Alexandrian Medicine and Surgery: An Introduction

A major step in the evolution of Hellenistic Medicine and Surgery resulted from the victories of Ale­xander the Great (356-323 BC), who conquered —more or less— the whole Eastern World, including today’s Turkey, the Middle East, Iraq, Persia, Afghanistan and Pakistan, as also Egypt, Sudan and Li­bya. With the founding of new cities, Hellenic Science and Culture were firmly implanted in these countries with their ancient civilizations. In the same time scholars were able to collect the preexisting knowledge from the newly embodied or surrounding countries. An impressive cross–fertilisation took place, which became even more profound as all the gold and silver found in the cellars of the palaces of the Great Kings of Persia and Egypt, as also of all local kings, were struck into coins. This immense amount of money was thrown into the Economy and major new cities were erected. By founding all these new towns (for example at least 22 towns named Alexandria were erected), huge amounts of mo­ney were released into the circulation and finally reached every citizen. This caused an impressive ex­pansion and flourishing of the Economy and even more. Poor people, who were unable before to reach a physician or a «Medical Centre», were now able to choose the best–ones. This resulted in a concentra­tion of patients in major «Medical Centres/Schools» called Asklēpieia, causing an excessive accumula­tion of medical experience and knowledge. At least 400 temples of god Asklēpios, called also Asklēpieia, have been excavated; from Spain to the Himalayas and from Danube down to Ethiopia. The most im­portant place of medical thought and practice became very early the famous Centre of Hellenic know­ledge, the city of Alexandria in Egypt (Alexandria ad Aegyptum). Alexandria, founded personally by Alexander the Great in 331 BC, became very quickly the most important city. It was governed by a Dy­nasty which descended from Alexander’s General Ptolemaios I, surnamed Laghos or Sōtēr (305-284 BC) and his successors Ptolemaios II and III. These three Kings founded and tremendously promoted both Arts and Science. They even built a Botanical and Zoological Garden, a so–called Mouseion, a Museum, which however served all Nine Muses, as also Medicine, and a Serapeion, a temple of the supreme syn­cretistic god of that era (bearing traits of Osiris, Ploutōn, Zeus et al.). Each of them was adorned with a vast library. The Library of the Mouseion, well known as the Alexandrian Library, became the biggest libra­ry of the whole Antiquity. This library was for more than 600 years (300 BC-342 AD) the true Centre of Knowledge of the whole Antique World and included about 900,000 book–scrolls. There most renow­ned Scholars, Scientists, Writers and Physicians of all possible cultural backgrounds could assemble to study and to teach. The prestige of having studied in Alexandria concentrated numerous scholars, tea­chers and students, making of Alexandria the greatest city of the Hellenistic World. A contemporary rival centre of learning existed in Perghamos of Asia Minor, though only after 250 BC, during the reign of Eumenēs I. However, the Ptolemaic Pharaoh jealously guarded the supremacy of Alexandria by for­bidding the export of the papyrus plant or its products. It is said that because of this forced shortage of papyrus Perghamos developed a material derived from animal skin, subsequently called Perghamēnē, i. e.: parchment. Medicine flouri­shed extremely well both in Perghamos (mainly due to its famous Asklē­pieion) and of course in Alexan­dria, due firstly to the Mouseion and the consecutive concentration of knowledge, and secondly due to the possibility of dissecting human corpses. As mummification of the dead bodies was practiced for centu­ries in Egypt it was easy to extend dissection as a post mortem exa­mination. Anatomy and Surgery pro­spered enormously from these dissections, reaching their peaks with Galēnos of Perghamos, better known in the West as Galen (c. 130-200 AD) some centuries later. His treatises became the basis of me­dical knowledge for more than 1300 years. In our study we are go­ing to examine thoroughly the prin­cipal Medical and Surgical Schools of Alexandria, with emphasis on the work of Celsus (Kelsos), Pau­los of Aighina, Dēmētrios, Hērophilos, Erasistratos, Galēnos et al.