EARLY MEDICAL SCHOOLS

THE CULT OF AESCULAPIUS AND THE ORIGIN OF HIPPOCRATIC MEDICINE

By G. E. GASK, C.M.G., D.S.O., F.R.C.S., (Hon .) F.A.C.S.

LONDON

N COMMENCING a study divine beings, and so it came about that of medical education in when sick of soul or body men turned Greece and the early Greek to the gods of healing for help and guid- medical schools, one is con- ance. fronted immediately by a serious diffi- Even to-day such beliefs do not strike culty. In writing of the early medical us as strange for since childhood we schools, the more important of which have heard of the dreams of Pharoah are those of Cos and Cnidos, the diffi- and Nebuchadnezzar and the stories culty arises of disentangling the associa- connected with their interpretation. tion of temple-medicine as practised in the Aesculapium of Cos and of the lay Aesculapius, the God of Healing medicine described in the Corpus Hip- From the earliest times there have pocraticum. been gods specially associated with heal- Writers in the past have believed that ing and in Greek mythology one of the Hippocrates received his training in the earliest is Apollo. As the son of Zeus, Aesculapium and derived his great Apollo appears as the god of light, the knowledge from this source. It becomes god of spring, the giver of crops, the therefore imperative to examine this averter of ills, the promoter of health. question critically and to dispose of it His fame grew and his worship became before attempting to describe the school established, the two chief centres of of Cos. which were his birthplace, Delos, and This article contains a description of Delphi with its far-famed oracle. the Cult of Aesculapius, related, it is Now according to common account hoped, without prejudice, and is fol- Apollo had a son by Coronis, the daugh- lowed by arguments intended to refute ter of Phlegeas, prince of Thessaly, and definitely the possibility of temple- it is interesting to note that it was in medicine having been the source of the Thessaly tradition states that the cult of Hippocratic inspiration. Aesculapius arose. Coronis is supposed to have been THE CULT OF AESCULAPIUS killed by Artemis, twin sister of Apollo, The origins of healing cults are for unfaithfulness, and Aesculapius, her buried deep in the mists, fancies and son, was brought up by Chiron, the make-believes of the infancy of man- Centaur, who taught him the art of kind, when dreams were thought to be healing. Aesculapius profited so well warnings or revelations of things to from his teaching that he is said to have come. In sleep, it was thought, the soul been able to bring dead men to life. could slip the body and soar into the In Homer Aesculapius is represented realm of spirits, there to commune with as a hero not yet a god, and he had two sons, Machaon and Podaleirius, skilled cent proportions that they compel our in medicine and surgery, who fought at wonder and admiration to this day. Troy. The ritual of the proceedings of the Later, we do not know just when, cult were somewhat as follows: Aesculapius becomes a god. He was a The patient who was about to be a wonder worker, a healer, a saviour from suppliant was first prepared by absten- trouble and disease and one who could tion from certain forms of food and be propitiated by gifts and worship. So drink, or by absolute fasting, for with- his cult grew and temples for his wor- out such due preparation no person ship were established far and wide, in might enter the temple. On entrance to Greece, in the islands, and in the coastal the temple the patient would be met by regions of Asia Minor. the priest, who was often accompanied Aesculapius is generally represented by his daughter, for the purpose of re- with a staff in his hand and accompa- calling, one may imagine, that Aescu- nied by a snake. From very early times lapius was assisted by his daughters snakes have been associated with medi- Hygieia and Panaceia. The patient cine and life. Sir James Frazier suggests would then be told stories of wonders that the snake became the emblem of effected by the god and everything done immortality, for it seems to renew its to excite the imagination and raise the youth yearly by shedding its skin. expectation of a cure to the highest It will be recalled that in the wilder- pitch. Next came prayers and some form ness Moses made a serpent of brass and of ceremonial purification by washing. put it up on a pole so that all those who Then came the offering in the shape of had been bitten by the fiery serpents a cake, a cock, a ram or an ox, according were cured. to the wealth of the patient. The offer- ing was placed on an altar before the The places devoted to the worship of statue of the god, and apparently it or Aesculapius were called Aesculapia, the a portion of it became the perquisite of most famous of which were Tricca in the priest. Next followed the ceremony Thessaly, Epidaurus, Cos, and Perga- of incubation (literally lying-in) or mos.1 temple-sleep, the most impressive part The sites chosen for the temples were of the ritual. generally beautiful places, commonly The patients lay side by side in a long on wooded slopes and close to a pure open-tag">air portico, or abaton, covered at and bountiful supply of fresh water or the top and open at the side. Lights a medicinal spring. In addition to the were put out by the attendants and all temple or shrine of the god there were were told to go to sleep. inns or hostels for the reception of the Here the suppliants spent the night sick and their friends, as well as abatons and during sleep dreams came to them or sleeping places in which the sick by which they were cured or a means of passed the night and where they re- cure revealed. But about the sleeping ceived the dreams or revelation or treat- places there came at night tame snakes, ment which was to effect their cure. or in some instances dogs, who licked Closely associated with the temple the sore places or the blind eyes and buildings were ample facilities for ex- aided in the cure. ercise and recreation, including stadia In many instances a cure did follow, and open-air theatres of such magnifi- in which case the will of the god had been obeyed, but if no cure ensued then his bonds. Straightway he departed cured, the patient had omitted to do some- and the floor of the abaton was covered thing that should have been done. with blood. In the case of a cure it was a custom Many more instances could be cited, to consecrate a votive offering to the some of them dealing with affections of god or present a model of the diseased the eyes. But these are a fair sample of part or limb, made perhaps of gold or the votive inscriptions. They mostly re- silver, which could be hung up in the late immediate and miraculous cures, temple. It was common also to adorn and some of them are even more fan- the walls with votive tablets describing tastic than those quoted. Any medical cures for the benefit of future patients. man reading them would agree at once In Epidaurus a number of such inscrip- that they do not bear the slightest evi- tions have been discovered, done on dence of rational diagnosis or rational large stone stelae. treatment. Cure is by miraculous inter- Here are three such inscriptions:2 vention of the god following propitia- 1. Kleo was with child for five years. tion by gifts, aided by the use of sugges- After these five years of pregnancy, she tion and perhaps also by drugs. came as a suppliant to the god and slept Exception might be taken to this in the abaton. As soon as she left it and judgment in the case of the third exam- got outside the temple precincts, she bore ple quoted—the man with the abscess. a son who, immediately after birth, Professor Singer thinks that the man was washed himself at the fountain and walked given a powerful narcotic and that, about with his mother. In return for this while he was under its influence, the favour, she inscribed on her offering: “Ad- mire not the greatness of this tablet, but priest, in the guise of the god, opened the divine power, in that Kleo was with the abscess with a knife “and the floor child for five years, until she slept in the of the abaton was covered with blood.” Temple and the god cured her.” The Rev. John Todd thinks it was 2. A man had his toe healed by a ser- merely an advertising stunt to impress pent. He was suffering dreadfully from a the patients with the power of the god. malignant sore in his toe, when the ser- In 388 b .c . Aristophanes exhibited vants of the Temple took him outside and his play “Plutus” in Athens, probably sat him on a seat. When sleep came upon in the theatre of Dionysus, which is him, a snake came out of the abaton and alongside of the Aesculapium. In this healed the toe with his tongue, and there- after went back to the abaton. When the play Aristophanes depicts what hap- patient woke up and saw that he was pened in the Temple, and, though healed, he said that he had had a dream the scene is interlarded with a good deal that a beautiful youth had put a drug of buffoonery, it is thought by scholars upon his toe. to be a good description of what went 3. A man had an abdominal abscess. He on, and it agrees in the main with other saw a vision and thought that the god descriptions. ordered the slaves who accompanied him The plot of the play turns on that to lift him up and hold him, so that the abdomen could be cut open. The man ancient problem— Why do the ungoldly tried to get away, but his slaves caught prosper while the righteous are needy him and bound him. So Aesculapius cut and poor? The question is answered him open, rid him of the abscess and then with a jest; it must be that Wealth or stitched him up again, releasing him from Plutus is blind. So Plutus is induced to become a suppliant in the Temple of Two enormous serpents . . . Aesculapius, and he has his sight re- And underneath the scarlet cloth they crept And licked his eyelids as it seemed to me. . . stored, and then the tables are turned. And behold! Plutus had his sight restored. The scene, laid in the sanctuary of the Aesculapium, is described by one For another contemporary account purporting to be an eye-witness, as fol- of an Aesculapium we may turn to the lows:3 Mimes of Herondas, who wrote them for Alexandria about 270-250 b .c . Then to the precincts of the god we went There on the altar honey cakes and bake- meats The scene is laid in the Temple of Were offered, food for the Hephaestian Aesculapius in Cos, and it describes the flame; visit of two country women, Kynno and There laid we Wealth as custom bids; and Kokkale, in an amusing dialogue. The we Mime is valuable also for the descrip- Each for himself stitched up a pallet near. . . . tion of the groups of statuary and paint- ings that adorned the Temple and also The narrator then tells how there were for the current opinion of them as ex- many others present . . . pressed by the women. This temple was Sick with many forms of ailment; enriched with many famous works of . . . soon the temple servitor art. There was the Venus of Cos by Put out the lights and bade us fall asleep, Praxiteles and paintings by Apelles, no- Nor stir, nor speak, whatever noise we heard; tably the Venus Anadyomene, which it So lay we down in orderly repose. is interesting to note was not mentioned Then the witness describes how he in the “Mime.” could not sleep, and he saw the priest It is thought by scholars that the “Boy whipping the gifts of food from the holy Strangling the Goose,” which is men- table and consecrating them—into a tioned, was the original of Boethus, of sack.* whom Pliny (n .h .xxx iv ) says (Bohn Then after some coarse jests he de- translation): scribes the action of the priest, on whom Boethus, although more celebrated for he spied through the holes in his man- his works in silver, has executed a beauti- tle with which he muffled his head. He ful figure of a boy strangling a goose. describes how the priest mixed a plaster, Copies of this exist now in the Vatican, mingled with verjuice and squills, and the Louvre and at Munich. anointed the eyelids of a patient near by, making him yell. DEDICATION AND SACRIFICES TO Then the turn of Plutus came— AESCULAPIUS Then, after this, he sat him down by Plutus, The Fourth Mime of Herondas. And first he felt the patient’s head, and next (Translation by Walter Headlam.) Taking a linen napkin, clean and white, Kynno Wiped both his lids and all around them dry. Then Panacea with a scarlet cloth Hail to thee, Lord Paieon, ruler of Covered his face and head; then the god Tricca, who hast got as thine habitation clucked, sweet Kos and Epidauros, hail to Ko- And out there issued from the sacred shrine ronis thy mother withal and Apollo; * This reminds one of the Sons of Eli as hail to her whom thou touchest with related in I Samuel, 2, who took for their thy right hand, Hygieia, and those to own use portions of the sacrificial offerings. whom belong these honoured shrines, Panake and Epio and Iaso; hail ye twain never seen in all your life. Kydilla, go which did sack the house and walls of and call the sacristan. It’s you I am Leomedon healers of savage sicknesses, speaking to, you who are gaping up and Podaleirios and Machaon, and what down! La! not an atom of notice does gods and goddesses soever dwell by thy she take of what I am saying, but stands hearth, Father Paieon; come hither and stares at me for all the world like with your blessings and accept the after- a crab! Go, I tell you again and call the course of this cock whom I sacrifice, sacristan. You glutton, there is not a herald of the walls of my house. For we patch of ground, holy or profane, that draw no bounteous nor ready spring; would praise you as an honest girl— else might we perchance, with an ox or everywhere alike your value is the same. stuffed pig of much fatness and no hum- Kydilla, I call this god to witness that ble cock, be paying the price of cure you are setting my wrath aflame, little from diseases that thou didst wipe away, as I wish my passion to rise. I repeat, Lord, by laying on us thy gentle hands. I call him to witness that the day will Set the tablet, Kokkale, on the right come when you shall have cause to of Hygieia. scratch your filthy noodle.

