EVOLUTION of HEALTH CARE
Health care has developed leaps and bounds over the centuries. Scientists have realised great advancements in knowledge and technology allowing healthcare workers to accomplish many extraordinary medical feats such as organ transplants, in vitro fertilization, and neonatal care for, in some cases, incredibly premature babies. Still, the control of contagious diseases continues to present a challenge in both the developing and developed nations. Diseases such as Ebola and MRSA illustrate that care of the sick continues to be a cultural as well as a public health concern.
Throughout history, people have searched for remedies to heal the body - and we still are! In ancient civilisations healing was provided almost entirely by the family. Over time, buildings were established and physicians were employed to care for the sick. In many ways, the buildings of old resembled our more modern day sanatoriums, infirmaries and hospitals.
Medical and pharmaceutical influences have spawned from all corners of the globe, including The Greek and Roman Empires, the Middle East (Persia, Egypt and Arabia), the Far East (China and India), and the West (Europe).
Greek Influence
Greek Temples co-habited as healing centres. Physicians practiced medicine and apprentices learned the healing art at these "Sleep Temples."Admission and medical records were inscribed in columns of the temples leaving a rather permanent and public display. Treatments included herbal remedies, mineral baths, exercise, fresh sea air and sunshine. Sounds like a cross between a modern day spa and rehab centre, does it not?
Hippocrates is known as the “Father of Medicine.” He lived between 400-300 BCE (Before the Common Era or BC - Before Christ). Hippocrates fulfilled the roles of a philosopher, a physician, and a pharmacist. His writings were valued in medicine for thousands of years. He used rational concepts based on objective knowledge to liberate medicine from the mystic and demonic. He believed that diseases were caused by nature, not as punishment from the gods. Hippocrates' theory of Crisis (the body reaches a point in which the disease will win or lose) led to the more modern concept of homeostasis. He believed that equilibrium could be attained and maintained in the body through a balanced diet and the use of drugs as a last resort. More than 200 drugs are mentioned in Hippocratic writing, including opium. Hippocrates also developed the theory of humorism which was believed and perpetuated by many physicians until proven by investigative science in the 1800s to be wrong.
Theophrastus is known as the “Father of Botany.” He was a philosopher and a botanist who lived from 371 to 287 BCE. Botany is the study of plants and is closely related to pharmacognosy, the study of the medicinal properties of living plants. Theophrastus classified plants by their leaves, roots, seeds and stems which in turn made a significant contribution to science.
Dioscorides is known as the "Father of Pharmacology." He was a Roman physician, botanist and pharmacologist but was of Greek decent. Dioscorides lived between 40 to 90 CE (Common Era or AD - anno domini meaning "The Year of our Lord"). He wrote De Materia Medica which remained a major authority on drugs for nearly 16 centuries. It contains descriptions of more than 600 plants and 90 minerals, preparation instructions (growing and preservation) and pharmacological effect (dosage, medicinal use and side effects).
Roman Influence
Claudius Galenus was a physician, surgeon and philosopher of Greek heritage in the Roman Empire. He lived from 130 to 200 CE. Galen organized humoral pathology (diseases as disturbances of body fluid called black bile, yellow bile, blood, and phlegm) into a scientific system following the theory first described by Hippocrates. He wrote “On the Art of Healing” which contains simple remedies and recipes, descriptions of compounded drugs and their properties and treatments (tinctures, fluidextracts, syrups, and ointments. Galenicals are no longer popular due to synthetic chemicals, antibiotics and biologicals, although the recent resurgence of homeopathy and naturopathy may see a renewed interest in his writings. Galen displayed a good understanding of Circulation due in large part to his experiments dissecting monkeys and pigs.
Eastern Influence
The Persian Empire of 3000-2500 BCE produced the Clay tablets of Mesopotamia. Nearly 800 clay tablets created during this era have been discovered describing over 500 remedies from plants and minerals.
Egyptian contributions to medicine were recorded on paper-like scrolls called Papyrus (pl. Papyri). The largest and oldest parchment scroll is the Ebers Papyrus written between 3000 - 1500 BCE and purchased by George Ebers in 1872. Ebers published a translation in 1875 using English-Latin vocabulary complete with an introduction. The original scroll is 20 meters long and 30 centimeters wide. It is one of 11 medical scrolls that preserves knowledge of early Egyptian medicine containing information on more than 400 drugs and 877 remedies, including an internal medicine reference, diseases of the eye, skin, extremities, gynecology and some surgical diseases. The scroll also describes anatomical and physiological terminology and use of mortars and pestles, hand mills, sieves, and scales.
