KHARKIV NATIONAL MEDICAL UNIVERSITY

HISTORY OF MEDICINE

Methodical developments
for teachers to conduct a practical lesson
on the topic «The Origin of Medicine. Pre-historic Medicine. 
Medicine of the Ancient World» 
for the preparation of students in specialties:
•	7.12010001 «General Medicine»,
•	7.12010005 «Dentistry».

Kharkiv
2018

MINISTRY OF PUBLIC HEALTH OF UKRAINE
KHARKIV NATIONAL MEDICAL UNIVERSITY

DEPARTMENT OF PUBLIC HEALTH AND HEALTHCARE MANAGEMENT

HISTORY OF MEDICINE

Methodical developments
for teachers to conduct a practical lesson
on the topic «The Origin of Medicine. Pre-historic Medicine. 
Medicine of the Ancient World» 
for the preparation of students in specialties:
•	7.12010001 «General Medicine»,
•	7.12010005 «Dentistry».

Approved by the Academic Council 
of Kharkiv National Medical University. 
Protocol № 9 from 21 September 2017

Kharkiv 
KhNMU
2018

UDC 61(091)«652»(076)

History of Medicine : methodical developments for teachers to conduct a practical lesson on the topic «The Origin of Medicine. Pre-historic Medicine. Medicine of the Ancient World» for the preparation of students in specialties : 7.12010001 «General Medicine», 7.12010005 «Dentistry» / Compiled by V. Ognev, O. Semenenko, N. Martynenko, O. Myakyna. – Kharkiv : KhNMU, 2018. – 20 p.

Compilers:	Ognev V.	
	Semenenko O.	
	Martynenko N.	
	Myakyna O.	

GUIDELINES FOR TOPIC TRAINING 

The aim of the class: students have to comprehend the main peculiarities of the development of medicine in the Primitive Society, Ancient Greece and Ancient Rome.
To know:
•	 Curriculum questions:
•	definition of the science history of medicine;
•	sources for studying history of medicine;
•	concept of disease in the Primitive Society;
•	medical arts of ancient people;
•	primitive medications;
•	mystic methods of treatment;
•	sources for studying medicine of Ancient Greece;
•	medicine of Ancient Greece in Crete-Mycenae period (3–2 mil. B. C.);
•	medicine of Ancient Greece in the Pre Polis period (11–9 cent. B. C.);
•	medicine of Ancient Greece in the Polis period (8–6 cent. B. C.);
•	medicine of Ancient Greece in the Classic period (5–4 cent. B. C.);
•	medicine of Ancient Greece in the Hellenistic period (4 cent. B. C.–30 A. D.);
•	medicine of Ancient Rome in the Regal period (8–6 cent. B. C.);
•	medicine in the Roman Republic (510–31 B. C.);
•	medicine in the Roman Empire (27 B. C.–476 A. D.).

Be able to:
•	to define periods of the development of medicine;
•	to group the sources in history of medicine and use them.
The form of class: seminar.
The place of class: a classroom of the department.
Methodical equipment of the class:
•	methodical guidelines to classes;
•	presentation materials;
•	tests;
•	Summary of lectures.

The algorithm of the class: Having checked students’ attendance, the teacher announces the topic and the aim of the class, explains the relevance of its studying and possibility of its use in the practical activity.
After the introduction to the class, the teacher finds out what questions students had learnt, during the preparing of the topic. Then the teacher moves to the consideration and control of students’ knowledge on the basic theoretical material, which students could not understand while preparing to class individually.
Applied forms of control: recitation; theoretical or problematic discussion; blitz-control according to variants – the amount of time allocated 5–7 min.; tasks on the definition of terminology; written control of theoretical tasks – individual tasks or tasks on a few variants, including 3–4 theoretical questions (the amount of time allocated not more than 20 min.); tests with further analysis of answers.
After the control of the theoretical knowledge the teacher makes key conclusions on the studied topic, he/she sums up the control of theoretical knowledge of students and announces students the marks they received at class.
The teacher also announces home task at the end of the class.

