1. Medical Sects and Galen

2. 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

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

4. 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

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

6. 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.

7. 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

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

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

10.  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

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

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

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

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

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

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

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

19. Medieval Medicine (c. 400- 1000 BCE)  Split in Roman Empire –4th century BCE  Eastern Empire –Byzantine –Greek speaking –Centred in Constantinople (now Istanbul)

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

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

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

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

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

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

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

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

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

31. Medicine in Islam Or How the East Saved Western Medicine

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

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

34.  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

35. The Islamic World c. 730 C.E.

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

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

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

39. Rhazes (865-925 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

40. Ibn Sina (Avicenna) 980-1037 C.E.  Distinguished between episodic diseases and epidemics  Believed air was the principal vehicle for spreading disease  Also, “evil eye”

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

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

43. 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