865-925: Rhazes describes allergies

Rhazes didn't choose to become a physician until he was
into his 40s, and this may have helped the man become among
the most well respected physicians of his era.  He wrote about
asthma, and is thought to be among the first physicians to
describe allergies. 

While allergies were alluded to before him, and would not be defined for the medical community for another thousand years after his death, many medical historians believe the Arabic physician Rhazes was the first to accurately describe allergies. So it's easy to see that he was a physician ahead of his time.

He was born Abu Bekr Mohammed ben Zechariah in the year 865, and is known best by the name of Rhazes. He was born in a town in Persia, in the province of Baghdad, in a town called Rai, "and it is from this that his last name was derived -- Ar-Razi,"  said historian Thomas Bradford in his 1898 book "Quiz questions on the history of medicine."  (9, page 62).

He was originally a musician, playing the flute in his youth. And even while he was a "passionate lover of music," he put this love aside in favor of philosophy and medicine, claiming "that music proceeding from between mustachios and a beard had no charm to recommend it," said V.J. Fourageaud in an 1868 article in the Pacific Medical and Surgical Journal. (1, page 164)(9, page 62)

Yet this turned out to be a great thing for the medical community, as "he is said to have been the ablest physician of his age; a master of all kinds of learning; skilled both in the theory and practice of medicine, said Bradford." (9, page 62)

He started studying medicine in his forties, explained Bradford, and traveled abroad to "Jerusalem, Syria, Egypt, Persia, and Spain, the better to perfect his knowledge by conversing with botanists, oculists and surgeons. Having thus become master of his profession, he settled in Bagdad, and so great was his learning that he was selected from over a hundred eminent competitors as the director-in-chief of the grand hospital in that place.  He is said to have been the ablest physician of his age; master of all kinds of learning, skilled both in the theory and practice of medicine." (9, page 62-63)

By this position he was "director of the hospitals of Ray (the same town he was born in), Jondisabour, and Baghdad, said Fourageaud..  (1, page 164)

Bradford and Fourageaud both said that his reputation was so great as an Arabian professor that students traveled from far away to hear him speak. (1, page 164)(9, page 62)

Edward Withington, in his 1894 book, "Medical history from the earliest times, said he became the "first and most original of the Arab physicians."   (2, page 145)

He is considered by many historians as the most independent thinker among the Arabic physicians.  (5, page 156)  He encouraged physicians to practice by empirical means (experience and observation) and in this way became the first physicians to encourage scientific based medicine. (3, page 31)

He wrote over 150 books, although some say he wrote as many as 220.  He wrote on philosophy, medicine, history, and chemistry, although his passion was medicine.  Unfortunately most of these works are lost to history, said Fred Ramon in his 2006 book "Albacasis."  (8, page 62) (9, page 63)

While he copied many of the idea of ancient physicians, such as Hippocrates and Galen, it's his scientific descriptions of diseases that make him among the most well known of the Arabic writers.

He became famous while being among the few Arabic physicians who did not earn a medical license.  And, despite his fame, he did not become rich, mainly because he chose to practice among peasants who could not afford much.  This type of 'boldness and originality' earned him the title "The experimenter," said Withington.  (2, page 145)

Among the medical community he is best known for writing the "oldest existing treaties on smallpox and measles," said Withington.  (2, page 146)(9, page63) and he is the first to have described fever as a defense mechanism of fighting off diseases.

He's also the first to describe asthma as a specific disease, and the first to mention allergies.  He was a chemist and pharmacist, and by this he gathered a collection of remedies (some of his own too) and recorded them in one of his publications.  Some of the remedies were for asthma, said Ramon. (8, page 70)

As noted by these writings, coupled by his writings about asthma and coryza (inflammation of the nasal passages/ hay fever), he was the first to write a treaties on the diseases of children.  (6, page 175)

During his life he would create voluminous volumes for the medical community.  In his Hawi or Continens, which exceeded the length of the works of his contemporaries (including the Canon of Avicenna) he gives an account of asthma and it's remedies: (2, page 146)

Ben Musue (an Arabian physician of the 8th century) said, 'Let persons troubled with asthma or shortness of breath take two drachms of dried and powdered fox lung with decoction of figs in their drink.'  Galen (De med. simple.) said that many cure asthma with owls blood given in the drink, or by giving owl's flesh with the blood in spidebeg(?), and taking it's blood afterword in wine. I say that owl's blood is not to be given in any case of asthma, for I have seen it administered, and it was useless."

Maimonides wrote of the remedies for asthma, and in doing so mentions Rhazes:

Maimonides endorses a remedy of Rhazes' to clear the lungs of moisture, ease respiration, and eliminate the cough: soak wheat bran over night in hot water, filter, and add sugar and almond oil; place on the first until it resembles a julep and drink when lukewarm.  (7, page 27)

Also of significance is he was the first to write a book about hay fever:  A dissertation on the cause of the coryza which occurs in the spring when the roses give forth their scent.  (3, page 31)(4, page 338)

In his work Essay on the cause of why Abu Zayd al-Bahli is subject to rhinorrhea in springtime when smelling roses, he described the inflammation and runny nose that occurred in the springtime when the roses were blooming.

Many consider this the first description of hay fever, or what would eventually be considered as springtime allergies, sinusitis, hay fever, seasonal allergies or rhinorrhea.  In a sense, he may also have been the first to describe allergic asthma.

Fourageaud said that near the end of his life he approached Al-Mansur, the Prince of Chorasan, in Baghdad to present to him a book on alchemy he dedicated to the prince.  The prince loved the work and rewarded Rhazes with a thousand dinars. (1, page 64)

The Prince said, "I wish for you to put into practice what you have laid down in this book."
Rhazes said, "That is a task for the execution for which ample funds are necessary, as also various implements and aromatics of genuine quality; and all this must be done according to the rules of art, so that the whole operation is one of great difficulty."

The Prince said, "All the implements that you require shall be furnished you, with everything necessary for the operation; so that you may be in the practice the rules contained in your book."

Rhazes said he was unable to perform the task, at which time the Prince said, "I should never have thought a philosopher capable of such faleshoods in a work represented by him as a scientific treaties, and one which will engage people's hearts in a labor from which they can derive no advantage.  I have given you a thousand dinars as a reward for this visit, and the trouble you have taken, but I shall assuredly punish you for being guilty of a falsehood." 

The Prince struck Rhazes in the head with a whip and sent him on his way with provisions to complete the task.  Rumor has it this is what made him blind, although some say it was because he was because he ate too many beans.

Believing his blindness was caused by cataracts, an "occultist" was about to operate on him when Rhazes said something like, "How many membranes does the eye have?" 

The occultist had no response.  Rhazes then said something like, "I will not entrust my eyes to someone who is ignorant of their structure."

Later, when further urged to have the operation, he said, "No, for I have seen so much of the world that I am weary of it."  (1, page 64)

So most historians describe his as a very wise man, and Bradford credits him with the following wise sayings: (9, page 63)

• When you can cure by regimen, avoid having recourse to medicine
• When you can affect a cure by a simple medicine, avoid a compound one.
• When a wise physician and an obedient patient, sickness soon disappears.
• Treat and incipient malady with remedies that will not prostrate the strength. (9, page 63)

Exactly when he died remains unknown, although much speculation of modern historians has the date at 925 A.D. Regardless, he was a renowned physician in his day, and was one of the Arabs who helped save medicine while a dark cloud hovered over western medicine.

