The Birth of Hospital, Asclepius cult and Early Christianity / 의사학

History of hospital is one of main fields of researches in medical history. Besides writing a history of an individual hospital, considerable efforts have been made to trace the origin of hospital. Those who quest for the origin of hospital are faced with an inevitable problem of defining hospital. As the different definition can lead to a different outcome, it is important to make a clear definition. In this article, the hospital was defined as an institution in which patients are housed and given medical treatments. According to the definition, the Great Basilius is regarded to have created the first hospital in 369 CE. The creation of hospital is considered to be closely related with Christian philantrophy. However, the question is raised against this explanation. As the religious philantrophy does not exclusively belong to the Christianity alone, more comprehensive and persuasive theory should be proposed to explain why the first hospital was created in the Christian World, not in the Buddhistic or other religious world. Furthermore, in spite of sharing the same Christian background, why the first hospital appeared in Byzantine Empire, not in Western Roman Empire, also should be explained. My argument is that Asclepius cult and the favorable attitude toward medicine in Greek world are responsible to the appearance of the first hospital in Byzantine Empire. The evangelic work of Jesus was heavily depended on healing activities. The healing activities of Jesus and his disciples were rivalled by Asclepius cult which had been widely spread and practiced in the Hellenistic world. The temples of Asclepius served as a model for hospital, for the temples were the institution exclusively reserved for the patients. The exclusive housing of patients alone in the temples of Asclepius is clearly contrasted with the other early forms of hospitals in which not only patients but also the poor, foreigners and pilgrims were housed altogether. Toward the healing god Asclepius, the Latin Church fathers and Greek Church fathers showed significant difference of attitudes. The Latin fathers were generally very critical on Asclepius while the Greek fathers were more favorable to the same healing god. This difference is also considered to be an important factor that can explain why the first hospital appeared in the Byzantine Empire.

Psicología de la culpa en la Grecia Antigua / Psychology of guilt in Ancient Greece

La noción moderna de culpa entendida como conflicto valorativo (moral) es una categoría psicológica construida históricamente. Los griegos de la época arcaica y clásica carecían de la experiencia de la culpa tal y como la sentimos ahora. En este trabajo se discute acerca de la problemática de la culpa en la antigua Grecia y de las condiciones que hicieron posible su nacimiento y funcionamiento. Entre estas destacan la moralización de la até; originariamente entendida como locura irracional, y transformada en la época arcaica en castigo de los dioses y, el aumento del gradiente de libertad personal en detrimento de los poderes religiosos, lo cual se atisba en el siglo V a. C. en Sófocles y Eurípides, y sobre todo en Aristóteles en el siglo IV a. C. Finalmente se presenta una línea de interpretación sobre el modo en que las prácticas históricas asociadas a la noción de culpa atraviesan o subsisten en la clínica y en la práctica psicoterapéutica...

The modern notion of guilt, understood as evaluative conflict (moral) is a psychological historically constructed category. The Greeks of the archaic and classical period lacked the experience of guilt as we feel it now. This paper discuss about the problem of guilt in ancient Greece and about the conditions that made possible his birth and operation. Between these they emphasize the moralization of até it; originally understood as a irrational madness, and transformed in the archaic period in punishment of the gods, and, increasing the gradient of personal freedom to the detriment of the religious powers, which is emerging in the 5th century B.C. in Sophocles and Euripides, and especially in Aristotle in the 4th century B.C. Finally we present a line of interpretation about how historical practices associated of the notion of guilt are crossing the clinic and psychotherapeutic work.

Mitología griega y medicina: asclepio, su bastón y una confusión de larga data / Greek mythology and medicine: asclepio, his stick and a long-data confusion

El pueblo griego brindó las bases no solo del llamado pensamiento occidental o racional, sino que influenció con su mitología en mu-chos aspectos que circundan el contexto mé-dico. Algunos de estos elementos son tratados en este artículo; a saber: el origen de Asclepio ­Esculapio para los romanos- Dios de la me-dicina, sus formas de curar, el símbolo que lo identifica -el bastón con la serpiente enrolla-da, y el origen de confusión con el caduceo de Hermes.

