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MINISTRY OF PUBLIC HEALTH OF THE REPUBLIC OF
KAZAKHSTAN
KARAGANDA STATE MEDICAL ACADEMY
N.F. Saifulina, G.F. Galina
LECTURES ON HISTORY OF MEDICINEEducational manual
KARAGANDA, 2008
УДК 61(09)ББК 63.3+5 я 7 S16
REVIEWERS: D.M. Dzhangozina - department of pharmacognozy with course of medical –biological disciplines of Pharmaceutical Institute of Karaganda University “Bolashak”, head of department, d.m.s., professor.F.A. Mindubayeva – physiology department of Karaganda State Medical Academy, head of department, d.m.s., professor.O.K. Nikitina – department of history of Kazakhstan and social-political disciplines of Karaganda State Medical Academy, head of department.
S16 Saifulina N.F., Galina G.F. Lectures on history of medicine. - Educational
manual.- Karaganda.-2008. – p. 101
ББК 63.3+5 я 7
There was description about development of doctoring and medicine in all periods of world history since the primitive system to present times in the educational manual. The educational manual was prepared according to the model program on discipline “History of medicine” approved by the Department of medical science and education in 2005y. Lectures are intending for medical students, post-graduators, residents and broad circle of the readers taken an interest in history of medicine.
Discussed and approved at the meeting of Methodical Council of KSMAProtocol № 7 of 12.03.2008Confirmed and recommended for edition by Academic Council of KSMAProtocol № 8 of 28.03.2008
© N.F. Saifulina, G.F. Galina, 2008
2
CONTENTS
Introduction …………………………………………………………………... 4
1. History of medicine as science and subject of teaching. Medicine in epoch of the primitive communal system……………………………… 5
2. Medicine in the slave-owning states of Ancient East: Babylon, Assyria, Egypt, India and China………………………………………. 17
3. Medicine development in Ancient Greece and Ancient Rome………… 27
3.1Medicine in Ancient Greece…………………………………………… 27
3.2 Medicine of Ancient Rome…………………………………………….. 36
4. Medicine during the period of feudalism in the countries of East and Western Europe……………………………………………………………… 42
5. Medicine development in capitalism epoch in Western Europe and Russia…………………………………………………………………………. 60
5.1. Medicine development in Western Europe…………………………… 60
5.2. Medicine development in Russia……………………………………… 69
6. Medicine development in Kazakhstan………………………………… 78
Test for the control of knowledge…………………………………………… 93
3
Introduction
The history of medicine as a science and a subject of teaching have great
importance for education of the future doctor, formation of his scientific thinking
and ethics, expansion of general cultural and medical outlook, it allows to make
representation about medicine as the developing science and brings up patriotism.
Being a component of the general history of science and culture, history of
medicine reflects struggle of ideas, as in past as in the modern world, gives criteria
for right estimation of medicine’s theories and understanding of the present stage
of medicine and public health development.
The scientific discipline “history of medicine” studies laws of development
and history of doctoring, medical knowledge and medical activity at all people of
the world during the all periods of history of mankind (since the ancient times till
the modern time). It is in integrative connections with development and changes of
socioeconomic structures, history, philosophy, achievements of natural sciences
and culture.
History of medicine as the subject of teaching is independent discipline though
separate data on medical specialties’ development are studied on corresponding
theoretical and clinical departments of medical high schools. They detail and
supplement materials of the course of medicine history (life and activity of
prominent doctors and scientific-physicians, scientific achievements of their
schools, history of discoveries, etc.).
Being separated and not connected among them in historical sequence, these
data cannot replace the complete and systematized course of medicine history. On
the basis of historical and logic methods there are studied development of medicine
directions and theories as the world- historical process, bases of historical-medical
education of the student - doctor.
4
1. HISTORY OF MEDICINE AS SCIENCE AND SUBJECT OF
TEACHING. MEDICINE IN EPOCH OF THE PRIMITIVE COMMUNAL
SYSTEM
History of medicine as science and subject of teaching.
Significance of history of medicine in the system of higher education
Medicine, as knowledge, is result of long and difficult process of
development. Medicine presents definite stage of development in connection with
health and diseases of people, what is why to study history of medicine is need in
historic development. Past study helps us to understand better present, to fore see
future.
Present is characterized by speeded up development in all fields of
knowledge, including medicine. It is increased the role of independent thought of
every specialist. Doctor‘s profession requires logic thought, to find correlation
between past events and modern scientific achievements, to correctly decide.
History of medicine is science which study development of medical activities
and medical knowledge in the connection with development and changes of
social-economic structures, with people culture. Significance of history of medicine
is to display role and achievements of scientists in medicine development, their
place in world progress. Scientists influence on adjacent field of science and
practice is promoting comprehension of tasks of public health. Doctor’s activity
was and is directed on care attitude and conservation of environment which
influence on health and study social –economic and social-cultural conditions in
which originated and developed medical science and practice. Study of each
medical discipline begins from analysis of historic development. It allows to learn
well medical material and to realize creative potential of student or young
specialist.
5
Study sources of history of medicine
History of medicine is obliged by its existence to sources. Sources are
divided into natural (physical, chemical, biological, etc.) and social (historic,
philosophical, etc.). Historic sources are subdivided into primary sources and
secondary sources. Primary source is an object, created by person on the base of
subjective image of objective world. Secondary source is based on various primary
sources, on the one hand, summing up, on the other hand, analyzing and
comparing it. Primary source often reflects concrete, particular fact, events or
phenomenon, but secondary source reflects total sum of facts, events and
phenomenon.
According to classification, proposed in 40th years of XX c. by professor
Tikhomirov M.N., and a more precise definition was given by professor Pronshtein
A.P., all historic sources are divided into 7 main groups: written, material,
ethnographical, verbal (folkloric), linguistic, cinema-photo-documentary, phone-
documentary.
Written source are monuments of past, which were passed with help of
graphic signs, i.e. manuscript or printed document on paper, papyrus.
Epigraphic sources are similar to written sources. They are inscriptions on strong
materials- stones, trees, clays, etc. Epigraphic material is transitional group
between written and material sources. Written sources can be original or copy.
Material sources are different by shape. Main parts of them are archeological
monuments, which are important for study of before written period. Material
sources also include paleoanthropological material (fossil relics of man).
Ethnographical sources are phenomenon of cultural and social life, inherited
from previous epochs, preserved by memory and continue to exist in new form in
present time. They are superstitions, beliefs, customs, and rites.
Verbal (folkloric) source is a source, created by people and characterized by
verbal form of transmission, shape of reality. This source does not contain precise
6
information about persons, facts, events. Folk-lore is important part of people
culture and history of culture, is creation of mass with class features, with own
people estimation of historic events.
Linguistic sources are reflection of real historic reality in speech form.
Typical peculiarities of language can serve sources for solving of scantily explored
problems: relationship and interrelation between whole groups of people, border of
settling on early period of development of human society.
Cinema-photo-documentary is source which originated due to development of
photography and cinematography. Photography is static document of history.
Cinema-photo-documentary fixes events more precisely and can reproduce past.
Phone-documentary reflects sound side of historic fact and present
phonogram which made at the instant of event.
Transitional groups of sources between material and written are works of
small forms of imitative arts which are coins, medals, stamps, post-cards and etc.
They are object of study for auxiliary historic science like numismatics, philately,
phylocratics, etc.
Philately is a science about signs of post payment and their collection.
Medical themes can be presented by sections: “Prominent workers”, “Struggle
against tuberculosis”, “Medicinal plants”, “Work of Red Cross”, etc.
Philomenia is a collection of match-boxes. It aroused in 30-th years of XIXc.
Medical themes can reproduce by labels.
Phylocratics is a collection of post-cards. Many post-cards devoted to
prominent medical workers.
Ex-libris from Latin means “from books”. There were medical symbology
and attributes in ex-libris.
Numismatics is a science about coins, which study their picture, legends,
weigh, size and quality, area and time of their circulation, technique of making.
Numismatics is not only science about coins, but medals also.
7
Bonistics is auxiliary historic discipline, which study paper monetary signs.
Paper money is objective and impartial documents of history. Legends on paper
money are fixed when and who issued them, their degree of securing, area of
circulation, etc.
Phaleristics is collection of badges. Nowadays every international meeting,
congress, jubilee of institutions is accompanied by issue of badge.
Main stages of medicine development in connection with development and
changes of social-economic structures
The one compulsory requirement in study of medicine history is
appointment of stages. Right division into periods is main precondition of
scientific historic research.
Character and level of medicine development is defined by social structure,
by productive forces, productive relations, and by level of knowledge.
History of medicine is divided into epochs, social-economic structures: primitive
communal system, slave-owning system, feudal, capitalist system and socialism.
Medicine has original features in every system. Medical science and practice
changed in connection with changes in economics, science and technique of each
epoch.
History of medicine visual shows progresses and changes in medicine, as
changes in society life.
Development of medicine during the epoch
of the primitive-communal system.
Becoming of the primitive society and origin of doctoring
(more 2 million years ago - about 40 thousand years ago)
8
The history of mankind begins with the advent of the human, since that time
they appeared labour activity. The primitive history covers more than 99 % of all
history of mankind. Through a primitive-communal system have passed all
peoples of a planet, therefore great value has studying the initial stage of mankind
for correct understanding of all subsequent course of its historical development.
Transition from the nearest ancestors of the human /Australopithecus/ to
hominid subfamily was on a boundary tertiary and quaternary periods. The
hypothesis about an origin of the human from fossil humanoid monkeys has been
put forward by Ch .Darwin He had developed the concept about evolution of
animate nature on the basis of a principle of natural selection which has stated in
work "The origin of species by natural selection, or preservation of the elected
breeds in struggle for a life" (“The Origin of Species by means of nature
selection”, 1859).
There are two approaches in an establishment of border between fauna and the
human: anthropological and philosophical. The biological originality of the
human, his morphological differences from the nearest ancestors are the basis of
the anthropological approach This difference is defined by the hominid triad: 1)
erected man, or biped; 2) free hand with opposable big finger, hand able to do thin
labour operations; 3) rather large mature brain.
Signs of hominid triads were generated at different stages of evolution so erect
pacing was developed at the end of the tertiary period at Australopithecus, free
hand - on a boundary of the lower and average Paleolithic periods, an advanced
brain at a stage Paleonthrop.
In a basis of the philosophical approach to definition of border between fauna
and the human was the social essence of the human - his thinking, language, social
relations, labour activity.
One of the major problems of anthropogenesis is the question about home of
mankind. By the opinion of Ch. Darwin, an ancestral home of mankind is the
African continent where live most close to the human anthropoids - chimpanzee
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and gorilla. Last finds of remains of the most ancient hominids are the evidence of
the African ancestral home of mankind. But there are also other points of view.
The final decision of this question can probably only on the basis of the further
scientific researches.
The primitive human herd was the early form of the organization of the
ancient people. The most ancient people (arhanthrops) were erected, carried on
nomadic or semi-nomadic way of life. Their labour activity promoted formation of
primitive articulate speech, sources of languages, development of thinking and
consciousness. Paleopsychology defines 3 spheres of the primitive human
consciousness: 1) empirical experience, 2) generalizations of results of empirical
experience and 3) abstract consciousness. The first and second spheres are
chronologically inseparable and have arisen together with primitive thinking,
articulate speech and sources of languages. The third sphere of consciousness -
abstract thinking of arhanthrops has been still insufficiently developed, therefore
on early stages of anthropogenesis there were no burials and cults of died,
religious representations and magic actions, was not rocky figures and other
rudiments of primitive art.
Ancient people (paleonthrops) - ancestors of the human of modern kind - have
created the stone industry, were engaged in collecting, fishery, hunting, supported
fire, skins of animals were used for manufacturing clothes, warming of dwelling.
The first burial places (in caves of Le-Musteua, La Ferassi in territory of France;
in Keek-Coba in Crimea), testify to perfection at of abstract consciousness.
Thousand-year acquaintance of the most ancient and ancient people with
properties of plants has allowed them to singled out by empirical way suitable
plants for a feed, poisonous and medicinal substances.
Doctoring during the prosperity of primitive society
(about 40 thousand years ago - X-V millenniums B.C.)
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The anthropogenesis process and becoming of the modern kind human- Homo
sapiens have come to the end to the beginning of the upper Paleolithic period.
Hominid triad was finally generated. Oicumena has considerably extended. The
adaptation to various environmental conditions and formation of modern races
(Negroid, Europiad, Mongoloid and Austroloid) were in parallel ways.
Developments of collectivism, gun techniques, invention of a bow and arrows
(XIV-VII c.c. B.C.) have led to rise of productive forces. Early tribal community
of hunters, collectors and fishers, and later - the developed tribal community of
farmers and cattlemen were aroused.
The early tribal community of hunters, collectors and fishers was quite
generated human society. The woman was the most stable part of a society in
early human collectives. She cared of children, kept house. The cult of mothers –
the original mothers, hearth’s keeper was in that time. Man and woman were
equal, the head of a clan could be both either the woman, or the man.
Rational and irrational notions were closely bound in spiritual culture of early
tribal community. Result of rational outlook was knowledge and methods of
doctoring. Natives of Australia lived in the Stone Age. They cured diseases of a
stomach, stopped bleedings by ashes, webs; they made washings by urine and put
clay at skin diseases; they could splint, phlebotomy, used medical products of
vegetative, animal and mineral origin. They could do ritual circumcision and
Cesarean section. The first surgical tools were stone and bone knifes, the fish
scales, thorns and prickles.
By the empirical way natives of America used narcotics as anesthetics.
Cactuses’ juices and extracts were used as anesthetics within several days.
But knowledge of the primitive human was not so large. The primitive human
thought, that he was related to animals and plants which had human properties.
Thus, early kinds of beliefs have arisen: totemism, fetishism, animism and magic.
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Totermism is a religious belief that is frequently associated with shamanistic
religions. The totem is usually an animal or other naturalistic figure that spiritually
represents a group of related people such as a clan.
Fetishism is attributing some kind of inherent value or powers to an object.
For example, the person who sees magical or divine significance in a material
object is mistakenly ascribing inherent value to some object which does not
possess that value. A fetish (from French) is an object believed to have
supernatural powers, or in particular a man-made object that has power over
others.
Animism (from Latin anima, "soul") is the belief that souls inhabit all or most
objects. Animism attributes personalized souls to animals, vegetables, and
minerals wherein the material object is—to some degree—governed by the
qualities which compose its particular soul. Animistic religions generally do not
accept a sharp distinction between spirit and matter, and they generally assume
that this unification of matter and spirit plays a role in daily life. Animism (soul,
spirit) - belief in souls, spirits and general spiritual of nature.
The magic (sorcery) is belief in ability to human influence on other people,
subjects, events or natural phenomena by supernatural way.
There was also a medical magic - magical doctoring of wounds and the
illnesses, based on cult practice. Primitive cult practice was finally arranged
during the period of advanced tribal community.
Anthropologists studied primitive societies in the 19th and early 20th centuries.
Among them treatment for injury and sickness was a mixture of common sense and
magic. People knew, of course, that falls cause broken bones and fire causes burns.
Animal bites or human weapons cause wounds. Primitive people had simple
treatments for these things e.g. Australian Aborigines covered broken arms in clay,
which hardened in the hot sun. Cuts were covered with fat or clay and bound up
with animal skins or bark. However primitive people had no idea what caused
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illness. They assumed it was caused by evil spirits or magic performed by an
enemy. The 'cure' was magic to drive out the evil spirit or break the enemies spell.
The later tribal community of farmers and cattlemen is characterized, first of
all, by transition from an appropriating economy to making productive agriculture
(from IX-III millennium B.C.) and to rearing of pets (from VI-III millennium
B.C.)
During this period of a mankind history a dog, a sheep, a goat, the bull and a
horse have been domesticated; spinning, weaving, ceramics, wheel transport and a
sailing boat construction of buildings from a brick have been invented.
Complication of production activity of the primitive human has expanded a
circle of his knowledge: accounting devices were appeared, religious notions were
complicated. Notion about disease was as installation in a body of ill spirit of died
ancestor. It influenced on methods of doctoring which purpose became
banishment of spirit of an ancestor from the patient’s body. The ritual ceremony
was operation of craniotomy. The first of the fossil man has been found in Latin
America - in area of Cusco (Peru) in 1865. The analysis of trephined skulls
shown, that in most cases (about 70 %) trepanation was successfully operated:
formation of a callus testified to it.
The skull with a high brain box which belonged to the Europiad man (V-IV
B.C.) was found in the place Karabie (Karaganda region). On the left temporal
the skull had trepanation as 5 holes drilled one after another. Scientists
established, that trepanation was made by a metal drill. On trepanation of the fifth
hole the vessel, probably, has been touched, and hemorrhage became the reason of
death.
Modern neurosurgeons were surprised by great skill of their colleague of VI c.
The skull was found out in the south of Kazakhstan.
The primitive human thought, that through the hole in a skull the disease’s
spirit could leave the body of the patient. On island Uvei in the Pacific ocean till
13
the middle of XIX c. absolute trepanation of skulls in newborns was exist as
preventive measure.
Many things of the primitive human usage were widely adopted in present
time: efedrum as a herb was known in China 5 thousand years ago. Medical
properties of cinchona had opened by Hincks. Adonis vernalis was used as drugs
for dropsy and breathlessness. Special knowledge was used in national medicine.
Knowledge of curative properties of some plants, herbs, leeches, mineral waters,
pitches of plants and many other things is inherited to us from national medicine.
Economic and social development of mankind during the advanced tribal
community has prepared preconditions for origin of the private property and
decomposition of the primitive-communal system which has begun before all in
fertile valleys of the largest rivers of our planet.
Doctoring during the period of the primitive society’s decomposition
(since X-V millenniums B.C.)
Decomposition of the primitive society passed in two forms: patriarchy and
late matriarchy which developed in parallel ways.
Patriarchy was more extended. The leading economic and social role of the
man was formed the social inequality.
Matriarchy was the rare form of decomposition of the primitive-communal
system and it was developed, when the public inequality was formed at leading
economic role of women. There were the tribes (hyraces, minanckbas, etc.) living
on traditions of matriarchy on our planet.
Process of decomposition of the primitive society in more favorable economic
regions had come to the end to III-II millennium B.C. (Mesopotamia, Egypt, basin
of Hind). In the least favorable areas of Oceania, Australia, Africa it is going on.
At the end of this period the major event was the invention of hieroglyphic
writing in IV c.B.C.: first at Sumerians and Egyptians, and later at Chinese.
14
Development of doctoring skills, usage of medical products, medical tools
from metal, and amputation of limb began to be applied. Obstetric aid was
improved.
Strengthening of the tribal organization promoted to development of religious
notions and professional servants of a cult have appeared. Their basic activity was
doctoring. Now in some countries of Asia, Africa, on islands of Oceania national
doctors-sorcerers are exists. Sorcerers are people with a high professional
standard. So, in Africa pupils of sorcerers forced to breathe up to a faint a smoke
in a special hut, and then they stood the test with big ants. In India since the
childhood pupils -vedyi should study medicinal substances, ways of their
preparation and usage, and also various spells and magic methods. If illness was
mighty evil, the healer should be more the big exorcist of demons. Frequently
sorcerers in the primitive society combined usage of special methods and medical
products: at treatment of gastrointestinal disturbance the patient drunk grasses’
extracts, at some other diseases he was whipped nettle. For treatment “magic
influence” was used: amulets which were frequently applied in a combination with
medicines. So, in beads of amulets was the medicinal substance. Amulets from
garlic were applied at such diseases, as a scarlet fever and diphtheria.
