Modern medicine has incredible attributes, whether that be life-saving transplants of vital organs, to simple over-the-counter drugs like Paracetamol to help relieve the symptoms of the common cold. But for all of this to arise, many cultures contributed to its eventual development to this astronomical force of healing, with each getting some parts right, but perhaps certain others wrong. Thus, in this article, the impact of the Alexandrian Medical School (AMS) on the development of medicine will be explored, with particular emphasis on anatomical dissection and the ethical boundaries it transgressed. The AMS represents a rare historical moment where scientific curiosity, political power, and moral compromise intersected, shaping medical practice in ways that remain relevant today.[1]
Figure 1 shows ancient Ebers Papyrus, one of the many sources used for ancient medical historical accountancy [1]
First and foremost, the AMS was established in 288BCE, and was a derivation of the Hippocratic principles of the ancient Greeks, but also deeply influenced by Egyptian medical practices, that is, evidence-based treatments amalgamated with a holistic approach of systematic vessels and mummification. [1][2] Before entering the anatomical niceties explored in AMS, it is important to note, the political and historical background of Alexandria, aptly named by its discoverer, a disciple of Aristotle, Alexander the Great. Following Alexander the Great’s founding of Alexandria, the city was rapidly developed by the Ptolemaic rulers into a centre of learning unlike anything seen in the ancient world. Their investment in scholarship transformed Alexandria into a hub where philosophy, science, and medicine could flourish side by side. The Ancient Library of Alexandria - one of the greatest intellectual stores of the ancient era - itself was established by Ptolemy I (Soter), which contained 3 main sections: an academy, a research centre, and an extensive ancient library.[3]
Dwelling on the historical aspects of the AMS is critical with the application of medicine, as so often science is often developed in the absence of societal constraints and moral boundaries, and thus when scientific inquiry advances without clear social or moral limits, it risks overriding fundamental human values rather than serving them. Hence, in this particular matter, the origin of the AMS demonstrates how this medical school was not solely reliant on the individual genius (however great it may have been) of anatomical minds, but rather reliant on the contribution of state-funding and scholarships.
To draw away from the cultural and societal derivation of the AMS, let us now have a purview of the many achievements ascertained during the next 500 years of its existence. Human cadaveric dissection.[4] Not even a 1000 years ago, such a practice would be deemed irrational, crude and against the Divinity itself. Cadaveric dissection was, and is still most definitely, a pivotal method of surgical education, wherein it involves the precise and careful cutting apart of deceased bodies, as a means of gaining further insight into the 3-dimensional structures which pertain within us. [5]
A pioneer of human cadaveric dissection, and the very first person to carry out such what was once thought a taboo and sacrilegious act, was Herophilus, and alongside him was Eriastritus. On that note, to define its taboo ideologies, one may go back to Plato’s era, wherein it was a strong belief that the soul was “imprisoned in the body”, and thus it need not be explained why dissecting the vessel seemed horrific. [6]
Herophilus derived many new theories - and accurately so - on how respective parts of the human body worked. On the neurological side, Herophilus identified astutely that the brain was the centre of intelligence and sensation (while also differentiating between the cerebrum and cerebellum, something which I know a lot of GCSE students were entangled within) which overruled Aristotelian cardiocentrism, which believed human emotions, sensations, and the seat of the soul all lied within the heart.[7] Even more impressively, Herophilus managed to differentiate between motor and sensory neurones within the CNS of humans merely by observation. [6]
Straying away from the neurological aspects, Herophilus also identified again a flaw in Aristotelian anatomy, wherein rather than the previously believed 3-chamber heart, with the right atrium being deemed as merely a ‘venous dilation’, whereas Herophilus, via his dissections, had evidence which suggested otherwise.[6] Perhaps his most heroic of efforts apart from the neurological and cardiological side lies within his attempts of the structural analysis of the human eye and the reproductive system: in the former, he identified the predominantly the front of the eye and the retina, and for the reproductive system, the principle of the uterus being a hollow organ, and sperm in ejaculate originating from the testicles. [6][7] [8]
Figure 2 (top) shows an Aristotelian heart, wherein the right atrium is just a venous dilation, whereas Figure 3 (bottom) shows a modern diagram of the heart. [11][12]
Figure 4 (top) shows Fabrica, one of the first diagrams of the uterus, drawn by Vesalicus, inspired by Galen and Herophilus’ works, whereas Figure 5 (bottom) shows a modern diagram of the uterus labelled [13] [14]
However, it does beg the question hence, why was such a champion of anatomical discovery not remotely remembered as much as Hippocrates, Galen, Aristotle. Aside from the already sinful act of tampering with the vessel of souls which have moved to the afterlife via such dissection, Herophilus and Eriastratitus were seemingly condemned of a much more sinister crime: human vivisections. [6][9] Vivisections are a term which may not come up often, due to the degree of cruelty undertaking such an endeavour obscuring it, but it involves the same dissection techniques done on cadavers, only this time, on live animals. If tampering with a soul’s afterlife was not approved of, dissecting a live person would surely be condemned.
