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A brief history of pathology

2010; Springer Science+Business Media; Volume: 457; Issue: 1 Linguagem: Inglês

10.1007/s00428-010-0934-4

1432-2307

Jan G. van den Tweel, Clive R. Taylor,

History of Medical Practice

The Queen to Alice in 'Through the Looking Glass'.Lewis Carol.Ch 5; Wool and Water.There is no single event, no 'Big Bang', that demarcates the beginning of pathology as a defined area of interest for early medical practitioners.In fact, the history of pathology has roots in common with all other medical specialties, arising in antiquity when men reasoned about the physical ailments that afflicted them.For obvious reasons, those gross features of disease that were directly visible, either in life, or after death in funereal preparations, came first to notice.In addition, over the last century, archaeological discoveries increasingly have been linked with palaeopathological investigations, furnishing a wealth of observations of gross external features of disease, from prehistoric peoples to the present time.As a result, museums around the world contain marble and terra cotta statues expressing processes that can now be interpreted as examples of hernias, breast tumours, varicose veins, ulcers and other diseases.Documentation of disease really begins with Egyptian medicine, where the most important sources are the Edwin Smith Papyrus (17th century BC) and Papyrus Ebers (about 1550 BC).These records contain information on different types of bone injuries, trachoma (Nile valley), ulcerating lumps (cancer?), parasites and other diseases.However, despite the many thousands of ritualistic and painstaking embalmings during nearly 5,000 years of successive Egyptian dynasties, these surviving papyri contain only a slender body of information on pathological anatomy.Today, we know from recent investigations of mummies that bone tumours and tuberculosis of the spine occurred in Ancient Egypt, as well as atherosclerosis, gallstones and abscesses, yet there is little evidence that the Egyptians developed any systematic knowledge of these phenomena.It was not until the last three centuries BC that the Alexandrian Greeks, heavily influenced by Hippocrates, made lasting contributions to anatomy and pathologyThe ideas related to Hippocrates of Cos (460-370?BC) and his school had an enormous impact on Greek and Roman medicine.With his humoural theory of the nature of disease, Hippocrates influenced medicine until the Renaissance, and beyond.Despite the flaws of this theory, Hippocratic writers left remarkably clear descriptions of many pathological features, such as wound inflammation, tumours, haemorrhoids, malaria and tuberculosis (Fig. 1).Animal dissection was practised in this time, but human dissection was not part of medical practice.Similar circumstances apply to Aristotle (384-322), who can be considered as one the founders of zoology.The first dissections of humans are attributed to the Alexandrian