Greek Medicine : Part 3

The Evolution of Modern Medicine
by William Osler

(Page 5 of 18)

But of no one of the men of this remarkable circle have we such definite information as of the Crotonian physician Democedes, whose story is given at length by Herodotus; and his story has also the great importance of showing that, even at this early period, a well-devised scheme of public medical service existed in the Greek cities. It dates from the second half of the sixth century B.C. - fully two generations before Hippocrates. A Crotonian, Democedes by name, was found among the slaves of Oroetes. Of his fame as a physician someone had heard and he was called in to treat the dislocated ankle of King Darius. The wily Greek, longing for his home, feared that if he confessed to a knowledge of medicine there would be no chance of escape, but under threat of torture he undertook a treatment which proved successful.

Then Herodotus tells his story - how, ill treated at home in Crotona, Democedes went to Aegina, where he set up as a physician and in the second year the State of Aegina hired his services at the price of a talent. In the third year, the Athenians engaged him at 100 minae; and in the fourth, Polycrates of Samos at two talents. Democedes shared the misfortunes of Polycrates and was taken prisoner by Oroetes. Then Herodotus tells how he cured Atossa, the daughter of Cyrus and wife of Darius, of a severe abscess of the breast, but on condition that she help him to escape, and she induced her husband to send an expedition of exploration to Greece under the guidance of Democedes, but with the instructions at all costs to bring back the much prized physician.

From Tarentum, Democedes escaped to his native city, but the Persians followed him, and it was with the greatest difficulty that he escaped from their hands. Deprived of their guide, the Persians gave up the expedition and sailed for Asia. In palliation of his flight, Democedes sent a message to Darius that he was engaged to the daughter of Milo, the wrestler, who was in high repute with the King.

Nostalgy Atossa, child of Cyrus king of kings, healed by Greek science of a morbid breast, gave lord Dareios neither love nor rest till he fulfilled her vain imaginings. "Sir, show our Persian folk your scepter's wings! Enlarge my sire's and brother's large bequest. This learned Greek shall guide your galleys west, and Dorian slave-girls grace our banqueting." So said she, taught of that o'er-artful man, the Italiote captive, Kroton's Demokede, who recked not what of maladies began, nor who in Asia and in Greece might bleed, if he - so writes the guileless Thurian - regained his home, and freedom of the Mede.

Plato has several references to these state physicians, who were evidently elected by a public assembly: "When the assembly meets to elect a physician," and the office was yearly, for in "The Statesman" we find the following: "When the year of office has expired, the pilot, or physician has to come before a court of review" to answer any charges. The physician must have been in practice for some time and attained eminence, before he was deemed worthy of the post of state physician.

"If you and I were physicians, and were advising one another that we were competent to practice as state-physicians, should I not ask about you, and would you not ask about me, Well, but how about Socrates himself, has he good health? and was anyone else ever known to be cured by him whether slave or freeman?"

All that is known of these state physicians has been collected by Pohl, who has traced their evolution into Roman times. That they were secular, independent of the Aesculapian temples, that they were well paid, that there was keen competition to get the most distinguished men, that they were paid by a special tax and that they were much esteemed - are facts to be gleaned from Herodotus and from the inscriptions. The lapidary records, extending over 1000 years, collected by Professor Oehler of Reina, throw an important light on the state of medicine in Greece and Rome. Greek vases give representations of these state doctors at work. Dr. E. Pottier has published one showing the treatment of a patient in the clinic.

That dissections were practiced by this group of nature philosophers is shown not only by the studies of Alcmaeon, but we have evidence that one of the latest of them, Diogenes of Apollonia, must have made elaborate dissections. In the "Historia Animalium" of Aristotle occurs his account of the blood vessels, which is by far the most elaborate met with in the literature until the writings of Galen. It has, too, the great merit of accuracy (if we bear in mind the fact that it was not until after Aristotle that arteries and veins were differentiated), and indications are given as to the vessels from which blood may be drawn.

Asklepios

No god made with hands, to use the scriptural phrase, had a more successful "run" than Asklepios - for more than a thousand years the consoler and healer of the sons of men. Shorn of his divine attributes he remains our patron saint, our emblematic God of Healing, whose figure with the serpents appears in our seals and charters. He was originally a Thessalian chieftain, whose sons, Machaon and Podalirius, became famous physicians and fought in the Trojan War. Nestor, you may remember, carried off the former, declaring, in the oft-quoted phrase, that a doctor was better worth saving than many warriors unskilled in the treatment of wounds. Later genealogies trace his origin to Apollo, as whose son he is usually regarded. "In the wake of northern tribes this god Aesculapius - a more majestic figure than the blameless leech of Homer's song - came by land to Epidaurus and was carried by sea to the east-ward island of Cos.... Aesculapius grew in importance with the growth of Greece, but may not have attained his greatest power until Greece and Rome were one."

A word on the idea of the serpent as an emblem of the healing art which goes far back into antiquity. The mystical character of the snake, and the natural dread and awe inspired by it, early made it a symbol of supernatural power. There is a libation vase of Gudea, c. 2350 B.C., found at Telloh, now in the Louvre (probably the earliest representation of the symbol), with two serpents entwined round a staff. From the earliest times the snake has been associated with mystic and magic power, and even today, among native races, it plays a part in the initiation of medicine men.

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).