Ancient Greek Medicine

Ancient Greek medicine revolved around the theory of humours. The most important figure in ancient Greek medicine is the physician Hippocrates, known as the "Father of Medicine", who established his own medical school at os. Hippocrates and his students documented many conditions in the Hippocratic orpus, and developed the Hippocratic !ath for physicians, still in use today. The writings of Hippocrates, and others, like "ocrates, had a lasting influence on #slamic medicine and Medieval $uropean medicine until many of their findings eventually became obsolete from the %&th century onwards.

Early influences
The first known Greek medical school opened in nidus in '(( ) . *lcmaeon, author of the first anatomical work, worked at this school, and it was here that the practice of observing patients was established. +espite their known respect for $gyptian medicine, attempts to discern any particular influence on Greek practice at this early time have not been dramatically successful because of the lack of sources and the challenge of understanding ancient medical terminology. #t is clear, however, that the Greeks imported $gyptian substances into their pharmacopoeia, and the influence became more pronounced after the establishment of a school of Greek medicine in *le,andria.-./

Hippocrates and Hippocratic medicine

The Hippocratic Corpus, a collection of around seventy early Greek medical works associated with Hippocrates and his teachings

* towering figure in the history of medicine was the physician Hippocrates of 0os 1ca. &2( ) 3 ca. 4'( ) 5, considered the "father of modern medicine."-4/-&/ The Hippocratic orpus is a collection of around seventy early medical works from ancient Greece strongly associated with Hippocrates and his students. Most famously, Hippocrates invented the Hippocratic !ath for physicians, which is still relevant and in use today. The e,istence of the Hippocratic !ath implies that this "Hippocratic" medicine was practiced by a group of professional physicians bound 1at least among themselves5 by a strict ethical code. *spiring students normally paid a fee for training 1a provision is made for e,ceptions5 and entered into a virtual family relationship with his teacher. This training included some oral instruction and probably hands6on e,perience as the teacher7s assistant, since the !ath assumes that the student will be interacting with patients. The !ath also places limits on what the physician may or may not do 1"To please no one will # prescribe a deadly drug"5 and intriguingly hints at the e,istence of another class of professional specialists, perhaps akin to surgeons 1"# will leave this operation to be performed by practitioners, specialists in this art"5.-8/ Hippocrates and his followers were first to describe many diseases and medical conditions. He is given credit for the first purple description of clubbing of the fingers, an important diagnostic sign in chronic suppurative lung disease, lung cancer and cyanotic heart disease. For this reason, clubbed fingers are sometimes referred to as "Hippocratic fingers".-2/ Hippocrates was also the first physician to describe Hippocratic face in Prognosis. "hakespeare famously alludes to this description when writing of Falstaff7s death in *ct ##, "cene iii. of Henry V.-'/-9/

The physician Hippocrates, known as the Father of Modern Medicine .-:/-%(/

Hippocrates began to categori;e illnesses as acute, chronic, endemic and epidemic, and use terms such as, "e,acerbation, relapse, resolution, crisis, paro,ysm, peak, and convalescence."-%%/-%./*nother of Hippocrates7s ma<or contributions may be found in his descriptions of the symptomatology, physical findings, surgical treatment and prognosis of thoracic empyema, i.e. suppuration of the lining of the chest cavity and hair loss and baldness. -%4/ His teachings remain relevant to present6day students of pulmonary medicine and surgery. -%&/ Hippocrates was the first documented chest surgeon and his findings are still valid.-%&/ TheHippocratic orpus contains the core medical te,ts of this school. *lthough once thought to have been written by Hippocrates himself, today, many scholars believe that these te,ts were written by a series of authors over several decades. -%8/ "ince it is impossible to determine which may have been written by Hippocrates himself, it is difficult to know which Hippocratic doctrines originated with him.

Asclepieia

=iew of the Askleipion of 0os, the best preserved instance of an *sklepieion.

Temples dedicated to the healer6god *sclepius, known as Asclepieia 1Greek> ?@ABCDEFGH, sing.Asclepieion !"#$%5, functioned as centers of medical advice, prognosis, and healing. -%2/ *t these shrines, patients would enter a dream6like state of induced sleep known as "enkoimesis" 1Greek> FIAJGKC@EL5 not unlike anesthesia, in which they either received guidance from the deity in a dream or were cured by surgery. -%'/*sclepeia provided carefully controlled spaces conducive to healing and fulfilled several of the reMuirements of institutions created for healing. -%2/ #n the *sclepieion of $pidaurus, three large marble boards dated to 48( ) preserve the names, case histories, complaints, and cures of about '( patients who came to the temple with a problem and shed it there. "ome of the surgical cures listed, such as the opening of an abdominal abscess or the removal of traumatic foreign material, are realistic enough to have taken place, but with the patient in a state of enkoimesis induced with the help of soporific substances such as opium.-%'/

