2640 B.C.: The first description of allergies?

Figure 1 -- King Menes (circa 2925 B.C.)

About 2,640 years before the birth of Christ, King Menes of Egypt was reported to have died after being stung by a wasp. This might very well be the first account of an allergic reaction.  

The Roman leader Caesar Augustus (100-44 B.C.) is believed to have suffered from seasonal symptoms that might have been allergies and asthma  (1)

Roman Emperor Claudius (10-13 B.C to 54 A.D) is also suspected of having suffered from seasonal allergy symptoms. His son Brittanicus (41?-55 A.D.) is thought to have suffered from an allergy to horses. Literature describes how exposure to horses made his eyes swell and a rash appear.

Figure 2 -- Prince Nero and Prince Brittanicus

Brittanicus was heir apparent to the throne.  Yet due to his allergies he was limited in what he could do.  And when his mother died, Claudius remarried to Agrippina the Younger.  She had a son named Nero, and Claudius adapted him.  Nero almost immediately won the favor of the public, and Nero ultimately eclipsed his younger brother and was named Emperor in 54 A.D.

Nero became famous for throwing Christians to the Lions.  Yet within only a few months of his reign, he poisoned his weaker, older brother Brittanicus to death.

Ancient Roman physicians were probably the first physicians to recognize allergy symptoms, although they failed to recognize it as anything other than a minor ailment. With limited anatomical wisdom, and deadly diseases in need of their immediate attention, minor ailments like allergies received barely a footnote in ancient literature.

For example, Roman philosopher Lucretius (99-55 B.C.) said, "What is good for some may be fierce poisons for others."  Some speculate speculate this was an allusion to allergies. (2, page 4)

Allergies were again alluded to by the Middle Eastern Physician El-Razi or Rhazes (865-924).  He wrote his observation of redness and swelling of the nasal passages in some of his patients.  Some of his contemporaries observed these symptoms occurred in the presence of roses, referring to it as Rose Fever.

Still, while the condition may have been recognized in a few patients, physicians had little time to spend on such a trifling ailment, especially given there were deadly diseases that needed their attention.

Plus most who suffered from it had too much work to do to let it slow them down. So most who suffered probably just brushed it off as a minor ailment, making the disease barely recognizable by the few men who recorded history.
References:

1. Cantani, "Pediatric Allergy, Asthma and Immunology," 2000, New York, page 724
2. Ehrlich, Paul M., Elizabeth Shimer Bowers, "Living with Allergies," 2008

1700-1940: 'The asthmatic pants into old age'

There is a stunning array of evidence that prior to the 1950s, and even into the 1980s, physicians had a view of asthma as a benign disease; that morbidity (severity) and mortality (the death rate) from asthma was negligible.  The evidence comes in the form of quotes from the physicians themselves.

Dr. William Cullen (1710-1790), who wrote extensively on asthma, said:

"The asthma, though often threatening immediate death, seldom occasions it; and many persons have long lived under this disease. In many cases, however, it does prove fatal; sometimes very quickly, and perhaps always at length." (6, page 451)

Dr. William Withering (1741-1799), who recommended the diuretic digitalis for asthma, said:

  "The disease does not cut short the usual period of life." (4)

Dr. Rene Laenec(1781-1826) , the inventor of the stethoscope, said:

Asthma gives the patient the best hope of a long life. (9)

An attack of purely nervous asthma is rarely fatal. (17, page 443) 

Dr. Armand Trousseau (1801-1867)said:

Asthma was "the certificate of a long life."  (9) 

Dr. Francis Hopkins Ramadge, in his 1835 book "Asthma, its species and complications," said:

The prognosis of asthma is seldom difficult.  Doubt can arise only in cases severely complicated. When asthma wears the purely nervous form, danger is rarely to be apprehended." (18, page 36)

Dr. Walter Hyde Walshe, in his 1871 book "A practical treaties on diseases of the lungs," said:

Spasmodic asthma not only does not directly destroy, but is compatible with remarkable prolongation of, life: the popular adage likens the possession of the disease to a " lease of a long life." (19, page 551)

Dr. Henry Hyde Salter, in his 1882 book "On Asthma: It's Pathology and Treatment, said:

"Asthma never kills; at least I have never seen a case in which a paroxysm proved fatal." 
(2, page 82)

Salter also said this:

"If death did take place from asthma it would by by slow asphyxia -- by circulation of imperfectly decarbonized blood; and before this occurred I think the spasm would yield."

