Table of Contents

Medicine in Ancient Times


This lecture was held on November 12th in the OOC Auditorium.


Sabella says, 'Croaker's been planning this lecture for a long-time, and, as you know if you checked the welcome board, he is a doctor real-life, so it should be really good.'

Outsider cheers for Croaker - huzzah!

Outsider is almost a doctor wannabe RL

McDougan cheers wildly!

Sabella turns it over to Croaker!

Croaker says, 'Thanks, Sabella :).'

Croaker clears his throat.

Croaker says, 'As an aside before the start of the talk, it is oddly appropriate that Croaker be giving this talk tonight, as he was the physician and historian for the Black Company in the fantasy series of that name by Glen Cook :).'

'The inspiration for my character. :),' Croaker says.

'My talk tonight will focus on Medicine in Ancient Times, from primitive peoples up through the Golden Ages in Greece and China,' Croaker says. 'If this lecture is well-received.'

Croaker says, 'I would be happy to lecture on medicine in Medieval and Industrial times at some future date.'

Croaker says, 'The talk will have 3 basic parts: 1) An examination of beliefs and attitudes of the peoples of the Ancient World, 2) Examples of methods and techniques employed in medicine in those times, .'

'And 3) The role of medicine in roleplay on LegendMUD and a few suggestions on the setup of medicine in the upcoming (??) skill trees,' Croaker says.

'And, of course, feel free to interrupt with questions or comments,' Croaker says. 'Any lag you may experience is due to the close proximity of immortals and should be suffered with accordingly.'

Pheasent2 giggles at Croaker.

McDougan chortles with amusement.

Kai chuckles politely.

Croaker says, 'Beliefs and Attitudes.'

Croaker pauses for effect

'Most primitive peoples and ancient cultures shared similar basic beliefs about the causes of health, illness, and death,' Croaker says.

Croaker says, 'Minor afflictions (colds, aches, small wounds) were a part of everyday life, but major illnesses and injuries were the result of the direct actions of outside forces on the person afflicted.'

Croaker says, 'Most primitive cultures ascribed these afflictions to nebulous and ill-defined entities such the wind, the night, evil spirits, ghosts, etc.'

Croaker says, 'With increasing sophistication (and more leisure time to ponder such philosophies), the blame was shifted over to specific entities such as particular gods, demons, malign spirits, and evil sorcerors.'

Croaker says, 'Some cultures went so far as to attempt to catalog all the ills in the world and ascribe them to specific entities so that prayers of supplication or attempts at warding could be directed at the root of the illness.'

'Because of this belief that ills were the result of outside agencies, the most prominent medical role in Ancient Times was that of the shaman (or medicine man, or witch doctor),' Croaker says.

Croaker says, 'He/she was generally a spiritual and sometimes secular leader whose main role was to either intercede with or counter the forces directed at the unfortunate patient.'

'The modus operandi of the shaman was spiritual and ritualistic and involved little actual medicine or surgery,' Croaker says.

'Quite advanced surgical techniques were employed in some ancient cultures, but these were generally performed by an underling and not the shaman him/herself (women could generally be shamans and this is one of the few areas,' Croaker says.

Croaker continues, 'in ancient politics where women had some power).

Croaker says, 'Similarly, midwifery was designated to specialists (women) and the shaman was not generally involved.'

Croaker says, 'Some refinement on these ideas occured during the "Golden Ages" in Greece and China.'

'The Greeks developed a system to explain illness in terms of 4 bodily "humours" - blood, phlegm, black bile, and yellow bile,' Croaker says. 'All bodily fluids were made up of a mixture of these 4 humours.'

'Illness and disease were the result of imbalances in the proportions of these humours,' Croaker says. 'Despite this more mechanistic view of disease, they still believed in outside forces as a cause of the imbalances, and thus, illness and injury.'

'These theories were echoed in the beliefs prevalent in China at the time, although 5 humours were postulated,' Croaker says. 'The Chinese further advanced the idea of the body in harmonious balance as a part of the Tao ("the way").'

Croaker says, 'Although malign spirits and evil beings still visited afflictions on mankind, straying from the Tao created an imbalance in the the body that manifested itself as disease.'

Croaker says, 'For example, lascivious or lustful ideas brought about diseases of the lung, while acting them out caused trouble for the heart.'

Agrippa starts coughing.

Mitra smirks.

Kahlan snickers at Agrippa nastily.

Croaker says, 'These ideas of the body in balance were later reflected in the writings of the Greek, Pythagorus.'

Drakkonn grasps his heart in pain.

Pheasent2 clutches his chest. HEART ATTACK!

Kahlan says, 'Figures, men.'

Kahlan rolls her eyes heavenward.

Ryssa giggles.

'It was not until the 18th century that the ideas of microbes as a cause of disease and the germ theory came about, and it was not widely accepted until proven by the demonstration of microorganisms in the early 19th century,' Croaker says.

