Transcript angelides_ancient medicine.ppt

ANCIENT METITTERANEAN
MEDICINE
N. S. ANGELIDES MD, PhD, FRCS, FACA
Introduction.
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The earliest practice of medicine was
theocratic. The approach to the disease
was magic and priests were also
considered as doctors.
Illness was believed to be the action of
evil spirits.
ANCIENT EGYPTIAN
MEDICINE
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The historian Herodotus wrote that Egypt “is the gift of
the Nile”, meaning that its civilization expanded on the
soil which was formed by the recurrent floods of the
Nile.
Step by step evolution.
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Egypt became an organized nation
about 3000 B.C.
Medicine as a discipline appeared
later when Egypt had an ambitious
Pharaoh named Zoser. His chief
minister was Imhotep.
In the Egyptian writings, Imhotep
was presented as a physician and
was considered as the god of
medicine in Egypt.
Imhotep was the
god of medicine in
Egypt
Medicine in Egypt was associated
with religion and magic.
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All papyri dealt with medicine, gave the
“aroma” of supernatural formulae.
But, Medicine in ancient Egypt
was not at all primitive.
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Some medical papyri were really explanatory.
Among them, the “Edwin Smith Papyrus” and
the “Ebers papyrus” were the most important.
In these ancient papyri many
case histories were found!
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In addition, a great number of internal
pathologies were reported, such as eye
diseases, diabetes and rheumatism.
Later on, physicians in Egypt
were organized in hierarchy.
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They gradually formed a distinct profession,
with the court physicians at the top of the
hierarchy.
ANCIENT GREEK
MEDICINE.
Acropolis is the landmark of
Ancient Greece
The beginning of Greek
Medicine.
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Homer
The history of
ancient Greek
Medicine begins
with “Iliad”, the
Homeric poem,
which is considered
as the oldest written
document in Greek.
Diseases were thought to be
theocratic, sent by gods, to punish
the mankind.
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Apollo.
In "Iliad" Apollo, the god of
light, was considered as the
disperser of epidemics, one
of which was spread upon the
Greek army before the
departure to Troy.
Asclepius.
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Æsculapius
Asclepius, lived in the
thirteenth century BC
and was considered as
the Greek god of
medicine.
His teacher was Chiron,
the Centaur, who was
taught medicine by
Apollo and Artemis.
The symbol of Asclepius.
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A serpent entwined round a
knotted staff is the symbol of
Æsculapius
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The symbol of
Asclepius was a
serpent around a
knotted staff.
Serpents produced
poisons, and had a
reputation for
wisdom as well as
the power of
renovation.
Hygia.
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Goddess
Hygia.
The Greek deity of
Health was Hygia,
known as Salus to the
Romans; she was
considered as the
daughter of Asclepius
and took care of the
sacred serpents.
“Asclepeion”: The Temple of
Asclepius
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Although the history of Asclepius was mixed with
mythology, solid facts were also present:
These facts were the splendid temples devoted to
him, which were always built in lovely and
healthy places.
These places were visited by sick people, and
this is why the priests of the temples also learned
the art of healing.
Τhe “Asclepeion” at
Epidaurus
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The
restored entrance of an
ancient “Asclepeion”
The chief
“Asclepeion” was at
Epidaurus.
Close to “Asclepeion”
there was a
magnificent theatre,
as well as a stadium
built to accommodate
20,000 spectators!
Τhe “Asclepeion” of Cos
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The
“Asclepeion” at Cos as it
is to-day
However, the most
important
“Asclepeion” was
the one in the island
of Cos, the birth
place of
Hippocrates, who is
considered as the
father of Medicine.
Hippocrates, the father of
Medicine.
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Hippocrates
Hippocrates (460 BC-377
BC), according to Mythology,
was a descendant of Zeus
and Hercules from his
mother, and a descendant of
Asclepius from his father .
Demystification of the spiritual
medicine: The great step!
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A
Greek stamp with the
head of Hippocrates.
Hippocrates rescued medicine
from speculation!
He did what no physician had
ever done before: He
examined the sick carefully, he
recorded the signs and
symptoms of the disease and
gave emphasis on the
evidence than on spiritual
causes.
