Story

The countries of the ancient world, located in the Mediterranean basin, had a great influence on the whole course of the subsequent development of mankind. Chief among them were Greece and Rome.

Periodization of history and healing

The history of ancient Greece is a history of the expansion of tribal and the formation of slaveholding relations. It is divided into five periods: 1) the Crete-Mycenaean, or Aegean (III — II millennium BC. E.), 2) pre-polic (XI — IX centuries BC.), 3) polisny (VIII — VI centuries BC), 4) the classical (V – IV centuries BC), 5) the Hellenistic (second half of the IV c. BC - the middle of the I c. AD). During each of these periods, the development of healing and medical knowledge had its own distinctive features (Table 8).

Sources on history and healing: written monuments (Homer's Iliad and Odyssey, History in nine books by Herodotus, Hippocratic Collection, works of philosophers and historians), data from archeology, ethnography, etc.

Mythology and healing

The beginning of Greek mythology is hidden in the thousand-year history of the peoples of the Aegean basin.

Hellenistic period. Second half of IV. BC e. - middle of I century. n e.

"Hippocrats collection" - the oldest monument to the medical literature of ancient Greece (compiled in the III century BC. In the Alexandria manuscript repository)

The writings of Aulus Cornelius Celsus on healing in the Hellenistic era (the writings of Herophile and Erazistratus in the originals have not survived to this day) Separate information in the writings of historians and poets

The gods in ancient Greece were thought of as anthropomorphic: they were represented in the image of people and endowed with all human qualities and passions, both good and bad. Honoring the gods in ancient Hellas was expressed not by grief, but by pleasure, not by self-flagellation and self-denial, but by noisy public fun: theatrical performances, gymnastic celebrations and the Olympic Games were considered religious ceremonies and were originally intended to glorify the gods.

The cult of Asclepius as a god-healer was formed in Hellas by the 7th century. BC e. In all likelihood, the prototype of this mythological hero was the real-life legendary healer of the times of the Trojan War (XII century BC) - the king of Thessaly and the head of the family medical school - Asclepius. The first mention of him and his sons Machaon and Podaliriya - heroes and military leaders and skilled healers ("the glorious both doctors, Asclepius are wise children") - is found in the Iliad.

When Menelaus, the "many-Orthodox king" of the Achaeans (Greeks), was wounded, his brother King Agamemnon ordered that Machaon be found:

How many, Tulbiby, perhaps, rather, call Machaon, -

Husband, whose parent - the doctor flawless Asclepius,

To come to see Menelaus, Ares' favorite ...

Immediately, immortal like, entered Machaon in the middle

And he tried to take the arrow out of the atrium belt;

But the pointed teeth did not let her back.

The belt is patterned then he unbuckled, and after - an apron

With a copper band, - the blacksmiths worked hard on it.

The wound saw then, inflicted by a bitter arrow,

Sucked the blood and sprinkled the wound with knowledge

How friendly his parent was trained by Chiron.

In Greek mythology, Asclepius is the son of Apollo, the god of sunshine, music and poetry, who was worshiped in the same way as the healer of the gods and the god of healers. According to the legend, Asclepius was born by a caesarean section, which was made by his father Apollo, who snatched a newborn baby from the womb of the dying Coronida mother - the daughter of fire titan Flegius. Asclepius learned the art of healing from the wise centaur Chiron, whom Apollo commissioned to raise his son. Soon the student surpassed his teacher and learned not only to heal the sick, but also to return the dead to life, which caused the wrath of the god of the underworld and the realm of the dead Hades.

According to legend, the god Asclepius married Epion, the daughter of Merops, the ruler of Fr. Kos, which later became one of the centers of medical knowledge of ancient Greece. Here the genus Asklepias flourished (descendants of Asclepius), to which Hippocrates, who was born on Kosa (c. 460 BC) and who considered himself a descendant of Asclepius, also counted himself. The most famous children of Asclepius are considered to be: Hygiene - the goddess of health, the all-healing Panakea - the patroness of medicinal medicine, Machaon, who became a famous military surgeon, and Podalirii, who became famous for healing internal diseases. They all learned the art of healing from their father. Among the gods of the Olympic pantheon (according to legend, they lived on Mount Olympus in Thessaly), many had to do with healing, maintaining health and a healthy lifestyle. So, Hera, the wife of the supreme god Zeus, was considered the goddess of marriage and earthly fertility. Artemis is a twin sister. Apollo, the patroness of the hunt and the mistress of the beasts — was also revered as the patroness of the parturient woman, the protector of the children and female chastity. Hestia was the goddess of the home, protected the house from all evil and cared for harmony, love, happiness and health of all its inhabitants. The winged Hypnos personified the dream; It was not only people who obeyed him, but also the gods (hence the origin of the word "hypnosis" from the Greek. Hypnos - sleep). Greek mythology is deeply reflected in Greek art and literature - without knowledge of mythology, it is difficult to understand many classical works, scenes of paintings and sculptural groups, medical terms and the origins of traditional healing techniques.

In ancient art, an integral attribute of Asclepius and his daughter, Hygiene was the snake, which was revered in the ancient world as a symbol of wisdom, renewal and power of nature. Asclepius (in ancient Rome was called Esculapus) was depicted with a staff (i.e. walk), entwined with a snake (fig. 37), and Hygieya - as a young beautiful woman in a tunic, with a diadem and a snake, which she held in her hand and fed from a bowl. Subsequently, the image of a staff entwined with a snake, a bowl with a snake in some countries main emblems of medicine, symbolizing, by m eniyu some authors, the wisdom and the power of the healing forces of nature, and according to others - fear of the unknown forces it (snake venom was a poison and medicine).

Snakes were also part of the symbolism of the god Hermes, who personified profit, exchange and trade. In a road hat and winged sandals, he accompanied the souls of the dead to the realm of the dead (Hermes — Psychopompos). In his hand, there was always a caduceus — a rod, around which two serpents were looking at each other (for comparison, see the emblem of the Babylonian god Ningishzida, p. 44). Hermes's caduceus was considered magical and served him to sleep, so Hermes was also worshiped as the god of dreams. Subsequently, caduceus became in some cases the emblem of commerce, in others - the emblem of medicine.

The most extensive and earliest collection of Greek myths are the epic poems Iliad and Odyssey attributed to Homer.

DOCTOR OF THE CRETO-MIKENSKY PERIOD (III-II millennium BC.)

The beginnings of Greek medicine are lost in ancient times and are undoubtedly associated with the medicine of the ancient cultures of the East: Egyptian, Babylonian, Indian and others.

The center of the oldest Greek civilization was about. Crete. The highest flowering of his kingdoms (Knossos, Malia, Festa, Zakro) falls at the end of III - beginning of the II millennium BC. e. and is associated with the development of the early slave society. In the II millennium BC. e. powerful Crete had well-developed crafts, art, maintained external relations with the Trojan kingdom and mainland Greece, Cyprus, Syria, Babylonia and especially with Egypt, which was of great importance for both countries.

