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Plato Aristotle The School Of Alexandria And Empiricism


Plato--Aristotle--Alexandrian School--Its Origin--Its Influence--

Lithotomy--Herophilus--Erasistratus--Cleombrotus--Chrysippos--

Anatomy--Empiricism--Serapion of Alexandria.





Two very eminent philosophers, Plato and Aristotle, were influenced by

the teaching of Hippocrates.



Plato (B.C. 427-347) was a profound moralist, and though possessed of

one of the keenest intelle
ts of all time, did little to advance medical

science. He did not practise medicine, but studied it as a branch of

philosophy, and instead of observing and investigating, attempted to

solve the problems of health and disease by intuition and speculation.

His conceptions were inaccurate and fantastic.



He elaborated the humoral pathology of Hippocrates. The world, he

thought, was composed of four elements: fire consisting of pyramidal,

earth of cubical, air of octagonal, and water of twenty-sided

atoms. The marrow consists of triangles, and the brain is the perfection

of marrow. The soul dominates the marrow and the separation of the two

causes death. The purpose of the bones and muscles is to protect the

marrow against changes of temperature. Plato divided the "soul" into

three parts: Reason, enthroned in the brain; courage in the heart; and

desire in the liver. The uterus, he believed, excites inordinate

desires. Inflammations are due to disorders of the bile, and fevers to

the influence of the elements. His theories in regard to the special

senses are very fantastic, for instance, smell is evanescent because it

is not founded on any external image; taste results from small vessels

carrying taste atoms to the heart and soul.



Aristotle, born B.C. 334, was the son of Nichomachus, physician to the

King of Macedonia, and of the race of the Asclepiads. His inherited

taste was for the study of Nature; he attained the great honour of being

the founder of the sciences of Comparative Anatomy and Natural History,

and contributed largely to the medical knowledge of his time. Aristotle

went to Athens and became a follower of Plato, and the close

companionship of these two great men lasted for twenty years. At the age

of 42, Aristotle was appointed by Philip of Macedon tutor to Alexander

the Great, who was then aged 15, and the interest of that mighty prince

was soon aroused in the study of Natural History. Aristotle and

Alexander the Great, teacher and pupil, founded the first great Natural

History Museum, to which specimens were sent from places scattered over

the then known world. Aristotle, besides his philosophical books, wrote:

"Researches about Animals," "On Sleep and Waking," "On Longevity and

Shortlivedness," "On Parts of Animals," "On Respiration," "On Locomotion

of Animals," and "On Generation of Animals." He was greatly helped in

the supply of material for dissection in his study of comparative

anatomy by his pupil, Alexander the Great. Aristotle pointed out the

differences in the anatomy of men and monkeys; he described the anatomy

of the elephant and of birds, and also the changes in development seen

during the incubation of eggs. He investigated, also, the anatomy of

fishes and reptiles. The stomachs of ruminant animals excited his

interest, and he described their structure. The heart, according to

Aristotle, was the seat of the soul, and the birthplace of the passions,

for it held the natural fire, and in it centred movement, sensation and

nourishment. The diaphragm, he believed, separated the heart, the seat

of the soul, from the contaminating influences of the intestines. He did

not advance beyond the conception that nerves were akin to ligaments and

tendons, and he believed that the nerves originated in the heart, as did

also the blood-vessels. He named the aorta and ventricles. He

investigated the action of the muscles, and held that superfoetation was

possible.



When Aristotle retired to Chalcis, he chose Tyrtamus, to whom he gave

the name of Theophrastus, as his successor at the Lyceum.

Theophrastus was the originator of the science of Botany, and wrote the

"History of Plants." He also wrote about stones, and on physical, moral

and medical subjects.





THE ALEXANDRIAN SCHOOL.



"In the year 331 B.C.," wrote Kingsley, "one of the greatest intellects

whose influence the world has ever felt, saw, with his eagle glance, the

unrivalled advantages of the spot which is now Alexandria, and conceived

the mighty project of making it the point of union of two, or rather of

three worlds. In a new city named after himself, Europe, Asia and Africa

were to meet and hold communion." The School of Alexandria became, after

the decay of Greek culture, the centre of learning for the world, and

when the Empire of Alexander the Great was subdivided, the Egyptian

share fell to the first Ptolemy, who, under the direction of Aristotle,

founded the Alexandrian Library, containing at first fifty thousand, and

finally seven hundred thousand volumes. Every student who came to the

University of Alexandria, and possessed a book of which there was not a

copy in the Alexandrian Library, was compelled to present the book to

the library. The first Ptolemy also fostered the study of medicine and

of dissection. Eumenes likewise established a library at Pergamos. It

is instructive to follow the history of the great Library of Alexandria.

