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At the temple of Hera (Juno) in Olympia lay a gold and ivory relief called “The Composition of the Contest”. It decorated the consecrational table over which the wreaths for crowning the victors of the Games were laid. One end depicted Mars, the god of war and Agon, the personification of the Games, with Asclepius, the god of Medicine and his daughter, Hygeia. It seems the relationship between Medicine and the Olympic Games in people’s minds is very old. However, this relationship did not remain unaltered through the centuries, nor indeed did the separate ideas of the Olympic Games or Medicine. This article analyses the evolution of this relationship in different historical eras.

The effort to describe the Ancient Olympic Games and their spirit encounters many obstacles, as does any effort to reconstruct the past accurately. Our sources are usually ruins of old buildings. As Giorgio Grasi put it: “Architecture is the established interpreter of collective meanings placed above historical circumstances that take part nonetheless in the historical process. If memorability is defined as the state of particular and continuous testimony, this belongs more to architecture than to any other form of reproduction”. The architectural remains that survive though are usually the largest and most durable. This means that they are expressive of each civilisation’s peak, obscuring thus its whole journey. For there is something more awe-inspiring than a monument, and that is its ruins.

On the other hand, if we use written sources, we always face the danger of the chance survival of particular texts whilst others, potentially equally

important, have been lost, thus creating a distorted image of an era. The gravest danger though is for the past not to be reconstructed faithfully, but as a distorted image, as later legends, ideologies and agendas have shaped it. This holds particularly true of the Olympic Games, which the collective consciousness of Greeks, the Greek Diaspora, Philellenes, or even those wishing to take advantage of tradition have adorned, through Antiquity to our modern times, with qualities they did not necessarily possess. The description of the various phases of the Olympic Games will be followed by a description of their architectural environment and will be linked to the contemporary relationship of Medicine with Sport.

The Olympic Games are separated into three different periods (Illustration 1). The first five centuries took place during a status quo of independent city-states of
	Archaic and Classical Greece, the following two during the era of the Hellenistic Kingdoms of mainland Greece, Asia and Africa and the remaining six under Roman rule. The exact date of their inauguration is not known. The year presented as holding the fist Olympic Games is 776 BC. This though is the year of their reorganisation by King Iphitus, whilst a previous format of the Games existed in Olympia. It was a small one-day festival with participants from Pissa, a small citadel near Olympia and two or three other nearby citadels.
The strongest men of those citadels would compete, in running only, in honour of Pelopas, the mythical hero of the Epic on the birth of the Olympics.

Pelops, from Asiatic Phrygia, comes to Olympia, which was then called Apia, participates in the horse races organised by the local king Oenomaus, wins, kills
	kills the king and marries his daughter, Ippodamia. He becomes king and gives his name to the whole southern Greek peninsula, the Peloponnese. In order that he be cleansed, he organises games at the burial site of Oenomaus, whilst his wife, Ippodamia, (illustration 2), organises female games in honour of the local archetypal female deity. The Olympics are associated in our consciousness with
complete nudity, but it is not clear if the athletes in those first games were actually naked. According to one theory, in distant Antiquity Greek athletes wore loincloths. As did, for many centuries after that, their barbarian counterparts. The Games had something of the simplicity and naiveté of various games that can be still sometimes seen in remote Greek village festivals in honour usually of some local saint, the Christian descendant of those ancient heroes. The Olympic Games started in a similar fashion, as a festival with a deeply religious content honouring not only the specific dead but also the deities of the underworld in general, at the ravine of the Kronaios hill. From that era, the only extant architectural remains are some humble foundations. From that faraway era we have no evidence, and there was probably no need, for medical support of the Olympic Games. At most we can hypothesise that some kind of first aid was given in case of injury.

