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Introduction to Ancient Greek Medicine

By Alexandros I. Tilikidis

The origins of Greek Medicine may be found in the Greek myths, especially to those that are related with the Greek gods’ lineage. As the founder of Greek Medicine, we could propose Apollo, who, among his other aliases, is Paionios, from the verb παίω (paio), which means to treat or heal. Other Paionioi Theoi, or healing gods, are Apollo’s twin sister Artemis, Athena and Asklepios.

It is interesting to note that Apollo is also the God Sun embodying the sun’s light on Earth. Thus, the ancient Greeks recognized the sun’s light as a paramount therapeutic force, which everyone knοws is true from our own day-to-day experience. Because of the region’s natural geomorphology, the sun’s light that diffuses in Greece exercises a particularly beneficial effect on human nature, which could explain the ancient Greeks’ intellectual and material achievements. In contrast with today’s Greeks, the ancients realized the area’s importance and used their energies to enhance all of the good things that God endowed this corner of planet Earth with. This beneficial effect of the sun’s light in healthy conditions offers wellbeing and longevity, whereas in the case of illness it provides a treatment. Thus, founder of therapy, starting with each therapeutic intervention, is the sun’s light, the god Apollo.

 Apollon- Olympia

It is also worth mentionting here that the god Apollo and his sister Artemis were born on Delos, one of the islands at the very center of the Aegean Sea, bathed in light of the finest quality in the world. Eilithyia was midwife to their mother Leto during labour. A midwife’s presence at the god of medicine’s birth shows that midwifery predates medicine and therapy. Indeed, because of the problems involved in their nine-month gestation, humans require a midwife’s care to survive as a species. The midwife’s skill and experience is the genesis of therapy and thus also gives birth to medicine, one of man’s great intellectual achievements. Midwifery is an instinctive achievement, which is why we attribute it to the female temperament. Conversely, Medicine is one of man’s intellectual achievements and so we attribute it to masculine nature. Thus, from the midwife Eilithyia we proceed to the doctor Apollo.

Apollo fell in love a mortal, Koronis, and entrusted their son Asklepios to the Centaur Chiron, son of Kronos and the Oceanid nymph Philyra. Chiron was Zeus’s brother and Apollo’s uncle, but also Asklepios’s great-uncle. Chiron taught at Pelion and counted all of the famed Argonauts among his students. He treated primarily with herbal remedies, but also surgery, and from his name we might suppose that he somehow influenced people’s auras with his hands (χειρ [cheir], meaning ‘hand’ in Greek). The term Centaur (Κένταυρος [Kentauros]) might also be associated to healing, since it is derived from the verb κεντεύω (kenteuo), which means to prick, stab, sting (as in acupuncture) and the noun αύρα, aura or cool breeze. Thus, with Apollo as his father and the Centaur Chiron as his teacher, Asklepios became the greatest of healers. Asklepieia come from his name and they represent the next step in the development of Greek medicine.

Asclepios- Epidauros

Before we leave Asklepios and proceed to the Asklepieia, it is worth recalling how he died. Asklepios had developed the art of medicine to such a degree of perfection that he began to raise the dead. When he resurrected Hippolytus, Hades protested to his brother Zeus that this disturbed the balance between the incarnate and non-incarnate souls and should not be permitted. Zeus acknowledged his grandson’s misconduct and struck Asklepios down with his thunderbolt. Thus came the end of Asklepios. This event is of particular symbolic significance as it shows that the ancient Greeks understood that the art of medicine, as a human intellectual achievement, could potentially be disrespectful to natural determinism. Human intellect can easily slide into the ways of arrogance. When dealing with the choice between life or death, the art of medicine might commit the act of hybris (ύβρις), or disrespect. Asklepios commited hubris by raising a man already dead and was consequently struck by lightning. Think of how often modern medicine is disrespectful, how often it commits hybris, in Intensive Care Units and genetic engineering laboratories! Asklepios’s own death tells us that a physician has no jurisdiction over death. Death is inevitable and a matter that does not concern the art of medicine. The fact that neither birth nor death were allowed to take place inside an Asklepieion demonstrates how important Asklepios’s death was to later physicians. The fate of their founding father Asklepios had taught them that when the human intellect touches upon matters of life and death through the art of medicine, it is in danger of committing hybris.