Dr. J.B. Berkart, in his 1878 book "On Asthma: It's Pathology and Treatment," said:

"The prognosis of life is generally favorable.. the patient lives to the age of seventy and beyond, in spite of the intercurrent attacks of dyspnea." (10, pages 204-205)

Dr. John Thorowgood, in his 1878 book "Notes on Asthma," said:

During the intervals between his attacks the patient probably enjoys fair health, and, as a rule, lives to a good age; should he, however, be cut off prematurely by death; should he, however, be cut off prematurely by death, what do we find as the morbid anatomy to explain the wel marked symptoms seen during life? (16, page 2)  

Thorowgood also notes the following:

The prognosis in asthma is generally good, and asthmatics are well known to be, as a rule, long-lived; so that invalids who may have been for some time suffering in the chest are wont to feel much satisfaction and comfort when they are assured that their complaint is " only asthma," or is likely to " turn into asthma."  (16, page 35)

Dr. William Aitken, in his book "The Science and Practice of Medicine, said:

"Asthmatic patients generally live to a good old age." (5, page 489)

Osler also wrote in his 1892 medical textbook "The Principles and Practice of Medicine:

"We have no knowledge of the morbid anatomy of true asthma.  Death during the attack is unknown." (8, page 4)

Dr. Anthony Rebuck and Dr. Kenneth R. Chapman said in 1987:

It is now general knowledge that asthma can be fatal and that in some countries with a sophisticated level of medical care the death rates appear to have been increasing. Yet as recently as 1983 an editorialist in the Lancet found it necessary to point out that some physicians still considered the disease "a benign nuisance related mainly to emotional problems" (14, page 353) 

Dr. William Osler (1849-1919), the father of modern medicine, said in 1901:

 "The asthmatic pants into old age." (4)(7, page 3 and 11)

Dr. Lawrence K. Altman, in the 1990s, said the following:

In 1963, Dr. H.L. Alexander of St. Louis concluded that, prior to 1930, "death during an asthmatic attack was almost unknown." 

Altman also said:

"It (this belief) persisted well into this century.  A textbook in 1935, for example, said that the life of an asthmatic is not endangered. (8, page 4)

Note:  Many references have sited the Osler quote, "The asthmatic pants into old age."  Many of them reference his book, "The Principles and Practice of Medicine." The first edition came out in 1892, and this is sometimes referenced. Other times, the 1901 edition is referenced. In other cases, the quote is attributed to Osler and no reference is sited.

I have looked through various editions of Osler's books, including the often sited 1892 and 1901 editions, and have never seen this quote. One source quotes this coming from page 498 of the 1892 edition. However, on this page I do not find this quote. Instead, what I find is this:

The disease often begins in childhood and lasts until old age."

This same passage also appears in the 1901 edition on page  629. So, unless there is some other version of this book available, I do not believe this quote comes from Osler's textbook. One source said this quote comes from a quip made by Osler during one of his speeches about asthma. His observation was that asthmatics rarely died in childhood and usually went on to live long lives with it.

One author noted that this quote is often attributed to Osler, and this I think we can say is probably true. However, it's also possible that the quote is a misquote that was repeated so many times that it simply became established over time as an Osler quip. As I learn more I will be sure to update this post.  (20, 21, 22)

References: 

1. Garrison, Fielding Hudson, "Introduciton to the history of medicine," 1922, London, W.B. Saunders Company
2. Salter, Henry Hyde, "On Asthma: It's Pathology and Treatment," 1882, New York, William Wood and Company
3. Brenner, Barry, editor, "Emergency Medicine," 1999, New York, Marcel Dekker;  Brenner writes in his forward that "Osler though asthma never caused mortality." 
4. Christennsen, Alan, Michael Antoni, editors, "Chronic Physical Disorders: Behavioral Medicine's Perspective," 2002, United Kingdom, Blackwell Publishers LTD., page 247
5.  Aitken, William, "The science and practice of medicine," volume II, 1872, Philadelphia, Lindsay and Blakiston
6. Cullen, William, "The works of William Cullen, M.D.," Volume II, London, 1827 (also see his book "First Lines of the Practice of the Phsych," 1784, Edinburgh, Vol. 3, 4th ed., page 399)
7. Altman, Lawrence K., "The Public Perception of Asthma," Chapter one of the book "Fatal Asthma," edited by Albert L. Sheffer, New York, Marcel Dekker, Inc, pages 3 and 11. Lawrence notes the following about this quotation by Osler: "The origin of this statement is obscure.  Many authors have said it was one of Osler's aphorisms.  However, it is not included in the book of aphorisms." Other notable authors credit the following: William Henry Osler, "Principles and Practice of Medicine," 4th ed, 1901, Pentland, Edinburgh,
8. Altman, ibid, page 4. Lawrence notes the following reference: "Osler W. The Principles and Practice of Medicine. Edinburgh: Petland, 1892
9. Quoted in a variety of sources
10. Berkart, J.B., "On Asthma: It's Pathology and Treatment," 1878, London, J&A Churchill
11. Altmon, op cit, page 4.  The reference Altmon is referring to comes from an article by Speizer and Doll (see reference 12 below)
12. Speizer, F.E., R. Doll, "A Century of Asthma Deaths in Young People," British Medical Journal, 1968, 3, 245-246
13. Altman, ibid, page 2
14. Rebuck, Anthony S. Kenneth R. Chapman, "Asthma: 1. Pathophysiologic features and evaluation of severity," Canadian Medical Association Journal, February 15, 1987, volume 136, pages 351-354.  The reference here referred to by the authors is "Childhood asthma", Lancet, September, 1983, volume 322, issue 8351, pages 659-660
15. Speizer, F.E., R. Doll, P. Heaf, "Observations on recent increase in mortality from asthma," British Medical Journal, February 10, 1968, 1, pages 335-339
16. Thorowgood, John Charles, "Notes on Asthma," 1878, 3rd edition, London, J and A Churchill
17. Laennec, Rene Theophile Hyacinthe, "A treaties on the diseases of the chest, and on mediate auscultation," tranlated by John Forbes, 1838, New York, Philadelphia, Samuel S. and William Wood, Thomas Cowperthwaite and Company
18. Ramadge, Francis Hopkins, "Asthma, its species and complications, or researches into pathology or disordered respiration; with remarks on the remedial treatment applicable to each variety; being a practical and theoretical review of this malady, considered in its simple form, and in connection with disease of the heart, catarrh, indigestion, etc." 1835, London,  Longman, Rees, Orme, Brown, Green, and Longman
19. Walshe, Walter Hyde," A Practical Treaties on the Diseases of the Lungs," 1871, 4th edition, London, Smith, Elder & Company
20. Adkinson, Franklin Jr., "Middleton's Allergy: Principles and Practice E Book," Volume 1, 7th edition, Mosby Elsevier, 2009, pages 756 and 766
21. Osler, William, "Principles and Practice of Medicine", 1892, D. Appleton And Company, page 498
22. Osler, William, "Principles and Practice of Medicine", 1901, D. Appleton And Company, page 629