The next period is the Archaic, which starts in the 8th century BC, era of the composition of the Homeric Epics, and ends in the 5th century BC, era of the Persian Wars and the Golden Age of Pericles. The point of reference is 776, when Iphitos reorganises the Olympic Games, a date that is conventionally regarded as the date of the first Olympiad. Characteristically, the mythological basis of the Games changes. The Dorians, the Northern people who succeeded the Mycenaean world of the Homeric Epics, introduce the idea that it was their hero, Hercules, who established the Games. He is supposed to have refereed a race run by his Cretan brothers, and to have crowned the winner with a branch of wild olive. Hence Hercules established the olive branch as the trophy for the Olympics.

The worship of Zeus, who is supposed to have lived as an infant at Olympia’s Kronaios hill, is imposed, without ever ousting the respect for the ancient proto-Grecian and Mycenaean deities. The citadel of Pissa, and then Elis, a town distinguished albeit not familiar to the general public, 35 kilometres from Olympia, hold responsibility for the organisation of the Games. It should be pointed out here that Olympia was never a town during Antiquity, but only an outdoors temple with additional gymnastic facilities.

The town that lived for and organised the Olympic Games was Elis. During that era, and for many centuries to follow, it was under aristocratic rule. A certain number of landowner and military families held political power, but were first and foremost the guardians of ancient traditions and morals. The gentility of their descent imposed their duty for the immaculate operation of the institution. It was mostly sons of such families who participated in the Games, pursuing the romantic ideal and connecting it, as happened during the Middle Ages, with a complete belief in God, in whose name the Games took place. The aristocracy of Elis had the full responsibility for the organisation of the Games, the maintenance of order and the declaration of the winners, a role that the small elite held for centuries. The athletes stayed in Elis for a month before the Games, participating in long qualifying games, and only the winners appeared at the official Olympics. The underlying competition between the two areas survives to our days.

The Games now lasted for three days and comprised of 11 sports. Only citizens of mainland Greece could participate. The architecture testifies to the existing spirit. In Olympia buildings such as the large temple of Hera, (in whose columns the names of the young female winners in the separate Games for women were inscribed), the Prytaneum and the House of Parliament were built – a temple of Zeus does not exist yet and only sacrifices take place at his altar, an outdoors temple that starts to rise in height due to the accumulation of ashes during successive offerings. Importantly, the stadium forms part of the sacred grounds of Altis, as the Games are still a primarily religious event. The winners are crowned with a branch of wild olive growing on Altis and sense that they are in some way adopted by the god and become his chosen.

The general spirit of the era regarded effort and exercise as characteristic of valiancy. Areti (Female personification of Virtue), in contrast to Kakia (Female personification of Vice), counsels Hercules, the founder of the Games that he must exercise his body with great effort. (illustration 3)
	This ideology prevails not only amongst the Greeks, but also in neighbouring peoples, as Xenophon describes of the king of the Persians, Ceros. Medicine makes the first important steps towards participation in the Games. The athletes staying at Elis undergo medical examination to test their aptness to compete, receive intensive physiotherapy with baths, massages, walking etc. Special diets are suggested for the competitors, as precursors of the contemporary complex dietary regimes followed by athletes. One such diet known to us consists of the consumption of a large number of figs, fruit with a great concentration of sugars, for the provision of energy. Medical interjections though were still restricted, since the primary function of the Games was to honour Zeus, and not to glorify the contestants.
A repeated mention is made in bibliography to the person of the “mediciomaniac” Herodikus who was the first to attempt to incorporate exercise in Medicine. Hippocrates in any case had later scolded him for the senseless use of exercise, which finally leads to injury and death. This comment is characteristic of the consequent disputes of important doctors, sports doctors and physiotherapists.

