History of MedicineHistory of Medicine

Sugana TSugana T

Padjadjaran UniversityPadjadjaran University

IntroductionIntroduction

Medicine has been scientific for a Medicine has been scientific for a long timelong time

During and after the nineteenth During and after the nineteenth century became obvious to a large century became obvious to a large extent scientificextent scientific

Natural science adapted to medicine Natural science adapted to medicine promote the development of promote the development of medicine in science and economicsmedicine in science and economics

Medical education is complete only if Medical education is complete only if it implant certain moral and ethical it implant certain moral and ethical values in the future doctorvalues in the future doctor

There are often pressure and There are often pressure and temptation to lower the professional temptation to lower the professional standard for the sake of money and standard for the sake of money and popularity are numerouspopularity are numerous

Medical history can play a valuable Medical history can play a valuable role those acquainted with the role those acquainted with the teaching of Hippocrates with the teaching of Hippocrates with the lives of such men with high ethic and lives of such men with high ethic and moral as Pare, Lister, Pasteur, Osier moral as Pare, Lister, Pasteur, Osier and many other will find them ever-and many other will find them ever-flowing sources of moral strengthflowing sources of moral strength

A man can be a competent doctor A man can be a competent doctor without a knowledge of medical historywithout a knowledge of medical history

But an acquaintance with medical history But an acquaintance with medical history can make him or her a better doctorcan make him or her a better doctor

Anyone who has seen how the truth of Anyone who has seen how the truth of today becomes the error of tomorrow will today becomes the error of tomorrow will adopt a more independent and critical adopt a more independent and critical attitude and will be better equipped to attitude and will be better equipped to assimilate new truthsassimilate new truths

In the middle ages medicine had In the middle ages medicine had cantered round libraries. During the cantered round libraries. During the following three centuries it had following three centuries it had focused upon the individual sickbedfocused upon the individual sickbed

In the 19th century it centered In the 19th century it centered around hospital. This particular period around hospital. This particular period might well be characterized as the might well be characterized as the period of hospital medicine, as period of hospital medicine, as distinguished from its predecessors, distinguished from its predecessors, library and bedside medicinelibrary and bedside medicine

Later it can be called laboratory Later it can be called laboratory medicinemedicine

Industrial revolution fostered rapid Industrial revolution fostered rapid urbanization. Number of hospital increasedurbanization. Number of hospital increased

Very many peasant, male and female Very many peasant, male and female streamed into the growing cities as streamed into the growing cities as seekers of jobs in industries. Having seekers of jobs in industries. Having neither homes nor families for care. Often neither homes nor families for care. Often they fell victims to typhoid fever or they fell victims to typhoid fever or tuberculosis tuberculosis hospitals became crowded hospitals became crowded

Patient became materials for clinical Patient became materials for clinical observations and of course for autopsies observations and of course for autopsies new discoveries new discoveries new theories new theories

History of medicine does not lack of History of medicine does not lack of dark pages. It is a long road which dark pages. It is a long road which man has made steps in his fight man has made steps in his fight against diseasesagainst diseases

As a whole it is considerably more As a whole it is considerably more encouraging than the history of encouraging than the history of many human activities. It is full of many human activities. It is full of interesting events and valuable interesting events and valuable lessons and will evoke fascination lessons and will evoke fascination and enthusiasmand enthusiasm

In the 17In the 17thth and 18 and 18thth centuries centuries nowhere in the world was a special nowhere in the world was a special system of medical services. Diagnose system of medical services. Diagnose skills of doctors and therapy was not skills of doctors and therapy was not practiced by persons who were practiced by persons who were special trained for itspecial trained for it

Treatment of diseases was based on Treatment of diseases was based on trial and errors and sometimes was trial and errors and sometimes was done harshly or unpleasantly rough, done harshly or unpleasantly rough, without thinking of the suffering of without thinking of the suffering of pain pf the patientpain pf the patient

Ultimate of the 18Ultimate of the 18thth and beginning of and beginning of the 19the 19thth century the western century the western medicine started to be introduced to medicine started to be introduced to the inhabitant of Indonesiathe inhabitant of Indonesia

First the Dutch only care for their First the Dutch only care for their own communityown community

