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THE COMMON HEALTHCARE APPROACHES IN THE ERA OF GRECO-ROMAN
ANTIQUITY
Kakhorova Mukhabat Askaraliyevna
Teacher of Uzbek and Foreign languages department,
Maqsudjonov Shahriyorbek Farxodjonovich
student of 102 group, Stomatology Faculty
Tashkent Medical Academy
Abstract:
This study explores the practices and training of medical practitioners during Greco-
Roman times. Medical education primarily occurred through apprenticeships with established
physicians, yet there were no formal qualifying medical examinations, resulting in significant
variability in the standards of practice.
Key words:
military hospitals, Greek medicine, advancements in public health, professional
organization, contemporary medicine.
In Rome, the traditional practices of magic-religious healing were gradually replaced by the
introduction of Greek physicians and their medical knowledge. Concurrently, Roman
administrative reforms led to enhancements in water and food supply systems, the establishment
of a comprehensive sewage disposal network, and the creation of military hospitals during the
Roman Period. As Rome emerged as the preeminent urban center in the Mediterranean, it drew
prominent Greek physicians, including Galen of Pergamon. His extensive writings, grounded in
original experimentation and comprehensive scholarship, epitomize the zenith of Greek medicine.
Galen's synthesis ultimately became the prevailing medical doctrine among the scholars of the
Byzantine Empire, who focused on clarifying, systematizing, and adapting the vast array of
ancient medical texts they inherited.
This study explores the practices and training of medical practitioners during Greco-Roman
times. Medical education primarily occurred through apprenticeships with established physicians,
yet there were no formal qualifying examinations, resulting in significant variability in the
standards of practice. During the Roman period, the majority of medical practitioners were
Greek and operated as itinerant physicians. Civic physicians, who were employed by local
communities, began to appear in Greek society from the 5th century BC, but this development
occurred much later in Rome, likely not until the 4th century AD. Rome's notable contributions
to medicine included advancements in public health, exemplified by their aqueducts, public
baths, and sewage systems, as well as a highly effective medical service for their military forces.
Hospitals, known as valetudinarian, were established for military personnel and slaves on large
estates from the 1st century BC, while civic hospitals for the general populace did not emerge
until the 4th century AD. The Greek medical schools of Cos and Cnidos eventually
overshadowed by the school of Alexandria in Egypt, and later by the school of Carthage in
northern Africa towards the end of the Roman Empire. The decline of these institutions during
the Christian era marked the end of significant medical advancements from antiquity.
The origins of contemporary medicine traced to the 5th century BC, coinciding with the
flourishing of literature, philosophy, arts, and sciences during the Golden Age of Athens. It was
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during this period that the Greek communities of Cos and Cnidos established the principles of
rational medicine. While the Hippocratic corpus provides significant insights into the logic and
ethics of this emerging medical practice, it offers limited information regarding the actual
conduct of practitioners. This article explores the fundamental aspects of medical practice in
ancient times, as well as the teachings of prominent physicians who shaped the field during the
Greek and Hellenistic periods, extending into the Roman era.
The origins of Greek medical history can be traced back to the era of Homer. In the Iliad (1.1
-43ff; 450- 480; XI.518 and 833), the god of healing, Apollo, along with his son Asclepius, a
physician, play significant roles during the Trojan War. Celsius (Proem, c.3) later noted that their
contributions were primarily in the treatment of battle injuries rather than in the management of
epidemic diseases. The Iliad itself records 147 injuries sustained in battle, comprising 106 spear
wounds, 17 sword cuts, 12 arrow injuries, and 12 wounds from slingshots (Porter 1997:51).
The prevailing belief during this period was that diseases were attributed to the will of the
gods, leading to a significant influence of religious and prophetic practices on health matters.
Consequently, priests, magical healers, herbalists, and those skilled in root cutting (rhizotomoi)
(Godderis 1997:235-237) predominantly managed the practice of medicine. However, by the 6th
century BC, a notable group of philosopher-physicians emerged, profoundly influencing the
evolution of healthcare. This group included Thales of Miletus and his disciple Anaximander, as
well as the distinguished Pythagoras (570-489 BC) from Croton in Southern Italy. In addition to
his substantial contributions to mathematics and physics, Pythagoras, possibly in collaboration
with his student Alcmaeon, proposed the theory of the four bodily humours, which, despite its
inaccuracies, remained a foundational concept in human physiology for over two thousand years
(Major 1954:110-116). It is clear that by the 6th century BC, there were established centers of
medical education in locations such as Croton, Cyrene (Northern Africa), and Cnidos (Nunn
19%: 12).
