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CUHSLROG M104.Pdf (519.3Kb) Nov. 71 ROMAN AND BYZANTINE MEDICINE Selected Readings Sarton G: Galen of Pergamon WZ 100/Gl535/1954 Siegel RE: Galen 1 s system of physiology and medicine. WZ 220/Gl535i/1968 (N. B. 11 Galen 1 s life and character 11 , pp. 4-18) Galen: On the usefulness of the parts of the body. Tr. by Margaret May. 2 v. WZ 220/Gl53M/1968 (N. B. 11 Introduction1 1 , vol. 1, pp. 3-64) Soranus: Gynecology. Tr. by Oswei Temkin. WZ 220/S713T/1956 Neuberger M: History of Medicine. WZ 40/N478P/1910 (especially: ---- "Medicine of the Roman encyclopedists 11 , pp. 213-19 11 Aretaios, Rhuphos, Soranos 11 , pp. 230-7 11 Galen11 , pp. 240-73 N. B. 11 Medicine in the decline of antiquity; general conditions 11, pp. 276-98 "Byzantine medicine and literature 11 , pp. 324-343) Allbutt C: Greek medicine in Rome. WZ 51/A42lg/1921 Stahl WH: Roman science. WZ 51/S78lr/1962 Scarborough J: Roman medicine. WZ 51/S285r/1969 ✓ GALEN (130-201 AD) The greatest of Greek physicians after Hippocrates, Galen was born in 130 AD in Pergamum (where St. John had fulminated against the seven churches of Asia). He studied medicine in Smyrna, Corinth, and Alexandria, and for four years was physician to the gladiators in Pergamum. In 162 he went to Rome, and became physician to the emperor Marcus Aurelius, and later tutor of the emperor's evil son Commodus. Galen was a voluminous author, and his surviving works number more than one hundred treatises. He was a great anatomist; his knowledge was gained chiefly through the dissection of monkeys and pigs. He was an out­ standing experimental physiologist -- he described the recurrent laryngeal nerve and its function; he transected the spinal cord at various levels in experiments which would not be repeated and enlarged until the early 19th century (by Sir Charles Bell). His pathology remained essentially humeral, and his therapeutics were schematic and methodic, with a great predilection towards polypharmacy. He developed a highly speculative system of medicine based on teleological tenets ---- he believed that the creator had endowed every organ with a special purpose from which its function could be deduced. In other words, the important question to Galen was why, rather than how. His systematism and his teleology, so dear to the Middle Ages, are uncongenial to the modern mind,and his wordy, aggressive, and self-laudatory writings prevoke prejudice. But "no other physician has ever occupied the commanding position of Galen. For fifteen centuries he dominated medical thought; not until the Renaissance did daring spirits begin to question his infallibility". He was the greatest medical experimentalist of any time preceding the seventeenth century; with him medicine took a great step forward. Writings of GALEN Should you wish to bring the region below the inc i .s ed portion of the spinal cord into the paralytic state, and to arrest its movements, then carry the incision tranversely, and sever the spinal marrow with a cut running completely through so that no sort of union remains between its parts ••• After the incision, in all the nerves which lie below the place where the transection has been made, both the two potentialities are lost, I mean the capacity of sensation and the capacity of movement, and also all the bodily parts of the animal in which they are distributed become insensitive and motionless ••• But as to what concerns that nerve stem which I myself discovered and have named the 'upwardly recurrent' one, the origin of this nerve from the two sides, the right and the left, does not take place in the same manner... Follow closely the vagus nerve, where it lies alongside the carotid artery, until it enters the thorax... The head of the upwardly recurrent nerve on the right side enters into its ascending stage much more hastily, and winds itself around the artery which ascends toward the axilla, its position being oblique. .,.., / 1...-~7 . / ,. -~ ~_j - ---------~· () 0 ~ --,____ 27 BC Augustus 54 AD Nero 98 AD Trajan 117 Hadrian 138 Antoninus Pius 161 Marcus Aurelius 284 Diocletian 324 Constantine 361 Julian 527 Justinian SORANUS (90-150 AD) Soranus of Ephesus practiced medicine in Rome at the time of the emperor Hadrian (117-138). His work on Gynecology presents ancient gynecological and obstetrical practices which would persist unchanged through the middle ages and into the sixteenth century. His insight into the problems of dystocia still seem enlightened. The text of Soranus exhibited is that translated by Dr. Oswei Temkin, Professor Emeritus of the History of Medicine at Johns Hopkins, at the instance of Drs. Nicholas J. Eastman and Alan F. Guttmacher. 11 0f the Latin writers, Pla:tttus and Terence are remarkable for sidelights on obstetrics and popular medicine; Lucretius for anatomy, physiology, dietetics, hygiene, climatology, and the famous account of the plague of Athens which terminates his sixth book; Vergil for veterinary medicine; Horace and Juvenal for satirical sidelights on diseases and drugs of the time, personal hygiene, criminal abortion, insanity; Ovid and Catullus for innumerable details about sexual vices, venereal diseases, aphrodisiacs, and cosmetics; Martial and Petronius for sexual perversions; Livy for Roman medico-military administration; Suetonius for the mental disorders of the Caesars. 