Учебное пособие (Методичка) по Истории Медицины. И.Ю.Худоногов

Theme 1. The history of medicine as a science and teaching subject. The main goals and objectives of the discipline. Sources of the study of the history of medicine.

The history of medicine is a scientific discipline that studies the development of medical activity and medical knowledge in connection with the development of socio-economic formations and culture – from the emergence in the form of primitive healing to the current highly technological state.

The history of medicine is divided into general and private. General issues of the historical development of medicine affect the identification of the main, characteristic laws of this development, the study of basic nodal problems, the connection of medicine with natural science, history, philosophy, the pecularities of medicine of individual civilizations, countries and regions, the activities of scientists and scientific schools that have influenced the development of medicine in whole. It is the subject of the general history of medicine as a science and as a special course in the system of medical education.

The particular history of medicine studies the history of individual medical disciplines, the development of specific problems, directions and scientific schools within the framework of medical discipline and is included in the competence of representatives of the corresponding field of science and medical specialty.

The main requirements for studying the history of medicine are historical and actual reliability, objectivity, documentary, logical analysis. The history of medicine uses various sources for knowing the past, which can be divided into the following main groups: material (substantial), written, ethnographic, oral (folklore), linguistic, film and photo documents, phonographic documents.

The main part of material sources are archaeological sites, paleoanthropological material (human remains), tools, household items, etc. Coins, coats of arms, medals, stamps, emblems, works of art (drawings on stones, cave walls, columns of temples, antique dishes, paintings, sculptures, etc.) also can be attributed to material sources.

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Written sources can be handwritten and printed, originals and copies made on clay tablets, papyrus, ceramics, fabrics, birch bark, parchment, paper, etc. Rites, customs, beliefs, rituals, i.e. the phenomena of modern life that arose in previous eras of humanity, which have survived to a greater or lesser extent and characterize the peculiarities of the healing of a particular nationality (ethnos), belong to ethnographic sources.

Oral (folklore) sources are the image of reality, created by the people and characterized by an oral form of continuity transmission from one generation to another. Myths, legends, epics, parables, ballads and fairy tales belong to oral sources. The lack of accurate information about the persons, facts, time of the event, preserved in memory and conveyed to us by the people, is a specific feature of this source.

as the relationship between entire groups of peoples, the boundaries of their

settlement at an early stage in the opment of human society, etc. Video film

and photo documents are sources that significantly complement written, for example, documentary photographs and films.

Video film and photo documents objectively record events and can repeatedly reproduce what has already happened.

Phono-documents reflect the sound parameters and characteristics of a historical fact and represent a phonogram (mechanical, magnetic, optical, etc.) having been made at the time of the event.

The history of medicine shows how practical skills of treatment, recognition of diseases and preservation of health arose and developed in the process of people's labor activity, and the ideas about the essence of the disease corresponding to each era were formed at the same time. The knowledge of the laws of the previous development of any phenomenon and the clarification of its current state help to better understand and scientifically predict future development paths.

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Questions for self-control:

1.Why “History of Medicine” is a science?

2.What are the peculiarities of teaching the subject “History of Medicine”?

3.For what purpose do students study the subject “History of Medicine”?

4.What tasks does the subject “History of Medicine” help to solve?

5.What are the main requirements for information about the history of medicine?

6.What can be a source of information for studying the history of medicine?

7.What is the reason for the appearance of sections in the course “History of Medicine”?

8.What does the general history of medicine study?

9.What does the particular history of medicine study?

10.What sources of information are material objects and why?

11.What are ethnographic sources of information and why are they considered

particularly valuable?

12.What sources of information are oral and why?

13.What is the reliability of the information contained in oral sources and how can

it be assessed?

14.What were objects material nature used for written on before paper appeared, and what is the reason for such a variety of materials?

15.Is it possible to photograph or record audio and video of medical events that took place 5-10-20 thousand years ago?

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Theme 2. Healing in a primitive society

The primitive communal system (tribal organisation of society, or the first socioeconomic formation in history) occupies 99% of the entire history of mankind. Material sources of information about this period are not supported by other sources, especially written ones. Therefore, all historical reconstructions of the preclass society do not provide 100% certainty. Nevertheless, ethnographic sources significantly complement the material ones. Visits to various tribes living at the stage of the primitive community and preserved to this day on various continents in the jungle or tundra, on islands in the oceans, etc., allow scientists to get acquainted with the pre-class life, lifestyle, and methods of healing. The principle of analogy makes it possible to transfer ethnographic information to historical reconstructions of the early stages of life of the ancestors of apopolitain (civilized) societies. However, ethnographic data on the primitive communal system must be accepted with a certain degree of conventionality.

Scientists believe that primitive healing (self-help and mutual aid) exists in all

animals caring for offspring. This of healing is called “collective medicine”.

It existed among ancient people However, about 40-60 thousand years ago, people

began to treat not at the of instinct (like animals), but consciously. It is called “folk medicine”. Such a healer appeared in every tribe. She (he) accumulated medical experience more than the rest, passed it onto her children (future generations) using an oral form of communication. And the good fame of the successful healing of a seriously ill patient quickly spread to neighboring tribes. Thus, the circle of patients now included not only family members or their relatives, but also representatives of other communities.