Class schedule and timing in percent to the duration of class:
1	Introduction to class	up to 5 %	
2	Control of initiative knowledge	5–10 %	
3	Consideration of the key questions of the topic	75–80 %	
4	Summing-up and the announcement of home task	up to 10%	
	Sum in total	100%	

Reference
Basic literature
1. Longrigg J. Greek Rational Medicine : Philosophy and Medicine from Alcmaeon to the Alexandrians. – London and New York : Psychology Press, 1993. – 296 p. 
2. Majno G. The Healing Hand: Man and Wound in the Ancient World. – Harvard University Press, 1991. – 600 p. 
3. Stupak F. Ya. History of Medicine : textbook / F. Ya. Stupak. – Кyiv : “Book-plus”, 2016. – 128 p.
4. The History of Medicine. Pre-history :  Student reference and support materials. – Plymouth : St Boniface’s College, 2009. URL: https://www.britishempire.co.uk/boniface/humanities/history/year10/prehistoric.htm

Auxiliary Literature
1. Hinrichs T. J., Barnes L. L. Chinese Medicine and Healing : An Illustrated History. / T. J. Hinrichs, L. L. Barnes. – Cambridge, Massachusettes, London, England The Belknap Press of Harvard University Press, 2013. – 424 p.
2. Nutton V. Ancient Medicine : 2nd ed. / V. Nutton. – New York : 2013. – 488 p.;
3. Wujastyk D. The Roots of Ayurveda / D. Wujastyk. – London ; New York : Penguin Books, 2003. – 361 p. 

Internet Resources
1.	http://www.historyworld.net/wrldhis/PlainTextHistories.asp?historyid=aa52
2.	https://www.slideshare.net/ebynoanne/medicine-in-the-primitive-society
3.	http://www.ulsu.ru/media/uploads/iriskor%40mail.ru/2017/10/30/1.History%20of%20medicine%20as%20a%20science.pdf
MAIN THEORETICAL MATERIAL FOR CLASS TRAINING

1. History of Medicine as a Science
Studying of the history of medicine enriches general cultural and medical world view of a future doctor, helps «to grow accustomed to» his/her profession, to preserve traditions of devotion and responsibility in front of society, unites different branches of sciences. At the same time history of medicine helps to acquire and develop knowledge, that are the components of the art of medicine: humanism, altruism, diligence, high moral ethic qualities.
History of medicine is sub-divided into general and special ones.
General history of medicine studies the development of medical knowledge in human society as a whole. General questions, main regularities of the historical development of medicine are the subject of the history of medicine as a separate science.
Special history of medicine studies the development of separate branches of medicine. It is a component of all medical disciplines.

2. Sources for Studying of History of Medicine
To learn the past the history of medicine uses such historical sources:
•	narrative sources – hand-written or printed texts, implemented on clay or papyrus, parchment, paper and etc., inscriptions upon the stone, metal and graffiti (texts, scratched on the walls, items);
•	artifacts – the main part of them consists of archaeological monuments (instruments of labour, remnants of dwellings, settlements, burial places, everyday objects, cultural items), and paleoanthropological material;
•	ethnographic sources, i.e. elements of ancient everyday life and culture of peoples, which remained till now, in particular, rites and elements of medical preventive activity;
•	oral sources – oral folk arts memorial (narrations, legends, songs, tales, proverbs etc.);
•	linguistic sources – language data, medical terminology, geographic names, personal names etc.;
•	cinema, photo- and audio- records;
•	modern types of sources, which carry information on the electronic recording media.

3. The Concept of a Disease in Primitive Society.
Medical Arts of Ancient People
According to recent archaeological funds, the primitive man appeared 3–4 million years ago. In the development of human they separate two turning points. First, and the most important, is characterized by the beginning of labour activity with a usage of labour instruments and shift from the stage of human’s animal ancestors to the stage of people formation. Such types of humans as Archanthropus (Pithecanthropus, Sinanthropus) and Paleoanthropus (Neanderthals) date back to this period, in its earliest stage.
The second turning point was at the turn of the Early and Late Paleolith was characterized by the transformation of Paleoanthropus into Modern Human – Neoanthropus with the shift (40–35 thousand years ago) and the social organization realized transfer from the stage of the Primitive Herd to the Primitive Clan Community.
The means, close to genetically determined, instinctive ones, were usual for highly developed animals remained and were used in treatment of diseases and injuries during the first period of the human formation along with other remnants of the animal past of the human. People mentioned that injured animals licked their wounds, if they were ill they were seeking out and ate up different herbs, they drank water from mineral springs, and tried to free themselves from parasites.
At the early stages of the formation of medicine instinctive self-help actions gradually picked up the forms of conscious help. Administration to one person by another in injuries and diseases already was the evidence of the emergence of medical care as a form of public practice. According to the researchers, early stages of such care may date back to the Stone Age, it was common for Neanderthals (“Homo Habilis”).
The major difference of the human from other species is a purposeful labour. First tools’ production was the result of a certain level of the brain development. The human changed his own nature by influence to the environment through the tools of labour made by him. At the same time the human naturally tried to preserve his physical strength, i.e. health. Elementary protective measures from unfavourable environmental conditions – cold, bad weather, caused covering human body or its separate parts with clothes, provision of primitive dwellings, – all these proved that the primitive people provided the elementary principles of hygiene.
Difficult life conditions, difficulties in finding food caused diseases. Human and animal skeletons, dated back to the oldest historical periods, already bear traces of both past diseases and medical interventions.
The beginning of medical activity, first of all, self-treatment was also connected with those life conditions. The oldest medical branches included assisted delivery (especially to primiparas), help with injuries (contusions, falls from a height, wild animals’ attacks), treatment of some indigestions, evident outer skin lesions.

