During the lengthy period of the ancient Greek civilization (700 B.C.E. – 600 C.E.) major developments (and setbacks) in medical practice took place that have influenced the way doctors and practitioners diagnose and treat patients today. In this article, I will talk about medicine and religion, Hippocrates and his influence and medical discoveries of the time and what they got right and wrong. During this time, medicine became more logic based where ailments were believed to come from a mixture of external forces and internal issues. Previously, sickness was thought to be a punishment or wrath from the gods and the only way to be cured was to appease them with offerings or sacrifice.
Although, doctors were now using natural remedies, as a last resort some doctors after treating them would prescribe to their patients that they go to the temple of Asklepios (The Greek god of healing) to sleep. The belief was “that the daughters of Asklepios, Hygeia and Panacea, would arrive with two holy snakes that would cure the people they were treating” (Brazier). These snakes became a symbol of pharmacy and is still used today. This temple was called the Asklepion and later, with other similar temples, became recreation centers with health spas, gymnasiums and public baths. Wealthy individuals would prioritize cleaning themselves (Including their teeth), exercising regularly and eating a balanced diet. This allowed the average age for wealthy men to rise to 70. The overall life expectancy was still not very high for everyone else as they did not have the privilege of healthy, reliable food and safe, comfortable living conditions. Infant mortality, poverty and death in childbirth were all very common. The poor had other concerns than going to the gym or washing their teeth. (1) Hippocrates: Born on the island of Cos in 460 BCE , Hippocrates became a famous Greek doctor and teacher and has now regarded as the “father of medicine”. He wrote and kept records of the epidemics of his time and what he thought was the disease and the factors that led to its spread. Other treatises include how to set fractures, treat wounds, feeding and comforting patients. Hippocrates was also an advocate of regular exercise and hygiene to keep the body healthy. Most of his knowledge on the human body came from assumptions based on myth and experience as human dissections for research purposes were not happening during his time and wouldn’t appear until the Hellenistic period. After his death in 375 BCE, many medical schools were formed and claimed Hippocrates as the origin and inspiration of their doctrines. Although as time went on and new discoveries were found, some of his ideas were proved to be untrue , but Hippocrates still remained a trusted and honoured figure in medical history. Part of this is because of his ethical standards that he used in his medical practice and taught to his pupils and is credited in making the Hippocratic oath (Which he likely did not write). (2)
The Hippocratic Oath is an ethical code adopted as a guide to conduct of the medical profession. This “Oath” or at least a fragment of it has been passed down through generations and is still a part of the graduation ceremony of some medical schools. In the oath, the physician pledges to “prescribe only beneficial treatments, according to his abilities and judgement; to refrain from causing harm or hurt; and to live an exemplary personal and professional life” (3)
At the time of Hippocrates, the oath was like a religious documents that ensured the doctor was operating within and for community values. They swore by Apollo, Hygieia and Panacea “to respect their teacher, never to administer poison or abuse patients in any way, use a knife or break the confidentiality between patient and doctor.” (4)
An updated version of the Hippocratic oath was written in 1964 by Louis Lasagna, Dean of the School of Medicine at Tufts university. This modern version is similar to the classic with the exception of a promise to call upon one’s colleagues for help when you do not know something, a promise to help prevent disease and that they are aware they have the ability to take a life away as well as save it. It also redacts the statements about respecting your teacher to the point of acting as their son and they no longer swear upon the gods. (8)
The Four Humours:
Some of the most important discoveries of the time included the pulse by Praxagoras of Cos, who also was the first to distinguish veins from arteries. Doctors also figured out better ways of diagnosing patients by examining the face, diet, bowel movements, appetite and sleeping habits, all of which are still used as indicators for illness today. (4) A popular medical theory was the four humours, which is essentially an attempt at equilibrium in the body. One must have an equal amount of each in the body to be healthy. Each was associated with and element, season, temper and organ. If you had too much of one, the doctor would prescribe to get more of the opposite to balance it out. (5) An example of an ailment and treatment would be if you had a dry cough. The sickness was warm and dry and therefore it was thought you had too much blood in body and taking some out would help heal your cough. This procedure was called bloodletting, they poke a hole in you artery or vein (they didn’t know the difference yet) and let your blood flow out of your body. When the doctor has deemed enough blood has been removed, they would patch you up again and send you on your way.
The four humours theory was known as true up until the 17th century in western Europe. Although the ancient Greeks made many advances in medicine, this was a stubborn idea that took a long time to be proven false. (1)
Medical Instruments:
As part of medical practice, one needs tools to aid them. Doctors used a variety of surgical instruments cut, poke and prod, many of which a variation of is used today in modern medicine. Most tools were made out of a copper alloy and sometimes decorated with engravings.
