CATHOLIC ENCYCLOPEDIA: History of Medicine Search: Submit Search Home Encyclopedia Summa Fathers Bible Library A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Home > Catholic Encyclopedia > M > History of Medicine History of Medicine Please help support the mission of New Advent and get the full contents of this website as an instant download. Includes the Catholic Encyclopedia, Church Fathers, Summa, Bible and more — all for only $19.99... The history of medical science, considered as a part of the general history of civilization, should logically begin in Mesopotamia, where tradition and philological investigation placed the cradle of the human race. But, in a condensed article such as this, there are important reasons which dictate the choice of another starting point. Modern medical science rests upon a Greek foundation, and whatever other civilized peoples may have accomplished in this field lies outside our inquiry. It is certain that the Greeks brought much with them from their original home, and also that they learned a great deal from their intercourse with other civilized countries, especially Egypt and India; but the Greek mind assimilated knowledge in such a fashion that its origin can rarely be recognized. Mythical, Homeric, and pre-Hippocratic times Greek medical science, like that of all civilized peoples, shows in the beginning a purely theurgical character. Apollo is regarded as the founder of medical science, and, in post-Homeric times, his son Æsculapius (in Homer, a Thessalian prince) is represented, as the deity whose office it is to bring about man's restoration to health by means of healing oracles. His oldest place of worship was at Tricca in Thessaly. The temples of Æsculapius, of which those at Epidaurus and Cos are the best known, were situated in a healthy neighbourhood. The sick pilgrims went thither that, after a long preparation of prayer, fasting and ablutions, they might, through of mediation of the priests, receive in their dreams the healing oracles. This kind of medical science already shows a rational basis, for the priests interpreted the dreams and prescribed a suitable treatment, in most cases purely dietetic. Important records of sicknesses were made and left as votive-tablets in the temples. Side by side with the priestly caste, and perhaps out of it there arose the order of temple physicians, who, as supposed descendants of the god Æsculapius, were known as the Asclepiadae, and formed a kind of guild or corporation. This separation of offices must have occurred at an early time, for even in Homer we find lay physicians mentioned, especially "the sons of Æseulapius", Machaon and Podalirius. In the vegetable drugs of Egyptian origin mentioned in Homer we recognize the early influence of the country of the Pharaohs upon Greek medical science. The schools of the philosophers likewise exerted no small influence upon development, medical problems being studied by Pythagoras of Samos, Alcmaeon of Crotona, Parmenides of Elea, Heraclitus of Ephesus (sixth century B.C.), Empedocles of Agrigentum, and Anaxagoras of Clazomenae (fifth century B.C.). The earliest medical schools were at Cyrene in Northern Africa, Crotona, Cnidus and Cos. From Cnidus came Euryphon and also Ctesias the geographer, who was at first physician in the army of Cyrus and, after the battle of Cunaxa (401 B.C.), to Artaxerxes Memnon. Of greater interest is the medical school adjoining the shrine of Æseulapius at Cos, for from it arose the man who first placed medicine upon a scientific basis, and whose name is even today well known to all physicians, Hippocrates. Hippocrates and the so-called Corpus Hippocraticum Tradition knows seven physicians named Hippocrates, of whom the second is regarded as the most famous. Of his life we know but little. He was born at Cos in 460 or 459 B.C., and died at Larissa about 379. How great his fame was during his lifetime is shown by the fact that Plato compares him with the artists Polycletus and Phidias. Later he was called "the Great" or "the Divine". The historical kernel is probably as follows: a famous physician of this name from Cos flourished in the days of Pericles, and subsequently many things, which his ancestors or his descendants or his school accomplished, were attributed to him as the hero of medical science. The same was true of his writings. What is now known under the title of "Hippocratis Opera" represents the work, not of an individual, but of several persons of different periods and of different schools. It has thus become customary to designate the writings ascribed to Hippocrates by the general title of the "Hippocratic Collection" (Corpus Hippocraticum), and to divide them according to their origin into the works of the schools of Cnidus and of Cos, and of the Sophists. How difficult it is, however, to determine their genuineness is shown that even in the third