Kokkale Kokkale La! Kynno dear, what beautiful stat- Don’t take everything to heart so, ues! What craftsman was it who worked Kynno; she is a slave, and a slave’s ears this stone, and who dedicated it? are oppressed with dulness.

Kynno Kynno The sons of Praxiteles—only look at But it is day-time, and the crush is the letters on the base, and Euthies, getting greater, so stop there! for the son of Prexon, dedicated it. door is thrown open and there is ac- cess to the sacristy. Kokkale Kokkale May Paieon bless them and Euthies for their beautiful works. See, dear, Only look, dear Kynno, what works the girl yonder looking up at the apple; are those there! See these, you would wouldn’t you think she will swoon say, were chiselled by Athene herself away suddenly, if she does not get it? —All hail, Lady! Look! This naked Oh, and yon old man, Kynno. Ah, in boy; he will bleed, will he not, if I the Fates’ name, see how the boy is scratch him, Kynno; for the flesh seems strangling the goose. Why, one would to pulse warmly as it lies on him in the say that the sculpture would talk, that picture; and the silver toasting iron! is, if it were not stone when one gets If Myllos or Pataikiskos, son of Lam- close. La! in time men will be able even prion, saw it, wouldn’t their eyes start to put life into stones. Yes, only look, from their sockets when they suppose Kynno, at the gait of this statue of Ba- it real silver! And the ox and its leader, tale, daughter of Myttes. Anyone who and the girl in attendance, and this has not seen Batale may look at this hook-nosed and this snub-nosed fellow, image and be satisfied without the have they not all of them the look of woman herself. light and life? If I did not think it would be unbecoming for a woman, I Kynno should have screamed for fear the ox Come along, dear, and I will show would do me a hurt; he is looking so you a beautiful thing, such as you have sideways at me with one eye. Kynno not really so many, there were a great Yes, dear, the hands of Apelles of number. Ephesus are true in all his paintings, Mention will only be made here of and you cannot say that he looked with some of the more important or, perhaps favour on one thing and fought shy of it would be better to say, those of which another; no, whatever came into his we know most, namely, Epidaurus, Cos, fancy, he was ready and eager to essay Athens, Pergamos and Rome. off-hand, and if any gaze on him or his works save from a just point of view, Epidaurus may he be hung up by the foot at the The temple of Epidaurus is beauti- fuller’s! fully situated on a little green plain sur- Sacristan rounded by hills, and prominent on the Your sacrifice is entirely favourable, hillside is the theater, the finest that ladies, with still better things in store; Greece can boast. The excavations of no-one has appeased Paieon in greater Kavvadias in 1881 have brought to light sort than you. Glory, glory to thee, the plan of the temple, the ruins of Paieon; may’st thou look with favour buildings as well as many inscriptions for fair offerings on these, and all that which have given valuable information be their husbands or near of kin, Glory, as to the forms and ceremonies, and the gloryl records of cures. The buildings con- Paieon sisted of the temple with its precincts, Amen, Amen! sleeping places or abatons, and a large building probably used as a hostel for Kynno the patients and their friends while Amen, Almighty, and may we come waiting for admission to the temple. again in full health once more, bring- In addition to these, which are com- ing larger offerings, and our husbands mon to most temples, there was a circu- and children with us. Kokkale, remem- lar building called the Tholos, the pur- ber to carve the leg of the fowl off care- fully and give it to the sacristan, and pose of which is not known. “One sees put the mess into the mouth of the a maze of circular walls, with two con- snake reverently, and souse the meat- centric series of columns. The floor was offering. The rest we will eat at home; paved with flagstones, and in the center and remember to take it away. was a well or pit. Kawadias believes Sacristan that it was used for rites and sacrifices connected with the ceremony of puri- Ho! there! give me some of the holy bread; for the loss of this is more seri- fication.”2 ous to holy men than the loss of our The whole of these buildings are portion. thought to date from the fourth century b .c ., though the worship may have ex- THE SITES OF THE CULT OF AESCULAPIUS isted in the same place for one or two There were a great many temples hundred years previously. The inscrip- erected for the worship of Aesculapius tions mentioned above were found at all over Greece, for the cult became Epidaurus. popular and fashionable. It has been estimated by one authority (Roscher) The Aesculapium at Pergamos that there were as many as three hun- The Aesculapium at Pergamos is sit- dred and twenty and even if there were uated on rising ground a mile or two away from the acropolis which overtops many of the white marble seats are still it, and the modern town of Bergama is in position. This theater was built and about a kilometer away. The area of the given by the Roman Emperor Caracalla site is big, covering some ten or more (211-217 a .d .) as a thank-offering and acres, and the extent of the ruins shows recognition for regaining his lost what an important place it was in the health.4 This is the only nice thing past. which stands to the credit of a vicious It is said to have been founded in and monstrous Emperor. the fifth century b .c ., and it enjoyed a very wide fame, especially during the The Temple at Athens Roman period. The Aesculapium of Athens lies This Aesculapium corresponds in under the South side of the Acropolis, principle with the general plan which adjoining, on the East, the theater of has been already described. There was Dionysus. the great temple with stairs leading up It was nothing like so large, if one to it, and there was a second temple, the can judge from what remains, as those use of which is not clear. There is a of Epidaurus and Pergamos, but similar clearly marked abaton or sleeping place in structure and general lay-out. There 82 meters in length, the supporting col- are the ruins of what was probably the umns of which are still visible, though temple of Aesculapius, and very obvi- badly broken, probably the result of the ous are the remains of an elongated many earthquakes which have visited portico or abaton, with a number of the town. broken columns of Pentelic marble. In the center of the site is a great Then there is a curious and mysterious square, and around it the foundations structure. It is a circular well-like affair, of buildings, the use of which one can surrounded by the bases of marble col- only guess at. In the center of the square umns. Most people think that it was the is a spring of beautiful water, which the pit in which the sacred snakes were inhabitants still use. kept. This, however, is only a guess, for The water from this spring flows there is no evidence on which to base an away in an underground channel, and opinion. There was no amphitheater in over the channel is a vaulted tunnel Aesculapium, but there was no need for some 80 yards long, which leads into an one because it was alongside of the great underground circular chamber, 50 or theater of Dionysus. In this theater the 60 yards in circumference, the center of priest of the Temple had a marble stall, which chamber is a solid core of ma- and his name inscribed on it can still be sonry. One can only guess at the use to seen. It is believed that the play by which this channel and chamber could Aristophanes, previously mentioned [p. have been put. It is as diflicult to ex- 8] was given here in 388 b .c ., and we plain as the circular Tholos at Epi- may imagine that it was witnessed by daurus. A suggestion is that it was in some of the patients in the Aesculapium. some way connected with the ritual of purification which we know from the The Temple of Aesculapius at Rome existing accounts formed a prelude to The temple and cult of Aesculapius admission to the Temple. which came to Rome was adopted di- In one corner of the area we find the rectly from Greece, and the new branch remains of a beautiful theater, where kept the same forms as its parent. According to tradition the founda- Greece. There is some evidence, worth tion of the temple at Rome was the out- consideration, that a similar cult had come of a severe and protracted plague existed for hundreds of years previously which occurred in 293 b .c . After con- in Egypt. sultation with the Sibylline books it was There is no doubt that incubation, decided to send an embassy to Epi- or temple sleep, was practised in Egypt, daurus, as the center of the cult, to ask and it is suggested that this cult was for help. The embassy came back bring- carried to Greece. It is suggested further ing with them one of the sacred snakes. that the Egyptian god of healing, Im- As they were sailing up the Tiber the hotep, was adopted by the Greeks under snake slipped over the side of the vessel the name of Aesculapius, even as the and swam to the island in the Tiber Greeks adopted other gods from foreign which is now called the Island of St. lands, and as the Romans in their turn Bartholomew. This was regarded as a adopted Greek gods. sign that here was the place to build the In these observations and records I temple. To recall the coming of the di- have followed J. B. Hurry, who has vine serpent the island was given the made an exhaustive study of the sub- form of a trireme, and when the river is ject.5 low the remains of the ancient stones Imhotep appears to have been born can still be seen, together with what about 3000 b .c ., a contemporary of probably is a representation of Aescu- Pharoah Zoser, of the Step Pyramid of lapius. There seems no doubt that a Sakkarah. temple was erected on this site, and that He was a talented and many-sided the cult of temple worship was carried man, occupying an exalted position as on for many years. vizier to Pharoah Zoser, a sort of Joseph, There is still a hospital on this island, with wide powers of administration and and according to tradition it was here jurisdiction. In addition, he was an ar- that, in about 1120 a .d ., Rahere, who chitect of no mean ability, as his father accompanied the court of King Henry was before him, and it is believed that the First, lay sick of a fever. Here he is he was the designer of the well-known supposed to have dreamt a dream in Step Pyramid, familiar to all who as- which it was revealed to him that he cend the Nile. What interests us more would be cured if, when he got back to than his skill as an architect or his wis- London, he would build a hospital for dom as a law-giver is his reputation as a the sick. As is well known, Rahere re- physician and fame as a healer. He has covered and went back to London, been described as the first inventor of where he founded St. Bartholomew’s the art of healing, and in the words of Hospital in Smithfield. So one may Sir William Osler as “The first figure of amuse oneself by thinking that there is a physician to stand out clearly from the still some connection between a modern mists of antiquity.” It was his power as London hospital and the old healing a healer, not as an architect, that gods of Greece. brought him lasting fame. It was for this he was deified and made the subject of Possible Source of the Cult of worship and his shrines a place of pil- Aesculapius in Egypt grimage for the sick, sorry, and suffer- So far the cult of Aesculapius has been ing. considered only as it was practised in The important Greek papyrus found at Oxyrhynchus in 1903, and known as adopted by the Greeks as Aesculapius is the “Oxyrhynchus Papyrus” enables the harder to accept. The evidence is not worship of Imhotep to be traced back convincing. Hurry was of the opinion to about 2850 b .c . We also learn that his that it was so, and we may leave it at temple was resorted to by the sick, and that. that incubation was practised. The Cult of