One of the most closely forgotten secrets in the history of civilization is that the conventional story of the history of Medicine is largely a crock. That is the story of the long slow advance of Medical science over thousands of years, which saw the steady accumulation of knowledge and with Medicine steadily advancing and getting better and better until today, is largely false.
The sad truth is that there was little real advancement and much Medical practice was so much woo and nonsense. In fact until very recently someone who was ill was well advised to NOT see a Doctor at all, because seeing one would all to likely shorten your life.
This was so because bluntly speaking the remedies suggested and practiced by Doctors were all to frequently death dealing and did the patient more harm than good. In fact in 1800 faced between going to a Zulu Witchdoctor and going to Western Doctor for treatment for a serious illness it is all to likely that overall the patient would have been better off with the Witchdoctor. Also in terms of Woo beliefs the similarity between the beliefs of the Witchdoctor and a "real" western Doctor in 1800 were a lot more than you would think.
The idea of a steady upwards growth in medical science and expertise over thousands of years in medical practice is in point of fact so much nonsense. And it goes back to a singularly blinkered view of the history of Medicine. Basically the notion that the Greeks and Romans practiced a unique and rational form of medicine. Thus we get books about the history of Medicine that assume that "Ancient Medicine" consists simply of Greek and Roman medicine.1
For despite the usual ways that the history of Medicine, including the interminable tendency to assume that the history of medicine is simply the history of Western Medicine, is written that is not the case.
The fact is Ancient Greek medicine had many, what can be called Woo elements in it. Despite modern claims concerning its rationality there were many irrational elements in Greek and Roman medicine.
For example the Ancient Greek school of Hippocatic, that was the basis of all Greco - Roman medicine, engaged in some serious theory building with no empirical support.
Many Ancient Greeks believed that everything was composed of four basic elements Fire, Water, Air and Earth. In the human body there were four "humors" Blood, Phlegm, Black Bile and Yellow Bile. In this scheme Blood was analogues to Air, Phlegm to Water, Black Bile to Earth and Yellow Bile to Fire. Illness occurred when the harmonious balance of the humors was disrupted or they were no longer mixing properly. In other words disease was the result of imbalance.2
The four basic elements were governed by 4 basic properties, Hot, Cold, Moist and Dry. Each basic element was governed by two dominant properties. Thus Fire was Dry and Hot, Water was Cold and Moist, Air was Moist and Hot and finally Earth was Dry and Cold. Regarding the four humours, Blood as Air was Moist and Hot, Phlegm as Water was Cold and Moist, Yellow Bile as Fire was Hot and Dry and Black Bile as Earth was Cold and Dry.3
Medical treatment was then shoe horned into this system of binary oppositions and treatments thought of in terms of how they were Fire, Water etc., and Cold, Dry etc. If a treatment met those criteria then whether or not it empirically worked was largely irrelevant.
That this system was not much better than the belief that illness was the result of evil spells cast by others, or demonic possession and / or the actions of gods is rather obvious. Certainly this system of Medicine led to the notion that the main cause of illness was internal disruption of the balance of the body of four essential and fictional "elements". Whereas a Witchdoctor at least asserted that often the source of illness was external to the body.
For most of human history the great majority of treatments of human beings was in the hands of local healers whose knowledge of various treatments was a combination of thousands of years of cumulative folk knowledge and various superstitions. Generally a healer usually helped and if not that generally did little harm.
Sadly until the mid 19th century the trained doctor in the West was not much of an advantage to a sick patient. Frequently his treatments were death dealing and as indicated above his views about the causes of disease were little better than the fantasies of spirit possession etc. In fact the "modern" procedures of such trained Doctors were such as to help mightily to shorten life at times.4
For example, due to the fact that for part of the Hellenistic period in Alexandria Egypt some early Doctors were able to get knowledge of the interior of the human body via dissection; although usually dissecting human bodies was generally taboo. This resulted in the development of surgery, and surgical procedures. However unaware of germs and the need for antiseptic procedures, to say nothing of anaesthetics for pain relief such procedures were of questionable value to the patient. In fact prior to modern surgery with its antiseptic conditions etc., minor surgery was a serious risk and major surgery virtually a death sentence to say nothing of hideously painful. The end result was that before the mid 19th century performing surgery overall probably resulted in vastly more deaths than lives that were saved. At least the Witch Doctor would not cut you open. It also explains why by the 15th century Western Doctors tended to leave surgery to Barbers rather than do it themselves.5
Another example of sheer superstition in Ancient Western Medicine was blood letting. Since the Greeks thought that illness was the result of a lack of balance in the four humors, one way to restore balance was to remove some of the excess humor by bleeding the patient. Thus the Greeks and Romans bled patients for everything including incredibly blood loss! The number of patients who died of this was legion. If you avoided being blood let by going to a healer instead of a Doctor you were way ahead in the game of staying alive. There can be no doubt that this practice killed countless numbers of people who would otherwise have lived.6
And it was the result of a superstitious abstract notion of "humors" and "balance" that were little better than the notion of Witchcraft, the Gods etc., causing disease.
