Download Review Article Ancient Greek medicine before and after Hippocrates

Balkan Military Medical Review
14, 52-65 (2011)
Review Article
Ancient Greek medicine before and after Hippocrates: the scientification of
medicine
Emmanouil MAGIORKINIS BSc, MD, PhD, Apostolos BELOUKAS Bsc, PhD, Aristidis
DIAMANTIS, MD, PhD *
Office for the Study of History of Hellenic Naval Medicine,
Naval Hospital of Athens, Greece
Corresponding author:
Captain Aristidis. DIAMANTIS, MD, PhD, HN
2 Karaiskaki, 15562 Cholargos
Athens, Greece
Tel: +30-210-7261154, mobile: 6944-323722
e-mail: [email protected]
Abstract
adventures and life of gods, godesses,
The path of Greek Medicine is
heroes and heroins. The purpose of this
lost through the centuries between myth
article is to present the evolution of
and history. The Greek mythology
medicine before and after the era of
flourishes
Hippocrates
with
stories
about
the
and
to
stress
the
Magiorkinis E. et al: Ancient Greek Medicine before and after Hippocrates
53
contribution of Hippocrates in the
the word “μύθος” which literally means scientification of medicine. A thorough
“on the side of myth” or alternatively “a study of ancient texts of the Greek and
story very close to that of myth” (“παρά το Roman literature, revealed that Greek
μύθον”). During prehistory, what was mythology abounds in examples of Gods
unable to be explained by reason, was
such as Apollo, semi-gods such as
attributed to transcendental entities, which
Asclepius
and
had either a human or animal form. In that
creatures such as Centaur Chiron who
way, diseases were thought to be of divine
practiced and taught medicine in pre-
origin and, therefore, their final outcome-
historical times in Greece. Hippocrates
either cure or death- was bestowed upon
will be the first to nominate medicine as
the will of God. The innate inability of the
a science rejecting the influence of Luck
individual as a unit or within the family or
and
the
the tribe led man to device different means
chronological order of the appearance of
with the superior, invisible deities, giving
those figures in Greek mythology depict
birth, in that way, to Magic and Ritual.
the
of
and
Gods.
course
of
Amphiaraus,
In
general,
transformation
of
Medicine from divine gift to practical
Medicine in Ancient Greek Mythology
art.
Ancient Greeks believed that Gods
Keywords:
mythology,
medicine,
sent disease and provoked death, punishing
“Ύβρις” (hubris) and injustice. All disease Hippocrates, Ancient Greece.
could be healed by the process of
propitiation of the Gods through sacrifices
and other rituals. Only the chosen ones
Introduction
could communicate with the Gods; they
Greek
were people who were worshiped after
mythology depicts a series of events which
their death as deities and were undertaking
are rather allegorically narrated than totally
the task to mediate between the patient and
fictitious. The word “μύθος” (mythos) in the God for the sake of the first.
The
world
of
Ancient
Greek is totally different by the word
The first figure in Ancient Greek
“παραμύθι” (fairy-tale): the second is a
mythology connected with Medicine is the
compound word of the word “παρά” and healer of Gods “Παιών” (Paeon or Paion)
54
Balkan Military Medical Review
Vol. 14, No 1, January 2011
who treated the wounds of Mars and Ades
using various ointments and remedies [1].
His name comes from the word “παίω” which means “heal the disease by a magic
hit”, whereas the word “Παιάν” was used to name the military lied of victory,
connecting
the
music
and
healing
properties of Paion. During the classic
years, the word Paean became a synonym
of Asclepius and, in many cases, he was
considered as a deliverer from any evil or
calamity [2].
