医学史简论 (3) A Brief History of Medicine

1. 医学史简论(3)A Brief History of Medicine YuHai ZhejiangUniversitySchoolof Medicine yuhai@zju.edu.cn

2. WhatisMedicine？什么是医学 Medicine is the art and science concerned with the maintenance of health and the prevention, alleviation or cure of disease （EncyclopediaBritannica) Medicineis the most humane of sciences, the most empiric of arts, the most scientific of the humanities (Edmund Pellegrino)

3. The Origin of Medicine 远古医学 PrehistoricMedicine： 神话和传说 mythology and legends 考古发现 archeological discovery

4. PrehistoricMedicine:myths and legends Asclepiusis the god of medicine and healing in ancient  Greek，love child of  Apollo and Coronis. His mother was killed for being unfaithful to Apollo but the unborn child was rescued from her womb. Asclepius means "to cut open.“ Daughters: Hygeia (hygiene)  and Panacea ("all-healing") Aesculapius God of Medicine and healing

5. PrehistoricMedicine:myths and legends Apollo carried the baby to the Centaur Chiron who raised Asclepius and instructed him in the art of medicine Chiron-chirurgeon -surgeon

6. PrehistoricMedicine:myths and legends The rod of Asclepius It symbolizes the healing arts by combining the serpent, which in shedding its skin is a symbol of rebirth and fertility with the staff, a symbol of authority befitting the god of Medicine.  One day Aesculapius killed a snake, but another snake emerged carrying an herbal leaf in his mouth; it placed the leaf on the head of the dead snake, which miraculously revived. The serpent became Aesculapius‘ constant companion. 

7. caduceus Caduceus Hermes-son of Zeus and Maia， Godofmessenger （Mercury）

8. PrehistoricMedicine:myths and legends God of Chinese Medicine-Shennong (Divine Farmer) - 神农氏（炎帝Yan Emperor） lived some 5,000 years ago, considered to be the father of Chinese agriculture, He is said to have tested hundreds of herbs to find their medical value.

9. 远古医学：神话和传说PrehistoricMedicine:myths and legends 黄帝 Huangdi（YellowEmperor）(2497 BC-2398 BC) • is considered in Chinese Mythologyto be the ancestor of all Han Chinese • Descendantsof Yan & Yellow Emperors (炎黃子孙，Yan Huang Zi Sun，means Chinese) • Among his many accomplishments, Huangdi has been credited with the invention of the principles of Traditional Chinese Medicine Gōngsūn Xuānyuán (公孙轩辕).

10. PrehistoricMedicine:myths and legends Qibo岐伯-“歧黄之学”(medicine, the study of Qi and Huang) Qibo is said as the minister of Huangdi, Hangdineijin is the a book comprising the dialogues regarding medicinal problems between Huangdi and Qibo. Qibo might actually have been Hippocrates-according to sinologist Paul Unschuld Tongjun桐君 Minister of Huangdi, practitioner and pharmacist (Tongjun Hill) 桐 君 歧 伯

11. Prehistoric Medicine-archeological discovery The Hemudu (河姆渡) culture  (5000 BC to 4500 BC) was a Neolithic culture in Yuyao, Zhejiang Animal part (shells of pangolin, turtle shell) and plant seeds , camphor leaves which are still used for traditional medicine were discovered in the Hemudu relics Reptile

12. Stone age man’s medicine The mummified body of iceman was discovered in the Tyrolean Alps in Northern Italy in 1991. In his possessions a birch fungus, Piptoporus betulinus was found, which contains oils that are toxic to certain parasites, thus acting as a form of natural drug. in the man's colon the eggs of a parasitic whipworm (Trichuris trichiura) Iceman lived in 5300 years ago stone age The fungus may be used as natural medicine

13. Prehistoric Medicine-archeological discovery Stone and bone needles were discovered considered to be used as acupuncture (针-金metal needle 砭-石，stone needle 箴-竹，bamboo needle)

15. trephination 颅骨环钻术 (Peru)

