Medicine: Social Content

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Medicine: Social Content

Epidemiology. It is hard to give a precise epidemiology of the ancient Greek world—that is, a clear picture of the kinds of diseases and ailments that were common in the Mediterranean at that time. The preservation of a large body of fifth- and fourth-century Greek medical writings provides less help than might be expected because the categories used by ancient doctors to diagnose their patients were often completely different from modern ones. Many of the symptoms and signs they considered important for identifying diseases are simply irrelevant in modern systems of classification. The same is true of their methods of investigation—the pulse, for instance, was not used as a diagnostic tool until the third century b.c.e.—which often omit what modern doctors consider to be crucial information. Greek physicians neither envisioned nor discussed diseases in the modern language of germ theory, which is only about one hundred and fifty years old. The results are vague descriptions that are impossible to match with contemporary ones.

Palaeopathology. What little can be learned from the texts must be supplemented by the modern science of palaeopathology, which studies skeletal remains for information on diet and health. From these sources, it is likely that dysentery, typhoid and malarial fevers, epilepsy, tuberculosis, diphtheria, rabies, and chicken pox were all common in ancient Greece. Various forms of conjunctivitis (a chronic inflammation of the eyes) seem to have been especially widespread. Evidence also exists for the presence of inheritable conditions such as certain strains of anemia. Beyond that, not much more can be said with any certainty. A devastating plague ravaged the city of Athens (430-427 b.c.e.). Despite the fact that we possess contemporary written accounts of the epidemic, its actual nature is still a matter of debate. Whether it was bubonic plague, cholera, or measles is uncertain.

Hippocratic Corpus. With Greek medicine, scholars are in the unusual position of having direct and rather extensive

evidence, instead of the secondhand fragments and quotations in which most other ancient thinkers are preserved. A group of about sixty texts named the Hippocratic Corpus and dating from roughly 420 to 350 b.c.e. have survived. The title is deceptive, since these texts represent neither the work of a single author—it is doubtful whether any was actually written by the legendary physician, Hippocrates of Cos—nor even the position of a single medical school.

Authors and Audience. The writings themselves cover a broad range of topics, including anatomy, physiology, pharmacology, embryology, gynecology, epidemiology, surgery, and dietetics. They are obviously the product of a group (or groups) of distinct individuals. Their styles also differ considerably. While some are clearly textbooks for professional physicians, others take the form of detailed, clinical case histories and even public lectures pitched to a nonspecialist audience. These different styles, moreover, imply widely different contexts of use. A book such as the one titled Airs Waters Places, for instance, was obviously written as a guide for itinerant doctors, allowing them to identify and treat diseases specific to particular regions and climates. The Aphorisms, on the other hand, which contains practical advice condensed into short, pithy sentences and slogans, was probably meant as a teaching tool.

Doctors. Their diversity offers a rare glimpse of the social context in which early medicine developed. It is important to recognize that doctors in ancient Greece had no formal, institutional status. No standardized course of training and examination authorized them to practice, no special licensing distinguished competent from quack, and no official control guaranteed the overall quality of care. Although some evidence exists of doctors hired at public expense to provide services for a particular community, by far the majority traveled from settlement to settlement like most other artisans, plying their trade alongside healers of all kinds—diviners, exorcists, priests, magicians, herbalists, midwives, athletic trainers, and hawkers of old family recipes and miracle cures. The kind of medicine represented by the Hippocratic Corpus was simply one among many therapeutic options. For that matter, in the fifth and fourth centuries, it was definitely considered to be newfangled and strange, and much in need of advertising its benefits in order to attract a clientele. The polemical tones of many of the Hippocratic texts in fact confirm that they were written in direct and often hostile competition with traditional medical practitioners. Just as in the case of Greek natural philosophy, open criticism and public debate accompanied the growth of rational medicine.

Cures. In the middle of the fifth century b.c.e.—and for many hundreds of years afterward, for that matter—an average person’s first choice in illness was most probably not to consult a professional Hippocratic doctor at all. Instead, the patient would most likely have turned to a folk remedy. These cures would have brought the person into contact with a variety of individuals and, consequently, different interpretations of disease and means of treatment.

Lore. On the one hand, there existed an ancient tradition of herbal and pharmacological lore, offering treatments for disease based on the medicinal properties of plants and minerals. This lore was the product of centuries of trial and error and undoubtedly offered practical and in some cases effective remedies, as it continues to do today in most parts of the world. On the other hand, popular belief generally explained disease by reference to some kind of supernatural agency. Sickness was caused by offended gods and angry demons, for instance, or else by the sinister workings of magical curses and spells. As a result, people sought remedies tailored to suit what they thought was the true cause of their affliction: prayers, incantations, sacrifices, cleansings, special dietary prescriptions, and ritual behaviors. The author of the Hippocratic text called On the Sacred Disease refers with contempt to quasimagical cures for epilepsy that included, among other things, prohibitions against wearing black and touching goats.

THE HIPPOCRATIC OATH

I swear by Apollo the healer, by Asclepius, by Health and all the powers of healing, and call to witness all the gods and goddesses that I may keep this Oath and Promise to the best of my ability and judgment.

I will pay the same respect to my master in the Science as to my parents and share my life with him and pay all my debts to him, I will regard his sons as my brothers and teach them the Science, if they desire to learn it, without fee or contract. I will hand on precepts, lectures, and all other learning to my sons, to those of my master, and to those pupils duly apprenticed and sworn, and to none other.

I will use my power to help the sick to the best of my ability and judgment; I will abstain from harming or wronging any man by it.

I will not give a fatal dose to anyone if I am asked, nor will I suggest any such thing. Neither will I give a woman means to procure an abortion.

I will be chaste and religious in my life and in my practice,

I will not cut, even for the stone, but I will leave such procedures to the practitioners of that craft.

Whenever I go into a house, I will go to help the sick and never with the intention of doing harm or injury. I will not abuse my position to indulge in sexual contacts with the bodies of women or of men, whether they be freemen or slaves.

Whatever I see or hear, professionally or privately, which ought not to be divulged, I will keep secret and tell no one.

If, therefore, I observe this Oath and do not violate it, may I prosper both in my life and in my profession, earning good repute among all men for all time. If I transgress and forswear this Oath, may my lot be otherwise.

Source: Hipposratic Writings, edited by G. E. R. Lloyd (Harmondsworth, U.K. & New Yorfc Penguin, 1978).