4. Primitive Medications
Primitive medications changed depending on gradual improvement of productive forces and development of the primitive human society. Before the human learnt how to make fire, he fed on plant foods: different berries, nuts, and roots. The human sought them out and ate in a natural way. Feeding in such a way the human had to learn their poisonous and healing properties.
With time the human began to distinguish herbs alone (laxative, emetic ones) and used them if it was necessary. Mostly women sought and picked foodstuff, because of that they were the first experts on them.
The discovery of fire-making method was crucial for the primitive man. It immediately reduced his dependence on the nature. Learning how to make fire gave people the chance to settle on broader area, and enriched them with new foodstuff, in addition, heat treatment of these products promoted their better assimilation by human organism.
Nutritive materials were used as medicinal in case of necessity. Having made sure in emetic, laxative, sudorific, soporific, sedative, analgesic, stimulant and other effects of some plants, used to satisfy one’s hunger, people, after some time, and started to use them specially to alleviate the suffering. The experience taught them to use certain substances in definite quantities, in certain condition, to subject them to the proper treatment.
Experimentally the human being also learnt to use water and sunlight for the purpose of healing, to massage tender spots, to stop bleeding by pressure, to immobilize seats of fracture, tying a stick or a piece of bark to the injured extremity. When the primitive man improved his tools, when he already used a spear, bow, knife – this made possible hunting big animals, fishing, he began to take medications of animal origin such as blood, fat, and certain animal organs. Further learning of pottery in 6–4 million B. C. made enable not only better cooking and preserving food, but also storing up medications as well.
When the human began to raise livestock, he gave animals the medical aid them in injuries, delivery, observation of the effect of different herbs had on them enriched his healing experience. Later, mineral substances began to be used for the healing purpose as well.

5. Mystic Methods of Treatment
In time along with empirical methods of medicine based on the beliefs of the human in supernatural forces began to be used. The beginnings of a religion went back to the period of the primitive human society, which was characterized by the clan system. In this period the human did not separate himself from the nature, he gave the nature the same life, its qualities and characteristics, as he lived himself. The human explained the surrounding natural phenomena, such as change of days and nights, reasons for wind, thunder etc. in a very specific way.
Empirical knowledge of the human at that time were very limited, because of that he could explain all these phenomena only by presuming the existence of supernatural forces, endowing all natural and animal phenomena with them. In time, the human got a primitive complex of the ideas about unexplainable phenomena, particular world view. So, religious beliefs appeared in such forms as totemism – the human belief in the presence of supernatural connection between the given lineage group and a certain kind of animals and plants; animism – the belief in the existence of spirits and soul; fetishism – the belief that certain objects have supernatural qualities; magic – the belief in the existence of supernatural means of influence on human, objects, events, natural phenomena through certain actions, rites and rituals.
In this world view a disease, if it does not have an obvious reason – a wound, strike, fall, is the result of moving of a hostile force into the human. It can be driven out either by prayers, a gift-sacrifice, threat or taking substances (wormwood, faeces) horrid to the taste, with foul smell. This hostile force can be forced to leave a sick person, by scaring it with unusual clothes (shaman’s clothes), shouting, whistling, knocking, it can be enticed into an animal or object, which later can be burned, thrown to a river or buried in the ground.
The primitive human deeply believed in the validity of his beliefs and from the very beginning he performed all curative measures and different magical actions himself. In time, by the experience of his personal setbacks, the human began to ask particular individuals, who knew better means, could better get into communication with supernatural forces. Like this foretellers, sorcerers, magicians, for whom all the secrets of nature “were open”, who knew and could find healing and poisonous substances and made by them proper medications gradually appeared.

6. Medicine of Ancient Greece
The only source of information about Ancient Greek medicine of Crete-Mycenae, Pre Polis and Polis periods were the first Greek literary monuments – epic poems of Homer “Iliad” and “Odyssey”. “Hippocratic Corpus”, compiled of the works of ancient Greek doctors and called after the name of Hippocrates told about medicine of the Classical Period of the Greek history. Herodotus’s “The History” contained some information about the activity of ancient physicians. Works of Alexandrian scientists retold by Galen and Celsius gave the information about medicine of the Hellenistic epoch as far as the originals didn’t remain.