He did not ask "Who is causing
a particular sickness?" but
"how and on what process
does this particular sickness
occur?"
Diagnosis and Prognosis
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Hippocrates always based
his conclusions on the
observations.
He believed that "the best
physician is the one who is
able to establish a prognosis
at the bedside, penetrating
the present, the past, and
the future of his patient”.
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The lunar crater
Hippocrates
in
of “Hippocrates”.
advanced
age.
Observations made by Hippocrates.
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The
famous tree of
Hippocrates in Cos as it is
demonstrated on a Greek
stamp.
Hippocrates classified
diseases into sporadic,
epidemic, and endemic, and
had also separated them
into acute and chronic.
He also divided the causes
of diseases into two
classes: general, such as
climate, water and sanitation
and personal, such as
improper food and absence
of exercise.
Homeric poems as a source
of information.
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Aris,
god of war.
As mentioned already, Greek
heroes in “Iliad” were
wounded regularly at the
battlefields and were in need
of medical treatment. This was
obtained either by the help of
the gods or by doctors.
However, many times, the
wounded heroes managed to
solve the problem by
themselves!
Achilles and wounded
Patroklos.
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War
injury over
Patroklos in Troy.
The picture on the
left shows Achilles
bandaging the
wounded arm of his
close friend
Patroklos with a
white bandage.
(From the British
Archaeological
Museum).
Ancient
Alexandrian
Medicine
The post Alexander the
Grate era.
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When the Empire of Alexander the
Great was subdivided, the Egyptian
share fell to Ptolemy the 1st, who
founded the Alexandrian Library under
the direction of Aristotle.
The School of Alexandria
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Ptolemy gathered a number of educated
men in Alexandria, organizing a system
that resembled a University.
For example, Euclides was the teacher of
Mathematics, and Hipparchus the father
of Astronomy.
Anatomy in Medicine was
inaugurated in Alexandria.
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The early Alexandrian doctors
described the organization of the
human body from actual dissections,
on the basis of the discoveries of
Aristotle in natural history and in
comparative anatomy.
Herophilus and Erasistratus
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Two famous Alexandrian physicians
and anatomists were,
Herophilus (335-280 B.C.), and
Erasistratus (280 B.C.).
Both took part in the early medical
teaching at the Alexandria School.
Anatomical discoveries in
Alexandria
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Herophilus made a lot of anatomical
discoveries;
He also described the connections
between the nerves and the brain,
recognizing the essential difference
between motor and sensory nerves.
Operations carried out in
Alexandria
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Herophilus was also a
good surgeon; he
operated upon the
liver and spleen and
had a good knowledge
of obstetric
operations.
The decline of the medical
School of Alexandria
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A description of the teaching in the
School of Alexandria was given by
Celsus.
However, the foundation of Empiricism
marked the decline of the Medical
School of Alexandria and the
destruction of an era occurred.
Ancient Cypriot
Medicine.
The beginning of Cypriot
Medicine.
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Hippocrates
The history of ancient
Cypriot Medicine started at
the time of Hippocrates.
Sources of information
were the various
archaeological findings,
the writings of ancient
Greek philosophers, as
well as ancient
inscriptions.
Onasilos the “healer”.
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The
“inscription of
Idalium”.
From the “inscription of
Idalium” which is the
oldest and longest ancient
written document found in
Cyprus, we learned that
Stasikipros, the king of the
town, signed an agreement
with a doctor named
Onasilos to treat, free of
charge, all soldiers that
were wounded in the
battles during the siege of
Idalium by the Persian
army. (5th century BC.)
Onasilos, the first military
doctor in Cyprus.
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Head of goddess
Aphrodite found in ancient
Salamina, Cyprus
The war ended with
an unexpected
victory of the Cypriot
army and the king
honoured Onasilos
and his brothers
offering them as a
price fields and
political posts.
Apollonius kitiefs.
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Another famous Cypriot doctor was Apollonius,
who lived in the 1st century B.C. His teacher was
Zoopiros from Alexandria.