Examining
the
Dodekatheon,
Apollo (Figure 1), the God of Light and
Music, was also connected to Medicine; he
Figure 1. Apollo
was considered to be the inventor of the art
of «θεραπεύειν» (healing). According to is doctor and prophet- and “ιατρός” (iatros) Hesiod [3] Apollo was the son of Zeus and
since he is referred by Hippocrates as the
Leto, the son of spiritual Light, of Music,
first doctor ever. Apollo was worshiped in
of Poetry and of Vaticination. Apollo is
the
considered to be the god who wards off
characterization “λοξίας” (loksias), but evil and offers help; different names have
also as a healer in various places in
been used to describe this property such as:
Ancient Greece such as Lindos, Tegea,
“αλεξίκακος” (aleksikakos) - a Greek word
Sparta, Athens, Oropos, Sicyon and Thraca
that means the one who prevents evil-
in various oracles. Other characterizations
“λοίμιος” (limios) - another Greek word
for Apollo include “ακέσιος”, “ακέστωρ”,
for the one who provokes epidemics
“σώτερ”, (“λοιμός”). Other characterizations
for
“επικούριος” (akesios, akestôr, alexikakos, Apollo regarding his medical dexterities
sôtêr, apotropaios, epikourios, iatromantis) was “υπερδέξιος” (hyperdeksios)- the one
[4-6].
who uses the right hand in order to heal-,
“ιατρομάντις” (iatromantis) – the one who
Oracle
of
Delphi
“αποτρόπαιος”, by
the
and Magiorkinis E. et al: Ancient Greek Medicine before and after Hippocrates
55
“χείρων” originates from the ancient greek word “χείρ” which means hand. Chiron’s name implied that he was "skilled with the
hands”, and, therefore, could heal by the use of magic through his hands. The name
was also closely associated in myth with
“χειρουργός» (kheirourgos or surgeon).
Except from Medicine, Chiron was an
adept in the use of herbs [10-11], the
augural
art,
music,
astronomy,
law,
hunting and the art of war ; therefore he
was a brilliant teacher. His students were
heroes that excelled in battles and in the
field of Medicine and many of them
participated in the Argonautic campaign
Figure 2. Centaur Chiron teaching
with Jason [12-13]. Chiron was “the wild archery to Achilles.
centaur who ruled in the glens of Pelion” who bred “Asclepius, the gentle artificer of Another important figure in the Greek
freedom-from-pain, that strengthens the
mythology connected with Medicine was
limbs, the demi-god that wards off
Centaur Chiron (Figure 2), son of the
diseases” and the “most just of all father of the gods, Cronos, and of a
centaurs” [14]. He was worshiped in nymph, Philyra [7]. Cheiron lived in
Magnesia, and, according to Propertius, he
Mount Pelion, until his forced expulsion to
healed the blindness of Phoenix, whereas
the forest of Laconia by Lapithae, decents
he was the one that converted medicine
of Lapithes who was son of Apollo and
from
Stilbe. Centaurs was a tribe of half-horse
therapeutics [15,16]
men. Mount Pelion in Ancient times was a
desolate
region
full
of
caves
magic
to
a
practical
art
of
Asclepius (Figure 3), the son of the
and
Trikkaian princess Koronis or Arsinoe and
impenetrable thickets [8]. Centaur Chiron
of Apollo, was taught the art of Medicine
was considered to be the founder and the
by Chiron [17, 18]. His mother died in
first teacher of Medicine [9]; his name
labour and was laid out on the pyre to be
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Balkan Military Medical Review
Vol. 14, No 1, January 2011
a new-born child, was to be sacrificed
along with his mother to the vengeance of
Gods, and Apollo took him out of the
funeral
pile
the
last
moment
and
transferred him to a cave in Mount Pelion
where Chiron lived, in order to learn how
to treat illnesses that afflict the mortals
[19]. According to the myth, Asclepius’ art reached in such a high level that he
managed imprudently to raise up from the
dead mortals. There were many theories
about how Asclepius obtain his power to
resurrect
the
dead.