The heyday of Crete coincides in time with the heyday of the Harappan civilization (on the territory of modern Pakistan). According to G. M. Bongar-du-Levine, at that time there were cultural connections between Hindustan and the Mediterranean; the civilizations of Crete and 'Harappas had a number of similarities. So, on the territory of Knossos de Oortsa on about. Crete as a result of archaeological excavations, begun in 1900 under the direction of A. Evans, sanitary and technical facilities were found: a system of pipes made of baked clay for the flow of polluted water, drainage channels, drains, excellent bath facilities, ventilation. By the time of its creation (the end of the 3rd millennium 'BC), they are close to the oldest known sanitary facilities in the world in years. Mohenjo-Daro, Changhu-Daro and Harappa in the Indus Valley. Small female ivory and gold figurines depicting a servant of the cult of Mother Earth with snakes in their hands (Fig. 38) were also found on the territory of the Palace of Knossos. However, there are no sufficient grounds to rank them as a cult of healing, as there are no written evidence or reliable interpretations.

In the middle of the II millennium BC. e. began the flowering of numerous kingdoms of mainland Greece, among which a special place was occupied by Mycenae. In the middle of the XIII century. BC e. they dominated Crete, which flourished earlier. At this moment, the culture of Achaean (mainland) Greece became the leading one for the entire Aegean basin. The activities of the king of the “gold-loving Mycenae” Agamemnon and his brother, the king of Sparta Menelaus, left a deep mark on the memory of the descendants. Episodes of the Trojan War, undertaken by them in the XII century. BC e. in order to subjugate the rich and prosperous Troy, subsequently formed the basis of the plot of the epic poem "Iliad", which is practically the only source of healing of this period.

Unfortunately, the written medical sources of the Cretan-Mycenaean period (as well as the Harappan) are not yet available: perhaps deciphering the Cretan-Mycenaean linear letter will allow in the future to fill this gap in our knowledge of. healing the earliest period of the history of ancient Greece.

DOCTOR'S DOCTORAL PERIOD (XI — IX centuries BC.)

The pre-policing period was for a long time called “Homeric”, as up to the 19th century. (when archaeological research began in the territory of ancient Greece) the epic poems Iliad and Odyssey attributed to Homer gave basic information about it. Created around the IX. BC e., they for centuries passed in oral tradition, in the VI. BC e. were first recorded and, thus, became the first Greek (and European) written literary monuments.

In Homer's poems, 141 damage to the trunk and extremities (surface and penetrating injuries, bruised wounds and suppurations resulting from the bites of venomous snakes, etc.) are described. The treatment of wounds consisted in removing arrows and other injurious objects, squeezing the blood and applying painkillers and hemostatic plant powders with the subsequent application of a bandage.

Despite the fact that the autopsy of the dead in ancient Greece were not made (up to the Hellenistic era), the medical nomenclature of the Iliad and Odyssey was the basis of the terminology of Greek healers and is part of the modern anatomical language. According to the national historian of medicine of the last century S. G. Kovner, it is “slightly below the anatomical concepts of Hippocrates”.

Healing and dressing wounds of the ancient Greek army was done by the soldiers themselves (Patroclus treated Evri-vila and Machaon; Achilles tied up Patrokl's wounds) (fig. 39) and skilled healers who knew the properties of healing herbs that "the earth gives birth to" (Iliad , Xi .740). They were deeply respected:

It is worth many people one healer skillful:

He will cut out both the arrow and the wound with medicine.

Homer's poems also mention the plague epidemic, the insanity of the friends of Ulysses, the Bellero-zone melancholy, the birth of a viable [Laduzha at the end of the seventh month of pregnancy; It speaks of the use of sulfur fumigations in order to prevent diseases and the use of sulfur as a medicinal agent, as well as of borrowing some knowledge of therapeutic agents from the ancient Egyptians.

The epic poems "Iliad" and "Odyssey" testify to the empi-enic character of the origins of ancient Greek healing, the widespread interaction of ancient Greek medicine with the achievements of other ancient civilizations.

DOCTORS OF THE POLICE PERIOD (VIII — VI centuries BC.)

In the VIII — VI centuries. BC e. in the territory of Greece everywhere city-states were formed - policies. They united free citizens, who became landowners and slaves. In highly developed policies, such as Athens and Corinth, slavery was widespread by the end of the 6th century. BC e. In others (Sparta, Argos) for a long time, along with slavery, survivals of the tribal system persisted.

The infertility of the land of the continent of Greece, the intensification of the struggle of the people (demos) and the nobility led to the emigration of the Greeks in search of new fertile lands. Thus arose the Greek polis settlements (Fig. 40) on the coast of Asia Minor, along the shores of the Mediterranean, Aegean, and later the Black Sea. The most notable among them were the cities of Miletus, Ephesus, Cnidus (in Asia Minor), Panticapaeum, Kherso-nes, Olvia (in the Northern Black Sea Coast), Navkratis (in the Nile Delta), Tarent, and Croton (in Italy). Extensive trade and cultural ties between numerous policies contributed to the economic and cultural development of ancient Greece. The polis period in the history of ancient Greece is marked by two phenomena that are important for the history of medicine: 1) the formation of the materialist ancient Greek philosophy, which took shape in the 7th century. BC Oe., mainly in Ionia, and finally took shape by the IV. BC e. (see p. 95), and 2) the formation of temple healing, which is associated with the strengthening of the slave system in ancient Greece, strengthening the position of religion and, consequently, the formation of temples. Temple healing in ancient Greece developed against the background of empirical healing (which existed long ago). As already noted, the cult of Asclepius as a god-healer was formed in ancient Greece in the 7th century. BC e. Somewhat later (in the 6th — 4th centuries BC), the first shrines in his honor, the Asclepions (Greek asclepieion), were erected in Trikka (Thessaly), Epidaurus (Peloponnese) and on the island of Kos. In general, ancient authors report more than 300 asklepleyon in the territory of ancient Greece.

The most magnificent was the sanctuary of Asclepius in Epidaurus (Fig. 41). Him. the central building was the temple of Asclepius (4th century BC). On the territory of the sanctuary there were also temples in honor of Gi-giei, Artemis, Aphrodite, Themis and Apollo, a large altar for offerings and a round temple of Volos - an outstanding work of ancient architecture, erected in the 5th century. BC e. Policlet Younger. In his dungeon there were three pools communicating with a mineral source.

The mineral spring, the water of which has a natural healing effect, and cypress grove (the air of which is also healing) were mandatory guidelines for choosing a place to build a temple in ancient Greece. The water of the spring was used as one of the main remedies, and therefore it was considered sacred.

