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6- https://doi.org/10.1097/00029330-200811010-00018
Evolution of medical education in ancient Greece
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Take Notes The study of ancient Greece is essential for the proper understanding of the evolution of modern Western medicine. An important innovation of classical Greek medicine was the development of a body of medical theory associated with natural philosophy, i.e. a strong secular tradition of free enquiry, or what would now be called "science" (Eπiστnμη). Medical education rests upon the ancient Greek foundations and its history remains a fascinating topic for modern physicians and medical teachers. As Drabkin so eloquently noted half a century ago: "the history of medical education will show how lasting was the influence of the ancient system of medicine, not only in its substantive contributions, but in its devotion to reason, in its attitude toward the relation between science and the medical art, in its concept of disease and classification of diseases, in its ethical attitudes and standards and in countless other ways".1 MEDICAL EDUCATION THROUGH "MAGIC" AND "RELIGION" In prehistoric times, magic and religion were a fundamental part of the healing practice. Therefore, the first primitive medical practitioners were witch doctors or sorcerers. Through a gradual process that lasted for centuries, superstition and religion were replaced by rational inquiry and explanation. At its beginnings, ancient Greek medicine was undoubtedly influenced by neighbouring regions such as Babylonia and Egypt or even more distant civilizations such as India and China.2 As medical practice was tied to magic and religion, so too was medical education symbolized in myth. Thus, the first Greek medical teacher was probably Chiron (Xípωv), the human-horse mythological figure. According to Homer, Chiron taught Asclepius the secrets of the drugs that relieve pain and stop bleeding. Chiron was so famous in his era that the sons of many noble families, including Jason (Iáσovαò), Achilles (Aχiλληαò) and other Homeric heroes, became his apprentices and lived with him during early adolescence studying philosophy and the sciences, including medical arts. Among his teachings the "techni" (τéχvη) (art) of caring for the ill and injured was included.3 Asclepius (Aσκληπióδ) was the God of Medicine in Ancient Greece and he was worshiped in hundreds of temples (Asclepions) throughout Greece. The remains of such shrines may still be seen at Epidaurus (Eπíδαvpoò), Cos (Kώ;ò), Athens (Aθηvα), and elsewhere. Asclepions (Aσκληπieíα) were founded at the 6th century B.C. and served as mysticistic centers of medical education for selected "godly blessed" priests. Patients visiting these sacred sanctuaries were treated by a healing ritual known as incubation, or temple sleep. They slept overnight in the dormitory, or abaton (áβατo), and were visited in their dreams by Asclepius and his daughters Hygeia and Panacea or by one of his priests, who gave them divine advice and inspiration. They reported their dreams to a priest the next morning. The pilgrims were either spontaneously healed or the priest prescribed a cure based on their dream. Evidently, the temple healers relied largely on the use of psychological methods, i.e. suggestion through the use of charms, rituals and incantations, but they also employed physical means, some if which were genuinely efficient. Thus, the temple patients were also offered hydrotherapy and enjoyed theatre, music, poetry and a good diet. It must be emphasized that the temple physicians of Asclepions differed from lay medical practitioners and there is no evidence that they acted as tutors to lay physicians. Patients who visited the Asclepions and treated by the ritual therapeutics were usually cases that were given up as incurable by lay medicine.4 Asclepius' legacy was bequeathed by his sons and students Podaleirius (IIoδαλpípeioò) (Internist) and Machaon (Mαχαóv) (Military surgeon) who also appeared in the homeric epics (8th century B.C.). It is notable how the passing of medical knowledge from generation to generation in Ancient Greece is so characteristically reflected in the Asclepius' family. Even Aclepius' father, Apollo, was originally considered the God of Medicine before inheriting his mantle to his sons. With the passage of time, the influence of superstition and religion on medicine steadily decreased until the boundary of rationality and magic was demarcated by the arrival of Hippocrates' rational medicine.5 However, it appears that, despite the occasional competitive bouts between these different types of healers, the Asclepian temple physicians generally existed side by side, in uneasy proximity, throughout the centuries with the Hippocratics until the formers' practice was eventually perceived as a pagan rite and thus rejected by early Christianity. MEDICAL "CRAFTSMEN" AND THE MENTORING OF MEDICINE IN ANCIENT GREECE The division between medicine as a "science" and medicine as an "art" is an ancient one. The ancient Greeks frequently contrasted the non-scientific practitioner to the theoretically grounded physician/philosopher. According to Plato, a medical apprenticeship that was based only on observation and experience was routine and impersonal in comparison to those physicians who strived to make the understanding of nature fundamental to their art and teaching.6 It appears that the majority of medical practitioners did not concern themselves with biological theories and philosophy. However, the few that did care about the nature of health and the underlying anatomic and physiological changes behind a particular disease, were considered the leaders of their profession.5 Greek doctors usually practiced privately but were occasionally employed by a city-state as public health officers who treated citizens without charge. These state-salaried physicians were supported by a special tax called "iatrikon" (Iαtpiκóv) and sometimes received additional benefits including tax reductions, free pass to recreational centres and statues erected in their honour. Such state participation in citizen health care is evidenced throughout antiquity and began as early as the 6th century B.C. However, no evidence exists that these civic physicians were involved in medical education or that special taxes like the "iatrikon" were used to finance public medical education. Various texts from the Hippocratic Collection help us understand Greek medical practice during the antiquity. A surprisingly large part of medical practice of that period seems to reflect the physician's insecure position. Thus, a good diagnostician aimed to impress the patient and win his confidence. The practice of prognosis was also an important proof of competence and a valuable psychological tool in gaining the patients' trust. On the other hand, physicians tended to decline cases that were obviously incurable in order to avoid any loss of reputation. To ensure that physicians would not amass too much wealth, they were advised to adjust their fees to each patient's means and, when necessary, treat them without payment. While some doctors were permanent residents in a particular city, a large number travelled from place to place searching for a living in response to the demand for doctors and seeking to possess intimate knowledge of the ailments peculiar to each region.5 No system of