Discussion beforehand 1/21/20

● Emphasis on food
○ It’s one of the only things that’s noticeably different from person to person
● Humours
○ Are like secretions of the body -- bile, blood, mucus, saliva
● Medicine builds on prior knowledge and reasoning based on information

Context of Ancient Medicine

● Written 425-400 BCE
● Intended for oral delivery (speaking verbs, rhetorical questions)
○ Intended for lay audience -- cooking analogies and everyday examples
■ They were the ones who judged a practitioner’s competence
● Criticism of general trend in medicine, not single thinker
○ the hot cold trend is present even in other hippocratic texts

Hippocrates and Hippocratic Corpus

● Hippocrates of Cos vs. Hippocratic Corpus
○ Considered to be author of a group of books of medicine labeled Hippocratic Corpus
■ Not sure on actual origin/author -- pretty sure not the same
● Not even sure if Hippocrates was real - like Homer
■ They support different medical theories, so cannot all be by Hippocrates
○ Two medical schools at Cos and Cnidos

Divine Aspects in Medicine - Starts with mythology

● Asclepius = god of healing
○ Asclepeions = healing temples of Greece
■ Stay and undergo incubation
● Dream therapy where patients are ‘visited’ by Asclepius
○ Carries a staff with a snake wrapped around it
■ Snake sheds its skin = renewal and healing
Philosophical Aspects in Medicine
● Presocratic philosophers showed interest in nature of man and diseases
● Hippocratic authors also had philosophical interests
○ Both mix and there’s not a clear line
● Theories of human nature (“physis = nature”) often based on general theories of nature
○ Many problems are seen as both medical and philosophical
■ Generation, soul/body, death, embryology

Rhetorical Aspects in Medicine

● Medicine not recognized as profession
○ Physicians migrate around and sell their services and expertise
■ Sometimes it was just who could sell themselves better
■ Give public lectures to convince possible clients -- interact w/ common ppl
 ● Similar to today -- getting funding, get phD, convince non-scientists --
need to convince
■ Fight between “real” doctors vs. traditional healers/magicians/witch doctors
■ variational inference, monte carlo for faster HMM version? -- for app

Nature of human body

● Hippocratic doctors looking for nature of human bodies and of diseases
○ Eliminate divine causes and focus on physical
○ The ‘sacred’ disease: epilepsy -- thought to be divine punishment but later disproved
● A mix of naturalism and religion is still present
● Cause and Power
○ Regularity of nature
■ They see regularity of nature -- seasons, day and night -- so they try to apply this
to the human body and trace back to pattern
○ Phenomena have natural causes -- not divine
○ Causes can be discovered by human mind
■ ‘Causes’ (aitiai): Need to find causal explanation
■ ‘Forces’ (dynameis): power that certain substances have to produce a certain
effect
● Substances have effects whether they are drugs, food, liquids, etc.
● At first: doctors base medicine on theory of human origins and development
○ Reduce variety of phenomena to limited number of first principles
■ Ex: On Regimen: dietary recommendations within theory that everything derives
from fire and water -- Thales and Heraclitus
○ Pangenetic theory: all parts of organism contribute to the formation of the entire
organism
○ Common view was that universe has an influence on the human body
● Anatomy and Physiology
○ Greeks could see surface anatomy and skeletal anatomy
■ Internal anatomy was problematic because it needed dissection
● It was taboo to open up a dead body in Greece
○ Ancient Medicine: powers vs. structures idk
○ Main elements in human body
■ Parts
● Organs/tissues e.g. brain, heart, blood vessels, spleen
■ Substances
● blood, water, phlegm -- these are known as humours
■ Poperties
● hot, cold, dry, wet; sweet, salty, bitter, etc
■ Relationships (among substances)
● balance, imbalance, proportions -- keep things balanced
■ Processes
● heating, cooling, concoction
■ Functions
 ● perception, thinking, digestion, etc.

