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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.

  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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