Later Greeks By F.Edwards

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Later GreeksBy F.Edwards S.Luscombe

• Applying Logic to Medicine !

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Real Progress ?

• The later Greek period became one of the periods
  of great breakthrough.
•  The Art of the physician began to take over
  from the cult of the priest

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Why was it possible to have a period of great
breakthrough in the later Greek period?
Any ideas from the map ?
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Why was it possible to have a period of great
breakthrough in the later Greek period?

• Competitive City States Try to out do each other
• Settled people have a hierarchical structure
• Upper classes have leisure time while their food,
  building etc is provided by lower classes
• As islanders the Greeks are forced onto the seas
  to trade, fish etc
• And as a result they become very familiar with
  the natural world winds, tides, stars, storms,
  etc.

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They begin to question the role the gods play in
the natural world.

• They never see Poseidon whenever they weather a
  storm at sea.
• They never meet Hephaistos whenever they deal
  with an erupting volcano.

They still believe the gods are their but that
they play a less prominent role in the natural
world
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Many of these leisured Greeks become philosophers
asking questions about the natural world in which
they live.

• Where do things come from ?
• What are things made of ?
• How does the world work?

Raphaels School of Athens
Raphael School of Athens
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These philosophers had no microscopes and very
little science so they worked all the answers to
their questions by observing the world around
them.

• From their observations they felt that every
  living thing was composed of The Four Elements
• Fire
• Water
• Air
• Earth
• These make
• Up everything living thing
• we see in the world

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The later Greeks had enquiring minds and while
they continued to believe in gods they
investigated

• Mathematics
• Geometry
• Science
• Astronomy
• Philosophy
• Politics
• as well as medicine

Pythagoras
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The Greeks were great believers in balance -

• Like Pythagoras,
• Pye,
• and algebra !
• They believed everything had to balance

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Greek doctors believed that the human body
contained four liquids or humours which were
linked to the four elements and the seasons

• Phlegm
• Blood
• Yellow bile
• Black bile

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Greek doctors noticed one or more of these
humours tended to be present when patients
presented with symptoms.

• Vomit??
• Too much yellow bile !
• Runny nose ??
• Too much phlegm!
• Diarrhoea ??
• Too much black bile!
• Red, blotched face ??
• Too much blood!

Diagnosis was easy !
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If the humours were all in perfect balanceyou
were in perfect health.

• But if the humours were out of balance the
  patient needed treatment to restore the balance
• Like blood lettingif there seemed to be too much
  blood
• or encouraging vomiting to get rid of excess
  yellow bile

A medieval illustration showing blood letting
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It was just applying Logic to Medicine.

• Enter Hippocrates !
• Hippocrates was the most famous of a group of
  Greek doctors who separated the art of the
  physician from the cult of the priest

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Hippocrates was one of a number of Greek doctors
who came from islands like Kos and began a new
approach to medicine
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They believed that each of these sources had
different qualities

• Water was cold and moist, for example
• and that these elements were linked to the
  seasons.

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The Hippocratic doctors began by assuming many
illnesses were natural rather than supernatural

• They started looking for natural symptoms
• Temperature
• Urine
• Face colour
• Pallor
• Blood, vomit, sweat, diarrhoea

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They applied the logic of the four humours theory
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This approach, known as the clinical method of
observation is exactly how doctors go about
their work today

• First of all the doctor should look at the
  patients face. If he looks his usual self this
  is a good sign. If not, the following are bad
  signs sharp nose, hollow eyes, cold ears, dry
  skin on the forehead.. Strange face colour such
  as black, green red or lead coloured. The doctor
  must ask if the patient has lost sleep or had
  diarrhoea, or not eaten

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The Hippocratic doctors realised it was really
important to make a case history of the course of
a patients illness and treatments.

• In this way they could forecast the prognosis of
  future illnesses
• And record which treatments were effective and
  which were not

• Silenus had a fever. He began with pains in his
  abdomen, heavy head, stiff neck
• First dayvomited, black urine
• Second daytongue dry no sleep at night
• Third day delirious
• Fourth dayno discharge from bowels, no urine,
  acute fever
• Eighth day cold sweat all over, red rashes,
  urine bitter and passed with pain
• Eleventh day..died

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The Hippocratic doctors believed prevention was
better than cure

• and encouraged Greeks to keep their humours
  balanced by
• good diet
• and
• exercise

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When illness was diagnosed the Hippocratic
doctors thought nature was the best healer

• Hot foods and brisk walks in winter.
• Cold foods and slow exercise in the summer
• Barley soup for chest diseases
• Vinegar and honey for phlegm
• Bathing to bring up phlegm

Can you see the way they tried to balance
opposites to keep the humours balanced ?
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Doctors were bound by a new professional code the
Hippocratic oath which doctors still swaer today
before they qualify.

• I swear by Apollo, Asclepius and all the gods
  ..to use treatment to help the sick but never
  with a view to injury or wrong doing.I will not
  give poison to anybody
• I will be pure and holy in my life and practice.
  Whatever I see and hear professionally which
  ought not to be told I will keep secret

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The Hippocratic doctors wrote lots of books which
meant their ideas influenced people forover 2000
years

• The Hippocratic collection is important
• Because it is the first detailed lost of symptoms
  and treatments

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The Humours

• "Blood, a hot, sweet, tempered, red humour,
  prepared in the meseraic veins, and made of the
  most temperate parts of the chylus (chyle) in the
  liver, whose office it is to nourish the whole
  body, to give it strength and colour, being
  dispersed through every part of it. And from it
  spirits are first begotten in the heart, which
  afterwards in the arteries are communicated to
  the other parts.
• "Pituita, or phlegm is a cold and moist humour,
  begotten of the colder parts of the chylus (or
  white juice coming out of the meat digested in
  the stomach) in the liver.
• "Choler is hot and dry, begotten of the hotter
  parts of the chylus, and gathered to the gall. It
  helps the natural heat and senses.
• "Melancholy, cold and dry, thick, black and sour,
  begotten of the more feculent part of
  nourishment, and purged from the spleen, is a
  bridle to the other two humours, blood and
  choler, preserving them in the blood, and
  nourishing the bones.

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Balance

• "An exact balance of the four primary humours
  makes the justly constituted man, and allows for
  the undisturbed production of the concoctions or
  processes of digestion and assimilation."