Medical Sects and Galen

1. Medical Sects and Galen

2. Rationalists Hippocratics Theory guided medical practice Speculative Humoural theory Anatomy & Physiology Empiricists Medical knowledge gained by experience Training in the art of observation Tensions in Ancient Medicine

3. Empiricist medicine still an art • Still separated medicine from other healers • Apprenticeship model of medical education persisted until 19th century

4. Rise of the Methodists(1st Century CE) • Challenged both Rationalist and Empiricist medicine • All illness result of either constriction or dilation of pores of body

5. Denied the learned basis of medicine • Anyone could learn medicine in 6 months

6. Hippocrates: Life is short, the art long, opportunity fleeting, experiment dangerous and judgment difficult Methodists: Life is long and the art is short. Thumbing Noses at Learned Medicine

7. Galen of Pergamon(129-c.219 CE) • Born in what is now Turkey • Son of an architect • Began medical studies at age 16 • Studied in Alexandria • Travelled widely in Egypt

8. Began medical practice in late 20s • Physician to the gladiators in Pergamon • Moved to Rome

9. Gained fame for • Public anatomical displays • His philosophical acumen • His successful medical treatments of the elite

10. Why was Galen successful? • He was a Roman citizen • He was a member of the elite • He was a shameless self-promoter • He was a prolific writer

11. The Context of Galen’s Practice • Regarded himself as Hippocrates’ heir • In some ways, he invented Hippocrates • Loathed the Methodists

12. Systematized Hippocratic medicine • Believed in a divinely ordered universe • Believed it could only be discerned through reason and intellect

13. Elaborating Hippocrates • Extended the humoural theory • Believed it confirmed Plato’s tripartite human soul • Liver (nutrition) • Heart (vitality) • Brain (reason/sensation)

14. Humoural theory also extended Aristotelian physics • Four humours • Four elements • Four seasons • Four primary qualities

16. Galen’s Innovations: Nosology • Classification of diseases • Diagnosis • Prognosis • Diseases are specific entities, not malleable

17. Galen’s Contributions Experimentation • Groundbreaking work in anatomy & physiology • Existence of psychosomatic disease • Belief in primacy of reason

18. Diminished the work of those he disagreed with • Plagiarized the work of those he did agree with

19. Medieval Medicine (c. 400- 1000 BCE) • Split in Roman Empire • 4th century BCE • Eastern Empire • Byzantine • Greek speaking • Centred in Constantinople (now Istanbul)

22. Constantinople sacked in 14th century • Empire reduced to city & its hinterland

23. Western • Latin speaking • Centred in Rome • Rome sacked in 410 CE • Political, social, & economic chaos

24. De-urbanization • Return to agricultural economy • Loss of trade relationships

25. Loss of traditional ways of transmitting knowledge • Decline in intellectual life • No centres of higher learning • Few masters training apprentices in medicine

26. Often referred to as the “Dark Ages” • Result was 2 types of medical literature 1.Latin • Encyclopedia • commentary

27. 2.Vernacular • Written by lay people • e.g.: Old English (Anglo Saxon) texts • Date from 10th century • Leechbook of Bald • Lacnunga • Non theoretical

28. Drawn from diverse sources • Indications of pre-Christian traditions • Magic • Overlaid with Christian elements

29. Impact of rise of Christianity • Issues of adjustment between “pagan” & Christian thought 1.Intellectual • What causes disease • What cures disease

30. 2.Practical • Healing institutions • Healing shrines • Hospices • Monasteries

31. Medicine in Islam Or How the East Saved Western Medicine

32. Important Variables • Former Eastern Roman empire spoke Greek • Political stability • Greek speaking physicians from the old eastern empire moved further east

33. Islamic Empire • Mohammed (d. 632 C.E.) • After his death, new faith spread rapidly in Arabian peninsula

34. By 642 C.E.: Armenia Mesopotamia Much of Persia Much of Egypt By 743 C.E.: North Africa Much of Spain Almost France Persia Kashmir Punjab

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

36. The Islamic Intellectual World • Centred in Bagdad • Presence of Greek speaking intellectuals • Sponsored by Islamic court • Translations of Greek medical texts

37. Muslim intellectuals drawn to rigour of Greek philosophy & medicine • 100 texts by Galen translated • Muslim intellectuals sought to build on the work already done

38. Both faithful to Greek/Roman traditions & innovative Integrated their own knowledge of remedies Advances in surgical procedures

39. Rhazes (865-925 C.E.) • Differentiated between small pox and measles • Much more difficult than it may appear • Other Muslim physicians described person-to-person spread of disease

40. Ibn Sina (Avicenna) 980-1037 C.E. • Distinguished between episodic diseases and epidemics • Believed air was the principal vehicle for spreading disease • Also, “evil eye”

41. Later Western Medicine’s Assessment of Islamic Medicine • Described as unoriginal • Unfair on several counts • Great respect for tradition • Difficulties associated with translation

42. Islamic Medicine’s Legacy • Preserved and advanced early western medicine • Avicenna • Prolific writer • The Cannon • Became known as the “Galen of Islam”

43. Spain under Muslim Rule • Important site for re-entry of ancient medicine into medieval Europe • Contribution of Spanish Jews • Moses Maimonides • Philosopher & physician • Guide for the Perplexed