1. Hippocrates & Hellenistic Medicine

2. Hippocratic Medicine  c. 450 – 370 BCE  Hippocratic Corpus –60 or so texts attributed to him –Range of subjects –He didn’t write all of them

3. –Written over ~70 years by several individuals –Collected in Alexandria, Egypt around 420 – 350 BCE  Hippocrates more of a legend –“malleable cultural artifact”

4.  Corpus does provide insights into Greek medicine  Hippocratic Oath –Insights into two aspects of Hippocratic medicine  Social context  Medical science

5.  Social context –Plurality of healers –Social status

6.  Scientific basis –Not anatomical –Highly speculative  Based on humoural theory

7.  Disease an imbalance  In community: epidemic –Environmental  In humans –internal

8.  Imbalance related to one of the 4 humours –Blood –Phlegm –Yellow bile –Black bile

9. Social Context  4 th century BCE  Alexander the Great & the Greek empire  Rise of philosophy, reason, science

10.  Plato  Socrates  Aristotle  Linkages between 4 elements theory & four humours theory

11. Plato, Aristotle & The Body Plato (427-347 BCE)  Brain: Reason  Heart: Spirit  Liver: Appetite Based on speculation Aristotle (384-322 BCE)  Brain: giant cooling system  Heart: seat of all vital functions  2 types of blood vessels Based on dissection of animals

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

13. Hippocratic Medicine  Hippocratic medicine did not believe that it was important to know about anatomy  Structure had little to do with theories of health & illness  Physiology more important

14. Hellenistic Medicine  Hellenistic medicine knew far more about anatomy  Rise of Alexandria (in Egypt) as centre of medical and scientific learning

15. Herophilus (ca. 330–260 BCE)  Delineation of nerves  Realization they were connected to the brain  Brain responsible for transmission of information to the body  Brain replaced heart as centre of body functioning

16.  Distinguished between arteries & veins  Arteries originated in heart  Distributed blood and pneuma

17.  Veins arose from liver  Distributed nutrients to the body

18.  Responding to anatomical findings on dissection –Liver (large organ) –Connected to heart by inferior vena cava –Heart (large organ) –Aorta leaves heart, all other arteries traceable to it –Brain (large organ) –All nerves traceable to it

19. Continuities from Plato Plato  Brain: Reason  Heart: Spirit  Liver: Appetite  Herophilus  Brain: Body Reg.  Heart: Pneuma  Liver: Nutrition

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

21. Learned Medicine in the Roman Empire  Greek empire fragmented after death of Alexander  Coincided with Rome’s rise to power  First Greek physicians arrived in Rome around 219 BCE  Athens sacked by Roman Army around 80 BCE

22. Roman Empire

23. Roman Attitudes to Greek Medicine  Ambivalence  Roman culture more pragmatic  Some believed doctors were harmful  Low social status of the physician  Roman citizenship

24. Roman Contributions to Public Health  Acquaducts  Sewage systems  Public baths  Architectural knowledge re: healthy locations  Development of health care institutions (valetudinaria)

25.  Military medicine