10,000 B.C.: The first Materia Medica

The year 30,000 B.C. is often considered as the dawn of medicine.  By then, men and women learned to socialize, and to love and care for their fellow human beings.  A pharmacopoeia had developed, and it, along with myths and food recipes, was shared by means of easy to remember lyrics. Most clans had at least one person, an elderly woman perhaps, who remembered the recipes, and utilized them when needed.

When a young boy becomes short of breath, his body stiff as he struggles to inhale, perhaps due to asthma, his mother recognizes his agony and she emphasizes with him.  She makes every effort to comfort him, and it's useless.
So she sends for the wise old lady, the medicine lady perhaps, who approaches the boy wearing animal skins, replete with charms and rattles and drums with the magic ability to communicate with the spirits and demons abounding.

The old magical lady reaches into her pocket and pulls out some herbs, perhaps with some poppy seeds included, and asks for a bowl that the boy's mother provides.  She then has the boy stand before her, as she whispers and sings incantations as she mixes and stirs the herbs into the solution.  Then she does a little dance, rattles her beads and pounds on her drums.  Then she places her hands upon the boy's forehead, and her lips to his lips, and then pops back as she shouts "The evil has now passed."

The boy continues to be stiff, and to work against the symptoms caused by the evil spirits that are no longer within him.  Then, finally, as though by some miracle or magical means, his tense shoulders relax, his breathing is easy, and he lies back and falls fast asleep.  The medicine woman sets forth on her knees, presses her hands upon the boy's shoulders, and blesses him with another incantation, before walking off into the distant night.

The medicine lady was proud of herself, and she continued to chant incantations as she walked.  She believed the medicine worked because of magic provided by the spirits or gods, and when it was used for good it was white magic. When it was used for evil purposes, as poison, it was referred to as black magic. Regardless, it's probable such original pharmacologists as this were "eyed with suspicion."  (1, page 24)(4, page 23)

Humans had already learned that living in small groups was advantageous, and made hunting for food, creating shelter, and, as seen here, healing the sick easier. By around 10,000 B.C. they learned how to better manage the land, and many of these smaller groups became united and formed the first civilizations.  They put their heads together and learned how to best irrigate and harvest crops, and they created gods and religions and laws.  These were all necessary in order to keep order among the society, and to provide an incentive for each man and woman to do his or her part for the benefit of the many.

There were many advantages to working together, and one was that "People began to specialize.  Some people farmed.  Others took care of the animals.  And now there were chances to do things people had never done before.  People had time to work on their crafts.  Weavers wove grass into fine baskets. Others made pottery from clay and baked it in ovens.  Using wool from sheep, some people learned to spin thread and to weave cloth," according to Joanne Suter in "World History."  (3, page 19)

She explains that "as different jobs developed, so did trading.  A weaver might trade his cloth for food from the farmer.  A goat might be traded for an ax from the toolmaker.  First, trading was carried on within the village.  Later people traded from one village to the next." This increased trading resulted in ideas and culture being shared, including medical wisdom.  Perhaps this might have been how knowledge of the first inhalers the medicine lady mentioned above traveled from one culture to the next.  (3, page 19)

This, perhaps, was what occurred in the earliest days of what would become ancient Egypt and Mesopotamia, and what was the beginning of the agricultural revolution in about 10,000 years before Christ.

The medicine woman had time to work on creating better incantations, and to search the forests and streams for herbs she needed for her potions.  Sometimes she discovered new herbs, and experimented with them to learn their magical abilities.  One day she discovered a plant that would later be called the belladonna plant, and she pulled it from the ground, and she let it sit in the sun for two days, allowing it to become sun dried.  She crushed the roots, leaves and stems into a bowl, and discovered that they, like the poppy seeds, had the ability to cause a soothing effect.

Several years later she was called to another asthmatic boy, and she had no poppy seeds with her.  So she grabbed a handful of the crushed and sun dried belladonna roots, and, in her usual dance routine, some of the herbs spilled onto a heated brick that was on the fire, and the asthmatic boy inhaled the smoke this created and the result was a soothing effect, and also it made his breathing easier. So the medicine lady had a new remedy to add to her pharmacopoeia.

There was another significant reason for people getting together in this way, and it was the unity required to irrigate the land and harvest the crops  The greatest minds got together and learned how to dig canals and build aqueducts to control the flow of water, and invent new tools and find new material for building.  As numbers increased, so to did the need to incentivize the people to be loyal, productive members of society.  For this reason laws and religions were created to encourage, even force compliance with the wishes of the aristocracy.

Kinds and queens were chosen to create these laws, and priests were selected to manage the religions.  They worked together to provide the people with a reason to get up in the morning, and to do the arduous work needed for the society to stay together.  They created the gods, and they ordered for large temples to be built where the people could go for worship, and see as a daily reminder that the gods are ubiquitous and can see everything you do, even hear your thoughts.

As society advanced in this way, a need arose for communication, and this lead to the invention of the first languages.  There also arose a need to keep track of when the sun rose and when it set, and to determine when the annual floods would occur.  Accurate measurements were needed to construct the monuments and temples.  For generations and generation legends, myths, recipes and formulas were relayed from one generation to the next by word of mouth, usually by easy to remember lyrics of poems and songs.  Yet this was no longer useful, as recipes and formulas became too abounding and complex.  So a written language was invented.

An early example of a written language was discovered on the wall of a cave in Pindal, where archaeologists discovered a crude drawing in red ochre the outlines of a mammoth with a dark dot in the middle, perhaps a representation of the heart.  This may have been the first time a person shared knowledge to future generations by writing.  It was also proof primitive, savage, or prehistoric people knew what parts of the body were essential to life. (2, page 21)(1, page 106)

Yet such primitive methods of communication were no longer valid by 4,000 B.C., and why great minds among the Sumerians created such the first written language.  Lyrics shared by word of mouth could now be written down, and this made it easier to share knowledge between generations.  Each generation no longer had to start from scratch, and this allowed for formulas and recipes to become more complex.  This provided increased time and another incentive to discover and invent, so new wisdom could be compiled above the old.

