Civilizations and Medicine
Mahmoud Karim
With the creation of Adam a new era started in our planet and civilizations appeared one
after the other. There was a long period of time when the earth was inhabited by the cave-man.
It was thousands of years until man settled around banks of rivers and started agriculture where
civilization started.
Throughout the dawning millennia and much of the recorded history, medicine was intimately
associated with magico-religious practices of various peoples groping for the light of knowledge.
The most ancient records presently known indicate the existence of two centers of civilization
having equal development between the Tigris and the Euphrates, and along the Nile.Organized
people enjoying the natural habitat advantages of these areas were flourishing 6000 years ago.
Egyptian Civilization
When recorded history began about 3ooo years B.C in Egypt medicine was already a well
developed profession, and its practitioners had a heritage of experience, knowledge and believes
handed down from a long line of predecessors by precept and word of mouth through countless
centuries.(The History of Medicine In Pictures by George Bender . Therapeutic notes Park Davis. 1957) .
Medical centers flourished in Egypt in the 3rd Dynasty (2980-2000 B.C). Pharaoh Zoser had for his
chief counselor a brilliant noble named Imhotep (The man who cometh in peace) the man who built
the Sakkarah pyramid.
The Egyptians had found no difficulty in recording Imhoteb as the Son of the God Ptah while his
mother and wife were but ordinary morals (E. Eramn. Hand Book of Egyptian . Religion 1907 p 217 ).
Such double filiations were possible since deities could borrow a human body so as to enable to
bear them a son.
Apart from the temples of Imhoteb , there are records of a sanatorium which was situated in the
upper terrace of the temple of Hatshepsowet .
Among the common graffiti in the sanatorium are the following (" homage of M. to the lord god
Asklepios, usually with the addition of the name Amennothes, and often with that of Hygiea.)
In the Egyptian writings of the Greco-Roman period (3rd century B.C), Imhoteb was presented as a
physician, and is assigned the role of God of Medicine in Egypt..
The Greeks identified him with their Asclepios to whom was attributed a similar regard (Bender).
There was a close association between Egyptian medicine , religion and magic Physicians of
ancient Egypt were trained in the temples as well as the priest magicians and sorcerers.
Among the earliest papyri (1600-1500 BC) are the Edwin Smith papyrus and the Ebers papyrus.
In the Smith papyrus (in possession of The New York Historical Society) there is a collection of 48
case histories, giving symptom diagnosis and treatment in each case. It was intended primarily for
the use of a surgeon.
(James H. Breasted "the Edwin Smith surgical Papyrus vol. 1) Breasted dates the Smith papyrus in the
seventeenth century B.C but states that, it is a copy of a document at least one thousand years older,
The Smith papyrus dealing primarily with wounds is admired for its diagnostic acumen
exhibited in its detailed case histories, where symptoms like feeble pulse were referred to
(2500 years before reference to the pulse appears in Greek medical treatises).
A great number of diseases, such as diabetes, rheumatism and intestinal worms were
described.The papyri prescribed many rational treatments, such as diet, physiotherapy as
well as vegetable products such as opium, aloes and castor oil, mineral products such as salts
of lead, sulphate of copper, lime and magnesia, other drugs were derived from the animal
body as gall and blood from the ox, lion and hippopotamus.
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Superficial such as gargles, inhalations,snuffs, fumigations and plasters are all employed.
The Edward Smith papyrus revealed to us that there were in early Egypt medical
practitioners who carried out dissection of the human body, organized their observations, and
based conclusions on facts they have observed.
The most important of these papyri is the Ebers papyrus which was actually written in the
early XVIII Dynasty , ca. 1550 B.C., but which was evidently complied from one or more
other books many centuries earlier. Indeed the document itself states that some portions date
from the 1st Dynasty, (for an excellent resume of the subject cf. W.R.Dawson's paper "Medicine and surgery
in ancient Egypt" New York medical times Feb 1925.), and therefore were in part at least in existence
during Imhotep's lifetime.
The Ebers papyrus contains a long list of prescriptions for numerous named ailments and
specifies the remedies to be used, as well as their doses and the mode of administration.
Evidently considerable progress had been made especially in clinical examination, diagnosis
and treatment .
The Ebers papyrus as well lengthy describes the vascular system , and the wide spread
influence of a disordered cardiac action is recognized. The heart being described as 'the
beginning of all the members'.(Papyrus Ebers ,99, I. W. Max Muller discovered some pictures which he
believed to represent surgical operations, 2500 B.C.). Egyptological Researchers, Carnegie Institution,
Washington, 1906. f. also Walsh, F. American Med. Ass., xlix,pp. 1593-5).
There is also some inkling of a circulation of the blood pulsation was perceived although the actual
pumping action of the heart was not understood. On the other hand the relation of the pulse to the
heart was well recognized. Thus the papyrus says : when the heart is diseased its work is
imperfectly performed : the vessel proceeding from the heart become inactive, so that you cannot
feel them, they become full of air and water, this latter statement Is explained by the belief that the
arteries contained air instead of blood. (Actually the vessels contain air as a constituent of the blood
to be distributed to the whole body).