950 B.C.: Solomon will heal your asthma

King Solomon engraving
by French artist Gustav Dore
(1832-1883)

He was the son of David, the slayer of Goliath, and he reigned as King of Israel from 970-931 B.C. He is considered one of 48 Biblical prophets, and that means that he had healing powers.

As an educated man, he most surely would have received knowledge of health and healing. What this healing powers entailed no one knows.  

For evidence of this healing power we need look no further than the Bible itself.  One example can be found in Acts of the apostles 5: 12-16:

And by the hands of the apostles were many signs and wonders wrought among the people; (and they were all with one accord in Solomon's porch.  And the rest durst no man join himself to them: but the people magnified them. And believers were the more added to the Lord, multitudes both of men and women.) Insomuch that they brought forth the sick into the streets, and laid them on beds and couches, that at the least the shadow of Peter passing by might overshadow some of them.  There came also a multitude out of the cities round about unto Jerusalem, bringing sick folks, and them which were vexed with unclean spirits: and they were healed every one.

Perhaps among them were folks with asthma, or allergies, or bronchitis, or heart failure, or kidney failure or some other respiratory disorder. Perhaps it was a person who was near death, dyspeic due to failure of the various organs of the body.  All of these would have been healed through the healing powers of the prophet and King: Solomon

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1200 B.C.: Asthmatic Hebrew Girl

The Israelite children were amused in song as the ladies stood by in delight. Yet one girl, her name is Adina, does not sing. She stands near the edge of the woods, leaning against a tree, her shoulders hunched high, her breathing obviously heavy. Instead of song she mouths words of prayer to the Jewish God for healing.

How blessed is he who considers the helpless; the Lord will deliver him in a day of trouble.The Lord will protect him and keep him alive,and he shall be called blessed upon the earth...The Lord  will sustain him upon his sickbed; in his illness, You restore him to health.

It's a psalm (Psalm 41:1-3) she sang when her breathing was labored, and lately this was often.  She prayed and she stood in the back of the group hoping no one would notice; hoping savta (grandma) didn't notice, because savta surely would pay Adina special attention Adina felt she didn't deserve.

I interviewed Adina for several hours as we walked through the woods.  She showed me her favorite place of worship in a clearing where the sun showed bright and hot overhead.  It was her God peering down upon her, blessing her with His touch.  She knelt in prayer and encouraged me to do the same.  

In a mellifluous whisper she prayed, a psalm of healing (Psalm 57: 2-3):  "I will cry out to God Most High, to God who performs all things for me.  He shall send from heaven and save me." 

As if on cue a soft, fresh breeze wafts over the field causing the grass and leaves to talk.  "It's our God talking," she says.  She smiles brightly, holding firmly in her grasp the device that saved her, the device that gave her her breath back, the device I brought with me from a distant time, a time when her God, the Israelite God, is still worshiped.  

"Do you not have natural remedies?" I ask.  "Something like that inhaler, something you inhale, that gives you your breath back like that inhaler did. It's a natural remedy."

"No," she answered swiftly.  "God alone decides who is sick and who is well.  His people see it as pointless, blasphemous, to take measures that would interfere with His will."  (Prioreschi, vol I, page 520)

"I consider that inhaler," I motion to the blue device in her grasp, "a gift from God. Why wouldn't your people?"