According
to
Apollodorus, he had received from Athena
the blood which had flowed from the veins
of Gorgon, and the blood which had
Figure 3. Statue of Asclepius
flowed from the veins of the right side of
consumed, but his father rescued the child,
cutting him from her womb, performing
the first caesarean section in the history of
medicine. There are many theories about
the origin of his name. Some believe that
he received his name from the fact that he
was born with a caesarean section and that
the name Asclepius means "to cut open”. Others believe that his name “Ασκληπιός” comes from the word “Αίγλη” which means brilliance or “Άσκλης”- the name of
a king whose eyes were ill and was
subsequently
healed-
and
the
word
“Ήπιος” which means calm. Asclepius, as her body possessed the power of restoring
the dead to life. According to the other
tradition, Asclepius on one occasion was
shut up in the house of Glaucus, whom he
was to cure, and while he was standing
absorbed in thought, there came a serpent
which twined round the staff, and which he
killed. Another serpent then came carrying
in its mouth a herb with which it recalled
to life the one that had been killed, and
Asclepius henceforth made use of the same
herb with the same effect upon men. When
he was exercising this art upon Glaucus,
Zeus killed Asclepius with a flash of
lightning, as he feared lest men might
Magiorkinis E. et al: Ancient Greek Medicine before and after Hippocrates
gradually
contrive
death
Hygeia, Panacea, Iaso and Akeso. Hygeia
altogether, or, according to others, because
was the goddess of good health, whereas in
Pluto
Asclepius
one of the Orphic Hymns, she is also
diminishing the number of the dead too
called the wife of Asclepius. Iaso was
much [19-21]. Asclepius, after his death,
considered to be the goddess of recovery,
was worshipped all over Greece, and many
Panacea was the “all-healing” goddess of towns claimed the (honor) of his birth.;
cures and of “πανάκειας” (panaceas), many magnificent temples- over 300- were
whereas Akeso was the goddess of wound
built in his honor in Cos, Knidos, and
healing and curing of illnesses.
had
Epidaurus,
to
escape
57
complained
of
the so-called «Ασκληπιεία» Asclepius
sons,
Machaon
and
Asclepieia, which were, in the same time,
Podalirius, according to Homer’s Iliad, the first Hospitals in Ancient Greece. The
participated in the siege of Troy as doctors
Asclepieia,
to
(chief medical officers) attached to the
patients from all over the Greece from the
Greek forces from Thessaly and warriors
beginning of sixth century B.C. till the
and were brilliant doctors and excellent
advent of Christianity in Greece in the
men. Machaon and Podalirius, thus, were
fourth century A.D. All founders of the
the first doctors who practiced medicine in
first schools of Medicine in Knidos, Kos,
the battlefield. In Iliad, in the second book,
Cyrenea and Rhodes in Ancient Greece
both of them were marshals of the tribes of
were students of the Asclepieia’s. His Trikka, Ithome and Oechalia who dwelt in
marriage with Epione gave him many
Thessaly [25]; in that way, they were not
children; his sons Machaon and Podalirius,
only military doctors but also brilliant
were his disciples who propagated his art
leaders who fought bravely. The name of
in
[22].
Machaon is named 11 times in Iliad,
to
whereas the name of Podalirius appears
he
founded
only one time [26]. Notably, in the fourth
sons
Alexanor,
the
offered
whole
Machaon
Asclepieia
Sphyrus,
Ancient
moved
Peloponnesus,
with
their
from
where
his
Nicomachus,
services
Greece
Thessaly
Gorgasus
and
book
of
Menelaus,
Iliad,
the
Homer
king
of
narrates
that
Sparta,
was
Polemocrates [23, 24]. Podalirius, on the
wounded by an arrow from the bow of
other hand, founded Asclepieia in Karia, in
Alexander, and Agamemnon, his brother
Aegean islands and in Apulia in Italy.
and king of Mycenae, addressed for help to
Epione gave birth to four daughters,
Talthybius, the divine herald. Talthybius,
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Balkan Military Medical Review
Vol. 14, No 1, January 2011
in turn, called for Machaon who removed
incompetence of Iphiclus by the use of iron
the arrow and healed the wound saving
rust [31].
