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Ancient Greek Medicine › Ancient History

Definition and Origins

by Mark Cartwright
published on 11 April 2018
Hygieia ()


In ancient Greek medicine illness was initally regarded as a divine punishment and healing as, quite literally, a gift from the gods. However, by the 5th century BCE, there were attempts to identify the material causes for illnesses rather than spiritual ones and this led to a move away from superstition towards scientific enquiry, although, in reality, the two would never be wholly separated. Greek medical practitioners, then, began to take a greater interest in the body itself and to explore the connection between cause and effect, the relation of symptoms to the illness itself and the success or failure of various treatments.

GREEK VIEWS ON HEALTH

Greek medicine was not a uniform body of knowledge and practice but rather a diverse collection of methods and beliefs which depended on such general factors as geography and time period and more specific factors such as local traditions and a patient's gender and social class. Nevertheless, common threads running through Greek medical thought included a preoccupation with the positive and negative effects of diet and a belief that the patient could actually do something about their complaint, in contrast to a more fatalistic and spiritual mindset of earlier times.

FOR THE ANCIENT GREEKS, THERE COULD BE BOTH A DIVINE & A PHYSICAL CAUSE OR REMEDY FOR ILLNESSES.

However, the distinction between the spiritual and physical worlds are often blurred in Greek medicine, for example, the god Asclepius was considered a dispenser of healing but also a highly skilled practical doctor. The god was called upon by patients at his various sanctuaries (notably Epidaurus ) to give the patient advice through dreams which the site practitioners could then act upon. Grateful patients at the site often left monuments which reveal some of the problems that needed to be treated, they include blindness, worms, lameness, snakebites and aphasia. As Epidaurus illustrates, there could, then, be both a divine and a physical cause or remedy for illnesses.
Lifestyle and such factors as heat, cold and trauma were discovered to be important factors in people's health and they could alleviate or worsen the symptoms of an illness or the illness itself. It was also recognised that a person's physical constitution could also affect the severity of, or susceptibility to, an illness. There was also a growing belief that a better understanding of the causes of an illness' symptoms could help in the fight against the illness itself. With a greater knowledge of the body there also came a belief that the balance of the various fluids (humours) within it could be a factor in causing illness. So too, the observation of symptoms and their variations became a preoccupation of the Greek doctor.

GREEK MEDICAL SOURCES

Textual sources on Greek medical practice begin with scenes from Homer ’s Iliad where the wounded in the Trojan War are treated, for example, Patroclus cleaning Eurypylus' wound with warm water. Medical matters and doctors are also frequently mentioned in other types of Greek literature such as comedy plays but the most detailed sources come from around 60 treatises often attributed to Hippocrates (5th to 4th century BCE), the most famous doctor of all. However, none of these medical treatises can be confidently ascribed to Hippocrates and next to nothing is known about him for certain.
Statue of Asklepios

Statue of Asklepios

The Hippocratic texts deal with all manner of medical topics but can be grouped into the main categories of diagnosis, biology, treatment and general advice for doctors. Another source is the fragmentary texts from the Greek natural philosophy corpus dating from the 6th to 5th century BCE. Philosophers in general, seeing the benefits of good health on the mind and soul, were frequently concerned either directly or indirectly with the human body and medicine. These thinkers include Plato (especially in Timaeus ), Empedocles of Acragas, Philistion of Locri and Anaxagoras.

DOCTORS & PRACTITIONERS

As there were no professional qualifications for medical practitioners then anyone could set themselves up as a doctor and travel around looking for patients on whom to practise what was known as the tekhnē of medicine (or art, albeit a mysterious one). The Spartans did, though, have specific personnel responsible for medical care in their professional army. Also, practitioners do seem to have generally enjoyed a high regard despite the lack of a recognised professional body to supervise and train would-be doctors and the odd mad doctor that crops up in Greek Comedy. As Homer states in the Iliad (11.514), 'a doctor is worth many other men'. Not only doctors gave medical advice and treatment but other groups who could utilise their practical experience such as midwives and gym trainers.