Epidemics and many victims of Epidemics and many victims of trouble and war against them, the trouble and war against them, the Dutch recruited Indonesian human Dutch recruited Indonesian human resourcesresources

Primitive MedicinePrimitive Medicine

When man was in the primitive stage of When man was in the primitive stage of civilization the character of the early civilization the character of the early medicine is very dimmedicine is very dim

Evidence that are encountered now from the Evidence that are encountered now from the past must be used with full awarenesspast must be used with full awareness

Primitive tribes lived and remained Primitive tribes lived and remained fundamentally on a stone age level, did not fundamentally on a stone age level, did not develop to more advanced level of develop to more advanced level of appropriate technology, social organization appropriate technology, social organization and ideologyand ideology

With the primitive mind they did not remain With the primitive mind they did not remain staticstatic

Though they do not have a written history, Though they do not have a written history, they have been subject to historical changethey have been subject to historical change

It is assumed that they have maintain many It is assumed that they have maintain many characteristics of their pre historic characteristics of their pre historic predecessors in the field of medicine and predecessors in the field of medicine and others.others.

Studying the primitive medicine has an Studying the primitive medicine has an important reason because it has the important reason because it has the fascinating feature of primitiveness much fascinating feature of primitiveness much more different from our own, but function more different from our own, but function static fotorily for them at that timestatic fotorily for them at that time

The best way to become familiar with The best way to become familiar with primitive medicine is to observe as typical primitive medicine is to observe as typical medical treatment as it is actually carried medical treatment as it is actually carried through in a given contemporary primitive through in a given contemporary primitive societysociety

As an example and for an illustration As an example and for an illustration that sometimes to still see an act of that sometimes to still see an act of primitive medicine in our primitive medicine in our contemporary modern worldcontemporary modern world

A man felt ill. He and his family behave A man felt ill. He and his family behave much as would a modern man does. At much as would a modern man does. At first there is not much speculation as to first there is not much speculation as to the character and origin of this the character and origin of this “indisposition” of feeling. The patient “indisposition” of feeling. The patient rests, and household remedies are rests, and household remedies are applied. Only when no improvement applied. Only when no improvement can be obtain in this way, the sick man can be obtain in this way, the sick man really thing of disease.really thing of disease.

From this point on two types of medicine From this point on two types of medicine separateseparate

The family assumes that the disease has been The family assumes that the disease has been caused by a supernatural agency :caused by a supernatural agency :

An animal spiritAn animal spirit A ghostA ghost A Sorcerer (santet)A Sorcerer (santet)

A medicine man or a magician was called A medicine man or a magician was called not a man who has been trained for not a man who has been trained for treating disease :treating disease :

Ceremony was organizedCeremony was organized Prayers, magic formulasPrayers, magic formulas Sometimes drumming or noisesSometimes drumming or noises Sacreed objectSacreed object

If the sick has been the victim of a If the sick has been the victim of a sorcerer, the medicine man “sucks sorcerer, the medicine man “sucks out” disease producing “arrow”out” disease producing “arrow” SmallbonesSmallbones PebblesPebbles From the body of the patientFrom the body of the patient (In Indonesia often the dukun take out (In Indonesia often the dukun take out

neeedles or other hard material)neeedles or other hard material) Other simpler treatmentOther simpler treatment

Prescribing drugs from herbPrescribing drugs from herb AmuleeetAmuleeet Taboo for a certain period of the timeTaboo for a certain period of the time

Such an idea concerning the causes of Such an idea concerning the causes of disease will be found in all primitive disease will be found in all primitive societiessocieties

Magico-religious or super naturalistic Magico-religious or super naturalistic ideasideas

Some diseases are sent by :Some diseases are sent by : GhostGhost Spirits or dewaSpirits or dewa

Due to taboo violationDue to taboo violation Inflicted by sorcererInflicted by sorcerer Supernatural forcesSupernatural forces Existence of a soul in the body (Kesambet)Existence of a soul in the body (Kesambet)

Primitive prophylaxis :Primitive prophylaxis : AmuletsAmulets Ritual mutilations (circumcisition)Ritual mutilations (circumcisition) Ritual painting of the bodyRitual painting of the body Clipped nail or cut hair must be hiddenClipped nail or cut hair must be hidden

