University of Nebraska at Omaha DigitalCommons@UNO
Journal Articles Department of Biomechanics
3-2007 Herodicus, the father of sports medicine Anastasios D. Georgoulis University of Ioannina
Irini-Sofia Kiapidou University of Ioannina
Lamprini Velogianni University of Ioannina
Nicholas Stergiou University of Nebraska at Omaha, [email protected]
Arthur Boland
Follow this and additional works at: https://digitalcommons.unomaha.edu/biomechanicsarticles Part of the Biomechanics Commons
Recommended Citation Georgoulis, Anastasios D.; Kiapidou, Irini-Sofia; Velogianni, Lamprini; Stergiou, Nicholas; and Boland, Arthur, "Herodicus, the father of sports medicine" (2007). Journal Articles. 96. https://digitalcommons.unomaha.edu/biomechanicsarticles/96
This Article is brought to you for free and open access by the Department of Biomechanics at DigitalCommons@UNO. It has been accepted for inclusion in Journal Articles by an authorized administrator of DigitalCommons@UNO. For more information, please contact [email protected]. HERODICUS, THE FATHER OF SPORTS MEDICINE.
Anastasios D. Georgoulis1, MD; Irini-Sofia Kiapidou1, PhD; Lamprini Velogianni1, Ma;
Nicholas Stergiou2, PhD and Arthur Boland3, MD.
1Orthopaedic Sports Medicine Center of Ioannina, Department of Orthopaedic Surgery, University of Ioannina, PO BOX 1330, Ioannina 45110, Greece
2HPER Biomechanics Laboratory, University of Nebraska at Omaha, Omaha, NE 68182, USA
3Massachusetts General Hospital, Sports Medicine/Shoulder Service, Yawkey Center 3G, Suite 3200, 55 Fruit Street, Boston, MA 02114, USA
Contact details
Anastasios D. Georgoulis, MD Methodiou Anthrakitou 1 Ioannina 45221, Greece E-mail: [email protected]
TEL/FAX: (+30) 26510-64980
1 ABSTRACT
Herodicus (5th century BC) is the first person in the history of medicine who actually combined sports with medicine. He used to be a sports teacher, who later studied medicine and managed to succeed Euryphon in the medical school of Cnidos, one of the most prominent in ancient Greece together with its neighbor medical school of Cos (Hippocrates’ home). In Cnidos Herodicus formed his own theoretical perspective of medicine. He considered, namely, bad health to be the result of imbalance between diet and physical activity and for this reason he recommended strict diet, constant physical activity and regular training. He believed that this combination was the ideal way to maintain good standards of health and he applied this type of treatment method to his patients. Unfortunately, Herodicus’ works are lost today. However, excerpts of his medical system, which can be traced in ancient texts, support the fact that Herodicus can be considered as the father of sports medicine.
Study design: Historical paper
Key words: Sports medicine, history of medicine, physical activity, Herodicus, training, diet.
2 INTRODUCTION
Herodicus, a Greek physician lived and practiced medicine in the fifth century BC.
However, it seems that there are two men, both doctors who have been living in the same period in the extended region of ancient Greece, that bear the name “Herodicus”. The existence of the second one became known only in 1893 when the codex Anonymus
Londiensis, which included the first history of medicine, was found and published7. In this text, a “Herodicus of Selymbria” (Anonymus Londiensis: 9.20) and a “Herodicus of Cnidos”
(Anonymus Londiensis: 4.40) are mentioned one after the other. This is the reason that some scholars believed that actually there were two different men.
Nevertheless, a more careful examination of the information that codex Anonymus
Londiensis and other ancient sources, can lead us to the conclusion that they refer to one and the same person. Firstly, these two Herodicus were not only contemporaries, but also shared the same medical theories. More specifically, they both recognized that the primary cause of diseases is the lack of balance between movement and nutrition. Moreover, according to the medieval lexicon of Suda, “Herodicus of Selymbria” was the teacher of Hippocrates
(Hippocrates, doctor from Cos… his first teacher was his father and after him Herodicus of
Selymbria…)1. Despite the fact that modern scholars disagree on the truth of this statement
(most of them accept it as it is given8,10,12,14,18,21, but there are those who react with scepticism5), there is obviously a connection between Hippocrates and Herodicus, since central hippocratic doctrines can be found in Herodicus’ claims. At the same time, it is known that Hippocrates spent a few years in Cnidos before he started his career in Cos. This can be an additional argument for recognizing that the two Herodicus are actually one.
Among the medical schools which existed in ancient Greece during the time of
Hippocrates, those of Cnidos and Cos were the most prominent 11,13,24. Cnidos was a colony of
3 the Spartans (the residents of the ancient Greek city of Sparta from southern Greece) and an important port situated in the peninsula of Caria in the south-east part of Asia Minor, opposite to the island of Cos. On this passage between the Middle East and ancient Greece, Euryphon founded the first important medical school and began a tradition of medicine separating it from magic and mythology.