formal medical education or any curriculum program that issued diplomas to successful medical students existed in the classical antiquity. Even the first centres of medical excellence such as Cos and Cnidos and, later on, the museum of Alexandria (Aλεξávδpiα) did not provide any legally recognized certification or formal system of teaching. On the other hand, physicians who were associated with one of the major medical schools were probably more in demand compared to their less prestigiously educated peers. The passing on of knowledge through mentoring was highly regarded in the Greek antiquity from as early as Homer's (Oμηpoò) time.7 Accordingly, medical knowledge was bequeathed from father to son or to the physician's assistant via a master-apprentice relationship: the apprentice learned by observing and assisting his master curing patients.8 Such medical education was fundamentally practical. The student learned to take detailed medical history from the patient, his relatives or friends, catalogue observable regularities, and accordingly formulate rational hypotheses, explanations and treatments. He was trained to properly use his senses of observation, hearing, smelling, palpating and carefully examine the patient's pains, mental state, position in bed, fever, breathing, and excretions (urine, feces and sweats). The patient's pulse was also examined but its profound diagnostic significance was not elaboratively catalogued at these times. Practical experience was an essential component of the medical craft taught to the apprentice. As was noted in the Hippocratic texts: "He who aspires to practice surgery must go to war". A competent student would also attend the patient as a nurse in serious cases. Good students would complement such practical work with the study of books (e.g. the Hippocratic Collection, Dioskorides' book of herbals and drug preparation) in order to combine knowledge with experience and obtain self confidence and autonomy. The quality of training depended on the master's skills and the student's prowess. The length of education depended on the depth of the apprentice's studies and on his intellectual skills and competence.1 In theory, medical training was open to every man. Of course, the aspiring physician required a master willing to train him and the successful medical protégée required certain characteristics, including above-average intelligence and a firm grasp of reality. But in principle, the pursuit of medical knowledge in ancient Greece was unrestrained. Evidently, medical practice retained a very "free market" approach throughout the ancient world. The Babylonians characteristically presented their sick at the market place in search of those persons who could advise and/or treat the disease. In line with this attitude, no legally recognized method existed to prevent amateur and inadequately trained physicians or various kinds of quacks from practicing in Greek antiquity. One established himself as a doctor not by presenting his training certifications but by vigorously defending the reputation he acquired in practice and by carefully cultivating the confidence of his clients. The physicians' fierce competition with other healers, his conscience, and the patient's demands for efficacy were his only restrictions and incentives for self-improvement. The only possible evidence of completed medical training and qualification may have been the Hippocratic Oath, as well as attendance to one of the major medical schools. It may be strange that the ancient Greek civilization, with all its sophistication, failed to establish any means of protection from ignorant and potentially dangerous physicians. But one needs to remember the distinct features of ancient Greece that could explain why this system persisted and even how it could work adequately for so many centuries. The Greek region was literally fragmented into hundreds of independent city-states and this hindered any possible attempt of a unified professional evaluation policy. Therefore the ancients had to rely on the self-policing apprentice system by which Greek medical education was organized. Each of the masters, who were successful and experienced physicians, would take care in recruiting, selecting and training their apprentices and carefully monitor their progress to ensure the quality of their education, which was important to reputation of the master as well as the student. THE ROOTS OF RATIONAL MEDICINE First medical schools The first medical schools were founded in Greece and in the Southern Italy (Magna Grecia) regions of Sicily and Calabria. In the classical antiquity, medical "schools" were essentially schools of thought formed by an influential medical practitioner and his followers. There were no academic buildings dedicated to medical training. The "school" was essentially realized wherever its adherents would gather. With the coming of the 5th century B.C. the most famous of such centers were Cos, where Hippocrates (Iππoκpáτηò) was born, and Cnidus, situated just opposite of Cos on Asia Minor. These ancient Greek states developed medical schools that served as hallmarks of medical education. The doctors associated with these schools shared knowledge and certain medical practices; medical students retained a master-apprentice relation with their teachers and observed their masters treating diseases and prescribing measures such as good diet, exercise, and herbal remedies. Aspiring surgeons were trained as assistants to a military surgeon accompanying troops on a campaign. The instruction was of course very informal and there was no established certificate of the student's right to practice.1 Hippocratic medicine Hippocrates was born in about 460 B.C. on the island on Cos, an island of the coast of Asia Minor in the Dodecanese (Δωδεκávησα), where he developed his immensely influential rational school bringing about the transition from empiricism to scientific medicine in antiquity. During his lifetime, Hippocrates was undoubtedly the most renowned physician and teacher of medicine. Soranus stated that Hippocrates traced his descent and medical knowledge from his father Heraclidos (Hpáκλεiδoò) and Asclepius. He practiced medicine in his birthplace of Cos but also ventured in other parts of Greece including Athens, Sicily, Alexandria, Cyrine and Cyprus; he died in Thessaly at an advanced age in about 377 B.C. Although Hippocrates is widely considered the father of medicine and well-known scribes such as Plato and Aristotle have documented a number his achievements, there is little knowledge about his actual life and biography. There is even a possibility that Hippocrates was actually not one but many men of the same name.9 Whether Hippocrates was one man or several, the works attributed to him mark the stage in Greek medicine where physicians were encouraged to offer rational explanations concerning the cause and character of disease and health, instead of superstition and magic. Hippocrates' rational medicine was notably based on common sense and substituted divine intervention in favour of a profound, practical philosophy. Hippocrates is thought to have originated the concept of the "four humours" (plegm, yellow bile, black bile and blood) in medical physiology. The humoural doctrine stated that good health was the result of the harmonious equilibrium and blending of the four humours. Thus, disease was explained as the consequence of humoural imbalance. Relative