Ancient Greece — 500 BC to 100 AD


Ancient Greece was in its heyday from around 5th century BC to 2nd century AD. That period is commonly referred to as the classical period and events in it led to major and long-lasting advances in medicine and rhetoric.

Medicine in ancient Greece

The ancient Greeks had two main theories that they used to understand bodily functioning, to understand the source of disease, and to guide them in healing diseases. The first theory was that specific gods had the powers to create disease as well as to restore health. The second was a theory of humors, which originated in Greek notions that body was made of four basic elements black bile, yellow bile, phlegm and blood. When the humors were in balance the body was healthy. Diseases resulted from an excess or deficiency in one or more of the humors.

Asclepios, (8th C BC) a man who was among the first known physicians in Greece, eventually came to be worshipped a Greek god of health and disease. As a god he was considered to have powers even to raise the dead. Asclepios’ human son, Machaon, was also worshipped as the god—the god of surgery, and another son, Podalirios, was worshipped as the god of medicine. Like their father and brothers, Asclepios’s daughters, Hygeia, Panacea, and Iaso were also associated with health. Hygeia was the goddess of public health, Panacea was the goddess of therapy and Iaso was the goddess of cures, remedies and modes of healing.

The Asclepiades, an ancient guild of doctors from the 6th to the 2nd century Greece, was made up of devotees of Asclepios. By 200 BC every large town in Greece had a temple where people could go to cure their ailments and appeal for help from the god Asclepios and his devotees. Temples and centers associated with Asclepios, such as the one at Epidaurus on Greece's mainland, contained spas, overnight sleeping arrangements, and sites of entertainment, such as theatres. Pilgrims would stay over night at the temples. They would request a health cure from Asclepios and then sleep before an image of the god. The god would visit them in a dream, or his snake would come to them, and when the person awoke from their temple sleep they would either be cured or have their dream interpreted by Asclepean priest-doctors to identify a cure. The ancient Greek playwright Aristophanes in his play Plutos, describes how Asclepios cured a pilgrim/god of his blindness.

One aspect of the cure was that a priest/doctor would represent Asclepios and interpret the pilgrim’s dream so as to identify a cure. One rendering of this is found in Foucault (1975):

Every morning a certain Aesculapius has fifty or sixty patients in his waiting room; he listens to the complaints of each, arranges them into four lines, prescribes a bleeding for the first, a purge for the second a clyster for the third, and a change of air for the fourth (from Foucault, Birth of the clinic p. 15, quote from Zimmerman Traite de l’experience, Paris, 1800, vol 2, p. 122).

Besides appealing to the god, ancient Greeks also designed cures derived from their theory of humors. Humors, the fluids in the body, were seen by the ancient Greeks as basic to health and illness.

Hippocrates of Cos (460--360 B.C.) was a Greek physician who founded his practice on the theory of humors. He was very important in his time not only for his writings and theories, but for his school of medicine. The writings Hippocrates and his followers have been preserved to form what is today called the Hippocratic Corpus. In the corpus are depictions of histories and clinical observations. The primary treatments by those in the Hippocratic School included herbal medicines and blood letting. They focused on prevention and health prescribing healthy diets, baths, and applying hot and cold compresses. Hippocratic surgery involved suturing wounds, cutting to drain infections, and trephining (drilling a hole in the skull).

Hippocrates forwarded the idea that brain was the seat of sensation, thought, and emotions. His cephalocentric focus was a departure from previous theories, such as those forwarded by the Egyptians, that placed the heart in a key role of bodily governance.

Hippocrates used the theory of humors to understand bodily functioning and disease. He, like his fellow Grecians, saw the world as being made up of four elements: earth, air, fire, and water. These elements, he theorized, are also expressed within each person as four “cardinal humors”, black bile, blood, yellow bile (choler), and phlegm.

Weather and seasons associated with the four elements, were thought to create sickness and disrupt the balance of the humors. The cold in winters the body heat was lowered, causing phlegm to be produced. A flow of excess phlegm would result in colds and coughs. In the summer people got hot, resulting in more bile, and causing the symptoms of diarrhea and vomiting. Mania also occurred in summers, resulting from bile boiling in the brain. The pasty, phlegmatic peoples of the North were contrasted with the swarthy, hot, dry, ill natured-bilious Africans. Both were regarded as inferior to the even-tempered Greeks who lived in a temperate climate.

Each of the four basic elements were seen by Hippocrates as having two qualities (e.g., fire: hot and dry), and these qualities applied to the humors as well. For example, blood makes the body hot and wet. Choler or yellow bile was gastric juice. It serves digestion and makes the body hot and dry. Phlegm, a fluid that made up the colorless secretions of the body results in a cold and wet body and serves as a lubricant and coolant. Black bile is a dark liquid almost never found in pure form. It was seen as being responsible for darkening other fluids such as when the blood, skin, or stools blackened. It produced a cold and dry body.

