Santacroce Luigi, Bottalico Lucrezia, Charitos Ioannis Alexandros
Ionian Department, University of Bari "A. Moro", Piazza Umberto I, 70121 Bari, Italy.
Policlinico University Hospital, P.zza G. Gesare 11, 70124 Bari, Italy.
Medicines (Basel). 2017 Dec 12;4(4):92. doi: 10.3390/medicines4040092.
In the pre-Hellenistic period, the concept of medicine was not well-defined. Usually, a disease was considered as a divine punishment and its treatment was devolved to the priests who asked for healing from the divinities. The only job that could be compared to medical practice was a kind of itinerant medicine, derived from the Egyptian therapeutic tradition based only on practical experience and performed by people that knew a number of remedies, mostly vegetable, but without any theoretical bases about the possible mechanisms of action. Opinions about the human nature (naturalistic thinking) and the origin of the illness and heal were the basis of Greek medicine practiced by ancient priests of Asclepius. However, with the evolution of the thought for the continuous research of "κόσμος" (world) knowledge, philosophy woulld become an integral part of medicine and its evolution. This close relationship between philosophy and medicine is confirmed by the Greek physician Galen in the era of the Roman Empire. Philosophical thought looked for world knowledge starting from mathematics, physics, astronomy, chemistry, medicine, psychology, metaphysics, sociology, and ethics. We must keep in mind that, according to the ancient people, the physicians could not heal the patients without the aid of a "divine God" until medicine, thanks to the Hippocratic practice, became more independent from the supernatural, and contemporary, ethical, and professional. Many physicians were philosophers, as confirmed by their views of life, such as Hippocrates of Cos, Aristotle (hailed as the father of comparative anatomy and physiology), Pythagoras of Samos, Alcmaeon of Croton, Empedocles, Praxagoras, Erasistratus, Galen, and others, including Asclepiades of Bithynia (atomists affinity). Asclepiades, a Greek physician born in Prusa, studied in Athens and Alexandria. His thought was influenced by Democritus' theories, refusing extensively the Hippocratic ideas that diseases are a result of mood imbalance. Differing from the current Hippocratic idea, only in extreme cases he prescribed medications and bloodletting, two of the most-used therapies of that time. He usually prescribed therapies based on the Epicurean thought, then consisting of walks and music, massages, and thermal baths. He anticipated the modern idea of the body consisting of atoms, and believed that between the atoms exist empty spaces called pores. As the founder of the so called , he was the first to divide acute and chronic diseases, and thought that body weakness was dependent on the excessive width of the pores, while their excessive shrinkage determines fever. According to his student Caelius Aurelianus he was the first to adopt tracheotomy as an emergency therapy for diphtheria. Although it is very difficult to reconstruct the theories of Asclepiades of Bithynia because of the lack of original texts, this paper attempts to focus his role and his thought in affirming the Greek medical practice in ancient Rome and to highlight his modernity.
在希腊化时代之前,医学概念并不明确。通常,疾病被视为神的惩罚,其治疗被交给向神灵祈求治愈的牧师。唯一能与医疗实践相媲美的工作是一种巡回医疗,它源自埃及的治疗传统,仅基于实践经验,由一些知晓多种疗法(大多是植物疗法)的人施行,但对于可能的作用机制没有任何理论基础。关于人性(自然主义思维)以及疾病和治愈的起源的观点,是阿斯克勒庇俄斯的古代牧师所践行的希腊医学的基础。然而,随着对“κόσμος”(世界)知识不断研究的思想演变,哲学将成为医学及其发展的一个组成部分。罗马帝国时期的希腊医生盖伦证实了哲学与医学之间的这种紧密关系。哲学思想从数学、物理学、天文学、化学、医学、心理学、形而上学、社会学和伦理学出发去探寻世界知识。我们必须记住,按照古人的看法,在医学借助希波克拉底的实践变得更加独立于超自然、同时具有现代性、伦理性和专业性之前,医生在没有“神圣之神”帮助的情况下无法治愈病人。许多医生也是哲学家,可以从他们的生活观点得到证实,比如科斯的希波克拉底、亚里士多德(被誉为比较解剖学和生理学之父)、萨摩斯的毕达哥拉斯、克罗顿的阿尔克迈翁、恩培多克勒、普拉西安哥拉斯、埃拉西斯特拉图斯、盖伦以及其他一些人,包括比提尼亚的阿斯克勒庇阿德斯(与原子论者有渊源)。阿斯克勒庇阿德斯是一位出生在普鲁萨的希腊医生,在雅典和亚历山大里亚学习。他的思想受到德谟克利特理论的影响,广泛拒绝希波克拉底关于疾病是情绪失衡结果的观点。与当前的希波克拉底观点不同,他只在极端情况下才开药方和放血,这是那个时代最常用的两种疗法。他通常根据伊壁鸠鲁的思想开出处方,当时的疗法包括散步和听音乐、按摩以及热水浴。他预见了身体由原子构成的现代观点,并认为原子之间存在被称为孔隙的空间。作为所谓……的创始人,他是第一个区分急性病和慢性病的人,并且认为身体虚弱取决于孔隙过度宽大,而孔隙过度收缩则会引发发烧。据他的学生凯利乌斯·奥雷利安努斯说,他是第一个采用气管切开术作为白喉紧急疗法的人。尽管由于缺乏原始文本,很难重构比提尼亚的阿斯克勒庇阿德斯的理论,但本文试图聚焦他在古罗马肯定希腊医学实践中的作用和思想,并突出他的现代性。