The image shown to left shows a pair of forceps with a dolphin decoration on the handle. This specific pair were found in the ancient city of Colophon (Turkey) in 2014. Forceps were used when the doctor’s fingers were to large to grasp the object or if multiple object needed to be held. A few uses were for epilation (hair removal), holding back flesh during surgery and instances of using forceps to crush the uvula to stop a patient from hemorrhaging have been recorded. Forceps are still used in modern surgery for very similar procedures. Forceps were also used for everyday use, similar to what one would use tweezers for.
The next image depicts a sharp hook. Sharp hooks were used for seizing and raising small pieces of tissue and for fixing and retracting the edges of wounds. Blunter hooks were also used for dissecting and raising blood vessels. A combination of hooks and forceps were often used for most procedures. This hook was also found in the ancient city of Colophon in 2014.
This image depicts a Spatula.Spatulas were a convenient all purpose tool. They had flat spatula at one end and a olivary point at the other. They were good for probing, but were mainly used for pharmaceutical purposes. The doctor could mix up the medicine with the rounded end and use the spatula side to spread the ointment where necessary. This tool was also were popular amongst painters, so they could mix their paint and apply it. (6)(7)
Although modern medicine uses a variation of these tools, the modern versions are usually made of a stainless steel rather than a copper alloy. This allows the tool to be properly disinfected, something that was not practiced in ancient Greece as they were unaware of the existence of germs and the infections they could cause. These were only a few of the tools they used, other include scalpels, speculums, catheters and scissors. (7)
Conclusion:
The doctors of ancient Greece came up with many different treatments and theories about how the human anatomy worked. Some are known as true today like that the brain controls the body, rather than the heart, but we also know now that bloodletting is not a good treatment for any ailment. Famous doctors like Hippocrates, despite their misconceptions about anatomy, have been an inspiration for the proper care of humanity. Western medical science today would be much different without the important discoveries of ancient Greece.
Notes:
1. M.D. Daniel Murrell & Yvette Brazier, “What is ancient Greek medicine?”, Medical News Today, , https://www.medicalnewstoday.com/articles/323596#medicine-and-math; accessed October 20, 2020.
2. Wesley D, Smith, “Hippocrates”, ” Encyclopædia Britannica, https://www.britannica.com/biography/Hippocrates accessed October 20, 2020.
3. “Hippocratic Oath”, Encyclopædia Britannica, https://www.britannica.com/topic/Hippocratic-oath; accessed October 20, 2020
4. Mark Cartwright, "Ancient Greek Medicine." Ancient History Encyclopedia. https://www.ancient.eu/Greek_Medicine/; accessed October 20, 2020.
5. N.S. Gill, “Hippocratic Method and the Four Humors”, ThoughtCo. https://www.thoughtco.com/four-humors-112072; accessed October 20, 2020.
6. Jennifer Torres, “Medical and Surgical Instruments. Part 1”, John Hopkins Archaeological museum, https://archaeologicalmuseum.jhu.edu/about-us/2014-institute-of-museums-and-library-sciences-grant-awarded/rehousing/medical-and-surgical-instruments-part-1/; accessed November 25, 2020.
7. “Surgical Instruments from Ancient Rome” University of Virginia, http://exhibits.hsl.virginia.edu/romansurgical/ accessed November 25, 2020.
8. William, C. Shiel Jr., MD, FACP, FACR. “Medical Definition of the Hippocratic Oath” MedicineNet,https://www.medicinenet.com/hippocratic_oath/definition.htm; accessed November 25, 2020.
Bibliography:
Cartwright, Mark. "Ancient Greek Medicine." Ancient History Encyclopedia. Last modified April 11, 2018. https://www.ancient.eu/Greek_Medicine/; accessed October 20, 2020
“Hippocratic Oath”, Encyclopædia Britannica, https://www.britannica.com/topic/Hippocratic-oath; accessed October 20, 2020
Murrell, Daniel M.D. & Brazier, Yvette “What is ancient Greek medicine?” Medical News Today. 2018, https://www.medicalnewstoday.com/articles/323596#medicine-and-math; accessed October 20, 2020.
Smith, Wesley D. “Hippocrates” Encyclopædia Britannica, 2020 https://www.britannica.com/biography/Hippocrates; accessed October 20, 2020.
“Surgical Instruments from Ancient Rome” University of Virginia, 2007 http://exhibits.hsl.virginia.edu/romansurgical/ accessed November 25, 2020.
Torres, Jennifer. “Medical and Surgical Instruments. Part 1”, John Hopkins Archaeological museum, https://archaeologicalmuseum.jhu.edu/about-us/2014-institute-of-museums-and-library-sciences-grant-awarded/rehousing/medical-and-surgical-instruments-part-1/; accessed November 25, 2020.
William, C. Shiel Jr., MD, FACP, FACR. “Medical Definition of the Hippocratic Oath” MedicineNet,https://www.medicinenet.com/hippocratic_oath/definition.htm; accessed November 25, 2020.