There was also a bathhouse, a library, a gymnasium, a stadium (for sports) and a theater, also built by Policlet, on the sanctuary in Epidaurus. Younger and reputed one of the largest and most wonderful in all of Greece. Everywhere there were numerous statues depicting gods, monuments erected in honor of famous healers, steles, on which were carved texts about cases of successful healing. During excavations in Epidaurus, images of the healed parts of the body were also found in large numbers (motifs). Made of marble, gold, silver, they were brought to the temple in payment for services (Fig. 42). These are marble hands and feet, silver hearts, golden eyes and ears.

Alone was not allowed in the sanctuary: it was impossible to die there. Religious ritual expelled from the sacred places both in Epidaurus and in other Asclepiones everything unclean, in particular, connected with birth and death. Therefore, women in labor and incurable solo, who sometimes came from the most distant places in Greece, were driven out of the sacred fence. The servants of asklepeyon strictly followed the cleanliness of the sanctuary and its visitors. Everyone who came in washed in the waters of the "sacred" source, after which he offered sacrifices to the gods.

Thus, the sanctuaries of Asclepius in ancient Greece were not hospitals in our understanding. According to the apt remark of Professor V.P. Karpov, they were of a “therapeutic-sanatorium” character.

Epidaurus never had a medical school, as was the case on Spit, Pergamum or Alexandria. Only those who gave the sacred medical "Oath" and thus joined the brotherhood of the asklepiades (this term first appeared in ancient literature in the 6th century BC) were accepted for service in Asklepayon.

Medical practice in asklepeyon combined empirical and magical techniques. The main means of treatment were: medicinal healing, hydrotherapy, gymnastic exercises. Along with them, there was a ritual of En-koimesis (which is incorrectly translated as “incubation” or “incubation sleep”) - the culmination of the rite of holy healing. It was held in the Abaton (Greek abaton) - long covered galleries along the wall of the temple, where no one could enter without special permission. There, patients were introduced into a state of "artificial sleep" (a state of ecstasy or hypnosis), which was achieved by using drugs or methods of psychological influence. The ritual was accompanied by theatrical performances, the appearance of God or his sacred serpent, and even the presentation of surgeries (many surgical instruments were found in Epidaurus and other asclepayons). Very soon the Enkoimesis ritual gained widespread popularity. He attracted a lot of patients and brought huge incomes to Asclepio-us. After the terrible plague of 430 BC. e., before which traditional medicine was powerless, attention to religion and magic increased. The sacred serpent from Asklepeion in Epidaurus was solemnly transferred to Athens, where a new Asclepeyon was laid on the slopes of the Acropolis, and the cult of Asclepius beamed with a new force.

However, in the enlightened circles of Greece, Enkoimesis ritual was very critical. So, in the comedy of Aristophanes "Plutus" (Greek: god of wealth), written in 388 BC. e., eloquently tells about the many disappointments about this ritual.

In ancient Greece there was no sharp boundary between secular medicine and healing in temples. This is evidenced by monuments to famous secular healers, erected on the territory of the Asclepayon, as well as numerous evidence of inviting well-known secular healers to the temples as "consultants" in difficult cases of disease.

Temple healing inherited many positive practices and hygienic traditions of empirical healing, which arose incomparably before religions. Greek medicine did not come out of the temples: “in the works of Homer, Hesiod ,. Pindara nd many other poets and historians, - S.G. Kovner noted, - we find ... many solid proofs of the undoubted existence from time immemorial of secular, natural medicine, which its powerful rival, temple medicine, was not in a position to overshadow, nor destroy.

MEDICINE CLASSICAL PERIOD (V — IV centuries. BC. E.)

In the classical period of the history of Greece, the polisny system reached its highest economic, political and cultural development. The “highest internal flowering of Greece” (K-Marx), closely connected with the state activity of Pericles (444-429 BC) and the rise of the power of Athens, as the hegemon of the Athenian maritime union, began. The epoch of Pericles became the time of the brilliant flourishing of Greek philosophy and natural science knowledge. Pericles gathered in Athens many famous scholars and artists. Among them are Phidias, Sophocles, Herodotus, Anaxagoras. Their views were largely free of religion, which distinguished the Greek culture periodically from all others. cultures of the ancient world. “In the epoch of Pericles,” Marx wrote, “- the sophists, Socrates, who can be called the personification of philosophy, art and rhetoric ousted religion” *.

Relatively extensive literature testifies to the medical knowledge of the classical period in the history of Greece: excerpts from the writings of poets and historians (Aeschylus, Euripides, Herodotus, Sophocles, Kretes, Aristophanes, and others); works of philosophers, among which a special place is occupied by the works of Democritus; "Hippocratic Collection" - the oldest monument of medical literature of ancient Greece.

The philosophical foundations of ancient Greek medicine

In ancient Greece, healing developed for a long time in the mainstream of common philosophical knowledge - natural philosophy (Latin philosophia naturalis, from the hell, philosophia - love of wisdom, knowledge). All the great healers were philosophers and, on the contrary, many great philosophers were very well versed in medicine.

The formation of Greek philosophy (as already noted) took place in the VII — VI centuries. BC e. mainly in Ionia, Greek settlements on the Asia Minor coast of the Aegean Sea. Its leading centers were the cities of Miletus, Ephesus, Kos, Knid and. BUT?-

The first ancient Greek philosophers perceived the world as a whole. In their opinion, “not a single thing arises ... and does not disappear, since the same nature is always preserved” (Aristotle). Each of them tried to find the origin of the world, i.e., to determine that unchanging fundamental principle of all things (the first matter) from which everything arises and into which everything returns again.

Thus, the founder of the Ionian natural philosophy Thales from Miletus (Tha-les, 624-546 BC) believed that everything came from the moisture or water on which the Earth rests.

A follower of Thales Anaksi-mandr from Miletus (Anaximandros, c. 61.1-546 BC.) Believed that the basis of all existence is a certain special primacy - apeiron (Greek apeiron - infinite, infinite), t. e. eternal and infinite matter, which is in constant motion. He was the first to try to find a comprehensive rational explanation of life and the world and sought natural interpretations of the origin of stars, clouds and earthquakes.

Another follower of Thales Ana-ximen from Miletus (Anaximenes, ca. 585-525 BC) considered the primary substance to be air, from which fire is released when it is discharged, and when condensed it produces wind, clouds, water, earth, stones ( that is, the quantity of the primary product, in his opinion, determines the quality of the substance).

Heraclitus of Ephesus (Greek Heraklei-tos, ca. 554-483 BC) saw the essence of being in constant motion and continuous change, in the unity and eternal struggle of opposites (his philosophy was inextricably linked with dialectics ). Unlike the first Ionian natural philosophers, who were looking for a sustainable primacy, Heraclitus believed that the embodiment of all transformations is fire.

