Medicine in ancient Greece

Probably inspired by the Egyptian medicine, the Médecine in ancient Greece is supposed to go up with the Homeric time. It takes however its true rise only at fifth century BC with Hippocrates.

Medicine and epopee

Iliade quotes for doctors the warriors Achaean Machaon and Podalire, two wire of Asclépios, god of medicine, as well as the god Péan, doctor of the gods. First is in particular charged to look after Ménélas, reached of a arrow. It starts by examining ( ἰδεῖν / ideĩn , literally “to see”) the patient then withdraws the arrow, strips the casualty, sucks the blood of the wound and applies drugs ( φάρμακα / phármaka ) on which us have not precision, if it is not that they were offered by the Centaure Chiron to Asclépios, which transmitted to Machaon. To explain the larger part granted to this one compared to his/her brother, the old commentators suggested that Homère saw in Swallowtail butterfly a Chirurgie N, his brother being simple doctor: its name would come from μάχαιρα , “knife”. Péan looks after of the same Hadès, reached of an arrow launched by Héraclès: it spreads on the wound of the drugs ( pharmaka ) which one specifies this time that they are Analgésique S ( ὀδυνήφατα / odynếphata ).

the Odyssey knows doctors of profession for its part: the pig-keeper Eumée quotes the doctor ( ἰατήρ / iatếr , literally “that which looks after”) as belonging to the “craftsmen who render service to all”, following the example roofer or Aède, but also of the Devin. Elsewhere, the poet pays homage to the science médecinale of the Egyptians, whom it describes as “wire of Péan”.

Medicine and religion

The title of doctor being checked no, no matter who can be made pass for tel. It thus exists many healers whose remedies rest on magic practices or religious.

In a general way, the worships healers have as a characteristic to be located out of the cities: developed in a late way, they are established with the margin. Thus, Asclépios is initially venerated with Trikka, in Thessalie, then in full shift close to Épidaure. With Corinth as with Athens, Délos or Cos, the god settles with the variation of the agglomeration. The visit with the sanctuary thus requires an excursion. Another characteristic, the sanctuaries are often related to a source or a river whose water has beneficial virtues.

Most of the time, the god healer acts by “incubation”: it is the case of Asclépios to Épidaure or Athens, or of Amphiaraos to Oropos and Thèbes. The ritual starts for the patient with a bath of purification, followed by a sacrifice relatively modest and thus accessible to all. In Épidaure, the patient also owes entonner a Péan in the honor of Apollon and Asclépios. Then, the pilgrim falls asleep under the crowned gantry ( ἅϐατον / ábaton ) - at least in Oropos, Pergame and Épidaure, each sex has its own gantry. Luckiest profit during their sleep of an appearance of the god; by touching the sick part of the body, this one cures it. The god can be also satisfied to dictate to the patient a list drugs that this one will hasten to get once awaked.

The found steles with Épidaure, kinds of Ex-voto, show that Asclépios cures all kinds of diseases: he treats the Ulcère S and cures the Maladie of the stone very as much as he returns the sight to the blind . “There would have been of it much more”, comments on Diogène about an other divinity healer, “if they had been offered by those which do not have not saved, p. 118. ” Undoubtedly the not cured patients allotted this failure to the unsoundable character of the will of the god.

The treatment is not free: thus, in Oropos, the sanctuary claims one ἐπαρχή / eparkhế or taxes with consultation to any visitor wishing to be made look after. Once its due discharged - one drachma béotienne at the beginning of fourth century BC, this last receives a lead plate with the inscription: “sancutuaire of Amphiaraos - health” -, which is used to him as ticket of entry. A néocore (sexton) supervises that the patients do not resquillent.

Some of the “ordinances” dictated by the god were preserved and make it possible to better include/understand the cures attested by the ex-votos. Initially, it should be stressed that the ritual learnedly mixes suggestion and setting in scene. Then, the god generally orders simple remedies (cataplasms, herb teas) and spendthrift of the councils of hygiene of life: need for making exercise (sport and walk), regulation of the food mode. Lastly, the religious shutter strictly speaking is generally supplied with true a cure at a watering-place, including/understanding baths and frictions. In Oropos, where no testimony of cure reached us, the medical instruments discovered testify to the practice of the surgery.

