by Jason Yousif
JYousif@ou.edu
BACKGROUND:
The Hellenistic Period roughly spans the years of 323-150 BC, and includes the medicine practiced by Greeks and Romans. Many physicians during this time were interested in theoretical issues, as to how medicine and philosophy were connected. It is evident that many healing traditions, medical beliefs, and practices from this time resembled those of the Egyptians, such as basic surgery, the use of internal medicines, religious incantations, and dream healing (Lindberg, 111). An example of the religious side of healing is Asclepius, the god of healing, who became the focus of a popular healing cult during this time. Hundreds of Temples to Asclepius have been identified, to which sick individuals would rush to for cures. Asclepius used a healing vision or dream as his central therapeutic process, which occurred as the individual slept in a special room. Throughout the dream, healing could occur, or advice obtained in the dream could lead to healing. Along with this, visitors could bathe, offer prayers and sacrifices, receive cleansings causing evacuation of the bowels (purgatives), be restricted to certain diets, exercise, and also be entertained (Lindberg, 113).
Asclepius, the God of Healing
David Lindberg, The Beginnings of Western Science, 1992 (pg. 112).
Theater at Epidaurus, center of the healing of Asclepius
David Lindberg, The Beginnings of Western Science, 1992 (pg. 114).
Hellenistic
Medicine didn't just revolve
around the findings of the Egyptians beforehand. Many
advances and discoveries were made during this time by Hippocratic
Medicine, Herophilus and Erasistratus, and Galen of Pergamum.
HIPPOCRATIC MEDICINE:
Hippocratic Medicine is a tradition influenced by Hippocrates of Cos (460-370 B.C.), the so-called "father of medicine". Some sixty or seventy writings, now called the "Hippocratic Writings" or the "Hippocratic Corpus" greatly influence the traits of this kind of medicine, however, it is unknown whether Hippocrates actually wrote any of them. Of great influence are On the Nature of Man and On the Sacred Disease, both helping to develop the groundwork of the Hippocratic Oath.
On the Nature of Man discusses the theory of the four humors. It states that the nature of man's body is made up of blood, phlegm, yellow bile, and black bile, and it is through these four humors that man either feels pain or enjoys health. When these four humors are proportioned in a proper manner to one another in respect to combination, power and bulk, and when they are perfectly mingled, man enjoys the most perfect health. It is when these humors are in defect or excess, or separated throughout the body without being combined with all the others does man feel pain, because when one of the humors is isolated, not only does the location it left become diseased, but the location where currently is also becomes diseased, due to an excess, causing pain and distress (The Genuine Works of Hippocrates). Each of the four humors was also associated with a pair of the basic qualities: hot, cold, moist, and dry. Through this idea, disease was linked to excess of deficient warmth and moisture, giving rise to the idea that a different humor dominates during different seasons. Phlegm, which is cold, dominates in the winter; blood in the spring; yellow bile in the summer; and black bile in the autumn (Lindberg, pg. 116).
On the Sacred Disease discusses the holiness of diseases according to natural causes. It primarily discusses the symptoms of one suffering from epilepsy, although the term epilepsy was not used to describe the disease at the time. They believed in order to cure the disease, one must apply purifications and incantations, and avoid baths and unwholesome food articles, such as the sea substances sur-mullet, blacktail, and eel; flesh substances of the goat, stag, and dog; and herbal substances such as mint, garlic, and onions (The Genuine Works of Hippocrates).
Some of the traits of the Hippocratic Oath include the representation of learned medicine, the defending of the nature of medicine as an art or science, the belief in the relationship of the human frame to the universe in a general sense, and the defense of the principles of treatment and cure. It also was designed to establish standards, drive out quacks or frauds, create an area of opinion favorable to learned medicine, stress successful prognosis, employ naturalistic principles of explanation and therapy, among other characteristics. When physicians took the Hippocratic Oath, they swore to "give no deadly medicine to any one if asked, nor to suggest any such counsel; and in like manner not give to a woman a pessary to produce abortion; and to not cut persons laboring under the stone, but to leave this to be done by men who are practitioners of this work," among other things (The Genuine Works of Hippocrates).