excess of each humour resulted in particular personality types. An abundance of blood, yellow bile, black bile or phlegm was respectively associated with the sanguine, phlegmatic, choleric and melancholic temperaments. Hippocratic medicine notably emphasized maximum conservation in all medical treatments according to the famous Hippocratic motto: "to help or at least to do no harm". Hippocrates put more emphasis on diet and recommended a restricted use of drugs, which is to be expected if one considers that the rational medical use of herbs required a thorough systemization of the botanical world that would only be achieved a century after Hippocrates' death by Theophrastus (Teófpασtoò). Hippocrates also knew well how to describe a disease clearly and concisely and recorded treatment outcomes, both failures as well as successes.9 He also introduced the first concepts of medical ethics contained in the Hippocratic oath which still serves as the ethical nucleus of today's physicians.10 Hippocratic medicine gave emphasis on the patient rather than the disease and concentrated on experience and on the visual aspect of observation rather than theory. On the other hand, Cos' rival school, Cnidus, focused on a reductionist conception of disease, similar to the modern approach. However, Hippocrates' school achieved more wealth and recognition because it focused on the patient, while the school of Cnidus concentrated on studying the disease in the absence of the necessary technical instruments and general scientific infrastructure that could carry out its ideas the School of Cnidus ceased to exist, whereas that of Hippocrates flourished. The conflicting philosophies of medical education and the different interpretations of the nature of medicine (medicine as science versus medicine as art) raged on for several centuries until the unifying influence of Galen's (ταληvóò) (129-200 A.D.). Theories and research became the standard system that was passed on to later ages all the way to the 16th century. Medical education through the Hippocratic collection It is possible that Hippocrates was the author of only some, or even none, of the texts that comprise the Hippocratic Collection (Corpus Hippocraticum), a compilation of over 70 medical treatises that are traditionally attributed to him. Hippocrates' students and his two sons, Thessalus and Draco, were the successors of the Hippocratic tradition and a large part of the Hippocratic Collection, including the Oath, was written by them. The Hippocratic tradition became the accepted standard for medical education and these texts were taught in universities throughout most of the ancient West and during the Renaissance until the 19th century. The Hippocratic collection contained a series of aphorisms, among which is the well-known "Life is brief, art is long, opportunity is fleeting, experience is fallacious, judgement is difficult" (often shortened to the Latin tag, "Ars longa, vita brevis"). These passages are the foundation of Hippocrates' philosophy and lay much stress to careful, repetitious thought before a medical intervention. Such aphorisms are followed by case histories, summary accounts of the climatic conditions, brief comments on diseases, symptoms and prognostic indications, many of which remain valid.9 Post-Hippocratic era In the following century the work of Aristotle (Apτστéληò), regarded as the first great biologist, incalculably influenced medicine. Aristotle was a student of Plato at Athens and tutor to Alexander the Great (Mέγας Aλέξαvδρoς). His interests and studies included the entire world of living things. He was the founder of comparative anatomy and embryology and his work influenced scientific and medical thinking for the next 2 millennia.5 Following Aristotle's time, the centre of Greek culture shifted to the Egyptian city of Alexandria. The famous medical school of Alexandria was established in about 300 BC and replaced Cos and Cnidos as the foremost centre of medical excellence. Its two founders and best medical teachers were Herophilus (Eρóφιλoς), who is known as the first anatomist in history, and Erasistratus (Eρασίστρατoς), whom some regard as the founder of physiology. Medical studies at this great school were based on a more professional tutorship by its renowned teachers supplemented by practical apprenticeship under one of these physicians. Thus, the earlier periods' master-apprentice relationship was gradually replaced by that of professor-student. Due to this notable change in the character of medical education, large numbers of students were tutored by fewer professors. This university atmosphere did not in itself preclude clinical instruction and bedside teaching. It did however introduce a new non-professional direction for medical education in the sense that some students studied biology and medicine not for the purposes of professional practice but as part of scientific and philosophic exploration. This division of studies probably depended on each student's social status, with the more wealthy protégées generally preferring to focus on an academic approach to medicine. There were also certain individuals who studied almost every possible subject matter (polymaths). Such an endeavour to encompass all knowledge would have been incompatible with a busy medical practice. The tripartite division of medical education can be seen from as early as Aristotle's time described as "the physician who is a craftsman, the scientific physician, and the man who has studied medicine as part of his education".1 The museum of Alexandria continued as a centre of medical teaching even after the Roman Empire had attained supremacy over the Greek world. The medical education of women Women in Greek antiquity avoided examination and treatment from male physicians, a fact that often hindered successful treatment. This should not come as a surprise considering that ancient Greek women were taught from a young age to be ashamed of their bodies. Before the 5th century B.C. childbirth was almost exclusively entrusted to female kin and neighbours who had themselves given birth. Some of these women stood out because of their skills and became known by the title of "maia" (Mαία) or "midwife". Most midwife practitioners were usually trained from other midwives. The story of Agnodice (Aγvoδίκη), who according to myth was the first female to achieve the role of physician despite this being forbidden by law, has been cited by many Western midwives during the Renaissance in an attempt to medicalize childbirth. It seems that there were women in ancient Greece who studied medicine serving alongside leading male physicians and practiced obstetrics and gynaecology. As of yet there are few data regarding the involvement of women in general medical practice other than gynaecology.1,5,11 CONCLUSION Medical education in ancient Greece closely mirroring the evolution of ancient Greek though originates from magic and religion which is gradually superseded by more objective and leading to the Hippocratic rational medicine that with the of of ancient medical education such as the reputation system of medical education and practice may be peculiar But on these ancient can also the fundamental concepts that to modern practice. In a world that was by the first great medical schools a more ethical practice to their students and these were and by the today's medicine. than two to the of modern medical education.
