The Encephalocentrism vs Cardiocentrism Controversy
Baccheius took a deep breath, went outside and watched the sunset. If the sun set he might have never seen, experienced it like this again, but the risks involved had been worth it. Hoooking up the wires to his senses had been exhilarating. This had been the shortcut he had been thinking about, when he last talked with Strato. Instead of investigating, the effects of pneuma topere indirectly through instruments like Strato was doing, or by experimenting with prisoner or animals like Herophilos did he had instead opted to expose his own five senses to its raw, vital force. This brought him one step closer to his
On Peneuma Topere, that he wanted to write one day. Although he might have found a lucrative cure for erectile dysfunction.
The first chapters he already had finished in his head. He would first outline, the contributions of the great doctor that came before him. First and foremost there was Hippocrates of Kos, Alcmaaeon of Croton and obviously Herophilios of Alexandria.
Hippocrates Secularization of Medicine
Hippocrates revolutionized medicine, the same way Strato was trying to revolutionize philosophy in general, by supplanting superstition with natural explanations:
“
It is thus with regard to the disease called Sacred: it appears to me to be nowise more divine nor more sacred than other diseases, but has a natural cause from the originates like other affections. Men regard its nature and cause as divine from ignorance and wonder, because it is not at all like to other diseases. And this notion of its divinity is kept up by their inability to comprehend it, and the simplicity of the mode by which it is cured, for men are freed from it by purifications and incantations. But if it is reckoned divine because it is wonderful, instead of one there are many diseases which would be sacred; for, as I will show, there are others no less wonderful and prodigious, which nobody imagines to be sacred. The quotidian, tertian, and quartan fevers, seem to me no less sacred and divine in their origin than this disease, although they are not reckoned so wonderful. And I see men become mad and demented from no manifest cause, and at the same time doing many things out of place; and I have known many persons in sleep groaning and crying out, some in a state of suffocation, some jumping up and fleeing out of doors, and deprived of their reason until they awaken, and afterward becoming well and rational as before, although they be pale and weak; and this will happen not once but frequently. And there are many and various things of the like kind, which it would be tedious to state particularly.
They who first referred this malady to the gods appear to me to have been just such persons as the conjurors, purificators, mountebanks, and charlatans now are, who give themselves out for being excessively religious, and as knowing more than other people. Such persons, then, using [p. 356]the divinity as a pretext and screen of their own inability to of their own inability to afford any assistance, have given out that the disease is sacred, adding suitable reasons for this opinion, they have instituted a mode of treatment which is safe for themselves, namely, by applying purifications and incantations, and enforcing abstinence from baths and many articles of food which are unwholesome to men in diseases…..All these they enjoin with reference to its divinity, as if possessed of more knowledge, and announcing beforehand other causes so that if the person should recover, theirs would be the honor and credit; and if he should die, they would have a certain defense, as if the gods, and not they, were to blame, seeing they had administered nothing either to eat or drink as medicines, nor had overheated him with baths, so as to prove the cause of what had happened.”
Further in his treaty
On Sacred Disease Hippocrates went into a long winded explanation on the topic of the human brain. This however was something great progress had been made since the time of Hippocrates, mostly by his teacher Herophilios.
The Encephalocentrism vs Cardiocentrism Controversy
Herophilos was born in Chalcedon in Asia Minor. Like Baccheius himself his master was moving to Alexandria at a fairly young age to begin his schooling. There he learned his trade from Praxagoras of Kos. Like Hippocrates Praxagoras was a member of the Asclepiads a family descent from the god of healing Asklēpiós . He like most of the family member took up the trade of physician. Praxagoras was held in high regard by Herophilos ´but he made one major mistake in his opinion. He further spread one of the few major flaws in Aristotle’s work, trough the introduction of cardiocentrism in his medical school of Kos. Before it followed the tradition of Hippocratic encephalocentrism.
The groundwork for encephalocentrism had already been laid by Alcmaeon of Croton. Alcmaeon, son of Peirithous, lived in the Greek city of Croton on the instep of the boot of Italy. He wasn’t a traditional doctor however but more of a physikoi (1). He was the first to identify the brain as the seat of understanding and to distinguish understanding from perception. Alcmaeon thought that the sensory organs were connected to the brain by channels (
poroi) and may have discovered the
poroi connecting the eyes to the brain (i.e. the optic nerve) by excising the eyeball of an animal, although he didn't use dissection as a standard method like master Herophilos did. Alcmaeon “merely” understood that all the senses are connected in some way with the brain observing that the sense organs for sight, hearing, smell, and taste are located on the head and appear connected to passages which lead inward towards the brain by gouging out the eyes of an animal.
He regarded the eye as composed of water and fire and vision as taking place when what is seen is reflected in the gleaming and translucent part of the eye.
“Eye sees through the water round about. And the eye obviously has fire within for when one is struck [this fire] flashes out. Vision is due to the gleaming—that is to say, the transparent—character of that which [in the eye] reflects the object; and sight is the more perfect, the greater purity of this substance. All the senses are connected in some way with the brain.” [a blow on the eye produced “a flash within it” (2). He also came up with similar explanations for the other senses (3).
Hippocrates and his students among them his son Polybus, refined these initial ideas about medicine developed by Alcmaeon and tried to strip them of their speculative parts, replacing them with direct observation:
“
Whoever has been accustomed to listening to speakers who discuss the nature of man beyond the scope, which pertains to medicine, is not suitable for listening to my present lecture. For I do not insist at all that a human being is air or fire or water or earth, or anything else that does not appear to the senses to be existing in the human being (Polybus).”
