0.05. Evidence-proof medicine from magic before searching for immortality with the fall of the Roman Empire, Christianity began to displace the Greco-Roman culture. New religion destroyed old temples and took

0.05. Evidence-based medicine from magic before searching for immortality

With the fall of the Roman Empire, Christianity began to push the Greco-Roman culture. The new religion destroyed the old temples and took control of all aspects of the life of the flock, from birth to death. Sex medicine of antiquity moved to the background.

Christianity was not only a religion of salvation, but also a religion of healing. Most wonders, manifested by Jesus and Christian saints, was medical. Jesus treated blindness, deafness, paralysis, leprosy, water and other diseases that are difficult to identify. In total, a thirty-one cure case is mentioned in the New Testament.

Many Christian saints specialized in the treatment of certain diseases. To St. Anthony applied to get rid of the grinding inflammation, to St. Vita – from Khalei, St. Rokhu – from the bubonic plague (this saint is easy to learn in the images on a plague bubon on the leg), to St. Sigismund – from fever, to St. Lavrentia – from back pain. St. Apollonia, who lost his teeth during torture, was protected from dental pain, now on her day of her memory we celebrate the international day of the dentist. The patrons of all medicine were the brothers of Kosma and Damian, who were simultaneously burned, clogged with stones, crucified and sawed, but they remained alive until they cut off their heads. One of the people shown by them was that, by amputating the patient an affected gangrea leg, they put the leg of the dead mara in her place. This frequently found in painting the plot is not confused with anything: the rescued is depicted with the legs of different colors – white and black.

For help to the saints, they treated either in prayers, or ordering a special service in the church. The stained glass challenges of the Holy Trinity in the Canterbury Cathedral eloquently indicate secular medicine in her place: the doctors depicted on them in despair turn away, being unable to compete with the healing gift of St. Foma Canterbury.

However, professional medicine continued to exist. Antique treatises have persisted and copied in monasteries that began to play the role of not only spiritual and intellectual, but also medical centers. It was at them that the first public hospitals and the first pharmacies were opened, where in the role of doctors and pharmacists the monks were performed for a long time.

At the same time, Greco-Roman medicine persisted in Arab countries, which thanks to the atmosphere of religious tolerance for several centuries became the center of culture and science. The most famous doctor of the Arab Middle Ages was the developing ideas of Galen Ibn-Sina, known in Europe as Avicenna.

Thanks to the Arab influence from the VII century, the revival of secular medicine began in Europe. Already in the VIII century, the first specialized medical school in Salerno opened in history. The study in it was built on the study of surviving ancient and Arabic texts – primarily Galen and Avicenna. After Dad Alexander III banned the monks to make blood consumption, secular medicine finally returned to themselves after the positions. Already more than two dozen universities trained the medical case. There was a developed network of pharmacies, including those located outside the monasteries. The independent professions of the surgeon, which makes bleeding and simple surgical manipulations, and pharmacist manufacturing drugs, began to develop.

The effectiveness of treatment that has offered this developed, diverse and profitable industry, a little differed from the fact that they offered prehistoric and antique doctors. In addition to the enema, the laxative and bloodletting, which constituted the basis of therapy, there was an incredible amount of drugs. For example, a pharmacope created in the XII century Antidotarium Magnum. contained 1100 recipes, sometimes very complex in the manufacture. However, the opium remained almost the only active agent until the opening of a new light, which added two drugs borrowed from American Indians. The bark of the hardwood turned out to be an effective antimalarial means, and Ipecacuana is a vomit.

Some of the distinguished drugs in the Middle Ages and the revival of drugs were very colorful. So, Pavel Eginsky who lived in the VII century, left detailed recommendations for the treatment of various blood diseases. With a breath, he recommended soviet blood, with kidney stones – goat. Blood lamb allegedly helped from epilepsy, and bearish – from injections. The crocodile, which, probably, was not easy to get, increased the sharpness, and the blood of bats solved any breast problems – however, it helped for some reason only virgins. One of the recipes of the XIII century offers to mix the oil from the puppy, from which the skin sodes alive, with the parts of the body of the vulture, goose, a bear, fox, wolf and seven other substances. Even the London Pharmacopus of the Enlightened XVII century contains recipes from worms, crushed precious stones, ants, wolves, spiders, feathers, hair, human sweat, cobwebs, saliva, the eye of the crab, human urine and lichen with a skull of the deceased violent death.