- Research Article
- 6
- 10.1017/s0025727300004658
- Jul 1, 2010
- Medical History
Although the history of modern medical reforms in nineteenth-century Egypt has received considerable attention from historians and scholars, the history of medicine when the country was under Ottoman rule from the sixteenth to the eighteenth century, is still largely unexplored.1 In the opinion of many scholars this was a time when the medical sciences in Egypt declined, qualified learned physicians were rare and people relied mainly on ignorant barbers and charlatans, and the period was deemed unworthy of study.2 This lack of interest mainly stems from the opinion of the physicians who accompanied the French expedition of 1798–1801 and other European physicians assigned to reform medicine in early nineteenth-century Egypt. Foremost among these was the French surgeon Antoine-Barthelemy Clot-Bey, entrusted by Muhammad Ali Pasha, ruler of Egypt from 1805 to 1848, to reform the country’s medical education and practice. Many of Clot-Bey’s writings provided readers with a gloomy picture of the status of Egyptian health care. He maintained that Egyptians preferred quackery to rational medicine; there were no qualified practitioners, only barbers and midwives; therapeutics were primitive and limited; and, finally, medical techniques were barbarous and disastrous.3 Although such views had a long lasting influence on the study of the history of medicine in Ottoman Egypt, revisionist scholarship has warned against blindly accepting them. The comments of French writers on eighteenth-century Egyptian medicine, as J Worth Estes and LaVerne Kuhnke argue, reflected the perspective of Enlightenment scholars and physicians for whom European culture was superior to all others, and who regarded themselves as “torch bearers” of European civilization, art and science.4 Estes and Kuhnke’s study shows that 78 per cent of the medical drugs used in Ottoman Egypt were also used in eighteenth-century France for the same clinical purposes, because both western and Egyptian physicians still functioned within the system of humoralism.5 Other scholars have also successfully challenged some of the accepted statements about medical care in Ottoman Egypt. Michael Dols’ study of medicine in sixteenth-century Egypt asserts that physicians were aware of the medical remedies used in Renaissance Europe, especially for the treatment of diseases that originated in the West such as syphilis.6 Despite the importance of these studies, certain areas of the history of medicine in Ottoman Egypt particularly that of medical practitioners, still requires more in-depth research. As has been pointed out, there is a tendency amongst historians of medicine in Muslim societies to focus only on the careers and writings of prominent physicians and the great institutions in which they practised medicine, with the aim of highlighting the important position that medicine and science occupied in Islamic society.7 With the exception of a few revisionist studies, historians have rarely questioned whether these well-known theoretical writings influenced hands-on medical practice, and have ignored the majority of medical practitioners who maintained everyday contact with their patients.8 Unfortunately, some scholars have assumed that the organization of medical practitioners remained unchanged from the medieval period until the nineteenth century. In her study of the history of the Arab medical profession, Anne-Marie Moulin argues that, contrary to what happened in post fifteenth-century Europe where medical education and practice were regulated by medical faculties, there were no effective means of regulating medical practice in pre-modern Arab states because of the absence of equivalent bodies.9 Similarly, Sylvie Chiffoleau’s study of the nineteenth-century medical profession in Egypt suggests that the organization of pre-modern medical and paramedical craftsmen was rudimentary. Only barbers were organized in guilds, while the rest of medical practitioners, including physicians, were authorized to practise only after receiving an ijazāh, a certificate confirming that a student had mastered certain medical texts, and this was not an adequate means of ascertaining their ability to practise medicine.10 Yet, the evidence provided by records from law courts, manuscripts and other primary sources demonstrates that physicians, surgeons, oculists, bonesetters, barber-surgeons, apothecaries and midwives were all organized in guilds in Ottoman Egypt. This study aims to examine the extent to which the medical guilds played a role in the professional regulation of the medical practice of their members, supervised apprenticeship, and promoted work values among their members regardless of religious belief. But, as will be shown, despite their best efforts the medical guilds did not have total control over medical practice. The plurality of the medical system made this impossible. The lack of consensus on where medical authority lay is reflected in the large number of medical healers who acquired their knowledge and skills through a variety of ways, and who employed interchangeably different sources of medical knowledge: Galenic, prophetic, astrological, magical and folk medicine, for the treatment of their patients.
