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Ancient & Medieval Medicine: Crash Course History of Science #9

January 15, 2020


We’ve seen how, from around 400 BCE to CE
1300, ideas in astronomy, math, and engineering were traded all the way from Beijing to Delhi,
and from Baghdad to Constantinople. In the next episodes, we’re going to dive
into how some specific kinds of knowledge evolved over time. First up: healing. The history of medicine is about two of our
big questions: one, what is life? What makes it so special, so fragile, so…
goopy!? Two, how do we know what we know? Why should I take my doctor’s advice? Why are deep-fried Oreos bad for me? It may be tempting to look at medicine as
a science that has simply progressed over time—that medicine used to be bad, and its
history is a story of how it got better. And don’t get me wrong: we love modern medicine! You’ll have to take my word for it until
“Crash Course: Deep-Fried Everything” drops, but the science behind lipid transport
is just fascinating. Focusing on progress, though, obscures what
worked in the past. Ancient and medieval medicine worked for millions
of people. They understood their bodies as bounded by
rules. And regardless of what worked, early medical
systems allowed people to make sense of bodies and health. You may think that medicine is a technē,
or practically oriented knowledge. But today, we’re going to focus on systems
of medicine as world-ordering theories, or epistēmē. These theories were built up into a textual
tradition, in which doctors wrote down what they saw and cited earlier doctors when explaining
their treatments. So let’s turn to medical education. What textbooks would a would-be doctor read
in a given place and time? [Intro Music Plays] Let’s say you lived in Song Dynasty China:
you’d study machine-printed textbooks on traditional Chinese medicine, or TCM. In this system, humans are small pieces of
one vast organism called the Entire Dang Universe. All things within this system are composed
of five elements: fire, earth, metal, water, and wood. In TCM, health means a balance between two
forces, yin and yang, representing dark and light, femininity and masculinity, hot and
cold, and so on. Disease means imbalance. Thus healthcare means restoring balance, in
TCM, by manipulating the energy that flows through living bodies, called qi. You, the would-be doc, would learn all about
how to move qi around using acupuncture and acupressure, herbal therapies, exercise, and
prescription diets. If you lived in Gupta Dynasty India, you’d
also get down with a five-element theory of matter. But you would study the science of life, Ayurveda. You’d probably pick up the popular textbook
Charaka Samhita, or one of the other samhita—or “collections”—that could help you memorize
hundreds of named body parts. In addition to anatomy, the samhitas would
also teach you etiology, or what causes different diseases, and symptomatology, or what diseases
look like. When it came to treatment, your samhita would
have information on the eight specialites: the diseases of children, those of the elderly,
mental diseases, diseases of the sense organs, surgery, poisons and antidotes, and aphrodisiacs. You would learn the five karmas or actions
that were used for removal of toxins from body tissues. And, to prepare treatments, you’d learn
a lot about plants, minerals, and animals. But treating patients is only part of Ayurveda. The science of life concerns healthful living
in general, including how to prevent disease and influence hygiene and diet. What if you lived in, say, fourteenth-century
Bologna, Italy—home to one of the oldest universities in the world, which opened in
CE 1088! You would attend lectures, and you’d have
a hand-copied textbook, not made by a press as in Song China. The medical theories in your textbook would
be founded on Aristotelian biology and physics. Bodies are composed of four special bodily
humors. Each of these corresponds to one of the four
elements of Empedocles: blood, made of air, phlegm, made of water, yellow bile, made of
fire, and black bile, made of earth. Illness is an imbalance in the humors. Too much black bile, for example, causes depression. Treatment means restoring the right humoral
balance—like, with bloodletting. When too much of one humor built up in the
body, one way to restore a balance was to let some of the excess drain off. But the most common treatment, then as now,
was simply offering good dietary advice. Aristotle linked the four elements with the
humors, but he wasn’t a doctor. The oldest nuggets of humoral wisdom in Western
Eurasian medical textbooks were attributed to a physician named Hippocrates of Cos, which
means “Gregory House” in classical Greek. We know something of his life—he died when
Aristotle was in his teens—but we don’t have many surviving works by him. What we do have is a collection of texts of
various age and unknown authorship called the Hippocratic corpus. According to the corpus, Hippocrates I was
a fan of the Pythagoreans. (Remember, the secret math cult?) But his skepticism—or doubt that certain
knowledge is possible—set Hippocratic medicine apart from a lot of Greek natural philosophy. Hippocrates emphasized reason, observation,
and medical prediction. He emphasized that diet and the environment
influence health, not the direct will of the gods. And his oath—“do no harm”—still underpins
medical education. Hippocrates was the Jimi Hendrix of Eurasian
and North African medicine, innovating a new style that challenged traditional ideas. But Hippocratic physicians had to compete
among many schools of healers. It was a Roman named Galen who became medicine’s
Michael Jackson—the popularizer of a standard humorism that would last until the 1800s. Galen’s system absorbed the smaller, uneven
Hippocratic corpus. Galen was born around CE 130 in Pergamon. But he made his career in Rome, treating gladiators. This gave him lots of experience peeking into
the body while sewing up wounds. Eventually he got the offer of a lifetime:
court physician to Emperor Marcus Aurelius, who was a battle-hardened general, Stoic philosopher,
and all-around hardcore dude. Galen wrote a huge number of influential texts—supposedly
