Hippocrates
and Galen. If the work of Hippocrates be taken as representing the foundation upon which the edifice of historical Greek medicine was reared, then the work of Galen, who lived some six hundred years later, may be looked upon as the summit or apex of the same edifice. Galen’s merit is to have crystallised or brought to a focus all the best work of the Greek medical schools which had preceded his own time. It is essentially in the form of Galenism that Greek medicine was transmitted to after ages.
The Beginnings
of
Medicine
in Greece. The ancient Greeks referred the origins of medicine to a god Asklepios (called in Latin Aesculapius), thereby testifying to their appreciation of the truly divine function of the healing art. The emblem of Aesculapius, familiar in medical symbolism at the present day, was a staff with a serpent coiled round it, the animal typifying wisdom in general, and more particularly the wisdom of the medicine-man, with his semi-miraculous powers over life and death.
[Pg x] “Be ye therefore wise as serpents and harmless as doves.”
The Asclepiea
or
Health-Temples. The temples of Aesculapius were scattered over the ancient Hellenic world. To them the sick and ailing resorted in crowds. The treatment, which was in the hands of an hereditary priesthood, combined the best of the methods carried on at our present-day health-resorts, our hydropathics, sanatoriums, and nursing-homes. Fresh air, water-cures, massage, gymnastics, psychotherapy, and natural methods in general were chiefly relied on.
Hippocrates
and the
Unity of the
Organism. Hippocrates, the “Father of Medicine” (5th to 4th centuries, B.C.) was associated with the Asclepieum of Cos, an island off the south-west coast of Asia Minor, near Rhodes. He apparently revitalized the work of the health-temples, which had before his time been showing a certain decline in vigour, coupled with a corresponding excessive tendency towards sophistry and priestcraft.
Celsus says: “Hippocrates Cous primus quidem ex omnibus memoria dignis ab studio sapientiae disciplinam hanc separavit.” He means that Hippocrates first gave the physician an independent standing, separating him from the cosmological speculator. Hippocrates confined the medical man to medicine. He did with medical thought what Socrates did with thought in general—he “brought it down from heaven to earth.” His watchword was “Back to Nature!”
At the same time, while assigning the physician his post, Hippocrates would not let him regard that post as sacrosanct. He set his face against any [Pg xi] tendency to mystery-mongering, to exclusiveness, to sacerdotalism. He was, in fact, opposed to the spirit of trade-unionism in medicine. His concern was rather with the physician’s duties than his “rights.”
At the dawn of recorded medical history Hippocrates stands for the fundamental and primary importance of seeing clearly—that is of clinical observation. And what he observed was that the human organism, when exposed to certain abnormal conditions—certain stresses—tends to behave in a certain way: that in other words, each “disease” tends to run a certain definite course. To him a disease was essentially a process, one and indivisible, and thus his practical problem was essentially one of prognosis—“what will be the natural course of this disease, if left to itself?” Here he found himself to no small extent in opposition with the teaching of the neighbouring medical school of Cnidus, where a more static view-point laid special emphasis upon the minutiae of diagnosis.
Observation taught Hippocrates to place unbounded faith in the recuperative powers of the living organism—in what we sometimes call nowadays the vis medicatrix Naturae. His observation was that even with a very considerable “abnormality” of environmental stress the organism, in the large majority of cases, manages eventually by its own inherent powers to adjust itself to the new conditions. “Merely give Nature a chance,” said the father of medicine in effect, “and most [Pg xii] diseases will cure themselves.” And accordingly his treatment was mainly directed towards “giving Nature a chance.”
His keen sense of the solidarity (or rather, of the constant interplay) between the organism and its environment (the “conditions” to which it is exposed) is instanced in his book, “Airs, Waters, and Places.” As we recognise, in our popular everyday psychology, that “it takes two to make a quarrel,” so Hippocrates recognised that in pathology, it takes two (organism and environment) to make a disease.