- Research Article
- 15
- 10.1159/000169102
- Jan 1, 1997
- American Journal of Nephrology
At the end of the 20th century, Hippocratic medicine--which developed at the cross-roads between the occidental and oriental civilisations--acts as a link, a bridge and a symbol for the need to combine both the experience of traditional (Eastern) and the trends of modern (Western) medicine. Hippocratic medicine is one vital pathway to the proper study of the evolution of the medical art. Not only is it the beginning of the art and science of medicine, but modern medicine can still learn from the Hellenic medicine of ancient Greece. Hippocratic medicine is both an antidote to an overconcentration and overemphasis on medical technology and a stimulus to more humane technical achievements. Hippocratic bedside examination has not died, but is merely pushed aside temporarily by modern technology. The fact that ancient Hellenic medicine was based on the coexistence of both Asclepian (traditional) and Hippocratic (rational) medicine on the island of Kos reveals and symbolises the necessary coexistence and cooperation of both systems, a synthesis of their concepts being essential to solve the problems threatening the future of humankind. Hellenic medicine serves to highlight that the parallels between Asclepian and Hippocratic medicine are closer than medical historians usually realise, and that alternative medicine may function in a complementary way to conventional primary medical care.
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- 90
- 10.1161/cir.0000000000000442
- Sep 6, 2016
- Circulation
A healthy lifestyle is fundamental for the prevention and treatment of cardiovascular disease and other noncommunicable diseases (NCDs). Investment in primary prevention, including modification of health risk behaviors, could result in a 4-fold improvement in health outcomes compared with secondary prevention based on pharmacological treatment. The American Heart Association (AHA) emphasized the importance of lifestyle in its 2020 goals for cardiovascular health promotion and disease reduction. In addition to defining “cardiovascular health” based on criteria for blood pressure and biochemical markers (lipids and glycemia), the AHA Strategic Planning Committee further identified lifestyle characteristics of central importance: nutrition, physical activity, smoking, and maintenance of a healthy body weight.1 The World Health Organization estimated that ≈80% of NCDs could be prevented if 4 key lifestyle practices were followed: a healthy diet, being physically active, avoidance of tobacco, and alcohol intake in moderation.2 To support healthy lifestyle initiatives, major changes are necessary at the societal level to improve population health. Numerous strategies might help to create a culture that promotes and facilitates healthy behaviors, including creating laws and regulations, mounting large-scale public awareness and education campaigns, implementing local community programs, and providing individual counseling.3 Physicians are uniquely positioned to encourage individuals to adopt healthy lifestyle behaviors: Approximately 80% of Americans visit their primary care physician at least once a year. Physicians directly communicate with their patients during clinical encounters across numerous settings, and research indicates that patients highly value recommendations provided by their physicians.4,5 However, data further indicate that lifestyle counseling does not routinely occur in physicians’ offices, thereby representing a lost opportunity. Physicians report that they perform lifestyle counseling during ≈34% of clinic visits.4 Patients, in turn, report an even lower frequency of physician lifestyle counseling. For example, obese patients reported receiving physical activity and …
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- 10.1016/j.jcjd.2015.06.002
- Jun 24, 2015
- Canadian Journal of Diabetes
Addressing Conflict of Interest and Bias in Research, Education and Clinical Practice.
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- 2
- 10.7710/2159-1253.1072
- Jan 1, 2015
- Health & Interprofessional Practice
Attitudes toward Healthcare Teamwork between Osteopathic Medical Students in an Interprofessional or Intraprofessional Clinical Education Program
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- 5
- 10.1086/495449
- Jan 1, 2000
- Signs: Journal of Women in Culture and Society
Previous articleNext article No AccessReview EssaySappho and Her Sisters: Women in Ancient GreeceMarilyn A. KatzMarilyn A. Katz Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Signs Volume 25, Number 2Winter, 2000 Article DOIhttps://doi.org/10.1086/495449 Views: 115Total views on this site Citations: 1Citations are reported from Crossref Copyright 2000 The University of ChicagoPDF download Crossref reports the following articles citing this article:V. Spike Peterson Sex Matters, International Feminist Journal of Politics 16, no.33 (Jul 2014): 389–409.https://doi.org/10.1080/14616742.2014.913384
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- 10.1353/jowh.2007.0041
- Jun 1, 2007
- Journal of Women's History
