Sir James Elliott

Apollo — Æsculapius — Temples — Serpents — Gods of Health — Melampus — Homer — Machaon — Podalarius — Temples of Æsculapius — Methods of Treatment — Gymnasia — Classification of Renouard — Pythagoras — Democedes — Greek Philosophers.

The history of healing begins in the Hellenic mythology with Apollo, the god of light and the promoter of health. In the "Iliad" he is hailed as the disperser of epidemics, and, in this respect, the ancients were well informed in attributing destruction of infection to the sun's rays. Chiron, the Centaur, it was believed, was taught by Apollo and Artemis, and was the teacher, in turn, of Æsculapius, who probably lived in the thirteenth century before Christ and was ultimately deified as the Greek god of medicine. Pindar relates of him:—

Æsculapius was too successful in his art, for his death was attributed to Zeus, who killed him by a flash of lightning, or to Pluto, both of whom were thought to have feared that Æsculapius might by his skill gain the mastery over death.

Amid much that is mythological in the history of Æsculapius, there is a groundwork of facts. Splendid temples were built to him in lovely and healthy places, usually on a hill or near a spring; they were visited by the sick, and the priests of the temples not only attended to the worship of Æsculapius, but took pains to acquire knowledge of the healing art. The chief temple was at Epidaurus, and here the patients were well provided with amusements, for close to the temple was a theatre capable of seating 12,000 people, and a stadium built to accommodate 20,000 spectators.

A serpent entwined round a knotted staff is the symbol of Æsculapius. A humorist of the present day has suggested that the knots on the staff indicate the numerous "knotty" questions which a doctor is asked to solve! Tradition states that when Æsculapius was in the house of his patient, Glaucus, and deep in thought, a serpent coiled itself around his staff. Æsculapius killed it, and then another serpent appeared with a herb leaf in its mouth, and restored the dead reptile to life. It seems probable that disease was looked upon as a poison. Serpents produced poison, and had a reputation in the most ancient times for wisdom, and for the power of renovation, and it was thought that a creature which could produce poison and disease might probably be capable of curing as well as killing. Serpents were kept in the Temples of Æsculapius, and were non-poisonous and harmless. They were given their liberty in the precincts of the temple, but were provided with a serpent-house or den near to the altar. They were worshipped as the incarnation of the god, and were fed by the sick at the altar with "popana," or sacrificial cakes.

Many of the Greek gods and goddesses were held to have power over disease. Hygeia, known as Salus to the Romans, was said to have been the daughter of Æsculapius, and to have taken care of the sacred serpents (Plate II).

Melampus was considered by the Greeks the first mortal to practise healing. In one case he prescribed rust, probably the earliest use of iron as a drug, and he also used hellebore root as a purgative. He married a princess and was given part of a kingdom as a reward for his services. After his death he was awarded divine honours, and temples were erected for his worship. The deification of Æsculapius and of Melampus added much to the prestige of doctors in Greece, where they were always held in honour; but in Rome the practice of medicine was not considered a highly honourable calling.

Something can be learned from the writings of Homer of the state of medicine in his time, although we need hardly expect to find in an epic poem many references to diseases and their cure. As dissection was considered a profanation of the body, anatomical knowledge was exceedingly meagre. Machaon was surgeon to Menelaus and Podalarius was the pioneer of phlebotomy. Both were regarded as the sons of Æsculapius; they were soldiers as well as doctors, and fought before the walls of Troy. The surgery required by Homer's heroes was chiefly that of the battlefield. Unguents and astringents were in use in the physician's art, and there is reference to "nepenthe," a narcotic drug, and also to the use of sulphur as a disinfectant. Doctors, according to Homer, were held in high esteem, and Arctinus relates that two divisions were recognized, surgeons and physicians, the former held in less honour than the latter—"Then Asclepius (Æsculapius) bestowed the power of healing upon his two sons; nevertheless, he made one of the two more celebrated than the other; on one did he bestow the lighter hand that he might draw missiles from the flesh, and sew up and heal all wounds; but the other he endowed with great precision of mind, so as to understand what cannot be seen, and to heal seemingly incurable diseases."[2]

Machaon fought in the army of Nestor. Fearing for his safety, King Idomeneus placed him under the charge of Nestor, who was instructed to take the doctor into his chariot, for "a doctor is worth many men." When Menelaus was wounded, a messenger was sent for Machaon, who extracted the barbed arrow, sucked the wound and applied a secret ointment made known to Æsculapius by Chiron the Centaur, according to tradition.