HEROPHILUS & ERASISTRATUS:
Herophilus of Chalcedon and Erasistratus of Ceos both made ever-lasting contributions to Hellenistic Medicine, primarily in the field of Anatomy and Physiology. These two were the first to partake in systematic dissection of the human body, and, according to the Roman encyclopedist, Celsus, and the church father Tertullian, they even engaged in the dissection of living prisoners, or vivisection (Lindberg, pg. 120).
Herophilus mainly focused on the anatomy of the brain and nervous system, and is credited with the identification of the dura mater and pia mater, two of the brain's membranes; and with tracing the connections between the spinal cord, nerves, and the brain. He was able to distinguish between motor and sensory neurons, revealing an understanding of the nervous system functions. He also identified the principal humors and tunics of the eye, thereby allowing for his creation of a technical nomenclature; he argued the eye was filled with a subtle soul or vital spirit based on his tracing of the optic nerve from the eye to the brain; he explored abdominal cavity organs, therefore presenting detailed descriptions of the intestines, reproductive organs, liver, heart, and pancreas; he distinguished veins from arteries based on their wall thicknesses; and finally he examined heart valves, and studied the arterial pulse, among other things (Lindberg, pgs. 120-121). Probably the most important contribution made by Herophilus was his theory of the diagnostic value of the pulse. He maintained that the pulse isn't a collection of the arteries possessed at birth, but rather it comes from the heart. In order to take the pulse of someone during a diagnosis, he used a water clock to measure its frequency (Michael Lahanas).
Drawing depicting Waterclock of Herophilus,
by Mitteilung zur Geschichte der Medizin
Weblink: Michael Lahanas
Erasistratus, on the other
hand, further developed the investigations
of Herophilus, by describing in detail the bicuspid and
tricuspid valves of the heart, and their function in determining
one-way
blood flow through the heart; he explained digestion, respiration, and
the
vascular systems; and he believed all tissues in the body are made up
of,
or contain, veins, arteries, and nerves, which serve as channels
through which different substances fundamental to the body's function
are conducted to its various organs, among other things (Lindberg, pg.
121). Erasistratus is best known for his discovery of the
"illness" of Antiochus, the son of Seleucus I Nicator, the King of
Syria. He came to the conclusion that Antiochus had fallen in
love with Stratonice, the young queen and wife of Seleucus (Michael Lahanas).
Celsus, a Roman medical writer, said it best in his On Medicine I Poem 23, when he claimed:
"Herophilus and Erasistratus proceeded in by far the best way: they cut open living men - criminals they obtained out
of prison from the kings and they observed, while their subjects still breathed, parts that nature had previously
hidden, their position, color, shape, size, arrangement, hardness, softness, smoothness, points of contact, and finally the
processes and recesses of each and whether any part is inserted into another or receives the part of another into itself." (Dissections and Vivisections)
HIPPOCRATIC MEDICINE:
Hippocratic Medicine is a tradition influenced by Hippocrates of Cos (460-370 B.C.), the so-called "father of medicine". Some sixty or seventy writings, now called the "Hippocratic Writings" or the "Hippocratic Corpus" greatly influence the traits of this kind of medicine, however, it is unknown whether Hippocrates actually wrote any of them. Of great influence are On the Nature of Man and On the Sacred Disease, both helping to develop the groundwork of the Hippocratic Oath.
On the Nature of Man discusses the theory of the four humors. It states that the nature of man's body is made up of blood, phlegm, yellow bile, and black bile, and it is through these four humors that man either feels pain or enjoys health. When these four humors are proportioned in a proper manner to one another in respect to combination, power and bulk, and when they are perfectly mingled, man enjoys the most perfect health. It is when these humors are in defect or excess, or separated throughout the body without being combined with all the others does man feel pain, because when one of the humors is isolated, not only does the location it left become diseased, but the location where currently is also becomes diseased, due to an excess, causing pain and distress (The Genuine Works of Hippocrates). Each of the four humors was also associated with a pair of the basic qualities: hot, cold, moist, and dry. Through this idea, disease was linked to excess of deficient warmth and moisture, giving rise to the idea that a different humor dominates during different seasons. Phlegm, which is cold, dominates in the winter; blood in the spring; yellow bile in the summer; and black bile in the autumn (Lindberg, pg. 116).