The cities of Cnidos and Cos were politically connected to the city-band of Exapolis and together with other cities in the area had as political and cultural center the Temple of
Apollo near to Cnidos16. The myth says that after the fall of Troya Asclepius’ son Podaleirios moved to the peninsula of Caria, where he married a local princess and set a new city named
Syrnos. Eventually his descendants, the Asclepiads, left this city and went either to Cnidos or to the island of Cos, where they passed the medical education from father to son. Among the
Asclepiads of both cities was an obvious connection and this is an additional argument for the existence of close communication between Cnidos and Cos15.
Collaboration and exchange of ideas, in parallel of course with scientific competition, can be traced in the relationship between the two nearby medical institutions. Despite the fact that doctrines of these two schools show more similarities than differences, there are some significant odds. The physicians of Cnidos gave great importance in taking the medical history of the patient and they also developed the process of differential diagnosis. In their descriptions of diseases, they were the first to differentiate the areas of symptomatology, aetiology, therapy, and prognosis. Unfortunately, only fragments are known today of these medical theories.
There is no doubt, however, that the great personality of Hippocrates shadowed both schools. This is why remarkable doctors such as Euryphon and Herodicus are rarely noticed by current scholars, although according to Sigerist23, both these two heads of the school of
Cnidos were outstanding physicians beyond any doubt.
4
SHORT BIOGRAPHY
Herodicus appears to have been born in the 5th century BC in Selymbria of Thrace.
The fact that this city was an old colony of Megara, situated on the north shore of the see of
Marmara, is responsible for his name “Megareus” (of Megara) in Greek documents (Platon,
Protagoras3, 316.d.9-316.e.1: Herodicus of Selymbria, primarily of Megara, who is still alive
[It means contemporary with Protagoras and Socrates, whose discussion recreates Platon] and a great sophist). Later, he studied and worked as a doctor-physician and dietician in
Selymbria, in Megara, and other cities of ancient Greece, such as Athens. In addition, he was educated as a sports teacher, which allowed him to better understand the role of exercise and balanced diet in medicine. Considering the fact that during his time sports teachers did not allow physicians to visit the gymnasiums and as a result physicians did not understand the world of sports, Herodicus had the unique chance to combine both areas: sports and medicine.
He was effective in this endeavor and he formulated his own theoretical perspective of medicine which he applied to his patients. Given the fact that they, as warriors who often participated to battles, were interested in keeping a good physical shape, welcomed
Herodicus’ strict principles and discipline approach to health. Herodicus emphasized the relationship between sports and health and he even lived by example as we will see below.
HIS THEORETICAL PERSPECTIVE
The founder of the school of Cnidos, Euryphon was the first to believe that diet has an important role in health7. According to him, the excrements which arise in abdomen after bad digestion are spread through the body, they reach the brain and eventually result in illness. On
5 the contrary, when the abdomen is empty, the digestive system works properly and people enjoy good health (Anonymus Londinensis: 4.31-40)9.
Influenced by this hypothesis, Herodicus formulated his own theoretical perspective.
He believed that food products are not correctly digested when people consume food without corresponding motion. Incorrect digestion can result to byproducts which generate two types of “bodily liquids”: a sharp and a bitter. The type of disease that results depends first on the domination of one bodily liquid over another (i.e. homeostatic imbalance) and secondly on location and organ, where bodily liquids congregate. Namely, there is a difference if the redundant bodily liquid is located at the brain, the liver, or the spleen (Anonymus Londinensis
4.40-5.34)9. The sharp and bitter bodly liquids are identical with the phlegm and bile, which constantly in later medical theories are considered to be pathogenic factors. Herodicus’ theory of “two bodily liquids” belongs to the fundamental medical doctrine from which the dominative “doctrine of four bodily liquids” came.19
It is obvious that Herodicus attached great importance to physical activity. He declared that sufficient physical activity and proper diet are vital to maintain good standards of health (Anonymus Londinensis: 9.20-36.)9. The restoration of a natural life was thought to be the basis for the healing of disease, which appears only as a result of a wrong way of life. It is very interesting to notice here that lack of physical activity and improper diet, have been implicated with numerous health problems in our present societies. Eventually Herodicus invented his own medical system, which first of all included a strict diet, consisted of grains and other foods generally regarded as unappetizing. His medical theory embodied also exhaustive training as a treatment method. Socrates in Platon’s Phaedros2 (227.d.2-5) admits that he was so pleased by the words of his interlocutor, that even “if Phaedros took the road to Megara, reached the city walls and turned back, as Herodicus did, he would follow him”.
According to the commentary of Hermias in this abstract of Platon’s6 (24.25-30) “Herodicus
6 the doctor used to train himself outside the city walls, starting from a certain distance, not very far away, but symmetrical. He was walking till the walls and then returning, and he did that many times”.
However, Herodicus sometimes followed this line of thinking to extremes and his instructions for a healthy life were quite complex. Thus, some ancient authors criticised him for being obsessive with his treatments. For example, the composer of Epidemics17 (: 6.3.18) notes that “Herodicus have killed fever patients by running exercises, many bouts of wrestling and vapour baths.” Platon in Res Publica4 (: 406.a.4-b.8) criticizes also his method to mix gymnastic training with medicine. It seems that the same opinion was shared by Aristoteles in
Rhetorica20 (: 1361b 4-6): “many men are in good health, for example Herodicus, but no one would congratulate them on their health, because they abstain from all or most human pleasures.” However, Herodicus persistency may be what separated him from others.