Leucippus from Miletus or Abder (Greek Leukippos, ca. 500–440 BC) explained everything that happens in the world by the movement of the smallest particles — atoms in absolute emptiness. The pupil of Leucippus — Democritus of Abder (Greek: Demokritos, 460–371 BC), based on the atomic doctrine of his teacher, created an integral system of ancient atomism. Being a man of encyclopedic knowledge, Democritus left behind a lot of philosophical and natural-scientific works, of which only fragments have survived to us. They contain arguments about embryology, diet, fever, prognosis, dog rabies, drugs, etc. Democritus believed that all life processes, even thinking, can be explained by the movement and connections of atoms. Philosphry Democritus was directed against the national religion. The gods for him were only the embodiment of the phenomena of nature: “Health is asked from the gods in their prayers by people, but they do not know that they themselves have at their disposal the means to this. By not tempered by opposing their health, they themselves become traitors to their health thanks to their passions. ” The philosophical views of Democritus represent the pinnacle of the natural-science (materialistic) teachings of antiquity.

For the first time, deliberate opposition of matter to consciousness in ancient philosophy was made by Plato from Athens (Plato, 427-347 BC. E. :), one of the eminent Greek thinkers, the founder of objective idealism in its original. sense. Shocked by the court and the execution of his teacher Socrates, Plato directed all his efforts to develop a project for an equitable state structure and as a result created the philosophy of objective idealism (the Pythagoreans laid the foundation for this doctrine, who considered the basis of the whole number and numerical relations). The main components of the teachings of Plato are: the doctrine of the state, the theory of ideas, ethics and gnoseology (the doctrine of knowledge). The main philosophical core of Plato's theory is the theory of ideas, according to which the existing real world is a reflection, a shadow of the ideal world of ideas. In 388–387 BC e. Plato founded his own Academy in Athens, whose members were mainly engaged in mathematics and a kind of dialectics built on it.

Thus, in the classical period of the history of ancient Greece, two main classical systems of ancient philosophy were formed: the natural science (materialistic) atomistic teaching formulated in the works of Democritus and the objective idealism created by Plato. Both had an impact on the formation of medicine, which in the ancient world was inseparable from philosophy. Ionian natural philosophy opened the way to studying the main causes of diseases and the process of the disease itself. The tendency towards systematization of knowledge, characteristic of ancient philosophical systems, contributed to the development of systematization in medicine, led to the creation of theories of the disease and the emergence of independent directions (anatomy and surgery of the Hellenistic period).

Medical schools

Healing in ancient Greece for a long time remained a family tradition. By the beginning of the classical period, the scope of family schools had expanded: they began to accept students - not members of this kind. Thus: advanced medical schools lay down, which in the classical period were located mainly beyond the Balkan Peninsula, outside Greece proper, in its overseas settlements. Of the early schools, the most famous are Rhodes (Rhodes in the eastern Aegean Sea) and Kyoto Renskaya (Cyrene in North Africa). Both of them disappeared early, and information: they are almost not preserved. The Crotonic ones that appeared later (Croton ^ in the south of modern Italy), Knid - :: <th (Cnidus on the west coast Asia Minor), siliciyskaya (Sic-yu island) and Koska (Kos island in the east Noah = asti Aegean) schools were the glory of ancient Greek medicine.

The Croton medical field reached its zenith already in the 6th century. BC e. Its main achievements are formulated in the following theses: 1) the organism is a unity of opposites, 2) a healthy organism is the result of a balance of opposing forces: dry and moist, warm and cold, sweet and bitter, etc., the domination of one (monarchy) there is a cause of the disease, 3) the opposite is cured by the opposite (“contraria contrariis curantur” - a thesis often attributed to Hippocrates). An outstanding representative of the Croton school was the philosopher and healer Alkmeon of Croton (Greek Alkmaion, Latin Alcmaeon, 6th — 5th centuries BC) - “a husband, skilled in natural science, who first dared to begin cutting of bodies [animals]” ( Chalcidia). He discovered the junction of the optic nerves and the auditory canal (later called the Eustachian tube), wrote about the brain as an organ of knowledge (after the Egyptians, but before Aristophanes) and the causes of certain diseases associated with the expiration of excess mucus.

Cnidus medical school became the main pride of the city and brought him fame. This school developed the doctrine of four bodily juices (blood, mucus, light bile and black bile): health is represented as a result of their favorable mixing (Greek eukrasia) and, on the contrary, adverse mixing of juices (Greek dyskrasia) was regarded as the reason most diseases. (Later, based on the ancient Greek teachings about body juices, a humoral (from Lat. Humores - liquid) theory was formed that existed in medicine until the 19th century, that is, for two millennia, with some changes.) Continuing the traditions of Babylonian and Egyptian healers, The Cnidus School developed a study on the signs of disease (symptoms) and diagnosis (the listening method used by Hippocrates and the discovery of pleural friction). An outstanding healer of this school was Eurifon from Cnidus (Eurifon, V in. BC), a contemporary of Hippocrates.

Sicilian School of Medicine was founded in the V century. BC e. Empedocles of Akraganta (Greek Et-pedokles, ca. 495-435 BC) and continued to exist during the time of Plato and Aristotle. Empedocles was a philosopher and politician, poet, orator, healer and priest. Fragments of his main work “On Nature” have been preserved, in which Empedocles' natural-philosophical position is expounded: he believed that the essence of all things are fire, water, air and earth; they are eternally immutable, unknowable and indestructible; they cannot transform one into the other and only mechanically mix with each other; the diversity of the world is the result of various proportions of this mixture. Thus, Empedocles laid the foundations of the classical theory of elements. Empedocles was highly esteemed adherents of his teachings. He is credited with rescuing Mr. Selinunte from an outbreak of a massive infectious disease (pestilence or malaria), to mark what the coin was cast. The healers of the Sicilian school recognized the heart as the main organ of consciousness; they identified the four juices with four states (hot, cold, wet, and dry).

The Kosovo Medical School is the main medical school of ancient Greece of the classical period. The first information about it refers to 584 BC. Oe., when the priests of the Temple of Delphi asked Nvbros with Fr. Kos and his son Chrysos will stop the pestilence raging in the army besieging Kirros. Both healers immediately responded to this request and, as the legend says, performed it in the best possible way: the epidemic was stopped.

Following the natural-philosophical views, the healers of the Kosovo school perceived the person, his health and illness in close connection with the outside world, and sought to maintain the natural healing powers in the body (his physis). The disease in their understanding is not the punishment of the gods, but the result of the influences of the whole environment and eating disorders. So, about epilepsy, which was considered a "sacred" disease, in the "Hippocratic Collection" it says: "The first to recognize this disease as sacred were the same people as magicians, charlatans and deceivers now turn out to be | ki ... not at all divine, but something human seems to me in this whole matter: the cause of this disease ... is] the brain. " Hence the cure is not a divine “condescension”, but the result of human knowledge gained as a result of previous experience.

Kosovo school physicians actively developed the doctrine of four bodily juices and four temperaments ;! developed the principles of observation and treatment at the bedside (later these ideas formed the basis of the clinical direction in medicine), developed the foundations of medical ethics.

