Greek Biology & Greek Medicine

by Charles Singer

Fig. 8. VOTIVE TABLET representing cupping and bleeding instruments from Temple of Asclepius at Athens.

In centre is represented a folding case containing scalpels of various forms. On either side are cupping vessels.

With the second century of the Christian era we terminate the creative period of Greek medicine. We are provided with the works of four important writers of this century, of whom three, Rufus of Ephesus, Soranus of Ephesus, and Aretaeus of Cappadocia, though valuable for forming a picture of the state of medicine in their day, were without substantial influence on the course of medicine in later ages.

Rufus of Ephesus, a little junior to Dioscorides, has left us the first formal work on human anatomy and is of some importance in the history of comparative anatomy. In medicine he is memorable as the first to have described bubonic plague, and in surgery for his description of the methods of arresting haemorrhage and his knowledge of the anatomy of the eye. A work by him On gout was translated into Latin in the sixth century, but remained unknown till modern times.

Soranus of Ephesus (a. d. c. 90-c. 150), an acute writer on gynaecology, has left a book which illustrates well the anatomy of his day. It exercised an influence for many centuries to come, and a Latin abstract of it prepared about the sixth century by one Moschion has come down to us in an almost contemporary manuscript.[133] It is interesting as opposing the Hippocratic theory that the male embryo is originated in the right and the female in the left half of the womb, a fallacy derived originally from Empedocles and Parmenides, but perpetuated by Latin translations of the Hippocratic treatises until the seventeenth century. His work was adorned by figures, and some of these, naturally greatly altered by copyists, but still not infinitely removed from the facts, have survived in a manuscript of the ninth century, and give us a distant idea of the appearance of ancient anatomical drawings.[134] We may assist our imagination a little further, in forming an idea of what such diagrams were like, with the help of certain other mediaeval figures representing the form and distribution of the various anatomical ‘systems’, veins, arteries, nerves, bones, and muscles which are probably traceable to an Alexandrian origin.[135]

Aretaeus of Cappadocia was probably a contemporary of Galen (second half of the second century a. d.). As a clinical author his reputation stands high, perhaps too high, his descriptions of pneumonia, emphysema, diabetes, and elephantiasis having especially drawn attention. In treatment he uses simple remedies, is not affected by polypharmacy, and suggests many ingenious mechanical devices. It would appear that Aretaeus is not an independent writer, but mainly a compiler. He relies largely on Archigenes, a distinguished physician contemporary with Juvenal, whose works have perished save the fragments preserved in this manner by Aretaeus and Aetius. Aretaeus was a very popular writer among the Greeks in all ages, but he was not translated into Latin, and was unknown in the West until the middle of the sixteenth century.[136] He is philologically interesting as still using the Ionic dialect.

There remains the huge overshadowing figure of Galen. The enormous mass of the surviving work of this man, the dictator of medicine until the revival of learning and beyond, tends to throw out of perspective the whole of Greek medical records. The works of Galen alone form about half of the mass of surviving Greek medical writings, and occupy, in the standard edition, twenty-two thick, closely-printed volumes. These cover every department of medicine, anatomy, physiology, pathology, medical theory, therapeutics, as well as clinical medicine and surgery. In style they are verbose and heavy and very frequently polemical. They are saturated with a teleology which, at times, becomes excessively tedious. In the anatomical works, masses of teleological explanation dilute the account of often imperfectly described structures. Yet to this element we owe the preservation of the mass of Galen’s works, for his intensely teleological point of view appealed to the theological bias both of Western Christianity and of Eastern Islam. Intolerable as literature, his works are a valuable treasure house of medical knowledge and experience, custom, tradition, and history.

As in the case of the Hippocratic corpus, so in the case of the Galenic corpus we are dealing to some extent with material from various sources. In the case of Galen, however, we have a good standard of genuineness, for he has left us a list of his books which can be checked off against those which we actually possess. The general standpoint of the Galenic is not unlike that of the Hippocratic writings, but the noble vision of the lofty-minded, pure-souled physician has utterly passed away. In his place we have an acute, honest, very contentious fellow, bristling with energy and of prodigious industry, not unkindly, but loving strife, a thoroughly ‘aggressive’ character. He loves truth, but he loves argument quite as much. The value of his philosophical writings, of which some have survived, cannot be discussed here, but it is evident that he is frequently satisfied with purely verbal explanations. An ingenious physiologist, a born experimenter, an excellent anatomist and eager to improve, possessing a good knowledge of the human skeleton and an accurate acquaintance with the internal parts so far as this can be derived from a most industrious devotion to dissection of animals, equipped with all the learning of the schools of Pergamon, Smyrna, and Alexandria, and rich with the experience of a vast practice at Rome, Galen is essentially an ‘efficient’ man. He has the grace to acknowledge constantly and repeatedly his indebtedness to the Hippocratic writings. Such was the man whose remains, along with the Hippocratic collection, formed the main medical legacy of Greece to the Western world.

Some of Galen’s works are mere drug lists, little superior to those of Dioscorides;[137] with the depression of the intelligence that corresponded with the break up of the Roman Empire, it was these that were chiefly seized on and distributed in the West. Attractive too to the debased intellect of the late Roman world were certain spurious, superstitious, and astrological works that circulated in the name of Galen and Hippocrates.[138] The Greek medical writers after Galen were but his imitators and abstractors, but through some of them Galen’s works reached the West at a very early period in the Middle Ages. Such abstractors who were early translated into Latin were Oribasius (325-403), Paul of Aegina (625-690), and Alexander of Tralles (525-605). Of the best and most scientific of Galen’s works the Middle Ages knew little or nothing.