Menelaus from death [27]. Podalirius,
Amphiaraus, son of Oicles (Oecles)
specialized especially in internal medicine,
or Apollon and Hypermnestra [32,33],
on the other hand, according to Homer,
daugther of Thestius, participated in the
could heal wounds using a miraculous
hunting of the Calydonian boar, which he
cure, whereas he was the first to diagnose
is said to have deprived of one eye, and
Ajax’s insanity by the glittering of his eyes also was as one of the Argonauts [34].
and the depression of his spirits [26].
Amphiaraus was a descedant of the
According to Virgil’s Aeneid, he was one Melampus on his father’s side and was of the soldiers hidden in the wooden horse
thought to have acquired the skill of
of Troy [28]. The reports on the death of
therapeutics
the two brothers differ. According to
grandfather. By his participation in the
Quintus Smyrnaeus, Machaon was killed
Argonautic campaign, it is our firm belief
during the siege of Troy by Eyrypylus son
that Amphiaraus was the first naval doctor.
of Telephus [29], whereas Podalirius
Amphiaraus was a hero of the war of the
married the daughter of King Damethus,
‘Seven Against Thebes’; he died during a
after healing her wounds when she fell off
battle, when he sought to flee from
her horse [26].
Periclymenus, son of the divine Poseidon
and
augury
from
his
Melampus, son of Amythaon and
[19], who wanted to kill him, but Zeus
ruler of Argos, was considered to be a
threw his thunderbolt, and the earth opened
healer and
name
to swallow Amphiaraus together with his
(‘Μελάμπους’) literally means the one who
chariot transforming him into an oracular
has black foot whereas his father’s name,
daimon (spirit) [35]. After his death, he
“Αμύθεος” means the “ineffable” or was worshiped and a sanctuary at Oropos,
“unspeakably great”. Melampus practiced
the so-called Amphiaraeion, was built.
a type of primitive psychiatry; according to
Amphiaraus was considered to be a healer
Herodote, he healed Pritos’ daughters of and a oracle who was associated with
their madness by the use of helebore [30].
divine
Later, according to Apollodorus, healed
relationship with Melampus. After making
the mania of the women in Messinia,
a sacrifice of a few coins, or sometimes a
whereas
ram, at the temple, a petitioner slept inside
he
a soothsayer. His
also
treated
the
sexual
Asclepius,
as
result
of
his
Magiorkinis E. et al: Ancient Greek Medicine before and after Hippocrates
59
and received a dream detailing the solution
attention paid to observing and evaluating
to the problem.
the physical findings. In Knidos, diseases
Agamede was princess of Elis,
are categorized according to the the
daughter of King Augeias and wife of
affected organ, a system resembling the
Mulius, and a practitioner of the art of
practice in the Mesopotamian lands east of
mixing medicinal herbs (the so called
Knidos.
pharmakeia). According to Homer, she
was acquainted with the healing powers of
all the plants that grow upon the earth [36].
Hippocratic
medicine:
the
transformation of medicine into science
Medicine during the ‘Classical Period’ in Greece was practiced by physicians, who have been trained by
renowed tutors or in medical schools, by
medical assistants, by empirical doctors,
and by charlatans who employed filters
and other magical therapies. During this
period, two medical schools dominate in
Greece: the Medical School of Knidos,
with his main representative Euriphon, and
Figure 4. Hippocrates of Kos.
the Medical School of Kos, with his main
representative Hippocrates (Figure 4).
Physicians of the School of Knidos
The Hippocratic corpus represents the
focused on the detailed recording of
first scientific recording of the ancient
symptoms and consider each variation of
greek medicine. Consisting of 60 ancient
the manifestation of the disease as a
Greek
separate clinical entity. On the other hand,
collection of books is strongly associated
Hippocratic
the
with the physician Hippocrates and his
patient rather than the disease with great
teachings, and although attributed to
medicine
emphasized
medical
works
strongly,
this
60
Balkan Military Medical Review
Vol. 14, No 1, January 2011
Hippocrates, most of them are of unknown
when administered to the sick, which
authorship.
