In the fourth century BCE one of the most important loci of medical thought was in Alexandria. The Ptolemaic rulers gave lavish financial support to the library and museum at Alexandria which consequently attracted researchers in all fields, including philosophy, mathematics, history, poetry and medicine.

Two of the most influential medical researchers of their day were Herophilos of Chalcedon (fl. circa 280 BCE) and Erasistratos of Iulis (fl. 250 BCE). Most of our knowledge of these two is derived from later famous medical men, Celsus and Galen.

Herophilos’ most important contribution to clinical medicine was his development of the theory of the diagnostic value of the pulse. Although the pulse is referred to occasionally by earlier writers (for example by Aristotle in his Inquiry Concerning Animals 521a5f), it was Herophilos’ teacher, Praxagoras, who first restricted the pulse to a distinct group of vessels, and thought it could be used as an indicator of disease. Herophilos advanced his master’s theories. He maintained that the pulse is not an innate property belonging to the arteries, but it is one that they derive from the heart. He thought it was possible to distinguish the pulse not merely quantitatively (i.e. how fast the heart was beating in a minute), but also qualitatively from palpitations, tremors and spasms, which are muscular in origin.

His theory of the pulse was very musical in nature. The essential phenomenon in the pulse was the rhythm, therefore to understand the pulse, one must undertake the study the theory of music. Herophilos was probably influenced by the musical theories of Aristoxenus of Tarentum, a Peripatetic philosopher and a musician, who was a pupil of Aristotle. Unfortunately, by following this route, the doctrine of the pulse became so complicated that no one but a skilled musician could possibly understand it!

Herophilos is also said to have constructed a portable waterclock that was used to measure the pulse of patients. Below is a representation of what it might have looked like.

There is a famous story involving Erasistratos -- Herophilos’ rival at Alexandria -- and Antiochus, son of Seleucus I Nicator, King of Syria. Antiochus was dreadfully ill and close to death. No doctor could help, so Erasistratos was called in. While he was examining the patient, the lovely Stratonice, one of the elderly king’s wives, entered the room. From the quickening of the sick man’s pulse and from the flush which spread over his cheeks, Erasistratos theorized that the illness was mental rather than physical. Perhaps a passion for the inaccessible Stratonice was at the root of the trouble!

The above painting is entitled Erasistratus Discovering the Cause of Antiochus’ Disease and was painted in 1774 by Jacques-Louis David. Notice the pretty young lady. She is one of our avatars here at Ancient Worlds. :)