The Kahun Papyri is a collection of scrolls with texts dated as far back as 1825 BCE which were discovered in 1889 by Flinders Petrie. Fragments of the papyrus are concerned with gynecology and describe such things as methods of diagnosing pregnancy, predicting the sex of the fetus, treating toothache during pregnancy, diagnosing diseases of women, and preparing and/or using feminine drugs, pastes and vaginal applications.
The most famous and elaborate Egyptian papyrus is named for the man who purchased it in 1862. The Edwin Smith Papyrus dates back to 1600 BCE but is thought to be a replica of a much older manuscript. It is approximately 5 meters long containing 377 lines of script in 17 "pages" or columns. The scroll is chiefly concerned with surgery in that it describes 48 surgical cases of wounds of the head, neck, shoulders, breast and chest. The scribe did not proceed past the thorax and in fact it ended abruptly in mid-sentence. Manifestations of individual cases are listed followed by prescriptions for each case .
Ancient documents (dated: 700-800 CE) have also been found in Arabia describing syrups and jams as dosage forms to deliver active ingredients such as aloe, senna, clover, and camphor. Mary Poppins may have been the first to sing the song "A Spoonful of Sugar" but the Arabians were the first to discover the secret to masking the bitter taste of medicines.
China made a significant contribution to medical and pharmaceutical knowledge, and to modern day Complementary and Alternative Medicine (CAM) through the work of Shen Nung (Emperor Shennong) at around 2737-2698 BCE. Shen Nung is also known as the "Father of Chinese Medicine", the "Father of Agriculture" and the “Patron of Pharmacists.” He is said to have personally tasted more than 365 herbs to test their medicinal value and perhaps? as a result died of a toxic overdose. Shen Nung inspired Pen Ts’ao Ching loosely translated as the "Divine Husbandman’s Classic Herbal" or "The Divine Farmer's Herb-Root Classic." Prior to its discovery, Wu Shi Er Bing Fang or “Recipes for 52 Ailments” was thought to be earliest Chinese pharmacopoeia dated at a mere 215 BCE.
Ayurvedic medicine originated in India around 1000 BCE and continues to be practiced today. Nearly 2,000 “drugs” are mentioned in the original writings including cinnamon and ginger, cardamom and turmeric, black pepper and licorice for internal use and mercury as an external antiseptic. Mercury is now know to be poisonous and therefore is not used in medicinal treatments.
Western Europe
The Magna Carta of Pharmacy was the first official document to declare pharmacy as an independent profession. It was a publicly proclaimed official Edict of 1231 written by Emperor Frederick II of Germany. Because of this, pharmacies were then subjected to government inspections and pharmacists were obligated to prepare drugs as they were prescribed by physicians. The Magna Carta influenced the practice of pharmacy across Europe. At the time, herbs were the main source of medication. Information was largely taken from De Materia Medica as well as other knowledge from the Greeks, Romans, and Arabians. English, German and French monasteries preserved the information over time and added medicinal herbs grown in their vast gardens.
Paracelsus was a Swiss (German) chemist who lived in time period 1493-1541 CE. He is credited to have changed pharmacy from a botanical to a chemical science. He used drugs to overcome excess acidity and/or alkalinity and wrote the Pharmacopoeia (Recipe Book, Formulary, Dispensatory) known as the “Art of the Drug Compounder.” It contained official drug standards and was first published under government authority in 1546 in Nuremberg, Germany. It later became the official pharmacy resource in Augsburg, Cologne, Florence, and Rome.
Health care has developed leaps and bounds over the centuries. Scientists have realised great advancements in knowledge and technology allowing healthcare workers to accomplish many extraordinary medical feats such as organ transplants, in vitro fertilization, and neonatal care for, in some cases, incredibly premature babies. Still, the control of contagious diseases continues to present a challenge in both the developing and developed nations. Diseases such as Ebola and MRSA illustrate that care of the sick continues to be a cultural as well as a public health concern.
Throughout history, people have searched for remedies to heal the body - and we still are! In ancient civilisations healing was provided almost entirely by the family. Over time, buildings were established and physicians were employed to care for the sick. In many ways, the buildings of old resembled our more modern day sanatoriums, infirmaries and hospitals.
Medical and pharmaceutical influences have spawned from all corners of the globe, including The Greek and Roman Empires, the Middle East (Persia, Egypt and Arabia), the Far East (China and India), and the West (Europe).
