Ancient Greek medicine was a compilation of
theories and practices that were constantly
expanding through new ideologies and trials.
Many components were considered in ancient
Greek medicine, intertwining the spiritual
with the physical. Specifically, the ancient
Greeks believed health was affected by the
humors, geographic location, social class,
diet, trauma, beliefs, and mindset. Early
on the ancient Greeks believed that illnesses
were "divine punishments" and that healing
was a "gift from the Gods". As trials continued
wherein theories were tested against symptoms
and results, the pure spiritual beliefs regarding
"punishments" and "gifts" were replaced with
a foundation based in the physical, i.e.,
cause and effect.
Humorism (or the four humors) refers to blood,
phlegm, yellow bile and black bile. It was
also theorized that sex played a role in medicine
because some diseases and treatments were
different for females than for males. Moreover,
geographic location and social class affected
the living conditions of the people and might
subject them to different environmental issues
such as mosquitoes, rats, and availability
of clean drinking water. Diet was thought
to be an issue as well and might be affected
by a lack of access to adequate nourishment.
Trauma, such as that suffered by gladiators,
from dog bites or other injuries, played a
role in theories relating to understanding
anatomy and infections. Additionally, there
was significant focus on the beliefs and mindset
of the patient in the diagnosis and treatment
theories. It was recognized that the mind
played a role in healing, or that it might
also be the sole basis for the illness.Ancient
Greek medicine began to revolve around the
theory of humors.The humoral theory states
that good health comes from a perfect balance
of the four humors: blood, phlegm, yellow
bile, and black bile. Consequently, poor health
resulted from improper balance of the four
humors. Hippocrates, known as the "Father
of Modern Medicine", established a medical
school at Cos and is the most important figure
in ancient Greek medicine. Hippocrates and
his students documented numerous illnesses
in the Hippocratic Corpus, and developed the
Hippocratic Oath for physicians, which is
still in use today. The contributions to ancient
Greek medicine of Hippocrates, Socrates and
others had a lasting influence on Islamic
medicine and medieval European medicine until
many of their findings eventually became obsolete
in the 14th century.
The earliest known Greek medical school opened
in Cnidus in 700 BC. Alcmaeon, author of the
first anatomical compilation, worked at this
school, and it was here that the practice
of observing patients was established. 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 imported Egyptian
substances into their pharmacopoeia, and the
influence became more pronounced after the
establishment of a school of Greek medicine
in Alexandria.
== Asclepieia ==
Asclepius was espoused as the first physician,
and myth placed him as the son of Apollo.
Temples dedicated to the healer-god Asclepius,
known as Asclepieia (Greek: Ἀσκληπιεῖα;
sing. Ἀσκληπιεῖον Asclepieion),
functioned as centers of medical advice, prognosis,
and healing. At these shrines, patients would
enter a dream-like state of induced sleep
known as "enkoimesis" (Greek: ἐγκοίμησις)
not unlike anesthesia, in which they either
received guidance from the deity in a dream
or were cured by surgery. Asclepeia provided
carefully controlled spaces conducive to healing
and fulfilled several of the requirements
of institutions created for healing. The Temple
of Asclepius in Pergamum had a spring that
flowed down into an underground room in the
Temple. People would come to drink the waters
and to bathe in them because they were believed
to have medicinal properties. Mud baths and
hot teas such as chamomile were used to calm
them or peppermint tea to soothe their headaches,
which is still a home remedy used by many
today. The patients were encouraged to sleep
in the facilities too. Their dreams were interpreted
by the doctors and their symptoms were then
reviewed. Dogs would occasionally be brought
in to lick open wounds for assistance in their
healing. In the Asclepieion of Epidaurus,
three large marble boards dated to 350 BC
preserve the names, case histories, complaints,
and cures of about 70 patients who came to
the temple with a problem and shed it there.
Some 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.The Rod of Asclepius is a universal
symbol for medicine to this day. However,
it is frequently confused with Caduceus, which
was a staff wielded by the god Hermes. The
Rod of Asclepius embodies one snake with no
wings whereas Caduceus is represented by two
snakes and a pair of wings depicting the swiftness
of Hermes.
== Ancient Greek physicians ==
Ancient Greek physicians regarded disease
as being of supernatural origin, brought about
from the dissatisfaction of the gods or from
demonic possession. The fault of the ailment
was placed on the patient and the role of
the physician was to conciliate with the gods
or exorcise the demon with prayers, spells,
and sacrifices.
