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E - 42 : When Medicine became Science

On our third last day, we are going to visit Epidavros with its magnificent 14’000 seats big amphitheater. Always wondered what such a large structure was doing in the middle of nowhere. In Syracuse, a theatre of similar size was sufficient for 200’000 people. Where there 175’000 people living in Epidavros? Looking around this is difficult to imagine.

The theatre of Epidavros - even in the top seats you clearly understand the spoken word

Digging a bit further, I found out that Epidavros was looted and partially destroyed by the Roman General Sulla in 87 BC. It had to be rebuilt and the Romans added at one point 8’000 more seats on top of the existing 6’000. Still, this translates into a Greek town of 75’000 people. Far too big for this place.

Epidavros was actually not in the middle of nowhere but was ancient Greece’s center of healthcare and healing. It was a prominent place. In the evenings, patients had nothing to do and probably looked for entertainment. Assuming that 24% of residents and guests went to see the daily performances instead of 8% as in Syracuse, the town size would drop to 25’000 people - a more reasonable and probably realistic number.

Epidavros Site Plan - only a good third of the ancient settlement is already excavated

Why did Greek people come to Epidavros in the first place? To get better of course. But what did they come for? On closer look, Epidavros looks like Lourdes. People came from all corners of Greece when there was no cure and no hope left. They must have walked for days and weeks. In Lourdes the pilgrims immerse into the holy, freezing cold water, in Epidavros they were fed essences to ease their pain.

The Godess Demeter bearing barley and poppy heads

From archeology digs in the vicinity of Epidavros we know that the area was settled since the early bronze age - around 4’000 BC. Pottery shards indicate that poppy seeds (opium) hemp (pot), deadly nightshade (alkaloids) and other herbs were widely used. Greeks also experimented with the healing properties of venom and poisons. It must have been these plants and the pharmacological knowledge of the people living in these hills which attracted the first visitors. Many people came to Epidavros to pass away without further pain. Suicide with the help of drugs was not taboo in Greek culture. We also know that many women came here to deliver their babies. Maternal mortality rates were high in ancient times – around 2% of mothers died in childbirth. Relaxing drugs made the delivery easier.

Asklepios - the Greek God of Healing

Legend has it differently. Mount Titthion behind Epidavros was apparently the birthplace of Asklepios, the son of Apollo and his lover Koronis. He was found by a shepherd’s dog and saved by the dog’s master with goat milk. Apollo sent occasionally a centaur to look after him. The centaur taught him how to heal people by using snake venom and other drugs. For this reason, Asklepios is often portrait with a dog and a snake. Since then, healing centers all over Greece were called Asclepeions. By the 6th century the Asklepios – Apollo cult was in full swing in Epidavros. People pilgrimed here to pray for their healing, offer sacrifices to the two Gods but also to consult with doctors and pharmacologists.

Nobody really knows how Hippocrates looked like

But there are many busts of him :-)

Before the time of Hippocrates (460 – 370 BC), medicine was not a unified discipline. There were surgeons for wounds from accidents and wars, pharmacologists for all types of drugs and doctors for diseases and illnesses. The site of Epidavros straddles an important transition in the history of medicine when these three disciplines merge. It all happened with the School of Hippocrates from Kos the island close to Bodrum. Rather than praying to the Gods, Hippocrates and his disciples started to systematically describe diseases and relate recognized symptoms to actual illnesses. These doctors carefully documented their observation and daily monitored pulse, fever, complexion, and pain. They started to classify illnesses into acute, chronic, endemic, and epidemic. In a further step, they combined their knowledge of anatomy with disease pattern and so discovered cancer. The School of Hippocrates eventually developed the theory of the four humors ( which had to be kept in balance to live a healthy life. I will cover the School of Hippocrates in more details next year when we visit Hippocrates' home island of Kos.

The oath of Hippocrates in a Byzantine Text around the 12th century

Epidavros was for one reason critical for the development of modern medicine. With so many visitors, doctors treated a critical mass of patients. This allowed them to recognise repeating disease pattern as well as finding out through trial and error which medical herbs were effective. Our entire knowledge of herbal medicine is based on these early trials.

We all know of Hippocrates from his famous oath which is still sworn by our doctors upon graduation. The vast body of his and his disciples’ work also survived in the Hippocratic Corpus which was composed from the writings of Hippocrates and 19 other disciples.

The acoustics in the theatre of Epidavros are great – to know that this place greatly contributed to the development of modern medicine is even greater.

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