Laws were carved into stone for all to see.  Perhaps the best and earliest example of this were the Hammurabi Codes carved into stone around 1772 B.C. This was perhaps the best incentive for people to be  loyal, productive members of society, because noncompliance meant you would be punished according to the crime you committed.  Food and medical recipes were written down, and these became the first cook book and the first written pharmacopoeia, or Materia Medica

The brightest members of society were chosen to be kings, queens, priests, and scribes.  These were among the few, perhaps less than ten percent, among the society who were educated.  The rest of society remained ignorant, and perhaps this was done on purpose to assure compliance with the wishes and desires of the aristocracy.

Temples became places of healing, and they became the schools.  Teachers were needed to educate children born to the aristocracy, and as wisdom progressed some of the scribes became teachers and priests became physicians.

References:

1. Sigerist, Henry E "History of Medicine," volume I: Primitive and Archaic Medicine, 1951, Oxford University Press, New York, pages 
2. Prioreschi, Plinio, "A History of Medicine," vol. 1
3. Suter, Joanne, "Fearon's World History," 2nd edition, 1994, U.S., Globe Fearon Educational Publishing
4. Garrison, Fielding Hudson, "An Introduction to the history of medicine," 1921
5. Wilder, Alexander, "History of Medicine, 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, adn especially a history of the American eclectic practice of medicine, never before published," 1901, Maine, New England Eclectic Publishing Co.

30,000 B.C.: Fumigations were the first inhalers

It is probably true that the first inhalers were fumigations.  And there's really no idea of knowing when the first fumigations occurred.  It probably first happened by accident; someone tossing poisonous herbs into a fire, accidentally inhaling them, and realizing the enjoyable side effects.

After a while it was probably done on purpose with the intentions of relaxing and listening to visions sent during hallucinations from the gods or spirits.  Medicine men may have experimented with small fires, and then large fires were made at night with the clan surrounding the fire.  This may have occurred as far back as 30,000 B.C.

Egyptian scribes made the first recordings of fumigations with cyphiac.  Cyphiac was, according to James Prosser in his 1884 book "Therapeutics of the Respiratory Passages,

"According to Dioscorides, a mixture of various drugs, and as the Egyptians had made great advances in the use of spices, balms, and other odorous medicines, it is probable that these entered largely into their cyphi. As soon as men began to use warm baths, indeed, as soon as they made water hot, they would become acquainted with its vapor, and probably notice the soothing effect of breathing steam, and endeavor to turn it to useful account."  (1, page 276)

So early on in human history mankind had access to fumigations of smoke and steam.

While this may have originally been part of religious ceremonies, there came a time in the course of history, perhaps at some point in both Ancient Egypt, where it was realized that smoke was more useful for medicinal purposes when the herbs were placed on heated bricks and inhaled this way.

Sometime around the time of Jesus people in nations some nations learned how to control smoke by making crude pipes for inhaling herbs. So now people had use of several methods of inhaling medicines, including fumigations of smoke and steam, insents, pipes, and ultimately cigarettes.

The Ancient Greeks also describe fumigations, as Homer mentions them.  And, much like the Egyptians learned to master smoke for medicinal purposes, the Greeks learned to master steam for medicinal purposes.  Around 400 years after Homer, Hippocrates mentions an inhaler-like device of which I describe in detail in an upcoming post (post will be published within the next few weeks) .

When Greek wisdom made it's way to Rome, this wisdom traveled with it.  When Roman knowledge made it's way to the Arabs, this wisdom traveled with it then too.  So, despite most of our efforts on the study of inhalers made by man, the first inhalers were probably simple fumigations. (1, page 276)

References:

1. Prosser, James, "The Therapeutics of Respiratory Passages," 1884, New York, pages 281-282

30,000 B.C.: The birth of allergies

Surely allergies have been around since the beginning of human existance.  Dr. Paul M. Ehrlich, in his 2009 book "Living with Allergies," explained one theory in which allergies are believed to be "a leftover survival tactic" whereby ancient people living along the Tigris and Euphrates Rivers where repeatedly exposed to harmful germs such as bacteria and parasites.  (1, page 6)

Ehrlich said that back then, perhaps as far back as 30,000 years before the birth of Christ, our immune systems needed to be powerful to fight off these germs.  The people with the strongest immune response survived while others died.  "So," he said, "being an allergic person may have been an advantage." (1, page 6)

Yet today we have many defenses against such invaders, such as shoes, clothing, clean drinking water, processed food, vegetables that are treated with pesticides, air conditioned buildings, etc.  We receive vaccinations and use hand sanitizers.  People today are barely exposed to germs, so the allergic response isn't needed.

For most of us, our immune systems have adapted to the change.  Yet for some of us, our immune systems continue to work overtime.  Lacking harmful germs to occupy our immune systems, they become bored and develop a sensitization to things that are supposed to be safe, such as dust mites, pollen, molds, and cockroach urine.

So this is the basis, at least one theory anyway, of why about 10 percent of the world's population develop allergies.  I would speculate the same holds true to asthma as well.

References:

1. Ehrlich, Paul M., Elizabeth Shimer Bowers, "Living with Allergies," 2009, page 6

30,000-2600 B.C.: Medicine man may cure your asthma

In the primitive world, the medicine man was the person you'd seek
out when you were sick.  He had the ability to communicate with
the spirits, and therefore had the ability to heal. 

Humans migrating to Europe around 30,000 years ago rationalized everything by transcendental forces. When you were sick or injured you were powerless, and you needed the help of the all powerful spirits and gods of healing.  For this reason a medicine man (or woman) was needed to intercede, creating a link between patient and the all powerful supernatural beings.

