Final exam Flashcards
miasma
means pollution
ie. the pollution of someone who has committed a crime
Comes to have a special medical meaning
Who are the 4 physicians we know of who came just after the time of Hippocrates?
Philistion of Locri
Diocles of Carystus
Threophrastus of Eresos
Praxagoras of Cos
Philistion of Locri
fl. early 4th century BCE
v little evidence for him and we know v little about him. None of the writings are preserved in fill. We have some fragments preserved of their writings in later authors
Believed in 3 general causes of disease:
1. internal excess or deficiency of the four qualities (hot, cold, wet, dry)
- external wounds, sores, too much or too little external heat and cold, bad nutrition
- Internal impediment of air flow throughout the body
Among the evidence we have for Philistion, there is an also a treatise by an anonymous author that introduced pneuma
Anaximenes - pneuma
concept of pneuma was originally a philosophical one. Just as our soul, which is air, dominates us, so too breath (pneuma) surround the whole world
pneuma has a slightly different meaning than air. something special
psychic pneuma
a theory was later developed for this type of pneuma - mediated between the heart and the brain
An extra special charged humor giving the brain the capacity THAT it has
Diocles of Carystus
We don’t have any of his writings, just fragments that are preserved in other authors.
Seems to have been very famous –> referred to as the ‘Second’ Hippocrates.
Supposedly wrote 20 works on various topics including anatomy, dietics, poisons, sexuality
SOme overlap with Aristotle especially on anatomy and gynaecology (so maybe a contemporary or student of Aristotle)
Supposedly wrote a specific treatise on animal anatomy. Used animals to make inferences about humans.
embraces the theory of the four elements, four qualities and the 4 humors
also paid special attention to the pneuma, the breath or refined air that spread through the vessels in the body. Linked pneuma to both mental states and physical disorders
also believed in the individualization of treatment. ie tailored treatments depending on the patient. Treat idvl, not the disease.
What did Diocles invent?
He supposedly invented a special spoon-shaped instrument called a cyathiscus.
Removed arrow heads from a wound. So we know bc of this that he is a practicing physician and not just a theorist
iron or copper
Theophrastus of Eresos
We have some of his writings!
- Not a physician
- A philosopher with wide ranging interests. He took over Lyceum (a school in Athens) after Aristotle’s death.
Sometimes called the ‘Father of Botany’ - writes on medicinal plants in a much larger botanical text called the Enquiry into plants.
-Provides both medical and non-medical uses for the plant (detailed)
- Gets his information from root cutters and drug vendors apparently
-Groups the plants according to their type. He questions whether the plants that have the same effect have a single shared property.
- also notices the reduced efficacy of a drug after continual usage - ie tolerance
- mostly removes magical/superstitious elements
Praxagoras of Cos
We do not have any of his writings, we just have fragments of what later authors said about him.
Practicing physician
Believed that the heart was the seat of soul and intellect (like Aristotle believed)
-Hippocrates, Alcmaeon, Plato, Praxagorus - thought brain/head
Performed animal dissections - recognizes that arteries began in the heart and that the veins began in the liver AND that only veins carried blood and that arteries carried pneuma
- also suggested that as arteries got smaller and branches - eventually became neura (sinews - later nerves)
Recognized the pulse has being a valuable diagnostic tool (but he thought the heart beat and pulse were different from one another)
- posited a theory of 11 humors. We know they are named but we don’t know the theory behind them.
Seems to have embraced the theory of the psychic pneuma - special pneuma mediated between the heart and the brain.
- something added to it that has given it a power.
ie. says that epilepsy occurs in the aorta – A blockage prevents the passage of the psychic pneuma to the brain and this makes the body convulse.
Teacher - taught Herophilus
a bridging figure between the comparative anatomy of Aristotle and the human anatomy of those who follow.
In what period do we see the temporary allowance in human dissection?
Hellenistic (323-31 BCE)
331 BCE - when Alexander the Great died
323 BCE - when the last of the Hellenistic kingdoms finally succommed to Roman Rule (Death of Cleopatra)
Hellenistic medicine and Alexandrian medicine – virtually synonomous
Phillip the 2nd
Son to Alexander the Great
Arrow removed by Diocles’ spoon tool
Ptolemy I Soter
Received Egypt and surrounding areas in the shake up after Alexander’s death
Wanted to make Alexandria (at the mouth of the Nile river, a center of intellectual excellence
Who was the first women ever depicted on a coin?
Ptolemy and his first wife, Berenike
Who was Ptolemy I’s son?
Ptolemy II Philadelphius
He married his sister (quite common in Egypt to keep all the belongings in the family)
Who founded the Mouseion Institution of the Muses and the Library of Alexandria
Ptolemy I or Ptolemy II Philadelphus
Intention of turning them into centres of intellectual research
Who officially sanctioned human dissection to occur during the ________ period?
One of the Ptolemy’s sanctioned this to be carried out at the Mouseion by Greek physicians or anatomists for medical research purposes.
Who were the two physicians we know of who took advantage of human dissection belong allowed?
Herophilus of Chalcedon (330-260 BCE)
Erasistratus of Ceos (fl. 260 BCE)
Greek physicians!
Prior to this, the most detailed anatomical studies were done by Aristotle, but all on animals.
