2nd century A.D.: Medical profession starts to decline

By the 2nd century A.D. there were so many schools of medicine that a person might scratch his head in a dumbfounded effort to actually find a real doctor. Some of the schools around at this time were: (1, page 39)

1. Empiric
2. Dogmatic
3. Methodist
4. Pneumatist
5. Eclectic/ Episynthetics

There were so many schools of medicine, so many "diverse and fanciful opinions" that the medical profession, much like the rest of Rome, was falling apart, said medical historian Thomas Bradford. (1, page 39)

He said the result of this was to "lower the standard of the real medical science. The physicians nowhere aimed at useful discoveries, but simply devoted themselves to making as much money as possible. In fact, medicine like everything else in Rome at this time was fast decaying." (1, page 39)

There was also no requirement to become a doctor, so any quack, trained or otherwise, could claim to be one. This made it so those seeking help were often left confused and deterred.

So, after the death of Galen, medicine collapsed with the rest of Rome.  Of this, Bradford said:

At the death of Galen (the end of the 2nd century) there began a period during which the art of medicine not only ceased to advance, but went backward, and became enveloped in the myth and ceremonies of the priesthood. For a while the schools of philosophy and medicine still existed at Alexandria, but in the year 372 the city was subjected to pillage and fire. The scholars were stripped of their elegant quarters, the buildings were completely destroyed, and the vast collection of manuscripts were used to heat the water in the public baths. (1, page 45)

Western Civilization entered a dark ages of medicine.  Medicine would not come out from under this dark cloud until after the invention of the printing press in 1450.   In the meantime, if you needed help in times of sickness you were on your own.

References:

1. Bradford, Thomas Lindsley, writer, Robert Ray Roth, editor, “Quiz questions on the history of medicine from the lectures of Thomas Lindley Bradford M.D.,” 1898, Philadelphia, Hohn Joseph McVey

50-200 A.D. The four schools of medicine

By 50 A.D., or about the time of the Roman invasion of Britain in 55-60 A.D., the Dogmatic School had competition from other schools originating in ancient Greece:

1. Rationalism/ Humoralism/ Dogmatism:  They basically followed the ideas of Hippocrates.  They attempted to rationalize diseases and made up theories to explain them.  Their main theory was that health was maintained by a balance of the four elements of Empedocles (fire, earth, air and water) and the four humors of Hippocrates (blood, phlegm, yellow bile, black bile). They basically believed diseases were caused by disturbances in the liquids of the body. 
2. Empiricism: They came to conclusions about disease based on their own experiences.  
3. Methodism/ Solidism/ Atomism: They believed diseases were caused by the arrest of molecules through invisible pores. They believed diseases were caused by disturbances in the solids of the body. 
4. Pneumatism: This was sort of an offshoot of Dogmatism where they believed a pneuma or spirit in the inspired air was responsible for maintaining a balance of the four elements and humors. They believed diseases were caused by disturbances in the gases of the body.

During the course of the first and second centuries, Roman physicians had problems with the basic tenets of Greek medicine, mainly that its remedies (bleeding, cupping, friction, and purging) for internal ailments were too harsh for their patients.  Or, worded another way, their patients preferred the prayers and magic offered by religion and mythology, as compared with the poisons and knives of Greek physicians.  

So Roman physicians were known to take the best ideas of the four Greek schools, becoming known as "free lances."  They became known as eclectics.  (1, page 98)

Now, was this a fifth school of medicine called the School of Eclectics?  Some experts would debate that it was.  Others, however, believe it was simply a term used to describe "any physician who deviated from the strict interpretation of the doctrine of the School to which he was supposed to belong and accepted some tenets from another." (4, page  170)

Agathinus of Sparta (50-100 A.D.) was a pupil of Athenaeus of Attaleia, who established the Pneumatic School of Medicine.  While a pneumatist at heart, he liked some of the ideas of Methodism and Empiricism. For this reason, he often referred to himself as an episynthetic, which was basically another term for eclectic.  (3, page 159)

Or, was this a fifth school of medicine called the Episynthetic School of Medicine?  Some experts would debate that it was a formal school.  Others would go as far as to suggest that Episynthetic and Eclectic were two separate schools that formed in the first two centuries.  (4, page 170)

Prioreschi said the basic tenets of the Pneumatic and Eclectic Schools were close, and wondered if the later might have been an "off-shoot" of the former, especially considering Agathinus considered himself an episynthetic, and that some referred to his pupil, Archegenes, as an eclectic.  Some say eclectic was basically a term used to describe a Pneumatist who accepted ideas of Methodism and Empiricism.

Regardless, an eclectic physician came to be one who adapted the best ideas of all four schools of medical thought.  He probably considered himself a member of one of the four Greek schools.  Although he was, as were most Roman physicians, an eclectic at heart.  Examples here include Celcus, Antyllus, Aretaeus of Cappadocia and, of course, Claudius Galen. These are all physicians whose practices, as you will soon see, would have an impact on our asthma history. (1, page 98)(2, page 111):

Now, you might be saying, who cares about the schools of medicine?  However, it is important, because our goal by writing this history is to learn how asthma would be treated in ancient Rome.  And, how your illness was treated totally depended on which one of these schools your physician belonged, and which tenets of the others he purported to believe.

The four Greek schools held the keys to all medical wisdom, and Roman physicians knew this.  Yet to appease their patients, they adapted the best tenets of Greek medicine and became eclectics.

References:

1. Garrison, Fielding Hudson, "An introduction to the history of medicine: with medical chronology, Bibliographic data and test questions," 1913, Philadelphia and London, W.B. Saunders company
2. Algra, Keimpe, Jonathon Barnes, Jaap Mansfeld, Maldolm Scholfield, editors, "The Cambridge History of Hellenistic Philosophy," 2002, Cambridge University Press
3. Prioreschi, Plinio, "A History of Medicine," volume III "Roman Medicine," 2001, NE, Horatius Press
4. "Agathinus, Claudius," encyclopedia.com, http://www.encyclopedia.com/doc/1G2-2830900054.html, accessed 6/24/14