Aristotle
*ncient Greek philosopher *ristotle was the most influential scholar of the living world from antiMuity. Though his early natural philosophy work was speculative, *ristotle7s later biological writings demonstrate great concern for empiricism, biological causation, and the diversity of life.-%9/ *ristotle did not e,periment, however, holding that items display their real natures in their own environments, rather than controlled artificial ones. Nhile in modern6 day physics and chemistry this assumption has been found unhelpful, in ;oology and ethology it remains the dominant practice, and *ristotle7s work "retains real interest".-%:/ He made countless observations of nature, especially the habits and attributes of plants and animals in the world around him, which he devoted considerable attention to categori;ing. #n all, *ristotle classified 8&( animal species, and dissected at least 8(. *ristotle believed that formal causes guided all natural processes.-.(/ "uch a teleological view gave *ristotle cause to <ustify his observed data as an e,pression of formal designO for e,ample suggesting that Pature, giving no animal both horns and tusks, was staving off vanity, and generally giving creatures faculties only to such a degree as they are necessary. #n a similar fashion, *ristotle believed that creatures were arranged in a graded scale of perfection rising from plants on up to manQthe scala naturae or Great hain of )eing.-.%/ He held that the level of a creature7s perfection was reflected in its form, but not foreordained by that form. Ret another aspect of his biology divided souls into three groups> a vegetative soul, responsible for reproduction and growthO a sensitive soul, responsible for mobility and sensationO and a rational soul, capable of thought and reflection. He attributed only the first to plants, the first two to animals, and all three to humans.-../ *ristotle, in

contrast to earlier philosophers, and like the $gyptians, placed the rational soul in the heart, rather than the brain. -.4/ Potable is *ristotle7s division of sensation and thought, which generally went against previous philosophers, with the e,ception of *lcmaeon.-.&/ *ristotle7s successor at the Syceum, Theophrastus, wrote a series of books on botanyQthe History of PlantsQwhich survived as the most important contribution of antiMuity to botany, even into the Middle *ges. Many of Theophrastus7 names survive into modern times, such as carpos for fruit, and pericarpion for seed vessel. Tather than focus on formal causes, as *ristotle did, Theophrastus suggested a mechanistic scheme, drawing analogies between natural and artificial processes, and relying on *ristotle7s concept of the efficient cause. Theophrastus also recogni;ed the role of se, in the reproduction of some higher plants, though this last discovery was lost in later ages.-.8/ The biologicalUteleological ideas of *ristotle and Theophrastus, as well as their emphasis on a series of a,ioms rather than on empirical observation, cannot be easily separated from their conseMuent impact on Nestern medicine.

Alexandria

Frontispiece to a %2&& version of the e,panded and illustrated edition of Historia Plantaru& 1ca. %.((5, which was originally written around .(( )

Following Theophrastus 1 d..92 ) 5, the Syceum failed to produce any original work. Though interest in *ristotle7s ideas survived, they were generally taken unMuestioningly. -.2/ #t is not until the age of *le,andria under the Vtolemies that advances in biology can be again found. The first medical teacher at *le,andria was Herophilus of halcedon, who differed from *ristotle, placing intelligence in the brain, and connected the nervous system to motion and sensation. Herophilus also distinguished between veins and arteries, noting that the latter pulse while the former do not. He did this using an e,periment involving cutting certain veins and arteries in a pig7s neck until the sMuealing stopped. -.'/ #n the same vein 1no pun intended5, he developed a diagnostic techniMue which relied upon distinguishing different types of pulse.-.9/ He, and his contemporary, $rasistratus of hios, researched the role of veins and nerves, mapping their courses across the body. $rasistratus connected the increased comple,ity of the surface of the human brain compared to other animals to its superior intelligence. He sometimes employed e,periments to further his research, at one time repeatedly weighing a caged bird and noting its weight loss between feeding times. Following his teacher7s researches into pneumatics, he claimed that the human system of blood vessels was controlled by vacuums, drawing blood across the body. #n $rasistratus7 physiology, air enters the body, is then drawn by the lungs into the heart, where it is transformed into vital spirit, and is then pumped by the arteries throughout the body. "ome of this vital spirit reaches the brain, where it is transformed into animal spirit, which is then distributed by the nerves.-.:/ Herophilus and $rasistratus performed their e,periments upon criminals given to them by their Vtolemaic kings. They dissected these criminals alive, and "while they were still breathing they observed parts which nature had formerly concealed, and e,amined their position, colour, shape, si;e, arrangement, hardness, softness, smoothness, connection." -4(/ Though a few ancient atomists such as Sucretius challenged the teleological viewpoint of *ristotelian ideas about life, teleology 1and after the rise of hristianity, natural theology5 would remain central to biological thought essentially until the %9th and %:th centuries. #n the words of $rnst Mayr, "Pothing of any real conseMuence in biology after Sucretius and Galen until the Tenaissance."-4%/ *ristotle7s ideas of natural history and medicine survived, but they were generally taken unMuestioningly. -4./