Medicine of Ancient Greece in Crete-Mycenae Period (3–2 million years B. C.). During Crete-Mycenae Period disintegration of clan relations and establishment of the early class society took place. During this period the most ancient Greek civilization emerged, and the island Crete was the center of it. Powerful Crete had highly developed crafts and art.
Luxurious palaces discovered as a result of archaeological excavations in the capitals of Crete kingdoms, especially in Knossos became a bright evidence of high level of Crete civilization. Sanitary facilities: water pipe, sewerage, baths, cesspools and even ventilation were discovered at the territory of Knossos castle that was the evidence of a high level of sanitation. These were the main achievements in medicine of that period.
Later the Acheans, who lived on the mainland, captured Knossos and started to rule by Crete. Among numerous Achean kingdoms of mainland Greece a special place belonged to powerful Mycenae, which conquered Crete. To conquer rich Troy the king of Mycenae Agamemnon together with his brother the king of Sparta Menelaus unleashed the Trojan War in the 12th century B. C. Later its episodes laid at the basis of Homer’s poem “Iliad”. In the poem some features of that time medicine were pictured. In the Trojan War the family of professional doctors, doctors-warriors, representatives of the family medical school took part. The head of the family Asclepius was a teacher for his two sons Machaon and Podalirius.

Medicine of Ancient Greece in the Pre Polis Period (11–9 century B. C.). In the Pre-Polis period weakening of the kingdoms and significant decay in many cultural branches were observed because of numerous civil wars.
Homer’s poems “Iliad” and “Odyssey” described 141 injuries of the body and extremities. The treatment of wounds consisted of the extraction of arrows and other objects, blood extrusion and use of anesthetic and haemostatic herbal powders with further dressing adjustment.
“Iliad” had spoken mostly about military medicine, characterized by a comparatively high level of anatomical knowledge, which required surgical skills, ability to make and use medicines, mostly of herbal origin, to relief the pain and to heal wounds. Along with this there were places in Homer’s poems, which proved the presence of magic elements in the early Greek medicine.
The treatment and bandaging of wounds in the ancient Greek army was between the hands of both warriors, and skillful doctors, who knew properties of herbs. They were highly respected.
Homer’s poems also mentioned of epidemics of plague, sulfur fumigations for prevention of diseases and use of sulfur as medication, as well as borrowing some knowledge about medications from ancient Egyptians.

Medicine of Ancient Greece in the Polis Period (8–6 centuries  B. C.). The Polis Period of the Ancient Greek history was marked by two events, important for history and medicine: 1) formation of the Ancient Greek philosophy and 2) formation of temple healing, which was connected with the strengthening of slave-owning system and religion in Ancient Greece, and, as a result, formation of temples.
In Greece asclepeions – the first sanctuaries dedicated to the god of medicine Asclepius were built. Ancient writers informed about more than 300 asclepeions at the territory of Greece. The sanctuary of Asclepius in Epidaurus was considered to be the biggest.
The practice of treatment in asclepeions was based on incubation, i.e. the condition of «the artificial sleep», which could be reached through taking of drugs or using methods of psychological influence. This ritual was conducted in a specially designated room – the abaton, and was followed by a theatrical performance and even by performing simple surgical operations. Dreams were interpreted by priests and, according to this, the treatment was appointed, mostly by physical methods. The cases of healing were written down on special tables, which were hung out in the temple.
The main methods of treatment included use of natural medications, water healing, diets, regime, and gymnastic exercises.
Prosperous professional doctors opened hospitals, called “yatreyas” in their houses.
Some cities established a position of a city doctor for their own cost.

