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76 Cards in this Set
- Front
- Back
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Greek Rational Medicine and Religious Healing |
Parallel development (Hippocratic vs. religion) 1. relationship: Hippocrates was a follower of Asklepiads, lineage with Asklepios as justification of position of iatros 2. proof- island of Cos associated with Hippocrates and school (400-370 BC), sanctuary established here after 350 BC
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Asklepios |
-healing diety -development of cult that would spread throughout the Mediterrean -evidence in Roman 3rd century medicine domestica (Roman folk medicine) |
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Origins of Asklepios
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-real physician (13th century BC) -Iliad, Homer calls him a blameless physician, iatros of Tricca, Thessaly -two sons, Machaon and Podalirios, served in the Trojan War
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Mythic tradition of Asklepios: Hesoid |
-8th-6th centuries -Hesiod, Ehoiai fragments: didactic poem of mortal women having affairs with Gods producing demi-gods. Contemporary of Homer in Ionic Greek. Son of Apollo and Coronis and raised by Chiron the centaur on Mount Pelion in Thessaly
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Mythic tradition of Asklepios: Epidaurean |
-according to Isyllos (c. 300 BC) -Asklepios abandoned and raised on Mount Tithion by a centaur -Epidaurus becomes cult center for Asklepios -goats and dogs associated with Asklepios, later snake |
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Deification of Asklepios |
-possibly at Tricca, Thessaly (6th century BC) -made healing deity -petitioned by people with no hope |
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Spread of Cult |
-evidence explained in Thomolson reading -6th century BC- 6th century AD -Epidaurus (end of 6th/early 5th BC) one of the artiest buildings with inscriptions that Asklepios was actually there -Corinth, Aegina, Mantinea, Athens (420 BC) -Cos sanctuary and Pergamum (competitior) |
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Asklepios vs Christ the Savior |
-spread of cult in Rome (c. 219 BC) -Europe -> the entire ancient world, little shrines due to barbarians -becomes competitor with Christ the Savior until 4th century -both known as saviors and performers of miracles |
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Cult at Epidaurus: Public
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-every 4 years: Corinth, Isthmian Festival; April, honoring Poseidon (games) -public worship after games: procession; paians (hymns), hiaromnamones (march to the sanctuary of Asklepios) |
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Buidlings of Epidaurus sanctuary |
-theater: built on hill in 430 BC (drama, opera) -hostel built in 4th century for those not allowed to approach divinity (Taboo: pregnant or near death) -Propylon: "gateway" entering cleansing minds of impure thoughts and filling with thoughts of Asklepios |
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Sequence of Events as Epidaurus Sanctuary |
-symbolic washing of the hands at well -sacrifice- used barley wheat and wine. Based on wealth of city state -banquet- listening to poets as entertainment -contests- athletic and artistic (stadium) |
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Cult at Epidaurus: Private Aspect |
-ritual: preliminary purification and sacrifice, relax in sanctuary, visit Temple of Asklepios -sleep in Abaton over night (incubatio): meeting Asklepios in sleep |
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Asklepios incubatio: Healing Experience |
-dream vision: (iama, plural: iamata) of healing -hallucinogenic drug administered in wine by priest -could meet anyone in Asklepios' family, or his serpent -snakes held at Thalos (plaque with snakes found here) -Hygeia was daughter |
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Healing by incubation: Asklepios attended by Hygeia |
-administers a miraculous cure to a sleeping woman -Marble votive plaque relief from Piraeus Asklepieion -depicted as beard, kind-looking with snake intertwined on staff -mortals depicted smaller than divinities |
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The iamata of the Epidaurian Marble Stelai (c. 350 BC) |
-made of grey limestone, 7 inches high, 4-7 inches thick -43 iamata of Stelai A and B -inscriptions of those who came to Asklepios -treated people of all age and social classes but had to pay for transportation (poor were locals) |
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Iamata in Stelai: Physical-chronic ailments |
-#30- pus in lung wound, miraculous treatment -other examples: gallstones, lice, tumors, abscesses, worms, wounds that wouldn't heal |
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Iamata in Stelai: Psychosomatic traits |
-consisted of 1/3 of cases -psychosomatic/psycho-hysterical -(#18) blind man given back his sight -due to psychological trauma, went to intros first |
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Iamata in Stelai: gynecological |
-separate/religious taboo -#1- not in range of approaching divinity -woman pregnant for 5 years, not clear how she approached Asklepios -someone who wanted to get pregnant would read this |
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Asklepios: Method of Healing |
