Abstract
Asclepius was the Greek god of healing and medicine. 1 Believed to be the son of Apollo, who entrusted him to the centaur, half man and half horse, Chiron (or Cheiron), to educate him in medicine. Incidentally, the tie of the Royal College of Physicians of Edinburgh has adopted an image of the centaur. 2 The earliest record is in Homer's Iliad around the 8th century BC. Many temples were built to venerate Asclepius, a notable one being at Epidaurus. However, by the 5th century BC healers began to turn their attention away from veneration of the god. Nevertheless it seems possible that the belief in Asclepius may have persisted for several generations in some communities. Recently the author noted in the Naples Archaeological Museum a small statue of Asclepius found in the ruins of Pompeii of 79 AD!
The change came with the introduction of Hippocratic medicine. Much has been written about Hippocrates, the man and his work, and there are several accessible and noteworthy texts on the subject, for example Phillips, 3 Lloyd 4 and Cruse. 5 Hippocrates was born on the island of Kos (c 460 BC), one of the Dodecanese islands opposite Halicarnassus, the birthplace of Herodotus, now the Turkish resort of Bodrum. He died (c370 BC) at Larissa as an old man. Some 60 or 70 works on medicine in Ionic Greek have been attributed to him though probably only half a dozen were actually written by him. Even nowadays several aphorisms are attributed to him: ‘Life is short, art is long’ and several medical conditions: clubbing of the fingers in lung disease (sometimes referred to now as ‘Hippocratic fingers’) and facial appearance in the very ill (‘Hippocratic facies’). However it is in relation to the causes of disease and in his holistic approach to patients that he made his most significant contributions.
Empedocles of Agrigentum (Acragas) in Sicily (c492-432 BC), a philosopher and healer, proposed that everything was composed of four basic elements: earth, air, fire and water, or cold, dry, hot and wet. From this idea the Hippocratic School derived the concept of the four humours:
hot & wet = Blood hot & dry = Yellow Bile cold & wet = Phlegm cold & dry = Black Bile
Hippocrates and his followers believed disease was caused by an imbalance of humours resulting from diet, weather, and occupation.
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In somewhat earlier times second cousin marriages are well documented in Sparta,
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and in classical Athens first-cousin marriages were favoured.
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We now know this could have caused certain inherited conditions. However a clear understanding of the underlying nature of many diseases was hampered at the time of Hippocrates by a lack of anatomical knowledge. In Greece human dissection was prohibited, at least until the third century BC, until the time of Herophilus of Chalcedon and Erasistratus of Chios. Nevertheless Hippocratic medicine continued to be followed and taught in many countries until at least the 18th century. This may have been influenced to some extent by the acceptance of Hippocratic medicine by the early Christian Church particularly in regard to its emphasis on compassionate healing (though in the belief that Jesus cured disease, not doctors) and against abortion.
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Having reviewed very briefly some of the main ideas of Hippocratic Medicine, many consider the most important legacy to be the Oath (OPKOΣ) which has been recently discussed in detail by Greek scholars. 10 At the time of Hippocrates the Oath was taken with a sworn pledge to Apollo, Asclepius, and Hygeia and Panacea (daughters of Asclepius).
The essentials of the Oath can be summarised as:
I will apply the regimens of treatment according to my ability and judgment for the benefit of my patients and protect them from harm and injustice I will not give a lethal drug to anyone who asks for it, nor will I make suggestions to this effect. Similarly, I will not give to a woman a pessary to cause an abortion. I will keep my life and my Art in purity and holiness. I will not do surgery, not even on sufferers from stones, but I will let this be done by practitioners of this kind of work. Into whatever house I enter, I will do so only for the benefit of the sick, and I will abstain from every intentional injustice and harm, and in particular of sexual acts upon the bodies of women and of men, be they free or slaves. Whatever I may say or hear in the course of a treatment, or even unrelated to treatment, in regard to the lives of men that should not be spoken of abroad, I will keep to myself, holding such things in confidence.
Nowadays we would not necessarily agree with every one of these precepts. However it has recently been argued convincingly that the view of Hippocrates of the importance of the individual – not merely as a subject of diagnosis and therapy, but as a whole person - is as important today as ever.
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