Thus, the medicine during an epoch of the primitive-communal system has
arisen and developed as a result of activity of primitive people at all stages of their
existence. Doctoring and usage of medical products were changed and improved
together with evolution of the society.
Experience taught primitive people to use natural medical remedies, to collect
plants and to prepare medicines, to apply antidotes, to use medical properties of
animals’ bodies. Numerous medical methods and medical products were the basis
of national medicine and national doctoring.
As a whole the primitive human had rather poor arsenal of medical products
and methods. Being weaker than his enemies, he created around himself other
15
nature and became the mightiest powerful creature on the Earth changed the
world.
According to world history stages, the end of the primitive society coincides
with the beginning of the history of class societies when have appeared first
slaveholding states 4000 years ago. But the rests of the primitive-communal
system were kept in all class societies during all their history.
BIBLIOGRAPHY
1. Арцишевский А. Этюды о врачевателях и фармацевтах /А.
Арцишевский //Казахстанский фармацевтический вестник. - 2002. -N 1. -C 8-
9; 2005.-
№ 16.- С 10-11.
2. Богоявленский Н.А. О значении данных археологии при изучении истории
отечественной медицины /Н.А. Богоявленский.- //Из истории медицины: Сб.
ст.- Рига, 1963.- С. 71-79.
3. Грибанов Э.Д. Источники изучения истории медицины и здравоохранения /
Э.Д. Грибанов.- Москва, 1980.- 19с.
4. Заблудовский П.Е. История медицины: Избранные главы /П.Е.
Заблудовский. - М.: Медгиз, 1953. – Вып. 1. - 88с.
5. История медицины / П.Е. Заблудовский, Г.Р. Крючок, М.К. Кузьмин, М.М.
Левит. - М.: Медицина, 1987. - 352 с.
6. Лисицын Ю.П.История медицины / Ю.П. Лисицын. - М.: ГЭОТАР-МЕД,
2004. -393 с.
7. Мультановский М.П. История медицины / М.П. Мультановский.-
М.:Медицина, 1967. - 272 с.
8. Петров Б.Д. От Гиппократа до Семашко: преемственность идей: [Очерки и
портреты] /Б.Д. Петров. - М.: Медицина, 1990.-168с.
9. Семенченко В.Ф. История фармации: Учебное пособие /В.Ф. Семенченко.-
М.: «МарТ»; Ростов н/Д: «МарТ», 2003.- 640 с.
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10. Сорокина Т.С. Атлас истории медицины. Древний мир/ Т.С. Сорокина. -
М.: УДН, 1981.-160с.
11. Сорокина Т.С. Атлас истории медицины. Первобытное общество. Древний
мир/ Т.С. Сорокина.- 2-е изд., перераб. и доп.- М.: УДН, 1987. - 170 с.
12. Сорокина Т.С. История медицины: Учебник для студ. высш. мед. учеб.
заведений / Т.С. Сорокина. – 4-е изд., стер.- М.: «Академия»,2005.-560с.
13. Сточик А.М. Избранные лекции по курсу истории медицины и
культурологии/ А.М. Сточик.- М.: МГП "ЭРУС", 1992.-88с.
2. MEDICINE IN THE SLAVE-OWNING STATES OF ANCIENT EAST:
BABYLON, ASSYRIA, EGYPT, INDIA AND CHINA
Epoch’s characteristics
In the conditions of decomposing primitive system the slave-owning system
was natural phenomenon. It showed wide opportunities of productive forces’
increase. Population was divided into free and slave in the slave-owning system.
Free persons were divided into class of big landowners (they were also big slave-
owners) and class of small producers (artisans, peasants). Priests played big role in
the epoch of slavery and they were big landowners and slave-owners.
Ancient East was cradle of human culture. Transition from primitive system to
slave-owning system happened there earlier than in other places. Slave-owning
system prevailed in Mesopotamia and Egypt (IV-III millennium B.C.), India (in
the middle of III millennium B.C.), China (II millennium B.C.), Transcaucasus
(state Urrartu, I millennium B.C.).
Predominant political system was despotic monarchy with survivals of tribal
system. Influential caste was priests.
Before some millenniums B.C. first sources of materialistic ideology and
knowledge about nature had occurred to East people. Materialistic thought of
17
Ancient East considered world as it is, wanted to understand it as dynamic and
developed single whole.
Common features of medicine development in slave-owning states
of Ancient East
Invention of a written language (since IV millennium B.C.) and creation of
first medical texts (since III millennium B.C. in Sumerians).
Forming of two direction of doctoring: 1) Folk (empirical) doctoring based on
practical experience of people and 2) Cultic (temple) doctoring based on religious
beliefs;
Notion about diseases origin (moral-ethic, connected with nature, with
religion);
Teaching of doctors -healers (family tradition and study in temple schools);
Creation of ancient sanitary-hygienic constructions. Development of hygienic
skills;
Class approach of doctoring in class society. Forming of medical ethics’
basics;
Mutual influence and succession in doctoring development in ancient
civilizations.
Medicine of Babylon and Assyria
The name Mesopotamia (meaning "the land between the rivers") refers to the
geographic region which lies near the Tigris and Euphrates rivers and not to any
particular civilization.
Babylon state appeared in the end of III-beginning of II millennium B.C.
18
Later in I millennium B.C., state Assyria arose in the south-eastern part of
Mesopotamia. The main place in economic and cultural development, especially in
medicine belonged to Babylon.
Numerous monuments testified to medicine existence in ancient slave-
owning states, which were between rivers Tigris and Euphrates - Babylon kingdom
(XX-IV B.C.) and Assyria (XV-VII B.C.).
Babylon kingdom reached high growth in the old-Babylonian period, great
ruler Hammurabi (1792-1750 B.C.) created powerful state during his reign for 42
years. After his death Babylon was many attacked by conquerors.
Great monument of Babylonian legislation – laws of King Hammurabi
(XVIII B.C.). These laws summarized all old laws. Articles, which engraved on
basaltic pillar, were devoted to activity of doctor and his responsibility.
Hammurabi, a great king of Babylon who lived around 2000 BC formulated
a set of drastic laws known as the Code of Hammurabi that governed the conduct
of physicians and provided for health practices. Doctors whose proposed therapy
proved wrong ran the risk of being killed. Laws relating to medical practice,
including fees payable to physicians for satisfactory services and penalties for
harmful therapy are contained in the Babylonian Code of Hammurabi, the very
first codification of medical practice. While the code of Hammurabi reflected a
high degree of social organization, the medicine of his time was devoid of any
scientific foundation.
Babylon’s neighbor was Assyria, which reached high growth by statesman
Assurbanipal (668-about 626 B.C.). During his reign, large royal library was
created in Nineveh. It had collection of clay tables. As a rule, tables began from
words “If a man ill …” The detailed description of disease’s symptom and advices
about preparing and use of medicine. Table ends with words “…he will recover”.
There were two different types of medical practitioners in Mesopotamia:
asutu (translation “art of doctors”) and ashiputu (“art of charmers”). Both
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traditions remained till the second half of I millennium B.C., then they became
one, closer to ashiputu.
Notions about diseases divided into three categories:
1. Supernatural reasons – “God’s hand”, “whiff of vicious ghost”, “embraces
of Lamashtu” (Old woman Lamashtu walked in night and spread children’
fever).
2. Retribution for violation of ritual, lawful, moral and other directions in
community.
3. Natural reasons, connected with nature phenomenon and way of life (usage
of unhealthy food, bathing in dirty river).
Doctor-asu thought that origin of diseases depends from natural reasons. His
prognoses were optimistically: “he will recover”, “he must treat”.
Doctoring of asu based on practice of doctor-empiric: his intuition plus
acquired knowledge. His aims of treatment were real: “to stop fever”, “lead
oedeata (hypostasis) ”, etc. Doctors - asu were great experts on medical flora. They
gathered, kept and made drugs by themselves. They cooked on honey, vinegar,
water or fat and used it as ointment, powder, pills, suppositories and plugs.
Ashipu’s set of medicinal remedies was less than asu’s set. But there were
instructions for using medicines. For example, “pound a sage and mix with oil, say
the conjuration three times and put on teeth”. This conjuration “Exorcism against
toothache” is great work of art of Ancient Mesopotamia.
Main method of doctoring ashipu was reading of invocations. Diagnosed a
disease and its cause, ashipu made prognoses before treatment. There were
inauspicious prognoses in his texts: “he will die”, “he will not recover”. Favorable
prognoses were rarely: “he will live”, “his disease will go”. If prognosis was
hopeless, ashipu didn’t treat.
Body structure was unknown in Mesopotamia, dissection didn’t make, but
dissections of sacrificial animals gave only common notion about internal organs:
liver, kidney, heart, stomach.
20
Only women were engaged in delivery (birth).
Big role played astrology in culture and in medicine of Assyrians and
Babylonians. They had astrologic calendar, there they defined star-location, good
or bad date for operation, for delivery, etc.
At the excavations of ancient towns (Babylon, Nineveh), remainders of
roadways, sewerage, and water pipes were found. Laws about sending away of
sick persons who had infectious disease.
Like in other countries of Ancient East, treatment was available for rich men
in Babylon. Greek historian Herodotus (V B.C.) described distinctive custom for
treatment of poor men: they went into streets and people, who were there, gave
poor men advices, based on their experience.
Medicine development in Ancient Egypt
The ancient hearth of Egypt civilization was lower reaches of the river Nile,
there appeared first settlements in VI millennium B.C., and then they became
cities-states. United state aroused about 3200 B.C.
Sources about medicine in Egypt are numerous hieroglyphic inscriptions on
sarcophagus, pyramids and papyruses (rolls, which were made from plant-papyrus
in the valley of the Nile.) More famous medical papyruses are: papyrus from
Kahun (about women’ diseases, 2000 B.C.), Smith’s papyrus (devoted to surgery,
1500 B.C.), big medical papyrus of Ebers (middle of II B.C.), Brugsh’s papyrus
(about 1450-1350 B.C.) devoted to treatment of children’s diseases. Papyruses
were studied especially by Russian Egyptologists.
The first doctor known to history was Sekhet-eanach who 'healed the pharaoh's
nostrils'. The second doctor we know of was Imhotep (2600 B.C.) who was vizier
or prime minister to the pharaoh. He was also a doctor and he was so famous that
after his death he was worshipped as a god.
21
Ancient Egyptians knew mathematical, astronomical, geographical and medical
knowledge. Knowledge acquisition in anatomy was lightening by methods of
embalming and mummification of dead body. Used in Egypt anatomical terms
testified about knowledge of internal organs: brain, liver, heart. Egyptians
emphasized heart with 22 divergent vessels.
Egyptians book described diseases of enteric, respiratory tract, skin,
bleeding, elephantiasis, eye diseases (widespread), and fever. Greek historian
Herodotus, traveled in Egypt in V B.C. said that “Egyptians had the doctors on
every body region”. It was evidence of doctor’s specialization in Ancient Egypt.
Big development achieved medical cosmetics; Egypt considered the land of
cosmetics. Only nobility could presume that medical branch. Rich people used of
massage, water-treatment, expensive drugs.
Military doctors what accompanied Egyptian host saved up knowledge about
treatment of wounds, fractures and traumas. Egyptian doctors used a huge range of
drugs obtained from herbs and minerals. They were drunk with wine or beer or
sometimes mixed with dough to form a 'pill'. Egyptian doctors also used ointments
for wounds and they treated chest complaints by getting the patient to inhale steam.
There were pictures of operations on tombs in Ancient Egypt.
However the Egyptians still believed that spells would help the sick and they
carried amulets to ward off disease. Nevertheless they were beginning to seek a
physical cause for illness.
Ancient Egypt was hearth of worm’s diseases. Moreover the Egyptians were
clean people. They washed daily and changed their clothes regularly, which must
have helped their health.
There were temple shelters chiefly for lunatics as in Mesopotamia as in Egypt.
They were more isolator, then treatment institution. These shelters were prototype
future hospitals attached to monasteries.
The profession of dentist was existed from of old in Egypt. Disease of tooth
and gums were described in papyruses. Toothache was explained by Egyptians as
22
worm is growing in tooth. Researches of mummies of Ancient Egypt revealed
about widespread inflammatory diseases of periosteum, which result was jaw’s
changes and falling of tooth. Even pharaohs had not stomatologic intervention:
packing of carious cavities, tooth filling by gold and other metals. Only witnesses
of tooth gold usage in Ancient Egypt were discovery of two lower molar (tooth)
which were connected by thin gold wire.
There were found diseased tooth on cemetery. It testified to stomatology was
conservative. Treatment was in medical pastes and solutions applying on disease
teeth. Papyruses of Ebers described about 11 prescriptions for sanitation and
treatment of tooth and gums. It helped to localize pain, but not to stop further
development of diseases.
They employed ointments, water solutions, bathing, enema (invention of
Egyptians), compresses, lotions, and plasters for treatment. Widely were used
plants, stones, salt. Products of organic origin (fats, animal blood, honey, livers,
etc.) were used.
Means for treatment of skin diseases were used, that’s why some historians
suppose Egypt is motherland of dermatovenerology.
Heritage of Egypt medicine had influence on medical knowledge development
in countries of Ancient East, Ancient Greece, and Rome.
Medicine in Ancient India
To the end of IV millennium B.C. – beginning of III millennium B.C. India had
slave-owning system.
Study sources about social system, economics, culture and medicine are Code of
laws of Manu (1000-500 B.C.), “Veda” – collections of religious and social
instructions, works of folk eposes – poems “Mahabharata”, “Ramayana” and
archeological data. Ayurveda (the science of living), the Vedic system of medicine
originating over 3000 years ago, views health as harmony between body, mind and
spirit. Its two most famous texts belong to the schools of Charaka and Sushruta.
23
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.
Information about body structure was very complete in Ancient India.
Dissection of corpse was not prosecuted. Corpse was under process of
maceration during 7 days in flowing water. Anatomic terms were indicative of
presence of anatomic knowledge, even about brains and spinal cord, but not exact.
Doctor used by methods of interrogatory and examination. Tachycardia and
respiration were studied either at rest, as in work and running.
Surgical tools, discovered in excavations, testify about development of
surgery. Sushruta, one of the authors of “Ayurveda” considered surgery is the first
and the best medical science.
Indian doctors made some operations: amputation, ophthalmologic and plastic
operations – substitutions of defects of nose, ears, and lips; obstetric – Caesarean
operation.
Sources of specialization, notion about unity of medical activity were exist.
By opinion of Sushruta: “doctor, who can operate but neglect medical
knowledge, is a bird with one pinion”. Doctor was liable to fine for unsuccessful
operation. Size of fine was depending on caste of sick person.
Strong side of Indian medicine was hygiene. Hygienic directions were
included in Code of laws of Manu. It was condemned surfeit; it was recommended
fresh food and vegetable diet. Rules about body care, cleanness of vessels. But it
all was available to rich people. During the excavations in Machendgo-Daro were
found sewerage, water pipes, and ponds, concerned to the IV-beginning of III c.
B.C.
It was described a hospital, based in the second half of VI c. B.C., hospitals in
ports and in big roadways.
Religion in India had strong influence on medicine, at first it was Brahmanism,
then Buddhism.
24
Secrecies of old Indian medicine consolidated in rules of deontology: respect
to teachers, blameless outward appearance, free treatment of poor and friends,
constant perfection of knowledge.
Medicine of Ancient India influenced on development of medicine in many
countries.
Medicine development in Ancient China
In the IV-III millennium B.C. one of the old civilizations was conceived in the
valley of the Hwang Ho River, then in the middle of II c. B.C. it was found state
system. Old China gave to world silk and powder, compass and paper, faience
(pottery) and porcelain, book-printing and many other discoveries in the field of
natural science and medicine.
Chinese medicine claims to be the world's first organized body of medical
knowledge dating back to 2700 BC. It is based on two principles - the yang and the
yin. The yang is believed to be an active masculine principle and the yin a negative
feminine principle. The balance of these two opposing forces meant good health.
Hygiene, dietetics, hydro-therapy, massage, drugs were all used by the Chinese
physicians.
The Chinese were early pioneers of immunization. They practised variolation
to prevent smallpox. To a Chinese, "the great doctor is one who treats not someone
who is already ill but someone not yet ill". The Chinese have great faith in their
traditional medicine, which is fully integrated with modern medicine. The Chinese
system of «bare-foot doctors» and acupuncture has attracted worldwide attention
in recent years.
Old hierologic books said about medicine development. The old is
encyclopedic work of Neijing (18 books). First nines (Su van) were devoted to
structure and functions of organism, diagnostics and treatment of diseases. The
others nine books (Lin Shu) described old method – chzen tzu therapy (chzen-
acupuncture or needle therapy; tzu-moxca or cauterization). Chinese doctors knew
about existence of “vital points”, irritation which had made medicinal effect. First
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detailed description was given in III B.C. To the XIV c. were counted 700 “vital
points”, which united in 14 “vital lines”.
Needles for irritation were made from flint and jasper, then from bones and
bamboo, later from metal – bronze, silver, gold, platinum. For training they had
special atlas and tailor’s dummies (mannequins).
Old doctors achieved big proficiency in pulse diagnostics. Their founder was
doctor Byan- tczyao; he recommended examining pulse in nine different places.
Chinese doctors marked out from 24 to 200 kinds of pulse, the main were 10.
In the III c. A.D. Chinese science about pulse were united in the 10 volumes
treatise (Mo-jing, 280).
Medicinal therapy achieved big proficiency in China. Monumental work of
Lee Shi Tjen in 52 volumes described 1892 medicinal means.
The system of payment to doctors widely used – not for treatment but for
prevention of diseases by advices.
They paid attention to treatment like diet, massage, water procedures, and
gymnastics.
China had state medical institution, main aim was service of emperor’s court,
but in fact their duties were wider (struggle with epidemics, etc.). Drug store also
existed as a special institution that time.
Thus, folk, secular and temple medicine existed in the conditions of slave-
owning system in the countries of Ancient East. Medicine much influenced on
temple medicine in Mesopotamia (Assyria), medical writing and first laws
(Babylon), sources of stationary attached to temples, especially for lunatics (Egypt)
and civil hospitals (India). There were drugs’ depot and places for its preparing in
Egypt, drug-store as special medical institution in China. Big towns of Ancient
East had elements of improvement and sanitation.
People of Ancient East had great experience for diagnostics and prophylaxis of
illnesses and means for their treatment.
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BIBLIOGRAPHY
1. Арцишевский А. Этюды о врачевателях и фармацевтах / А. Арцишевский
// Казахстанский фармацевтический вестник - 2002.- N1-2. -С.8-9.
2. Богоявленский Н.А. О раковых заболеваниях в рабовладельческом
обществе / Н.А. Богоявленский.- // Из истории медицины: Сб. ст.- Рига, 1967.-
С. 129-135.
3. Георгадзе В.И.Эмблемы медицины / В.И. Георгадзе, Э.Д. Грибанов.-
Тбилиси, 1979. - 112с.
4. История медицины / П.Е. Заблудовский, Г.Р. Крючок, М.К. Кузьмин,
М.М. Левит. - М.: Медицина, 1987. - 352 с.
5. Камов Б. Секреты тибетских лекарей /Б. Камов.- // Фармацевтический
бюл. -2001.- N9.- С.35-36.
6. Лисицын Ю.П. История медицины /Ю.П. Лисицын. - М.: ГЭОТАР-
МЕД, 2004. -393 с.
7. Мультановский М.П. История медицины /М.П. Мультановский. - М.:
Медицина, 1967. - 272 с.
8. Сорокина Т.С. Атлас истории медицины. Древний мир / Т.С. Сорокина. -
М.: УДН, 1981.-160с.
