Medicine in Ancient Greek Civilization Assist.Prof.Dr. Mehmet KARATAŞ Department of History of Medicine and Ethics

Medicine in Ancient Medicine in Ancient Greek Civilization Greek Civilization

Assist.Prof.Dr. Mehmet KARATAŞAssist.Prof.Dr. Mehmet KARATAŞ

Department of History of Medicine and EthicsDepartment of History of Medicine and Ethics

Ancient Greek Civilization Ancient Greek Civilization

This civilization was established on the island of This civilization was established on the island of Crete in 2000 BC and lasted until 1400 BCCrete in 2000 BC and lasted until 1400 BC.. It is It is believed that those civilizations on this island believed that those civilizations on this island had spread to the Greek territory in 1600 BC had spread to the Greek territory in 1600 BC Archaic Period:Archaic Period: ((700-500 BC700-500 BC) The period until ) The period until the war with the Persiansthe war with the PersiansClassic PeriodClassic Period: (: (480–330 BC) 480–330 BC) It ends with the It ends with the death of the Alexander Great.death of the Alexander Great.Hellenistic PeriodHellenistic Period: : The ancient Greek The ancient Greek civilization affected other civilizations, which civilization affected other civilizations, which wasn’t situated on the Greek peninsula.wasn’t situated on the Greek peninsula.

Medicine before Hippocrates and the Cult of Medicine before Hippocrates and the Cult of AsclepiusAsclepius

The information about the medicine in ancient Greek The information about the medicine in ancient Greek civilization before Hippocrates can be learned from the civilization before Hippocrates can be learned from the epics of Homerepics of Homer ((IliadIliad and the and the Odyssey)Odyssey)

These pieces are including the realistic definitions about These pieces are including the realistic definitions about the injuries at wars. According to this pieces, it can be the injuries at wars. According to this pieces, it can be said that the warriors had a quite enough knowledge said that the warriors had a quite enough knowledge about the medicine andabout the medicine and the surgery.the surgery.

The Cult of AsclepiusThe Cult of Asclepius

The culture of the ancient Greek civilization is The culture of the ancient Greek civilization is reflecting a polytheistic structure.reflecting a polytheistic structure.

Asclepius Asclepius is the God of Medicine. According to is the God of Medicine. According to the Greek mythology,the Greek mythology, Asclepius Asclepius is the son of is the son of Apollo, the son of Zeus the king of the gods, and Apollo, the son of Zeus the king of the gods, and the the CCoronis (oronis (crow or raven), crow or raven), a nymph a nymph ( fairy). ( fairy). AApollo punished Coronis with death because of pollo punished Coronis with death because of her infidelity. Then he cut the unborn child out of her infidelity. Then he cut the unborn child out of her womb (her womb (maybe the first cesarean in historymaybe the first cesarean in history) ) and gave it to the centaur Chiron to raise. After and gave it to the centaur Chiron to raise. After that Asclepthat Asclepiius learned the mystery of the nature us learned the mystery of the nature and healing from Chiron.and healing from Chiron.


There were too many priest physicians which There were too many priest physicians which work in Asclepions They were called as work in Asclepions They were called as AsclepiadAsclepiad. They kept the medical knowledge and . They kept the medical knowledge and the medical techniques as a secret. Therefore the medical techniques as a secret. Therefore they passed from father to son as well as being they passed from father to son as well as being physician.physician.

They deified Asclepius as a God and built They deified Asclepius as a God and built temples,temples, which are called as Asclepion. They which are called as Asclepion. They used these temples as hospitals. The treatment used these temples as hospitals. The treatment methods were associated with the religion.methods were associated with the religion.


The Greek gods are similar to men. Thus, the god The Greek gods are similar to men. Thus, the god Asclepius had also a family. He had 2 daughters. One of Asclepius had also a family. He had 2 daughters. One of them, Hygeia, was responsible for hygiene and the other them, Hygeia, was responsible for hygiene and the other one, Panacea, was responsible for medical plants. His one, Panacea, was responsible for medical plants. His sons, Podaleiros and Machaon, were responsible for sons, Podaleiros and Machaon, were responsible for surgical treatments.surgical treatments.The critical patients were brought to Asklepions. The The critical patients were brought to Asklepions. The patients must be clean and wear white dress. Treatment patients must be clean and wear white dress. Treatment was depends on temple sleep and interpretation of the was depends on temple sleep and interpretation of the dreams. Patients slept overnight in temples and dreams. Patients slept overnight in temples and expected to be visited by Asclepius in order to be cured. expected to be visited by Asclepius in order to be cured. A special part of the temple (A special part of the temple (abatonabaton) is reserved for the ) is reserved for the patients to sleep.patients to sleep.Because of the symbol of the God Asclepius was snake, Because of the symbol of the God Asclepius was snake, they fed harmless snakes, which can circulate they fed harmless snakes, which can circulate independent around and inside the temple.independent around and inside the temple.