The mental turbid are also cured by cathartic practices . Thus, the chorus in the Hippolyte carry-crown of Euripide distinguishes three types of “mislaying”. One is of type panic (associate with Pan), the other of whimsical type (associate with Hécate, lunar goddess), it last finally is associated with Cybèle and the Corybantes. Hippocrates itself takes again this type of considerations, with an extra effort of typology, in Of the evil crowned . The cure generally consists of a ritual dance with the sound of a music in the mode Phrygie N.

In the species, it is not the ritual which is adapted to the disease but the reverse: if the patient reacts to ritual of such god, it is although its evil was sent by this god. In the absence of reaction, one passes to the following god. Aristophane, in the Wasps , illustrates well the indifference of the Greeks to the nature of the treatment: the important thing, it is that it is effective. Thus, the Bdélycléon young person tries successively to treat his father by a hippocratic cure (baths and purging), a passage by Corybantes (treatment by the Hypnose) then by one night in the sanctuary of Épidaure.

Scientific medicine

The contribution hippocratic

The scientific development of Greek medicine is traditionally allotted to Hippocrates de Cos, doctor of fifth century BC One attaches to him a whole of treaties, the “Corpus hippocratic”, although probably he did not write any of them. Relating to subjects varied like the Gynecology or the Surgery, they are indeed spread out end of the 5th century until the hellenistic time: it is generally estimated that it is about a library of medical school.

The teaching which out of spring brings three innovations which will mark Western medicine durably. Firstly, it draws aside the religious considerations. Thus, the author of On the crowned disease undertakes to show that the epilepsy, called then “crowned disease”, “divine or is not crowned than any other disease. ” Its proof is simple: the disease is caught any only with “phlegmatic” (cf below the theory of moods); however if the disease were truly a divine Visitation, all should be able to be reached about it. If the treaty Of the mode recognizes the importance of the dreams, it is to consider them - partly - as symptoms related to the physiological state of the patient: if this last fact of the nightmares with repetition, that can testify to a mental disorder. However, the corpus hippocratic is not completely free from irrational considerations: in the same treaty, the author considers that the dream is the demonstration symbolic system of a diagnosis that the heart, during the sleep, poses on the body which she lives. Thus makes it meet Oniromancie and medicine.

Hippocratic medicine is thus founded, in a general way, on the observation and the reasoning. The Épidémiques thus include/understand series of daily observations carried out by the doctor on his patient: he starts by describing the symptoms precisely then observes day after day the general state (calm, agitation) in day before and during the sleep. Its examination also relates to the state of the language, the urine and the saddles. An effort of rationalization is made: one distinguishes third fever or quad according to the rate/rhythm observed in the sudden rises of temperature.

Secondly, teaching hippocratic tent to give a theoretical framework. Most known is the theory of the Humeur S (yellow bile, black bile or Atrabile, phlegme or Lymphe and Sang), whose imbalance causes physical disease but also mental health disorder. It is known that others allot the cause of the diseases to imbalances between the heat and the cold, dryness and the wet one in the body. However, other authors like those of On old medicine or On the nature of the man warn against any temptation of excessive simplification: for them, the doctor must above all act and reflect in an empirical way.

In addition to the investigation into the great causes of the diseases, the doctors hippocratic are interested in problems of rather theoretical nature, as the biological Croissance (how the food leads it to a growth of the body) and the reproduction (how the seed can it give rise to a complete being?). On a more practical level, they study the operation of the human body, making thus considerably progress the Anatomie. With this intention, they are based especially on clinical knowledge: thus, the knowledge of the bones and the tendons is probably based on the study of the Entorse S and others Luxation S. the doctors also resort, as of this time, with the Dissection, but the practice remains very marginal.

