Post on 20-Dec-2015
transcript
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