Wednesday, January 28, 2015

Martyr COPDer: Too Tough for Treatment

They tend to suffer needlessly because they are too tough or too proud to seek help. Actually, and closer to the truth perhaps, they are too scared to seek help. They are what we call Martyr COPDers.  

Like Undiagnosed COPDers, they tend to brush off symptoms as not serious. Even as their symptoms get worse, they think their sheer willpower will beat their disease to submission. Because of this they do not seek medical help when they should, and might even forgo COPD medicine.

There are only two things that will get them to seek help. The first is a caring spouse who is aware of the fact that help is needed, and who encourages the martyr to seek help. The other is a COPD-flare-up that gets so severe a mad dash to the hospital becomes essential.  

COPD Attitude:  “Yes it’s true I can’t take a deep breath. I’m fine! Leave me alone!”

COPD Strength:  They do not overplay their symptoms for empathy. They only seek help when they need it.

COPD Weakness:  Breathing trouble is important not to ignore, and no level of toughness will make it go away.  

Lessons to Live By:  C
OPD is a difficult disease, and it requires some toughness. But you should never ignore breathing trouble. The earlier help is sought when breathing trouble starts the easier it is for a physician to fix you. The longer you wait to seek help the harder it is for a physician to help. Get help when you need it immediately, and work with your doctor to develop a COPD Action Plan that will help you decide when to seek help.

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Saturday, January 24, 2015

800 B.C.: The Greeks transform medicine

While medicine was born around 30,000 B.C., it was revolutionized around 800 B.C. by the Ancient Greeks.  The Greeks were the first to reap the rewards of accumulated wisdom and technological advancements.  They had time to enjoy life, to think, discover, and invent.

Around 1500 B.C. villages started to form in Greece that grew to become powerful city-states.  Each city state was separated by mountains, so they each developed their own government and culture.  Sometimes they even fought with each other.  The most famous such war was between the two wealthiest and most powerful city-states: Sparta and Athens.  (1, 88-90)

Each city-state was surrounded by villages and farms that provided food for everyone.  The trade off was the city-states offered protection from invaders.  (1, page 88-90)  Because of this arrangement, and because of slaves who did most of the work, people who lived within the city-states had plenty of time to think.

The people of wealthy city-states such as Athens decided to use this time to create things that made life more enjoyable.  At first each landowner was declared a citizen and had a say in government, yet by 508 B.C. many traders, merchants and business people who came to the city got rich there and wanted a say in government.  (1, page 93)

This resulted in one of the worlds first compromises that resulted in one of the world's first constitutions. The constitution declared that all free men were citizens. Each citizen had a right to vote and sit on a jury. This constitution, coupled with slavery and the hard work of the farmers, gave the citizens of Athens plenty of time to loaf around. (1, page 93)

They created bath houses where slaves kept the fires going so those who had time could take nice hot baths and socialize while doing so. They built a large Acropolis with huge theaters, a huge temple to their goddess Athena called the Parthenon. They spent time there bantering and philosophising. They asked questions about the world around them, and came up with theories.(1, page 88-90)

Lord Macaulay (1800-1859) described it best, perhaps humorously:
Almost all of a Greek consisted in talking and listening. His opinions on all subjects were picked up casually. If he wished to study physic, instead of shutting himself up with books, he walked down to the market-place to look for a gymnastic physician.
They built huge gymnasiums where the young could train and participate in various sports. They created Olympic events where the various city-states would compete every four years. They created schools amid the gymnasiums where children were educated about life. They were trained to be thinkers. Or, if you lived in Sparta, you were trained to be a warrior.

They watched as men were hurt in battle and while playing the sports they so enjoyed to watch, and saw that something could be done to help the wounded. They learned that certain medicines made the wounds better, and certain procedures helped the process of healing. After caring for the wounded they started wondering about other diseases: What causes disease? What is the cure?