It can be used against the original ownerIt can be used against the original owner

Main ground for the basic differences Main ground for the basic differences between medical approach and the between medical approach and the modern scientific methods is a modern scientific methods is a supernatural orientationsupernatural orientation

Humanity has believed in super natural Humanity has believed in super natural forces, rather than in natural lawforces, rather than in natural law

A strong believe in natural forces STILL A strong believe in natural forces STILL exist EVEN IN MODERN COMMUNITYexist EVEN IN MODERN COMMUNITY

Primitive pharmacopeias :Primitive pharmacopeias : It was a moisture of innumerable in effective It was a moisture of innumerable in effective

drugs with a few of marked effect which are drugs with a few of marked effect which are valued element of our own pharmacopeiasvalued element of our own pharmacopeias

The different point of view is magic power The different point of view is magic power and magic relationand magic relation

No distinction between No distinction between Organic functional and mental disease. There Organic functional and mental disease. There

is only disease and treatmentis only disease and treatment Treatment always contained psychotherapeutic as Treatment always contained psychotherapeutic as

well as objective elementswell as objective elements Epidemic diseasesEpidemic diseases

TyphoidTyphoid MeaslesMeasles DiphtheriaDiphtheria SmallpoxSmallpox Yellow feverYellow fever CholeraCholeraWere unknown to primates beforeWere unknown to primates before

Life expectancy was lowLife expectancy was low

MEDICINE IN ANCIENT MEDICINE IN ANCIENT CIVILIZATIONCIVILIZATION

Nature favored some places for Nature favored some places for human settlementhuman settlement

Usually valleys of great riversUsually valleys of great rivers Due to :Due to :

Easy transportEasy transport Soil is fertile, no need to be fertilize because Soil is fertile, no need to be fertilize because

every year flood bring fertilized mudevery year flood bring fertilized mud Plenty of waterPlenty of water Enough protein from fisheryEnough protein from fishery

Tribal group grew into organized Tribal group grew into organized communitycommunity Later became empires and developed Later became empires and developed

urban civilization with someone as urban civilization with someone as leaderleader

Advanced civilized empire developed Advanced civilized empire developed writing, which was needed for writing, which was needed for communication and informationcommunication and information

Thanks to these old writing, we know Thanks to these old writing, we know their historytheir history

Information concerning the ancient Information concerning the ancient happeninghappening Are derived from written records as well Are derived from written records as well

as from rich archeological findings-as from rich archeological findings-proper history beginsproper history begins

Changes in social structures, technology Changes in social structures, technology and ideology brought in the and ideology brought in the development of empires also brought development of empires also brought about important changes in medicineabout important changes in medicine

Outstanding civilization were found inOutstanding civilization were found in Egypt, Babylonia, Mexico, Peru, Persian, Egypt, Babylonia, Mexico, Peru, Persian,

Jew, Phoenicia, Cretan and EtruscanJew, Phoenicia, Cretan and Etruscan At the same time : the valley of Indus At the same time : the valley of Indus

and Yang Tse Kiang (maybe older)and Yang Tse Kiang (maybe older) Social change influenced pathology and Social change influenced pathology and

medicine. Densely settled empires and medicine. Densely settled empires and their large cities made it possible for acute their large cities made it possible for acute infection to last and for the great infection to last and for the great epidemics to spread –until the twentieth epidemics to spread –until the twentieth centurycentury

EGYPTEGYPT Year 1000 BC Egypt enjoyed great fame Year 1000 BC Egypt enjoyed great fame

antiquityantiquity Homer (Greece) : many good doctorsHomer (Greece) : many good doctors Herodotus (5Herodotus (5thth century BC) : people in century BC) : people in

Egypt as being particularly healthy in Egypt as being particularly healthy in contrast to what was observed in the contrast to what was observed in the middle age (500-1500 AD) and modern middle age (500-1500 AD) and modern timestimes

2700 BC in Egypt there were already 2700 BC in Egypt there were already physicians and dentist especially at court physicians and dentist especially at court for the need of the emperorfor the need of the emperor

Egyptian physician were demand in the Egyptian physician were demand in the near east and after the advent of Greek near east and after the advent of Greek physician are liked in the Mediterraneanphysician are liked in the Mediterranean