References:

1. Fourageaud, V.J., "Historical Sketches: XIII: The epidemics of the sixth century, the plague, small pox, and measles.  Ahrun, Bachtishwa, Mesue the Elder, Honain, Serapion, Alkhandi, and Rhazes," Pacific Medical and Surgical Journal,  Medical and Surgical Journal, edited by V.J. Fouregaud and J.F. Morse, Volume VII, 1864, San Francisco
2. Withington, Edward, "Medical history from its earliest times: a popular history of the healing art," 1894, London, The Scientific Press 
3. Colgan, Richard, "Advice to the Young Physician: on the art of medicine," 2009, New York
4. Lehrer, Steven, "Explorers of the body: Dramatic Breakthroughs in Medicine from Ancient Times," 2006, United States
5. Fantini, Bernardino, Grmek Mirko editors, Antony Shugaar, translator., "Western Medical Thought from Antiquity to the Middle Ages," 1998, U.S., 
6. Gee, Samuel, "A Survey of the Literature of the Diseases of Childhood:  An address delivered at the offering of the section of diseases of children at the annual meeting of the British Medical Association in Liverpool, August, 1883, The Medical Times and Gazette, Vol. II, 1883, London, Pardon and Sons
7. Rosner, Fred, translator, "The Medical Legacy of Moses Maimonides," 1998, KTAV Publishing House, U.S.
8. Ramen, Fred, "Albucasis (Abu Al-Qasam Al-Zahrawi):  Renowned Muslim Surgeon of the 10th Century,"  2006,New York
9. Bradford, Thomas Lindsley, writer, Robert Ray Roth, editor, “Quiz questions on the history of medicine from the lectures of Thomas Lindley Bradford M.D.,” 1898, Philadelphia, Hohn Joseph McVey

628-330 B.C.: Medicine among the early Persians

So we know now what life was like for asthmatics in ancient Mesopotamia and ancient Egypt, now I'd like explain, if only briefly, what life was like for asthmatics in Ancient Iran.  The simple truth of the matter is it really wasn't much better than anywhere else in the world.  If you had asthma, as with any other disease, your best bet was to have someone pat you on the back, provide you with moral support, and to simply allow nature (or spirits or gods) to heal you.

The first people to live in this area, which was not far from Assyria in Upper Mesopotamia, were the Elamites, the Medes and the Persians.  I think these folks were essential to our asthma history because, when western civilization went into a dark ages of medicine after the fall of Rome in 476 A.D., medicine would rise in the east, and mainly in Persia.  This would happen around the 10th or 11th centuries A.D.  So it is essential that we not ignore these folks.

John Hermann Baas, in his 1898 book, "Outlines in the history of medicine,"  explained, that along with the Mesopotamians, the Chaldeans also had a major impact on Persian culture.  The Chaldeans worshiped a series of sacred texts called the Zen Avesta, also referred to as the "Living Word."  This Avesta was put into writing by the Zoroaster (Zaruthustra, Zerdutscht), who was supposedly a Persian prophet.  According to Encyclopedia Britannica, he lived from 628-551 B.C. (3, page 25)

This book, according to Baas, "was subsequently lost, but afterword collected from memory into a book of its present form."  So what is available today is from later copies, of which knowledge of religion, prayers, hymns, origin of the world, and also one section that includes knowledge of physicians and their medicine.
Plinio Prioreschi, in his 1991 "A history of medicine," says this this section was probably copied sometime around 250-200 B.C.  (1, page 488).

The Zen Avesta is among the few sources of knowledge of Persian religion, myths and medicine.  So knowledge of their religion, and their medicine, is scanty. According to Prioreshi:

The religion of the early Iranians, until the sixth century B.C., was similar to that of other Aryan (people who lived in ancient Iran and northern India) populations as, for example, the Vedic Indians.  Their priests were the Magi (wise men); they sacrificed to many gods, among whom Mithra (see below) held a prominent place; and they did not bury their dead but let them exposed to be devoured by wild animals." (1, page 487)

I find this interesting, because Prioreschi also notes that these people have left behind very few monuments, and very few documents, for modern day historians to learn from.  As the bodies of their dead were devoured by animals, their history was devoured by time.  Historians, therefore, have only a few texts to learn about their religion and mythology, and even fewer to learn about their medicine (which, in all essence, was blended into mythology).  So, unless more documents lie unearthed, it is apparent that the ancient Iranians "did not contribute much to world medicine." (that  is, until about the 10th or 11th centuries)  (Prioreschi, pages 487,495)

Yet we can use our imaginations to figure what life was probably like for them, considering, as Henry Sigerist notes in his 1961 "A History of Medicine," most societies pretty much believed sickness and injuries were basically all caused by magic, and healed by magic.  You did not just happen to become dyspneic, or just happen to get bit by an alligator, these things happened because of magical intervention either by enemies, by evil spirts, angry demons, or upset gods or goddesses.  (2)

These people, therefore, paid tribute to the various deities in order to maintain health and order among the civilization.  Some of their most essential deities to our history are:

Ormuzd (Ahuramazda):  Belongs to light, which emanates the good spirits, the supreme Amschaspands.  (3, page 25)

Amschaspand (Ahmeschaepenta):  Decrees diligently executed by their subordinate Izeds (Angels, archangels).  There are 32 angels of Amschaspand, some of these angels are listed here: (3, pages 25-26)

• Korschid:  The sun
• Mithra:  In the middle between the sun and the moon
• The Supreme Diws (Dews, Dewas):  They are the causes of all disease.  The cure will come from Amschaspands through mediation by a priest or priests.  The following emanate from him (Ahriman also belongs to them):  
• Aschmosch: 
• Eghetasch:
• Bochasp:
• Astujad: 
• Tarik:
• Tosius  
• Ahriman (Angramandscha): The evil principle darkness

Ardibehescht:  He is another god who might provide a cure through mediation of the priests, or a priest, on your behalf or on the behalf of the society.  (3, page 26)

Ainyama:  God of healing (3, page 26)

Thrita:  Physicians were his disciples.  To them he was highly esteemed.  He was the god of physician. (3, page 26)

There is much more detail in their mythology than I mention here, and probably enough to entail an entire book.  Still, if you had asthma in ancient Iran, these are the basic deities most relevant to you.
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So if you lived in ancient Iran, did you have other options besides simply worshiping deities?  Perhaps, although, due to the scanty writings from this era, it's difficult to know for sure.  Although, there may be evidence that there were physicians available to assist you with their enemas, salves and potions.

Prioreschi said that there were essentially three types of physicians in ancient Iran: internal priests who used herbal remedies, surgeon priests who used the knife, and incantation priests who used magical words.  (1, page 490).

Baas said these priests were not paid very well, and this may be a sign of disrespect for physicians, because all other professionals were paid very well.  Likewise, he suspected physicians may have occupied a low position, as only Egyptian and Greek physicains were known to be used as court physicians.  (3, page 27)

Baas notes how Cyrus II, who conquered the Babylonians and created the Persian Empire around 530 B.C., surrounded himself with military physicians, although there are many descriptions of Egyptian and Greek physicians coming to the Persian courts.  (3 page 26)

Prioreschi lists a few quotations where Egyptian or Greek physicians were called upon to treat members of the monarchy.  Prioreschi quotes the great Greek historian Herodutus as explaining how Darius hurt his foot while hunting, and even after seven days of Egyptian physician therapy "the king could get no sleep for the pain."  On the eighth day Democedes of Croton was summoned, and he "applied Greek remedies and used gentleness instead of the Egyptian's violence; whereby he made the king able to sleep and in a little while recovered him of his hurt..." (1, pages 496-7)

Of this, Prioreschi explained:

"This could mean that Persian physicians did not enjoy a great degree of professional respect.  On the other hand, it is difficult to assess the accuracy of Herodutus in this matter as it may simply reflect an opinion held among Greeks in his time (that is, in the fifth century B.C.)  (1, pages 496-7)

Persian physicians may have been disrespected mainly because few people survived the surgeries that were performed.  This may have been true despite the fact the the patient may have died anyway.  Yet because the physician acted, he (or she) would probably get blamed.  The same was true of their medicine, which, when the patient died, must have been blamed.  Herbal remedies, by an ignorant populace, must have been viewed as nothing more than poisons.