THE HIPPOCRATIC OATH WAS ACTUALLY A RELIGIOUS DOCUMENT ENSURING A DOCTOR OPERATED WITHIN & FOR COMMUNITY VALUES.

The famous Hippocratic Oath was probably reserved for a select group of doctors and it was actually a religious document ensuring a doctor operated within and for community values. With the Oath the practitioner swore by Apollo, Hygieia and Panacea to respect their teacher and not to administer poison, abuse patients in any way, use a knife or break the confidentiality between patient and doctor.
Famous medical practitioners included the 4th century BCE figures of Diocles of Carystus (who had a head bandage and spoon instrument for removing arrowheads named after him), Praxagoras of Cos (noted for his 'discovery' of the pulse and being the first to distinguish veins from arteries), and the Athenians Mnesitheus and Dieuches. These experts in their field could examine a patient's face and make a diagnosis helped by information such as the patient's diet, bowel movements, appetite and sleeping habits. Treatments often utilised natural plants such as herbs and roots but could also include the use of amulets and charms. Surgery was generally avoided as it was considered too risky but minor operations may have been carried out, especially on soldiers wounded in battle.

MEDICAL TREATMENTS: WAR

Wounded soldiers were actually one of the best ways for a doctor to learn his trade and widen his knowledge of the human body and its internal workings. There was probably also less risk of the soldier causing problems if things went wrong, which could happen with private patients. Aside from the health problems which may also have affected civilians such as malnutrition, dehydration, hypothermia, fever and typhoid, those doctors treating soldiers had to deal with wounds made by swords, spears, javelins, arrows and projectiles from slings. Medical practitioners knew the importance of removing foreign bodies such as arrowheads from the wound and the necessity to properly clean the wound (which is why arrowheads became barbed to be more difficult to remove and therefore more lethal). Greek doctors knew that it was important to stop excessive blood loss as soon as possible in order to prevent haemorrhage (although they also thought blood-letting could be beneficial too). Surgery may also have included the use of opium as an anaesthetic, although the many references in literature to patients being held down during surgery would suggest that the use of anaesthetic was rare.
Caduceus

Caduceus

Post-operation, wounds were closed using stitches of flax or linen thread and the wound dressed with linen bandages or sponges, sometimes soaked in water, wine, oil or vinegar. Leaves could also be used for the same purpose and wounds may also have been sealed using egg-white or honey. Post-operation treatment was also considered - the importance of diet, for example, or the use of plants with anti-inflammatory properties such as celery.

DISCOVERIES & DEVELOPMENTS

Over time doctors came to acquire a basic knowledge of human anatomy, assisted, no doubt, by the observation of grievously wounded soldiers and, from the 4th century BCE, animal dissection. However, some claimed this was useless as they believed the inner body changed on contact with air and light and still others, as today, protested that using animals for such purposes was cruel. Human dissection would have to wait until Hellenistic times when such discoveries as the full nervous system were discovered. Nevertheless, there was an increasing urge to discover what made a healthy body function well rather than what had made an unhealthy one break down. The lack of practical knowledge, though, did result in some fundamental errors such as Aristotle ’s belief that the heart and not the brain controlled the body and the idea proposed in the treatise On Ancient Medicine (5th century BCE) that physical pain arises from the body's inability to assimilate certain foods.
Greek medical practice may have included errors, perhaps many and probably even fatal ones, but Greek practitioners had started the medical profession in the right direction. Observation, experience and experimentation meant that those who followed in Hellenistic and Roman times such as Galen and Celsus could continue their enquiries along the long road towards greater and more accurate scientific knowledge of the human body, the illnesses it is susceptible to, and the potential cures available.

