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A comparison of two greek medical doctors of ancient times

Received 2015 Mar 18; Accepted 2015 Apr 3. Greek medicine, Hippocratic medicine, medical ethics, medical history, naturalistic medicine, Oath of Hippocrates Copyright: This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Open in a separate window In our review of the first volume in this series we introduced the medical scholar Dr. Plinio Prioreschi, the author of this marvelous narrative of the history of medicine, and listed the composition of this series of tomes for the benefit of the readers. A History of Medicine — Volume I: Renaissance Medicine 2007 ; 801 pages.

In this review, we will restrict ourselves to reviewing the second tome in the series — Greek Medicine as it relates to medical history and ethics. As we will see, Prioreschi also does not hesitate to deviate from orthodox or dogmatic views when new facts have come to light or previous information has been neglected or misinterpreted, or when logical reasoning calls for a new interpretation of the facts.

This second volume comprises the following subjects and chapter topics in ancient Greek medicine: Historical outline and socioeconomic background sets the tone of the book and provides the necessary background material to understand Greek philosophy and medicine. Prioreschi also uses this introductory chapter to deal with the controversial subject of the perceived ubiquitousness of homosexuality in the Greek and Hellenistic world.

What Is Ancient Greek Medicine?

In this context, the case of the celebrated treatise Against Timarchus by Aeschine, political and juridical opponent of Demosthenes, as well as the writings of Plato and Aristotle are discussed.

Religion and philosophy in Greece; pre-Socratic philosophers; Socrates 469—399 B. The inclusion of this chapter underscores the ongoing influence of philosophy on ancient naturalistic Greek medicine. Although Prioreschi defines science in the stricter sense of knowledge acquired by the scientific method, the term is defined here in the broader sense as knowledge gained by the ancients via the naturalistic, nonscientific paradigm.

In ancient Greece, as in the rest of the ancient world, supernaturalistic medicine continued to be practiced by the physician-priests followers of the god of medicine Aesculapius at the temples side by side naturalistic medicine practiced by Hippocratic physicians. But even Hippocratic physicians did not completely abandon supernaturalistic notions, such as the occasional invocation of the gods or assignation of astrological signs e.

Greek medicine before Hippocrates 460—370 B. This included the famous School of Croton, which flourished c. Croton was the city-state of Magna Graecia where Pythagoras c. He propounded that the harmony of nature was found in numbers, and believed in reincarnation, transmigration and the immortality of the soul. The celebrated Greek physician Democedes and the influential Alcmaeon managed to separate medicine to some extent from philosophy while still associated with the Pythagoreansand were the leaders of the medical group in Croton.

Democedes became physician to Polycrates, the tyrant of Samos, was captured by the Persians, and while in captivity successfully treated the Persian king, Darius I. He managed to escape Persia and return to Greece where he married the daughter of the famous Greek wrestler Milo. Empedocles also posited cosmic cycles of the universe as a result of the opposite forces of love and strife. Miletus and Ephesus were the leading commercial and intellectual cities of Ionia.

Heraclitus of Ephesus c. Divinity is in nature but it follows natural laws. The Greek Ionian dialect became the literary as well as the medium for philosophy and the Corpus Hippocraticum. The physician Diogenes of Apollonia gave an interesting description of the vascular system suggesting that human dissection may have been performed before the Alexandrians.

In physiology, he subscribed to the theory that universal substance of the body, the pneuma, was not only the vital force but also the soul of man. Prioreschi concludes a comparison of two greek medical doctors of ancient times by the end of the 5th century two concepts had evolved: First, that the seat of intelligence was either in the heart or the brain, and second, that pneuma was identified as the vital force, if not the seat of the soul in both man and animal.

Philosophy encouraged speculation; medicine, observation; but the two were entwined in medicine, which as in the case of Greek science had developed from philosophy. Hippocrates and Hippocratic medicine. The Schools of Cos Coan and Cnidus Cnidian are the two main sources of material for the Corpus Hippocraticum and consist of writings by physicians from approximately 450—350 B. The other source of Hippocratic medicine, the Anonymous Londinensis, is a compendium of medical texts now known to have been composed by Melo or Melona student of Aristotle.