The heyday of the Kosovo School of Medicine is associated with the name of Hippocrates II Velia-1 whom (ca. 460 — ca. 370 BC), which went down in history as Hippocrates (Greek Hippokrates, lat. Hippocrates) .1 "His legendary The name became a symbol of the medical art in ancient Greece. A few years after Hippocrates dived Kos, on the island, in the place where there was a modest sanctuary and medical school, there was a great Asclepeon, which was expanded several times.

Praxagoras (Praxagoras. 4th century BC), a teacher of Herophile, one of the founders of the Alexandrian medical school (the Hellenistic period), was also a prominent healer of the Kosovo school.

Thus, the analysis of the classical period that has come to us about the healing in ancient Greece of the classical period shows that its achievements are not limited only to the name of Hippocrates (as is often done) - the formation of numerous, different in directions medical schools, equal in their achievements, natural science Understanding the unity of man and the surrounding world and the associated natural look at the causes of diseases, the formation of the theory of bodily juices and temperaments, the development of diagnostic methods, prognostics and treatment in fasting whether the patient - all this was the result of the work of many generations of healers of various policies of ancient Greece.

Hippocrates

Reliable information about the life of Hippocrates (Fig. 43) is very limited. The very first biographies of Hippocrates (or Hippocrates) were written no earlier than several centuries after his death. Their authors (Soran, 2nd century; Svida, 10th century and others) were not his contemporaries, and therefore their narrative bears the imprint of that legend which surrounded the name of this great doctor. So, Svyda in his “Lexicon” (“Suida Lexi-kon”) represents Hippocrates in the following words:

"Hippocrates is a Kosovo doctor, the son of Heraklides ... became the star and the light of the most useful medical art for life ... He was a student of his father first, then Herodik from Selimbriya and Gorgiy from Leontiny, a orator and philosopher, according to some— also Democritus from Abder ...

Having two sons of Thessalus and the Dragon, he died 104 years old and was buried in Larissa Thessaly. "

Thus, it is known that Hippocrates was born on Fr. Kos According to his father, he belonged to the noble family of Asclepads and led his ancestry from the son of Asclepius - Podaliria. Being a wandering healer, Hippocrates traveled a lot. The fame of his medical art has spread in many states. The last years of his life he spent in Larissa (Thessaly), where he died in the same year as Democritus, according to some sources at the 83rd, and according to others - at the 104th year of his life. Locals for a long time honored his grave and even in the II. n e. showed her travelers.

Hippocrates lived during the highest heyday of Hellenic culture, when each branch of human activity had its own distinguished representatives. In politics, it was the age of Pericles, in history - the age of Herodotus and Thucydides, in philosophy - the age of Leucippus, Democritus, Empedocles, Anaxagoras, Gorgias, Socrates and Plato, in poetry - the centuries of Pindara, Aeschylus, Sophocles, Euripides and Aristophanes, in the region of Sculpture and architecture - the age of Po-liklet, Praxitele and Phidias, in the field of medicine - the age of Hippocrates, Ev-rifon, Praxagoras ...

Hippocrates was not the "father of medicine", which existed for thousands of years before him, but in his great time he was the head of an outstanding medical school, personifying the best achievements of ancient Greek medicine of the classical period.

"Hippocratic Collection"

The question of what works left after Hippocrates, still windows not decided. According to tradition pits of the time, doctors are not signing Do their essays, and they all with time we were anonymous. The first collection of works of ancient greek whose was drafted many years later after the death of Hippocrates - in the III.

BC e. in the famous alexandria manuscript repository Kingdom of the Ptolemies), founded Diadocho (Greek: follower) Alec Sandra Macedonian - Ptolemy I Soter, the first ruler

(323-282 BC) Hellenistic Egypt. At the behest of the Ptolemies from all over the world manuscripts were brought to Alexandria by scholars who were systematized in catalogs, studied, translated and copied. Over time, the number of manuscripts exceeded 700 thousand scrolls. Among them were 72 medical writings written in Greek, in the Ionian dialect. All of them were nameless: the history has not retained a single original, which would have indicated the authorship of Hippocrates or other doctors of ancient Greek classical period. About 300 BC. e. All medical manuscripts were combined into the Hippocratic Collection (Latin Corpus Hippocraticum). Thus, the Alexandrian scholars preserved for posterity the works of Hippocrates and other Greek physicians who lived in the 5th — 3rd centuries. BC e. (Fig. 44).

Most researchers believe that Hippocrates owns the most outstanding works of the collection: "Aphorisms", "Prognostics", "Epidemics", "On the air, water, localities", "On fractures", "On the wounds of the head", "On ancient medicine", and possibly some others.

"A f o r and smy s" consist of eight sections. They contain dietary and medical instructions for the treatment of internal diseases, surgery and obstetrics. A special place is given to prognostics.

“Aphorisms” begin with the words: “Life is short, the path of art is long, a quick transition is possible, experience is deceptive, judgment is difficult. Therefore, not only the doctor himself should use everything that is necessary, to the patient, and the surrounding, and all external circumstances should contribute to the doctor in his work. ”

“In order to put it so briefly,” wrote the doctor of the Russian translation (1840), doctor S. Volsky, “extraordinary intelligence, many years of experience and extensive scholarship, keen attention, a rare love of science and humanity were needed.”

“The Progress” is an outstanding work on ancient Greek therapy. It describes in detail the elements that make up the forecast of that time (observation, examination and questioning of the patient), and highlights the principles of observation and treatment at the patient's bedside.

“E p and d e m i u” (in seven parts) are close in their spirit to the “Prognostics”. The word "epidemics" in ancient Greece was understood not as epidemic, that is, infectious, infectious), but widespread diseases among the people (from the Greek epi - above and demos - people). These are endemic marsh fevers, phthisis, paralysis, colds, skin, eye and other diseases. In parts I and III are given the 42 most interesting and instructive case histories. They give a concrete idea of ​​the origins of the clinical approach to medicine in ancient Greece, when the doctor observed the patient daily and described his condition and treatment.

“On airs, water x, mess ts i x” is the first essay that has come down to us, in which various forms of the influence of the surrounding nature on the human body are summarized from the standpoint of materialistic philosophy. A large place in this work is devoted to analyzing the causes of diseases, which are divided into two groups: 1) causes of diseases common to all people of a given area, depending on the specific conditions of the surrounding nature, and 2) individual causes determined by the lifestyle of each. The image of life in ancient Greece was given great importance. In line with compulsory literacy and music were personal hygiene, hardening and physical education. This essay describes various types of characters that were associated mainly with the place of residence of a person (in the south, in the east, high in the mountains, in fertile valleys), that is, with the conditions of the surrounding nature. According to the ancient Greeks, people of each type have their own characteristics, which determine the predisposition to certain diseases, affect their course and, therefore, require a different approach to treatment.

Subsequently (during the periods of late antiquity and the Middle Ages), the theory of four temperaments was formed on the basis of ancient Greek ideas about four bodily juices and different characters, each of which was associated with the predominance of one of the four bodily juices in the body: blood (Latin sanguis) - sanguine type, mucus (Greek phlegma) - phlegmatic, yellow bile (Greek chole) - choleric, black bile (Greek melaine chole) - melancholic (the names of these types in the work “On air, water, area” are not contained, as s only after several centuries).