9. Сорокина Т.С. История медицины. Краткий курс лекций / Т.С. Сорокина. -
М.: УДН., 1988.- 72 с.
10. Сорокина Т.С. История медицины: Учебник для студ. высш. мед. учеб.
заведений / Т.С. Сорокина. – 4-е изд., стер.- М.: «Академия», 2005.-560с.
3. MEDICINE DEVELOPMENT IN ANCIENT GREECE
AND ANCIENT ROME
Medicine in Ancient Greece
27
Countries of Mediterranean basin, in the first place Ancient Greece (Ellada)
and Ancient Rome had big influence on historic development of humanity. Ancient
Greece in the VI – IV B.C. consisted of small slave-owning states.
Originality of geographic and economic conditions of Ancient Greece
promoted that its people played big role in culture development. Greece was
commercial mediator between more ancient countries of Southern and Western
Europe, widely developed trade and handicrafts.
The highest internal growth of Ancient Greece, rise of art, science, philosophy
and culture was in V B.C. This growth was stipulated by social contradictions and
struggle in the country. Greece had big social upheaval, transition from primitive
system to class slave-owning system. Struggle for freedom and independence from
Persian conquerors, defeat of slave-owning aristocracy and successes of slave-
owning democracy provoked growth of art, science and philosophy.
Knowledge of Ancient Greeks was united in one notion - “philosophy”.
Ancient Greece’s natural history was characterized by limited accumulation of
exact knowledge and abundance of hypothesis and theories. Philosophy of Ancient
Greece was characterized by natural dialectics.
Philosophical tendencies – matherialism and idealism – reflected sharp class
struggle. Struggle of materialistic “line of Democritus” with idealistic “line of
Platoon” was struggle of progressive slave-owning democracy with reactionary
land slave-owning aristocracy.
Greeks’ participants in international commercial intercourse, communication
with different people, contact with different religions and cultures - all of them
promoted development of Greek world view, which came into history under the
name the Greek natural philosophy.
Democritus was a Greek materialist philosopher (born at Abdera in Thrace ca.
460 B.C.-370 B.C.). Democritus was a student of Leucippus and co-originator of
the belief that all matter is made up of various imperishable, indivisible elements
which he called atoma (atom) or "indivisible units".
28
Though intelligence is allowed to explain the organization of the world,
according to Democritus, he does give place for the existence of a soul, which he
contends is composed of exceedingly fine and spherical atoma (now called atoms,
as mentioned above). He holds that, "spherical atoma move because it is their
nature never to be still, and that as they move they draw the whole body along with
them, and set it in motion." In this way, he viewed soul-atoma as being similar to
fire-atoma: small, spherical, capable of penetrating solid bodies and good examples
of spontaneous motion.
Democritus explained senses along these lines, as well. He hypothesized that
different tastes were a result of differently shaped atoms in contact with the tongue.
Smells and sounds could be explained similarly. Vision works by the eye receiving
"images" or "effluences" of bodies that are emanated. He stated that, "Sweet exists
by convention, bitter by convention, color by convention; but in reality atoms and
the void alone exist." Atomism was opposite to god’s influence on fate of world
and people.
There are two forms of knowledge: one legitimate, one bastard. To the sort
belong all the following: sight, hearing, smell, taste, touch. The legitimate is quite
distinct from this. When the bastard form cannot see more minutely, nor hear nor
smell nor taste nor perceive through the touch, then another finer form must be
employed. Democritus extracted the essence of every known herb and then
devoted the rest of his life to researches into the properties of minerals and plants.
Successor of Democritus was Epicurus.
Greek natural philosophy had influenced on development of material notions
and diseases.
Study sources about medicine of Ancient Greece
29
Ancient Greece’s literature is very old literature of Europe. First Greek literal
monuments are “Iliad” and “Odyssey” of Homer and they are only sources about
medicine of ХII – VI B.C.
Great monument of medical literature – “Hippocrates collection” testified
about medicine of classical period in Greece history. Some medical articles were
written by Herodotus (V B.C.) in his work “History in the 9 books”.
Archeological investigations in Miken (i. Crit) don’t yield to the values of
discovery of Tutankhamen’s tomb. Evans discovered ruins of great Cnoss palace
on i. Crit in 1900. There were catch pits, bath-houses, airings in III B.C. Treasure
from Kul – Ob funeral- is famous gold vase aimed for devotions, it kept in
Hermitage. By diggings it was discovered old temples, among it sanctuary of God
for doctoring Asclepios – asclepions. There was found one of the famous sanctuary
of Asclepios in town Epidavr in 1881-1887.
Мythology and medicine
“Childhood of human society was developed only splendid” in Ancient
Greece. It was more reflected in mythology and religion. Greek gods were invested
with all human qualities as good as bad.
Important place had gods-healers in Greek mythology. First of all was god
Apollo, he was father of god –doctor Asclepios. He embodied sun, which could
heal by its heat. He was healing god and god -prophet. Apollo was not only doctor
of gods and god of doctors but he was god of wisdom, poetry, music and beauty.
The most important medical deity was god of doctoring Asclepios. He was
pupil of Herron. Asclepios surpassed his teacher: he could not only treat, also he
could return died people to life. Asclepios healed people and may have even made
them immortal.
Antique art depicted Asclepios with stick embraced by snake, Hygeia was as
young beautiful girl in tunic with diadem and snack. Later snack became medicine
symbol. The famous children of Asclepios were Hygeia – goodness of health,
30
Panaceia – patroness of medicinal doctoring, Machaon became famous military
surgeon and Podalirius treated internal diseases. They all learnt medicine by their
father.
Folk and temple medicine
Roots of Greek medicine connected with medicine of Ancient East. Doctors
were respectable.
Homer in his poems described 141 damages on body and extremities, he knew
about medicinal properties of sulphur.
Herodotus described treatment of illnesses, climate influence on health, high
status of doctor in society, respect to this profession.
Sophocles had mentions about shivering (fever), medicinal mineral sources.
Development and strengthening of slave-owning system to the VI B.C.
stipulated intensification of religion positions. Those times were origin of temples
and temple medicine. So, Greek medicine was secular, folk, which temple
medicine couldn’t destroy.
On the one hand most Greeks believed in a god of healing called Asclepios.
Sick people made sacrifices or offerings to the god. They then slept overnight in
his temple. They believed that the god would visit them in their sleep (i.e. in their
dreams) and when they woke up they would be healed.
At the same time Greek doctors developed a rational theory of disease and
sought cures. However one did not replace the other.
There were more then 300 asclepieions in Ancient Greece. The majestic temple
was temple of Asclepios (IV B.C.). There were temples of Hygeia, Aphrodite,
Femida, and Apollo on the territory of sanctuary.
There were bath-house, library, gymnasium, stadium and theater on the
territory of sanctuary in Epidavrium.
Abaton – one from three component parts of asclepieions (temple, source and
abaton). Interpretation of dreams was base of temple medicine. Priests asked and
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then treated by physical methods of doctoring: massage, gymnastics, water
procedures, etc.
The cult of Asclepios and Greek medicine existed side by side.
Medical schools of Ancient Greece
Doctoring was family profession and handed down from father to son – it was
secret of family in Ancient Greece. Such system became family medical schools.
Later those schools were wider, because it had pupils for payment. Medical schools
were formed in Greece and in Greek colonies around the Mediterranean.
Greek medicine reflected two directions of philosophy: materialistic and
idealistic.
Idealistic tendency was in schools of Pythagoras, Plato.
Materialistic tendency displayed in schools on islands (i. Rodos, i. Cos, Asia
Minor), in towns (Cyrene, Crotona, Cnidus).
Glory of ancient medicine was in Crotona, Cnidus and Cos schools.
Crotona medical schools had growth in VIc.B.C. Their thesis: 1) organism – is
unity of opposites; 2) healthy organism – is a result of balance of opposite forces:
dry and wet, hot and cold, etc., prevalence of one is an illness cause; 3) opposite is
recovered by opposite. Prominent representative of this school was philosopher
and doctor Alcmaeon of Crotona (IV – V c. B.C.) in Italy said that a body was
healthy if it had the right balance of hot and cold, wet and dry. If the balance was
upset the body grew ill.
Cnidus medical schools 1) based humoral teaching, then health is favorable
mix (dyscrasia) of fourth liquids (blood, mucus, light bile and dark bile), but their
unfavorable mix (dyscrasia) is illnesses cause; 2) developed teaching about
symptoms of diseases and diagnostics (method by auscultation). Prominent
representative of this school was Euryphon of Cnidus (V c. B.C.).
32
Cos medical school was the main one in Ancient Greece. First information
was to 584 B.C. Growth of school was connected with name of Hippocrates II The
Great (about 460-about 377 B.C.), he is known as Hippocrates. Cos medical school
1) considered organism in close connection with nature; 2) elaborated principle of
observation and treatment near patient’s bed; 3) elaborated basis of doctor ethics.
33
Hippocrates. “Collection of Hippocrates”
Hippocrates, or Ippocrates (“horse-tamer” in Greek) lived in the period of the
highest internal bloom of Greece, there were many prominent representatives in
every field of human activities: in politics - Periclus, history had – Herodotus and
Phucididus, philosophy – Leucippus, Democritus, Empedocles, Socrat, Plato,
poetry had Sophocles, Euripides, Aristophanes, and in medicine it was epoch of
Hippocrates.
Hippocrates II The Great, was born on island Cos. His genealogy was from
clan asclepiads, from son of Asclepios – Padalirius. Asclepios clan had seven
Hippocrates. Hippocrates II The Great was doctor – periodevtist, he visited many
towns of Greece, Asia Minor, Skiff lands, Livia, east seaboard of the Black Sea,
Egypt. His fame about doctoring was spread in many countries.
The last days of his life, Hippocrates spent in Larissa (Fessaliya), when he died
in one day with Democritus.
Hippocrates had real notions about medicine, its possibilities, difficulties and
purposes. He was doctor- philosopher. He challenged the tradition of magic in
medicine, and initiated a radically new approach to medicine i.e., application of
clinical methods in medicine.
Heritage of Hippocrates and other doctors of Ancient Greece generalized in
“Collection of Hippocrates”, which was composed in III c. B.C. and was in famous
Alexandrian library. Library was based by successors of Alexander Macedonian -
Ptolemaists. By their order manuscripts of world scientists were brought in library.
72 medical works were written in Greek.
Works of Hippocrates are: “Aphorisms”, “Epidemics”, “About air, water,
places”, “About ancient medicine”, etc.
Hippocrates and other Greek doctors believed that the work done by a doctor
should be kept separate from the work done by a priest. They believed that
observation of a patient was a vital aspect of medical care. Ancient Greek doctors
34
did examine their patients but Hippocrates wanted a more systematic period of
observation and the recording of what was observed. Today, we would call this
‘clinical observation’. Such ideas have lead to Hippocrates being called the ‘Father
of Medicine’.
The Hippocratic Collection gave Greek doctors detailed advice on what to
do with their patients.
In the book "On Epidemics", doctors were told to note specific symptoms
and what was observed on a day to day basis. By doing this they could make a
natural history of an illness. Hippocrates and other doctors believed that by doing
this they could forecast the development of the illness in future.
The ideas of Hippocrates and others spread in the eastern Mediterranean and
others took to writing down what they saw with regards to illnesses. These writings
have survived and have given historians a vast resource to study.
Hippocrates and other doctors worked on the assumption that all diseases had a
natural cause rather than a supernatural one.
The definition of word “epidemics” was not clear, the Greeks called diseases
widely spread in people, such as fever, consumption, eye diseases, skin diseases,
etc.
Illness was considered by Hippocrates as change of 3 conditions: dampness,
welding and rarity. Hence, teaching about period, rhythms of diseases and main
methods of treatment:
1) First of all not to harm
2) Opposite is recovered by opposite.
3) Follow to law of proportionality.
4) Treat in conformity with nature laws, i.e. take into account “nature” of sick
man, conditions of his life, influence of environment.
Big significance had mode of life in ancient Greece. Teaching music, reading
and writing, hygiene, physical training and hardening were stand in one row.
35
Study of mode of life allowed Hippocrates to define 4 basic types of frame and
temperament of people. They based on notions of ancient Greeks about
predominance of one from 4 basic liquids in organism.
Works on surgery – “About fractures”, “About head wounds”, etc. gave notions
about high development teaching about bandages, treatment of fractures, wounds,
etc.
Doctors of Ancient Greece did not dissect and had not special knowledge on
anatomy. Their notions were empiric.
259 medicinal means of vegetable and 50 of organic origin were described in
“Collection of Hippocrates”. Hippocrates used 60-70 medicinal means.
There were 5 works in the “Collection of Hippocrates”, which were devoted to
deontology and behavior rules of doctor in Ancient Greece. They are: “Law”,
“Oath”, “About doctor”, “About decent behavior”, “Admonitions”.
Stable rules of behavior were devotion to teachers and respect to colleagues,
which consolidated in “Oath”, written down in III B.C. in Alexandrian library and
named after Hippocrates.
The Greeks gave a new direction to medical thought. They rejected the
supernatural theory of disease and looked upon disease as a natural process, not a
visitation from a god of immolation. The Greeks believed that matter was made up
of four elements - earth, air, fire and water. These elements had the corresponding
qualities of being cold, dry, hot and moist and were represented in the body by the
four humors - phlegm, yellow bile, blood and black bile.
Greeks postulated that health prevailed when the four humors were in
equilibrium and when the balance was disturbed, disease was the result. The
human body was assumed to have powers of restoration of humoral equilibrium,
and it was the physician's primary role to assist in this healing process. While the
humoral theory of Hippocrates was based on incorrect foundations, the concept of
the innate capacity of the body of responding to disturbances in the equilibrium
that constitutes health is highly relevant to modern medicine.
36
Outstanding amongst post-Hippocratic medical centre was Alexandria's huge
museum, the first University in the world which sheltered a library containing over
70,000 books. To this house of learning came eminent men. Between 300 BC and
30 BC, thousands of pupils matriculated in the school of Alexandria, which
replaced Athens as the world's centre of learning. In short, the Hippocratic school
inspired in turn the Alexandria school and the Arabo-Persian medicine. The
Hippocratic school changed the destiny of medicine by separating it from magic
and raising it to the status of a science. They had scientific method, although not
scientific knowledge. The glorious Greek civilization fell into decay and was
succeeded by the Roman civilization.
Medicine of Ancient Rome
Ancient Rome was a civilization that grew from a small agricultural
community founded on the Italian Peninsula in the IX B.C. to a large empire
straddling the Mediterranean Sea. In its twelve centuries of existence, Roman
civilization shifted from a monarchy, to a republic based on a combination of
oligarchy and democracy, to an increasingly autocratic empire. It came to
dominate Western Europe and the area surrounding the Mediterranean Sea through
conquest and assimilation.
To the end of III B.C. Ancient Rome became strong centralistic slave-owning
state of Western Mediterranean. Ancient Rome in I B.C. – was gigantic empire,
which includes territories of Western and South-Eastern Europe, Northern Africa,
and Asia Fore (Front). Period from II c. B.C. to II A.D. was the high blossom of
slave-owning social-economic structure and slave-owning production way.
Roman civilization is often grouped into "classical antiquity" with ancient
Greece, a civilization that inspired much of the culture of ancient Rome. Ancient
Rome contributed greatly to the development of law, war, art, architecture,
37
rhetoric, agriculture, philology, literature, technology, language and medicine in
the Western world.
Significant part of ancient Roman written monuments was lost. Some sources
(from III B.C.) have special interest, such as poem of T. Lucrecius Car “About
nature of things”, treatise “About medicine” by Cornelius Celsus, Galen’s work
“About aim of human body organs”. Information about medicine is also Greek and
Latin epigrams, devoted to doctor activity.
The healing profession was in the hands of priests, magicians, and elders of
the family. At first it was just the herbs that Romans used to cure their illnesses.
Diggings of ancient Rome cities allowed becoming the common property of the
history the life and medicine development. There were found set of medical
instruments, first in archeological history, in Pompey which was buried because of
volcano Vesuvius in 79 A.D. Second set consisted of 150 antique medical
instruments was discovered in 1893 in Baden, and third one was discovered in
1925 in Bingham.
Ancient roman hygienic constructions – therms or bath houses, aqueducts or
water-pipe, sewage are of big interest for medicine.
The Romans made fine roads throughout their empire, brought pure water to all
their cities through aqueducts, drained marshes to combat malaria, built sewerage
systems and established hospitals for the sick.
The Law of the Twelve Tables (about 450 B.C.) was the ancient legislation
that stood at the foundation of Roman law. The Law of the Twelve Tables formed
the centerpiece of the constitution of the Roman Republic. They were post up
behind Rome Senate. Official - edibles saw to realization of these laws. Also they
watched building and improvement in towns.
The Romans knew that dirt encourages disease and they appreciated the
importance of cleanliness. They built aqueducts to bring clean water into towns
since IV B.C. There were 11 aqueducts in Rome in I B.C. total length which was
436 kilometers. Aqueducts had state protection.
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They also knew that sewage encourages disease. The Romans built public
lavatories in their towns. Streams running underneath them carried away sewage.
The famous underground channel - cloaca maхima – functions to present day.
Therms were wide spread in Roman Empire. Therms’ capacity allowed
washing 10 -100 thousand persons simultaneously. Splendid decoration had to bear
similarities to museums. There were checkrooms, rooms for physical activities,
rooms for oil rubbing, hot bath and basins in therms. Pictures of Asclepios and
Hygie were in honor place. Therms were centers of public and cultural life in
Roman Empire. Libraries, halls for banquet and meetings were attached to therms.
By the historians’ opinion therms were the best gift of Roman emperors to
population.
There were not doctors- professionals in Ancient Rome. The Romans
conquered Greece and afterwards doctors in the Roman Empire were often Greeks.
Many of them were slaves - prisoners of war. Every rich Roman wanted to have
slave-doctor. High cultural and professional levels of slave-doctor raise him and he
became free person. But he must treat his ex-master and his family free of charge.
Doctors had low status in Rome. However the state paid public doctors to treat
them poor.
Ancient Rome made contribution into military medicine. Constant roman
army waged war and needed in doctors-professionals. Each cohort consisted from
1000 soldiers and 4 surgeons. The Romans also had hospitals called valetudinarian
for their wounded soldiers.
Medical business was developed together with military medicine. Authority
established places of profit of doctors – arkhiatrs. Their duties were teaching
medicine in special schools in Rome, Alexandria and other towns. Besides state
schools there were private schools. Great one was school founded by Asclepiad.
With time doctor‘s position became consolidate. They had many rights and
privileges. During the war doctors and their sons were excused from compulsory
military service, and that attracted many foreign doctors. To the end of II B.C.
39
there were doctors of eyes, tooth, and surgeries in Ancient Rome. They made
herniotomy and lithotomy.
The Romans borrowed their medicine largely from the Greeks whom they had
conquered. While the politics of the world became Roman, medicine remained
Greek.
Philosophy of Lucrecius. Medical system of Asclepiad
World outlook of ancient Romans had influence of Greek philosophy.
Atomistic teaching, created by Greek philosophers – materialists Levkipius,
Democritus and Epicure, found their expression in poem of Titus Lucrecius Car
“About things’ nature”, there he gave characteristics of some illnesses, described
infectious diseases, etc.
He paid attention on spread infection from water, food and other things; he
outlined first ways of contagious concepts of transmission of infection.
Epicure teaching and Lucrecius looks had influence on Asclepiad from
Bithynia. His rule was: “treat safely, quickly and pleasantly”. His treating methods
were: diet, hygiene, massage, water treatment and moving.