Medicine of Ancient Greece in the Classical Period (5–4 centuries B. C.). Natural philosophy was a philosophical and scientific basis of Ancient Greek medicine. During the Classical Period of the Greek history two major systems of ancient philosophy were formed. There was an atomism (Democritus) and an objective idealism (Plato). Both of them influenced a lot on the formation of medicine which was inseparable from philosophy.
Greek doctors were sub-divided into different categories: military doctors, specialists in wound treatment, archiaters, public doctors and periodeuts, who did not belong to a certain place and moved from a city to city, sometimes they moved to the service inside the cities.
For a long time medicine in Ancient Greece was a family tradition. By the beginning of the Classical Period family medical schools expanded: they began to take pupils – who were not members of that clan. Thus, leading medical schools were formed. During the Classical Period they were situated mostly beyond the borders of the Balkan Peninsula. Among them we have to mention such ones:
Croton Medical School. The main achievements of this school were formulated in the following positions: an organism was the unity of opposites; a healthy organism was a result of the balance of opposite forces; the opposite was treated by the opposite ones. Alcmaeon of Croton was an outstanding physician of Croton School. He discovered the intersection of optic nerves and an ear channel.
Knidos Medical School can be characterized as a school of special pathology. The representatives of Knidos School marked out complexes of painful symptoms and described them as separate diseases. Special pathology and therapy were developed in the school, based on medical diagnostics. The School representatives laid down clearly humoral pathology as studies about four main liquids of an organism (blood, mucus, light bile and black bile), and health was considered to be their favourable mixing and, on the contrary, non-favourable mixing of them was regarded to be the reason for the most number of diseases. Eurithon was the famous doctor of Knidos School.
Cicilian School was founded by Empedocles – a philosopher, a politician, a poet, an orator, a physician and a priest. He thought that fire, water, air and earth were the essence of all things; they were always permanent, non-cognized and indestructible; they could not turn the one into the other, but could only mix with each other in a mechanical way; the world diversity was a result of different proportions of this mixing. Thus, Empedocles laid the foundations for classical studies about elements.
Kos Medical School was the main medical school of Ancient Greece of the Classical Period. The physicians of Kos school perceived the human, his health and diseases in a close connection with the outside world, tried to maintain natural healing forces in a human organism. The disease in their understanding was a result of the influence of the environmental and feeding disorders. The physicians of Kos School introduced basics of medical ethics; developed the principles of monitoring and treatment directly at the bed of the sick person. Later this idea laid down at the basis of the clinical direction in medicine. The flourishing of Kos Medical School was connected with the name of Hippocrates.
Hippocrates originated from the island Kos (460–377 B. C.) is considered to be an outstanding Ancient Greek physician.
Hippocrates’s line extended to Asclepius’s son – Podalirius. As a periodeut he traveled much. The fame about his medical skill spread in many countries. The last years of his life he spent in Larissa (Thessaly).
Long after Hippocrates death, around 280 B. C. in the Alexandrian library of manuscripts the first collection of ancient Greek medical works, written in Greek language was compiled. The collection of texts was called “Hippocratic Corpus” in honour of Hippocrates.
This collection consisted of the works of different medical schools it was an encyclopedia of Ancient Greek medicine of the Classical Period. It contained around 250 medications of herbal and 50 ones of animal origin.
Most researchers think that Hippocrates was the author of such works from the given collection as: “Aphorisms”, “Prognostics”, “Epidemics”, “On Airs, Waters, Places”, but perhaps, as well as some others.
The system of Hippocrates’s treatment was based on certain principles: “Do not harm!”; “the opposite is treated by the opposite”; to help the nature, to co-ordinate your actions with its efforts to get rid of a disease; to adhere to moderation, and consistency in prescription of medications.
Hippocrates developed the studies about the types of the structure of the human body and tempers.

Medicine of Ancient Greece in the Hellenistic Period (4 century B. C.–       30 A. D.). The Hellenistic Period was the final stage of the development of Ancient Greece. After Alexander the Great death in 323 B. C. his empire split into several Hellenistic states, which existed for some centuries. One of the biggest states of them there was Greek-Egyptian Ptolemaic kingdom with the capital in the city Alexandria. The differentiation of scientific disciplines became a characteristic feature of this period.
The studies of the greatest Ancient Greek philosopher and thinker Aristotle were of great importance for the development of natural-scientific knowledge of that time.
Aristotle (384–322 B. C.) was a son of a physician and a researcher of nature, scientist and encyclopaedist. He researched the structure and functions of the organs of different animals and laid the foundations for the descriptive and comparative anatomy.
The anatomy became a separate medical branch in the Hellenistic epoch.
Herophilos (around 335–260 B. C.) was an outstanding Ancient Greek physician of the Alexandrian School of the Hellenistic epoch, and a founder of the descriptive anatomy.
In the work “Anatomy” Herophilos described in detail dura mater and pia, parts of the brain and especially its ventricles, traced some nerves trunks and determined their connection with the brain. He described some internal organs: liver, duodenum, the former he named for the first time.
In his work “On eyes” Herophilos described the vitreous body, fovea, choroid, sclera and retina, and in the treatise “On pulse” – the vessels anatomy and the studies about arterial pulse.
Erasistratus (around 330–255 B. C.) was an outstanding Ancient Greek physician of the Alexandrian School of the Hellenistic epoch, one of the founders of the descriptive anatomy. He described gyrus of the cerebral cortex. Erasistratus is considered to be the founder of the scientific physiology.

7. Medicine of Ancient Rome
Medicine of Ancient Rome in the Regal Period (8–6 centuries  B. C.). In the Regal Period there were no professional physicians in Rome – they treated at home using traditional means: herbs, roots, fruit, their decoctions and extracts, often added to magical incantations.
In certain branches of medicine Etruscans achieved wonderful progress. In particular, numerous Etruscans bridges, made of the animal bones and fastened with the help of a golden bridge remained till nowadays.

