1
Father Alexander Lapin
Orthodox Military Chaplain
____________________________________________
…Priest of the Orthodox Church of Czech Lands and Slovakia
…born in Prague; Grandparents from Russia
…in 1968 to Vienna; Baccalauréat du Lycée français de Vienne
…from 1970 Study of Chemistry and Medicine at the University of Vienna (PhD, MD)
...in 1984 Service in Austrian Army
…from 1997 Study of the Orthodox Theology at the University of Prešov, SK (ThD)
…today as specialist for Laboratory medicine in Sophienspital of Vienna (Uinv.Doz.)
…since 2009 in teaching staff of the Kirchliche Pädagogische Hochschule Wien/Krems
…married, three adult children
2
Orthodoxe
Militärseelsorge
in Österreich
In Holy Trinity Greek-Orthodox Church of Vienna
Wien I., Fleischmarkt 13, on 17.06.2011
Signature of contract for Orthodox Chaplaincy,
Ministry and HE Metropolitan Michael (Staïkos)
Objectives:
Education in Professional Ethics, “LKU”
Spiritual Support
Counseling in Religious Concerns
Support in Cases of Personal Crisis
 for all Orthodox at Austrian Army (300 – 500 person)
3
Great Saint Martyr Mercurios
Patron oft the Orthodox Military Chaplaincy in Austria
• Roman Officer of Skythian Origin
• born in Asia Minor in 3th century
• died as Martyr in 250
• in Caesarea of Cappadocia
• Feast on 24. November / 7. Dezember
Byzantine Fresco in 1295
Ochrid, MK (Wikipedia)
4
Christlian Denominations…
…Eastern Christianity
Protestant:
Evangelic, Reformed…
since 1517
Anglican
Old-Oriental:
1552
Nestorian, Monophysitic, Maronite
431 451
680
Old Catholic
1870
RomanCatholic
Gr.-Cath.
1054
Great Schism
1204
Fourth Crusade
1596
Union of Brest
Orthodox
1453
Fall of Constantinople
0
200
400
600
800
1000
1200
1400
1600
1800
2000
Year
5
The Christians of the East…
…about 250 M
15 autocephalous Churches - One Confession
ORTHODOX CHURCH
Patriarchates
Constantinople
Alexandria
Antioch
Jerusalem
6M
350.000
2M
130.000
Turkey, Crete, Greek Diaspora…
Egypt, Africa
Syria, Turkey, Lebanon, USA…
Palestine Jordan, Israel
Moscow
Serbia
Romania
Bulgaria
Georgia
150 M Russia, Ukraine, Diaspora..
15 M Serbia, Bosnia, Montenegro
23 M
10 M
OLD- ORIENTAL (since 5th cty.)
5M
Ethiopia
40 M
Other Autocephalous Churches
Copts (Egypt)
12 M
Greece (cont.)
9M
Armenians
7M
Cyprus
450.000
Syrian-Orthodox (Jakobitic)
3M
USA (OCA)
1M
Assyrian (Chaldeic, Malabric..)
0,3 M
Poland
750.000
Albania
460.000
CZ / SK
70.000
IN UNION with Rome
(since 16th cty.)
Greek-Catholic (UKR, RO, BG)
6M
Maronites, Syrians, Assyrian…
7M
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7
“Health and Healing”
in Context of Early Christian Theology
as well as of Today’s Medicine
--------------
Alexander Lapin
Orthodox Military Chaplain of Austrian Army
General Assembly of the Apostolat Militaire International (AMI)
September 08 – 13, 2013
The Christian Soldier in the Service of Just Peace.
“To live authentically according to the Word of God and to spread the gospel”
New Understanding of Vaticanum II
Dom Sveti Jožef,
Educational and Pastoral Center of Celje Diocese
Plečnikova 29, 3000 Celje
www.jozef.si
8
“Health and Healing”
WHO definition of Health
“Health is a state of complete physical, mental and social well-being
and not merely the absence of disease or infirmity.”
in Human history
Healer of Body and Healer of Soul was always the same person
 Priest and Physician
…what about Christianity,
…what about the history and today?