century before Christ the Alexandrian librarians, who for the first time collected the anonymous scrolls scattered through Hellas, could not reach a definite conclusion. For the development of medical science it is of little consequence who composed the works of the school of Cos for they are more or less permeated by the spirit of one great master. The secret of his immortality rests on the fact that he pointed out the means whereby medicine became a science. His first rule was the observation of individual patients, individualizing in contradistinction to the schematizing of the school of Cnidus. By the observation of all the principles were gradually derived from experience, and these, uniformly arranged, led by induction to a knowledge of the nature of the disease, its course, and its treatment. This is the origin of the famous "Aphorismi", short rules which contain at times principles derived from experience and at times conclusions drawn from the same source. They form the valuable part of the collection. The school of Cos and its adherents, the Hippocratics, looked upon medical science from a purely practical standpoint; they regarded it as the art of healing the sick, and therefore laid most stress on prognosis and treatment by aiding the powers of nature through dietetic means, while the whole school of Cnidus prided itself upon its scientific diagnosis and, in harmony with money with the East, adopted a varied medicinal treatment. The method which the school of Cos established more than 2000 years ago has proved to be the only one, and thus Hippocratic medial science celebrated its renascence in the eighteenth century with Boerhaave at Leyden and subsequently with Gerhard van Swieten at Vienna. In his endeavour to the truth the earnest investigation often reaches an impassable barrier. There is nothing more tempting than to seek an outlet by means of reflection and deduction. Such a delusive course may easily become fatal to the physicist; but a medical system, erected upon the results of speculative investigation, carries the germ of death within itself. The dogmatic school In their endeavour to complete the doctrine of their great master, the successors of the Hippocratics fell victims to the snares of speculation. In spite of this, we owe to this so-called "dogmatic school" some fruitful investigation. Diocles Carystius advanced the knowledge of anatomy, and tried to fathom the causal connection between symptom and disease, in which endeavours he was imitated by Praxagoras of Cos, who established the diagnostic importance of the pulse. Unfortunately, there already began with Aristotle (38-22 B.C.) that tendency — later rendered so fatal through Galen's teaching — to regard organic structure and function not in accordance with facts but from the teleological standpoint. The Alexandrian period The desire to give to medicine a scientific basis found rich nourishment in the ancient civilized soil of Egypt under the Ptolemies. Herophilus of Chalcedon (about 300 B.C.) and Erasistratus of Iulis (about 330-240 B.C.) are mentioned in this connection. As anatomists, they were the first systematic investigators, and, following Hippocrates, they tried to complete clinical experience by exact methods. This tendency was opposed by the empires, whose services lay solely in the field of drugs and toxicology. Erasistratus as well as Philinus, the empiric, attacked the doctrine of humors (humoral pathology), which developed out of the Hippocratic tendency. The former alone was a serious opponent since, as an anatomist, he looked for the seat of the disease in the solid parts, rather than in the four fundamental humors (blood, mucus, black and yellow gall) and their different mixtures. The methodizers One of the opponents of humoral pathology was Asclepiades of Prusa in Bithynia (born about 124 B.C.). He tried to use in medicine the atomistic theory of Epicurus and Heracleides of Pontus. He taught that health and disease depend upon the motion of the atoms in the fine capillaries or pores, which, endowed with sensation, pass through the entire body. With Themison as their leader, the followers of Asclepiades simplified his doctrine by supposing disease to be only a contraction or relaxation, and later only a mixed condition (partly contracted, partly relaxed) of the pores. This simple and convenient explanation of all diseases without regard to anatomy and physiology, taken in conjunction with its allied system of physical dietetic therapeutics, explains why this doctrine enjoyed so long a life, and why the works of the methodist, Caelius Aurelianus of Sicca in Numidia (beginning of fifth century A.D.), were diligently studied down to the seventh century. Galen Departure from the Hippocratic observation of nature led physicians to form numerous mutually opposing sects. A man of great industry and comprehensive knowledge, Galen of