Fall of the Western Roman Empire › Antique Origins

Ancient Civilizations

by Donald L. Wasson
published on 12 April 2018


To many historians, the fall of the Western Roman Empire in the 5th century CE has always been viewed as the end of the ancient world and the onset of the Middle Ages, often improperly called the Dark Ages, despite Petrarch's assertion. Since much of the west had already fallen by the middle of the 5th century CE, when a writer speaks of the fall of the empire, he or she generally refers to the fall of the city of Rome. Although historians generally agree on the year of the fall, 476 CE, they often disagree on its causes. English historian Edward Gibbon, who wrote in the late 18th century CE, points to the rise of Christianity and its effect on the Roman psyche while others believe the decline and fall were due, in part, to the influx of 'barbarians' from the north and west.
Whatever the cause, whether it was religion, external attack, or the internal decay of the city itself, the debate continues to the present day; however, one significant point must be established before a discussion of the roots of the fall can continue: the decline and fall were only in the west. The eastern half - that which would eventually be called the Byzantine Empire - would continue for several centuries, and, in many ways, it retained a unique Roman identity.
Roman Empire under Augustus

Roman Empire under Augustus

EXTERNAL CAUSES

One of most widely accepted causes - the influx of a barbaric horde - is discounted by some who feel that mighty Rome, the eternal city, could not have so easily fallen victim to a culture that possessed little or nothing in the way of a political, social or economic foundation. They believe the fall of Rome simply came because the barbarians took advantage of difficulties already existing in Rome - problems that included a decaying city (both physically and morally), little to no tax revenue, overpopulation, poor leadership, and, most importantly, inadequate defense. To some the fall was inevitable.

UNLIKE THE FALL OF EARLIER EMPIRES SUCH AS THE ASSYRIAN & PERSIAN, ROME DID NOT SUCCUMB TO EITHER WAR OR REVOLUTION.

Unlike the fall of earlier empires such as the Assyrian and Persian, Rome did not succumb to either war or revolution. On the last day of the empire, a barbarian member of the Germanic tribe Siri and former commander in the Roman army entered the city unopposed. The one-time military and financial power of the Mediterranean was unable to resist. Odovacar easily dethroned the sixteen-year-old emperor Romulus Augustalus, a person he viewed as posing no threat. Romulus had recently been named emperor by his father, the Roman commander Orestes, who had overthrown the western emperor Julius Nepos.With his entrance into the city, Odovacar became the head of the only part that remained of the once great west: the peninsula of Italy. By the time he entered the city, the Roman control of Britain, Spain, Gaul, and North Africa had already been lost to the Goths and Vandals. Odovacar immediately contacted the eastern emperor Zeno and informed him that he would not accept that title of emperor. Zeno could do little but accept this decision. In fact, to ensure there would be no confusion, Odovacar returned to Constantinople the imperial vestments, diadem, and purple cloak of the emperor.

INTERNAL CAUSES

There are some who believe, like Gibbon, that the fall was due to the fabric of the Roman citizen. If one accepts the idea that the cause of the fall was due, in part, to the possible moral decay of the city, its fall is reminiscent of the “decline” of the Republic centuries earlier. Historian Polybius, a 2nd century BCE writer, pointed to a dying republic (years before it actually fell) - a victim of its declining moral virtue and the rise of vice within. Edward Gibbon reiterated this sentiment (he diminished the importance of the barbaric threat) when he claimed the rise of Christianity as a factor in the “tale of woe” for the empire. He held the religion sowed internal division and encouraged a “turn-the-other-cheek mentality” which ultimately condemned the war machine, leaving it in the hands of the invading barbarians. Those who discount Gibbon's claim point to the existence of the same religious zealots in the east and the fact that many of the barbarians were Christian themselves.
Roman Priest

Roman Priest

To Gibbon the Christian religion valued idle and unproductive people. Gibbon wrote in his book The History of Decline and Fall of the Roman Empire,
A candid but rational inquiry into the progress and establishment of Christianity, may be considered as a very essential part of the history of the Roman empire. While this great body was invaded by open violence, or undermined by slow decay, a pure and humble religion greatly insinuated itself into the minds of men, grew up in silence and obscurity, derived new vigour from opposition, and finally erected the triumphant banner of the cross on the ruins of the Capitol.”
He added that the Roman government appeared to be “odious and oppressive to its subjects” and therefore no serious threat to the barbarians.
Gibbon, however, does not single out Christianity as the only culprit. It was only one in a series that brought the empire to its knees. In the end, the fall was inevitable:
…the decline of Rome was the natural and inevitable effect of immoderate greatness. Prosperity ripened the principle of decay; the causes of destruction multiplied with the extent of conquest, and as soon as time or accident has removed artificial supports, the stupendous fabric yielded to the pressure of its own weight.