five hundred! Though only eighty-three survive today. These show that Galen built on the systems
of Hippocrates and Aristotle, but also made detailed notes on human anatomy drawn from
experience. He accurately observed how the larynx works
and demonstrated the the lungs fill up with air. Oh ya, and he innovated cataract surgery. But Galen definitely got some things wrong. One reason is that human dissection was illegal
in imperial Rome and the states that succeeded it. So a lot of anatomy was still guesswork based
on observations of animals. For example, dissecting sheep heads, Galen
identified a circulatory organ called a rete mirabile or “wonderful net” that is found
in animals like sheep and dolphins… but doesn’t actually exist in humans. After Galen, the most notable medical theorists
in the Greater Mediterranean weren’t Greeks or Romans, but Arabs or Persians who had access
to both Greek and Indian sciences. First among was the Persian polymath Abū
Bakr al-Rāzī —whose name also means “Gregory House.” Born in CE 854, al-Rāzī was prolific: he
wrote dozens of books, including detailed accounts of his cases. He is considered by many historians to be
one of the founders of several disciplines, from psychology to opthamology. And he was the first to describe smallpox
and measles as distinct diseases. Al-Rāzī also wrote for general audiences,
educating them about health and disease. Many of his works were encyclopedias based
on Greek humoral medicine and natural philosophy. His big one, al-Hawi al-Kabir or The Virtuous
Life, was a large, influential medical encyclopedia. Al-Rāzī was a unique dude who did exactly
what he wanted. Although he was one of the most scientific
doctors of his time, he also wrote works of Islamic prophetic medicine, al-tibb al-nabawi. This discipline, an alternative to the Hippocratic–Galenic
system, advocated traditional medical practices mentioned in the Qur’an. Al-Rāzī also influenced medicine by becoming
the first fan of Greco-Roman humoral medicine to beef with Galen! He wrote a book called Shukuk ‘ala alinusor—Doubts
About Galen—in which he said that his own observations contradicted some of Galen’s
claims. Remember nullius in verba—“on the word
of no one”—the motto of the Royal Society of London, founded in 1660? Al-Rāzī advocated this approach to medicine
circa the year 900, over seven hundred years earlier! But, if you were really a medieval Italian
medical student, the book you’d read probably wouldn’t be by Hippocrates, Galen, or al-Rāzī. Instead, you’d read a translated encyclopedia
featuring all of them. In doing so, you’d participate in the scientific
wonder called Scholasticism—or learning through close readings of approved texts that
recorded the observations and theories of earlier thinkers. Take it away, Thought Bubble! One of the all-time greatest hits of medical
education was al-Qānūn fī al-Ṭibb, or The Canon of Medicine. The Canon was written by another Persian polymath,
Ibn Sina, born in 980. Ibn Sina was widely seen as the best writer
to summarize and comment on the Greco-Roman doctors. His Canon became one of the most important
medical textbooks—and introductions to Aristotle’s physics—for six hundred years. Your textbook is really a mashup of several
different books. Each page is like an onion: at its heart,
one punctum or big idea by Aristotle, or Hippocrates or Galen. These are surrounded by layer upon layer of
annotatio, or notes, by famous physicians from distant cities such as Baghdad. Your main throughline are the summaries by
Ibn-Sina, whose name has been latinized as “Avicenna”. But there are notes by Latin translators such
as Gerard de Cremona or Constantinus Africanus, plus outer layers of notes by other medical
students. Maybe you even jot down your own. Thus—way before WebMD—you’re in conversation
with doctors from all across space! And time! In universities such as Bologna or Salerno,
you might also have access to another textbook, this one by… wait for it… a lady! Trota of Salerno wrote Practical Medicine
According to Trota and Treatments of Women, one of books of the The Trotula Ensemble. This group of three texts from around 1200
traveled widely throughout medieval Europe. The Trotula became foundational to gynecology
and all other topics related to women’s health. But you might not know that this foundational
text on women’s health was written by a woman, because her identity was systematically
written out of history until the late twentieth century. Because of course it was. Thanks Thought Bubble! So what was “life” for many educated people
in Asia and North Africa between roughly 400 BCE to CE 1300? Life was a universal property of which humans
were just interesting examples. Life was linked to the movements of special
fluids, which were the objects of medical treatments. Life was ultimately built out of a smaller
number of elements, and good health meant balancing fluids and elements in the right
way. How did we know what life is? For some physicians in classical Greece or
imperial Rome, careful observation and comparison to animals were crucial methods. Persian doctors, influenced by both Greek
and Indian ideas, synthesized earlier ideas, expanded evidence for them, and challenged
and reworked them. Why did you, medieval citizen, trust this
information? Because books told you to! And with that, dear student, we leave you
to deal with… the Black Plague of 1347. Bummer! Next time—we’ll deep-dive into the eternal
question of “what is stuff” with a group of thinkers who tried to “science” lead
into gold—the alchemists. Crash Course History of Science is filmed
in the Dr. Cheryl C. Kinney studio in Missoula, Montana and it’s made with the help of all
this nice people and our animation team is Thought Cafe. Crash Course is a Complexly production. If you wanna keep imagining the world complexly
with us, you can check out some of our other channels like Scishow Psych, Animal Wonders,
and The Art Assignment. And, if you’d like to keep Crash Course
free for everybody, forever, you can support the series at Patreon; a crowdfunding platform
that allows you to support the content you love. Thank you to all of our patrons for making
Crash Course possible with their continued support.