There were various names for these medicine men and women, such as witches, witch doctor, magicians, sorcerers, seers, shamans, healers, wizards, priests, etc. He would make noise with rattles and drums, chant incantations, and use a variety of magical maneuvers to hide whatever he was doing.  (1, page 21)

In the meantime, he'd be "pretending (or endeavering) to extract the active principle of the disease by sucking it through a hollow tube," according to Fielding Hudson Garrison in his 1922 history of medicine.  "To prevent future attacks, in other words, to keep the demon away for the future, he provides his patient with a special fetish or amulet to be worn or carried about his person."(1, page 21)

He would create potions using a variety of plants and herbs, and these were believed to work by their magical qualities, probably provided by the spirits or gods. And over time he developed "a special talent for herb doctoring, bone setting, and rude surgery," said Garrison. "We find that savages in widely separated countries easily get to know the most fatal arrow poisons—curare, ouabain, veratrin, boundou—as well as the virtues of drugs, like opium, hashish, hemp, coca, cinchona, eucalyptus, sarsaparilla, acacia, kousso, copaiba, guaiac, jalap, podophyllin, or quassia." (1, page 25)

They also learned about viable remedies for asthma by experimenting with the leaves, stems and roots of the deadly nightshade called belladonna and another similar plant called strammonium.  And he also must have experimented with the effects of drugs like opium, tea, coffee, and alcohol and learned they caused a sort of "artificial paradise," said Garrison. (1, page 30)

All of these would provide at least some relief to the sick and injured, if for no other reason than to provide some mental relief and relaxation, or to help them forget their misery.  Such relaxing effects may even have ended an attack caused by the spirits. (1, page 30)

And if these remedies didn't work, he might try a remedy called bleeding by using a sharp stone or flint knife to balance the humors of the body. Or perhaps he might try trepanation to let the evil spirits out of the sick man's body by cutting or sawing an opening in the scull.(1, page 26)

Although the emphasis of the medicine man was on more than just as a healer of the human body.  Garrison said: (1, page 23)

Primitive medicine is inseparable from primitive modes of religious belief. If we are to understand the attitude of the primitive mind toward the diagnosis and treatment of disease we must recognize that medicine, in our sense, was only one phase of a set of magic or mystic processes designed to promote human well-being, such as averting the wrath of angered gods or evil spirits, fire-making, making rain, purifying streams or habitations, fertilizing soil, improving sexual potency or fecundity, preventing or removing blight of crops and epidemic diseases, and that these powers, originally united in one person, were he god, hero, king, sorcerer, priest, prophet, or physician, formed the savage's generic concept of 'making medicine.' A true medicine-maker, in the primitive sense, was the analogue of our scientific experts, philanthropists, and "efficiency engineers," a general promoter of human prosperity. (1, page 20-21)

When these "sorcerers" first appeared is unknown, although it's speculated they originated as the smartest, wisest, most sagacious, most knowledgeable, most curious members of the families, clans or societies that grew from the ashes of mankind. These individuals listened to the lyrics told at night, and remembered them.  They asked questions about the human body, and searched for and experimented with the various plants and herbs amid the lands around them until they found the answers.

They created various medical recipes, and, by experimentation, learned of their poisonous or healing properties. Many of these sorcerers were seen as healers, and were sought out when needed.  Others were seen as utilizing what was referred to in Egypt as the "black art," and they were punished with death.  So how they were viewed differed from one nation to the next. Although, what is known about them is they were the first physicians, with their specialty in healing, divination, pharmacy, chemistry, and magic. Although many of these specialties evolved over time.

Primitive and ancient people did not have an understanding of the human body, and their curiosities of it were nary satiated because to investigate the human body was considered to be offensive to the gods and the spirits. What they did learn about anatomy was accumulated by animals they dissected for food and sacrifices, and later by the process of embalming, although due to fear of the ubiquitous gods even the priests performing these duties were fearful to exceed the bounds of the task at hand.

The ancient Egyptians had knowledge of the vessels of the body, and they knew that they originated in the heart.  They knew the heart beat could be felt at various points on the body. And although they had some knowledge of anatomy, they in no way associated this with the various ailments and the remedies used to treat them.  They did not know diseases were caused by germs, or problems with the inner workings of the body, and they did not know that the remedies they created over time had anything to do with their effects on the body.

For thousands of years transcendental forces were at work all the time.  People had to "know prayers, sacrifices, rites, spells," to keep the transcendental forces happy and at balance.  (2, page 270)

They were educated about these by the medicine man, and when their own self remedies failed, or when they could no longer tough it out, the medicine man was sought for his wisdom.

By all means, the spirits of the dead were abounding, and they needed to be satisfied and even fed.  If they were not satisfied, they caused diseases and injuries.

Another thing that caused disease was when a person was not pure, or did something wrong.  Often times when a person was sick the rest of the clan would wonder what god or spirit he offended.  And, of course, the only person who had the ability to learn this, and learn how to placate that god or spirit, was the medicine man; the sorcerer; the priest. He also had the ability to drive out demons, and to counteract black magic that might have been used to cause the ailments.

So the ailments that plagued the various clans, villages and civilizations were not caused by germs or problems with the body, and injuries did not just happen by chance: they were caused by spirits, demons, gods, and black magic.  People, therefore, didn't think of diseases the way we do today.  What we have today are a variety of diseases based on quantitative evidence about various systems of the body. We see diseases such as asthma, allergy, cold, sinusitis, rhinitis, etc.  Through most of history, however, ailments were diagnosed by the symptom.  If more than one symptom persisted, the diagnosis was based on the one most prominent.

In other words, your sypmptom was your disease.

In this sense, even while the following may be caused by various disorders, most prehistoric, primitive and ancient people/societies considered them diseases (1):

• Fever
• Coughing
• Dyspnea (shortness of breath)
• Nausea
• Hematuria
• Headache
• Excessive sputum
• Pain

The following definitions will help you understand the role of the medicine man/sorcerer:

1.  Black magic:  This is evil.  The use of supernatural powers for selfish and evil purposes.  An example is casting a spell on someone you don't like to cause a disease or to cause something bad to happen.  It can be as simple as an evil eye, witchcraft, or finding someone to make an evil potion for someone to drink.