Ancient Medicine this is the treatise we read called ‘Tradition in Medicine’

● Previous knowledge and methods are starting point (‘arche’) and a known method (hodos)
○ Medicine is not arcane/divine -- the human mind can understand this w/ work
■ Makes science available
■ When they say human mind, did they mean all humans minds -- lower class?
● Techne = a set of procedures organized in a highly systematic fashion
○ Speaker argues that medicine is already a techne: has principles and methods
■ Based on knowledge of nature of human body and causes of health and disease
■ Importance of causes: necessity to know not only that cheese is harmful but also
why
○ Limits of techne
■ Sometimes there is no other criterion to describe something other than bodily
feeling -- the senses (unreliable)
● Ex: eating food that makes you feel bad
● says that “infallibility is rarely to be seen”
■ Even though not always accurate, it can approach infallibility through reasoning
● Does rely doctor’s senses and patients senses to make conclusions
● Medicine effectiveness limited by human nature (physis)
○ Humans are very complex and varied
■ Medicine cannot obtain the accuracy typical of other sciences (math mostly)
○ Tools to obtain knowledge are very limited
● Focus on Diet in Medicine
○ Deeper point: Use food/diet as example to show that trial and error is very present in
medicine -- takes time to develop
■ Eat to learn what’s bad, so you can separate it from what’s good
● Cooked vs. Raw
○ Linked food and human body: we are what we eat
■ Recall Anaxagoras -- food contains same things as body, which nourishes
○ Analogy between cooking and medicine
■ Change state of food to make it better/safe to eat
■ Mixing and boiling in cooking is applied to human body to understand behavior
of humors (black/yellow bile, blood, phlegm)
■ If ingredients are balanced and blend is good, dish is good
● Otherwise you are sick
● Medicine and Nature (of man)
○ Some say (sophists) you cannot understand medicine unless he know what man is --
needs to understand Nature
■ Understand origins and the cosmos
○ New medicine says you can understand the world and Nature and what man is by
studying medicine
■ As opposed to understanding medicine by first understanding the world/Nature
 ○ Speaker’s opponents say diseases are caused by same one or two opposite factors (causal
reductionism)
■ hot and cold, dry and wet
● Good to an extent to find root causes, but body is very complex and
needs a broader set of principles