Do we have any writings of Herophilus preserved?
No, just fragments preserved in later authors. Apparently he wrote a lot though
trained with Praxagoras apparently
Wrote 6 books with wide range - Anatomy, on the Pulse, Midwifery, etc
Galen mentions he has good skill in anatomy and is a competent physician (high praise for someone who doesn’t give praise too much).
Gives first accurate description of the human liver
Noted a further difference between arteries and veins than his teacher Praxagoras. He noticed a difference in their structure - the walls of arteries were much thicker than those of veins. Wasn’t clear of whether he thought the arteries carried blood or pneuma or both
Recognized that it was the heart responsible for the pulsating of the arteries - due to systole (together) and diastole (apart) of the walls
Indicates that he was potentially working on live subjects! vivisection
Portable water clock
Made by Herophilus
Klepshydra
To compare pulse rate during fever to a standard pulse rate for the age
No concept of a minute - but this could measure a specific elapsed amount of time
Likened the pulse to a fall and rise of a node, natural rhythm.
What were Herophilus ‘most’ significant discoveries?
those regarding the brain and the nervous system
He distinguished the cerebrum from the cerebellum like Aristotle but in contrast to Aristotle, he said there were four ventricles in the brain, instead of 3 like Aristotle
Who first distinguished the 3 layers surrounding the brain?
Herophilus first discovered the meninges.
He also proposed that the brain was the seat of intellect based on anatomical evidence even though his teacher, Praxagorus thought it was the heart
Did Herophilus ascribe to the Humoral theory?
We know really nothing about his theorizing but there is an excerpt that suggests he subscribed to a humoral theory - although we do not not which humoral theory …. 2,3,4, 111(like his teacher)
talked about excess and deficiency
Erasistratus of Ceos
Don’t have his writing, just fragments preserved in other authors. WE think he overlapped with Herophilus but not sure.
We have some titles of his works - General Principles, On Fevers, On Drawing blood, Diseases of the intestine
Galen doesn’t like Erasistratus really.
Made significant advances in description of the brain and NS -greater accuracy than Herophilus.
Said the reason that humans have much larger brains is because of increased intellect (like animals with larger muscles can run faster) - making observations AND correlations
Recognized and described the heart valves and coordinates their workings… Saw them opening and closing so likely doing vivisection as well.
Believed that the arteries carried pneuma. But he would have seen the blood in the arteries? Maybe it got reported wrong
Galen said that E said blood got into the artery when it got pierced (E’s principle - the following towards what is being emptied) Galen ridiculed how the pneuma could escape so quickly without notice and how the animal could still live if pneuma escaped.
Seemed to be more interested in physiology than Herophilus.
Galen’s thoughts on Erasistratus
Galen doesn’t like Erasistratus really. He praises he praises him on his research ethic but Erasistratus doesn’t seem to be a big fan of Hippocrates but G is.
He didn’t acknowledge the properties that H does like wet, dry, etc.
Galen acknowledges that the previous theories might not be entirely accurate but that Erasistratus is very arrogant for disregarding them completely.
Galen said that E said blood got into the artery when it got pierced (E’s principle - the following towards what is being emptied) Galen ridiculed how the pneuma could escape so quickly without notice and how the animal could still live if pneuma escaped.
Who distinguished nerves from arteries and their responsibility for movement?
Herophilus
He traced the origin and course of neura from the brain and spina; cord and correctly distinguished that the nerves were responsible for movement rather than arteries!
HE also made anatomical distinctions between motor and sensor nerves
Detailed more than 7 pairs of cranial nerves, including the optical.
What are some analogies that Erisistratus made with respect to physiology?
dilating heart to coppersmith’s bellows
kidneys, liver, bladder = filters
stomach = grinding and crushing food like flour mill
humoral fluids getting blocked or overflowing in vessels like a spout
this level of detail makes us wonder if the pneuma in the artery idea has been misinterpreted.
Who might be the most painted physician of all time?
Eristratus
Story involving Eristratus
Seleucus (one of Alexander’s generals- got Asia)
2nd wife of Seleucus = Stratonice
Seleucus son = Antiochus
Antiochus fell in love with Stratonice (his step mother) - love-sickness and forbidden love
E told Seleucus it was his wife Antiochus was in love with and then Seleucus asked him to give her up. E said no no and that Seleucus wouldn’t do it if he was in the same position. But then he said he would and so E told him the truth about how his son was in love with his wife but ultimately he just wanted his son to be cured. so they ended up together
E determined it was love sickness by checking his pulse every time a woman walked by Antiochus.
peripatetic
meant travelling from city to city (as a physician)
archiatroi
some cities in Greek world and the Roman world later on employed archiatroi or public physicians to serve the community
Given civic rights, immunity for taxation and military service, and a salary. Patients likely still needed to pay a bit.
foreign-some of them. So competition to attract the best elite physicians to the roles
Medical ‘schools’
centres of discourse, teaching, learning, not necessarily physical buildings (though there could have been)
A matter of GEOGRAPHY
Endless debate as to which of the Hippocratic texts were written by the Coan School and which by the Cnidian school - with the general assumption that the superior texts belong to the Coan school and the inferior ones belong to the Cnidian.
Coan school had an association with Hippocrates which ensured it maintained a big reputation
