Early Greek Medicine

Apollo--AEsculapius--Temples--Serpents--Gods of

Health--Melampus--Homer--Machaon--Podalarius--Temples of

AEsculapius--Methods of Treatment--Gymnasia--Classification of

Renouard--Pythagoras--Democedes--Greek Philosophers.





The history of healing begins in the Hellenic mythology with Apollo, the

god of light and the promoter of health. In the "Iliad" he is hailed as

the disperser of epidemics, and, in this respect, the ancients were well

informed in attributing destruction of infection to the sun's rays.

Chiron, the Centaur, it was believed, was taught by Apollo and Artemis,

and was the teacher, in turn, of AEsculapius, who probably lived in the

thirteenth century before Christ and was ultimately deified as the Greek

god of medicine. Pindar relates of him:--



"On some the force of charmed strains he tried,

To some the medicated draught applied;

Some limbs he placed the amulets around,

Some from the trunk he cut, and made the patient sound."[1]



AEsculapius was too successful in his art, for his death was attributed

to Zeus, who killed him by a flash of lightning, or to Pluto, both of

whom were thought to have feared that AEsculapius might by his skill gain

the mastery over death.



Amid much that is mythological in the history of AEsculapius, there is a

groundwork of facts. Splendid temples were built to him in lovely and

healthy places, usually on a hill or near a spring; they were visited by

the sick, and the priests of the temples not only attended to the

worship of AEsculapius, but took pains to acquire knowledge of the

healing art. The chief temple was at Epidaurus, and here the patients

were well provided with amusements, for close to the temple was a

theatre capable of seating 12,000 people, and a stadium built to

accommodate 20,000 spectators.



A serpent entwined round a knotted staff is the symbol of AEsculapius. A

humorist of the present day has suggested that the knots on the staff

indicate the numerous "knotty" questions which a doctor is asked to

solve! Tradition states that when AEsculapius was in the house of his

patient, Glaucus, and deep in thought, a serpent coiled itself around

his staff. AEsculapius killed it, and then another serpent appeared with

a herb leaf in its mouth, and restored the dead reptile to life. It

seems probable that disease was looked upon as a poison. Serpents

produced poison, and had a reputation in the most ancient times for

wisdom, and for the power of renovation, and it was thought that a

creature which could produce poison and disease might probably be

capable of curing as well as killing. Serpents were kept in the Temples

of AEsculapius, and were non-poisonous and harmless. They were given

their liberty in the precincts of the temple, but were provided with a

serpent-house or den near to the altar. They were worshipped as the

incarnation of the god, and were fed by the sick at the altar with

"popana," or sacrificial cakes.





Many of the Greek gods and goddesses were held to have power over

disease. Hygeia, known as Salus to the Romans, was said to have been the

daughter of AEsculapius, and to have taken care of the sacred serpents

(Plate II).



Melampus was considered by the Greeks the first mortal to practise

healing. In one case he prescribed rust, probably the earliest use of

iron as a drug, and he also used hellebore root as a purgative. He

married a princess and was given part of a kingdom as a reward for his

services. After his death he was awarded divine honours, and temples

were erected for his worship. The deification of AEsculapius and of

Melampus added much to the prestige of doctors in Greece, where they

were always held in honour; but in Rome the practice of medicine was not

considered a highly honourable calling.



Something can be learned from the writings of Homer of the state of

medicine in his time, although we need hardly expect to find in an epic

poem many references to diseases and their cure. As dissection was

considered a profanation of the body, anatomical knowledge was

exceedingly meagre. Machaon was surgeon to Menelaus and Podalarius was

the pioneer of phlebotomy. Both were regarded as the sons of AEsculapius;

they were soldiers as well as doctors, and fought before the walls of

Troy. The surgery required by Homer's heroes was chiefly that of the

battlefield. Unguents and astringents were in use in the physician's

art, and there is reference to "nepenthe," a narcotic drug, and also to

the use of sulphur as a disinfectant. Doctors, according to Homer, were

held in high esteem, and Arctinus relates that two divisions were

recognized, surgeons and physicians, the former held in less honour than

the latter--"Then Asclepius (AEsculapius) bestowed the power of healing

upon his two sons; nevertheless, he made one of the two more celebrated

than the other; on one did he bestow the lighter hand that he might draw

missiles from the flesh, and sew up and heal all wounds; but the other

he endowed with great precision of mind, so as to understand what cannot

be seen, and to heal seemingly incurable diseases."[2]



Machaon fought in the army of Nestor. Fearing for his safety, King

Idomeneus placed him under the charge of Nestor, who was instructed to

take the doctor into his chariot, for "a doctor is worth many men." When

Menelaus was wounded, a messenger was sent for Machaon, who extracted

the barbed arrow, sucked the wound and applied a secret ointment made

known to AEsculapius by Chiron the Centaur, according to tradition.