42 Comments

  • Reply Ashlee Knowlton January 19, 2019 at 2:44 am

    Why didn’t I know about this crash course series yet?!? Bad YouTube algorithm. Bad.

  • Reply Jose Hernandez January 28, 2019 at 6:15 am

    modern times medicine just want money nature can prevent most, we just need modern for emgergency

  • Reply Abigail Savage January 31, 2019 at 4:53 am

    Did you really use ATLA element symbols omg I can't

  • Reply Corban Miniel January 31, 2019 at 3:06 pm

    Nice little doctor who easter egg you did there.

  • Reply Little Miss Positivity February 9, 2019 at 12:34 pm

  • Reply Wondreska Pearl March 3, 2019 at 6:29 pm

    What is with these elements in medieval times?

  • Reply Azzarinne March 9, 2019 at 2:13 am

    I'm so looking forward to Crash Course: Deep Fried Everything! XD

  • Reply Ronald Reagan March 15, 2019 at 7:23 am

    God that was boring. I was hoping for some fun facts about the technology of the time and ending up with a bunch of names and definitions. 3/10 wouldn’t recommend

  • Reply Matt Matti April 2, 2019 at 8:47 am

    The woman thing is wrong. She was only one of 3 others and her name was changed due to time. Idk where you got the idea that she somehow was systematically cast out

  • Reply firenz shah April 23, 2019 at 11:56 pm

    what is deep-fried oreo? I'm from Malaysia, among the largest Palm Oil producing countries and we never EVER deep fried an oreo. you sick…

  • Reply Andy Wilson April 26, 2019 at 9:49 pm

    this theme song is so much less stressful

  • Reply Charles Tucker May 1, 2019 at 5:11 am

    The Entire Dang Universe

  • Reply Denarius Wright May 2, 2019 at 1:19 am

    the history of medicine is such a vague thing!

  • Reply Fatt Philosopher May 12, 2019 at 1:36 pm

    You say Hippocrates was the Jimmy Hendrix of medicine, but Hendrix played the guitar left handed, while the animation has Hippocrates playing it right handed. Please correct this.

