Greek medicine

Medicine of ancient Greece, the most powerful and advanced civilization in Europe around 1000–300 BC. Building on the traditions of ancient Egyptian medicine, and those of India, China, and Mesopotamia (Iraq), the Greeks developed two major contrasting medical movements: the cult of Asclepius, god of medicine, and the rational medical theories of the Greek physician Hippocrates. Unlike Egypt, where spiritual and rational medicine were inextricably combined, patients were able to choose between the two traditions, although they often used both spiritual and rational treatments.

The civilization of ancient Greece was at its most powerful and advanced around 600–300 BC. During this period Greek wealth and power allowed doctors and philosophers to develop advanced medical theories as part of a mass of cultural and scientific innovations. Greeks travelled and traded widely, collecting and developing medical ideas from other and earlier civilizations.

The cult of Asclepius Asclepius was probably originally a Greek doctor of around 1200 BC, who became deified over the centuries as the Greek god of medicine. According to tradition he healed the sick and injured who visited his temples, assisted by his daughters Hygeia and Panacea, goddesses of healing. Asclepia, the temples of Asclepius, were built all over Greece after about 600 BC, although his main sanctuary was at Epidaurus.

A large part of an asclepion was devoted to physical health, including baths, a stadium with a running track, and a gymnasium. However, although patients were encouraged to undergo a physical regime as part of their treatment, the main reason for their attendance was spiritual. The asclepion's two main buildings were a temple dedicated to Artemis, goddess of chastity and the young, and the abaton, a long, low building with open ends and sides where the patients slept.

In the temple of Artemis, sister of Apollo, god of prophecy, patients would pray and make offerings for aid. The most important building, however, was the abaton. After making offerings to the gods, patients were ordered to sleep in the abaton and not to open their eyes under any circumstances. During the night Asclepius, his daughters, and his priests would visit patients in turn. Asclepius was believed to examine each patient before applying remedies, medicines made of natural ingredients. Some patients reported that Asclepius had sent snakes to lick their wounds clean. When the patients woke the next morning, they would often declare themselves totally cured. Even patients suffering from blindness or other seemingly incurable conditions reported success. The priests would also prescribe treatments and regimes based on a patient's visions or dreams while asleep. Patients who had been cured left offerings of money or inscribed tablets detailing their treatment at the temples. Success may have been more to do with the physical regime or the practical treatments devised by the priests, but belief in the healing powers of Asclepius also had a positive effect.

Hippocrates While many Greeks were visiting asclepia for treatment, others received medical help from the Hippocratic doctors who followed the rational theories of Hippocrates (c. 460–c. 377 BC), a Greek physician who established a medical school on the island of Kos. Regarded by many as the founder of modern medicine, Hippocrates rejected the idea that illness was caused and cured by the gods, and looked for more rational explanations related to the natural world and environment. His theory of humours reflected the Greek belief that all matter was made up of four elements: earth, fire, water, and air. Hippocrates believed that the human body had four basic ingredients, or humours: blood, phlegm, yellow bile, and black bile; and that their imbalance resulted in illness. Treatments aimed to restore the balance of the humours, allowing patients to recover.

Doctors who attended the medical school on Kos were trained in the rational analysis and treatment of illness. One of Hippocrates' most important legacies to modern medicine was his belief in clinical observation, part of a system of diagnosis and treatment based on observation of the patient's symptoms and assessment of the course of an illness. In the diagnosis stage the patient's initial symptoms were studied. These symptoms were then analysed with reference to past medical cases in the prognosis stage, when the course of the illness was predicted. In the observation stage, the Hippocratic doctor observed and noted the condition as it developed. Once the doctor was sure of the disease and its causes, the treatment stage was entered, and an attempt made to cure the illness based on past experience with confidence of success. Hippocratic doctors took the Hippocratic oath on qualification, a statement of medical ethics in which they promised never to harm their patients and to give the best possible treatment to enable recovery. The complete absence of spiritual ideas in Hippocrates' rational approach to medicine marked a major change in medical diagnosis and treatment.

One of the greatest legacies of Hippocratic medicine was his theory regarding the four humours of the human body. Treatments were designed to restore the balance in the humours. If a patient was diagnosed as having too much bile, then they would be made to vomit. If a patient had too much blood they would be cut and blood drawn off to restore the balance in the humours. The theory of humours was also linked to the seasons. Winter illnesses, for instance, were characterized by an excess of wet phlegm and cold, for which the treatment could include compensatory foods such as hot and dry foods. Such explanations assumed that phlegm was a cause of the illness, whereas it is in reality a symptom. However, although the theory of the four humours was incorrect, it represented a major leap forward in medicine, as it was purely rational and based on observation. Following further interpretation by classical theorists such as Aristotle in the 4th century BC and Galen in the 2nd century AD, the theory of the four humours remained virtually unchallenged in European medicine until the Renaissance in the 16th century.

Hippocrates' theories were recorded in the Corpus Hippocraticum/Hippocratic Collection, a collection of over 60 works that include Prognostic, Coan Prognostic, and Airs, Waters, and Places. The Corpus Hippocraticum also included two works on exercise and hygiene, Regimen and Regimen in Acute Diseases. They included regimes similar to those prescribed for the followers of Asclepius, and proposed healthy lifestyles, with moderation in eating and drinking, cleanliness, and fresh air to avoid disease or to recover from it.

The Alexandrian school Dissection was illegal in ancient Greece, except in the city of Alexandria. Alexander the Great, King of Macedonia, founded Alexandria in Egypt in 331 BC. A pupil of Aristotle, he valued wisdom and built a library that housed over 500,000 books, manuscripts, and exhibits, the greatest medical collection in the world at the time. Alexandria became an important centre of learning and attracted students from all over the Mediterranean. The relaxation of the religious ban on dissection in the city made Alexandria particularly significant as a centre for medicine. Doctors were able to dissect human corpses to discover more about the anatomy of the human body. Greek doctors were able to advance on the knowledge of the ancient Egyptians for the first time, as the organs could be cut up and their purpose discovered. Time could be taken to understand the anatomy of the human body. For a while criminals condemned to death were available for vivisection (live dissection), enabling doctors to begin to understand the functions of the organs. Herophilus of Chalcedon learned much about the stomach and the role of the brain in controlling the body through his many dissections and vivisections. Understanding of medicine advanced at Alexandria to a level never previously achieved in the world. Over two centuries later, by which time the Romans had banned human dissection, the Greek doctor Galen spent time at Alexandria. Here he learned much of his medical knowledge and gained many of his skills. In Alexandria Galen was able to see human skeletons, and study their anatomy. He later went on to work in Rome and became famous as an expert in anatomy. Galen forms a direct link between the Greek and Roman medical worlds.

Impact of Greek medicine Ancient Greek medicine represented a great advance on the medical achievements of earlier civilizations. Its influence lived on for centuries in the Roman Empire, where the ideas of the Greeks were widely adopted. The Greeks developed a rational curative tradition under Hippocrates, with emphasis on observation, while retaining their belief in the healing spiritual power of Asclepius. The development of Hippocrates' four humours by Aristotle and others lived on for over 1,500 years. With the knowledge gained from dissection at Alexandria, medicine was advanced still further. Greek medicine saw medicine move into the increasingly separate spheres of spiritual and rational practices, as although Hippocrates and Asclepius were in existence at the same time, the ideas that they embodied were very different.