Greek society
The success and wealth of the Greek Empire allowed the
Greeks to develop a love of learning and to try to find
answers to the mysteries around them.
There were two main strands to Greek medicine.
The first stemmed from their strong
belief in the gods. The god of healing
was Asclepius (also spelt Asklepios
or Aesculapius).
The second stemmed from new ideas
from Greek doctors, the most famous
of whom was Hippocrates.
Greek gods and medicine
The Greeks believed in gods
for almost all aspects of life.
Poseidon was god of the sea;
Ares was god of war; Asclepius
god of healing.
Temples were built to him, called
Asclepeia. It was believed that if a
sick person went to sleep in an
Asclepion, Asclepius and his
daughters would visit him in his
dreams and cure them.
The most famous of these Asclepeia was built at a remote
location called Epidaurus, and was part of what would be
regarded today as a health complex!
Remains of the stadium at Epidaurus.
Remains of the gymnasium at Epidaurus.
There were baths, a gymnasium, a stadium, a library, a
theatre and accommodation, as well as temples to other
gods.
Asclepius
Greek God
of
Medicine & Healing
Asclepius: Birth Mythology
 He was son of Apollo and
Apollo Snatching the Unborn Asclepius
from the Flaming Womb of Coronis
Coronis.
 A mythological story is attached
to his birth that his mother was
killed for being unfaithful to
Apollo but the unborn child
was rescued from the womb
of his dead mother.
 He was called as Asclepius
which means “to cut open”.
 Apollo took the baby to
Centaur Chiron, son of
Saturn, who brought him up
and taught him art of medicine.
Daughters of Aesculapius
had five daughter, each reflecting a specific feature
of medical art:
 Asclepius
Hygieia -
Hygiene
Panacea
Universal remedy
Laso
Medicine
Aceso
Healing
Aglæa
Hygieia
Healthy glow
Panacea
Laso
Staff of Asclepius: Askelepian
 Asclepius carried with him a Staff
round which twists the serpent,
this was the symbol of ancient
medicine and is still the symbol of
medicine in modern world.
 This staff of Aesculapius was called
as Askelepian.
 The snake symbolizes the shedding of
skin as a sign of rejuvenation or
alternatively it signifies dual nature
of physician as dealing with life and
death, health and sickness, medicine
and poison etc.
Medical Emblem
Temple of Aesculapius: Asclepieia
 The temples of his cult, dedicated to healer
Temple of Aesculapius
God Aesculapius, were known as Asclepieia.
Most celebrated Asclepieia were in Cos,
Epidaurus, Cnidus and Pergamus.
 In the state of induced sleep, called as
enkoimesis, the priest presented himself
before the patient to administer medical
advice, if he happened to be awake.
 If he slept, as was usually the case, the advice
came in a dream, which was interpreted
afterwards by the priests, who then prescribed
catharsis, emesis, blood-letting or
whatever remedy seemed appropriate.
 Before these patients left the temple a tablets
were hung on the wall of the temple engraving
there name, brief history and treatment
offered.
From an inscription found on a stone column in the
temple at Epidaurus, c. 370–250 BC:
A man with an abscess in his abdomen went
to sleep in the Temple of Asclepius. In his
dreams, Asclepius ordered the servants that
accompanied him to grip him and hold him
tightly so that he could cut open his
abdomen. The man tried
to escape but they gripped him and bound
him. Asclepius cut open his belly, removed
the abscess, stitched him up and released
him. The man woke up sound and left the
temple, but the floor was covered in blood.
New Greek medical ideas
 In addition to the belief in the healing powers of Asclepius,
there was also a lot of respect for other medical theories.
 The Greeks loved philosophy and came up with lots of new
ideas as a result. One important theory was the Theory of the
Four Humours which became the basis for Greek medical
practice.
 The theory of the four humours was thought to have
originated in ancient Egypt or Mesopotamia but Hippocrates
developed the theory further.
 Despite being wrong, it was a theory which was to be widely
used by doctors for nearly 2,000 years. The reliance on the
theory was so heavy that it prevented doctors from looking
elsewhere for causes of disease.
The Theory of the Four Humours
The Theory of the Four Humours was influenced by Greek
ideas about balance.
The Greeks believed that the world was made up of
four elements:
Air
Fire
Earth
Water
They noted that these elements had different properties –
water was wet, fire was hot, etc.
Through observing the four seasons, they believed that
each season must have a dominant element.
Air
Fire
Earth
Water
Warm
and
moist
Hot and dry
Cold and dry
Cold and
wet
Spring
Summer
Autumn
Winter
The Four Humours
 Greek doctors noted that patients’ symptoms varied with the seasons –
heat rashes in summer, wet runny noses in winter.
 From this, they deduced that the human body was made up of four vital
liquids which they referred to as ‘humours’:
 Blood
 Phlegm (sputum)
 Yellow bile
 Black bile
Each of the humours was related to a season and element:
Air
Fire
Earth
Water
Spring
Summer
Autumn
Winter
Blood
Yellow bile
Black bile
Phlegm
The theory stated that these humours had to be in balance
for the body to be well, that is there had to be the correct
amount of each fluid.