Lastly, teaching hippocratic rests on true a medical Déontologie, expressed in the treaty On old medicine , the Aphorismes of the Corpus and especially celebrates it Hippocratic oath :

“I will never give poison to anybody, even if one asks some to me; I will never give to a woman drugs suitable to make it fall through; in some house that I enter, I will come there for safety from the patients, abstaining from any injustice and any voluntary misdeed, especially of any seduction of the women and the boys as well slaves as free. ”

Hellenistic medicine

With the hellenistic time, Alexandria becomes the capital of the biological and medical studies. Their principal innovation is the introduction of the practice of the Dissection, thus going against the religious practices prohibiting the opening of the body. In its treaty On the dissections , Hérophile describes the brain and identifies it, against the opinion of Aristote, as the center of the Nervous system. It distinguishes principal the Ventricule S and described the calamus scriptorius (small cavity of the floor of the fourth ventricle), the “concatenations chorioïdes” (the Méninge S) and the “press” (the sine venous, which one will then call in his honor the torcular Herophili ). Hérophile is also interested in the anatomy of the eye and the Cœur.

In order to better know the internal anatomy, Hérophile and its contemporary Érasistrate practice even the Vivisection. According to the testimony of the Roman doctor Celse, both examine the conformation of the bodies of still alive criminals, placed at their disposal by the king. In spite of this progress, anatomical science remains limited since Hérophile, seems it, supports that the optical nerves are hollow.

Galien

Born with Pergame in 129 a. J. - C., Galien follow studies of medicine to Smyrna, Corinthe and Alexandria. During four or five years, he exerts near Gladiateur S and acquires a practical experiment of the major traumatisms. After a short stay in Rome, it acquires such a fame that it is called by Marc-Aurèle and Lucius Verus as surgeon of the armies. He becomes then personal doctor of Commode and enjoys the imperial favor until the end of his career.

The tradition allots to Galien a great number of treaties, of which only a small number survived. Through the latter, it shows a solid knowledge of work of its predecessors (Hippocrates, Hérophile, Érasistrate, Asclépiade) but also of Plato and Aristote. In That the best doctor is also philosophical , it underlines the need for the doctor for having a solid formation of Logique and theoretical biology. It also protests against the cupidity of his colleagues, whose medical vocation is justified by the lure of gain.

Its dissections on the animals prolonged its knowledge in anatomy guided by a Finalisme influenced by Plato. Its thesis on the blood circulation will make authority a long time. For him, blood is formed in the liver after digestion of food. The arteries contain blood and not of the air as thought it of Érasistrate. Arterial blood, in charge of the vital spirits, undergoes a movement rate/rhythm which corresponds to the Pouls. Galien supplements the theory humorale of Hippocrates. It privileges the brain and not the heart.

Posterity of Greek medicine

Works of the Greek eminent doctors could be mainly preserved thanks to Oribase, Greek doctor of which joined together in his monumental synthesis, medical Collection , the Greek medical texts most important.

August 1st

Medical professions

Doctors

The treaties which compose the Corpus hippocratic are not always written by what we would call a doctor. Aristote thus recognizes three categories of people entitled to speak about medicine: the expert ( δημιουργός / dêmiourgós ), the professor of medicine or erudite doctor ( ἀρχιτεκτονικός / arkhitektonikós ) and the cultivated man who studied medicine during his general course. The sophists also claim to be able to teach, inter alia disciplines, medicine.

However, a distinction is done day, in the Corpus hippocratic itself, between on the one hand the doctor and the layman ( On old medicine ), on the other hand the doctor and the charlatan ( On the crowned disease ). We are informed of a specialized school with Cnide and the family of the Asclépiades, with Cos, can be regarded as a school.

If the doctors are often free men, it happens that slaves learn medicine, either in contact with their Master, itself doctor, or on request of their Master who wishes to profit from a private doctor.