== The Hippocratic Corpus and Humorism ==
The Hippocratic Corpus opposes ancient beliefs,
offering biologically based approaches to
disease instead of magical intervention. The
Hippocratic Corpus is a collection of about
seventy early medical works from ancient Greece
that are associated with Hippocrates and his
students. Although once thought to have been
written by Hippocrates himself, many scholars
today believe that these texts were written
by a series of authors over several decades.
The Corpus contains the treatise, the Sacred
Disease, which argues that if all diseases
were derived from supernatural sources, biological
medicines would not work. The establishment
of the humoral theory of medicine focused
on the balance between blood, yellow and black
bile, and phlegm in the human body. Being
too hot, cold, dry or wet disturbed the balance
between the humors, resulting in disease and
illness. Gods and demons were not believed
to punish the patient, but attributed to bad
air (miasma theory). Physicians who practiced
humoral medicine focused on reestablishing
balance between the humors. The shift from
supernatural disease to biological disease
did not completely abolish Greek religion,
but offered a new method of how physicians
interacted with patients.
Ancient Greek physicians who followed humorism
emphasized the importance of environment.
Physicians believed patients would be subjected
to various diseases based on the environment
they resided. The local water supply and the
direction the wind blew influenced the health
of the local populace. Patients played an
important role in their treatment. Stated
in the treatise "Aphorisms", "[i]t is not
enough for the physician to do what is necessary,
but the patient and the attendant must do
their part as well". Patient compliance was
rooted in their respect for the physician.
According to the treatise "Prognostic", a
physician was able to increase their reputation
and respect through "prognosis", knowing the
outcome of the disease. Physicians had an
active role in the lives of patients, taking
into consideration their residence. Distinguishing
between fatal diseases and recoverable disease
was important for patient trust and respect,
positively influencing patient compliance.
With the growth of patient compliance in Greek
medicine, consent became an important factor
between the doctor and patient relationship.
Presented with all the information concerning
the patient's health, the patient makes the
decision to accept treatment. Physician and
patient responsibility is mentioned in the
treatise "Epidemics", where it states, "there
are three factors in the practice of medicine:
the disease, the patient and the physician.
The physician is the servant of science, and
the patient must do what he can to fight the
disease with the assistance of the physician".
== Aristotle's influence on Greek perception
==
Ancient Greek philosopher Aristotle was the
most influential scholar of the living world
from antiquity. Aristotle's biological writings
demonstrate great concern for empiricism,
biological causation, and the diversity of
life. Aristotle did not experiment, however,
holding that items display their real natures
in their own environments, rather than controlled
artificial ones. While in modern-day physics
and chemistry this assumption has been found
unhelpful, in zoology and ethology it remains
the dominant practice, and Aristotle's 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 categorizing. In all, Aristotle
classified 540 animal species, and dissected
at least 50.
Aristotle believed that formal causes guided
all natural processes. Such a teleological
view gave Aristotle cause to justify his observed
data as an expression of formal design; for
example suggesting that Nature, 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.
In a similar fashion, Aristotle believed that
creatures were arranged in a graded scale
of perfection rising from plants on up to
man—the scala naturae or Great Chain of
Being.He held that the level of a creature's
perfection was reflected in its form, but
not foreordained by that form. Yet another
aspect of his biology divided souls into three
groups: a vegetative soul, responsible for
reproduction and growth; a sensitive soul,
responsible for mobility and sensation; 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.
Aristotle, in contrast to earlier philosophers,
and like the Egyptians, placed the rational
soul in the heart, rather than the brain.
Notable is Aristotle's division of sensation
and thought, which generally went against
previous philosophers, with the exception
of Alcmaeon. Aristotle's successor at the
Lyceum, Theophrastus, wrote a series of books
on botany—the History of Plants—which
survived as the most important contribution
of antiquity to botany, even into the Middle
Ages. Many of Theophrastus' names survive
into modern times, such as carpos for fruit,
and pericarpion for seed vessel. Rather than
focus on formal causes, as Aristotle did,
Theophrastus suggested a mechanistic scheme,
drawing analogies between natural and artificial
processes, and relying on Aristotle's concept
of the efficient cause. Theophrastus also
recognized the role of sex in the reproduction
of some higher plants, though this last discovery
was lost in later ages. The biological/teleological
ideas of Aristotle and Theophrastus, as well
as their emphasis on a series of axioms rather
than on empirical observation, cannot be easily
separated from their consequent impact on
Western medicine.