Creusa nods her agreement with Kahlan.

'Essentially, little occurred to change attitudes and beliefs from ancient times until comparatively recently,' Croaker says. 'Instead, the ideas were merely refined and applied more specifically to problems.'

'Many parallels to the modern world are seen in the ancient world,' Croaker says. 'Payment was expected for services (usually commensurate with the patient's wealth and status), and physicians were often very wealthy.'

'From the Code of Hammurabi : " If a doctor has treated a freeman with a metal knife for a severe wound and has cured the freeman...he shall receive 10 shekels of silver." (about 18 months pay for the average craftsman),' Croaker says.

Croaker says, 'However, penalties could be severe: "If a doctor has treated a freeman with a metal knife for a severe wound and has caused the man to die, his hands shall be cut off." .'

Croaker winces.

Drakkonn goes EEK! in distress.

Croaker says, 'Finally, even today the roots of beliefs in the impact of outside forces on health have not been expunged - when I took the Hippocratic Oath, I swore by Apollo, Asclepios, Hygeia, and Panacea !!'

'Methods and Techniques,' Croaker says.

Croaker clears his throat and peers around before resuming.

'So break it!' McDougan says. 'Ye dunna worship those gods!'

'The mainstay of the shaman was the use of closely guarded rituals,' Croaker says. 'This often involved complicated chants, dances, beating on drums, and magical gestures.'

'A frequent trick of the shaman was to swallow small objects such as frogs or arrowheads and regurgitate them at the bedside to impress the family of the patient,' Croaker says.

Croaker says, 'Incense and mind-numbing drugs were frequently employed to decrease consciousness and alleviate pain.'

'A common ritual known as transference was often used,' Croaker says. 'A small creature (such as a cockroach) was captured and imprisoned next to the patient.'

'The shaman would then "transfer" the malign spirit into the creature's body and direct his efforts at the imprisoned being,' Croaker says. 'The animal would eventually die which caused improvement in the patient as the evil force was vanquished.'

Croaker says, 'Certain ancient cultures had extensive knowledge of medicinal plants (especially the native american indians).'

Croaker says, 'Primitive man had many herbal concoctions: laxatives, antilaxatives, antipyretics (anti-fever), emetics (induced vomiting), diuretics, analgesics, sedatives, and stimulants to name a few.'

'Most popular were the hallucinatory drugs because these put the patient in the proper frame of mind for the shaman's rituals,' Croaker says.

Croaker says, 'Peyote is a good example.'

'Very little in the way of advancement in drug therapy occurred until the last century. Recent purification methods have made drugs more potent with fewer side effects, ,' Croaker says.

'But there was little difference in drugs used in ancient times and in the 18th century,' Croaker says.

Croaker says, 'Medical interventions such as enemas, bloodletting, and purging (inducing vomiting) were frequently used to "adjust" imbalances in the bodily humours.'

'The surgical arts were quite advanced in ancient times,' Croaker says. 'Practicioners could release pressure on the brain by trepanation, drain pleural abscesses with chest tubes, perform tracheostomies, and many other procedures.'

'Suturing (stitching wounds) was common using fishbone needles and catgut thread,' Croaker says. 'There are even reports of Roman surgeons skin grafting a new foreskin onto Jewish patients who wanted to hide their origins for political reasons.'

Croaker says, 'The main differences in modern and ancient surgery (on a gross level, at least) are in 2 areas: instruments and septic technique.'

'A Roman physician with modern instruments and sterile technique could perform most basic surgeries as well as many modern surgeons,' Croaker says.

Croaker snickers at his surgeon friends.

'In China, the techniques of acupuncture and moxibustion were utilized,' Croaker says. 'This focused on the idea of special points on the body where yin and yang could be altered.'

'Moxibustion?' McDougan says.

'In the case of acupuncture, this was by inserting needles to certain depths at these spots,' Croaker says. 'With moxibustion, herbs (usually mugwort) were heaped on the points and burned, raising a blister.'

Croaker smiles at McDougan.

McDougan winces.

Siachet says, 'Ouch.'

Croaker says, 'Applications of this talk to LegendMUD .'

Croaker looks around to see who's still awake.

Agrippa smiles at Croaker.

Ryssa giggles.

Sabella smiles at Croaker.

McDougan waves a welcome to Croaker. Hello!

Siachet smiles happily.

Ryssa smiles at Croaker.

'There are many opportunities for roleplay using medicinal skills,' Croaker says. 'The shaman character could be particularly entertaining.'

Pheasent2 giggles at Croaker.

Pheasent2 ponders a loincloth and bag of herbs for RP.

'How about my emoting "Croaker regurgitates a frog in your lap" everytime I heal someone?' Croaker says. 'Or constantly beating a drum during healing sessions.'

Siachet giggles.

McDougan says, 'Like the nazca "Mr. Hole-in-ye-head?"'