"I guess we are not there yet," she closes her eyes.  "We do have physicians, although they are from distant lands.  They have what you call natural remedies.  They have salves and smoke to inhale through reeds.  Savta has me use such from the chabash (Prioreschi, page 521), although sometimes they make me worse.  I don't want to insult her, so I try to hide my," she pauses as though in search of the best word, "dyspnea, as you call it."  

After saying several prayers with her, and listening to her sweet voice sing many others, I was summoned back to the time machine.  On the way back to 2012 I reviewed Plinio Prioreschi's "A History of Medicine, where he listed the following Biblical references to physicians and natural medicine:

And Joseph commanded his servants the physicians to embalm his father...  (Genisis, 50: 2)

And Asa in the thirty and ninth year of his reign was diseases in his feet, until his disease was exceeding great: yet in his disease he sought not to the Lord, but to the physicians. And Asa slept with his fathers, and died in the fortieth year of his reign. (II Chronicles, 16: 12,13)

But ye ar forgers of lies, ye are all physicians of no value.  (Job, 13: 4) 

Is there no balm in Gilead; is there no physician there?  why then is not the health of the daughter of my people recovered? (Jeremiah, 8: 22)

...shall grow all trees... and the fruit thereof shall be for meat, and the leaf thereof for medicine. (Ezekiel, 47: 12) 

...thou has no healing medicines... (Jeremiah, 31: 13)

...in vain shalt thou use many medicines;; for thou shalt not be cured.  (Jeremiah, 46:11)

A merry heart doeth good like a medicine:  but a broken spirit drieth the bones. (Proverbs, 17:22)

We must understand that the Ancient Hebrews, the Israelites, as Adina said, had access to physicians and natural medicine, although they were more focused on using prayer for it's healing purposes.

The reason was, or may have been, because the Hebrews believed God created all things, including health and sickness.  For this reason, to seek a physician for medicine may have been seen as "blasphemous," said Prioreschi (1, page 526-7).

Physicians were only sought when prayer failed to work.

This may have been for the best too, as natural remedies were sometimes worse than allowing nature to take it's course.

Note:  Chabash is a Biblical term used for healer (Prioreschi, "A History of Medicine," Vol. I, second edition, 1996, page 460, page 521 in the first edition printed in 1991).  Teruphah is Hebrew for "healing reemedy." (Prioreschi page 535)

References:

1. Prioreschi, Plinio,"A History of Medicine," volume I, pages 516 and 521

1500 B.C.: Asthma in Ancien Egypt: the Ebers Papyri

Thoth: Scribe of the Gods ( The British Museum)

Thoth was the Egyptian moon god, and he had a significant role in medicine that was eerily similar to that of Apollo a thousand years later in ancient Greece. 

It is believed he talked to an Egyptian priest (or priests) during the early ages of Egypt, and this priest (Imhotep perhaps?) wrote down the wisdom he learned from the god. There are various references to these documents by various physicians, although the original texts have long disappeared. (2, page 19)(4, page 49)

However, this theory, while garnishing some excitement, was ultimately believed to be untrue, as experts now figure the document to be an encyclopedia of all sorts of medical wisdom from various ancient documents. (9, page xv)

Smith Quotes Warren R. Dawson from his 1929 book "Magician and Leech" as saying the Ebers Papyrus is basically a compilation of recipes for the various ailments of that time taken from various other books that are "many centuries older."  (9, page xv)

Dawson, referencing Smith, said the Ebers Papyrus... (9, page xv)

"...is not a book in the proper sense of the word: it is a miscellaneous collection of extracts and jottings collected from at least forty different sources. It consists mainly of a large collection of prescriptions for a number of named ailments, specifying the names of the drugs, the quantities of each, and the method of administration." (9, page xv)

As noted above, a few sections deal with diagnosis, symptoms and anatomy. (9, page xv)

This theory may be supported by the fact the papyrus has scribbles in the margins, such as "this is a genuine remedy," or "Excellent. I have often made it, and also proved it," said medical historian Edward Withington. (2, page 17) 

Perhaps notes similar to these were scribbled next to the description of our first inhaler:

Thou shalt fetch 7 stones and heat them by the fire, thou shalt take one therof and place (a little) of these remedies on it and cover it with a new vessel whose bottom is perforated and place a stalk of a reed in this hole; thou shalt put thy mouth to this stalk, so that thou inhalest the smoke of it. Likewise wit all stones. Thereafter thou shalt eat something fat, of fat meat or oil." (6, page 9)

It is unclear exactly what herbal preparations were used, although it's probable that they used stramonium, belladona, henbane, and bitumen to "alleviate catarrh and coughs, and ease breathing," said Mark Jackson in his article, "'Divine Stramonium': The Rise and Fall of Smoking for Asthma." (14, page 174)

One major difficulty with interpreting these old documents, or so the experts say, was that it may sometimes be difficult to translate Egyptian writing into our modern language. This in mind, I think, therefore, I can honestly say there is scanty evidence this Egyptian "inhaler" was used for anything more than a priest-physicians's trick to fool a patient into thinking something was being done, perhaps by the magic of the gods.