He was well known for his antidotes to various
poisons. That is why Mithridates, King of Pontus,
had asked him to prepare for his sake a general
antidote, in order to avoid poisoning. This
preparation was taken in small doses for a
prolonged period and since then this way of
treatment was called “mithridadism”.
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These are the famous
“warmers” made from
terracotta.
They could be applied on
almost any surface of the
body filled with fluid and were
very popular as a mean of
treatment of various
diseases.
Ancient Roman Medicine
This is the centre of
ancient Rome today
Rome’s main source of
knowledge was Greece
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Roman philosophy and Roman medicine were
borrowed from the Greeks, who were well
known for their philosophy, their arts and
their culture.
On the contrary, the Romans were
distinguished for their genius laws and their
governmental status.
Aristotle
In the earlier times and before the
settlement of Greek doctors in
Rome medical care was under the
jurisdiction of the head of the
family.
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The father had great powers by the Roman law,
and he acted as physician as well as judge over
his family!
Archagathus
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The first regular doctor in Rome was
Archagathus, a Greek doctor who began
practicing in the city by 219 B.C.
He was very popular, the Roman
authorities received him favorably and
arranged a surgery for him
surgical instruments
The structure of the Roman
society made medical practice in
ancient Rome difficult
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The lower classes were poor and the
relatively small upper classes were
tyrannical, superstitious, selfish and cruel.
Esculapius
Later on, the number of doctors
was increased, especially
during the reign of Nero.
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Andromachus, as the 1st physician to the
Emperor, had the title of archiater
In general, there were two classes of
archiaters:
archiatri sancti palati, and
archiatri populares.
The former attended the Emperor; the latter
attended the people.
The most eminent doctor
of Rome was Claudius
Galen, Greek in origin.
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He went to Rome for the first time in 163 AD.
Galen had probably influenced the progress of
medical science by his writings more than any
other medical writer.
In his youth he was initiated into the idealism
of Plato, the realism of Aristotle, the skepticism
of the Epicureans, and the materialism of the
Stoics.
Galen
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Galen was also an admirer of Hippocrates.
His actions were based on Hippocrates
principles, and he manage to expand and
support his ideas and discoveries by new
facts and new observations.
Roman doctors had many
tools in use.
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Some of these were:
The vaginal speculum (dioptra in Greek)
The cautery (kauterion in Greek) and
the various hooks.
A spectacular viginal
dilator
The Romans also used
techniques that killed germs!
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Although they did not understand how germs
were related to the diseases, they boiled their
tools before using them!
And they used "acetum" an antiseptic, to
clean and wash all wounds.
Gymnastics,
water supply and
baths as a
medical tool in
ancient Greece
and the Roman
empire
Gymnastics in ancient
Greece and Rome
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had a very high
reputation and were
also used for medical
purposes.
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The exercises were applied mainly by
the Greeks, and the baths were
applied mainly by the Romans.
The water supply.
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In ancient Greece, the
cities were supplied with
water from springs.
The Greek aqueducts
were simple channels cut
in the rock.
On the contrary in Rome, the water was carried
from a long distance, with magnificent aqueducts.
Near Tarragona, Spain
The important factor about these aqueducts is
that no machinery was used to pump the water!
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This is the magnificent Roman “Pont
Du Diable” in France.
and this is the aqueduct system in Segovia, Spain.
A similar one exists in Cavalla, Greece.
Baths were always very popular in the
whole Roman Empire.
These are the Baths of
Caracalla
Thermae
They could
accommodate 3,200
bathers!
of Diocletian
*From the medical point of
view, baths in Rome were
used for the treatment of
various diseases, and also
for physical culture.
*But their legitimate use
became increasingly limited,
and their abuse promoted
the decay of the Roman
Empire.
In summary
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Great civilizations were developed in the
Mediterranean region in ancient times,
giving to this area the reputation of being
the Cradle of Civilization.
Medicine had a long history in the
Mediterranean. It goes back to the
ancient Egyptians; later on to the ancient
Greeks, to continue with the descendants
of Alexander the Great and with the
Romans.
Thank you
for your
attention!