medical sects and galen

Medical Sects and Medical Sects and GalenGalen

Tensions in Ancient MedicineTensions in Ancient Medicine

RationalistsRationalists HippocraticsHippocratics Theory guided Theory guided

medical practicemedical practice SpeculativeSpeculative Humoural theoryHumoural theory Anatomy & Anatomy &

PhysiologyPhysiology

EmpiricistsEmpiricists Medical knowledge Medical knowledge

gained by gained by experienceexperience

Training in the art Training in the art of observationof observation

Empiricist medicine still an artEmpiricist medicine still an art Still separated medicine from other Still separated medicine from other

healershealers Apprenticeship model of medical Apprenticeship model of medical

education persisted until 19education persisted until 19thth century century

Rise of the MethodistsRise of the Methodists(1(1stst Century CE) Century CE)

Challenged both Rationalist and Challenged both Rationalist and Empiricist medicineEmpiricist medicine

All illness result of either constriction All illness result of either constriction or dilation of pores of bodyor dilation of pores of body

Denied the learned basis of medicineDenied the learned basis of medicine Anyone could learn medicine in 6 Anyone could learn medicine in 6

monthsmonths

Thumbing Noses at Learned Thumbing Noses at Learned MedicineMedicine

Hippocrates:Hippocrates:

Life is short, the art Life is short, the art long, opportunity long, opportunity fleeting, fleeting, experiment experiment dangerous and dangerous and judgment difficultjudgment difficult

Methodists:Methodists:

Life is long and the Life is long and the art is short.art is short.

Galen of PergamonGalen of Pergamon(129-c.219 CE)(129-c.219 CE)

Born in what is now TurkeyBorn in what is now Turkey Son of an architectSon of an architect Began medical studies at age 16Began medical studies at age 16 Studied in AlexandriaStudied in Alexandria TravelledTravelled widely in Egypt widely in Egypt

Began medical practice in late 20sBegan medical practice in late 20s Physician to the gladiators in Physician to the gladiators in

PergamonPergamon Moved to RomeMoved to Rome

Gained fame forGained fame for– Public anatomical displaysPublic anatomical displays– His philosophical acumenHis philosophical acumen– His successful medical treatments of the His successful medical treatments of the

eliteelite

Why was Galen successful?Why was Galen successful?– He was a Roman citizenHe was a Roman citizen– He was a member of the eliteHe was a member of the elite– He was a shameless self-promoterHe was a shameless self-promoter– He was a prolific writerHe was a prolific writer

The Context of Galen’s PracticeThe Context of Galen’s Practice

Regarded himself as Hippocrates’ Regarded himself as Hippocrates’ heirheir

In some ways, he invented In some ways, he invented HippocratesHippocrates

Loathed the MethodistsLoathed the Methodists

Systematized Hippocratic medicineSystematized Hippocratic medicine

Believed in a divinely ordered Believed in a divinely ordered universeuniverse

Believed it could only be discerned Believed it could only be discerned through reason and intellectthrough reason and intellect

Elaborating HippocratesElaborating Hippocrates

Extended the humoural theoryExtended the humoural theory

Believed it confirmed Plato’s Believed it confirmed Plato’s tripartite human soultripartite human soul– Liver (nutrition)Liver (nutrition)– Heart (vitality)Heart (vitality)– Brain (reason/sensation)Brain (reason/sensation)

Humoural theory also extended Humoural theory also extended Aristotelian physicsAristotelian physics– Four humoursFour humours– Four elementsFour elements– Four seasonsFour seasons– Four primary qualitiesFour primary qualities

Galen’s Innovations:Galen’s Innovations:

NosologyNosology Classification of diseasesClassification of diseases DiagnosisDiagnosis PrognosisPrognosis Diseases are specific entities, not Diseases are specific entities, not

malleablemalleable

Galen’s ContributionsGalen’s Contributions

ExperimentationExperimentation Groundbreaking work in anatomy & Groundbreaking work in anatomy &

physiologyphysiology Existence of psychosomatic diseaseExistence of psychosomatic disease Belief in primacy of reasonBelief in primacy of reason

Diminished the work of those he Diminished the work of those he disagreed withdisagreed with

Plagiarized the work of those he did Plagiarized the work of those he did agree withagree with

Medieval Medicine Medieval Medicine (c. 400- 1000 BCE)(c. 400- 1000 BCE)

Split in Roman Empire Split in Roman Empire – 4th century BCE4th century BCE

Eastern EmpireEastern Empire– ByzantineByzantine– Greek speakingGreek speaking– Centred in Constantinople (now Centred in Constantinople (now

Istanbul)Istanbul)

Constantinople sacked in 14Constantinople sacked in 14thth century century

Empire reduced to city & its Empire reduced to city & its hinterlandhinterland

WesternWestern– Latin speakingLatin speaking– Centred in RomeCentred in Rome

Rome sacked in 410 CERome sacked in 410 CE

Political, social, & economic chaosPolitical, social, & economic chaos

De-urbanizationDe-urbanization– Return to agricultural economyReturn to agricultural economy