From school of Lucrecius was Soran from Effess (II B.C.). He wrote the
biggest work on obstetrics, gynecology and pediatrics in ancient medicine.
Celsus (about 25-30 B.C. to 45-50 A.D.) is the only Roman who worked with
distinction in the medical field, but it is doubtful whether he was a physician. His
work, “About medicine” "De re medica libri viii", which is written in classical
Latin, and for which he used seventy-two works lost to posterity, gives a survey of
medical science from Hippocrates to imperial times. Very famous is his description
lithotomy. He wrote about hygiene, dyetetics, pathology, therapy and surgery.
Celsus was altogether forgotten until the fifteenth century, when Pope Nicholas V
(1447-1455) is said to have discovered a manuscript of his works.
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Galen - doctor and naturalist
One of the most influential people of ancient medicine was Galen. Departure
from the Hippocratic observation of nature led physicians to form numerous
mutually opposing sects. A man of great industry and comprehensive knowledge,
Galen of Pergamum (130-200 A.D.), tried to rescue medical science from this
labyrinth. He was from family of architect. Since 17 years he devoted himself to
medicine. He knew many languages (Greek, Latin, Persian and others), and
traveled a lot.
Galen- was an author of 125 medicine works, only 80 retained till our time.
There were “About purposes of human body parts”, “Therapeutic ways”, “About
anatomy”, etc.
Dualism of Galen displayed in his hesitation between materialism and
idealism.
Materialistic position was in his researches in anatomy and physiology.
Dissection of dead bodies was forbidden by religion in Alexandria, so Galen
anatomized monkeys, pigs, dogs, etc. He described bones, muscles, chords,
internal organs, and his great contribution to research of nervous system.
He correctly described structures of heart, vessels. But he thought heart
partition was permeable.
Galen had drug store; there was laboratory (officina) for preparing medicines.
He introduced into practice regulation for preparing medicine from plants: weight
and volume of materials, proportions and extragents.
Galen took the entire anatomical knowledge of his time, and out of it produced
a work the substance of which was for centuries regarded as inviolable. His
anatomy was to a large extent based upon the dissection of mammals, especially of
monkeys, and, like his physiology, was under teleological influence. Instead of
explaining the functions of organs on the basis of their structure, Galen chose this
reverse method. His anatomy and physiology were the most vulnerable part of his
system, and an earnest re-examination of these fields must necessarily have shaken
41
his entire scheme of teaching. Galen expressed the greatest respect for
Hippocrates, published his most important works with explanatory notes, but never
entered into the spirit of the school of Cos, although he adopted many of its
doctrines.
Galen is the culminating point and end of ancient Greek medical science. He
produced the concepts of anatomy, physiology, therapeutics, and philosophy. He
distinguished seven pairs of cranial nerves, described the valves of the heart, and
observed the structural differences between arteries and veins. One of his most
important demonstrations was that the arteries carry blood, not air, as had been
taught for 400 years. His vivisection experiments were also very notable. Such
experiments included performing a series of transactions of the spinal cord to
establish the functions of the spinal nerves, and tying off the ureters to demonstrate
kidney and bladder functions.
Galen and many other physicians used many tools in their practice. The most
interesting thing about these tools and procedures is that many of them have the
same names and uses today. His merits were either in making new medicinal
preparations, as in their theoretical substantiations. In the The Middle Ages
prominent scientists Paracelsus called whole group of medicinal preparations and
institutions in honor of Galen.
Galen correctly described that he saw, but he wrong interpreted getting results.
This was a dualism of Galen.
Galen was a prominent doctor of world; he was in one row with Hippocrates
and Abu Ali Ibn Sina.
BIBLIOGRAPHY
1. Афоризмы Гиппократа // Твое здоровье. - 1996. - N4. -С.130 – 143.
2. Гиппократ. Избранные книги /пер. с греч. Под ред. В.П. Карпова.- М.:
Биомедгиз, 1936. -736с.
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3. Георгадзе В.И. Эмблемы медицины / В.И. Георгадзе, Э.Д. Грибанов. -
Тбилиси, 1979. - 112с.
4. Грибанов Э.Д. Источники изучения истории медицины и здра-
воохранения /ЭД Грибанов. -М., 1980. - 19с.
5. История Древней Греции: Учеб.для вузов по спец. "История"
/ Под ред.В.И. Кузищина: - М.: Высш. шк., 1986. - 381с.
6. История медицины / П.Е. Заблудовский, Г.Р. Крючок, М.К. Кузьмин,
М.М. Левит. - М.: Медицина, 1987. - 352 с.
7. Лисицын Ю.П. История медицины /Ю.П. Лисицын. - М.: ГЭОТАР-МЕД,
2004. -393 с.
8. Медицина в поэзии греков и римлян/Сост.Ю.Ф.Шульц. - М.:Медицина,
1987. - 128с.
9. Мультановский М.П. История медицины / М.П. Мультановский. - М.:
Медицина, 1967. - 272 с.
10.Сорокина Т.С. Медицина в рабовладельческих государствах
Средиземноморья /Т.С. Сорокина. - М., 1987. - 97с.
11. Сорокина Т.С. История медицины: Учебник для студ. высш. мед. учеб.
заведений / Т.С. Сорокина. – 4-е изд., стер.- М.: «Академия», 2005.-560с.
12. Семенченко В.Ф. История фармации: Учебное пособие / В.Ф.
Семенченко.- М.:«МарТ»; Ростов н/Д: «МарТ», 2003.- 640 с.
4. MEDICINE DURING THE PERIOD OF FEUDALISM IN THE
COUNTRIES OF EAST AND WESTERN EUROPE
Epoch’s characteristics
Materialistic notion about history includes obligatory consistent historism that
is to study of social phenomena in the process of its development. Feudal system
had been established in different time in different countries. In 476 Western Roman
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Empire fall down by rush of barbarian German tribes. This date is considered de
bene esse as beginning of the Middle Ages and feudalism in Europe.
Feudal system was formed earlier in East countries: China – in IIIc., Caucasian
countries – in IVc. , Byzantine and countries of Middle Asia - in VIIc. , Russia –
in IXc.
Feudal epoch had division into three periods. First period (V – XI) was early
The Middle Ages, economics was concentrated in villages. Second period (XI –
XV) was period of developed feudalism, significance of towns – centers of trade
and handicraft. Third period (XV - XVII) was period of feudal decomposition and
origin of capitalistic elements. The end of The Middle Ages was a time of first
bourgeois revolutions and the main one was in England (1640 – 1649) That is why
1640 year was symbolized the beginning of new time and epoch of capitalism in
Europe.
Making of world religions – Christianity and Islam - had grave consequences.
Church influenced on all sphere of life.
With the fall of the Roman Empire, the medical schools established in Roman
times also disappeared. Europe was ravaged by disease and pestilence: plague,
smallpox, leprosy and tuberculosis. The practice of medicine reverted back to
primitive medicine dominated by superstition and dogma. Rejection of the body
and glorification of the spirit became the accepted pattern of behavior. It was
regarded as immoral to see one's body; consequently, people seldom bathed.
Dissection of the human body was prohibited. Medicine developed in difficult and
contradictory conditions.
Medicine in Byzantine Empire
Byzantine medicine is the medicine practiced in the Byzantine Empire from
about 400 A.D. to 1453 A.D. It drew largely on Ancient Greek and Roman
knowledge. However, Medicine was also one of the few sciences in which the
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Byzantines improved on their Greco-Roman predecessors. The Byzantine
civilization has significant place in world history. It was the center of bright culture
within ten centuries. The history of Byzantine Empire began from the reign of
Constantine I the Great, (306 – 337); he was revered under the title "The Great" for
his contributions to Christianity. Emperor Constantine proclaimed Christianity the
state religion. In 324, Constantine announced his decision to transform Byzantium
into Nova Roma and on May 11, 330, he officially proclaimed the city the new
capital of the Roman Empire. The city was renamed Constantinople (modern
Stambul), The City of Constantine, after Constantine's death in 337. It would
remain the capital of the Byzantine Empire for over a thousand years, a reign
interrupted only briefly by its 1204 sacking and occupation in the Fourth Crusade,
until it finally fell to the Ottoman Empire in 1453.
30 palaces and temples, more than 4 thousand buildings for nobility, two
theatres, a circus, a hippodrome, more than 150 bath-houses and 8 aqueducts have
been constructed during the reign of Constantine I.
Byzantine culture united cultural achievements of all people. One of
achievement was creation of Slavic alphabet – Cyrillic alphabet in IX. Alphabet’s
authors were brothers Cyril and Mefody.
An important contribution of Byzantium is arguably the fact that it was the first
Empire in which dedicated medical establishments - usually set up by individual
Churches or the State, which parallel modern Hospitals in many way, flourished.
Although similar establishments existed in Ancient Greece and Rome, they
differed in that they were usually either institutions for Military use, or places were
citizens went to die in a more peaceful way. Medical Institutions of this sort were
common in Imperial Cities such as Constantinople and later Thessaloniki.
The first hospital was built by Basil of Caesarea in the 370, and although these
Institutions flourished, it was only throughout the VIII - IX c.c. that they began to
appear in Provincial Towns as well as Cities, (although Justinian's subsidization of
private physicians to work publicly for six months of the year can be seen as the
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real breakthrough point). Byzantine Medicine was entirely based around Hospitals
or walk-in dispensaries which formed part of the Hospital complex, there was a
dedicated hierarchy including the Chief Physician (archiatroi), professional nurses
(hypourgoi) and the orderlies (hyperetai).
Doctors themselves were well trained and most likely attended the University
of Constantinople as Medicine had become a truly scholarly subject by the period
of Byzantium (despite the prominence of the great physicians of antiquity, its
status as a Science was greatly improved through its application in formal
education (particularly in the University of Constantinople. Thus, we know that in
the twelfth century, Constantinople had two well organized hospitals staffed by
medical specialists (including women doctors), with special wards for various
types of diseases and systematic methods of treatment. Drug-stores also were
appeared in Byzantine Empire.
Byzantine physicians often compiled and standardized medical knowledge into
textbooks. These books tended to be elaborately decorated with many fine
illustrations, highlighting the particular ailment. Oribasius (325 – 403) perhaps the
greatest Byzantine compiler of medical knowledge, frequently made revisions
noting where older methods had been incorrect. Several of his works, along with
many other Byzantine physicians, were translated into Latin. His famous medical
encyclopedic work was “Sinopsis” in 70 volumes. Doctors Aetius and Alexander
of Tralles as well as Paul of Aegina were encyclopedists and they gathered and
systematized the heritage of ancient medicine. The Medical Compendium in Seven
Books, written by the leading physician Paul of Aegina, is of particular
importance. The compendium was written in the late seventh century and remained
in use as a standard textbook for 800 years.
Bizantine stopped its existence as state when Turkish army captured
Constantinople and came into the territory of the Ottoman Empire in 1453.
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For 10 centuries of the history Byzantium not only has kept and systematized
the antique heritage, but also has created original medieval culture which rendered
big influence on development of culture of many world nations.
Medicine in Arabian caliphates
The political structure of the Islamic states in the Middle East, North Africa,
and Spain was called the caliphate; the term is from the Arabic word for "successor."
The caliphs were successors of Muhammad, the founder of Islam, who died in 632
A.D. Arab conquests that began soon after Muhammad's death incorporated vast
territories into the realm of Islam within a few decades.
In the beginning of VII c. Arabs populated in west part of Arabian
Peninsula, had formed religion Islam, had organized Islamic state, which became
great feudal empire – Caliphate because of Arabian conquests.
First stage of conquest was in VIIc. States- Syria, Palestine, Iran, Egypt,
Cyprus and territories of Armenia and Georgia were included into part of Caliphate.
In the outcome of second conquest (end of VII c. и 30th years of VIII c.)
there were conquered North Africa, the biggest part of Pyrenean Peninsula, Asia
Minor and Caucasus. Borders of caliphates were from Atlantic Ocean to Hind, from
Asia Minor to North Africa. The armies of Islam set out from the Arabian Peninsula
to make conquests in nearly every direction. At its height the Muslim empire
stretched across North Africa and up into Spain, while eastward it incorporated the
entire Near East and extended into India. Caliphate exceeded in its size Empire of
Alexander Macedonian and Great Roman Empire.
Arabian culture influenced other countries of Asia, Africa, Europe and made
great contribution into world culture.
Medicine had got high development, according to prophet, knowledge
consisted from two parts: knowledge of religion and knowledge of body, i.e.
medicine.
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During the eight centuries Arabian medicine hold a main place in
Mediterranean region. It kept and returned in improved type to Europe all important
knowledge of that time.
The greatest contribution of Arabs, in general, was in the field of
pharmacology. Seeking the "elixir of life", they developed pharmaceutical
chemistry, introducing a large number of drugs, herbal and chemical. Pioneers in
pharmacology, they invented the art of writing prescriptions, an art inherited by our
modern pharmacists.
They introduced a wide range of syrups, oils, poultices, plasters, pills,
powders, alcoholates and aromatic waters. The words drug, alcohol, syrup and sugar
are all Arabian.
Muslim physicians set up the earliest dedicated hospitals in the modern
sense, known as Bimaristans, which were establishments where the ill were
welcomed and cared for by qualified staff, and which were clearly distinguished
from the ancient healing temples, sleep temples, hospices, assylums, lazarets and
leper-houses which were more concerned with isolating the sick and the mad from
society "rather than to offer them any way to a true cure." The Bimaristan hospitals
later functioned as the first public hospitals, psychiatric hospitals and diploma-
granting medical universities.
Hospitals in the Islamic world featured competency tests for doctors, drug
purity regulations, nurses and interns, and advanced surgical procedures. Hospitals
were also created with separate wards for specific illnesses, so that people with
contagious diseases could be kept away from other patients. One of the features in
medieval Muslim hospitals that distinguished them from their contemporaries and
predecessors was their significantly higher standards of medical ethics. Hospitals in
the Islamic world treated patients of all religions, ethnicities, and backgrounds,
while the hospitals themselves often employed staff from Christian, Jewish and
other minority backgrounds. Muslim doctors and physicians were expected to have
obligations towards their patients, regardless of their wealth or backgrounds. The
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ethical standards of Muslim physicians was first laid down in the 9th century by
Ishaq bin Ali Rahawi, who wrote the Adab al-Tabib (Conduct of a Physician), the
first treatise dedicated to medical ethics. He regarded physicians as "guardians of
souls and bodies", and wrote twenty chapters on various topics related to medical
ethics.
Dissection was prohibited by religion, but doctors – Muslims contributed a
lot of to anatomy and surgery development. Investigating of animals eye structure,
Egyptian doctor Ibn- al-Haisam (965 – 1039), who was the first explained beam
refraction in eyes and gave names to the parts (cornea, lens). Arabian school of
ophthalmology influenced till the XVIIc.
Ibn Nafis (d. 1288) described human blood circulation. This discovery
would be rediscovered, or perhaps merely demonstrated, by William Harvey in
1628, who generally receives the credit in Western history.
Big significance had questions on personal and general hygiene, rational
nourishments and dietetics.
Great scientists of East – Ar-Razi, Al-Farabi,
Al-Biruni, Abu Ali Ibn Cina
The Islamic World rose to primacy in medical science with such thinkers as
Ar- Razi (Rhazes), Al-Farabi, Al-Biruni, Ibn Sina (Avicenna).
Abu Bakr Muhammad Ibn Zakariya Ar-Razi (known in the west as Rhazes)
was the greatest physician of Islam and the Medieval Ages. He remained up to the
XVII c. the undisputable authority of medicine.
Ar-Razi was born at Ray near modern Tehran in 850. It is said that early in
his life al-Razi was interested in singing and music besides other professions.
Because of his eagerness for knowledge, he became more interested in the study of
alchemy and chemistry, philosophy, logic, mathematics and physics. It was the field
of medicine that he spent most of his life, practicing it, studying and writing about it.
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Due to his fame in medicine he was appointed head of the physicians of the Ray
Hospital, and later put in charge of the Baghdad main Hospital during the reign of the
Adhud-Daulah.
An interesting episode of Al-Razi's remarkable method of choosing the right
spot for the Baghdad main hospital is described as follows. When Adhud Daulah
asked Al-Razi to build a hospital, he had pieces of fresh meat placed at various parts
of the city of Baghdad. Some time later, he checked each piece to find out which one
was less rotten than the others, and he chose the spot of the least rotten pieces of meat
a site for the hospital.
The greatest medical work of Ar-Razi, and perhaps the most extensive ever
written by a medical man, is al-Hawi, i.e., the "Comprehensive Book," which
includes indeed Greek, Syrian, and early Arabic medical knowledge in their
entirety. Throughout his life Ar-Razi must have collected extracts from all the
books available to him on medicine. In his last years, he combined these with his
medical experience into an enormous twenty five volume medical encyclopedia.
Al-Rhazi was the first to distinguish between smallpox and measles. Rhazes
became the first physician to systematically use alcohol, cotton in his practice as a
physician.
Abu Nasir Muhammad ibn Tarkhan ibn Uzlagh al-Farabi, Al -Farabi (870 –
950) was the great scientist – encyclopedists , philosopher who introduced Plato
and Aristotle to Muslim philosophy. He was born in Farab in Asia Minor (modern
Otrar) He was schooled in the towns of Farab and Bukhara, before continuing his
studies of Greek philosophy in Hanan and Baghdad. Al –Farabi knew 70 languages
and traveled widely throughout the Arabian kingdoms of Persia, Egypt, and Asia
Minor.
He made great contributions to astronomy, logic, music, mathematics,
sociology and ethics, philosophy and justice, medicine and psychology.
Al-Farabi had great influence on science and philosophy for several
centuries, and was widely regarded to be second only to Aristotle in knowledge
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(alluded to by his title of "the Second Teacher"). He got title of “The Second
teacher” in Baghdad, political and cultural centre of that time.
He was author of more than 200 philosophical works. Treatises about
medicine were “About organs of human body”, “About soul”, “About objection
Galen in occasion of its disagreements with Aristotle concerning to organs of human
body”, “About Diseases of gastrointestinal tract and other diseases”. In his treatment
of the human soul, al-Farabi draws on a basic Aristotelian outline, which is informed
by the commentaries of later Greek thinkers. He says it is composed of four faculties:
The appetitive (the desire for, or aversion to an object of sense), the sensitive (the
perception by the senses of corporeal substances), the imaginative (the faculty which
retains images of sensible objects after they have been perceived, and then separates
and combines them for a number of ends), and the rational, which is the faculty of
intellection. It is the last of these which is unique to human beings and distinguishes
them from plants and animals. It is also the only part of the soul to survive the death
of the body.
Al-Farabi's treatise “Meanings of the Intellect” dealt with music therapy, where
he discussed the therapeutic effects of music on the soul.
He died in Damascus in 950 at the age of 80. Al-Farabi's work greatly
influenced the Islamic philosophers who followed him. Al-Farabi was world man, he
brought together and systematized achievements of Arabian, Persian, Greek, Indian
and his own Turks culture.
Al-Biruni (973-1048) was astronomer, geographer, ethnographer and historian.
He knew Greek, Arabian, Syrian, and Sanskrit languages. He worked in Kat, capital
of Horesmshah’s state. Al – Biruni wrote fundamental works devoted to
pharmacology, astronomy, medicine such as “Chronology”, “Pharmacology”,
“Mineralogy”, “Pharmacognosy”.
“Pharmacgnosy” was one manuscript which discovered in 1927 in Brucc and
valuable monument in East.
