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What do we know about Erasistratus? Part 1
Abstract
The work of renowned 3rd century BC Alexandrian doctor Erasistratus is significant in the history of ancient medicine. The author of the article calls into question numerous assessments of his work, which have evolved in domestic and foreign historiography. The article summarizes Erasistratus’ views on medical theory and practice, using supporting sources. The author comes to the conclusion that the natural philosophical views of Erasistratus, unlike generally accepted views, were far from the teachings of the peripatetics, and suggests that the clinical practice of Erasistratus be considered as the basis for the future development of the teaching of the school of methodologists. The works of Galen are an important source of information about Erasistratus. Using a comprehensive analysis of these sources, a definite idea can be formed of the approaches of Erasistratus and his later followers to solutions for practical clinical problems. By comparing known data, it is possible to carry out a historically reliable reconstruction of the doctrine of Erasistratus. New sources introduced into Russian-language scientific discourse allow us to determine the continuity of the views of Chrysippus of Cnidus and Erasistratus. This, in a broader context, raises the question of the influence of atomistic natural philosophy on the medicine of antiquity in the 4th and 3rd centuries BC. The principal rejection of venotomy, the tactics of using pressure dressings and the patient's fasting as a means of combating the plethora were the key moments of the clinical tactics not only of Erasistratus, but of generations of members of certain ancient medical schools. This allows us to conclude that Herophilos and Erasistratus did not adhere to similar views on the theory and practice of medicine. It can be assumed that completely different fields of medical scientific thought were developed in Alexandria in the 3rd century BC.
... Nothing in it is superfluous, and if the purpose of any its parts or the meaning of a physiological process is unclear to a doctor, this is a cause for further research. There is nothing useless or unnecessary in the body of a living being, and there cannot be -such is the essence of one of Galen's fundamental disagreements with Erasistratus and his followers (Balalykin 2018a, Balalykin 2018b, Balalykin 2018c). ...
The heart is a sublime instrument of nature keenly touched by the emotions as well as by physical demands. It responds swiftly to fear, love, anxiety, illness, and exercise. As such it has played a central role in mysticism and religion and still does in many civilisations. However, whatever we may think of the role of the heart it is irrefutably a muscle pump. Until the wide acceptance of the circulation, postulated by William Harvey, and even after that time, in the absence of any understanding of the metabolism of the body, it was considered the source of body heat, heating the blood by churning it within and between the ventricles. The Galenic theory required a degree of valve incompetence to allow mixing and churning of the blood which through friction generated heat. However, some two millennia earlier philosophers such as Erasistratus, recognised that the presence of the valves prevented the free reflux of blood. Indeed, this trans-generational inconsistency of thought about the role of the valves inhibited rational thought and understanding. One man, Leonardo da Vinci recognised their real role but never published his work. Once the theory of circulation became accepted the fundamental need for competent heart valves was made. However, it has only been in very recent times that the integrated nature of function between the atrioventricular valves, in particular the Mitral valve, and the ventricle, as a machine complex has been realised. Each needs the other for complete function. This chapter reviews the progress in knowledge towards this more complete understanding of the functional anatomy of the mitral valve.
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