Pentara gets a handful of barberries from a large duffel bag.

'Many items could be customized to fit the shamanistic character,' Croaker says. 'Hats, cloaks, coats, drums, knives, and magical implements could all be altered to fit the character.'

'I'm sure you can come up with many other interesting ideas on your own,' Croaker says. 'Just be creative.'

'It seems to me that there are 3 basic medical skills sets on LegendMUD: shamanistic/magical, herbal/medicinal, and surgical,' Croaker says.

McDougan says, 'Shamanistic? .'

McDougan says, 'We have those?'

'The shamanistic/magical means of healing are contained within the current spell system and are loosely based on the old D&D system of healing (cure light wounds, cure serious wounds, etc.),' Croaker says.

'Oh.... ,' McDougan says.

Croaker says, 'The herbal /medicinal system, as it stands, is a subset of the larger herbal system, with bandaging and poulticing the main medicinal skills.'

McDougan withdraws inwards and begins regurgitating frogs under his breath.

'Other herbal skills are magical and unrelated to medicine,' Croaker says. 'Herbal medicine is currently restricted to certain ancient and medieval hometowns.'

Ryssa giggles at McDougan.

Croaker says, 'The surgical skills are fairly self-explanatory, but are currently limited to certain industrial and medieval hometowns.'

'Given this, I would like to submit a few humble suggestions for the immorts' consideration when (????) the medical skill trees are designed,' Croaker says.

Croaker snickers softly.

Croaker says, 'I doubt the healing spells will be altered any time soon, however, certain things could be done to modify their effects (since they're so wimpy now).'

Croaker says, 'For instance, a requisite skill for using the healing spells could be created (? shamanism ? ritual medicine), or wands or staves in the new system could be used as focuses for healing power, augmenting the caster's effect.'

Siachet ponders a regurgitate animals skill.

'Eew,' Kahlan says.

McDougan chortles with amusement. Croaker smiles at Siachet.

'And they call the German uncivilized,' Kahlan says.

'This would make the ancient healer (shaman) a more viable character by increasing the potency of healing spells,' Croaker says.

'For herbal/medicinal skills, there is no reason to restrict use of herbs or poultices for healing to ancient only,' Croaker says.

'Under the new skill trees everyone should be able to use herbs this way, although magical uses (brew, flavor, etc.) could be restricted to ancient hometowns,' Croaker says.

'Sure there is,' McDougan says. 'It makes us ancient-types feel special!'

Croaker says, 'Naming the skill something different (? pharmacotherapy, ? pharmacy) could differentiate the skills by era although they would be the same in both instances.'

'An additional skill could be created (? purify herb) to increase the potency of herbal preparations made by industrial-based characters due to their superior purification procedures,' Croaker says.

'For surgery I have several suggestions :) First, there should be no restrictions by era or hometown on the basic surgical skills,' Croaker says.

'Pharmacotherapy should double as an isolated herblore for poultices,' McDougan says.

Croaker says, 'Proficiency or effectiveness could be altered by the instrument used (modern surgical instruments of differing strengths found in Industrial vs. dull knives or trephines (Tumi) in Ancient).'

McDougan looks up into the sky and ponders.

Croaker says, 'Another idea to reflect improved surgery in Industrial times would be to implement a skill (? hygiene, ?sterile technique) which improves the potency of the surgery.'

Croaker says, 'Alternatively, there could be major BAD effects of surgery in ancient times (gangrene, exsanguination, etc) which could be avoided by learning this industrial-restricted skill.'

Croaker grins evilly.

Siachet giggles.

'Ancient characters would not be able to learn such skills because their world-view would not encompass the ideas of microbes as a cause of disease,' Croaker says.

Croaker pauses.

'Well, that is all I have to say tonight,' Croaker says. 'Thank you for your patient attendance. If there are questions or discussion, I would be happy to stay for awhile.'

Croaker smiles happily.

'Purge demon skill?' McDougan says.

Croaker purges Mcd :)

Sabella smiles at Croaker.

Kahlan cackles gleefully at Croaker - whatever she's going to do to him, glad it's not you!

Pentara shows her approval by clapping her hands together.

Croaker steps down from podium.

McDougan grumbles to Croaker.

Sabella thanks Croaker heartily.

Sabella cheers for Croaker - huzzah!

Siachet claps for Croaker approvingly.

Pentara claps for Croaker approvingly.

McDougan thanks Croaker heartily.

Pheasent2 claps for Croaker approvingly.

Agrippa bows before Croaker.

Mitra applauds Croaker's quick thinking and good judgment.

Croaker thanks Sabella heartily.

Croaker smiles happily.

'If there are no questions, then I'll see you later. :),' Croaker says.

Siachet thanks Croaker heartily.

Mitra cheers for Croaker - huzzah!

Croaker waves happily.

Croaker returns to being In Character.