Alexandrian School of Medicine
The dispersion of Greek science and intellectual activity through the world by the conquests of Alexander and his successors led to the formation of more than one learned centre, in which medicine among other sciences was represented. Pergamum was early distinguished for its medical school; but in this as in other respects its reputation was ultimately effaced by the more brilliant fame of Alexandria. It is here that the real continuation and development of Hippocratic medicine can be traced.
In one department the Alexandrian school rapidly surpassed its Greek original, namely, in the study of anatomy. The dissection of the human body, of which some doubtful traces or hints only are found in Greek times, was assiduously carried out, being favoured or even suggested perhaps by the Egyptian custom of disemboweling and embalming the bodies were also examined by opening the bodies of living persons, -- criminals condemned to death being given over to the anatomists for this purpose.
Two eminent names stand in the first rank as leaders of the two earliest schools of medicine which arose in Alexandria, Herophilus and Erasistratus.
Herophilus was a Greek of Chalcedon, a pupil of the schools both of Cos and of Cnidus. He was especially noted for his profound researches in anatomy (see vol. i. p. 802), and in the knowledge and practice of medicine he appears to have been equally renowned. He professed himself a close adherent of Hippocrates, and adopted his theory of the humours. He also made extensive use of drugs, and of bleeding. The reputation of Herophilus is attested by the fact that four considerable physicians wrote works about him and his writings, and he is further spoken of with the highest respect by Galen and Celsus. By the general voice of the medical world of antiquity he was placed only second to Hippocrates.
Erasistratus was the contemporary and rival of Herophilus. Little is known of his life, except that he spent some time as the court of Seleucus Nicator at Antioch before coming to Alexandria, and that he cultivated anatomy late in life, after he had taken up his abode in the latter city. His numerous works are also almost entirely lost, fragments only being preserved by Galen and Others. Erasitratus, instead of following Hippocrates as Herophilus did, depreciated him, and seems to have been rather aggressive and independent in his views. He appears to have leaned to mechanical explanations of the symptoms of disease, as was especially the case with inflammation, of which he gave the first rational, though necessarily inadequate, theory.
The two schools composed of the followers of Herophilus and Erasistratus respectively long divided between them the medical world of Alexandria. The names of many prominent members of both sects have been preserved, but it would be useless to repeat the. The Herophilists still reverenced the memory of Hippocrates, and wrote numerous commentaries on his works. They produced many eminent anatomists, but in the end seem to have become lost in theoretical subtleties, and to have maintained too high a standard of literary cultivation. The school of Erasistratus was less distinguished in anatomy than that of Herophilus, but paid more attention to the special symptoms of diseases, and employed a great variety of drugs. It was longer-lived than that of Herophilus, for it still numbered many adherents in the 2d century after Christ, a century after the latter had become extinct.
The Erasistrateans paved the way fro what was in some respects the most important school which Alexandria produced, that known as the empiric, which, though it recognized no master by name, may be considered to have been founded by Philinus of Cos (280 B.C.), a pupil of Herophilus; but Serapion, a great name in antiquity, and Glaucias of Tarentum, who traced the empirical doctrine back to the writings of Hippocrates, are also named among its founders. The most striking peculiarity of the empirics was that they rejected anatomy, regarding it as useless to inquire into the causes of things, and thus, as they contended being the more minute in their observation of the actual phenomena of disease. They professed that their whole practice was based upon experience, to which word they gave a special meaning. Three sources and , and three only, could experience draw from" – observation, history (i.e., recorded observation), and judgment by analogy. These three bases of knowledge were known as the "tripod" of the empirics. It should not, however, be forgotten that the empirics read and industriously commented on the works of Hippocrates. They were extremely successful in practical matters, especially in surgery and in the use of drugs, and a large part of the routine knowledge of diseases and remedies which became traditional in the times of the Roman empire is believed to have been derived from them. In the 2d century the school became closely connected with the philosophical sect of the Sceptics, whose leader, Sextus, was an empirical physician. It lived and flourished far beyond this time, when transplanted to Rome, not less than in its native Alexandria, and appears to be recognizable even up to the beginning of the Middle Ages.
If we look at the work of the Alexandrian schools in medicine as a whole, we must admit that the progress made was great and permanent. The greatest service rendered to medicine was undoubtedly the systematic study of anatomy. It is clear that the knowledge of function (physiology) did not by any means keep pace with the knowledge of structure, and this was probably the reason why the important sect of the empirics were able entirely to dispense with anatomical knowledge. The doctrines of Hippocrates, though lightly thought of the Erasistrateans, still were no doubt very widely accepted,. But the practice of the Hippocratic school had been greatly improved in almost every department, -- surgery and obstetrics being probably those in which the Alexandrian practitioners could compare most favourably with those of modern times. We have now to trace the fortunes of this body of medical doctrine and practice when transplanted to Rome, and ultimately to the whole Roman world.
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