Document2 - StudentVIP · PUBH2209!ExamRevision:!! Short9Answer!section:!Havetoanswer’2’questions’! Revise!(basedoff2014questions):! • Ancient Egyptian medical thought and

PUBH2209  Exam  Revision  

PUBH2209  Exam  Revision:    Short-­‐Answer  section:  Have  to  answer  2  questions      Revise  (based  off  2014  questions):    

• Ancient Egyptian medical thought and practice • The role of Hippocratic writings in the history of medicine • The “Columbian exchange” of infectious diseases • Scientific developments from 1500-1800 and their impact on medicine,

focusing on the following THREE topics: approaches to anatomy (Vesalius), theories of circulation (Harvey), and iatrochemistry (Paracelsus)

• The relationship between medicine/health and warfare, which will assume you have knowledge of AT LEAST ONE relevant conflict prior to 1950 (e.g. from the Napoleonic Wars or Crimean War or American Civil War or WWI or WWII)

Extended-­‐Answer  section:  Have  to  answer  3  questions      Revise:  

• The role of Galen and Galenic theory in the history of medicine • The main types/classifications of “health care” practitioners involved in

health provision (that is, those groups who were broadly responsible for aspects of health and illness) around the time of the Renaissance

• Social and medical perceptions and impacts of epidemics, with a focus on the Black Death in the 1300s and the plague outbreaks of the 1600s

• Major developments in health and medicine during the Victorian era • A general conception of the changing explanations and management of

mental illnesses from 1750 to the modern day • Approaches to health and medicine under authoritarian political systems,

with a focus on Nazism/Hitler’s Europe

   Ancient  Egyptian  medical  thought  and  practice:      ANCIENT  EGYPTIAN  CIVILISATION:  oriented  along  the  Nile  River    

• Ancient  Egyptian  dynasties  could  be  divided  into:  Peaks  of  Egyptian  power  o Old    o Middle    o &  New  Kingdoms  and  related  dynasties    

• Sources  of  historical  medical  information:  o Hieroglyphics    o Artistic  representations    o Medical  papyri    o Study  of  human  remains,  both  skeletal  and  soft  tissue  (used  special  

methods  to  preserve  the  body)  of  ancient  Egyptians    • Four  main  peaks  of  Egyptian  history  with  events  of  medical  relevance  in  the  Old  

Kingdom    o (a)  the  first  hieroglyphs  o (b)  the  physician  Hesy  Re  o (c)  splints    o (d)  circumcision  on  a  bas  relief    

• Main  medical  papyri  in  Middle  and  New  Kingdoms      What  sorts  of  health  issues  and  diseases  affected  the  ancient  Egyptians?      

• Average  life  expectancy:    o Probably  around  30-­‐35  years,  very  few  people  lived  over  60  years  of  age    

• Nutritional  state:    o Part  of  Egypt’s  long-­‐standing  success  was  the  adequacy  of  nutrition  for  

most  of  its  population  =  most  of  the  daily  calories  from  grains  and  bread    § Barley  and  emmer  =  an  early  form  of  wheat    § Reasonably  mixed  diet  including  waterfowl,  fish,  vegetables  (e.g.  

beans,  peas  and  celery),  fruit,  palm  nuts  § Beef  for  the  wealthy    § Widespread  production  of  beer  and  wine    

o BUT  there  is  some  evidence  of  malnutrition/nutrition  deficiencies  in  skeletal  remains    

o Years  of  famine  did  exist    • Infections:    

o Infected  wounds/abscesses    o Parasitic/worm  infestations    

§ E.g.  bilharzia,  or  schistosomiasis  which  is  still  common  today  à  evidence  of  these  worms/eggs  found  in  mummified  remains  and  are  referred  to  in  medical  papyri    

o Malaria    o Tuberculosis  (including  evidence  of  spinal  TB  in  skeletal  remains)  o Leprosy    o Chronic  eye  infections  (trachoma)    

• Other  health  problems  included:    o Animal  bites/stings  (scorpians/snakes)    o Industrial  accidents    o Injuries  from  warfare    o Pneumoconiosis  (lung  disease  from  mineral  dusts)    

o Based  on  recent  CT  scans  of  Egyptian  mummies  (of  wealthy  and  high  status  individuals)  à  there  is  also  evidence  of  atherosclerosis/heart  disease  (so  not  just  a  modern  problem!)    

 Health  care  in  Ancient  Egypt      

• Physicians  (“swnw”)  à  held  highest  regard  in  society    • Priests  (“w’bw”)  • Magicians  (“s’w”)  • Hierarchy    

o At  the  top:  pharaoh’s  personal  physicians    o Other  palace  physicians,  including  an  overall  administrator    o Inspectors  of  physicians    o The  ‘general’  physicians  treating  the  mass  of  the  population    o Also  some  records  of  separate  groups  of  ‘occupational’  doctors  

responsible  for  workers/miners  (these  may  have  been  salaried  positions)    

• Physicians  often  prepared  their  own  medicine  and  charge  for  these  or  exchanged  these  for  other  goods  (barter  system)    

• Little  evidence  of  formal  training  à  medical  knowledge  seems  to  have  been  passed  down  in  families    

o BUT  may  have  also  been  some  medical  training  attached  to  temples    o Physicians  were  expected  to  have  some  knowledge  about  the  working  of  

gods/demons  in  causing  and  treating  disease    o Others  may  have  used/learned  from  medical  papyri  (which  were  often  

written  in  the  style  of  reference  texts)    o May  have  been  a  degree  of  specialisation  à  a  Greek  observer  noted  that  

in  Egypt  “one  physician  is  confined  to  the  study  and  management  of  one  disease  “  (e.g.  eyes,  teeth,  bowels,  head  etc.)  

§ E,g,  one  of  the  most  important  physicians  were  known  as  the  “Keeper  of  the  Royal  Rectum”  and  was  responsible  for  administering  the  pharaoh’s  enemas    

 Some  physicians  in  the  records  

• Hesy-­‐Ra  à  first  recorded  doctor’s  name  in  history;  given  the  title  of  the  ‘greatest  of  physicians  and  dentists’  

• Imhotep  à  considered  as  the  “founder  of  medicine”;  afterwards  he  was  to  become  a  deity  (worshipped  as  a  god  of  healing)    

• Merit-­‐Ptah  à  first  woman  physicians  known  by  name  in  the  history  of  medicine    

 Ancient  Egyptian  medical  knowledge      

• Primarily  based  on  careful  observation  and  some  degree  of  experimentation  i.e.  assessment  of  what  worked  and  what  did  not    

• Some  reliance  on  magic  superstition    o Usually  prior  to  medical  treatment  or  for  diseases  with  no  external  

manifestations  (usually  associated  with  influence  of  evil  spirits)    • Moderate  knowledge  of  anatomy    

o External  and  internal    § E.g.  mummification    

For  high-­‐profile  individuals:  usually  the  brain  would  be  extracted  through  the  nostrils  with  hooks  via  the  nostrils.  The  abdominal  contents  and  lungs  were  then  extracted  and  placed  in  separate  preservation  jars.  The  body  would  then  be  washed  and  soaked  

Continuum  of  health  care