Science is a complex term and it is sometimes difficult to distinguish it from other forms of knowledge. In the ancient world, for example, temples and sanctuaries were fundamental settings for the development of scientific activity. In Mesopotamia (2,000 BC), the cities of Ur and Babylon had large temples with priests whose practice of medicine was very common. Its methods and practices intertwined with others and reached ancient Greece, where the way of thinking in medical science was completely changed.
Appearance of rational thought in ancient Greece
Greek thought produced a truly brilliant and revolutionary intuition: the idea that the universe as a whole, and also all things in particular, have a physis that characterizes them. The physis (which the Latins later translated as ‘nature’) was understood as the way of being born and developing that is proper to each thing. The properties of the physis are: unity, diversity, fecundity, divinity, harmony or beauty and reasonableness. But the most important thing was to come to think that the physis is subject to immutable and rationally understandable laws, and that it can be manipulated by man through the tékhne or “art”.
It is precisely the idea of physis that allowed us to contemplate the Universe as an ordered cosmos and not as a result of the whim of the gods. And it was also the idea that made science possible as universal and necessary knowledge.
medical mythology
In ancient Greece, there was a tradition of religious medicine linked to the temples of Asclepius and cultivated by priests.
Asclepius was an underground god who resided in caves. He was educated and initiated into the medical art by the centaur Chiron and put his science at the service of men. He performed numerous cures and even raised the dead, an inordinate act of hubris that Zeus punished by striking him down with lightning.
The temples of Asclepius became places of pilgrimage for the sick from all over the ancient world. Curiously, the rise of this cult coincides in time with that of rational medicine practiced by Hippocratic doctors. The Hippocratic doctors themselves were called asclepiads, in the sense of disciples of Asclepius. And let us remember that in the famous Hippocratic oath the entire family of Asclepius is put as witness. Still today, the caduceus, a symbol of medicine, recalls the staff of Asclepius with the coiled serpent associated with the god.
Emergence of scientific-speculative medicine
Apart from the aforementioned religious tradition, a body of medical artisans independent of the priesthood could arise, which were grouped into schools (Cyrene, Crotona, Cos, Cnido and others). In this way, the supernatural interpretations of the disease began to be replaced by natural explanations.
Historical development of classical medicine in the West
The first historical remains of rational medicine date back to the beginning of the V century BC. C. Since then, and until the beginning of the Modern Age, all the educated medicine that was cultivated in the West had its source in these first doctors:
- Alcmaeon of Crotona (circa 500 BC) was a Pythagorean physician, author of the oldest known “scientific” medical writings. “What preserves health is the balance of powers: of the wet and the dry, of the cold and the hot, of the bitter and the sweet, etc., but the predominance of one of them is the cause of disease.”
- Hippocrates of Cos (460-379 BC) Considered the “father of Western medicine.” 53 medical books were attributed to him, and the so-called Corpus Hippocraticu, in which medicine is already fully scientific-technical. He is aware of the limits of knowledge, but also of the possibility of expanding it through observation and method.
- Herophilus and Erasistratus (School of Alexandria 322 BC) The city of Alexandria, with its famous library, was a center of research and education that promoted important progress. There, Herophilus and Erasistratus made great contributions to anatomy and founded very influential medical schools. He especially advanced anatomy and the first dissections of human beings were made.
- Galen (130-201) was a Greek physician born in Pergamum who practiced in Rome and became the leading medical figure of the late classical period. He was the author of almost 400 works, of which 150 are preserved. His fundamental contribution was to elaborate a canonical scientific synthesis that included all the previous Greek tradition.
Historical development of classical medicine of the East
The merit of Islamic medicine consisted above all in collecting, systematizing and transmitting ancient Greek knowledge, which otherwise would have been largely lost. During its heyday, Arab medicine was far superior to Christian medicine. They reached a better knowledge of classical medicine; They had greater pharmacological resources and splendidly developed hospitals.