Nowadays, the study of four types of constitution and temperament in humans, developed by IP Pavlov (see p. 255), is based on the ratio of excitation and inhibition processes in the central nervous system and has experimental scientific substantiation.

Works on surgery (Greek: cheirurgia from cheir - hand and ergon — action; lat. Chirurgia) “On fractures”, “On wounds of the head”, “On reduction of joints”, etc. give a harmonious picture of the high development in ancient Greece teachings about bandages, surgical apparatus, treatment of wounds, fractures, dislocations, head injuries, including the facial skull. In the work "On the reduction of joints" described "bench (Hippocrates)" - a lever device for reducing dislocations. The complex surgical dressing, known as the “Hippocrates cap,” is still used in surgery (ancient Greek physicians were mainly engaged in the field of surgery, which today includes traumatology and desmurgery — the study of dressings).

In the classical period, the ancient Greeks did not have special knowledge of anatomy, since they did not open the bodies of the dead. Their ideas about the structure of the human body were empirical. That is why the surgery of the ancient Hindus surpassed at that time the surgery of the ancient Greeks.

The Hippocratic Collection contains descriptions of diseases of the teeth and gums (from pulpitis to alveolar abscess and bone necrosis) and the oral cavity (gingivitis, stomatitis, grief, language diseases). For dental pains, they used both general (bleeding, laxatives and vomiting, a strict diet), as well as local remedies (drugs, rinsing with infusions of herbs, poultices of lentil decoction, astringents, etc.). They resorted to removal only when the tooth was loose (possibly due to the imperfection of extraction forceps; their sample is stored in the temple of Apollo in Del Fax). At the same time, in the treatment of dislocation and fracture of the jaw, the ancient Greeks achieved great perfection: they set the bone in place and tied the teeth with a gold wire. The Hippocratic Collection also describes conditions associated with teething (fever, diarrhea, cramps, cough), and provides recommendations for eliminating bad breath from the mouth.

Helping with dental diseases or maxillofacial injuries is depicted in ancient art. One of the evidences of this is a chased image on a ritual vessel, discovered in 1830 in a rich Scythian burial of the 4th century. BC e .— Kul-Oba barrow, located six kilometers from the city of Kerch (formerly Panticapaeum). In the classical period of the history of Greece, Panticapaeum was the capital of the Bosporian kingdom, which arose in the 5th century. BC e. after the unification of the Greek cities-colonies, located on both sides of the Kerch Strait. As a result of the mutual penetration of cultures, an original Greco-Scytho-Meotian culture was formed there.

The vessel depicts four scenes, which, as scientists believe, illustrate the ancient Scythian myth about the ancestor of the Scythian people Targitai and his three sons: one of them passed the test and pulled the string on his father's bow; the other two failed, with the result that a broken shaft of a bow caused one of them to be damaged in the left jaw (Fig. 45), and another to the left shin. To assert that the extraction of a tooth is depicted on a Kul-Oba vessel (as Professor LF Zmeyev assumed in 1896) is not currently possible due to recent historical research.

The Hippocratic Collection, which combines the works of various medical schools, is an encyclopedia of ancient Greek medicine of the classical period. It lists more than 250 herbal remedies and 50 animal products. His work reflected the natural scientific ideas of ancient Greek physicians about the indissoluble unity of man with the surrounding nature, about the causal relationship of diseases E to the living conditions and the healing forces of nature, absorbed progressive views and achievements in the field of therapy, traumatology and medical ethics.

Medical ethics in ancient Greece

The Hippocrats Collection contains five essays on medical ethics and the rules of medical practice in ancient Greece. These are “Oath”, “Law”, “About doctor”, “About good behavior” and “Instruction”. Together with other works of the Collection, they give a complete picture of the training and moral education of healers and the requirements that were placed on them in society.

In the process of learning, the future healer had to cultivate in himself and constantly improve “contempt for money, conscientiousness, modesty ... determination, tidiness, abundance of thoughts, knowledge of all that is useful and necessary for life, aversion to vice, denial of superstitious fear gods, divine superiority ... After all, the doctor-philosopher is equal to God ”(“ On the benevolent behavior ”).

The physician must learn to keep the medicine in mind, how they are compiled and applied correctly, not to get lost at the patient’s bed, to visit him often and to carefully observe the deceptive signs of change. “All this should be done calmly and skillfully, hiding much from the patient in his orders, ordering with a cheerful and clear look what should be done and discouraging the patient from his wishes with perseverance and rigor” (“On good conduct”). However, when treating a patient, it is necessary to remember the first commandment: “above all not to harm”. Later this thesis will appear in the Latin literature: “Primum pop-ge”.

Concerned about the health of the patient, the healer does not have to start with taking care of his fee (reward), since “paying attention to it is harmful for the patient.” Moreover, it is sometimes appropriate to treat “for nothing, considering a grateful memory above minute glory. If the case presents itself to help a stranger or a poor man, then in particular she must deliver it ”(“ Instruction ”).

Along with high professional requirements, great importance was attached to the appearance of the healer and his behavior in society, “for those who themselves do not have a good appearance in their body, the crowd is considered not able to have proper care for others.” Therefore, the healer befits "to keep yourself clean, have good clothes and rub in fragrant ointments, for all this is usually pleasant for the sick ... It must be fair in all circumstances, because in many cases justice is needed" ("About the Doctor").

Finishing training, the future healer gave the "Oath", which he invariably followed throughout his life, because "who has time in the sciences and is lagging behind in morality is more harmful than useful."

Hippocratic Oath

I swear by Apollo the doctor, Asclepius, Hygieia and Panakeia and all the gods and goddesses, taking them as witnesses, perform honestly, according to my powers and my understanding, the following oath and written commitment: to take it. To teach me the art of medicine on a par with my parents, to share with him their wealth and in case of need to help in his needs; consider his posterity to be his brothers, and this art, if they choose to study it, teach it without compensation and without any contract; instructions, oral lessons, and everything else in the teaching to communicate to his sons, the sons of his teacher, and students bound by an obligation and an oath by law to the medical, but to no one else.

I direct the regime of the sick to their advantage, in accordance with my powers, by my own understanding, refraining from causing any harm and injustice. I will not give anyone the lethal means I ask for and I will not show the way for such a plan; likewise, I will not give any woman an abortive pessary.

Purely and immaculately will I spend my life and my art. In no case will I cross-section in stone sufferers, giving it to the people involved in this matter. Whatever house I enter, I will go there for the benefit of the patient, being far from everything that is intentional, unjust and pernicious, especially from love affairs with women and men, free and slaves.

So that during treatment — as well as without treatment — I would neither see or hear about human life from that which should never be divulged, I will keep silent about this, considering such things to be a secret. To me, unswervingly fulfilling the oath, may happiness in life and in art and glory be given to all people for all eternity; To the one who transgresses, and who gives the false oath, let it be the opposite.