Greek Influence
Greek Temples co-habited as healing centres. Physicians practiced medicine and apprentices learned the healing art at these "Sleep Temples."Admission and medical records were inscribed in columns of the temples leaving a rather permanent and public display. Treatments included herbal remedies, mineral baths, exercise, fresh sea air and sunshine. Sounds like a cross between a modern day spa and rehab centre, does it not?
Hippocrates is known as the “Father of Medicine.” He lived between 400-300 BCE (Before the Common Era or BC - Before Christ). Hippocrates fulfilled the roles of a philosopher, a physician, and a pharmacist. His writings were valued in medicine for thousands of years. He used rational concepts based on objective knowledge to liberate medicine from the mystic and demonic. He believed that diseases were caused by nature, not as punishment from the gods. Hippocrates' theory of Crisis (the body reaches a point in which the disease will win or lose) led to the more modern concept of homeostasis. He believed that equilibrium could be attained and maintained in the body through a balanced diet and the use of drugs as a last resort. More than 200 drugs are mentioned in Hippocratic writing, including opium. Hippocrates also developed the theory of humorism which was believed and perpetuated by many physicians until proven by investigative science in the 1800s to be wrong.
Theophrastus is known as the “Father of Botany.” He was a philosopher and a botanist who lived from 371 to 287 BCE. Botany is the study of plants and is closely related to pharmacognosy, the study of the medicinal properties of living plants. Theophrastus classified plants by their leaves, roots, seeds and stems which in turn made a significant contribution to science.
Dioscorides is known as the "Father of Pharmacology." He was a Roman physician, botanist and pharmacologist but was of Greek decent. Dioscorides lived between 40 to 90 CE (Common Era or AD - anno domini meaning "The Year of our Lord"). He wrote De Materia Medica which remained a major authority on drugs for nearly 16 centuries. It contains descriptions of more than 600 plants and 90 minerals, preparation instructions (growing and preservation) and pharmacological effect (dosage, medicinal use and side effects).
Roman Influence
Claudius Galenus was a physician, surgeon and philosopher of Greek heritage in the Roman Empire. He lived from 130 to 200 CE. Galen organized humoral pathology (diseases as disturbances of body fluid called black bile, yellow bile, blood, and phlegm) into a scientific system following the theory first described by Hippocrates. He wrote “On the Art of Healing” which contains simple remedies and recipes, descriptions of compounded drugs and their properties and treatments (tinctures, fluidextracts, syrups, and ointments. Galenicals are no longer popular due to synthetic chemicals, antibiotics and biologicals, although the recent resurgence of homeopathy and naturopathy may see a renewed interest in his writings. Galen displayed a good understanding of Circulation due in large part to his experiments dissecting monkeys and pigs.
Eastern Influence
The Persian Empire of 3000-2500 BCE produced the Clay tablets of Mesopotamia. Nearly 800 clay tablets created during this era have been discovered describing over 500 remedies from plants and minerals.
Egyptian contributions to medicine were recorded on paper-like scrolls called Papyrus (pl. Papyri). The largest and oldest parchment scroll is the Ebers Papyrus written between 3000 - 1500 BCE and purchased by George Ebers in 1872. Ebers published a translation in 1875 using English-Latin vocabulary complete with an introduction. The original scroll is 20 meters long and 30 centimeters wide. It is one of 11 medical scrolls that preserves knowledge of early Egyptian medicine containing information on more than 400 drugs and 877 remedies, including an internal medicine reference, diseases of the eye, skin, extremities, gynecology and some surgical diseases. The scroll also describes anatomical and physiological terminology and use of mortars and pestles, hand mills, sieves, and scales.
The Kahun Papyri is a collection of scrolls with texts dated as far back as 1825 BCE which were discovered in 1889 by Flinders Petrie. Fragments of the papyrus are concerned with gynecology and describe such things as methods of diagnosing pregnancy, predicting the sex of the fetus, treating toothache during pregnancy, diagnosing diseases of women, and preparing and/or using feminine drugs, pastes and vaginal applications.
The most famous and elaborate Egyptian papyrus is named for the man who purchased it in 1862. The Edwin Smith Papyrus dates back to 1600 BCE but is thought to be a replica of a much older manuscript. It is approximately 5 meters long containing 377 lines of script in 17 "pages" or columns. The scroll is chiefly concerned with surgery in that it describes 48 surgical cases of wounds of the head, neck, shoulders, breast and chest. The scribe did not proceed past the thorax and in fact it ended abruptly in mid-sentence. Manifestations of individual cases are listed followed by prescriptions for each case .
