What was the role of doctors in the last few thousand years up until the modern age of medicine (maybe around 1900ish with Pasteur’s discoveries of infectious agents)? I know that surgery has been around for a while, but did doctors actually do anything of use to fight infections or were amputation and bloodletting the only choices? Were there any diseases curable before the discovery of antibiotics in the late 20s (other than vaccinations or bacteriophage experiments), and any treatment for cancer before modern drugs other than amputation? I see doctors of the past incorporated into many stories with their mysterious bottles and pills and am wondering what their true powers were…like Hippocrates, why was he such a great physician without the aide of modern medicine?
Leech wrangler.
I heard a doctor from Sloan-Kettering medical center say on TV that until the advent of anti-biotics there was really no god way to combat infections other than the individual’s own resistance.
There are a couple of pretty good books, one quite factual,* The Century of The Surgeon* (scroll to the bottom) and the other a fact based account of the work of Ignaz Semmelweiss,The Cry And The Covenant. If your library doesn’t have them they can probably get them by interlibrary loans.
Doctors, or barbers, closed wounds, set broken bones, lanced boils, and all kinds of other stuff before the advent of modern drugs. Not all of the older drugs were valueless, either.
Doctors weren’t just flailing about blindly back in the day. The bio of John Adams mentioned that his daughter had breast cancer - this would have been in the late 1700s or early 1800s. She had a mastectomy and lived for quite a while before it finally came back and killed her.
And, of course, there’s evidence that the ancient Mayans successfully practiced brain surgery.
They were mostly intelligent men who were well trained. Unfortunately of course some of the ideas of the time were more harmful than good.
But some of the herbal remedies do provide some relief for certain things. Doctors of the 19th century would apply anesthetic for various reasons, they could also close up wounds, perform necessary amputations, and in some cases remove malignancies.
Even before the discovery of microbacterias/germs many doctors understood that it was important to keep their instruments and themselves clean when working on patients.
The big difference between then and now is there was not much standardization. Some parts of the world doctors were little more than witch doctors, sometimes within the same country you’d have lots of crackpots but at the same time many doctors who were professionals that relied as much as they could on scientific fact to treat their patients.
For most of Western history since classical times, doctors have been Church officials who would try to figure out which of the four humours was out of balance, and would send patients to barber/surgeons to correct it. It wasn’t until the 1860s that Cell Pathology replaced Four Humours as the dominant medical model in Europe and America. Doctors were learned men, but they put all their stock in a demonstrably false system of scientific beliefs.
Cite: An Underground Education : The Unauthorized and Outrageous Supplement to Everything You Thought You Knew About Art, Sex, Business, Crime, Science, Medicine, and Other Fields of Human Knowledge by Richard Zacks
Very few pre-modern drugs were really effective, and many of them were harmful. Until the advent of aspirin, chemical companies weren’t very interested in pharmaceuticals; they made their profits from dyes and other commercial chemicals that were used on a larger scale than pharmaceuticals. The impetus to research new, effective drugs really wasn’t present until they had a few pharmaceuticals that were profitable.
It’s not quite true that doctors were useless before the explosion of new synthetic drugs. Once they knew about antisepsis and the germ theory of disease, it was possible to prevent infection to a certain extent, and even fight infections that weren’t systemic. Surgery was relatively well-developed even before anesthesia, and, when anesthetics were introduced, surgery became a practical way of treating certain problems.
But, even in 1900, the drugs that were available were rather primitive and few were effective. Before modern synthetic drugs, many medicines were toxic and dangerous. Syphilis was treated with mercury compounds, for example. There were a very few treatments that were effective: quinine for malaria, certain vitamin-rich foods for some nutritional deficiencies, and opiates for pain. Many early drugs had substantial side effects and some are even considered too dangerous or addictive for medical use today (such as cocaine, used as a stimulant and local anesthetic, and heroin). There seems to have been an over-reliance on opiates in an era without effective non-narcotic painkillers. Opium and opium preparations like laudanum (opium in alcohol) and paregoric (opium in alcohol with soothing camphor) were commonplace remedies that would have been found in many households, and morphine and eventually heroin were also used for a variety of conditions. Compared with some of the drugs being used in the pre-modern era, opiates were relatively safe and far more effective. There were other drugs that were effective, including certain herbal remedies, but there at least as many drugs that were not effective and/or very dangerous.
In the old days, the doctor was the undertaker’s best friend! If he didn’t kill you with harmful medicines (calomel, bichloride of mercury), or give you a fatal infection (by poking around a wound with unwashed fingers), he might hasten your end with a horrific procedure like “bleeding”.
Before the acceptance of the germ theory of infection, you really had better chances of recovery by utilizing a faith healer, or some other non-harmful quack.
What is really frightening: the mortality rates in hospitals reached 90%! Surgeons could be very skillful…but unless they washed their hands and instruments, you were as good as dead from secondary infections.
That said, most people went to barbers for simple operations (like tooth extractions, broken arms). They were considerably safer than the average physician.
Incidentally, the era of primative medicine gave rise two two bogus healing disciplines: Christian Science and Homeopathy. Both owe their popularity to the dangerous rresults of conventional medicine at the time.