It is so named because the invaluable papyrus scroll Iatrike synagoge was only discovered in the 19th century at the British Museum in London. Roman History about the three schools of medicine in the 5th century B. Cos, Cnidus, and Sicily.

The Cnidian school apparently based its teachings of the etiology of diseases on the theory of perittoma or perissomaa concept eerily similar to the Egyptian formula for the pathophysiological basis of disease as previously discussed in our review of Prioreschi's A History of Medicine, Vol.

Primitive and Ancient History. The Coan School from the island of Cos in contrast subscribed to the humoral doctrine of disease in which an imbalance of the four humors — i. Illness could also result from corrupted bile and phlegm and putrefaction, but only as secondary factors to the primary humoral doctrine of the Coan school.

  1. In this context, the case of the celebrated treatise Against Timarchus by Aeschine, political and juridical opponent of Demosthenes, as well as the writings of Plato and Aristotle are discussed. As in Ancient Egypt, the Greeks had no anesthetics, and only some herbal antiseptic mixes.
  2. Aristotle affirmed the importance of the naturalistic paradigm that observation is important and credence must be given to evidence procured by the senses more than to theories.
  3. Greek doctors were strong believers in doing things in moderations. Although we now have a far more detailed and accurate picture of medicine, I think the ancient Greeks can help us think through a number of topics that are still relevant today.
  4. Hippocrates and Hippocratic medicine.
  5. Although we now have a far more detailed and accurate picture of medicine, I think the ancient Greeks can help us think through a number of topics that are still relevant today. They would refer to their Hippocratic books for guidance on how to carry out the examinations and which diseases they should consider or try to rule out.

Although Prioreschi does not discuss this, I believe the origin of the humoral theory is based on two concepts. One has already been mentioned, and it is the theory of the Four Primordial Elements posited by the physician and natural philosopher Empedocles.

The other concept arises, according to medical historian Dr.

  1. Although we now have a far more detailed and accurate picture of medicine, I think the ancient Greeks can help us think through a number of topics that are still relevant today.
  2. A History of Medicine; pp. A History of Medicine — Volume I.
  3. The snake today is the symbol of pharmacists. Their qualities were subjectively determined as were their sites of origin or organ predilection according to the Hippocratic humoral theory.
  4. Well off and educated Greeks worked at remaining at a constant temperature, cleaning their teeth, washing regularly, keeping fit, and eating healthily. Roman medicine seems to have been a simple, home-based approach with the head of the family collecting and applying remedies.
  5. Although I read opinions for and against Edelstein's thesis, the matter remained unresolved and somewhat murky until the advent of this volume which, in my opinion, settles the matter and places the origin of the Oath and ethics of Hippocrates back on a clear and more solid foundation. Human dissection as a way of finding out how the body works was carried out in the third century BC but was then abandoned for hundreds of years.

Blood serum; blood; blood sediment; and the fibrin layer. Higher sedimentation rates denote more and more fibrin floating to the top. And so by tracing the layers of blood components and their shifts in position in the test tube, we have arrived to the four components of blood corresponding to the Hippocratic theory of the four humors.

Their qualities were subjectively determined as were their sites of origin or organ predilection according to the Hippocratic humoral theory: The top serum layer: Yellow Bile; qualities, hot and dry; originating in the liver corresponding to the original element fire The middle layer oxygenated blood cells: Blood; qualities, hot and wet; originating in the heart and corresponding with the element air The dark sediment layer deoxygenated blood cells: Black bile; qualities, cold and dry; originating in the spleen and corresponding with the element earth The bottom fibrin layer: Phlegm mucus ; qualities, cold and wet; originating in the brain and corresponding with the essential element water.