Beside good physicians, super Beside good physicians, super naturalism in Egypt reminded dominant naturalism in Egypt reminded dominant for disease and treatmentfor disease and treatment Firaun was consider as a God and he Firaun was consider as a God and he

named himself also as God, whose pyramid named himself also as God, whose pyramid and mummies bore witness to its and mummies bore witness to its tremendous preoccupation with life after tremendous preoccupation with life after death and whose priests played an death and whose priests played an important political roleimportant political role

Training of physician happened in temple Training of physician happened in temple schools and probably as priest like in the schools and probably as priest like in the westwest

Spirits and demons continued from the Spirits and demons continued from the ancient time to “cause” disease and spells ancient time to “cause” disease and spells continued to be used against themcontinued to be used against them Later spells were replaced by prayers demons Later spells were replaced by prayers demons

are overshadowed by Godsare overshadowed by Gods There were special Gods for protection against There were special Gods for protection against

special diseasespecial disease God would both send a disease and also can cure itGod would both send a disease and also can cure it Amulet were used extensivelyAmulet were used extensively Healing Gods were : Re, Thoth and IsisHealing Gods were : Re, Thoth and Isis

About 2900 BC Imhoptep was a new About 2900 BC Imhoptep was a new healing God healing God

He is a historical figureHe is a historical figure

was fizier of Firaunwas fizier of Firaun

from a medical herd later he became God from a medical herd later he became God of medicine. Later Asclapius became also of medicine. Later Asclapius became also God of medicineGod of medicine

Beside the super naturalistic orientation Beside the super naturalistic orientation Egypt had also highly organized medicine Egypt had also highly organized medicine to contain unknown to primitive societiesto contain unknown to primitive societies This is the beginning of a rational theory of This is the beginning of a rational theory of

disease and life in generaldisease and life in general

Historically Egyptian medicine is Historically Egyptian medicine is known based on certain known based on certain papyripapyri, , written documents on material made written documents on material made from stems of papyrus plant. Papyri from stems of papyrus plant. Papyri are easily destroyed by natureare easily destroyed by nature

Papyrus reflects the medical ideas of Papyrus reflects the medical ideas of about thousands years agoabout thousands years ago

There are still a variety of papyri There are still a variety of papyri preserved and well kept in Museaspreserved and well kept in Museas

1.1. Kanun papyrus : deals with gynecology Kanun papyrus : deals with gynecology (2000 BC)(2000 BC)

2.2. Edwin papyrus : deals with surgery Edwin papyrus : deals with surgery (1600 BC)(1600 BC)

3.3. Eber papyrus is a kind of medical text Eber papyrus is a kind of medical text book (1500 BC)book (1500 BC)

4.4. Berlin papyrus and prescription and Berlin papyrus and prescription and 5.5. Hearst papyrusHearst papyrus magical spells magical spells

(1350BC)(1350BC)6.6. London papyrus (1350 BC) contains London papyrus (1350 BC) contains

more magical spellsmore magical spells

As it happened in the west Egyptian As it happened in the west Egyptian medicine experienced also a decline. medicine experienced also a decline. It started out with a comparatively It started out with a comparatively rational approach and became more rational approach and became more and more magical and went parallel and more magical and went parallel with the decline of Egyptian with the decline of Egyptian civilizationcivilization

Edwin Smith papyrus and the Ebers Edwin Smith papyrus and the Ebers papyrus is more informative and papyrus is more informative and reveal considerable talent in reveal considerable talent in presenting case histories and in presenting case histories and in establishing a general disease notionestablishing a general disease notion

Surgeon of the past limited himself to Surgeon of the past limited himself to wound treatment and bone settingwound treatment and bone setting

Operative procedure remained rare Operative procedure remained rare up to the second half of the up to the second half of the nineteenth centurynineteenth century

Also was encountered the refusal of Also was encountered the refusal of the medical practitioner to treat the medical practitioner to treat hopeless cases, an attitude which hopeless cases, an attitude which remained legitimate and ethical while remained legitimate and ethical while many as late as the eighteenth many as late as the eighteenth centurycentury

GreeceGreece Ancient Greek medicine is incomparably closer to Ancient Greek medicine is incomparably closer to

modern medicine than any other historical form of modern medicine than any other historical form of medicinemedicine

Modern terminology is to a large extent Based on Greek.Modern terminology is to a large extent Based on Greek. Greek medicine covered a period of about one thousand Greek medicine covered a period of about one thousand

years.years. Diseases was no longer regarded as a super natural Diseases was no longer regarded as a super natural

phenomenon but approached from a rational, phenomenon but approached from a rational, naturalistic and scientific point of view.naturalistic and scientific point of view.