The Greeks provided not just the bases of the western though or rationalism, but their knowledge also influenced with their mytholo-gy in many aspects related to medicine. Some of those aspects are shown in this paper. We will start with the origin of Asclepius ­Aescula-pius for the Romans- God of medicine, his the-rapeutic system, the symbol that identifies it ­a wooden staff encircled by a single snake-, and finally with the origin of confusion with the ca-duceus of Hermes.

A noção mítica de Kháos na Teogonia de Hesíodo / The mythical notion of Khaos in Hesiod’s Theogony

Sobre a noção mítica de Caos se formulam e se analisam três questões, a saber, 1) em que e 2) por que 3) o que se lê no livro O universo, os deuses, os homens de Jean-Pierre Vernant se distingue e difere do que se pode ler no texto da Teogonia de Hesíodo?.

On the mythical notion of Khaos, we can ask three questions: 1) in which and 2) why 3) what can be read in the book L’univers, les dieux, les hommes by Jean-Pierre Vernant is distinct and different from what can be read in Hesiod’s Theogony?.

O caos, o acaso e o trágico / The chaos, the hazard and the tragic

O trabalho discute a concepção de caos, de acaso e de trágico desde a Antiguidade Grega, passando pela filosofia trágica, até chegar à psicanálise.

This paper considers the concept of chaos, hazard and tragic, from the Ancient Greece, passing through the tragic philosophy, finally coming to psychoanalysis.

Alma, corpo e a antiga civilização grega: as primeiras observações do funcionamento cerebral e das atividades mentais / Soul, body and the ancient greek civilization: the first observations of brain functioning and mental activities

Muitos dos conceitos existentes na neurociência moderna possuem suas origens nas especulações elaboradas pelos antigos filósofos e médicos gregos. Questões centrais sobre a fonte dos pensamentos humanos, o mecanismo da atividade cognitiva, e a natureza das emoções, percepção e movimento voluntário, por exemplo, foram levantadas pelos pensadores gregos. É a partir desta civilização que surgem as observações mais sistemáticas sobre a estrutura e o funcionamento do corpo, da mente e a relação entre estas duas entidades. Assim, o presente trabalho pretende observar as principais tentativas iniciais gregas em vincular estruturas do corpo (tais como o cérebro ou o coração) e atividades mentais, ao longo das diversas especulações gregas sobre a natureza, a filosofia, a psicologia e a medicina.

Many of the existing concepts in modern neuroscience have their origins in the speculations made by ancient Greek philosophers and physicians. Core questions about the source of human thought, the mechanism of cognitive activity as well as the nature of emotions, perceptions and voluntary movements, for example, were raised by Greek thinkers. It is from this civilization that arise more systematic observations on the structure and functioning of body, mind and relationship between these two entities. The present paper intends to adhere to the first Greek attempts to link structures of the body (such as the brain or the heart) and mental activities regarding various Greek speculations about the nature, philosophy, psychology and medicine.

Da importância da tragédia: o gênero dramático e a finitude humana / La importancia de la tragédia: el género dramático y la finitud humana / On the importance of tragedy: the genre dramatic and human finity

O caráter deste estudo teórico é realizar uma reflexão acerca da experienciação dos antigos helenos em relação às grandes Tragédias. Mostrar-se-á a Tragédia em suas dimensões como forma de poesia e de celebração, além de ser fonte perene de meditação do “sentido do trágico” da finitude humana...

The character of this theoretical study is to realize a reflection concerning the experiencing of the old greeks in relation to the great Tragedies. To show Tragedy in its dimensions to it as form of poetry and celebration, beyond being perennial source of meditation of the “sense of tragic” of the finity the human being...