2.  Black art:  This was the use of drugs for evil purposes.  This involved the mixing and matching of various drugs and solutions to create potions that were used to evil purposes, such as poisons to kill people you did not like.  Early alchemy, chemistry, and pharmacy was considered to be a black art in the early days of ancient Egypt.  

3.  Omen: Telling the future.  It can tell you if something good or bad is going to happen to you.  If something bad is going to happen you can seek out help in order to prevent it from happening.  

4. Amulet: An object that possesses magic properties to ward off evil spirits. Generally it can be anything from a bone from prey, a rondel (bone chipped away during trepanation), a rabbit's foot, a squirrel's tail, stones, rocks, etc. It may be an object such as an ax, knives, necklace, bracelet, etc. They meet and destroy evil spirits. They catch and neutralize black magic directed toward the owner of the amulet. These are often the chief means of preventative medicine in many primitive and ancient societies. (1, page 40)(2, page ?) They are objects that must be worn at all times in order for their magic to work. Ancient Roman children were made to wear necklaces with amulets made of amber hanging from them. This was so that its magic would protect the child when the parents were not around. (4, page 80)

5. Fetish: An object that is the seat of magic power. It may be the abode of a spirit or may have been charged by the medicine man with the mystic power, mana, or manitou, or whatever it may have been called. It may be an object of worship. The owner of a fetish expects it to act according to his intentions. 

6.  Totem:  The totem is usually an animal or other natural figure that spiritually represents a group of related people such as a clan. 
7: Charm: Something worn or carried on one's person for its supposed magical effect, such as an amulet, talisman, incantation, conjuration, prayer and even exorcisms. It could be a bracelet, necklace, ring, or just about anything. It could be anything that provides the magic necessary to ward off evil, either words or some object. It could be words like ABRACADABRA. (1, page 41)

8.  Talisman:  These are amulets or charms that were "closely guarded but not worn." (1, page 41) It could consist of stone, metal, or even parchment paper that has certain characters engraved on it. (4, page 80) The ancient Romans would often have a talisman in their homes in order to protect it, although it would also have the ability to protect the owner too. It's simply any object that possesses magic properties and brings good luck, and does not have to be worn at all times like a an amulet does.

9.  Mascot:  An animated talisman, a person or animal that brings good luck

10.  Incantation: The chanting or uttering of words that are supposed to have magic qualities, as through preventing or healing disease.

11.  Prayer:  Words, a petition, meant to provide protection and healing by calling to the divination for such help.

12. Spells: According to dictionary.com it's "a word, phrase, or form of words supposed to have magic power" which may include a charm or incantation.

The following are what the sorcerer evolved into:

13.  Fumigation: Creating fumes or smoke with fires, incense, pipes, steam, etc., with the intent of healing through inhaling the fumes of burned or steamed herbs or otherwise, and more likely in ancient times, to please or ward off evil spirits to prevent and treat diseases, prevent bad things from happening, etc.

Now, it is true that you might see the medicine that is described here as poppycock and quack medicine. However, when you think of it, this was probably the best medicine available at the time as it gave people hope and faith. This was observed by Garrison in his 1922 history of medicine:

In surveying these different superstitions, one point becomes of especial moment. It is highly improbable that any of the remedies mentioned actually cured disease, but there is abundant evidence of the most trustworthy kind that there have been sick people who got well with the aid of nothing else. How did they get well? Short of accepting the existence of supernatural forces, we can only fall back upon such vague explanations as "the healing power of nature," the tendency of nature to throw off the materies morbi or to bring unstable chemical states to equilibrium, the latter being the most plausible. But, in many cases of a nervous nature or in neurotic individuals, there is indubitable evidence of the effect of the mind upon the body, and in such cases it is possible that a sensory impression may so influence the vasomotor centers or the internal secretions of the ductless glands as to bring about definite chemical changes in the blood, glands, or other tissues, which, in some cases, might constitute a "cure." (1, page 42)

He also wrote:

"The best inspirer of hope is the best physician," an aphorism which contains the germ of the Freudian theory of psycho-analysis—to "minister to the mind diseased" by removing the splinter of worry or misery from the brain, in order to restore the patient to a cheerful state of mental equilibrium... It is also the secret of the influence of religion upon mankind, and here the priest or pastor becomes, in the truest sense, tin Arzt der Seele. In practical medicine, the principle now has a definite footing as psychotherapy... Psychotherapy cannot knit a fractured bone, antagonize the action of poisons, or heal a specific infection, but in many bodily ills, especially of the nervous system, its use is far more efficient and respectable than that of many a drug which is claimed to be a specific in an unimaginable number of disorders. (1, page 33-34)

So while the magic of the medicine man/ sorcerer/ weer/ priest may not have healed you physically, it may have provided you with the mental relief, or peace of mind, necessary to buy time for nature to cure what ails you, even the dyspnea caused by asthma.

Note:  Some societies, even in today's world, have yet to advance past the primitive state.  Where this is the case, medicine men and women continue to communicate with the spirits and gods around them for health and prosperity.

References:

1. Garrison, Fielding Hudson, "An introduction to the history of medicine," 1922, 3rd edition, Philadelphia and London, W.B. Saunders Company
2. Sigerist, Henry,"History of Medicine: Primitive and Archaic Medicine," volume I, 1951, Oxford University Press, page 322
3. More references will be listed here soon as some of the wording among the lexicon here is not mine.  Sorry for any invonvenience.  Much of the lexicon comes from Sigerist's 1922 history of medicine, and I will update this reference as soon as his book arrives in the mail. 
4. 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

30,000 B.C.: The dawn of medicine

The first humans in Europe were cro magnums.  They are thought
to have marched into Europe sometime around 40,000 B.C. 