The Classical period, the 5th century, is the golden era of Olympia, both in architectural activity and in its rise to fame throughout Greece. In accordance with a general cultural bloom, the temples are extended and the whole area is redesigned. The most characteristic feature of the changes that took place during the 4th century BC is the isolation of the stadium from the religious area, which is fenced off and becomes independent of the gymnasium. Although this appears to attribute due respect and holiness to the place of worship, what happens in reality is that the purely religious element is divided from the spirit of competition. Gradually, this religious element retires and secularisation advances. The same happened in Medicine. From having tended to injuries and offering some simple dietary advice is has started to specialise in sports. The first step consists of the rejection of what we would call a Mediterranean diet, the consumption that is primarily of fruit carbohydrates, such as figs, and their replacement specifically for athletes with a large amount of animal proteins, such as beef. Such a high protein diet is recommended today for competitive sports. Pythagoras is said to be the first to have introduced this method. Athletes have always tried to find ways of enhancing their natural strength through special diets. Of course, the argument between those favouring a high protein diet and those promoting a high carbohydrate diet still exists. A second step is the intensification of training.

Hippocrates mocks this tactic and it is interesting to note the distinction he makes between true health and excessive strength, demonstrated by hypertrophic muscles. He regards health indeed as an opposite to exercise as the later aims to change the state of the body; something a healthy person has no need for. This distinction is still not clear and the ambiguity surrounding the subject is the base of all gym advertising. Hippocrates goes a step further and stresses that heavy training – what would be called bodybuilding today – is extremely dangerous as it leads
	to excess and does not allow the body to regain its strength. (Illustration 4). Furthermore, he continues by saying that the body benefits from a stroll after each meal more than from heavy training, which makes the skin weak and sensitive. The continuous occupation of Ancient Greeks with skin and its breathing and with the exchange of substances and heat through it is shown in the extremely detailed instructions on the powders and oils that should he used for massaging the athletes during summer and winter. Strangely, they seem to have reached the conclusion that athletes’ hairy bodies are more prone to respiratory infections. However, regardless of his contempt of strenuous exercise, Hippocrates in his treatise “On Joints” describes a method of reducing a shoulder dislocation … a method simple and useful in the wrestling ring, as elsewhere.

Plato’s opinion on the subject is even more clearly defined: he denounces professional sport as a selfish and vain exhibition, whilst praising the general training of the young as extremely beneficial for the country. He characterises exercise, together with Medicine and Farming, as providers for the body. He believes indeed that the pedagogic value of exercise and a closely bound society are touchstones of democracy and therefore not popular amongst the barbarians. , He tries to make a distinction between Medicine and Exercise, saying that even though both disciples are concerned with the same subject, the body, they do differ. As in politics, where Justice is the general principle and the laying of laws its practical application, so is Medicine the higher principle and Exercise is concerned with some practical applications. , Plato’s general view of Exercise is completed with his support, in many cases, that its benefits are visible only when it is combined with the cultivation of the mind and especially with music. This combination produces useful citizens, whereas exercising on its own aggravates a man and music on its own makes him soft and effeminate. , , , , Although Plato is considered a chauvinist, he did advocate that women can exercise in equal terms with men, can be educated by music and should not be viewed as sentenced by their nature to participating only as an audience of gymnastic games. , In an era where women’s participation at Olympia was only peripheral, Plato’s opinions must be viewed as pioneering. Special attention should be given to another point he makes. That is that exercise is compatible with Medicine when it aims at health, not beauty. He considers the quest for aesthetic perfection a characteristic of people who are not free. , The coexistence of gyms with aesthetic establishments such as hair salons, clothes shops and beauty centres is absolutely condemned.

The fame of Olympia though has not yet been darkened. Shortly after Plato, Isocrates in a festive speech describes emphatically his faith to the pure athletic ideals of the Games: “About that time, having seen the festivities at Olympia beloved and admired by everybody, and the Greeks to exhibit there their wealth and strength and culture, and the athletes to be envied and the home – towns of the winners to become famous, and thinking moreover that in the homeland the functions of the citizens are aimed to the benefit of themselves, while, during that festivities, these take place in the whole of Greece for the benefit of the city […]” Despite this, he does not refrain from expressing the timeless complaint of literati that they get paid less than athletes. The athletes’ reward continues to be an olive branch from the courtyard of the temple of Zeus, a tangible symbol of good will, of the, in a sense, adoption of the winner by god.