Medicine in the Roman Republic (510–31 B. C.). In the field of medicine this period is marked by the following achievements: the development of sanitary legislation; construction of sanitary facilities; emergence of professional physicians; the rise and the development of medical care and the elements of its state regulation.
The earliest evidence of the attention to sanitary measures was “the Law of the Twelve Tables” (451–450 B. C.). The law contained provisions regarding sanitary state of the city, in particular about prohibition of the burials in the city, about the accomplishment of cemeteries, and the prohibition of use of the water from the river Tiber etc.
Thermae were sanitary, healing, public and cultural centers in Rome. First thermae in the city were built in the 3rd century B. C. by Marcus Vipsanius Agrippa (63–12 B. C.) and delivered free possession of them to city residents. According to the traditions of then-medicine bathing belonged to effective medications, and for treatment of some diseases it was necessary.
There were no professional doctors in Ancient Italy till the 2nd century A. D. The slaves from prisoners of wars, mainly Greeks were the first doctors. The high cultural and professional level of slaves-physicians increased their authority. The free practice of such a specialist seemed quite beneficial to a slave-owner, therefore they began to let slaves-specialists find a free work for a certain payment. A freed physician was obliged to treat his former owner, as well as the family, slaves and friends of the latter for free and to give his owner a part of his profits.
It is considered that Archagathus was the first free Greek physician in Rome. He moved from Peloponnesus and was given the Roman citizenship in 219 B. C., and was granted a state house for private practice.
Asclepiades (128–56 B. C.) was an outstanding Greek physician who worked in Rome. The development of the natural-scientific approach in Ancient Roman medicine was closely related to the methodological school founded by him. He considered a disease as the result of the stagnation of corpuscles in the body channels. From this perspective, Asclepiades attached great importance to proper sweating and respiration of the coverlets. His treatment was directed on the restoration of injured functions and represented simple natural measures (diet, bathing, water-healing etc.).
Celsius (25 B. C.–50 A. D.) was an outstanding Roman scientist-encyclopaedist, a physician, the author of the multivolume encyclopedia “De Medicina”. From 20 volumes of the encyclopedia up to nowadays were survived only 8 ones, devoted to medicine. This work is the oldest treatises from known works in Latin language. Celsius preserved for history the priceless information about Alexandrian Medical School. He provided description of four symptoms of inflammation (reddening (rubor), swell (tumor), fever (calor) and pain (dolor)).

Medicine in the Roman Empire. The development of medical care during the Imperial period was manifested in the formation of military medicine. The final formation of the Roman army and broad expansionist campaigns demanded the organization of medical care in the army. Professional physicians appeared in all subunits and in all Roman armies. After the battle all the wounded were brought to the institutions named valetudinarii, specially provided for the wounded and sick.
Special valetudinarii for slaves were set up in slave-owning mansions. They were attended by slaves-physicians. Though, slaves were usually not treated. A sick slave was sent to the Asclepius Island on the river Tiber and left there to die. In case of recovery such a slave became free and did not have to come back to the owner.
Along with military medicine during the Imperial Period medical care developed in the cities and provinces, where authorities established paid positions of physicians – archiaters.
Court archiaters served at the imperator’s court, provincial ones worked in the provinces, peoples’ ones – in the cities. Archiaters united into collegiums and were under the control of local and central authorities, which monitored their elections and assignments.
Medical education was private in Ancient Rome: experienced physicians taught their pupils the art of medical science for a certain determined fee. The term of study varied.
State teaching of medicine began from the 3rd century A. D. The archiaters’ duty was teaching medicine in special schools.
Galen (129–199) was one of the greatest physicians of the Ancient World. A Greek by origin, he was born in the East of the Roman Empire in the city Pergamon. He worked as an archiater in a gladiators’ school. After his move to Rome, Galen came to fame with his lectures and his successful medical practice, – he was a court archiater of the Roman emperors.
Galen had written about 400 works. The most important of them were “On Anatomical procedures”, “f the Uses of Different Part of the Human Body”, “Of the Method of Curing Diseases” etc.
Galen described bones, muscles, ligaments, internal organs. He played a significant role in the study of the nervous system. He described all the departments of brain and spinal cord, 7 from 12 cranial nerves pairs, 58 spinal nerves and nerves of the internal organs. He described in detail anatomical structure of the heart, coronary heart vessels and ductus arteriosus, thinking though, that blood penetrates septum. In Europe this erroneous view was considered to be the only right one and was out of the reach of criticism for centuries up to the 16th century.
Galen contributed to the development of pharmacology. The number of medications, which were gained by mechanical and physiochemical treatment of natural drug raw material and maximal isolation of active ingredients from the bulk of ballast substances, taken at certain proportion are called “Galenic preparations” so far.
In the history of science Galen was and remains the founder of experimental anatomy and physiology, a brilliant therapist, pharmacist and surgeon, physician-philosopher and explorer, who cognized nature.
Since the 2nd century A. D. the territory of the Roman Empire began to reduce under the pressure of neighboring states and tribes. In 395 the empire split into two parts: Western Roman Empire, which ceased to exist in 476 and Eastern Roman Empire, which existed till 1453.
The fall of the slave-owning system of the Western Mediterranean caused the beginning a new period in the history of humanity – the Middle Ages with a new social order – feudalism. The culture of the feudal society (including medicine) was formed in difficult economic, social and political conditions. However, in spite of all difficulties of the development one of its most important sources were achievements of great civilizations of the Ancient World, which became a basis for the further development of all humanity.