Pergamum (about A.D. 130-201), tried to rescue medical science from this labyrinth. He chose the path of eclecticism, on which he built his (as he thought) infallible system. Whatever sense-perception and clinical observation left obscure, he tried to explain in a speculative manner. That this system of teaching could hold medicine in bondage until modern times shows the genius of the master, who understood how to cover up the gaps by brilliancy of style. Galen took the entire anatomical knowledge of his time, and out of it produced a work the substance of which was for centuries regarded as inviolable. His anatomy was to a large extent based upon the dissection of mammals, especially of monkeys, and, like his physiology, was under teleological influence. His presentation of things lacks dispassionateness. Instead of explaining the functions of organs on the basis of their structure, Galen chose this reverse method. His anatomy and physiology were the most vulnerable part of his system, and an earnest re-examination of these fields must necessarily have shaken his entire scheme of teaching. Galen expressed the greatest respect for Hippocrates, published his most important works with explanatory notes, but never entered into the spirit of the school of Cos, although he adopted many of its doctrines. Galen is the culminating point and end of ancient Greek medical science. In his vanity he thought he had completed all investigation, and that his successors had only to accept without effort what he had discovered. As will be shown in the following paragraph, his advice was, unfortunately for science, followed literally. Pedanius Dioscurides Pedanus Dioscurides, who was from Anazarbe and lived in the time of Nero and Vespasian, may be mentioned here as the most important pharmaceutical writer of ancient times. He simplified greatly the pharmacopoeia, which had then assumed unwieldy dimensions, and freed it from ridiculous, superstitious remedies. Our modern pharmacology is based on his work, Ta ton tylikon biblia. Cornelius Celsus Cornelius Celsus (about 25-30 B.C. to A.D. 45-50) is the only Roman who worked with distinction in the medical field, but it is doubtful whether he was a physician. His work, "De re medica libri viii", which is written in classical Latin, and for which he used seventy-two works lost to posterity, gives a survey of medical science from Hippocrates to imperial times. Very famous is his description lithotomy. Celsus was altogether forgotten until the fifteenth century, when Pope Nicholas V (1447-55) is said to have discovered a manuscript of his works. Byzantine period In Byzantine times medicine shows but little originality, and is of small importance in the history of medical development. The work handed down to us are all compilations, but as they frequently contain excerpts from lost works they are of some historical value. The notable writers of this period are: Oreibasios (325-403), physician in ordinary to Julian the Apostate; and Aëtius of Amida, a Christian physician under Justinian (597-66). A little more originality than these men exhibited was shown by Alexander of Tralles (525-605), and Paulus Ægineta of the first half of the seventh century, of whose seven books, the sixth, dealing with surgery, was greatly valued in Arabian medicine. Paulus lived at Alexandria, and was one of the last to come from its once famous school, which became extinct after the capture of the city by Omar in 640. At the end of the thirteenth century Nicolaus Myrepsus, living at the court in Nicaea, made a collection of prescriptions which was extensively used. In the time of Emperor Andronicus III (1328-42) lived a highly gifted physician, Joannes Actuarius, and the mention of his writings closes the account of this period. Arabian medicine Arabian medical science forms an important chapter in the history of the development of medicine, not because it was especially productive but because it preserved Greek medical science with that of its most important representative Galen. It was, however, strongly influenced by oriental elements of later times. The adherents of the heretic Nestorius, who in 431 settled in Edessa, were the teachers of the Arabs. After the expulsion these Nestorians settled in Dschondisapor in 489, and there founded a medical school. After the conquest of Persia by the Arabs in 650, Greek culture was held in great esteem, and learned Nestorian, Jewish, and even Indian physicians worked diligently as translators of the Greek writings. In Arabian Spain conditions similarly developed from the seventh century. Among important physicians in the first period of Greek-Arabic medicine — the period of dependence and of translations — come first the Nestorian family Bachtischua of Syria, which flourished until the eleventh century; Abu Zakerijja Jahja ben Maseweih (d. 875), known as Joannes Damascenus, Mesue the