  • Reply Navesblue May 14, 2019 at 1:16 pm

    I'm actually wondering now if names have a prophetic affect on future careers. Hear me out: if I want my kid to grow up to become a doctor, then apparently I name him Gregory, if I want him to become a butler, I name him Jeeves, and if I want him to become a landscaper, apparently I name him José. Coincidence? I think not!

  • Reply Cool Lock May 15, 2019 at 3:06 pm

    Once again with this "whitewashing" of history! IMHOTEP of Egypt (a black African…yes, the original Egyptians were BLACK) was the "real" father of Medicine. He laid the foundation for the standard of treatment we see today! He was around 2,000 yrs. before Hippocrates was even born! in fact Hippocrates studied at one of his schools! IMHOTEP was written out of European history, so that Hippocrates can get the credit for most of IMHOTEP's genius. Don't get me wrong, Hippocrates was a very good "Student" of Medicine, and should be regarded as the "SON" of modern day Medicine. But the "FATHER" of modern day medicine, is IMHOTEP all day! Look him up…do your own research.

  • Reply Joshua Beard May 21, 2019 at 12:10 am

    Deep fried oreos are awesome but so incredibly rich that its hard to have more than one of them at a time

  • Reply KingSoutH KingSoutH June 16, 2019 at 11:18 am

    I don't understand why mention China here?? Bodhidharma was the most important person for China..if this person didn't visit China ,,means there is no such kungfu self defense or medicine would exist in China..i see very clearly that how people use media to spread good bad fake anything that will make them benefit..make the truth disappear and thinking they had successful destroy the truth..no such thing that dharma would let wrong doing win over ..stop dream ..absolutely no way..time comes it will make it work..

  • Reply David San June 17, 2019 at 11:13 am

    5:21 if he is Jimi Hendrix shouldn't he be playing a lefty guitar?

  • Reply Gaura Cappelletti July 1, 2019 at 6:14 pm

    He mentioned how ayurveda also uses five elements, but left out the fact that the elements aren't the same.

  • Reply taili huang July 2, 2019 at 10:49 am

    the five "elements" in TCM are NOT elements, but phases of change.

  • Reply SnoopyDoo July 15, 2019 at 7:13 pm

    I consult the Voynich Manuscript when I need medical advice.

  • Reply Jarin July 20, 2019 at 5:39 pm

    Avicenna is boss

  • Reply Your friendly neighbourhood nobody July 23, 2019 at 3:32 pm

    I have a passion for medical history and the evolution of medical architecture. I struggle to find good learning resources hhh.

  • Reply Marc Schneider August 9, 2019 at 6:03 pm

    I don't undrestand what gives him and the people who are commenting in a funny way the right to make a mockery of what the ancients invented ! You just don't have the right to do so, we currently live in a world which medicine is no longer a nobel art intended to cure the sick and discover about our lives instead is a meritocracy aiming to make millions of dollars to the gouverment and pharmaceutical industry.. never in the history of man kind we had such neurological diseases (Parkinson, adhd…) our brains are damaged by sodium florid and electromagnetic waves, our nervous systems are disrupted by halides, and you guys make fun of healing !! The elements he was talking about whether in western tradition such as in alchemy or greek tradition or in the east in Ayurveda serve as an allegory for both physical and psychological aspects such as intuition and feelings… all of this is important cause our bodies are not only organs and blood and bones we're also energy and when energy is unbalanced we are exposed to illness and disease. ancient medecine worked wonders and we should appreciate it and learn from it and apply it let along mock it

  • Reply Rowshon Nabi August 15, 2019 at 1:55 am

    You forgot to mention the most important Arab physician Al-Zahrawi, who invented modern surgery and some of his works are still used today in surgery, and even important is that from reading his books, Europe slowly began to borrow books on medicines from the east in masses and slowly began to come out of the dark ages.

  • Reply Vive l'Iran August 27, 2019 at 10:54 am

    Fun facts : Razi and Avesina Both Were Not Muslim and Both Were Persian not Arab

  • Reply Stephanie Hendricks September 2, 2019 at 11:30 pm

    I thought he would have had a banana…I mean chom chom as the textbook

  • Reply Linda Vilma Ole September 13, 2019 at 11:37 am

    An excellent summary… Thank you….