Treatment MethodsTreatment Methods

The treatments methods in Asclepions include The treatments methods in Asclepions include diet, bath and exercise. Priest physicians were diet, bath and exercise. Priest physicians were also interpreting the patients dreams or using also interpreting the patients dreams or using them to give advice. It is believed that Priest them to give advice. It is believed that Priest physicians were healing the patients this way physicians were healing the patients this way ((inculcationinculcation).).Some Asclepions last until today: In GreeceSome Asclepions last until today: In Greece;; Epidaurus, KosEpidaurus, Kos.. IIn Anatolian Anatolia;; Pergamum Pergamum ((BergamaBergama) and Cnidus) and Cnidus..

Hippocrates and Hippocratic MedicineHippocrates and Hippocratic Medicine

Hippocrates is a turning point in medicine Hippocrates is a turning point in medicine history. He was born in Kos (history. He was born in Kos (İstanköyİstanköy) Island ) Island and it is believed that he lived between 460–377 and it is believed that he lived between 460–377 BCBCHippocrates argued that diseases are natural Hippocrates argued that diseases are natural processes and the symptoms are the reactions processes and the symptoms are the reactions of the body to diseases. With this consideration of the body to diseases. With this consideration diseases were no more thought as punishment diseases were no more thought as punishment to men because of their sins. Whereat diseases to men because of their sins. Whereat diseases weren’t thought as they are associated with weren’t thought as they are associated with supernatural forces and they were explained supernatural forces and they were explained rationally.rationally.

Hippocrates Hippocrates and and Hippocratic MedicineHippocratic Medicine

The documents which explicate Hippocratic The documents which explicate Hippocratic Medicine are called as Medicine are called as Corpus HippocraticumCorpus Hippocraticum. . Several of them belong to Hippocrates, the Several of them belong to Hippocrates, the others are written by another physicians.others are written by another physicians.

Hippocrates’ principle “Hippocrates’ principle “primum non nocere”primum non nocere” (first (first of allof all don’t harm) is still a main principle in don’t harm) is still a main principle in modern medicine.modern medicine.


Hippocrates‘ theoretical approach and medical Hippocrates‘ theoretical approach and medical practices are based on the concept of the practices are based on the concept of the philosophy on that period, especially on philosophy on that period, especially on Empedocles' doctrines. According to Empedocles' doctrines. According to Empedocles, there are 4 elements: air, water, Empedocles, there are 4 elements: air, water, earth and fire. He called these elements as earth and fire. He called these elements as macro cosmos. The human body is seen as a macro cosmos. The human body is seen as a little model of the universe. Thus, it is called as little model of the universe. Thus, it is called as micro cosmos.micro cosmos.


The equivalents of the 4 elements which formed the The equivalents of the 4 elements which formed the nature in body are black bile, yellow bile, mucusnature in body are black bile, yellow bile, mucus and and bloodblood..

BLOODBLOOD ((wwhich circulates through the bodyhich circulates through the body)) fluent and warm fluent and warm → → AIRAIR MUCUS (MUCUS (wwhich is located in brainhich is located in brain) cold and fluent ) cold and fluent → → WATER WATER YELLOW BILE (YELLOW BILE (wwhich comes from liverhich comes from liver) dry and warm ) dry and warm → → FIREFIRE BLACK BILE (BLACK BILE (wwhich is located in spleenhich is located in spleen) cold and dry ) cold and dry → → EARTHEARTH

It is believed that all disease are a result of imbalance in It is believed that all disease are a result of imbalance in these component. The aim of the treatment was these component. The aim of the treatment was restoring the balance. This philosophy and these restoring the balance. This philosophy and these practices had an influence since 19th century. practices had an influence since 19th century.

Hippocratic OathHippocratic Oath

It is neither the first nor the only oath in the It is neither the first nor the only oath in the history of the medicine. But it still defines history of the medicine. But it still defines the moral rules of physicians. That’s why it the moral rules of physicians. That’s why it was and is important for centuries.was and is important for centuries.

Hippocratic OathHippocratic Oath

Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses, making them my witnesses, that I will fulfill according to my and goddesses, making them my witnesses, that I will fulfill according to my ability and judgment this oath and this covenant:ability and judgment this oath and this covenant:

To hold him who has taught me this art as equal to my parents and to live To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art - if they desire to learn it - without fee and lineage and to teach them this art - if they desire to learn it - without fee and covenant; to give a share of precepts and oral instruction and all the other covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him who has instructed me and to learning to my sons and to the sons of him who has instructed me and to pupils who have signed the covenant and have taken an oath according to pupils who have signed the covenant and have taken an oath according to the medical law, but to no one else.the medical law, but to no one else.