La calidad de este estudio teórico es lograr un reflexion con respecto a el experienciacion de los viejos Hellenos en relación con las fenomenales Tragedias. La Tragedia será mostrada en sus dimensiones como forma de poesía y de la celebración, además de ser la eterna fuente de la meditación del “sentido del trágico” de la finitud humana...

La depresión en la tragedia griega clásica: la mecancolía delirante de Orestes / Depression in ancient greed tragdy: Orestes delusional melancholia

Severely depressed patients may have delusions of guilt and sinfulness, and persecution. They believe they are being singled out for their past mistakes and that everyone is aware of their errors. A minority of depressed persons have fleeting genuine affective auditory or visual hallucinations with extremely unpleasant content along the lines of their delusions. The insights into the human psyche contained in Greek tragedy are profound. There is much to learn from the psychological assumptions of Aeschylus, Sophocles, and Euripides, because their views are different to modern ones. Orestes is characterized by a virtually psychotic fear of persecution, the consequence of guilt over his matricide. It may be argued that he suffered from a depressive disorder with psychotic features.

Los pacientes que sufren de una depresión grave pueden presentar delirios de culpa, pecado y persecución. Ellos están convencidos que son estigmatizados por sus faltas anteriores y que todo el mundo sabe de sus errores. Una minoría de personas deprimidas tiene alucinaciones visuales y auditivas auténticas pero pasajeras de naturaleza afectiva con contenidos extraordinariamente desagradables que están en concordancia con sus delirios. La riqueza del conocimiento sobre la psiquis humana que está encerrada en la tragedia griega es particularmente profunda. Hay mucho que aprender de los supuestos de Esquilo, Sófocles y Eurípides porque sus visiones son muy diferentes de las modernas. Orestes se caracteriza por exhibir un temor psicótico de persecución a consecuencia de su culpa por su matricidio. Se puede plantear que él sufrió de un trastorno depresivo con rasgos psicóticos.

Recuento histórico y análisis epistemológico de la sepsis secundaria a lesiones y su control quirúrgico. Desde el papiro de Edwin Smith hasta el pus bonum et laudabile / Historical recount and epistemological analysis of the sepsis derived from wounds and its surgical control: From thepapyrus of Edwin Smith to the "pus bonum et laudabile".

La sepsis como complicación temible del trauma ha acompañado al hombre a través de la historia en especial en la antigüedad. En el presente trabajo se analiza la evolución histórica del controlquirúrgico de la sepsis desde el Antiguo Egipto hasta la Edad Media. Se describe cómo los diferentes tratamientos tuvieron una evolución paradójica: empezando desde una relativa cura apiógena de los egipcios y alejandrinos, hasta el irrefrenable deseo de ver supurar la lesión, típico en la EdadMedia. También se exponen las causas de la ambigüedad de los griegos a la hora de promover o limitar la supuración, sustentadas en el humoralismo clásico, y cómo esta concepción fue la semilla del dogma galénico “la pus es buena y laudable”, dogma que marcó la pauta del cuidado de las heridas durante más de mil años, y que fue responsable, junto con la pérdida de valiosos conocimientos quirúrgicos en el Medioevo, del establecimiento de la cauterización como tratamiento de elección para muchos tipos de lesión. Finalmente, se presentan las razones epistemológicas del fracaso del intento de derrumbar el dogma galénico durante el siglo XIII.

Sepsis, as a fearsome complication of trauma, has accompanied mankind throughout history, particularly in the Antiquity. In this article the historical evolution of surgical sepsis control and of the importance of suppuration is reviewed, from the Ancient Egypt through the Middle Ages. The evolutionof different therapeutic approaches for wounds is described, from the non-suppurative healing of the Egyptians and Alexandrians to the irrepressible desire of seeing wound suppuration that was common in the Middle Ages. The causes of the ambiguity of Greeks concerning the promotion or limitation of suppuration are presented. They were based on the classical theory of Humoralism. This conception became the framework of the Galenic dogma expressed as the “good and laudable pus”, which served as the basisfor wound care during more than one thousand years. It was responsible, together with the loss of valuablesurgical knowledge during the Middle Ages, of the establishement of cauterization as the treatment of choice for different types of lesions. The epistemological reasons for the failure to overthrow the Galenic dogma duringthe XIII Century are also discussed.