When the “Oath” was first made is not known. Orally, it passed from one generation to another and in its basic features was created before Hippocrates. In the III. BC e. The “Oath” was included in the “Hippocratic Compilation”, after which in wide circles it was called Hippocratic.

Along with the medical "Oath", in ancient Greece there existed a legal "Oath", oath of witnesses and many others. They all assumed the assistance of the gods, who consecrated the Oath and punished the perjurement of the oaths (in the case of the medical Oath, the gods Apollon, Asclepius, Hygieus and Panakey). Thus, the “Oath”, given by the healer at the end of the training, on the one hand, defended patients, being a guarantee of high medical morality, and on the other, provided the healer with full public confidence. The laws of medical ethics in ancient Greece were enforced rigorously and were unwritten by the laws of society, for, as stated in the "Instructions", "where there is love for people, there is love for their art."

Today, each country has its own “Oath” (or “Oath”) of Noach. Keeping the general spirit of the ancient Greek “Oath”, each of them corresponds to the modern level of development of medical science and practice, reflects national peculiarities and general trends of world development. An example of this is the latest addition, which is included in the text of the oath of the doctor of the Soviet Union "in: Tzet to the appeal of the III Congress of the movement" Doctors of the World for the Prevention of Nuclear War ", held in Amsterdam in 1983. Here are the lines:

Aware of the danger posed by nuclear weapons, to tirelessly fight for peace, to prevent nuclear war.

Today, this call unites the pupils of all continents of the earthly sha-ea and with a new force reminds us of the great wisdom inherent in antiquity: high professionalism has the right to life only under the condition of high morality.

MEDICINE OF THE ELLINISTIC PERIOD (IV B. BC. N. E. — I V. N. 3.)

The Hellenistic period is the final, external stage of development of ancient Greece - its “highest external flourishing” (K-Marx). It covers three centuries in the history of the Eastern Mediterranean, the Near and Middle East: starting from the accession of Alexander the Great to the throne (336 BC) —the son of the Macedonian king Philip II (who in 337 BC combined the weakened policies in a large Greek-Macedonian state), it ends in the middle of I century. n Oe., when the conquest of the last Hellenistic state - Egypt -; completed the creation of the Great Roman Empire. After Alexander's death, his huge power, which stretched from Sicily to the Himalayas, from the Black Sea to the Arabian Peninsula, and included large areas of Europe, Asia and Africa, split into several Hellenistic states (Fig. 46) that existed for almost four centuries . The most prosperous among them was the Greek-Egyptian kingdom of the Ptolemies (Hellenistic Egypt and Libya) with the capital Alexandria, a major center of world trade and culture of the Mediterranean, founded by Alexander in 331 BC. e. in the Nile Delta.

As a result of Alexander's campaigns, fruitful interaction of cultures of ancient Hellas and Eastern countries (Egypt, Syria, Par-Fi, Palestine, Armenia, Arabia, India) was realized. The medicine of the Hellenistic era absorbed, on the one hand, Greek philosophy and medical art, and on the other, a thousand-year empirical experience of healing and theoretical knowledge of the peoples of the East.

The teaching of the largest ancient Greek philosopher and thinker Aristotle from Stagira (lat. Aristote-les, 384–322 BC) was of great importance for the development of the natural science knowledge of the time. According to Marx, “Alexander’s era was the era of Aristotle. Aristotle's father was a court healer of the Khmak-Don king and considered himself a descendant of Machaon. At the age of 17, Aristotle joined Plato's Academy, where for 20 years he was a student, a teacher and an equal member of the community of Platonist philosophers. After the death of Plato, Aristotle left the Academy and traveled a lot, then for three years he was the teacher of Alexander the Great. In 335 BC. e. Aristotle founded. his own, the most famous school of peripatetics at that time (from Greek peripatos - the covered gallery, that is, the place where classes were held).

In his natural-philosophical views, Aristotle sought to link the strengths of the teachings of Democritus with the achievements of Plato. He accepted the Platonic “idea” (and tried at the same time to overcome the idealism of his teacher), as well as the mechanistic materialism of Democritus, whose atomistics could not explain the expedient organization of living beings (that is, the teleology of Aristotle). According to Aristotle, the Earth rests in the center of the Universe, which is eternal. In the earthly nature there is a hierarchy of various substantive forms (from inorganic to human); they all consist of fire, air, water and earth (fig. 47) and are eternal and unchanging.

Aristotle's works on logic, politics, rhetoric, psychology, ethics, physics, mathematics, astronomy, zoology, natural history, comparative animal anatomy and medicine are an encyclopedia of the ancient science of the end of the classical period. They had a great influence on the philosophical trends of the Hellenistic period, the Middle Ages and the new time. On the one hand, Aristotle's natural-philosophical views were further developed in the school of peripatetics (who asserted causal principles instead of teleological principles and put forward ideas about nature, suppressing ideas about God) and in the Middle Ages were embodied in Arabic philosophy. On the other hand, his doctrine of the immortality of the soul was used by medieval scholasticism, which for many centuries slowed down the development of natural science in Europe.

The epoch of Hellenism was a period of systematization of knowledge accumulated over the preceding millennia, and a time of new achievements and discoveries. "This epoch," wrote S. G. Kovner, "is significant not so much by the brilliant flight of the human spirit, characteristic of the youthful age of humanity, but by careful collection and sorting of the data obtained so far and ordering, comparing and understanding the accumulated material so far."

During this period, the centers of Greek science moved to the East — to Alexandria, Pergamum, Antioch, Seleucia, and Tire. The leading place among them took Alexandria. The Ptolemies invited to their capital Greek scientists, writers and poets from all countries of the Hellenistic world. In the Hellenistic era, there were about one million Greeks in the seven million indigenous people of Egypt (Greek was the official language of Hellenistic Egypt).

Given the economic and political needs of the state, the Ptolemies favored the development of various areas of knowledge. When they were founded Alexandrian Musey-on (Greek museion - the seat of the muses; hence the term "museum") and the famous Alexandrian repository of manuscripts, the largest in antiquity (ur. P. 100): as already noted, at the beginning of the 1st century. BC e. there were more than 700 thousand papyrus scrolls. Manuscripts were kept in the temple of Sarapis {Gk. sarapeion), which was repeatedly subjected to fires, and in 391 AD e. was finally burned during clashes between pagans and Christians.

Alexandria Museyon was one of the main scientific and cultural centers of the ancient world. In addition to the repository of manuscripts, he had a botanical and zoological gardens, observatories and an anatomical school. He united in himself a research academy, a higher school, and a boarding school for scientists who lived there with complete royal support and were engaged in research in the fields of philosophy, astronomy, mathematics, botany, zoology, medicine, philology and other sciences. Each branch of knowledge of that time had its outstanding representatives in the Alexandrian Museyon. Among them - the mathematician Euclid, the mechanic and mathematician Archimedes of Syracuse, the astronomers Aristarchus from Fr. Samos and Ptolemy are from Ptolemy in Egypt, Zenodot of Ephesus grammar, who first headed the Alexandrian manuscript repository, and healers Hero-Phil from Chalcedon in Asia Minor and Erazistrat from Keos.