The practice of Greek medicine became almost entirely restricted to the temples of Æsculapius, the most important of which were situated at Rhodes, Cnidus and Cos. The priests were known as AsclepiadÆ, but the name was applied in time to the healers of the temple who were not priests. Tablets were affixed to the walls of these temples recording the name of the patient, the disease and the cure prescribed. There is evidence that diseases were closely observed. The patients brought gifts to the temples, and underwent a preliminary purification by ablutions, fasting, prayer and sacrifice. A cock was a common sacrifice to the god. No doubt many wonderful cures were effected. Mental suggestion was used greatly, and the patient was put to sleep, his cure being often revealed to him in a dream which was interpreted by the priests. The expectancy of his mind, and the reduced state of his body as the result of abstinence conduced to a cure, and trickery also played a minor part. Albeit, much of the treatment prescribed was commendable. Pure air, cheerful surroundings, proper diet and temperate habits were advocated, and, among other methods of treatment, exercise, massage, sea-bathing, the use of mineral waters, purgatives and emetics, and hemlock as a sedative, were in use. If a cure was not effected, the faith of the patient was impugned, and not the power of the god or the skill of the Asclepiades, so that neither religion nor the practice of physic was exposed to discredit. Great was the wisdom of the Greeks! These temples were the famous medical schools of ancient Greece. A spirit of emulation prevailed, and a high ethical standard was attained, as is shown by the oath prescribed for students when they completed their course of study. The form of oath will be found in a succeeding chapter in connection with an account of the life of Hippocrates.

The remains of the Health Temple, or Asklepieion, of Cos were brought to light in 1904 and 1905, by the work of Dr. Rudolf Herzog, of TÜbingen. Dr. Richard Caton, of Liverpool, has been able to reconstruct pictorially the beautiful buildings that existed two thousand years ago. They were situated among the hills. The sacred groves of cypresses were on three sides of the temple, and "to the north the verdant plain of Cos, with the white houses and trees of the town to the right, and the wide expanse of turquoise sea dotted by the purple islands of the Ægean, and the dim mountains about Halicarnassus, to the north-east."[3]

The ancient Greek Gymnasia were in use long before the Asclepiades began to practise in the temples. The Greeks were a healthy and strong race, mainly because they attended to physical culture as a national duty. The attendants who massaged the bodies of the athletes were called aliptÆ, and they also taught physical exercises, and practised minor surgery and medicine. Massage was used before and after exercises in the gymnasium, and was performed by anointing the body with a mixture of oil and sand which was well rubbed into the skin. There were three classes of officials in the gymnasia; the director or magistrate called the gymnasiarch, the sub-director or gymnast, and the subordinates. The directors regulated the diet of the young men, the sub-directors, besides other duties, prescribed for the sick, and the attendants massaged, bled, dressed wounds, gave clysters, and treated abscesses, dislocations, &c.

There is no doubt that the Greeks, in insisting upon the physical training of the young, were wiser in their generation than the people of the present day; and not only the young, but people of mature age, took exercises suited to their physical requirements. The transgression of some of Solon's laws in reference to the gymnasia was punishable by death.

The third stage in the history of Greek medicine has now been reached. The first stage was primitive, the second associated with religion, and the third connected with philosophy. The classification of Renouard is accurate and convenient. In the "Age of Foundation," he recognizes four periods, namely:—

(1) The Primitive Period, or that of Instinct, beginning with myth, and ending with the destruction of Troy, 1184 years before Christ.