How well they practiced this principle can be seen in the detailed description of the brain that was outlined in On Scared Disease:
“T
he brain of man, as in all other animals, is double, and a thin membrane divides it through the middle, and therefore the pain is not always in the same part of the head; for sometimes it is situated on either side, and sometimes the whole is affected; and veins run toward it from all parts of the body, many of which are small, but two are thick, the one from the liver, and the other from the spleen. And it is thus with regard to the one from the liver: a portion of it runs downward through the parts on the side,….(Hippocrates)”
Aristotle observing and recording his environement.
Herophilos vs Paraxagoras
The discovery of pneuma topere began with a strong diagnostic disagreement between Herophilos and his teacher Praxagoras (4). Underling the discussion was the age old question is the heart or the brain the seat “in charge” of the body. Many great man had discussed and disagreed on this this question like Alcmaeon and Empdocles, or more recently Plato and Aristotle. Plato followed the encephalocentric as he argued that the
“eyes, ears, tongue, hands, and feet act in accordance with the discernment of the brain”
But Aristotle observation and experiments (mis-)lead him on a different part. First he recognized that the heart moved and contained blood while the brain “
has the least blood and moisture of all the moist parts”. The heart was unlike the brain centrally located, and feels warm while the brain was distant and rather cold. Since people lose their “warmth” when they die, he saw a connection here as well. The body grows cold when the heart stops beating so the heart is the vital hearth of the body. Further the beating heart can be seen well before the brain in embryos.
Based on his extensive research in the comparative anatomy of many different species, he reasoned that not all animals capable of movement and sensation have a brain, but at least a heart, therefore the brain can’t be responsible for these functions. He also noticed that if an exposed brain of an injured person or animal was touched, it did not induce pain or any other sensation. He thus came to the conclusion that the brain is not engaged in perception of any kind. To protect the heart from overheating, Aristotle assigned the function of cooling the unremitting heart to the brain instead of any intellectual capacity.
Going Now Praxagoras inspired by Aristotle stated that palpitation, tremor and spasm are an affection of the arteries, differing not in kind but in size from the pulsating motion in them. For the pulse, Praxagoras said, occurs when the arteries are in a natural state, without any difficult circumstance. But when their motion is increased to an unnatural extent, spasm is caused in the first place, and secondly, following upon it, tremor, and thirdly palpitation is caused. All these affections differ from each other in size. Praxagoras did not qualitatively differentiate between pulsating motion and these affections of the body (i.e. spasm, tremor and palpitation) by connecting all of them with the arteries.
Herophilos, who had a more accurate knowledge of this topic thanks to pursuing state sanctioned human dissections, found their differences to lie in quality instead. For, his master says, pulse occurs only in the arteries and the heart, while palpitation and spasm and tremor occur in muscles as well as in nerves. And the pulse, he says, is born with an animal and dies with it, while these other motions do not. Also, the pulse, he says, occurs both when the arteries are filled and when they are emptied, while these others do not. And the pulse always attends us involuntarily, since it exists naturally, while the others are also within our power to choose, by pressing out and depressing the parts frequently
Praxagoras’ cardiocentric model of the human being however had a serious problem, because his model could not give an account of clinical cases in which some of these affections occur in some particular parts of the body, while the heart and the arteries are observed on the normality of the pulse to be functioning well. In other words, with a view to give a persuasive account of these cases, it is theoretical necessary to regard the system of muscles and nerves as essentially different from that of arteries, which have their origin in the heart. Still, brooding over the matter and seeking a way to decisively win this argument that Herophilos, made his fateful observation of electric fish.
People
Hippocrates of Kos (460 BCE – 370 BCE)
Herophilos of Chalcedon (335 BCE – 280 BCE)
Praxagoras of Kos (BCE 340-???)
Alcmaeon of Croton (510 BCE - ???)
Notes
(1) Pre-Socratic philosophy is ancient Greek philosophy before Socrates and schools contemporary to Socrates that were not influenced by him. In classical antiquity, the pre-socratic philosophers were called physiologoi (physical or natural philosophers). Aristotle called them physikoi ("physicists", after physis, "nature") because they sought natural explanations for phenomena, as opposed to the earlier theologoi (theologians), whose philosophical basis was supernatural.
(2) A phosphene is a phenomenon characterized by the experience of seeing light without light actually entering the eye. The word
phosphene comes from the Greek words
phos (light) and
phainein (to show. The most common phosphenes are pressure phosphenes, caused by rubbing or applying pressure on or near the closed eyes. The pressure mechanically stimulates the cells of the retina.
(3) Hearing is by means of the ears, he (Alcmaeon) says, because within them is an empty space, and this empty space resounds. A kind of noise is produced by the cavity, and the internal air re-echoes this sound. Smelling is by mean of the nostrils in connection with the act of respiration when one draws up the breath to the brain. By the tongue we discern tastes. Forsince it is warm and soft, the tongue dissolves [substances] with its heat; and because of its loose and yielding texture it readily receives and transmits [the savours]. (Theophrastus, 1917, p. 89)
(4) An OTL disagreement recorded by Galen. The big different an POD of this timeline is that Herophilos finds an igneous way to once and for all proof his point and as a little side effect discover electricity.
Sources
Stanford Encyclopedia of Philosophy; Alcmaeon
On the Nature of Man and On Sacred Disease by Hippocrates of Kos
Herophilus of Chalcedon (and the Hippocratic Tradition in Early Alexandrian Medicine by Mashiro Imai
Alcmaeon of Croton's Observations on Health, Brain, Mind, and Soul by Gastone G. Celesia
Minds Behind the Brain: A History of the Pioneers and Their Discoveries by Stanley Finger