-immediate and miraculous -treatment: Administration of a drug (#40 & #41) Timon spear under eye, herbal mixture administered (miraculous surgery) -laying of hands; lick of serpent (#17) toe healed, malignant sore, sleeping outside Abaton (youth with beautiful appearance had healed) |
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Comedy by Aristophanes |
-Plutus, 380 BC -character depicted as blind, as it is an unprecedented distribution of gifts? |
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Aelius Aristides, Sacred Discourses |
-2nd century AD -best source of information on Asklepios -hypochondriac, visits Asklepios for 17 years at Pergamon -treatment spanned weeks and months, complicated, consistent with rational technai -not immediate |
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Votive offerings to Asklepios |
-could be set up before healing -votive plaques, terracotta votives -representations of body parts healed in Corinth (arms, genitals, feet, and hands) |
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Cult of Asklepios in antiquity |
-continuity of Asklepios in Western healing -Virgin Mary healing shrine in Lourdes, France -Bernadette Soubirous 11 Feb-16 Jul 1858: 18 apparitions of Virgin Mary to go to an are and a spring would appear -350,000 pilgrims per day during pilgrimage period (Easter-October) -miraculous in result of prayer, penitence, and immersion in spring water |
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Placebo Effect |
-rise of Christian martyrs -19th Century- Lourdes/Virgin Mary (assimilation of Asklepios) -65 miraculous healing |
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Evidence of the Practitioner from Homer to Hippocrates |
-no extant medical literature -Asklepios was reference to first real physician but only literary |
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Fragmentary poetry of Solon |
-(c. 640 BC) -Athenian statesmen, poet, JH Phillips in an article -status and therapeutic means of physician are those reflected in Homeric poems (8th century BC) -disease is thought of as a punishment as reflected in Works and Days of Hesoid (late 8th century) Solon's emphasis on the relationship between part and whole (contemporary Ionian philosophy) |
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Etiology of disease: Hesiod |
-8th century -mortal judgement concept in Work and Days -if there is a sin committed there is judgement -born out of community through, or generation -looking back for disease |
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Ionian Philosophies |
-Solon's emphasis on relationships of cause and effect, whole and part; Ionian philosophers -Pre-Socratic philosophy looking at phenomena in physical world and trying to define reality -applies to society as a whole |
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Sombritidas |
-"physician son of Mandrocles from Megara Hyblea, Sicily" -statue of young man representation of Sombritidas -Kouros usually made as a tombstone -indicates that intros was wealthy with a family in order to have elaborate tombstones
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Democedes |
-of Croton, Italy (520 BC) -Herodotus, Historia (129-132), describes him as traveling iatros motivated by money in travel -money involved getting him to move around -Croton, Italy>Aegina (1)>Athens(1.5)>court of Polycrates of Samos> court of King Darius in Persia (c. 522 BC) -significance of Egyptian medicine being displaced by Greek medicine |
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Aineios |
-name of intros with "sophia" on grave in Ionia -iatros in Cos -(c. 500 BC) -"sophia" = wise |
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Ionian physician grave stele |
-(c. 480) patient in front of physician -elaborates seat/robe with wealth -representing physician staff (traveling) and bronze bleeding cups (venesection) |
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Arbaylle: Iatreion |
-Iatreion (clinic) -Arbaylle (c. 470 BC) -red figure, 9 cm high, the physician in his clinic w/ bleeding cup - didn't ask for payment before -bandages and patients waiting, could indicate if the intros thinks they will live -dwarf illustrated on bottle |
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The Monists |
-Miletus, Ionia: center of cosmopolitan learning, culture and interaction -monists believed from one substance all elements are derived -"method" of philosophical investigation, don't know much all we have is fragments |
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Thales of Miletus |
-(c. 585) [mythical] -monist, travled and spent a lot of time in Egypt -water is the primary element of all things |
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Anaximander of Miletus |
-(c. 560 BC) - to apeiron= infinite, inexhaustible, and interdeterminate -> water, earth, air, and fire with their qualities (four basic elements) -cosmic swirl= creation of the physical world -all living things arose from water and became land animals when water evaporated, man from fish like features |
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Anaximenes of Miletus |
-(c. 546 BC) -monist, air is the primary element -"as our soul, being air, holds us together, so do breath and air surround the whole universe" -from air all other elements arose= changes of density, through rarefaction and condensation -* important for the idea of quantitative changes responsible for changes in quality, breath/air important for life/explaining disease |
