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
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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