Medical Decision Making in Greco-Roman Antiquity

Abstract

This project investigates medical decision making in Greco-Roman antiquity, using modern studies of cognitive bias, heuristics, and the development of expert intuition as a lens through which to view the theoretical constructs and practical instructions of the physicians of the past. The epistemology of the physicians and medical writers of antiquity has been examined extensively by successive generations of scholars, with more recent efforts confronting the issue of heuristics explicitly (though as yet there is no book-length, diachronic treatment of the subject). Past and present endeavors have focused on the epistemological approaches of various medical sects, noting similarities and differences in how these groups elicited, privileged, analyzed, classified, organized, and applied information related to their patients and the problems from which they were suffering. Focusing on the practical aspects of decision making that surround diagnosis, prognosis, and treatment, this dissertation evaluates ancient Greco-Roman clinical decision making through the lens of modern cognitive decision-making theory. The source material evaluated in the dissertation is presented chronologically, arranged according to broad epochs of medical practitioners: the Hippocratic corpus (chapter 2), the Alexandrian anatomists Herophilus and Erasistratus (chapter 3), the Empiricists (chapter 4), the Methodists (chapter 5), and Galen (chapter 6). Chapter 1 is an introductory chapter outlining the theoretical approach used. Comparison of these epistemological groups, with reference to modern studies of heuristics and the development of expert intuition, demonstrates that shifts in the limits of observability of anatomical and physiological phenomena encouraged re-evaluation of disease categories and reassessment of how information from a clinical encounter was privileged. Practitioners of antiquity were often aware of the benefits and pitfalls of the nosological and diagnostic systems they used, and the revision of their epistemological approaches over time reflects self-conscious attempts to redress flaws in these thought patterns.