The most expensive medicine was made from a non-existent animal. The horny of the unicorn treated fever, plague, epilepsy, forgetfulness and poisoning. It was sold for the amount of gold, tenfoldly exceeding his weight. In terms of current prices, the four-kilogram horn cost approximately 150 thousand dollars. Those who could not afford so expensive treatment, bought just one penny of the United Nichrobe Drink: a glass of water, missed through hollow horn.When Danish merchants were deciding whether to invest in unicorn horns, they ordered a zoological examination that determined that all the horns on the market once belonged to male narwhals. Although this lowered the price somewhat, overall the drug's popularity was not greatly affected.

Until the 17th century, preparations from the mandrake, the root of which resembled the human body, were in great demand. Popularity was provided by the myth that it is a strong aphrodisiac. It was believed that when the mandrake is pulled out of the ground, it squeals and the one who hears this screech will die or go crazy. Therefore, the miners took serious security measures: while one dug up the root, the second muffled the cries of the mandrake, blowing the horn with all his might. There was another safe way: to tie a dog to a plant, and then beckon it with food – the dog rushed to the food and pulled out the mandrake.

Another medicine available only to wealthy nobility was a crushed Egyptian mummy. Like any very expensive medicine, it supposedly cured almost every known ailment. The problem of fake mummies has been the subject of several medical conferences. According to the famous 16th-century surgeon Ambroise Pare, all the mummies on the French market were made from the bodies of gallows stolen from the scaffold. However, Pare believed that fake mummies "are no worse than those brought from Egypt, because there is no sense in either of them." By the way, if the medicine was made from real Egyptian mummies, it could be deadly: the components that the ancient Egyptians used for mummification contained a large amount of lead and, if ingested, could cause serious poisoning.

“Now, Mr. Billy Bones, we will see what color your blood is.”

Perhaps none of the methods of treatment was not so popular and did not claim so many lives as bloodletting. It is curious that it was practiced in different eras, in various parts of the world and cultures, by magicians and secular doctors.

Bloodletting is more than three thousand years old. The first mention in ancient Egyptian papyri dates back to the second millennium BC. Bloodletting was used in the Ayurvedic medicine of ancient India, where almost all of its varieties were used: vein dissection, blood banks, leeches, and even medical scourging to the point of blood. Originating in China and spreading around the world, acupuncture also probably originated from a more bloody procedure and only relatively recently transformed into the current bloodless version. Bloodletting was done by the Indians of pre-Columbian America, tribes in Africa and Northern Australia, the natives of Tasmania, the inhabitants of Patagonia, Fiji and Sumatra, the latter burying “bad blood” in the ground so that evil could not return to the patient. Although the magical meaning of the procedure was often forgotten, sometimes healers remembered that along with the blood, the evil spirits that had settled in it left the body.

When Danish merchants were deciding whether to invest in unicorn horns, they ordered a zoological examination that determined that all the horns on the market once belonged to male narwhals. Although this lowered the price somewhat, overall the drug's popularity was not greatly affected.

Until the 17th century, preparations from the mandrake, the root of which resembled the human body, were in great demand. Popularity was provided by the myth that it is a strong aphrodisiac. It was believed that when the mandrake is pulled out of the ground, it squeals and the one who hears this screech will die or go crazy. Therefore, the miners took serious security measures: while one dug up the root, the second muffled the cries of the mandrake, blowing the horn with all his might. There was another safe way: to tie a dog to a plant, and then beckon it with food – the dog rushed to the food and pulled out the mandrake. Another medicine available only to wealthy nobility was a crushed Egyptian mummy. Like any very expensive medicine, it supposedly cured almost every known ailment. The problem of fake mummies has been the subject of several medical conferences. According to the famous 16th-century surgeon Ambroise Pare, all the mummies on the French market were made from the bodies of gallows stolen from the scaffold. However, Pare believed that fake mummies "are no worse than those brought from Egypt, because there is no sense in either of them." By the way, if the medicine was made from real Egyptian mummies, it could be deadly: the components that the ancient Egyptians used for mummification contained a large amount of lead and, if ingested, could cause serious poisoning.“Now, Mr. Billy Bones, we will see what color your blood is.”