Aesculapius in the Early Here is an account of one recorded Christian Era case: So far the description given has been Nechautis himself felt ill, suffering from of the cult in the late centuries b .c . pain in his right side, violent fever, loss of breath and coughing, associated with taken from the few sources available. pain in his side. He too, in his turn, and Several hundred years are to elapse be- accompanied by his mother, hastened to fore any more reliable information is the shrine and lapsed into half-conscious forthcoming. It appears that during this sleep. Meanwhile his mother, who was time the essential principles of the cult wide awake, suddenly perceived in a vi- had not changed but additions had been sion a being of supernatural stature, made in the shape of treatment by clothed in shining raiment and carrying means of dieting, bathing and exercises. a book, who regarded the patient intently Perhaps the belief in miracles was not from head to foot and then vanished. so easy to hold, and relief was demanded When the mother had recovered from her from all sorts of ailments which were surprise at the vision, she woke up the not easy to cure. They seem to have invalid and found that his fever had de- parted, leaving him in a profuse perspira- been fashionable resorts, for we hear of tion. As soon as the invalid was able to Emperors and notabilities visiting them, speak he began to recount what he had and one might say that in these respects seen in a dream . . . The pains in his side the temples took on a resemblance to a soon ceased, the god having given him an modern spa or watering place. assuaging cure. The best account of the cult in the second century a .d . is from the writings, There is another story of a man the Sacred Orations, of Aristides, one o£ named Satmi Khamuas, who was dis- the most celebrated of Greek rhetori- tressed because he had no man-child by cians. (An excellent résumé of the refer- his wife. His wife slept in the temple ences of Aristides is given by Mary and dreamed a dream that she would Hamilton in her book “Incubation.”) have a son, and she did. Aristides had a long illness and ac- Votive tablets were also hung up in cording to his own account derived the temple, and models of diseased or- much help from treatment received at gans, such as an eye, an ear, a foot, or various Aesculapia, and eventually he even a head, were dedicated to the god. accepted the office of priest of Aescu- It seems obvious then that the cult of lapius at Smyrna, which he held until incubation was practised in Egypt at a his death, about 180 a .d .6 He was obvi- very early date, and it bears a marked ously a neurasthenic suffering from in- similarity to the cult of Aesculapius as ternal pains, shivering fits, want of carried on in Greece, and it may well breath, choking in the throat, indiges- be that it was imported from Egypt into tion and sleeplessness. He spent a con- Greece. siderable time at Pergamos, where Aes- The suggestion that Imhotep was culapius himself sent him. He describes a night spent there, and how he was temple medicine is provided by Philo- given prescriptions, such as balsam to stratus in his Life of Apollonius of be used on leaving a hot bath for a cold Tyana. (Loeb Edit.) one, and soap, a mixture of raisins and This work was given to the public in other ingredients. The god ordered him 217 a .d ., and describes the life of Apol- to rub himself with mud and wash in lonius, the sage of Tyana, who lived in the well: that night he was told to wrap the first century a .d . himself over with mud and run three Here it is described how Apollonius, times round the temple: it was a north at the age of sixteen, became an ob- wind and keen frost: he did as ordered, server of the almost monastic rule of then bathed in the well and found him- Pythagoras. He renounced wine, be- self in fine condition. came a vegetarian, let his hair grow Aristides’ account of his illness and long, and went barefoot. (The type still the records of his symptoms and feelings seems quite familiar.) Philostratus nar- occupy many pages and are reminiscent rates how Apollonius found . . . of the long accounts with which neu- the atmosphere of the city (Tarsus) harsh rasthenic patients still deluge their and strange and little conducive to the medical practitioners. The accounts in- philosophic life, for nowhere are men terest us greatly, because they show us more addicted than here to luxury; jes- the sort of patients that visited the tem- ters and full of insolence are they all; and ples and the kind of treatment prac- they attend more to their fine linen than tised in this later period of their activi- the Athenians did to wisdom; and a stream ties. It is clear from the description just called the Cydnus runs through their city, given and also from the inspection of along the banks of which they sit like so the ruins, especially those at Pergamos, many water-fowl. that a change had taken place in the So Apollonius went with his teacher ritual of the cult. The temples were no and his father’s consent “to the town of longer merely the shrines of the healing Aegae, which was close by, where he god; they approximated more nearly to found a peace congenial to one who one of our modern spas. There was ob- would be a philosopher, and a more viously some form of direction in the serious school of study and a temple of treatment of a patient possibly by a resi- Aesculapius, where that god reveals dent physician. There was treatment by himself in person to men.” means of exercise and bathing and diet, Here Apollonius seems to have been as well as by therapeutic means, and no a great success, for the narrative records doubt they did a lot of good to many that people. A visit to the Aesculapium at Per- the people round about the Temple were gamos shows at once that the place was struck with admiration for him, and the admirably adapted for its purpose. god Aesculapius one day said to the priest Beautifully situated, a lovely view, and that he was delighted to have Apollonius with all the adventitious aids at hand as witness of his cures of the sick; and for amusement and recreation, one can such was his reputation that the Cilicians believe it would not be hard to spend a themselves and the people all around flocked to Aegae to see him. few weeks there and feel all the better for it. Interesting as this account is, yet it Another source of information on does not include one shred or tittle of evidence that any serious medicine was sion at the time of pilgrimage: the carried on in this temple. On the con- painting is on wood and is undoubtedly trary, the reputation that was gained by old, and is attributed there to the brush Apollonius may rather be attributed to of St. Luke. the belief in his magical and supernat- Need one say more than that there ural powers. Froude7 denounces him always have been, that there still are bluntly as an adventurer and classes him and always will be, people who prefer with Alexander of Abonotichus, the the magical, mysterious and unortho- greatest of rascals, the story of whose dox forms of medicine to the lay, the impostures have been told by Lucian. orthodox and rational? These are the chief sources of our in- formation as regards the cult of Aes- THE RELATION OF HIPPOCRATIC MEDI- culapius. They reveal that it existed for CINE TO THE CULT OF AESCULAPIUS many hundreds of years, that it was Having now completed a survey of widespread and fashionable, and was a the Cult of Aesculapius we may turn notable feature of Grecian life. It has to study Hippocratic Medicine and con- also been shown quite clearly that the sider the source of its inspiration. treatment practised in these temples was It was necessary to adopt this order based on magic and mysticism, and had because it has been stated and accepted nothing to do with scientific and ra- by many that Hippocrates gained his tional medicine. knowledge of medicine from the votive Lack of information makes it difficult inscriptions which he found in the to say what was the end of the cult. It Aesculapium at Cos, and that he actu- seems to have faded away as the Chris- ally was a priest in the temple. tian religion replaced the old paganism. The object of this article is to show Yet it did not disappear entirely, and that this hypothesis becomes untenable traces of it can be found through the on examination. mediaeval period and even into our It seems that Strabo was the first own times. Instances of this have been person to start this theory which has collected by Mary Hamilton.2 It need been so widely accepted. It must be re- only be mentioned here that certain membered, however, that Strabo was holy people such as St. Cosmas and writing some four hundred years after St. Damian, St. Cyrus and St. John, were the time of Hippocrates, and his evi- reputed to have miraculous healing dence need not be accepted blindly and powers, and that incubation was prac- without examination. It will be as well tised at their shrines. to see exactly what Strabo said.8 “It is As instances of the practice as carried out in our own times, one may refer to said that Hippocrates learned and prac- the pilgrimages which are still made to ticed the dietetic part of medicine from the island of Tenos and to Ayassos in the narrative of cures suspended there” Mitylene. Crowds of sick frequent these (meaning in the temple of Cos). churches at certain times of the year. Pliny also refers to Hippocrates in They sleep in the church or in the his Natural History (29.4) in similar courtyard, lying on mattresses or rugs, but more precise terms. Again we must and commonly a picture of the Virgin remember that Pliny was writing more is exhibited. Ayassos possesses a picture than four hundred years after Hippoc- of the Virgin which is carried in proces- rates. This is what he says: Hippocrates, born in Cos, was dedi- Plato (427-348 b .c .), who was a con- cated to Aesculapius; he is said to have temporary of Hippocrates, and who, copied out the temple records of treat- though younger, might well have ment, dedicated by the convalescents, and, known him, mentions him twice in his as Varro believes, after the temple was Dialogues (Protagoras and Phaedrus). burnt, to have established that art of medi- Here Plato calls him “Hippocrates of cine that is called “clinic.” Cos, the Asclepiad.” These two references are, as far as Now what did Plato mean exactly is known, the basis of the tradition that when he described Hippocrates as an has been handed down, that Hippoc- “Asclepiad”? rates drew the source of his infor- Much importance attaches to the mation and his experience from the correct interpretation of this term. medicine practised in the temple of Three interpretations have been ex- Aesculapius at Cos. pressed: Before embarking on the discussion, 1. The old view, now discarded by let us see what are the known facts con- competent authorities, is that the Ascle- cerning the life of Hippocrates. Unfor- piads were the priests of the temple of tunately these are but few. Aesculapius, and that they combined in We know that he was born in Cos, their persons the functions both of priest probably in the year 460 b .c ., and that and physician. he lived to an old age, till 80 or 90, or Dr. E. T. Withington has produced perhaps even longer. powerful and convincing arguments We know also that he came of a long against this view.11 family of physicians who claimed de- 2. A second view is that the Asclepiads were a guild of physicians supposed to scent from Aesculapius, and that they have been founded by Aesculapius, the were called Asclepiads. members of which were bound together His father was a physician named and swore the Hippocratic oath. Such is Heracleides. His grandfather, Hippoc- the view of Dr. Withington himself, rates 1, was probably a physician, and though it is supported by the scantiest of his great-great-grandfather, Nebrus, positive evidence.12 who lived in Cos during the seventh 3. A third view is that the term means and sixth centuries, was reputed to be literally “the family of Aesculapius and the most celebrated physician of his