On the Sacred Disease discusses the holiness of diseases according to natural causes. It primarily discusses the symptoms of one suffering from epilepsy, although the term epilepsy was not used to describe the disease at the time. They believed in order to cure the disease, one must apply purifications and incantations, and avoid baths and unwholesome food articles, such as the sea substances sur-mullet, blacktail, and eel; flesh substances of the goat, stag, and dog; and herbal substances such as mint, garlic, and onions (The Genuine Works of Hippocrates).
Some of the traits of the Hippocratic Oath include the representation of learned medicine, the defending of the nature of medicine as an art or science, the belief in the relationship of the human frame to the universe in a general sense, and the defense of the principles of treatment and cure. It also was designed to establish standards, drive out quacks or frauds, create an area of opinion favorable to learned medicine, stress successful prognosis, employ naturalistic principles of explanation and therapy, among other characteristics. When physicians took the Hippocratic Oath, they swore to "give no deadly medicine to any one if asked, nor to suggest any such counsel; and in like manner not give to a woman a pessary to produce abortion; and to not cut persons laboring under the stone, but to leave this to be done by men who are practitioners of this work," among other things (The Genuine Works of Hippocrates).
HEROPHILUS & ERASISTRATUS:
Herophilus of Chalcedon and Erasistratus of Ceos both made ever-lasting contributions to Hellenistic Medicine, primarily in the field of Anatomy and Physiology. These two were the first to partake in systematic dissection of the human body, and, according to the Roman encyclopedist, Celsus, and the church father Tertullian, they even engaged in the dissection of living prisoners, or vivisection (Lindberg, pg. 120).
Herophilus mainly focused on the anatomy of the brain and nervous system, and is credited with the identification of the dura mater and pia mater, two of the brain's membranes; and with tracing the connections between the spinal cord, nerves, and the brain. He was able to distinguish between motor and sensory neurons, revealing an understanding of the nervous system functions. He also identified the principal humors and tunics of the eye, thereby allowing for his creation of a technical nomenclature; he argued the eye was filled with a subtle soul or vital spirit based on his tracing of the optic nerve from the eye to the brain; he explored abdominal cavity organs, therefore presenting detailed descriptions of the intestines, reproductive organs, liver, heart, and pancreas; he distinguished veins from arteries based on their wall thicknesses; and finally he examined heart valves, and studied the arterial pulse, among other things (Lindberg, pgs. 120-121). Probably the most important contribution made by Herophilus was his theory of the diagnostic value of the pulse. He maintained that the pulse isn't a collection of the arteries possessed at birth, but rather it comes from the heart. In order to take the pulse of someone during a diagnosis, he used a water clock to measure its frequency (Michael Lahanas).
Drawing depicting Waterclock of Herophilus,
by Mitteilung zur Geschichte der Medizin
Weblink: Michael Lahanas
Celsus, a Roman medical writer, said it best in his On Medicine I Poem 23, when he claimed:
"Herophilus and Erasistratus proceeded in by far the best way: they cut open living men - criminals they obtained out
of prison from the kings and they observed, while their subjects still breathed, parts that nature had previously
hidden, their position, color, shape, size, arrangement, hardness, softness, smoothness, points of contact, and finally the
processes and recesses of each and whether any part is inserted into another or receives the part of another into itself." (Dissections and Vivisections)
GALEN OF PERGAMUM:
Galen is well known for the production of an enormous amount of writings, which, the surviving ones occupy twenty-two volumes. It was through these writings that Galen was established as the leading medical authority of antiquity, and unequaled influence well into the modern period as well. Galen combined the knowledge and ideas of Herophilus and Erasistratus, the Hippocratic Corpus, and Roman medical writings of his time, in order to create a one-of-a-kind mixture of Platonic, Aristotelian, and Stoic natural philosophy. In his On the Hand, Galen described why the hand was oriented the way it was, why the fingers were positioned where they were, and the space between them (On the Usefulness of the Parts of the Body). Another important contribution of Galen was his physiological system, in which he adopted Plato's tripartite soul theory and correlated it with the three basic physiological functions defined by Erasistratus, resulting in a physiological tripartite organizational framework (Lindberg, pg. 127). In this system, the brain (seat of the soul's rational faculties) was the source of the nerves, accounting for sensation and motor functions; the heart (seat of the passions) was the source of the arteries, conveying life-giving arterial blood (and vital spirit) to all parts of the body; and the liver (seat of desire or appetite) was the source of the veins, nourishing the body with venous blood. These three physiological systems, according to Galen, had interconnections, and were not totally independent (Lindberg, pg. 127).
