Tuesday, October 28, 2014

2600 B.C.: Hermetic Books allow medicine to flourish in Egypt

The Hermetic Books, mainly the last six of them, or the Embre, were memorized by every priest/ physician in Egypt.  These contained all the medical wisdom of the gods, and the laws regulating their practice. (1, page 3)(4, page 14)  Memorizing the texts, and sticking to them when practicing, protected physicians from any malpractice, allowing the profession to flourish in Egypt.

The Embre are broken down as follows: (7, page 4)
  • Book 37: Anatomy
  • Book 38: Diseases
  • Book 39: Surgery
  • Book 40: Remedies
  • Book 41: Disease of the Eye
  • Book 42: Disease of Women
Deviating from these texts made the physician liable for any assumptions regarding their medical treatment. For instance, if it was assumed that a patient became sicker or died as a result of a physicians black magic, the physician could be held responsible.  So memorizing the texts was deemed essential.  

Of course a disadvantage of this is that it prevented experimentation, which ultimately prevented any physician from inventing a new potion that might have healed patients better or faster.  

In his 1872 history of medicine, Robley Dunglison said the script forced physicians to diagnose by the position of the patient, which must be observed as "a mode of discrimination, as may readily be conceived, at once nugatory and absurd." (8, page 25)

Dunglison said:
The blind adherence to the opinions and rules of their predecessors, and the criminality, as it was considered, of all innovation— whilst they continued—effectually prevented any improvement in the science, or as it might, at that time, be more properly styled, the art of medicine. (8, page 25) 
In his 1831 history of medicine, William Hamilton said that "Improvement to medical knowledge was effectually arrested by the penal discouragement of every attempt to deviate from the canons of practice laid down in the volumes ascribed to Thouth (Thoth); and the interests of the priests led to the perpetuation of the popular delusion respecting the cause of disease." (10, pages 13 and 14)

Hamilton added:
While the door of salutary competition was effectually closed by the exclusion of all but the initiated few, and no opportunities afforded for the display of superior talent, or the exercise of superior skill; it cannot be a matter of surprise that medical knowledge should have remained so long stationary, and should have become almost retrogressive, or that the conquest of disease should have been effected rather by the efforts of nature counteracting the operations of art, or by the fortunate by unpremeditated concurrence of circumstances, than by any combination of skill, or exertion of judgement. (10, pages 13-14)
So from around 2,700 B.C. to the opening of the school of Alexandria in 331 B.C., it was considered as "offensive to the Gods as the violation even of those bodies which they had slain without compunction in the fields, much more the dissection of those who had died from natural causes in their beds," said Hamilton. (10, page 8)

This pretty much made physicians slaves to their own profession.  Not only were they not able to experiment, they were also not able to learn by their own investigations.  In fact, Theodor Puschmn, in his 1891 history of medicine, said that even "embalming exercised thus no beneficial influence upon the development of anatomical knowledge."  (11, page 23)

While physicians did understand that the heart was the "seat of origin of the blood vessels," they were prevented from, even discouraged, from deviating from the traditional means of mummification.  (11, page 23)  In other words, priest/ physicians were forbidden from inspecting the bodies of dead people for scientific gain.

"Hence," Hamilton said, "it was that men, being destitute of the means of acquiring a just knowledge of the structure, functions, and relative positions, of the human viscera, were unable to form a correct judgement as to the seat or causes of disease, or to adopt a rational method of cure." (10, pages 8-9)

Garrison said that Aristotle wrote a century later, in his Politics, that, if after the fourth day the patient was not cured, a physician was allowed to deviate from script, and this allowed for some experimentation to take place. (9, page 49)(10, page 15)

But this was certainly not enough to advance the profession. While Egyptians, partially due to the Hermetic Texts, are often credited for giving rise to rational medicine, the art did not grow into a full and flourishing tree until the philosophical days of ancient Greece.

  1. Bradford, Thomas Lindsley, "Quiz questions on the history of medicine: form the lectures of Thomas Lindsley Bradford, M.D," 1898, Philadelphia
  2. Withington, Edward theodore, "medical history from the earliest times: a popular history of the art of healing," 1894, London, The Scientific Press
  3. Von Klein, Carl H., "The Medical Features of the Papyrus Ebers," The Journal of the American Medical Association, December 23, 1905, Volume 45, page 1928, George H. Simmons, editor, volume XLV, July - December, 1905, Chicago, American Medical Association Press.  This article provides a fuller story of how the document ended up in the hands of Georg Ebers, how it came to existence, etc.  
  4. Baas, Johann Herman, author, Henry Ebenezer Sanderson, translator, "Outlines of the history of medicine and the medical profession," 1889, New York
  5. Dunglison, Robley, author, Richard James Dunglison, editor,  "History of Medicine from the earliest ages to the commencement of the nineteenth century," 1872, Philadelphia, Lindsay and Blakiston
  6. Renouard, Pierce Victor, "History of Medicine: From it's origin to the 19th century," 1856, Cincinnati, Moore, Wistach, Keys and Co., page 26, chapter 1, "Medicine of the Antique Nation."
  7. Bryan, Cyril P., translator, "The Papyrus Ebers," 1930, London, Garden City Press
  8. Dunglison, Robley, author, Richard James Dunglison, editor,  "History of Medicine from the earliest ages to the commencement of the nineteenth 
  9. Garrison, Fielding Hudon, "An introduction to the history of medicine," 1922, Philadelphia and London, W.B. Saunders Company, page 49
  10. Hamilton, William, "The history of medicine, surgery, and anatomy, from the creation of the world to the commencement of the nineteenth century," 1831, volume I, London, Henry Colburn and Richard Bentley
  11. Puschman, Theodor, translated by Evan H. Hare, "A history of medical education from the most remote to the most recent times," 1891, London, H.K. Lewis
  12. Wilder, Aleander, "History of Medicine," 1901, Maine, New England eclectic Publishing
  13. Sandwich, Fleming Mant, "The medical diseases of Egypt, part I," 1905, London
  14. Puschman, Theodor, translated by Evan H. Hare, "A history of medical education from the most remote to the most recent times," 1891, London, H.K. Lewis
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