11 (F. H. Garrison) CELSUS (25 BC - 50 AD) All that survives of the large encyclopedia of the sciences written by Celsus is the medical portion. This compendium, by a man who was not a physician, was intended for use by the laity; it abounds in fresh and animated descriptions. While it owes its inspiration to the works of Hippocrates, "Celsus arrives at decisive judgments, frequently drawing his conclusions from personal experiences, and impresses upon his compilation the stamp of originality". (Neuberger) The most notable section of the book is the extensive section on surgery, which includes descriptions of lithotomy, plastic surgery, obstetrics, and the first description in the literature of the operation for cataract. The copy of De medicina shown here is the famous Aldine edition of 1528 (Venice). "There were sickness insurance associations and medical societies in Rome; there was an increasing tendency toward specialization and the state employment of physicians; and, toward the end, mystical healing cults grew increasingly popular. "The greatest medical contribution of the Romans was an indirect one. Inspired by their Etruscan predecessors, they built aqueducts, sewage systems, and bathing installations of unequaled magnificence••• Vitruvius, the great architect of the emperor Augustus, advanced the bold hypothesis that malarial fever was produced by small animals or insects coming out of the swamps••• 11 (Ackerknecht) PLINY (23-79 AD) In his encyclopedic Natural Hi story, Pliny devoted Books XX - XXXII to medical matters. Pliny gives a good account of the condition of the profession in his day, with quacks and magical charms in profusion. After giving a properly skeptical assessment of their claims, he proceeds to furnish us with a vast compilation of remedies even more fantastic. "Whosoever professes himself a physician is readily believed, say what he will; and yet to speak truly, there are no lies dearer sold or more dangerous than those that proceed out of a physician's mouth''. Pliny. PAUL OF AEGINA (625-690 AD) Paul compiled an Epitome of medicine in seven books. He was a very capable surgeon, and "gives original descriptions of lithotomy, trephining, tonsillotomy, paracentesis, and amputation of the breast. In describing herniotomy he recommends removal of the testicles, a mutilation which was perpetuated by the Arabians, and continued to be the vogue with the outcast medieval surgeons until far into the 16th century. Paul gives the fullest account we have of the eye surgery and military surgery of antiquity. The Pauline pediatrics and obstetrics summarize all that was known of these subjects from classical antiquity up to the Renaissance. 11 (F. H. Garrison) (The best English translation of Paul is by Francis Adams, the Scots practitioner who also translated Hippocrates. His three volumes on Paul, published by the Sydenham Society in 1844-47, are his magnum opus. (WZ 220/P333A/1844-7)) ALEXANDER TRALLES (525-605) His 11 twelve books upon pathology and the therapeutics of internal dis eases, in spite of the most careful consideration of antecedent literature, never lack fresh observation, clear conceptions and independent judgment. Although in matters of theory he avows himself a disciple of Galen, he yet maintains in practical questions an unshaken independence. Raised above the blind belief in authority of the age, Alexander does not hesitate to express individual opinions founded on genuine experience. The writings of Alexander exercised considerable influence upon the development of medicine; they were not only much used by all later Byzantines, but, in the shape of translations, penetrated both east and west; they stood, even in the most unenlightened times, as worthy models of genuine medical observation and criticism. 11 (Neuberger) One of his highly original books is on intestinal worms and vermifuges. He was the first to recommend colchicum in the treatment of gout. .. ORIBASIUS (325-403 AD) Court-physician to Julian the Apostate. He 11caught a reflection from the setting sun of antiquity and, full of reverence for the greatness of the far distant past, drew what was best from the medical works of his predecessors and by intelligent classification united the extracts into a coherent whole (70 volumes). Unfortunately a considerable portion of this encyclopedia has been lost, but what remains affords us a surprising insight into the wonderful richness of ancient medicine; the surgical sections --- the most complete technical treatise of antjq uity --- allow a reconstruction of the astonishingly developed surgical technique of the Roman-Alexandrian epoch 11• (Neuberger) I BYZANTIUM The western Roman empire lasted for 500 years; the eastern Roman empire, with its capital at Byzantium, lasted for over 1000 years (395 AD - 1453 AD).
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