The Byzantine Empire lasted for over 1100 years and the organization of a functional health care system was undeniable merit of Byzantine medicine.
Aetius of Amida
In Byzantium, hospitals functioned near monasteries. The administrative head of the entire institution was called the nosocomos. Two doctors and a lot of assistants, who learned, not helped, were working in each section.
Women were cared for by a woman doctor, and at night there was a service call.
Two inspectors were visiting the hospital day and night inquiring whether patients are satisfied or have any complaint to make.
Each hospital had a dispensary in which worked two doctors and a number of assistants.
There were specialized hospitals – e.g. hospital doctors in Mangane dealt exclusively with diseases of the digestive tract.
Nurses were instructed on the spot and formed health care professionals’ associations.
Doctors were trained in two ways, individually or in groups ie in school.
Generally, medical profession was transmitted from father to son.
Medical schools were established around hospitals and one of the doctors acted as a teacher. Students were practicing in hospitals or clinics. Education was free. Teachers were chosen very carefully and students had to accumulate a lot of experience before start practicing as physicians. This period of training was called kronia.
After the training, the student had to pass proficiency exam and answer question of a maestro, the head of the school or the emperor’s physician, bearing the title of actuarios.
The candidate who passed the examination received as a sign of promotion a medal or badge to distinguish himself from impostors.
Medical practice was based on the theory of the four humors.
In therapy, Byzantine physicians used, along with the old remedies, new exotic ones, made from the three regna. An important role was played by diet recommendations. There were used curative and preventive diets, but there were also exaggeration. Doctors used to recommend to their patients diets according to different seasons, months, professions or social class.
In order to master these diets and astrological data, doctors had to read a lot and collect many books. So, they had copies of classical medicine textbooks and many copybooks of diets and complicate recipes.
Hospitals sheltered vast libraries with valuable medical works.
Oribasius (c. 320 – 403)
No doubt, one of the famous Byzantine physicians was Oribasius, born in Pergamos, as Galenus, and received medical training under supervision of Zenon from Cyprus. He was the physician and friend of Flavius Claudius Julian, the Renegate.
At the Emperor’s request, a Medical books collection was created. It contained 70 books, but only 25 resisted through ages.
Alexander of Tralles (c. 525 – c. 605)
The greatest physician from the times of Galen until the Renaissance was probably Alexander of Tralles.
His work, 12 medical books, inspired medical schools in the Middle Ages, even if he criticized some opinions of Hippocrates and Galenus.
He studied medicine, in private, at Ephesus, Pergamus, Athens and, certainly, in Alexandria. After he finished studies, he arrived in Constantinople, where his brother Antemios, a well known engineer and mathematician, together with Isidor of Milet, was building famous church of Saint Sofia.
He inspired from Hipocrates’s work, who considered that the first mission of a doctor was to ease the illness by all the means.
Paul of Aegina (c. 625 – c. 690)
Alumni of Alexandria’s Medical School, Paul of Aegina was well-known as a great surgeon who practice nasal polyps’ extraction, catheterize of the bladder, tracheotomy. He was the one who gave the name of cancer – Karkinos, crab – to malignant tumors, because he differentiated them from the benign ones and discover that malignant tumors send branches as a crab’s pincers in the surrounding tissues. He treated breast cancers by excision, not by cauterization.
Paul from Aegina used rectal and vaginal speculum. In his days, medical art had no essential progress, but based on the known techniques it was improving.
He thought of the use of catheter to treat liver abscess and he described correctly the technique of lithotomy.
He remains in the history as an expert in lymph nodes surgery, superficial tumors surgery, uterine and breast tumors removal.
Only Abreviar medical, a 7 volume textbook wrote by Paul lasted till our days.
Aetius of Amida (end of the 5th century or beginning of the 6th)
Aetius of Amida was born in Mesopotamia and was trained in Alexandria. He became physician at imperial court of emperor Justinian. It is said that Aetius was the first Greek physician who embraced Christianity.
He knew very well the Asian remedies. He wrote a medical synthetic textbook with medical recipes and mineral, vegetal and animal remedies. He was the first doctor who used camphor and cloves in therapy.
His most important work is called Tetrabiblion and contains 16 books. It is Aetius’ worth to a better knowledge of surgical skills of Rufus of Ephesus and Leonidas, as well as of obstetrics and gynecological skills of Soran and Philumenos.
The best Aetius’s clinical descriptions were his observations on the diphtheria with suffocation, palate paralysis and regurgitation through the nose. He made the first description of brachial artery’s ligature in case of aneurism. He was interested in intestinal worm infestation.
Nicolaus Alexandrinos (Late 13th Century)
Nicolaus Alexandrinos was known as Myrepsos – “The one who makes ointmens”.
He wrote Dynameron, divided in 48 chapters, an important work containing 2656 drug formulations, as well as an important number of other pharmaceuticals remedies, based on their action.
Symeon Seth (c. 1035 – c. 1110)
Symeon Seth is the author of an encyclopedia of material medica – an alphabetical presentation of food beneficial effects. It contains an important number of remedies.
(Source: “The Byzantine physicians”, by M. Besciu, 2009)
Paul of Aegina
Research-Selection for NovoScriptorium: Maximus E. Niles