J Scull writes biographies and historical articles. Occasionally, he writes about common social issues impacting people in general.
Those who remember Dr. Leonard McCoy or Bones in the original TV series Star Trek and in other subsequent reboots of the show, will most likely recall him referring to 20th century level medical procedures as “barbaric.” Ironically, the nickname “Bones” originated with the term “sawbones” used to refer to military doctors during the American Civil War who performed large numbers of amputations.
Today, we look back at many ancient medical procedures as either barbaric or totally ineffective. Advancements in science have opened the way for improvements in medicine that have allowed humans to increase their life expectancy from 36 years in the late 1800s to a global average of 72.6 today.
As people routinely live into their 90s, even their 100s, the average life expectancy horizon is continually expanding thanks to advances in medical sciences. As scientific discoveries break new ground, humanity comes closer to understanding the complexity of disease and aging. Today, medicines and treatments are available that save innumerable lives.
From the attempts made by Edward Jenner in 1796 to use a rudimentary form of inoculation to push back on the deadly smallpox virus to today’s vaccines which have wiped out many diseases of the past, medical science continues to break new ground. Diseases such as tuberculosis, cholera, rabies, polio, and measles have either been totally eradicated or are in the process of being relegated to the annals of history. Even the dreaded Ebola will soon be confronted with new vaccines that are already approved or in the process of receiving government authorization.
Advanced surgical procedures which include organ transplantation, coronary artery bypass, cancer removal and much more, are done routinely. Surgery has advanced from the traditional method of slicing into a patient manually to cutting edge laparoscopic techniques. Robotic surgery or as it is often called robot-assisted, allows doctors to perform procedures with more precision, flexibility and control.
In the 21st century we are fortunate to have medical treatments available to us that our ancestors could not have even imagined.
The following past medical procedures give us a glimpse into the world of our ancestors. The challenges they faced and how often the purported cure was worse than the disease.
In medical terms apoplexy is a condition of bleeding within internal organs. Modern health care professionals describe different types of apoplexy, mainly ovarian, cerebral or pituitary. Today, cerebral apoplexy is commonly known as stroke or the sudden loss of consciousness due to the rupture or occlusion of a blood vessel leading to lack of oxygen in the brain.
Even within medical circles the word apoplexy is not a very common term. Apoplectic, on the other hand is a more frequently used word which means being furious with uncontrollable rage. However, in the 1700 and 1800s the word allowed for a simple explanation of sudden loss of consciousness often leading to death.
Since the 20th century strokes have been normally treated with blood thinners, tPa clot buster, Alteplase, a drug used for heart attacks and stroke, statins for lowering cholesterol, antihypertensive drugs and ACE inhibitors for widening the arteries.
In the 1800s, however, treatments for the dreaded apoplexy included:
- Bleeding the patient or bloodletting of approximately two cups of “bad blood.” This was done in order to balance the humors which were identified as blood, phlegm, black bile and yellow bile. Usually performed with a fleam, a blood letting tool.
- Stimulate the circulatory system. This was done through cupping and scarification for the purpose of wet cupping. The dry cupping would be done over the neck and arms in order to create areas of large welting.
- “Strong glisters” or enemas would be administered.
- Holding a red hot fire shovel near the patient’s head for further stimulation.
- A poultice, also called a cataplasm, which is a paste made of herbs, plants, and other substances with “healing” properties would be applied to the souls of the feet.
- Submerging the patient’s hand in boiling water.
While today a vast majority of stroke victims survive and can be rehabilitated back to health, in premodern times the survival rate for apoplexy was dismal.
The first reported cases of epilepsy go back to Assyrian texts dated circa 2,000 B.C. Multiple references to this condition can also be found in the ancient writings of all civilizations including the Greek medical books of the Hippocratic collection. In his book On Sacred Disease Hippocrates referred to the need of craniotomy to be performed at the opposite side of the brain of the seizures, in order to spare patients from “phlegma” (phlegm) that he felt caused the disease.
The first advancements into the treatment of epilepsy, however, did not occur until the disease was finally separated from religious superstition that promoted the idea of it being due to divine punishment or demonic possession. It was in the 18th century that William Culen (1710–1790) and Samuel A. Tissot (1728–1797) accurately described various types of epilepsies opening the way to new procedures in modern epileptology.
However, the invention of EEG, advances in neurosurgery, the development of antiepileptic drugs, and the understanding of the pathophysiological mechanisms involved did not come until during the 20th century. Today, while epilepsy cannot be cured with drugs, seizures can be kept under control for great portion of the time. About 80% of those suffering from this disease can control their seizures with these medications.
In previous centuries epilepsy was simply known as the “falling disease”, as it was known during the time of the Babylonians. Other civilizations called it an ictal period which originates from the Latin word “ictus” meaning blow or stroke. Irrespective of how it was called, most of the treatments for this complicated disease in which sufferers fell to the ground trembling and foaming from their mouths, for the most part bordered on hocus pocus.