Diagram of Galen's Physiological System (From Charles Singer)
Allen G. Debus, Man and Nature in the Renaissance, 1978 (pg. 56)
Galen is well known for the production of an enormous amount of writings, which, the surviving ones occupy twenty-two volumes. It was through these writings that Galen was established as the leading medical authority of antiquity, and unequaled influence well into the modern period as well. Galen combined the knowledge and ideas of Herophilus and Erasistratus, the Hippocratic Corpus, and Roman medical writings of his time, in order to create a one-of-a-kind mixture of Platonic, Aristotelian, and Stoic natural philosophy. In his On the Hand, Galen described why the hand was oriented the way it was, why the fingers were positioned where they were, and the space between them (On the Usefulness of the Parts of the Body). Another important contribution of Galen was his physiological system, in which he adopted Plato's tripartite soul theory and correlated it with the three basic physiological functions defined by Erasistratus, resulting in a physiological tripartite organizational framework (Lindberg, pg. 127). In this system, the brain (seat of the soul's rational faculties) was the source of the nerves, accounting for sensation and motor functions; the heart (seat of the passions) was the source of the arteries, conveying life-giving arterial blood (and vital spirit) to all parts of the body; and the liver (seat of desire or appetite) was the source of the veins, nourishing the body with venous blood. These three physiological systems, according to Galen, had interconnections, and were not totally independent (Lindberg, pg. 127).
Diagram of Galen's Physiological System (From Charles Singer)
Allen G. Debus, Man and Nature in the Renaissance, 1978 (pg. 56)
Galen
was quite popular during his time,
and because of his introduction of a massive dose of teleology (the
study of design or purpose in natural phenomena) into anatomy and
physiology, he was also popular among Islamic and Christian
readers. "Galen pulled together several strands of ancient
thought: he summed up more than six hundred years of Greek and Roman
medicine; at the same time, he fitted that medicine into an ancient
philosophical and theological framework" (Lindberg, pg. 131).
INTERPRETATION:
To me, the Hellenistic Period contributed a substantial amount of knowledge and findings to the development of medicine. Hippocrates provided an oath by which some physicians today choose to undertake, while others choose not to, due to some of the restrictions enforced in the Hippocratic Oath (see above). Herophilus and Erasistratus provided a foundation for the development of human anatomy and physiology, along with the grounds for establishing human dissection, although others during the time disagreed to dissecting humans. They also helped to further advance the understandings of the human brain, heart, eyes, intestines, and reproductive organs, among other things. Galen helped to further influence the progression of medicine, with his numerous publications, along with his further development of a physiological tripartite organizational framework, which depicted how the human body functions overall. In my eyes, without the Hellenistic Period and the advancements made during this time, there would be no medicine to be practiced today. The above-mentioned men, along with others, allowed medicine to advance and progress into later time periods, so others could have an affect on its progress.
BIBLIOGRAPHY:
My primary sources are reliable because most of them are focused on the translations of surviving texts, written first-hand by Galen, Hippocrates, or others, who were alive during the Hellenistic period. My secondary source is reliable because it was written by a professional historian of science, and it is quite evident in the work that the author, David Lindberg, is extremely knowledgeable on the issues he chose to discuss in his work. In order to create my own interpretation of this episode, I chose to review the numerous sources available to me, and then I formed a combined summary of the sources, using key topics that I wanted to explore in my project.
