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History of Medicine

Majid Ali, M.D.

 

European and African historians agree that the knowledge of healing traditions traveled north from the Nubian and Egyptian regions to Greece—the "Northern Track" seems an appropriate designation for it—and then to the rest of Europe. I hypothesize that there was also an "Eastern Track"—from east Africa to south India, the Far East, and on to China—of greater significance in the spread of those traditions from the pre-Nubian and Nubian civilizations. The Eastern Track hypothesis offers the tantalizing possibility of integrating the ancient Indian and Chinese advances with the African enlightened philosophy and practice of medicine. I address this important subject in an article in my History of Medicine Series on this site entitled: 

Africa: the Mother of Medicine

Humans have been preoccupied with death for a very long time—the quest for immortality appears to have begun as soon as they recognized the difference between life and death. One of the earliest records of man's quarrel with death is in the adventures of Gilgamesh, the fabled Babylonian king. He was deeply disturbed when told that he could not live forever. How could a supreme lord like himself not be able to do something about death? So he declared his 'resolve' to engage and prevail over the gods of death with the following words that have been famous ever since:

I want to prove....that the boundaries set by the gods are not unbreakable.

Gilgamesh evidently did not know—or care to consider—the immutable law of oxidative death.2-5 That law dictates that no oxygen-breathing being can defy the oxidative molecular pathways of death forever. Spontaneity of oxidation in human biology decrees that all human cells and tissues must eventually be oxidatively denatured to death.6-14 History teaches us that Gilgamesh was not alone in his pursuit. Most empire builders in history were loathe to simply yield their hard-earned empire to death. They doggedly pursued immortality and commissioned many a physician to concoct remedies against death. Most notable among them were the pharaohs of the Nile.

The Egyptians also had a plan B. If they had to die once, they vowed they would return to reclaim their empires and treasures. They persuaded the commoners to build pyramids for them. Deep in the bowels of those pyramids, their architects built funerary palaces of transcendent splendor. The pharaohs did not have any doubt about the effectiveness of their plan B for re-entering life after trips to their tombs. They spent decades building splendid structures replete with offerings tended by funerary priests. Hieroglyph records of plan B may be summarized as follows:15

Everlasting afterlife would commence with a journey from the tomb through the underworld. After the burial, ka (the life force) would leave the body followed by the exit of ba (the soul). Horus, the falcon-headed god of redemption, would escort ba through doorways of fire, guarded by cobras, into the hall of judgment. The charge would then pass to Anubis, the jackal-headed god, who would determine the 'state of consciousness of the heart' of the dead by weighing the heart of the deceased. Osiris, the king of the underworld (the Egyptian counterpart to the Greek god Hades) and other gods would sit in judgment. A part-lion, part-crocodile, part-hippopotamus monster would eat the heart if it was found lacking the optimal consciousness, dooming the deceased to perpetual coma. If the heart balanced, the winged ba and ka would reunite to form akh, the spirit, which would then reenter the world to live happily ever after, with all the worldly pleasures at its feet and a thousand servants waiting upon it. Consider the following translation of hieroglyph found on the walls of a royal funerary palace at Saqqara, Egypt15:

Death: Raise yourself. You have not died. Your life force will dwell with you

forever.

Judgment: Oh my heart that I have had when on Earth, do not stand up against me as a witness, do not make a case against me beside the great god.

Eternity: I have come forth in this day-time in my true form as a living spirit. The place of my heart's desire is among the living in this land forever.

Not unexpectedly, the royal physicians played central roles in pharaoh's plan B. But sometimes things did not go well for the exalted docs. Recently unearthed evidence shows that the chief physician of pharaoh Teti, the father of the celebrated pharaoh Pepi I, incurred the wrath of his lord (perhaps by implied collusion with the pharaoh's enemies) and was given the worst possible punishment: his tomb was reassigned by Pepi I to assure eternal damnation of the plotter. (On the opposite side of the globe, the ancient Chinese had also understood the hazards of being at the inner orbit of power. Staying too close to the emperor, they had cautioned, imperils one's life.)

Those who followed Gilgamesh rarely displayed his chutzpah, but their quarrels with death were equally consuming. One would not expect that the obsessions of the ancient Greeks for defying death would be any less relentless. They pledged that if they could not be immortals themselves, they would bestow immortality upon their gods. They were an imaginative lot who structured their gods well to fit the roles assigned to them.

Could the problem have escaped the searching minds among the early Chinese? Hardly! Their determination and drive were equally unrelenting. There is a record of a Chinese emperor who ordered, at the pain of death, his physician to secure for him an immortality potion. His doc administered him a mercury compound. The emperor became insane—from mercury neurotoxicity, it may be deduced with reason. So it is possible that in that way the emperor did manage to defy the anguish of the process of dying.

History is never a complete story. The discoveries of today cast shadows over those of yesterday—just as the discoveries of tomorrow will force the future historians to revise our history. So, history is not about the exact origin of who said what and dating of who did what. Rather, it is about the historian's attempt to be faithful to whatever words, bits of scrolls, shards, or inscribed stones are bequeathed to him, and about his loyalty to his sense of the messages left behind by the earlier peoples. That being said, I proceed with presenting what seems significant to me in the history of medicine.

Conversations with the Spirits

The spirits—or demons, as some would call them—have forever been at the center stage of all dramas of human suffering. But where did they come from? How did the early humans in the Rift Valley first learn about them? Before there were rain dances and brew trances to please or appease the spirits, how did the very notion of their existence evolve? Where did the idea of unseen spirits come from? How did they learn that the invisible could determine the fate of the visible? Perhaps it all began with some phenomena they could not understand—some storm, lightning, or flood might have triggered the questions of why, where, and how. Or perhaps it was thirst and hunger that led someone to ask for rain or food—the forerunner of our prayer —from something or someone they knew nothing about. Could it be pain or illness that created the need for deliverance? I suppose some early people must have looked up to the sky when such things happened. They hoped for some understanding—revelation, as it might be called today. Or perhaps they gazed at the sun when they were overwhelmed with grief, or the moon during some celebratory moments. Some began to associate what they experienced with what they saw in the sky, the sun, or the moon. Perhaps that eventually led them to what they could not see—the spirits.

Conversation came easily to the early African. He learned to speak with his spirits freely, not unlike the way an African bushman does today. An American teacher taught in the West African bush country. She told me that what impressed her most there was how natural were the conversations her children held with the spirits of their ancestors. In the tribal folklore of bygone eras, the men of the spirits doubled as the men of medicine. That notion is also sustained in the available archeological records of the earlier peoples. Indeed, one can see clear evidence of that even today among the African bush people and Australian aborigines. How might that have happened?

Life is essentially an injury-healing-injury cycle. It seems plausible that the pain of injury initiated the search for relief. It also seems likely that conversations with the spirits about injury and healing started soon after the dialogue was established with them about such matters as lightning and storms. So it is likely that the men of the spirits became the men of medicine for the same reason. The current enchantment with the alternative medicine has brought the mind-body-spirit trio back in focus. Not unexpectedly, that is also evoking the wrath of placebo haters and quack-busters. So, the matters of the spirit are not merely of hollow historical interest. I return to this important subject later.

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* Africa: the Mother of Medicine

 

 

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