Priest bureaucracy was prevented by political division.Priest bureaucracy was prevented by political division.

The radical change happened of a sudden in the The radical change happened of a sudden in the history, and without explanation what ever.history, and without explanation what ever.

Greece is located in the most eastern part of the Greece is located in the most eastern part of the Mediterranean.Mediterranean.

This part is a busy trade area between Egyptian, This part is a busy trade area between Egyptian, Mesopotamian, Phoenician and Cretan who are Mesopotamian, Phoenician and Cretan who are already highly civilized people were free people already highly civilized people were free people with a variety of culture.with a variety of culture.

Greeks were intellectually and physically a kind of Greeks were intellectually and physically a kind of “Hybrid vigor”.“Hybrid vigor”.

Greek physicians separated their practice from Greek physicians separated their practice from their religious beliefs. their religious beliefs.

Religious medicine was also knownReligious medicine was also known - especially for the poor- especially for the poor - for the incurable- for the incurable There were many godsThere were many gods Apollo was regarded the god ofApollo was regarded the god of disease and healingdisease and healing After the fifth century replaced by asclepiusAfter the fifth century replaced by asclepius (Aesculapius, askulap) with the staff and the (Aesculapius, askulap) with the staff and the holy snake of medical profession.holy snake of medical profession. Treating patient was by “incubation” by sleeping a night in temples Treating patient was by “incubation” by sleeping a night in temples

hoping a dream would give guideline of therapy and prognosis.hoping a dream would give guideline of therapy and prognosis.

In the year 460-377 BC Emerged Hippocrates. In the year 460-377 BC Emerged Hippocrates. Treatises of Hippocrates collection known as corpus Treatises of Hippocrates collection known as corpus

Hippocraticum.Hippocraticum. Probably have bee written between 400-380 BCProbably have bee written between 400-380 BC Before Asclepius and Hippocrates about the year 1000 cc Before Asclepius and Hippocrates about the year 1000 cc

appeared a book written by homer.appeared a book written by homer. In this writing of Homer apeare respected craftsmen, In this writing of Homer apeare respected craftsmen,

consists almost entirely of military surgery. His epics deal consists almost entirely of military surgery. His epics deal mostly with warfare.mostly with warfare.

VIIVIIthth century A.D in Cnides (Asia Minor) There was a Greek century A.D in Cnides (Asia Minor) There was a Greek settlement with a school, concerned primarily with settlement with a school, concerned primarily with diagnosis of diseases, developing a some what elaborate diagnosis of diseases, developing a some what elaborate system of classification.system of classification.

Arab and their Medicine Scientific Development of the Arab is part of Scientific Development of the Arab is part of

Medieval MedicineMedieval Medicine In 1130 council of Clermont forbade practice In 1130 council of Clermont forbade practice

of medicine in monasteryof medicine in monastery Arab science came into force to change the

direction of medicine this had an impact also on the field.

NumeralChemistryPhysicAstronomy

School emerged University founded

HIPPOCRATIC MEDICINEHIPPOCRATIC MEDICINE

Greek medicine was greatly influenced by philosophers development of medicine was practical effort in the field of clinical observation

Hippocrates is a symbol of creative period of Greek medicine (480 – 377 BC) His name has come to represent the beauty value and dignity of medicine off all time

His golden period was between the victory of Salami (480 BC) and the beginning of Peloponnesian war (431 BC). Here begin the distinction of Greek

CORPUS HIPPOCRATICUMCORPUS HIPPOCRATICUM Is a collection of 50-60 books in the 3Is a collection of 50-60 books in the 3rdrd

century BC in Alexandria +/- 480 – 380 century BC in Alexandria +/- 480 – 380 BC.BC.