So Persian physicians were known for their "poisons," and for this reason, you may have been scared to seek out one.  However, if you did, they might have had a potion or two that might have allayed your nerves enough to take the edge off your suffering.  Or, maybe not.
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The following chart should explain how ancient Iranians commingled with other nations in the area, and it is by this means that ideas and culture (including medicine) were shared.

Ancient Iran
Elam:  2850-640 B.C. Sumerian control: 2850-2180 B.C. Elamites regain control: 2180-1830 B.C. Aryan invasions: 1800 Elams invade Babylon: 1176 B.C. Elams plunder temple of Akkad: 1150 B.C. Assyrians defeat Elams: 721-640 Elam civilization ends: 640 B.C.	While under control of the Sumerians they picked up much of their culture. The Aryans invade around 1800 and bring with them knowledge of medicine.  Before this time, ancient Iranian medicine probably mostly involved magic and religion.  (1, page 496)
Medes:  835-550 B.C. Attacked by Assyria: 835-705 B.C.  Assyrian Rule: 705-625 B.C. Median Empire founded: 625-585	Together with the Babylonians, the Medes destroy Nineveh, the capital of Assyria in 612 B.C. Medes declined, and in 550 B.C. was absorbed by Persian Empire.
Persia:  600-330 B.C. Persian Empire formed: 550-530 B.C. Egypt Conquered: 530-521 B.C. Unsuccessful war with Greeks …Battle of Marathon: 490 B.C. Xerxes I defeated by Greeks: 480&489 B.C Decline of Empire:  465-338 B.C. Conquered by Greece: 336-330 B.C.	Cyrus II conquers Babylon, Lydia and Medes to form the Persian Empire.  His son, Cambyses, conquers Egypt.  Darius extends borders of Empire beyond Indus Valley between 521-486 B.C. but cannot conquer Greece. Persia abandons plans to conquer Greece.  They were ultimately conquered themselves by Alexander the Great of Greece between 336-330 B.C.

Please note that these are approximate dates according to Plinio Prioreschi. (1, pages 485-487)

If you have any further questions about what life might have been like in ancient Iran, you might have to step into our time machine and take a ride. Or, you can wait and hope some more ancient Iranian documents are unearthed by archaeological expositions.

References:

1. Prioreschi, Plinio, A History of Medicine: Primitive and Ancient Medicine," Volume I, 1991, UK, The Edwin Mellen Press
2. Sigerist, Henry, "A History of Medicine," volume 2, 1961, Oxford University Press, page 202; also see Plinio Prioreschi, "A History of Medicine: Primitive and Ancient Medicine," Volume I, 1991, UK, The Edwin Mellen Press, page 490
3. Bass, John Hermann, translated by H.E Handerson, "Outlines in the history of medicine and the Medical Profession," 1889, New York, J.H. Vail and Company

2000-539 B.C.: Assyro-Babyonian physicains

Code  of Hammurabi

The ancient Greek historian Herodotus (484-425 B.C.) observed that there were plenty of physicians in Egypt and no physicians in ancient Mesopotamia.  Yet the evidence seems to disagree with Herodotus, that there were plenty of physicians in Mesopotamia, perhaps even as early as 4000 B.C. when the Sumerians were forming the first civilization, says Henry E. Sigerist in his 1951 book, "A History of Medicine: Primitive and Archaic Medicine.  (Sigerist, page 425)

Herodotus said:

They have no physicians (in Babylon), but when a man is ill, they lay him in the public square, and the passers-by come up to him, and if they have ever had his disease themselves or have known any one who has suffered from it, they give him advice, recommending him to do whatever they found good in their own case, or in the case known to them; and no one is allowed to pass the sick man in silence without asking him what his ailment is.

There is evidence that much of this statement is true, as there were laws requiring anyone passing by to ask the sick: "What is ailing you."  If this passerby knew of the remedy due to past experience, he was required to share the remedy.

Pierre-Victor Renouard, in his 1867 history of medicine, said this time of medical therapy was common early on in most ancient civilizations.  He said they essentially went by the axiom: (16, page 570)

The same cause, acting under identical circumstances, produces, always, the same effect. (16, page 570)

When applied to medicine, Renouard said, the axiom means:

A treatment which has procured the cure of any disease whatever, will cure, also, all diseases identical, or rather homogeneous to the first. (16, page 570)

So this would explain the logic of the sick lying in the streets in the hopes a passerby would recognize the symptoms and offer a remedy.

Medical historian Henry Sigerist agreed with the notion that there were "no physicians in ancient Mesopotamia," although he said it was an incomplete statement.  He said: (Sigerist, page 425)

Herodotus' statement about Egyptian physicians, about the many specialists, is fully confirmed  by Egyptian literature and also by archaeological findings.  In Babylonia, however he must have been grossly misinformed.  Perhaps he meant that the Babylonians had not the kind of physicians he encountered  in Egypt, that great variety of specialists.  There can be no doubt that patients were occasionally placed in front of the houses or even on the market place and that the neighbors gave their opinion about them.  This still happens with poor people all over the east.  but we have an infinity of documents to prove that all ancient civilizations of Mesopotamia had physicians, and not only one category but several.  Patients, therefore, were not left to the mercy of their families or of neighbors but received expert treatment according to standards prevailing at the time. (Sigerist, page 425)

Medical historian John Hermann Baas also noted that there was evidence of physicians existing in Babylon, although he stated that the profession began through the interventions of Chaldean priests, who, along with their Chaldean friends and relatives, were scattered all over Babylon.  (Baas, page 25)

Alexander Wilder, in his 1901 history of medicine, explains that Herodotus might have been referring to the "'atroi (magoi) or the professional mediciners, like Demokedes, and the Asklepiades and Hippokratians who were members of an oath bound or sacerdotal order.  Before his time, the Chaldean priests, including the Asaphim, had been exiled by Dareios Hystaspis and had migrated to Pergamos. This probably accounts for the assertion of Herodotus." (1, page 17)

Wilder notes that the...

..."practice of placing the sick in the public thoroughfares, is shown by other writers, 'Is it nothing to you, all ye that pass by?' demands the Hebrew prophet;  'Behold and see, whether there be any pain like mine."...It is recorded that wherever Jesus went the sick were brought and placed in his way in the expectation that he would restore them to health.... to suppose there were not physicians in the Euphraatean countries during the archaic period, would be preposterous." (1, page 17)

Priests were educated, and well educated, at schools near the temples.  As was usual for ancient societies, anyone who was educated was well versed in all subject areas, such as writing, math, science, weights and measures, legends, myths, magic, lore, medicine, etc.  If you were educated, you were probably trained in just about every area of knowledge available at that time. (Sigerest, page 432)

There were basically three types of priests who specialized in health and healing: (Sigerist, page 432)

1. (Seer Priest (baru):  He specialized in divination. He was basically responsible for assessing the patient and making a diagnosis, and he studied the stars and liver (or other organ) of a sacrificed animal and determined the prognosis (Will the patient get better? Will the patient die?).  He he thought it was necessary, he'd recommend an ashipu to heal you.(Sigerist, page 432)
2. Exorcist or Incantation Priest (ashipu):  He used magical words and motions to drive out the evil spirits or demons.(Sigerist, page 432)
3. Healing Priest (asu, azu):  He was the physician. He's the one who used magical incantations and herbal remedies to heal you. (Sigerist, page 432) Azu comes from Sumerian "A" for water and "Zu" for knows. He was famous for his knowledge of water in treatment of sickness)(Biggs)

Chances are, however, that these specialties didn't develop until the Chaldeans blended into Mesopotamian culture near the end or after the Sumerian Civilization. They came from the north, and brought with them knowledge of herbs, astronomy, astrology, and hepatoscopy.  As these people blended into Babylonian and Assyrian culture and were readily accepted, so to was their knowledge and medical practice.

