Alexandria Medical School

Following the conquests of Alexander the Great (356-323 BC) and the formation of new kingdoms by his successors, the center of Greek learning and medicine shifted from Athens and the Greek Islands to Alexandria in Egypt.

A famous medical school was established in old Alexandria during the third century BC. The Alexandria medical school introduced the notion that the level of understanding was dependent upon the detail of the observation.

The medical school was dominated by the ‘empirical’ outlook represented by Serapion of Alexandria (220 BC).

Anatomy was particularly advanced due to the possibility of dissecting the human body. Among the doctors attracted to work at Alexandria two were outstanding - Herophilus of Chalcedon and Erasistratus of Ceos.

Herophilus of Chalcedon

Herophilus, the Elder, moved to Alexandria after initial training under Praxagoras. His greatest contributions to medical research were largely in anatomy and he conducted important investigations, based at times on human dissection, into the brain and nervous system, the vascular system, the liver, the eye and the reproductive organs.

Many graduates of this medical school traveled and practiced throughout the Mediterranean basin. Galen (131-210 AD), born of Greek parents in the region that is now Turkey, was influenced by the teachings of Alexandria and Greek schools of thought. He later moved to Rome where he developed a considerable following, Galen wrote over five hundred medical treatises of which over one hundred have survived into modern times.

The medical school of Alexandria was still active until late in the 3rd century AD. However, it slipped slowly into oblivion after the fire of 389 AD, which also devastated its famous library.
Alexandria Medical School

Retinal anatomy

The retina was first described by Herophilus of Chalcedon around 300 BC. It was named by Rufos of Ephesus (c, 110 AD) and appeared to early anatomists as a surrounding net which supported the vitreous.

Herophilus of Chalcedon was one of only two scientists (the other one being Erasistratus of Ceos) to perform systematic scientific dissections of human cadavers. The sensitive layer at the back of the eye seemed to him rather like a spider’s web. Hence he named it the amphiblestroides, the Latin translation of which is ‘retina’.

Though Galen noted structural similarities to the brain, he was unable to provide further understanding regarding its function.

For Galen, the crystalline lens was the ‘receptive organ’ of the eye, while the retina was an organ of nutrition and conveyors of visual spirits to and from the lens.

Galen emphasized the similarities between the retina and the brain and maintained that the retina and optic nerves were really displaced parts of the brain.

Apparently, William Briggs in 1685 first illustrated the fibrous nature of the retina. Briggs trained as a physicist and wrote several texts on the anatomy of the eye.

It was Johannes Kepler who first suggested that the retina served as the eye’s primary photoreceptor tissue. By using alcohol fixation, Treviranus in 1835 performed the first detailed microscopic retinal studies.

A better understanding of the structure of the retina came after 1840 the year in which Adolph Hannover began to use chromic acid to harden tissue, in order to slice thinner sections.

He then described the receptors as facing away from the vitreous chamber and identified and numbered the principle layers of the retina.

Only with the subsequent development of electron microscopy, trypsin digest, clinical fluorescein angiography, and optical coherence tomography have scientists been able to understand the retinal’s cellular connections, ultra-structure and retinal vasculature, as well as correlate anatomical and clinical findings.
Retinal anatomy

Father of Anatomy – Herophilus of Chalcedon (335-280 BC)

Often called the father of anatomy. Herophilus of Chalcedon was a well respected physicians and teacher of medicine in Alexandria.

Herophilus was born at Chalcedon, Greek city on the Propontus, nearly opposite to Byzantium.

Herophilus received his early training as physician from Chrysippus, a widely known Stoie philosopher, who had taught at the school of Cnidus and had also written on medical topics.

Herophilus showed a decided learning toward the study of anatomy. He was the pupil of Praxagoras of Cos. He was an original investigator and the first of the Hippocratic school to distinguish himself as an anatomist.

Herophilus lived during a period in Greek medical history when human dissection was allowed, and he greatly advanced the study of scientific anatomy through his extensive dissections of human cadavers.

He experimented on living animals and even on condemned criminals placed at his disposal in the prisons.

Some of the books written by Herophilus have been used for several centuries but only a few fragments from his texts have survived.

He had a good picture of the nervous system, including the connection between the brain, spinal cord and nerves.

He argued that the brain was the center of the nervous system, rejecting Aristotle’s claim that the heart was the seat of intelligence.
Father of Anatomy – Herophilus of Chalcedon (335-280 BC)

Aristotle and the end of Athens

Aristotle and the end of Athens
Aristotle (384-322 BC) followed closely after Hippocrates and although not himself a physician, had a profound effect on medical thought and practice for succeeding centuries.

Indeed he can regarded as one of the greatest scientific geniuses the world has ever seen. Aristotle was the son of a physician, and a pupil of Plato; later he became tutor to the young Alexander the Great.

Although Aristotle never dissected a human being, he carried out anatomical studies of a wide range of animals, laid the foundation of embryology by studying the developing chick, and gave an accurate account of the life of bees.

He laid the basis of the doctrine of evolution, describe a ladder of nature ascending through lower plants, higher plants, insects, fish, mammals to man.

Soon after the deaths of Hippocrates and Aristotle. The great days of Athens drew to an end. The Macedonian, Alexander the Great the pupil of Aristotle conquered Greece, Asia Minor and Egypt, marched through Persia and reached India.

In his progress he founded a string of at least 17 Alexandria but it was Alexandria of Egypt that was by far the most important.

After the death of Alexander, one of his generals, Ptolemy declared himself Pharaoh, took up residence in Alexandria and there founded a great medical school and library at about 300 BC; into these institutions were imported scientist, mainly from Greece.

Unfortunately the vast library said to have contained some 700 000 manuscripts, was burned by a mob of fanatics intent on destroying the past, a phenomenon not unknown in later periods of history.

We have to rely, therefore on the writings of Galen and other authors to learn something of the Alexandria school of medicine.

Of particular fame were two surgeons, Herophilos and Erasistratos, both of whom flourished around 300 BC.

Their most important contribution was systematic dissection of human bodies; indeed, Celsus states that they actually performed vivisections on condemned criminals.

Herophilus named the duodenum and prostate and established the brain as the center of consciousness; his name survives in one of the venous sinuses of the brain.

Erasistratos is regarded by some as the founder of physiology; he distinguished the cerebrum from the cerebellum, noted the difference between sensory and motor nerves, and gave a good description of the heart valves.

With the absorption of Egypt into Roman Empire in 50 BC and with death of Cleopatra in 30 BC, marking the end of the Ptolemaic dynasty, Alexandria ceased to have medical influence and Rome became of central importance.
Aristotle and the end of Athens