Dioscorides
The first century *+ Greek physician, pharmacologist, botanist, and Toman army surgeon Vedanius +ioscorides authored an encyclopedia of medicinal substances commonly known as 'e Materia Medica( This work did not delve into medical theory or e,planation of pathogenesis, but described the uses and actions of some 2(( substances, based on empirical observation. Wnlike other works of lassical antiMuity, +ioscorides7

manuscript was never out of publication and his materia medica formed the basis for the Nestern pharmacopeia through the %:th century, a true testament to the efficacy of the medicines described O moreover, the influence of this work on $uropean herbal medicine eclipsed that of the Hippocratic orpus -44/.

Historical legacy
Through long contact with Greek culture, and their eventual conMuest of Greece, the Tomans absorbed many of the Greek ideas on medicine. $arly Toman reactions to Greek medicine ranged from enthusiasm to hostility, but eventually the Tomans adopted a favorable view of Hippocratic medicine.-4&/ This acceptance led to the spread of Greek medical theories throughout the Toman $mpire, and thus a large portion of the Nest. The most influential Toman scholar to continue and e,pand on the Hippocratic tradition was Galen 1d. c. .('5. "tudy of Hippocratic and Galenic te,ts, however, all but disappeared in the Satin Nest in the $arly Middle *ges, following the collapse of the Nestern $mpire, although the Hippocratic6Galenic tradition of Greek medicine continued to be studied and practiced in the $astern Toman $mpire 1)y;antium5. *fter *+ '8(, *rab, Versian and *ndalusi scholars translated Galen7s and +ioscorides7 works in particular translated. Thereafter the Hippocratic6Galenic medical tradition was assimilated and eventually e,panded, with the most influential Muslim doctor6scholar being 1#bn "ina5. )eginning in the late eleventh century, the Hippocratic6Galenic tradition returned to the Satin Nest with a series of translations of the lassical te,ts, mainly from *rabic translations but occasionally from the original Greek. #n the Tenaissance, more translations of Galen and Hippocrates directly from the Greek were made from newly available )y;antine manuscripts. Galen7s influence was so great that even after Nestern $uropeans started making dissections in the thirteenth century, scholars often assimilated findings into the Galenic model that otherwise might have thrown Galen7s accuracy into doubt. !ver time, however, lassical medical theory came to be superseded by increasing emphasis on scientific e,perimental methods in the %2th and %'th centuries. Pevertheless, the Hippocratic6Galenic practice of bloodletting was practiced into the %:th century, despite its empirical ineffectiveness and riskiness.

Chiron

In Greek mythology, the centaur, Chiron, was wounded by Hercules. Though he was immortal, it is said that he invented medicine in order to heal himself. He taught Asclepius the art of healing, which became the source of all divine medical knowledge among the Greeks. Chiron was also the teacher of the hero, Achilles, who was thought to have had some special medical knowledge. Achilles

any depictions of Greek medicine involve battle in!uries, especially of the Heroes. In this noted vase painting, Achilles tends to the wounds of "atroclus.
QUOTE
#...$ut save me. Take me to the ship, cut this arrow out of my leg, wash the blood from it with warm water and put the right things on it % the plants they say you have learned about from Achilles who learned them from Chiron, the best of the Centaurs.# &The Iliad of Homer, $ook 'I

Introduction

Ancient Greek Medicine and Modern Foundations

any foundations of modern (estern medicine lie in Classical Greece, from about )** $.C.+. to about ,** C.+. -uring this period, Greek medicine departed from the divine and mystical and moved toward observation and logical reasoning. These ideas spread throughout the editerranean world and as far east as India, and their influence has remained strong in the (est to this day.

The Ancient Greek

orld

The Ancient Greek world included parts of modern%day Greece, Turkey, +gypt, and Italy. Hippocrates and the !ise of !ational Medicine

.irtually nothing is known of the first physician named Hippocrates, but there are considered to have been several, all of them teachers at the famous medical school on the thought. Hippocrates is generally credited with turning away from divine notions of medicine and using observation of the body as a basis for medical knowledge. "rayers and sacrifices to the gods did not hold a central place in his theories, but changes in diet, beneficial drugs, and keeping the body #in balance# were the key. editerranean island of Cos. It was in the /th century $.C.+., however, that Hippocrates0 name and image began to emerge as a leader in medical research and

Central to his physiology and ideas on illness was the humoral theory of health, whereby the four bodily fluids, or humors, of blood, phlegm, yellow bile, and black bile needed to be kept in balance. Illness was caused when these fluids became out of balance, sometimes re1uiring the reduction in the body of a humor through bloodletting or purging. The Hippocratic Corpus, or the collected writings attributed to Hippocrates, contains about si2ty works on a variety of medical topics, including diagnosis, epidemics, obstetrics, pediatrics, nutrition, and surgery. There are assumed to be several authors, however, probably scattered over several centuries, and different treatises often give contradictory advice.