Comparative Research into the Process of Forming the Theory of Constitution in Ancient Western Medicine and that of Four Trigrams Constitution in Korean Medicine and Contents of Two Theories of Constitution / 의사학

After conducting comparative research into the process of forming the Theory of Constitution in Ancient Western Medicine and that of Four Trigrams Constitution(Sasang Constitution) in Korean Medicine and contents of two Theories of Constitution in terms of medical history, both theories were found to be formed by an interaction between philosophy and medicine, followed by a combination of the two, on a philosophical basis. The Theory of Constitution in Ancient Western Medicine began with the Theory of Four Elements presented by Empedocles, followed by the Theory of Four Humors presented by Hippocrates and the Theory of Four Temperaments by Galenos, forming and developing the Theory of Constitution. After the Middle Ages, there was no significant advance in the Theory of Constitution by modern times ; however, it developed into the theory of constitution type of Kretschmer and others after the 19th century and into the scientific theory of constitution based on genetics presented by Garrod and others early in the 20th century. The Theory of Four Trigrams Constitution began with the Theory of Constitution in Huangdi Neijing, followed by developments and influences of existing medicine called beginning, restoration, and revival periods and DongeuisoosebowonSaSangChoBonGwon based on the original philosophy of Four Trigrams presented by Lee Je-ma, which is found in GyeokChiGo, DongMuYuGo and so on, ultimately forming and developing into the Theory of Four Trigrams Constitution in Dongeuisoosebowon. Recently, a lot of research is being conducted into making it objective in order to achieve reproducibility in diagnosis and so forth of Four Trigrams Constitution.

Heat and Fever in Ancient Greek Physiology / 의사학

This paper aims at clarifying the relationship of physiological heat and pathological heat(fever) using the theoretical scheme of Georges Canguilhem as is argued in his famous book The Normal and the Pathologic. Ancient authors had presented various views on the innate heat and pathological heat. Some argued that there is only pathological heat while others, like Galen, distinguished two different kinds of heat. Galen was the first medial author who had the clear notion of the relationship between the normal heat and the pathological heat. He conceptualized their difference as the heat conforming to nature (kata phusin) and the heat against nature (para phusin). However, the Peripatetic authors, such as ps-Alexander Aphrodisias, who laid more emphasis on physiology tended to regard pathology in continuation with physiology as Claude Bernard attempted to do it. Therefore, Canguilhem's theoretical scheme turns out to be very useful in analysing the relationship of normal heat and pathological heat as is manifested in ancient Greek physiology.

Para uma semiologia psicanalítica da paixão na antiguidade grega e seus sentidos adictivo e tóxico / Pour une sémiologie psychanalytique de la passion dans l’antiquité grecque et ses sens addictif et toxique / Para una semiología psicanalítica de la pasión en la antiguedad griega y sus sentidos adictivo y tóxico / For a psychoanalytical semiology of passion in greek antiquity and its addictive and toxic meanings

Trata-se de pesquisa de revisão de literatura. Seu objetivo foi realizar a semiologia psicanalítica da paixão na Antiguidade grega. Discutiu-se a hipótese central que compara “paixão” com “adicção” e “tóxico”. Analisou-se: 1o - Os sentidos e a origem etimológica da paixão em Aristóteles. Destacou-se aqui, em sentido amplo, “paixão como fato de sofrer passivamente uma ação” e, em sentido restrito, como “fato de sofrer passivamente uma ação dolorosa ou prejudicial”; 2o - Os sentidos da paixão em Platão. Evidenciaram-se aqui, em sentido geral, “paixão-sensível como fato de se sofrer passivamente uma ação” e, em sentido particular, “paixão como cegueira da realidade”, “como ilusão sensorial” e “como submissão a uma ação do mundo exterior sobre o corpo”; 3o - O sentido paradoxal das paixões em Platão persistiria a partir da Renascença, especialmente em Descartes e em Freud?; e 4o - Seria o “phármakon” platônico a origem semiológica dos sentidos “tóxico” e paradoxal das paixões em geral?