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The great philosopher and doctor Ibn Sina (also known as Avicenna in the
western world) was another influential figure. His The Canon of Medicine, sometimes
considered the most famous book in the history of medicine, remained a standard text
in Europe up until its Age of Enlightenment and the renewal of the Islamic tradition of
scientific medicine.
He was born in Persia around 980 in Afshana, in Bukhara province, his
mother's home, a small city now part of Uzbekistan.
About 100 treatises were ascribed to Ibn Sina. Some of them are tracts of a
few pages, there are works extending through several volumes. The best-known
among them, and that to which Ibn Sina owed his European reputation, is his 5-
volume “The Canon of Medicine”, which was a standard medical text in Europe
and the Islamic world up until the XVIII c. The book is known for its introduction
of systematic experimentation and quantification into the study of physiology, the
discovery of contagious diseases and sexually transmitted diseases, the
introduction of quarantine to limit the spread of infectious diseases, the
introduction of experimental medicine, clinical trials, neuropsychiatry, risk factor
analysis, and the idea of a syndrome in the diagnosis of specific diseases, and
hypothesized the existence of microorganisms. It classifies and describes diseases,
and outlines their assumed causes. Hygiene, simple and complex medicines, and
functions of parts of the body are also covered. In this, Ibn Sīnā is credited as being
the first to correctly document the anatomy of the human eye, along with
descriptions of eye afflictions such as cataracts. It asserts that tuberculosis was
contagious, which was later disputed by Europeans, but turned out to be true. It
also describes the symptoms and complications of diabetes. Both forms of facial
paralysis were described in-depth. “The Canon of Medicine” was the first book
dealing with experimental medicine, evidence-based medicine, randomized
controlled trials, and efficacy tests, and it laid out the following rules and
principles for testing the effectiveness of new drugs and medications, which still
form the basis of clinical pharmacology and modern clinical trials:
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1. "The drug must be free from any extraneous accidental quality."
2. "It must be used on a simple, not a composite, disease."
3. "The drug must be tested with two contrary types of diseases, because
sometimes a drug cures one disease by its essential qualities and another by
its accidental ones."
4. "The quality of the drug must correspond to the strength of the disease. For
example, there are some drugs whose heat is less than the coldness of certain
diseases, so that they would have no effect on them."
5. "The time of action must be observed, so that essence and accident are not
confused."
6. "The effect of the drug must be seen to occur constantly or in many cases,
for if this did not happen, it was an accidental effect."
7. "The experimentation must be done with the human body, for testing a drug
on a lion or a horse might not prove anything about its effect on man."
First book contained medicine definition, anatomical and general
knowledge, health and treatment of diseases. Second book was devoted to simple
drugs and its action. Third book was about pathology and therapy, description of
some diseases and ways of its treatment. Surgery and fever were described in fourth
book. There were compound medicinal substances and antidote in fifth book.
“The Canon of Medicine” became the text book for medical education in the
schools of Europe. Scientists of Arabian Caliphates and Asia Minor influenced on
development of medicine in all world.
Medicine in Western Europe
In 476 the last Roman emperor Romul Augustul was decrowned. This date
designated the downfall of slave owning epoch in Europe and beginning of new
epoch – feudalism.
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Church was the main institution in feudal epoch. Christian church was
unified till the middle of XIc., then it was broken up into west (Catholic) and east
(Orthodox) in 1054.
First hospitals (co-called God’s houses) were attached to monasteries in
Western Europe. God’s houses appeared in Lion (VI c.) and Paris (VII c.) then
hospital of Saint Bartholomew in London (XII c.). Monks cultivated medical
plants, made room for its keeping. Connecting of religion and medicine put the
brakes on the scientific thought.
In the Middle Ages medicine was dominated by the ideas of Galen and the
theory of the four humours. Medieval scholiasts forget his many experimental
achievements in anatomy and physiology while weak points of his study about
pneuma, supernatural powers was rise to religious dogma and it became standard
of scholastic medicine. It aroused galenism – corrupt, one-sided understanding of
Galen’s study.
Furthermore outside many towns were leper 'hospitals' (really just hostels as
nothing could be done for the patients). Leprosy was a dreadful skin disease.
Anyone who caught it was an outcast. They had to wear clothes that covered their
whole body. They also had to ring a bell or a wooden clacker to warn people they
were coming. Fortunately leprosy grew less common in the XV c. and it died out
in Britain in the XVI c. In the The Middle Ages only monasteries had sanitation.
Streams provided clean water. Dirty water was used to clear toilets, which were in
a separate room. Monks also had a room called a laver where they washed their
hands before meals. However for most people sanitation was non-existent. In
castles the toilet was simply a long passage built into the thickness of the walls.
Often it emptied into the castle moat. Despite the lack of public health many towns
had public bath-houses were you could pay to have a bath.
The Black Death (bubonic plague with pulmonary infection), originating in
Eastern Asia, passed through India to Asia Minor, Arabia, Egypt, Northern Africa,
and directly to Europe by the Black Sea. In Europe the epidemic began in 1346,
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and spread first of all in the maritime cities of Italy (especially Genoa) and Sicily,
in 1347 it appeared in Constantinople, Cyprus, Greece, Malta, Sardinia and
Corsica, and, towards the end of the year, at Marseilles; in 1348 in Spain, Southern
France (Avignon), Paris, the Netherlands, Italy, Southern England and London,
Scbleswig-Holstein and Norway, and in December, in Dalmatia and Jutland; in
1349 in the Austrian Alpine countries, Vienna, and Poland; in 1350 in Russia,
where in 1353 the last traces disappeared on the shores of the Black Sea. First
quarantines were introduced in seaports of Italy in 1348.
In the XIII c. a new type of craftsmen emerged in towns. He (or she because
not all were male) was the barber-surgeon. They cut hair, they pulled teeth and
they performed simple operations such as amputations and setting broken bones.
However doctors looked down on barber-surgeons because they did manual
work. Therefore they were regarded as inferior to doctors who did not.
In the late XI c. a medical school was founded in Salerno in Italy. In the XII
c. another was founded at Montpellier. In the XIII c. more universities were
founded at Bologna, Padua, Neapol, Oxford, Paris and etc. Furthermore many
students studied medicine in European universities. Medicine became a profession
again. But it had dogmatic features.
Bologna has stained incomparable glory from the fact that Mondino de
Liucci (about 1275-1326), the reviver of anatomy, taught there. There, for the first
time since the Alexandrian period (nearly 1500 years), he dissected a human
corpse, and wrote a treatise on anatomy based upon personal observation - a work
which, for nearly two and a half centuries, remained the official textbook of the
universities. Although Mondino's work which appeared in 1316, contains many
defects and errors, if nevertheless marked an advance and incited men to further
investigation. Text book on surgery by Guy de Chauliac (XIV c.) was wide spread
in Western Europe.
Medicine of medieval Europe developed in difficult and negative conditions.
Nevertheless in depths future medicine of Renaissance became generated.
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Medicine development during the period of Renaissance
Medicine of the Renaissance era in Europe was from around 1400 to around
1750. The Renaissance marked a change of direction for medical knowledge and
practice following the stagnation of medieval medicine in the preceding period. A
rebirth of interest in the pursuit of new knowledge and scientific enquiry began,
similar to that found in ancient Greek medicine. The known world expanded for
Europeans, as they discovered the Americas and explored the continents of Asia
and Africa, making contact with new peoples and civilizations. New medicinal
plants and treatments were brought back to Europe and new technologies such as
the microscope emerged, influencing medical development. The spirit of discovery
encouraged scientific research that overturned the traditional practices of the
Middle Ages, which had been based on the classical teachings of Egypt, Greece,
and Rome.
During the XVIc. there were some improvements in medicine. However it
remained basically the same as in the Middle Ages. Medicine was still dominated
by the theory of the four humours.
From the time of Mondino, anatomy had been diligently cultivated at the
universities, especially in Italy. Anatomy made special progress because of the
artists. Thus Raphael Sanzio (1488-1520) already makes use of the human skeleton
when making his sketches, so as to give his figures the proper posture. We possess
numerous anatomical descriptions and sketches by Leonardo Da Vinci . Leonardo
Da Vinci (1452-1519) dissected some human bodies and made accurate drawings
of what he saw. The great Michelangelo (1475-1564) left sketches of the muscles
and in 1495, in the monastery of Santo Spirito at Florence, made studies for a
picture of the Crucified with cadavers as models.
Big influence on development of natural science had activity of English
philosopher F. Beckon (1561 – 1626) – forefather of English materialism and
modern experimental science.
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René Descartes (1596-1650) was a highly influential French philosopher,
mathematician, scientist, and writer. He made sketches of reflex arch, divided
nerves into centripetal and centrifugal. He considered that all life movement
subordinated to laws of mechanics.
In 1478 a book by the Roman doctor Celsus was printed. (The printing press
made all books including medical ones much cheaper). The book by Celsus
quickly became a standard textbook. However in the early 16th century a man
named Theophrastus von Hohenheim called himself Paracelsus (meaning "equal to
or greater than Celsus", a Roman encyclopedist from the first century known for
his tract on medicine). Theophrastus Aureolus Bombastus von Hohenheim (1493-
1541), was born in Einsiedeln, Switzerland. He denounced all medical teaching not
based on experiment and experience. However traditional ideas held sway for long
afterwards.
In 1506 he went to the University of Basle; from Trithemius he learned
chemistry and metallurgy in the smelting houses at Schwaz (Tyrol), and he visited
the principal universities of Italy and France. In 1526 he became town physician of
Basle, and could as such give lectures. His first appearance is characteristic of him.
He publicly burned the works of Avicenna and Galen and showed respect only to
the "Aphorisms" of Hippocrates. He was the first to give lectures in the German
language. But as early as 1528, he was compelled, on account of the hostility he
evoked, to leave Basle secretly. After this he travelled through various countries
working constantly at his numerous writings, until death overtook him at Salzburg
in 1541.
He considered illnesses were abnormity of organism, i.e. simple chemical
violation of balance, and chemical remedies and means could help to restore the
balance. Human is created from earth and he consists from incombustible and
refractory substances: sulfur, mercury, and salt (chemical theory of Paracelsus).
Main task of chemistry was making drugs, he thought. He used many chemical
drugs for treatment. His popular expressions were: “All is poison and all is
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medicine. Only one doze makes substance either poison or medicine”, “Theory of
doctor is experiment. Nobody can be doctor without science and experiment”.
Andreas Vesalius (1514 – 1564), studied at Louvain, Montpellier and Paris,
then became imperial field-surgeon. His eagerness to learn went so far that he stole
corpses from the gallows to work on at night in his room. He soon became
convinced of the weakness and falsity of the anatomy of Galen. His anatomical
demonstrations on the cadaver, which he performed in several cities and which
attracted attention, soon earned him a call to Padua where he had recently
graduated and where, with some interruptions, he taught from 1539 to 1546. His
chief work, “On the Workings of the Human Body” or "De corporis humani fabrica
libri vii", which appeared at Basle in 1543, brought him great fame. Vesalius is the
founder of scientific anatomy and of the technique of modern dissection. The work
emphasized the priority of dissection and what has come to be called the
"anatomical" view of the body — seeing human internal functioning as an
essentially corporeal structure filled with organs arranged in three-dimensional
space. It contained accurate diagrams of a human body. Unfortunately, he himself
destroyed a part of his manuscripts on learning that his enemies intended to submit
his work to ecclesiastical censure. While engaged on a pilgrimage, he received
word in Jerusalem of his reappointment as professor in Padua, but he was
shipwrecked in Zant and died there in great need on 15 October, 1564.
In the XVIc. – the beginning of XVII c. there were many doctors-
anatomists: Fallopii, Eustacchi, Bottalo, Fabricio, etc. Their names introduced in
anatomical terms.
Galen's theory, according to which the left heart and the arteries contained
air, the blood being generated in the liver, had long been regarded as improbable,
but in spite of every effort no one had as yet discovered the truth about circulation.
The solution of this problem, which brought about complete fall of Galen's system
and a revolution in physiology, came from the English physician William Harvey
of Folkstone (1578-1657). His work is “Anatomical research about heart and blood
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in animals”. Harvey's discovery published in 1628, that the heart is the centre of
the circulation of the blood must return to the heart, at first received scant notice
and was even directly opposed by Galen's adherents; but further investigation soon
made truth victorious.
A new field of investigation was opened by the invention of the microscope
(the end of the XVIc.), by which Marcello Malpighi (1628-1694) discovered the
smaller blood-vessels and the blood corpuscles. From Harvey's time starts a series
of important anatomists and physiologist. In 1658 Jan Swammerdan first observed
red blood corpuscles. Then in 1665 Robert Hooke was the first person to describe
cells in his book “Micrographia”.
Finally in 1683 Antoine van Leeuwenhock (1632-1723) observed
microorganisms. He made more than 200 microscopes, which increased to 270
times. However he did not realize microorganisms caused disease.
Girolamo Fracastoro (1478- 1553) was an Italian physician, scholar (in
mathematics, geography and astronomy), poet and atomist.
In 1546 he proposed that epidemic diseases are caused by transferable tiny
particles or "spores" that could transmit infection by direct or indirect contact or
even without contact over long distances. In his writing, the "spores" of disease
may refer to chemicals rather than to any living entities. His book (De contagione
- "On Contagion") also gave the first description for typhus. The name for syphilis
is derived from Fracastoro's 1530 epic poem in three books, Syphilis sive morbus
gallicus ("Syphilis or The French Disease"), about a shepherd named Syphilus. The
poem suggests using mercury and "guaiaco" as a cure. The collected works of
Fracastoro appeared for the first time in 1555.
Doctor Montano (1489 – 1552) resumed clinical study in Padua University.
The activity of the physician was mainly to assist "nature". Hermann
Boerhave (1668-1738), the most famous practitioner of his time, who in 1720
became clinical professor at Leyden. He tried to explain most physiological
processes as purely mechanical.
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The French field-surgeon Ambroise Paré (1510 -1590) was famous for a
marked change in the treatment of gunshot wounds and arterial hemorrhage. He
abandoned the Arabic method of work with a red-hot knife, declared that
supposedly poisoned gunshot wounds were simple contused wounds, and
proceeded to bandage them without using hot oil. He was the first to employ the
ligature in the case of arterial hemorrhage. He improved technology of amputation,
herniotomy and tracheotomy. Pare also designed artificial limbs.
European doctors contributed in the field of stomatology. Italian doctor
Chigovanni Archoli propagandized ten rules on teeth care after meal. Since XVc.
in England the barber-surgeon cut hair and pulled teeth. The Chinese invented the
toothbrush. (It was first mentioned in 1498). Toothbrushes arrived in Europe in the
XVII c. In the late XVII c. they became popular with the wealthy in England.
The Middle Ages made great contribution into cultural history of mankind.
It was not only earlier bourgeois culture of Italian Renaissance and humanistic
world outlook in Western Europe of XVI c., but also Byzantine music and icon
painting, Hellenistic novel, Arabian medicine and many other heritages. Cultural
horizon became extend. World unity was more notable.
BIBLIOGRAPHY
1. Абдуллаев К. Этюды о казахской традиционной медицине /К. Абдуллаев //
Казахстанский фармацевтический вестник. - 2002. - N 7. - С.8.
2. Аль - Фараби. Естественно - научные трактаты: Пер. с арабского. - Алма -
Ата: Наука, 1987. - 496с.
3. Арнольд из Виллановы. Салернский кодекс здоровья: Пер. с латин. - М.:
Медицина, 1964. - 136с.
4. Воскобойников В.М. Великий врачеватель. Авиценна: жизнеописание /
В.М. Воскобойников. - 2-е изд. - М.: Мол.гвардия, 1980. - 206с.
5. История медицины / П.Е. Заблудовский, Г.Р. Крючок, М.К. Кузьмин,
М.М. Левит. - М.: Медицина, 1987. - 352 с.
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6. Кубесов А. Педагогическое наследие Аль – Фараби / А. Кубесов. - Алма -
Ата: Мектеп, 1989. - 152с.
7. Лисицын Ю.П.История медицины / Ю.П. Лисицын. - М.: ГЭОТАР-МЕД,
2004. -393 с.
8. Ошанин Л.И. Талисман Авиценны: Роман в балладах / Л.И. Ошанин. -
Ташкент: Литература и искусство, 1980.- 112с.
9. Сорокина Т.С. История медицины: Учебник для студ. высш. мед. учеб.
заведений / Т.С. Сорокина. – 4-е изд., стер.- М.: «Академия», 2005.-560с.
10. Ястребицкая А.Л. Западная Европа XI-XIII веков / А.Л. Ястребицкая. -М.:
Искусство, 1987.-176с.
5. MEDICINE DEVELOPMENT IN CAPITALISM EPOCH IN WESTERN
EUROPE. MEDICINE DEVELOPMENT IN RUSSIA
5.1. Medicine development in Western Europe
Epoch’s characteristics
Historically in comparison with previous formations capitalist mode
of production developed earlier in the countries of Western Europe, there were first
bourgeois revolutions: the Netherlands (1566 - 1609), England (1640-1649), and
France (1789 - 1794). Revolutions in England and France were revolutions of
European scale and proclaimed victory of new social order. On level with
precapitalist relations there was other: feudal, slave-owning and yet kin-tribal.
Decomposition of feudal and development of capitalistic relations first of all
began in towns of Northern Italy, because of process of manufacturing origin and
increase. They became to speak about diseases of workers in industry. This new
question in medicine reflected in work of doctor from Padua B.Ramaccini (1633 -
1714) “About diseases of artisans”. Origin of industrial pathology marked the end
of feudal medicine. From XVII – XVIIIc. culture, science and medicine had
61
features reflecting social-economic formation. Feudal medicine and prevalence of
religion stemmed the tide of natural science and medicine. But medical practice
and natural scientific thought promoted medicine development in capitalistic
society, in particular activity of scientist Hermann Boerhave (1668-1738), –
teaching of student and observing of patients near their beds.
French materialism of XVIII c. and its role
in dissemination of materialistic conception of disease
Capitalistic production felt necessity in development of mechanics, physics
and chemistry. Great influence upon their making had French materialism of
XVIIIc. which played role in ideological preparation for Great French bourgeois
revolution . Activities of doctors-materialists had big significance in medicine: A.
Lerua (1598-1679), J. LaMetree (1709-1751) and P. Cabanisue (1757-1808). C.
Marx wrote in his “Holy family” that doctor Lerua began this school, doctor
Cabanisue – is climax, doctor La Metreue –is a centre of this school.
A. Lerua understood progressive discovery of Harvey and defended study
about blood circulation. He published the book “Physics’ founding” in the
Netherlands.
J. La Metreue was one of an instigator of French materialism. His main work
was “Human being - machine” (1747), there he proclaimed study’s program of
living processes by experimental ways. He fought for materialism and criticized
idealistic systems of XVIII c.
P. Cabanisue was eminent figure of French bourgeois revolution, participant
for reforming of hospital business and medical education in France. He paid
attention on process’ study of human thinking. He considered that brain is special
organ for thought’s production.
Great natural-scientific discoveries of
the second half of the ХVIII and the first half of the ХIХ centuries
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Big significance for development of dialectic views on nature and medicine
development had great natural-scientific discoveries of the second half of the
ХVIII and the first half of the ХIХ c., among them F. Engels marked out 3 main
discoveries: theory of cellular texture of living organisms, conservation of energy
and doctrine of evolution.
Scientists of the first half of the ХIХ c. investigated microscopically texture
of living organisms that promoted origin of teaching about cell.
Y. Purkyje (1787-1869) was founder of modern histology. He concluded
about commonness of primitive component elements of animals and plants.
