2 the beginnings

Chapter 2 / The Beginnings 9

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2 The Beginnings

CONTENTS

MYTH AND MAGICMESOPOTAMIAEGYPT

It is part of the human condition to attempt to describe, explain, and control nature. This is seenin the Paleolithic representations of animals and ancient skull surgery. In the Mesopotamian

civilization, more accurate anatomical descriptions serve more sophisticated divinational pur-poses. In early ancient Egypt, a specialized system of medical practice is supported by more detailedanatomy and speculation on the function of some body parts.

MYTH AND MAGIC

The compulsion to describe nature, for whateverreasons, the need to interfere physically to alleviateillness, and the drive to control one’s destiny aredeeply engrained human activities with roots at thebeginnings of homo sapiens: The evidence is uni-versal and ancient. For the vast majority of human-kind, throughout almost all of history, natural events,such as the rising and setting of the sun and thewaxing and waning of the moon, are compellingillustrations of vital significance. They are signs oromens of humans’ place in an all-encompassingdrama of life, a drama that involves both natural andsupernatural forces.

Explanations of natural phenomena are immedi-ate and complete in themselves. Take, for example,the terrifying phenomenon of lightning: Who did it?In the myths of Northern Europe, the answer is, thegod, Thor. Why did he do it? To show great anger,as witnessed in the flash and the roar. How did hedo it? By throwing a magic thunderbolt, or bystriking his gigantic mallet on a great flintstone.If any further explanation is needed, Thor is amember of a large family of gods who fit into anall-embracing assemblage of supernatural beings,which gives similar explanations of naturalevents. These divine beings provide an overarchingcosmic structure that is responsible for the past,determines the present, and controls the future. The

10 The Rise of Experimental Biology

mere description of the phenomenon suffices; nofurther details are needed. The importance of thephenomenon lies in its relevance to the supernatu-ral scheme of nature, and this is what is explainedand argued about. Such explanations are global andancient, and clearly satisfy a basic human need.The thunder god is universal and tenacious: Theoriginal Zeus of Greece and Guamansuri of ancientPeru; in Nigeria, the traditional god of war andthunder of the Yoruba tribe is Shango, who carriesa lightning spear (Fig. 2.1). This god is still wor-

shipped today in the African-derived cults of Cen-tral America and Brazil, and in the present-daySanteria religion of Cuba. His likeness can beenpurchased today in any Santeria (Botanica) shop inthe Little Havana district of Miami. In English-speaking countries, we still commemorate Thor inThursday.

But besides providing interpretations of naturalphenomena, the religious belief system had towork, in the sense that it had to contain kernels ofpractical knowledge for supplying essential needs

Fig. 2.1. Religious explanations of natural phenomena such as thunder are universal. Wooden sculpture of the NigerianYoruba tribe god of thunder, Shango, holding his spear. (From Peter Lutz, 2001.)


(Bernal, 1965). Although diverse cultures talked agreat deal of nonsense about explanations, thosethat survived acted with a great deal of sense. Thisis a necessary condition, i.e., the group’s actionswith respect to getting food, providing protectionfrom disease, making tools, weapons, fortifica-tions, and so on—all must be practical and suc-cessful to the degree that allows the tribe, city,empire to survive against natural forces and otherhuman rivals. They must be able to predict whencritically important seasonal changes will happen,such as when winter starts, when rain will come, orwhen to gather and when to sow the crop. To thisend, the priest has sacred formulas to encourage orcompel the gods to cause the sun to rise each day,or to end winter. Through this secret knowledgethe priest has the power to change the future byinvoking prayers that will avert, defeat or deflectpestilence. These functional requirements areembedded in all of the widely diverse particulars ofthe mythological formulas that regulate law andbehavior in different cultures throughout the world.However, early civilizations share one commonfeature: The most important and essential ritualsare practiced in specialized powerhouses, thetemples, by expert professionals, the priests.

