Week 10: Alexandrian Medicine

Significant Factors

• Rise of Macedonia: Philip II & Alexander the Great (4th c BCE); significant political & geographical change

• Magna Graecia: 70 Alexandrias, spread of Greek culture (Mesopotamia, Egypt, the Levant)

• “Macedonian backwater”: different customs to CG (Classical Greece): polygamy, regional kingship; similar: Olympian gods

• Cultural connections between Macedonia & Greece

• Hybrid form: Hellenistic culture

• 323 BCE: Successor kings (Diadochi), Ptolemy; religious changes

• West: Rome emerges

Religion & Culture

• Cultural hybridization: Delos (Apollo & Artemis) trading port —> incorporation of temples

• Sarapis & Isis (Egypt), Atargatis & Hadad (Syria), Astarte & Baal (Canaanite), Jewish synagogue, Roman shrines

• Movement of people

• Cults: geographical transfer & increased popularity: e.g. Asklepieion (Delos) —> Sarapieion

• Favour of ruling dynasty & religion

• Similarity between deities: Baal-Poseidon

• Healing deities part of medical culture: Epione (Soothing), Hygieia (Health)

Philosophy

• Aristotle

• The Successors: patronage for scholars & physicians

• Competition between kingdoms: libraries (centers of learning)

• Aggressive acquisition of material

• Different philosophical schools (e.g. Dogmatists, Methodists)

  • Pragmatism: draw from various theories as needed

Major philosophical/ medical schools

• Dogmatism: later name

• “Logical” or “the rationalists”: role of deductive & inductive logic to understand phenomena

• Bring medicine into philosophical realm (not just “practical craft”)

• Basic humoral theory: not same understanding (Praxagoras’ 11 humours)

• Relationship between humours & environment: “hidden causes”

• Empiricists oppose “hidden causes”

Empiricism

Ø Phyrron of Elis (365-275 BCE) & Philinos of Kos (~250 BCE): response to Dogmatism

Ø Roman times: Empiricists = Skeptics

Ø Observation & recording of experiences; not “hidden causes”

Ø Don’t look for disease causes; no need for etiology

Ø Focus: treating symptoms based on experiences & “bigger picture”

Ø Reject study of anatomy & physiology (thus also dissection)

Ø Differences between living & dead; treatment by analogy

Ø 3 principles of effective healer: accurate observation, extensive library/ collective case memory, knowing limits & virtues of similarities

Ø Noteworthy: Epicureanism (from Atomists)

Ø Natural world made up of individual & unobservable things (specific properties of shape, size, spatial ordering, orientation)

Important figures & texts

• Theophrastus (371-287 BCE): student of Aristotle, similar theories; only fragments

  • History of Plants: one of first herbalists to influence pharmacological texts

• Diocles of Carystus (4th c BCE): long-term medical experience, overarching theory of nature (Rationalist)

  • First systematic investigation of anatomy (animal dissections); coined “anatomy”

  • Study on dietetics

  • 3 categories of medicine: symptomatology, etiology, therapeutics

• Praxagoras of Kos (Asklepiad)

• No extant work; influential on later writers

• 11 humours: sweet, mixed, clear, sour, salty, soapy, bitter, oniony, yolky, corrosive, and blood

• Heart: seat of soul; origin of thought: brain an appendage to spinal cord

• Arteries (pneuma) from heart, veins (blood) from liver; veins eventually turn into nerves controlling movement

• Pulse as diagnostic tool; but thought pulse & heartbeat were distinct

Hellenistic botanists

ØFocus on pharmacology

ØMantias (120-100 BCE): compound medicines (elite)

ØKrateuas (100-60 BCE): “root-cutter”

ØMantias & Krateuas most prominent botanists/ pharmacologists

ØApollodorus (~280 BCE): earliest study on poisons

Ptolemaic Egypt (323-30 BCE)

ØMost significant contributor to Hellenistic medicine

ØBrief toleration of human dissection (Seleucids & others ABSOLUTELY NOT)

ØAlexandria main hub; centers of healing (e.g. Memphis)

ØInfluenced other regions that adapted Hellenism

ØVariety of religious practices

ØAlexandrian medicine from cultural traditions of CG

ØDebate: influence of traditional (Pharaonic) medicine

Cosmology

ØMaat (balance, order): Ptolemies uphold maat; legitimize themselves

ØRespect religions (Alexander’s example)

ØRosetta Stone

ØPeasants: submit questions to temples; elites can enter temples easily, afford fancy

medicine

ØContinued popularity of temples & shrines (Osiris, Imhotep, Sarapis)

Healing deities

ØRational medicine further develops BUT deities still relevant

ØSarapis: Ptolemaic invention (hellenized Osiris + aspects of Aphrodite & Dionysus);

protector of dynasty, active healing deity

ØIsis

ØImhotep

ØAmenhotep son of Hapy/ Hapu

Sources

ØComplicated; blending of Ptolemaic & Roman concepts

ØFragmentary

ØLater references & quotations (Galen, Pliny, Diogenes, Celsus, Tertullian)

ØInscriptions: e.g. Deir el-Bahari: cult of Amenhotep & Imhotep

ØGreek papyri of the Fayum: treatises explaining vision & surgeries on eyelid defects

ØZenon Archive (papyri): mentions physicians by name

ØLetters (fragmentary): refer to illnesses, requests for supplies

ØMore papyri

ØArchaeological: museum (mouseion), library

ØHealing sanctuaries & cultic sites

ØStatues & votive offerings

ØSimilar to other medical cultures so far