The practice of Greek medicine became almost entirely restricted to the

temples of AEsculapius, the most important of which were situated at

Rhodes, Cnidus and Cos. The priests were known as Asclepiadae, but the

name was applied in time to the healers of the temple who were not

priests. Tablets were affixed to the walls of these temples recording

the name of the patient, the disease and the cure prescribed. There is

evidence that diseases were closely observed. The patients brought gifts

to the temples, and underwent a preliminary purification by ablutions,

fasting, prayer and sacrifice. A cock was a common sacrifice to the god.

No doubt many wonderful cures were effected. Mental suggestion was used

greatly, and the patient was put to sleep, his cure being often revealed

to him in a dream which was interpreted by the priests. The expectancy

of his mind, and the reduced state of his body as the result of

abstinence conduced to a cure, and trickery also played a minor part.

Albeit, much of the treatment prescribed was commendable. Pure air,

cheerful surroundings, proper diet and temperate habits were advocated,

and, among other methods of treatment, exercise, massage, sea-bathing,

the use of mineral waters, purgatives and emetics, and hemlock as a

sedative, were in use. If a cure was not effected, the faith of the

patient was impugned, and not the power of the god or the skill of the

Asclepiades, so that neither religion nor the practice of physic was

exposed to discredit. Great was the wisdom of the Greeks! These temples

were the famous medical schools of ancient Greece. A spirit of

emulation prevailed, and a high ethical standard was attained, as is

shown by the oath prescribed for students when they completed their

course of study. The form of oath will be found in a succeeding chapter

in connection with an account of the life of Hippocrates.



The remains of the Health Temple, or Asklepieion, of Cos were brought to

light in 1904 and 1905, by the work of Dr. Rudolf Herzog, of Tuebingen.

Dr. Richard Caton, of Liverpool, has been able to reconstruct

pictorially the beautiful buildings that existed two thousand years ago.

They were situated among the hills. The sacred groves of cypresses were

on three sides of the temple, and "to the north the verdant plain of

Cos, with the white houses and trees of the town to the right, and the

wide expanse of turquoise sea dotted by the purple islands of the AEgean,

and the dim mountains about Halicarnassus, to the north-east."[3]



The ancient Greek Gymnasia were in use long before the Asclepiades began

to practise in the temples. The Greeks were a healthy and strong race,

mainly because they attended to physical culture as a national duty. The

attendants who massaged the bodies of the athletes were called aliptae,

and they also taught physical exercises, and practised minor surgery and

medicine. Massage was used before and after exercises in the gymnasium,

and was performed by anointing the body with a mixture of oil and sand

which was well rubbed into the skin. There were three classes of

officials in the gymnasia; the director or magistrate called the

gymnasiarch, the sub-director or gymnast, and the subordinates. The

directors regulated the diet of the young men, the sub-directors,

besides other duties, prescribed for the sick, and the attendants

massaged, bled, dressed wounds, gave clysters, and treated abscesses,

dislocations, &c.



There is no doubt that the Greeks, in insisting upon the physical

training of the young, were wiser in their generation than the people of

the present day; and not only the young, but people of mature age, took

exercises suited to their physical requirements. The transgression of

some of Solon's laws in reference to the gymnasia was punishable by

death.



The third stage in the history of Greek medicine has now been reached.

The first stage was primitive, the second associated with religion, and

the third connected with philosophy. The classification of Renouard is

accurate and convenient. In the "Age of Foundation," he recognizes four

periods, namely:--



(1) The Primitive Period, or that of Instinct, beginning with myth, and

ending with the destruction of Troy, 1184 years before Christ.



(2) The Sacred or Mystic Period, ending with the dispersion of the

Pythagorean Society, 500 years before Christ.



(3) The Philosophic Period, ending with the foundation of the

Alexandrian library, 320 years before Christ. This period is made

illustrious by Hippocrates.



(4) The Anatomic Period, ending with the death of Galen, about 200 years

after Christ.