The training of the doctors is done most of the time by training. The disciples learn art from the diagnosis and the prognostic near their Master, just as the medical acts: bleeding S, rectal injections by Clystère S, poses suction cups but also surgical acts like the Trépanation. Others choose a more theoretical course: they travel in all the Mediterranean basin, attending the various medical schools. Those which supplement their course by the study of the magic practices are not rare. Thus, at 1st century a. J. - C., the Thessalos doctor, after having learned dialectical medicine, goes it to Diospolis (Thèbes) to learn the virtues from the plants. This training passes for him by the astrology and a consultation of Asclépios, via an Egyptian priest…

Contrary to Egypt, Greece hardly knows but the general doctor; neither the surgery nor the Gynécologie are specialities. The schools of Cos and Cnide all the same respectively left treaties in these two disciplines. One is informed of ophthalmologists, looking after at bases of κολλὐρια / kollúria , i.e. solid plasters, moulded in the shape of sticks. There exist also dentists, able to lead the decayed teeth. Lastly, the armies comprise army medical officers specialized in the grooming of the casualties, and the doctors of the sport.

Public doctors

The doctors can exert on a purely private basis. In this case, they are generally itinerant, which poses problem to them to make recognize from the start their competences in their town of arrival. There also exists to be public doctors, paid by the quoted itself. Thus of a famous doctor of the beginning of the 5th century, Démokédès of Crotona: it makes career initially with Égine, then with Athens and Samos, before being captured by the Perses and entering to the service of the king Darius I {{er}}, which it cures of an affection to the foot. By reporting this episode of the life of the Large King, Hérodote affirms, for the first time in the Greek literature, the superiority of Greek medicine on Egyptian medicine. In Égine, Démokédès gains a talent per annum as of the second year, and in Athens, hundred mine S. a plate of bronze of the same time (cf illustration) also learns to us that called Onasilos and its brothers are engaged by Idalion, with Cyprus, to be public doctors.

In the city Attic, the procedure is well-known for us: it returns in Ecclésia to examine the titles of each candidate and to select able. The recruited doctor then sees himself placing at the disposal a room being used for the consultations. The prescribed drugs are refunded by the State thanks to a special tax, it ἰατρικόν / iatrikón . In a general way however, it is less a question of setting up an health-care system free, following the example modern Social securities, to have a doctor always within reach, in cities where the medical condition is often precarious (cf the “plague” of Athens of 430 - 429 av. J. - C.), the seismic activity often present and where the armed conflicts are frequent.

The inscriptions in the honor of public doctors enable us to know which qualities one waited of such an expert. Thus, a stele of Samos gone back to 201 - 197 av. J. - C. rents Diodoros, wire of Dioscouridès, to be itself, at the time of a seism, “also shared between everyone to carry help to all” and “to have placed the common help above any tiredness and any expenditure. ”

Other professions of health

Greek remedies being elaborate starting from spice S and of Plant S, the Pharmacist ( φαρμακοπώλης / pharmakopốlês ) occupies an important place in the health-care system, even if it happens that the doctor prepares his own remedies. The pharmacist prepares the drugs prescribed by the doctor but also of the directly sold remedies. Thus, in Thesmophories (v. 504), Aristophane describes the husband of a woman about to be confined running “the shops by buying the specific ones to hasten the delivery. ”

Another important profession is that of Sage-femme. If there exist some ladies doctors, the obstreticians and nurses are much more numerous. According to the Théétète (149a), Phénarètè, the mother of Socrate, is midwife, and Socrate takes again the childbirth like metaphor of its art, the Maïeutique.

Lastly, it is necessary to mention the pédotribes, person in charge of sporting teaching within the Gymnase. Learning on the heap generally, they are at the same time dieticians, masseurs and Kinésithérapeute S: they must deal with the Entorse S, Luxation S, Tendinite current S and other traumatisms in practice sporting. Some convert with medicine strictly speaking: thus of Hérodicos de Sélymbria, mentioned on several occasions by Plato (for example Republic , III, 406 a-b or Protagoras , 316 E).

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