Medicine in Ancient Greece
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Many people believe Greece was the home of the first Western medical science, when doctors stopped relying on superstition and divine cures, and replaced them with rational curiosity about the causes of illness (the ancient Greeks were practically unique in being a largely secular country). According to tradition, the pioneer of this attitude of observation was Hippocrates (c.460 - 377 BC). According to his traditional biography, Hippocrates based his medical practices on careful observation and keeping records of case histories. He is therefore often regarded as the "father of Western medicine", as it was his ideas and interest in the whole patient that was the basis of further medicine for hundreds of years.
Origins
According to mythology, the Greek god Asclepius was trained as a doctor. Along with his daughters Hygieia and Panacea, he was worshipped in a type of healing temple called asclepieion. Such admiration for doctors and healing was not restricted to the gods; the ancient Greeks also greatly admired Ancient Egyptian medicine. The reputation of the Egyptians for their knowledge of herbs can be seen in the Odyssey (4.220).The first known medical school opened in Cnido in 700 BC. Alcmaeon, author of the first anatomical work, worked at this school, and it was here that the practice of observing patients was established. One hundred years later, Hippocrates established his own medical school at Cos.Atlas of Anatomy, ed. Giunti Editorial Group, Taj Books LTD 2002, p. 9. Despite their known respect for Egyptian 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. It is clear, however, that the Greeks definitely imported Egyptian substances into their pharmacopoeia, and the influence becomes more pronounced after the establishment of a school of Greek medicine in Alexandria.Heinrich Von Staden, Herophilus: The Art of Medicine in Early Alexandria (Cambridge: Cambridge University Press, 1989), pp. 1-26.
Hippocrates and Hippocratic medicine
Hippocrates, founder of the school at Cos, was also regarded in Antiquity as the founder and developer of the concept of physis, or considering the human being as an organic whole, as he believed that the environment would influence the whole body.
Hippocrates taught Greek doctors to recognise in the outward appearance of the patient which symptoms might be caused by disease, skills which were developed by later doctors into the more precise science of diagnosis. From these beginnings, four main aspects—observation, diagnosis, prognosis, and treatment—became the basis for professional clinical observation.
Hippocrates was said to be the founder of a school of doctors (actually trained through apprenticeship, not in a formal school) who practiced what might be called "Hippocratic medicine". The Hippocratic Corpus contains the core medical texts of this school. Although once thought to have been written by Hippocrates himself, today, many scholars believe that these texts were written by a series of authors over several decades. Since it is impossible to determine which may have been written by Hippocrates himself, it is difficult to know which Hippocratic doctrines originated with him.
The existence of the Hippocratic Oath implies that this "Hippocratic" medicine was practiced by a group of professional physicians bound (at least among themselves) by a strict ethical code. Aspiring students normally paid a fee for training (a provision is made for exceptions) and entered into a virtual family relationship with his teacher. This training included some oral instruction and probably hands-on experience as the teacher's assistant, since the Oath assumes that the student will be interacting with patients. The Oath also places limits on what the physician may or may not do ("To please no one will I prescribe a deadly drug") and intriguingly hints at the existence of another class of professional specialists, perhaps akin to surgeons ("I will leave this operation to be performed by practitioners, specialists in this art").Owsei Temkin, "What Does the Hippocratic Oath Say?," in "On Second Thought" and Other Essays in the History of Medicine (Baltimore: Johns Hopkins University Press, 2002), pp. 21-28.
The theory of the four humours
The Hippocratics, along with many other Greeks, also believed in the theory of the four humours. This theory had its roots in the belief in four elements which, Empedocles argued, made up everything in the world: earth, air, fire and water with their associated qualities of dryness, coldness, heat and wetness respectively. These, in turn, were linked to the four seasons; dry autumn, cold winter, hot summer and wet spring (it followed that you were more likely to suffer from a particular humour in the corresponding season). Among other corollaries, this theory meant that for some diseases, remedies to purge excess humours, such as bloodletting or vomiting, seemed advisable.
These ideas influenced Western medicine for over 1500 years, being later taken up by Galen and absorbed into medieval medicine, even stretching into some 19th century medical practices.
As to the exact relationship between the humours and illness, beliefs varied. The Hippocratics taught that an imbalance of the humours, or dyscrasia, was symptomatic of an illness. Aristotle (384-322 BC), however, suggested that it was the cause of illness. It was believed that one could only be in perfect health when the humours were in balance, known as crasis or eucrasia. The natural tendency towards balance, or recovery, was called pepsis or coction.
Alexandria
When Alexander the Great founded Alexandria, Egypt in 332 BC, it had a major impact on Greek medical ideas and practices. The Library of Alexandria was soon established, and its collections of important scientific and philosophical texts became famous throughout the Hellenistic world, even into the Roman Empire. Alexandria was also the only city in Ancient Greece where dissection (and maybe even vivisection of criminals sentenced to death) was legal, which meant that doctors could gain a far more detailed knowledge of the workings of the human body, i.e., anatomy. The anatomists Herophilus and Erasistratus worked here, and many other doctors from all over the world went to study; for a time, Alexandria became the centre for medical knowledge in the West.Influence on Rome & Christianity
Through long contact with Greek culture, and their eventual conquest of Greece, the Romans absorbed many of the Greek ideas on medicine. Early Roman reactions to Greek medicine ranged from enthusiasm to hostility, but eventually the Romans adopted a favorable view of Hippocratic medicine won out.von Staden, "Liminal Perils: Early Roman Receptions of Greek Medicine," in Tradition, Transmission, Transformation, ed. F. Jamil Ragep and Sally P. Ragep with Steven Livesey (Leiden: Brill, 1996), pp. 369-418.This acceptance led to the spread of Greek medical theories throughout the Roman Empire, and thus a large portion of the West. Following the collapse of the Empire, however, official Catholic support for Galen's teachings made these the only politically acceptable ideas on medicine until the Renaissance. This support was a major reason for the huge impact of his teachings, despite their sometimes questionable value. For example, the theory of bloodletting was popular into the 19th century, despite its total inefficacy and the extreme riskiness: many people, including possibly George Washington, died from its failure.
See also
References
Further reading
- Louis Cohn-Haft, The Public Physicians of Ancient Greece, Northampton, Massachusetts, 1956
- W. H. S. Jones, Philosophy and Medicine in Ancient Greece, Johns Hopkins Press, Baltimore, 1946
- James Longrigg, Greek Rational Medicine: Philosophy and Medicine from Alcmæon to the Alexandrians, Routledge, 1993.
External links
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