Olive oil was a necessary substance for the treatment of the athletes as it was with this that they were massaged. (Illustration 5)The coupling of olive oil with the
branch of olive did not have a mythological base only. In Athens, in an effort to compete with the Olympics, they gave the winner of the Pan-Athenian Games specially decorated urns with oil. This was not only a sign of respect, but constituted a commercial product. The athletes sold the olive oil, which could be as much as five and a half tons for a champion. Similarly to what happens now, secondary sources of income were more important to athletes. The first steps towards the commercialisation of the Games had an impact on sports medicine. Since the motive is, to a great extent, financial, athletes follow extreme diets in order to increase their performance. Aristotle, in the 4th century BC now, describes the distortion of athletes’ faces, which look like animals, due to the special diets they follow for the augmentation of their physical strength. These comments remind one of contemporary athletes’ faces, distorted by the use of growth hormones. The wildest contest was pancration, a kind of extreme

fighting, where only biting and gouging were forbidden. (Illustration 6). Plato comments on it as “a contest combining imperfect wrestling with imperfect boxing”.
	Bad injuries and even deaths were reported during it. In the following, Hellenistic, period, the spirit of the Games undergoes a major transformation.

	Using spurious reasoning, the rule that all the participants should be Greek is bent, and many athletes from outwith mainland Greece are hellenified (Illustration 7). They are supposedly all of Greek extraction. How contemporary does this all sound! The actual moral superiority of the Elioi (the people of that area) was questioned by Agis, king of Sparta, who sarcastically said: “Do they really think they’re that important, those Elioi, when one day they

	impose armistice, and for five years they do what they want?” The aim is now primarily to win, no matter at what cost, and honouring the dead Pelops takes second place, whilst the incidents of fixed games multiply. Architecture celebrates this big pan-Hellenic event. Foreign elements intrude even in the most sacred space in Olympia, the sancta sanctorum of the temple of Zeus. The Seleukid king of Syria, Antiochus the Fourth, offers the gold-sewn curtains he has removed from the temple of Solomon in Jerusalem there. The one that finally replaced it was torn in two after the Crucifixion of Christ. The world of the Orient has started to permeate Olympia. It was the Western world though that altered it irreversibly. The Roman era is characterised by grandeur and excess and, during the imperial era at least, by a relaxation of moral barriers. (Illustration 8)
The fine balance of religion and secularism preserving the Olympic Spirit is starting to retreat. When this happens, all is lost. The secular on one hand radiates deadly cold, the religious on the other a stuffy, ill odour. All these signs appear in Olympia as well. The architectural landscape becomes grander. The same happens at Elis. The actual Games are internationalised and all Roman subjects can now participate as they are regarded as “Greek” by law. Of course, apart from the relaxation of morality, the participation of foreigners played a role in the alteration of the behaviour of the Greeks. From the initial “All not Greek are barbarians”, that is to say they speak in incomprehensible bar-bar, we come to the view that “It is more apt to call Greek all those that share our culture and education than those who were just born such”.The Greek sense of balance is distorted. Nero is welcomed with unprecedented jubilations in Olympia and grand buildings are built on Altis for him and his court. The champions, with their strength and their physical superiority exert a sensual power over the female, and male, population of the Roman Empire, especially amongst the higher classes.

Athletes’ sweat, mixed with the various oils they used and dust from the rink, were sold as a balsam, a beauty product and an aphrodisiac. This was the famed rypos. (dirt). Medicine was quick to affirm the value of the product, which is mentioned in official pharmacologies, such as Dioscurides’. This habit was taken to excess and even the humidity from athletes’ statues or from rink walls was sold as therapeutic. That of the statue of Polyadamandas in Olympia especially, which “sweated”, was regarded as an extremely potent therapy. Lucian satirises this exploit. An athlete’s skull, crowned with a gold halo, discovered in East Crete and dating from the era of Tiberius is characteristic of this excess. (Illustration 9)
	Less exotic medications are of course used. Dioscurides again, recommends a rosemary infusion to warm one up before exercising, a primitive quick fix. A kind of primitive doping consisted of the consumption of a stone from a cockerel’s stomach, choosing a cockerel that won at cockfights. The whole cock was also consumed, who did not thus announce the day but the victory of the athlete, according to the words of Sextus the African. (Illustration 10)