Henry Sigerist, in his 1951 book "A History of Medicine: Primitive and Archaic Medicine," said that "Fumigations were not infrequently used in the treatment of anus and vagina and a recipe of the Berlin Papyrus (and Ebers Papyrus) tells us what the technique was. Seven bricks were heated, and the cold drug was poured over one after another while the patient was held over the developing fumes."

My point here is we must be careful in thinking any inhalers or fumigations used by the ancient Egyptians were anything more than just something that was not understood being used for an ailment that was not understood. 

Jackson said:

While (Eber's) specific interpretation has been challenged by other translators, the papyrus certainly appears to list remedies to remove phlegm, alleviate catarrh, coryza, and coughs, and to ease breathing. Significantly, Egyptian treatments for respiratory conditions included not only the oral consumption of a variety of concocted vegetable, mineral, and animal products but also the delivery of active substances directly to the lungs by inhalation. (13, page 38)

So, as you can see, we could easily use our imaginations here as it comes to the treatment of asthma in ancient Egypt. You are short of breath, you call for a priest/physician, and a specialist comes to your house. You hope he's an Internist who specializes in diseases of the chest, and you hope he has knowledge to this primitive inhaler, and that he also has a medicine called Belladonna that he tosses on those heated bricks. Belladonna would take the edge off by easing both your breathing and your mind.

Sigerist said the teeth, where food enters, and the anus, where food exits, were highly regarded by the ancient Egyptians. Sigerist even notes various references to "the holy anus," and "shepherd of the Anus." (5, page 317, 335)

These shepherds were probably physicians who specialized in ailments of the anus, such as "hemorrhoids, prolapsus recti, inflammation and pruritus of the anus." (5, page 317, 335)

The pharaoh had his very own anal physician to take care of it, and perhaps this physician recommended this inhaler for hemorrhoids, a remedy we might think of as purely irrational, although to the Egyptians, it was most surely rational. (5, page 317, 335)

We must realize that Egyptian physicians had scanty knowledge of anatomy, and this is true despite the fact they prepared animals for food and sacrifice, and humans for mummification. They knew about the inner organs, and they knew about vessels and blood, but they didn't know about the relationship with these and ailments of the body. They did not make that connection.

So they would have no idea about diseases like asthma, nor other diseases that would make a person short of breath. Basically, all physicians could do was note the symptoms -- chest pain, short of breath, wheezing -- and what remedies seemed to work.

Likewise, it must be understood here that Egyptian medicine was based on mythology, and ailments were caused by the wrath of gods, particularly the god Isis. So remedies, in a sense, were believed to be gifts from the gods of health and healing, such as Isis, Thoth, Sekhmet, Heka, Serket, and Ta-Bitjet. They worked by magical means. So while these remedies may seem irrational to the modern reader, they were quite rational given the medical wisdom of the time.

Once translated, the Ebers Papyrus scroll was learned to contain over 700 magical formulas as remedies for the most common ailments of that time, with various incantations randomly assorted through the text. Some of the remedies included pills in the form of dough, herbs and minerals that were put into beer and wine, salves and oils to rub onto the skin and wounds, a salve made from honey was put over wounds, and gargles and inhalations.

If you had complained of an ailment, a physicians would be summoned. Egyptian physicians specialized in particular symptoms, so you would see a physician who specialized in treating your symptoms. If your specialist was an internist, perhaps you would be provided with the remedy above, which may actually contain breathing relief, considering Belladonna was later proven to contain a mild bronchodilator component.

Yet, more than likely, your treatment would be a general treatment. Since the Egyptians were among the first society to attribute sickness to good health, he might suggest something simple to cleanse your body, which may involve any of the following:

• Enemas (the stomach was believed to be a cause of most diseases, including breathing problems)
• Emetics (to vomit out the poisons)
• Animal excreta (including crocodile and camel)
• Herbs such as squill and henbane
• Fumes of burned sundried and crushed Belladonna leaves and roots (as noted above)
• Eating foods such as figs , grapes, frankincense, cumin and juniper fruit
• Drinking wine and sweet beer 

Along with the above treatments, the following were considered routine in order to keep your body clean: (11, page 18, 23)

• Daily baths
• Abstinence from certain foods (like cow flesh, pigs, flatulent beans, etc.)**
• Gymnastics
• Linen clothing worn for cleanliness
• Purgatives and emetics every three months to cleans body***
• Friction and inunction of the body (basically involves rubbing certain parts of the body)
• Fumigations (usually during epidemics to "purify the air."  
• Inhaling steam from inhalations 
• Careful system of nurturing from childhood
• Incantations (magic words)
• Amulets (to wear or keep close to you and or your home to ward off spirits and for healing)

Or, if your asthma-like symptoms were diagnosed as being caused by witchcraft, the following remedy may be used:

"Against all kinds of witchcraft -- a large beetle; cut off his head and wings, boil him, put him in oil, and apply to the part. Then cook his head and wings, put them in serpent's fat, warm it, let the patient drink it." (2, page 18)

If your physician didn't heal you, you might consult a priest or magician who would provide you with an amulet or incantation to say each morning. Or he might place his gentle palm over your throat or chest and chant an incantation to induce healing and scare away the evil demons that were causing you to breathe heavy. Perhaps the good feeling of hope by this method was more healing to you than what your physician might recommend.