So humans must have developed empathy early on.  They must have made sacrifices to help the suffering in any way they could.  Perhaps this meant something as simple as pulling out a splinter.  Perhaps it meant sacrificing a meal so a child could eat.  Or perhaps it meant pulling out an arrow that pierced a brother or friend.  Or perhaps it meant providing a sympathetic shoulder to a child suffering from respiratory distress.  By around 30,000 B.C., such empathy would reach a culmination of sorts, into an era that many refer to as the dawn of medicine.

Once again, it's hard to know what internal ailments man suffered from 2.5 million years ago, let alone 30,000 years ago.  It's highly probable, or so I would think, that heart and kidney failure plagued mankind since the beginning, and Lord knows these ailments cause shortness of breath, even air hunger, or what the ancient Greeks referred to as asthma (and what later was referred to as dyspnea, allowing the term asthma to be redefined).

It's hard to imagine what it would be like to suffer from heart failure, bronchitis, tuberculosis, pneumonia, or any such respiratory disease 2.5 million years ago, let alone 30,000 years ago.

The asthmatic boy leaned up against a tree or rock and dealt with the agony as best he could, trying hard to keep up with his clan, performing the duties expected of him.  But as his breathing worsened, or failed to get better, he'd more than likely become a burden to his clan, and they'd have to go out of their way to help him, to guide him along, to feed him, to provide him with drinks, to provide him with incantations and magical words of healing. If he died it was because he was poisoned, if he lived it was because of the magic.

By pondering about the world around them, by learning from events they observed and experienced, and speculating about that of which they could not learn by empirical means, these people created the first myths about what happened before birth, and what happened after death, and why a person got sick.

Perhaps it was by this means that fears of the unknown lead to evil spirits abounding all around, peering amid the trees, and in the dark crevices of caves, and in the fields, and in the sky, even lurking in dreams. Some of these possessed friends and family members, and no doubt one of these had entered the asthmatic boy.  Other spirits became real beings in the Heavens, and these turned into the first gods, and these gods became the first physicians who were responsible for health and healing.

A young girl was excited to see her mother give birth, and after her brother was born, her mother became very sick and she died.  That night the girl did not sleep, instead she was haunted by the creepy sounds in the night.  She decided the sounds must have been made by her mother, who died too soon.  Her mother was now a ghost or spirit, and she was ever present and probably very unhappy because she died too soon.  She might protect her family, or she might be too blind sighted by her own death and haunt those she loved when she was alive. As noted by Henry Sigerist in his 1951 history of medicine: (6, page 137)

Particularly feared are the ghosts of people who died without having fullfilled their mission on earth, young children, brides, women in childbirth or childbed. they more than any other dead must be eager to return to life or, feeling lonely, they may wish to kill some who were close to them so as to enjoy their company in the world of the spirits. (6, page 137)

One early man or woman realized a sharp bone could be used to slice into prey, and another learned to attach this sharp object to a stick to be used as an ax for killing prey or cutting down brush or trees for making shelter.  By cutting up food the heart was found to still be beating, and the heart was learned to be the best target when hitting prey with a knife, spear or arrow.  The head was learned to be the best target for the blunt ax as it shattered the skull. As noted by Plinio Prioreschi in his 1999 history of medicine: (5 Prioreschi, page 29)

Neolithic man must have noticed that the results of the wounds inflicted by the two kinds of weapons were quite different. Deep wounds of the abdomen and chest inflicted by piercing weapons were always mortal either soon or after, or some time later (in the later case because of infection -- e.g. peritonitis). On the other hand, head blows delivered with blunt weapons often had strange results: the animal (or the enemy) would immediately fall "dead" and whereas sometimes it (or he) would stay dead, sometimes, after a short period, it (or he) would revive, that is, would become "undead." The individual who became "undead" after a head blow had always a small head wound, whereas those who failed to revive usually showed a massive injury. (5, page 29)

It must have been assumed that the "undead" was a person with magical powers, or who was blessed by the demons, spirits or a god.  He was thus "brought back from the dead." He was "cured." Those who came into contact with this "cured" person were blessed. This was probably where superstitions and religion were started. Yet it was also by these observations where people learned what weapons were best for what purpose.  In this way, people learned by trial and error, and they speculated, and they came to conclusions.

People learned early the benefits of bathing in the rivers, lakes and streams to keep themselves clean and pure, because purity was the way to keep the body in balance and to keep the evil poisons out of your body.  This may have been the first observation that cleanliness resulted in better health; the first hygienic practices.  Some men washed daily, and maybe had their wives check them for ticks and fleas or whatever bugs crawled onto them while they were busy hunting in the forest.

Slowly the tree of knowledge blossomed and grew.  Mankind learned that by working together they could accomplish more in life, and as part of working together they learned how to socialize.  They therefore learned to have empathy for a fellow human who was suffering, as was evidenced by the efforts to emphasize and help the ailing boy.  They learned they could make a difference in the lives of others by the love they offered, or simply by offering a kind shoulder to lean on.  Although the earliest help was primitive indeed, this was the beginning of medicine. (1, page 2)

Perhaps a dad provided pressure on a cut to stop bleeding, or made a splint out of stick to aid the healing of a broken finger, or used wool of a sheep to produce a basic bandage, or used a sharp stick or stone to pluck out a sliver.  When the cause of suffering was unknown (as was the case with internal ailments), incantations were chanted to suck out the evil spirits and demons.

So while allaying illness may have originally been a personal task -- each man or woman for him or herself, it eventually became a task of the many.  People developed consciences; they learned to love, care and appreciate the people in their lives.  They cared for and doted the sick, young and old.  Each person becoming pseudo nurses, physicians and respiratory therapists. So in essence, all of these jobs were born amid the primitive or prehistoric world by savage humans.