It is not a work of one man or groupIt is not a work of one man or group Dealing with :Dealing with :

Diet (regulation of the whole existence not just of Diet (regulation of the whole existence not just of food intake)food intake)

Epidemic diseases (island thasos)Epidemic diseases (island thasos) PrognosisPrognosis AirAir WaterWater PlacesPlaces Surgical dealing with fractures dislocation wound, Surgical dealing with fractures dislocation wound,

ulcers etc.ulcers etc. Sacred diseasesSacred diseases Nature of manNature of man Book of oathBook of oath Law and physicianLaw and physician

Professional attitude and the ethical Professional attitude and the ethical obligation of the physicianobligation of the physician

The last one dealing in the corpus The last one dealing in the corpus Hippocraticum is :Hippocraticum is : The aphorism The aphorism discusses all aspect of discusses all aspect of medical medical practice particularly on the practice particularly on the subject subject of the “critical days” in the of the “critical days” in the development of diseases.development of diseases.

All the Hippocratic books have some All the Hippocratic books have some fundamental trait in commonfundamental trait in common

They stress the naturalistic approach They stress the naturalistic approach declaration of independencedeclaration of independence

Value of observation of the disease Value of observation of the disease process on the practical non on the process on the practical non on the theoreticaltheoretical

THE HIPOCRATIC OATHTHE HIPOCRATIC OATH

I swear by Apollo the physician and all Gods I swear by Apollo the physician and all Gods and Goddesses, that according to my ability and Goddesses, that according to my ability and judgment, I will keep this oath and this and judgment, I will keep this oath and this stipulation to recon him who thought me this stipulation to recon him who thought me this art equally dear to me as my parents, to art equally dear to me as my parents, to share my substance with him and relieve his share my substance with him and relieve his necessities if required : to look upon his off necessities if required : to look upon his off spring in the same footings my own spring in the same footings my own brothers, and to teach them this art if they brothers, and to teach them this art if they shall wish learn it, without fee or stipulation shall wish learn it, without fee or stipulation etc.etc.

This oath is sworn by physician when they This oath is sworn by physician when they finished the apprenticeship to behave facing finished the apprenticeship to behave facing patientpatient

For the benefit of patient the part of oath wasFor the benefit of patient the part of oath wasI will follow that system of regimen which according to I will follow that system of regimen which according to my ability and judgment, I consider for the benefit of my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to any and mischievous. I will give no deadly medicine to any one if asked, nor suggest any such council, and in like one if asked, nor suggest any such council, and in like manner I will not give a women apessary to produce manner I will not give a women apessary to produce abortion. With purity and with holiness I will pass my abortion. With purity and with holiness I will pass my life and practice my art I will not cut persons laboring life and practice my art I will not cut persons laboring under the stones, but will leave this to be done by under the stones, but will leave this to be done by men who are practitioners of the work. Into whatever men who are practitioners of the work. Into whatever houses I enter, I will go into them for the benefit of the houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of sick, and will abstain from every voluntary act of mischief and corruption, and further the seduction of mischief and corruption, and further the seduction of females or male, of freemen and sleeves.etcfemales or male, of freemen and sleeves.etc

FOR THE PATIENT SECRET

……..I see or hear, in live of men, which ought not to be spoken of abroad, I will not divulge as reckoning that all such should be kept secret, etc

But should I trespass and violate this oath, may the reverse be my lot

MEDIEVAL MEDICINE Greek medicine roughly speaking covered

the millennium 500 BC to 500 AD

The next millennium is AD 500 – AD 1500 called the middle ages, in this century the medieval medicine faced the problem of the invading Barbarian

Franken – Viking – Germanium Defunct empire Christian religions – Crusades Latin language – became medical text for the next

1300 years

Middle ages

Dark ages = monastic medicine end

1000 AD Late middle ages scholastic medicine

Arabic period

John S. Wellington (Univ. of John S. Wellington (Univ. of California)California) Western medicine entered Indonesia in Western medicine entered Indonesia in

the year 1700 (18the year 1700 (18thth century) century) Toward the Second World War it Toward the Second World War it

speeded up because the Dutch army speeded up because the Dutch army needed more manpower including needed more manpower including medical Indonesian physician got more medical Indonesian physician got more authorityauthority

In the 17In the 17th th and 18and 18thth century everywhere century everywhere in the world medical service system in the world medical service system was not orderly arrange yet. Skill of was not orderly arrange yet. Skill of diagnosis and treatment did not a diagnosis and treatment did not a school yet as a whole but more in the school yet as a whole but more in the form of trial and errorform of trial and error

Sometimes surgical was done in a Sometimes surgical was done in a harshly manner.harshly manner.