M. Shleiden and T. Shwann made generalization of research about texture of
plant and animals and completion of new stage in development of cellular
teaching. They were discoverers of the cell as the fundamental element of the body
of plants and animals. They considered that cells of plant and animal descend from
living, microscopically anhistous mass.
T. Shwann’s introduction of definition of cell as elementary particle,
common for plant and animal organisms, was one from natural-scientific proofs of
unity of living nature. But if all multicellular organisms – plants, animals, human
grow from one cell according to the law of cell division, then whence are endless
varieties of these organisms? Answer on this question gave third great discovery –
theory of development, which was organically based by Ch. Darwin.
Second discovery was conservation of energy. Priority of discoveries of
these nature laws belong to M.V. Lomonosov (1711-1765). He formulated the laws
of conservation of matter and power. French chemist La Vuazeue (1743-1794),
knew about Lomonosov’s work, and gave the same results in 1773 as M.V.
Lomonosov. German scientist R. Mayer pointed out on connection between
mechanical work and heat. Englishman Joule confirmed experimentally and
determined mechanical heat equivalent. Thus, they discovered law of energy
change. Laws of conservation of matter, conservation of energy promoted
development of biology and medicine.
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Question about origin of organic world interested human thought.
Ch. Darwin (1809-1882) opened the reasons of variety and unity of organic
world, its adaptation to existing conditions in the XIX c. He created scientific,
materialistic theory of volatility species and succession among them. Main
regulations he said in book “About origin of species by natural selection, or
preservation of species in struggle for life” (1859). Darwin‘s theory was a powerful
incentive to progressive development of natural scientific thought.
Medicine development
The ХIХ c. was the period of consolidation and prosperity of capitalism for
European countries.
The ХIХ c. was rich for medicine: it was created new methods, discoveries.
Medicine was connected with natural science and techniques.
As the scientific founder of pathological anatomy was Giovanni Battista
Morgagni (1682-1771).
He became a medicine doctor in 19 years old, 24 years old he was a head of
anatomy department of Bologna University. From 1711 year he was head of
practical medicine in Padua.
He published in 1761 six-volume research "De sedibus et causis morborum
per anatomen indagatis" (“About location and causes of diseases, opening by
dissection”), usually contains, besides the results of post-mortem examinations, a
corresponding history of the diseases. He described in detail organ’s changes under
the influence of diseases. Brining anatomy and clinical medicine he started
clinical-anatomical principles and created first scientifically significance nosology.
Hi was conferred on diploma of science academy in Berlin, Paris, London and
Petersburg.
Important role in development of methods of physical research belong to
Vienna doctor L. Auenbrugger (1722-1809).
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In 1754, Leopold Auenbrugger developed a new technique of physical
examination, which he called percussion. He tapped on the chest with the
fingertips with the hand drawn closed, and noted of the sounds that were conveyed
to identify a site of abnormality. He referred to these "percussed" sounds as either
high pitched, muted or dull. Auenbrugger attributed his discovery to his boyhood
experience watching his father tapping to define the level of fluid in kegs. He
published his new technique and findings in a short monograph in 1761.
In 1761 he published work on Latin “New method: how by means of percussion of
chest to discover latent diseases”. In spite of importance of this discovery,
percussion shared fare of many great discoveries: it met with inimical. Doctors of
Vienna had thought he was mad and he was victimized. L. Auenbrugger spent
latest years of his life in mental hospital; there he died in 1809.
Percussion was not widely recognized until 1808, with the publication of
Jean Nicholas Corvisart's translation of the Auenbrugger treatise. Corvisart
annotated the text and turned a 49 page monograph into a 400 page book. Corvisart
(1755-1821) - was a prominent physician, of Napoleon Bonaparte and the teacher
of Laenneck. He was an adamant supporter of percussion and taught it to his
students. He was an initiator of clinic medicine in France. He could promote to
inculcation percussion as a diagnostic method.
Next important step in development of clinic medicine was opening of
auscultation. This merit belonged to French doctor Rene Teophill Giacint
Laenneck (1782-1826). He was pathologist, clinician and teacher in Medical
school in Paris.
The origin of this idea occurred when Laenneck saw some young children
playing near the Louvre listening to the ends of a long piece of wood that
transmitted the sounds of pin scratches. The next day, he rolled up a piece of paper,
tied it with a string, and listened to his patients' chests with it. Laenneck was a
carpenter and then built a 25 cm by 2.5 cm hollow wooden cylinder which he also
used to listen to the chest sounds of his patients. He later modified this cylinder to
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have detachable parts. He noted the various sounds that he heard and then
correlated them to the anatomical findings at their autopsies. He also used a solid
piece of wood to 'listen' to heart sounds. In February of 1818, he presented his
findings in a talk at the Academy de Medicine, later publishing his findings in his
work “About mediate auscultation”, 1819. Six years after he died from
tuberculosis.
Quick development of natural science was on boundaries of ХVIII-ХIХc.
French doctor K. Bish (1771-1802) developed Morgagni‘s position and he
promoted to development of pathological anatomy in the first half of XIX c.
Physiologists experimented on central nervous system during the XVII- XVIIIc.
Check scientist I. Prohaska published his work “About structure of nerves”,
(1799) there he raised a question about functional significance of morphological
distinction between ventral and dorsal roots of spinal nerve. Later English surgeon
and physiologist Ch. Bell (1774-1842) started experimental study of distribution of
sensory nerve fibers and motor fiber between ventral and dorsal roots of spinal
nerve.
Further development of experimental line of investigation in physiology
gave Fr. Majandi (1783-1855); he considered sole source of knowledge was
experiment. He proved that ventral roots of spinal nerve were motor and dorsal
roots of spinal nerve were sensory, receptor.
German scientist I. Muller (1801-1858) studied structure and functions of
organs of vision, hearing, sound and speech in human and animals. He traced
development of nervous system in different animals, studied blood, lymph
compositions and glands structure.
C. Bernard (1813-1873) in the middle of XIX c. posed a problem to create
experimental medicine connecting physiology, pathology and therapy. His works
about sugar exchange in organism and liver functions got maximum fame.
German naturalist, doctor, physiologist and physician G. Gelmgholcz (1821-
1894) first gave mathematic interpretation of conservation of energy in 1847.
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Idealistic views of I. Muller, C. Bernard and their many followers
conditioned Western Europe physiology limitation in a number of main cases and
hampered the development of biology, physiology, experimental pathology and
clinical medicine.
The important discoveries in microbiology connected with name of French
scientist, chemist and microbiologist l. Pasteur (1822-1895).
All history of microbiology divides into 2 periods: before Pasteur (empiric)
and after Pasteur (experimental). In the early XIX c. many scientists believed in
spontaneous generation i.e. that some living things spontaneously grew from non-
living matter, before discovery of Pasteur. Nevertheless, as said R. Boil in XVIIc.
who comprehends the nature of contagious diseases who can explain the nature of
fermentation.
This scientist became L. Pasteur. Pasteur proved that microscopic organisms
caused disease. His main discoveries are enzymatic nature of lactic (acid)
fermentation (1857), alcoholic fermentation(1860) and butyric fermentation
(1861); study diseases of vine and beer (from 1857), disproof of hypothesis of
spontaneous origin (1860), research of diseases of silkworms(1865), bases of
concepts of artificial immunity (1880), anthrax vaccine (1881). Then, in 1885,
Pasteur successfully used the vaccine on a boy who had been bitten by a rabid dog.
Pasteur also invented a way of sterilising liquids by heating them (called
pasteurisation). It was first used for wine (in 1864) and later for milk.
Significance of those discoveries was great for French economics, but L.
Pasteur was generally recognized only to the end of his life. His discoveries were
bases for microbiology development and struggle with infectious diseases. He
organized first antirabic station in Paris in 1885.
Big significance for microbiology development had discoveries of German
doctor, the Nobel Prize laureate of 1905y. R. Koch (1843-1910). He determined
etiology of anthrax (1876), opened pathogens of tuberculosis (1882) and cholera
(1883).
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Microbiology got wide development in many countries, from the end of 70-
beginning of 90 years of XIXc. were opened pathogens of many infectious
diseases. This period has name of bacteriological epoch.
In 1865 Joseph Lister (1827-1912) discovered antiseptic surgery, which
enabled surgeons to perform many more complicated operations. He had
precursors: N.I. Pirogov used spirit and tincture of iodine for disinfection,
Hungarian obstetrician I.F. Semmelweiss used chloral water for hand disinfection.
Lister atomized grout of carbolic acid in the air before and during the
operation. His method reduced postoperative complications and mortality in
several times. German surgeons developed a better method.
Method of antiseptic was added method of asepsis in the end of XIXc.
Founders of asepsis were German surgeons E. Bergmann (1836-1907) and his
follower K. Shimmelbush. The surgeons’ hands and clothes were sterilized before
the operation and surgical instruments were sterilized with super heated steam.
They first reported about method of asepsis in 1890 on International doctors’
congress in Berlin. Rubber gloves were first used in surgery in 1890.
A new epoch of progress begins in 1846 with the introduction of narcosis.
The discoverer of the narcotic effect of ether is the American physician and
chemist, Charles Jackson (1805-80), who together with dentist William Morton
(1819-1868), made experiments upon his own person. The first narcosis was
undertaken in 1846 by Warren, and in the same year in London by Robert Liston.
G. Warren eliminated neck tumor under ether anesthetic.
N.I.Pirogov for the first time used ether anesthetic in field conditions in
summer of 1847. T.Billroth (1829 - 1894) first carried out successful partial
gastrectomy in 1881, 1892- esophagectomy, 1893- larynx resection.
T. Cokher (1841 - 1917) – was a follower of T. Billroth and B. Langenbeck,
he was awarded to Nobel Prize for work in physiology, pathology and surgery of
thyroid gland. He made his contribution to development of abdominal surgery,
traumatology and military-field therapy.
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Era of antiseptic and aseptic became wide perspectives for emergency
surgery. There were first operations on appendectomy in German and England in
1884. Narcosis and antiseptics now make possible a series of daring operations,
before impossible, with essentially better chances of success. There were used
instrumental methods for checkup and treatment in surgical clinics.
Founder of experimental hygiene was German doctor M. Petencoffer (1818 -
1901). He opened department of experimental hygiene in Munchen University in
1865. He contrived method in the field of home hygiene, which one called by his
name.
On the whole, medicine in the beginning of XX c. was enriched by natural
science progresses. V.K. Roentgen opened radiation in 1895; it enlarged ability of
sick person examination and started new medical discipline – radiology.
Scientific substantiation of theory of evolution was opening law heredity by
Czech naturalist G. Mendel. His role was recognized in 1900, then C. de Fries
(Holland), C. Corrence (Germany) and A. Chermack (Austria) almost reopened
simultaneously laws of Mendel and experimentally proved his conclusions. From
this time experimental genetics had begun, it is science about heredity and mobility
of organisms. Important stage in genetics development was creation of
chromosome theory of heredity in 1911 (G. Morgan, C. Bridges, Ck. Muller).
From that moment fundamental genetic theory became materialistic conception of
gene. The XX c. became the period of rapid development of genetics and on its
base - molecular genetics and molecular biology.
The Nobel Prize laureates in medicine were R. Ross for study malaria (1902)
and A. Lavern for malaria pathogen (1907), R. Koch - for tuberculosis pathogen
(1905), I.I. Mechnicov and P. Erlikh for working up immunity theory (1908); G.
Dogmack substantiated the use of sulfanilamide’s for treatment of bacteritic
infections in 1939; A. Fleming got penicillin and used it in doctor’s practice in
1945.
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5.2. Medicine development in Russia
Epoch’s characteristics
Russia was feudal –serf country in the end of XVII – the beginning of XVIII
c. capitalistic relations just began to engender. Thanks to efforts of Peter I the
Great (1672-1725) Russia became powerful land and sea country.
Genius Russian scientists – M.V. Lomonosov was the head of struggle for
independent development of native science. His views were philosophic and
natural-scientific base for development of natural science and medicine.
The period from the end of XVIII - to the middle of XIX c. was
decomposition of serfdom and accelerated forming of capitalistic relations.
Tsarist government climbed to save and secure serfdom, it carried out a
reactionary internal and foreign policy, but scientific ideas was developed and
achieved big successes in Russia of the first half of XIX c.
Russian medical doctors with university degrees appeared only in the XVIII
c. after the politics of westernization by Peter I.
Russian doctors and medical students took part in the liberation movement
of 60-70 years. Social medicine was origin and developed in that period under the
influence of revolutionary enthusiasm. The process of differentiation of medical
disciplines considerably precipitated.
Reorganization of public health authority
Betterment of medical business management in Russia began from 1716, and
when Pharmaceutical Board was subordinated to archiyatr. At the suggestion of
archiyatr I.L. Blumentrost Pharmaceutical Board and chancellery were reorganized
to Medical chancellery. In 1763 it was transformed to Medical Board. In 1804
medicine management was passed to the Ministry of Internal Affairs there Medical
Council had questions on medical science. Military-medical institutions were
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under the jurisdiction of Military and Sea Ministry. Public medicine in Russia of
XVIII c. had bureaucratic features.
Medicine development of Russia in the XVIII century
First hospital school was opened in 1707 under the jurisdiction of land
hospital. Holland doctor N.L. Bidloo was the head of this school. Later hospital
schools were opened in Petersburg, Cronshdatd, Kiev and other towns. In 1786
Hospital schools were reorganized to medical-surgical schools (colleges). In 1725
Medical-surgical academy of science was opened in Petersburg. In 1755 was
opened Moscow University and under its jurisdiction the medical faculty in 1764.
There were medical institutions in Russia among them: monastic, public,
military (land and sea) hospitals, founding hospital with obstetric institutions,
variolous houses, and chemist’s shops. It was begun accounting of birth rate and
mortality, decrees about improvement of Moscow, cleansing of settlements,
foodstuffs were under surveillance in markets.
Russian doctors began to use new methods of examinations: percussion,
auscultation.
Prominent scientists- doctors in Russia of XVIII c.:
P.Z. Condoidi (1710 -1760) was a prominent manager in Russian medical
business. His name was connected with first medical library (1756).
A.P. Protasov (1724-1796) was a first Russian professor – anatomist,
physiologist, and academician of Petersburg academy of science, one of the first
initiator of Russian anatomic terminology.
C.I. Schepin (1728-1770) - first Russian teacher in Moscow hospital school.
S.G. Zybelin (1735-1802) - first student of Moscow University and first
professor of medical faculty of this University. First clinician, first hygienist, first
pediatrician.
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D.S. Samoilovich (1744-1805) - founder of domestic epidemiology. He paid
attention on teaching of medical personnel.
N.M. Maximovich –Ambodic (1744-1812). He was one of first initiator of
Russian obstetrics, pediatrics and pharmacognosy. He published first original
Russian manual “Art of midwife’s business or science about womanish business”.
A.M. Shumlyansky (1748-1795) had great place in histology. In his work
“About kidneys” (Strasburgh, 1782) he described peculiarities of kidneys structure.
Medicine development of Russia in the XIX century
The time from the end of XVIIIc. to the middle of XIXc. – was time of
serfdom’s decomposition and accelerated forming of capitalistic relations. Russian
czarism played role of “zhandarm of Europe” on international arena.
Philosophical views of V.G. Belinskii, A.I. Gerczen, decembrists and
materialistic views of Radischev A.N. (1749-1802) had influence on medicine
development. Radischev A.N. was a writer, revolutionist.
Raise of Russian patriotic and medicine development were during the
patriotic war of 1812.
Basic features of medicine development of the first half of XIX c. :
- opening of new universities with medial faculties in Derpt (Yuriev, 1802),
Vilna (1803), Kazan (1804), Charckov (1805), Kiev (1833);
- formation of two main centers of medical science- medical surgical
academy and medical faculty in Moscow University, preparation of native
text-books and manuals, origin of first science medical school;
- first Russian anatomical school, its founder Zagorsky (1764-1846). His
work “Short anatomy”(1802) – was a top of pedagogical activity in
anatomy;
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- first surgical school of I.F. Bush (1771-1843), his work “Manual for
teaching surgery” (1807) in 3 volumes, was the original Russian text book
on surgery.
Prominent scientists- doctors:
E.O. Mukhin (1766-1850) was anatomist and physiologist, hygienist and
judicial doctor. He contributed to Russian anatomical nomenclature. His works:
“The beginning of science of bonesetter” (1806), “Description of surgical
operations” (1807), Manual on anatomy in 8 volumes (1818).
I. V. Buyalsky (1789-1866) was world known great anatomist and
surgeon. He developed many new surgical operations and created new surgical
tools. First in Russia he made bandage of nameless arteries.
M.Y. Mudrov (1776-1831) was a founder of native clinical teaching and
clinical therapy. He followed the Hippocratic credo "to treat not a disease but a
patient". His working out of inquire methods of sick person, schemes of writing of
case records. He contributed into medical hygiene.
I.E. Dyadkovskii (1784-1841) was a prominent therapeutics – clinicist,
pathologist – thinker. Main method of cognition was experience, observation and
common sense.
N.I. Pirogov (1810-1881) – founder of topographical and surgical
anatomy, military-field surgery, anatomical- physiological approach in surgery. He
reformed in organization of surgical departments (division into “clean” and
“purulent” departments), consummation of antiseptics, working out of teaching
about prophylaxis of surgical infections. He in fact created a new medical science,
field surgery, and suggested new, rational principles for the grouping, distribution
and evacuation of the wounded. His, work, "Fundamentals of Field Surgery"
(1864), had soon become a reference book for field surgeons in all countries. He
paid attention on hygiene as a science which can help to save humanity from
diseases. He considered that future belong to preventive medicine.
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It was founded society of Russian doctors in 1892 in memory of Pirogov.
Russian doctor’s society met on conference by the name of Pirogov till 1918. And
only in 1995 this tradition reactivates.
Prominent representatives of clinical medicine in Russia of second half of
XIXc.: S.P. Botckin (1832-1889), G. A. Zakharian (1829-1897), А. А. Ostroumov
(1844-1908) – founders of clinical schools .
S.P. Botckin (1832-1889), was a founder of the biggest scientific
therapeutic school in Russia. He developed clinical experimental direction in
medicine. He opened first laboratory of experimental medicine in Russia, and first
discovered nature of catarrhal jaundice (co-called “Botckin’s disease”, 1866) he
was great teacher, during his 28 professor’s activity he had 106 residents among
them 87 persons became doctors and 45 – professors of high school.
G.A. Zakharian (1829-1897) was a founder of big clinical school. He
developed original method of anamnesis – questions to patient. He described zones
of perception disorders at the internal diseases; these zones had got name “zones of
Zakcharian - Ged”. He got fame of the best doctor; his “Clinical lectures” became
classical and was republished many times.
A.A. Ostroumov (1845-1908) – representative of Russian clinical medicine
of second half of XIXc. In his lectures he spoke about synthesis of treatment and
prophylactic medicine.
Independent direction of medicine became pediatrics in second half of XIX
– beginning of XX c. First lecturer was S.F. Khotoviscky (1796-1885), he wrote
“Pediatrics” in 1847. He gave prove to existence of pediatrics as independent
discipline, he described anatomical-physiological peculiarities of children
organisms, diseases of any ages, etc.
First department on pediatrics was opened in Petersburg medical-surgical
academy in 1870-1876. Its founder N.I. Bystrov (1841-1906) developed first
program of teaching pediatrics, such as questions on hygiene, physical culture and
treatment management.
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In 1897 professor of department was N.P. Gundobin (1860-1908). His
works “General and particular therapy of childhood” (1896) and “Peculiarities of
childhood” (1906) became standard in world and native medicine.