Perhaps none of the methods of treatment was not so popular and did not claim so many lives as bloodletting. It is curious that it was practiced in different eras, in various parts of the world and cultures, by magicians and secular doctors. Bloodletting is more than three thousand years old. The first mention in ancient Egyptian papyri dates back to the second millennium BC. Bloodletting was used in the Ayurvedic medicine of ancient India, where almost all of its varieties were used: vein dissection, blood banks, leeches, and even medical scourging to the point of blood. Originating in China and spreading around the world, acupuncture also probably originated from a more bloody procedure and only relatively recently transformed into the current bloodless version. Bloodletting was done by the Indians of pre-Columbian America, tribes in Africa and Northern Australia, the natives of Tasmania, the inhabitants of Patagonia, Fiji and Sumatra, the latter burying “bad blood” in the ground so that evil could not return to the patient. Although the magical meaning of the procedure was often forgotten, sometimes healers remembered that along with the blood, the evil spirits that had settled in it left the body.Bloodletting came to Western medicine from ancient times: already Hippocrates recommends bleeding the patient until he loses consciousness. "Materialistic" humoral medicine explained the application of the method by the need to remove excess blood. Galen, with his usual thoroughness, described in which places to cut the veins and how much blood to release, depending on the season, age, sex and temperament of the patient. He recommended bloodletting for fevers, inflammation, trauma, angina pectoris, amenorrhea [24], dementia, hepatitis, gout, epilepsy, and, paradoxically, bleeding. Galen also prescribed prophylactic bloodletting: healthy people with a calm character should get rid of excess blood in advance with the onset of spring.

The ancient Greeks and Romans used several techniques, but the simplest and most popular was

phlebotomy

– dissection of the vein with a sharp instrument. There were disputes between supporters of bloodletting, in which part of the body to make an incision, closer to the sore spot or as far as possible from it, and which days to choose. The usefulness of the method was not in doubt.After the fall of the Roman Empire, with the work of Galen, bloodletting penetrated into the Arab countries, where its variant, called

hijama

(from the Arabic "sucking"). First, a jar is placed on the patient, in which a vacuum is created, burning a piece of tissue in it – this causes a noticeable swelling. After some time, the jar is removed, several incisions are made, it is re-placed in the same place and left there until the blood stops flowing. The Prophet Muhammad himself was treated with hijama and recommended it to his friends. In one of the most authoritative collections of hadiths [25], Jami at-Tarmizi, it is mentioned that on the night of the journey to heaven, the angels conveyed a message to the prophet: “O Muhammad, order your people to put the banks.” Arab doctors not only placed blood banks, but also used copious bloodletting for pain relief during childbirth or when reducing a dislocation.The analgesic effect was achieved by the fact that due to the large blood loss, the patient lost consciousness for a while.

Bloodletting returned to Europe with ancient medicine and remained the most common procedure until the 19th century. They treated most of the diseases known to doctors of that time: fever, cancer, acne, herpes, strokes, pneumonia, tuberculosis, colds, epilepsy, dementia, gout, gangrene, and even coma. In England, at most abbeys, there were houses of bloodletting – phlebotomaria, where the monastic brethren on certain days of the year relieved each other and patients of excess blood.

Over time, this role shifted from monks to barbers. However, the popularity of the procedure was so great that representatives of various professions competed with hairdressers: doctors, pharmacists, wandering leeches and even tinkers, who, moving from village to village, offered not only to “tin, repair, solder”, but also to release blood for anyone. Hirudotherapy, or treatment with leeches, is an equally ancient and no less popular method of bloodletting. These annelids attach themselves to the skin of the victim and, biting through it, feed on blood. Their saliva contains substances that prevent blood clotting and cause local anesthesia. They have been used since ancient Egypt, but their popularity peaked in Europe in the 18th and 19th centuries: in the middle of the 19th century, France alone imported up to 40 million leeches a year. The use of leeches was not safe: one leech can suck out no more than ten milliliters of blood at a time, but taking into account the violation of blood clotting, the loss can be up to fifty milliliters. And since some doctors put up to fifty leeches at a time, their use led to serious blood loss.

The understanding that the heart pumps a finite volume of blood through a closed system of blood vessels came only in the 17th century thanks to the work of William Harvey. Until then, there was no idea of ​​the cyclic movement of blood.In accordance with the teachings of Galen, it was believed that all venous blood is re-formed in the liver, which means that the loss of even a large volume of blood is not terrible. Bloodletting was done repeatedly, while the total blood loss could be up to two liters per day. Since the volume of circulating blood is approximately equal to four liters, this posed a serious threat to health. Patients treated with bloodletting often already suffered from dehydration, injury, and blood loss. In such cases, the patient needs an immediate restoration of blood volume, and by applying bloodletting, the doctor did the exact opposite and dramatically reduced the patient's chances.