16. Excavatedin Dawenkou Shandong, China 山东大汶口出土 （Neolithic age 5000 year ago ）

17. Prehistoric Medicine-Trephination • Trepanation is surgery in which a hole is drilled into the human skull to treat epidural and subdural hematomas 1497 18th Century French

18. 颅骨环钻术（穿颅术）Trephination (7000-3000B.C. Neolithic period) for both medical reasons (epileptic  seizures, migraines and mental disorders and mystical practices by letting evil spirits escape done by wizard

19. Prehistoric medicine-witch-doctor Prehistoric societies believed in both the natural and supernatural being able to variably cause and treat disease. It was believed that evil spirits could inhabit the body and cause illness within someone.   Medicine Men (witch-doctors/shamans) maintained the health of their tribe by gathering and distributing herbs, performing minor surgical procedures  providing medical advice and supernatural treatments, such as charms, spells and amulets  to ward off evil spirits 巫医 Witch-doctor

20. 医字的演变Evolution of the character 医 醫 毉 酉winealcohol 巫 witch wizard

21. 古代四大文明 Mesopotamia China India Mesopotamia Egypt

22. 古埃及的医学 Ancient Egypt 4000 B.C. Invention of hieroglyph 3100 B.C. First dynasty

23. 古埃及的医学Ancient Egypt 伊姆荷太普(Imhotep） was an Egyptian polymath who served under the Third Dynasty king Djoser (2650 BC-2600 BC) as chancellor to the pharaoh and considered to be the first engineer, architect and physician in history known by name. The founder of Egyptian medicine and the God of Medicine

24. 古埃及的医学 Ancient Egypt The embalming of mummy shows highly advanced the knowledge of human anatomy and preservation technique Brain- sinuses ethmoidal

25. 古埃及的医学Ancient Egypt CT scanning for mummy of Tutankhamun to find the cause of death (gangrene  after breaking his left leg ) Tutankhamun (1341–1323 BC)

26. 古埃及的医学 Ancient Egypt 2000-1500BC纸草(Papyrus)文献 The Ebers papyrus (circa 1550 BC) is full of incantations and foul applications meant to turn away disease-causing demons, and also includes 877 prescriptions. Edward Smith Papyrus is a textbook on surgery and details anatomical observations and the examination, diagnosis, treatment, and prognosis of numerous ailments. It was probably written around 1600 BC, but is regarded as a copy of several earlier texts. Medical information in it dates from as early as 3000 BC.  Imhotep  is credited as the original author of the papyrus text.

27. 古埃及的医学Ancient Egypt • Other information comes from the images that often adorn the walls of Egyptian tombs and the accompanying inscriptions.  • A ceremonial circumcision. In the tomb of Ankh-ma-hor of the 6th Dynasty (circa 2200 BC)

28. Ancient Egyptian medical instruments depicted in a Ptolemaicperiodinscription on the Templeof Kom Ombo. Avictim of Poliomyelitis with typical polio-derived equinovarus 18th Dynasty1405-1356 BC

29. 古巴比伦的医学Ancient Babylon Cradleof civilization 5000-4000 B.C Sumer 2000 B.C. Babylon 7th century  Islamic Sassanid Empire (Iraq) The Hanging Garden and Tower of Babil

30. 古巴比伦的医学Ancient Babylon Well developed astronomy, mathematics and medicine The most extensive Babylonian medical text, however, is the Diagnostic Handbook written by the physician Esagil-kin-apli, If a patient could not be cured physically, the Babylonian physicians often relied on exorcism to cleanse the patient from any curses. 楔形文字 cuneiform (arrowheaded characters; wedge-shaped characters)

31. 古巴比伦的医学Ancient Babylon Code of Hammurabi (the sixth Babylonian king1792-1750 B.C) contained 282laws，law 215~240is concerned about physicians, barbers and architect etc. Louvre Museum in Paris discovered in 1901

32. 古印度的医学 Ancient India Indus Valley Civilization back to c.3300 BC Four period of ancient Indian medicine: Veda Brahman Buddhist Hindu。

