1.The Contradictive Tendencies in Medical Treatment of the Hellenistic Age: Diversity versus Simplification, Chronic Extension(Physical Therapy) versus Rapidity, Humane Medicine versus Worldly Success.
Korean Journal of Medical History 2008;17(1):1-22
It is a one-sided view to find the greatness of Hippocrates just in seeking after scientific medicine(medicina scientia) and sublating superstitious treatment. The scientific medicine did not begin with him, and the succeeding generations of him were not one and the same in opinions. For example, there were the confrontations between the school of Kos and that of Knidos in the very age of Hippocrates, as well as the opposition of rationalism and empiricism. The school of Kos was alleged to succeed the tradition of Hippocrates, taking into consideration individual physical conditions and being based on the principle of various clinical methods of physical therapy assuming chronical extension. On the contrary, the school of Knidos tended to define the diseases in simple aspects, paying no much attention to the difference of physical conditions and developmental stages of illness. Futhermore, the latter grasped the diseases rather in the point of individual organs than the disorder of physical state of the body. It can be said that the anatomical knowledge was more useful for the school of Knidos. The difference between the two schools can also be found in what purpose the medicine sought after. While Hippocrates attached much importance to physical therapy and made the people including the poor as object of medical treatment. there were doctors in no small number, we can suppose, in pursuit of money, power, worldly glory. As time passed, however, the two schools gradually got similar to each other, the difference of them reduced as well as the tradition of Hippocrates faded. The opposition between rationalism and empiricism in the Hellenistic Age shared, in some aspect, the difference of Kos and Knidos. According to Celsus, the conflict between rationalism and empiricism did not refer to pharmacy or anatomy, but just to diet. The rationalism materialized various methods of therapy considering environmental elements as well as individual physical conditions, but the empiricism in reality tended to expedite simplification of treatment. This tendency of simplification of the latter corresponded to the contemporary need of society, that is, speedy and effective treatment for the wounded in war or for epidemic in the army, farms of collective labour or much crowded cities. The bigger the groups were, the more the methods of treatment got simplified, individual conditions not much accounted. Then, the empiricism came to be united with anatomy, as the anatomy, being much developed in the process of curing the wounded in war, goes with simplification of medical treatment in the hospital of large scale. It can be said that the origin of simplified definition of diseases goes back far to the school of Knidos. On the other hand, in Hippocrates the drugs were in contrast to the diet. While the diet was to help health and rehabilitate physical conditions, the drugs were to result in strong effects of change. The drugs like as poison, eye-salve, ointment were to be made use f for rapid, effective change of physical state or for the treatment of a concrete, limited part of the body, These drugs were also much developed in the Hellenistic Age of the state of chronic war. In initial stages, the toxical drugs as well as the anatomy and surgical operations must have been developed on peaceful purpose, such like as 'theriaca' detoxicating(antidoting) animal's poison, or for easing childbirth. With the increasement of social inequality and unexhausted human desire, however, the toxical drugs or anatomical knowledges got to be used for undesirable purposes. Thus, we can not estimate Hippocrates simply in the point whether he developed scientific medicine or not. The great fame of Hippocrates could be found rather in his method of medical treatment as well as the principle of medicine, as he believed that the medicine should not be exploited for worldly power or wealth but for the convenience of all the people. He pursued healthy life matching to natural state(physis) and took much account of different physical states of individual to embody various methods of treatment, which presupposed chronic delay. The opposite to the Hippocratic medicine is called for the wounded by war, or the collective labourer of large farm with intensive labour exploitation. The medical treatment for them assumed anatomical surgery and drugs of rapid, strong effect.
Greek World/*history
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*History, Ancient
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Humans
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Philosophy, Medical/*history
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Physical Therapy Modalities/history
2.Cataract Change after Vitrectomy and Gas Injection in Patients with Epiretinal Membrane and Macular Hole.
Jayoung AHN ; Che Ron KIM ; Mingui KONG ; Yong Seop HAN ; In Young CHUNG ; Jong Moon PARK
Journal of the Korean Ophthalmological Society 2016;57(11):1745-1751
PURPOSE: To investigate the outcomes of quantitative lens nuclear opalescence change after pars plana vitrectomy and intravitreal gas injection in patients with idiopathic epiretinal membrane and macular hole. METHODS: All patients were divided into two group according to the kinds of injected gases, either Group 1 (fluid/air exchange) or Group 2 (20% SF₆ gas injection). Lens nuclear opalescence according to the classification of Lens Opacities Classification System (LOCS) III, mean nuclear density and maximal nuclear density of Pentacam® scheimpflug image changed by image J, besides refractive errors were evaluated before surgery and 1, 2, 4, 6, and 12 months after surgery. RESULTS: Out of 40 eyes of 40 patients included in the analysis, 21 received only fluid/air exchange (Group 1) and 19 received 20% SF₆ gas injection (Group 2). There were significant changes in lens nuclear opalescence between the study and control (unaffected) eyes. In both groups, the study eyes experienced significant progression of cataract compared with the control eyes, in terms of mean nuclear density, maximal nuclear density and LOCS III. In comparison according to the kinds of injected gases, there was a significant difference in mean nuclear density after 4 months, maximal nuclear density after 2 months and 4 months, LOCS after 2 months and 4 months, and refractive error after 1, 2, 4, and 6 months between both groups (p = 0.003). CONCLUSIONS: After vitrectomy and intravitreal gas injection, changes in postoperative lens nuclear opalescence of the study eyes progressed more rapidly compared with the control eyes. This study identified that lens nuclear opalescence of Group 2 progressed rapidly, but after 12 months there was no significant difference of lens opacity between the kinds of injected gases.
Cataract*
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Classification
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Epiretinal Membrane*
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Gases
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Humans
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Iridescence
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Refractive Errors
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Retinal Perforations*
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Vitrectomy*