	In reality, it was an effort to acquire the winning cock’s high levels of testosterone. This same aim must have been the reason for the consumption of urine from strong animals. The herb polytrihi (maiden-hair) was given for the enhancement of muscle mass. Massaging and anointing was also regarded as such a powerful aid to the physical well being of athletes that the art was considered as a sister art of Medicine. In any case, the athletes, their parents and the coaches still swear to punishing Zeus that they have followed all the rules of preparation. The works of Galen dominate the bibliography of the Roman era on sport, as in all other medical subjects. In his effort to react to this excessive worship of championship, he reached the other end of the spectrum. He had maintained his powers of perception though and was able to delineate the side effects of excessive exercising. Initially, in his work “Incentives to cure”, he voices his opposition to professional athletes, comparing the profession to that of a doctor.
He argues that, despite the public approval and praise for athletes, we must objectively judge what they offer the country. He is of the opinion that they can offer no more than animals, as they can become neither faster than the hare, nor stronger than the elephant. He calls on the confession of Euripides that: “innumerable being the evils in Greece nothing is more evil than the athletes’ species” (Illustration 11)

	and Hippocrates that: “To live a sporting live is not natural, the healthy habits are superior in everyway”. He continues with a catapult of arguments: “We must examine, he says, athletic performance naked, without its external decorations. It is common knowledge that three kinds of assets exist: Mental, physical and external. Athletes have not even dreamed about mental assets, and they are not even capable of understanding that they have a soul, since they fill their bodies to a sickening extent with flesh and blood and cover their souls with blackness. But they do not even possess true physical assets as, as Hippocrates said, true health is based on the restriction of one’s diet and the minimalisation of effort. Athletes though consume an abundance of nutritional substances and constantly torture their body.

They become thus opposed to the basic Hippocratic rule that: “hardship, eating, drinking, copulation, everything in moderation”. (Illustration 12)
	At the end of the day, professional sportsmanship is an exercise of illness, not of health. Hippocrates indeed, did not even call exercise well being, since well-being comes from the permanent adhesion to one lifestyle, whereas with exercise one often falls from one kind to another. Champions rarely live to be very old. As Homer said, they become squint and lame. They look like the walls of a city that have been attacked by seizing machines and collapse easily during an earthquake or some other cause. In the same way, athletes’ bodies are ready to collapse, due to the blows they have received at times. Their teeth might inexplicably fall, their limbs, twisted, might not be able to suffer any external violence and no other group of people is so miserable. It actually appears that the word athlete (athletes) and the word miserable (athlios) derive from this same source of misery (athlioteta). (Illustration 13)

	But even if we are to comment on their beauty, it is a fact that exercise not only does not beautify them, but also in many who have a symmetrical appearance, after their coaches have worked them upon, has developed completely distorted faces, especially in wrestling and pancration. And if someone proposes that athletes become strong, they will have to be questioned concerning the use of this strength, as it is not used for any constructive work. Compared to those who wander shoe-less and dress in tatters, suffering from cold and heat, they appear as infants. They could not beat lumberjacks in the rink, nor builders. Maybe we have to worship them because they cover themselves in special powders? But quails and pheasants do the same.” He mentions indeed, as a paradigm of stupidity, the well-known episode of the winner of the Olympic games Milo, who ran round the Olympic Stadium with a bull round his shoulders.
Galen’s attack on athletes seems extortionate and indeed it is. It is of course explained by Galen having served as a doctor to gladiators, and as a reaction to the fuss Roman society made over athletes, but some points he makes are affirmed. It is true that the excessive consumption of calories for the enhancement of physical mass alters one’s moods and distorts the body. It is also true that many athletes die at a young age as a result off excessive training. He goes on to analyse how athletes’ strength is useless, as it is not used in any productive work and cannot be compared with that of animals in equivalent fields. They cannot even feel sensuality as during training they subject themselves to pain and effort and when they retire they are invalid. Even the wealth they acquire cannot be compared to that of successful businessmen. Apart from his polemic against champions, Galen dealt professionally with sports medicine. He gained his medical experience, to a great extent, form his time in gladiator circles. In his work “On the synthesis of drugs” he mentions the ointment “Olympic winner’s Grey” which is recommended for sports injuries. Additionally, he explains in detail why the testicles produce a substance – known today to be testosterone – necessary for the masculinity and strength of Olympic athletes, differentiating between the reproductive and the endocrine function of the testicles. Another