Why did the VOC (Dutch East India Why did the VOC (Dutch East India Company) need more doctors, and Company) need more doctors, and accept native peopleaccept native people Sea travel from the Netherlands took Sea travel from the Netherlands took

almost one year. All kind of disease almost one year. All kind of disease could attack the travelers could attack the travelers

No fresh food during the sea voyageNo fresh food during the sea voyage At the landing in East India many were At the landing in East India many were

sick, Hospital were lack of doctors.sick, Hospital were lack of doctors. Every ship had to have a doctorEvery ship had to have a doctor

In the 19In the 19thth century the colonial grip of century the colonial grip of the Dutch enforced and expand. the Dutch enforced and expand. Security must in the hand of the Security must in the hand of the military. So also services.military. So also services. 1825-1830 Diponegoro War1825-1830 Diponegoro War

Medical officers killedMedical officers killed

1947 Aceh war begin1947 Aceh war begin First 5 year 28 med. officers killed.First 5 year 28 med. officers killed. The Dutch need more medical assistanceThe Dutch need more medical assistance

In the 1870 total Dutchmen in Indonesia In the 1870 total Dutchmen in Indonesia were 36.000 with 300 doctors.were 36.000 with 300 doctors.

Hospitals were military hospitals.Hospitals were military hospitals. Medical services were only for the Dutch.Medical services were only for the Dutch.

Native people did not get medical Native people did not get medical attention from the Dutchattention from the Dutch

1879 there were 191 med officers1879 there were 191 med officers 2/3 got western military training2/3 got western military training 1/3 were Dutch civilian physician1/3 were Dutch civilian physician 37 men were non Dutch (German and 37 men were non Dutch (German and

Denmark)Denmark)

1804 The first vaccination against 1804 The first vaccination against smallpox with forced by military smallpox with forced by military men native aids called = mantri men native aids called = mantri cacar. Since then all nurses is cacar. Since then all nurses is called mantricalled mantri 1851 Army need additional medical 1851 Army need additional medical

manpower manpower medical skill training place foundedmedical skill training place founded 1931 Native medical training teacher started1931 Native medical training teacher started

Japanese occupation periodJapanese occupation period March 8, 1942 Dutch surrender to the March 8, 1942 Dutch surrender to the

Japanese. Many Dutch doctors imprisoned.Japanese. Many Dutch doctors imprisoned. Medical school in Jakarta (Batavia) and Medical school in Jakarta (Batavia) and

Surabaya closedSurabaya closed The last year medical student recanted by the The last year medical student recanted by the

JapaneseJapanese Medical school reopened by the Japanese (29 Medical school reopened by the Japanese (29

April 1943) also the pharmacy facultyApril 1943) also the pharmacy faculty Lectures in the faculties for the first time in the Lectures in the faculties for the first time in the

Indonesian languageIndonesian language

The initiative for using our own The initiative for using our own language in medical faculty werelanguage in medical faculty were Dr. Bahder DjohanDr. Bahder Djohan Dr. A.RamaliDr. A.Ramali Dr. Soetomo TjokronegoroDr. Soetomo Tjokronegoro

Dean of Med. faculty (ika dai gaku) in Jakarta Dean of Med. faculty (ika dai gaku) in Jakarta was Prof. Itagaki other faculties werewas Prof. Itagaki other faculties were Dr. Asikin WijayakusumaDr. Asikin Wijayakusuma Dr. AuliaDr. Aulia Dr. Bahder DjohanDr. Bahder Djohan Dr. A.RamaliDr. A.Ramali Dr. SarwonoDr. Sarwono Dr. SoemediDr. Soemedi Dr. Sartono KertopatiDr. Sartono Kertopati