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Greek Medicine

Greek Medicine. Early Greek Medicine Hippocratic Medicine Hellenistic Anatomy and Physiology Galen (129 – 210) . I. Early Greek Medicine. A. Homer (ca. 900 BCE) . 1. Gods cause disease. 2. Cure: incantations and herbal medicines. B. Cult of Asclepius (300 BCE – 200 CE).

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Greek Medicine

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  1. Greek Medicine • Early Greek Medicine • Hippocratic Medicine • Hellenistic Anatomy and Physiology • Galen (129 – 210)

  2. I. Early Greek Medicine A. Homer (ca. 900 BCE) 1. Gods cause disease 2. Cure: incantations and herbal medicines B. Cult of Asclepius (300 BCE – 200 CE) 1. Greek hero who became a god

  3. B. Asclepius 2. Major cult in 4th and 3rd century BCE Greece and into Roman era 3. Healing temples widespread and very popular 4. Treatment: baths, prayers, sacrifices, herbal medicine, diet and exercise 5. Central to cure: healing vision/ dream

  4. II. Hippocratic Medicine A. Large body of writings – dubious authorship 1. Natural causation and natural cures emphasized 2. Gods not completely absent B. One of aims: legitimize profession 1. Time of many charlatans 2. Established standards for practice and education Hippocrates of Cos (460 -370) C. Theory of health and disease 1. Intervention by gods ruled out 2. On the sacred disease (epilepsy or stroke?) • Hippocrates: blockage of veins by phlegm • Point: cause is universal, predictable “Those who first called this disease “sacred” were the sort of people we now call witch doctors, faith healers, quacks, and charlatans. These are exactly the people who pretend to be very pious and to be particularly wise. By invoking a divine element the aware able to hide their own failure to give suitable treatment and so called this a “sacred” malady to conceal their ignorance of its nature.”

  5. Hippocratic Oath I swear by Apollo, Asclepius, Hygieia, and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and my judgment, the following Oath. To consider dear to me, as my parents, him who taught me this art; to live in common with him and, if necessary, to share my goods with him; To look upon his children as my own brothers, to teach them this art. I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone. To please no one will I prescribe a deadly drug nor give advice which may cause his death. Nor will I give a woman a pessary to procure abortion. But I will preserve the purity of my life and my arts. I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners, specialists in this art. In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction and especially from the pleasures of love with women or with men, be they free or slaves. All that may come to my knowledge in the exercise of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and will never reveal. If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all men and in all times; but if I swerve from it or violate it, may the reverse be my lot.

  6. C. Theory of health and disease 3. Disease caused by imbalance of bodily humors (homeostatic imbalance) • Bodily humors: blood, phlegm, yellow bile, black bile • Earth in black bile, Fire in yellow bile, water in phlegm, all in blood • Associated with hot, cold, wet, dry • Different humors dominant in • different seasons: • Phlegm – winter • Blood – spring • Yellow bile – summer • Black bile - autumn • Excess or lack of warmth and moisture causes • imbalance of humors which results in disease • Temperaments: melancholy (moody, glum) – black bile; choleric (irritable) – • yellow bile; sanguine (happy, healthy) – blood; phlegmatic (slow, droopy) – • phlegm • Standard belief until 19th century 4. Other causes of disease: poor diet and lack of exercise

  7. C. Theory of health and disease 5. Therapy • Restore balance of humors • Purging: bloodletting, emetics, laxatives, diuretics • Diet and exercise • Nature heals D. Not the dominant medicine 1. Supernatural healing popular (Asclepius) 2. Natural approach combined with supernatural (especially dream healing)

  8. Questions • In the Asclepius cult of healing, what was central to every cure? • Restoring a balance of bodily humors • Bloodletting • Dream healing • Allowing nature to take its course • Yellow bile is ______ . • Hot and dry • Cold and dry • Hot and wet • Cold and wet • A person with excess phlegm is ____ . • Moody and glum • Irritable • Happy • Slow and droopy

  9. III. Hellenistic Anatomy and Physiology A. Human anatomy 1. Dissection initially taboo • Knowledge of human body from surgery, wounds, animals • 3rd Century BCE (post Alexander) Ptolemy says ok • Vivisection of prisoners ok’d 2. Anatomy of body systems roughly worked out

  10. C. Human Physiology Example of digestion • Food into stomach reduced to juice (chyle) • Chyle through pores in stomach and intestines to liver • In liver, chyle becomes blood • Blood moves through veins to nourish body

  11. C. Physiology • Arteries contain only pneuma (physis and psychic) inhaled from air • Physis (vital pneuma) to heart via pulmonary vein • From heart, physis distributed through arterial system • Nerves distribute finer form of pneuma: psychic pneuma • Responsible for sensations and motor responses • Problem with pneuma theory: artery cut, blood comes out • Explanation: loss of pneuma could cause vacuum • Blood from veins rushes in to prevent vacuum What really happens?

  12. Questions • What becomes of chyle once it reaches the liver? • It passes to the intestines • It becomes blood • It moves through the veins to nourish the body • It becomes psychic pneuma • What is responsible for sensations and motor responses? • Physis pneuma • Psychic pneuma • Phlegm • Yellow bile

  13. IV. Galen (129 – 210) A. Life 1. Began study of medicine at 16 2. Physician first to gladiators then to rich and powerful Romans 3. Wrote extensively (22 volumes); most survive 4. Main interest in nature of disease 5. The main source of medical knowledge in middle ages 6. Unchallenged until Vesalius (1514 – 1564)

  14. B. Galen’s anatomy 1. Based on animal dissection: Roman law • Led to many errors • Galen is main source for medieval medicine • Four humors combine to form tissues which • form organs which form body Sub-atomic atoms

  15. C. Galen’s physiology 1. Based on Plato and Erasistratus 2. Three major organs • Brain • Source of soul’s rational functions • Source of nerves: sensory and motor • contain psychic pneuma • Heart • Source of passions • Source of arteries • contain vital pneuma (physis) • Liver • Source of desire and appetite • Source of veins that nourish body

  16. C. Galen’s physiology 3. The three major organs work together • food through stomach reduced to chyle • chyle through stomach to liver • in liver, chyle becomes venous blood • venous blood through veins nourishes body and is consumed • venous blood enters right side of heart pumped to lungs • lungs regulate heat created by heart and provide pneuma • arteries a mix of pneuma and thinned venous blood

  17. IV. Galen (129 – 210) D. Diagnostic 1. Each patient unique; therefore examine entire body 2. Pay special attention to urine and pulse E. Galen the creationist • Evidence for Demiurge in his creation: beginnings of • Natural Theology “When anyone looking at the facts with an open mind sees that in the slime of fleshes and juices is yet an indwelling intelligence and sees too the structure of any animal whatsoever- for they all give evidence of a wise Creator – he will understand the excellence of intelligence in the heavens.”

  18. Questions • According to Galen, which of the following organs is the source of • passion? • The liver • The heart • The brain • The lungs • According to Galen, what happens to venous blood? • It is converted into pneuma • It is converted into chyle • It is consumed • It continuously circulates throughout the body • According to Galen, what is the function of the lungs? • To produce chyle • It is the source of appetite • To produce blood • To regulate vital heat

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