In order to find out which humour was imbalanced, Greek
doctors would perform a diagnosis on the patient by
studying their symptoms.
Diagnosis
Prognosis
Observation
Treatment
Clinical diagnosis
If there was too much or too little of one or more of the
humours it was thought that the person would become ill.
Medical treatments aimed to put the humours back in balance.
Treating illness
 Greek medical treatments aimed to rebalance the
humours. Treatments prescribed included:
Bleeding
Vomiting
purging.
Bleeding
 Bleeding a patient was a treatment which was used
right through to the 19th century. A scratch was
made in the skin and the blood was let out into a cup.
Purging
 Purging the bowel or making the patient vomit involved
herbal concoctions:
 “If the pain is under the diaphragm, clear the bowels with a
medicine made from black hellebore, cumin or other fragrant
herbs.”
 The Greek doctors were also aware of the need to prevent
illness and advised their patients on hygiene, diet and exercise:
 “He should wash face and eyes using pure water. He should rub his
teeth inside and outside with the fingers using fine peppermint powder.
Long walks before meals clear out the body … and give it more power
for digesting.”
Hippocrates – the 'father' of modern medicine
 Legend has it that Hippocrates was born in Cos in about
460 BC. He was the most famous Greek doctor, and
recorded his ideas and discoveries in a number of books.
 He and his followers broke with the tradition of believing
that the gods caused and cured disease and he is looked
upon as the founder of modern medicine.
 He encouraged doctors to observe symptoms
and to look for causes based on those symptoms.
Review Questions - 1
Who is known as the world's first physician?
A. Imhotep (Egyptian 2650 BC)
B. Babylonians
C. Hippocrates
D. Romans
2
Who is considered to be the Father of Western
Medicine?
A. Imhotep
B. Romans
C. Hippocrates
D. William Harvey
3
Historians rely on materials from the past to understand the
present. A first hand pieces of evidence from the people who
saw an event is usually classified as:
A. Tertiary source
B. Primary Source
C. Secondary Source
D. All of the above
4
Egypt developed as a civilization and their theory of
diseases around which of the following rivers
A. Tigris
B. Euphrates
C. Nile
D. Amazon
5
Priests in ancient Egypt held special power because:
A. they judged people's lives.
B. their magic and prayers were believed to
influence the gods.
C. they served the pharaoh.
D. they set rules for people's lives.
6
 Greek medicine partly stemmed from their strong
belief in the gods. The god of healing in ancient
Greek is:
A. Hygieia –
B. Panacea
C. Laso
D. Aceso
E. Asclepius
The Four Humurs
Humour
Season
Element
Organ
Quality
warm
and
moist
Blood Spring
air
Heart
Yellow Summ
Bile
er
fire
Liver
warm
and dry
Black
cold
Earth
Spleen
Autum
Bile
and dry
Phlegm Winter
Water
Brain
cold
and
moist
Ancient
Name
Tempram
ent
Sanguis
sangui
ne
Kholé
Choleric
melas
kholé
Melanc
holic
phlégma Phlegma
tic
The Four Humurs
Humour
Temperament characteristics
sanguine
courageous, hopeful, playful, carefree
Choleric
Melacncholic
Phlegmatic
ambitious, leader-like, restless, easily angered
despondent, quiet, analytical, serious
calm, thoughtful, patient, peaceful
Herophilus (335 – 280 BC)
Herophilus was a rationalist physician who taught
and practiced in Ptolemaic Alexandria during a
golden period of scientific enquiry.
He was born in Chalcedon on the Asiatic side of the
Bosporus and may have been apprenticed to
Praxagoras of Cos during his medical training
Herophilus Contribution to Medicine
 Herophilus had extensive anatomical knowledge, acquired
by dissecting human bodies. He is considered to be the
“father of anatomy” and co founder of autopsy.
 His most important contribution in the history of medicine
was the development of a theory for the diagnostic value of
the pulse.

A pulse it the rhythmic expansion of an artery produced when a bolus of
blood (stroke volume) is forced into it by a contraction of the heart .

It can be described based on its:






Rate
Rhythm
Volume
Hypokinetic pulse
Hyperkinetic pulse
Herophilus (cont)
 He discribed and named the Prostate gland
 He first applied the name of twelve-inche or duodenum
(dodekadaktulos) to the first part of small intestine
 He studied the brain and was the first to apply the name
choriod or vascular membrane to that which is found in
the cr.ebral ventricles
 Herophilus also knew the straight venous sinus which
still bears his name.
 He wrote 9 books on medicine which have been lost in
the Library of Alexandria
 ‘[Herophilus] that doctor, or rather butcher, who cut up innumerable
human beings so that he could investigate nature’ – Tertullian, On the Soul
Herophilus (Summary)
 Father of anatomy
 Medical training from Praxagoras
 One of the firsts anatomists
 First to dissect humans and animals,
discovering many mysteries about the body
 Wrote about nine works
 Helped set basis for anatomists
Erasistratos (250 - 204 B.C)
 Erasistratos studied in Athens and continued the
work of Herophilus in Alenxandria. He is considered
to be the “father of physiology” and co-founder
of autopsy.