	valid point he makes is that no matter what physical talents an athlete has naturally, they will never be an Olympic winner if they do not train hard. In approximately the same era as Galen we encounter the famous doctor Rufus Ephesius. His only mention to sports events is his condemnation of a coach for not having interpreted his athlete’s dream that he was drowning, and did not conduct – as he should have done after such a sign - resulting in the death of the athlete during training amidst signs of a cardiac failure due to a hypertensive crisis. It is fitter that he be remembered as the most accurate investigator of severe renal dysfunction during fatigue syndrome. Pseudo-Galen, in the 2nd century AD, returns to the differentiation between health and agility, writing that there are three results of health. Beauty (but not beautification), well-being (as a result of health, not training) and wholeness (as a symmetrical development of body parts). (Illustration 14) It follows that well-being is part of health, that it is an aspect of health, but well-being due to exercise is not and should not be called health.
There exists a wonderful text by Flavius Philostratus, written in the 2nd-3rd century AD, mourning the decadence of the athletic ideal. There are no more athletes like the old Olympic champions, he says. The era of spartan, tough, heroic men is gone! The athletes of today are useless and lazy. And a basic reason for that is the impact of Medicine on Sport. I will not dispute that medicine is valuable, but, with its strictly regulated diets, its supplements, its specifications as to the hours of training and rest, it has made our athletes soft. , All this daintiness lead to briberies and to fixed games that, exempting (maybe) Olympia, had becomes tolerated at all other games, as did the transcriptions of athletes and the false age registration. They became especially prone to sexual abuse of all kinds and severe consumption of alcohol after their victory at Olympia. The coaches’ morals were beyond control, and there was even an incident of an athlete’s murder at Olympia for disobeying his coach, as he would have lost the trophy. He then suggested the practice of using eugenics to select athletes with the necessary characteristics for each sport. Indeed he described with pedantic attention the length and width of various muscles, bones and veins required for each sport. He moreover hypothesized about the importance of race, social class, and education for an athlete to achieve his goal. Emphasis was given to the expression of the eyes as a mirror of a sportsman’s moral and physical equilibrium. He declared that: “As Nature indicates the hours by the stars, the ethos of the eyes indicates the proportions of the body. We cannot dismiss Philostratus’ ideas as racist, because indeed race does have an impact on performance. We know, for example, the excellence in running shown by Kenyan athletes, a phenomenon that required in March 2004 the launch of the International Centre for the East African Running Science at Glasgow University. From the same 2nd century AD, is the work “Anacharsis” by Lucian with the usual nostalgic tendency of the declining descendents to praise the glorious past. It contains a hypothetical dialogue between the Scythian representative who had actually visited Athens in the 6th century and met the famous philosopher, and Solon. In it, the merits of strenuous exercise are described, not only for the benefit of the city and democracy, but also for strengthening the young men’s resistance to the natural elements and the diseases.

The Ancient world is slowly approaching its nightfall. The Olympic Games have in reality lost any religious or patriotic coating and have become a theatre where wandering champions display their skills. They too are approaching their end. Cicero was already mocking the festivities at Olympia as the greatest shopping centre in the world, the maximus mercatus. In the beginning of the 4th century AD, Julian the Apostate made a final effort to resurrect the institution. Athletes gather from everywhere and the priests gain power. As is natural, medical books were written concerning sports medicine, whilst the study of Medicine and all other sciences was forbidden to Christians.