The earliest Greek medical philosopher was Pythagoras (about 580 B.C.).

He was born at Samos, and began life as an athlete, but a lecture which

he heard on the subject of the immortality of the soul kindled

enthusiasm for philosophical study, the pursuit of which led him to

visit Egypt, Phoenicia, Chaldea, and perhaps also India. He was imbued

with Eastern mysticism, and held that the air is full of spiritual

beings who send dreams to men, and health or disease to mankind and to

the lower animals. He did not remain long in Greece, but travelled much,

and settled for a considerable time in Crotona, in the South of Italy,

where he taught pupils, their course of study extending over five or six

years. The Pythagorean Society founded by him did much good at first,

but its members ultimately became greedy of gain and dishonest, and the

Society in the lifetime of its founder was subjected to persecution and

dispersed by angry mobs. Pythagoras possessed a prodigious mind. He is

best known for his teaching in reference to the transmigration of

souls, but he was also a great mathematician and astronomer. He taught

that "number is the essence of everything," and his philosophy

recognized that the universe is governed by law. God he represented by

the figure 1, matter by the figure 2, and the universe by the

combination 12, all of which, though fanciful, was an improvement upon

mythology, and a recognition of system.



In the practice of medicine he promoted health mainly by diet and

gymnastics, advised music for depression of spirits, and had in use

various vegetable drugs. He introduced oxymel of squills from Egypt into

Greece, and was a strong believer in the medicinal properties of onions.

He viewed surgery with disfavour, and used only salves and poultices.

The Asclepiades treated patients in the temples, but the Pythagoreans

visited from house to house, and from city to city, and were known as

the ambulant or periodic physicians.



Herodotus gives an account of another eminent physician of Crotona,

Democedes by name, who succeeded Pythagoras. At this time, it is

recorded that the various cities had public medical officers. Democedes

gained his freedom from slavery as a reward for curing the wife of

Darius of an abscess in the breast.



The dispersal of the Pythagoreans led to the settlement of many of them,

and of their imitators, in Rome and various parts of Italy. Although

Pythagoras was a philosopher, he belongs to the Mystic Period, while

Hippocrates is the great central figure of the Philosophic Period.

Before studying the work of Hippocrates, it is necessary to consider the

distinguishing features of the various schools of Greek philosophy.

Renouard shows that the principles of the various schools of medical

belief depended upon the three great Greek schools of Cosmogony.



Pythagoras believed in a Supreme Ruler of the Universe, and that spirits

animated all life, and existed even in minerals; he also believed in

preconceived purpose. With these views were associated the Dogmatic

School of Medicine, and the name of Hippocrates, and this belief

corresponds to modern vitalism.



Leucippus and Democritus, rejecting theology, considered vital action

secondary to the operation of the laws of matter, and believed that

atoms moved through pores in the body in such a way as to determine a

state of health or disease. With this philosophy was associated the

Medical School of Methodism, a system said to have been founded by

Asclepiades of Prusa (who lived in Rome in the first century before

Christ), and by his pupil Themison (B.C. 50). The third school of

medical thought, that of Empiricism, taught that experience was the only

teacher, and that it was idle to speculate upon remote causes. The

Empirics based these views upon the teaching of philosophers known as

Sceptics or Zetetics, followers of Parmenides and Pyrrho, who taught

that it was useless to fatigue the mind in endeavouring to comprehend

what is beyond its range. They were the precursors of modern

agnosticism.



The Eclectics, in a later age, formed another medical sect, and had no

definite system except that they made a selection of the views and

methods of Dogmatists, Methodists and Empirics.



The Greek philosophers as a class believed in a primary form of matter

out of which elements were formed, and the view held in regard to the

elements is expressed in Ovid's "Metamorphoses."[4]



"Nor those which elements we call abide,

Nor to this figure nor to that are ty'd:

For this eternal world is said of old

But four prolific principles to hold,

Four different bodies; two to heaven ascend,

And other two down to the centre tend.

Fire first, with wings expanded, mounts on high,

Pure, void of weight, and dwells in upper sky;

Then air, because unclogged, in empty space

Flies after fire, and claims the second place;

But weighty water, as her nature guides,

Lies on the lap of earth; and Mother Earth subsides.

All things are mixed of these, which all contain,

And into these are all resolved again."



Fire was considered to be matter in a very refined form, and to closely

resemble life or even soul.