As noted by Sigerist:

Health was considered a great good. 'May Shamash and Murduk give thee health' was a formula frequently used in Babylonia letters of Hammurabi's time.  And in Assyria the letter writer addressed the king with 'May Ninib and Gula give to the king my lord happiness and health.' Hence, disease was a great curse and the position of the sick man in society was aggravated particularly by the views that illness was a punishment for sin.  This at least was the case as soon as the Semitic (Chaldean) influence became strong. (Sigerist, page 425-6)

Babylonia and Assyrian civilizations existed for nearly 2000 years side by side, with Babylonia in the southern regions of Mesopotamia, and Assyrians in the northern regions of Mesopotamia.  They worshiped similar, and often the same, gods, and so too they shared pretty much the same medicine.  Priests became physicians, and they had various remedies to aid the sick and injured.

The Babylonians were the first to determine the importance of rest, and therefore people were strictly prohibited from treating the sick on the 7th day of the week, or the Sabbath day.  This was a day reserved for resting, feasting and worshiping the gods and demons.  (Bradford, pages 7-8)(Baas, page 28) 

This is noted in the following translation from a cuneiform tablet by George Smith: (Baas, page 28)

"The seventh day, feast of Mnrodnch and Zir: Panibti, a great feast, a day o rest. The prince of the people will eat neither the flesh of birds nor cooked fruits He will not change his clothing. He will put on no white robe. He will bring no offering. The king will not ascend into his chariot. He will not perform his duties as royal law-giver. In a garrison city, the commander will permit no proclamations to his soldiers. The art of the physician will not be practised."

Physicians also didn't perform any of their miracles on the 7th, 14th, 19th, 21st, and 28th days of the month because they were considered unlucky.  So if you were sick on those days you had to use whatever remedies you had access to. (Garrison, page 434)  

Average citizens did have access to their own herbal remedies and magic words, such as the following incantation asking for help from the gods for an internal disease: (Baas, page 28)

"Let the witch sit upon the right;
Let her leave the left side free!
Adisina, do thou tie the knot,
Hind up the head of the sick.
His limbs in like manner with fetters!
Seat thou thyself on his bed,
With the water of youth besprinkle him!"

They were also able to perform their own rituals and celebrations.  So, in this way, as in ancient Egypt, every citizen was a physicians. Although the better educated members of society looked to physicians and his medicine for aid, only to resort to incantations and prayers when all else failed. (Bradford, pages 7-8)

The asu were famous for their incantations, but they were also famous for their herbal poisons.  In this way, they earned a bad reputation.  Surely what they did might help the sick, if by no other means than by creating hope, although their herbal remedies also made some people sicker, and they killed some.  And some priests/ physicians abused their power.  So, this forced various societies to create laws to protect physicians from the magical abilities of these priests/ physicians.

In fact, this can be noted by many of the passages in the ancient stone tablets, or books.  In fact, Akkadian kings were forbidden to "take medicine for the ailments of the body."  (Wilder, page 17)

There was initially no formal method of payment of physicians, even though they were required to take care of the sick, particularly the kings and princes.  Although their services were appreciated, and often they were paid in the usual methods of the time, which included gifts of "large and small draught oxen, cows, horses, and camels." (Bradford, page 7-8)

In the 17th century B.C., however, a mighty ruler by the name of Hammurabi established a uniform code for everyone to follow, including physicians.  The code worked out great, because not only did it increase respect for physicians, it established a formal method of payment for them.  

Hammurabi was a mighty Amorite king of Babylon who gained fame as a great warrior and disciplinarian.   He fought the neighboring nations of Babylonia, including Larsa, Eshunna, Mari, and Assur.  He also fought a 30 year war with Elam, and defeated them.  (Sigerist, page 286)

In this way, he spread the boarders of Babylon, and spearheaded the process of assimilating the cultures of these other nations. 

Hammurabi was the 6th king of Babylon, ruling the city, civilization and the empire from 1792 to 1750 B.C.  While he was a great leader, perhaps he gained his harsh reputation for his strict rules, many of which influenced medicine for the Babylonians and future generations.

He did not write laws, per se, but he had the laws that already existed inscribed in stone and placed at the temples for all to see.  If you were not aware of the laws, this was no excuse.  The laws were pretty intense: an eye for an eye, a tooth for a tooth, and a limb for a limb  

They also applied to physicians to assure they did nothing to make their patients worse off by their remedies.  This was necessary to protect the people from the magic of priests/ physicians, but it also had the end result of improving respect for them as well.

The laws were basic, and included: (Garrison, page 56)

• Adequate fees
• Carefully prescribed remedies
• Regulations to assure remedies were safe  (Garrison, page 56)

These laws were inscribed in stone and set near or inside the temples for all to see.  This way there was no excuse for anyone to be ignorant of the laws. In total there were 282 laws (for a full list of laws click here), with Laws 215 to 223 pertaining specifically to the physicians. The laws created regulations for them to follow, although they also provided for respectful payment for their services:

Here are some of the laws pertaining to physicians:

• 215:  If a physician makes a large incision with an operating knife and cure it, or if he open a tumor (over the eye) with an operating knife, and saves the eye, he shall receive ten shekels in money.
• 216:  If the patient be a freed man, he receives five shekels.
• 217:  If he be the slave of some one, his owner shall give the physician two shekels.
• 218:  If a physician make a large incision with the operating knife, and kill him, or open a tumor with the operating knife, and cut out the eye, his hands shall be cut off.
• 219:  If a physician make a large incision in the slave of a freed man, and kill him, he shall replace the slave with another slave.
• 220:  If he had opened a tumor with the operating knife, and put out his eye, he shall pay half his value.
• 221:  If a physician heal the broken bone or diseased soft part of a man, the patient shall pay the physician five shekels in money.
• 222:  If he were a freed man he shall pay three shekels.
• 223:  If he were a slave his owner shall pay the physician two shekels.

There is an epilogue to the laws, which includes a long promise, part of which includes:

"LAWS of justice which Hammurabi, the wise king, established... May Nin-karak, the daughter of Anu, who adjudges grace to me, cause to come upon his members in E-kur high fever, severe wounds, that can not be healed, whose nature the physician does not understand, which he can not treat with dressing, which, like the bite of death, can not be removed, until they have sapped away his life."

While Assyrian and Babylonian priest physicians were initially all trained the same, over time they each became specialized in a particular disease as occurred in Egypt.  You'd have one physician for the eyes, one for the liver, one for prophylaxis, one for divination, etc.  (Garrison, page 56)

So now, thanks to such laws, the sick and injured were less likely to fear the priest/ physicians.  If you were in need of medical attention, surely you could attempt to heal yourself, and surely you could lie in the streets and hope to find someone with the remedy, yet you also had access to physicians, even if they were merely priest/ physicians.  

