1. Classical Ayurveda (aka Arsha Period or period of sages / rishis)—6th C. BC to 1000 AD Different kinds of physicians existed at this time—surgeons (shalya vaidyas or shalyaharas), physicians (bhishaks or rogaharas), bhishagatharvans (magic doctors), viÂaharas (poison curers), krityaharas (demon doctors).
2. Pythagoras is credited as founding the healing arts of ancient Greece.
3. Pliny and Solen borrowed heavily from Indian sciences.
4. Alexander the Great (356-323 BC) had Indian physicians.
5. Hippocrates (470 – 377 BC) opened a school on Greek isle of Eresus and christened it The Aesculupian. He was influenced by Greek, Egyptian, and Indian medicine. Hippocrates probably tried to liberate medical science from the speculative metaphysics and theocratic interests of his time. The humoral theory of disease of Ayurveda was accepted in modified state. His system of health was based upon 4 elements & 4 humors—choler-yellow bile (air), black bile-melancholy (earth), blood-sanguine (fire), phlegm (water), wherein a state of balance was equality of each of the humors. Elimination of excess humor produced balance. His new medical system advocated prevention by requiring person to eat in moderation, exercise, get fresh air, take proper sleep—“whosoever shall eat or drink more or less than he should, or shall sleep more or less, or shall labor more or less from idleness or from hardship, or who, used to being bled, refrains from doing so, without doubt he will not escape sickness.”
6. Galen (131-200 AD)
· adopted the Hippocratic humoral theory; practitioner need only diagnose the excessive humor
· codified plants to guide therapeutics
· notions of simple and specific arose to describe a single herb, which would have specific energy (s) – hot, cold, dry, moist in 4 gradations, low to high, and which would be applied in this energetic way according to the theory, without regard to patient progress of symptoms or folklore use of plants.
· this was a plant based system emphatically rejecting the medicinal use of mercury (banned by Rome)
7. Arabic medicine incorporated AV medicine in translation under patronage of caliphs Harun Al Rasid and Al Mansur.
8. Buddhism carried it into China and Southeast Asia. It’s asserted that teachings of Buddha gurus or Buddha included Ayurveda aphorisms
9. Tibetan scholars studied at Nalanda U.7th C. AD
10. During the Dark Ages formal training in Europe was limited mainly to monastics; during The middle Ages a rise of universities and opportunities for formal medical education was seen
11. Arab, Rhazes / Ar-Razi (869-925), practitioner
· at first following in the tradition of Hippocrates, medical practice became clinical medicine with teaching hospitals and learning as the bedside instead of in the lecture hall
· emphasis on environmental factors in disease etiology
· emphasized role of diet and hygiene rather than over-use of drugs; simple drugs rather than complex ones
12. Avicenna (980 – 1037) gifted practitioner at age 17
· Further systematized Galen’s work = million word Canon of Medicine (As-Qanum)
· Advocated astrology in diagnosis and treatment (patient and herb)
13. Philippus Theophrastus Bombastus, aka—Paracelsus (1493-1546)
· educated in chemistry/alchemy and medicine
· advocated simple compounds—plant or mineral, rejuvenative (not depletive) therapies prescribed according to one’s experience and not a theoretical framework
· often called the founder of modern medicine (chemical pharmacology) for his interest in “hidden principles” (active principle) of plants that were to be used as specifics for a given disease
· advocated homeopathic rationale (found in Greek medicine and German folklore)--similis similibus curentur--and the “Doctrine of Signatures”
· was concerned about iatrogenic disorders from strong poisonous medicines of the formally trained doctors and disdained the galenicals
· approved of minute dosing with mercury from earlier success by others using it for syphilis
14. In US notable sectarian movements arose and disappeared from early 1800’s to 1939
a. Herb doctors/ indian healers (non-sectarian)
· important herbalists include Jethro Kloos, Back to Eden, 1939
· with Paul Ehrlich’s work in organic chemistry and laboratory synthesized compounds that acted against syphilis and encephalitis-20th C. specialization of medical practice + influence of Eclectics saw herbals recede into background of medicine
· theory of disease apparently largely infectious as treatment was sweating, purging, and vomiting; disease was believed to start in the stomach with digestion
· education had three common forms: 1) University (Pa.), 2) teacher, 3) self experience; most practicing were of the first two types and pharmacists largely the form of the second
b. Thomsonians:
· popularized a patented, licensed technique involving only herbs to cause: stimulating, puking, steaming and shower bath, with such other directions as Dr. Thomson gives in his “New Guide,” discarding in toto cathartics, laxative, and other means advocated by (the other) well experienced botanic authors, but using lobelia emetics, scalding capsicum and herb teas, medicated enemas, and parboiling steam baths—in short internal and external scouring.
· decried education, theory, culture, education
· many of his followers carried his methodology to Canada, Mexico, Europe
· on the nature of disease Thomson advocated a vitalistic pathology in which disease was regarded as a unit, loss of body heat/fire (digestion) it’s cause, and fever proclaimed as a beneficent manifestation of the “life principle.”
· Affirmed the Hippocratic dictum “vis medicatrix naturae” and role of doctor to support it
c. Some of Thomson’s followers formed the Independent Thomsonians / Botanico-Medicals / Physio-Medical movement—came to advocate didactic, research-based, education/theory, apprenticeship rather than clinical instruction, different therapeutics than the Thomsonians—natural healing excluding poisonous plants, called sanative medication. This group accused others of using disease-producing remedies. Rejected was the Thomsonian reductionism that experience not necessary was reduced to the Thomsonian method: “Do as I say.”
d. Eclectics, those not interested in the Thomsonian methodology, homeopathy, or allopathy, exclusively,
· emerged as a sectarian movement advocating use, in succession: 1) phlogistics-antiphlogistics of plant origin only, 2) concentrates, 3) specifics
· their movement influenced growth and form of pharmacy (testing, quality control, standardization, etc.
· their motto was every man was responsible for himself—he should reject all authority and make no pledges (of alliance)
· interested only in efficacy not purity of their medications, but not an active-principle-based empiricism
· rejected germ theory and its treatment implications and held fast to their specifics
· John Uri Lloyd expert in phytochemistry, colloidal chemistry, manufacturing pharmacy; NF formed APA (American Pharmaceutical Assoc.)
· readily embraced any new perspective that worked
· eclecticism lives on in naturopathy, which after Lust’s death in 1947 formally documented and accepted 310 compounds defined in a rigorous manner.
· The value of a plan of theory of causation (bacterial pathogen, etc.) held by regulars/allopaths began to work against the eclectics with their hodge podge of specifics
e. Heroics / “Regulars”
· theory of causation phlogistics; treatment antiphlogistics—sweating, blistering, vomiting, purgation, blood-letting with lancet and leeches, cupping glass, minerals—tartarized antimony, mercury, Spanish fly, croton oil, ipecacuanha, etc
· use of mercury in syphilis effective enough to gain popular acceptance of mercury in medicine in the modern era.
· active medication to destroy the diathesis = magic bullets emerged to defeat infectious diseases as the “germ theory” took hold; penicillin esp. in 1929.
· Rush was the important champion of this approach—served Geo. Washington
f. Education and related considerations:
· As a matter of record that most important difference among the factions rested more on therapeutics than on a difference of medical science (theory of causation)
· The Flexner Report decried the eclectic schools and lauded such as Johns Hopkins Univ., which led to funneling of $91 from Rockefeller’s General Education Board into the schools the likes of Johns Hopkins; laboratory research and clinical based instruction became the mandates of a medical education
· Social change moved away from seeking physicians self made, self-educated to educated, certificated
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