In the realms of diagnosis and therapeutics, the most astounding advance had been made
indicating a real interest in disease.
Knowledge was admittedly emperic, but the accumulated experience of remedies employed during
many centuries had born rich fruit. At least 15 distinct diseases of the abdomen, 11 of the bladder,
10 of the rectum and anus, 29 of the eyes, 6 of the ears, 18 of the skin were diagnosed & treated on
definite principles. From the symptoms described in the papyri about 250 kinds of disease can be
differentiated. Evidently the physicians practiced in the bank of the Nile possessed in some measure
the scientific spirit, were capable of accurate clinical observations and competent to co-ordinate &
interpret symptoms. (Jamieson B. Hurry, Imhotep the Egyptian god of medicine).
Greek and Roman Civilization
Ancient medicine made its way from Egypt and Babylon , to Greece where the physicians were
called Asclepiads after Aesculapias, the patron god of medicine. Temples were erected for this god
and great hospitals in the vicinity. One of these hospitals was erected in the island of Cos, and it
was here that, there appeared the greatest figure in Greek medicine, Hippocrates called The Father
of Medicine (460 to 377B.C), many writings are credited to him.
He combined judgment with careful observation .his knowledge of human anatomy was gained
directly from the dissection of animals(Ancient Greeks did not permit dissection of the human
body). ( David Dietz The Story of Science p381 The New Home Library New York 4 th edition 1934)
Aristotle(384 to 322 B.C.) has been called the Father of Natural History, as an Asclepiad.
Aristotle was tutor to Alexander the Great before he ascended the throne, his three most important
works on biology are known as "Historia Animalium.
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Aristotle started the 1st library in Greece similar to the library of the university of Zios which
he joined for two years and sent to the library in Greece manuscripts and papayri which he and his
followers collected from Egypt.
Aristotle perfected his knowledge of the Egyptian language when he studied the Egyptian Faith
by the priests of the Temple of Memphis , this knowledge helped him to translate the manuscripts
( Dr Sayed Karim The Puzzle of The Egyptian Civilization.)
Aristotle is credited for the establish of The Library of Alexandria.
"Other important Greek physicians are Galen and Dioscorides. The most imminent physicians of
the greco-roman is Soranos (95-183 AD), he had a very valuable medical encyclopedia , he studied
medicine in Alexanuria (Egypt ). in the Greek era and practiced later as a physician to the Emperor
of Rome. With the rise of Rome, Greek knowledge passed into the hands of the Romans
Collapse of the Egyptian Civilization
The collapse of ancient Egyptian civilization was due to a variety of causes acting cumulatively.
One of these causes was the passing of the country under the guardianship of Rome in the year 30
B.C. Henceforth she became a vassal of the Roman Empire and was governed by its representative.
The steady drain involved by the annual tribute of corn to feed the hungry Romans, combine with
the extortions of her governor depleted the supply of the capital wealth. From this period down to
about A.D. 300 the land became more and more impoverished,
Another potent influence at work in the ancient regime was the spread of Christianity whose
doctrines were well established in Alexandria in the 2nd century and gradually being diffused
throughout the country.(Jamieson B. Hurry. Imhotep The Egyptian God of Medicine. Ares Publishers
Chicago.1987). Associated with the progress of Christianity was the growth of Christian
monasticism.
A 3rd factor in the general disruption was the introduction of Greek culture and science including
Greek medicine. Ever since the foundation of Alexandria in 331 B.C. Hellenic influence had
gradually been permeating and undermining the ancient methods of treating the sick.
Islamic and Arabic Civilization
Moslim conquest of Egypt was easy in A.D. 639 and for over three centuries Egypt became a
province of the Eastern Caliphates.(Muslims came to Egypt by invitation of the high priest of
Egypt to save the Romans without any struggle .)
During the 7th century Islamic era flourished with The Holy Koran and the Arabic civilization
quickly developed into a mature state.
Hime states in his book that. Arabic medical literature and remedies are so numerous that it
would be quite impossible to furnish even a superficial survey of such methods (as
contraception) without several years of research in many lands .and moreover on many hundreds
of Arabic manuscripts dispersed in libraries throughout the world.
Hime Medical History of Contraceptives (Book Published 1963 by Gamut Press New York p136).
Islamic scientists and philosophers dominated the field during the dark ages in Europe.
Abu Bakr al-Razy (835-925 AD ) who flourish in Ray and Bagdad was the greatest clinician of
Islam in fact the greatest physician in the middle ages. He made many contributions to gynecology,
obstetrics and opthalmic surgery, compelled several encyclopedic works, the best known was Kutab
al-Hawi (Continents}. (George Sarton. Introdution of the History of Science
(Baltimore,William & Wilkins p,1927-31 2nd vol.).