References:  See post "2000 B.C.:  Assyrian physicians will treat your dyspnea"

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2000-539 B.C.: Babylonians describe first lung diseases

Ancient Babylonian texts describe both diseases of the lungs and heart, and they even describe diseases such a`s chronic bronchitis and pneumonia. These respiratory diseases were more frequent than in ancient Egypt, and the reason may be due to the climate of Mesopotamia which can result in scorching hot days as hot as 120 degrees, and very cold nights. (Sigerist, page 381)

Generally, what is described are the symptoms, which was generally how it was in the ancient world These ailments that caused you to become short of breath, or to develop a cough, were caused by demons sent by the gods. The gods made you get inured or sick because either you or your ancestors had sinned. Another way you might get sick or injured was when dark magic was used by other people, either in the form of words or poisons. (Garrison, page 420)

If, for example, a demon possessed your lungs or heart, this resulted in shortness of breath, chest pain, increased sputum, wheezing, and similar symptoms.  Other diseases described were rumination, acid stomach, nerualgia, and various diseases of the eyes. They also knew about epilepsy and contagion, which was epilepsy caused by demons.  (Garrison, page 56)

They new that some diseases were hereditary, and this was probably caused by a sin of your ancestors.  They also observed some diseases were contagious, and this was probably due to demons possessing anyone who comes into contact with the diseases.  It was probably for this reason people with diseases like leprosy or syphilis were forced to live in exile, and people were discouraged from coming into contact with them. They were also struck by various plagues, and of course these were during times when the gods were exceptionally irritated. (Garrison, page 426)

Many of their remedies, especially exorcism and herbal, were picked up by later societies, including the Egyptians, Hindu, Chinese, Islam, and Medieval Christians.  So what was learned by one society greatly impacted future societies. (Garrison, page 56)

If you were sick or injured, if you were short of breath, you had a variety of options.  You could grin and bear it.  You could treat yourself with your own incantations, prayers and herbal remedies.  You could go to a smaller temples and perform a ritual for health and healing.  You could rely on the priests to perform such rituals at the larger temples.  You could lie in the streets.  You could call for a priest/ physician.

Primitive indeed the options were, you did have options for health and healing in ancient Babylonia.  Around 700 B.C. the Babylonians were defeated by the Assyrians, and sometime around 612 B.C. they conquered the Assyrians and there was a resurgence of sorts, with the capital city of Babylon reaching the peak of its glory.

However, Babylonian civilization grew weak, and was conquered by the Persians and Medes in 539 B.C. The Persian Empire rose to glory, becoming the preeminent civilization of the Near East, and in itself helped to advance medicine.

However, while knowledge was growing in ancient Greece and Rome, the Near East, Mesopotamia included, went into a dark ages of sorts, meaning knowledge was stalled, even regressed.

References:  See post "2000 B.C.:  Assyrian physicians will treat your dyspnea"

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2500-539 B.C.: Chaldeans create system of medicine

Originating with the Chaldeans was the Zend Avista, or the Living Word.  This was a compilation of all the Chaldean knowledge accumulated around 2500 B.C. by Zarathustria (Zerdutscht Zoroaster), who was a "priestly lawgiver who lived around 2500 B.C.  

As the most educated Chaldean, he was probably a member of the priesthood. His writings were lost to time, although they were ultimately rewritten into a book consisting of: (Baas, page 25)

• Yanza -- A liturgy
• Vispered -- Prayers (this would include the medical portions)
• Jesch -- History of Chaldeans
• Bundehesch -- Cosmology

Priests were educated at the world's first universities, some of which were created amid the Sumerians, and included locations in Urikh (Erech), Akkad, Nipur, Kutha, Larsa, and Borsippa.  The various branches of learning were not separated as they are today, so if you attended one of these universities you were pretty much educated in all wisdom, which included literature, writing, mythology, religion, medicine, science, mathematics, astronomy, cosmology, weights and measures, magic lore, divination, and astrology. (wiley, page 20)(Garrison, page 54)

Although, the priesthood was ultimately broken down by the Jews/ Hebrews as follows: (Garrison, page 58)

• Priest: Used words to create heal and prevent sickness and injuries. Hebrew priest were the "hygiene police" There is no mention of Biblical priests acting as physicians. (Garrison, page 57)
• Prophets: Had the ability to heal using knowledge they obtained at the universities.  Both Elijah and Elisha had the ability to cure and raise people from the dead. There are various references to them "making medicine" in the bible. 
• Physicians:  Used various herbal remedies and surgeries to heal
• Pharmacists: Created various herbal remedies and poisons to be used in healing

So most of the medicine was contained in the vispered, and it was all theurgic in character, meaning that it was based on mythology and divination.  These priestly magicians were the most excellent physicians, and they cured by their words, and thus they were: (Baas, page 26)

• Word doctors: They healed with their charms, incantations, and prayers. 
• Herb doctors: They healed with their potions
• Knife doctors: They performed surgery, which mainly consisted of blistering, bleeding, or operating on eyes, castration, etc. It rarely consisted of internal surgery.

According to Wiley, they were familiar with the following: (Wiley, page 20)

• Astrology:  Mainly consisted of using astronomy, the alignment of stars, planets, comets, etc. to determine the words of the gods to predict the future. (Wiley, page 20)
• Divination: Mainly consisted of determining the words of the gods by reading the alignment of internal organs, mainly the liver (called hepatoscopy). Garrison notes that the liver was important because it was the source of blood and the seat of the soul.  He says, "to inspect the liver was to see into the soul of the sacrificed animal, and the mind of the gods." (Garrison, page 55) This also involved palmistry (reading palms) and astrology (reading stars, planets, comets, etc.)
• Herbs: They had poisonous and healing properties, and worked by powers invested in them by gods. Herbal recipes were used as medicine, both internal and external (Wiley, page 20)
• Words: Included magical incantations, conjurations, spells and charms that were disgusting to evil spirits and demons, and remedied and cured ailments 
• Amulets: Their magical powers were able to suck out demons and spirits to cure ailments
• Talisman: Warded off evil demons and spirits
• Pharmacy: Medicine kept in vases and jars (Wiley, page 20)(Recipe page 21)

Garrison said priests or physicians would use one or more of the above in the following fashion: (Garrison, page 54-57 )

• Aetiology: Blaming demons (similar to modern physicians blaming germs)
• Diagnosis:  Based on inspection of patient
• Prognosis: Based on the following: 
• Divination or augury from liver of sacrificed animals:
• Abnormally large organ: token of future power and success
• Abnormality on right side of organ: token of future power or success
• Abnormally small organ: token of weakness or failure
• Abnormality on left side: token of weakness or failure
• Divination of astrological signs
• Birth omens, which determined whether person was going to be a super power or a failure.  These were based on augury of liver of sacrificed animals, astrology and palmistry.  They also studied fetal abnormalities.
• Disease omens:  Inspection of the body, abnormalities, studying liver of sacrificed animals, astrology, and palmistry. 
• Palmistry:  foretelling future through study of palms
• Therapy:  The goal of various remedies was to "disgust demons inside the body." (Garrison, page 56)
• Exorcisms by special ritual.  May be performed by the sick at home or at one of the smaller temples, or by the priests at your home, or as part of the regular rituals held at the larger temples. 
• Herbal remedies 
• Words: incantations, charms, spells, prayers, or conjurations
• Prophylaxis:  Prevention
• Incantation
• Talisman
• Charms (may place seal of gods on both sides of door of invalid) (Garrison, page 56)
• Good behavior
• Good hygiene (this was later perfected by Egyptians and Hebrews, although there is evidence of Babylonian drains, indicating they made the link between feces and disease) The Babylonians did wash their hands before meals, however, mainly because they ate with their fingers. They usually only washed the rest of their bodies only once a week. It was a sin to urinate in canals. (Sigerist, page 402)

In this way, it was the Chaldeans who created the first system of medicine. After the fall of Sumeria in 2000 B.C., their medical wisdom would be assimilated into Babylonian culture. 

References:  See post "2000 B.C.:  Assyrian physicians will treat your dyspnea"

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2000 B.C.: Chaldeans introduce physicians to Babylon

Chaldeans introduced astronomy/ medicine to ancient Mesopotamians?