An elderly man, perhaps, found relief for his ailing back when he stood by the hot fire.  He learned that by removing the splinter of wood in a boy's hand this would speed recovery of the wound. Perhaps by the quest to find food when hungry, early humans discovered the poisonous and medicinal properties of various herbs.  An elderly lady must have mixed some herbs with berries and learned it didn't make such a good meal, although later she rubbed some on her skin and found it to have soothing or healing properties. (6, page 115-116)

Perhaps by such experimentation, these early humans came up with the first herbal remedies, creating the first recipes that turned into salves, ointments,  potions, pills and even inhalents. Perhaps, just perhaps, an elderly lady was experimenting with poppy seeds.  It is believed by many historians that poppy seeds, or opium, was one of the first remedies used by mankind for its hallucinogenic and pain relieving effects.  Perhaps this was one of the most important drugs of the primitive world (5, page 7), as it relieved pain and suffering.

Perhaps she experimented with the leaves and roots of a belladonna plant, and she laid them out in the hot sun for days to dry, and then after they dried she tried to make food or a potion from them, and she learned that when ingested the result was soothing to the mind, definitely a gift from the gods.  And one day, when the asthmatic boy was huffing and puffing over the fire, she inadvertently discarded the remaining roots and stems into the fire, and the smoke created by them was inhaled by the boy, and his breath returned instantly, his mind at ease by the hallucinogenic effects.

The boy's father investigated this remedy, and he remembered the recipe, creating easy to remember lyrics so the recipe could be shared from one generation to the next.  By trial and error, in this way, they learned what remedy worked best for what ailment.  If an elderly lady was sick, for example, her husband, or sister, or friend, used knowledge obtained by lyrics sung by the campfire late at night to help in any way they could.  Perhaps an elderly sister rubbed salves on her aching back, or made her drink a soothing potion (perhaps containing a drug such as opium). And it was rationalized these remedies had powers of healing because they were gifts from the gods above. (5, page 35)  

If the magic available to these folks didn't work, it was time to call for the medicine man, who was able to form a link between the patient and the spirits, demons and gods. He was the wisest member of the tribe, the one who remembered all the recipes, and held all the esoteric knowledge of the privileged few. He was the earliest magician/ sorcerer/witch/priest/physician all rolled into one, who had the ability to create a link between the sick and the spirits, demons and gods that were ubiquitous and invisible.  He would dress in animal skins to mimic a spirit or demon, he'd use rattles and drums to set the milieu, and he'd suck out the evil spirit from the sick woman. He had different names in different places of the world, although some called him Shaman or Seer, because he had the ability to "see" into the netherworld. (3, page 22)

If this magic didn't work, there were other options the medicine man, or woman, might experiment with, and one was was called trepanation. Experts have shown this can be easily done using flint knives and "scratching the (parieetal) bone (of the scull), or by making a circular incision that was gradually deepened, or finally by drilling a series of small holes arranges in a circle and then cutting the bridges between them." (6, page 110-113)

Many such sculls have been found by archaeologists in various parts of the world,  and no one knows exactly why this procedure was performed, although many speculations have been made.  Perhaps the patient was driven insane or possessed by demons, and this was a last ditch effort to cure the person. Perhaps the person was seizing due to epilepsy.  Perhaps the person had end stage emphysema, or was having a severe, prolonged asthma attack. (Lord help the boy with asthma if this was the remedy.)(6, page 110-113)

The medicine man may provide the sick lady, or her family, with an amulet and an incantation to recite at various times of the day.  An amulet was blessed with magical powers of healing, and could be made of the teeth of animals, claws of eagles, knives, axes, dried rabbits heart, dried rabbits foot, the bone fragment from trepanation (called rondelles), or just about anything. He may also provide such an object as a talisman, and these would be for good luck, to keep you healthy, and to keep you alive. Such objects may also be just about anything, from a wood carving or replication of an eye, heart, liver, kidney, liver, arm or leg. It could be a dried rabbits foot, necklace, bracelet, etc. (6, page 145)

In times when suffering and death inflicted several members of the clan, in times of epidemics of disease, the medicine man would use his magic on the entire family or clan.  They would gather around the fire at night, under the moon-lit sky, and the medicine man would shake his rattles and beat his drums and hum magical incantations and prayers, and he would toss the dried and crushed herbs of opium or belladonna onto the fire, and the smoke would be inhaled, and the recipients would sit around the fire and hallucinate about the world around them. These hallucinations would surely be revelations from the gods, and they would be interpreted by the medicine man.  These were the first mass inhalations, or fumigations.  In times of trouble, in times of great plagues, such fumigations would provide an explanation for the suffering, and a divination of the end of the suffering, or what could be done to end it.  

Much of this knowledge had matured into a flourishing tree by 30,000 B.C. Knowledge that was slowly picked up by previous generations was now habitual.  Basic methods of maintaining health, and for offering healing, were standard. The cause of illness, and the reason for healing, was by the wishes of the ubiquitous spirits, demons and gods.  Some historians consider this period as the dawn of medicine.

References:

1. Wilder, Alexander, "History of Medicine, 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, adn especially a history of the American eclectic practice of medicine, never before published," 1901, Maine, New England Eclectic Publishing Co.
2. Netzley, Patricia D, "World History Series: The Stone Age," 1998, San Diego, CA, Lucent Books
3. Garrison, Fielding Hudson, "An Introduction to the history of medicine," 1921
4. Unknown reference
5. Prioreschi, Plinio, "A History of Medicine: Primitive and Ancient Medicine," Vol. 1, 1999, reprinted edition, originally published 1995, Horatius Press
6. Sigerist, Henry E "History of Medicine," volume I: Primitive and Archaic Medicine, 1951, New York, Oxford University Press
7. Suter, Joanne, "Fearon's World History," 2nd edition, 1994, U.S., Globe Fearon Educational Publishing

100,000-70,000 years ago.: The first doctors?

It's possible one member of a Neanderthal clan or family
acted as physician, caring for the injured and aging.
It's possible the entire clan doted over the sick person
stricken with dyspnea due to aging, sickness or injury.

