ABSTRACT
Few episodes in the history of ancient medicine have been so well studied as the rise and development of human anatomy in the first half of the third century BC.1 Herophilus and Erasistratus are rightly famous for their pioneering investigations that, for the first time in the Western tradition of medicine, revealed many of the hidden structures of the human body.2 But this concentration solely or even largely upon the achievements of these two men in anatomy and physiology is not without its dangers. There is a tendency to forget that their dissections were performed within the wider pattern of their activity as physicians, and, even more, that what might be termed investigative or experimental anatomy based on human beings was carried out only for a limited period and in a limited area.3 Although anatomical demonstration by means of a skeleton or surface musculature continued longer in medical teaching, especially at Alexandria, anatomical experimentation, whether using humans or animals, seems to have died out well before the end of the third century BC and not to have been revived until the late first or early second century AD.4 When discussions of anatomical and, especially, physiological phenomena appear in later Hellenistic texts, they are largely, if not entirely, based either on chance observation or on the data provided by these early anatomists. The achievements of Herophilus, Erasistratus and the less familiar Eudemus thus mark not only the beginning of Greek human anatomy but also, paradoxically, its ending, leaving historians to account for its restricted temporal and geographical development. As we have seen, the second half of the fourth century BC saw a vigorous interest in describing and interpreting a wide range of diverse natural phenomena. Aristotle and his followers, to say nothing of Diocles, had dissected animals, birds and fishes to gain a wider understanding of the world of nature, while Praxagoras’ investigations into and speculations about the pulse led to further consideration of the physiological processes within the body.5 Euenor, an Acarnanian doctor resident in Athens in the 320s, is said to have called the horns of the uterus the ‘coils’, although whether this was as a result of animal dissection or his experience with difficult births is far from clear.6 The theories of these medical thinkers were elaborated with the aid of reason,
but within a new epistemological space, that of the visible.7 The influence of these developments on the anatomists of early Alexandria can be easily surmised. Herophilus is said to have been a pupil of Praxagoras, presumably on Cos, and tradition linked Erasistratus with the school of Aristotle through his alleged master, Theophrastus of Eresus.8 At one level, then, the decision to cut into a human body is an understandable extension of a technique of investigation that had become relatively commonplace in Greek intellectual circles; from seeing the internal structures of a bird or a sheep to seeing those of a human being had thus become a small step.9 But it was a step fraught with problems, not least because it breached a long-standing Greek taboo on touching, let alone mutilating, a human corpse. Religious laws imposed a ban on interfering with a dead body, and continued to do so in Greece long after the arrival of human anatomy.10 Although by now it was widely believed, especially among intellectuals, that the soul was something transient and immaterial, residing merely temporarily within the body and leaving it, at death, an empty physical shell, this view was not accepted by most Greeks, for whom the corpse continued to represent an individual human being.11 Studies of the introduction of human dissection into Renaissance Europe and elsewhere have revealed the strength of the reluctance to interfere with a human corpse, and there can be little doubt that such a repugnance was also widespread among the Greeks.12 But there was one area of the ancient world where this taboo apparently did not exist. The Greeks had been familiar since the days of Herodotus, if not long before then, with the common practice among the Egyptians of removing the major organs of the dead and storing them in large jars before proceeding to mummify the body. Herodotus expresses a mixture of fascination and disgust at this strange procedure, and other travellers sent back similar reports.13 Alexander the Great’s conquest of Egypt in 332-331 BC brought the Egyptians under Greek rule, and his foundation of the city of Alexandria ‘by Egypt’, just west of one of the mouths of the Nile, was a symbol of Greek domination. This was a Greek city, created to be a military as well as a political strong point in the newly acquired land. Although it later became a cosmopolitan giant, in its earliest years the relationship between the Greeks and the native Egyptians was far from equal. The Greeks were firmly in control; the administration, economy and culture of the city were entirely in their hands; and for a long while native Egyptians were barred from obtaining Alexandrian citizenship.14 Added to the common Greek urban prejudice against those who lived and worked in the countryside, this would have helped to create an apartheid mentality, which regarded the natives, and particularly Egyptian peasants, as almost sub-human. If they showed no abhorrence at what was, to Greek eyes, the mutilation and desecration of their own dead, there was little reason why the Greeks should be concerned about what happened to Egyptian corpses.15 Whether Herophilus or Erasistratus owed anything more to Egyptian mummifiers than the freedom from the Greek taboo is controversial. Those
who seek a non-Greek origin for human anatomy and for an understanding of the internal organs of the body can rightly point to the sophisticated Egyptian anatomical vocabulary and to the technique of the Egyptian mummifiers in opening up the body.16 But there is no clear evidence that Egyptian mummifiers carried out any systematic investigations into the human organs they removed or that their cutting open of the corpse served any purpose other than the ritual preparation for burial.17 Egyptian medical authors and practitioners, if one may judge from what little survives of their medical texts, did not make use of the information provided by the removal of bodily organs to create new theories or provide further justification for old ones. While there was nothing to stop Greek anatomists from observing Egyptian mummifiers in action, without an interpreter to explain what was being done (for the Greeks were notoriously reluctant to learn the language of others) many of the details of their procedures would have remained obscure.18 Contacts between leading Greek intellectuals and Egyptians in early Alexandria were slight at best, and, even as these developed over time, no evidence for any linkage between medicine and mummification emerges. Mummifiers and medics remained separate professional groups.19 At most, then, the Egyptian practice of mummification would have provided an encouragement to break a Greek taboo in pursuit of an intellectual challenge that had been foreshadowed in medical and scientific discussions for at least a generation. Alexandria under the early Ptolemies offered a remarkably supportive environment for intellectual innovation.20 The example of Aristotle in his close relationship with Philip of Macedon and Alexander undoubtedly encouraged their successor monarchs to invest in culture and science. The new courts, especially in Alexandria, Antioch and, later, Pergamum, attracted intellectuals of all kinds, poets, sculptors, mathematicians and doctors. Their presence should not be taken simply as a sign of a disinterested love of culture on the part of the ruler: it served also more practical purposes – propaganda, warfare and the supervision of his general health.21 When the savage persecutions of the Alexandrians by Ptolemy VIII in 145-144 BC drove many intellectuals to become refugees, they were eagerly welcomed elsewhere in the Greek world, with the result that, as one contemporary put it, Alexandria became the teacher of Greeks and barbarians alike.22 It was Ptolemy I who, perhaps around 300 BC, established the two intellectual institutions that gave Alexandria its great reputation as a cultural centre, the Museum and the Library (or rather libraries, since there was more than one in the city). If Galen is to be believed, Ptolemy endeavoured to obtain by fair means or foul copies of everything written that he could find. Once in Alexandria they were placed in one of the royal libraries, where they were catalogued by a distinguished series of scholar-librarians. It was probably in Alexandria, as part of this process, that the writings that form our Hippocratic Corpus were first brought together.23