Physicians were first educated between the ages of six or seven and twenty in the gymnasium, where they learned the arts of reading, writing, geometry, computation and astronomy: (2, page 18)
At the Gymnasia the course of education consisted, first, of music, which according to the ancient use of the term, included every study for developing the intellectual and moral faculties; and secondly, of gymnastics, in which was included every exercise for strengthening and improving the body. It was a rule with these people that what the boy first learns in sports he will afterwords love, and exercise with more ability as the serious occupation of his manhood; and hence, that children should practice as amusements such sports as are best suited to prepare them for their future occupations. (2, page 18)
It was at the gymnasiums, and the battlefield, where the Greeks were exposed to accidents, such as twisted ankles, broken bones, cuts, and bruises. From these experiences, and watching those skilled in treating them, young Greek boys were exposed to medicine. Some speculate the "Homeric heroes had probably acquired their surgical skill in this manner." (2, page 20)

About a hundred years before Plato and Hippocraetes, Pythagorus (570-495 B.C.) traveled to Egypt to be educated in the art of medicine, and he traveled back to Greece ("Crotona Graecia, now south of Italy). Thus it was in Crotona "where medicine was first cultivated as a department of philosophy." (2, page 21)

The Pythagorum school of medicine was formed. It was from here that the first known Greek physicians were educated: (2, page 21)
  • Empedocles, who wrote a medical poem (See The Beginning of Western Medicine)
  • Alcmaeon, who dissected brute animals
  • Democedes, the most skilled physician of his time
  • Acron, the first to prefer practical rather than speculative "inquiries." This idea will play a part later in our history.
The Pythagorean schools were ultimately replaced by schools formed around Asclepions. And in either case, medicine continued to be taught at schools of philosophy where "some attention was always devoted to medicine as a department of speculative knowledge." (2, page 20)

In this way, physicians were being taught by philosophers.  They were taught by the same philosophers who educated non physicians like Plato (427-347 B.C.) and Aristotle (384-322 B.C.).  This can be seen by "allusions" they made in their writing.  Plato, for example, divided medicine into five branches (2, page 22)
  • Pharmaceutic: Cures by many drugs
  • Chuirurgic:  Cures by cutting and burning
  • Dietetic:  Produces a change in the disease by a change in their diet
  • Nosognomic: Makes known the character of disease
  • Boethetic: Instant assistance palliates suffering (2, page 25)
So it was in this way medicine was transformed in Ancient Greece.  It was transformed from superstition to philosophy, and ultimately from theory to experience.

References:
  1. Suter, Joanne, editor, "Fearon's World History," 2nd edition, Paramount Publishing, 1994
  2. Watson, John, "The medical profession in ancient times," 1856, Baker and Godwin, New York
  3. Meryon, Edwared, "The History of Medicine:  Comprising a narrative of its progress from the earliest ages to the present and of the delusions incidental to its advance from empiricism to the dignity of a science," volume I, London, 1861, from the miscellaneous writings of Lord Macaulay
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Friday, January 23, 2015

800 B.C: Homer was first to use the term asthma

Bust of Homer (British Museum, London).
  
As a child, Homer (800 or 850 B.C.) listened to poems recited by his dad about a war that occurred almost 400 years before he was born.  He was so impressed that as a young man he spent many hours in the open courtyard writing them down.

He couldn't remember word per word the stories his dad told. What made it even more confusing was that his uncle sang the same stories, only the twists and turns were different. The names used, the plot, the ending, and the morals learned, however, were the same no matter who told the stories.

So, many years later, as he was jotting down the stories from memory, he realized it was okay to exaggerate and to expound at times in order to make his story more complete.  The important thing was to have the story in writing so future generations could tell the same story every time it was told.  

As the years passed Homer became so rapt in his task that he became the slightly obese middle-aged, bearded man that is represented in the various busts of him. He would go down in history as one of the first and greatest story tellers of all time.