TESTS

1.	History of medicine is one of the branches of the general history of culture of humanity. It studies the development of knowledge, connected with the diseases, treatment of the human, protection and strengthening of his health. The history of medicine is divided into general and special. What does general history of medicine study?	
	A	The development of medical knowledge in connection with history of religion	
	*B	The development of medical knowledge in human society as the whole	
	C	The development of practical medicine in the connection with the history of the culture of peoples 	
	D	The development of separate medical branches	
2.	History of medicine is one of the branches of general history of culture of humanity. It studies the development of knowledge, connected with the diseases, treatment of the human, protection and strengthening of his health. The history of medicine is divided into general and special. What does special history of medicine study?	
	А	The development of medical knowledge in connection with history of religion	
	B	The development of medical knowledge in human society as the whole	
	С	The development of practical medicine in the connection with the history of the culture of peoples	
	*D	The development of separate medical branches	
3.	The means, close to genetically determined, instinctive ones, which were distinctive for highly developed animals remained and were used in the treatment of diseases and injuries during the first period of human formation. At the early stages of the formation of medicine instinctive self-help actions gradually picked up the forms of conscious help. The beginning of medical help as a form of public practice starts in:	
	*A	The Stone Age 	
	B	The Copper Age	
	С	The Bronze Age	
	D	The Iron Age	
4.	Primitive medications changed depending on the gradual improvement of productive forces and development of the primitive human society. The first ingredients of drugs were:	
	*A	Herbs 	
	B	Metals	
	C	Minerals	
	D	The parts of animals’ bodies 	
5.	The beginnings of religion go back to the period of the primitive human society. In this period the human had been sought explanation to the surrounding natural phenomena. Since empirical knowledge of the human at that time was very limited, he could explain all these phenomena only by presuming the existence of supernatural forces. Magic was:	
	A	the belief that certain objects have supernatural qualities	
	B	the belief in the existence of spirits and a soul 	
	*C	the belief in the existence of supernatural means of influence on the human, objects, events, natural phenomena through certain actions, rites and rituals	
	D	the belief in the presence of supernatural connection between the given lineage group and a certain kind of animals and plants	
6.	During Crete-Mycenae period the most Ancient Greek civilization emerged, the center of it was Island Crete. Crete-Mycenae civilization had:	
	A	The developed system of medical institutions 	
	*B	The high level of sanitary facilities	
	C	High medical educational enterprises	
	D	Mobile hospitals	
7.	To conquer rich Troy the king of Mycenae Agamemnon together with his brother the king of Sparta Menelaus unleashed the Trojan War in the 12th century B. C. Later these episodes laid at the basis of Homer’s poem “Iliad”. In the poem some features of that time medicine were pictured. Who were the great doctors of the period of the Trojan War?	
	A	Alcmaeon and Hippocrates	
	B	Celsius and Galen	
	*C	Machaon and Podalirius	
	D	Sushruta and Charaka	
8.	In the Pre-Polis period weakening of the kingdoms and significant decay in many cultural branches were observed because of numerous civil wars. Greek medicine of the Pre-Polis Period was characterized by the level of the development of:	
	A	Dentistry	
	B	Internal Medicine	
	*C	Military medicine	
	D	Preventive medicine	
9.	The Polis Period of the Ancient Greek History is marked by two important for history and medicine events: 1) formation of the Ancient Greek philosophy and 2) formation of the temple healing, which was connected with the strengthening of the slave-owning system and religion in Ancient Greece, and, as a result, formation of temples. Who did Ancient Greeks proclaim a god of medicine?	
	*A	Asclepius	
	B	Asclepiades	
	C	Hippocrates	
	D	Ibn Sina	
10.	During the Polis Period more than 300 asclepeions were built at the territory of Ancient Greece. They represented large medical complexes. The main method of treatment in asclepeions was:	
	A	Diet 	
	B	Gymnastics	
	*C	Incubation	
	D	Water-cure	
11.	For a long time medicine in Ancient Greece was a family tradition. By the beginning of the Classical Period family medical schools expanded: they began to take pupils – not members of one clan. Thus, leading medical schools were formed. Which Greek medical schools do you know?	
	A	Athenian, Croton, Kos, Sicilian	
	*B	Croton, Knidos, Sicilian, Kos	
	C	Croton, Sicilian, Athenian, Knidos	
	D	Kos, Pergamon, Knidos, Croton	
12.	Hippocrates of Kos (460–377 B. C.) is considered to be a great Ancient Greek physician. What studies did Hippocrates develop?	
	A	About the cell structure of organisms	
	B	About the reasons of diseases	
	C	About the reasons of treatment	
	*D	About the types of the body structure and tempers	
13.	The Hellenistic Period is the final stage of the development of Ancient Greece. The anatomy became a separate medical branch in the Hellenistic epoch. Who of Ancient Greek physicians of the Hellenistic Period is considered to be the founder of anatomy?	
	A	Alcmaeon, Empedocles, Hippocrates	
	*B	Aristotle, Herophilos, Erasistratus	
	C	Asclepius, Machaon, Podalirius	
	D	Galen, Aristotle, Plato	
14.	There were no professional doctors in Ancient Italy till the 2nd century A. D. The slaves from prisoners of wars, mainly Greeks were the first doctors. At the end of the 3rd – beginning of the 2nd centuries A. D. free Greek doctors started working in the capital of the Roman Republic. Who of Ancient Roman doctors do you know?	
	*A	Asclepiades, Celsius, Galen	
	B	Celsius, Galen, Puthagoras	
	C	Galen, Hippocrates, Asclepius	
	D	Plato, Hippocrates, Asclepiades	
15.	Galen (129–199) – one of the greatest physicians of the Ancient World. Galen had written about 400 works. The most important of them were “On Anatomical procedures”, “On the Uses of Different Parts of the Human Body”, “On the Method of Curing Diseases” etc. Galen contributed the most into the study of:	
	A	Digestive tract	
	B	Blood circulation	
	*C	Nervous system	
	D	Respiratory organs	

