Exam 1 Flashcards
What does the Hippocratic corpus contain?
Theories about the causes of disease
Techniques that the doctor should use to cure and prevent diseases
The way a doctor should behave
Which of the following statements about the relationship between philosophy and Hippocratic medicine is true?
Both early philosophers and Hippocratic doctors saw rationality as the correct religious attitude, not as a complete departure from religion.
There was a direct influence of Pre-Socratic ideas on Hippocratic Medicine.
The seeds of both traditions are already planted in the Homeric poems
Who came up with the four-element theory (everything is made up out of air, earth, fire, and water)?
Empedocles
Name features of Hippocratic medicine?
Attention to preventative medicine, especially in the form of dietary advice
Medicine is an art, not a set of rules to be applied automatically. The doctor must learn to size up each patient as an individual case.
The commitment to holism: one should treat the whole body, not just the one part of the body where we find an ailment.
Hippocratic doctors showed an admirable reluctance to engage in what we would now call “invasive procedures”: they knew that their art had serious limits.
First anatomical dissections of human bodies?
In classical Greek civilization, there was a firm taboo against the dissection of human bodies. Thus Aristotle, for instance, did not extend his program of anatomical investigations past fish and other animals to include humans.
The two main anatomists were named Herophilus and Erasistratus
They were carried out in Alexandria, perhaps in its famous Museum
The protection of the Ptolemies was a factor that contributed to them being carried out
What questions did the knowledge gained by the first human dissection raise?
How do the nervous system and blood vessels relate to breathing and the motion of muscles?
Can we now give a more detailed account relating our immaterial soul to these physical structures?
Should the human body be understood as a bewilderingly complex machine?
What theory did ancient authors hold about breath (pneuma)?
Veins are full of blood, but arteries are filled with breath (pneuma)
Nerves are allowing us to control our bodies through pneuma that passes along hollow channels within the nerves.
Pneuma is a kind of physical lifeforce that pervades and sustains the body
What important contribution to medicine did Herophilus make?
Contribution of terminology like the ‘pineal’ gland to modern anatomy
The distinction between the sensory and motor nervous systems
A treatise describing what makes someone a good midwife
Name the three classical ‘sects’ that differed in their opinion on how doctors should discover their treatments?
The methodists, empiricists, rationalists
How did the Empiricists think that doctors should discover their treatments?
They need only use experience, and in fact no theory is required.
How did the Rationalists think that doctors should discover their treatments?
They should have an understanding of the underlying causes of illness and health.
How did the Methodists think that doctors should discover their treatments?
They should identify the appropriate ‘commonalities’, the specific types of blockages or fluxes.
Of which part of philosophy did Galen think was especially useful for doctors?
Ethics, logic, physics
How does Galen define human health?
As that good condition, which enables us to carry out all our activities as nature intends
What aspects did not enter into Galens’ view of disease prevention and which did?
Letting blood did NOT
These did: The extent to which Patients bathe, the extent to which Patients take exercise, patients’ diet
What philosopher or philosophical school does Galen seem to follow most closely in his discussion of the soul?
Stoics (the Stoic idea that the soul controls the body through a pervasive ‘breath’ or pneuma is used extensively by Galen in his medical writings)
How easy does Hippocrates think it is to learn medicine?
Not easy at all. “Life is short and the art is long” he would say.
This makes sense, because he wants doctors to take a personal approach, waying all circumstances. Getting a feel for such complexity, and understanding the core issues takes time.
What is the relationship between pre-socratic philosophy and Hippocratic writers?
They originate from the same area in Greece, and more importantly they take the same rational approach to their object of study.
“Medicine and philosophy in the Greek world went hand-in-hand, especially in the generations leading up to the time of Socrates, Plato and Aristotle – the same period that gave rise to the understanding of medicine enshrined in the Hippocratic corpus.”
What was the attitude of Hippocratic doctors towards religion and how that’s different from other cultures?
They said: “In a sense all diseases are sacred, because they are brought about in our bodies by natural forces like the winds or the sun, and these forces are themselves divine. He concludes with an aphorism worthy of Heraclitus: all diseases are divine, and all are human.”
“Xenophanes, like the author of The Sacred Disease, saw rationality as the correct religious attitude, not as a complete departure from religion.”
“As one Hippocratic author says, ‘prayer is good, but in addition to calling on the gods, one should lend a hand.’”
The pre-socratics have influenced their culture. What stood out was the rational approach, which here also is described as “the right religious attitude”. This merger of reason and religion is typical of Greek culture.
What was the difference in treatment between rationalist and empiricist doctors?
“At first blush, it seems that the Rationalists and Empiricists would thus have offered very different treatments. Galen explicitly says that they did not. Rather, they would prescribe the same drugs and other treatments, recommend the same kind of diet, and so on (On the Sects, ch.4). The disagreement rather concerns method and justification.”
What did Galen think about empiricism, rationalism and Methodism?
“Galen wants to emphasize that he is not simply a Rationalist. A good doctor must also pay close attention to experience, both the findings of others and what one can discover for oneself. Thus he suggests that the best method is a kind of fusion of the Rationalist and Empiricist approaches. By contrast, he finds nothing to value in a third sect of doctors, the Methodists (On the Sects ch.6).”
How difficult did methodists think it is to learn medicine?
They believed anyone could be doctor in a few months and essentially reversed the sentence of Hippocrates which was “life is short, but the art is long” into “life is long, but the art is short”.
Who is the foundational thinker of the Methodist school, and what is his theory?
Asclepiades
“For Asclepiades, the body is made up of tiny particles. Disease results when corpuscles cluster in such a way as to block appropriate motions in the body, or scatter so that things flow too freely.”
“According to the Methodists, all bodily disorders come about because of one of three conditions: either a blockage, a flux, or a mixture of blockage and flux. They identified a limited number of certain so-called ‘commonalities’, specific types of blockages or fluxes that were revealed by evident signs, like inflammation or a leaking of fluid like pus or phlegm. Because the range of commonalities they recognized was relatively small, they thought it was easy to remember both them and the appropriate remedy in each case.”
How did Galen’s physiological system work, especially the bloodflow?
Part of blood passed through ventricle wall, mixed with pneuma, to brain > nerves > motion + sensation
Stomach < food
How did Galen demonstrate of the importance of the brain?
“He (…) realized that there are close parallels between human anatomy and the anatomy of non-human animals. He thus undertook to demonstrate that the brain, and not the heart, as claimed by Aristotle and the Stoics, is the seat of the ‘ruling faculty’ (hegemonikon). This could be accomplished by compressing different parts of an exposed brain in a living animal, with different impairments being observable as a result. Galen also showed in public dissections that tying off or cutting nerves branching from the brain could cause an animal to go lame in some of its limbs, or to become unable to use its voice. He remarks that this is particularly effective with a pig, since its screams prior to the cutting of the nerve are so loud, creating a more impressive effect when the animal is suddenly rendered mute (On Anatomical Procedures K 2.663).”
In what did Galen’s methodological rigor consist?
“Galen refuses to commit himself on matters that cannot be settled by solid proof.” Which means to say that he highly valued empirical evidence. He did also engage in philosophical thought about nature, especially in so far as it had a bearing on medicine.
What is Galen’s view on ethics, physics and logic for a doctor?
Galen “encouraged all doctors to undertake the study of philosophy. He even wrote a little text on the subject, with the self-explanatory title The Best Doctor is Also a Philosopher. Adopting the Stoic division of philosophy (see above, chapter 8), he says that doctors can profit from all three branches of philosophy (K 1.60-61). Ethics will help him focus on the welfare of his patients, rather than the potential of his art for making money. Physics will help him understand the composition of the human body: the four elements, which lend their properties of hot, cold, dry and moist to the humors, for instance. And logic will train the doctor in the rules of demonstration, ensuring that he accepts theories that are not merely plausible but actually well-grounded.”
What does Galen’s refutation of atomism consist of?
We can see how he thought atomism can be refuted by turning to his still extant treatise On the Elements According to Hippocrates. Here he complains that atoms are meant to be unalterable and to remain ‘unaffected’. They can be moved around and bounce off each other, but they can never feel anything. Imagine pricking your skin with a needle (K 1.420-24). How would you feel the pain if your body were made of atoms? An atom will not feel a needle jabbing into it, since it cannot be affected. Nor does it matter how many atoms the needle strikes: the concussion of atoms will never yield the sensation of pain.”
What is Galen’s teleological understanding of nature, and what is its inspiration?
He agreed with Plato’s Timaeus, Galen sees the entire universe as bearing the marks of intelligent design, with the example of the human body to support this perspective. Moreover, Galen also thought that material possibility does place constraints on what nature can do which was also inspired by Timaeus. Galen further talks about nature as exhibiting the providence of a divine craftsman.
What did Galen’s anecdote with emperor Marcus Aurelius illustrate?
It elucidated how Galens own medical method is a compromise of the approaches of rationalists and empiricists. Furthermore, it illustrated his belief on how doctors should apply a personalized approach, providing a tailored treatment with respect to the patients particular needs. This was elucidated by Galen comparing Marcus’ pulse to what it should be for an old man.
What was the influence of Galen on philosophy?
He is one of the five ancient philosophers who is most influential on later philosophy. This is also due to many philosophers being doctors. Galen’s centrality in medicine outlasted that of Aristotle in philosophy. Therefore, when authors such as Avicenna and Descartes pondered the nature of humankind they had to factor in the most recent physiology and anatomy which was provided from Galen’s works.
You have a headache, and are in a medieval city. Which were seen as a licit option to go to for a cure?
A qualified doctor, The Church, A local healer
Name ways of medieval diagnosis?
Feeling the pulse of the patient, Examining the urine sample of the patient, Treating each patient as an individual
What would a medieval doctor prescribe?
Unguents, potions and other herbal treatments, Bed rest, a special diet and relaxation, Bleeding off superfluous blood
What sources did Paracelsus use for his thought?
Medicine, Magic, Natural Philosophy, Religion
In what area did surgeons NOT make headway in the Middle Ages? and which did they?
They did NOT develop correct understanding about how donated organs will be rejected by a host
They did: They treated wounds with antiseptics instead of letting them putrefy, They developed techniques for skin-grafting, They developed techniques for reconstructing noses
What did NOT contribute to the emergence of human dissection during the middle ages? and what did?
Professional physicians looked down on surgeons as manual workers because they used their hands. Professors also stayed well away from this work, which assistants would carry out.
The first dissections may have been post-mortem examinations intended to ascertain cause of death for legal purposes
Bologna was a pre-eminent place to study law, the first dissections took place in Northern Italy.
Pope Innocent is on record for ordering the forensic examination of a murder victim, helping to break the taboo.
How did Vesalius see himself in relation to Galen?
He saw himself as carrying though Galen’s project to its logical conclusion – investigating man himself.