Whether or not he was actually the first to tell these stories may never be known, although what is known is he is often given credit.  This was because, unlike the ancient Egyptians and Mediterraneans, the ancient Greeks liked to associate works of writing to either the author or some famous person.  While Homer may not have been the creator of the Iliad, he is given credit as it's creator because he was the first to take the time to write it down on paper.  (1, page 19-20)

It was a story of a siege at Troy estimated to have occurred between 1194-1184 B.C. (4, page 46)  After writing this story, Homer would write many more.  As eluded to above, he probably obtained most of his stories from those told by his ancestors by word of mouth, mainly through poems and songs that were easy to remember.  (1, pages 19-20)

Another thing Homer did, as his father and uncle did earlier, was add into the story modern events.  This made the story more interesting to the modern audience. While he may not have known it at the time, this would give future historians a better idea of what life was like in ancient Greece.  (1, page 19-20)

The story would also become significant to medical historians, because Homer made allusions to the state of medicine at the time.  While he described the battles, he also described battle wounds, and the symptoms that resulted from these wounds, sometimes in the process of dying.  So various medical historians have made reference to these allusions as some of the earliest knowledge of medicine. (1, page 19-20)

Homer was also the first, or so it is thought, to use the term asthma (άσθμα) in an actual piece of literature. (2, pages 10-11)

The term asthma is referenced in the Iliad, book XV, line 10:
"He saw Hector lying on the plain, his companions
sitting round him. Hector was gagging painfully,
dazed and vomiting blood." 
In this scene Zeus wakes up as the Greeks are trying to push a line of Trojans back, and he finds the Trojan leader Hector breathing painfully and vomiting blood. The above is the English translation, although the word Homer used for "gagging painfully" was asthma or asthmati.

Homer later made another reference to asthma in the Iliad, book XV, line 290:
"He was just starting to recover,
to recognize his comrades round him. He'd stopped
gasping and sweating, for aegis-bearing Zeushad revived his mind"
In this scene Homer described Hector as just starting to catch his breath.

Homer used the term asthma to refer to being winded as from fighting in battle, or as from wounds obtained in battle.  It made sense to use the term asthma this way, because it was a term meaning short, gasping breaths.  It was a vague term used simply to describe the symptom of dyspnea, or shortness of breath, regardless of the cause.

Another term that was sometimes used by the Greeks was panos, which meant panting.  Homer apparently preferred the term asthma, as opposed to panos. Perhaps due to this preference the term asthma is still used to this day, and panos has been lost to history.

Another early description of asthma was the sacred disease.  Actually, epilepsy was the sacred disease because the seizures were thought to be caused by divine intervention.  Those with the disease were thought to be rewarded with happiness in the next world.

Asthma was also referred to as the sacred disease simply because it was thought to be epilepsy of the lungs.  Perhaps the gasping efforts of the asthmatic made the chest appear as though it were seizing.  So if you had asthma you were blessed with eternal happiness.

While asthma was considered a divine blessing, this does not mean that the gods didn't cause all other diseases too, because they did.  This is confirmed, perhaps, by homer in his Odyssey (ix. 411):
"The blinded and howling Cyclops is told by his friend that, if he is ill, he should remember that sickness comes from Zeus and is unavoidable." (3, page 38)  
Homer did not, however, refer to the "disease" asthma. His use of the term was simply to describe the symptom of dyspnea, or air hunger, or shortness of breath.

References:
  1. Sigerist, Henry E, "A History of Medicine," Volume II, 1961, Oxford University Press, New York, pages 19-20
  2. Jackson, Mark, "Asthma: The Biography," 2009, Oxford University Press, pages 10-11.  Note:  While Mark Jackson is not the only person to acknowledge the Iliad as the first reference to the term asthma, I still want to give him credit here.  
  3. Withington, Edward, "Medical History from the earliest times," 1894, London, page 38
  4. Buck, Albert Henry, Williams Memorial Public Funds, "The growth of medicine from the earliest times to about 1800," 1917, London, Oxford University Press
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Wednesday, January 21, 2015

Laryngospasm: It's often confused for a wheeze

Comics and writers like Stephen King can call it a wheeze.
But clinicians should know that if it's audible, it's laryngospasm.
For lack of a better description, you can call it rhonchi.
Clinicians don't learn about laryngospasm in nursing school, medical school, nor respiratory therapy school.  The reason is because most clinicians confuse it as bronchospasm, and call it a wheeze.  However, it is not bronchospasm, and it is not a wheeze: it's laryngospasm.  You should call it rhonchi.