As a result, bloodletting has become one of the deadliest treatments in the history of medicine and has likely claimed tens of thousands of lives. Many contemporaries understood this. This is how Molière's play The Imaginary Sick (1673) parodies the commission examining a medical student. The student is asked how to treat various diseases, and he confidently answers all questions with the same phrase: “Enema, bleed, give a laxative.” After that, the satisfied examiners solemnly declare him a doctor and issue a certificate for the right to "with impunity to drug, feed laxatives, bleed, cut, stab and kill throughout the Earth."

Enemas, emetics, bloodletting, and laxatives were often used simultaneously, aggravating dehydration and worsening the patient's condition. For example, one of the recommendations of the German psychiatrist Heinrich Neumann looks like this: “The patient should be put on a strait chair, tied, bled, put 10-12 leeches on his head, cover his body with ice towels, pour 50 buckets of cold water on his head and give him good taking laxative salt. Probably, this was done with the best of intentions, but you will not envy the patient.

With a serious illness, the chances of surviving such treatment in a patient are small. Bloodletting was the main method of dealing with the cholera epidemic in 1831.Cholera in itself causes the strongest dehydration, leading to death, and the bloodletting made in this background deprived patients of the last chance of recovery. The number of those who died during this epidemic could be much less if not for the well-free interference of doctors. It is noteworthy that some of them drew attention to negative results, but instead of casting doubt on the feasibility of treatment, they launched discussions about

when

It is better to apply it. So Great was the conviction that the technique recommended by their teachers and the great authorities of the past could not be erroneous.

☛ Among the victims of blood consumption were very famous people.

The King of England Karl II, which ruled in the second half of the XVII century, suffered a stroke, after which the courthery lacquers were released from it 700 milliliters of blood. The king died, and his doctors had been prudently fled. Lord Byron died of encephalitis, passed before this several sessions of bloodletting approaching his death. According to one of the versions, Mozart died due to an attempt to treat rheumatoid fever intense bloodsucms and laxatives. And the first President of the United States George Washington died after the sadness of a cold, the doctors released more than two and a half blood liters from it. Napoleon Bonaparte suffered an intense bloodletting and survived, but after that he began to call medicine "science of murderers."

Why did the United Nogi not worked How could it turn out that the huge millennium has offered almost exceptionally inefficient medicines and procedures? There were several reasons, but a significant role was played by the selection of treatment by logical reasoning, the starting point for which was served the erroneous understanding of the body of the body, the mechanisms of the disease and the principles of action of certain substances [26].Cognition is a consistent process, it is impossible to jump over several steps in it. To understand the causes of fever, you need to be at least to know about the existence of microorganisms.And this is impossible until a microscope has been created. The development of the microscope should be preceded by the development of optics and the emergence of technologies, allowing to create lenses of the desired force and quality.

Then you need to establish a link between a specific bacterium and a disease, and this is a separate, not always simple task [27]. Then examine the physiology and biochemistry of the pathogen, to understand how it feeds and breeds, and only then we can assume that a certain substance can stop its reproduction or kill it. And the assumption will not necessarily be correct, before obtaining a reliable result, there will be still a lot of steps. Even now, when we know the pathogens of most infectious diseases and well studied them, the development of new antimicrobial and antiviral substances is extremely complex and more often ends with the failure than success.

If we were waiting for all these steps and we would be able to offer an antibacterial drug formula based on the deep knowledge of the biology of causative agents of the disease, we may have lived the 20th century without antibiotics. Accidents helped open Penicillin, and behind him and other medicines. But we were ready for this chance: Microbiology helped to understand the meaning of what happened, the level of development of chemistry and physics allowed first to allocate the drug from natural raw materials, and then synthesize it. The ancient Egyptians who treated the inflamed wounds by moldy bread crusts were probably faced with a similar chance. But the level of knowledge and technology did not allow it to interpret it correctly and create antibiotics for thousands of years earlier.

However, every generation lives hereby, using those tools and knowledge that already exists at his disposal. The patient will not wait a few centuries: treat patients and teach new doctors now. Therefore, from the century in the age of medicine, it relies on the modern ideas about the mechanisms of the disease, whatever far from reality they are. For teaching medicine, medieval universities resorted to help Scholastics