I will apply dietetic measures for the benefit of the sick according to my I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.ability and judgment; I will keep them from harm and injustice.

I will neither give a deadly drug to anybody if asked for it, nor will I make a I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.remedy. In purity and holiness I will guard my life and my art.

I will not use the knife, not even on sufferers from stone, but will withdraw in I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.favor of such men as are engaged in this work.

Whatever houses I may visit, I will come for the benefit of the sick, Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves.sexual relations with both female and male persons, be they free or slaves.

What I may see or hear in the course of the treatment or even outside of the What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself holding such things shameful to be spoken abroad, I will keep to myself holding such things shameful to be spoken about.about.

If I fulfill this path and do not violate it, may it be granted to me to enjoy life If I fulfill this path and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely. may the opposite of all this be my lottransgress it and swear falsely. may the opposite of all this be my lot

The Hippocratic Oath: Text. Translation. and Interpretation. by Ludwig Edelstein, Supplements to The Hippocratic Oath: Text. Translation. and Interpretation. by Ludwig Edelstein, Supplements to the Bulletin of the History of Medicine. no. 1 1943).the Bulletin of the History of Medicine. no. 1 1943).

Medicine in AlexandriaMedicine in Alexandria

After the establishment of the Alexandria in 322 After the establishment of the Alexandria in 322 BC first ruler Ptolemy Soler from Ptolemy BC first ruler Ptolemy Soler from Ptolemy dynasty had constructed the worlds famous dynasty had constructed the worlds famous library. In this atmosphere many famous library. In this atmosphere many famous philosophers, poets and physicians grew up. philosophers, poets and physicians grew up. This period is also called as Hellenistic Period.This period is also called as Hellenistic Period.


Herophilus from Chalcedonies (Herophilus from Chalcedonies (KadıköyKadıköy) and ) and Erasistratus are famous scientists of Alexandria.Erasistratus are famous scientists of Alexandria. They They defined some anatomical terms by Vivisection defined some anatomical terms by Vivisection ((from Latin vivus, meaning "alive", and sectio, meaning from Latin vivus, meaning "alive", and sectio, meaning "cutting""cutting"). It is believed that they worked on criminals ). It is believed that they worked on criminals and their work was open to public.and their work was open to public.

Besides Erasistratus also worked on metabolism. Besides Erasistratus also worked on metabolism. It It isis believed that believed that Erasistratus Erasistratus was was the first one who defined the first one who defined the heart valves.the heart valves.


In this periodIn this period,, it is believed that the mind was it is believed that the mind was located in brain and a fifth element, pneuma, located in brain and a fifth element, pneuma, was circulating in veins in order to protect the was circulating in veins in order to protect the liveliness. liveliness.

This period is short-lived and the students didn’t This period is short-lived and the students didn’t follow their teachers.follow their teachers.

Konuyla İlgili SORU/CEVAPKonuyla İlgili SORU/CEVAP

Soru 1: Soru 1: Antik Yunan tıbbının Hipokrat döneminde tıbbi Antik Yunan tıbbının Hipokrat döneminde tıbbi uygulamalardaki kuramsal yaklaşımı neydi?uygulamalardaki kuramsal yaklaşımı neydi?

Cevap 1: Dört unsur (Cevap 1: Dört unsur (hıltlar teorisihıltlar teorisi) )

Soru 2: Soru 2: Hipokrat’ın eserlerinin toplandığı kitabın adı nedir?Hipokrat’ın eserlerinin toplandığı kitabın adı nedir?Cevap 2: Corpus HippocraticumCevap 2: Corpus Hippocraticum

ReferencesReferences

A. Selim ATAY, İnönü Üniversitesi Tıp Fakültesi, A. Selim ATAY, İnönü Üniversitesi Tıp Fakültesi, translationtranslation

Tolga GÜVEN, Marmara Üniversitesi Tıp Tarihi ve Etik Tolga GÜVEN, Marmara Üniversitesi Tıp Tarihi ve Etik AD ders notlarıAD ders notları

Ali Haydar BAYAT, Tıp TarihiAli Haydar BAYAT, Tıp Tarihi

Emine ATABEK, Şefik GÖRKEY, Başlangıcından Emine ATABEK, Şefik GÖRKEY, Başlangıcından Rönesansa Kadar Tıp TarihiRönesansa Kadar Tıp Tarihi

Çağlar Boyu Tıp, Roche YayınlarıÇağlar Boyu Tıp, Roche Yayınları

http://en.wikipedia.org/wiki/Main_Page

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Medicine in Ancient Greek Civilization Assist.Prof.Dr. Mehmet KARATAŞ Department of History of Medicine and Ethics