== Herophilus and Erasistratus ==
Following Theophrastus (d. 286 BC), the Lyceum
failed to produce any original work. Though
interest in Aristotle's ideas survived, they
were generally taken unquestioningly. It is
not until the age of Alexandria under the
Ptolemies that advances in biology can be
again found. The first medical teacher at
Alexandria was Herophilus of Chalcedon, who
differed from Aristotle, 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 experiment involving cutting
certain veins and arteries in a pig's neck
until the squealing stopped. In the same vein,
he developed a diagnostic technique which
relied upon distinguishing different types
of pulse. He, and his contemporary, Erasistratus
of Chios, researched the role of veins and
nerves, mapping their courses across the body.
Erasistratus connected the increased complexity
of the surface of the human brain compared
to other animals to its superior intelligence.
He sometimes employed experiments to further
his research, at one time repeatedly weighing
a caged bird and noting its weight loss between
feeding times. Following his teacher's researches
into pneumatics, he claimed that the human
system of blood vessels was controlled by
vacuums, drawing blood across the body. In
Erasistratus' 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. Some of this vital spirit reaches
the brain, where it is transformed into animal
spirit, which is then distributed by the nerves.
Herophilus and Erasistratus performed their
experiments upon criminals given to them by
their Ptolemaic kings. They dissected these
criminals alive, and "while they were still
breathing they observed parts which nature
had formerly concealed, and examined their
position, colour, shape, size, arrangement,
hardness, softness, smoothness, connection."Though
a few ancient atomists such as Lucretius challenged
the teleological viewpoint of Aristotelian
ideas about life, teleology (and after the
rise of Christianity, natural theology) would
remain central to biological thought essentially
until the 18th and 19th centuries. In the
words of Ernst Mayr, "Nothing of any real
consequence in biology after Lucretius and
Galen until the Renaissance." Aristotle's
ideas of natural history and medicine survived,
but they were generally taken unquestioningly.
== Galen ==
Aelius Galenus was a prominent Greek physician,
surgeon and philosopher in the Roman Empire.
Arguably the most accomplished of all medical
researchers of antiquity, Galen influenced
the development of various scientific disciplines,
including anatomy, physiology, pathology,
pharmacology, and neurology, as well as philosophy
and logic.
The son of Aelius Nicon, a wealthy architect
with scholarly interests, Galen received a
comprehensive education that prepared him
for a successful career as a physician and
philosopher. Born in Pergamon (present-day
Bergama, Turkey), Galen traveled extensively,
exposing himself to a wide variety of medical
theories and discoveries before settling in
Rome, where he served prominent members of
Roman society and eventually was given the
position of personal physician to several
emperors.
Galen's understanding of anatomy and medicine
was principally influenced by the then-current
theory of humorism, as advanced by ancient
Greek physicians such as Hippocrates. His
theories dominated and influenced Western
medical science for more than 1,300 years.
His anatomical reports, based mainly on dissection
of monkeys, especially the Barbary macaque,
and pigs, remained uncontested until 1543,
when printed descriptions and illustrations
of human dissections were published in the
seminal work De humani corporis fabrica by
Andreas Vesalius where Galen's physiological
theory was accommodated to these new observations.
Galen's theory of the physiology of the circulatory
system endured until 1628, when William Harvey
published his treatise entitled De motu cordis,
in which he established that blood circulates,
with the heart acting as a pump. Medical students
continued to study Galen's writings until
well into the 19th century. Galen conducted
many nerve ligation experiments that supported
the theory, which is still accepted today,
that the brain controls all the motions of
the muscles by means of the cranial and peripheral
nervous systems.Galen saw himself as both
a physician and a philosopher, as he wrote
in his treatise entitled That the Best Physician
is also a Philosopher. Galen was very interested
in the debate between the rationalist and
empiricist medical sects, and his use of direct
observation, dissection and vivisection represents
a complex middle ground between the extremes
of those two viewpoints.
== Dioscorides ==
The first century AD Greek physician, pharmacologist,
botanist, and Roman army surgeon Pedanius
Dioscorides authored an encyclopedia of medicinal
substances commonly known as De Materia Medica.
This work did not delve into medical theory
or explanation of pathogenesis, but described
the uses and actions of some 600 substances,
based on empirical observation. Unlike other
works of Classical antiquity, Dioscorides'
manuscript was never out of publication; it
formed the basis for the Western pharmacopeia
through the 19th century, a true testament
to the efficacy of the medicines described
; moreover, the influence of work on European
herbal medicine eclipsed that of the Hippocratic
Corpes.