Loss of trade relationshipsLoss of trade relationships

Loss of traditional ways of Loss of traditional ways of transmitting knowledgetransmitting knowledge– Decline in intellectual lifeDecline in intellectual life– No centres of higher learningNo centres of higher learning– Few masters training apprentices in Few masters training apprentices in

medicinemedicine

Often referred to as the “Dark Ages”Often referred to as the “Dark Ages”

Result was 2 types of medical Result was 2 types of medical literatureliterature

1.Latin1.Latin– EncyclopediaEncyclopedia– commentarycommentary

2.Vernacular2.Vernacular– Written by lay peopleWritten by lay people– e.g.: Old English (Anglo Saxon) textse.g.: Old English (Anglo Saxon) texts– Date from 10Date from 10thth century century

Leechbook of BaldLeechbook of BaldLacnunga Lacnunga

Non theoreticalNon theoretical

Drawn from diverse sourcesDrawn from diverse sources

Indications of pre-Christian traditionsIndications of pre-Christian traditions– MagicMagic

Overlaid with Christian elementsOverlaid with Christian elements

Impact of rise of ChristianityImpact of rise of Christianity– Issues of adjustment between “pagan” Issues of adjustment between “pagan”

& Christian thought& Christian thought

1.Intellectual1.Intellectual– What causes diseaseWhat causes disease– What cures diseaseWhat cures disease

2.Practical2.Practical– Healing institutionsHealing institutions

Healing shrinesHealing shrinesHospicesHospicesMonasteriesMonasteries

Medicine in IslamMedicine in Islam

Or How the East Saved Or How the East Saved

Western MedicineWestern Medicine

Important VariablesImportant Variables

Former Eastern Roman empire spoke Former Eastern Roman empire spoke GreekGreek

Political stabilityPolitical stability

Greek speaking physicians from the Greek speaking physicians from the old eastern empire moved further old eastern empire moved further easteast

Islamic EmpireIslamic Empire

Mohammed (d. 632 C.E.)Mohammed (d. 632 C.E.)

After his death, new faith spread After his death, new faith spread rapidly in Arabian peninsularapidly in Arabian peninsula

By 642 C.E.:By 642 C.E.:– ArmeniaArmenia– MesopotamiaMesopotamia– Much of PersiaMuch of Persia– Much of EgyptMuch of Egypt

By 743 C.E.:By 743 C.E.:– North AfricaNorth Africa– Much of SpainMuch of Spain– Almost FranceAlmost France– PersiaPersia– KashmirKashmir– PunjabPunjab

The Islamic World c. 730 C.E.The Islamic World c. 730 C.E.

The Islamic Intellectual WorldThe Islamic Intellectual World

Centred in BagdadCentred in Bagdad

Presence of Greek speaking Presence of Greek speaking intellectualsintellectuals

Sponsored by Islamic courtSponsored by Islamic court

Translations of Greek medical textsTranslations of Greek medical texts

Muslim intellectuals drawn to rigour Muslim intellectuals drawn to rigour of Greek philosophy & medicineof Greek philosophy & medicine

100 texts by Galen translated100 texts by Galen translated

Muslim intellectuals sought to build Muslim intellectuals sought to build on the work already doneon the work already done

Both faithful to Greek/Roman traditions Both faithful to Greek/Roman traditions & innovative& innovative

Integrated their own knowledge of Integrated their own knowledge of remediesremedies

Advances in surgical proceduresAdvances in surgical procedures

Rhazes (865-925 C.E.)Rhazes (865-925 C.E.)

Differentiated between small pox and Differentiated between small pox and measlesmeasles

Much more difficult than it may Much more difficult than it may appearappear

Other Muslim physicians described Other Muslim physicians described person-to-person spread of diseaseperson-to-person spread of disease

Ibn Sina (Avicenna) 980-1037 C.E.Ibn Sina (Avicenna) 980-1037 C.E.

Distinguished between episodic Distinguished between episodic diseases and epidemicsdiseases and epidemics

Believed air was the principal vehicle Believed air was the principal vehicle for spreading diseasefor spreading disease

Also, “evil eye”Also, “evil eye”

Later Western Medicine’s Later Western Medicine’s Assessment of Islamic MedicineAssessment of Islamic Medicine

Described as unoriginalDescribed as unoriginal

Unfair on several countsUnfair on several counts– Great respect for traditionGreat respect for tradition– Difficulties associated with translationDifficulties associated with translation

Islamic Medicine’s LegacyIslamic Medicine’s Legacy

Preserved and advanced early Preserved and advanced early western medicinewestern medicine

AvicennaAvicenna– Prolific writerProlific writer– The CannonThe Cannon– Became known as the “Galen of Islam”Became known as the “Galen of Islam”

Spain under Muslim RuleSpain under Muslim Rule

Important site for re-entry of ancient Important site for re-entry of ancient medicine into medieval Europemedicine into medieval Europe

Contribution of Spanish JewsContribution of Spanish Jews– Moses MaimonidesMoses Maimonides

Philosopher & physicianPhilosopher & physicianGuide for the PerplexedGuide for the Perplexed