9
Medicine in Antiquity
Babylonian Medicine
• Physicians are in the same time Priests
• educated in temple schools:
bârû
- fate interpreters
ashipû - exorcists
asû
- physicians
• Nemequi – Madiator between God Marduk and people
• strong healing rituals
• notion of „philosophers“ doesn’t exist…
• patients are males…
…Babylonian Medicine applies constant and immutable procedures
10
Medicine in Antiquity
Egyptian Medicine
healers were also priests
health care as a state institution
anatomy - excellent knowledge
Heart - haty - anatomic organ,
ib - spiritual center related to cosmos
Death – separation from „eight elements“ of
Human being
…Egyptian medicine: high level skill and knowledge; public institution
11
Medicine in Antiquity
Ancient Greek Medicine
“Corpus Hippocraticum” - collection of 60 medical works
Hippocrates of Kos
(460-377 BC)
Medicine is an Art ! - „ars nobilissima“
- Physician is „Philosopher“ – of virtuous eager for knowledge
- Physician is „Pilot“
– “which helps the captain to keep
his `little boat of life on course”
Hippocratic Oath - `nihil nocere! , not to harm!
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Hippocratic Oath…
Honor in respect to the teachers
Loyalty to the colleagues
Ethicals standards (no euthanasia, no abortion, morality…)
Hippocrates
(460-377 BC)
Confidentiality
Longing for knowledge (Pythagorean tradition)
Responsability and denial of unjustifiabls risk (surgery…)
… at that time:
revolutionary in respect to the ritualized Medicine
… today:
criticism because of paternalism
and non-consideration of patients autonomy
13
The Logic of Ancient Greek Medicine…
• Health - ευκρασία
- eukrasía - Harmony of body fluids
• Illness - δυσκρασία - diskrasía - Disharmony...
• Death
- θάνατος
- thánatos - Decay...
Hippocrates of Kos
(460-377 BC)
Symptoms: physio - logic
patho - logic

Dia - gnosis
Disease ..Patho - logy
..Patho - genesis 
Pro - gnosis
Galen of Pergamon
(129-200 )
clear deterministic distinction between Health and Disease
evidence based facts
objective: `restitutio ad integrum
14
Judaism…
…much older than Hellenistic culture
Abraham, Isaac, Jacob… Patriarchs
Exodus - liberation from slavery “Egyptian experience“
The Law - Thorah, 10 commandements
- Sabbath, Passover, feasts
Priests in Old Testament…
Rabbi - teacher, judge, commander, physician…
15
Mention of Diseases in the Old Testament…
Exodus 9, 3
the hand of the Lord will put on your cattle in the field,…
…on the herds and the flocks, a very evil disease.
Rinderpest
Exodus 9, 10
…it became a skin-disease bursting out on man and on beast
Smallpox
Leviticus 13, 2
on his skin a growth or a mark or a white place,
and it becomes the disease of a leper
Skin diseases *)
Laviticus 26,16
I will put fear in your hearts, even wasting disease and burning pain
Chills, Malaria
1 Samuel 16, 23
… David took his instrument and made music:
so new life came to Saul, and he got well
Depression
2 Samuel 12, 15
And the hand of the Lord was on David's son,
the child of Uriah's wife, and it became very ill
Childhood Disease
2 Kings 6, 18
And He made them blind…
Trachoma
2 Kings 20, 7
Take a cake of figs. …and put it on his wound, and he got better
Abscess
Job 29, 15
I was eyes to the blind, and feet to him who had no power of walking.
Blindness
Psalm 38, 14
So I was like a man whose ears are shut,
and in whose mouth there are no sharp words.
Deafness,
Dementia
Isaiah 49, 10
…They will not be in need of food or drink,
or be troubled by the heat or the sun
Sunstroke
Zechariah 14, 12
…their flesh will be wasted away while they are on their feet,
their eyes will be wasted in their heads and their tongues in their mouths.
Cholera
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*)...according to Mishnah there are altogether 72 different skin diseases
Levin M, Birnbaum I, J Med Philos 2000
Muller A, Schweiz Med Wochenschr (1995)
Halachah - Jewish religious law…
- Halachah „Way to go“, religious law and parameter of behavior which
regulates all aspects of life.