== Historical legacy ==
Through long contact with Greek culture, and
their eventual conquest of Greece, the Romans
adopted a favorable view of Hippocratic medicine.This
acceptance led to the spread of Greek medical
theories throughout the Roman Empire, and
thus a large portion of the West. The most
influential Roman scholar to continue and
expand on the Hippocratic tradition was Galen
(d. c. 207). Study of Hippocratic and Galenic
texts, however, all but disappeared in the
Latin West in the Early Middle Ages, following
the collapse of the Western Empire, although
the Hippocratic-Galenic tradition of Greek
medicine continued to be studied and practiced
in the Eastern Roman Empire (Byzantium). After
AD 750, Arab, Persian and Andalusi scholars
translated Galen's and Dioscorides' works
in particular. Thereafter the Hippocratic-Galenic
medical tradition was assimilated and eventually
expanded, with the most influential Muslim
doctor-scholar being (Ibn Sina). Beginning
in the late eleventh century, the Hippocratic-Galenic
tradition returned to the Latin West with
a series of translations of the Classical
texts, mainly from Arabic translations but
occasionally from the original Greek. In the
Renaissance, more translations of Galen and
Hippocrates directly from the Greek were made
from newly available Byzantine manuscripts.
Galen's influence was so great that even after
Western Europeans started making dissections
in the thirteenth century, scholars often
assimilated findings into the Galenic model
that otherwise might have thrown Galen's accuracy
into doubt. Over time, however, Classical
medical theory came to be superseded by increasing
emphasis on scientific experimental methods
in the 16th and 17th centuries. Nevertheless,
the Hippocratic-Galenic practice of bloodletting
was practiced into the 19th century, despite
its empirical ineffectiveness and riskiness.
== See also ==
Medical community of ancient Rome
Medicine in ancient Rome
On Ancient Medicine (Hippocratic Corpus)
Ibn Sina Academy of Medieval Medicine and
Sciences
History of medicine
== References ==
== Bibliography ==
Connor, J. T. H. An English Language Bibliography
of Classical Greek Medicine
== Further reading ==
Annas, Julia. Classical Greek Philosophy.
In Boardman, John; Griffin, Jasper; Murray,
Oswyn (ed.) The Oxford History of the Classical
World. Oxford University Press: New York,
1986. ISBN 0-19-872112-9
Barnes, Jonathan. Hellenistic Philosophy and
Science. In Boardman, John; Griffin, Jasper;
Murray, Oswyn (ed.) The Oxford History of
the Classical World. Oxford University Press:
New York, 1986. ISBN 0-19-872112-9
Cohn-Haft, Louis. The Public Physicians of
Ancient Greece, Northampton, Massachusetts,
1956.
Guido, Majno. The Healing Hand: Man and Wound
in the Ancient World, Harvard University Press,
1975.
Guthrie, W. K. C. A History of Greek Philosophy.
Volume I: The earlier Presocratics and the
Pythagoreans. Cambridge University Press:
New York, 1962. ISBN 0-521-29420-7
Jones, W. H. S. Philosophy and Medicine in
Ancient Greece, Johns Hopkins Press, Baltimore,
1946.
Lennox, James (2006-02-15). Aristotle's Biology.
Stanford Encyclopedia of Philosophy.
Longrigg, James. Greek Rational Medicine:
Philosophy and Medicine from Alcmæon to the
Alexandrians, Routledge, 1993.
Lovejoy, Arthur O. The Great Chain of Being:
A Study of the History of an Idea. Harvard
University Press, 1936. Reprinted by Harper
& Row, ISBN 0-674-36150-4, 2005 paperback:
ISBN 0-674-36153-9
Mason, Stephen F. A History of the Sciences.
Collier Books: New York, 1956.
Mayr, Ernst. The Growth of Biological Thought:
Diversity, Evolution, and Inheritance. The
Belknap Press of Harvard University Press:
Cambridge, Massachusetts, 1982. ISBN 0-674-36445-7
Nutton, Vivian. The Healing Hand: Man and
Wound in the Ancient World. Routledge, 2004
Heinrich von Staden (ed. trans.). Herophilus:
The Art of Medicine in Early Alexandria. Cambridge
University Press, 1989. ISBN 0-521-23646-0,
ISBN 978-0-521-23646-1]
Longrigg, James. Greek Medicine From the Heroic
to the Hellenistic Age. New York, NY, 1998.
ISBN 0-415-92087-6
== External links ==
Ancient Greek Medicine in medicinenet.com
Greek Medicine by the History of Medicine
Division of the National Library of Medicine.
(in French) (in English) Medicine in Antiquity
greekmedicine.net
Greek and Roman Medicine: An Introductory
Bibliography for Graduate Students in Classics
at Ancient Medicine compiled by Lee T. Pearcy
