The good -- and the not-so-good -- lessons learned from ancient Greek doctors.

By Neil Osterweil
WebMD Feature

Reviewed By Brunilda Nazario

History doesn't record whether the first Olympic athletes in 776 B.C. went to sports medicine doctors, or if they took performance-enhancing substances.

But the record does indicate that even 3,000 years ago, medicine was considered to be a good career path: "A physician is worth more than several other men put together, for he can cut out arrows and spread healing herbs," says a character in Homer's Iliad, referring to a battlefield medico who was the Trojan War equivalent of Hawkeye Pierce from M*A*S*H*.

Today's doctors don't spend much time yanking out arrows, and while some still spread healing herbs, we call it "alternative and complementary medicine" and hope that Medicare will cover it.

Still, modern medicine is riddled with relics of ancient Greek science, from versions of the Oath of Hippocrates that some graduating medical students still utter ("I swear by Apollo, the Physician and Asclepius and Hygeia and Panacea and all the gods and goddesses ..."), to the techno-jargon that doctors spout. According to Dorland's Illustrated Medical Dictionary, nearly 90% of medical terms used today have Greek or Latin roots. So the next time someone tells you you've got hyperkeratosis, you can reply, "I don't know what it is, but it's Greek to me!"

Yet apart from confusing technical terms and solemn oaths, do we really owe the ancients any thanks for modern medical wisdom? It depends on what bits of medical wisdom you value, historians say.

Humor Me

According to legend, the field of medicine was created by the centaur Chiron after he was wounded by Hercules and needed to heal himself. Chiron is also said to have passed on his medical wisdom to the hero Achilles. Whether the centaur invented the waiting room or managed care is unknown.

Greek gods, goddesses, and demigods such as Apollo, Asclepius, Hera, and Hygea were also credited by ancient worshipers with healing power. But it was the revered Greek doctor Hippocrates, who lived around 400 B.C. who is given the nod as history's first medical superstar.

"Hippocrates is generally credited with turning away from divine notions of medicine and using observation of the body as a basis for medical knowledge. Prayers and sacrifices to the gods did not hold a central place in his theories, but changes in diet, beneficial drugs, and keeping the body 'in balance' were the key," notes an article on the National Library of Medicine's History of Medicine division web site.

OK, so the old boy knew a thing or two about maintaining health. But the same source goes on to note that Hippocrates had some ideas that, while all the rage infifth century B.C., aren't given much credence in 21^st century A.D.: "Central to his physiology and ideas on illness was the humoral theory of health, whereby the four bodily fluids, or humors, of blood, phlegm, yellow bile, and black bile needed to be kept in balance. Illness was caused when these fluids became out of balance, sometimes requiring the reduction in the body of a humor through bloodletting or purging."

In truth, what Hippocrates and his contemporaries didn't know about medicine could fill a book, but what they thought they knew could also fill a book, or even a whole set of encyclopedias.

Nearly 60 treatises on everything from diagnosis, infectious diseases, pediatrics, and surgery have been attributed to Hippocrates, but these works, known as Hippocrates' "corpus" were probably penned by several different authors spread out over a couple of centuries, and the treatises often contradict one another, according to the NLM.

"If you read through the corpus, what you find is not so much medical knowledge that's of use to us, but you find a way of thinking about medicine -- the obligation of the doctor to his patient and to his fellow doctors and so forth," Ann Ellis Hanson, PhD, senior research scholar and senior lecturer in Classics at Yale University in New Haven, Conn., tells WebMD.

Teaching New Docs Old Tricks

Hanson says that like the writings of Plato on questions of justice and ethics, and the writings of Aristotle on biology and physics, the medical knowledge of ancient Greece was an attempt to put the world "into if not the physical control, the mental control of human beings."

She notes that while the ancients also performed medical research, they did so only to confirm what they actually knew, rather than to test an unproven idea as we do today.

But by the middle of thethird century B.C., doctors in Alexandria, Egypt, were beginning to conduct systematic dissections of animals and human bodies, and even (if you're squeamish, you may want to skip this part) vivisection (dissection of a living body).

The knowledge of anatomy gained through these practices was put to use by another famous doc of antiquity, known only as Galen. Born in Asia Minor in the year 131, Galen earned his reputation as a surgeon to the gladiators of Pergamos, an ancient Greek city located in what is now Turkey.

After nearly four years of patching up hacked-up combatants, Galen moved to Rome where he soon gained fame as an anatomist and as a doctor to Roman emperor Marcus Aurelius and three of his successors.

Galen wrote on anatomy, physiology (how the body functions), and treatment; his surviving works (many which were lost after the fall of the Roman Empire in thefifth century, later to be rediscovered in the libraries of the Moorish empire) had a profound influence on European medicine.

Like any good scientist, Galen was an observer and an experimenter, commenting, for example, with a good deal of insight into the nature and function of the kidneys and the secretion of urine. In his treatise titled On the Natural Faculties, Galen matter-of-factly points out that "practically every butcher is aware of this, from the fact that he daily observes both the position of the kidneys and the duct (termed the ureter) which runs from each kidney into the bladder, and from this arrangement he infers their characteristic use and faculty."

"Galen, for all his mistakes, remained the unchallenged authority for over a thousand years. After he died in 203 C.E., serious anatomical and physiological research ground to a halt, because everything there was to be said on the subject had been said by Galen, who, it is reported, kept at least 20 scribes on staff to write down his every dictum," describes an article on the web site of the historical collection of the University of Virginia.

What's Old Is New

Even though we frown on bloodletting and the notion of humoral balance these days, at least a few of the ancient's ideas as embodied in the Hippocratic Oath, such as abortion and euthanasia, still resonate today, Hanson tells WebMD.

In about the middle of the first century A.D., she notes, the Latin writer Scribonius Largus cited the Hippocratic Oath in support of his anti-abortion position. "His argument is that medicine is an art of healing, therefore abortion is not right," Hanson says. "And then 50 years later you get the Greek doctor Soranus actually quoting the Oath, and saying yeah, but there's another treatise in the corpus that does permit abortion, and therefore I'm going to follow that because there are times when you have to abort because the woman is going to die without it."

Some things never change.

Published Aug. 2, 2004.

SOURCES: Ann Ellis Hanson, PhD, Yale University, New Haven, Conn. Dorland's Illustrated Medical Dictionary, 27th edition. Selections from the works of Homer and Galen courtesy, Internet Classics Archive. National Library of Medicine, History of Medicine division. University of Virginia Historical Collections.

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