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Old 02-24-2020, 11:59 AM
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Ancient Greek Medicine Question


Since this involves speculation I will start this thread here. Mods feel free to move it if it belongs somewhere else.

It's 500 BC in Athens, Greece, and I'm a healthy, 20 yo male who is from a wealthy family of spice traders. I eat well, exercise, and live in a house with all the modern conveniences of the day. I have a job as a bookkeeper in my father's company. I'm heading home from work one day and feel a sharp pain in the lower right side of my abdomen. I feel warm to the touch, nauseous, and I am perspiring profusely.

If this was happening today we would suspect acute appendicitis, but given this is Ancient Greece I might have been diagnosed with an imbalance of humors. Since they didn't have a way to look inside my body and see that my appendix was inflamed, whatever they did to help me would likely not have helped if it didn't involve removing my swollen appendix.

Did the ancient Greek doctors have the knowledge and ability to deal with acute appendicitis? Would they have tried to treat me or leave it to my body to deal with the issue? What is the chance I would have survived without surgery, and if they performed surgery what were the odds I would have survived that?
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Old 02-24-2020, 01:26 PM
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The only effective treatment for acute appendicitis is antibiotics and possible surgery, neither of which the Ancient Greeks had. So you're basically asking for mortality statistics if appendicitis is left untreated. The only ethical way in which we could have such data would be if, historically, we had developed methods to reliably diagnose appendicitis prior to the development of antibiotics and surgery; or if other medical conditions precluded antibiotics and/or surgery in certain patients. I don't think either of those is the case, so I'm pretty sure we just don't have any data to estimate the mortality statistics that you're looking for.
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Old 02-24-2020, 01:58 PM
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The only effective treatment for acute appendicitis is antibiotics and possible surgery, neither of which the Ancient Greeks had. So you're basically asking for mortality statistics if appendicitis is left untreated. The only ethical way in which we could have such data would be if, historically, we had developed methods to reliably diagnose appendicitis prior to the development of antibiotics and surgery; or if other medical conditions precluded antibiotics and/or surgery in certain patients. I don't think either of those is the case, so I'm pretty sure we just don't have any data to estimate the mortality statistics that you're looking for.
Fair enough. Do we know what they would have done in that situation? Did they do abdominal surgery in those days? Was there some other kind of treatment they probably did instead of surgery? I suppose that some people might survive without surgery or antibiotics, but I assume most people wouldn't.
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Old 02-24-2020, 04:16 PM
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Here is a description of the history of appendicitis treatment. Nothing effective until the 19th century.

An aspiring surgeon back then wouldn't know what he was looking for. The appendix wasn't reliably described in writing until the Renaissance. It's unlikely that anyone in ancient Greece had reliable knowledge of the appearance of a healthy appendix sufficient to recognize an inflamed one, even if they cut the patient open to see what might be wrong.

My WAG would be that they would treat for possible food poisoning by administering an emetic, and hope for the best.
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Old 02-24-2020, 08:01 PM
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According to the Merck Manual, over 50% of acute appendicitis patients without access to antibiotics or surgery will die.

The death rate in ancient Greece would likely have been markedly higher due to complications of therapy or secondary effects of untreated appendicitis such as abdominal cavity scarring leading to bowel obstruction.
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Old 02-24-2020, 08:05 PM
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According to the Merck Manual, over 50% of acute appendicitis patients without access to antibiotics or surgery will die.
Do they reference a data source? I'm intrigued as to where that estimate could come from.
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Old 02-24-2020, 09:26 PM
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Well, that begs the question of how did most people survive given the lack of antibiotics and other medicines that cure real diseases. They must have had massive epidemics every now and then. I know the life span was much shorter back then, but at least some people lived to a ripe old age.

Do the ancient writings talk about all the sick people that must have been around during those times? When we read about ancient Greece in high school everyone seemed healthy as could be, although a lot of women apparently died in childbirth. How wonderful could it have been if people were dying from common ailments that rarely kill people today?
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Old 02-24-2020, 11:20 PM
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You don't have to go back to the ancient Greeks. The situation was much the same right up to the 19th century. People died from many illnesses that they wouldn't die from today.
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Old 02-24-2020, 11:22 PM
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Tooth infection leading to sepsis was a significant cause of death, I seem to remember.
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Old 02-25-2020, 12:13 AM
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The only member of Lewis and Clark's Voyage of Discovery crew to die was Charles Floyd, who likely had appendicitis.

