Ancient Greek medicine
Ancient Greek medicine was a compilation of theories and practices that were constantly expanding through new ideologies and trials. The Greek term for medicine was iatrikē (Greek: ἰατρική). 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".[1] 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.[1]
Humorism (or the four humors) refers to blood, phlegm, yellow bile and black bile. Each of the four humors were linked to an organ, temper, season and element.[2] 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.[3]
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",[4] established a medical school at Cos and is the most important figure in ancient Greek medicine.[5] Hippocrates and his students documented numerous illnesses in the Hippocratic Corpus, and developed the Hippocratic Oath for physicians, which is still in use today. He and his students also created medical terminology that is part of our vocabulary today. Medical words included acute, chronic, epidemic, exacerbation, relapse, and others.[2] 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,[6] worked at this school, and it was here that the practice of observing patients was established. Despite their known respect for ancient 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.[7]
Aristotle's influence on Greek perception[edit]
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.[17] 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".[18] 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.[19] 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.[20]
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.[21] Aristotle, in contrast to earlier philosophers, and like the Egyptians, placed the rational soul in the heart, rather than the brain.[22] Notable is Aristotle's division of sensation and thought, which generally went against previous philosophers, with the exception of Alcmaeon.[23]
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 pericarpium 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.[24] 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.
Dioscorides[edit]
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 plants drugs, 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.[54]
Herodicus[edit]
Herodicus (Greek: Ἡρóδιĸος) was a Greek physician of the 5th century BC, who is considered to be the father of sports medicine. The first use of therapeutic exercise for the treatment of disease and maintenance of health is credited to him, and he is believed to have been one of the tutors of Hippocrates. He also recommended good diet and massage using beneficial herbs and oils, and his theories are considered the foundation of sports medicine. He was specific in the manner that a massage should be given. He recommended that rubbing be initially slow and gentle, then subsequently faster, with the application of more pressure, which was to be followed by more gentle friction.[55]
Historical legacy[edit]
Through long contact with Greek culture, and their eventual conquest of Greece, the Romans adopted a favorable view of Hippocratic medicine.[56]
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 Avicenna. 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.