The Book of Phisick written in 1710 by an anonymous author, describes a strange treatment that called for the hair of a strong young man and the bone of a deer to be cooked and powdered. The concoction was to be fed to the sufferer of epileptic fits two days before a new moon. The logic behind the treatment stemmed from the belief that a full moon was the worst time for a person suffering from the falling disease as the lunar cycle triggered madness.
Avicenna, (c. 980 AD) a Persian-speaking Iranian physician, made various recommendation on treating epilepsy in his book The Canon of Medicine. Most had to do with administering various herbs, natural substances and following ketogenic-type diets which he felt eased the symptoms and incidence of epileptic fits. He recommended abstinence from olives, celery, coriander, leek, radish, turnip cabbage and broad bean. On the other hand turtle blood and camel brain were highly recommended.
While these treatments were totally ineffective, they were however, innocuous to the patients with the exception of his recommendation that patients who suffered from epilepsy swim in tanks with electric eels. Keep in mind these sea creatures are capable of producing a shock of up to 500 volts of electricity. Four times the voltage electrical outlets in U.S. homes produce.
Interestingly, ancient Egyptians also recommended the exposure to electric fish to cure this disease. In their case they recommended contact with an electric marine ray in order to treat epilepsy.
While potentially deadly, rabies is a preventable viral disease that spreads to humans and other mammals through bites or scratches by a rabid animal. In the United States, rabies is mostly found in racoons, bats, foxes, skunks and cayotes. Cats are the most common household pets to carry the rabies virus. This is because many cat owners do not vaccinate them and allow them to be exposed to wildlife which in turn often carry the rabid virus. On a global scale, however, dogs are the most common animals to carry the disease, with 99% of the rabies cases being the result of dog bites.
The rabies virus causes inflammation of the brain. Early symptoms include fever and tingling at the site of exposure. These are followed by violent movements, over excitement, hydrophobia, confusion and paralysis in certain parts of the body. Eventually, loss of consciousness and nearly always death. The time period between contracting the virus and the start of symptoms can be between one to three months but in rare occasions as much as a year.
In 1885, two French scientists Louis Pasteur and Emile Roux, developed the first rabies vaccine, which is 100% effective if it is administered prior to the onset of any serious symptoms. Once the symptoms described above are evident, the disease is unstoppable and eminent death is assured.
Prior to the development of the rabies vaccine, treatments were woefully inadequate as the bite from a rabid animal was a virtual death sentence. Despite this, doctors attempted to save the patients through various methods which included incantations, incising the affected area and herbs. Dog movements were restricted during lunar eclipses as they were thought to be more susceptible to rabies during this time.
Many treatments in 16th century Europe were based on nothing more than old myths and folklore. They instructed the afflicted to ingest 40 grains of ground liverwurst, 20 grains of pepper in half a pint of milk. To take this quantity four mornings in a row, followed by a cold bath every day for a month. After the madness had begun, the patient was to sip tea made of cinnabar, musk and syrup of cloves with an alcoholic beverage. Follow this treatment for 30 days and then repeat. Unfortunately, at the end of the 30 days the patient would not need further treatment; death would have come well before that.
Syphilis is a sexually transmitted disease (STD) caused by a highly infectious bacterium called Treponema pallidum. It can be passed through sexual contact as well as through blood transfusions or mother to fetus in the womb. If not treated, syphilis can cause irreversible damage to nerves, brain and body tissues.
The disease typically progresses through four stages, although not all may be evident.
- Primary phase: In this stage a painless sore or chancre appears at the site of the infection; usually the male or female genitals. The sores are highly infectious and develop 2 to 3 weeks after infection and heals spontaneously after 3 to 6 weeks. Although the sores heal, the disease is active and will progress to the next phase.
- Secondary phase: Develops 4 to 10 weeks after the chancre has disappeared. This stage has many symptoms which include fever, joint pain, muscle aches, sore throat, flulike symptoms, whole-body rash, headache, decreased appetite, swollen lymph nodes and patchy hair loss.
- Latent or dormant phase: This is a stage characterized by an absence of symptoms. While patients are asymptomatic, they are still contagious. This phase usually occurs 12 months after infection.
- Tertiary Phase: With the advent of penicillin, few people reach this stage. It usually takes years, even decades to enter tertiary syphilis. During this stage the heart, brain, skin and bones become affected. Late stage syphilis can cause strokes as well as dementia characterized by cognitive deterioration, hallucinations and disturbances in behavior.
Today, syphilis is easily treatable with penicillin. However, prior to the development of antibiotics, this disease was quite intractable. Up till the turn of the 20th century treatments for the disease were at times painful and toxic. The best treatment available to doctors at that time was administering mercury to patients indefinitely.