So what is laryngospasm.  It's a harsh (coarse) audible sound during expiration. It's the sound of air moving through secretions sitting around the vocal cords, so when the patient exhales it is made audible.  Sometimes it is caused due to dehydration, such as when a patient suffers from detox or ETOH.

Many times it gives the appearance of airway obstruction, because the patient has a prolonged, forced, expiratory phase.  But when you ask these patients if they are short of breath they deny it.  This is because they are not experiencing bronchospasm, and the sound is perhaps "annoying" but it is not a wheeze.

If you don't want to call it "laryngospasm" you can call it rhonchi.  Rhonchi is the sound of air moving through secretions, and, more than likely, this is what you are hearing.  But you are certainly not hearing a "bronchospasmic wheeze," because a bronchospasmic wheeze is never audible.

Tuesday, January 20, 2015

11 myths about asthma

The following was originally published at healthcentral.com on November 21, 2013.

11 Asthma Myths Debunked

For most of human existence the best cure for asthma was a prayer or incantation. People believed shortness of breath, increased sputum, excessive coughing, and wheezing were all caused because some god or spirit was mad. Yet it turns out that was just a myth.

Thanks to science, we've learned quite a bit about asthma in the past 100 years, and have been able to shed light on old myths about this disease that many people still think are true. So here are some common myths about asthma.

1. You will grow out of your asthma. Man, if I had a dime for every time some doctor told me this I'd be rich by now. I so looked forward to my growth spurt so I'd grow out of my asthma. Then it never happened. I'm sorry to say it, folks, but it's simply not true. Once you have asthma you have it for life. Sure, it may go into hibernation, but it's still there. Sorry, there is no cure for asthma.

2. You will become tolerant to asthma rescue medicine. If you became tolerant of medicines like Albuterol, there would be no medicines left to get rid of an asthma attack. I've taken in more Albuterol in my life than the next 100 asthmatics combined, and the medicine still works for me. I've been taking it regularly since 1985.

  • 3. Inhaled steroids are unsafe. The truth is, side effects of inhaled corticosteroids are almost negligible. Because you are inhaling it, you are applying the medicine directly where it's needed, as opposed to taking it in systemically. As long as you rinse your mouth after each use to eliminate any residue of the medicine in your mouth that could be swallowed, systemic steroids are proven safe.

    4. Asthmatics should avoid exercise. This is so far from the truth it's not even funny. The truth is, exercise is essential for asthmatics, and can make your heart and lungs stronger. It can make you less winded. It can increase your immune response and make you less likely to get a cold. It can make you feel better overall. It will decrease your anxiety. Most asthma experts would agree that even asthmatics with hardluck asthma should exercise. Here are tips on how to exercise when you have asthma.

    5. Asthmatics should move to dry climates. Not true at all. No matter where you move, your asthma will move with you. You may be leaving one asthma trigger, but your new location will present new ones. And some allergens, like dustmites, are ubiquitous, so you'll never get away from them no matter where you go. The good news is asthma can be controlled and prevented no matter where you live, so you don't need to make a stressful move.

    6. Asthmatics are weak. Surely asthmatics and people with allergies have their limitations, but they can still be productive, and very useful, members of society.

    7. All asthmatics should be treated the same. Every case of asthma is unique. Some mild cases require no medicine, some require few medicine, and some require a variety of treatments to gain good control. Some asthmatics struggle to gain control no matter what they do.

    8. Asthma is all in your head. Over 1,500 years ago it was perceived that asthmatics were different than other sick people. A boy that had a cut on his finger had a scar that can be seen. Asthmatics, on the other hand, were sick, but they had no obvious scars. Ancient physicians, therefore, decided that their asthma was all in their head. They were sick because they were anxious or depressed. In the 1950s this myth was debunked by science. Stress and anxiety are asthma triggers, but not all asthma is psychological.