Among the doctors, the following stood out: Ali Abbas; Al Biruni, author of a treatise on pharmacy; Rhazes, author of an original treatise on smallpox and measles, and, above all, Avicenna, who wrote the Canon, a famous systematic exposition of all Galenic medical knowledge, which was influential until the seventeenth century.
XII century. Splendor phase of Arab medicine. Hispano-Arabic doctors stood out: Abulcasis, Ibn Al Baytar, Avenzoar and, above all, two Cordovan physician-philosophers greatly influenced by Aristotle: the Muslim Averroes and the Jewish Maimonides.
Christian Western Medieval Medicine
Period of monastic medicine (6th to 12th century)
- Salerno School (10th century), southern Italy. Greek texts from Alexandria were translated there in a first stage. Soon after, Arabic books on Greek medicine began to be translated.
- Toledo School of Translators (12th century) and the Sicilian court. Numerous Arabic books were translated within a predominantly Aristotelian philosophical framework.
Scholastic medicine period (from the 12th century to the Renaissance)
Various ecclesiastical councils issued prohibitions to the medical and, above all, surgical practice of the monks. However, in the cathedral schools general studies and universities began to be created. In all of them, medical knowledge was developed that was very respectful of the classical tradition, although extremely dialectical, systematic and speculative: it was the so-called ‘scholastic knowledge’ (or of the schools).
Crisis and overcoming of ancient medicine in the Modern Age
In a first stage of the Renaissance, the old Galenic system reinforced its intellectual validity thanks to the recovery movement of medical humanism. And the inaccuracies that were being detected in the Galenic works were blamed on a faulty medieval transmission. However, new diseases were described for the first time, including syphilis, diphtheria (or garrotillo) and exanthematic typhus (or tabardillo). New medicines were also used, many of them brought from America, such as guaiac, ipecac, quina or coca. And then, at this time, the classical Galenic system began to be discarded.
Harvey demonstrated the existence of a blood circulation that was in contradiction with the old ideas. New medical treatments were also discovered. And the first microscopists visualized unsuspected structures. Gassendi reformulated a corpuscular theory of matter. And the fibers were replacing the humors as the last elements of living matter. All of this led to the appearance of medical systems that claimed to be total alternatives to Galenism.
Constitution of scientific-experimental medicine
At the beginning of the Contemporary Age, the great experimental sciences were already constituted, and physics, in particular, seemed to provide the best model to follow. Medicine, however, could not ensure that he had reached a fully scientific condition.
Hence, the main objective of doctors at the beginning of the Contemporary Age was to turn medicine into a true natural science. This objective was pursued from three different methodological perspectives that appeared successively. These perspectives, which Laín Entralgo has described as ‘the three great medical mentalities of the 19th century’:
- The clinical anatomy of the School of Paris. He developed a research program that consisted of correlating clinical observations and examinations with autopsy findings. The disease as an anatomical lesion.
- The pathophysiology of the German School. They trusted above all else in the measurable experimentation of physiological processes. The disease as functional alteration.
- The etiopathology of the last third of the 19th century. Illness such as infection or poisoning.
We can think that current medicine is based on the synthesis of the three great clinical-pathological mentalities that developed in the 19th century, hence the current pathology treatises describe diseases by successively alluding to their:
- Etiology.
- Pathological anatomy.
- Pathophysiology.
In the 20th century, studies on the constitution and genetic inheritance have been added to all of the above, and non-biological medical sciences have also developed, including psychopathology, psychosomatic medicine and social pathology. And in recent decades, these three dimensions of pathology have been greatly enriched thanks to the contributions of molecular biology.
As we can see, medical science was not born suddenly, rather it is due to a series of partial and often ambiguous developments that took place in various places and times. This is just one of the multiple approaches from which one can speak of the history of medicine. To learn a little more and go deeper into the subject, we recommend the reference source book for this article:
