Medical Sects and
Galen
Tensions in Ancient Medicine
Rationalists
Hippocratics
Theory guided
medical practice
Speculative
Humoural theory
Anatomy &
Physiology
Empiricists
Medical knowledge
gained by
experience
Training in the art
of observation
Empiricist
medicine still an art
Still separated medicine from other
healers
Apprenticeship model of medical
education persisted until 19th century
Rise of the Methodists
(1st Century CE)
Challenged
both Rationalist and
Empiricist medicine
All illness result of either constriction
or dilation of pores of body
Denied
the learned basis of medicine
Anyone could learn medicine in 6
months
Thumbing Noses at Learned
Medicine
Hippocrates:
Life is short, the art
long, opportunity
fleeting,
experiment
dangerous and
judgment difficult
Methodists:
Life is long and the
art is short.
Galen of Pergamon
(129-c.219 CE)
Born
in what is now Turkey
Son of an architect
Began medical studies at age 16
Studied in Alexandria
Travelled widely in Egypt
Began
medical practice in late 20s
Physician to the gladiators in
Pergamon
Moved to Rome
Gained
fame for
– Public anatomical displays
– His philosophical acumen
– His successful medical treatments of the
elite
Why
– He
– He
– He
– He
was Galen successful?
was
was
was
was
a
a
a
a
Roman citizen
member of the elite
shameless self-promoter
prolific writer
The Context of Galen’s Practice
Regarded
himself as Hippocrates’
heir
In some ways, he invented
Hippocrates
Loathed the Methodists
Systematized
Believed
universe
Believed
Hippocratic medicine
in a divinely ordered
it could only be discerned
through reason and intellect
Elaborating Hippocrates
Extended
the humoural theory
Believed
it confirmed Plato’s tripartite
human soul
– Liver (nutrition)
– Heart (vitality)
– Brain (reason/sensation)
Humoural
theory also extended
Aristotelian physics
– Four
– Four
– Four
– Four
humours
elements
seasons
primary qualities
Galen’s Innovations:
Nosology
Classification of diseases
Diagnosis
Prognosis
Diseases are specific entities, not
malleable
Galen’s Contributions
Experimentation
Groundbreaking work in anatomy &
physiology
Existence of psychosomatic disease
Belief in primacy of reason
Diminished
the work of those he
disagreed with
Plagiarized the work of those he did
agree with
Medieval Medicine
(c. 400- 1000 BCE)
Split
in Roman Empire
– 4th century BCE
Eastern
Empire
– Byzantine
– Greek speaking
– Centred in Constantinople (now
Istanbul)
Constantinople
century
Empire
sacked in 14th
reduced to city & its
hinterland
Western
– Latin speaking
– Centred in Rome
Rome
sacked in 410 CE
Political,
social, & economic chaos
De-urbanization
– Return to agricultural economy
Loss
of trade relationships
Loss
of traditional ways of
transmitting knowledge
– Decline in intellectual life
– No centres of higher learning
– Few masters training apprentices in
medicine
Often
referred to as the “Dark Ages”
Result
was 2 types of medical
literature
1.Latin
– Encyclopedia
– commentary
2.Vernacular
– Written by lay people
– e.g.: Old English (Anglo Saxon) texts
– Date from 10th century
Leechbook
of Bald
Lacnunga
Non
theoretical
Drawn
from diverse sources
Indications
of pre-Christian traditions
– Magic
Overlaid
with Christian elements
Impact
of rise of Christianity
– Issues of adjustment between “pagan”
& Christian thought
1.Intellectual
– What causes disease
– What cures disease
2.Practical
– Healing institutions
Healing
shrines
Hospices
Monasteries
Medicine in Islam
Or How the East Saved
Western Medicine
Important Variables
Former
Greek
Political
Greek
Eastern Roman empire spoke
stability
speaking physicians from the
old eastern empire moved further
east
Islamic Empire
Mohammed
After
(d. 632 C.E.)
his death, new faith spread
rapidly in Arabian peninsula
By 642 C.E.:
–
–
–
–
Armenia
Mesopotamia
Much of Persia
Much of Egypt
By 743 C.E.:
–
–
–
–
–
–
North Africa
Much of Spain
Almost France
Persia
Kashmir
Punjab
The Islamic World c. 730 C.E.
The Islamic Intellectual World
Centred
in Bagdad
Presence
of Greek speaking
intellectuals
Sponsored
by Islamic court
Translations
of Greek medical texts
Muslim
intellectuals drawn to rigour
of Greek philosophy & medicine
100
texts by Galen translated
Muslim
intellectuals sought to build
on the work already done
Both faithful to Greek/Roman
traditions & innovative
Integrated their own knowledge of
remedies
Advances in surgical procedures
Rhazes (865-925 C.E.)
Differentiated
measles
between small pox and
Much
more difficult than it may
appear
Other
Muslim physicians described
person-to-person spread of disease
Ibn Sina (Avicenna) 980-1037 C.E.
Distinguished
between episodic
diseases and epidemics
Believed air was the principal vehicle
for spreading disease
Also, “evil eye”
Later Western Medicine’s
Assessment of Islamic Medicine
Described
Unfair
as unoriginal
on several counts
– Great respect for tradition
– Difficulties associated with translation
Islamic Medicine’s Legacy
Preserved
and advanced early
western medicine
Avicenna
– Prolific writer
– The Cannon
– Became known as the “Galen of Islam”
Spain under Muslim Rule
Important
site for re-entry of ancient
medicine into medieval Europe
Contribution
of Spanish Jews
– Moses Maimonides
Philosopher
& physician
Guide for the Perplexed
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