Another neat thing to note here is that by dating the Ebers Papyrus to around 1500 or 1550 B.C., this would place it as being written about the time of the Exodus. That means it was probably written around the time Moses walked the earth, and the wisdom it contained was available to him. So the Bible may provide us with another good source for learning what life was like for Asthmatics in Ancient Egypt.

Further reading:

• 5000-50 B.C.: Ancient Egypt: the Physicians
• 5000-50 B.C.: Asthma in Ancient Egypt: the Bible
• 2700 B.C.: Imhotep invents rational medicine
• 1550 B.C.: Moses preaches good hygiene
• Check out the Edwin Smith scroll here

*Hieratic is a form of Egyptian cursive, and was used "chiefly on sacred and medical papyri and on wooden coffins... the characters are written from right to left... about 300 A.D. all knowledge of the meaning of the characters had died out, and it was not until the discovery in 1799 of the Rosetta stone (by Boussard, a French artillery officer) that any real progress was made in the decipherment." (10)

** Note that the upper classes of Egypt did not eat pig, and despite this, historians note a high incidence of hardened arteries.  One study of Egyptian mummies found hardened arteries in three fourth of the mummies studied.  While this was a recent study, some historians noted this as far back as the 1930s. You can read more about this here. 

***While many historians have noted the Egyptians to drink to excess, others speculate, that while beer and wine was consumed during meals (and mostly wine), it was watered down and not very potent.   

 References: 

1. Selin, H., "Encyclopedia of the History of Science, Technology and Medicine in Western Cultures," 2nd edition, 2008, Springer
2. Withington, Edward Theodor, "Medical History from its earliest times," 1894, London, Aberdeen University Press
3. Nunn, John F, "Ancient Egyptian Medicine," 1996, University of Oklahoma Press
4. Garrison, Fielding Hudson, "An introduction to the history of medicine," 1922, Philadelphia and London, W.B. Saunders Company
5. Sigerist, Henry E, "A History of Medicine," vol II, "Primitive and Archaic Medicine," 1951, New York, Oxford University Press
6. Ebell, B.,  translator, "The Papyrus Ebers: The Grea)test Egyptian Medical Document," 1937, Copenhagan, page 67.  I found references to this passage by Mark Jackson (Asthma: A biography," 2009, New York, Oxford University Press, page 39), and Henry E. Sigerist (see reference immediadely above, page 339).  Sigerist says that a similar passage can also be found in the Berlin Papyrus.  
7. Reference Pending
8. Osler, William Henry, "The evolution of modern medicine," 1921, New Haven, Yale University Press
9. Smith, G. Elliot, introduction to Cyril, Bryan,s book, "The Papyrus Ebers," 1930, London, The Garden City Press, Bryan's book was an English translation of the German translation of the papyrus. 
10. 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.  
11. Baas, Johann Herman, author, Henry Ebenezer Sanderson, translator, "Outlines of the history of medicine and the medical profession," 1889, New York
12. Libby, Walter, "The history of medicine in its salient features," 1922, Boston and New York, Houghton Mifflin Commpany
13. Jackson, Mark, Asthma: A biography," 2009, New York, Oxford University Press
14. Jackson, Mark, "'Divine Stramonium': The Rise and Fall of Smoking for Asthma," Medical History, 2010, 54: 171-194
15. "Medicine in Ancient Egypt," Indiana.edu, http://www.indiana.edu/~ancmed/egypt.HTM, accessed on 6/5/14

1550 B.C.: Moses preaches good hygiene

Moses (12th and 13th century B.C.)
He is the father of hygiene therapy,
or prophylactic medicine.

While most people don't think of Moses in this light, he had a significant impact on health and healing. In fact, many medical historians give Moses credit as the father of preventative medicine.

Moses (sometimes referred to as Mesu, Mouses and Mosheh) was a Hebrew liberator, leader, lawgiver, profit and historian. He lived at the end of the 13th and early part of the 12th centuries before the birth of Christ.  (2)

The Bible records that his cradle was set into the Nile river by his Hebrew mother Jochebed when the Pharaoh ordered that all first born Hebrew sons be killed. Moses was rescued by the Pharoah's daughter, and adapted by the family of the Pharaoh.  He was then educated "in all the knowledge of the Egyptian priesthood, in which he became proficient," said medical historian Pierre Victor Renouard in 1856. (1, page 32)

Of interest here is that Egyptian priests were educated in all the wisdom of the Egyptian gods, as their studies included all the wisdom of the Sacred books, or the Hermetic books. This knowledge would have include mathematics, weights and measures, law, cosmology, religion, and medicine. So it is very likely that Moses was as adept at health and healing as he was at being a leader.