This is a literature review research. It aimed to produce a psychoanalytical semiology of passion in Greek Antiquity. the central hypothesis which compares “passion” to “addiction” and “toxin” was discussed. The following aspects were analyzed: 1st- The senses and the etymological origin of passion in Aristotle. We have highlighted passion here, in a broader sense, as “the fact of undergoing an action passively” and, in a restricted sense, as “the fact of suffering a painful action passively”; 2nd- The senses of passion in Plato. We have accentuated here, in a general sense, “passion-sensitive as the fact of undergoing an action passively” and, in a specific sense, “passion as blindness to reality”, as a “sensorial illusion” and as “submission to an action coming from the outside world onto the body”; 3rd- Would the paradoxical sense of passions in Plato remain from the Renaissance, especially in Descartes and in Freud? and 4th- Would the Platonic “phármakon” be the semiological origin of the “toxic” and paradoxical senses of passions in general?

Il s’agit d’une recherche de révision de la littérature. Son objectif a été faire la sémiologie psychanalytique de la passion dans l’Antiquité grecque. On a discuté l’hypothèse centrale qui compare la “passion” à l’“addiction” et au “toxique”. On a analysé: 1o- Les sens et l’origine étymologique de la passion chez Aristote. On y a souligné, au sens large, “passion comme fait de subir passivement une action” et, au sens restreint, comme “fait de souffrir passivement une action douloureuse ou nuisible”; 2o- Les sens de la passion chez Platon. On y a mis en valeur le sens général de “passion-sensible comme fait de subir passivement une action” et les sens particuliers de “passion comme aveuglement face à la réalité”, comme “illusion sensorielle” et comme “soumission à une action du monde extérieur sur le corps”; 3o- Le sens paradoxal des passions chez Platon persisterait à partir de la Renaissance, notamment chez Descartes et chez Freud? et 4o- Faut-il voir dans le “phármakon” de Platon l’origine sémiologique des sens “toxique” et paradoxal des passions en général?

Se trata de una pesquisa de revisión de la literatura. Su propósito fue hacer la semiología psicoanalítica de la pasión en la Antiguedad griega. Se discutió la hipótesis central que compara la “pasión” con la “adicción” y “tóxico”. Se analizó: 1o - Los sentidos y el origen etimológico de la pasión en Aristóteles. Se enfatizó aquí, en el sentido amplio, “pasión como hecho de sufrir pasivamente una acción”, y, en el sentido restricto, como “hecho de sufrir una acción dolorosa o prejudicial”; 2o - Los sentidos de la pasión en Platón. Se valorizó aquí, en sentido general, “pasión-sensible como hecho de sufrir pasivamente una acción” y, en sentido particular, “pasión como ceguera de la realidad”, “como ilusión sensorial” y “como sumisión a una acción del mundo exterior sobre el cuerpo”; 3o - ¿El sentido paradójico de las pasiones en Platón persistiría a partir del Renacimiento, especialmente en Descartes y en Freud?; y 4o - ¿Sería el “phármakon” platónico el origen semiológico de los sentidos “tóxico” y paradójico de las pasiones en general?