With the advent of scientific medicine the humors have been discarded but the descriptive psychosocial traits are still in use today. The primary doctrine in the Corpus Hippocraticum, as a whole, is the humoral doctrine, and it is only in the Anonymous Londinensis that the secondary doctrine of perittoma is actually named. It is in this section that one of the most interesting discussions takes place in the history of medical ethics.

The medical historian Ludwig Edelstein had in various articles, most notably in the Bulletin of the History of Medicine 1943argued that the Oath of Hippocrates was a Pythagorean document followed by a very small number of Greek physicians with little influence in the classical world. Edelstein managed to convince such authorities as Henry E. Sigerist, who published a book on medical history in 1961 supporting many of Edelstein's points. These references are included in Dr.

Hippokrates of Kos, The Father of Western Medicine

Edelstein's assertions have gone uncorrected for more than half a century. As a medical student, I remember scratching my head and pondering Edelstein's assertions. For example, Edelstein asserted that the Oath of Hippocrates did not represent the accepted ethical practices of Greek physicians and that it proscribed the practice of surgery.

Although I read opinions for and against Edelstein's thesis, the matter remained unresolved and somewhat murky until the advent of this volume which, in my opinion, settles the matter and places the origin of the Oath and ethics of Hippocrates back on a clear and more solid foundation.

In fact, as we will see in our review of Volume III: This Preface is translated and quoted in full by Prioreschi. The fallacious but well-known concept of the benignity of suppuration, as being a sign of wound healing — i. The concept, which survived into the 19th century, may have arisen due to the fact circumscribed suppurative staphylococcal infections may have had a better prognosis than disseminated streptococcus infections.

Transitional chapter from Hippocratic medicine to the Alexandrian Hellenistic medicine.

1. New (old) treatments

This chapter expounds on the medical insights and theories of Plato and Aristotle, the latter contributing also to biology, anatomy, physiology as well as medicine. Aristotle affirmed the importance of the naturalistic paradigm that observation is important and credence must be given to evidence procured by the senses more than to theories. And theories must agree with what is observed dataeffectively a dictum of modern science. Aristotle also urged the teleological principle stipulating that nature always accomplishes the best result for a specific purpose.

Plato subscribed to the four elements and posited the principle of necessity; for Aristotle it was purpose final cause. Aristotle's minutely observant and eloquent description of a chick embryo is a classical masterpiece quoted in full by Prioreschi. In his own right Theophrastus wrote a treatise on sensation and propounded the Doctrine of Signatures that applied botany to pharmacopeia and therapeutics — i. Strato of Lampsacus c.

Bleeding from an artery, therefore, was explained by the great Erasistratus fl. Cthe Alexandrian anatomist and physician, as the result of instantaneous horror vacui with blood rapidly filling the arterial void and then bleeding into the wound! This chapter relates the advances in science and medicine achieved at and promulgated from Alexandria, the intellectual capital of the Hellenistic world ushered in by Alexander the Great's conquest of Egypt and the Middle East.

Alexandria had become known for the cultivation of the arts and sciences, the reputation for learning and the acquisition of books by its Library and Museum, policies begun by Ptolemy I and continued by his successors.

Ancient Medicine

The two great figures in medicine and surgery at this time in the Museum of Alexandria were Herophilus and Erasistratus, who were contemporaries in the mid-3rd century B. Herophilus and Erasistratus performed surgery and human dissection and conducted anatomical studies that could have revolutionized medicine.

Prioreschi discusses why this did not take place. The fact is the rest of the medical community and the scientific world were not yet ready. Prioreschi ends his magnum opus with a chapter on Greek physicians, discusses their social standing, and notes inscriptions dedicated to them, etc.

He then makes concluding remarks as to why the major similarities existed in the medical systems of antiquity — the answer of course was the concept of limited options discussed previously. Greek Medicine by Dr. Plinio Prioreschi, belongs in every public library and in the book repertoire of every physician, medical historian, bioethicist, and student of medical ethics. Surg Neurol Int 2015. A review of Prioreschi P. Primitive and Ancient Medicine. MD Publications Inc; 1961.

A prelude to Medical History; pp. A History of Medicine.