Elements Seasons Qualities Humors Illness/Symptoms Temperament
Fire Summer Hot-dry Yellow bile Fever, Vomiting, Yellow skin Choleric
Earth Autumn Cold dry Black bile Dry skin, Vomiting Melancholy
Air Spring Hot-moist Blood Dysentery/Nose bleeds Sanguine
Water Winter Cold moist Phlegm Sneezing/colds Phlegmatic

Imbalance in the humors was seen as the source of disease, by Hippocrates and his followers. Symptoms of humor imbalance were seen as depending upon the amount of particular humor present in the system. Excess blood may cause a seizure, an apoplectic fit, mania, nose bleeds or dysentery. Poor blood quality or blood loss resulting from poor diet or injuries could lead to fainting, coma and even death. An excess of yellow bile could cause fever, vomiting, and yellow skin; an excess of black bile could cause dry skin and vomiting; and an excess of phlegm could cause sneezing or colds.

The humors were also seen as related to personality types or temperaments of individuals. Individuals were seen as having a unique natural balance or makeup of humors and qualities. A person whose temperament is based on blood is filled with energy. The result is a sanguine personality. Someone with a yellow bile temperament is bilious and choleric, showing a predilection toward anger. A melancholic temperament comes from an abundance of black bile. And a phlegmatic temperament results from an excess of phlegm.

Good health, according to those in the Hippocratic school, results when the humors are in balance with one another and in tune with one's constitutional nature and temperament--a condition Hippocrates and his followers called “being in temperament.” Conversely, the further one strays from this harmonious, balanced state of being in temperament, the more out of balance and unhealthy one becomes. This state of being out of balance with one's innate constitutional nature was called a distemperament.

The role of the Greek physician during Hippocrates time was to restore a balance to an imbalanced system. The doctors first made a determination through various examinations of whether the humors were in balance. For instance they examined the color and taste of the urine, inspected the feces, listened to the breathing, looked at temperature change, and asked the patient questions about their symptoms.

In order to restore the proper balance and remove excess humors, a patient might be made to sweat or to vomit or might be purged with laxatives, or starved. Blood letting, a practice developed by Hippocrates, was often done to draw off the excess of blood so as to restore balance. A bleeding cup was heated and placed over a scratch. The warmth drew blood to the surface of the skin and out through the scratch. Doctors used bleeding in the spring and summer, when it was thought that people had too much blood. They determined this from observation that people often became hot and red in the summer.

Trepanation, another method based on humor theory involved drilling a hole in the skull and draining out cranial fluids. In the Hippocratic corpus, Hippocrates described different types of skull fractures and laid out methods for the positive use of trepanation as well as its potential dangers (Missios, 2007).

Other humor-based preventions and remedies included dietary changes and herbal medicines. For example, to eliminate the excess of blood in the spring, when the weather got hot, recommendations were made to lower blood-rich foods like red meat.

Hippocratic treatments also included the application of poultices to wounds, gargles, eating pungent substances, massage with herbs, changes in diets, vigorous exercise.

Aristotle (384-322 BCE), the Greek philosopher, researcher, logician, and mathematician lived around the same time as Hippocrates. He, like Hippocrates, subscribed to humor theory. When construing causes of speech problems, Aristotle focused on how bodily temperature can create humor imbalance. Here is and example of Aristotle theorizing from within humor theory about why cold temperatures result in difficulty speaking:

Why does the tongue of men who are chilled stumble like that of a drunkard? Is it because it becomes congealed and hardened by cold and so is difficult to move, and when this occurs it cannot articulate clearly? Or is it because, when the outward parts thicken through cold, the moisture collects and soaks the tongue, wherefore the tongue cannot perform its own proper function... (Aristotle, 1957).

Plato, another Greek philosopher, was a student of Socrates and teacher of Aristotle. When considering the nature of speech, Plato’s focus was on the mind and on life forces, rather than bodily function associated with humor theory. Plato subscribed to pneuma theory (as did Aristotle). He saw life as involving three levels of pneuma or natural spirit or soul. All three levels arose from the vital organs. The pneuma of the body originated from god whose spirit was in the air. The inhaled air was transformed into the first form of pneuma. Another form of pneuma or natural spirit was in the veins, which moved with a tidal motion through the alimentary canal. When this venous fluid entered the heart it became transformed into a third, and higher form of pneuma, the “vital spirit.” This enriched pneuma passed to the base of the brain where it was again transformed into the highest form of pneuma—animal spirit. Animal spirit, the essence of life, was diffused through the body via the hollow nerves, according to Plato (Lorenz, 2009).