Surgery in ancient Greece consisted mostly of amputations, but they weren't operating deep inside the body. With no anesthesia (ether wasn't first used in surgery until 1846), no antiseptics (or knowledge of germs-- no microscopes) and no means of controlling bleeding, the Greeks simply couldn't have done major surgery on a living human.

And yes, there were epidemics. The Plague of Athens killed an estimated 75,000 to 100,000 people, about 1/4 to 1/3 of the population.
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Old 02-25-2020, 04:09 AM
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I had a ruptured appendix, and came VERY close to dying from it, even with modern medicine. I can't imagine anyone surviving that.
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Old 02-25-2020, 02:05 PM
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I had a ruptured appendix, and came VERY close to dying from it, even with modern medicine. I can't imagine anyone surviving that.
mrAru did as well. He has an amazingly ugly scar in the usual place, for some reason they had to go back in and he jokes they should have just put in a zipper [apparently one of the times they just sort of packed it and kept draining it. Yuck.]

<His mom is a nurse, and just figured he had a stomach bug because it was horrible for a while, then *suddenly* stopped hurting, just before he started projectile vomiting everywhere. Oops.>

We are very glad you survived =)
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Old 02-25-2020, 03:27 PM
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Well, that begs the question of how did most people survive given the lack of antibiotics and other medicines that cure real diseases. They must have had massive epidemics every now and then. I know the life span was much shorter back then, but at least some people lived to a ripe old age.
If they got sick enough, they didn't survive - they died. Most of the shorter average life span was due to high rates of infant and maternal mortality, but not all of it.

And yes, they sure did have epidemics.
Quote:
Do the ancient writings talk about all the sick people that must have been around during those times? When we read about ancient Greece in high school everyone seemed healthy as could be, although a lot of women apparently died in childbirth. How wonderful could it have been if people were dying from common ailments that rarely kill people today?
I think it was taken for granted - women and infants and poor people died. So it goes.

History is mostly about war, and rich people. If some peasant got an open wound, and it turned septic and he died, BFD. Aristotle said that many children died during the first week of life, so they didn't name them until later.

Sick people were sort of part of the background, and thus not necessarily worthy of comment.

I notice road kill when I am out for a walk, but I don't mention it a lot when I get home. Sort of the same thing.

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Old 02-25-2020, 03:29 PM
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Quote:
Originally Posted by dolphinboy View Post
Well, that begs the question of how did most people survive given the lack of antibiotics and other medicines that cure real diseases. They must have had massive epidemics every now and then. I know the life span was much shorter back then, but at least some people lived to a ripe old age.

Do the ancient writings talk about all the sick people that must have been around during those times? When we read about ancient Greece in high school everyone seemed healthy as could be, although a lot of women apparently died in childbirth. How wonderful could it have been if people were dying from common ailments that rarely kill people today?
Well, first of all, "most people" didn't survive; about half of all children died in infancy or early childhood, and the death rate at all ages was higher than it is today because of infectious diseases, childbirth, war, and random strokes of bad luck like the hypothetical appendicitis patient in the OP. But that doesn't mean there were a ton of sick people around in ancient Greece. Certainly, there were some people who were suffering from chronic illnesses that would be treatable today, but a lot of the time, people either died fairly quickly or got better on their own. And most people who died, especially in infancy or early childhood, are pretty much invisible in historical records -- unless they were the child of somebody famous, or we happen to have a surviving grave monument or something, there's no reason why anybody would be writing about them.

Even for their contemporaries, people who die young are sort of invisible in society. We aren't usually very aware of all the kids who died of measles or polio in the 1940s and 1950s, even though the majority of them would otherwise be alive today, and most of the power players in business and government today are people of the same generation who didn't die. It's the survivors who make it into the history books.

And I don't think anybody thinks life in ancient Greece was wonderful compared to modern times. Has someone been saying it was?
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Old 02-25-2020, 11:24 PM
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Do infectious diseases thrive when the host populations are large or crowded?

Are bacteria less likely to evolve to infect a particular species which is small in numbers or with low density?
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Old 02-25-2020, 11:45 PM
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My Daddy nearly died of his appendix bursting as a young Marine in the 50s. They found he was allergic to penicillin. Which is really what actually nearly killed him.
So even modern medicine is sometimes not sufficient.
Antibiotics have saved so many lives. I'm a living testament as to its power.
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