As societies became more complex, so did theirreligions. In sophisticated ancient Rome, it wasbelieved that the world was full of little gods thathad to be invoked on special occasions, even to the minutiae of life. There was the god, Vatican,who caused the infant to utter his first cry;Fabulinus, who prompted his first word; and Cuba,who guarded him when old enough to exchangethe cradle for cot (Osler, 1921). The priests wereresponsible for interpreting exquisitely detailedomens. Specialized Roman augurs read the will ofthe gods from the patterns of flying birds and theirsounds. But even more, there was one set of priestsfor eagles and hawks, and another set for swifts andowls. No war was undertaken and no decisionmade, no matter how small, until the priests hadread the omens.

In contrast to religious dogma, natural explana-tions of the natural world, its properties, and their

changes, do not depend on, or even use, the inter-vention of a god or spirit. In contrast to mythologi-cally driven accounts, a close examination of thephenomenon is important: Natural explanations aredependent on detail. Initially, the most plausibleexplanation is the one that is in closest agreementwith current knowledge of natural forces. This isestablished by argument. Later, the proposedexplanations are subjected to increasingly rigor-ous tests of demonstration and experimentation.Here we are involved in a chain of explanations, inwhich the immediate natural cause has a naturalcause, which itself must have a natural cause, andso on. In principle, we are on a path ad infinitum,or one that halts at some ultimate cause.

However, building up a corpus of descriptionand explanation of the natural world requires theluxury of a group of people that has the leisure notto work for a living, so that they can spend theirtime reading, writing, and discussing: a philoso-pher class. The freedom of this privileged groupdepended on the stable social organization of thecity-state, the material wealth of which was sup-ported by the labor of an underclass, usually boundslaves. The development of a system of record-keeping, writing, which could transmit knowledgefrom generation to generation, was a critical ele-ment in this process. Such conditions arose in theancient civilizations of China, the Indus Valley,Mesopotamia, and Egypt. Once a critical popula-tion mass was reached, technical revolutions hadto provide the essential material bases of these civi-lizations. An increased population density couldonly be supported by higher productivity. Conse-quent practical innovations included the domesti-cation of animals, higher-yield agriculture throughthe selection of grain crops, and the techniquesof pottery, brick making, and metal work. Forexample, through the experience of trial and error,the Egyptian smiths gradually developed a highpractical knowledge of metallurgy. They found thatthe hardest bronze was made of 12% tin and 88%copper, that decreasing the tin content resulted in asofter bronze, and that increasing it resulted in a morefragile product (Bernal, 1965). Increasingly accurate


anatomical descriptions also appear in these earlycivilizations, but they mainly serve in divination.

MESOPOTAMIA

Although civilization flourished in ancientIndia and China, the strongest roots for the futuredevelopment of science lie in the Middle East, thetrue start of our story.

The area between the Tigris and Euphrates riv-ers, in what is now Iraq, is the site of ancientMesopotamia, homeland of one of the world’s firstcivilizations. Settlements there have been dated asfar back as 10,000 BC. About 5000 BC, the Sumeriancivilization was established. One of the greatestrulers of Mesopotamia, Hammurabi, who ruledfrom his capital Babylon about 1790–1750 BC,caused a massive pillar of stone to be erected, whichcontained the Codex of Hammurabi. Although pri-marily a legal document, concerned with propertyrights, it also laid down the law for medical andveterinary practice. A sliding fee schedule is givenof payments and penalties for treatments to gentle-men, slaves, and domestic animals (Sarton, 1952).The Codex provides a fascinating picture of therobust dangers to both doctor and patient of ancientsurgery, and describes the first managed healthcare: “If the doctor shall treat a gentleman and shallopen an abscess with a bronze lancet and shall pre-serve the eye of the patient, he shall receive tenshekels of silver. If the doctor shall open anabscess with a blunt knife and shall kill the patientor shall destroy the sight of the eye, his hands shallbe cut off or his eye be put out” (Gardner, 1965).

Veterinary surgeons were similarly regulated,but less vulnerable to such drastic malpractice con-sequences: “If a veterinary surgeon perform amajor operation on an ox or an ass and has causedits death, he shall give the owner of the ox or the assone-fourth of its value” (Sarton, 1952 ).