Traces of Power:Recent Books on Women in Antiquity Laura McClure (bio) Philippe Borgeaud . Mother of the Gods: From Cybele to the Virgin Mary. Trans. Lysa Hochroth. Baltimore: Johns Hopkins University Press, 2004. xix + 186 pp. ISBN 0-8018-7985-X (cl). Susan Guettel Cole . Landscapes, Gender, and Ritual Space: The Ancient Greek Experience. Berkeley: University of California Press, 2004. xiv + 292 pp.; maps. ISBN 0-520-23544-4 (cl). Barbara Goff . Citizen Bacchae: Women's Ritual Practice in Ancient Greece. Berkeley: University of California Press, 2004. xiii + 400 pp.; ill. ISBN 0-520-23998-9 (cl). Diane Kleiner . Cleopatra and Rome. Cambridge, MA: The Belknap Press of Harvard University Press, 2005. 340 pp.; ill. ISBN 0-674-01905-9 (cl). These four ambitious books provide welcome new perspectives on the lives of ancient women, the spaces they inhabited, and the ways in which they influenced their societies. Although long a commonplace of classical scholarship that religion provided the primary access to power for ancient women, scant attention has been paid to the subject. All of these books address some aspect of gender and religion, from the ritual activities of women in ancient Greece, to the evolution of a maternal divinity in pagan religions and her translation to Christianity, and to the profound impact of a deified Egyptian queen on Roman culture. In Landscapes, Gender, and Ritual Space, Susan Guettel Cole explores the intersection of gender and ritual practice in ancient Greece, with close attention to the epigraphical evidence. Meticulously researched, the book weaves together a broad range of evidence, from inscriptions, literary and medical texts, to archaeological remains. What emerges is a complex picture of the organization of ritual space in ancient Greece and the ways it structured political communities. Cole begins by exploring three related and coextensive landscapes: the natural, the human, and the imagined. In Greece, the division of space always had political implications, and stories about the organization of space and the natural landscape were often "infused with gender." Early Greek epics, such as Hesiod's Theogony and the Catalogue of Women, contain [End Page 184] numerous geographical narratives that "locate the individual community in its landscape and connect it to mythic representations of the larger universe" (21). Such narratives also reflected human categories and social hierarchies: for instance, fixed locations, like the hearth, were associated in the Greek imagination with the female. Chapter 2 examines the ways in which the ancient Greeks delimited the human from the divine. Injunctions against washing in a woman's bathwater, setting a boy on a grave, or eating from an unconsecrated pot, illustrate the profound need to separate human physical processes from the divine. Directed to an exclusively male audience, they also show the importance of delineating male from female. The inability to maintain these boundaries could infect the entire political community with pollution, thus requiring constant maintenance through the symbolic marking of perimeters and the repetition of ritual. In chapter 3, Cole considers the form and function of regional sanctuaries. These helped to merge autonomous cities—separated by geography and fiercely independent political structures—into a unified culture of shared traditions. The gods worshipped at these sites—Zeus at Olympia and Apollo at Delphi—promoted the universal recognition of divine laws. Apollo in particular was invested with a judicial authority that transcended political and territorial boundaries, supporting the "process by which cities made decisions and protected citizens from capricious leaders" (73). The fact that his sanctuary at Delphi marked the imaginary center of the world attests to the god's universality. Just as Delphi provided a sacred center that unified separate city-states into a culture of shared traditions and common laws, so, too, each city-state itself was organized around the prytaneion, "a space . . . both sacred and political" (80) that enclosed its common hearth and sacred fire and forged male solidarity and community. Chapter 4 elucidates the gender asymmetries entailed in ritual practice. Because the ancient Greeks worshipped in groups, gender often came into play in ritual contexts. Although it was less common for men and women to participate in shared rituals, there was no single formula for determining ritual constituency. Rituals connected with the body, especially...
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- 2
- 10.1353/tech.1993.0006
- Oct 1, 1993
- Technology and Culture
Losing Touch: The Controversy over the Introduction of Blood Pressure Instruments into Medicine HUGHES EVANS Blood pressure measurements are an expected feature of American health culture. The machinery is integral to a doctor's office, and the measurements typically start the physical examination. Previously found solely in medical settings, blood pressure machines, or sphyg momanometers, have made their way into more ordinary settings. In fact, their presence in supermarkets and airports comes as no surprise to most Americans. Like weight and heart rate, blood pressure has become a statistic that Americans know about themselves. Entrenched in images of medicine and health, blood pressure is an expected feature of the doctor/patient interaction that has assumed symbolic significance in our society. And yet, in spite of their mundane modern setting, blood pressure machines are a product of the mid- to late-19th-century physiology laboratory. They did not become a regular feature of medical practice until after 1910. The concept of high blood pressure as a disease was only introduced in 1913.1 It was years before this controversial notion of a virtually symptomless disease met widespread acceptance. In fact, the introduction of blood pressure machines, and hence blood pressure measurements, caused an uproar in the American medical community. Physicians felt threatened by the apparatus and the implications of incorporating it into medical practice.2 The technology Dr. Evans is a pediatric resident at the University of Alabama at Birmingham School of Medicine. She thanks Mark Barrow, Merriley Borell, Charlotte Borst, Ruth Schwartz Cowan, Naomi Rogers, Barbara Rosenkrantz, and the Technology and Culture referees for their comments and suggestions on earlier versions of this article. It was presented, in modified form, at the 1989 Sacramento, California, meeting of the Society for the History of Technology. 