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The Hippocratic Oath and the four humours: 4th c. BC
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Hippocrates practises and teaches medicine in about 400 BC on the Greek island of Kos. He will later be regarded as the father of medicine - partly because he is unlike his more theoretical contemporaries in paying close attention to the symptoms of disease, but also because a century or more after his death a group of medical works is gathered together under his name.
This Hippocratic Collection, and in particular the Hippocratic oath which is part of it, has remained the broad basis of medical principle up to our own day.
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A slightly later Greek text, called On the Nature of Man and attributed to an author by the name of Polybus, introduces a medical theory which will be orthodox in Europe for some 2000 years. It states that human beings are composed of four substances or 'humours', just as inanimate matter is made up of four elements. India has a similar theory based on three.
The humours are blood, phlegm, black bile (melancholia) and yellow bile (chole). Too much of any one will give a person certain recognizable characteristics. He or she will be sanguine, phlegmatic, melancholy or choleric.
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Human vivisection: c.300 BC
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Early in the 3rd century BC two surgeons in Alexandria, Herophilus and Erasistratus, make the first scientific studies designed to discover the workings of human anatomy.
The cost of their contribution to science would be considered too high in modern times (they acquire much of their information from Human vivisection, the patients being convicted criminals). But Celsus, a Roman writer on medical history, energetically justifies the suffering of the criminals as providing 'remedies for innocent people of all future ages'.
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Acupuncture: 3rd century BC
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A Chinese text, the Nei Ching or 'Book of Medicine', describes the practice of acupuncture. The document is written in about the 1st century BC, by which time acupuncture is already a long-established tradition.
The underlying theory is that a healthy body depends on a flow of energy. This can be interrupted by blockages, which may be either the symptom or the cause of illness. Inserting a needle into the correct spot on the energy path (as many as 365 possible places are specified) will improve the energy flow by clearing a blockage or releasing pressure. The use of acupuncture as a form of anaesthetic, familiar in China today, is a modern development of the traditional science.
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The influential errors of Galen: 2nd century AD
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The newly appointed chief physician to the gladiators in Pergamum, in AD 158, is a native of the city. He is a Greek doctor by the name of Galen. The appointment gives him the opportunity to study wounds of all kinds. His knowledge of muscles enables him to warn his patients of the likely outcome of certain operations - a wise precaution recommended in Galen's Advice to doctors.
But it is Galen's dissection of apes and pigs which give him the detailed information for his medical tracts on the organs of the body. Nearly 100 of these tracts survive. They become the basis of Galen's great reputation in medieval medicine, unchallenged until the anatomical work of Vesalius.
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Through his experiments Galen is able to overturn many long-held beliefs, such as the theory (first proposed by the Hippocratic school in about 400 BC, and maintained even by the physicians of Alexandria) that the arteries contain air - carrying it to all parts of the body from the heart and the lungs. This belief is based originally on the arteries of dead animals, which appear to be empty.
Galen is able to demonstrate that living arteries contain blood. His error, which will become the established medical orthodoxy for centuries, is to assume that the blood goes back and forth from the heart in an ebb-and-flow motion. This theory holds sway in medical circles until the time of Harvey.
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