Hippocrates of Cos, a contemporary of Socrates and the most famous name in
the history of ancient medicine, is traditionally credited as the first medical theorist
and practitioner to have regarded illness entirely in physiological terms in its cause
and treatment, that is to say to have severed the connection between illness and the
gods, though the famous oath to which he has given his name is now often thought to
be of Alexandrian origin. What is known about early medicine is derived from a large
body of material called the Hippocratic corpus, compiled at a later date and probably
emanating from his followers rather than from Hippocrates himself. It seems that the
Hippocratic school worked from the basis of a theory of humours, associated with the
elements, earth, water, fire and air, sometimes analysed in terms of hot, cold wet and
dry, and associated with blood, yellow bile, black bile and phlegm, illness being an
imbalance between these constituent elements. A locus classicushere is the extended
description in Plato’s Timaeus82a–90. The theory of the four humours recalls the
physics of Empedocles (c. 492–432) in which the world is in a constant state of flux as
the four elements are moved variously by Love and Strife. The rational medicine of
the Greek enlightenment might be considered as a logical development following on
from the physical speculations of the Ionian philosophers applied to the human body.
Progress in medical understanding was hindered by a lack of knowledge of the
interior anatomy. Aristotle in his History of Animalsbased observations on autopsy
but dissection of the human corpse, let alone vivisection, was undoubtedly taboo in
Classical times. Alexandrian advances may have partly resulted from vivisection.
Celsus (a late witness from the second century AD) reports that Herophilus and
Erasistratus, both founders of schools at Alexandria in the third century, cut open the
live bodies of criminals obtained out of prison from the kings. Whether or not this is
true, they certainly dissected corpses, no longer impeded by the customs and
attitudes of the Greek poleis.Knowledge of their advances can only be pieced together
from references in later sources, notably the celebrated medical writer Galen in the
second century AD.
Herophilus was the first in differentiating the cerebrum and the cerebellum to
assign different functions to each, and in so doing establishing beyond doubt that the
brain rather than the heart was the seat of the intellect. This had long been a matter
ofdispute; previously Aristotle had championed the heart. The terms, calamus
scriptorius, torcular Herophiliand chorioid plexus,all still used, derive from his anatomy
of the brain. He discovered the nerves, distinguishing between the motor and sensory
nerves, and described the optic nerve in a new and more detailed understanding
of the workings of the eye. The English word ‘retina’ is derived from one of his
descriptions. He made advances in appreciation of the workings of blood vessels
and the pulse, though there was no full understanding of the circulation of the blood
in antiquity. He also identified the duodenum. He also made advances in the
understanding of the reproductive system. Whereas Aristotle had believed that the
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