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The primitive world Mesopotamia Egypt India China Greece Rome The primitive world Medicine and pharmacotherapy are one of the oldest human activities The therapeutics system combined empirical, rational, religious, and magical elements The priest, the sorcerer, and the medicine man Ancient civilizations The Nile Valley The Tigris-Euphrates Valley about 4000 BC The Indus Valley about 3500 BC The Yellow River Valley about 1500 BC Mesopotamia Sumerian (4000-2000BC) Babylonian (2000-1350BC) Chaldean (612-539BC) Mesopotamia A big contribution to the development of pharmacy and medicine Cures involved a spiritual - religious purification and catharsis Dual nature of cleansing – the purification of both soul and body last out in medical practice for centuries Healers were much respected in society and belonged to the most educated classes Mesopotamia plant drugs, wound washing, plasters and bandaging mathematics, geology and metallurgy, astrology and astronomy early systems of weights and measures manufacture of soap, leather, vinegar, beer, wine and glass extract natural plant aromas and animal products Mesopotamia Clay tablets – sumerian language, cuneiform More than 250 plants Myrrh, poppy, thyme, castor seed, liquorice, storax, peppermint, cannabis, mandragora, opium, oils Animal products - milk, honey, waxes Animal excreta are also mentioned - to disgust the evil spirits Mesopotamia Numerous pharmaceutical forms – aqueous and oil extracts mixtures decoctions medicinal wines enemas poultices ointments King Hammurabi 1795 – 1750BC Hammurabi’s Code Medical and surgical practice regulated Diagnosis and treatment became separated from the preparation of medicines Apothecaries (= the perfumer ) First druggist’s stalls or shops in about 1900BC Resume Significant contribution to the advancement of pharmacy More than 250 used drugs, many dosage forms Regulation of medical practice The first apothecary shops The first international trade Egypt Egyptian civilisation arose about 4300 BC, and collapsed 1087 BC Egypt then fell under the control of Libyans, Nubians, Asyrians, and Persians. In the conquest of Alexander the Great Egypt became a centre of the Ptolemaic Empire and then Roman Empire Egypt inscriptions on tombs, ceramics and papyri a picture language spirits, demons and evil forces Thoth the inventor of science and medicine Imhotep deified in Egypt in Greco – Roman times. Egypt Egyptian physicians generally specialized in one part of the body, priestly titles Diagnosing and treating disease and making medicine separated The pastophor preparer of medicines member of the priestly profession highly respected member of society The Papyrus Ebers George Ebers, a German Egyptologist about 4,5m length 875 prescriptions 700 drugs vegetable, animal and mineral sources Other medical papyri deal with gynaecological, surgical and veterinary matters Materia medica about 700 drugs vegetable, animal and mineral origin spices, castor seed, poppy, accacia, senna, opium… the animal sources include milk, liver, waxes, excreta… the minerals include alum, stibnite (antimony), salt, copper carbonate Materia medica wines, beers and milk as excipients for their liquid medicines honey, a part of pills, waxes for ointments the range of formulations included infusions, decoctions, teas, gargles, inhalations, snuffs, fumigations, lozenges, pills, enemas, suppositories, poultices, lotions and plasters Resume Significant contribution to the advancement of pharmacy 700 drugs vegetable, animal and mineral sources Sophisticated dosage forms Specialization India Beginning about 3250BC Mohenjo-Daro, Harappa 2800-2500BC Vedic Age 1500BC The Vedas - the earliest sacred books Rigveda, Samaveda Yajurveda Atharvaveda The term Ayurveda was given to the ancient Indian system of medical sciences The Ayurveda is considered to be a branch of the fourth Veda, the Atharvaveda. Ayurveda had reached a high stage of development during the period of Atreya, i.e. 1500 BC By this time, medical science had already developed eight specialized branches, namely: (1) internal medicine (2) paediatrics (3) psychotherapy (4) oto-rhino-laryngology (5) general surgery (6) toxicology (7) geriatric (8) the science of virility Charaka the Physician Sushruta the Surgeon They are believed to have lived about 300 BC Charaka Samhita Sushruta Samhita Charaka Samhita More than 2000 drugs the substances and their properties described their action explained measures and dosages defined Materia Medica Sandalwood, cinnamon, cardamom, asafoetida, ginger, pepper, aconite, licorice… Drugs and spices were basis of trade with the Romans and later played an important part of history Medical Education: Medical education became institutionalized Universities of Takshashila and Nalanda in the North India Well-organized institutional type of training in all aspects of medicine both theoretical and practical Anatomy, including dissection, and physiology Aetiology Pathology and pathogenesis Therapeutics Climatology Pharmacology Medical and surgical procedures The Ayurvedic system Three doshas Kapha (phlegm) Vaata (wind/spirit/air) Pitta (bile) existing in a balanced proportion in health A disturbance in this balance resulted in disease. State Control of Medical Practice: Before undertaking the practice of medicine or surgery, the medical graduate had to obtain the permission of the king University education was compulsory Stated by Sushruta Resume A high stage of development of medicine More than 2000 drugs Compulsory university education China The Yellow River Valley about 1500 BC China Shen-nung pents‘ ao Legendary emperor Shen –nung Compilation of medicinal texts Confucianism and Taoism Confucius (557- 479 BC) was a social reformist and a teacher. Confucianism teachings were practical, they were later turned into a very elaborate set of rules and practices. Lao-zi (born in 590 BC), was the founder of Taoism. Their philosophies are still important in the Chinese culture, and have helped shape the practice of Chinese medicine. Basic principles The Yin Yang Theory The Five Elements Theory The Meridian System Yin Yang Theory According to the philosophy, yin and yang are complementary opposites within a greater whole. Everything has