nothing more.” time.9 The view expressed here is that, after It is believed that Hippocrates trav- weighing all the evidence, direct and elled widely, and that he taught and indirect, the most likely view is the last, practised in Thrace, Thessaly, Delos, namely, that the term “Asclepiad” im- Athens and elsewhere. It is believed plies membership of an hereditary that he died at Larissa in old age. These family of physicians and nothing more. are the only facts conceming Hippoc- There is nothing strange or unusual in rates of which we can reasonably be this, for we know that in the past it sure. His life was written by Soranus of was common for families to exercise Ephesus in the second century a .d .; by certain trades and professions, by which Suidas the lexicographer, in the elev- means knowledge, especially of a tech- enth, and by Tzetzes, the historian, in nical character, was handed down from the twelfth century. None of them con- father to son. We know that there were tain much concerning him.10 such instances within the ranks of the medical profession. There were families Disease, it was thought, could be who specialised in couching for cata- averted or cured by the god of healing ract, and others were professional lithot- whose services were to be bought with omists. As facilities for education in- a cock or a ram, or even a honey cake. creased and books multiplied, the need The votive inscriptions show little or and desirability of such hereditary suc- no attempt at diagnosis and the ac- cession no doubt diminished, but in the counts of the cures are too fantastic for early days it had its uses. words. Take, for instance, the case of It may be considered presumptuous the delivery of the five-year-old child, on the part of a clinician without any or that of the broken goblet which was pretence of scholarship to venture on miraculously mended. They are all on an examination of this difficult subject. a par, and these, forsooth, are the al- It is thought permissible, though, to leged sources of scientific medicine. profit by the work of the scholars, to In the words of Gomperz (Greek make a critical examination of their Thinkers) they might appropriately findings, and to form an opinion as to find a home in the Arabian Nights. the correctness of their conclusions in Contrast this mentality with that re- matters affecting medicine. vealed by the Hippocratic treatises. It is so important to get this difficulty Perhaps the fairest and most judicial straightened out that the venture has summing-up has been made by Dr. been made. Charles Singer. He says: It will not be disputed, in fact it is The works of the Collection contain generally acclaimed, that Greek Medi- nothing of superstition. They are some- cine, as described in the Hippocratic times wearisomely sophistic; they are fre- treatises, reached a high standard, such quently ludicrously wrong; they often ad- a standard as was not equalled or sur- vance absurd hypotheses; they are not passed until recent times. Whether the seldom obscure; but the attitude of their Hippocratic collection was the work of authors to the supernatural is the same one man or of a number of men, and throughout, and none swerves in his loy- alty to the idea of the natural law.13 what were the dates at which they were written, need not concern us here. Such This revolt of the Hippocratians matters can be left in the safe hands of against the general acceptance of the scholars. divine origin of disease is well brought The point for discussion is whether out in the treatises on the Sacred Dis- there is any justification for the view ease or Epilepsy:14 expressed by Strabo and Pliny that Hip- It (epilepsy) is not in my opinion any pocrates gained his knowledge from the more sacred or divine than any other dis- temple practice. ease, but has a natural cause, and its sup- An examination of the records of posed divine origin is due to men’s in- temple medicine and the methods of experience and to their wonder at its dealing with the sick, and a comparison peculiar character.14 with the Hippocratic treatises show Contrast again the standard of that there is not the slightest similarity thought and action of temple medicine between the two. Temple medicine is as shown in the accounts of Aristoph- shrouded in magic and mystery. The anes, of Herodes and Aristides, with cause of sickness, being unknown, was the high moral tone of the Hippocratic attributed to a supernatural agency. Oath. This little document is a priceless not be accepted. Anyone who has seen possession. Here we have committed in the sort of things which still exist to- writing these noble rules, loyal obe- day in certain churches must realize dience to which has raised the calling of that the idea is ludicrous. a physician to the highest of all pro- It is true that the source of our fessions. knowledge of temple inscriptions is I will use treatment to help the sick based on those found at Epidaurus. No according to my ability and judgment, but inscriptions of this sort have been found never with a view to injury and wrong- at Cos. The assumption to be drawn doing. Neither will I administer a poison from Strabo is that at one time they did to anybody when asked to do so, nor will exist and that Hippocrates copied them. I suggest such a course. Similarly I will If they did exist there is no reason to not give to a woman a pessary to cause believe that they would have been any abortion. But I will keep pure both my different from those at Epidaurus. All life and my art. the evidence shows that the practice of The best of the Hippocratic collec- temple medicine at Cos was on the tion, and they are not all equal, as Dr. same lines as that at Epidaurus. Singer has shown, proves that the Since writing the above, the oppor- knowledge gained was the result of a tunity has been taken of consulting the close observation of nature and infer- findings of Rudolf Herzog,15 the exca- ences drawn from the results of ex- vator of the Aesculapium of Cos, who perience. Here we have the results of produces some important evidence the cool, clear light of reason rather which does not seem to have received than the vapourings of mystics and the attention of scholars. magicians. Yet, says Gomperz (Greek Herzog says, after reference to Pliny, Thinkers): Tacitus, and Herodas: Though advanced thinkers (c.p. Aris- From this it was the common opinion that the cult of Aesculapius at Cos was tophanes) poured their contempt on these old, and that his sanctuary dated from superstitious practices sanctioned by the before the time of Hippocrates. . . Paton natural religion, yet they were held in re- certainly (Paton and Hicks) had referred spect by wide classes of the populace and to the late appearance of Aesculapius in their efficacy was occasionally proclaimed the Coan coins (2nd cent. b .c .) and in the by the ravings of learned but foolish men, scanty appearance (of Hippocrates) in the such as Aristides, the rhetorician of Im- list of names and on the older inscriptions; perial Rome. but the picture might have been changed The fable that Hippocrates burnt through discoveries in the Aesculapium. the records of the cures in the temple of The result was the contrary and the inter- Cos, or, according to another version, pretation of the abundant material found in the temple of Cnidos, in order to se- since the time of Paton can bear but one meaning: a national cult of Aesculapius cure his own reputation, is too silly to did not exist before the middle of the require refutation. Similarly, the sug- 4th century, that is, before the death of gestion that the Hippocratians learnt Hippocrates. It can be no chance that in their anatomy from the replicas of dis- all these holy sites, where the gods con- eased limbs, eyes, ears, and other organs tinually recur in the different months, we that were hung up in the temples, mak- find no trace of Aesculapius and his fam- ing a sort of anatomical museum, can- ily. This is important evidence and con- was colonised at an early period by set- firmatory of the opinion based on the tlements from the Grecian mainland. medical evidence that the source of This coast, now so barren, is sparsely Hippocratic medicine was definitely inhabited, its natural harbours silted not taken from the temple cult of up, and the people backward, suffering Aesculapius. from hundreds of years of Turkish neg- The question that now naturally fol- lect. lows is where did Hippocrates and his It is difficult to imagine what it was disciples get their knowledge and ex- like in the sixth century b .c . Then it perience if they did not get it from the was the centre of the civilised world. temple practice of Cos. Beautiful buildings adorned the towns, The following pages will show that their temples were enriched by fine in the time of Hippocrates there ex- paintings and superb sculptures and isted a considerable body of scientific their harbours full of ships which sailed knowledge and that a number of books to Egypt, to the Black Sea and even to had already been written on Natural the Atlantic. Science, including the early exploration These were the surroundings in of the fields of biology, anatomy and which lived those men, filled with in- physiology. Evidence will be brought to satiable curiosity, who first pried into show that Hippocrates and his disciples the secrets of the universe. Philoso- availed themselves of this knowledge. phers, they were called, but the name There seems to be a vague idea that of natural scientists would perhaps give Greek Medicine sprang full-fledged into us a better idea of their activities. They being with the coming of Hippocrates. were not the impossible, abstract, dull This is really not the case, and there is people we are apt to associate with the as much reason for so thinking as to term philosopher: on the contrary, they suppose Greek art, architecture and were active, sensitive men, engaged in sculpture started in the time of Per- the most exciting pursuit of which the icles and that the preceding culture of human mind is capable and, as will be Mynos and Mycenae counted for seen later, they did not shut themselves nought. up in their laboratories, oblivious to This study sets out to show that the the world around them, but took an roots of Medicine lie deep in the work active share in the life and fortunes of of the early Greek philosophers or nat- their country. ural scientists and that it is possible to These early philosophers were en- trace, though admittedly in places with gaged in the study of the universe. They difficulty, a gradual development in were not doctors in our sense of the thought and practice until there came word, that is to say, specialised physi- the sudden outburst of intellectual ac- cians, for the separation of Medicine tivity which characterised the Golden from Philosophy did not come till the Age of Greece, in which Medicine took time of Hippocrates. For them at that its full part. time the study of man, the working of the human body and the way in which THE IONIC TRADITION our sense organs operate were as much The birthplace of science and of ra- part of their activities as mathematics, tional medicine was Ionia; the coastal music, physics and astronomy. In the fringe of western Asia Minor, which following pages slight reference will be made to their general work and atten- and though he was not a physician nor, tion riveted on their studies bearing on as far as is known, specially interested medicine. in medicine, the impetus he gave to Of the various Greek philosophers the study of Natural Science from which the following have been selected on ac- all medicine springs, was of such last- count of the influence they had on ing importance that his name must be Medicine: Thales of Miletus, Anaxi- mentioned when considering the be- mander, Anaximenes, Diogenes of Apol- ginnings of Medical Science. lonia, and Anaxagoras. Anaximander (fl. c. 565 B.C.) Thales of Miletus (639-544 B.C.) Anaximander was also a citizen of Miletus was the home of Thales, the Miletus and has been described as a first man of Science. In the sixth cen- younger associate