33. 古印度的医学 Ancient India Indian Medicine vadic period 1500 BC-500 BC Ayurvedic period 500BC-600AD Islamic period 1300-1600 AD Western Medicine 1600 AD- Sanskrit The three doshas (energy)(Vata, Pita,Kapha)and the 5 great elements(Ether,Water,Fire,Earth,Air) from which they are composed (Vata= air+ether, Pita=fire+water, Kapha=earth+water). Body constitutions are depends the proportion of different doshas Taj Mahal Mausoleum

35. 古印度的医学 Ancient India Sushruta (Around 800 BC) was an ancient Indian surgeon and is the author of the book SushrutaSamhita, in which he describes over 300 surgical procedures and 120 surgical instruments and classifies human surgery in 8 categories, so he is horned as the father of surgery. 妙闻 Sushruta

36. 印度鼻成形术 ItalianGasparo Tagliacozzi （1546－1599） with skin flap from forearm Indianrhinoplasty first developed by Sushruta

37. 中国传统医学Traditional Chinese Medicine 《山海经》Shanhaijing, an encyclopedia compiled in Spring-autumn and warring period (770-221 BC) 137 drugs recorded including 76 animal drug and 54 plant and 7 others with clear medical effects Nipples as eye Navel as mouth

38. 中国传统医学Traditional Chinese Medicine 《黄帝内经》The  Huangdi Neijing (Inner Canon of Huangdi)compiled in warring states period（475-221 B.C）is the fundamental doctrinal source for Chinese medicine The work is composed of two texts each of eighty-one chapters or treatises in a question-and-answer format between Huangdi and his ministers. 素问 灵枢 （suwen and lingshu）

39. 《神农本草经》Shennong Bencaojing First compiled in Western Han Dynasty (202BC-26AD) This work is considered to be the earliest Chinese  pharmacopeia. It includes 365 medicines derived from minerals, plants, and animals. ” 中国传统医学Traditional Chinese Medicine

40. 中国传统医学Traditional Chinese Medicine 哲学基础- “阴阳五行” Philosophicalbasis- Yingyang and 5 Element theory

41. 中国传统医学Traditional Chinese Medicine Zhang Zhongjing (张仲景), “the Hippocrates of China”, who was mayor of Changsha toward the end of the 2nd century AD, wrote a  Treatise on Cold Damage (伤寒论）, which contains the earliest known reference to Neijing Suwen. 张仲景150-219

42. 中国传统医学Traditional Chinese Medicine • Hua Tuo (华佗）Eastern Han physician  (c. 140 – c. 208 AD), who anesthetized patients during surgery with a formula of wine and powdered hemp (麻沸汤）. Hua‘s physical, surgical, and herbal treatments were also used to cure headaches, dizziness, internal worms, fevers, coughing, blocked throat, and even a diagnosis for one lady that she had a deadfetus within her that needed to be taken out. 

43. 中国传统医学Traditional Chinese Medicine Huangfu Mi (皇甫谧），the JinDynasty practitioner and advocate of  acupuncture and moxibustion  (215 - 282 AD), also quoted the Yellow Emperor in his Zhengjiu Jiayi jing (针灸甲乙经), ca. 265 AD. 皇甫谧（215－282）

44. 中国传统医学Traditional Chinese Medicine Li Shizhen (李时珍)(1518-1593 AD) created “Bencao Gangmu.” (本草纲目）Itcontains 1892 herbs, classified in 6 sections, 52 scrolls, and 60 categories. 李时珍1518－1593）

45. Origin of Medicine EgyptBabylon IndiaChina Greek Rome Mediaeval Arabia (Islamic) Renaissance Pre-modern medicine Modern medicine TCM

46. Student Presentation • Time：3/21，3/24 and 3/28 • Topic: Any thing related to History of Medicine • Grouping: 3-5/group, on volunteer basis • The list of each group and the name(s) of presenter should submitted by 3/20 to yuhai@zju.edu.cn • Each presentation should be less than 10’ with ppt, followed by 5’ discussion.

47. Thanks