The “Asklepieia” were the first hospitals both in ancient Greece and worldwide. They operated according to priestly canons and the healers that worked in them were also necessarily priests of Asklepieios. The aim of the “Asklepieia” was to relieve human suffering by either natural or supernatural means. The healing methods and techniques used in the “Asklepieia” included fasting, diet, cleansing (with thermal water), massage, surgery, cupping, bloodletting, exercise, herbs, hypnosis, dreams, burning incense, singing, theatre and other techniques yet unknown to us. The Asklepieia’s effectiveness is evidenced both by their great number (approximately 300 throughout Greece in the 5th century BC) and by their longevity, since they continued to function until the 4th century AD, when the Christian Emperor Theodosius I banned them along with the practice of pagan religion. The end of the Asklepieia was not the result of the trials of time, but of religious fanaticism.

Hippocrates, the foremost medical personality of all times, at least in the West, was a child of the Asklepieia. His father and grandfather were Asklepiads – that is, priests of Asklepios – at the Asklepieion on the island of Kos, where he was born. Hippocrates, however, chose not to become a priest at the Kos Asklepieion. Instead, he chose to lead the art of medicine in new directions, different from those of the Asklepios priesthood. The time of Hippocrates (born in 480 BC) was a time of intellectual freedom and democracy. The human intellect strived to free itself from the bonds of the priesthood, which had been eroded by greed. Using the knowledge amassed by his Asklepiad ancestors and his own medical practice, he wrote books and taught students. He was paid to teach, and anyone could follow his courses. Thus, medical knowledge was no longer the privilege of the priesthood, but accessible to all. Hippocrates’s innovative approach was the foundation for modern Western medicine.

Hippocrates understood how the human body works and recorded his conclusions with remarkable accuracy. His writings are a complete guide to the way in which humans function both in health and in sickness. Hippocrates’s successors were merely commentators on his work. The philosophical basis of the Hippocratic opus is the dualist model of fire and water – what the Chinese refer to as ‘Yin-Yang’ – and the four elements. In his work, illness is no divine punishment, but the body’s voice protesting against the abuse caused when the balance between fire and water, or motion (exercise) and food, is disrupted. The ideal is balance and measure, as dictated by natural determinism. Healing comes as the result of the healer’s encouragement, rather than blocking, of the body’s natural state.

Hippocrates was a therapist who healed people not through divine grace, like Asklepios, but through his understanding of human’s nature. Of course, this realization may have been divinely inspired. His achievements made him a legend in his own time, but his writings and teachings are his greatest contribution to humanity.

Hippocrates’s opinions and claims may seem incomprehensible and even unfounded to the uninitiated scholar. They did to me. When I was studying medicine and came upon Hippocrates’s writings, they seemed totally incomprehensible. It was much later, after I returned from China, where I had been initiated in Traditional Chinese Medicine, that I began to understand the Hippocratic medical code. I repeat that in order to understand the Hippocratic teachings, one must be versed in the Yin-Yang and four elements theory.

Galen was another important physician who based his practice on Hippocratic ideas. Galen studied closely the Hippocratic teachings and elucidated several points, which, five centuries after Hippocrates’s death, were inevitably misinterpreted and unclear. Thus, through Hippocrates and his successors, ancient Greek medicine developed into the only system of medical knowledge available to the known world West of Greece. In the 4th century AD, however, Greek culture in general and Greek medicine in particular suffered a fatal blow. An edict of Emperor Theodosius I ordered the closure of the Asklepieia, the oracles, and the philosophical schools, including Plato’s Academy, which had been functioning for nearly a millennium. Greece and Europe entered the Middle Ages. However, the practice of Greek medicine continued, since no other alternative system existed.