The medicine of the Hellenistic era is characterized primarily by the rapid development of anatomy and surgery; Many outstanding achievements in these areas are closely related to the work of the Alexandrian School of Medicine.

Anatomy (from the Greek. Anatome — dissection) became an independent branch of medicine in the Hellenistic era. According to S. G. Kovner, its development in Alexandria was greatly contributed to the ancient Egyptian custom of embalming, as well as the permission of Ptolemy to anatomize the bodies of the deceased and to perform live-feeding on those sentenced to death. According to A.C. Celsus, Ptolemy II Philadelphus (285–246 BC) gave scientists for vivisection convicted criminals: first, the abdominal cavity was opened, then the diaphragm was dissected (then death occurred), then the thoracic cell and investigated the location and structure of organs.

The founder of descriptive anatomy in the Alexandrian school (and in ancient Greece as a whole) is Herophilus of Chalcedon (Greek Negor-hilos, ca. 335–280 BC), who lived under Ptolemy I Soter (323–282. BC.). He is recognized as the first Greek to begin revealing human corpses (Fig. 48). As a student of Praxagoras with Fr. Kos, Hero-fil was a supporter of the humoral teaching and developed the traditions of the Kosovo medical school.

In the work "Anatomy" he described in detail the hard and soft meninges, parts of the brain, and especially his ventricles (the fourth of which he considered to be the seat of the soul), traced the course of some nerve trunks and determined their connection with the brain. Some internal organs are described to them: the liver, the duodenum, which he first gave this name to, and others. In his opinion, the four most important organs - the liver, intestine, heart, and lungs - correspond to four forces: nourishing, warming, thinking and feeling. Many of these provisions subsequently developed in the writings of Galen, who a few centuries later also worked in Alexandria.

Some anatomical structures still carry the data of Gerofi l name: Calamus Scriptorius, Torcular Herophili, Plexus chorioidei, Sinus Venosi.

In his essay “On the Eyes,” he described the vitreous body, the membranes and the retina, and in his treatise On Pulse he described the anatomy of the vessels (described the pulmonary artery, gave the names to the pulmonary veins) and the teaching of the arterial pulse, which he considered to be a consequence of the heart’s activity. This important postcard (scheduled by Aristotle) ​​was subsequently forgotten for many centuries. (Note that in ancient China, the earliest mention of the pulse is contained in the treatise "Nei Jing", which dates from approximately the same time - III century BC. E.)

Herophile's successor was Erazistratus (Greek Erasistratos, ca. 300 -  ca. 240 BC . E. ). According to Pliny, he was born on about. Keos, he studied medicine from Chrysippus and Metrador ^ —the famous healers of Cnidus ly, and then on Fr. Kos have followers Praxagoras. For a long time, Erazistrat was the court healer of the ruler of the Syrian kingdom, Selev I of Nicator (323–281 BC), and during the time of Ptolemy II, Philadelphus lived and worked in Alexandria.

Erazistrat studied the structure of the brain well, described its ventricles and meninges, for the first time divided the nerves into sensory and motor ones (assuming that mental pneuma that dwells in the brain moves along them) and showed that they all originate from the brain. He defined the cerebral ventricles and cerebellum as the receptacle of mental pneuma, and the heart as the center of vital pneuma. Subsequently, these ideas were fixed in the writings of Galen. Erazistrat first described the mesenteric lymphatic vessels (reopened by G. Azelli (Q. Asel-li) in 1622) and so carefully investigated the structure of the heart and its valves, which he named so that Galen practically did not add anything to his description.

Erazistrat believed that all parts of the body are interconnected by a system of nerves, veins and arteries; moreover, he believed that blood flows in the veins (nutrient substance), which is formed from food, and in the arteries - vital pneuma, which in the lungs is in contact with blood. Having concluded that the arteries and veins are interconnected by small vessels “cinanastomo-zami”, he came very close to the idea of ​​blood circulation (its logical conclusion, in all likelihood, was hampered by Erazistrata’s conviction that the arteries are filled with air; adhered to and Galen, existed in medicine for almost 20 centuries).

Erazistrat partially departed from the widely held theory of the predominance of the role of juices in the Organism (humoralism) and gave preference to particulate matter. He believed that the organism consists of many solid indivisible particles (atoms) that move along the channels of the body; violation of this movement due to indigestion of food, blockage of the lumen of the vessels and their overflow - pletora (Greek. plethora - filling) are the cause of the disease. In his opinion, pneumonia is the result of blood entering the arteries and inflammation of the pneuma there, in other words, moisture causes diseases not because of their changes, but because of the clogged lumen of the canals into which blood enters through synanastomoses for disorders.

Based on these ideas, Erazistrat directed treatment to eliminate the causes of stagnation: a strict diet, emetic and diaphoretic drugs, exercise, massage, dousing; thus, the ground was prepared for the Asklepiad methodological system.

According to Celsus, Erazistrat performed an autopsy on deceased patients. He found that as a result of death from dropsy, the liver becomes as hard as a stone, and poisoning caused by the bite of a poisonous snake leads to damage to the liver and large intestine. Thus, Erazistrat took the first steps towards future pathological anatomy.

The followers of Erasistratus were called erazistrators; Their students were prominent doctors of ancient Rome - Asklepias, Dioscorides, Soran, Galen.

Hellenistic era surgery combined two powerful sources: Greek surgery, mainly related to bloodless methods of treating sprains, fractures, wounds, and Indian surgery, which was familiar with complex operations. Among the most important achievements in the surgery of the Alexandrian period is the introduction of vascular ligation, the use of mandrake root as an anesthetic, the invention of a catheter (attributed to Erazistrata), complex operations on the kidney, liver and spleen, amputation of the extremities, laparotomy during volvulus and ascites. Thus, Erazistrat did drainage with empyema, with liver disease, applied drugs directly to the liver after laparotomy, let down ascites, etc. Thus, in the field of surgery, the Alexandrian school made a significant step forward compared with surgery of the classical period of the history of ancient Greece (when not necropsies were performed and abdominal operations were not performed, and surgical interventions were practically reduced to the treatment of paradise and injuries).

The Hellenistic period was the time of the most fruitful development of medicine in ancient Greece. F. Engels wrote on this subject: "The beginnings of an exact study of nature were ... developed for the first time only in the Greeks of the Alexandrian period ...".

Roman conquest (I century. BC. E. - 30 g. E. e.) Put an end to the independence of the Hellenistic states. Rome has become the political, economic and cultural center of the Mediterranean. But Hellenistic culture survived Hellenistic states. It retained its influence for several centuries and constituted an essential part of the foundation on which European culture successfully developed over thousands of years, and with it world culture and medicine.