Various groups of people continued to emigrate into Mesopotamia even as the Sumerian civilization was fading. Among these were the Syrians, Babylonians, Hebrews, Phoenicians, Akkadians and Arabs. Some of these matured to form villages, towns, cities, empires and even civilizations. Yet it was another group of people who had the greatest impact on medicine: the Chaldeans (Chaldees). (Baas page 25)

No one knows when they emigrated into the area, although many speculate they came from the north. The Hebrew Bible says they came from the "extremities of the earth," which may be Armenia, Cephenin, and Arrapachitis. Job mentions gold, and Jeremiah the iron of the north. It's also believed they left their homeland (and nobody knows why) over a century before they landed in Babylonia and Persia, or "before they besieged Jerusalem." (Asiatic Journal, page 36-37)

As time went by they were assimilated into Babylonian and Persian society to the point that they were often referred to as Babylonians and Persians, as opposed to Chaldeans. (Asiatic Journal, page 36-37) 

The dominant element of their way of life "consisted of servants to the deity," (Baas, page 25) and they are even referred to in the Bible as the "Magi" or the "Wise men," or "haruspices."  (Asiatic Journal, page 37)(Baas, page 25)

Magi or wise men were magicians, priests who were proficient in all the knowledge of the universe.  They specialized in mythology, religion, and medicine.  They were, perhaps, the most well educated people among society, and they were, in essence, magicians.

Haruspices, according to Britanicca.com, refers to the study of organs, such as the liver, and astronomical phenomenon, such as thunderstorms, lightning, alignment of stars, planets, comets, etc.  This was all done for the purpose of divination, or predicting the future.

The Chaldeans were known for their knowledge of mathematics, astronomy, astrology, interpretations of dreams, and medicine. Some referred to them simply as "skygazers."

Perhaps by gazing at the stars they developed the first calendars based on the phases of the moon.  Perhaps they are the ones who introduced Babylonians and Persians to a numerical system based on the number 60.  This system included the 360 degree circle, 60 seconds in a minute, 60 minutes in an hour, and so forth. They are also sometimes credited as helping the Babylonians advance mathematics, astronomy, astrology and medicine. 

Henry Sigerist, in his 1922 history of medicine, said that ancient societies did not study the sky because they were interested in the alignment of the planets, stars, comets, etc. What they were interested in was interpreting the words of the gods, and this alignment, so they thought, was how the gods communicated. It was the job of the Chaldean priests, and later the Babylonian priests, to interpret astrological signs. (Sigerist, page 392)

Or, as William Osler wrote in his history of medicine:

A belief that the stars in their courses fought for or against him arose early in their civilizations, and directly out of their studies on astrology and mathematics. The Macrocosm, the heavens that “declare the glory of God,” reflect, as in a mirror, the Microcosm, the daily life of man on earth. (Osler, page 24)

As they themselves were, their knowledge and culture were assimilated into Babylonian culture, and this is how medicine evolved into a science of divination through astrology and hepatoscopy in ancient Babylonia, or so it is believed. (Baas, page 25)(Sigerist, 392)

Actually, not only were the Chaldean Priest known for their astrology and hepatoscopy, they were also known for their herbal remedies and incantations. In fact, it was probably due to the Chaldean Priests that the Babylonians became well known for their poisons. (Baas, ?)

Babylonian medicine was initially referred to as poison because it was used for its poisonous effects, which sometimes included killing people who were not wanted.  It was this effect, some believe, that gave Babylonian medicine, at least initially, a bad name.  Perhaps for this reason most physicians were seen as bad people, and for this reason they worked behind the scenes.

Perhaps this was among the reasons that when the Greek historian Herodotus traveled through Mesopotamia, he wrote that "they have no physicians."  Various historians have noted ample evidence that there were, especially after the assimilation of the Chaldeans.

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2000 B.C.- 1538 A.D.: Civilization arrives in Mesoamerica

Figure 1 -- This is a map of Mesoamerica with some modern and some ancient
names.  The first American civilizations originated in this region.

So what would it be like if you had breathing trouble and lived among the ancient cultures of North and South America.  To answer this question, it's best to understand the people who lived there.

The experts estimate that people migrated across the Bering Land Bridge, Beringia, probably sometime between 50,000 and 10,000 years ago, and probably continued to find ways to communicate even after that.  After arriving in Alaska from Siberia, some people continued to migrate south, some ending up in Mexico, Belize, northern Costa Rica, Honduras, Guatamala, and El Salvador.

Historians refer to the stretch of land from central Mexico to Honduras as Mesoamerica, and it was here, perhaps in the tropical forests around Peru, where the first American lands were cultivated.  This would have been done for food, but also for fiber, raw material for baskets, mats, houses, boats, and fuel, said William Brandon in his 2003 book "The rise and fall of North American Indians." (8, page 22, 23)

Around 5,000 B.C. this knowledge spread around the Americas, creating an American Agricultural Revolution.  It was also around Peru where the first civilizations in the Americas arose.  Here is a brief chronology of Mesoamerican civilizations, and a brief discussion of what it would be like to live among them. (some dates are estimations):

Mesoamerica
Migration to America Bering Land Bridge:  30,0000-10,000 B.C.	A land bridge across the Bering Straight, and connecting Asia with North America, allowed humans, animals and plants to migrate between the two continents. Some crossed on foot, and others crossed on boats in shallow water along coastal lines.  Once the glaciers melted, the waters were cold and treacherous, and crossing them would have been difficult.  Over time, the poeple of the Americas were isolated from the rest of the world.
Agricultural Revolution in Mesoamerica The beginning of agriculture: Around 5000 B.C. Cities based on farming spread: 2000-250 B.C.	People living in Mesoamerica would have been able to fish, and hunt monkeys, jaguars, iguanas, deer, turkey, wild boar, and birds. There was also an ample supply of maize, squash, potatoes, beans, chili peppers, tomatoes, and tobacco. They also made chocolate from the cocoa plant. By around 5,000 B.C. people around Peru, perhaps in the tropica forests, learned how to cultivate and harvest these crops, and this knowledge spread. The people made tools and other materials of wood, stone, and obsidian (hardened lava).
The Olmec  Ceremonial centers in Peru: 2000 B.C. Olmec civilization flourished: 1500 B.C.-200 B.C. Chavin Civilization formed:  900 B.C. Olmec Collossal Heads made: 900 B.C. Olmec Civilization formed:  800 B.C. Olmec civilization begins decline: 100 A.D.	They Lived on the eastern Gulf Coast of Mexico. Similar to how the Sumerians influenced later Mesopotamian societies, the Olmecs influenced the Mayans, Aztecs, and Incas in math, architecture, astronomy, and religion.  They are most famous for large colossal heads they carved out of basalt boulders (see figure 2)
Zapotec Zapotec civilization:  600-800 A.D.	They Lived in southern states of Mexico.  The Mixtecs had a system of writing where they drew pictograms on deer skins.
Mixtec Mixtec civilization:  800-1500 A.D.	Lived in southern states of Mexico.  Zapotecs invented a system of writing called hieroglyphs, and wrote on stone tablets (did they learn this from a Mesopotamian trader?).
Mayan First Mayan Settlements:  2600 B.C. Maya Civilization flourished:  200 B.C.-900 A.D. Written language invented (hieroglyphics): 700 B.C Solar calendar carved in stone: 400 B.C. Maya "Golden Age:" 250-900 A.D Mayans flee southern city-states: 900-1600 A.D.   90% of population dead: 950 A.D.  Mayans flee northern city-states: 1200 A.D. Spanish Arrive: 16th Century At its peak, over 13 million people lived under Mayan rule. The ancient Maya lived in Mesoamerica for over 3,000 years, until their last city fell to Spanish invaders in 1697 A.D.	They lived in rain forests of Central America in what are now Mexico, Belize, Guatemala and Honduras. They studied the stars and planets without the aid of a telescope.  They developed exemplary skills in mathematics, astronomy and astrology. They created a system of writing, a calendar, and a religion based on legends.  Cities banned together to form city-states, each with its own king.  The king was well respected, and could communicate with the gods.  Wars were only fought to obtain slaves, and some of which were sacrificed so life could continue.  No life was taken, whether animal or human, except out of need.  Spanish Conquistadors invaded, robbed, and destroyed their cities in the 16th century.
Toltec Mornarchy began  667 A.D. Toltec Civiliation: 800-1200 A.D. Empire ended:  1052 A.D.	They were banished from their home country in the year 1 of their calendar (596 A.D.)  They were the cultural predecessors  of the Aztecs.  They settled in the basin of Mexico (what Aztec referred to as the Anahuac), and their capital was Tula. According to Aztec legend, their monarchy lasted 384 years, and there were only 7 kings, each ruling for 52 years.  Many stories were told of them by the Aztec, although it's difficult to determine how accurate these stories (and dates) were.  They were known more for their art than as warriors. Drought caused famine, and monarchy ended with death of last emperor in 1052 A.D.. (4, page 86-7)
Aztec Aztecs settle in Mexico:  1200 A.D. Aztec civilization flourished:  1325-1500 A.D. Tenochtitlan built on island: 1325 A.D. Aztec Empire:  1400-1519 20,000 sacrificed at religious ceremony: 1460 Attempt to conquer Mixtecs fails: 1470 Attempt to conquer Zapotecs fails: 1470 Great temple built in Tenochtitlan: 1481-1486 Spanish arrive and destroy empire: 1521 At the peak, there were over 15 million people living under Aztec rule.  The largest city was Tenochtitlan, which had over 50,000 residents.	Ruled much of southern and central Mexico. Unlike the Mayans, they had one king who ruled over all society, and he lived in the great city of Tenochtitlan (modern day Mexico City). Around 1400 they started attacking neighboring tribes for food, land, and human captives to sacrifice to the gods. Like the Mayans, they performed human sacrifices to make sure life would continue.  They were fierce warriors, and many simply fled rather than face them.  They were also skilled in wwriting, building, arts and crafts.  Spanish Conquistadors invaded, robbed, and destroyed their cities in 1521.
Inca First ceremonial centers built in Peru: 700 B.C. First civilizations arose:  1200? A.D. Inca Empire: 1438-1538	The Inca owned the largest empire in pre-Columbian America.  The capital was Cusci (modern day Peru). They also settled the Andean Mountain ranges, Peru, and parts of Ecuador, Bolivia, Argentina, Chile, and Columbia. They referred to themselves as Tawantinsuyu, which means 4 parts.  The land was divided into 4 parts to make it easier to rule.  It was a centralized government, where everyone was housed and there was no crime due to harsh laws.