of Thales. His ideas tury b .c . Miletus was a thriving colony on the universe are very difficult to situated near the mouth of the river understand, but he seems to have taught Meander. Owing to its excellent situa- that there was an eternal indestructible tion and convenience of four harbours, something, out of which everything it became the principal Greek city of arises and to which everything returns. that period. It is believed, and the be- This information is derived from Theo- lief is confirmed by finds of pottery, phrastus, wTho appears to have quoted that Miletus was already old when oc- Anaximander’s own words. Here is cupied by the Ionians, and that its his- what he says of him: tory went back to the time of the Mi- Anaximander of Miletus, son of Prax- noan civilisation. Burnet in his “Early iades, a fellow-citizen and associate of Greek Philosophy” refers to this point Thales, said that the material cause and and makes it clear that these early first element of things was the Infinite, he Ionian sages were not at all in the posi- being the first to introduce the name of tion of men setting out on an untrod- the material cause. He says it is neither water nor any other of the so-called ele- den path, for already the people living ments, but a substance different from round the Aegean Sea had reached a them which is infinite, from which arise high level of culture. all the heavens and the worlds within But with Thales a new thing came them.16 into the world. He was called the first Scholars have written pages and man of science and he was the founder pages on these metaphysical specula- of the Milesian school of scientists. tions, which do not seem to get us far. Many discoveries are put to the What really excites our admiration and credit of Thales. He is said to have amazement are his daring biological foretold an eclipse of the sun,* to have concepts. It is truly astonishing to find introduced geometry into Hellas and to in the sixth century b .c . a man pro- have started the practice of navigating pounding theories, which sound sur- ships by the “Little Bear.” In addition prisingly modern, of the evolution of to these things he held that the earth man. The following is the account of floats on water and that water is the Anaximander’s biological theories as ultimate origin of all things. given by Theophrastus: Altogether Thales was a great man Living creatures arose from the moist * Herod, i, 74. element as it was evaporated by the sun. Man was like another animal, namely, a nate, like Anaximander, but determinate, fish, in the beginning. The first animals for he said it was Air.18 were produced in the moisture, each en- closed in a prickly bark. As they advanced He thought that air, which he called in age, they came upon the drier part. pneuma, was the important primary When the bark dried off, they survived substance on which life and everything for a short time. depended and he thought that air was just as important to man as to the rest Further he says that originally man of the world. There is one fragment of was born from animals of another spe- his work that has come down to us that cies. His reason is that while other ani- goes to show what he thought: mals quickly find food by themselves, man alone requires a lengthy period of “Just as our soul, being air, holds us together, so do breath and air encompass the whole suckling. Hence had he been originally world.”18 as he is now, he would never have sur- vived. This phrase is one of the first to sug- He declares that at first human be- gest that these ancient philosophers ings arose in the inside of fishes, and were beginning to take an interest in after having been reared as sharks and physiological matters. become capable of protecting them- Scholars say that the influence of An- selves, they finally cast ashore and took aximenes was great on Pythagoras and his disciples, and that when science to land.17 once more revived in Ionia after the As Burnet says, it is clear that Anaxi- devastating incursions of the Persians mander, even if he does not deserve the it was the “philosophy of Anaximenes” title of precursor of Darwin, yet had a on which it was based. clear idea of what is meant by adapta- An interesting letter from Anaxi- tion to environment and the survival of menes to Pythagoras, his brother scien- the fittest. tist, has been preserved by Diogenes Anaximenes (fl. c. 546 B.C.) Laertius, describing his reactions to the troublous times in which he was living. Like Thales and Anaximander, who He writes: preceded him, Anaximenes was a cit- izen of Miletus. You are more prudent than we, in that you have migrated from Samos to Cro- Anaximenes added lustre to his na- tona, and live there in peace. For the de- tive town, for though, as far as we know, scendants of Aeacus commit unheard-of he did not do much to advance Medi- crimes, and tyrants never cease to oppress cine, he left behind him a reputation as the Milesians. The King of the Medes too a sound researcher in Natural Science. is formidable to us: unless, indeed, we He wrote a book, but very little of it choose to become tributary to him. But has survived. Theophrastus wrote a the Ionians are on the point of engaging special monograph on him, of which in war with the Medes in the cause of uni- versal freedom. For if we remain quiet the following is a passage: there is no longer any hope of safety to Anaximenes of Miletus, son of Eurys- us. How then can Anaximenes apply his tratos, who had been an associate of An- mind to the contemplation of the skies, aximander, said, like him, that the under- while he is in perpetual fear of death and lying substance was one and infinite. He slavery? But you are beloved by the peo- did not, however, say it was indetermi- ple of Crotona, and by all the rest of the Italians; and pupils flock to you, even there is inflammation of the vessels of the from Sicily. eye, the mixture with the air within being interrupted, vision is impaired, although Then comes the reply from Pythagoras: the image is reflected in the pupil as usual. You, too, my most excellent friend, if Similarly he said that “When the air you were not superior to Pythagoras in birth and reputation, would have de- within the head is struck and moved by parted from Miletus and gone elsewhere. a sound, hearing takes place.” But now the reputation of your father The longest of his surviving observa- keeps you back, which perhaps would tions was inserted by Aristotle in the have restrained me too, if I had been like third book of his History of Animals, Anaximenes. But if you, who are the most which deals with the origin and distri- eminent man, abandon the cities, all their bution of the veins. Here is the opening omaments will be taken from them, and passage of his description:20 the Median power will be more danger- ous to them. Nor is it always seasonable Diogenes of Apollonia writes thus: to be studying astronomy, but it is more “The veins in man are as follows: There honourable to exhibit a regard for one’s are two veins pre-eminent in magnitude. country. And I myself am not always oc- These extend through the belly along the cupied about speculations of my own backbone, one to the right, one to the fancy, but am busied also with the wars left; either one to the leg on its own side, which the Italians are waging against one and upwards to the head past the collar- another. (Bohn Edit.) bone, through the throat. . .” How fresh and modern these letters This passage, as indeed the whole of still read, though written over 2,000 Aristotle’s description of the vascular years ago. They might have been sent system, is a curious medley of fact and by a scientist in one of our poor dis- fancy. It surely must have been founded tracted European countries to a fellow- on direct observation by dissection, but workers in America. why is he so often and so flagrantly wrong? It suggests that careful drawings Diogenes of Apollonia (fl. c. 430 B.C.)12 were not made at the time of dissection, Diogenes of Apollonia was a pupil of and that when the author came to write Anaximenes and, like his master, he relied on his memory, and his mem- thought that air was the divine thing, ory played him false. the origin of all things, and the source Diogenes also discussed the subject of the senses and of thought. He wrote of memory and reminiscence, and was a book “On Nature,” of which a few probably the first to do so. On this ac- fragments have survived. He was clearly count Professor Beare calls him one of one of the earliest physiologists, and the most interesting of the pre-Platonic one of the first to make a study of the psychologists. special senses. The following passage is It is really surprising to think that taken from Theophrastus, (de Sens), at such an early time Diogenes got as and quoted by Beare.19 far as he did in understanding the func- Seeing takes place, according to Diog- tions of sensation, and though we know enes, by the reflexion of objects in the now, through the use of the microscope, pupil of the eye; for this, by being mixed that his observations were incomplete, with the internal air, produces the sense they undoubtedly indicate that he had of vision; a proof of which is that when a certain knowledge of the anatomy of the organs of the special senses. It also In Phaedrus (270) Plato puts into the seems impossible to believe that this mouth of Socrates: knowledge could have been obtained All the superior arts require many without dissection, though there is no words and much discussion of the higher documentary evidence to that effect. truths of nature; hence comes all lofti- Anaxagoras of Clazomenae ness of thought and perfectness of execu- tion. And this, as I conceive, was the qual- (born c. 499 B.C.) ity which, in addition to his natural gifts, Though an Ionian by birth, Anaxa- Pericles acquired from Anaxagoras whom goras is said to have gone to Athens he happened to know. He was thus im- about the age of twenty, and to have bued with the highest philosophy, and lived and taught there for thirty years. attained the knowledge of Mind, which He seems to have been well thought of was the favourite theme of Anaxagoras, and applied what he learnt to the art of by the Athenians, and became the speaking. (Jowett’s Transl.) teacher of Pericles and perhaps of Eu- ripides. Later he fell into disfavour, and Plutarch in his life of Pericles tells was accused of impiety, and quitted us that in Athens a decree was procured Athens for Lampsacus, where he died “that those who disputed the existence and was honoured by the inhabitants.9 of the gods, or introduced new opin- The chief thing for which Anaxa- ions about celestial appearances, should goras is remembered is that he con- be tried before an assembly of the ceived the universe to be composed of people.” permanent elements, unlimited in Now we know that Anaxagoras held number, directed by a spirit or Intelli- very advanced views, and for many very gence, which he called “Nous,” a word unsettling views, about the heavenly that has become part of our common bodies. He thought, and was daring speech. He was also a natural scientist enough to say, that the sun was a and had views on the physiology of the red-hot stone, and that “it is the sun organs of special sense which have been that puts brightness into the moon.”22 collected by Professor Beare.20 He also Perhaps it was for such views that An- had ideas on pathology, and held that axagoras was accused of impiety, and diseases were caused by bile penetrat- one’s mind leaps 2000 years to see Gali- ing into the blood-vessels and lungs.21 leo arraigned before the Inquisition for A review of his life affords the oppor- his heretical opinions on the solar sys- tunity of establishing the fact that, in tem. It seems likely that it is to these the time of Plato, Athens, and so pre- views of Anaxagoras on the heavenly sumably the rest of the Greek world, bodies that Plato refers in the Apology commanded a well-informed body of (26), when Socrates says: scientific opinion and also could buy books at a cheap rate. It seems reason- That is an extraordinary statement, Meletus . . . Do you mean that I do not able therefore to suppose that, if scien- believe in the godhead of the sun and tific books were sold in Athens, Hippoc- moon, which is the common creed of all rates also could obtain them. men?