Elder, a Christian who was a director of the hospital at Bagdad, did independent work, and supervised the translation of Greek authors, Abu Jusuf Jacub ben Ishak ben el-Subbah el-Kindi (Alkindus, 813-73), who wrote a work about compound drugs, and the Nestorian Abu Zeid Honein ben Ishak ben Soliman ben Ejjub el 'Ibadi (Joannitius, 809-about 873), a teacher in Baghdad who translated Hippocrates and Dioscurides, and whose work "Isagoge in artem parvam Galeni", early translated into Latin, was much read in the Middle Ages. Wide activity and independent observation — based, however, wholly upon the doctrine of Galen — were shown by Abu Bekr Muhammed ben Zakarijia er-Razi (Rhazes, about 850-923), whose chief work, however, "El-Hawi fi'l Tib" (Continens) is a rather unsystematic compilation. In the Middle Ages his "Ketaab altib Almansuri" (Liber medicinalis Almansoris) was well known and had many commentators. The most valuable of the thirty-six productions of Rhazes which have come down to us is "De variolis et morbillis", a book based upon personal experience. We ought also to mention the dietetic writer Abu Jakub Ishak ben Soleiman el-Israili (Isaac Judaeus, 830-about 932), an Egyptian Jew; the Persian, Ali ben el Abbas Ala ed-Din el-Madschhusi (Ali Abbas, d. 994) author of "El-Maliki" (Regalis dispositio, Pantegnum). Abu Dshafer Ahmed ben Ibrahim ben Abu Chalid Ihn el-Dshezzar (d. 1009) wrote about the causes of the plague in Egypt. A work on pharmaceutics was written by the physician in ordinary to the Spanish Caliph Hisham II (976-1013), Abu Daut Soleiman ben Hassan Ibn Dsholdschholl. Of the surgical authors, Abu'l Kasim Chalaf ben Abbas el-Zahrewi of el-Zahra near Cordova (Abulkasem, about 912-1013) alone deserves mention, and he depends absolutely on Paulus Ægineta. While he received scant attention at home, since surgery was little cultivated by the Arabs, his work, written in a clear and perspicuous style, became known in the West through the Latin translation by Gerardus of Cremona (1187), and was extensively used even in later days. Arabian medicine reached its culmination with the Persian Abu Ali el-Hosein ben Abdallah Ibn Sina (Avicenna, 980-1037), who based his system entirely upon the teaching of Galen and tried in various ways to supplement the latter. His chief work, "El-Kanûn" (Canon Medicinae), written in a brilliant style and treating all branches of medical science, soon supplanted in the West the works of the Greeks and, until the time of the Humanists, served as the most important textbook for physicians, but in Arabian Spain his fame was small. One of his chief rivals was Abu-Merwan Abd el-Malik ben Abul-Ala Zohr ben Abd el-Malik Ibn Zohr (Avenzoar, 1113-62) from the neighbourhood of Seville. His friend, the philosopher and physician Abul-Welid Muhammed ben-Ahmed Ibn Roshd el-Maliki (Averroës, 1126 -98), of Cordova, is regarded as the complement of Avicenna. His book was also popular in the West and bears the title "Kitâbel-Kolijjat" (Colliget). With the decline of Arabian rule began the decay of medicine. In the Orient this decline began after the capture of Cordova in 1236, decay becoming complete after the loss of Granada in 1492. The predominance of Arabian medicine, which lasted scarcely three centuries, seriously delayed the development of our science. A brief survey of this period shows that the Arabs bent in slavish reverence before the works of Aristotle and Galen without examining them critically. No other Greek physician obtained such a hold on the Arabs as Galen, whose system, perfect in form, pleased them in philosophy. Nowhere did dialectics play a greater part in medicine than among the Arabs and their later followers in the West. Independent investigation in the fields of exact science, anatomy, and physiology was forbidden by the laws of the Koran. Symptomatology (semiotics) at the bedside, especially prognosis, based on the pulse and the of the urine, were developed by them with an equally exaggerated and fruitless subtlety. Much, and perhaps the only credit due to them is in the field of pharmaceutics. We are indebted to them for a series of simple and compound drugs of oriental and Indian origin, previously unknown, and also for the polypharmacy of later times. Until the discovery of America the Venetian drug-trade was controlled by Arabian dealers. Christianity's share in the development of medical science As long as the cruel persecution the Church lasted throughout the Roman Empire, it was impossible for Christians to take direct part in the development of medical science. But provision had been made for medical aid within the community, because the priest, like the rabbi of small Jewish communities in the late Middle Ages, was also a physician. This is clear from the story of the two brothers, Sts. Cosmas and Damian, who studied medicine … truncated (129,085 more characters in archive)