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Heraclitus |
- (c. 500 BC) fire being the primary element -everything flows, is in constant flux, and nothing remains unchanged -world is NOT static but dynamic -innate force involved that leads to tension between to tension opposites -* everything moves and accords to eternal laws |
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The Pluralists |
-from multiple elements all things are derived |
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Pythagoras of Samos |
-Samos> Croton, Italy (c. 530 BC) - NOT a physician, liked the number "4" -believed number and mathematics could explain the physical world -establishes a school/religious cult, believes in reincarnation -liked the number 4 because if could be broken into pairs -* health is condition of perfect equilibrium; psychosomatic approach, importance of numerical definition |
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Definition of medical school |
- a free association of teachers, students, practitioners, and apprentices -develop in the LAST THIRD OF 6th century BC -(Croton, Italy; Cyrene, Libya; Akragas, Sicily; Rhodes, Cos, Cnidus) |
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"Medical School of Croton" |
-Democles (c. 520 BC) -Alcmaeon (c. fl. 500-450 BC) "father of physiology", physician, pre-Socratic philosopher -cerebrocentrist -perception and reason had to do with the senses/ the brain -based diagnosis on physical evaluation (dissections) -*isonomia (equality of rights) and monarchia (single rule among them opposites creates disease) -excess or deficiency of food, as to the affected parts (humoral theory) -* NOTION OF IDEAL EQUILIBRIUM, TWO PAIRS OF ELEMENTS WITH OPPOSITE QUALITIES IN IDEAL BALANCE |
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"Medical School" of Akragas, Sicily |
-Empedocles (c. 450 BC) -poet associated as physican -wrote On Nature, Purifications: 150 fragments -all objects are of nature (inanimate or animate) -combinations of four elements -2 didactic poems incorporated into humoral thoery -driving force that impels elements to combine or separate (LOVE vs. HATE) -*assimilation of the four elements into Hippocratic humoral theory |
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Akron, Euryodes, Philistion |
-accept the four elements theory of Empedocles -cardiocentrist (beginnings of this idea) -develop the theory of Pneuma as an etiology of disease -air is breathed in through nose, mouth, pores, manifestation of the pathological disease
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Hippocrates |
-(c. 460-370 BC) -father of Western Clinical Medicine, island of Cos -taught for a fee -Asklepiad, held Asklepios as his patron God even though he used rational thinking, wanted to align lineage with religious figure |
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Sources of Knowledge about Hippocrates |
-Plato (427-370 BC) -Papyrus Anonymous Londinensis (2nd Century AD) |
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Plato |
-(427-370 BC) -Protagoras (311 B-C) and Phaedrus (270 B-D) -felt the body was an organism was made up of parts to come up with what you felt -looked at symtomatology and tried to tell what disease was |
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Papyrus Anonymous Londinesis |
- 2nd century AD -Aristotle (384-322 BC) assigned student Menon area of medcine -contents- medical definitions, causes of disease, physiology up until 300 BC -Menon-phusai (what Hippocrates thought was the cause of disease) -scribe wrote something Hippocrates didn't believe which was inflammation/imbalance of elements/bad regimen |
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Sculptured bust of Hippocrates
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-mutilated, found in cemetery near part of Ostia in Rome, on tomb of Demtrius -first aphorism inscribed on bust; "Life is short, the Art is long, opportunity fleeting, experiment treacherous, judgement difficult. The physician must be ready, not only to do his duty himself, but also to secure the cooperation of the patient, of the attendants and of the externals." |
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coin from Cos |
-1st century AD -portrait on one side that looks like picture of bust -copy of bust on generation after death |
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Corpus Hippocraticum |
- (c. 430-330 BC) - we have texts from much later (some 1st century) -60+ texts in Ionic Greek dialect, Greek translation gets lost among Arabic, Syrian and Latin translations -The Heart and Precepts, Nature of Man |
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The Heart and Precpts |
-3rd or 2nd century BC commentary -Galen preserves in AD, writes commentaries and quotes |
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Decorum |
1st or 2nd century AD |
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Creation of the Hippocratic Corpus |
-not all associated with Hippocrates -Nature of Man- Polybus, son-in-law of Hippocrates -Alexandria (3-2nd century BC) library -Posagorus student of Cos (320) brought Hippocratic texts with him after being attracted by pharaoh |
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"The Medical Schools" of Cos and Cnidus |
-concept of medical schools, thought they differed until the 1980s -no longer rigidly defined as you can define whichever text as a iatros |