“Traditional Judaism follows Talmudic conventions defined as the “Divine Will revealed
at Mount Sinai to the children of Israel as interpreted by recognized authorities
in subsequent periods”
Mitzvah,
, commandment: 365 prohibitions (... as much as days per year)
248 bids (...as much as bones in the body)
…903 kinds of death; but the worst is asthma
gesiah: „approaching death“,
goses: life after death; different opinions
…time of death: under 50 years
between 60-70 years
more than 70 years
- „sawing“
- “mature”
- “old”
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„HEALTH“ – from Hellenistic and Hebraic Perspective
Two Alternative Notions of Health, Jan Payne (2000)
...when defined as an excellent state of soul and described by philosophical terms
Hellenistic
wisdom
truth
VIRTUE
- σοφία
-
λήθεια
- αρετή
Hebraic
- sofía
=
- chokma - wisdom
- alíthea
=
- emet
- arété
≠
- chesed - also MERCY
≠
- tikva
RECOGNITION - επιστήμη - epistémé
- truth
- also HOPE
„HEALTH“
Hellenistic
clear deterministic
distinction between
physiology / pathology
Hebraic
...in social context
...in context of time
...as a „relative risk“
„evidence based medicine“
„quality of life“
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Christianity…
…originating from Judaism
in the Époque of late Hellenism
in a society of - high culture and civilization
- slavery, paganism, gladiators…
- political stability of Roman Empire
The Gospel…
not a new cult or new philosophy, but the healing from the consequences of Original Sin
by mercy, by philanthropy, by sharing the suffer with the Next…
because of the own salvation in a Kingdom, which is not from this world (…eschatology)
19
Apologetics, Church Fathers…
charismatic personalities…
of spiritual and ascetic experience
often with a classical education
Plato‘s Academy of Athens (270 BC - 529 AC)
„Let no one ignorant geometry enter“
classical sciences:
Basil the Great (330-379)
John Chrysostomos (349-407)
Gregory the Theologos (329-390)
philosophy, rhetoric,
mathematics, law…
…and MEDICINE
20
Christian hospitality practice…
… to the hungry give food, to the thirsty give drink
… to the naked give the clothes
… to the wanderers give the stay
… to the sick and to the prisoner give the care
Ξενόνες, Ξενοδοχεία - xenónes xenodocheía - Hospices, Hospitals, Asylums
Νοσκοκομεία - nosokomeía - Homes for sick
Capadoccia
Basil The Great
(330-379)
 in Caesarea (370) – first asylum for lepers
other hospitals follow: Edessa (375), Antioch (398 ), Ostia (Rome) (4th century)
Ephesus (451), Tébessa (500), Alexandria (~520)...
21
Hospitals in Byzantine History…
in Jerusalem (565)
hospital with 200 beds
in Constantinople
secular foundations:
Isidorian (~520), Samsonian (536), Arkadian (~540)
monastic hospitals:
M. Evergetis (1049), M. Pantocrator (1137)
Hospital of M. Pantocrator
- by Emperor John II, Komnenos
- 55 beds in 5 specialized depts.
- School of Medicine
22
From the “Typikon” of Pantocrator Monastery…
not only monks, also laymen as doctors, nurses
„celibately workers for service on diseased”
also women as physicians and nurses
(12th cty)
meal - twice per day
bath - twice per week
special beds
clear competences aud duties
Andrews diptych, 13th c.
Byzantine Ivory in Victoria and Albert Museum
 The expenses for hospitals burdened the Byzantine state budget
23
Byzantine clinical medicine
...Famous Physicians
 Didymos The Blinde (310-398)
 Oribasius of Pergamon (324-403)
John Lascaratos (1984 –2003)
...Medical Disciplines
 cataract operations
 Nemesios of Emesa (400-450)
 therapy of eyes injuries
 Aetius of Amida (527-565)
 otolaryngological surgery
 Alexander of Tralles (525-605)
 urological operations (epispadias)
 Paul of Aegina (625-690)
 Theophilos Protospatarios (*670)
 lithotripsy
 Meletius Iatrosophist (7th cty.)
 vein stripping
 Theophan Nonnos (7th cty.)
 plastisc surgery
 Stephanos Athenaeus (7th cty.)
 separation of Siamese twins
 Leo Iatrosophist (9th cty.)