This potentially lethal liquid metal was used to make the patient salivate, which was thought to expel the disease. However, the treatment carried many unpleasant side effects including gum ulcers and teeth loss. The usage of mercury gave rise to a saying about lovers: “one night with Venus, a lifetime with Mercury.”
Other dire measures used to treat syphilis were the use of arsenic and deliberately infecting the patient with malaria. This latter treatment was done with the idea that a high fever would kill the bacteria. Thankfully, the development of penicillin ended these barbarous treatments.
A migraine headache is a moderate to severe throbbing pain that occurs episodically. Often on one side of the head, it carries other symptoms such as nausea, weakness as well as sensitivity to light and sound. It can last from several hours to as long as three days. Although researchers believe migraines to have a genetic component, there are several other factors that can produce symptoms.
These factors vary from person to person and can include stress; anxiety; hormonal changes in women; bright and flashing lights; noise; strong smells; too much to eat; not enough to eat; overexertion; tobacco; caffeine; overuse of migraine medication.
Foods and ingredients can also trigger migraines. They include alcohol; chocolate; aged cheese; some fruits and nuts; fermented foods; yeast; processed meats.
Migraines are often preceded by an aura, a type of sensory disturbance which can include flashes of light, blind spots, vision changes and tingling in the hands or face. They are also associated with major depression, bipolar disorder, anxiety disorders, and obsessive compulsive disorder.
Approximately, 15% of people are affected by migraines making it one of the most common causes of disability.
Fortunately, there are many different treatment options for migraine sufferers which include antiepileptic and anticonvulsant medications, beta blockers, eye drops for ocular hypertension, hypertensive medicines, triptans and analgesics. Alternative therapies may include acupuncture, physiotherapy, massage for relaxation, and chiropractic manipulation.
In ancient times, however, migraines presented a stubborn problem for medical practitioners. Often, the cures were worse than the disease. Some of these ghastly and/or ineffective treatments included:
- Arateus of Cappadocia, an ancient Greek physician treated patients by shaving their heads and burning the flesh down to the bone. This was typically done on the forehead along the border of the hair.
- Ali ibn Isa al-Kahhal (“the oculist”) would lash a dead mole to the head of the patients suffering from severe headaches.
- Moses Maimonides, a 12th century physician and astronomer from Cordoba, Spain would recommend to patients to immerse in a bath of warm, honey-sweetened water in order to draw out the “vapors” that bring on the headaches.
- In 1762, the Dutch Society of Science espoused the usage of electric eels as a way of curing severe headaches. They wrote in one of their publications that when any South American slave complained of a bad headache, they should grab an electric eel with one hand and put the other hand on their heads. This would help the headache sufferer immediately!
- During the 19th century some doctors recommended lounging in warm tub with a small electric current passing through the water.
Also known as enterobiasis, oxyuriasis, seatworm infection or threadworm infection are small parasites that can live in the colon and rectum. They enter people’s bodies by the swallowing of their eggs. Also, when infected people touch their anus and the eggs attach to their fingertips. The eggs can then be transmitted to others through touch or contaminated clothing, bedding or food. The eggs can also live on household surfaces for up to two weeks.
Once the eggs enter the human body, they hatch in the intestines. While the infected person sleeps, the female pinworms exit the intestine through the anus and lay eggs on nearby skin. Many people have no symptoms at all, other than itching around the anus or vagina. The itching may become more intense at night and interfere with sleep. While the infection is more common among children, people of all ages are susceptible.
The best way to diagnose pinworm infections is by finding the eggs which can be accomplished by using a clear sticky tape. Mild infections might not need treatment, however if the patient does need medication, everyone in the household should take it as well.
To prevent becoming infected it is recommended to bathe after waking up; wash pajamas and bed sheets often; wash hands often, especially after using the bathroom and changing diapers; change undergarments daily; do not bite nails; do not scratch the anal area.
For those who prove positive for pinworms, the available treatments today are inexpensive and effective. Medications such as mebendazole, or albendazole are available. Both require a doctor’s prescription, but are inexpensive and easy to use. Also effective for pinworms is pyrantel pamoate which is available without prescription.
In ancient times, intestinal worms of any kind were extremely common and difficult to treat. The Book of Phisick from 1710 suggests creating a meat suppository tied to a string for easy removal. The idea was to entice the worms to make a home and consequently be trapped in the fake host. The suppository is removed and discarded. The process was to be repeated until the patient was free of worms.
Garlic has been thought to be a good home remedy for centuries in eliminating pinworms. In fact it is still used today by those who wish a natural, but unscientific way of getting rid of these worms.
It is recommended that the patient eat lots of fresh garlic as it will help to kill the pinworm during vowel movements.It is also recommended to make a garlic paste and apply it to the rectal area. It is thought the paste will kill the worms but also stop the itching by lubricating the area.
To make the paste, crush two or three cloves of fresh garlic and add three teaspoons of caster oil. The paste should have a high viscous consistency so that it can be rubbed in the anal area.