Hippocrates" " Omnia opera Hippocratis" #enice$ Aldus Manutius% &'()"

This first Greek edition of Hippocrates0 complete works benefited from Aldus anutius0 careful editing, which made its te2t the standard for the Greek Corpus for over a century.

$orn in 3)4 $.C.+. the son of a physician at 5tageira in

acedonia,

Aristotle was one of the most noted philosophers and scientists of the ancient world. 6nce a student of "lato at his Academy in Athens, Aristotle adopted his own methods of in1uiry different from that of his teacher. 7nlike "lato, Aristotle felt that one could, and in fact must, trust one8s senses in the investigation of knowledge and reality.

At "lato8s death, Aristotle was not chosen to be his successor as head of the Academy and he left Athens. He eventually returned to rest of the acedonia, where he was teacher to the young Ale2ander the Great. After Ale2ander con1uered Athens and the iddle +ast and +gypt, Aristotle returned to Athens to found the 9yceum, a school similar to "lato8s Academy. After Ale2ander8s death, Aristotle was forced to flee Athens to the nearby island of +uboea, where he died soon afterwards in 3,, $.C.+ Aristotle8s writings cover a wide variety of sub!ects, from human and animal anatomy, to metaphysics, statesmanship, and poetry. His treatises on human anatomy are lost, but his many works on animals advocate direct observation and anatomical comparisons between species through dissection. He wrote e2tensively on the soul, classifying the souls of different forms of life and inanimate ob!ects, including the earth and the heavens. Aristotle wrote e2tensively on animal life and both se2ual and ase2ual reproduction, making him in many ways the founder of (estern natural philosophy.

Aristotle" De animalibus. *#enice$ Iohannem de Colonia% &+,)-"

This first 9atin edition of Aristotle0s initials are hand colored.

De animalibus

was translated by

Theodore Ga:a, a Greek refugee to Italy after the fall of Constantinople in ;4/3. The

Aristotle" . */arisiis$ Apud Guil" Morelium% &')&-"

This early edition of Aristotle includes the Greek te2ts of his treatises on physics, dreams, and the soul.

/seudo0Aristotle
Aristotles Master-piece improved

*1ondon$ /rinted% and sold 2y the 2ooksellers%

3&,))4-"

Aristotle0s

aster%piece first appeared in +ngland in the ;<=*s as a

popular guide to human reproduction> it was later published in more than ;** editions. Aristotle0s name was most likely used in order to add legitimacy to the work by claiming it had ancient, scientific sources. The true author is unknown. The frontispiece of nearly every edition shows a hirsute woman and child by the desk of a scholar, most likely depicting popular notions of the time about the causes of birth defects.

The 1oss and !eco5ery of Greek Medicine in the

est

After the fall of the ?oman +mpire in the /th century, most works of the Greek physicians were lost to (estern +urope. In the ;4th and ;/th centuries, however, (estern +uropeans began to rediscover Greek scientific and medical te2ts. This was due in part to the discovery of Arab repositories of learning in 5pain and elsewhere during the Crusades as well as the immigration to Italy of $y:antine scholars at the fall of Constantinople in ;4/3.

At first Greek theories, prescriptions, and procedures were accepted as medical dogma bout human anatomy, physiology, and treatment. 9ater, however, the Greeks0 entreaties to their readers to observe the human body and the world around them won out, and scholars began to perform their own research, leading to much of the medicine practiced in the (est today

Galen was born in "ergamos in Asia

inor in the year ;3; C.+. After receiving

medical training in 5myrna and Ale2andria, he gained fame as a surgeon to the gladiators of "ergamos. He was eventually summoned to ?ome to be the physician of the +mperor arcus Aurelius. Galen spent the rest of his life at the Court writing an enormous corpus of medical works until his death in ,*; C.+. Taking Hippocrates0 notions of the humors and pathology, Galen incorporated the anatomical knowledge of noted Ale2andrians such as Herophilus of Chalcedon @33/% ,)* $.C.+.A. A supporter of observation and reasoning, he was one of the first e2perimental physiologists, researching the function of the kidneys and the spinal cord in controlled e2periments. Galen0s works in many ways came to symboli:e Greek medicine to the medical scholars of +urope and the iddle +ast for the ne2t fifteen centuries. His message of observation and e2perimentation were largely lost, however, and his theories became dogma throughout the (est. In the mid%;<th century, however, his message that observation and investigation were re1uired for through medical research began to emerge, and modern methods of such research finally arose.