Boulogne J
Med Nowozytna. 2001;8(2):33-52.
The article deals with the views on health and disease prevalent in Ancient Greece, the cradle of modern European medicine, focusing on the ever-present myths functioning in that realm despite attempts to rationally explain medical phenomena. On the basis of the works of Hippocrates and Galen, the author has distinguished five different epistemological attitudes towards those phenomena: the holistic, macrocosmological, monistic, anti-hypothetical and eclectic. The first was based on the idea of mechanical and logical causes. In medicine it is marked by determinism connected with climatic conditions. Hippocrates believed that health depended on the weather, in particular on the effects of winds, types of water and properties of soil. Myth emerged in this conception in the way matter - earth, water, air and fire - was conceived, particular in the properties ascribed to them: cold, humidity, aridity and warmth. The author charges that this conception was permeated with ethnocentrism and cites examples invoked by Hippocrates on the basis of his observations on the Scythians. The macrocosmological attitude involves subordinating medicine to cosmology. Man's body is a microcosm. The author cites the treatise 'On Diets', in which the greatest importance both in the universe and in processes taking place in the human body as ascribed to two factors - fire and water. Their combination was said to have played a crucial role in the typology of corporal and mental constitutions. Those features, together with the seasons of the year, mode of behaviour and food, constitute the four forces guiding vital processes. The author then presents the embryogenic conception contained in the cosmological treatise. It was based on such things as numerological speculations, hence - despite its rationalistic assumptions, consigns it to the mythic. The third attitude, the monistic approach, presents a treatise ascribed to Hippocrates 'On the Sacred Disease' and dealing with epilepsy. The author of the article cites evidence desacralising epilepsy and, by the same token, other diseases. But the treatise stops short of separating medicine from meteorology, as the treatise attempts to present overall phenomena as dependent on one factor - air. The anti-hypothetical attitude marks a turning-away from cosmology towards the observation of man as such. Medicine is the art of applying the proper diet according to a given individual's digestive capacity. Nevertheless, this anti-methaphysical medicine creates a fictitious scheme explaining health-related phenomena through the antagonism of two forces: the force of food and the inborn force of the body consumming it. The last attitude- the eclectic approach, is associated with its most distinguished representative, Galen, whose cognitive pursuits combined observation with logic. The author cites Galen's opinions about then current philosophical schools and portrays his method of reasoning and behaviour. But Galen also relied on his imagination with regards to the physiological processes taking place in the human body. That can be illustrated by numerous examples, especially the introduction of the concept of a demiurge, in the author's words - a transcendental craftsman setting the universe in order. The conception made medicine metaphysical once again. In summing up, the author states that Greek authors, despite their attempts at objectivity, became slaves of mythical thinking whenever they tried to explain the invisible. Nevertheless, the significance of imagination, both in the realm of heuristics and in the creation of structures, cannot be denied. Modern medicine also makes use of imagination when faced with the limits of what is available to observation, even though those limits are constantly being extended.
本文探讨了现代欧洲医学发源地古希腊盛行的健康与疾病观,重点关注尽管人们试图合理解释医学现象,但该领域中始终存在的神话观念。基于希波克拉底和盖伦的著作,作者区分了对这些现象的五种不同认识论态度:整体论、宏观宇宙论、一元论、反假设论和折衷论。第一种基于机械和逻辑原因的观念。在医学中,它以与气候条件相关的决定论为特征。希波克拉底认为健康取决于天气,特别是风的影响、水的类型和土壤的特性。在这种观念中,神话以对物质——土、水、气和火——的构想方式出现,尤其是赋予它们的特性:冷、湿、干和热。作者指责这种观念充满了民族中心主义,并引用了希波克拉底基于对斯基泰人的观察所举的例子。宏观宇宙论态度涉及将医学从属于宇宙论。人体是一个微观宇宙。作者引用了《论饮食》这篇论文,其中在宇宙以及人体发生的过程中,火和水这两个因素被赋予了最重要的地位。据说它们的结合在身体和精神体质的类型学中起到了关键作用。这些特征,连同一年中的季节、行为方式和食物,构成了指导生命过程的四种力量。然后作者介绍了宇宙论论文中包含的胚胎发生观念。它基于诸如数字命理学推测之类的东西,因此——尽管有理性主义假设——却将其归入神话范畴。第三种态度,一元论方法,呈现了一篇归在希波克拉底名下的论述癫痫的论文《论圣病》。文章作者引用了使癫痫以及同样其他疾病非神圣化的证据。但该论文并未将医学与气象学分离,因为它试图将整体现象呈现为依赖于一个因素——空气。反假设论态度标志着从宇宙论转向对人的直接观察。医学是根据个体的消化能力应用适当饮食的艺术。然而,这种反形而上学的医学创造了一个虚构的方案,通过两种力量的对抗来解释与健康相关的现象:食物的力量和身体消耗食物的内在力量。最后一种态度——折衷论方法,与其最杰出的代表人物盖伦相关,盖伦的认知追求将观察与逻辑结合起来。作者引用了盖伦对当时哲学流派的看法,并描绘了他的推理和行为方式。但在人体发生的生理过程方面,盖伦也依赖于他的想象力。这可以通过众多例子来说明,尤其是引入了造物主的概念,用作者的话说——一个使宇宙有序的超验工匠。这个概念再次使医学形而上学化。总之,作者指出希腊作者尽管试图保持客观,但每当他们试图解释不可见的事物时,就会成为神话思维的奴隶。然而,想象力在启发式方法领域和结构创造中的重要性是不可否认的。现代医学在面对观察的局限性时也会利用想象力,尽管这些局限性在不断扩大。