 Michael Psellos (1018-1081)
 infectology (Anthrax, Gonorrhoea...)
 Meletios The Monk (11th cty.)
 pediatrics
 Symeon Sethos (12th cty)
 phytopharmacology
 Ioannes Actuarios (1275-1330)
 Nikolas Myrepsos (1th cty.)
 neuroanatomy
 dietetics
 gerontology and geriatrics
24
Famous Byzantine Physicians…
Didymos of Alexandria (310-398)
theologian and physician
precursor of Louis Braille (1809-1859)
Oribasios of Pergamon (324-403)
personal physician of Emp. Jul. Apostate
Synagogae medicea (70 bands)
continued Hippocratic tradition
...the method of Helidoros
(1.Jhdt)
25
Alexander of Tralles (525-605)
Libri duodecim de re medica
Military doctor of Emp. Herakeios
Natural healer, balneologist, helmintologist…
investigated epilepsy (epilambanesthai = „taken by illness“)
febrile diseases, cholera
Paul von Aegina (625-690)
surgeon and practitioner
various operation techniques
Colchicin for gout
medical law…
Pragmateia; Epitomes iatrikes biblio hepta
...continued tradition of Galén
26
„Forceps“ of Paul of Ägina
Aetius of Amida (527-565)
In Persia and Alexandria; worked for Emperor Justinian I.
Tetrabiblion (16 Bücher)
described diphthery
operations on vesels and thyroid glad
Aetii Medici, there is an interesting description of the amputation of the
uvula by first crushing it in a forceps so as to prevent haemorrhage and
then cutting it off. Hippocrates mentions the uvula crusher as one of the
27
instruments necessary for the outfit of the physician.
Michael Psellos (1018-1081)
scholar, historian, scientists
Didaskalia pantothape (different med. techniques)
Ponema iatrikon (in verse)
Symeon Sethos (11th cty.)
in Antioch and Constantinople
philosopher and dieteticist
Syntagma de alimentorum facultatibus
De odoratu, de gustatu et de tactu
Manuscript from Byzantium, ca. 1100
Apollonius Dislocations in Greek Bone setting of jaw
Florence Laurentian Library, MS 74.7:
The doctor seizes the jaw between his fingers and puts it
in place while an assistant holds the patient’s head
28
Nikolas Myrepsos (13th cty.)
Dynameron,
2.656 recepies for different diseases
Ioannis Actuarios (1275-1330)
Court physician in Constantinople
De urinis libri septem, quibus omnia,
quae de urinis dici possunt, continentur.
hygienist
therapy of venereal diseases,
first descibed the tapeworm
29
Portrait of Hippocrates
Greek Manuscript 2144, f 10v c.1342
Bibliotheque Nationale, Paris
The father of medicine as envisioned by a Byzantine artist represent the
physician with a noble face and impressive body to match his intellectual
attributes. Various dignified ancient busts have been said to represent
Hippocrates, yet no original Greek portraits have
survived; hence, our evidence comes from Roman copies.
Hippocratic Oath
Byzantine manuscript
12th century
Vatican Library
30
Two different “professional philosopies“ of doctors…
PAGAN
according to B.Maier (1991)
CHRISTIAN
============================================================================================
Medicine
Patient
the art to cure
(techné, Heilkunst)
the subject, “the case”
Diesease
state of the organism
...somatic disharmony
Etiology
how and where from
comes the illness
Aim of Treatment
Physician
to overcome disharmony
...by somatic healing
...great specialist
healing of body and soul
(psychosomatic approach)
“the Next”, `imago Dei
pain (páthos)
...illness of body and soul
why and which significance
it has for the patient
to share suffering of patient
...salvation also in spiritual sense
...family doctor
(ideal)
31
Ideal Image of Byzantine Physicians …
Holy Unmercenary Healers -
νάργυροί, anargyrí, бессрéбренники
Saint Patnteleimon
Saint Kosmas and Damian
Saint Hermione, Philonella and Zenaida
32
Holy Unmercenary Healers (Womdermakers)…
νάργυροί - anargyrí, бессрéбренники,
JG Demakis
2004
1. were pious Christians even before they become physicians
2. lived an exemplary Christian life with preyer life, meditation, fasting;
prayed regularly for their patients
3. were excellent students of medical school, with serious interest for medicine
4. unmercenary, self-sacrificing, ready to make their own home to Hospital of Christ
5. believed their skill to heal were God-given
6. saw the image of Christ in each of their patient
7. always humble, without arrogance...