Several hundred cuneiform tablets concernedwith medical issues have survived. These dealmostly with prescriptions for illnesses, but a fewdescribe diseases, the causes of which were typi-cally spirits (one spirit for one type of ailment), and

Fig. 2.2. By as early as 3000 BC, hepatoscopy had becomean extraordinarily complex art in Babylonian prognosti-cation. A clay model of a sheep’s liver used to teach divi-nation in ancient Babylonia, about 2000 BC. Anatomicalfeatures are labeled by Singer (1957). Reproduced withpermission from Dover Publications.

Fig. 2.3. Imhotep, who lived in the twenty-seventh centuryBC, was later worshipped as the god of medicine in Egypt,and identified with the Greek god of medicine, Asclepius.A representation of Imhotep, the Egyptian god of medi-cine, Temple of Ptah at Karnak. (From Hurry, 1928.)


vive, made to assist or teach liver divination. Theearliest known, dating from about 2000 BC, is amodel of a sheep’s liver, with an included divina-tion text (Fig. 2.2). In many of these models, theliver is divided into lobes, then into squares, witheach square having its own special prognostica-tion. Surviving texts provide some of the rulesthat the priests used in their interpretations. Forexample, a gallbladder, swollen on the right side,indicated superiority in the king’s army, and wasfavorable; but swelling on the left side indicatedsuccess of the enemy, and was unfavorable. Along bile duct pointed to a long life (Jastrow, 1935).

EGYPT

Ancient Egypt is the first civilization with writ-ten records that show an extensive interest inmedicine. However, like all of the early civiliza-tions, Egyptian biological science was essentiallyempirical and pragmatic, dealing directly withmagic and healing, and with little interest in theory.

A hierarchical medical profession was estab-lished early in Egypt. Imhotep (Fig. 2.3), who livedin the twenty-seventh century BC, was consideredby Osler (1921) as “the first figure of a physicianto stand out clearly from the mists of antiquity.” He

Fig. 2.4. The earliest representation of circumcision. From the Necropolis of Sakkara, dated at the beginning of sixthdynasty. (From Castiglioni, 1958.) A stone knife was used for the operation.

the treatments often aimed at the expulsion of themalingering spirits (Frey, 1975).

There is abundant evidence of an interest inanatomy in the Babylonian-Sumerian Empire. Butthe details are sharply pragmatic—almost all areconnected to the art of divination, which is the tell-ing of the future through inspection of the organs ofsacrificed animals.

Organ divination was an important and special-ized skill, one that required many years of training.Of all the organs, the liver, from its size, centralposition, and richness in blood, was the most impres-sive. Furthermore, for generations blood wasbelieved to be the essence of life, so the blood-richliver was naturally regarded as the seat of life.Although other organs of the sacrificial animal hadtheir own specialized uses, reading the liver—hepa-toscopy—was the most important way to learn thedivine will.

By as early as 3000 BC, hepatoscopy had be-come an extraordinarily complex art in Babylonianprognostication. The lobes, gallbladder, swellingsof the upper lobe, and their markings, were all care-fully inspected by the priest. A large number oftexts were written on this topic, and many illustra-tive and anatomically accurate clay models sur-


Fig. 2.5. Hieroglyphic of case six in the Edwin Smith surgical papyrus. (From Breasted, 1930.)

was chief minister to Djoser, the second king ofEgypt’s third dynasty. In later times, Imhotep wasworshipped as the god of medicine in Egypt, andwas identified with the Greek god of medicine,Asclepius, in Greece. A physician class soon devel-oped that became powerful and specialized. Therewere physicians of the eye, stomach-bowel physi-cians, and “guardians of the anus” (Sarton, 1952).

The Egyptian concept of life differed from that ofMesopotamian medicine in that while the latter sawthe liver as the source of life-giving blood, the Egyp-tians apparently gave a greater emphasis to the act ofrespiration as central to life. They believed, quiteaccurately, that life failed when respiration stopped.

But blood was still important. The Book of the Deadrelates how the gods Hu and Lia arose from the bloodthat gushed from the sun god Ra, when he cut off hispenis, and mummies were painted red to give themthe strength of blood (Castiglioni, 1958).