In 1888 pediatrics department was opened in Moscow University. Since
1891 head of department was N.F. Filatov (1847-1902). He described chickenpox
(1872), rubeola scarlatinosa (1885), early symptom of measles.
Development of native physiology is connected with activities of I.M.
Sechenov (1829-1905), his researches: physiology of higher nervous activity and
labor physiology. He was known as the Father of Russian physiology. He
introduced electrophysiology into laboratories and also into teaching. His life work
was always concentrated on neurophysiology. He wrote a major classic “The
Reflexes of the Brain” (1863). He also maintained that physiochemical factors in
the environment of the cell are of equal if not greater importance. He will also be
remembered for his intellect and his knowledge, as well as for his scientific
achievements. He founded physiological school of Russia; his successor was N.I.
Wedensky (1852-1922). Wedensky introduced notion about lability and created
study of parabiosis in his work “Excitation, slowdown, narcosis” (1907).
Ideas of Sechenov were continued by Great Russian scientist I. P. Pavlov.
I. P. Pavlov (1849-1936) – founder of first-rate physiological school and
opening of method of conditioned reflex.
Pavlov's main area of research throughout his scientific career was on the
digestive process, which brought on a series of experiments exploring the
correlation between the nervous system and the autonomic functions of the body.
Pavlov experimented with dogs, studying the relationship between salivation and
digestion. By applying stimuli to the animals in a variety of ways, using sound,
visual, and tactile stimulation, he was able to make the animals salivate whether
they were in the presence of food or not; a phenomenon he called the conditioned
reflex (1901).
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Pavlov was elected a corresponding member of the Russian Academy of
Sciences in 1901. His famous work “Lecture about work of main digestive
glands“(1897), for this work he was awarded by Nobel Prize in 1904. He was also
elected Academician of the Russian Academy of Sciences in 1907, given an
honorary doctorate at Cambridge University in 1912, and awarded the Order of the
Legion of Honour in 1915, the recommendation of the Medical Academy of
Paris. Pavlov‘s works on study high nervous activity showed that conditioned
reflex produced in cortex of big cerebral hemispheres – the great achievement of
XX c.
He wrote “Letter to youth” (1935) as testament to young people who
devoted themselves to science.
Second half of XIX c. was marked by development of new branch –
bacteriology (latest it became microbiology). Prominent scientists I. I. Mechnicov
(1845-1916) - biologist, pathologist, immunologist and bacteriologist, founder
phagocytes theory, he was awarded Nobel Prize in 1908y.; Gabrichevsky (1860-
1907) – founder of first course on microbiology in Moscow University (1892),
organizer of antidiphtheric serum ‘s production in Moscow;; D. K. Zabolotny
(1866-1929) – initiator of epidemiology(1922), he organized Institute of
epidemiology and microbiology in Ukraine N.F.; Gamaleya (1859-1949) – founder
of bacteriological station (Odessa, 1896), initiator of prophylaxis hydrophobia,
cholera, smallpox, plague and typhus.
Many great scientists made their contribution into development of native and
world science. Important meaning had works of scientists in study of infectious
pathogen, etc.
Economical and social progresses made for separation and development
hygiene as independent science. First hygienic schools were schools of А. P.
Dobroslavin, F.F. Erisman.
First professor on hygiene was А. P. Dobroslavin (1842-1889). He was the
author of first text books on hygiene: “Hygiene. Course of public health” (1882-
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1884) and “Military hygiene” (1885-1887). By his initiative it was founded
“Russian society of public health protection” and popular magazine “Health” in
1878.
F.F.Erisman (1842-1915) was an outstanding Russian hygienist, one of the
founders of scientific hygiene in Russia, an active figure of public medicine. He
paid great attention on school hygiene and hygiene of living premises, fought for
improvement of sewerage system and for “proper organization of sanitary
conditions in Russia”.
In 1881 F.F.Erisman was elected professor of Moscow University, and in
1882 headed department of hygiene – the first in Moscow and the second in
Russia. His lectures and research papers and books exhibited a wide social
approach to solution of medical problems.
Second half of XIXc. was marked by great achievements of Russian
medicine. Sanitary development in physiology, microbiology, experimental
hygiene and practical medicine determined the perspectives of improvement
medical – sanitary legislation in Russia.
Table # 1
Prominent natural scientificdiscoveries of XVIII-XIXc., incidental with medicine
Year Author Essence of his discovery
1756 Lomonosov M.V. (1711-1765)- Russian
scientist, academician of Petersburg academy of
science (1745)
Law of conservation of mass
in chemical changes
1774 La Vuasie Antaean Loran (1743-1794)- French
chemists
Regardless of Lomonosov
M.V. opened the same law
1838 Shleiden Matthias Jacob (1804-1881) – German
botanist
Theory of cellular texture of
plants
1839 Shwann Theodore (1810-1882) – German Theory of cellular texture of
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zoologist and physiologist animals and plants
1841 Mayer Julius Robert (1814-1878) – German
doctor and naturalist
Law of conservation of
energy and determination of
mechanical heat equivalent
1843
1847
Ghoul James Prescott (1818-1889) – English
physician
Gelmgholtz German Ludwig Ferdinand (1821-
1894) – German physician, physiologist,
naturalist, member correspondent of Petersburg
academy of science (1868)
Regardless of Mayer opened
the same law
1859 Darwin Charles (1809-1882) – English
biologist, member correspondent of Petersburg
academy of science (1867)
Doctrine of evolution «Origin
of species by natural
selection, or preservation of
selected species in struggle
for existence»
BIBLIOGRAPHY
1.Блинкин С.А. Героические будни медиков /С.А. Блинкин. - М.: Медицина,
1980. - 190с.
2.Глязер Г. О мышлении в медицине / Г.О. Глязер. - М.: Медицина, 1969. -
268с.
3.Вам жить в XXI веке: Сборник / Сост. Г.А. Юркина. - М.: Мол.гвардия,
1986. - 206 с.
4.История медицины / П.Е. Заблудовский, Г.Р. Крючок, М.К. Кузьмин,
М.М. Левит. - М.: Медицина, 1987. - 352 с.
5. Лисицын Ю.П. История медицины / Ю.П. Лисицын.- М., ГЭОТАР-
МЕД, 2004. -393 с.
6. Сорокина Т.С. История медицины. Краткий курс лекций /Т.С. Сорокина.-
М.: УДН., 1988.-72с.
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7. Сорокина Т.С. История медицины / Т.С. Сорокина. - М.: Медицина, 1994.
- 384с.
8. Сорокина Т.С. История медицины: Учебник для студ. высш. мед. учеб.
заведений / Т.С. Сорокина. – 4-е изд., стер.- М.: «Академия», 2005.-560с.
9. Стоун И. Происхождение: Роман - биография Чарлза Дарвина: Пер. с
англ. / И. Стоун. - 2-е изд. - М.: Политиздат, 1985. - 447с.
10. Петров Б.Д. От Гиппократа до Семашко: преемственность идей [Очерки
и портреты] / Б.Д. Петров. - М.: Медицина, 1990. - 168с.
6. MEDICINE DEVELOPMENT IN KAZAKHSTAN
Medicine of Ancient Kazakhstan. Development of medicine in the Middle
Ages
Two thousand years ago in territory of Kazakhstan there lived various tribes
- usuni, alany, kangly. Basically they were engaged in cattle breeding and
consequently often changed places of parking - wandered. They grew up horses.
Inhabitants of river valleys of Syr-Dariya, Chu, Irtysh except for cattle breeding,
were engaged also in agriculture.
There, where the river Arys runs into Syr-Dariya, was a green oasis. Above
it the big hill towers. Local residents speak, that on a place of this hill there was a
city of Otrar with magnificent palaces, minarets, with beautiful streets. During that
far time for territories of Kazakhstan there were also other cities similar to Otrar. It
were Sauries, Sauran, Taraz, Kulan.
On the grounds of Kazakhstan from the east hordes Mongols - Tatars have
rushed in the beginning of XIII c., in 1218. People of Kazakhstan courageously
battled against conquerors, but they could not stop an army of aggressors. Only in
XVI c. the Mongolian yoke was overthrow on a greater part of territory of
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Kazakhstan. With falling the Mongolian yoke in Kazakhstan uniform language and
a uniform facilities began to be formed.
In the beginning of XVII c. Kazakhs shared on three zhuz - the Senior,
Middle, Younger. The Kazakh society at that time consisted of two social groups.
They differed to political and legal attributes. They were ak suiek (white bone),
concerned chingizids (descendants of Chingiz - khan and hajji - descendants of
associates of prophet Mohamed. Other groups concerned to kara suiek (black
bone). The Supreme authority concentrated in hands of khan. Attempts of khans to
create the uniform centralized state, having united all Kazakh zhuz, did not give
due results.
In XVIII c. on territory of Kazakhstan there was no uniform state, and
separate khanstvo which were in constant enmity. Heavy was externally - political
position. The main danger proceeded from the east, from Jungar khanstvo.
Abulhair - khan has collected notable people, has told about heavy position,
about enemies. Long spoke gathered and have decided to pass under the Russian
citizenship. Empress has accepted ambassadors of Kazakhstan on October, 30th,
1730. In 1731 Abulhair - khan and his citizens have sworn about voluntary
connection to Russia.
In the history of Kazakh people voluntary connection to Russia was of great
importance. More advanced Russian economy and culture have rendered
progressive influence on economic and cultural development of Kazakhstan. Also
it was necessary to consider the period of connection by the beginning of
occurrence of medical aid in territory of Kazakhstan. Before connection in
Kazakhstan there were no neither doctors, nor medical institutions.
Roots of the Kazakh national medicine leave in an extreme antiquity.
Studying of the written sources which have reached us testifies, that people had
various knowledge and skills on doctoring, in one cases benefited people, in others
- obvious harm, in the third, appeared indifferent collected and cultivated.
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People occupied territories of Central Asia and Kazakhstan had three large
religions of the East influence: zoroastrism, Buddhism, Islam. On the large
territory the final victory was gained with Islam, and it became officially
recognized religion.
Thus, the national medicine has arisen on the basis of practical experience of
many generations. Anatomic knowledge at Kazakhs were deep, it was promoted by
knowledge of anatomy of animals. They considered as principal organs of the
person brain, heart, liver. The big attention was given influence of mentality on
health that follows from the legend. Great wise men have asked how long he lives.
He has answered: "1000". Every joyful, cheerful and useful day he equated with
one year.
Pregnancy and delivery at people of Kazakhstan have been surrounded by an
aura of mystery and superstition. Delivery accepted by women whom Kazakhs
named kindik sheshe, translated as mother who tie up umbilical cord. They could
make turning, Caesarian section. The first 40 days of baby’s life were considered
very dangerous. In conditions of nomadic way of life care of newborns had great
value the cradle of a special design – besik.
For treatment of the population widely used medicinal grasses: as
expectorant applied inula, for treatment gastric - intestinal diseases - grass
("kumuzdyk"), for increase it is intimate - a vascular tone - grass ("kyzylsha").
According to separate authors, doctors of Kazakhstan knew 247 medicinal grasses.
The important place in treatment had horse and camel milk of various
preparations (koumiss and shubat). Koumiss used for treatment of tuberculosis,
scurvy, anemia, illnesses of heart and a stomach.
Healers rendered the surgical help. Skilled dargers (healers) could make
laparotomy, herniotomy, remove a cataract.
One of the greatest disasters among people was smallpox. The local
population did not know the reasons of occurrence of this illness and measures of
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struggle with it. They wandered from the places amazed by smallpox, also did not
come back. They spent artificial infection - vaccination by natural smallpox.
The magic medicine was showed widely in Kazakhstan in ways of
diagnostics, treatment, and the prevention of diseases.
To protect from illnesses Kazakhs hang on a neck the fish teeth, the wolf
legs, feathers and legs of an owl. During pregnancy the woman should not eat
camel meat. It was considered, that differently she would pregnant 12 months as
the camel.
Magic "diagnostics" was based on various ways of a guessing. Globule
divination was widely spread on the territory of Kazakhstan.
But the leading role in magic ways of diagnostics and treatment belonged to
baxes. Baxes before the beginning of a session got acquainted with patients.
Historically compounded social – economic culture of Kazakhstan promoted
to origin of great scientists.
Al-Farabi (870 - 950), the native from Otrar, has created immortal works on
philosophy, mathematics, music, history, medicine. In the published works medical
views were presented by separate fragments in philosophical treatises, in the
medical treatise "About objection to Galen in occasion of its disagreements with
Aristotle concerning bodies of a human body ". The ideas stated in this treatise
quite correspond to modern representations about medicine as sciences, about the
reasons of occurrence, treatment and the prevention of illnesses.
In Karahanid state existing at X-XIc. on the territory of Kazakhstan the
outstanding poet and thinker was Zhusup Balasuguni (b.1020) . His work
“Kutadgu bilik” (“Beneficial Knowledge”) became known in many countries. He
described healers, doctors, etc.
Healer O. Tleukabyl uly (1397-1492) was born in Semirechie. By order of
khan he began to write his medical work “Shipagerlic bayan” (“Healer’s
confession”) in 1470 till 1480. The book consisted from three parts; he described
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organism and environment relations, questions of diagnostics and treatment. He
gave 10 medical directions which still actual nowadays.
Works of great Al-Farabi, poet – philosopher Z. Balasuguni, scientist- healer
O. Tleukabyl uly big influenced on development of Kazakh and world medicine.
Medicine during the period of connection of Kazakhstan to Russia and
the bourgeois reforms in the XIX century
In 1731 after connection of Younger zhuz to Russia doctors of the Boundary
commissions appeared on territory of Kazakhstan.
The primary goal of these doctors was epidemiological supervision: not to
admit penetration of epidemic illnesses into the central provinces of Russia.
Rendering of medical aid to the population was not included into duties of doctors
of the Boundary commissions.
After 101 year’s connection to Russia, on March, 15th, 1832 Asian
committee has been established the position of doctor for health services of the
population in Younger zhuz. The first doctor was A.A.Sergachev who has finished
in 1824 medical faculty of the Kazan University. In 1840 under the petition of
khan of horde it was authorized to have the midwife in horde. But Only on April,
24th, 1868 the medical department of the Ministry of Internal Affairs had been
directed the midwife Nadezhda Lebedeva for work in the Internal horde
In 1845 the Regulations about “Internal Kirghiz horde”: “the public hospital
with 15 beds in which all Kirghiz will be free of charge “.
Preventive measures against drift and distributions of epidemic illnesses
were carried out by medical workers of the Boundary commissions. In 1844
boundary commission consisted from one doctor, one medical assistant and 10
pupils - medical assistants from Kazakhs. Training of medical assistants was spent
at the Orenburg military hospital.
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One of the greatest disasters among Kazakhs was smallpox which was
characterized by high death rate. The first convincing data about vaccination
among Kazakhs concern to 1863 when it has been imparted against smallpox 221
people. Epidemics of natural smallpox, malaria, tuberculosis, syphilis were in 1874
in the Internal horde.
The next stage of development of medicine in Kazakhstan was connected
with zemstvo medicine in Russia which was engaged in rendering of medical aid,
mainly, to rural population. The zemstvo reform was a continuation of the 1861
reform which abolished serfdom in Russia. The zemstvo reform started in 1864; it
was introduced zemstvos - new self-administration organs in the rural localities.
The districts zemstvos started inviting doctors, tried to organize medical sanitary
service.
Zemskaya medicine could not bring basic changes on surburbs of zhuz.
After some times government was forced on improvement of medical service of
rural population of Kazakhstan.
On May 29th, 1897 the opinion of State Council “About reform of medical
sector in the districts of Akmolinsk, Semipalatinsk and Semirechensk areas”.
According to this document the health services to rural population should be lead
by local principle for what districts shared on sectors with head - doctor.
Doctors repeatedly, but unsuccessfully brought an attention to the question
on expansion and strengthening of medical institutions, however their offers, as a
rule, deviated under various pretexts.
Doctors-Kazakhs got high medical education, and studied in Kazan,
Moscow, Kiev, Tomsk, Saratov universities with support of the Kazakh societies.
A.D. Aitbakin (1859 - 1919) finished in 1894 medical faculty of Tomsk
University. He organized the first medical ambulance station, the drugstore in
village Katen-Karagay. He printed in the newspaper on Kazakh language with the
purpose of propagation of medical knowledge. Last 2 years of his life he worked in
Ust Kamenogorsk.
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D.U. Kusyabgaliev (1870-1914) received a degree of the doctor with
distinction. Since 1900 till 1928 he worked in the Ural area as manager of medical
sector. In the thirtieth years he worked on different medical posts in Alma-Aty and
Chimkent areas, rendered medical aid to the population, spent sanitary-epidemical
actions.
N. Zhakupbayev (1890-1032) finished medical faculty of Kiev University
with distinction in 1916. He worked in Semirechensk and Semipalatinsk areas, he
took active participation in foundation of red medical jurt. He spent active work on
training of the medical staff, participated in work of the First All-Russia congress
of doctors in Moscow.
In 1902-1905 in Kazakhstan in connection with resettlement of Russian
peasants there was origin migratory medical organization which was under central
administrative board of land management and agriculture. Zemskaya medicine was
in charge of the Ministry of Internal Affairs. Such dissociation led to inconsistency
of actions of medical workers that affected rendering of medical aid to the
population.
The system of medical service was spent as dispersal; medical aid was on an
outpatient basis. Thus, zemskaya medicine was introduced in Kazakhstan later than
in other Russian provinces.
Development of medicine and public health in Kazakhstan
in the XX - XXI centuries
The decree from August, 26th, 1920 had been organized Independent Kirghiz
Socialist Soviet republic, this decree alongside with others narcoms (national
commissariat) had been created national commissariat of public health. The first
national commissar of public health was M.S.Shamov, his deputy was M.M.
Chumbalov.
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M.S. Shamov was born in Sevastopol in worker’s family. He finished
medical faculty of Kharcov University in 1914, then he worked in Soviet army as a
doctor till 1917. Since 1920 till 1928 he was commissar of public health services in
Kazakhstan. He made greater work on teaching of the medical staff, especially
from Kazakhs. Under his management in 1925 the first regional sanitary-
bacteriological institute in Kazakhstan, medical assistant's schools in Orenburg and
Uralsk have been created, short-term courses on teaching of medical nurses were
organized.
M.M. Chumbalov (1873-1940) was born in Kaztolov district of Ural oblast.
He finished medical faculty in Kazan in 1899. In the 1929-1938 he headed
republican board of drug-stores and then he was head of anti plague station in
Uralsk.
In an initial stage of public health becoming the greater help was rendered
by the national commissariat of public health services of Russian federation to
Kazakhstan. On struggle with infectious illnesses there were directed
epidemiological groups and medical workers. In 1922 number of doctors was 247.
The important role in struggle with dangerous infections has played mobile
medical and antiepidemical laboratories.
Alongside with development of a network of treatment-and-prophylactic
institutions there were opened medical colleges in many towns of Kazakhstan.
There were opened republics scientific research institutes, dermato-
venereologic scientific research institute in 1931, institute of protection of
motherhood and childhood in 1932, Kazakh Scientific Research Institute (SRI) on
tuberculosis, Scientific Research Institute (SRI) of public health services and
hygiene.
In the beginning of the 30th years of XXc. it was created conditions for
teaching of the national medical staff. Medical institute was opened in Alma-Ata in
1931. The first rector became S.D. Asfendiyarov.
86
S.D. Asfendiyarov (1889-1937) finished Petersburg military- medical
academy in 1912. From 1928 he worked as a rector of Kazakh State University till
1937. He was illegally victimized in 1937 and 23 of February he was sentence to
be shot. He had been rehabilitated in the 26 of May, 1937.
