Greek Colonies in Italy, Early Healthcare, and Guinea Worms

"About things invisible, and things mortal, the Gods alone have a certain knowledge; but men may form conjectures"

                                -Alcmaeon (quoted by Diogenes Laertius)

Crotone, Italy today

Near the southern end of the Italy, on the 'sole' of the boot, in the region of Calabria, is the small city of Crotone with a population of a little more than 61,000.  Crotone is a pleasant little city with white-sand beaches on one side and a backdrop of rolling hills in the other side.  Two of the biggest tourist attractions are the 16th century Castle of Charles V and a 9th to 11th century Cathedral dedicated to Our Lady of Capocolonna, the patron saint of Crotone.  To find out about Crotone's earliest history, you can visit the city's Archaeological Museum, and here you will find out that Crotone (or Croton, or sometimes Kroton) was an important city of Magna Grecia, a region of southern Italy fist colonized by Greeks in 6th and 5th century.  "Magna Grecia"  was the phrase that Romans called the Greek colonial cities. The Greeks colonized the coastal areas of southern Italy from the Gulf of Taranto to Sicily.  Other colonial cities include Syracuse on the island of Sicily, one the largest  Greek cities, Elea on the west coast of Italy and Neapolis (later Naples), the northernmost of the Greek colonies which acted as buffer to the Etruscans.

The Greek colonies were a response to population pressure from mainland Greece, the Greek islands, and the Turkish coast. The commercial and economic boom of ancient Greece from 800 to 700 BC had led to exponential population growth, forcing many farmers to cities to take up other occupations. Most of the land the Greeks occupied was not well suited for farming anyway, with mountain ridges and clefts in rocky terrain surrounded by sea water for the most part.  When a male landowner died, the land was traditionally divided between sons, but with smaller and smaller plots, the eldest son often fought off his younger brothers, and the younger brothers were forced to emigrate.  The poet Hesiod was from Boeotia and was a victim of swindling from an older brother, which he describes in his Works and Days : 

Our inheritance was divided; but there is so much you grabbed and carried away as a fat bribe for gift-devouring kings, fools who want to be judges in this trial.

Just as the industrial revolution in the 1700s and 1800s led to population explosions in Europe and drove thousands of Europeans out of Europe, a smaller-scale industrial revolution drove hundreds of Greeks, both rich and poor, out of the Greece.  Many of the people sought a better life in the colonial Greek cities of southern Italy.
 

The Greek colonial city of Croton was the home of Pythagoras, the Greek philosopher-mathematician, after he immigrated from his birthplace of Somos, an island off the coast of present-day Turkey.  Pythagoras, and many of his followers, flourished in Croton, and influenced the political and philosophical climate with a 'school' of philosophy.  Ancient Croton was famous for another 'school', as well; it's medical school.  Back then, colleges did not have ivy-covered brick buildings and well-manicured lawns, but they were, rather, colleges in the old-fashioned sense of the term: a group of people with certain skills that they taught and passed along to others. Education was apprentice-based.  

One of the most famous physicians to 'graduate' from Croton's medical school was a man named Democedes. We are told a great deal of detail of Democedes' life by the Greek writer Herodotus, primarily because he was the personal physician to the tyrant of Samos before being captured and enslaved by the Persian king Darius.  After relieving the pain from the king's sprained ankle, he became his personal physician as well, at least until he escaped back to Croton. 

Alcmaeon
Another well-known physician from Croton was a Greek man by the name of Alcmaeon, although Alcmaeon may have been a philosopher, and possibly a Pythagorean, who took an interest in medical science.  No one seems to be quite sure if he actually 'practiced' medicine. Back then, knowledge had not yet been channeled off into different disciplines. Alcmaeon wrote at least one book, but none of his complete writing survived.  Much of what we know about him comes from Iamblichus, in his book on the Pythagoreans. It is because Iamblichus lists Alcmaeon as a Pythagorean, that most people think he was one, but there are some scholars who disagree. Alcmaeon comes up often enough in references of other later Greek and Roman writers, among them Aristotle, the "father of botany" Theophrastus, and even Diogenes Laertius includes a short essay on him in his Lives of Eminent Greek Philosophers.