The Bible says that "One day, after Moses had grown up, he went out to where his own people were and watched them at their hard labor. He saw an Egyptian beating a Hebrew, one of his own people. Looking this way and that and seeing no one, he killed the Egyptian and hid him in the sand."

When Pharaoh learned of this, he tried to kill Moses, but Moses escaped to Midian.

Concerned about the Israelites, God sent Moses back to Egypt to free the Israelites. He allowed Moses to perform miracles before the Pharaoh to convince the king that Moses was sent by the Israelite God, and the Pharaoh sent for "wise men and sorcerers."

These wise men and sorcerers were the high priests, the Chief Priests of Egypt, who were learned in all the greatest magic of the gods. Pharaoh was convinced the power of the gods was more powerful than the god of the Israelites.

The Bible then says:

"So Moses and Aaron went to Pharaoh and did just as the Lord commanded. Aaron threw his staff down in front of Pharaoh and his officials, and it became a snake. Pharaoh then summoned his wise men and sorcerers, and the Egyptian magicians also did the same thing by their secret arts. Each one threw down his staff and it became a snake. But Aaron's staff swallowed up their staffs. Yet Pharaoh's heart became hard and he would not listen to them, just as the Lord had said."

Moses lead the Israelites out of Egypt in what became known as the Exodus. He helped them escape the Pharaoh's army to Midian by creating an opening in the Red Sea.

God appeared to Moses once again in a burning brush on Mount Sinai. Thus, it was through Moses that God said:

"I will put none of these diseases upon thee, which I have brought upon the Egyptians: for I am the Lord that healeth thee." (Exodus 15:26)

And then God provided Moses with laws for the people of Israel to follow, including the ten commandments. The Catholic translation is as follows (translations may vary, although the basic idea is always the same):

1. I, the Lord, am your god.  You shall not have other gods besides me.
2. You shall not take the name of the Lord God in vain
3. Remember to keep holy the Lord's Day
4. Honor your father and your mother
5. You shall not kill
6. You shall not commit adultery
7. You shall not steal
8. You shall not bear false witness
9. You shall not covet your neighbor's wife
10. You shall not covet your neighbor's goods

Renouard explained that wisdom obtained while living among the Egyptians, along with wisdom learned from the Isrealite God, allowed Moses to lead the Hebrews to the promised land. He would have had knowledge of the Egyptian Pharmacopoeia, and known that their recipes would be hard to put together while traveling to the promised land.

So god appeared to him and encouraged him to educate the people in how to prevent disease, as opposed to treating it. In order to accomplish this, Moses, through the Lord, preached good hygiene. He encouraged the Hebrews to only eat the purest foods, such as the rabbit and hog, even though these animals were considered impure in Egypt. Perhaps, Renouard proclaims, this is evidence that Moses held "his own views other than those ascribed to him."

Medical historian Fielding Hudson Garrison said that the ultimate goal here was to prevent the people from getting sick. He inculcated the idea that it was especially important to wear clean clothing, and to wash and bathe, especially while traveling to foreign lands, and when touching strangers. He inculcated good hygiene when surrounded by sick people, and handling dead bodies or other unclean objects. He encouraged good hygiene during menstrual periods. He discouraged sexual perversion because sexual perversion was linked with illness. These were techniques of keeping people "pure" in order to avoid sickness. (4, page 60)

For an example Renouard refers us readers to the Bible, Numbers Chapter 15, which starts like this: And the Lord spake unto Moses, saying: (1, pages 32-33)

Speak unto the children of Israel, and say unto them, When ye be come into the land of your habitations, which I give unto you. And will make an offering by fire unto the Lord, a burnt offering, or a sacrifice in performing a vow, or in a freewill offering, or in your solemn feasts, to make a sweet savour unto the Lord, of the herd, or of the flock. (Numbers 15: 2-3)

Renouard also refers to Levaticus 11 and 12, which show God telling Moses what to teach the Israelites about what they should and should not do in order to maintain their health. Here is a small sample of what Moses said: 

The Lord said to Moses and Aaron, "say to the Israelites: 'Of all the animals that live on land, These are the ones you mayt eat: You may eat any animal that has a divided hoof and that chews the cud. "There are some that only chew the cud or only have a divided hoof, but you must not eat them. The camel, though it chews the cud, does not have a divided hoof; it is ceremonially unclean for you. The hyrax, though it chews the cud, does not have a divided hoof; it is unclean for you. The rabbit, though it chews the cud, does not have a divided hoof; it is unclean for you. And the pig, though it has a divided hoof, does not chew the cud; it is unclean for you. You must not eat their meat or touch their carcasses; they are unclean for you. Of all the creatures living in the water of the seas and the streams you may eat any that have fins and scales. But all creatures in the seas or streams that do not have fins and scales—whether among all the swarming things or among all the other living creatures in the water—you are to regard as unclean. And since you are to regard them as unclean, you must not eat their meat; you must regard their carcasses as unclean. Anything living in the water that does not have fins and scales is to be regarded as unclean by you. (Levaticus 11: 1-10)