33
„Proskomidia“ – Praparatory Part of the Divine Liturgy
…in Orthodox Liturgy:
John Chrysostomos
(349-407)
...every day*) and since 1600 years
"silvercoin-less" unmercenary wondermakers
are commemorated
*) except some days of liturgical calendar
34
„Anoiting of the Sick“: Ancient Christian rite in the Orthodox Church…
James 5:14-15: Is anyone among you sick? Let him call for the elders of the church, and let them pray over him,
anointing him with oil in the name of the Lord. And the prayer of faith will save the one who is sick, and
the Lord will raise him up. And if he has committed sins, he will be forgiven.
grain, oil, wine, incense…
7 priests (presbyters), 7 candles,
7 Gospel readings; prayers
“Therapeutic effect”…?
spiritual: Gospel readings and prayers by the whole community (…after confession)
somatic: transdermal application of a oil-water-alcohol suspension…
35
hvs.kz/soborovanie-tainstvo-svyatogo-isceleniya
 anointing at various points of the body
…Metropolitan Hierotheos (Vlachos) 1994
The Orthodox Theology…
…how it considers itself?
neither as ”philosophy”, or “ideology
nor as “natural religion” or “cult”
but as “healing” of sickness, distress
…from the loss of sense of life
…from the spiritual disorientation
Church: …is an “inn”, a “hospital”
(in parable of the good Samaritan, Luke 10,25)
Holy Fathers: “Experts Physicians”
Monasteries: “Medical Schools”
Psychotherapy: …is understood in original sense
Theology of the East uses the language of Medicine !!!
…not jurisprudence
36
The End of Byzantium and its Medicine…
1056 Great Schism
1024 Crusaders take a Byzantium
1453 Fall of Constantinople under Ottomans
 Christian East becomes merely a part of the “Orient”
Christianity becomes “Westernized”;
 Western theology begins to be more rational,
less mystical and ascetic…
37
Renaissance …
enthusiasm for the heritage of „NON CHRISTIAN“ Antiquity
new sciences come from the Orient astronomy, alchemy, medicine…
religious orders of the West bring the expertise of hospital medicine
…Byzantine physicians are considered merely
as “compilers” of Ancient Greek Medicine
Galileo Galilei
(1564-1642)
The Church of Middle Age enters in conflict with the Science
38
The Age of Enlightenment …
after religious wars in Europe
 … SKEPTICISM
Thirty Years' War (1618–1648)
…The Age of “Anthropocentric Humanism”…
Voltaire
(1694-1778)
J.- J. Rousseau
(1712-1778)
Denis Diderot
(1713-1784)
Immanuel Kant
(1724-1804):
 “Enlightenment is man's emergence from his self-incurred immaturity”
39
The Church of Middle Age is in conflict with the Science…
The “Sin” of Galileo …
Not – “why the objects fall down?”
“but how the phenomenon of free fall occurs…”
“Great Book of the Nature is open before us…
…it is written in the language of mathematics”
Galileo Galilei
(1564-1642)
Il Saggioatorre
asc-csa.gc.ca
 the Knowledge become to be measurable and reproducible…
…and only this kind of knowledge counts !!!