    9. You don't need to take asthma controller medicine when you feel fine. Wrong! Unless you are the lucky few, in order to keep your asthma controlled, and to prevent asthma attacks, you need to take your asthma controller medicines especially when you are feeling well. By taking your medicine every day, your lungs will be stong and prepared when you're exposed to your asthma triggers.

    10. All asthmatics wheeze during an asthma attack. Wrong again! Waiting to hear a wheeze to diagnose an asthma attack may result in prolonged suffering and even death. The truth is, many asthmatics -- myself included -- don't wheeze at all. Sometimes asthma gets so bad there's not enough air movement to cause a wheeze. So not all asthmatics wheeze.

    11. All lungs that wheeze are asthmatic. We know there are many airway diseases that cause a wheeze. For example, heart (cardiac) failure causes a loud, audible, upper airway wheeze we now refer to as a cardiac wheeze. Asthma wheezes are silent, and can only be heard with the aid of a stethoscope (with a few exceptions of course). 
  • Saturday, January 17, 2015

    800 B.C.: The beginning of Western Medicine

    Thales of Miletus (620-546 B.C.) is known
    as the first Greek philosopher. 
    Why?  How?  These are questions people in Ancient Greece started asking around 800 B.C., the same time that Homer was busy transcribing ancient prose into writing.  They asked questions like:  are the gods really responsible for all good and evil?  Why was the world created?  How was the world created?

    According to Henry Sigerist, "A History of Medicine," prior to this time people tried to master nature, to live within it, and to cope with it.  Yet after this time the emphasis was changed to an effort to understand nature.  Why are the trees green?  What are the main substances of life?

    One of the first Greek men to record such thoughts was Thales of Miletus, who lived around 585 B.C.  While he didn't have access nor knowledge of science, he made speculations based on his observations.  Sigerist said he concluded that "life was bound to the presence of water." (1, page 90)

    Likewise, Sigerist said, Thales believed that life was not created spontaneously by the gods but "developed gradually from a primary element through natural processes which could be observed every day.

    Aristotle (384-322 B.C.) later listed Thales as the first of the great Greek philosophers.  This is significant to the history of medicine because it got people to thinking about the most common problems of life.  They started asking questions about life, and health, and disease.  They started speculating of solutions other than seeking out the gods for answers.

    Anaximander (610-546 B.C.) was the pupil of Thales.
    Around 560 B.C. Anaximander didn't believe one element could make up the world, and he speculated their were four such elements:  "water, earth, fire and air, with their qualities, wet, dry, hot, and cold -- were derived from one common indeterminate substance.  

    From these substances, with their primary pairs of opposites, he came to his own speculations as to how the world was formed.  He even went as far to speculate that lightning was not caused by the god Zeus but by a natural phenomenon.  

    Yet his theory of two pairs of elements with their opposite qualities may have been the beginnings of the theory of opposites later postulated by Heraclitus  and refined by other scientists until the Hippocratic writers tied all these theories together to the culmination of ancient Greek medicine.

    Around 450 B.C. Empedocles provides us with a variety of writings about his view of the world.  He likewise believed the world was created by four basic elements:  water, earth, fire and air.  He was the first to speculate that air was a substance that could affect other substances including the flow of blood.  For his many speculations he's often given credit as the Father of Modern Chemistry.  (1, pages 105-107)

    Empedocles (490-430 B.C.) was the first to write about the
    power of the four elements, qualities and humors.  
    Ideas that started with a few men asking questions evolved through time.  It started out as philosophy and ultimately turned into the science. From here it turned into the first medical schools that pre-dated the Ancient Greek Schools of Medicine that influenced the authors of the "Corpus Hippocraticum."

