30:725:424:01 History of Pharmacy and Medicine
Professor John L. Colaizzi
Class Outline
Friday, September 5, 2008
Pharmacy and Medicine in the Earliest Civilizations and Cultures of the Middle East
Methods for learning about diseases in pre-literate cultures and early civilizations:
 Paleontology/fossils  Paleo – prehistoric times
 Paleolithic  lith=stone, “the stoneage”, stone tools
 Paleopathology  “study of ancient diseases” in prehistoric times, ancient civilization, offers skeletal remains and
soft tissue evidence
 Skeletal remains  gives us information on diseases, skeletons don’t decay easily, fractures osteoporosis, TB (results
in deformity of the spine, Rickets  deficiency of Vit D and calcium
 Soft tissue evidence  “mummy”, DNa testing gets significant information
Some documented diseases:
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Cancer(s)  evident in both bone and soft tissue
Cerebral hemorrhage  observed, but relatively rare
Cirrhosis (of the liver)  common, alcoholic today, parasitic infestations in old times
Coronary artery disease (CAD)  only began to appear as civilizations emerged. Agriculture – food availability
beyond subsistence levels, dietary excess
Malaria  ancient disease, zoonotic, caused by an animal ie. Mosquito. Prevalent in tropical climates, caused by a
protozoa organism (Plasmodium falciparum)
Fungal Infections  very common in ancient times, dominant in tropical climates. Affected particularly the lungs
Leprosy  still around today, bacterial infection that affects the skin, mucous membranes, and the nerves
Pneumonia  can be either bacterial or viral infectious disease that affects the respiratory system, caused is linked to
an aftereffect of influenza, elderly are most susceptible
Tuberculosis  bacterial, very ancient, not indigenous to Western Hemisphere, discovered mummy in South America
in 1994, DNA testing, contained Tubercle bacillus
Syphilis and STDs  mostly bacterial, widespread. AIDS not ancient (viral)
Trypanosomiasis  parasite infestation caused by protozoal organisms
Trauma  animal attacks, battles, accidents
Pneumoconiosis  (cf. asbestosis; silicosis; “black lung disease”) – from inhaling particulate matter into the
lungs(sandstorms)
Obstetrical morbidity and mortality  childbirth and delivery, much greater then than today, did not have knowledge
of aseptic practices until midwives (assisted delivery)
For the following diseases which have a high degree of prevalence in modern times, comment on their probable and
relative prevalence in the early civilizations or in pre-historic times.
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Cancers  pollution, dietary issues, people live longer, the greatest single risk factor is cancer, unprevalent in ancient
world (shorter lifespan)
Alzheimer’s disease  not sure if it existed in ancient world
Parkinson’s disease  1817, identified in England by Dr. Parkinson, the “shaking palsy”, don’t know if existed in the
past, usually prevalent in elderly
Arteriosclerotic Heart Disease (ASHD)  build up of fatty deposits in coronary artery, stenosis (blocking of a blood
vessel), more widespread today because of dietary excess
IDs in general probably less prevalent in ancient world because population density was less, many IDS are
transmissable
Theoretical basis for disease causation (etiology), cure, prevention or treatment
Earliest civilizations – the prehistoric period, emergence of writing, agriculture, occupations,
1. Mesopotamia – between Tigres and Euphrates 2. China 3. India
Comparisons with Western (Allopathic) Medicine (“Empirical therapy to true science”) – very empirical (trial and
error)
Therapeutic approaches of early civilizations emphasized ________cleansing________ and
________purging_________ with the idea of ____________purification______________ by the expulsion of evil spirits
or influences (and sin).
Examples of such therapeutic approaches:
 Purgatives (purging agents)  powerful evacuants of the lower colon
 Cathartics  less harsh than purgatives
 Laxatives  more gentle than cathartics
 Enemas (clysters)  same as purgatives, inserted rectally
 Venepuncture, Venesection, phlebotomy  bleeding, blood-letting, popular for treatment of many diseases, up until
18th century, early 19th, no scientific basis
 Medicinal Leeches (Hirudo Medicinalis)  bloodsucking worms that attach to skin and suck out blood, prevalently
sold in pharmacies in the early 20th century
In ancient civilizations, the administration of certain medications was accompanied by ritualism and incantations (chanted
prayers). Examples:
 Soil/clay samples  used often, administered orally, topically, contains active drug substances  antimicrobials,
antacid, antidiarrheal
 Fungi  (from mummy), topically, orally, psychoactive properties, antimicrobial(Iceman)
 Scarifications and tattoos  tribes in Africa today, intradermal injections (not as deep as IM and SC), pustules (dried
up scabs from small pox), would induce immunization of ancient form, snake venom (immunity from future snake
bites), and dyes
 Opium  fundamental base of narcotic analgesics
 Alcohol  religious rituals
o Opium and alcohol are common in CNS depressants, have addictive properties
Mesopotamia: the first definitive written records of drugs used as medicines:
 Mesopotamia, Babylonia, Sumaria, Chaldea, Iraq  refer to same civilization
 Dates associated with the “Clay Tablets”  3000 BC
 Cuneiform writing  wedge-shaped characters
 Types of drugs represented on the Clay Tablets  botanical, mineral, animal parts, opium, cannabis
The Code of King Hammurabi of Babylon:
 Hammurabi’s identity – very well documented king and military ruler in present day Iraq 1792-1750 BC
 Hammurabi’s well-documented “Code” and its influence on the historical development of medicine and subsequent
healthcare professions –
o First documented evidence of laws and regulations related to healthcare
o 182 laws and regulations, severe punishments for malpractice
o Tiered reimbursements – rich(more pay), slaves (less), legal and regulatory
o Hippocrates added ethics and care