Despite the negative criticism, Herodicus had achieved significant results with his methodology. His theoretical perspective was greatly influenced from the philosophy of
Pythagoras, but no one can verify today if Herodicus was actually a student of Pythagoras; text tradition of ancient sources is disorderly and full of gaps22.
It is also obvious that his theory of the homoiostasis of the two liquids influenced later
Hippocrates, who developed the theory of the homoiostasis of the four liquids. Under this perspective one can says that Herodicus was a pioneer in setting the basis of the explanative westernized medicine.
CONCLUSION
Herodicus was a sports medicine doctor, one of the oldest of Cnidos’ medical school, who is known to us by name. He combined his knowledge of physical education and medicine
7 to develop new treatments that could benefit his patients. He formulated his own medical theory and he applied his ideas to his patients. His methodology is clearly relevant for our times since we have finally realized the importance of physical activity and proper diet to healthy living. He may be the first doctor that suggested patients to get off their beds and start moving after an injury. This is common practice today since we try to minimize bed rest.
Everyone had to recognize the value of the treatises of Herodicus. They were taken under consideration from doctors of that time and the years after19. His theory for the explanation of the diseases through the homoiostasis of the two liquids makes him a pioneer. Unfortunately, his works are lost and only excerpts of his theories and concepts can be traced today in ancient sources. There is no doubt, however, that Herodicus influenced directly the medical history by proposing the use of diet, training and physical activity. He has set the basis not only of sports medicine, but of all medicine in every field.
8 REFERENCES
1. Adler A., Suidae lexicon, v. I-IV, Leipzig 1928-1935 (repr. 1967-1971).
2. Burnet J., Platonis opera, v. II. Oxford 1901 (repr. 1967).
3. Burnet J., Platonis opera, v. III. Oxford 1903 (repr. 1968).
4. Burnet J., Platonis opera, v. IV, Oxford 1902 (repr. 1968).
5. Cohen M.R. – Drabkin I.E., A source book in greek science, Harvard University Press,
Cambridge, Massachusetts 1966, p. 503.
6. Couvreur P., Hermeias von Alexandrien. In Platonis Phaedrum scholia. Paris 1901
(repr. Hildesheim 1971).
7. Dambasis Ι.Ν., Historikai Iatrikai Meletai Seira Proti, Athens 1966, pp. 259-265.
8. Deichgräber K., Die ärztliche Standesethik des hippokratischen Eides, Quellen und
Studien zur Geschichte der Naturwissenschaften und der Medizin, 1932; 3:162.
9. Diels H., Anonymi Londinensis ex Aristotelis iatricis Menoniis et aliis medicis
eclogue. Commentaria in Aristotelem Graeca suppl. 3.1, Berlin 1893.
10. Edelstein L., Ancient Medicine. Selected Papers of Ludwig Edelstein, Baltimore-
London 1987, p. 138.
11. Grensemann H., Knidische Medizin. Teil I: Die Testimonien zur ältesten knidischen
Lehre und Analyse knidischer Schriften im Corpus Hippocraticum, Berlin-New York
1975.
12. Hartofilakidis-Garofalidis G. – Papathanassiou B. T., Orthopaedics in Ancient Greece,
Clinical Orthopaedis and Related Research, 1972; 88:309.
13. Jouanna J., Hippocrate. Pour une archéologie de l’Έcole de Cnide, Paris 1974.
9 14. Kiel F., Herodikos, Der Kleine Pauly, 1967; 2:1098.
15. Kollesch J., “Knidos als Zentrum der frühen wissenschaftlichen Medizin im antiken
Griechenland”, 1989; (46) 12-13.
16. Legrand Ph.-E., Hérodote. Histoires, v. I-IX, Paris 1932-1954 (repr. 1968-1970).
17. Littré É., Oeuvres complètes d'Hippocrate, v. II, III, IV, Paris 1840-1846 (repr.
Amsterdam 1961-1962).
18. Pauly-Wissowa, Realencyclopaedie, v. VIII1, pp. 978-979.
19. Pollak K., Die Heilkunde der Antike. Griechenland-Rom-Byzanz. Die Medizin in
Bibel und Talmud, Düsseldorf-Wien 1969.
20. Ross W.D., Aristotelis ars rhetorica, Oxford 1959 (repr. 1964).
21. Sarton G., A History of Science. Ancient science through the golden age of Greece,
Cambridge 1960, pp. 334-337.
22. Schumacher J., Antike Medizin. Die naturphilosophischen Grundlagen der Medizin in
der griechischen Antike, Berlin 1963, pp. 81-85.
23. Sigerist H.-E., A history of medicine, v. I-II, New York, 1951-61.
24. Thivel A., Cnide et Cos? Essai sur les doctrines medicales dans la collection
hippocratique, Paris 1981.
10