The greater part of the library, which contained the collected

literature of Greece, Rome, India and Egypt, was housed in the famous

museum in the part of Alexandria called the Brucheion. This part was

destroyed by fire during the siege of Alexandria by Julius Caesar. Mark

Antony, then, at the urgent desire of Cleopatra, transferred to

Alexandria the books and manuscripts from Pergamos. The other part of

the library was kept at Alexandria in the Serapeum, the temple of

Jupiter Serapis, and there it remained till the time of Theodosius the

Great, until in 391 A.D. both temple and library were almost completely

destroyed by a fanatical mob of Christians led by the Archbishop

Theophilus. When Alexandria was taken by the Arabs in 641, under the

Calif Omar, the destruction was completed.



Ptolemy gathered to the museum at Alexandria a number of very learned

men, who lived within its walls and were provided with salaries, the

whole system closely resembling a university. Grammar, prosody,

mythology, astronomy and philosophy were studied, and great attention

was given to the study of medicine. Euclid was the teacher of

Mathematics, and Hipparchus of Alexandria was the father of Astronomy.

The teaching of medicine and of astronomy was for long based upon

observation of ascertained facts. The Alexandrian School endured for

close upon a thousand years, and its history may be divided into two

periods, namely, from 323 to 30 B.C., during the period of the

Ptolemies, and from 30 B.C. to 640 A.D. The second period was

distinguished for the study of speculative philosophy, and of the

religious philosophy of the Gnostics, and was not a scientific period.



Julius Caesar was not the only Roman Emperor who brought trouble upon the

Alexandrian School, for the brutal Caracalla took away the salaries and

privileges from the savants, and prohibited scientific exhibitions and

discussions. In recent excavations in the Baths of Caracalla in Rome,

the ruins of a library have been discovered, and it is believed by some

archaeologists that Caracalla supplied this library with books and

parchments from Alexandria.



The Asclepiadae of Cos and Cnidos had discoursed upon the phenomena of

disease, without attempting to demonstrate its structural relations;

like the sculptors of their own age, they studied the changing

expression of vital action almost wholly from an external point of view.

They meddled not with the dead, for, by their own laws, no one was

allowed to die within the temple. But the early Alexandrians were

subject to no such restrictions; and turning to good account the

discoveries of Aristotle in natural history and comparative anatomy,

they undertook for the first time to describe the organization of the

human frame from actual dissections.[7]



Thus there was inaugurated at Alexandria the Anatomic Period of

Medicine, which lasted till Egypt came under the sway of the Romans.

Medical practice became so flourishing at Alexandria that three great

specialities were established, namely, Surgery, Pharmacy, and Dietetics,

and a great variety of operations were performed. Lithotomy was much

practised by specialists. A foul murder was perpetrated by lithotomists

at the instigation of Diodotus, the guardian of Antiochus, son of

Alexander, King of Syria (150 B.C.), young Antiochus, at the age of 10,

being done to death under the pretence that he had a stone in his

bladder.



About 150 B.C. a sect called the Essenes was established for the study

of curative and poisonous substances. The members were not all

physicians, by any means, for one of the chief was King Mithridates, who

invented the remedy known as mithridaticum. This celebrated nostrum of

antiquity is said to have been a confection of twenty leaves of rue, a

few grains of salt, two walnuts, and two figs, intended to be taken

every morning and followed by a draught of wine.



Two famous physicians and anatomists, Herophilus (335-280 B.C.) and

Erasistratus (280 B.C.) took part in the medical teaching at

Alexandria in the early days of that seat of learning. It is recorded

that they did not confine their investigations to the dissection of the

dead, but also vivisected criminals. Cleombrotus, another physician

at this school, was sent for to attend King Antiochus, and was rewarded

with a hundred talents, equal to about L15,000 sterling.



There were several physicians of the name of Chrysippos connected with

the Alexandrian School. One was physician to Ptolemy Soter, the King of

Egypt, and tutor to Erasistratus. This Chrysippos introduced the

practice of emptying a limb of blood before amputation, according to the

recent method of Esmarch, and is said to have employed vapour baths in

the treatment of dropsy.



