History of medicine test 1

medical professionals in ancient medicine

healers! anyone could be one, learned through apprenticeships, mostly male, and many ideas about health & healing

Hippocrates belief on providing care

• healing should be free when necessary

• do no harm

Hippocrates

• ~460-370 BCE

• born in Kos and traveled all around Greece

Hippocratic Corpus

• 60 texts discussing medical matters

• some of the texts were written by his followers and were expanded and modified over 200 years

• some notable texts: The Aphorisms, On The Sacred Disease, and Epidemics

• not all entirely consistent with each other

• casual explanations of diseases based on the 4 humors

Hippocratic oath

fundamental to medical ethics

On the Sacred Disease

• specifically presents disease as physical causes and not religious or superstitious ones

• specifically discusses epilepsy

The four humors

blood, yellow bile, black bile, and phlegm

blood and its correlations

• season- spring

• qualities- hot and moist

• organ- heart

yellow bile and its correlations

• season- summer

• qualities- hot and dry

• gall bladder

black bile

• season- winter

• qualities- cold and dry

• organ- spleen

phlegm and its correlations

• season- autumn

• qualities- cold and moist

• organ- brain

according to ancient medicine where does disease come from?

imbalance in the 4 humors

Aristotle

• (348- 322 BCE)

• created The History of Animals (philosophical and causal)

• The Parts of Animal (teleology)

• believed the body is the instrument of the soul

• His flops:

  -claimed the heart only had 3 chambers

  -didn’t distinguish veins from arteries

  -lacked understanding of nervous system

  -thought the heart was hot and counterbalanced the wet, cold brain

Limitations for anatomical studies in ancient medicine

human dissection could not occur because of religious reasons

Herophilus and Erasistratus

• Herophilus- (325-255 BCE)

• Erasistratus- (~315-240BCE)

• big deals in anatomy

• they were greeks living in Alexandria (major center for learning)

• allowed to do human dissections and animal vivisections because in Alexandria

• all their work has been lost and only recovered through other texts citing them

• favored a mechanist understanding of body

• Their wins:

  -distinguished veins and arterties

  -identified nervous system

  -distinguished motor and sense nerves (done by animal vivisection)

Galen of Pergamon

• (129-200 CE)

• anatomist

• did no human dissection

• wrote the biggest corpus out of any other Greek author

• super arrogant, was always challenging other people and didn’t like Alexandria

• believed that anatomical knowledge was key to medicine

• Believed the body was made by design and everything has a purpose

• loved animal vivisections 😐

Galen’s ligature experiment

applied ligatures to the ureters in a live animal & noticed urine collected on the sides of the kidneys and this determined where urine comes from. Also demonstrated that if the bladder is squeezed urine doesn’t go back up ureters.

Atomist and the empirical sect

believed that the body was unknowable and their was no reason to the body

Galen’s work

• On the Natural Faculties: describes the faculties of generation, growth, and nutrition. attacked people who denied their existence

• Usefulness of The Parts of The Body: defends the teleological standpoint

• On Anatomical Procedures: detailed description on techniques for dissections and vivisections

Galen’s views on venous and arterial blood

• food is turned turned into chyle in stomach & intestine → liver & turns into venous blood

• venous blood originates in liver

• venous blood goes to heart through pores from right to left ventricle

• on the left side of the ehart, the blood is transformed into arterial blood by means of heat from the heart

• exhaust fumes released from heart heating and expelled through pulmonary veins

• pulmonary veins have 2 way air flow, one fresh air & one exhaust

• heart is the center of the arterial system

• Believed arterial and venous are 2 separate systems

• portion of arterial blood goes to network of arteries in rete mirable (only in animals) and transformed into animal spirits and animal spirit controls movement

Medieval Period

• began after the fall of the Roman Empire

• 5th-15th century

• Rise of Islam

• political turmoil led to a decline in learning

The Canon of Medicine

• Written in 1025

• Written by Ibn Sina

• most influential texts in medieval and renaissance Europe

• originally written in Arabic and later translated to Latin in the 13th century

Centers for learning in Medieval Europe

• cathedral schools and madrasas

• Abbey’s and monasteries

The school of Salerno

• in Southern Italy

• key center of medieval learning

• teaching texts were translated and commentary on the text was the primary teaching strategy

Articella

• created ~1200

• collection of texts used to teach medicine

• was a key text until 16th century

Translation movements

Arabic & Greek translated to Latin

Urosopy in medieval medicine

• study of urine

• would look at color and overall appearance

• they would also taste it

Burgundio

• (1110-1193)

• merchant who translated Galen’s “On The Natural Faculties”

Gerard of Cremona

• (1114-1187)

• main medieval translator

• knew language and also science

Arnold of Villanova

• (1235-1312)

• summoned by popes and princes

• translated Galen and Avicenna

Pietro d’Abano

• (1257-1315)

• translated Galen’s work

Niccolo’ da Reggio

• (1315-1348)

• translated Galen’s “Usefulness of the Parts of the Body”

Main center for learning in Medieval times

Paris

faculties

inherent, invisible powers or capacities within a living organism that cause its functions

Liver faculties

produce veinous blood

kidney faculties

attraction (draws urine from blood)

heart faculties

pulsation

professional pyramid in medieval period

1. physicians-university trained and used latin

2. •surgeons - 2 categories:

   -barber surgeon- did blood-letting, lower level

   -higher surgeon- performed elaborate operations like amputations

   •apothecaries- trained by apprenticeships

3. •itinerant healers & quacks- found at markets and fairs, not educated

   •midwives- women practitioners

   •nuns & monks- provide nursing service

Mondino de’ Liuzzi

• (1270-1326)

• First person to rely on anatomy lessons on cadavers ~1315