History of Medicine: Ancient Greece

The name that has become synonymous with Greek medicine and even the origins of western medicine is Hippocrates (460-377 BCE). There is little knowledge on his life, but he made revolutionary strides for the young and growing medical field.

The constant pattern seen in medicine across the ancient world is that it was inseparable from magical, supernatural thinking. Greeks would go to temples for healing, where priests would preforms sacrifices and rituals, praying to the gods for relief. And just as in other lands, there was no clear distinction between priests and priest-physicians. But eventually, priests were seen as imposters and physician came out in their own rite as the true healers of Greece.

The medicine of the Hippocratics (followers of Hippocrates) dissociated itself from the idea of superstition. No more were demons and angry gods the cause of illness. Rather the main culprit was biological in nature. Our exposure to the physical, natural world disposed us to harmful agents (Pollack).

HippocraticOath-new-bb72

The Hippocratic Oath (ancient version)

While Greek physicians did not believe in magical influences, they still revered the gods as their guardians. Asclepius was the patron god of physicians. A son of Apollo, the god of the sun, music, and medicine, Greek mythology speaks of how Asclepius brought the dead back into the living, and was subsequently killed by Zeus as punishment, but then ended up becoming a god (Watts). The original Hippocratic Oath actually started by praising Apollo and Asclepius, and other healing gods. The Cult of Asclepius was the ritual priestly kind of healers, whereas the Asclepiads became the original Greek physicians (including Hippocrates) (Pollack).

The Caduceus (pronounced Cah-doo-cee-us, of the messenger god Hermes) has been mistaken as the medical symbol for decades. The Rod of Asclepius is the true symbol, but now both are used.

The Hippocratic Corpus, which is the fundamental Greek text on medicine, was a compilation of writing that accumulated over the centuries, with numerous anonymous authors (so not solely written by Hippocrates). In the 3rd century BC, they were put together in Alexandria. It was 52 works on 72 scrolls. It was named after Hippocrates, who was the most famous physician even at that time. The corpus does not mention any specific surgeons. The Greek physician embraced both internal medicine and surgery (Pollack). The corpus also talks about epilepsy, head wounds, gynecology, the importance of recording patient history, and diet ( ex. citrus fruit was good in reducing phlegm, one of the humors) (Pickover).

Hippocrates was the symbol of the first creative phase in Greek medicine, and is even today the model for doctors all over the world. Neither his knowledge nor his theories have remained of importance, but what is important is his interpretation of the doctor’s profession, the eternal principles of medical thought and treatment. The collection of Hippocratic writing, the Hippocratic Corpus, forms the oldest description of Greek medicine that has come down to us. It was the source of knowledge for countless doctors, and it influenced the theory and practice of medicine for two thousand years.

—- Pollack

HUMORALISM

Even though Hippocratic medicine was based on rationalism, it was still hundreds of years behind technological advances to really understand what was going on inside. The Greeks had their own system of understanding how the body worked. Similar to Ayurvedic and traditional Chinese medicine, which both had five elements as the makeup of the universe and life, Greek medicine was centered on humoralism (humors are fluids), in which their four elements (earth, air, fire, and water) influenced the body. The chart below shows the relationships.

Element          Quality        Humor             Organ

Earth                  Cold          Black Bile          Spleen

Air                       Dry            Blood                Heart

Fire                     Hot            Yellow Bile          Liver

Water                  Wet             Phlegm             Brain

Illness was caused by imbalance of the humors. Treatment would then have to oppose the excess. For instance, if the disease was labeled as cold and wet, then the illness had to be hot and dry to return the body to balance (Pollack).

ETHICS

What the Hippocratics are best known for creating the standards of conduct and ethics required of a physician. A physician had to have a noble and kind disposition to care selflessly for others, and also immerse himself in a search for knowledge. They had to remain friendly and modest amongst their patients and with other physicians (cooperation over competition). The status of payments are not clear, but there isn’t anything to suggest it was looked down upon. Many were paid handsomely by royalty, while the poor were allowed free care. Gifts were not out of the ordinary.

There were ranges of Greek doctors, from philosopher-physicians, to fake quacks. Educated physicians, if treating in public, would discuss the cases with bystanders. Pollacks states,

“Much more than the doctor of today, the Greek physician was not only a healer, but at the same time a health-educator”

ANATOMY AND PHYSIOLOGY: HEROPHILUS AND ERASISTRATUS

Eventually, the center of Greek medicine moved from Greece to Alexandria in Egypt, where the Ptolemies reined. There at the Museum, a distinguished academy, dissection was first allowed, and so advances in anatomy and physiology were made (Pollack).

The giants of the time in Alexandria were Herophilus (dubbed the father of anatomy) and Erasistratus (and he the father of physiology), who were best known for their work in neuroanatomy. Herophilus saw that nerves transmit motor impulses and traced the nerve paths in the brain and spinal cord (He also discovered the duodenum and named it such because it was twelve fingers long). Erasistratus described the ventricles of the brain, and distinguished between sensory and motor nerves. He also believed, against Aristotle and with Plato, that the brain, not the heart, was the center of intelligence (Porter).

More info on Herophilus http://www.encyclopedia.com/topic/Herophilus.aspx

and Erasistratus: http://www.encyclopedia.com/topic/Erasistratus.aspx#1

As I’m reading all this, I can’t help but think of the irony. Just imagining these two ancients dissecting through brains and trying to understand it, while unknowingly using their own to figure it out!

The Greek medical tradition lived on under the Romans, which is next up.

From the first page of “The Medical Book” by Clifford Pickover

Sources:

The Healers by Kurt Pollack

The Medical Book by Clifford Pickover

The Greatest Benefit to Mankind: A Medical History of Humanity by Roy Porter

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