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"Coan" |
-Epidemics I-III, The Tradition in Medcine, The Sacred Disease, The Nature of Man -about making observations and humoral theory |
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"Cnidian" |
-Regimen in Acute Diseases, Regimen in Health, Internal Affections, Diseases of Women -targeting of certain organs and making diagnosis |
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Epidemics 1 and 3 |
-end 5th/early 4th century BC Thessaly, Thrace, Island of Thasos -epidemic= "sojourning in a place" illness occuring in a given place or time -constitution- patients primarily acute disease and progress -No diagnosis, prognosis, rarely treatment, critical days important (quotidian, tertians, quartans) |
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Epidemics 1 and 3: Case Examples
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-typical cases stress the critical days, symptoms, all recorded in the premise that they would be read by other physicians who could identify the disease and treat it in the future -Pythion, description of symptoms and sufferings -emphasis on the turning point (either die or live)
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Epidemics 1 and 3: Diseases |
-consumption (phthisis)- tubercolosis -Malaria (Anopheles) black bile -tetanus= lock jaw -peurperal sepsis (Lloyd for all below) -mumps -lobar pneumonia (Epid) -acute colecystitis (gall bladder) ( Lloyd) -black bile= hemoglobinuria |
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Plage of Athens |
-(430 BC) decimated third of population -occurred during Pelopponnesian War between Spartans and Athens (431-427 BC) -information provided by general Thucydides |
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Thucydides |
-commander who wrote History of Peloponnesian War (431-404 BC) plague in book 2.47-54 -symptoms -identification (1998 found plague pit, typhoid from dental pulp) Before thought it was scarlet fever -idea of contagion and immunity -contemporary medical language and emphasis on symptoms -impact of an epidemic on an entire population |
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Disease Etiology: The Nature of Man and The Theory of the Four Humors |
-Polybus, son-in-law of Hippocrates -explanation if diagram: humors; relationships between the four elements, their degrees of heat and moisture, the seasons of the year, the period of human life, and the prevalence of diseases |
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Disease Etiology: The Sacred Disease and the Theory of Pneuma |
-air (pneuma)- the vital principle -According to the Sacred Disease: -2 phlebes act as vents drawing most of the air from mouth, nose and into pores to themselves) -residual air is breathed out -if air is blocked anywhere and cannot move freely- illness (epilepsy/phlegm/speechlessness/convultions) |
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The Hippocratic physician and astonomie |
-necessity of determining seasonal change -to predict effects of season on probable occurrence of disease, its prevention and disease -Hesiod in Work and Days
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Difference between astrology and astronomie |
-Astronomie: knowing how to distinguish the various seasons according to particular recurrent astronomical events, such as rising and setting of particular stars (Pleiadus or Arcturus), the equinoxes and the solstices
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Need of astronomie proof |
-3 treaties -Airs, water and places -Epidemics I-VII -On Nutrition 3
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Implication of mathematical astronomy and use of parapegmata |
-parapegmata- texts used to determine seasonal variation for weather -implication for the dating of the above treaties spanning the last decades of the 5th to early 4th century BC |
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Hippocratic Anatomy and Physiology: Diogenes of Apollonia |
-iatros depends on palpation for most part, analogy to animals -father allowed to determine whether children brought up or abandoned (possible place for dissection for iatros)
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Vascular system of Diogenes of Apollonia |
-bi-lateral symmetry, two main phlebes= hepatitis and splenitis -phlebes cary BOTH pneuma and blood -cerebrocentrist -two discoveries in 3rd century BC alter cerebrocentrist view (distinction of arteries and veins, and discovery of cardiac valves) |
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Blood
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air, spring, childhood wet/hot |
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Yellow Bile |
fire, summer, adolescence hot/dry connection with Black bile being malarial fever connection |
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Black Bile
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earth, fall, adult Dry/Cold malarial tendency of dark urine, and blackening of the spleen more likely in others parasitization of red blood cells to burst |
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Phlegm |
water, winter, old age Wet/Cold pneumonia, bronchitis |
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eucrasisa |
proper balance |
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dycrasia |
if one or more is out of balance there is a plethora or deficiency resulting in dycrasia (improper balance) |