In the 7th century AD, the king of Tibet invited Greek, Chinese, and Indian doctors to teach the Tibetans the art of medicine. Thus, Tibetan medicine came to be a synthesis of Greek, Chinese, and Indian medicine. This is particularly important, because Tibetan medicine remains alive and unchanged to this day carrying inside it a piece of ancient Greek medical thought.

Greek medicine dominated Europe throughout the Middle Ages and Renaissance. However, because it represented the establishment, some Renaissance physicians (such as Paracelsus) began to question it. Of course, all of those who challenged Greek medicine were still trained in it. They could not surpass it, but they were looking for something else. This ‘something else’ came in the 19th century as a result of alchemy and the rapid development of technology. This ‘something else’ was the chemical drug. The chemical drug has therapeutic properties that do not exist in Greek medicine, since these drugs did not exist when Greek medicine was developed in Hippocrate’s times. Chemical drugs were the primary reason for West European doctors to abandon Greek medicine. Thus, after 24 centuries of sovereignty, Hippocratic medical thinking began to fade.

The move away from Greek medicine and Hippocratic ideas is the cause for the crisis in Western medicine today. Nevertheless, modern Western medicine, despite its distance from Hippocratic thought, uses Greek terms. This shows that modern medical language, wherever it is used in both the West, and the East, is the child of Greek medicine.

Before ending this short introduction to Greek medicine through time, it is worth mentioning the case of Nikolaos Hieropais,[1] who was the reason I wrote my book “Basic Theory of Ancient Greek Medicine” and implemented the homonymous course (not translated in English yet).

During the Ottoman period, Greek medicine of the Asklepieia and Hippocrates was still taught and practiced in Greece. Nikolaos Hieropais, who lived in the 17th century AD and whose actions date from around 1650, was one of those physicians who continued the ancient Greek tradition. He taught and healed according to the teachings of Hippocrates in the medical schools of Tyrnavos and Aitoliko in central Greece. Two of his books have survived: his “Treatise on Physiology and Pathology” and his “Some lessons for beginner doctors”. His first book in particular records in a remarkable manner much of the Hippocratic thinking. Hieropais’s writings have the following very important qualities:

Firstly, they have a didactic character. Hieropais used Hippocratic notions to formulate a medical handbook intended for medical students, presumably his own. The book’s structure recalls that of books on Traditional Chinese Medicine. Neither Hippocrates’s nor Galen’s books have this clearly didactic character. Their works are more like medical treatises, making it difficult to evaluate and classify the information for teaching purposes. Hieropais did this for us. He worked hard on the raw Hippocratic material and turned it into a condensed medical handbook, which can easily be used to teach ancient Greek medicine.

Secondly, Hieropais lived at a turning point in history. Since his times, Greek medicine began to gradually loose its supremacy, as new ideas developed in the West. Hieropais, however, lived far away from these new ideas and was thus unaffected by them. He is our evidence that Hippocratic and ancient Greek medicine were very much alive until the 17th century.

Thirdly, Hieropais wrote in a language that is very close to Modern Greek. Of course, his text has many archaic elements, but these can be easily understood with a second reading. Generally his text is readily accessible without a great effort. This brings us even closer to Hippocrates and ancient Greek medicine.

Finally, through his work, Hieropais responds to the ethical dilemma of how much one is entitled to tamper with, comment on, use, and adapt Hippocrates’s work when adjusting it to contemporary thought.

Hieropais’s work reinforces our faith in his vision that ancient Greek medicine – that is, Hippocratic thought – can be revived and taught universally in our times. This is the essence of the work carried out at the Academy of Ancient Greek and Traditional Chinese Medicine: the revival of ancient Greek medicine and Hippocratic thought, not out of some nationalistic fancy, but because our times really do need it.

This is the reason for the publication of this book “Greek Acupuncture” and the following “Basic theory of Greek Medicine”.

[1] Nikolas Hieropais was ‘rediscovered’ by the palaiographer Agamemnon Tselikas, whom we are honoured to have as a teacher at the Akadimia of Ancient Greek and Traditional Chinese Medicine.

 

Prologue of the book “Greek Acupuncture – Meridians and points according to Hippocrates”, written by Alexandros Tilikidis

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