Figure 2 -- Large Obsidian heads carved out of basalt
 boulders by the Olmecs around 900 B.C. Some are
estimated to weigh about 50 tons, and some were even
transported up to six miles "through the surrounding
mangrove swamps. (8, page 26)(9)

Most of the people that settled in Mesoamerica started out as nomads, roaming the land from place to place, eventually settling in one area.  They built houses made from mud-brick thatched straw and reeds.

Homes had very little furniture if any, and the people usually slept on mats that were spread on the floor. Legends (some from the Old World perhaps) were shared by word of mouth until a written language was learned, and they were recorded. These legends formed the basis of society and life among the various tribes and civilizations of the area.

Most people lived off crops of maize, beans, chili peppers, squash, tomatoes, and tobacco.   Volcanic soil, lakes and underground streams made this land good for growing such crops.  During times when crops did not grow, there were plenty of animals in the area to hunt, such as monkeys, jaguars, iguanas, deer, turkey, wild boar, and birds.  (2, page 6-7, 10)

It is still debated what tribes formed the first civilization in Mesoamerica, although many believe it was the Olmecs, as noted in the chart above.  However, Brandon notes that there is evidence of "undoubted Maya communities as early as, or maybe earlier than, the Olmec centers.  (7, page 27)

Another debate that rages is who created the first calandar.  Many historians believe it was the Mayans, although some speculate it was the Olmec.  However, Brandon explains the calandar was more commonly used by the Maya, particularly during their classic age.  He describes the calandar this way:

The Maya calandar was in its totality a family of related calandars locked together in a gearbox of considerable complexity.  The simplest was the tzolkin, or book of the days, a ceremonial round of 260 days, eventually in use all over ancient Mesoamerica; it may have originated in the annual coming and going of Venus, or it may have been founded originally on the period from autumn through spring, since the other 105 days of the year were devoted to the planting and growing season... The 260 days of the tzolkin involved a series of twenty different day names revolving through an endlessly repeated number series of one to thirteen.  This series meshed with the haab, a solar calendar using nineteen named months (eighteen of twenty days each and one of five days); the two calendars repeated their original conjunction after revolving through 18,980 days, or fifty-two years... the calandar swallowed itself, like the two headed serpent, every 260 days and every fifty-two years, spinning out the revelation that everything comes to an end and yet is reborn, everything changes and yet remains the same, only the circle, revolving forever, remains unchanged... The sacrifice of flowers, birds, dogs, human beings -- the sacrifice, in short, of life -- was an act meant to recognize and sustain this process of the gods." (8, page 27. 48)

All of these societies believed in a vast number of gods, and they believed these gods must be kept happy in order for life to continue. They also believed that the gods must be kept happy for good health, healing, and for victory in war.  For this reason, they made human sacrifices to make sure that life continued, and to make sure of victory in war.  The Aztecs were known to make mass human sacrifices prior to wars, and they would perform them on top of the great temples, and hold the still beating hearts up high so the gods would be sure to see. Other cultures sacrificed humans as well, although various animals, insects, and even plants were also sacrificed.

Figure 3 -- North Acropolis, Tikal, Guatemala. Photo from Wikepedia.  The Maya were
among the many civilizations of Mesoamerica to "build pyramids and surround them
with courts and avenues and buildings dedicated to religion," explained William
Brandon. (8, page 44)

When these peoples went to war, they usually did so in order to obtain slaves to perform labor, and to be used for sacrifices. They usually did not go to war to obtain material possessions or to obtain land.  They went to war, and killed, out of need, not out of greed.  Although, there were occasional wars between Mayan cities, and the victors combined the various captured cities under one government, ruled by one king.  These groups of cities were called city-states (similar to ancient Mesopotamia and Greece).

Sometime around 300 B.C. the Mayans adapted a hierarchical society, whereby their was an upper class that consisted of the king and nobles (about 10% of the people), and a lower class that was ruled by the king and his nobles (about 90% of the people).  The lower class consisted of serfs and slaves who worked the land owned by the wealthy nobles.  (2)

Although, it is believed by some experts, that farming "occupied only 105 days of the year," explains William Brandon.  "The possibility must therefore be considered that some farmers may have been also practicing artists, masons, and so on, and some artists may have been farmers.  That farmers, in their off time were used only for properly low-class manual labor (dragging heavy stone about, for example, under the whips of overseers) can scarcely be made to fit the population proportions." (8, page 34)

During Mayan civilization, each city-state had its own gods and king.  The king was the mediator between the gods and the people, and so he was usually loved and adored and well respected by the people.  The Aztecs were ruled under one king, and they too loved, adored, and respected their king.  Their king was called emperor, and he was treated as a god.  Only the nobles were allowed to have contact with him, and as he traveled the land, perhaps carried by his slaves, the serfs were required by law to look at the ground, and, therefore, not to look at him.

It was the kings job to keep the gods happy, often by making human sacrifices, in order for life to continue.  Each individual could also worship the gods, although this was the main job of the king.  So, it was in this primitive and perhaps grotesque and freakish fashion that health and healing was performed by ancient societies in America.

