A short review of the evolution of Medical Practiceon Crete from the pre-Minoan era until today

Basile P. Spyropoulos

Technological Educational Institution of AthensMedical Instrumentation Technology Department

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Introduction

■ The concepts, the classificatory schemes and the methods involved indiagnosis and treatment are subject to the prevalent at the timetheoretical model of disease.

■ The historical record corroborates the view that diagnostic processes aswell as the concepts of health and disease vary from one medicaltradition to another and are influenced by the theoretical assumptionsof the practitioners themselves.

■ The location of Crete, on the crossroads of literally all importantcultural streams, during the last 6000 years, offers a characteristicexample for the evolution of the medical practice, from the pre-Minoan era until the present and their influence on the Patient-Physician-Nosos relation.

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Primitive Medicine

Archaeological investigationshave brought in light traces ofprehistoric medical practice,during the Neolithic stage ofdevelopment dating from about6000 BC until 3000 BC.

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Ancient Medical Practice

■ Pre-scientific systems of medicine, based primarily on magic, folkremedies, and elementary surgery, before the more advanced Greekmedicine about the 6th century BC, such as the Egyptian,Mesopotamian, and Hebrew Medicine and their influence on Creteduring 3000 to 1200 BC.

■ The diagnostic procedure was based on determining the extra-corporaland non-corporeal cause of the evil, i.e the disease, and the therapywas based on the attempt to appeal to a spirit to intervene and cure thesick.

■ During this period, Crete was the center of a flourishing Bronze Agecivilization, classified as the Aegean and specifically called theMinoan Culture.

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Medical Mystic

Pre- scientific systems ofmedicine, based primarily onmagic, folk remedies, andelementary surgery, before themore advanced Greek medicineabout the 6th century BC, suchas the Egyptian, Mesopotamian,and Hebrew Medicine and theirinfluence on Crete during 3000to 1200 BC.

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The Minoan Culture.

■ The diagnostic procedure wasbased on determining the extra-corporal and non-corporealcause of the evil, i.e the disease,and the therapy was based onthe attempt to appeal to a spiritto intervene and cure the sick.

■ During this period, Crete wasthe center of a flourishingBronze Age civilization,classified as the Aegean andspecifically called the MinoanCulture.

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Hippocratic medicine

■ Hippocratic medicine haschanged the approach toillness and treatment byintroducing the concept ofhumours by which diseaseswere explained in terms ofintra-corporeal causes.

■ Further, this theory allowedfor the first time theindividuation of thediagnostic examination andthe treatment.

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Archaic and classical Greek era

■ The traces of the evolution ofmedical practice cover the post-Minoan, archaic, and classicalera (12th-3rd century BC).

■ Important was the influence ofthe most famous of the Greekmedical schools at Kos andCnidus, located relatively closeto Crete, that flourished in the5th century BC under theAsclepiades.

■ Equally important was theeffect of the CorpusHippocraticum.

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Alexandrian Greek Medicine

■ By the 3rd century BC, thecenter of Greek medical sciencewas firmly established againrelatively close to Crete, inAlexandria, Egypt, the seat of afamous medical school andlibrary.

■ Alexandrian Greek medicineinfluenced conquering Romedespite initial resistance fromthe Romans.

■ The exact way of influence onthe island is under examination.

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Greco-Roman Medicine

■ Asclepiades of Bithynea, AulusCornelius Celsus, PedaniusDioscorides, Artaeus ofCappadocia, Rufus of Ephesus,Soranus of Ephesus, and mainlyGalen of Pergamum, the mostimportant physicians of thisperiod, have further improvedmedical theory and practice.

■ An undisputed authority overmedicine in the Middle Ageshas been established during 1st

century BC and 2nd century AD.

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The Roman Public Health System

■ This system was combined tothe Roman contributions in thefields of public health andhygiene, such as:

◆ The organization of streetsanitation.

◆ Water supply.◆ Public hospitals.

■ This facts have essentiallychanged medical practice in theregion around MediterraneanSea, including Crete, that in 67BC was conquered by theRomans.

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Byzantine Empire

■ In 395 Crete passed to theByzantine Empire.

■ Only a few outstanding Greekphysicians in Constantinopleand the rest of the ByzantineEmpire, such as:

◆ Oribasius.

◆ Alexander of Tralles.

◆ Paul of Aegina.

maintained the older tradition.

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Arab Occupation

■ The island fell to the Arabs in826 and remained under theirrule until 961.

■ The Arabs learned of Greekmedicine at the schools of theNestorian Christians, that hadpreserved many texts lost in thedestruction of the AlexandrianLibrary.

■ Translations from Greek wereinstrumental in the developmentof a scientific revival and anArabic system of medicine.

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The Arabs and the Western medicine

■ The Arabs did much to elevateprofessional standards byinsisting on examinations forphysicians before licensure,influencing, thus, stronglymedical practice.

■ Western medicine in the earlyMiddle Ages consisted of tribalfolklore, mingled with poorlyunderstood remnants ofclassical learning and even aseries of epidemics served onlyto initiate a revival of magicalpractices.

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Venetian Occupation

■ Following the Fourth CrusadeCrete was sold (1204) to theVenetians and remained apossession of Venice for almostfive centuries.

■ At the beginning of the 11thcentury Salerno became the siteof the first Western school ofmedicine.

■ Teaching was primarilypractical and secular in tone andemphasized diet and personalhygiene.

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The spread of Western Medical Schools

■ Latin translations from theArabic of many Greek medicalclassics have been prepared,for students at both Salerno andMonte Cassino.

■ By the 12th century medicalinstruction has becomeincreasingly theoretical andscholastic and spread to themedical school at Montpellierand later to the universities ofParis, Oxford, Padua, andBologna.

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The period of the Ottoman Occupation

■ In 1645 the Ottoman Empirebegan military operations inCrete against the Venetians,completing conquest of most ofthe island in 1669 and acquiringcomplete control in 1715.

■ The direct connection of theisland to Western Europebrakes during the two mostimportant centuries, for thebirth of modern MedicalTechnology.

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The interaction

■ The examination of theevolution of Medical Practice inCrete, is representative for thisprocedure in the boundaries ofthe Ottoman Empire, beyondIstanbul (Constantinople).

■ The consequences of the ideasof Renaissance Medicine fromAndreas Vessalius to WilliamHarvey on the medical practiceare still under investigation.

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The 20th century

■ By the terms of the Treaty ofLondon (May 31, 1913), Cretewas ceded to Greece.

■ Crete follows the developmentof the modern Greek State.

■ The University of Cretebecomes, in close cooperationwith European and AmericanInstitutions, an internationallyrecognized Medical ResearchCenter, especially in the fieldsof Molecular Biology, MedicalInformatics and LASER.