Ancient documents (dated: 700-800 CE) have also been found in Arabia describing syrups and jams as dosage forms to deliver active ingredients such as aloe, senna, clover, and camphor. Mary Poppins may have been the first to sing the song "A Spoonful of Sugar" but the Arabians were the first to discover the secret to masking the bitter taste of medicines.
China made a significant contribution to medical and pharmaceutical knowledge, and to modern day Complementary and Alternative Medicine (CAM) through the work of Shen Nung (Emperor Shennong) at around 2737-2698 BCE. Shen Nung is also known as the "Father of Chinese Medicine", the "Father of Agriculture" and the “Patron of Pharmacists.” He is said to have personally tasted more than 365 herbs to test their medicinal value and perhaps? as a result died of a toxic overdose. Shen Nung inspired Pen Ts’ao Ching loosely translated as the "Divine Husbandman’s Classic Herbal" or "The Divine Farmer's Herb-Root Classic." Prior to its discovery, Wu Shi Er Bing Fang or “Recipes for 52 Ailments” was thought to be earliest Chinese pharmacopoeia dated at a mere 215 BCE.
Ayurvedic medicine originated in India around 1000 BCE and continues to be practiced today. Nearly 2,000 “drugs” are mentioned in the original writings including cinnamon and ginger, cardamom and turmeric, black pepper and licorice for internal use and mercury as an external antiseptic. Mercury is now know to be poisonous and therefore is not used in medicinal treatments.
Western Europe
The Magna Carta of Pharmacy was the first official document to declare pharmacy as an independent profession. It was a publicly proclaimed official Edict of 1231 written by Emperor Frederick II of Germany. Because of this, pharmacies were then subjected to government inspections and pharmacists were obligated to prepare drugs as they were prescribed by physicians. The Magna Carta influenced the practice of pharmacy across Europe. At the time, herbs were the main source of medication. Information was largely taken from De Materia Medica as well as other knowledge from the Greeks, Romans, and Arabians. English, German and French monasteries preserved the information over time and added medicinal herbs grown in their vast gardens.
Paracelsus was a Swiss (German) chemist who lived in time period 1493-1541 CE. He is credited to have changed pharmacy from a botanical to a chemical science. He used drugs to overcome excess acidity and/or alkalinity and wrote the Pharmacopoeia (Recipe Book, Formulary, Dispensatory) known as the “Art of the Drug Compounder.” It contained official drug standards and was first published under government authority in 1546 in Nuremberg, Germany. It later became the official pharmacy resource in Augsburg, Cologne, Florence, and Rome.
One of the most significant contributions to the advancement of medical knowledge so far in the 21st Century has been the completion of the Human Genome Project which successfully mapped the entire DNA (deoxyribonucleic acid) sequence of the human body. This 13 year effort (1990-2003) involved contributions from 18 countries world wide. Canada joined the project in 1992 making it the 7th country on board. The Human Genome Project was coordinated by the United States Department of Energy and the National Institutes of Health.
The Human Genome Project could not have been completed without the initial discovery of DNA as a double-helix structure by Watson and Crick (and Rosalind Franklin) in the early 1950s. Other researchers had been investigating DNA as early as 1869.
Genetic analysis now enables doctors to screen people for serious diseases such as cancer (e.g. BRCA gene) as well as providing a new understanding of hereditary diseases to allow for development of treatments. Genetic analysis may soon be seen as standard procedure for diagnosing, treating and preventing diseases. However, this intricate knowledge has brought with it controversies (e.g. prenatal genetic testing) that require discussions by ethicists, researchers, and the public.
CHECKPOINT Question ONE: Complete the attached worksheet by visiting the American and Canadian Genome websites to improve your understanding of genetics and its impact on the medical field.
The Human Genome Project could not have been completed without the initial discovery of DNA as a double-helix structure by Watson and Crick (and Rosalind Franklin) in the early 1950s. Other researchers had been investigating DNA as early as 1869.
Genetic analysis now enables doctors to screen people for serious diseases such as cancer (e.g. BRCA gene) as well as providing a new understanding of hereditary diseases to allow for development of treatments. Genetic analysis may soon be seen as standard procedure for diagnosing, treating and preventing diseases. However, this intricate knowledge has brought with it controversies (e.g. prenatal genetic testing) that require discussions by ethicists, researchers, and the public.
CHECKPOINT Question ONE: Complete the attached worksheet by visiting the American and Canadian Genome websites to improve your understanding of genetics and its impact on the medical field.