Medical Sects and Galen

Tensions in Ancient Medicine Rationalists  Hippocratics  Theory guided medical practice  Speculative  Humoural theory  Anatomy & Physiology Empiricists  Medical knowledge gained by experience  Training in the art of observation

 Empiricist medicine still an art  Still separated medicine from other healers  Apprenticeship model of medical education persisted until 19 th century

Rise of the Methodists (1 st Century CE)  Challenged both Rationalist and Empiricist medicine  All illness result of either constriction or dilation of pores of body

 Denied the learned basis of medicine  Anyone could learn medicine in 6 months

Thumbing Noses at Learned Medicine Hippocrates: Life is short, the art long, opportunity fleeting, experiment dangerous and judgment difficult Methodists: Life is long and the art is short.

Galen of Pergamon (129-c.219 CE)  Born in what is now Turkey  Son of an architect  Began medical studies at age 16  Studied in Alexandria  Travelled widely in Egypt

 Began medical practice in late 20s  Physician to the gladiators in Pergamon  Moved to Rome

 Gained fame for –Public anatomical displays –His philosophical acumen –His successful medical treatments of the elite

 Why was Galen successful? –He was a Roman citizen –He was a member of the elite –He was a shameless self-promoter –He was a prolific writer

The Context of Galen’s Practice  Regarded himself as Hippocrates’ heir  In some ways, he invented Hippocrates  Loathed the Methodists

 Systematized Hippocratic medicine  Believed in a divinely ordered universe  Believed it could only be discerned through reason and intellect

Elaborating Hippocrates  Extended the humoural theory  Believed it confirmed Plato’s tripartite human soul –Liver (nutrition) –Heart (vitality) –Brain (reason/sensation)

 Humoural theory also extended Aristotelian physics –Four humours –Four elements –Four seasons –Four primary qualities

Galen’s Innovations: Nosology  Classification of diseases  Diagnosis  Prognosis  Diseases are specific entities, not malleable

Galen’s Contributions Experimentation  Groundbreaking work in anatomy & physiology  Existence of psychosomatic disease  Belief in primacy of reason

 Diminished the work of those he disagreed with  Plagiarized the work of those he did agree with

Medieval Medicine (c BCE)  Split in Roman Empire –4th century BCE  Eastern Empire –Byzantine –Greek speaking –Centred in Constantinople (now Istanbul)

 Constantinople sacked in 14 th century  Empire reduced to city & its hinterland

 Western –Latin speaking –Centred in Rome  Rome sacked in 410 CE  Political, social, & economic chaos

 De-urbanization –Return to agricultural economy  Loss of trade relationships

 Loss of traditional ways of transmitting knowledge –Decline in intellectual life –No centres of higher learning –Few masters training apprentices in medicine

 Often referred to as the “Dark Ages”  Result was 2 types of medical literature 1.Latin –Encyclopedia –commentary

2.Vernacular –Written by lay people –e.g.: Old English (Anglo Saxon) texts –Date from 10 th century  Leechbook of Bald  Lacnunga  Non theoretical

 Drawn from diverse sources  Indications of pre-Christian traditions –Magic  Overlaid with Christian elements

 Impact of rise of Christianity –Issues of adjustment between “pagan” & Christian thought 1.Intellectual –What causes disease –What cures disease

2.Practical –Healing institutions  Healing shrines  Hospices  Monasteries

Medicine in Islam Or How the East Saved Western Medicine

Important Variables  Former Eastern Roman empire spoke Greek  Political stability  Greek speaking physicians from the old eastern empire moved further east

Islamic Empire  Mohammed (d. 632 C.E.)  After his death, new faith spread rapidly in Arabian peninsula

 By 642 C.E.: –Armenia –Mesopotamia –Much of Persia –Much of Egypt  By 743 C.E.: –North Africa –Much of Spain –Almost France –Persia –Kashmir –Punjab

The Islamic World c. 730 C.E.

The Islamic Intellectual World  Centred in Bagdad  Presence of Greek speaking intellectuals  Sponsored by Islamic court  Translations of Greek medical texts

 Muslim intellectuals drawn to rigour of Greek philosophy & medicine  100 texts by Galen translated  Muslim intellectuals sought to build on the work already done

Both faithful to Greek/Roman traditions & innovative Integrated their own knowledge of remedies Advances in surgical procedures

Rhazes ( C.E.)  Differentiated between small pox and measles  Much more difficult than it may appear  Other Muslim physicians described person-to-person spread of disease

Ibn Sina (Avicenna) C.E.  Distinguished between episodic diseases and epidemics  Believed air was the principal vehicle for spreading disease  Also, “evil eye”

Later Western Medicine’s Assessment of Islamic Medicine  Described as unoriginal  Unfair on several counts –Great respect for tradition –Difficulties associated with translation

Islamic Medicine’s Legacy  Preserved and advanced early western medicine  Avicenna –Prolific writer –The Cannon –Became known as the “Galen of Islam”

Spain under Muslim Rule  Important site for re-entry of ancient medicine into medieval Europe  Contribution of Spanish Jews –Moses Maimonides  Philosopher & physician  Guide for the Perplexed