    These original schools were not associated with buildings, and there were no school books, or no medical texts.  Rather, schools were associations of teacher and student.  The students would follow the teacher to learn the craft, and the teacher would hold classes at random places to teach his wisdom.  The students and the teachers would carry with them the tools and drugs needed and they would practice medicine and even perform surgeries.  As the need arose these "schools" could move from one location to another with ease.  (1, page 100)

    Philosophy is the search for wisdom, and all known wisdom -- mathematics, philosophy, science, astronomy, astrology, natural medicine, mythology, etc. --was taught at these schools, regardless of what career was ultimately sought.  Both Hippocrates and Galen would later explain that this was a good thing, because a good physicians would be well rounded in all wisdom.

    Of this, Hippocrates said:
    It may be concluded then... that knowledge and medicine must go hand in hand. The physician who is truly a philosopher is a demigod. Medicine and philosophy are closely allied. That which is taught by the latter, is practised by the former,—contempt of riches, moderation, decency, modesty, honour, justice, affability, cleanliness, gravity, a just appreciation of all the wants of life, courage in adversity—opposition to fraud and superstition, and due consideration of the Divine power. (2)
    As historians traced Ancient Greek history by studying available literature, they learned that some of the first medical schools were formed in Greece sometime around 550 B.C. "in the periphery of the Greek world, in Croton, in Cyrene, and... Sicily, Rhodes, Cnidus, and Cos."  (1, page 89-93)

    An ignorant public must have had more faith in the priests at the Asclepion than the remedies of the physicians.  It would be the family of physicians at the school of Cos who aimed to improve this image. This school would ultimately give rise to a man, Hippocrates, who would transform medicine from myth to fact.

    What started as a few thinkers asking questions turned into a slow evolution that transformed what would ultimately make Greek philosophy the key to all medical wisdom.

    References:
    1. Sigerist, Henry E, "A History of Medicine," Volume II, 1961, Oxford University Press, New York, pages 89-93
    2. Hippocrates, "On decency in manners and in dress," epitomised from the original Latin translations, by John Redman Coxe, "The Writings of Hippocrates and Galen," 1846, Philadelphia, Lindsay and Blakiston
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    Friday, January 16, 2015

    1194-800 B.C. Medicine in Ancient Greece

    If you had an internal disease like asthma around 1194-800 B.C. and lived in Greece, chances are you wouldn't go to see a doctor. Physicians existed, but they were more trained to treat wounds such as those obtained in battle.   The person you'd go to see would be your priest, magician or witch.

    The reason was simple:  most ancient societies, the Greeks included, believed disease was caused by the wrath of the gods.  To get your remedy you needed to find a person -- a priest, witch or magician -- to help you find out which god was mad at you and why.  Then you'd have to learn how to make that god happy again so you would have a shot at getting better, explains Henry E. Sigerist in his book, "A History of Medicine."  (1)

    Yet the more common option, as Sigerist notes, would be to seek out your priest to learn what kind of offerings to make to the gods for healing.  This was more common because it was far less expensive than seeking a potion offered by a magician or witch.  (1)

    He may prescribe for you a magic amulet, an incantation, and quite possibly an animal sacrifice, a pig perhaps, or a goat. Such a sacrifice would show the angry god that you value his wisdom over your own possessions. Since the gods were thought to live and breathe and eat like men in the Heavens, the sacrifice was thought to provide a food offering to the god.

    This was a common form of medicine in the ancient world, a bribe of sorts.  I will provide you with this food offering if you make me well again.

    A common ritual was to travel to the god's temple by walking, riding a horse, riding a donkey, or riding a cart.  The temple belongs to one of the healing gods, such, as Asclepius.  You'd spend time amid the priests, who had the ability to talk to the gods and hear their advice for healing.  Most often you'd sleep among them, and in the morning your cure would be revealed.

    (I will expound on the god Asclepius and his healing temples in a future post).

    In this way, you received the healing benefits this god had to offer.