Those two examples are just two of many examples of wrong headed notions like pus was good or that a diet of grain and meat was perfect for recovering patients and that fruit and vegetables were bad for you. Starving and purging patients was also a good idea. Thus they nutritionally deprived their patients and encouraged the formation of pus in wounds!!7
Concerning Greco-Roman Medicine it has been said:
Impressed as they were by the possibilities of the 'soul's walk,' the Greek physician studied disease primarily by giving it a lot of thought. Nobody expressed this better than Charles Daremberg: 'they tried to explain Nature while shutting their eyes.'
The result was an overall, synthetic, but wholly imaginary theory of disease, in which the basic disturbance, and therefore the treatment, was always of the same kind, even in the case of a wound. The reasoning went about as follows. In nature everything is balanced. 'Too much' or 'too little' causes an imbalance, which is disease.8
Thus for quite sometime people were well advised to stay away from Doctors and go to their local Witchdoctor, Healer or Wise Women. At the very least the poor patient would avoid surgery or bloodletting! And frankly the treatments given by such people would be on average be aside from the disastrous surgery or blood letting at least as good as a Doctor's.
So despite a Doctor's greater knowledge of the human body etc., the basic theory was little better than imaginary and the treatments worst than what was given by a "Amateur" - Witchdoctor, Healer and Wise Women.
It was only in the 19th century that Medicine finally overcame its generally lethal nature in terms of treatment and became both truly scientific and truly helpful to people.
1. See for example Nutton, Vivian, Ancient Medicine, Second Edition, Routledge, London, 2013.
2. Majno, Guido, The Healing Hand, Harvard University Press, Cambridge MASS, 1975, pp. 178-179.
3. IBID, and The Four Humors, Greek Medicine Here and The Development of the Greek Concept of Nature Here.
4. Majno, pp. 176-180, pp. 24-28.
5. IBID, and Barber, Wikipedia Here.
6. IBID, Majno, pp. 179-182, 418-420.
7. IBID, pp. 182-184, 188-189, 205.
8. IBID, p. 178.
Pierre Cloutier
2. Majno, Guido, The Healing Hand, Harvard University Press, Cambridge MASS, 1975, pp. 178-179.
3. IBID, and The Four Humors, Greek Medicine Here and The Development of the Greek Concept of Nature Here.
4. Majno, pp. 176-180, pp. 24-28.
5. IBID, and Barber, Wikipedia Here.
6. IBID, Majno, pp. 179-182, 418-420.
7. IBID, pp. 182-184, 188-189, 205.
8. IBID, p. 178.
Pierre Cloutier
Great entry! It is actually frightening, and this extended not only to medical doctors treating illnesses, but also tending to labour and other non-sickness related matters: no wonder infant mortality was so high until very recently!
ReplyDeleteNow I have to go and extract one ounce of blood, I think I have humour imbalance... :-P
Thanks for your comment. Yes it is indeed more than a little scary about how dangerous "advanced" medical treatments used to be.
ReplyDeleteYou gave the example of childbirth. Well in some respects that is true. In Vienna in the mid 19th century it was much more dangerous to give birth in a "modern" hospital than to stay home to have your child and a midwife was generally preferable to a Doctor. Why because Doctors spread Childbed fever because they didn't wash their hands! Countless women died because of this over the years.
Dr. Semmelweis, who was one of the first doctors to practice systematic antiseptic medicine was ruthlessly and viciously attacked by other Doctors for suggesting they spread disease by not washing their hands. Dr. Semmelweis practiced in the Vienna General Hospital and he noticed that compared to the midwife section of the Hospital the section of the hospital for women giving birth tended by Doctors had a rate of Childbed fever 3 times higher. He concluded it was because the Doctors were spreading infection by not washing their hands etc. They were dirtier than the midwives it seems.He was right. Doctors thought he was insulting them by suggesting they wash etc. Later Dr. Semmelweis created in Budapest, after he was driven out of the Vienna General Hospital by irate doctors, a model obstetric clinic that through his antiseptic and hygienic measures virtually eliminated childbed fever. His reward was to die in obscurity.