552 health and disease: Greece many senses, these ancient healers functioned as experimental scientists, observing symptoms, trying herbal treatments, and assessing what seemed to help The ancient Europeans also practiced a form of surgery Near Munich, Germany, archaeologists discovered the tomb of a “warrior-surgeon” that contained a number of medical and surgical implements This tomb dates to about the third or early second century b.c.e Among these instruments were probes, retractors, and a trepanning saw, or a saw used to cut holes in the skull Trepanning was a widely used technique for treating head injuries and psychological disorders, and healers used both saws and drills to make their holes A large number of skulls have been found that have neat holes drilled or cut into them While many people died during this type of surgery, a surprising number did not, for the holes in some skulls show evidence of healing Trepanning evolved from the notion that the health of the body was based on a balance of substances Allowing substances that caused ill health to escape the body could, it was believed, lead to a cure For the same reason, blood-letting (opening a vein to let blood flow out) was a common early practice GREECE BY TOM STREISSGUTH Asclepios reigned in ancient Greece as the god of health and medicine According to Greek myth, Asclepios was the son of Apollo and was taught the arts of healing and surgery by the centaur Chiron His daughter Hygieia was the goddess of cleanliness and good health; his daughter Panaceia was the goddess of healing In ancient Greece the asclepeion was a sanctuary built to honor Asclepios and as a health retreat, to treat the sick and the injured There were asclepia in Athens, Corinth, Trikkala, Pergamon, Kos, and Epidauros in the Peloponnesus, the traditional center of the cult Asclepia were also built in distant Greek colonies and throughout the Mediterranean region Patients arrived to receive the god’s blessing through healing waters and treatment, through offerings at the temple altar, and through the interpretation of their dreams by the priests of the sanctuary The fame of the healing god spread to the early republic of Rome, where sanctuaries were built in imitation of the Greek asclepeion On the outbreak of a plague in the early third century b.c.e., the Romans appealed directly for his services The Greeks responded by sending the god in the form of a snake; in many depictions of the god, a snake adorns the Rod of Asclepius This symbol of the healing arts survives in medical emblems to the present day Traditional Greek medicine relied on the use of herbs and other natural remedies and on incantation and prayer to the gods Greek medicine began to pass from religious belief to scientific observation at a school of medicine at Cnidus in the seventh century b.c.e Historians believe that Egyptian medicine, which had some supernatural elements and which prescribed very strict courses of treatment for every occur- rence of a disease, had an important influence on the early medical practices of the Greeks (The skill of Egyptian healers and the power of their medicines are mentioned in the Odyssey of Homer.) Alcmaeon (fl sixth century b.c.e.), a member of the school of Cnidus, was the first Greek to set down in writing his observations of the human body His surgical experiments led to the first rational debates over the structure and functions of the human body On performing the first eye operations, Alcmaeon theorized that the brain was the seat of memory, thought, and emotion Empedocles (fl fift h century b.c.e.), a philosopher from the island of Sicily, advanced the notion of the four elements—earth, air, fire, and water—and extended this idea to the human body in the four “humors.” The Greeks believed that a combination of four elements, or humors, made up an essential balance within the human body The humors originated in the physical location of the person and the place of his or her birth, with the ideal balance being found in the civilized people of the Greek world The humors were blood, phlegm, yellow bile, and black bile Through their proportions, the humors shaped the human intellect and personality and also affected life’s physical existence from birth to maturity and on to old age and death A balance of the humors was needed to keep the body free of disease, and achieving or repairing that balance was the task of a physician A patient suffering from disease could be put right by purging, by bloodletting, or by some other method of relieving the body of a humor found to be in excess The theory of the four humors was followed by Hippocrates (460–377 b.c.e.), the most renowned Greek physician Hippocrates was a native of the island of Cos who founded a new school of medical practice, which for a time became the most important center of healing in the Greek world Using case histories, Hippocrates took a scientific approach to disease, discarding religious superstitions and investigating causes, symptoms, and physis, or the overall state of the body, including its inner functioning as well as environmental effects In dealing with their patients, physicians at Cos carried out observation, diagnosis, prognosis, and treatment—the basic elements of clinical medicine that survive to this day They discarded the Egyptian notion of strictly prescribed treatment; all patients were considered individually through careful observation and treated accordingly Medical students at Cos served a paid apprenticeship of several years, which involved classroom teaching, study of medical texts, and observation and treatment of patients The most enduring product of the school was the Corpus Hippocraticum, a collection of essays by several authors that described case histories and accounts of treatment This work included essays on nutrition, surgery, and obstetrics, as well as the Hippocratic oath, a lengthy instruction on proper care and treatment of patients that survives as the foundation of modern medical treatment and ethics After the conquest of North Africa by Alexander of Macedon (r 356–323 b.c.e.) and the founding of Alexandria