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The Evolution of Doctors and Medicine

By: Ahmed Mahmood

Recently, the public perception of doctors has been dramatically unfavorable. Chris Barrett, special registrar of neurosurgery of Newcastle General Hospital in Newcastle, England, writes in his Medical Classic: The Doctor, “…perhaps the greatest irony for today’s profession is that while the science has changed beyond measure for the better, the high watermark of public perception represented by The Doctor has long passed.” In reality, doctors today are more than just glorified pharmacists who prescribe pills left and right. They carry thousands of years of medical knowledge.

In prehistoric times, Mother Nature was not so kind to our primitive ancestors. Disease, natural disasters and calamities kept life expectancy to a low 20-40 years; doctors could have helped, but they didn’t exist. Men were hunters, chasing only animals, and did not encounter any natural remedies. It was up to the women to bring back medicinal plants while they were out gathering fruits, nuts and vegetables. By default, the women played the role of doctor by using the gathered medicinal plants to treat the ill. Yarrow and rosemary were used as general antiseptics, pain-relievers and blood clotting agents. Surgery was nonexistent during this time period. Extreme pain was met with an equally extreme treatment called trepanning in which holes are bored into the skull in hopes of releasing the inner demons causing the pain. Like our ancestors, medical knowledge and procedures were primitive back then, and it didn’t change for a very long time.

The age of the Ancient Egyptians, Greeks and Romans brought a revolution, albeit a small one, to the practice of medicine. Doctors of Ancient Egypt were religious priests. Their working knowledge of the human body stemmed from practicing mummification in which organs like the brain and liver are removed from a corpse and then preserved. Ancient Egyptian doctors had advanced surgical tools and were trained in institutions called Houses of Life which made them highly coveted by wealthy families and rulers. Unlike Ancient Egyptian doctors, who believed that magic and religion caused and cured disease, the Ancient Greek doctors practiced logic-based medicine. The teachings of Plato and Aristotle resulted in people asking questions, many of which concerned nature and the human body.

Ultimately, it was deduced that the body is composed of four humors. Hippocrates, the “Father of Western Medicine”, believed that an imbalance of these four humors caused illness, and to eliminate the illness, the patient must be treated with remedies that would either increase or decrease the amount of humor in the body. For example, laxatives would be used as a purgative to restore balance to excess biles in the body. Doctors of Ancient Greece followed the Hippocratic school of medicine and learned how to examine living patients based on detailed clinical observations and focus on prognosis. The Ancient Greek civilization lasted until the Roman conquest which resulted in many great medical minds moving to Rome. The initial doctors of Ancient Rome were mostly Greek prisoners of war. They helped heal the wounded soldiers, and afterwards, some of Roman medics learned from the Greeks and became military doctors. Unlike their Greek counterparts, Roman doctors emphasized on advancing disease prevention rather than finding a cure. Constant warfare forced Roman surgeons to develop highly advanced surgical tools to fix broken bones or to remove arrows or spears. They sterilized the tools in boiling water, used opium as a sedative and pain killer and used vinegar as an antiseptic. The collective knowledge of Ancient Greek and Roman doctors would prove to be vital stepping stones for future doctors.

Medieval Islam in the Middle East coupled with the Renaissance prompted another revolution in medicine. Doctors of Medieval Islam were students of many disciplines including chemistry, math, philosophy and poetry. Islamic doctors used the foundations of the Greeks and Romans to further advance medical knowledge. They  focused more towards research rather than classic patient-doctor cases. Ibn Al-Nafi, an Arab physician, was the first person to describe pulmonary circulation of blood and gas exchange in the lungs. Ibn al-Haytham, an Iraqi physician, was the first person to describe the eye as an optical instrument. Ibn Sina or Avicenna (Latin), a Persian polymath, wrote the Canon of Medicine, an encyclopedia based on the teachings of Hippocrates and Galen-another Greek physician- which set the standard of medicine throughout the Middle East and Europe. The medical knowledge contributed by doctors of Medieval Islam was so powerful it brought Europe out of the Dark Ages.

During the Middle Ages, the lack of educational institutes and widespread illiteracy caused Europe to stagnate in terms of academic enhancement which included medicinal research. The Catholic Church had a strong hold on what forms of medicine should be practiced, and the Church urged doctors of Medieval Europe, who were mostly monks, to abandon Greek, Roman and Islamic medicine. Europe would be left in the dark for centuries until the Crusades when monks would relearn the teachings of Hippocrates, Galen and Ibn Sina from Arabic scholars. After the Crusades, the knowledge brought back to Europe allowed for the perfect conditions for the Renaissance to begin. Medical research skyrocketed during the Renaissance. William Harvey, an English doctor, was the first to properly the pumping mechanism of the heart based on the findings of Ibn Al-Nafi. The famous polymath Leonardo Da Vinci drew precise, mechanistic drawings of the heart, bones and muscles that were great contributions to medicine. Zaccharias Janssen and Galileo Galilei, also famous Renaissance men, perfected the light microscope which proved to be one of the greatest inventions that advanced medicine. For centuries to come, researchers would make great discoveries through the lenses of the microscope. Now, they were able to see the microorganisms that caused illnesses. To fight these microorganisms, the active compounds from medicinal plants were extracted, purified and made extremely potent, and their efficacy would be observed through a microscope.

Medicine evolved from being rare plants to synthetic derivatives of active compounds in medicinal plants. Doctors evolved from being ignorant medicine men to advanced researchers. To some, a doctor is someone who writes prescriptions for pills to fix them. Just remember that the doctor and the pills are both products of thousands of years of medical evolution.