'Theodore Janeway introduced the notion of essential hypertension. See Theodore Janeway, "A Clinical Study of Hypertensive Cardiovascular Disease," Archives ofInternal Medicine 12 (1913): 755-98. '-'In an interesting essay on the electrocardiogram, for instance, Joel Howell shows how resistance to clinical instrumentation and preconceived notions about its applica-© 1993 by the Society for the History of Technology. All rights reserved. 0040-165X/93/3404-0002S01.00 784 The Introduction of Blood Pressure Instruments into Medicine 785 and the scientific, rational thinking it epitomized implied new ap proaches to medical knowledge, education, and practice. This article is a case study of the incorporation of the progressive ideals of efficiency and objectification into American medicine. I will examine the controversy over the introduction of blood pressure devices that occupied American doctors in the years between 1890 and 1915. Instead of merely analyzing the designs of the various instruments invented for clinical use, I concentrate on the reasons why many doctors felt ambivalent and even antagonistic toward the new instrumentation? Similar in some ways to a contemporaneous tension between artisan and factory worker, this symbolic struggle between man and machine was carried out in the professional arena of medicine with subsequent reverberations on medical education and practice. Physicians for and against the machine highlighted the debate by waging a battle between the two most popular measurers of blood pressure: the finger and the sphygmomanometer. Characterizing blood pressure held an honored place in medical tradition. Since ancient times doctors have palpated the pulse in the belief that the throbbing of the blood vessel transmitted information about an individual's state of health.4 Pulse diagnosis was central to both Greek and Chinese medicine? Until early in this century, most physicians estimated blood pressure by feeling the force of the arterial pulsation. A doctor noted the hardness of the artery, the power of the arterial thrust, the speed with which the pulse reached its peak and tions blinded physicians to some of the electrocardiograph's most important uses. See Joel Howell, "Early Perceptions of the Electrocardiogram: From Arrhythmia to Infarction," Bulletin of the History ofMedicine 58 (1984): 83-98. For original sources on physician reaction to blood pressure machines and other technology, see Joel D. Howell, ed., Technology and American Medical Practice, 1880—1930 (New York, 1988); and James M. Edmonson, Nineteenth Century Surgical instruments: A Catalog of the Gustav Weber Collection at the Howard Dittrick Museum of Historical Medicine (Cleveland...
- Research Article
- 11
- 10.1111/j.1365-2923.1996.tb00856.x
- Nov 1, 1996
- Medical education
Medical humanities in medical education.
- Book Chapter
- 10.9734/bpi/rtass/v2/19137d
- May 8, 2023
Ancient Greece was a deeply religious, anthropomorphic and polytheistic civilization. Greek medical education and practice were impacted by supernatural and religious ideas during the pre-Hippocratic period. With Hippocrates of Cos, the doctor transitioned from religious healer to naturalist, as he explored sickness as an objective natural phenomenon for the first time. Medical schools were formed on a model of disciple education, with strong ethical content, but no study plans or formal titles. Later, the School of Alexandria, where the first chair of anatomy in history was created, came to hold the dominant position in medical education. In the cities of Cos, Cnido, and Alexandria medicine was taught with an educational model that persisted until the first part of the Middle Ages, based on: freedom (teacher and student defined their own goals), disciple learning (started from observation: “see how I do it so you can do it later”): teaching-learning process based on the experience over the texts; strong ethical content (do good and do no harm). During the Roman Empire, the hand of Claudius Galenus conserved and strengthened Greek knowledge, and progress was made in the creation of the first hospitals, an assortment of instruments, and medical specialization. Both the Greek and Roman periods were free of religious influences, which encouraged physical activity and rational medical instruction. With a few exceptions, there was not any place for women.
- Research Article
- 19
- 10.1080/10872981.2022.2143920
- Nov 8, 2022
- Medical Education Online
The importance of medical genetics and genomics in medical practice has grown proportionally with scientific advances in these areas. Purpose The objective of this study was to determine physician perceptions regarding the importance of and comfort with the use of medical genetics and genomics in medical education and practice, as well as physician expectations for medical trainees. Methods A retrospective survey was sent to physicians employed by a health system associated with a public medical school to assess their perceived training in medical genetics and genomics and their comfort level with ordering genetic testing. Results Despite reporting formal genetics training in medical schools, clinicians’ comfort with and knowledge in this content area does not meet personal expectations of competency. Though physicians report some discomfort with the use of medical genetics and genomics, the majority also believe that its impact on practice will increase in the next five years. Survey recipients were also asked about their expectations for preparation in the same domains for medical students and incoming residents. The surveyed physicians expect a high level of competency for medical students and incoming residents. Conclusions Our study revealed that practicing physicians feel current medical curricula do not produce physicians with the necessary competency in medical genetics and genomics. This is despite physicians’ perceived importance of this domain in medical practice. Our findings suggest a need for re-evaluation of medical genetics and genomics education at all levels of training.