Diagram showing the optic
nerve from a 1922 editon
of Gray's Anatomy

One 4th century writer, Chalcidius, in a commentary on Plato's Timaeus, credits Alcmaeon as the "first to undertake dissection" so Alcmaeon is often considered to be the first to dissect human cadavers.  It is unlikely, however, that he did so, because, up until the Renaissance, most people held the dead in such veneration that they left bodies of dead humans alone.  This veneration did not, however, extend to other animals.  Vivisections were common.  Even before evolution, most physicians recognized that humans were like other animals in many respects, and our resemblance to other mammals made them ideal for anatomical comparisons.  The Barbary apes (monkeys, actually) of southern Spain were an especially favored test animal of Greek and Roman anatomists.

Diagram showing Eustachian tube

Among the discoveries Alcmaeon was given credit for is the optic nerve, a large bundle of nerve fibers that connects the eye to the brain.  He also understood the connection between other sense organs and the brain, and that was probably why he thought the brain is the center of intellectual activity.  Many people at the time thought the heart and the gut were the intellectual and emotional centers and the brain was merely a cooling device, like a radiator. Alcmaeon was also credited with discovering the Eustachian tubes, the cavity that connects the ear with the oral cavity and the source of the most common ailments in children, ear aches, although it is named after an Italian anatomist who rediscovered it some 2000 years later.

Alcmaeon also distinguished arteries from veins and made some of the first observations on embryology, noticing that the brain was the first organ to develop. Alcmaeon is credited with so many discoveries that it may lead one to suspect that he may not have, in fact, discovered anything new but merely wrote down what had already been known.  Alcmaeon may instead be the author of the first medical encyclopedia.

Asclepius
The physician often considered to be the father of Medicine is a Greek physician from the 4th century BC by the name Hippocrates.  Long before Hippocrates however, physicians provided services, conducted research, and even wrote about medicine, not only in Greece, but also in Egypt, China and Mesopotamia.  There is evidence that even prehistoric shamans practiced minor surgery. In some regards, the myths about heroes and gods giving humans the art of medicine come closer to the true origins of medicine.  In Egyptian mythology, Imhotep is the semi-legendary figure who 'starting it all'. According to Greek mythology, Asclepius, a son of the god Apollo, is the god of medicine who taught humans the medical arts.  The father of Democedes, Croton's most famous physician, was a priest from a temple dedicated to Asclepius. Some historians speculate that Asclepius may have been a real person who lived some time in the Homeric 'dark ages', but he could have just as likely been a personification of hundreds of early physicians, shaman, and healers. 

The 'rod of Asclepius' remains to this day a symbol of medicine.  It is found on a wide variety of logos for health-care organizations around the world. The 'rod' is thought to be a staff and always has a snake (or sometimes 2 snakes) wrapped around it. The origins of Asclepius' rod is  mystery but there is one interesting hypothesis.  There were certain diseases and ailments that were much more common and widespread in the ancient world then there are now.  Parasites in particular were more common in areas and at times when water treatment facilities were lacking.  Many of those parasites were worms.  In fact, worms were such a problem to early humans and our hominid ancestors, that the human immune system's first line of defense is a host of proteins and antibodies that may have been specifically designed to protect us from parasitic worms.  These same antibodies are the main culprit that cause allergies.  Allergies may then be an evolutionary legacy of our early relationship with parasitic worms.

One of those parasitic worms is something called the Guinea worm.  The Guinea worms enter it's host as larvae when the host drinks contaminated water.  Eventually the worms find their way into connective tissue, usually skin, bones and related tissue, and often appear as painful blisters on the surface of the skin.  Despite it's ancient origins, there is still no vaccine and medical treatment. The only known treatment was to tease out the tip of the worm and wrap it around a stick or small rod a little at a time, since pulling it would only break it and may worsen the infection.  It was (and is) a long and painful procedure, often taking days.  The worm in it's adult stage can grow up to three feet long. Thanks to modern sanitation, the Guinea worm is no longer widespread, but it still afflicts people in a region of sub-Sahara Africa from west Africa to the Sudan, and about half the cases are in the Sudan.

At one time, however, the disease was quite common. The procedure using a small rod to remove the worm was described in one of the earliest known medical documents, the Egyptian Ebers Papyrus. The rod of Asclepius may be a stylized version of the rod used to extract the worm, and the 'snake' was actually a Guinea worm.  The rod could have been used as a symbol to advertise a doctor's service, using one of the most important procedures as a form of promotion.

Further Reading

Carter Center.  2011. Nigeria, Niger Receive Carter Awards for Guinea Worm Eradication. Feb. 17.

Foca, A. 2002. "The Origin of Experimental Medicine in the School of Alcmaeon from Kroton and the Diffusion of His Philosophy within the Mediterranean Area". Skepsis 13-14: 242–253.