Many medical papyri have been preserved,indicating the vast amount of biological/medicalknowledge in ancient Egypt. The oldest are ahalf-dozen or so from the period between 2000and 1500 BC, which are probably based on oldertexts dating to around 3000 BC (Frey, 1975). One ofthe oldest, the Kahun medical papyrus (ca. 2000BC), is the most ancient document on gynecologyknown. The largest, the Ebers papyrus, is 20 m


long, with more than 2000 lines. It begins grandly:“Here begins the book of the preparations of medi-cines for all parts of the bodies of a person”(Stevens, 1966). The Ebers papyrus contains 877recipes or prescriptions for a great variety of dis-eases or symptoms, systematically arranged andtreated in an orderly fashion, and some instruc-tions for surgery. For example, according to theEbers papyrus, male circumcision was performedat the age of fourteen (Fig. 2.4). The circumcisionof girls was also of general use in ancient Egypt(Castiglioni, 1958).

The most famous medical papyrus, the EdwinSmith surgical papyrus, written about 1700 BC, ismuch shorter, being only about 5 m long, and isavailable to us in a widely quoted translation byBreasted (1930). It deals, not with general recipes,but with definite cases. The Smith papyrus con-tains a systematic treatment of 48 cases of injuryand wounds, starting at the head and going to theshoulder region. It is likely that the rest of the bodywas dealt with in a continuation of the manuscript,now lost (Sarton, 1952).

The cases are systematically discussed underthe following formal arrangement: title, examina-tion, diagnosis, treatment, and glosses (an expla-nation of technical terms used). In 13 cases, the

Fig. 2.6. Some early Egyptian animal sculptures show a beautiful naturalism. A 3500 year old bas-relief, from the templeof Assassif, of an Egyptian panther.

opinion is that the wound is fatal, and not to betreated, i.e., there is a scientific interest in record-ing and discussing observable facts for which thereis no treatment (translation from Breasted, 1930).

One example (case six [Fig. 2.5]) deals with agaping wound on the head, penetrating the boneand revealing the brain.

Title: Instructions concerning a gaping woundin his head, penetrating to the bone, smashing hisskull, (and) rendering open the brain of his skull.

Examination: If you examine a man having agaping wound in his head, penetrating to thebone, smashing his skull, and rendering open thebrain of his skull, you should palpitate hiswound. Should you find that smash which is inhis skull like those corrugations which form inmolten copper, and something therein throbbing,fluttering under your fingers, like the weak placeof an infant’s crown before it becomes wholewhen it has happened there is no throbbing andfluttering under thy fingers until the brain of (thepatient) is rent open-and he discharges bloodfrom both nostrils, and he suffers with stiffnessin the neck.

Diagnosis: following this detailed descriptionis rather an anti-climax: “an ailment not to betreated.”


Egyptian medicine incorporated many funda-mental physiological observations about the liv-ing body that had been made from ancient times.But the Egyptians’ very complicated religionruled all. For them, the distinction between lifeand death was of especially deep concern. Theliving body is warm, breathes, and moves. Deathis the absence of these qualities, and the corpse iscold and still. The heart was the center of life. Itis the source of life-giving heat and the house ofthe soul. The rapid beating of the heart in anger,fear, and surprise indicated that these emotionsarose in the heart. It was believed that the pulsewas the heart “speaking” to the rest of bodythrough the blood vessels (French, 1978a). TheEgyptians, accordingly, treated the heart withspecial reverence during embalming: It waselaborately wrapped and carefully preserved in aspecial jar, or placed back in the body cavity. Thebrain, by contrast, was considered worthless. It

was removed part by part by a hook through thenose, and discarded.

Some early Egyptian animal sculptures show abeautiful naturalism (Fig. 2.6). In the period ofthe Middle Kingdom (starting about 2000 BC),however, the nascent rational and empirical spiritseen in the Edwin Smith papyrus graduallywaned and Egyptian science became fossilized,subsumed into magic and mysticism. An exampleof mystical logic, which will be referred to later;the number 4 became especially revered; therewere four columns to support the roof of thetemple, four sides of the pyramid, and medicinewas to be taken four times a day. We see then thatin some early civilizations, such as inMesopotamia and Egypt, there was an initial at-tempt to ascribe natural causes to some naturalphenomena. But the effort was not sustainableand was engulfed by overwhelming, conservativereligious forces.

2 the beginnings

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