The world of medical research, manufacture and pharmaceutical distribution is an exceptionally fast-paced, high-tech environment where medicines undergo rigorous modelling, tests and clinical trials before they are rolled out onto the market.

Thanks to advances in biological and genetic knowledge such as the recent AlphaFold protein library, there is more data than ever that can be used to find and isolate potential molecules that could be used to provide effective medicines to treat a range of conditions.

The earliest pharmaceutical traditions were somewhat different, although the concept of a library of potentially therapeutic substances is almost as old as medicine itself and traces itself back to some of the first-ever great civilisations.

Medicine And Mysticism

The use of medicinal plants is as old as humanity itself, with early Neanderthals treating illnesses and injuries through the use of water, leaves and herbs.

The areca nut, a mild stimulant that whilst known now to be a carcinogenic but has been used in traditional medicine as a treatment for tapeworms and other parasites, was found in the prehistoric Spirit Cave.

The earliest known medical writings came from the Sumerians, one of the earliest civilisations in history that would form part of Mesopotamia, which took the form of cuneiform tablets holding prescriptions for medicines that date back to the third millennium BC.

This is matched by other Mesopotamian cultures such as the Babylonians, the first known culture to run an apothecary, or early pharmacy business, and also had written the extensive Diagnostic Handbook, an early compilation of Babylonian medical knowledge.

At the time, there was a conflation between the mysticism that persisted in the beliefs of many ancient cultures and the therapeutic properties of the balms, herbs and medicines provided, as well as the earliest example of modern diagnostic principles.

This means that a cuneiform tablet detailing a treatment for poisoning would not only explain how to determine and treat a disease but also had a prayer or incantation to say during treatment.

Because of how similar later era Babylonian medicine is to early Ancient Greek medicine, there is a firm connection between the earliest tradition of medicine and De Materia Medica, one of the longest-lasting pharmaceutical books in human history.

Ancient Public Health

Parallel to the Mesopotamians creating many foundational principles for modern medicine and medical prescriptions, the Ancient Egyptians had a comprehensive public health system of their own, including the first-ever example of medical specialisation.

Much like in Mesopotamia, Egyptian medicine combined clinical diagnosis, anatomy and rational empiricism with mystic incantations and a belief that supernatural forces are part of medical ailments.

By far the most interesting surviving medical papyrus is an exception to this, however. The Edwin Smith Papyrus, which dates between 3000BC and 1600BC, mentions magic very rarely in favour of case studies of particular medical conditions, treatment options and the likelihood of success.

The Ebers Papyrus is one of the most important Egyptian written work with regards to medicine, as it contained 700 remedies for different conditions, once again including a mix of rational medical epistemology with incantation meant to turn away demons.

Some of the treatments are still used today, such as the treatment for Guinea-worm disease which involves wrapping the end of the worm around a stick and slowly pulling it out.

Exactly which of these documents was the first medical document is uncertain, as there is a tradition in Ancient Egypt of rewriting and redrafting old papyrus documents compared to the long-standing stone tablets used in Mesopotamia.

However, they highlight how even early in human civilisation, medicine was a fundamental part of survival and an understanding that this knowledge needed to be preserved, shared and used to help others.