QUESTIONS FOR SELF-CONTROL

1.	What does history of medicine study?
2.	What sources do we use to get the information about the development of medicine?
3.	What methods of treatment were used in the Primitive society?
4.	What was the influence of religion on medicine of the Primitive society?
5.	What were the peculiarities of medicine of the Pre-Polis Period?
6.	What were the peculiarities of the temple medicine in Ancient Greece?
7.	What Ancient Greek medical schools do you know and what were the peculiarities of their studies?
8.	What were the reasons of diseases according to Hippocrates?
9.	What were Hippocrates’ principles of treatment?
10.	What features were particular for Hellenistic medicine?
11.	What were the main features of the development of medicine in Ancient Rome?
12.	What was the medical system and methods of treatment of Asclepiades?
13.	What do you know about Celsius and his treatise “De Medicina”?
14.	What was Galen’s contribution to the development of medicine?
15.	What a scheme of blood circulation in human body did Galen offer?

CONTENT

Guidelines for Topic Training………………………........................................	3	
Main Theoretical Material for Class Training…….…………….......……..….	5	
1. History of Medicine as a Science ...……………....……..…………	5	
2. Sources for Studying of History of Medicine………..……………..	5	
3. The Concept of a Disease in the Primitive Society. Medical Arts of Ancient People.......................................................………………………..	
5	
4. Primitive Methods of treatment………………………….………...	6	
5. Mystic Methods of Treatment……………………….……………..	7	
6. Medicine of Ancient Greece ……….………………………………	8	
7. Medicine of Ancient Rome ……………….………………………..	12	
Tests……………………………………….………….………………………..	15	
Questions for Self-Control.......................……………………………………..	19	

Educational publication

HISTORY OF MEDICINE

Methodical developments for teachers 
to conduct a practical lesson on the topic 
«The Origin of Medicine. Pre-historic Medicine. 
Medicine of the Ancient World» 
for the preparation of students in specialties: 7.12010001 «General Medicine», 7.12010005 «Dentistry».

Compilers:	Ognev Viktor	
	Semenenko Olena	
	Martynenko Nataliya	
	Myakyna Olexander	

Responsible to sign-off V. Ognev

Формат А5. Ризографія. Ум.друк. арк. 1,25.
Тираж 100 прим. Зам. № 17-33461.
______________________________________________________________
Редакційно-видавничий відділ
ХНМУ, пр. Науки, 4, м. Харків, 61022
izdatknmu@mail.ru, izdat@knmu.kharkov.ua
Свідоцтво про внесення суб’єкта видавничої справи до Державного реєстру видавництв, 
виготівників і розповсюджувачів видавничої продукції 
серії ДК № 3242 від 18.07.2008 р.