    There were many such temples scattered around ancient Greece, and often they were associated with nearby hostels to house those who traveled for this purpose. Some early historians, Sigerist said, believed these "hostels attached to the Ascelpia were the first Western hospitals and poorhouses where indigent sick people stay and are treated by priest," writes Sigerist (1, page 73)

    Later historians noted that these weren't hospitals in the way we think of them today, as the sick merely spent time there to learn the cure; they did not stay in the hostels until they were healed, but just one night.

    Priestly healing was very common during this era.  In fact, the belief gods were responsible for good luck and bad luck, health and healing, made worshiping the god Ascepius very popular even up to the Birth of Jesus Christ.  Sigerist explained that it was for this reason the pagan god Asclepius was the greatest competitor of Jesus Christ. (1)

    Sigerist said that one of the main reasons Asclepius was the greatest competitor to Jesus Christ was because he wasn't as greedy as the other gods, and he would accept even modest gifts.  This made it possible for him to be worshiped by both the rich and the poor. (1)

    This was significant, because poverty was one of the main attractions of Christianity.  The poor couldn't afford physicians, nor the sacrifices demanded of most gods, and so Christianity was a viable option.  Yet so too was the god Asclepius.

    Over time there was another medical paradigm that was growing in popularity and significance in ancient Greece, and that was the belief in natural medicine.  Some priest physicians were knowledgeable of which plants had medicinal and poisonous properties.  As time progressed, even the common folks were privy to this knowledge.

    A good example of this was explained in the Odyssey by the great Greek poet Homer.  Henry E. Sigerist, explains the following: (1)
    "There is relatively little mention of magic in the Homeric epics although the ancient Greeks believed in magic and, like everyone else in antiquity, practiced some...  The drug given to Helen by the Egyptian lady, Polydamna, had strong euphoric properties, so that whoever took it forgot all unpleasant memories and would not shed a tear even if his closest relative died; this drug might be opium or hashish, but it could just as well be the kind of miracle drug found in many fairy tales." (1)
    As Sigerist explained, the Odyssey cannot be taken seriously.  However, it was based on real life events. The Greeks probably had access to various medicines, such as opium and hashish, and simply told of this medicine as a magic potion created by, say, witches or magicians.  Since the gods created everything, then they must have also created the magical powers present in some plants.

    Knowledge of the inner organs and what they did was limited, yet observations from experience working with the wounded and the dead gave soldiers a pretty good idea where to aim their weapons to produce the most damage to the enemy's body.  They knew the best places to aim their arrows were the lower abdomen or, better yet, the nipples.

    Physicians had magic healing powders and soothing drugs used to help people who were wounded in battle.  These tales also describe various poisons.  For example, Sigerist noted a line from Homer's Odyssey:
    "Circe was a beautiful witch who could transform human beings into pigs, and it is absurd to assume that Eurylochus (a companion of Odysseus) who told the story had been the victim of hallucinations."  (1)
    While these stories are twisted and turned into a memorable fairy tales, they may actually be descriptions of poisons used to punish or kill an enemy.   Although, whether this was the case we may only speculate.

    While all ancient medicine started off as mythical, natural medicine was soon a viable option. Natural medicine may have been resisted at first, although through time its benefits were so obvious they could no longer be resisted.  So, of course, natural remedies found their way into mythology.

    Over time, the two forms of medicine -- mythology and natural medicine -- would separate into two separate paradigms.

    *Note: The dates chosen for this article are based on the estimated dates for the writings of Homer (800 B.C.) and the siege of Troy as described in Homer's Iliad (1194-1184 B.C.). The medical knowledge expressed in this post may also have effected you prior to and after these listed dates, which are mainly listed simply as a reference to make it easier to write a history, and easier to picture in your head where these events may have occurred. And even if you lived in Greece during these times, you may also have been subjected to primitive medicine, or pre-Greek medicine. I obtained the dates from Albert Henry Buck in his book "The growth of medicine from the earliest times to about 1800." (1917, London, Oxford University Press, page 46).

    References:
    1. Sigerist, Henry E, "A History of Medicine," vol. II, "Early Greek, Hindu, and Persian Medicine," 1961, Oxford University Press, pages 19, 20, 23, 28, 51
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