INTERPRETATION:
To me, the Hellenistic Period contributed a substantial amount of knowledge and findings to the development of medicine. Hippocrates provided an oath by which some physicians today choose to undertake, while others choose not to, due to some of the restrictions enforced in the Hippocratic Oath (see above). Herophilus and Erasistratus provided a foundation for the development of human anatomy and physiology, along with the grounds for establishing human dissection, although others during the time disagreed to dissecting humans. They also helped to further advance the understandings of the human brain, heart, eyes, intestines, and reproductive organs, among other things. Galen helped to further influence the progression of medicine, with his numerous publications, along with his further development of a physiological tripartite organizational framework, which depicted how the human body functions overall. In my eyes, without the Hellenistic Period and the advancements made during this time, there would be no medicine to be practiced today. The above-mentioned men, along with others, allowed medicine to advance and progress into later time periods, so others could have an affect on its progress.
BIBLIOGRAPHY:
- Galen, On the Usefulness of the Parts of the Body. Translated by Margaret Tallmadge May (Ithaca, New York: Cornell University Press, 1968). http://www.wls.wels.net/conted/Science/day04/galensha.pdf . This site discusses Galen and his accomplishments, primarily dealing with his description of the hand. The thing that interests me most about this website is the fact that it as a translation of one of Galen's actual works, depicting exactly what Galen thought.
- Hippocrates, On the Nature of Man, On the Sacred Disease, Hippocratic Oath, adapted from The Genuine Works of Hippocrates. Translated from the Greek by Francis Adams (Huntington, New York: Robert E. Krueger Publishing Co., 1972, from 1946 reprint of 1849 original). http://www.med.virginia.edu/hs-library/historical/antiqua/texto.htm, http://www.humanistictexts.org/hippocrates.htm , http://classics.mit.edu/Hippocrates/ancimed.html , . These sites discuss On the Nature of Man, On the Sacred Disease, and the Hippocratic Oath, major works contributing to the Hippocratic Corpus and to Hippocratic Medicine. The thing that interests me most about this collection of works is the amount they all contributed to the beliefs of others practicing medicine, during the Hellenistic Period, but also today.
- Michael Lahanas, "Dissections and Vivisections in Ancient Greece, Alexandria and Rome", Dissections and Vivisections, http://www.mlahanas.de/Greeks/Dissection.htm. This site discusses the contributions of Herophilus and Erasistratus. The thing that interests me the most about this website is the detail Lahanas goes into about the dissections and vivisections performed by Herophilus and Erasistratus.
- Michael Lahanas, "Herophilus of Chalcedon, Erasistratus of Ioulis and the Illness of Antiochus", Herophilus of Chalcedon, Erasistratus of Ioulis and the illness of Antiochus, http://www.mlahanas.de/Greeks/Erasitratos.htm. This site discusses the use of a waterclock by Herophilus to measure the pulse, and the diagnosis of Antiochus by Erasistratus, among other things. The thing that interests me the most about this website is again the detail Lahanas goes into about the individual contributions of Herophilus and Erasistratus, aside from dissections.
- David Lindberg, The Beginnings of Western Science (Chicago, Chicago University Press, 1992). This text is an amazing view of pre-modern science, not just in medicine, but also in astronomy, mathematics, physics, and many other aspects of science. The thing that interests me the most about this work is the large amount of detail and information depicted on many different eras of pre-modern history, instead of just focusing on one. It is a greatly useful source.
My primary sources are reliable because most of them are focused on the translations of surviving texts, written first-hand by Galen, Hippocrates, or others, who were alive during the Hellenistic period. My secondary source is reliable because it was written by a professional historian of science, and it is quite evident in the work that the author, David Lindberg, is extremely knowledgeable on the issues he chose to discuss in his work. In order to create my own interpretation of this episode, I chose to review the numerous sources available to me, and then I formed a combined summary of the sources, using key topics that I wanted to explore in my project.