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In the fourth century BCE the most important locus of medical thought and
practice was not the island home Cos of Hippocrates, but the great center of
Greek learning at Alexandria, founded in 331 BCE by Alexander the Great and
governed by a dynasty stemming from his general Ptolemy. The Ptolemaic
rulers gave lavish financial support to the library and museum at Alexandria
which consequently attracted researchers in all fields, including
philosophy, mathematics, history, poetry and medicine. Medical research in
the Alexandrian museum became world renowned. Two of its most influential
investigators were Herophilos of Chalcedon (fl. circa 280 BCE) and
Erasistratos of Iulis (fl. 250 BCE). Most of our knowledge of these two is
derived from later commentators, such as Celsus and Galen in the Roman
period.

  Herophilos? most important
  contribution to clinical medicine    Roman wall painting from    
  was his development of the theory    Boscoreale, first century
  of the diagnostic value of the       BCE Citharista
  pulse. Although the pulse is
  referred to occasionally by earlier  Herophilos elaborated a
  writers (for example by Aristotle    far-reaching doctrine of the pulse.
  in his Inquiry Concerning Animals    The essential phenomenon in the
  521a5f), it was Herophilos?          pulse, according to Herophilos, is
  teacher, Praxagoras, who first       rhythm, as in music. To understand
  restricted the pulse to a distinct   the pulse, then, we must study the
  group of vessels and held that it    theory of music. Herophilos was
  could be used as an indicator of     chiefly guided by the musical
  disease. Herophilos corrected his    theories of Aristoxenus of
  master?s teaching on several         Tarentum, a Peripatetic philosopher
  points, maintaining that the pulse   and a musician, a pupil of
  is not an innate faculty of the      Aristotle. By following this route,
  arteries, but one they derive from   the doctrine of the pulse became so
  the heart, and distinguishing the    complicated that no one but a
  pulse not merely quantitatively,     skilled musician could possibly
  but also qualitatively from          understand it. Thus, the theory was
  palpitations, tremors and spasms,    still-born.
  which are muscular in origin.

Erasistratos, Herophilos? rival at Alexandria, made remarkable progress in
anatomy. Erasistratos described the brain more accurately than Herophilos.
He distinguished the cerebrum from the cerebellum, and he determined that
the brain was the originating point for all nerves. He distinguished sensory
from motor nerves and he was the first to dispel the notion that nerves are
hollow and filled with pneuma (air); but are solid, consisting of marrow of
the spinal kind. In his account of the heart and its function, he
distinguished between pulmonary and systemic circulation.

           Jacques-Louis David, 1774 ?Erasistratus Discovering the Cause of
           Antiochus? Disease?

Antiochus, son of Seleucus I Nicator, King of Syria, was dangerously ill,
and, when other physicians failed to help him, Erasistratos was called in.
While he was examining the patient, Stratonice, a young woman, one of the
elderly king?s wives, entered the room. From the quickening of the sick
man?s pulse and from the flush which spread over his cheeks, the doctor
recognized that the illness was mental rather than physical--that a passion
for his inaccessible step-mother was at the root of the trouble.

Dissection and Vivisection

In Alexandria the dissection of corpses was a regular practice, whereas
before it had been condemned on religious principle and thus outlawed.
Celsus reported the rumor that the anatomists used living people, most
likely condemned criminals, in vivisection. The changed attitude to
dissection among learned men was due to the philosophical teachings of
Aristotle. First Plato had taught that the soul was an independent and
immortal being which during earthly life carried the body as a mere envelope
and instrument to be discarded at death. Then Aristotle, Plato?s pupil,
declared that the soul, though not separable and immortal, constituted a
higher value than the whole organism, implying that after death there was no
more than a physical frame remaining, without feelings or rights. From this
position it was no great leap to claiming that the dead body could justly be
used for dissection and anatomical study. In the period following their
lifetimes, the Hellenistic period, the greatest medical discoveries of
antiquity were made in a place called Alexandria.

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