I know we all think of ancient medicine as complete quackery but it makes me wonder how effective was it? It seems unlikely to me that if it always lead to death or disease that people would have kept practicing it for so many centuries. It makes me wonder if these treatments actually had some benefit.
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the “four humors” idea is bullcrap.
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people had little else to choose for health care.
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people get better on their own in many circumstances (look up regression to the mean and confirmation bias). If they had Barber Sam bleed them at the peak of their illness and managed to survive, then the act of bleeding would have preceded their improvement and thus received credit for it.
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all sorts of dubious to outright quack therapies have lasted for a gazillion years (see also homeopathy, “energy healing”, “traditional Chinese medicine” and so on. Longevity does not equate to effectiveness.
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stupidity is part of the human condition.
If a treatment started with healthy folks and always resulted in death/disease, yeah, people might have caught on. But if you have patients who arrive sick and then you apply a treatment, and sometimes patients get better and sometimes they don’t, it’s much more difficult to sort out what’s happening unless you pay rigorous attention to the results of treatment, and compare it to what happens when you don’t apply treatment.
Even nowadays that can be difficult. I once saw a web-based simulation of drug testing for MS patients: you could select the number of patients in the experiment and control groups, and a few other parameters. MS being a disease with highly variable and transient symptoms, a substantial percentage of people in the untreated control group will spontaneously improve; the same is true in the experiment group. If the drug is effective in only a portion of all cases, its effect can be completely hidden by all the people who got better on their own. You can get totally different results by running the same trial over and over again; in some cases a drug that’s actually moderately effective can be erroneously shown to be deleterious. It was difficult to produce a study size that reliably showed whether a given drug was effective; you needed a lot of patients, at which point you could start to understand why drug testing is so expensive.
So no, I’m not terribly surprised that ineffective theories/treatments persisted for a very long time - especially before the modern advent of evidence-based medical research/practice.
It wasn’t stupidity, just ignorance.
We might even give them credit for attempting to be scientific. The same goes for Astrology: they thought they perceived a natural relationship, and tried to refine and categorize it. They were wrong, but their instincts really were in the right place.
See Placebo.
Then, too, consider that a lot of things the local healer was doing probably did work. Even today, our best treatment for a great many diseases is “Drink plenty of fluids and get enough rest”. And maybe the healer used some plants that actually did have an appropriate medicinal effect, or effective wound dressings or bone splints, or the like. So if you went to the doctor and he did A, B, and C, and you got better, maybe all three of those things were good, maybe just one or two of them were (and if so, which ones?), and maybe they were all hooey and you just got better on your own.
Some very primitive medicine was effective. Herbs and balms were known; many people had detailed knowledge of anatomy. Eskimos had techniques of acupuncture and martial arts similar to those of the Chinese.
Stone Age surgery procedures included trepanation, Caesarean section, and lipoma excision, in some cases with success rates better than those of 19th-century Western surgeons.
What does “herbs and balms were known” mean? I suspect basically it means merely: were applied. Doesn’t mean they worked.
Detailed knowledge of anatomy? A vast proportion of illnesses are bacterial or viral, and a key to understanding the body’s fluids is knowledge of cells. There was no substantial knowledge of the key role of bacteria, virii or cells in human anatomy or disease prior to the late nineteenth century.
Stone age surgery occurred in some cases with success rates better than those of 19th century surgeons? There has seldom been a comment that better justified this:
Cite?
How the heck would we have any reliable knowledge of stone age surgery success rates?
I believe that you can see signs of continued bone healing after trepaning surgery, implying the patient survived at least for a time.
Sure, but some of them did. Pine and honey have antibacterial properties and antifungal properties. Aspirin is made from antiinflammatory compounds found in willowbark, etc.
They may have wrong ideas about WHY they worked, but they existed and in some cases are still in use today.
Beat me to it. There were some famous photos of this in one of the told Time-Life science and nature series of books. They cut a hole in a guy’s head about as big as a business card – square, too, bu making four intersecting linear cuts – and the damn hole grew nearly closed again.
Now, they may have been doing it to let demons out, rather than actually to reduce cerebral-spinal fluid pressure, but they did, and the patient lived. More than you might expect for bloomin’ brain surgery without anaesthesia or disinfectant!
But rates of success? Do we have enough skeletons to form a view on rates?
What do you think that treatment according to the four humors was? What do you think was available in the Middle Ages that would have done better? One of the big things that was introduced as balancing humors was starting to decline was purging (strong laxatives) and dosing with mercury. Not a particular improvement.
Actually, it did start with healthy folks. According to humerism, all foods had qualities along two scales: hot to cold and moist to dry. Human bodies were held to be mildly hot and mildly moist. So the food you ate was supposed to support that. I’m trying to remember some examples, and it’s been awhile.
IIRC, beef was considered to be relatively dry and cold, and thus was boiled rather than roasted, and would be served tempered with warming herbs and spices or with another ingredient that was warm and moist. Tempering usually required that the beef be cut into small pieces before the tempering sauce was added, so that the sauce could properly disburse and each bite would be properly balanced.
So far, so good. Then you add in personalities. A person with a choleric personality was too hot and too dry. So her doctor could prescribe that she eat foods that were balanced to be slightly cool and moderately moist, rather than mildly moist, so that when they combined with her personality, she would be made more temperate and less angry.
