625-690.: What did the ancients know about the pulmonary system?

What did ancient physicians know about the lungs?  What did they think was the purpose of the soft, sponge-like organs that surrounded the heart in the chest?  The best answer to this comes from one of the world's first medical historians: Paulus Aegineta, who lived from 625-690 A.D.

He said:

Not only does the stomach render us thirsty and otherwise, and excite a desire of warm and cold drink, but also the thoracic viscera, namely, the heart and lungs, and likewise the liver. And drinking does not straightway allay the desire, but a small quantity of cold drink will rather allay the thirst than a great quantity of warm. Persons so affected are refreshed by inhaling cold air, which has no effect in alleviating the thirst of the stomach. Thus, also, those who are contrariwise affected, suffer sensibly from breathing cold air; this is the strongest mark of coldness of the lungs; but they also hawk up phlegm, and expectorate it with coughing. Dryness of the lungs is marked by freedom from excrementitious discharges and from phlegm; and humidity, by being excrementitious, and rendering the voice dull and hoarse; and the recrementitious discharge is also very great when they attempt to speak in a louder or sharper tone.

While that sounds like a bunch of nonsense to the modern healthcare professional, it makes total sense if you understand the lungs from the perspective of the ancients.  Francis Adams (1807-1886), who translated the writings of Aeratus, clarified what Aerateus was saying.  Adams said:

The ancients were of opinion, that the lungs are an accessory organ, made to administer to the heart. "It" is the heart," says Aretaeus, "which imparts to the lungs the desire of drawing in cold air." And in like manner, Theophilus holds that the other organs of respiration were made for the sake of the heart, in order that its innate heat may be cooled, increased, and nourished.

So, the purpose of the lungs was to cool and nourish the heart.   He continued:

The physiologists differed respecting the uses of respiration. Thus, according to Galen, the famous Asclepiades held that it is for the generation of the soul itself, breath and life being thus considered to be identical...

The Asclepiades were temples in ancient Greece where the sick visited, and while sleeping inside the god Asclepius would reveal the cure, which would be interpreted by a priest. These cures were recorded on votive tablets stored inside the temples, and it was from these that some speculate Hippocrates obtained his medical wisdom.

Adams continued:

(The purpose of the lungs, according to) Hippocrates "'for its nutrition and refrigeration; and Erasistratus for the filling of the arteries with spirits. All these opinions are discussed and commented upon by Galen, who determines the purposes of respiration to be twofold: first, to preserve the animal heat; and second, to evacuate the fuliginous portion of the blood. He was aware of the analogy between respiration and combustion, and comes to the conclusion that they are processes of a similar nature: he accordingly compares the lungs to a lamp, the heart to its wick, the blood to the oil, and the animal heat to the flame.

Aristotle gives the name of pneuma to the vital heat of animals, and ascribes the source and maintenance of it to the double functions of respiration and digestion.

The following extract from Alexander Aphrodisiensis will explain the opinions entertained by physicians... of a later age:  "Wherefore there is a natural tepidity, the same I mean as the innate heat, whence springs the origin of the animal, its nature; for it is congenital with the animal, and therefore is called natural, being in the main the instrument of the soul's powers."

The following extract from Haly (Abbas) will show that the opinions of the Arabians on this subject did not differ from those of their Grecian masters, and more especially of Galen: "Respiration is necessary, for the sake of the heart, which is the fountain, and, as it were, the focus of vital heat, whence it is diffused over the rest of the body. It requires some aerial substance to ventilate the heat and ebullition of the heart, and in order to evacuate the fuliginous vapours which are found in it."

So you can see that the ancient Greeks created theoeries regarding the lungs, and the heart too, that were regarded by the medical community long after the fall of Rome in 476 A.D. and the end of what many consider the ancient world.

References:

1. Aegineta, Paulus, "The Seven Books of Paulus Aegineta," translated by Francis Adams, volume I, 1834, London, Snydenham Society, pages 93-94

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