  • Reply Jon Patterson September 19, 2019 at 2:09 am

    5:56 just saying Marcus Aurelius was a total badass who had a an immense understanding of discipline and self control. He was probably the most powerful and rich person in Rome during the time, but, he still had such a strong control over himself that he never abused his power (at least from stories I’ve heard of him). If you have the time I would recommend you read his book “Meditations” it had an immense impact on me and can help you have great control over your actions and reactions to to things. Anyways that’s all I had to say I just like the fact that he was very briefly referenced in this video and figured I could leave a comment about him.

  • Reply Michael Pytel September 21, 2019 at 5:35 pm

    Did you know Hank Green 's name means Gregory House?

  • Reply Sordatos Cáceres September 25, 2019 at 2:07 am

    First thing I learned in this video: the existence of deep fried oreos…oh Americans

  • Reply Duan Torruellas September 29, 2019 at 4:19 pm

    Too much of one of the 4 humors , namely Black bile would cause melancholia.
    If I were constipated I'd be sad as well lol. But balance in important as is preventive medicine as well as proper diet
    and exercise. The balance of the 5 elements are important .
    This is why we take vitamins , they have your metals like copper zinc iron , and minerals
    That is the earth . Drink water stay warm and exercise that is the fire and breathe air which is the intake of the air element. Here all the 5 elements speaks to a modern western use of the 5 elements but the asians understand the true science of balancing these 5 elements and reading the imbalance just by feeling your pulse and the chi with they're hand.

  • Reply tnleung1 October 11, 2019 at 4:20 am

    Totally understate the history of TCM. Too Eurocentric

  • Reply Aspiah Macaurog October 22, 2019 at 7:08 am

    All living things with in this system are composed of five elements: Fire, Earth, Metal, Water, and Wood. Life was linked to the movement of special fluids, which was the objects of medical treatments. Life was ultimately built but of a smaller number of elements and good health meant balancing fluids and elements in the right way. And also Trotula became foundational to gynecology and all other topics related to women's health. But you might got know that this foundation text on women's health was written by a woman. Because her identity was systematically written out of history until the late 20th century.

  • Reply sanchita October 30, 2019 at 5:40 pm

    im still waiting for crash course deep fried everything. [not utting ideas in your head, but probably a good april fools tidbit teehee]

  • Reply Drake Dorosh November 7, 2019 at 5:35 pm

    House is a fictional character and a drug addict on TV. These sort of reference date your material.

  • Reply Wanda L November 16, 2019 at 11:42 am

    Why the medieval China doesn't open?

  • Reply Ramin Dehghan November 27, 2019 at 6:02 am

    My mum attended the old university in Bologna and met my dad there….. interesting history for me

  • Reply Ramin Dehghan November 27, 2019 at 6:08 am

    As far as I knew Al-Razi hated Islam. Apparently he thought Muhammed was a fraud and got stripes of some high ranking positions because of his belief.

  • Reply Leo Sousa December 15, 2019 at 5:59 pm

    Trotula is a group of three texts originally without author names, including a Latin compilation that gathered some of the therapies proposed by Trota of Salerno. Her fame was well spread as far as France and England by the 13th century. Being a rough ensemble of texts without much appreciated identification, Trotula was reworked in new editions including by people centuries later who didn't know they were initially three different texts and some confusion led to even mislabeling its date from medieval to ancient. The first text only mentions male sources: Hippocrates, Oribasius, Dioscorides, Paulus, and Justinus. The second text is the only one of the three that mostly overlaps another known paper which bores an author name: Trota of Salerno, which immediately led to the name Trotula, 'little work of Trota'. The 2nd text itself didn't have Trota's name though, and was apparently a modified copy by another autor. The ensemble spread out of Italy and more confusion ensued as now people started assuming the name of the author was literally Trotula, an ancient sounding name, who wrote all texts. In the third text the author refers to himself with a masculine pronoun and he credits specific practices to Muslim women. Due to a progressive and accumulated lack of knowledge and confusion, as new editions tried to fit assumptions for consistency, the author or authors were in practice given as unknown before Modern times. Then in the 1970s, second-wave feminism rediscovered Trotula and started propagating the conspiracy of Trota being "systematically written out of history". This conspiracy is of course taken to be beneficial to justify the socialist agenda the Green Brothers make sure to push here without you noticing it. You can read wikipedia's articles on Trota of Salermo and Trotula better, more accurate information than what you get here.

  • Reply ☁️Heaven on Earth☁️ January 9, 2020 at 11:22 pm

    I really appreciate the avatar symbols for the elements

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