Herophilus and Eriastratitus were both accused by the later physicians, in the likes of Galen and Celsus, to have performed live dissections on criminals, rewarded by the Alexandrian rulers. However, there are two things to note, which can heavily influence your perception of these otherwise incredible anatomical trailblazers:
Evidence: there are no physical records of the pair committing the crime, and any evidence of all of these, achievements and sins, mainly originate from Galen of Permagon, and Aulus Celsus, as all the original works were lost or destroyed. Hence, the exact accuracy of the recount of all of this, good and bad, may be warped or misinterpreted, and thus must be taken with caution. [6][8][10]
Philosophy: people have multiple different viewpoints on this matter, and it is up to each individual to determine whether they see themselves aligning with the actions of these two Alexandrians and justifying it so, or condemning them completely, deeming it a grievous sin. There have been multiple trains of thoughts, whether that be religious concepts e.g. the Ten Commandments, leading a virtuous life and abiding to rights and duties, or contrastingly, the utilitarian’s perspective, where in a hedonistic oversight, the benefits of scientific exploration benefiting the many may outweigh the lives of the few lost. [10]
Upon the note of philosophy, it is important to remain conscientious around the boundaries of scientific ambition, as morally unconstrained sciences are a damning tool for society. In relation to Herophilus, if one were to grant that the vivisections he performed were morally right, then perhaps A philosophical parallel is sometimes drawn between Herophilus’ alleged actions and later cases of unethical medical experimentation, such as those conducted by Nazi physicians during the Second World War. While the historical contexts differ significantly, both raise enduring questions about whether scientific progress can ever justify extreme human suffering.
Ultimately, this article should have hopefully provided a short flavour of the intricacies and visionary exploration of the Alexandria Medical School, focusing on its key figures Herophilus and Eriastratitus, but more importantly, emphasised the critical flaw commonly seen within the scientific community: medicine (science overall in fact) and society are not independent, they are interdependent, wherein the development of one relies on the other, and the downfall of one can catalyse the downfall of another.
Edited by Seyon K
Bibliography:
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[2] Metwaly AM. Traditional Ancient Egyptian Medicine: a Review. Saudi Journal of Biological Sciences [Internet]. 2021 Jun 19;28(10). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8459052/#:~:text=The%20ancient%20Egyptians%20practiced%20medicine,could%20diagnose%20diabetes%20and%20cancer.
[3] View of Ancient Alexandria and the dawn of medical science [Internet]. Globalcardiologyscienceandpractice.com. 2026 [cited 2026 Jan 2]. Available from: https://globalcardiologyscienceandpractice.com/index.php/gcsp/article/view/144/142
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[7] Cardiocentric hypothesis [Internet]. Wikipedia. 2022. Available from: https://en.wikipedia.org/wiki/Cardiocentric_hypothesis
[8] Herophilus and Erasistratus: The Butchers of Alexandria [Internet]. SCIplanet. Available from: https://www.bibalex.org/SCIplanet/en/Article/Details.aspx?id=10296
[9] Ganz J. Herophilus and vivisection: a re-appraisal. History of Medicine/ru. 2014;1(4).
[10] View of “Father of Anatomy” or “Butcher of Alexandria”? [Internet]. Lib.uwo.ca. 2024. Available from: https://ojs.lib.uwo.ca/index.php/lajur/article/view/10741/11237
[11] Wee JZ. The comparable body : analogy and metaphor in ancient Mesopotamian, Egyptian, and Greco-Roman medicine. Leiden: Brill; 2017.
[12] Wikipedia Contributors. Atrium (heart) [Internet]. Wikipedia. Wikimedia Foundation; 2023. Available from: https://en.wikipedia.org/wiki/Atrium_%28heart%29#/media/File:Diagram_of_the_human_heart_(cropped).svg
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[13] Wikipedia Contributors. Herophilos. Wikipedia. Wikimedia Foundation; 2025.
[14] Uterus [Internet]. Wikipedia. 2023. Available from: https://en.wikipedia.org/wiki/Uterus#/media/File:Illu_cervix.svg