—I assure you judges that he does Plato mentions Anaxagoras several not believe in them, for he says that the times in his Dialogues, and he seems to sun is a stone, and the moon earth. have held him in high esteem. Friend Meletus, you think that you are accusing Anaxagoras; and you have The Italo-Sicilian School was but a bad opinion of the judges, if you founded somewhere about the fifth cen- fancy them ignorant to such a degree as tury b .c . by Ionian poets, philosophers not to know that these doctrines are found and physicians who emigrated from the in the books of Anaxagoras, the Clazo- Eastern to the Western shores of the menian, who is full of them. And these Mediterranean, settling in Sicily and are the doctrines which the youth are said Southern Italy, that part which was to learn of Socrates when there are not infrequently exhibitions of them at the known as Magna Graecia. theatre (price of admission one drachma The reason for this migration is un- at the most), and they might cheaply pur- certain, but in all probability it was in- chase them and laugh at Socrates if he fluenced by the loss of intellectual lib- pretends to father such remarkable views. erty which followed a change of (Jowett’s Transl.) government in Ionia. In the reign of Croesus (560-545 b .c .) the cities of Ionia So the books of Anaxagoras were cheap and easily obtained, and we can which were previously self-governing learn just what Socrates thought of fell under Lydian rule. Then shortly came the Mede, and all was changed. them. Socrates, speaking in the Phaedo Cyrus, King of Persia, defeated Croesus 97 and 98 (Jowett’s Transl.) says: and conquered all the Ionian cities. I heard someone who had a book of The Mede was feared and hated, and Anaxagoras . . . out of which he read his rule abhorred, and the great intellec- that mind was the dispenser and cause tual development which characterised of all, and I was quite delighted at this Ionia ceased. One is tempted to draw notion, which appeared admirable ... I an analogy between the dispersal of the had hopes which I would not have sold for much, and I seized the books and read Ionian philosophers by the Persians and them as fast as I could in my eagerness the persecution of the Jews by modern to know the better and the worse. What Nazism. Whatever the cause, the fact hopes I had formed and how grievously remains that there appeared in Magna was I disappointed. As I proceeded I Graecia scholars who studied philos- found my philosopher altogether forsak- ophy and science, and founded a school ing mind or any other principle of order, which Galen thought as good as those but having recourse to air and ether and of Cos and Cnidos. Of these men four water and other eccentricities. have been picked out for study, namely, The Italo-Sicilian School Pythagoras, Democedes, Alcmaeon and Empedocles, for the reason that their It has been seen from the preceding work influenced the writers of the Hip- remarks that the beginnings of the pocratic corpus. study of Natural Science were made by the philosophers of the Ionic School Pythagoras of Samos (c. 530-489 B.C.) and that they at the same time were in- It is difficult to know what to say teresting themselves in biology, physi- about Pythagoras. He was such a cu- ology and anatomy, the basic sciences rious character and, though much has from which rational Medicine sprang. been written about him, little is really We must now turn to another im- known. It seems that he was born at portant source of medical knowledge, Samos about 570 b .c ., and left there to the Italo-Sicilian School, which over- settle in Croton in Southern Italy, a lapped and succeeded the Ionic. town which was famous for its doctors. The reason why he left Samos is not Pythagoras had a theory that positive revealed to us, but perhaps it was be- agencies were included in numbers, cause he did not get on well with the that is to say, that numbers had impor- tyrant Polycrates (see the letter from tance in themselves and virtues in them- Pythagoras to Anaximenes, page 48). selves. Unity was perfection; the mate- He must have been a strange man, rial universe was represented by the though full of personal magnetism and number 2, and so on. The whole idea is capable of inspiration and leadership, incomprehensible and fantastic to us for he established a sect or brotherhood now, but it seems to have meant much which had a great influence on his con- to Pythagoras and his disciples. Out of temporaries and for a long time after. this theory that numbers possessed posi- The objects of the sect were partly re- tive agencies rose the conception that ligious, partly philosophical, and partly life was made up of four elements, earth, political; in fact, he set out to put his air, fire and water. Now to each of these world straight, a world which seems to four elements, earth, air, fire and water, have been in as great a need for setting was appended a quality, namely, dry, right as our own does to-day. There can cold, hot and moist. These four quali- be little doubt that the religious and ties could be arranged according to a mystic elements were predominant in scheme: his character, and that these made the profoundest impression on his contem- hot + dry = fire poraries, who regarded him as standing hot + moist = air in close connection with the gods.9 cold 4- dry = earth When one comes to study the other cold 4- moist = water qualities attributed to him, it is difli- Further it was thought that the four cult to dissociate fact from fancy. He is elements, earth, air, fire, water, together said to have believed in the transmigra- with their four qualities, hot, cold, dry, tion of souls, apparently on the grounds moist, formed the four humours (or, as that he begged that a dog should not be we should call them, fluids) of the body, beaten for he heard in its cries the namely, blood, phlegm (or mucus), voice of a departed friend. He is sup- yellow bile and black bile. posed to have discovered the pons asi- It must constantly be borne in mind, norurn and also to have constructed the in trying to understand this theory, that musical scale from noticing that a black- the word “humour” denotes always smith’s hammers were harmonious. It “fluid” and not “mood” or “state of is almost impossible at this distance of time to find out what he really did and mind.” thought. Next, these three sets of four ele- One may well ask, then, what had ments, qualities and humours, could be Pythagoras and his theories to do with brought by various permutations and medicine, and why should we worry to combinations into a complex system of understand what he was driving at. He arrangement based on the following is included here because scholars hold scheme: that his teaching had a great and last- hot 4~ moist = blood ing influence on science as a whole and hot 4“ dry = yellow bile thus on medicine. An attempt is made cold 4~ moist = phlegm (mucus) here to explain what this influence was. cold 4- dry = black bile The idea was also held that the rela- bile genders dreams of arrows and of tive proportions of the cardinal hu- fire with red flames and great beasts. mours of the body, blood, phlegm, Then she tells of the troubles caused by choler or yellow bile, and melancholy black bile: or black bile, determined a man’s dis- the humour of melancolye position and his physical and mental Causeth ful many a man, in sleep, to crye, qualities were influenced, in the view of For fere of blake beres, or boles blake, many, by the forces of astrology and the Or else blake develes wole him take. star under which a person is born. Then in effect she tells him that what This conception of disease and health he wants is a good dose. was known as “humoural pathology” and with various changes and additions For Goddes love, as take some laxatyf . . . I conseille yow the beste . . . was accepted and existed for many cen- That both of colere and of melancolye turies; indeed, until quite recent times, Ye purge yow . . . when it was finally swept away by the Ye been ful colorik of compleccioun. illuminating work of Pasteur. Ware the sonne in his ascencioun Many of the terms used to describe Ne finde yow nat repleet of humours hote. this humoural pathology have passed Then the good wife expounds the right into current literature. For instance, purgatives to use and where they are the use of the words “phlegm” and to be found. “choler” have become general, though undergoing some change of meaning There can be no doubt whatever that with the passage of time. Thus, now, Hippocrates and the writers of the Hip- the word “choleric” signifies irascibility pocratic corpus were quite familiar but in earlier times it meant “bilious- with the doctrine of Humours, and one ness” or a disorder of the bile and some- may presume that they had access to thing to be got rid of. An excellent de- the writings of these early philosophers scription of the humoural pathology to and physicians, from whom they took it. which the reader is referred, for it is Two passages are selected, though more comprehensible than most, is there are many more which might be given by Chaucer in his Nonne Preestes quoted. These should be sufficient to Tale of the Cok and Hen. Here the show that Hippocrates was familiar effects of the humours choler and mel- with them. ancholy on poor Chauntecleer are told The body of man has in itself blood, in Chaucer’s inimitable manner. phlegm, yellow bile and black bile; these It will be remembered that Chaunte- make up the nature of the body, and cleer awakes frightened out of a bad through these he feels pain or enjoys dream, and Pertelote, like a good wife, health. Now he enjoys the most perfect rated him roundly and told him that health when these elements are duly pro- portioned to one another in respect of dreams came from over-eating. . . compounding, power and bulk, and when and oft of fume, and of complecciouns, they are perfectly mingled.22 Whan humours been to habundant in a wight. Here is another instance taken from Certes this dream which ye han met to-night Ancient Medicine, XIX, Loeb Edit.: Cometh of the grete superfluitee Of your rede colera, pardee. No relief from these symptoms is se- cured until the acidity is purged away, She goes on to tell that the excess of red or calmed down and mixed with the other humours. But coction, alteration, thin- of Athens), where he set up in practice ning or thickening into the form of hu- and succeeded so well that in the second mours . . . to all these things surely heat year the state of Aegina hired his serv- and cold are not in the least liable. . . ices at the price of a talent; in the third For what shall we call it? Combinations year the Athenians hired him at a hun- of humours that exhibit a property that dred minae, and in the fourth Polyc- varies with the various factors. rates at two talents (say £500). This doctrine of “humoural pathol- So Democedes went to live at Samos. ogy” was not entirely the work of Py- How he achieved even greater fame thagoras. It was elaborated by Emped- under Darius the Great is a strange and ocles, an account of whom is given later, romantic story. A certain Oroetes, a but it is included here for the sake of Persian, was governor of Sardis in the lucidity. reign of Cyrus and later under Darius. It shows clearly that the views of Now Oroetes for some reason or other, Pythagoras and Empedocles were well which does not matter to us, conceived known to Hippocrates and his co-work- a hatred of Polycrates and wished to kill ers and that they adopted many of their him. By a ruse Polycrates was induced ideas. to pay him a visit, and he set sail from It shows also another aspect of the Samos accompanied, among others, by Greek mentality. They were intensely Democedes as his body physician. curious and had fertile imaginations. On arrival at Magnesia, Polycrates They were not content