Transcript Vestiges of Greek Medicine

Vestiges of Greek Medicine in
Modern Medicine
Denis Hadjiliadis, M.D.
Introduction
Greek Medicine: 6th century BC to 4th
century AD
Classical, Hellenistic and early Byzantine
era
Significance
Terminology
Diseases are thought not as acts of wrath of gods
Diseases are thought as imbalance of humors in
the body (krasiV) Systematic observation, history
and physical exam become the focus of physicians
Many medical and surgical treatments are
introduced
Terminology
Nosocomial infections are caused by Staphylococcus,
Pseudomonas, Enterococcus, Enterobacter and other
pathogens. Pneumonia and sepsis are paradigms of
nosocomial infections and they are commonly iatrogenic.
Sepsis when caused by gram negative bacteria has an
ominous prognosis. Endotoxin, which is released by gram
negative bacteria, is a microscopic protein that initiates a
series of symptoms and signs: tachypnea, tachycardia,
dilatation of arteries, cardiomyopathy and pulmonary
edema. Despite advancements in microbiology and new
methods of therapy, mortality remains high.
Terminology cont’d
Word count: 53 different words
Greek words: 27
English: 20
Latin: 6
Disease etiology
Classical Greece context:
Philosophy: effort to explain natural
events without attributing them to
supernatural forces.
History: documentation of events in a
logical manner, with causation and results
of human actions analyzed.
Disease etiology cont’d
Classical Greece context:
Politics: democracy first appeared.
Equality of citizens against the law and the
city-state acknowledged (unfortunately only
free men).
Medicine: contact with Phoenicians,
Egyptians brings new ideas.
Disease etiology cont’d
Disease etiology cont’d
Health: harmony of humors in balance;
“natural way” (eucrasia)
Disease: harmony disturbed, imbalance;
dyscrasia.
Nature (physis) has healing powers.
Physician supports patient till nature heals
him/her.
Treatment was generally conservative
Disease etiology cont’d
Allopathic medicine is created
Example in modern times: patient has a
fever, s/he is treated with acetaminophen to
take the fever away.
Disease etiology cont’d
Other theories were opposing humoralists
Disease is caused by factors that need
treatment (methodists, empiricists and
pneumatists are in this group).
Disease descriptions
Hippocrates: father of Medicine.
Born in Cos 460 BC; died 70 to 90 years
later.
Little known about his life, but traveled a
lot; spent large amount of time in Athens.
Multiple medical works of Classical Greece
attributed to him: “Corpus Hippocraticum”.
Disease descriptions cont’d
Disease descriptions cont’d
Epidemics Book I (Case IX)
“Crito, in Thasos, while walking about, was seized with a
violent pain in the great toe. He took to bed the same day
with shivering and nausea; regained a little warmth; at
night was delirious.
Second day. Swelling of the whole foot, which was rather
red about the ankle, and distended; black blisters; acute
fever; mad delirium. Alvine discharges unmixed, bilious
and rather frequent. He died on the second day from the
commencement.”
Disease descriptions cont’d
Epidemics III (constitution)
“Many were attacked by the erysipelas all over the body
when the exciting cause was a trivial accident or a very
small wound…Many even while undergoing treatment
suffered from severe inflammations, and the erysipelas
would quickly spread in all directions. Flesh, sinews and
bones fell away in large quantities. The flux which formed
was not like pus but a different sort of putrefaction with a
copious and varied flux…The bones were bared and fell
away, and there were copious fluxes. Fever was sometimes
present and sometimes absent…
Disease descriptions cont’d
Epidemics III (constitution cont.)
“There were many deaths. The course of the disease
was the same to whatever part of the body it
spread. Many lost the arm and the entire forearm.
If the malady settled in the sides there was rotting
either before or behind. In some cases the entire
thigh was bared or the shin and the entire foot. But
the most dangerous cases of all such cases were
when when the pubes and genital organs were
attacked.”
Disease descriptions cont’d
Diseases described:
Vibrio vulnificus
Strep. Pyogenes
Other diseases: tuberculosis, puerperal fever,
Cheyne-Stokes breathing, frostbites
Treatment of diseases
On Joints (Spinal diseases and treatment)
Hippocratic ladder
Hippocratic board
Both were early brace devices used to
correct kyphosis or scoliosis
Treatment of diseases cont’d
Treatment of diseases cont.
Treatment of diseases cont’d
Dislocations of the shoulder:
Hippocratic method is still taught in medical
school.
Treatment offered for chronic dislocation.
Other physicians
Galen: born in Pergamon in 130 AD. Died in 201
AD.
Great contributions in anatomy by dissection of
animals.
Multiple commentaries on earlier medical
literature.
Prescriptions for medications.
Bridged humoral theory with non-humoral;
believed in medications.
Other physicians
Cosmas and Damian: 3rd century AD in Asia
Minor.
First transplant of a limb from one person to
another
Christian patron saints of medicine