The Lord said to Moses:

"You will make yourselves unclean by these; whoever touches their carcasses will be unclean till evening. Whoever picks up one of their carcasses must wash their clothes, and they will be unclean till evening." (Levaticus 11: 24)

He said:

"And if any beast, of which ye may eat, die; he that toucheth the carcase thereof shall be unclean until the even. And he that eateth of the carcase of it shall wash his clothes, and be unclean until the even: he also that beareth the carcase of it shall wash his clothes, and be unclean until the even. And every creeping thing that creepeth upon the earth shall be an abomination; it shall not be eaten." (Levaticus 11: 39-41)

And the Lord spake unto Moses, saying, Speak unto the children of Israel, saying, If a woman have conceived seed, and born a man child: then she shall be unclean seven days; according to the days of the separation for her infirmity shall she be unclean. And in the eighth day the flesh of his foreskin shall be circumcised. And she shall then continue in the blood of her purifying three and thirty days; she shall touch no hallowed thing, nor come into the sanctuary, until the days of her purifying be fulfilled. (Levaticus 12: 1-4)

Moses also makes a reference to healing:

The one who struck the blow will not be held liable if the other can get up and walk around outside with a staff; however, the guilty party must pay the injured person for any loss of time and see that the victim is completely healed.

“Anyone who beats their male or female slave with a rod must be punished if the slave dies as a direct result, but they are not to be punished if the slave recovers after a day or two, since the slave is their property. (Exodus 21: 19-21)

Thanks to Moses, the Hebrews were freed from the bonds and prejudices of Egyptian laws and tradition, said medical historian Theodor Puschmann in 1891. (3, page 28)

It was also thanks to Moses that the Jewish (and later the Christian) community was introduced to the method of good hygiene as a method of preventing disease.

Perhaps, said Puschman, it was this new found freedom that allowed Moses to encourage the Hebrews to eat some of the foods Egyptian gods forbade, such as rabbit and hog. Yet this may also have been a byproduct of the necessity of eating the foods that were available in the lands the Hebrews happened to be in at the time, for Moses surely wouldn't want his followers to starve on the way to the promised land due to Egyptian laws. (3, page 28)

Puschmann said this newfound freedom also allowed the Hebrews to be influenced by the people they came into contact with, such as the Assyrians, Babylonians, Chaldees, and Persians. This exposure further increased their medical knowledge as well. (3, page 28)

The Hebrews were able to adapt these new cultures and incorporate them into their own. For example, you no longer had to be a priest in order to be a physician. For the first time ever, anyone interested in learning could learn, and this meant anyone could become a doctor. (3, page 28)

This was perhaps a gift of the God of Israel.

1. 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."
2. "Moses," Catholic Encyclopedia, http://www.newadvent.org/cathen/10596a.htm, accessed 3/21/13
3. Puschmann, Theodor, translated by Evan H. Hare, "A history of medical education from the most remote to the most recdent times," 1891, London, H.K. Lewis
4. Garrison, Fielding Hudson, "An introduction to the history of medicine, with medical chronology, suggestions for study, and bibliographic data," 3rd edition, 1922, Philadelphia and London, W.B. Saunders Company

2000-539 B.C.: Babylon had help giving birth to Medicine

The Babylonians are often said to have advanced medicine.  While this is true to a certain degree, it would not have happened if not for other groups of people who migrated to the region, particularly the Chaldeans and the Phoenicians.

While the Chaldeans are sometimes credited with introducing astrology, divination, and poisons to Babylon, this knowledge would have gone nowhere if not for the assimilation of Phoenician wisdom, particularly their system of writing. This allowed medical wisdom to be shared from generation to generation, and civilization to civilization.

The Phoenicians invented writing even before the Sumerians invented Cuneiform and before the Egyptians invented hieroglyphics. Even while their written language was primitive, it created a basic system that people could later advance and improve upon.  The Phoenician writing system, therefore, was the basic model for letters of all later people. (1, page 29)

The Phoenicians must have influenced the Sumerians, who influenced the Akkadians, who formed an empire around their capital Akkadia.  Over time, this allowed all the various groups of people emigrating to or rising from the fertile soils of Mesopotamia to learn the same language.  This, perhaps, allowed for the assimilation of all the wisdom from all the cultures that emigrated into the region.

Thus, it might have been due to the wisdom of the Phoenicians that even gave medicine a chance to evolve around the Tigris, Euphrates and Nile Rivers.  So it was the assimilation of the Phoenicians, and not just the Chaldeans, who helped the Babylonians advance medicine.

There, chomp on that wisdom while you wait for my next post.

References:

1. Baas, Johann Herman, author, Henry Ebenezer Sanderson, translator, "Outlines of the history of medicine and the medical profession," 1889, New York, page 29