Greek Medicine : Part 2

The Evolution of Modern Medicine
by William Osler

(Page 4 of 18)

"We can trace the springs of Greek success achieved and maintained by the great men of Hellas on the field of scientific inquiry to a remarkable conjunction of natural gifts and conditions. There was the teeming wealth of constructive imagination united with the sleepless critical spirit which shrank from no test of audacity; there was the most powerful impulse to generalization coupled with the sharpest faculty for descrying and distinguishing the finest shades of phenomenal peculiarity; there was the religion of Hellas, which afforded complete satisfaction to the requirements of sentiment, and yet left the intelligence free to perform its destructive work; there were the political conditions of a number of rival centers of intellect, of a friction of forces, excluding the possibility of stagnation, and, finally, of an order of state and society strict enough to curb the excesses of 'children crying for the moon,' and elastic enough not to hamper the soaring flight of superior minds....

We have already made acquaintance with two of the sources from which the spirit of criticism derived its nourishment - the metaphysical and dialectical discussions practiced by the Eleatic philosophers, and the semi-historical method which was applied to the myths by Hecataeus and Herodotus. A third source is to be traced to the schools of the physicians. These aimed at eliminating the arbitrary element from the view and knowledge of nature, the beginnings of which were bound up with it in a greater or less degree, though practically without exception and by the force of an inner necessity. A knowledge of medicine was destined to correct that defect, and we shall mark the growth of its most precious fruits in the increased power of observation and the counterpoise it offered to hasty generalizations, as well as in the confidence which learnt to reject untenable fictions, whether produced by luxuriant imagination or by a priori speculations, on the similar ground of self-reliant sense-perception."

The nature philosophers of the Ionian days did not contribute much to medicine proper, but their spirit and their outlook upon nature influenced its students profoundly. Their bold generalizations on the nature of matter and of the elements are still the wonder of chemists. We may trace to one of them, Anaximenes, who regarded air as the primary principle, the doctrine of the breath of life - the psychic force which animates the body and leaves it at death - "Our soul being air, holds us together." Of another, the famous Heraclitus, possibly a physician, the existing fragments do not relate specially to medicine; but to the philosopher of fire may be traced the doctrine of heat and moisture, and their antitheses, which influenced practice for many centuries. There is evidence in the Hippocratic treatise peri sarkwn of an attempt to apply this doctrine to the human body. The famous expression, panta rhei, - "all things are flowing," - expresses the incessant flux in which he believed and in which we know all matter exists. No one has said a ruder thing of the profession, for an extant fragment reads: ". . . physicians, who cut, burn, stab, and rack the sick, then complain that they do not get any adequate recompense for it."

The South Italian nature philosophers contributed much more to the science of medicine, and in certain of the colonial towns there were medical schools as early as the fifth century B.C. The most famous of these physician philosophers was Pythagoras, whose life and work had an extraordinary influence upon medicine, particularly in connection with his theory of numbers, and the importance of critical days. His discovery of the dependence of the pitch of sound on the length of the vibrating chord is one of the most fundamental in acoustics.

Among the members of the school which he founded at Crotona were many physicians, who carried his views far and wide throughout Magna Graecia. Nothing in his teaching dominated medicine so much as the doctrine of numbers, the sacredness of which seems to have had an enduring fascination for the medical mind. Many of the common diseases, such as malaria, or typhus, terminating abruptly on special days, favored this belief. How dominant it became and how persistent you may judge from the literature upon critical days, which is rich to the middle of the eighteenth century.

One member of the Crotonian school, Alcmaeon, achieved great distinction in both anatomy and physiology. He first recognized the brain as the organ of the mind, and made careful dissections of the nerves, which he traced to the brain. He described the optic nerves and the Eustachian tubes, made correct observations upon vision, and refuted the common view that the sperm came from the spinal cord. He suggested the definition of health as the maintenance of equilibrium, or an "isonomy" in the material qualities of the body. Of all the South Italian physicians of this period, the personality of none stands out in stronger outlines than that of Empedocles of Agrigentum - physician, physiologist, religious teacher, politician and poet. A wonder-worker, also, and magician, he was acclaimed in the cities as an immortal god by countless thousands desiring oracles or begging the word of healing.

That he was a keen student of nature is witnessed by many recorded observations in anatomy and physiology; he reasoned that sensations travel by definite paths to the brain. But our attention must be confined to his introduction of the theory of the four elements - fire, air, earth and water - of which, in varying quantities, all bodies were made up. Health depended upon the due equilibrium of these primitive substances; disease was their disturbance. Corresponding to those were the four essential qualities of heat and cold, moisture and dryness, and upon this four-fold division was engrafted by the later physicians the doctrine of the humors which, from the days of Hippocrates almost to our own, dominated medicine. All sorts of magical powers were attributed to Empedocles. The story of Pantheia whom he called back to life after a thirty days' trance has long clung in the imagination. You remember how Matthew Arnold describes him in the well-known poem, "Empedocles on Etna" -

But his power
Swells with the swelling evil of this time,
And holds men mute to see where it will rise.
He could stay swift diseases in old days,
Chain madmen by the music of his lyre,
Cleanse to sweet airs the breath of poisonous streams,
And in the mountain-chinks inter the winds.
This he could do of old -

a quotation which will give you an idea of some of the powers attributed to this wonder-working physician.

About the Author

William Osler (1849 - 1919) was a Canadian physician. He has been called one of the greatest icons of modern medicine and the Father of Modern Medicine (which is what he himself considered Avicenna to be).