 He determined that the brain was the originating
point of all nerves.
 He distinguished sensory from motor nerves. He was
the first to dispel the notion that nerves are hollow
and filled with air
Erasistratos (cont)
 He understood that the hear served as a pump and
described the function of the heart valves.
 Erasistratos theorized that arteries and veins originate
from the heart finally spreading into minute capillaries
invisible to human eye.
 He also described the structure and function of the gastic
muscles
 He is credited with one of the first in-depth descriptions
of the cerebrum and cerebellum.
 He wrote more than 50 medical works the majority of
which is now lost.
Erasistatus (summary)
 Born on the island of chios
 Differentiated between cerebrum and
cerebellum.
 Distinguished motor vs. sensory nerves.
 Found function of the epiglottis & the valves of
the heart.
 Theory that parts of the body supplied with
nutrients and blood through veins and
capillaries.
 Following the rise of Christianity in the first century CE,
popular opinion once again turned against human
dissection, which the early Christian Church labeled a
sin.
 Keen to denounce such unholy behavior, some ancient
scholars seized upon tales that Herophilus and
Erasistratus’ dissections were not limited only to the
dead, but that they experimented on the living as well,
branding the two anatomists the ‘butchers of Alexandria’.
To the Asklepieia came many sick persons for the
healing ritual known as “incubation," or temple
sleep. On arrival the patient was expected to make a
sacrificial offering, arid to purify himself by bathing.
Then he lay down to sleep in the abaton, a long
colonnade open to the air at each side. During the
night Aesculapius appeared in a dream and gave
advice, or in certain cases performed an operation,
and in the morning the patient departed cured.
 The revelation which came to the sleeping patient in
a dream consisted of a vision of Aesculapius
surrounded by dazzling lights, or, in other cases, only
the voice of the god. Incubation apparently depended
upon the methods adopted by the Delphian Oracle,
and both phenomena could doubtless be explained
as forms of psychotherapy.
 Our knowledge of incubation is largely derived from
inscriptions on the stone stela, or tablets, which have
been found at Epidaurus. Forty-four cases are
described, and among them are the following :
Case of Post dated pregnancy
Klco was with child for five years. After these five
years of pregnancy she came as a uppliant to the god
and slept in the abaton. As soon as she left it and got
outside the temple precincts she bore a son, who
immediately after birth washed himself at the
fountain and walked about with his mother.
A Dumb boy
 A dumb boy came as a suppliant to the temple to
recover his voice. When he had performed the sacrifices
and fulfilled the rites, the temple priest who bore the
sacrificial fire turned to the boy's father and said, " Do
you promise to pay within a year the fres for the cure, if
you obtain that for which you have come ?
 Suddenly the boy answered, “ I do." His father was
greatly astonished at this, and told his son to speak
again. The boy repeated the words and so was cured.
Case of Trauma
 Euippos had had for six years the point of a spear in
his cheek. As he was sleeping the god extracted the
spear-head and gave it to him into his hands. When
day came Euippos departed cured, and he held the
spear-head in his hands.
Case of Insomnia
 Agestratos suffered from insomnia on account of
headaches. As soon as he came to the abaton he fell
asleep and had a dream. He thought that the god
cured him of his headache and, making him stand
up, taught him wrestling. When day came he
departed cured, and after a short time he competed
at the Nemean games and was victor in restling.
Summary
 In reading those records of temple treatment one is
impressed by two facts. All cases without exception
were cured, and the cure appeared to be miraculous,
as many had been regarded as incurable. Failures
were not recorded and deaths were never
mentioned.
Summary
Although in the early days of the cult of incubation
the methods employed were mystical and
supernatural, physical therapy, comprising diet,
bathing, and exercise, played an increasingly
important part in the cure.
Incubation Today
 Though incubation was practiced as early as the
eighth century B.C. It was continued far into the
Christian era, and even to-day, in
Greece, in Asia Minor and in Italy, traces of this
ancient cult may still be found.
Incubation and Hippocrate
 While these healing temples were an important part
of Greek medical care, the values they embodied had
little impact on the Hippocratic Corpus.
 The Corpus treatises assume that disease has a
natural cause, even with the dreaded disease called
“The Sacred Disease” – i.e epileptic attack.
Hippocrates and Cause of illness
“it is thus with regard to the disease called Sacred: it
appears to me to be nowise more divine nor more sacred
than other diseases, but has a natural cause from which it
originates like other affections. Men regard its nature
and cause as divine from ignorance and wonder, because
it is not at all like to other diseases. And this notion of
divinity is kept up by their inability to comprehend it ,
and the simplicity of the mode by which it is cured, for
men are freed from it by purifications and incantations.
But if it is reckoned divine because it is wonderful,
instead of one there are many diseases which would be
sacred”
Next Week Presentation Topics
 Hippocrates
 Claudius Galen
 Gargilius Martialis
 Bartholomeus Anglicus
1/26/2015
1/27/2015
1/28/2015
1/29/2015