A DIVIDED EMPIRE

Although Gibbon points to the rise of Christianity as a fundamental cause, the actual fall or decline could be seen decades earlier. By the 3rd century CE, the city of Rome was no longer the center of the empire - an empire that extended from the British Isles to the Tigris and Euphrates Rivers and into Africa. This massive size presented a problem and called for a quick solution, and it came with the reign of Emperor Diocletian. The empire was divided into two with one capital remaining at Rome and another in the east at Nicomedia; the eastern capital would later be moved to Constantinople, old Byzantium, by Emperor Constantine. The Senate, long-serving in an advisory capacity to the emperor, would be mostly ignored; instead, the power centered on a strong military. Some emperors would never step foot in Rome. In time Constantinople, Nova Romaor New Rome, would become the economic and cultural center that had once been Rome.
Byzantine Empire c. 460 CE

Byzantine Empire c. 460 CE

Despite the renewed strength that the division provided (the empire would be divided and united several times), the empire remained vulnerable to attack, especially on the Danube-Rhine border to the north. The presence of barbarians along the northern border of the empire was nothing new and had existed for years - the army had met with them on and off since the time of Julius Caesar. Some emperors had tried to buy them off, while others invited them to settle on Roman land and even join the army. However, many of these new settlers never truly became Roman even after citizenship was granted, retaining much of their old culture.

ROMAN VULNERABILITY BECAME MORE OBVIOUS AS A SIGNIFICANT NUMBER OF GERMANIC TRIBES, THE GOTHS, GATHERED ALONG THE NORTHERN BORDER.

This vulnerability became more obvious as a significant number of Germanic tribes, the Goths, gathered along the northern border. They did not want to invade; they wanted to be part of the empire, not its conqueror. The empire's great wealth was a draw to this diverse population. They sought a better life, and despite their numbers, they appeared to be no immediate threat, at first. However, as Rome failed to act to their requests, tensions grew. This anxiety on the part of the Goths was due to a new menace further to the east, the Huns.

THE GOTH INVASION

During the reign of the eastern emperor Valens (364 -378 CE), the Thervingi Goths had congregated along the Danube-Rhine border - again, not as a threat, but with a desire only to receive permission to settle. This request was made in urgency, for the “savage” Huns threatened their homeland. Emperor Valens panicked and delayed an answer - a delay that brought increased concern among the Goths as winter was approaching. In anger, the Goths crossed the river with or without permission, and when a Roman commander planned an ambush, war soon followed. It was a war that would last for five years.
Although the Goths were mostly Christian many who joined them were not. Their presence had caused a substantial crisis for the emperor; he couldn't provide sufficient food and housing. This impatience, combined with the corruption and extortion by several Roman commanders, complicated matters. Valens prayed for help from the west. Unfortunately, in battle, the Romans were completely outmatched and ill-prepared, and the Battle of Adrianople proved this when two-thirds of the Roman army was killed. This death toll included the emperor himself. It would take Emperor Theodosius to bring peace.
Sack of Rome by the Visigoths

