Medical Writers
Hippocrates and the corpus: Ionian
Hippocrates a rough contemporary with Socrates
most treatises of the corpus written bet . 430-330
-some to specialists, some to laymen
-work of a large number of writers, different and sometimes opposed
schools;
they are all anonymous
schools at Cos and Cnidus
-no medical licences
-doctors treated for a fee
-some public physician,
often hired on an annual contract
doctors often itinerant:
so Airs, Waters, Places
must be familiar with various
locales and
their medical impact
-with strangers, prognosis was a powerful means of persuasion
rational medicine
disease not of divine origin
cf. Cyclops: sickness comes from Zeus
Odysseus and the chants over the wound
importance of detailed and methodical observation: historia
examination of symptoms: stool, urine, temperature,
skin color, etc.
-daily records of the progress of disease:
clinical histories
minimum of interpretation
little mention of treatment
The Problem
-means of treatment limited:
surgery, cautery, blood-letting, purgative drugs,
and control of regimen
-doctors are insecure about their status as technicians
repeatedly draw the distinction between lay and
expert
with the extent of expert knowledge fairly small, the difference bt
layman and expert was slight.
Medical education was often part of general
education.
There were educated layman who knew as much as
doctors
some of the treatises are addressed to educated
laymen
The Solution
-battle between the rationalists and the empiricists
the axiomatistic vs. the historicists
the philosopher and the doctor
the problem of explicating causes
the Aristotelian fact and reason
-anti-Eleatic: importance of observation against theory
BUT: even the empiricists used theory
there is no one dominant medical theory about diseases:
that all diseases had basically one cause
that they are as many causes as diseases
that they are as many causes as different
manifestations in different people
-winds and seasons cause diseases
-balance of opposites,
either Empedoclean elements,
others like astrigent, bitter, sweet. etc.
or the humors balance of humors; development of four
humor theory to Galen
already present in the Nature of
Man
-common method of treatment is by opposites (allopathic):
diseases of starvation by eating
of overeating by starvation
of indolence by work
of overexertion by rest
-some theories, such as that in Nature of Man, are very systematic and
theoretical: lining up the humors with the season and the elements
On Ancient Medicine (Tradition in Medicine)
on the side of the empiricists
general attack on the hypothetical method, not just in medicine
hypothesis: theoretical entity
often
unobserved
cf.
Democritus' atoms
assuming a postulate, e.g. heat, cold, moisture, dryness
-medicine doesn't need a postulate,
only in studies where there are insoluble mysteries,
e.g. things in the sky (i.e. cosmology)
everyone needs a postulate
e.g. the whirl, the apeiron, etc.
with a postulate you can do anything, prove anything
it is the realm of the unverified
imagination
anyone can make up a story
so no one's story will be any
better than anyone else
for postulates there is no proof, no verification
but in medicine there are better and worse
practitioners
-difference from modern scientific method:
invent hypothesis
deduce conclusions from it
look for verification of these conclusions
e.g. dark matter
-so we do have an important place for hypotheses
which On Ancient Medicine denies
because of lack of practical bent in Greek science
Medicine is effective without postulates:
medicine has its own method
discoveries have been made and will be made by it
in discussing medicine we must use ordinary language
postulates involve dialectical language which is
obscure
discoveries must use past experience
obvious proof that and how progress has been made:
the regimen of the healthy does not profit the sick
this has been the impetus of medicine
-now embarks on a history of medicine:
a sort of anthropological treatise:
the discovery of new kinds of food:
elimination of the raw and strong
elements in our diet
discovery of bread through
experimentation
admission that the art is imperfect
the art is inexact
but following postulates won't help
there are many variables in the regimen of the sick with varying
effects:
the doctor treat not man, but a man
one can best hope for small errors
can't expect perfect accuracy
mistakes occur in delicate cases where the margin
for error is slight; this is where especial skill is required
-the causes the author attributes to various ailments are
commonsensical, hardly theoretical
but also as a result are prey to false analogy
so the cause of indigestion: not letting the
previous meal digest:
some people's organ digest much more slowly than
others, and need longer rest and quiet: supposition that digestive
organs need a rest like the whole body does
specific arguments against the postulates:
if a change in regimen is required, how will these
postulates help?
the ancient (empirical) style is useful, because it
gives practical direction
the author (15) suspects that the new practitioners use the old
methods, but just append fancy new names to their potions