It's difficult for people to understand what life was like on earth 100,000 years ago, although based on archaeological evidence we can make educated guesses.  It's unknown whether asthma, allergies or similar diseases existed back then, although it's known that people got sick due to infections caused by viruses, bacteria and parasites.  Chances are these people got short of breath at times too, and that they simply had to deal with it.  

Or maybe not?  There is evidence that Neanderthals, who roamed the earth for about 60,000 years between 130,000 and 70,000 years ago, grew to love and care for those in their family or clan.  This would be a natural effect of working together for a common goal of surviving the challenges of life; a natural side effect of sitting around the fire in a cozy cave to stay warm on a dark and cold night.  

During the day the women without children, and the men, would use their large, muscular bodies to search for food, and then they'd bring what they could back to the cave to share with the women and children.  They would cook the meat and prepare it in different ways, even sucking the marrow out of the bones.  The women would use wood and stone tools to make clothing from the hide, and ornaments from the bones.

When a hunter wrestled with an animal and broke a leg, the women would take care of him in the cave, and he would be provided a portion of the food.  Those who were too sick or old to work were also taken care of in this way. Evidence suggests they probably didn't live much longer than 30, although those who did must have provided knowledge necessary to survive changes in the environment.

Perhaps the elderly told stories late at night, under the moon lit sky, about what happens before birth or after death.  Perhaps in order to allay the feeling of grief after a mother passed away in childbirth, he explained what life was now like for the person who died, of how she was in a happy place like Heaven.  Or perhaps she was a spirit watching over her children.  By doing this, Neanderthal's created religious beliefs and tradition that were passed on from one generation to the next. 

Before long these stories became realities, and the spirits became living entities. The elderly may even have used these beliefs to the advantage of the clan or family.  He told of stories of how, if you fight with your brother, or if you steal food from the sick, or if you didn't do your share of the work, you would be punished by the spirits.  In this way, he encouraged the young to grow up to be productive and trustworthy members of the clan.

I can speculate like this because there is evidence of Neanderthal burial sites where the dead person was intentionally set in a certain position, and surrounded by items that he could use in the afterlife, such as stick and stone tools. Some speculate this is evidence that these hominids mourned their dead, and believed in an afterlife.  

There may also be evidence some members of the the clan may have specialized in taking care of the sick and injured.

Patricia D. Netzley, in her 1998 book "The Stone Age," quoted archaeologist Richard Leaky's description of a burial site where "dense clusters of fossil pollen show that flowers were arranged around the body making a colorful grave of white, yellow and blue.  The flowers are all medicinal herbs, suggesting the possibility that the man was some sort of doctor and these were the herbs he used in his medicine."  (1, pages 54-55)

References: 

1. Netzley, Patricia D, "World History Series: The Stone Age," 1998, San Diego, CA, Lucent Books

200,000 years ago: the dawn of caring

Modern humans are called homo sapiens sapiens, and started to appear in Africa around 200,000 years ago, and around 100,000 years ago they migrated out of Africa.  These men and women were even more human-like than the homo habilis, homo erectis, and home sapiens who lived before them.  Homo Sapiens Sapiens had better bodies for walking long distances, and they ventured to various places of the earth where food was most plentiful. In the process they created better tools as a means of adjusting to new environments and different kinds of wild game. (1, page 66)(3)

Patricia Netzley explained in her 1998 book, "World History Series: The Stone Age," that:

These new hominids lacked the projected facial features of the Neandertal, and their bodies were taller and less robust; in appearance, they were quite close to today's humans. Longer legs gave them the ability to travel longer distances, which meant that they came in contact with many other tribes of people.  This exposure to other cultures and ideas may be the source of their greater creativity, in comparison to their ancestors. (1, page 66)

She explains that early home sapiens sapiens, sometimes referred to as cro magnum, made a "wide variety of tools" compared to their ancestors. They were able to put their minds together to utilize rock, bone, antlers, ivory, and wood. They were able to use various materials from animals and plants to connect sharp rocks to make the following weapons: (1, page 66-67)

• Saws
• Chisels
• Knives
• Flint axes
• Wooden axes
• Spears
• Bows
• Arrows

They were even able to use thin pieces of bone as needles to sew pieces of hide together in order to make clothing and materials to build crude homes. They worked together using these tools and fire to hunt for larger game, such as the Woolly Mammoth. And of course they ate all the meat, sucked all the marrow from the bones, and used what was left over to experiment. The made ornaments and beads to adorn their bodies, clothing, homes and burial sites. They even made fences of ivory. (1, page 70-79)

They probably had a language as well, communicating both by their art and their words. They painted crude drawings in color on the walls of caves, and these would have been available for new generations to learn from. They also must have had a verbal language so they could share ideas, plan hunts, and relay knowledge of myths, religions, tradition, and recipes of food and medicine.   (1, page 70-79)

Surely they had medicine (although there is no evidence of this, as I noted in the introduction). It may have been crude, but any form of help they provided to the sick and injured would have been medicine. Perhaps they helped a man with one leg walk, or provided sympathy for the old man who was short of breath, or the boy suffering from the flu. They probably experimented with herbs, perhaps at first to find new foods. Although their poisonous and healing properties would have been learned and shared.

Better yet, perhaps they experimented with magical words in an attempt to expectorate whatever poisons the spirits or demons put into your friend. Since prehistoric man would have no concept of the inner workings of the body, they would have no concept of internal diseases. So they would rationalize the only way they could, and this was to use their imaginations.