(2) The Sacred or Mystic Period, ending with the dispersion of the Pythagorean Society, 500 years before Christ.

(3) The Philosophic Period, ending with the foundation of the Alexandrian library, 320 years before Christ. This period is made illustrious by Hippocrates.

(4) The Anatomic Period, ending with the death of Galen, about 200 years after Christ.

The earliest Greek medical philosopher was Pythagoras (about 580 B.C.). He was born at Samos, and began life as an athlete, but a lecture which he heard on the subject of the immortality of the soul kindled enthusiasm for philosophical study, the pursuit of which led him to visit Egypt, Phoenicia, Chaldea, and perhaps also India. He was imbued with Eastern mysticism, and held that the air is full of spiritual beings who send dreams to men, and health or disease to mankind and to the lower animals. He did not remain long in Greece, but travelled much, and settled for a considerable time in Crotona, in the South of Italy, where he taught pupils, their course of study extending over five or six years. The Pythagorean Society founded by him did much good at first, but its members ultimately became greedy of gain and dishonest, and the Society in the lifetime of its founder was subjected to persecution and dispersed by angry mobs. Pythagoras possessed a prodigious mind. He is best known for his teaching in reference to the transmigration of souls, but he was also a great mathematician and astronomer. He taught that "number is the essence of everything," and his philosophy recognized that the universe is governed by law. God he represented by the figure 1, matter by the figure 2, and the universe by the combination 12, all of which, though fanciful, was an improvement upon mythology, and a recognition of system.

In the practice of medicine he promoted health mainly by diet and gymnastics, advised music for depression of spirits, and had in use various vegetable drugs. He introduced oxymel of squills from Egypt into Greece, and was a strong believer in the medicinal properties of onions. He viewed surgery with disfavour, and used only salves and poultices. The Asclepiades treated patients in the temples, but the Pythagoreans visited from house to house, and from city to city, and were known as the ambulant or periodic physicians.

Herodotus gives an account of another eminent physician of Crotona, Democedes by name, who succeeded Pythagoras. At this time, it is recorded that the various cities had public medical officers. Democedes gained his freedom from slavery as a reward for curing the wife of Darius of an abscess in the breast.

The dispersal of the Pythagoreans led to the settlement of many of them, and of their imitators, in Rome and various parts of Italy. Although Pythagoras was a philosopher, he belongs to the Mystic Period, while Hippocrates is the great central figure of the Philosophic Period. Before studying the work of Hippocrates, it is necessary to consider the distinguishing features of the various schools of Greek philosophy. Renouard shows that the principles of the various schools of medical belief depended upon the three great Greek schools of Cosmogony.

Pythagoras believed in a Supreme Ruler of the Universe, and that spirits animated all life, and existed even in minerals; he also believed in preconceived purpose. With these views were associated the Dogmatic School of Medicine, and the name of Hippocrates, and this belief corresponds to modern vitalism.

Leucippus and Democritus, rejecting theology, considered vital action secondary to the operation of the laws of matter, and believed that atoms moved through pores in the body in such a way as to determine a state of health or disease. With this philosophy was associated the Medical School of Methodism, a system said to have been founded by Asclepiades of Prusa (who lived in Rome in the first century before Christ), and by his pupil Themison (B.C. 50). The third school of medical thought, that of Empiricism, taught that experience was the only teacher, and that it was idle to speculate upon remote causes. The Empirics based these views upon the teaching of philosophers known as Sceptics or Zetetics, followers of Parmenides and Pyrrho, who taught that it was useless to fatigue the mind in endeavouring to comprehend what is beyond its range. They were the precursors of modern agnosticism.

The Eclectics, in a later age, formed another medical sect, and had no definite system except that they made a selection of the views and methods of Dogmatists, Methodists and Empirics.

The Greek philosophers as a class believed in a primary form of matter out of which elements were formed, and the view held in regard to the elements is expressed in Ovid's "Metamorphoses."[4]

Fire was considered to be matter in a very refined form, and to closely resemble life or even soul.