In the 5th century BC, coinciding with the Golden Age of Athens, a rational approach to
medicine, known as technê iatrikê, emerged. The Greek medical community on the island of Cos,
inspired by Hippocrates, primarily developed this system, which minimized the influence of
religion and supernatural elements. Notable earlier figures such as Anaxagoras and Empedocles
also played crucial roles in this evolutionary advancement (Major 1954:113-138).
Hippocratic doctors offered their services to patients across all segments of society, though
Godderis (1997:252-3) indicates that wealthier individuals likely received more focused care
than poorer ones. Physicians typically gained their training through apprenticeships, with the
fortunate few attending the renowned schools of Cos and Cnidos. The absence of a formal
professional registration system resulted in a wide range of training quality and standards. While
most physicians were male (iatroi), there were also female practitioners (iatrinai), midwives
(maiai), and those who practiced both professions (iatro-maiai). The role of modern nurses was
not recognized, but there are accounts of assistants (huperetoi ton iatrón), who were generally
slaves in the process of training.
The writings attributed to Hippocrates provide minimal insight into the professional
organization or the social dynamics of doctor-patient interactions. Given the diverse nature of
Greek physicians during this period, it is challenging to make broad generalizations regarding
their status, societal acceptance, or methods of practice. Nevertheless, Edelstein (1987:87-90)
posits that the typical Hippocratic physician likely engaged in an itinerant practice, seeking to
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establish a professional presence within the community. This individual would have functioned
more as an artisan than as a modern professional, possessing a limited social standing. His
reputation would have been contingent upon his clinical achievements, necessitating that he
promote himself in competition with other medical practitioners or healers.
Greek medicine began to permeate Roman society as early as the 4th century BC. Prior to this,
traditional Roman medical practices, akin to those of the Greeks four to five centuries earlier,
relied heavily on folk remedies, herbal treatments, religious beliefs, and superstitions (Nutton
1988c:31-40). While many Romans welcomed Greek physicians, there was notable opposition
from prominent individuals. Cato the Elder (234-149 BC), who treated his family, dependents,
and slaves with conventional remedies such as cabbage and wine, vehemently opposed the
Greeks and even barred them from his residence (Nutton 1988b:42). Cicero (106-43 BC)
regarded physicians as individuals of low status mere tradesmen rather than men. Ironically, he
held his own Greek doctor in high esteem (Nutton 1988a:28). Pliny the Elder (AD 23-79)
launched a comprehensive and influential critique of all things Greek, particularly targeting
Greek medicine, which he believed contributed to the gradual decline of Roman culture (Nutton
1988a:43). Despite this resistance, Greek physicians came to dominate the medical landscape,
with Nutton (1988b:37) estimating that over 90% of Rome's doctors in the 1st century AD were
Greek, 75% in the 2nd century, and around 65% in the 3rd century.
Several medical sects or schools emerged during the Roman era, but their practical
contributions to the evolution of medicine were likely restricted. The Methodist school, which
dates back to the 1st century BC, maintained that all ailments arose from the abnormal operation
of minute div pores. This perspective led to the belief that treatments were relatively simple,
thus negating the necessity for physicians to have a profound understanding of anatomy or
physiology.
This study encompasses a thousand-year period characterized by the evolution and
solidification of medical science and practice. It recounts a narrative of significant Greek
ingenuity and original thought, bolstered by meaningful practical input from the Romans,
culminating in a medical framework that managed to survive a millennium of scientific inertia.
Although Galen's scholarship, dogma, and authority prevailed during the medieval period, much
of his theoretical framework was invalidated by the new insights that emerged during the
Renaissance. The fundamental clinical guidelines and ethical principles established by
Hippocrates have demonstrated remarkable durability and are still revered in contemporary
discourse.
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