The Contradictive Tendencies in Medical Treatment of the Hellenistic Age: Diversity versus Simplification, Chronic Extension(Physical Therapy) versus Rapidity, Humane Medicine versus Worldly Success / 의사학

It is a one-sided view to find the greatness of Hippocrates just in seeking after scientific medicine(medicina scientia) and sublating superstitious treatment. The scientific medicine did not begin with him, and the succeeding generations of him were not one and the same in opinions. For example, there were the confrontations between the school of Kos and that of Knidos in the very age of Hippocrates, as well as the opposition of rationalism and empiricism. The school of Kos was alleged to succeed the tradition of Hippocrates, taking into consideration individual physical conditions and being based on the principle of various clinical methods of physical therapy assuming chronical extension. On the contrary, the school of Knidos tended to define the diseases in simple aspects, paying no much attention to the difference of physical conditions and developmental stages of illness. Futhermore, the latter grasped the diseases rather in the point of individual organs than the disorder of physical state of the body. It can be said that the anatomical knowledge was more useful for the school of Knidos. The difference between the two schools can also be found in what purpose the medicine sought after. While Hippocrates attached much importance to physical therapy and made the people including the poor as object of medical treatment. there were doctors in no small number, we can suppose, in pursuit of money, power, worldly glory. As time passed, however, the two schools gradually got similar to each other, the difference of them reduced as well as the tradition of Hippocrates faded. The opposition between rationalism and empiricism in the Hellenistic Age shared, in some aspect, the difference of Kos and Knidos. According to Celsus, the conflict between rationalism and empiricism did not refer to pharmacy or anatomy, but just to diet. The rationalism materialized various methods of therapy considering environmental elements as well as individual physical conditions, but the empiricism in reality tended to expedite simplification of treatment. This tendency of simplification of the latter corresponded to the contemporary need of society, that is, speedy and effective treatment for the wounded in war or for epidemic in the army, farms of collective labour or much crowded cities. The bigger the groups were, the more the methods of treatment got simplified, individual conditions not much accounted. Then, the empiricism came to be united with anatomy, as the anatomy, being much developed in the process of curing the wounded in war, goes with simplification of medical treatment in the hospital of large scale. It can be said that the origin of simplified definition of diseases goes back far to the school of Knidos. On the other hand, in Hippocrates the drugs were in contrast to the diet. While the diet was to help health and rehabilitate physical conditions, the drugs were to result in strong effects of change. The drugs like as poison, eye-salve, ointment were to be made use f for rapid, effective change of physical state or for the treatment of a concrete, limited part of the body, These drugs were also much developed in the Hellenistic Age of the state of chronic war. In initial stages, the toxical drugs as well as the anatomy and surgical operations must have been developed on peaceful purpose, such like as 'theriaca' detoxicating(antidoting) animal's poison, or for easing childbirth. With the increasement of social inequality and unexhausted human desire, however, the toxical drugs or anatomical knowledges got to be used for undesirable purposes. Thus, we can not estimate Hippocrates simply in the point whether he developed scientific medicine or not. The great fame of Hippocrates could be found rather in his method of medical treatment as well as the principle of medicine, as he believed that the medicine should not be exploited for worldly power or wealth but for the convenience of all the people. He pursued healthy life matching to natural state(physis) and took much account of different physical states of individual to embody various methods of treatment, which presupposed chronic delay. The opposite to the Hippocratic medicine is called for the wounded by war, or the collective labourer of large farm with intensive labour exploitation. The medical treatment for them assumed anatomical surgery and drugs of rapid, strong effect.

Peregrinaciones a las fuentes de la medicina clásica / A journey to the foundations of classical medicine

The author narrates his trips, between 1951 and 2006, to the main historical sites of antique medicine, where physicians of pre-Columbian cultures of Mexico and Peru, Egypt, Greco Latin culture and Islamic civilizations, lived. The trip ends with a visit to medieval European medicine before Renaissance. A description of the main historical sites and the features of these medical and sanitary cultures is made. In antique civilizations, diseases were considered a punishment of pagan deities. Supernatural and magical influences were decisive in medical practice. The Greco Latin culture of Galen and Hippocrates freed manhood from these causes of diseases and gave a rational basis to the practice of medicine. The Islamic civilization allowed the transmission of Greco Latin culture to medieval Europe. This permitted the renaissance of European creativity and the foundation of modern scientific medicine in the sixteenth century. The author highlights the main virtues of classical Greco Latin medicine, that are the foundations of humanistic thoughts that will restrin the technological revolution of modern medicine.