with not know- was put to death in such a revolting ing the cause of things; if they did not manner that Herodotus refused to de- know a reason, they invented one. They scribe it (522 b .c .). The followers of failed, however, greatly in not checking Polycrates were made slaves, and with their hypotheses by experiment. The them Democedes. age of the experimental method had But Oroetes was not allowed to en- not arrived. joy his triumph for long. Darius was now King of Persia, and Oroetes had Democedes of Croton (525 B.C.) somehow earned his ill-will. Instead of Democedes was another contempo- sending an army to punish him, Darius rary of Pythagoras, and was no doubt resorted to a stratagem whereby Oroe- influenced by his teaching. He was not tes was killed by his own guards, and a scientist or a researcher, but a prac- his treasure and slaves passed into the titioner and a clinician. For this we hands of Darius. Not long after this it have the authority of Herodotus, who “happened that King Darius, as he says: “It was by the success of Demo- leapt from his horse during the chase, cedes that the Crotoniats came to be sprained his foot.” (Herod.) It can have reckoned such good physicians; those of been no ordinary sprain, for Herodotus Croton the best and those of Cyrene the tells that the ankle-bone was forced out second in all Greece.” of the socket. Herodotus also relates that Demo- Darius called in his Egyptian physi- cedes left his native Croton because his cians, then reckoned the most skilled, father Calliphon had a savage temper but they only made matters worse, and and treated him cruelly. When he could the poor king was in such pain that for stand it no longer, Democedes sailed seven days and nights he had no sleep. away to the island of Aegina (just south On the eighth day Darius was told of the skill of Democedes the Crotoniat, Atossa accordingly approached the and he commanded him to be brought king, and the thing pleased him. So a forthwith. Democedes was found among party of fifteen Persian nobles were the slaves, and they brought him as he sent off with Democedes as their guide, was before the king, clanking with fet- with instructions to explore the coasts ters and clothed in rags. At first Demo- of Greece and to be sure to bring Demo- cedes refused to acknowledge who he cedes back. was, or admit that he was a physician, Soon they set off from Sidon in two lest he should be prevented from re- triremes and a trader, and they ex- turning home. It was only on the threat amined the shores of Greece, taking of torture that he was prevailed on. He notes of all they saw until they came to set to work and cured the king, but the bay of Tarentum in South Italy. We there is no clue to the methods he em- may be sure that it was Democedes who ployed, except that he used milder guided them, for this was his home. means instead of the violent treatment When they got to Tarentum, the king of the Egyptians. of the Tarentines kindly removed the As a thank-offering for his cure, Da- rudders from the Persian ships and de- rius presented Democedes with two sets tained the crew as spies. Meanwhile of fetters made of gold. These Demo- Democedes slipped away and made for cedes boldly refused, saying that he did Croton. The Persians pursued and not want his sufferings doubled. This found him in the market place, but the boldness pleased Darius, and Demo- people would not let him go. So the cedes was rewarded instead with a heap Persians sailed for home, but as they of gold. Thereafter Democedes lived in were departing Democedes sent a mes- comfort in a large house, and feasted sage asking them to tell King Darius, as daily at the king’s table; and he showed an excuse for his desertion, that he was his tact by interceding for the lives of going to marry the daughter of Milo, the Egyptian physicians who had failed the famous wrestler. There we must to cure the king, His heart, however, leave him with the hope that he lived was not in Persia; he was longing all happily ever after, for he now disap- the time to get home, and soon his pears from the pages of history. chance came. Atossa, wife of Darius, Alcmaeon of Croton (fl. c. 500 B.C. had an abscess of the breast, and when Garrison ) she could conceal it no longer she sent for Democedes, who promised to cure Among the pupils of Pythagoras the her on condition that she would grant most distinguished in Medicine was him his request, assuring her at the same Alcmaeon. time that this would not bring a blush He is of great interest because in his to her cheek. He cured Atossa and then work we can just catch a glimpse of the made his request. This was that Atossa beginnings of the experimental method should persuade Darius to send an ex- and also perhaps a vivisection. Unfor- pedition into Greece, with Democedes tunately it is only a glimpse, for only with them to show the way. This was the opening lines of one of his works not because he had traitorous designs and a few odd fragments have survived. on Greece, but simply because he His book began as follows: thought it would give him a chance to Alkmaion of Kroton, son of Peirithous, escape. spoke these words to Brotinos and Leon and Bathyllos: as to things invisible and portant discoveries respecting the anatomy things mortal the gods have certainty; but, of the eye and the optic nerves are due. so far as men may infer. . ,16 What we really want to know is, what Here the quotation breaks off, and for exactly Chalcidius meant by the word further information we have to rely on “exsectionem.” references by succeeding writers, Now Chalcidius lived a long while amongst whom was Aristotle, who men- after Alcmaeon, probably in the sixth tioned him twice in his Historia Ani- century of the Christian era, so that one malium (492 a. and 581 a. 16). He is cannot rely on him for any exact knowl- said to have discovered the Eustachian edge, and one is driven to circumstan- tubes and also the optic nerves, but his tial evidence to arrive at a conclusion. real claim to immortality lies in the The most obvious interpretation of fact that he was the first to regard the the word “exsectionem” is “excision,” brain as the seat of all sensation, and though it has generally been accepted not the heart or the blood round the that Chalcidius meant what we now heart, like Empedocles and Aristotle. term dissection. If one asks oneself the It is quite clear that Hippocrates was question whether it would be possible familiar with the work of Alcmaeon, for anyone to discover any such struc- for he adopted the conclusion that the ture as the Eustachian tube or the optic brain was the seat of sensation.23 nerve without laying bare these parts, The greatest interest for us in the the answer undoubtedly must be that life of Alcmaeon lies in the elucidation of the methods he employed in making it is impossible without cutting or dis- these discoveries. He is said to have section. We may therefore assume with been the first to practice dissection. Did fair certainty that Alcmaeon did prac- he dissect, and if so, did he dissect ani- tise dissection. But we have no evidence, mals or man? Was he a surgeon and did as yet, as to whether he used animals he excise the eyeball, as Clifford Allbutt or man for this purpose. Perhaps, how- says? Or did he practise vivisection? One ever, we may get a hint from Aristotle. finds on analysis that the source of all Even if it be accepted that Alcmaeon the information on this point rests did discover the Eustachian tubes, there solely on a statement made by Chalcid- is no evidence that he interpreted cor- ius in his work: “Interpretatio latina rectly the physiological function of partis prioris Timaei Platonici.” these tubes, that is, the equalisation of The passage reads: the atmospheric pressure on each side demonstranda igitur oculi natura est, de of the drum of the ear. Aristotle leads qua com plerique alii tum Alcmaeo Cro- us to think that he did not, for in his toniensis in physicis exercitatus quique Historia Animalium (492 a.) Aristotle primus exsectionem adgredi est ausus, et writes: Callisthenes, Aristotelis auditor et Hero- Furthermore, there is a portion of the philus multa et preclara in lusem protu- head whereby an animal hears, a part in- lerunt. . . . capable of breathing, the “ear.” I say “in- This may be translated freely: capable of breathing,” for Alcmaeon is mistaken when he says goats inspire Alcmaeon was the first to venture to through their ears. practise “exsectionem” and to him, as well as Callisthenes and Herophilus, many im- Take also a passage giving Alc- maeon’s idea of hearing (quoted by appears on the scene Empedocles, who Beare from Diel’s Fragments): lived in Agrigentum (Akragas) on the Alcmaeon says that we hear by means southern shore of Sicily. He was poet, of the vacuum within the ear, for this it philosopher, physician and scientist, is that transmits inwards the sounds though tinged withal with a mixture of (which come from without) at every emis- magic and mysticism. sion of the soniferous waves (into the His brilliant oratory, his profound outer ear), for all vacua are resonant. knowledge of nature and his success in It may be inferred from these pass- averting epidemics (probably malaria) ages that, though Alcmaeon may have by draining marshes have spread a halo discovered the Eustachian tubes, he did round his name which makes it difh- not recognise their true function, and cult to disentagle truth from tradition. thought that they formed part of the Like other philosophers of his time, mechanism of respiration. Further, the Empedocles wrote in verse and he ex- reference by Aristotle makes one think pounded his system in a long poem “On that the animal he used for dissection Nature” which consisted of 2000 hexa- was the goat. meter verses. As regards Alcmaeon’s work on the Of this poem considerable fragments eye, Hirschberg24 has written an ex- still remain and from these and from haustive account. Here he reviews all the writings of his successors, who pre- the evidence he has been able to collect sumably had access to his entire work, it to explain the term “exsectionem,” and is possible to form some idea of his he quotes the views of men who have views. In this study but little reference made a study of the subject. His conclu- will be made to his philosophical doc- sions seem to be most reasonable and trines, attention being concentrated on the most acceptable of any. his anatomical and physiological knowl- He says that it is unlikely that Alc- edge. maeon used human corpses for his re- Galen gave Empedocles the credit of searches, because the Pythagoreans ab- founding the Italian school of medicine horred touching the dead body, and that which he put on a level with those of human dissection first started with the Cos and Cnidos.25 Alexandrines. The school was still living in the In the opinion of Hirschberg, Alc- time of Plato, on whom it had a con- maeon was the first to venture to cut siderable influence, and still more on through or to cut out the connections Aristotle. between the eye and the brain, and to The work of Empedocles was also show that the cut was followed by blind- well known to Hippocrates, who refers ness. to it thus: The exact truth we shall probably Certain physicians and philosophers as- never know, but we can give to Alc- sert that nobody can know medicine who maeon the credit of being the first ex- is ignorant what of man is; he who would perimental researcher and the founder treat patients properly must, they say, of empirical psychology. learn this. But the question they raise is one for philosophy; it is the province of Empedocles of Agrigentum those who, like Empedocles, have written (fl. c. 444 B.C.) on natural science, what man is from the A little later than Pythagoras there beginning, how he came into being at the first, and from what elements he was should be given them for their pioneer originally constructed.25a work in the fundamental sciences. The fundamental doctrine of the This is the quotation from the poem Italian school was the identification of of Empedocles dealing with respira- the four