It is believed that the first folk healers appeared among the Neanderthals (Shanidar Cave, dating from around 65,000-35,000 years ago). Apparently, plants (leaves, roots, berries, etc.) became the very first therapeutic agents, because before the invention of arms, hominids fed primarily on plant foods. Massive jaws and abrasion of enamel on the teeth confirms this. The food of the hominids was raw; it was consumed in large quantities and required careful chewing. Heat treatment of

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food (fire) appeared only 200 thousand years ago. Until that time, people, searching for food, came across various plant properties (healing or poisonous), and this experience became conscious. The first healers could notice and realize first of all those plants whose effect was quick: painkillers, narcotic, aphrodisiac, hemostatic, wound healing, acting on the gastrointestinal tract, etc. Gradually, the arsenal of medicinal plants expanded.

There is a high probability that it was women who were the first to consciously collect plants for treatment, because they gave birth to children, raised them and protected both their own and others' children, relatives and the whole tribe. The first sculptors dedicated their works to women first. The oldest female figures, figurines made of clay, stone, wood date back to 20-30 millennia BC.

Describing the social structure of human tribes, scientists believe that women were leaders for most of our history (matriarchy). The transition to patriarchy was associated with the moment of the emergence of cattle breeding and was especially accelerated during the emergence of society. Until that time, it was women who provided the tribe (family) with food products by 70-90%. The extraction of meat food, which was mainly occupied by men at Homo Sapiens, was risky, requiring a lot of time and energy with very low productivity (10-30% of the total nutrition). Thus matriarchy correlates with primitive communism.

But man does not live by bread alone. Over the long 99% of the life of human society, people have been looking for answers to various questions that worried them, including: who to blame for the onset of illnesses or to thank for healing, who or what is behind it? The answers came from the advent of various cults. Mankind has successively gone through several stages of its development in this direction: through animalism, fetishism, animism and other cults. One of the earliest cults related to healing developed when people began to hunt, invented bow and arrows, and began to use various animals for food.

At the same time, plants remained the main food of hominids belonging to the species Homo Sapiens. So, this went on for 95-99% of their (our) entire history. Meat food, although it was tastier, was consumed very rarely, so every meal was

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considered as a celebration, and the animal that caused the celebration was perceived as a object of worship (cult). However, not all animals were turned into a cult because they were eaten. Very often, the tribe chose a cult animal-protector, which in nature hunted itself and could attack a person. Tigers, lions, bears, wolves, hyenas, jackals, kites, vultures, hawks, eagles, snakes, crocodiles and many animals were very relevant (dangerous) for some tribe. People regularly saw this animal, were afraid of it, thought about it, composed fairy tales and epics about it. It continued until this animal, its image, reflected in the minds of people, was beginning to connect with the tribe self-representation.

Ethnographers have established that the Indians of Alaska call such animal “Totem” (North Amer. – his (her) genus). The word "To-tem" comes from the word "ototeman" – «belonging to the clan» – and is used in the speech of the North American Indians Ojibwe, who belong to the Algonquins – a related group of languages – and is the second most common group of Indian languages of Canada (after Cree) and the third in North America (after Navajo and Cree).

A totem animals or plants in a supernatural way were associated with both the life of the group and the life of individual. Totem poles with the image of a cult animal were installed near dwellings. Primitive people danced around these pillars, sang ritual songs, asked for a totem about something, thanked for something, etc. One animal was the patron of the whole tribe. At the same time other animals could be patrons for each individual person. The choice of such an animal was due to the emergence in the discourse of ancient people of the new concept of “Manitou”. This term was also borrowed from the Algonquins and means “soul”, “spirit” or “strength”, in the medical sense “medicine”. Manitou was used as a medicine orally and out. Such way various organs of sacred animals were used blood, bile, bone meal, fat, etc. The second method of treatment was that the ancient healer applied to a sore spot a feather, a not big bone, a claw, a tooth or another part of the animal, which was small and not rotting. The power of "Manitou" could be transmitted to artificial amulets made of clay, wood and other

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materials. In other words, directly from the cult of “To-tem” came the cult of “Fetish”.

The new cult of Animism also emerged from Manitou. Now all the objects and phenomena surrounding a person began to be animated i.e. began to be considered alive. We began to worship the spirits of the Sun, Thunder, Water, etc.

This breakthrough in representations allowed us to move on to the next stage in the development of cults, which is called “Magic”. Being the highest level of cult practice, magic made it possible not only to reflect reality, but also to control objects and phenomena of the surrounding world. The technology of magic included two main actions: modeling the object of control (creating its reduced copy) and ritual actions in relation to the manufactured model.