This is a wonderful game to play and could be a source of drama and entertainment. It was also a way to display wealth. If you were a moderately important person, you would have a doctor advising you on what to eat. If you were an extremely important person, you could have three to five doctors sitting behind you at banquets and offering competing advice on which dishes you should eat and which you should decline. (It also mattered which foods you ate at the beginning of a meal, which in the middle, and which at the end, as your stomach had to be opened and closed.)
You could argue with relatives about the proper balance of this and that, and about who shouldn’t be eating what, no matter what their own doctors said, because everyone could plainly see that their humors were . . . No drug in the world could possibly provide this much entertainment.
Also, remember that you’re supposed to be aiming for mildly warm and mildly moist. So adding a food that’s 1) mildly warm and mildly moist and 2) held to be highly tempering would be the perfect thing to add to anything to make it a little more balanced. While doctors, cooks, and philosophers argued about many foods, all agreed that two foods reached that perfection: sugar and pork fat.
When was the last time that your doctor encouraged you to eat more sugar and pork fat? Doesn’t that make the occasional cupping or leeching a little more attractive? I mean, those things aren’t fun, but they only happen when you’re feeling bad anyway. While you’re well, you get to play with your food and add sugar and port fat. No matter how expensive they are. They’re medicinal.
They didn’t have our words for them, they had their own language to describe what they saw.
One doesn’t need to know that honey “is an effective broad-spectrum antibacterial agent” and will “lower prostaglandin levels and elevate nitric oxide end products” and provides “stimulation of tissue growth, enhanced epithelialization, and minimized scar formation”. One can say that honey can “clear away toxic materials” or “chases away evil spirits” and it will still work to heal a wound.
Obviously people pick up the very few salve/herbal things that, as it turns out, work and run with them. Honey, aspirin. But these are just the tiny grains of truth that allow people to allege whole silos full of horseshit.
Further, the claim was that there was a “detailed knowledge of anatomy” and - presumably - this was alleged to be relevant to “humors” as medically understood in times past. Read up on what was actually believed about humors. It’s horseshit from one end to the other, let alone underpinned by any “detailed knowledge of anatomy”.
[1] Trial and error – not so different from modern pharmacology! That some prehistoric herbs were “effective” is certainly not in dispute; opium poppy was cultivated by 6000 BC and several other anesthetics and psychoactives were known in the Stone Age.
[2] I could have written “gross anatomy,” though am surprised there was confusion. But no, to be explicit, man did not use microscopes before microscopes were invented.
[3] Much of the evidence comes in modern times observing and interviewing people who still practiced Stone-age techniques, e.g. Aboriginal Australians, Polynesians, and (though perhaps not technically Stone Age) Ugandans at first European contact.
Successful trepanation, for reasons others have noted, is most likely to be apparent in archaelogical sites, but other stone-age surgery included dental drilling, amputating leg and replacing with peg, and in one case suturing an intestine!
My source for most of this is The Lost Civilizations of the Stone Age by Richard Rudgley, a somewhat controversial book but with a very extensive bibliography.
For reasons given above, trial and error of medicines without strict controls and (usually) high sample numbers is utterly useless. That just plain hasn’t been done except very recently. As above, mentioning a few herbal or traditional medicines that lucked out is no justification for the conclusion that the historical cornucopia of snake oil treatments worked to any significant extent. Not to mention that none of what you say in any way justifies a conclusion that the “four humors” theory of medicine was anything other than purest horseshit.
The confusion concerning anatomy - if any - was caused because of you mentioning (what you have now clarified to be) knowledge of gross anatomy in the context of a discussion about the “four humors” theory. Perhaps you just threw your comment in for no reason. Not my fault if I thought you were intending to make a relevant comment ie that you were suggesting that ancient knowledge of gross anatomy might mean that the “humors” theory had any substance, a suggestion which is patently ridiculous.
Your vague reference to some book that you admit is “controversial” isn’t good enough. You claimed not that these operations were performed but that *rates of success *were better in the stone age than in the 19th century. At least give me a quote from your book. Although having read the wiki entry for the author in question, it sounds like he is someone known best for reaching wild if entertaining conclusions so I’m not sure I’d be too convinced even if you could provide a quote.
My comment was standalone, and reacted to general errors in the thread. Since the “four humors” was not “Stone Age” medicine, your confusion was self-inflicted.
Actually the comparison was between 19th-century surgery by some Stone-Age surgeons and 19th-century surgery by Western surgeons. Please try to write more precisely.
Make up your mind. I’d have been happy to post a relevant excerpt, but not with it pre-disparaged.
You want precision writing? Firstly in your first sentence in your first post you simply said that “Some very primitive medicine was effective. Herbs and balms were known; many people had detailed knowledge of anatomy”. Since “very primitive medicine” could be a reference to anything from the stone age through to the bronze age (when the “four humor” theory was dreamed up) and beyond your comment was entirely imprecise. Confusion arising is not down to me.
Secondly what you said was “Stone Age surgery procedures included trepanation, Caesarean section, and lipoma excision, in some cases with success rates better than those of 19th-century Western surgeons.” Nothing in there about “19th-century surgery by some Stone-Age surgeons”.
Your final comment is ironic considering that you were the one who first disparaged your own source.
It was in the follow-up. At this point you seem more interested in attacking the messenger than the message. Count me out.