elements, earth, air, fire and tion:26 water, with the qualities hot, cold, moist Thus do all things draw breath and and dry. This theory has been noticed breathe it out again. All have bloodless tubes and explained in the life of Pythagoras, of flesh extended over the surface of their bodies; and at the mouths of these the outer- and needs no further reference here. most surface of the skin is perforated all over Its adoption by the Italian school seems with pores closely packed together, so as to to show that it was accepted and taught keep in the blood while a free passage is cut by the leading scientists of the time. for the air to pass through. Then, when the The fragments of the poem “On Na- thin blood recedes from these, the bubbling ture” which still exist have been col- air rushes in with an impetuous surge, and when the blood runs back it is breathed out lected by Diels and translated by again. Just as when a girl, playing with a Burnet (Early Greek Philosophy). Quo- water-clock of shining brass, puts the orifice tations will be made from these to of the pipe upon her comely hand, and dips illustrate the views in the evolution of the water-clock into the yielding mass of medicine which Empedocles had silvery water—the stream does not then flow into the vessel, but the bulk of the air inside, reached. pressing upon the closely-packed perfora- It will be seen that respiration was tions, keeps it out till she uncovers the com- regarded as taking place through the pressed stream; but then air escapes and an pores of the skin and that the circula- equal volume of water runs in. tion of the blood was closely related to This passage is quoted by Aristotle.27 respiration. The heart too was regarded The water-clock is the klepshydra. as the centre of consciousness and not As regards vision Empedocles, as the brain, as Alcmaeon held. others about his time, speculated as to It could not be expected that people the conditions of seeing. Their knowl- at this time should have any intimate edge was slight. They knew that the knowledge of the working of the body, eye was the organ of sight and that light for observation did not go beyond what is essential for vision. They knew of the could be accomplished with the naked lens as an anatomical fact but had no eye. idea of its refractive properties or of Their theories of vision and of the the need of accommodation. They other special senses were arrived at thought that vision was connected with without a settled notion of physics or fire within the eye, being influenced by of the exact anatomical structure of the the fact that when the eye is pressed a sensory organs. The distinction be- flash of light is seen. They were entirely tween arteries and veins had not been ignorant of the existence and import- made and some even thought that these ance of the retina, though they knew vessels were channels for air and dis- that the eye contains “water.” charged the functions of the sensory and The following Fragment (84) is motor nerves. what Empedocles wrote: Still we can see the beginnings of sci- And even as when a man thinking to entific medicine and though these early sally forth through the stormy night gets men often went woefully astray credit him ready a lantern, a flame of blazing fire, fastening to it horn plates to keep lected all the accounts by Empedocles out all manner of winds, and they scatter on the Special Senses. He finds it diffi- the blasts of the winds that blow, but the cult to gather just what Empedocles light leaping out through them shines knew of the structure of the ear and across the threshold with unfailing beams, what he meant by the “fleshy sprout” as much of it as is finer; even so did she and the bell that rang in the ear. He (Love) then entrap the elemental fire, the round pupil, confined within membranes comes to the conclusion that he must and delicate tissues which are pierced have dissected the ear and found some through and through with wondrous pas- structure, though whether it was the sages. They keep out the deep water that drum of the ear or the cochlea is quite surrounds the pupil, but they let through uncertain. the fire, as much of it as is finer. It is clear, too, that Empedocles had some knowledge of embryology, for For the views of Empedocles on hear- Aetius, quoted by Burnet, tells us: ing and smell and taste we have the original words of Theophrastus.28 . . . that Empedocles held that the foetus was enveloped in a membrane and that Empedocles speaks in the same way of its formation began on the thirty-sixth all the senses, and says that perception is day and was complete on the forty-ninth. due to the “effluences” fitting into the pas- The heart was formed first, the nails and sages of each sense. And that is why one such things last. Respiration did not be- cannot judge the objects of another; for gin till the time of birth when the fluids the passages of some of them are too wide round the foetus were withdrawn. and those of others too narrow for the sensible objects, so that the latter either This statement surely implies some hold their course right through without careful and accurate observation of the touching or cannot enter at all. He tries developing embryo, for the beating of too to explain the nature of sight. He the heart is one of the earliest phe- says that the interior of the eye consists of nomena to be seen. May one not give fire, while round about it is earth and air, through which its rarity enables the Empedocles the credit for being the fire to pass like the light in lanterns. . . earliest embryologist? Hearing, he holds, is produced by sound Baas (History of Medicine) says that outside, when the air moved by the voice Empedocles was the first to recognise sounds inside the ear; for the sense of that the foetus is nourished through the hearing is a sort of bell (or gong) sound- navel (though the authority for this is ing inside the ear, which he calls a “fleshy not stated) and also that we owe to him sprout”. . . the term “amnion.” Smell, he holds, arises from respiration, and that is why those smell most keenly One cannot leave Empedocles with- whose breath has the most violent mo- out referring, though with some misgiv- tion, and why most smell comes from sub- ings as to its justice, to the strange mys- tle and light bodies. tic strain which pervaded his poem. His As to touch and taste, he does not lay followers have been blamed for leaving down how nor by means of what they the realm of pure science and cleaving arise, except that he gives us an explana- to ideas of a magical nature, and it is tion applicable to all, that sensation is believed that a protest was made against produced by adaptation to the pores. them as magicians and charlatans by a Professor Beare, in his “Greek The- Hippocratic writer.29 ories of Elemental Cognition,” has col- The passage reads: My own view is that those who first ocles on Etna.” He represents the man, attributed a sacred character to this mal- philosopher and physician, adored by ady (epilepsy) were like the magicians, crowds fretting vainly against the in- purifiers, charlatans and quacks of our consistencies and difhculties of life: own day, men who claim great piety and superior knowledge. Being at a loss, and In vain our pent wills fret having no treatment that would help, they And would the world subdue; concealed and sheltered themselves be- Limits we did not set Condition all we do. hind superstition and called this illness Born into life we are, and life must be our sacred in order that their utter ignorance mould. might not be manifest. Finally, with true poetic license, he Then the description of Empedocles makes Empedocles cast himself into the by himself is staggering, coming from crater of Etna, though for this dramatic the mouth of a scientist, such as he has end, scholars tell us there is no justifi- proved himself to be.30 cation. And thou shalt learn all the drugs that How shall we regard Empedocles? are a defence against ills and old age; It has been shown that he did a lot since for thee alone I will accomplish all of sound scientific work and then one this. Thou shalt arrest the violence of the is confronted by the astonishing state- weariless winds that arise to sweep the ment from himself that he went about earth and waste the fields and again, when crowned with fillets and flowery gar- thou so desirest, thou shalt bring back lands, honoured as an immortal god ca- their blasts in return. Thou shalt cause pable of arresting the winds and bring- for men a seasonable drought after the dark rains, and again thou shalt change ing rains in due season. the summer drought for streams that feed The two things do not hang together. the trees as they pour down from the sky. Was it mere bombast and had the adu- Thou shalt bring back from Hades the lation of the public turned his head? life of a dead man.30 Or was it rather the exaltation of a man Friends that inhabit the great town of science, who, having accomplished looking down on the yellow rock of Akra- much, believed that with increasing gas (Agrigentum) up by the citadel, busy knowledge and perfection of method, in goodly works, harbours of honour for the stranger, men unskilled in meanness, man could in time rule the elements? all hail! I go about among you an im- We shall never know the truth but the mortal god, honoured among all as is latter view is more reasonable and com- meet, crowned with fillets and flowery prehensive especially as the medium garlands. Straightway, whenever I enter Empedocles chose for his writing was with these in my train, both men and poetry. women, into the flourishing towns, is rev- erence done me; they go after me in CONCLUSION countless throngs, asking me what is the It is hoped now that the myth that way of gain; some desiring oracles, while Hippocrates drew his knowledge and some, who for many a weary day have inspiration from the practice in the been pierced by the grievous pangs of all Aesculapium in Cos is finally and for manner of sickness, beg to hear from me ever exploded. It has been shown that the word of healing.31 there is not a semblance of similarity Matthew Arnold has made Emped- between temple-medicine, if it is ocles the subject of a poem, “Emped- worthy of such a name, and the medi- cine described in the Hippocratic entirely the product of one man or one works. It has been shown also that the group of men, but the accumulation of origin of scientific medicine was not knowledge through many generations.

Ref ere nce s 1. Baas . Hist. of Med. 19. Greek Theories of Elementary Cogni- 2. Mary Hamil to n . Incubation. tion, p. 41. 3. Plut us , Aris top hanes , Loeb Transl., 20. Aris toi le . Hist. An. Book, 3, G2, 511 b. connnencing line 657. Edit. Smith & Ross. 4. Arc ha eolo gy Soci ety of Izmir No. 18. 20a. Beare . Greek Theories of Elcmentary 5. Hurry , J. B. Imhotep, 1928. Cognition. 6. Smith ’s Dict. of Greek and Roman Biog. 21. Baas . History of Medicine. and Myth. 22. Fragment 18, arranged by Diels and 7. Froud e . Short Studies in Great Subjects, quoted by Burnet, p. 261. Vol. iv. 22a. Hippo crat es . Nature of Man, IV, Loeb 8. Bohn , Edit. Strabo. B. XIV. C. 2:§ 19. Edit. mith s 9. S ’ Dict. of Greek and Roman Biog. 23. Hipp ocr ate s . The Sacred Disease, XVII, and Myth. Loeb. Edit. 10. Char le s Sing er , Brit. Encycl. 24. Hirs chbe rg . Arch. f. Ophth. 105:129, 11. Jones , W. H. S. Malaria and Greek His- tory. 1921. 25. Galen . Meth. Med., i, I. 12. Loeb , Edit. Hipp ocr ate s , Introduction 25a. Hipp ocr ate s . Ancient Medicine. Vol. I, by W. H. S. Jones, p. 45. 13. Brit. Encycl., 14dl Edit. p. 53. Loeb Edit. urne t 14. Loeb , Edit. The Sacred Disease. 26. B . Ibid. Fragment 100. 15. Herzo g , R. Heilige Gesetze von Kos: 27. De respir., 473, b, 9. Abhandlungen d. Preuss. Akad. der 28. Burnet . Ibid., p. 246. Wissenschaften, 1928. 29. Jones , W. H. S. Hippocrates, Locb, Edit. 16. Quoted by Burnet , Early Greek Philos- Introd. to The Sacred Disease. ophy, p. 52. 30. Fragments from the Poem of Empedocles. 17. IbicL, pp. 70-1. Quoted by Burnet. Fragment 111. 18. IbicL, p. 73. 31. Ibid. Fragment 112.