As we mentioned in the introduction, this series will tell the story of drugs throughout
the ages, and there is no better place to begin a story than the beginning, so let’s
reach back in time as far as recorded history will allow.
As soon as human civilizations invented some form of written language and began documenting
their activities, early examples of applied medicine began to materialize.
The first known civilization emerged in what is now Iraq.
These were the Sumerians, who developed urban civilization around 4,000 BC in ancient Mesopotamia.
Their documents show that they studied astronomy, metallurgy, geology, mathematics and also
pharmacy.
The typical pharmacy compendia around 2,000 BC involved plant ointments, infusions, and
concoctions from poppies, peppermint, mandragora, thyme and many other herbs.
The Sumerians were already aware of the medicinal properties of cannabis and morphine.
They also used animal organs for their alleged medical properties, and even animal excrements,
to repel evil spirits.
A similar sort of “traditional medicine” emerged in practically every other organized
civilization, and a common thread linked them all.
They were all based on the systematic trial and error of all possible natural sources
of chemicals available, mostly from the world of plants.
The Egyptians left copious logs of their discoveries by way of a pharmacopoeia, which refers to
books and other documents containing lists of medicinal drugs, along with their effects
and instructions for their usage.
For example, the famous Papyrus Ebers dates from 1,500 BC and contains over 700 treatments
described in 100 pages of hieroglyphics.
This body of knowledge was probably acquired over many centuries.
The physicians in ancient Egypt belonged to the middle class, much like modern Western
societies, and they were highly respected.
They embraced magic and sorcery, but they incorporated pharmacy more and more as time
passed.
The ancient Egyptian deity Thoth was credited with the foundation of all scientific knowledge,
including the act of giving Egyptian physicians their knowledge of medicine and drugs.
In essentially every culture, the knowledge of medicine is represented as a gift from
the gods.
One might wonder if these gods were a creation of collective fantasy, or if they described
real historical figures endowed with advanced knowledge, and were therefore deified.
Western medicine, like most of Western culture, draws its origins from Greek thought.
In ancient Greece, the god who gave mankind the gift of medicine is Asklepios.
He is usually represented with a serpent-entwined rod, which may look familiar.
Its meaning is the object of speculation, but it is still used to represent the disciplines
of medicine and pharmacy today.
The symbol is unfortunately often confused with the Caduceus, a symbol of the god Hermes,
and therefore not a symbol of medicine and health care but rather of commerce and trade.
However, because of the similarity, the two images are often used interchangeably.
A temple in Asklepios’s honor was founded in Epidaurus, which could be considered the
first hospital in history.
Patients travelled from all over Greece to be treated there.
Patients would receive what was called “Pharmakon”, which in Greek means both “poison” and
“drug”.
This lack of distinction alludes to one of the most important underlying principles of
modern pharmacology, which is that the dose makes the poison.
This means that a drug can save your life or kill you, depending on the dose, a fact
which can be applied to any other type of substance, even those that we depend on for
life, such as water and oxygen.
One of the most famous doctors of all time, the legendary Hippocrates of Kos, practiced there.
Hippocrates lived from 460 to 370 BC, during the golden age of Athens.
This was an enlightened era characterized by democracy and freedom of expression.
Hippocrates has been seen, over the ages, as the founder of modern medicine, distinguishing
it as a discipline finally free of theology and philosophy.
Some of his precepts are used even today.
Among his professional principles, primum non nocere, which means “first, do not harm
the patient” is still recognized as a pillar of experimental medicine.
Hippocrates was probably the first medical practitioner who believed that diseases are
of natural origin, and not caused by astrological connections or evil spirits.
He supported humorism, which was the theory of the four humors, those being blood, phlegm,
yellow bile, and black bile.
At the time, disease was thought to be due to an imbalance of these four humors.
Although the theory had no true scientific basis, it must be credited as the first attempt
to create a foundation upon which to build fact-based medicinal practices.
His theory and his practice of medicine are collected in an impressive body of work called
the Corpus Hippocraticum, which remained an important reference through the Middle Ages.
It was a collection of about 70 medical treatises, originally written in Ionic Greek, probably
by his disciples and followers, and later translated into Latin, the official language
of science in Europe until the 18th century.
In particular, the section called Hippocratic Oath documents the ethics of medical practice,
and constitutes the most influential section of the Corpus Hippocraticum.
In fact, the current laws and guidelines defining good medical practice are derived from the
original work of Hippocrates.
After his death, the practice of medicine suffered a serious setback, mainly due to
political strife in ancient Greece.
Hippocrates’s work was eventually taken up by the Romans, who adopted the Greek mythological
origin of medicine, and renamed the god Asklepios as Aesculapius.
During the Roman imperial age, the most famous physician was Galen, also of Greek origin,
who lived during the second century AD.
Born in Pergamon, a Greek colony which is in present-day Turkey, he spent most of his
life in Rome, where, thanks to his exceptional knowledge and abilities, he became the personal
physician to several emperors, including Marcus Aurelius.
Medicine in ancient Rome had regressed, reintroducing elements of divination and mysticism.
Galen fought an uphill battle to apply and perfect the Hippocratic theory of disease,
based on the four humors.
In addition to surgery, Galen strongly promoted venesection and bloodletting as an approach
to disease, as opposed to divination.
Galen is famous for his approach to complex formulations of remedies and elixirs, and
to date the field of drug formulation is often referred to as “Galenics” in his honor.
Galen’s work, the Galenic Corpus, is truly immense.
It was written in Greek, which was the elite language in ancient Rome, and it was believed
to amount to over 500 treatises, equivalent to almost a million pages.
As the Western Roman empire collapsed, the political center of the Western world migrated
to Byzantium, the Eastern capital of the Roman Empire, and to the Arab world surrounding it.
The Materia Medica, a medical compendium widely employed in the West and based on Galen’s
work, was the bible of the medical profession until the 17th century, when elements of modern
science were finally introduced.
His work was translated into Latin and Arabic, and his tradition was slowly embraced by the
Arabs, who took his work a step further in the centuries that followed.
As the Arab world became the center of excellence in medical treatment during this era, let’s
move forward and learn all about that time period next.