The Oath
● Establishes trust and ethos with the doctor
○ Gives assurances that the doctor will not do -- will not do harm
● References Apollo
● Mentions relationship between master and pupil
○ Family relationship
○ Like being admitted to a club
■ It’s a privilege to be admitted
■ Do not hand on knowledge to people outside the club
● Will not administer abortions
○ In nature of the child, sees a six-day old egg
○ “Neither will I given a woman means to procure an abortion”
● Privacy concern
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Epidemics and Experimentation (log of symptoms of the diseased)
● Lots of details about secretions and bodily fluids -- shows importance
● Appears to be a log of symptoms and happenings day to day
● No records of any actual treatments
● Observations
○ Inference from external signs
■ Touching, smell and taste, auscultation (listening to bodily sounds)
○ Use analogy and reason to make inferences
■ Inference of invisible from visible
● Experiments and dissections
○ Forcing nature - creating/simulating natural phenomenon so you can observe
○ Animal dissections
■ Cut open animal and make inferences about humans working the same way
■ Dissection was limited early
● Doctors never say how they got knowledge of internal parts of body
● Errors in anatomical descriptions
○ Experiments
■ Do we have evidence, and did Greeks have concept of experiment? idk
● Epidemics (what are they) and Case histories
○ “The diseases that are among the people”
○ Importance of prognosis/diagnosis
■ Important for them to know what disease it is and how it will progress
● Curing is another, separate matter
■ Main way doctor would establish credentials
 ● Knowledge/understanding separated them from traditional healers
○ Case studies in epidemics are them just trying to record data for diagnosis in later cases
■ Diagnosis not present -- only record data
○ Patients
■ Patients could be slaves, women, men -- all social classes
■ 25 died 17 survived in case studies
● Of survivors, all mentioned crisis
○ Concerned only with individual dispositions and changes
■ No interest in putting observations together and try to pinpoint
symptoms/signs/cause to a disease
■ Mainly wanted to divide important and unimportant symptom groups
■ Observations do not lead to general doctrinal statements
○ Central concepts
■ crisis
● “Crisis was reached’ -- from verb meaning “to judge”
● Time when patient’s fate is decided (either patient dies or recovers)
● Often attempted to measure the number of days btwn each crisis
○ Trying to link different fevers together through this property
● Occurs only on certain days -- events outside of these days are never
critical
● Crisis occurs when certain symptoms come to pass
○ Fever and rigor
○ Relapse of harmful matter
■ “relapse”
● Release/discharge (of bodily matter/fluid?)
○ Epidemics may have been text for insiders -- written like notes
■ Most obvious symptoms (runny nose, cough) are not mentioned → specialists
who read this already assume these
■ Need only to write down what is specific/different about individual patient
● The “signs” of an illness -- signs were important -- how to treat was not b/c they didn’t know how
○ What are most significant features of a certain illness
○ You should look at
■ Nature of specific patient (diet/living conditions)
■ Way of life and practices
■ Age
■ way of talking, mannerism and habits of sleep etc.
■ plucking, scratching, weeping
■ Excretions (vomit, stool, mucus, sputum)
■ stages of disease and where crisis could be
● Interventions and Therapies -- how they cure
○ Patients’ death was n oseen as fault of doctor -- part of limits of medicine
○ Therapies
■ Surgery
■ Blood letting
 ● Take blood out to cleanse
■ Cauterization with caustic drugs and hot irons
■ Trepanation -- drilling into skull
■ On joints - distinction btwn. unsafe and unsafe practices
○ Dietetics -- common, less extreme cures
■ Central to greek medicine
■ diet may be cause of bad systems
● Emphasis on which foods heat and cool the body
● Sick body is out of balance -- need to add/subtract what is deficient
○ Pharmacology
■ Drugs only seen as a means to reestablish balance in the body
■ Many plant/animal/mineral can be identified
● As a result, we can see that the way they were used does not correlate to
modern uses
○ Would not actually have effect
● hellebore is poisonous
■ Placebo effect possibly prevalent
■ Imprecise dosages

Embryology and Origin of Human seed

● Not just medical -- also a philosophical matter
○ 3 parts
■ How much/in what ways the male and female contribute to reproductive process
■ Origin of semen
● Spinal marrow? blood? whole body (pangenesis)?
● pangenesis = origin from everywhere
■ Question of inherited characteristics
● Ex: resemble mother or father
● “Seed emits breath”
○ Analogy to wood burning and producing smoke
○ “Everything that is heated acquires breath”
■ Takes this breath from the mother
○ As it grows, seed forms membrane around it
■ Similar to bread baking and forming a crust around it
○ Need a way to explain what is hidden
● Six day embryo observation
○ Problems
■ Seems to induce an abortion against the words of the Hippocratic oath
● Difference between physically and pharmaceuatically induced abortions
■ Seed is seven days from conception, girl does seven jumps
● Too perfect for Greeks -- seven is important
● Seven connected to periods of life and the development of fetus in
Hippocratic corpus
 ■ Description of embryo does not correlate to actual human development after six
days
● Date of conception could be wrong; embryo might not be embryo; or
entire account is fake
● Could have been a mole -- type of tumor develops during pregnancy
● Description influenced by what he was expecting
● Egg experiment
○ Twenty eggs and break one each day to see the general development cycle
■ Creates analogy (comparison) between human qualities and embryo qualities
■ human egg ~ chicken egg
■ Does not, however, take an analogy to extreme -- only a partial analogy
● Makes allowance for the fact that one is a chicken and the other is human
○ Systemic test -- almost a full experiment -- of a single point

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Presentation
● 20 mins?
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