Another area of advancement in ancient Greece had to do with the use of plants for medicinal purposes. A leading figure in medical botany was Dioscorides, a Greek physician who lived during the first century AD. He grew up in Cilicia, modern southern Turkey and studied at nearby Tarsus, which was a center for the study of pharmacology. In about AD 65, after studying plants in their natural habitats and gaining practical experience on the medicinal uses of herbs, he wrote De Materia Medica. It was a five volume series "on the preparation, properties, and testing of drugs" (Preface, I). His book served as a basis for pharmaceutical and herbal use for 1500 years.

Oratory and rhetoric in ancient Greece

Speech in Ancient Greece was considered to be god-given. In Plato’s pneuma theory, for example, speech or logos flowed from the soul, or animal spirit. Plato used the term logos to refer not only to the spoken word but also of the unspoken word, the word still in the mind. When applied to the universe, logos was taken to mean rational principles that govern all things. Plato viewed speech and hearing as arising from such principles, and as having god given contents (Jowett, 1892).

The art of effective speaking was of valued tremendously in ancient Greece. In Homer's epic, the Iliad, the warrior, Achilles, was described as "a speaker of words" and "a doer of deeds." It was later in the 5th century BCE, during the period of radical democracy, that oratory became a means for Greeks who were not born into aristocratic families to become political leaders. They did this not result only through deeds but also through their rhetorical prowess.

Classical rhetoric developed along with democracy in Sicily in the 5th century BC. Rhetorical techniques were used by landowners to claim their land, after it had been dispossessed. Teachers of oratory were then hired to make the best arguments.

The early theoretical foundations of the discipline of rhetoric are drawn from the writings of Plato and Aristotle. They were interested in rhetoric because oratorical arguments based more on form rather than truth raised philosophical issues associated with language and morality. Aristotle, in his book on rhetoric, for example, argues that content is more important than delivery (Aristotle, 350 BC).

Oratory was not formally taught in Greece until the 5th century. A Sicilian orator, Corax, along with his pupil, Tisias, began a formal study of rhetoric. In 427 BCE, another Sicilian named Gorgias of Leontini, Sicily visited Athens and gave a speech, one that apparently dazzled his audience. Gorgias’s approach to oratory included new ideas, forms of expression, and methods of argument. His innovations were continued by Isocrates, an educator and rhetorician. Oratory eventually became a central subject of study in the formalized Greek education system.

Progymnasmata (Greek "fore-exercises’) are rhetorical exercises used by the ancient Greeks to familiarize those studying rhetoric with the elements of the discipline. Progymnasmata was the first step in one’s education before practicing full speeches (Gymnasmata) and before giving ones own speeches.

Three scholars associated with the creation of curricula for teaching progymnasmata were Hermogenes of Tarsus who wrote in the second century AD and Aphthonius of Antioch and Libanius of Antioch both of whom wrote in the fourth century AD (See next section for more on these two figures).

Aristotle also wrote extensively on rhetoric in his Rhetorica (Aristotle, 2010). His focus, generally was on persuasive discourse. He felt that in order for a speaker to be a good rhetor, he needed training in philosophy and psychology. Plato, Aristotle’s teacher focused, instead, on the importance for the rhetor to know men’s souls.

There were ten Greek orators who were selected by Aristophanes of Byzantium and Aristarcus of Samothrace as the best Attic orators and speech writers of classical Greece (5th century BCE–4th century BCE). The work of these ten orators inspired the later rhetorical movement of Atticism, an approach to speech composition emphasizing a simple rather than flowering oratory style (Asiatic). Among the ten was Demosthenes whom we will meet up with later when we talk about communication disability and its treatment (see below).

Disability in Ancient Greece

In ancient Greece those who were devalued (slaves, criminals, those with physical deformities) were sometimes expelled from the community. On the first day of the Thargelia, a festival of Apollo at Athens, two men, the Pharmakoi, were led out as if to be sacrificed as an expiation. Some scholars of the time say that they actually were sacrificed (thrown from a cliff or burned) and others contend that they were not killed but rather beaten or stoned. Aesop, the supposed creator of Aesop’s fables was said to be among those killed, but in Delphi, not Athens.

In Sparta, a Greek community on the Island of Peloponesus, the tolerance for difference was even more oppressive. All babies were brought to the tribe elder to be inspected for fitness to live in that society. Babies deemed fit were assigned to a training program to become a soldier. If considered unhealthy or deformed, babies were left on a mountain chasm at the foot of Mount Taygetos, just outside Sparta to die or in the marketplace for others to find and adopt.