both yin and yang aspects, which constantly interact, never existing in absolute stasis. Yin Yang Theory Yang Light Bright Temperature Hot Position Upper Action Movement Direction Outward Physiological functions Excitatory Yin Dark Cold Lower Rest Inward Inhibitory The Five Elements Theory The Meridian System Chinese food therapy Chinese herbal medicine Cupping Acupuncture Moxibuscion Fire cupping Moxibuscion Chinese herbal medicine Shen-nung pents‘ ao (Classic of Herbal Medicine) 365 Chinese medicines 252 plant origin 67 from animals, 46 from minerals. Three categories The first category - non-toxic (Panax ginseng) The second category - could sometimes be toxic and should be used carefully for certain ailments (Ephedra sinica) The third category toxic substances with side effects specifically used for therapeutic purposes to treat diseases (Croton tiglium) Pents‘ao Kang-mu by Li Shin-chen (1596) Described more than 1000 plants 450 animal substances 11 100 prescriptions 52 volumes Classification Chinese physicians used several different methods to classify traditional Chinese herbs: The Four Natures The Five Tastes The Four Natures Cold Cool Warm Hot The Five Tastes Pungent Sweet Sour Bitter Salty Each taste has a different set of functions and characteristics Pungent herbs are used to generate sweat and to direct and vitalize qi and the blood. Sweet-tasting herbs often tonify or harmonize bodily systems. Sour taste most often is astringent or consolidates, Bitter taste dispels heat, purges the bowels and get rid of dampness by drying them out. Salty tastes soften hard masses as well as purge and open the bowels. In traditional Chinese medicine (TCM), herbal therapies are generally formula based and single herbs are rarely used. Prescription Monarch Minister Assistant Guide Monarch the ingredient that exerts the major and leading effects in a formula Minister known as the associate ingredient to support the monarch drug treat the accompanying symptoms or coexisting disharmony pattern Assistant the ingredients can play one of the following roles to force the effects of the monarch or minister drug to treat the less important coexisting disease to eliminate the toxicity of the monarch and minister ingredients Guide two different functions to force the actions of the formula on the target meridian area of the body to harmonize and integrate the effects on other drugs Alchemy Alchemists can be considered the first pharmacists. In their search for the magic elixir of life, alchemists experimented with different methods of combining chemicals and minerals to create new medicines or tonics. Resume Sophisticated medicinal system Specialists for pharmacy Pharmacies Prescription Greece Ancient Greece between 600 – 150 BC Part of Roman Empire Byzantine Empire Asclepeion Greece medicine was closely associated with religion in its beginnig. Sick people went to the temples, treatment there included diet, bathing, exercise and some religious ceremonies, these temples were told asclepeion. Hippocrates Ιπποκράτης (ca. 460 BC – ca. 370 BC) one of the most important figures in the history of medicine The Hippocratic Corpus contains textbooks, lectures, research, notes and philosophical essays on various subjects in medicine. There is also the text of The Hippocratic Oath. Anatomical knowledge wasn't the strong point of Hippocratic medicine, there was a religious ban on the dissecting of cadavers. His theory of humoral pathology became basis of medicine for following centuries. Pharmacists Rhizotomoi Migmatopos – seller of mixtures Pharmacopoeos – maker of medicine Pharmacopolos – drug seller who traved from market to market Myropoeos or myrepsos – maker of ointment Roma Roman Kingdom 753 BC – 509 BC Roman Republic 508 BC – 27 BC Roman Empire 27 BC The Western Roman Empire collapsed in The Eastern Roman or Byzantine Empire endured until 1453 Pedanius Dioscorides Πεδάνιος Διοσκορίδης (ca. 40-90) an ancient Greek physician, pharmacologist and botanist wrote a five-volume book De Materia Medica, Περί ὕλης ἰατρικής a base to all modern pharmacopeias De Materia Medica more than 600 plants, 35 animal products, and 90 minerals. habitat botanical description properties or type of action medicinal usage and side effects quantities and dosages instructions on harvesting, preparation and storage methods of adulteration and test for detecting adulteration the veterinary, magical, and nonmedical usages location Claudius Galenus Γαληνός (AD 129 – 200/217 ) a prominent Roman physician and philosopher of Greek origin His theories dominated and influenced Western medical science for over a millennium. His major contribution lay in his classification of drugs by their pharmacological effects, based on their qualities in humoral pathology organised the pharmacotherapy of humoral pathology into a system of rigid and dogmatic procedures and rules The system divided drugs into three groups. The first group - simples, they are defined as hot, cold, dry or moist, each simple is further categorized by degree of strenght The second group - composites, compounded drugs, they were also categorised by their strenght The third - remedies that had a specific action – emetics, evacuants and diuretics In his medical treatises Galen described 473 drugs of vegetable, animal or mineral origin and many formulas of for compound drugs. Three remedies were supposed to be panacea – a remedie for each illness. Hiera picra Terra sigillata Theriaca Galenic concepts dominated pharmacy and pharmaco- therapeutics until the sixteenth century, many of his ideas persists much longer. Galen brought order to drug therapy various forms of vegetable drugs are still referred as galenicals the preparation and testing of medicaments has long been known as galenics Roman physicians were responsible for making drugs, but they too employed special preparers of remedies or owned slaves trained to do pharmaceuticals. pharmacopoei – makers of remedies pharmacotribae – drug grinders unguentarii – makers of ointments pigmentarii – makers of cosmetics pharmacopolae – sellers of drugs pharmacopollae circumforaneae – itinerant vendors of drugs sellularii – vendors of drugs, who kept shops or stalls aromatarii – sellers of spices pharmacist, as now known, had not still evolved