In Alexandria, anatomy was properly studied.[8]



Herophilus made many anatomical discoveries, and some of the names he

gave to parts of the body are now in use, for instance, torcular

Herophili, calamus scriptorius, and duodenum. He described the

connection between the nerves and the brain, and the various parts of

the brain, and recognized the essential difference between motor and

sensory nerves, although he thought the former arose in the membranes

and the latter in the substance of the brain. He believed that the

fourth ventricle was the seat of the soul. He attributed to the heart

the pulsations of the arteries, but thought that the pulmonary veins

conveyed air from the lungs to the left side of the heart, and he

observed the lacteals without determining their function. Herophilus

operated upon the liver and spleen, and looked upon the latter as of

little consequence in the animal economy. He had a good knowledge of

obstetric operations. His ideas in relation to pathology did not proceed

much further than the belief that disease was due to corruption of the

humors. He was more scientific and accurate when he taught that

paralysis results from a defect in the nerves.



Erasistratus studied under Chrysippos (or Chrysippus), and under

Metrodorus, the son-in-law of Aristotle. Herophilus had been a student

at Cos, Erasistratus at Cnidos, so that the teaching of the two great

Greek medical schools was introduced into Alexandria. Xenophon, of Cos,

one of the followers of Erasistratus, first resorted to the ligation of

vessels for the arrest of haemorrhage, although for many years in later

times this important practice was lost through the neglect of the study

of the history of medicine. Erasistratus and Herophilus, it is sad to

relate, considered that vivisection of human beings, as well as

dissection of the dead, was a necessary part of medical education, and

believed that the sufferings of a few criminals did not weigh against

the benefit likely to accrue to innocent people, who could be relieved

or cured of disease and suffering as the result of the knowledge gained

by dissection of the living. This cruel and nefarious practice was

followed "so that the investigators could study the particular organs

during life in regard to position, colour, form, size, disposition,

hardness, softness, smoothness, and superficial extent, their projection

and curvatures."



The followers of these teachers, unfortunately, became very speculative

and fond of discussions of a fruitless kind, and, according to Pliny, it

was easier "to sit and listen quietly in the schools than to be up and

wandering over the deserts, and to seek out new plants every day,"[9]

and so, in the third century before Christ, the school of Empiricism

was established, the system of which resembled the older Scepticism. It

rested upon the "Empiric tripod," namely, accident, history and analogy.

This meant that discoveries were made by accident, knowledge was

accumulated by the recollection of previous cases, and treatment adopted

which had been found suitable in similar circumstances. Philinus of

Cos, a pupil of Herophilus, declared that all the anatomy he had

learned from his master did not help him in the least to cure diseases.

Philinus, according to Galen, founded the Empirici, the first schismatic

sect in medicine. Celsus[10] wrote of this sect that they admit that

evident causes are necessary, but deprecate inquiry into them because

Nature is incomprehensible. This is proved because the philosophers and

physicians who have spent so much labour in trying to search out these

occult causes cannot agree amongst themselves. If reasoning could make

physicians, the philosophers should be most successful practitioners, as

they have such abundance of words. If the causes of diseases were the

same in all places, the same remedies ought to be used everywhere.

Relief from sickness is to be sought from things certain and tried, that

is from experience, which guides us in all other arts. Husbandmen and

pilots do not reason about their business, but they practise it.

Disquisitions can have no connection with medicine, because physicians

whose opinions have been directly opposed to one another have equally

restored their patients to health; they did not derive their methods of

cure from studying the occult causes about which they disputed, but from

the experience they had of the remedies which they employed upon their

patients. Medicine was not first discovered in consequence of reasoning,

but the theory was sought for after the discovery of medicine. Does

reason, they ask, prescribe the same as experience, or something

different? If the same, it must be needless; if different, it must be

mischievous.



In the third and second centuries before Christ, many physicians wrote

commentaries on diseases and attacked the teaching of Hippocrates.

Among these, Serapion of Alexandria, an Empiric who lived in the third

century before Christ, is noteworthy for having first used sulphur in

the treatment of skin diseases, and Heraclides wrote on strangulated

hernia. Serapion added somewhat to the system of Philinus, and was

responsible for introducing the principle of analogy into the system of

Empiricism. The foundation of Empiricism marked the decline of the

medical school of Alexandria. We are indebted to Celsus for a full

description of the teaching of this sect, and, at the same time, for an

exposure of its fallacies. Serapion was a convert from the school of

Cos, which was the stronghold of medical dogmatism, and, like nearly all

apostates, he was consumed with animosity and bitterness towards those

with whom he had formerly been in agreement. Cnidos was the stronghold

of the Empirics.



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