There were three gods described in the Greek literature as having disabilities: Hephaestus, Thersites, and Teiresias. Hephaestus was a mythical Greek God of fire and artisans. His mother was Hera and his father was Zeus. He was lame, and his lameness was the source of humor in the Homeric texts, though his work was highly respected.

Thersites was a fictional figure described by Homer in the Illiad (book 2). He was said to be bow-legged and lame and to have shoulders that cave inward. His head was described covered in tufts of hair and as coming to a point. Vulgar, obscene, somewhat dull-witted, he called Agamemnon greedy and Achilles a coward, causing Odysseus to hit him with Agamemnon's sceptre.

And Teiresias was a prophet who was blind and who was affiliated Zeus. There are a variety of stories about how he became blind, most involving his being punished by the gods for revealing their secrets.

Aristotle believed that: those “born deaf become senseless and incapable of reason.”

Asclepiades of Bithynia advocated humane treatment for those with of mental disorders. He freed those previously imprisoned because of insanity, treating them instead with natural therapy methods such as diet and massages.

Rehabilitation and education in ancient Greece

The view in classical Greece that reason and speech were both divinely inspired led Plato to propose that knowledge was given or innate rather than acquired through the senses. This, in turn, led to Plato’s forwarding the educational use of Socratic dialogues in which a teacher, through dialogic questions, guides a student’s education—a method that might today be called self discovery or non-directive counseling (see Plato’s Meno for an example, Plato, 380 BCE).

Demosthenes (384-322 BCE) a Greek statesman, lawyer, and orator, achieved prominence in Ancient Greece through his exceptional oratory and political skills. His speeches concerned contemporary issues in Athens. Several hundred years later Plutarch, a Greek historian, wrote about how Demosthenes overcame his own speech problem.

Demetrius the Phalerian, tells us that he was informed by Demosthenes himself, now grown old, that the ways he made use of to remedy his natural bodily infirmities and defects were such as these; his inarticulate and stammering pronunciation he overcame and rendered more distinct by speaking with pebbles in his mouth; his voice he disciplined by declaiming and reciting speeches or verses when he was out of breath, while running or going up steep places; and that in his house he had a large looking-glass, before which he would stand and go through his exercises (Plutarch, 75 CE).

Demosthenes’s self-directed speech therapies reflect his beliefs that speech, like walking, was a physical act involving the coordination and strength of the muscles of the body. This construal was in keeping with the more general cultural view of the time that exercise produces a healthy body (Finney, 1966). Indeed, Finney has reported on a commonly adopted exercise of vociferation in which people vocalize loudly as part of a general exercise regimen. These remedies are in stark contrast to those emanating from the humor theory of Hippocrates and Aristotle and the pneuma theory of Plato.

Oratory was not formally taught in Greece as a formal subject until the 5th century. A Sicilian orator, Corax, along with his pupil, Tisias, developed a rhetoric course of study. In 427 BCE, another Sicilian named Gorgias of Leontini, Sicily visited Athens and gave a speech, one that apparently dazzled the audience. Gorgias’s approach to oratory included new ideas, forms of expression, and methods of argument. He was considered to be a sophist—a professional teacher. His innovations were continued by Isocrates, an educator and rhetorician. Oratory eventually became a central subject of study in the Greek education system.

Sophists were itinerant teachers in 5th century BC Greece, who provided education through paid lectures. Responding to the growing demand for education, these teachers were scattered throughout Greece. Sophists were identified as a professional class rather than as a coherent intellectual school. They taught subjects such as rhetoric, politics, grammar, etymology, history, physics, and mathematics. Early on they were seen as teachers of virtue in the sense that they taught people what they needed to know to take part in society.

Protagoras of Abdera (490-420 bc) is considered to be the first Sophist; after him the most important Sophists were Gorgias of Leontini, Prodicus of Ceos and Hippias of Elis. Wherever they appeared, especially in Athens, they were received with enthusiasm with people flocking to hear them. Even such people as Pericles, Euripides, and Socrates sought their company.

Some, sophists, like Protagoras, were respected thinkers. Others were lesser figures who focused more on teaching persuasive techniques than they did on teaching about the truth. Thrasymachus and Hippias, sophists who were skeptics, challenged the possibility of knowing the truth. Gorgias, also a skeptic, asserted that it was not necessary to have any knowledge of a subject to give satisfactory replies to questions about it. Thus, he answered any question on any subject instantly and without consideration.

Later Sophists taught their students a set of techniques that could be used to argue any position on any subject. They attained their goals of rhetorical persuasion by confusing their opponents, by harassing them with violence and noise and by dazzling them with flowery metaphors and unusual figures of speech. Their aim was to show their students how to appear clever and smart rather than how to convey truthfulness.