They mourned the dead, and then they had dreams where a dead relative appeared.  So they came to the conclusion that people have souls that live on as spirits after death.  These spirits watch over the clan or family.  Like people these spirits must be fed, so the living made sacrifices and created words to appease the spirits.  However, when the spirits weren't satisfied, they caused disease.  Or, if one member of the clan or family did something that was considered a sin -- had a bad thought, perhaps, that person was inflicted with a poison. (5, page 131)

As humans do today, these early humans felt pain when they stepped on a sharp twig or rock, and they felt winded and irritable when they picked up germs that caused colds.  They suffered the side effects of ailments like asthma, allergies, and bronchitis, and they yearned for further understanding. It's highly probably these diseases weren't present in the lower paleolithic era, although it's likely people still got short of breath due to airway inflammation caused by infections, or by heart failure, or kidney failure, or some other ailment.

At first men and women were only concerned with themselves, yet as these early human's spent more time together, perhaps at first simply taking care of their children, they learned to love and have empathy.  At some point a woman saw her son step on a twig, and she must have known it hurt by her own personal experience.  So she did what she could to help the child.  She pulled out the thorn, and she massaged the wound, perhaps even rubbed mud or water on it to allay the pain.  Or, at the very least, she provided a shoulder for the boy to lean on.  (5, page 115-116)

She also remembered from her childhood when her mom and dad and brother died.  She remembered feeling sad.  She remembered the bad feelings when she realized for the first time the world is a gloomy place.  The ghosts or spirits of the dead were looming all over, and they had the ability to allow you to get sick or even to die.  Many times they let good people get sick and die, people who did not sin.  It was an unfair world.  And so she provided a soothing shoulder, and perhaps soothing words, to her son when he was old enough to come to this same realization.

Yet it also must be realized, however, that prehistoric men and women did not live their entire lives in fear of the spirits, demons or gods that were ever present.  They did not fear them any more than you or I fear the viruses and bacteria that are ever present in our world.  Sure we know they are there, and surely we respect them, but we do not live in fear every day.  We take precautions.  We wash our hand, and we brush our teeth, and we take baths.  We are careful who we come into contact with.  (5, page 442)

In this same way, prehistoric men and women took precautions.  They made sure not to have impure thoughts, and they made sure to teach the same to their children.  They made sure not to take things that don't belong to them, and to take care of the natural resources they were allowed to live among.  They made sure to take care of the sick who were living, and they also learned to feed and nurture the spirits, demons and gods.  They created words to appease them, and these would become the first incantations and prayers.  In this way men and women learned to have empathy, and they learned about the importance of caring.

This mom burned her hand, perhaps, in the fire when she was a child, and she remembered how she found relief when she stuck her hands in the mud.  And so when her son burned himself, she found some mud, scooped it up into her cupped palm, and she took it to the boy, and rubbed it onto his burn.  This was, perhaps, the first form of medicine.

Perhaps when she was a child she loved figs, one day she was amid an ample supply and she ate too many.  She got a stomach ache and she threw up the figs.  She felt miserable for the entire day, and her mother comforted her by rubbing the base of her back.  So when she was a mother herself, she told her son not to eat too many figs. Or, perhaps, she watched her son eat poison berries, and she thought that if she didn't do something he would die.  So she gave her son figs, lots and lots of figs.  She sat by him while made him eat them until he puked.  Her son did not die.  So the poisonous quality of eating too much figs now became a remedy.  (5, page 114-115)

Primitive people, more appropriately termed prehistoric or savage people, were "puzzled if not awed by the rustling of leaves in the forest, the crash and flash of thunder and lightning, the flicker and play of sunlight and firelight, and he could see no causal relation between a natural object and its moving shadow, a sound and its echo, flowing water and the reflections on its surface. Winds, clouds, storms, earthquakes, and other sights and sounds in nature were to him the outward and visible signs of malevolent gods, demons, spirits, or other supernatural agencies. The natural was to him the supernatural, as it still is to many of us," according to Fielding Hudson Garrison in his 1921 history of medicine. (4, page 21)

He continues:

"He therefore worshiped the sun, the moon, the stars, trees, rivers, springs, fire, winds, and even serpents, cats, dogs, apes, and oxen; and, as he came to set up carved stocks and stones to represent these, he passed from nature worship to fetish-worship. Even in his artistic productions, the savage is at first animistic and ideographic, tends to vitalize inanimate objects, and aims at the portrayal of action and movement rather than perfection of form.  Disease, in particular, he was prone to regard at first as an evil spirit or the work of such a spirit, to be placated or cajoled, as with other deities, by burnt offerings and sacrifice. A further association of ideas led him to regard disease as something produced by a human enemy possessing supernatural powers, which he aimed to ward off by appropriate spells and sorcery, similar to those employed by the enemy himself. Again, his own reflection in water, his shadow in the sunlight, what he saw in dreams, or in an occasional nightmare from gluttony, suggested the existence of a spirit-world apart from his daily life and of a soul apart from his body, and in this way he hit upon a third way of looking at disease as the work of offended spirits of the dead, whether of men, animals, or plants." (4, page 21-22)

We can only assume that one early human suffered from asthma, or at the very least from asthma-like symptoms.  Sometimes the symptoms went away in time, and sometimes they lingered until death occurred.  Since men and women are empathetic, they yearned to help in any way they could.  This brings us to around 30,000 years before the birth of Jesus Christ, a time many speculate was the dawn of medicine.

References:

1. Netzley, Patricia D, "World History Series: The Stone Age," 1998, San Diego, CA, Lucent Books 
2. Roberts, J.M., "The illustrated History of the World: Prehistory and the first civilizations: volume I," 1999, New York, Oxford University Press 
3. "Neanderthal: Their bodies were well equopped to cope with the ice age, so why did the Neanderthals die out when it ended," bbc.co.uk, Science and Nature, http://www.bbc.co.uk/sn/tvradio/programmes/horizon/neanderthal_prog_summary.shtml, accessed 4/4/13 
4. Garrison, Fielding Hudson, "An Introduction to the history of medicine," 1922, 3rd edition, Philadelphia and London, W.B. Saunders Company 
5. Sigerist, Henry E "History of Medicine," volume I: Primitive and Archaic Medicine, 1951, New York, Oxford University Press