The Zapotec and Mixtec civilizations were the first to have a system of writing in America, although the Mayans were the only civilization to have a "developed" system of writing. They used hieroglyphs (pictures representing ideas) that modern linguists continue to struggle with deciphering.  They wrote books called codices, although most that survive were written in post-Columbian times, with material dating back to 300 A.D. (3, page 140-541, 546)

Figure 3

Mayan Hieroglyphs are also found on pottery and structures, and considering most  of the codices were probably burned by the Spaniards because they contained religious content, this is probably where most of our knowledge of the Mayan culture comes from. It is from these writings historians can get a good idea of their legends, myths, religious practices, laws, and medicine.  (3, page 140-541, 546)

Like the Mayans, the Aztecs had a calendar that they wrote on using ideograms (symbols representing ideas, see figure 3), although they never developed a formal system of writing.  (3, page 547)

Their official language was called quechua, although the people spoke a variety of other languages.

The Inca built great structures to view the stars and moon, and they had a calendar, and to write on it they "did not evolve a writing system (not even pictographic representation like the Aztec) and, for recording events, they used a device, called quipa, to aid the memory of functionaries whose job was to remember the past.  (3, page 545)

The quipa, or knot record, consisted of a complicated system of tying knots in strings to produce a mnemonic record... The quipa was used primarily for recording numbers and was used to remember historical events, lists of rulers, and probably even poems and stories."  (3, page 545)

The Inca had perhaps one of the best road systems in all the ancient world, and these roads were paved and even consisted of a series of bridges over gorges in the mountains.  There were guards at various stages of the roads, and there were also boarding houses so government officials could rest for the night and eat.  They were mainly used to transfer food to the citizens, and during times of natural disasters, food, blankets and other items needed to survive.  

If local tribes tried to invade or attack the empire, the Inca simply burned the bridges and there was no way for them to get in.  The Inca were surrounded by natural barriers: The Andes Mountains, the coastal dessert, and the Amazon Jungle in the east.  They did not expand their empire into the jungle, and instead expanded it north and south.  However, they did find various fruits in the jungle, and they also found many plants and herbs to be used as natural remedies for healing (I will get to these natural remedies in a future post).  

One other thing that is interesting about them is they had a very strong central government.  According to one legend the Inca were created by the sun god Inta, and so they referred to their ruler, the emperor, as the "Sapa Inca," or the "child of the sun."  Because he was the "child of the sun" he had a close relationship with the gods, and therefore, while each person could worship the gods, the Sapa Inca had special power.  It was by his doing that the gods were kept happy, and it was mainly this belief that made him loved and respected by his people. So the people willingly worked hard for the Sapa Inca, and they even paid a tax each year to support the central government.  Since there was no money, they paid by donating hours each year to work on the roads, and build palaces for the rulers, aqueducts to control flow of water to homes, etc. (5)

Another really good incentive for the Inca populace to be respectful citizens was a harsh series of laws.  If you were caught insulting the gods, or if you committed murder, you were tossed off a cliff.  If you were caught stealing, you had your hands or feet cut off.  If you were caught stealing a second time, you were killed. If you committed a lesser crime, you were stoned.  If you survived, your new job was to sit by begging bowls which were situated by the gates to the city, and you had to tell of your crimes to anyone passing by.  If your stories were interesting they tossed food or trinkets into your bowl, and this was how you proved you did your work.  This was a major deterrent for those passing by to respect Inca laws.  (5)

These criminals did not try to escape because only government officials were allowed on the roads, and the gates of the city were heavily guarded.  If a criminal was caught escaping, he lost his life.  So in this way, even the criminals had an incentive to perform their jobs willingly.  (5)

Map of Inca lands from Wikepedia. Notice
that their territories spread north and south,
as opposed to east.  They had no interest in
living in the tropical forrests

The Inca believed health and disease were caused by the gods, and they also believed they were responsible for life continuing. They therefore celebrated one of their gods each month with music, dances, stories and sacrifices. Most sacrifices were animals, although for special events they did sacrifice humans. The Inca believed health and illness were caused by the gods, and they believed that the only way to be reborn into the next world was to die in battle, or to be sacrificed.

After the fall of the Toltec Empire the "anahuac remained desert, almost depopulated, for the space of a century until the arrival of the Chechemecas."  Like the Toltecs they were nomads until they settled in the anahuac, thus creating a civilization there, of which many kings ruled for many years. They were hunters who lived off game and fruit of land, although they were not barbarous.  They worshiped the sun, and provided sacrifices of flowers (as opposed to animals or humans) to satiate or propitiate the gods. (4, page 90)

I would love to go on and on writing about life in ancient Mesoamerica, because it is quite fascinating. However, for the sake of our asthma and respiratory therapy history,  this is the basic information we need. Also keep in mind there were various tribes who lived under the rule of the above civilizations, or as barbarians in the surrounding lands. So while this history describes some of the more prominent cultures, there were many, perhaps hundreds, more.  Some of these tribes may have had access to medicine that might benefit the asthmatic, although are probably lost to time and history.

Overall, change was slow to occur in the New World prior to the Spanish Invasion. The only change that did occur may have been self imposing, perhaps due to religious belief that some things are "supposed" to end.  The Mayan Classic Era ended without any signs of war, famine, or disease.  Many wonder why it ended, even to this day.  Brandon explains one possible theory:

Death, renewal, divination, being key factors in Maya religion, may also have been factors in the ending of the Maya Classic age.  A story was told centuries later of Maya resistance to Spanish invasion in a particular region, that the resistance ended because calendric divination said that at this point it would.  Could one factor in the departure of the Classic Maya from their shining cities have been that divination told them to go?

This is the way it was in the ancient Mesoamerican world.  Life was based on cycles, and for the cycle to continue the people must obey the will of the gods, and keep them happy.  The best way to keep them happy was by feeding them, and among the best foods was provided through sacrifice: of humans, animals, insects, birds, and even, perhaps, the entire Mayan civilization.

If you lived with asthma during this era, pretty much you were at the whims of nature and the gods. Although, as you will see in this post, there were actual healers, and there was medicine available.

References: (All these references were used in creating the chart above)

1. Bell-Rehwoldt, Sheri, "Amazing Maya Inventions," 2006, Chicago, Nomad Press
2. Maxwell, Harold, Sydney Selwyn, "A history of medicine," 2nd edition, 1947, U.S., Alfred A. Knopf Inc. 
3. Prioreschi, Plinia, "A History of Medicine: Primitive and Ancient Medicine," volume I, 1991, New York, The Edwin Mellon Press
4. Gordon, Thomas Frances, "The History of ancient Mexico, from the foundation to its destruction by the Spaniards," volume I, from the "Cabinet of American History: Mexico," volume IV,  1832, Philadelphia, printed and published by the author, 
5. "Aztec Empire for Kids: The Awesome Aztec," http://aztecs.mrdonn.org/, accessed 5/14/13
6. Wilder, Alexander, "History of Mediicne: A brief outline of medical history and sects of physicians, from the earliest historic period; with an extended account of the new schools of the healing art in the nineteenth century, and especially a history of the American Eclectic practice of medicine, never before published," 1901, Maine, New England Eclectic Publishing Co.
7. "Bering Land Bridge National Preserve," NPS.gov, http://www.nps.gov/nr/feature/indian/2003/park.htm, accessed 5/20/14
8. Brandon, William, The rise and fall of North American Indians from prehistoric through Geronimo," 2003, Lanham, New YHork, Toronto, Oxford, Taylor Trade Publishing
9. "Olmec Colossal Heads," Wikepedia.com, http://en.wikipedia.org/wiki/Olmec_colossal_heads, accessed 5/23/2013. The picture is also from Wikepedia.

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