1. Later Greeks By F.Edwards & S.Luscombe Applying Logic to Medicine !

2. Real Progress ?  The later Greek period became one of the periods of great breakthrough.  The “Art of the physician” began to take over from the “cult of the priest”

3. Why was it possible to have a period of great breakthrough in the later Greek period? Any ideas from the map ?

4. Why was it possible to have a period of great breakthrough in the later Greek period?  Competitive City States Try to out do each other  Settled people have a hierarchical structure  Upper classes have leisure time while their food, building etc is provided by lower classes  As islanders the Greeks are forced onto the seas to trade, fish etc  And as a result they become very familiar with the natural world – winds, tides, stars, storms, etc.

5. They begin to question the role the gods play in the natural world.  They never see Poseidon whenever they weather a storm at sea.  They never meet Hephaistos whenever they deal with an erupting volcano. They still believe the gods are their but that they play a less prominent role in the natural world

6. Many of these leisured Greeks become philosophers asking questions about the natural world in which they live. Where do things come from ? What are things made of ? How does the world work? Rap hael’ s Scho ol of Athe ns Raphael – School of Athens

7. These philosophers had no microscopes and very little science so they worked all the answers to their questions by observing the world around them.  From their observations they felt that every living thing was composed of The Four Elements: Fire Water Air Earth These make Up everything living thing we see in the world

8. The later Greeks had enquiring minds and while they continued to believe in gods they investigated…  Mathematics  Geometry  Science  Astronomy  Philosophy  Politics  as well as medicine Pythagoras

9. The Greeks were great believers in balance -  Like Pythagoras, Pye, and algebra !  They believed everything had to balance

10. Greek doctors believed that the human body contained four liquids or humours which were linked to the four elements and the seasons  Phlegm  Blood  Yellow bile  Black bile

11. Greek doctors noticed one or more of these humours tended to be present when patients presented with symptoms.  Vomit?? Too much yellow bile !  Runny nose ?? Too much phlegm!  Diarrhoea ?? Too much black bile!  Red, blotched face ?? Too much blood! Diagnosis was easy !

12. If the humours were all in perfect balance…you were in perfect health.  But if the humours were out of balance the patient needed treatment to restore the balance  Like blood letting…if there seemed to be too much blood;  or encouraging vomiting to get rid of excess yellow bile A medieval illustration showing blood letting

13. It was just applying Logic to Medicine.  Enter Hippocrates !  Hippocrates was the most famous of a group of Greek doctors “who separated the art of the physician from the cult of the priest”

14. Hippocrates was one of a number of Greek doctors who came from islands like Kos and began a new approach to medicine

15. They believed that each of these sources had different qualities…  Water was cold and moist, for example  and that these elements were linked to the seasons.

16. The Hippocratic doctors began by assuming many illnesses were natural rather than supernatural  They started looking for natural symptoms Temperature Urine Face colour Pallor Blood, vomit, sweat, diarrhoea

17. They applied the logic of the four humours theory

18. This approach, known as the “clinical method of observation” is exactly how doctors go about their work today  “First of all the doctor should look at the patient’s face. If he looks his usual self this is a good sign. If not, the following are bad signs… sharp nose, hollow eyes, cold ears, dry skin on the forehead.. Strange face colour such as black, green red or lead coloured. The doctor must ask if the patient has lost sleep or had diarrhoea, or not eaten”

19. The Hippocratic doctors realised it was really important to make a case history of the course of a patient’s illness and treatments.  In this way they could forecast the prognosis of future illnesses  And record which treatments were effective and which were not  Silenus had a fever. He began with pains in his abdomen, heavy head, stiff neck  First day…vomited, black urine  Second day…tongue dry no sleep at night  Third day… delirious  Fourth day…no discharge from bowels, no urine, acute fever  Eighth day… cold sweat all over, red rashes, urine bitter and passed with pain  Eleventh day..died

20. The Hippocratic doctors believed prevention was better than cure …  and encouraged Greeks to keep their humours balanced by good diet and exercise

21. When illness was diagnosed the Hippocratic doctors thought “nature was the best healer”  Hot foods and brisk walks in winter.  Cold foods and slow exercise in the summer  Barley soup for chest diseases  Vinegar and honey for phlegm  Bathing to bring up phlegm Can you see the way they tried to balance opposites to keep the humours balanced ?

22. Doctors were bound by a new professional code the Hippocratic oath which doctors still swaer today before they qualify.  I swear by Apollo, Asclepius and all the gods..to use treatment to help the sick but never with a view to injury or wrong doing….I will not give poison to anybody  …I will be pure and holy in my life and practice. Whatever I see and hear professionally which ought not to be told I will keep secret

23. The Hippocratic doctors wrote lots of books which meant their ideas influenced people for over 2000 years  The Hippocratic collection is important  Because it is the first detailed lost of symptoms and treatments

25. The Humours  "Blood, a hot, sweet, tempered, red humour, prepared in the meseraic veins, and made of the most temperate parts of the chylus (chyle) in the liver, whose office it is to nourish the whole body, to give it strength and colour, being dispersed through every part of it. And from it spirits are first begotten in the heart, which afterwards in the arteries are communicated to the other parts.  "Pituita, or phlegm is a cold and moist humour, begotten of the colder parts of the chylus (or white juice coming out of the meat digested in the stomach) in the liver.  "Choler is hot and dry, begotten of the hotter parts of the chylus, and gathered to the gall. It helps the natural heat and senses.  "Melancholy, cold and dry, thick, black and sour, begotten of the more feculent part of nourishment, and purged from the spleen, is a bridle to the other two humours, blood and choler, preserving them in the blood, and nourishing the bones.

26. Balance  "An exact balance of the four primary humours makes the justly constituted man, and allows for the undisturbed production of the concoctions or processes of digestion and assimilation."