Hippocrates & Hippocrates & Hellenistic MedicineHellenistic Medicine

Hippocratic MedicineHippocratic Medicine c. 450 – 370 BCEc. 450 – 370 BCE

Hippocratic Hippocratic CorpusCorpus– 60 or so texts attributed to him60 or so texts attributed to him– Range of subjectsRange of subjects– He didn’t write all of themHe didn’t write all of them

– Written over ~70 years by several Written over ~70 years by several individualsindividuals

– Collected in Alexandria, Egypt around Collected in Alexandria, Egypt around 420 – 350 BCE420 – 350 BCE

Hippocrates more of a legendHippocrates more of a legend– ““malleable cultural artifact”malleable cultural artifact”

Corpus does provide insights into Corpus does provide insights into Greek medicineGreek medicine

Hippocratic OathHippocratic Oath– Insights into two aspects of Hippocratic Insights into two aspects of Hippocratic

medicinemedicineSocial contextSocial contextMedical scienceMedical science

Social contextSocial context– Plurality of healersPlurality of healers– Social statusSocial status

Scientific basisScientific basis– Not anatomicalNot anatomical– Highly speculativeHighly speculative

Based on humoural theoryBased on humoural theory

Disease an imbalanceDisease an imbalance

In community: epidemicIn community: epidemic– EnvironmentalEnvironmental

In humansIn humans– internalinternal

Imbalance related to one of the 4 Imbalance related to one of the 4 humourshumours– BloodBlood– PhlegmPhlegm– Yellow bileYellow bile– Black bileBlack bile

Social ContextSocial Context 44thth century BCE century BCE

Alexander the Great & the Greek Alexander the Great & the Greek empireempire

Rise of philosophy, reason, scienceRise of philosophy, reason, science

PlatoPlato

SocratesSocrates

AristotleAristotle

Linkages between 4 elements theory Linkages between 4 elements theory & four humours theory& four humours theory

Plato, Aristotle & The BodyPlato, Aristotle & The BodyPlato Plato (427-347 BCE)(427-347 BCE) Brain: ReasonBrain: Reason Heart: SpiritHeart: Spirit Liver: AppetiteLiver: Appetite

Based on speculationBased on speculation

AristotleAristotle (384-322 BCE) (384-322 BCE) Brain: giant cooling Brain: giant cooling

systemsystem Heart: seat of all vital Heart: seat of all vital

functionsfunctions 2 types of blood 2 types of blood

vesselsvessels

Based on dissection of Based on dissection of animalsanimals

Alexander the Great (d. 323 BCE) Alexander the Great (d. 323 BCE) & His Empire& His Empire

Hippocratic MedicineHippocratic Medicine Hippocratic medicine did not believe Hippocratic medicine did not believe

that it was important to know about that it was important to know about anatomyanatomy

Structure had little to do with Structure had little to do with theories of health & illnesstheories of health & illness

Physiology more importantPhysiology more important

Hellenistic MedicineHellenistic Medicine Hellenistic medicine knew far more Hellenistic medicine knew far more

about anatomyabout anatomy Rise of Alexandria (in Egypt) as Rise of Alexandria (in Egypt) as

centre of medical and scientific centre of medical and scientific learninglearning

Herophilus (ca. 330–260 BCE)Herophilus (ca. 330–260 BCE) Delineation of nervesDelineation of nerves Realization they were connected to Realization they were connected to

the brainthe brain Brain responsible for transmission of Brain responsible for transmission of

information to the bodyinformation to the body Brain replaced heart as centre of Brain replaced heart as centre of

body functioningbody functioning

Distinguished between arteries & Distinguished between arteries & veinsveins

Arteries originated in heartArteries originated in heart Distributed blood and pneuma Distributed blood and pneuma

Veins arose from liverVeins arose from liver Distributed nutrients to the bodyDistributed nutrients to the body

Responding to anatomical findings Responding to anatomical findings on dissectionon dissection– Liver (large organ)Liver (large organ)– Connected to heart by inferior vena Connected to heart by inferior vena

cavacava– Heart (large organ)Heart (large organ)– Aorta leaves heart, all other arteries Aorta leaves heart, all other arteries

traceable to it traceable to it – Brain (large organ)Brain (large organ)– All nerves traceable to itAll nerves traceable to it

Continuities from PlatoContinuities from Plato

PlatoPlato Brain: ReasonBrain: Reason Heart: SpiritHeart: Spirit Liver: AppetiteLiver: Appetite

HerophilusHerophilus Brain: Body Reg.Brain: Body Reg. Heart: PneumaHeart: Pneuma Liver: Nutrition Liver: Nutrition

Erasistratus (ca. 330-255 BCE)Erasistratus (ca. 330-255 BCE) Arteries only contained pneuma; no Arteries only contained pneuma; no

bloodblood

Learned Medicine in theLearned Medicine in theRoman EmpireRoman Empire

Greek empire fragmented after Greek empire fragmented after death of Alexanderdeath of Alexander

Coincided with Rome’s rise to powerCoincided with Rome’s rise to power First Greek physicians arrived in First Greek physicians arrived in

Rome around 219 BCERome around 219 BCE Athens sacked by Roman Army Athens sacked by Roman Army

around 80 BCEaround 80 BCE

Roman EmpireRoman Empire

Roman Attitudes to Greek MedicineRoman Attitudes to Greek Medicine

AmbivalenceAmbivalence Roman culture more pragmaticRoman culture more pragmatic Some believed doctors were harmfulSome believed doctors were harmful Low social status of the physicianLow social status of the physician Roman citizenshipRoman citizenship

Roman Contributions to Public Roman Contributions to Public HealthHealth

AcquaductsAcquaducts Sewage systemsSewage systems Public bathsPublic baths Architectural knowledge re: healthy Architectural knowledge re: healthy

locationslocations Development of health care Development of health care

institutions (valetudinaria)institutions (valetudinaria)

Military medicineMilitary medicine