René Descartes
(1596-1650)
L’essai sur la méthode
Isaac Newton
(1642-1727)
Principia
40
The Origin of Modern Science… discoveries in natural sciences
Year
Scientists
Country
Discovery
1608-1647
Torricelli Evangelista
Italy, Toscany
Mercury barometer; atmospheric pressure
1620-1684
Mariotte Edme
France, Dijon
Theory of hydraulics; osmosis in plants
1627-1691
Boyle Robert
Ireland, Great Britain
Chemical “element”, gas physics
1701-1742
Celsius Andres
Sweden, Uppsala
Thermometer; thermal scale
1700-1782
Bernoulli Daniel
Groningen, Basle
Kinetic gas theory, „Bernoulli equation“
1743-1794
Lavoisier Antoine
France
Stoichiometrics, `chem. Element
1711-1765
Lomonosov Michail
Russia
Polyhistor; continuation of Lavoisier’s findings
1745-1827
Volta Alessandro
Italy, Como, Padua
Electric current; electrostatics
1737-1789
Galvani Luigi
Italy, Bologna
Fundaments of electrochemistry
1775-1856
Ampère André Marie
France, Marseille
Electric conductibility in solutions
1791-1867
Faraday James
Great Britain
Electrolysis
1766-1844
Dalton John
Great Britain
Modern atomic theory
1776-1856
Avogadro Amadeo
Italy, Turin
Fundamentals of stoichiometric chemical reactions
1822-1888
Clausius Rudolf
Germany
Entropy; 2nd thermodynamic law
1796-1832
Carnot Nicolas
France
2nd thermodynamic law and ‘Machine of Carnot
1779-1848
Berzelius Jöns Jakob
Sweden
Isomerism & catalysis in organic chemistry
1803-1873
Liebig Justus
Germany
Fundamentals of organic chemistry
1814-1874
Ångström Anders J.
Sweden
Measurement of molecular structures
41
Klinikum.uni- heidelberg.de
…and the Modern Medicine?
becomes a Science and Technology
its discoveries and methods are based on facts
of experimental research and statistical evaluations
 “Evidence Based Medicine”
Technology dominated medicine…
The Aim of Modern Medicine is…
to heal the people
to bring people back to active life
to restore the perspective of the working life
… but the modern medicine conceals also some paradox results
42
The eternal dream of mankind to live longer was finally realized!
2000
1900
20
40
60
80
100
AGE
Ageing !!!
What to do with old people ?
- new demographic problem
…who cares ?
- new challenge for medicine and society
…who pays ?
- moral and cultural problem…
…why all this?
 change of paradigms in medicine, in health care policy, in society…
43
Geriatrics - Medicine for old people
…rapidly growing discipline
…a perfectly healthy old individual
is rather a “biological rarity”
than the “normal case”
Therapeutic objective?
…complete healing?
…”restitutio ad integrum” ?
 optimizing the “Quality of Life”!
…but what’s about perspective for later life?
44
Another phenomenon changing the culture of today's world
Mobility and Migration…
Labor Migration – Refugees – Tourism…
Never before in history was mobility and migration
on such a large scale as today
45
Ethnogeriatrics: ”The Old in the Strange…”
…to obtain confidence and compliance
• language, gestures, mentality
• daily activities, dress, appearance
• adaptation to the environment
• relationship to technology
…to consider spiritual back-ground
• ideology, experience of life
• economic and legal situation
• educational level, type of profession
• habits, tradition, food (fasting and feasts…)
…to respect intimacy
• family, ethnicity, relatives, old and young...
• spiritual needs (prayers, pictures, items…)
• M/F relation, taboos, sexuality…
• illness and death
• last things
…Perspective?
…eschatology
46
“Post-Modern” Medicine…
 from collectives
to the individuals 
Prosopon
47
What is „Human Being“?
C Scoutéris (2002) S Harakas (1993)
the Highest Creation of God
[Genesis 1, 27]
Image of God because of...
- uniqueness of the person (prosopón)
- abilities for:
…abstract thinking
…to enter into relationship with himself
with the Fellows
with God
- creativity (positive or negative)
- able to distinguish between Good and Evil
 ČeloVek (Human Being) = “FACE FOR ETERNITY”
48
…who are you?
…who am I ???
If you point one finger at somebody,
you are pointing three fingers at yourself…
49
M26. Christ Teaching the Doctors
Russian circa 1800
40.1 x 36 cm
The Temple Gallery
Thank you for your attention
50
Country
Assimilation Model
 „Melting Pot“, New York …
culture
1
culture
2
culture
3
Country
Multi-Culturalism Model
culture
1
culture
2
culture
3
Trans-Culturalism
internet, mobility, communication…
globalized tourism, business..
seasonal migration…
 barriers become permissible
mutual interactions are inevitable
„Ghettos“, China Towns…
Toronto
Country
culture
2
culture
1
culture
3
51
Prosopón - Person: …Who is The Human Being?
The Highest Creation of God
[Gen 1,27]
`Image of God
ČeloVek = Face for Eternity
52