Article abstract: Roman physician. Considered by many the greatest ancient physician after Hippocrates, Aretaeus wrote the best and most accurate descriptions of many diseases and made landmark studies of diabetes and neurological and mental disorders.
Not even the exact century of Aretaeus (ar-uh-TEE-uhs) of Cappadocia’s birth is known; most scholars agree on the second century c.e., although a few offer the first or third century. Aretaeus’s epithet is “Cappadocian,” implying that he was born in that most eastern of Roman provinces. No other information about his life is certain. Scholars conjecture, however, that he studied in Egypt at Alexandria, founded in 331 b.c.e. as the major center for medical study, research, and teaching. Aretaeus mentions Egypt in his works and describes its geography and some diseases and therapeutics unique to that country. Some scholars believe that Aretaeus also practiced medicine in Rome; he prescribed wines known to second century Rome—namely, Falernian, Fundian, Sequine, and Surrentine.
Aretaeus was an Eclectic by practice and a Pneumatist by training. After Hippocrates in the fifth century b.c.e. there was little advance in the knowledge of disease and its treatment, although there were significant gains at Alexandria in the area of anatomy because of the dissections of human bodies. Instead, post-Hippocratic physicians tended to theorize about medicine as a philosophy and to develop various schools of medicine. Dogmatism and Empiricism were the first schools. The Dogmatists employed theoretical principles; they believed that reason and systematic studies of anatomy and physiology were necessary for the physician. The Empiricists, on the other hand, rejected theory and anatomy; they stressed experience and observation. The “tripod” of the Empiricists’ knowledge was personal observation, researched historical observation, and use of analogy in analyzing unknown cases.
Two schools developed in reaction to the Dogmatists and Empiricists. Methodism, founded in the late first century b.c.e., rejected the theory of the humors so prevalent in Hippocratic medicine and advocated an atomic stance. The Methodists considered disease an interference of the normal position and motion of the atoms in the human body; treatments were prescribed to restore the proper order of the atoms—relaxants to counteract excessive tension, astringents to counteract excessive looseness.
The Pneumatic school, established around 50 c.e. by Athenaeus of Attaleia, stressed pneuma, meaning “vital air” or “breath.” The beliefs of the Pneumatists were a combination of the Stoic philosophy, with its emphasis on primordial matter, the pneuma, from which all life comes, and Hippocratic pathology. Disease occurs when an imbalance of the four humors (blood, phlegm, black bile, and yellow bile) disturbs the pneuma in the human body.
Each of these various schools had both strengths and glaring weaknesses in its theories and practices. The knowledge of these weaknesses, coupled with Roman common sense, which rejected the Greek love of theory, led most Roman physicians, beginning with Archigenes (fl. c. 100 c.e.), to pick and choose among the various doctrines and ideas of the four schools. Such physicians were called Eclectics. That Aretaeus was an Eclectic is obvious from his work: For example, although he followed Pneumatism in its concept of the vital breath and its relation to the four humors, Aretaeus pursued anatomy and physiology avidly, as the Dogmatists did, yet he also relied heavily on observation and experience in the manner of an Empiricist. His emphasis on simple regimens and treatments recalls the Methodist school as well as Hippocrates.
Aretaeus refused to be dogmatic and speculative. He attempted to describe diseases in clear, scientific, and rational terms, and his writings bear the marks of careful thought and extensive clinical experience. Aretaeus wrote seven works, two of which survive: Peri aition kai semeion oxeon kai chronion pathon (On the Causes and Symptoms of Acute and Chronic Diseases, 1856) and Oxeon kai chronion nouson therapeutikon biblion (Book on the Treatment of Acute and Chronic Diseases, 1856). The lost works discussed fevers, surgery, pharmacology, gynecology, and prophylaxis. Aretaeus wrote in Ionic Greek, a dialect that had not been in use for centuries; he chose the Ionic style to imitate Hippocrates, who also wrote in that dialect.
Aretaeus followed the Methodist classification of diseases into chronic and acute; the distinction was made on the course of the disease, that is, whether the disease lasted over a long period of time or was of a short duration and reached a “crisis” (the point in the progress of the disease when the patient recovered or died). Chronic diseases include paralysis, migraine headaches, and insanity, while examples of acute diseases are pneumonia, pleurisy, tetanus, and diphtheria. Aretaeus’s descriptions of these and other diseases show him to be an accurate observer who was concerned more for the patient than for theory itself. His accounts, so important in the history of...
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