- Research Article
- 10.30770/2572-1852-98.3.7
- Sep 1, 2012
Improving America's Medical Education System: Perspectives From a State Regulator
- Front Matter
- 4
- 10.1378/chest.121.5.1385
- May 1, 2002
- Chest
Pneumonology or Pneumology?: An Etymologic Approach
- Research Article
- 4
- 10.1967/s002449910140
- Nov 12, 2014
- Hellenic journal of nuclear medicine
Asclepius was called "a great doctor for every disease". Asclepius was born in Trikala, Thessaly, in the middle of Greece, where the first Asclepeion was established. Patients coming to the Asclepeia were first taking cleaning baths and then entered the main Asclepeion, where they were examined by priests-therapists and were accommodated in certain areas-rooms of the Asclepeion. Inscriptions found in marble plaques describe treatment of some diseases and the sum of money paid for every treatment. These were the first medical records and fees in ancient Greece. Patients were considered as a unique psychosomatic entity. Patients followed many instructions in order to relax and rest, submitted daily baths, exercises, massages, entertainment attending theatrical or poetic or athletic races, reading special books, promenades, special diets or were kept fasting and were instructed to take many kinds of medicine per os, suppositories, ointments, eye drops etc. The main diseases treated in the Asclepeia were: chronic neuropsychological disorders, skin diseases and chronic lung diseases. Other diseases gynaecological, ophthalmic and surgical were also treated. Today, like in the ancient Asclepeia, the psychology of patients is important and certain preparatory drugs are administered before the actual main treatment of surgery or of some psychic disorders. In Aalborg, Denmark, a large prototype medical university hospital, is scheduled to be built in an area of 350acres within the next 15 years. The psychosomatic dogma and principals of a "green building" will be well respected. The Asclepeion of the island of Kos, where as we know Hippocrates was born, was built on the 5th century B.C. and functioned till the 4th century A.D. and had three floors. The Asclepeion had many dedications, of which many parts of the human body in marble: an ear, a damaged penis and two breasts. Surgical tools were also found and are now exhibited in the Dion Museum. After the 4th century A.D. the Asclepeion was destructed and/or destroyed by religious groups, more earthquakes, conflagrations, the Saint John's Knights of Jerusalem and the Turks. Recent excavations in the area in order to find and restore the old Asclepeion started in 1902. Now Asclepeion is partly restored. In conclusion, it is suggested that Hippocratic medicine, as practiced in the Asclepeion of the island of Kos, using psychosomatic means of treatment in a green natural environment was effective for many diseases at that time but also inspired modern medicine and as an example a large university institution is now under constructions based on the above ideals.
- Research Article
- 10.1353/phx.2015.0024
- Jan 1, 2015
- Phoenix
BOOK REVIEWS/COMPTES RENDUS 181 and Italian), but because—with the exception of the “mask” of the “furious mother”— the similarity between dogs and women in ancient Greece is not confined to qualities attributed to female dogs (bitches) as such. Rather, it is dogs as a class that are culturally gendered as feminine, in structural opposition to the “masculinity” of wild beasts such as the wolf (142–153). (One might compare the modern English construction of cats as “feminine” as opposed to the “masculine” dog.) This makes perfect sense, yet “bitch” keeps intruding, starting with the dust jacket, which asserts, bafflingly, that in ancient Greece “the word bitch” was “exclusively figured as female.” In the book itself, “she-dog” and “bitch” sometimes appear on the same page in a way that seems arbitrary (e.g., 125). And what are we to make of “bitchiness” and “bitchy” on 153? The word and its cognates would have been better avoided entirely. Such quibbles aside, Shameless not only translates but supersedes the Italian original. It has been significantly updated and revised, and also sports a substantial new Appendix. This explains the project’s genesis and methodology and provides a valuable introduction to the field of animal studies, with a useful survey of the relevant scholarly literature (including the decade subsequent to the Italian edition). Much of this is introductory in a methodological sense, and as such will be of great interest to classicists (and others) who may be entering this burgeoning subfield for the first time. I wish, in fact, that Franco had used this material to create a new introduction to the book, relegating just the survey of literature to the Appendix. That would have been a more effective way to invite her readers into the world of animal studies and locate this particular project in its larger intellectual framework. The English edition does, however, have a new Preface. Here Franco explains that she has eschewed the “British and American” practice of “setting out one’s thesis statements at the head of the work,” in favor of the allegedly Italian practice of presenting one’s hypothesis as a “riddle,” making the path to the conclusion “both more enjoyable and more informative” (vii–viii). Disoriented readers are therefore advised to start with the Conclusion. But this is completely unnecessary, even for a died-in-the-wool AngloAmerican like myself. The argument is perfectly clear from the outset (even in the Italian edition), and the structure of the book will pose no obstacle to Anglophone readers. I very much hope that no reader is deterred by the oddly defensive tone of this Preface. Shameless is an exceptional book that should be read not only by students of gender and/or animal studies, but by anyone with a scholarly interest in ancient Greek cultural history or literature. The University of California Press is to be applauded for making this remarkable and ground-breaking work available to an Anglophone audience. University of Washington Ruby Blondell Death to Tyrants! Ancient Greek Democracy and the Struggle against Tyranny. By David A. Teegarden. Princeton and Oxford: Princeton University Press. 2014. Pp. xiv, 261. In this study, David Teegarden examines the ancient Greek legislation on tyrannicide . Beginning with the observation that the number of democracies increased during the classical and early hellenistic periods, he concludes that pro-democratic agents had developed effective methods to sustain local democratic regimes over time and identifies tyrant-killing legislation as one of their core measures. By encouraging bold individuals 182 PHOENIX to kill (potential) tyrants and by convincing others that such actions were acceptable, the laws and decrees against tyrants facilitated mobilization in the face of anti-democratic threats. To verify these assumptions, Teegarden analyzes six cases: tyrant-killing laws from Athens, Eretria, and Ilion, the Anti-Tyranny Dossier from Eresos and the Philites Stele from Erythrai. Unquestionably, an up-to-date study of tyrant-killing legislation was necessary. The last contribution to this subject by Hans Friedel was published in 19371 and two relevant inscriptions have been discovered since then. Moreover, while Friedel locates the tyrantkilling laws within the broader context of anti-tyranny discourses in ancient Greece, Teegarden recreates the historical and...
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