370 B.C.: The dogmatic school of medicine

While Hippocrates is credited with creating the humoral hypothesis, it was his sons, Thessalus and Draco, who are credited with creating the first school, or sect, of medicine: the Dogmatic School of Medicine. (1, page)

There were various names for this school, depending on the era it was being described, and who was describing it.

Since it was based on the writings of the Hippocratic writers and Hippocrates himself, it was sometimes called the Hippocratic school, and physicians called Hippocratici. 

Since it was based on philosophers who believed it was necessary to rationalize about medicine, it was sometimes called the Rationalist school, and physicians called rationalists.

Since it was based on the belief that health was determined by a balance of the four humors (blood, phlegm, black bile and yellow bile) of Hippocrates, and diseases caused by an imbalance thereof, it was often called the Humoral school, and physicians called humoralists.

And, finally, since it was based on the dogma of Hippocrates, it was also called the Dogmatic school, and physicians called dogmatists or dogmatici. 

Regardless of the name, the general idea here is best explained by medical historian Edward Withington in 1894:  (3, page 57)

The ancient Greeks loved talking; his mind was more philosophical than scientific, and he preferred to speculate on things in general rather than to investigate particular facts... A Hippocratic writer had said, 'The physician who is also a philosopher is godlike.' This became the motto of the dogmatic school, was made the excuse for an immense amount of useless speculation, and was finally taken as the text of a special treaties by Galen himself. (3, page 57)

The dogmatic school of medicine was generally taught at the School of Cos, and was based on the opinions of Hippocrates, yet it was also based on the Stoic philosophy. This led to much "useless speculation," (3, page 57)

Part of this "useless" speculation was that diseases were caused by imbalances of the four elements and humors, and remedies were a means to re-establish the balance.  Remedies may be as simple as a lifestyle change, and as harsh as bleeding and purging.  Any particular remedy did not require any specific evidence that it worked.

You can  also learn more about Hippocratic medicine by reading about the medical wisdom of Hippocrates.

Followers of this school believed in the importance of studying anatomy, and often performed autopsies on animals such as pigs, monkeys and apes.  They performed autopsies on humans if possible, although this was frowned upon and illegal in the ancient world.  Human autopsies were performed when permission was granted, and in such cases was usually performed upon stolen corpses or, worse, live prisoners.

They had a basic understanding of human anatomy: the layout of the main organs, the vessels that line the body.  They understood the importance of correlating medicine with physiology.  The obvious problem with their school was the reliance on opinions as opposed to observation, experience and science.  Of course when the school was formed there was no knowledge of any of those things.  (3, page 60)

By about 50 A.D., when most referred to it as the Humoral or Rational School, it was under fierce competition by four other schools that also formed in Greece. Despite this competition, the basic tenants of this school would be followed by physicians all the way to the middle of the 18th century.

References:

1. "Rationalism (philosophy), Encyclopedia Britannica.com, http://www.britannica.com/EBchecked/topic/492034/rationalism
2. Withington, Edward Theodore, "Medical History from the Earliest Times," 1894, London
3. Watson, John, "Medical Profession in Ancient Times, "
4. Magill, Frank N., editor, "Dictionary of World Biography," Volume I: The Ancient World, 1998, Salem Press Inc., California
5. Meryon, Edward, "History of Medicine: comprising a narrative of its progress from the earliest ages to the present and of the delusions incidental to its advance from empericism to the dignity of a science," volume I, London, 1861,
6. Adams, Charles, Kendall, editor, "Johnson's Universal Cyclopedia: A new edition," volume V, A. Johnson Company, New York, 1894
7. 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
8. Neuburger, Max, writer, "History of Medicine," 1910, translated by Ernest Playfair, Volume I, London, Oxford University Press

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