is also accredited to ancient Egypt. In countries such as Greece, India and China, early attempts began at the same time to treat medicine as a science instead of a superstitious ritual.

The world’s first plastic surgeon is accredited to India. Susruta, who lived during the sixth century BC, was the founder of Indian medicine and creator of rhinoplasty, a plastic surgery technique that alters the shape of the patient’s nose.  This was a very important operation in ancient India as cutting off the nose was a common punishment for adultery during the time, and is the second most common plastic surgery procedure nowadays.

The roots of modern medicine lie in ancient Greece, with the famous Greek doctor Hippocrates who is often termed the father of modern medicine. As well as being the first documented chest surgeon, Hippocrates was the first to document several diseases and medical conditions and many of his findings are still valid to this day. Most famously he is said to have created the Hippocratic Oath for physicians, which is still in use today.

This golden age of medicine was torn apart by the fall of the Roman Empire and during the Dark Ages, a shadow of superstition settled back over Europe. While at the same time the new medicine continued to flourish in the east during the Middle Ages.

During the Middle Ages, western medicine was based on the theory of the four humours of the body, that the human body contains four fluids or ‘humours’- blood, phlegm, yellow bile and black bile. Most doctors believed that illnesses were caused by an imbalance of these humours in the body, which had to be restored in order to cure the patient. Medieval doctors were great advocates of bloodletting, believing that regular bleeding would keep the body healthy.

Ideas about the origins and cures of diseases were often based on the widespread beliefs of the time, and fear and superstition played a large part in medieval medicine. In a largely uneducated society rife with ignorance and superstition, many thought that illnesses were a punishment from God and caused directly by the sins of the person. Instead of consulting a doctor, many turned to prayer or gruelling pilgrimages in the hope of being cured of their illnesses or conditions.

Medieval medicine was set back even further by the Black Death that swept through Europe in the middle of the 14th century, killing approximately 25 million people in just under five years. This pandemic was widely blamed on the sins of the people of Europe.

But later centuries saw a turnabout in medical practises. During the 18th century medicine saw very slow progress, but the start of the 19th century saw the development of the world’s first vaccine, the first successful human blood transfusion and the first uses of general anaesthetics and in 1884, cocaine (which was discovered in the 1960s) was used as a general anaesthetic before being replaced with Novocaine. Louis Pasteur identified germs as the cause of disease in the 1850’s, while William Roentgen discovered x-rays in 1895. Another golden age of medicine had begun.

Before the 1930s there weren’t many effective treatments in existence: we had insulin, x-rays, anaesthesia, vaccines against a number of illnesses, aspirin and the electrocardiograph. Then suddenly, in the space of 40 years or so, science poured out a constant stream of miracles. Many things that we associate with modern medicine were discovered in that time: treatments like antibiotics in the 1940s, dialysis in 1943, kidney transplants in 1963 and heart transplants in 1967, intensive care, heart surgery, almost every drug you’ve ever heard of, and more.

These miracle treatments form the cornerstones of our modern medical practises. But alongside these great medical advances, some of the more ancient and bizarre treatments of the past have survived.

Mercury was used since ancient times to treat just about anything and has even been found in Egyptian tombs dating as far back as 1,500BC. It was believed to heal wounds, cure illnesses and prolong life. In second century China, the study of mercury was centred on a search for an elixir of life. It was also used to treat syphilis starting from the 16th century.

The 19th century saw the production of a cough syrup containing heroin, as well as a demand for children’s soothing syrups, each ounce of which could contain up to 65mg of pure heroin, as well as other narcotics such as cannabis and powdered opium.

One of the more gruesome and unethical practises was lobotomy, a surgical procedure in which an ice pick is inserted through the eye socket and into the brain, severing certain neurological connections particularly in the frontal lobe. Thought to treat depression, violent behaviour and mental illnesses, this procedure was brought into many psychiatric hospitals during the 1950s. It became so popular that its inventor, Antonio Egaz Moniz, was given a Nobel Prize in 1949. By the 1960s, parents were getting them for their moody teenagers, and over 18,000 people were lobotomised before this practise was deemed barbaric.

Medicine is on the brink of several important advancements. Scientists are still fighting to find a cure for cancer, stem cell research is giving us more and more possibilities and some predict that in the not-so-distant future, we will be able to grow artificial organs. Scientists talk excitedly about one day alleviating ageing and death altogether.

The medical beliefs of ancient civilizations, of the Middle Ages and even of the past century or two seem alien and bizarre to us. It is impossible to comprehend how people thought drilling a hole in your skull could relieve headaches. But medicine and its related technology is advancing at such an increasingly fast rate so that in the years to come, future generations may look back on our medical practises and wonder how we managed at all.