The Hippocratic Corpus
agreed with them when in good health,
contain textbooks, lectures, research, notes
neither did nor do agree with them….. To and case histories without any particular
such a discovery and investigation what
order. For example Books I and Books III
more suitable name could one give than
of Epidemics contain case reports of which
that of Medicine? since it was discovered
60% had a fatal outcome [37].
for the health of man, for his nourishment
In many parts of the Hippocratic
and safety, as a substitute for that kind of
Corpus one can find in parallel empiricism
diet by which pains, diseases, and deaths
and rationalism, since the writter of the
were occasioned.”[38]
Hippocratic
corpus
medical
The writter of On the Places in
knowledge not only in theories but also on
Man states that medicine is art (τέχνη) in
experience.
Ancient
order to defend against opponents who
Medicine , one of the oldest books of the
claim it produces no better results against
Hippocratic Corpus, the writter deals with
disease than chance:
the evolution of human diet and will stress
“I think that Medicine has already
that man chooses his diet based on his
discovered all its sections and, at the
experience of the effect that various food
current stage, teaches what is necessary in
exert on human health. The next step in the
each cases and when circumstances are
history of medicine is the separation of diet
favorable. Whoever knows Medicine in this
during health and ilness:
way, nothing is based on luck……” [39]
For
bases
eample,
in
“For the art of Medicine would not have In The Law, one can read the
been invented at first, nor would it have
following:
been made a subject of investigation (for
“Medicine is of all the Arts the most
there would have been no need of it), if
noble; but, not withstanding, owing to the
when men are indisposed, the same food
ignorance of those who practice it, and of
and other articles of regimen which they
those
eat and drink when in good health were
judgment of them, it is at present far
proper for them, and if no others were
behind all the other arts” [40]
who,
inconsiderately,
form
a
preferable to these. But now necessity itself
According to the Hippocratic texts,
made medicine to be sought out and
medicine draws conclusions based on facts
discovered by men, since the same things
which are gathered on the basis of patient
Magiorkinis E. et al: Ancient Greek Medicine before and after Hippocrates
interview
and
thorough
patient
examination. In that way, based on facts,
61
advice on good manners that a physician
must have when visiting patients.
on observation and on reason, medicine, as
recorded in the hippocratic texts, becomes
Conclusion
a science.
The writters of the Hippocratic
In
summary,
Hippocrates,
as
texts agree in rejecting divine and religious
depicted through the Hippocratic Corpus,
causes and remedies of disease in favor of
inaugurates the scientific era of medicine.
natural mechanisms. For example in the
In the years to come, the principles of the
treatise On the Sacred Disease considers
Hippocratic School of medicine formed the
that epilepsy has a natural cause and its
basis of medical thought and research. In
supposed divine origin is due to men’s the pre-hippocratic era, Medicine mingled
inability to explain its peculiar character:
between
“It is thus with regard to the disease called
mythology is full of examples of deities
Sacred: it appears to me to be nowise more
and heroes who possessed the art of
divine nor more sacred than other
healing and practiced primitive forms of
diseases, but has a natural cause from the
medicine during pre-history period in
originates like other affections. Men
Greece. The practice of medicine from
regard its nature and cause as divine from
Gods, semi-gods and then from humans
ignorance and wonder, because it is not at
and Hippocrates could symbolize the
all like to other diseases.” [41].
different stages of the rationalization of
Finally,
another
Myth
and
history;
Greek
important
medical practice in Ancient Greece from
contribution of the Hippocratic school in
the cult of Apollo, Amphiaraus and
Medicine was the formulation of Medical
Asclepius to the practice of medicine from
Ethics. The Hippocratic Oath represents a
Melampus, Machaon and Podalirius and
landmark declaration of Medical Ethics
the use of herbs, surgical operations and
with
various other remedies.
practical
projections.
The
and
writter
philosophical
of
On
the
Physician offers the ideal image – physical
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