Sack of Rome by the Visigoths

AN ENEMY FROM WITHIN: ALARIC

The Goths remained on Roman land and would ally themselves with the Roman army. Later, however, one man, a Goth and former Roman commander, rose up against Rome - a man who only asked for what had been promised him - a man who would do what no other had done for eight centuries: sack Rome. His name was Alaric, and while he was a Goth, he had also been trained in the Roman army. He was intelligent, Christian, and very determined. He sought land in the Balkans for his people, land that they had been promised. Later, as the western emperor delayed his response, Alaric increased his demands, not only grain for his people but also recognition as citizens of the empire; however, the emperor, Honorius, continually refused. With no other course, Alaric gathered together an army of Goths, Huns and freed slaves and crossed the Alps into Italy. His army was well-organized, not a mob. Honorius was incompetent and completely out of touch, another in a long line of so-called “shadow emperors” - emperors who ruled in the shadow of the military. Oddly enough, he didn't even live in Rome but had a villa in nearby Ravenna.
Alaric sat outside the city, and over time, as the food and water in the city became increasingly scarce, Rome began to weaken. The time was now. While he had never wanted war but only land and recognition for his people Alaric, with the supposed help of a Gothic slave who opened the gates from within, entered Rome in August of 410 CE. He would stay for three days and completely sack the city; although he would leave St. Paul and St Peters alone. Honorius remained totally blind to the seriousness of the situation. While temporarily agreeing to Alaric's demands - something he never intended to honor - 6,000 Roman soldiers were sent to defend the city, but they were quickly defeated. Even though the city's coffers were nearly empty, the Senate finally relinquished; Alaric left with, among other items, two tons of gold and thirteen tons of silver.
Some people at the time viewed the sacking of the city as a sign from their pagan gods. St. Augustine, who died in 430 CE, said in his City of God that the fall of Rome was not a result of the people's abandonment of their pagan gods (gods they believed protected the city) but as a reminder to the city's Christians why they needed to suffer. There was good, for the world was created by good, but it was flawed by human sin; however, he still believed the empire was a force for peace and unity. To St. Augustine there existed two cities : one of this world and one of God.
Invasions of the Roman Empire

Invasions of the Roman Empire

BARBARIAN INVASIONS

Although Alaric would soon die afterwards, other barbarians - whether Christian or not - did not stop after the sack of the city.The old empire was ravaged, among others, by Burgundians, Angles, Saxons, Lombards, and Magyars. By 475 CE Spain, Britain, and parts of Gaul had been lost to various Germanic people and only Italy remained as the “empire” in the west. The Vandals would soon move from Spain and into northern Africa, eventually capturing the city of Carthage. The Roman army abandoned all hope of recovering the area and moved out. The loss of Africa meant a loss of revenue, and the loss of revenue meant there was less money to support an army to defend the city. Despite these considerable losses, there was some success for the Romans. The threat from Attila the Hun was finally stopped at the Battle of Chalons by Roman commander Aelius who had created an army of Goths, Franks, Celts and Burgundians. Even Gibbon recognized Attila as one “who urged the rapid downfall of the Roman empire.” While Attila would recover and sack several Italian cities, he and the Hun threat ended with his death due to a nosebleed on his wedding night.

THE LOSS OF REVENUE FOR THE WESTERN HALF OF THE EMPIRE COULD NOT SUPPORT AN ARMY CAPABLE OF DEFENDING THE ALREADY VULNERABLE BORDERS.

CONCLUSION: MULTIPLE FACTORS

One could make a sound case for a multitude of reasons for the fall of Rome. However, its fall was not due to one cause, although many search for one. Most of the causes, initially, point to one place: the city of Rome itself. The loss of revenue for the western half of the empire could not support an army - an army that was necessary for defending the already vulnerable borders. Continual warfare meant trade was disrupted; invading armies caused crops to be laid to waste, poor technology made for low food production, the city was overcrowded, unemployment was high, and lastly, there were always the epidemics. Added to these was an inept and untrustworthy government.
The presence of the barbarians in and around the empire added to a crisis not only externally but internally. These factors helped bring an empire from “a state of health into non-existence.” The Roman army lacked both proper training and equipment. The government itself was unstable. Peter Heather in his The Fall of the Roman Empire states that it “fell not because of its 'stupendous fabric' but because its German neighbors responded to its power in ways that the Romans could not ever have foreseen… By virtue of its unbounded aggression, Roman imperialism was responsible for its own destruction.”
Rome's fall ended the ancient world and the Middle Ages were borne. These “Dark Ages” brought the end to much that was Roman. The West fell into turmoil. However, while much was lost, western civilization still owes a debt to the Romans.Although only a few today can speak Latin, it is part of our language and the foundation of the Romance languages of French, Italian, and Spanish. Our legal system is based on Roman law. Many present day European cities were founded by Rome.Our knowledge of Greece comes though Rome and many other lasting effects besides. Rome had fallen but it had been for so so long one of the history's truly world cities.

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