Various types of man, including the Cro-Magnon type, have mastered the basic types of magic. For example, cattle magic, did it come about? In the late stages of the primitive community system, people stopped eating young wild animals. it is a strange behavior for ernally hungry gatherers fell, isn't it. Obviously, it is associated with emergence of planning skills, i.e. we realized that not only “tomorrow” will or “the day after tomorrow”, but “next year” and “next five years” will also and we should think about them now. Therefore, instead of eating, our distant ancestors began to take care of young wild animals (tame them). A baby-animal is a model of the future large animal. Taming is a magical ritual that allows full control of large animals in the future. Both men and women were actively involved in taming. In addition to managing pets, cattlebreeding magic provided, first of all, hearty meat food, which was always at hand. The need to chew for a long time plants (in a large number) has disappeared. However, all the benefits must be paid for – in the course of the emergence of a new social situation, a new cult has developed that brings us closer to the creation of God, i.e. the formation of gods from dead people, our relatives (ancestors), whom we saw and heard, and who are well remembered by us. At the stage of evolution of religious beliefs under consideration, the concept of “God” is still too early to use, but it is already possible to consider a deceased ancestor as “Spirit”.

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Our ancestor (regardless of gender) gave a good life to his descendants and did not get well-deserved intravital thanks. He scolded us and beat us while we were little, reproached with food, aroused fear. But his death did not change the situation for the better. The discontent of the deceased ancestor was manifested by the instillation of his spirit in the body of his descendant, which, according to the laws of psychosomatics, always causes illness. Thus, the disease was understood as a punishment for disrespectful attitude to the ancestor. Therefore, the methods of treatment consisted in the expulsion of the infused spirit of the ancestor by good or by force, by intimidation. Kindred beat or pinched the patient, shouted, trying to scare, gave bitter food. There was such a method of exile, reminiscent of the principle of modern cans (“aspiration”). For it fellow tribesmen used a hollow tube (buffalo horn, reeds), placed it tightly against the body, and sucked air through the other end with force. After a bruise was formed on the body, primitive healers made incisions and scratches on it, causing capillary bleeding to bring the spirit of the ancestor out. The craniotomies, which belong to the late stages of the primitive social system, continued the logical chain of development of techniques for expelling the evil spirit of ancestor. Trepanized skulls are found on all continents. Most of the in the found turtles have intravital signs. Most scientists are inclined to believe that the holes in the skull were made not for the purpose of treating head injuries or killing, but for ritual purposes, there was a need to prepare a hole through which the spirit of the ancestor could leave the human body. Gradually, members of the community appear who take on the function of expelling the spirit of the ancestor. Ancient people began to call them the word “shaman”. Shamans used various rituals: rhythmic murmurs, incantations, incense, low-frequency sounds (blows to a tambourine, a drum), put frightening masks on their faces and achieved their main goal – they pacified (deactivated) the evil spirit of patient's ancestor.

In addition, the medical technology of the primitive society included such ancient operations as cesarean section and castration. In the later stages of the primitive communal system upon transition to a class society, healers began to conduct

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variolation to prevent smallpox. The material for vaccination was taken from a slightly ill person (pus from the smallpox vesicle) or recovering (removed the crust from the surface of the pustule, crushed) and rubbed into the scratch on the forearm of a person who never had smallpox. There were not so many receptions and methods of treatment during the period of primitive society, but some survived and have survived to our time. On the other hand, it was during this period that the foundations of medical practice were laid: from environment it was seized nature medications, which possessed all the main therapeutic effects, ancient surgery was able to solve quite complex operational problems, and shamanic psychotherapy provided complete compensation for psychosomatics. A separate mention must be made about medical theory. The depth of understanding of pathological processes using vivid images of a cult worldview based on intuition strikes the imagination with its logic, objectivity and high medical efficiency.

Questions for self-control:

1.What sources of information made it possible to carry out the reconstruction of the methods of healing in pre- society?

2.What was the basis the further development of mankind at the stage of primitive society, and why in some tribes this basis was not formed?

3.What percentage of the duration of primitive society is from the duration of world history, and why is the figure so large?

4.When and why did signs of division of labor appear in human tribes and healing became an independent occupation?

5.What information does modern science obtain by analyzing bone remains and preserved soft tissues of the human body?

6.How drugs are classified by origin, and which of them are the most ancient, give examples, explain why them are exactly the most ancient?

7.What medicinal properties do medicinal plants possess, which of them were discovered by ancient people earlier than others, and why?

8.What is the essence of the animalistic worldview?

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9.How did the emergence of the cult of the animal contribute to the expansion of methods of treatment in primitive society?

10.What operations are considered the most ancient and why?

11.What cult expanded the worldview of ancient people, and how did this cult help to realize the unity and mutual influence of all things in the Nature?

12.What cult is aimed at realizing the control of all things, list the basic principles of cult control of the surrounding world?

13.What cult contributed to the emergence of shamanism, and why exactly it?

14.Which exactly the techniques were used to drive out the evil spirit of the ancestor, and what theoretical basis did these techniques have?

15.Why primitive people performed a craniotomy operation, and how did such operations usually end?

16.What surgical treatments have emerged in connection with the domestication

of animals?

17. How does animal domestication to expanding the arsenal of medicines, give examples?

18.What infectious disease did humans learn to fight in the later stages of pre-class society, and how is this related to the domestication of animals?

19.From whom the smallpox material was usually taken for vaccination, give a brief description of the method?

20.From whom the smallpox material was usually taken for variolation, give a brief description of the method?

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