The next years: Karaganda state medical institute (1950), Semipalatinsk
state medical institute (1953), Actubinsk state medical institute (1957),
Tcelinograd state medical institute (1958), Chimkent state medical institute (1979)
were organized for teaching of medical staff.
The public health service of Kazakhstan before Great Patriotic War has
reached successes in health services of the population, in struggle with infectious
diseases. On rates of growth bed networks in 1938 Kazakh SSR won the first place
among union republics. The public health service of Kazakhstan has got stronger.
In 1940 the sanitary-bacteriological institute has been transformed to institute of
epidemiology and bacteriology.
Within Great Patriotic War (1941-1945), despite of greater difficulties which
were tested with the country, the public health services and medical science
continued to develop. Academy of sciences of Kazakh SSR has been created in the
end of war. The institutes of medical structure - physiology, clinical and
experimental surgery, regional pathology were attached to the Academy of
sciences. Kazakh SRI on oncology and radiology was opened in 1960, Kazakh SRI
on pediatrics in 1972, Institute of nourishment in 1974, Republic scientific
research center of childhood and motherhood protection in 1975, SPI on
cardiology in 1977.
Fundamental works of the Kazakhstan scientists are widely known not only
in our country, but also abroad. These are researches on physiology and
pathologies lymph and blood circulations (A.P.Polosuhin), epidemiology of
cancer, endemic craw (A.N.Syzganov), epidemiology of brucellosis
(I.K.Karakulov), infectious allergology (N.D.Beklemishev), functional
morphology of vegetative nervous system (A.R.Rahishev), neurosisand its
87
treatment (A.M.Svyadosch), diabetes, pulmonary edema (J.A.Lazaris, and
I.A.Serebrovskaya), questions on abdominal and urgent surgery, angiosurgery
(S.V.Lokhvitsky), hygiene of nourishments (T.Sh. Sharmanov) etc.
T.Sh. Sharmanov - graduator of Karaganda state medical institute (1955)
became a minister of public health of Kazakh SSR (1971-1982). He is a doctor of
medical science, professor, academician of Russian academy of medical science
and national academy of science of the Republic of Kazakhstan. He is a president
of Kazakh academy of nourishment. T.Sh. Sharmanov is a laureate of many prizes:
State Prize of the Republic of Kazakhstan, independent prize “Platinum Tarlan” in
science field, prize of WHO for contribution to world public health (2005).
The Republic of Kazakhstan in structure of the USSR adhered to principles
of the Soviet model of public health services: state character, free, preventive
direction, general availability, planned character, connection of science and
practice. The country has achieved successes in decrease of many infectious
diseases, prophylactic medical examination, training of experts, in the decision of
problems of rural public health services.
Crisis of the Soviet system of public health services is consequence of crisis
of the Soviet system of statehood. Developed command-administrative system
suffered from bureaucratism, suppressed the initiative and creativity, activity was
under construction without taking into account economic feasibility. Financing of
the Soviet public health services was under construction by a residual principle.
Sovereign republics of USSR, including Kazakhstan had the deformed parameters
of health and public health services. So, number of doctors and sick-lists beds was
the highest in the world, 143 doctors and 131 hospitals on 10.000 populations, but
it was not accompanied by improvement of parameters of health of the population.
The 25th of October, 1990 Supreme Soviet of Kazakh SSR signed the
declaration about state sovereignty. In 1991, the 10th of December the Kazakh SSR
was renamed into Republic of Kazakhstan.
88
In 1992 Kazakhstan became independent and full member of World health
organization and accepted state liability for appeal to all people “Health for all in
XXI c.”(1998).
The modern period of development of the country is characterized by
transformation of all sectors of public life and an economic mechanism of
Kazakhstan; there were new requirements of perfection of system of public health
services, public health care. Successful promotion in achievement of the purpose -
"Health for all in XXI century" is directly depends on heads of the state that make
political decisions on public health services in partnership with other public forces
of the country and are guided by recommendations of WHO. For development and
improvement of public health services the government, the international
organizations should find not ordinary approaches with reorientation to a modern
situation in the world, having directed the efforts to development of medicine and
improvement of health in Kazakhstan.
Development of medicine in the Central Kazakhstan
The territory of modern Karaganda area was a part of Bayanaul, Akmolinsk
and Karkaralinsk districts before revolution. Along border of districts there were
first settlements - villages - Karkaralinsk (1824), Ulytau (1941), etc., populated
mainly the Siberian Kazaks. In 1833 A. Baizhanov discovered Karaganda coals, in
1834 Russian merchant S.Popov discovered in Berkara (Karkaralinsk) - the first
copper and silver - lead.
Malaria, returnable typhus, skin diseases, cholera, trachoma were wide
spread in the Central Kazakhstan.
All medical aid was provided by the one medical sector with staff - the
doctor, the medical assistant, the midwife. Medical aid was rendered by medical
assistants, who finished Omsk College, in 1880 then have entered posts of volost
89
medical assistant. They made simple surgical operations, accepted deliveries,
treated teeth. They concerned to execution of their duties honesty.
One of the first doctors in territory of modern Karaganda area was
G.Niyazbekov, he finished Omsk medical institute in 1900. He rendered the
therapeutic and surgical aid, he was engaged in health protection of women and
children, and distributed patients the medicines. The significant role belongs to the
professional revolutionary and medical assistant I.V.Deyev - graduator of the Chita
medical assistant's school. He was banished to Kazakhstan. He made prophylaxis
of treatment tuberculosis, infectious disease and syphilis.
On May, 20th, 1930 in the composition of explorer expedition generated in
Moscow by K.O.Gorbachev (in the subsequent the first head of trust
Karagandaugol) the first doctors G.N.Alalykin, Y.F.Alalykina, L.G.Livas arrived
to Karaganda. The unique brick one-storied house of 6 rooms was a first-aid post.
“The red hospital” – such it was called by people.
In the first day of opening of an ambulance station there were only 4 persons
on reception, but soon there were greater turns. The ambulance station with three
doctors existed almost year till April, 14th, 1931, before arrival of new doctors.
Karaganda got the status of city in 1934; there were 62 doctors, 338 middle
medical workers, 8 hospitals with 652 beds, the polyclinic, 12 ambulance stations,
and 8 health centers.
G.N.Alalykin played the great role in becoming of surgical service in
Karaganda; within the Second World War he was the adviser of all evacuation
hospitals of Karaganda. Y.F.Alalykina rendered the therapeutic help, accepted
deliveries, and took sanitary-educational work.
In 1934 A.V.Timofeyevich and T.A.Kolomenskaja arrived from Russia to
Karaganda. The traumatologist and the surgeon - they made a lot of for
development of public health services in city. Miners tenderly named
A.V.Timofeyevich as “Our miner's doctor”.
90
By the direction of narcomm (national commissariat) of public health of
USSR the graduator of Kuban medical institute - P.M.Pospelov arrived to
Karaganda in 1933.
Pospelov Peter Moiseyevich (1903 – 1985) was born in stanitsa Rasshevatka
in Stavropol. He finished Kuban medical institute in 1929. He was manager of
doctor sector in stanitsa Georgievskaya (1929 -1931). P.M. Pospelov was manager
of therapeutic and infectious department in city hospital of Georgievsk.
Since 1933 more than 6 years he was the head physician and manager of
hospital’s department of the second mine in Karaganda. In September, 1939 he has
been appointed by manager of regional public health department.
He had dream about opening of high school in Karaganda, he could prove
the necessity of institute’s opening and his dream became true in 1950. The first
rector of Karaganda state medical institute was P.M. Pospelov.
He was given rank “Honored doctor of Republic” in 1943.
Being the rector of KSMI from 1950 till 1974, his life was devoted to the
development of institute, the opening of faculties: medical, sanitary-hygienic,
pediatrics, the construction of new buildings for study, rest and hostels. The
institute had got first category in 1961.
He defended the thesis on theme “Industrial traumatism on Karaganda mines
and its analysis for period of 1941-1950”. He was founder and head of department
of social medicine since 1953 till 1984.
All his life he many researched on study of natural and healing resources of
Central Kazakhstan. He developed sanitary-hygienic and balneotherapeutic
characteristics of Karakaralinsk, it was opened recreation zones in Karakarlinsk,
Topar, sanatoriums in Shalgie and Zhosaly.
He was awarded by Lenin’s orders, “Red Star”, “Honour sign”, and medals.
In his memory and respect P.M.Pospelov became freeman (honourable
citizen) of Karaganda in 1973.
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Since 1947 graduator of Alma-Ata state medical institute - H.D.Makazhanov
(1915-1987) worked in Karaganda, within 25 years he was the main surgeon of
oblast health department, since 1958 he was head of traumatology and orthopedics
department of KSMI, he was the founder of school of traumatologists. One of city
clinics has name by the professor H.D.Makazhanov.
Doctor of medical sciences, professor S.V.Lokhvitsky arrived in Karaganda
in 1975. He had based large surgical school and created modern surgical clinic,
there prepared 25 doctors and more than 100 candidates of medical sciences.
Favorable conditions of independent Kazakhstan gave possibilities to
effective cooperation with foreign countries in the medicine and education.
Preparatory department for foreign citizens was founded in Karaganda State
Medical Institute (1991). First students were 36 Syrians; they studied Russian and
Kazakh language, chemistry, biology, mathematics, history of the Republic of
Kazakhstan for further education in KSMI.
1993 was a year of opening of dean’s office on work with foreign citizens.
Students were from Syria, Lebanon, Turkey, India, Pakistan and Saudi Arabia.
Contingent of foreign students was extended; it was decided to open on base of
dean’s office the department of international cooperation in 1998. Many students
wanted to get knowledge in English and first English groups were organized in
2001. Nowadays foreign citizens can get higher education in three languages:
Kazakh, Russian and English in Karaganda State Medical Academy.
The best traditions and creative atmosphere which was based by the founder
of KSMI - P.M.Pospelov, are kept teachers of all generations and they impart it to
their students. Government regulation of RK reorganized Karaganda State Medical
Institute into Karaganda State Medical Academy in 1997.
People who betrayed to medicine, to their country play great role in
development of public health services of Central Kazakhstan. They create history
every day working in new modern clinics, the diagnostic center, in medical
academy.
92
BIBLIOGRAPHY
1. Абдуллаев К. Этюды о казахской традиционной медицине /К. Абдуллаев
// Казахстанский фармацевтический вестник.- 2002.- N7. - С.8.
2. Байпаков К.М. По следам древних городов Казахстана: [Отрарский оазис]
/ К.М. Байпаков. - Алма-Ата: Наука, 1990. - 208с.
3. Здравоохранение Казахстана / Под ред. Т.Ш.Шарманова.- Алма-Ата:
Казахстан, 1978. -135 с.
4. Камалиев М.А. История народной медицины и общественного
здравоохранения Казахстана / М.А. Камалиев, Р.К. Бигалиева, Т.Х. Хабиева.-
Алматы, 2004.- 174 с.
5. Карагандинская государственная медицинская академия: страницы
истории / Гл. ред И.Р.Кулмагамбетов, К.А.Алиханова (отв. ред.).- Караганда,
2005.- 644 с.
6. Люди, события, факты. Здравоохранение Карагандинской области
/ К.К. Ермекбаев, В.Б. Аликов, Е.Т. Токбергенов и др. - Караганда, 2003. -
104с.
7. Очерки по истории народной медицины в Казахстане. / Под ред.
Т.Ш.Шарманова, Б.А.Атчабарова.- Алма-Ата, 1978.- 209с.
8. Поспелов П.М. Карагандинский государственный медицинский
институт /П.М. Поспелов, В.А. Брейдо.- Алма-Ата: Казахстан, 1973.-84с.
9. Самарин Р.И. Очерки истории здравоохранения Казахстана /Р.И. Самарин.
- Алма-Ата: Казгосиздат, 1958. - 163с.
10. Чокин А.Р. Очерки развития санитарно-эпидемиологической службы в
Казахстане /А.Р. Чокин.- Алма-Ата: Казгосиздат, 1975. -176с.
11. Чокин А.Р. Санжар Джафарович Асфендияров [к 100-летию со дня
рождения] / А.Р. Чокин, А.С. Саятова, М.А. Арыкова. - // Здравоохранение
Казахстана.- 1989.- N10. - С. 69-71.
12. Шарманов Т.Ш. Долгое восхождение к праву на здоровье / Т.Ш.
Шарманов. - Алматы: Атамура, 1998. - 232с.
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Test for the control of knowledge
1. Primitive history had duration:
А) more than 99 % of all history of mankind
В) 50 % of all history of mankind
С) 30 % of all history of mankind
D) 70 % of all history of mankind
Е) 60 % of all history of mankind
2. What scientist offered a hypothesis about an origin of the human from the
monkeys?
А) A.N. Beketov
В) Ch. Darwin
С) K. Ber
D) K. Rulje
Е) L. Boyanus
3. What is oikumena?
А) the articulation of speech
В) the first burial
С) territory of the man dwelling
D) abstract thinking
Е) rudiments of languages
4. I. P. Pavlov considered, that medical activity is
А) coeval of religions
В) began since the written period
С) appeared during the Paleolithic epoch
D) coeval of the first man
Е) appeared during the matriarchy epoch
5. Where was made the first trepanation of scull?
94
А) Central Kazakhstan
В) Australia
С) Latin America
D) Africa
Е) Southern Kazakhstan
6. What was the basis of doctoring in the slaveholding states of the Ancient
East?
А) national medicine
В) priestly medicine
С) temple medicine
D) magic medicine
Е) monastic medicine
7. With the advent of writing who wrote down national experience in the field of
doctoring in the Ancient East?
А) slaveholders
В) priests
С) farmers
D) sumerians
Е) handicraftsmen
8. Name the monument of the Babylon legislation which is kept to our time
А) law code of Ashurbannipal
В) law code of Mannu
С) Aurveda
D) laws of tsar Hammurabi
Е) poem of Homer "Iliad" 9. How many first elements of the material substance contains from the point of
view of the Chinese philosophers?
А) two
В) three
95
С) four
D) five
Е) six
10. The first needles for acupuncture in Ancient China were from …
А) gold
В) silver
С) stone
D) platinum
Е) bone
11. What papyrus described the medicines which promoted improvement of oral
cavity and strengthening of teeth?
А) Smith's papyrus
В) Brugsh’s papyrus
С) Ebers’s papyrus
D) Cakhun papyrus
Е) papyrus from Ramesseum
12. What was«The Indian method» in medicine history?
А) rhino plastics
В) reposition of dislocation
С) removals of the grown turbid crystalline lens
D) turning on a leg
Е) preparations 13. What was in the base of the world by the doctrine of Democritus?
А) God
В) mind
С) matter
D) soul
Е) atom
96
14. Name the doctor living in the Northern Greece deified and was included in the
world literature as the god of medical art?
А) Hippocrates
В) Machaon
С) Asklepius
D) Erazistratus
Е) Podalirius
15. Name the work of Hippocrates, where he condemned the doctors starting
patient’s visit from the requirement of payment and an establishment of its size?
А) "Epidemics"
В) "Prognostics"
С) " About wounds of a head "
D) " About fractures»
Е) " Oath of the doctor "
16. Name the post of the main doctor who observed others doctors, in imperial
Rome?
А) periodeut
В) brachman
С) daca
D) ckshatri
Е) archiyatr
17. Name the doctor who entered into medicine the principle “To treat safely,
quickly and pleasantly”?
А) Celsus
В) Asclepiad
С) Soran from Efesses
D) Galen
Е) Epicurus
97
18. Who from scientists of Ancient Rome brought in a regulation the preparation
of medicines from plants, established the certain weight and solid ratio at
preparation of tinctures and concoctions?
А) Dioskirid
В) Asklepiad
С) Soran
D) Celsus
Е) Galen
19. Who was the author of work «About smallpox and measles»?
А) Ar-Razi
В) Al-Farabi
С) Al-Birhuni
D) Ibn Cina
Е) Ibn Nafis
20. How East philosophers named Al-Farabi?
А) The wisest
В) The greatest
С) The philosopher
D) The second Teacher
Е) The professor
21. Name the main medical work of Al- Farabi?
А) «About organs of a human body»
В) «About soul »
С) «Word about diseases of gastrointestinal tract and other»
D) «About objection to Galen because of his disagreements with Aristotle
concerning organs of a human body»
Е) « Aphorisms of the statesman»
22. What medical work brought world glory to Ibn Cina?
А) «Book of healing »
98
В) «Book of knowledge »
С) «Canon of medical science »
D) «Book of rescue »
Е) «Book of instructions»
23. Who was the author of work «One doctor cannot treat all diseases»?
А) Al Birhuni
В) Al- Horezmi
С) Ar-Razi
D) Al-Farabi
Е) Ibn Cina
24. How K. Linney in XVIII century named an evergreen tropical plant in honour
of Ibn Cina?
А) harcinia
В) avicenia
С) ibncinia
D) rudbekia
Е) aphshania 25. Who was the author of work «About structure of human body» (1543)?
А) A. Vesalius
В) W. Harvey
С) D. Frakastoro
D) G. Montano
Е) A. Pare
26. Name the doctor from Padua, the author of work «About diseases of artisans»
(1700)?
А) G. Boerhave
В) G. Montano
С) B. Ramaccini
D) A. Pare
99
Е) N. Bidlow
27. Name the work of Harvey which has been published in 1628 after long-term
supervisions, experiences on animals and checking on men?
А) " Anatomic research about movement of heart and blood at animals "
В) " About structure of a human body "
С) "Epitome"
D) "Treatise about medicine”
Е) "Treatise on anatomy "
28. Name G. Fracastoro‘s work which played big role in clarification of nature of
infectious diseases and its systematization?
А) " About syphilis or Gallic diseases "
В) " About contagious and infectious diseases and its treatment "
С) " About contagion and its treatment "
D) " About infectious diseases"
Е) " About contagion, contagious diseases and its treatment "
29. What has been developed the best in the Kazakh national medicine?
А) obstetrics
В) work of bonesetter
С) herniotomy
D) laparotomy
Е) trepanation
30. What played the big role at baby-minding in conditions of Kazakh’s nomadic
mode of life?
А)carriage
В) besic
С) cot
D) khodunki
Е) manezh
31. What was great importance by the opinion of national doctors of Kazakhstan?
100
А) prognosis
В) diagnosis
С) pathogenesis
D) etiology
Е) clinic
32. Name the main ritual tool of baxes?
А) tambourine
В) kobyz
С) dombra
D) guitar
Е) drum
33. Who was the first head of national commissariat of public health in
Kazakhstan?
А) M. S. Shamov
В) N. P. Lebedeva
С) P. M. Pospelov
D) M. M. Chumbalov
Е) A. A. Sergachev
34. Name the prominent statesman, scientist, teacher, large organizer of
Kazakhstan public health, knew many foreign languages?
А) N. D. Zhakupbaev
В) A. D. Aitbakin
С) H. D. Dosmuhametov
D) S. D. Asfendiyarov
Е) A.B . Aldiyarov
35. Name the first rector of Karaganda state medical academy?
А) N. A. Hlopov
В) P. M. Pospelov
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С) I. R. Kulmagambetov
D) A. P. Filin
Е) M. T. Aliakparov
KEYS:
1- A 8- D 15- E 22- C 29 - B2- B 9- D 16- E 23- C 30- B3- C 10- C 17- B 24- B 31- A4- D 11- C 18- E 25- A 32- B5- C 12- A 19- A 26- C 33- A6- A 13- C 20- D 27- A 34- D7- B 14- C 21- D 28- E 35- B
102