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Also a similar view was held by Ibn El-Nefis (the discoverer of the pulmonay
circulation)13thcentury (Sharh tashrih Al-Qanun)=(explanation of dissections).
He wrote a special chapter on dissecting the following parts: bones, and internal organs of the chest
(heart, lungs and the diaphragm) (Cumstone C G.: "Islamic medicine." in ( Cumstone history of
medicine from Pharaohs to the end of the XVIII century I Dowsons of Pall Mall1978 p 23-26)
Dissection in Islam was not prohibited in either the religion of Islam or the Islamic world.
In Europe according to Singer the ban upon dissection of the human bodies continued after the
renaissance. It was due to the theological concept of the sanctity of the human body and its
resurrection.
The practice of dissection for teaching purpose was approved by the Pope Clement VII (1523—
24AD). Therefore while in the renaissance, their physicians relied only on the anatomy of the Arabs
especially Avicenna --- whom no body doubted " in the middle ages, they relied only the writings
of Galen. (Gsrrison).
Galen (130-200 AD) was however criticized by eminent Islamic physicians, Rhazes, Avicenna and
others for errors in some of his works including anatomical texts. .This was confirmed by the
statement of Ibn El Nafis "that as regards the function of organs, we only rely on what is dictated by
investigations, observations and accurate research not caring whether it conformed with or differed
from the opinion of those who came before us.
Another figure is Aly ibn Abbas during the 2nd half of the tenth century ( 994 AD ) who produced a
treatise called Kamil al Sana(perfection of the art ) or (The Royal Book )the best portions being on
materia medica.
Abdallah Ibn Sina ( Avicenna) 1037. "was not only an encyclopedist, philosopher , physician,
mathematician and astronomer. He was the most famous scientist in Islam and one of the most
famous of all races and places. one may say that his thought the climax of mediaeval
philosophy.(G,Sarton :Introduction to History of Science p1709 Published for the Carngie Inst
Wash )..His book is under the Latin title Cannon Avicenne. This enormous medical encyclopedia ,
contains about a million words is a codification of the whole of ancient knowledge. (page
710),because of its formal perfection as well as its intrinsic value.
These examples prove the importance of Muslim scientists in preserving and adding to the
heritage of previous civilizations from Ancient Egyptians to Greeks and Romans throughout
eight hundred years of scientific darkness of the middle ages in Europe.
The best of the Greek and Roman knowledge began to flow back into Europe through the
Arabs universities in Spain and the Middle East.
Europe During The Middle Ages
"Surely, it is an established fact that we have found nothing comparable to the accounts of Soranos
and Aetios nothing that equals that of such writers as Aly ibn Abbas,Ibn Sina , Al Jurdani, and Ibn
al-Jami and Razy".( Norman E .Himes. Medical History of Contraception.Gamut Press, INC. New York 1939)
Though it would be fallacious to attribute the circumstances in Europe to a single factor , it is
difficult to avoid the conclusion that the rise of Christianity especially in the form of the dominance
of the Catholic Church was especially responsible. Service to the City of God was, the central
object of life, salvation in the hereafter rather than on the earth .This is not to suggest the Church
neglected to cultivate medicine. It did but, the objects were quite different from those modern
scientific medicine. (Himes p 160)
After the Middle Ages and Renaissance , Europe and U.S.A had the leading role in progress of
medicine and science.
In conclusion , civilizations followed one another in a continuous accumulated knowledge without
any gap ,from Ancient Egyptians, to the Greeks in (Greece and Alexandria )followed by the
Romans then the Arabs and the Islamic civilization throughout eight hundred years preserving the
treasures of the Greek and Roman civilizations to the new world after the Renaissance.
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All civilizations and cultures can live together in peace and prosperity ,if everybody or nation
respect the tradition and believes of the other. If all nations have a prototype of living, life will be
just like an animal farm and there will be an increase of sycological diseases and suicides.
Koran "O mankind. We created you from a male and a female and made nations and tribes, that
you may know one another"
Koran Surly the most honorable of you in the sight of God is the most pious of you. (49:30)
As shown in the text all the descendants of Abraham Judaism , Christianity and Islam have the same
believes ,with minor differences come from misinterpretation or lack of knowledge .
Koran "He has sent upon thee the Book with the truth , confirming what was before it, and He sent
down Torah ,and the Gospel aforetime, as guidance to the people ,and He sent the Salvation.(3:3-4).
Koran " and do not dispute with people with earlier Scriptures save in a good manner, except with
those of them do wrong." (3:-4)
Koran "And say we believe in what has been revealed to us, and what has been revealed to you,
and our God and your God is one.—"( 49:26)
Author.
M.F. Karim
Prof. Obf & Gyl. Ain Shams University – Cairo – Egypt.
Hon. (FRSH)
Hon. President. Society for the health of woman and child.