Ancient Medicine: Greece and Roman Empire


Around 800 BCE   Homer in The Iliad gives descriptions of wound treatment by the two sons of Asklepios, the admirable physicians Podaleirius and Machaon and one acting doctor, Patroclus. Because Machaon is wounded and Podaleirius is in combat Eurypylus asks Patroclus to cut out this arrow from my thigh, wash off the blood with warm water and spread soothing ointment on the wound. Asklepios like Imhotep becomes god of healing over time.

Temples dedicated to the healer-god Asclepius, known as  Asclepieia, functioned as centers of medical advice, prognosis, and healing.  At these shrines, patients would enter a dream-like state of induced sleep known as enkoimesis .  Asclepeia provided carefully controlled spaces conducive to healing and fulfilled several of the requirements of institutions created for healing.. Some of the surgical cures listed, such as the opening of an abdominal abscess or the removal of traumatic foreign material, are realistic enough to have taken place, but with the patient in a state of enkoimesis induced with the help of soporific substances such as opium. Alcmaeon of Croton wrote on medicine between 500 and 450 BCE. He argued that channels linked the sensory organs to the brain, and it is possible that he discovered one type of channel, the optic nerves, by dissection.

Hippocrates

A towering figure in the history of medicine was the physician Hippocrates of Kos (c. 460 – c. 370 BCE), considered the father of Western medicine.  The Hippocratic Corpus  is a collection of around seventy early medical works from ancient Greece strongly associated with Hippocrates and his students. Most famously, Hippocrates invented the Hippocratic Oath for physicians, which is still relevant and in use today.

Hippocrates and his followers were first to describe many diseases and medical conditions. He is given credit for the first description of clubbing of the fingers, an important diagnostic sign in chronic suppurative lung disease, lung cancer and cyanotic heart disease. For this reason, clubbed fingers are sometimes referred to as “Hippocratic fingers”. Hippocrates was also the first physician to describe Hippocratic face in Prognosis.

Hippocrates began to categorize illnesses as acute, chronic, endemic and epidemic, and use terms such as, “exacerbation, relapse, resolution, crisis, paroxysm, peak, and  convalescence.

Another of Hippocrates’s major contributions may be found in his descriptions of the symptomatology, physical findings, surgical treatment and prognosis of  thoracic empyema. Hippocrates was the first documented person to practice cardiothoracic surgery, and his findings are still valid.

Some of the techniques and theories developed by Hippocrates are now put into practice by the fields of Environmental and Integrative Medicine. These include recognizing the importance of taking a complete history which includes environmental exposures as well as foods eaten by the patient which might play a role in his or her illness.

Herophilus and Erasistratus

Two great Alexandrians laid the foundations for the scientific study of anatomy and physiology, Herophilus of Chalcedon and Erasistratus of Ceos.  Other Alexandrian surgeons gave us ligature (hemostasis), lithotomy, hernia operations, ophthalmic surgery,plastic surgery,  methods of reduction of dislocations and fractures, tracheostomy.

Herophilus of Chalcedon, working at the medical school of Alexandrians placed intelligence in the brain, and connected the nervous system to motion and sensation. Herophilus also distinguished between  veins and arteries, noting that the latter pulse while the former do not. He and his contemporary,  Erasistratus of Chios, researched the role of veins and  nerves, mapping their courses across the body. Erasistratus connected the increased complexity of the surface of the human brain compared to other animals to its superior intelligence. In . Erasistratus ‘ physiology, air enters the body, is then drawn by the lungs into the heart, where it is transformed into vital spirit, and is then pumped by the arteries throughout the body

Galen

The Greek  Galen (129–c. 216 CE) was one of the greatest physicians of the ancient world, studying and traveling widely in ancient Rome. He dissected animals to learn about the body, and performed many audacious operations—including brain and eye surgeries— that were not tried again for almost two millennia. In Ars medica (“Arts of Medicine”), he explained mental properties in terms of specific mixtures of the bodily parts.

Galen’s medical works were regarded as authoritative until well into the Middle Ages. Galen left a physiological model of the human body that became the mainstay of the medieval physician’s university anatomy curriculum, but it suffered greatly from stasis and intellectual stagnation because some of Galen’s ideas were incorrect; he did not dissect a human body nor did the medieval lecturers.

The Renaissance rediscovered Galen. In 1523 Galen’s On the Natural Faculties was published in London. In the 1530s Belgian anatomist and physician  Andreas Vesalius  launched a project to translate many of Galen’s Greek texts into Latin. Vesalius’s most famous work,  De humani  corporis fabrica was greatly influenced by Galenic writing and form.

Ancient Roman  Medicine contributions

The Romans invented numerous  surgical instruments, including the first instruments unique to women, as well as the surgical uses of forceps, scalpels, cautery, cross bladed scissors, the surgical needle, and speculas.  Romans also performed cataract surgery.

The Roman army physician Dioscorides (c. 40–90 AD), was a Greek botanist and pharmacologist. He wrote the encyclopedia  De Materia Medica  describing over 600 herbal cures, forming an influential pharmacopoeia which was used extensively for the following 1,500 years.

 

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