	The most important work of that era is a huge effort by Oreivasius, a famous doctor, and friend of Julian’s, who wrote it at his order. In this he gathered selected extracts from important doctors of Antiquity. The sixth chapter discusses athletes and refers continuously to relevant works by Galen, Antylus and Herodotus. He begins by commenting on diet, saying that a restricted diet is the best guard of health, with the exemption of athletes who are more interested in the enhancement of their strength than in their health. They are allowed to eat and sleep as much as they like and they can drink twice as much as all other people. , They can also receive stronger enemas than usual. He continues by saying that vocal exercises are very good for overall health, as they make the throat and chest stronger, they improve breathing and render the flesh flexible, and not hard, like other forms of exercise that additionally “they harden the flesh and make it insensitive, hence athletes become more idiotic than the general public” (Illuastration 15)
He describes the procedure and benefit from various forms of exercise in great detail, such as the hammock, strolling, horse-riding, trundling of hoops, swimming, fighting, practising for a fight in the gymnasium, working the arms, jumping, bounding in the air, various ball games, boxing with a sand sack, tight-rope walking and fencing.

After the brief biannual reign of Julian the ancient gods die and Christianity becomes the status quo. Phidias’ workplace, where the unique statue of Zeus was crafted, is converted in to a palaeochristian basilica. With an order of Theodosius II, in 393, the Games are cancelled, having been diminished by this point to a cheap folklore festival. It has been said that their termination by the Emperor was the greatest gift for their posthumous fame. Slav settlers settle in Olympia and the place in called Serviana (Serbs country). The ancient Olympic Village, with all its buildings, vanishes beneath the mud of the river Alpheus. (Illustration 15)
	Elis similarly vanishes. Only a few medical authors in Byzantium are still regurgitating the old texts on sport. Aetius Amidanus, in the 6th century AD, returns to the old belief in the healing power of the humidity of statues in gyms – Christianity has in parallel promoted the collection of hallowed moisture (agiasma) from relics, buildings and various objects associated with certain saints. The same author repeats Oreivasius’ opinions on the right colour of urine before training and on the freedom of athletes to consume larger quantities and more nutritious food than common mortals. A 7th century author, Paul Aeginites, is a typical critic and commentator of the above.

	He is precise in voicing his ideas on the value of exercise in the maintenance of good health and mentions different kids of exercises, such as tonic, fast and combination. He warns that training will have to be stopped immediately if symptoms of disturbances appear in respiration, pulse, skin colour or muscle mass. He makes an effort to explain various athletic injuries, such as stretching, cramps, non-septic inflammations and muscle ischaemia. Following in the footsteps of Oreivasius, he places particular emphasis on the kinds and benefits of massage: He categorises them, according to their relationship with sport in: preparatory, therapeutic and, particularly, rubs. (Illustration 16)
Depended on the time of the day: morning and night, and depended on the quality and quantity: multiple, few, hard, soft, symmetrical and combinations of the above. He ends by presenting the familiar opinion that phonetic exercises are an excellent form of training. In the next century, Alexandrinos comments on Hippocrates’ opinion that exercise feeds the muscles, stating – the obvious – that the Father of Medicine does not mean that muscles eat exercise, but that they become stronger by it. Finally, Theophilus Protospatharius, in his commentary on Hippocrates’ Aphorisms delves into an interpretation of the well-known aphorisms on the malignancy of extreme physical well-being and argues that extreme physical well-being should be understood as the abundance of flesh on athletes that drowns their strength. Few remains of sports

survive, either officially at the Hippodrome in Constantinople, or usually as local clubs and not as Olympic Games. (Illustration 17)
	They had a limited appeal and were in some way linked to religious festivals. The Byzantines tried, in general, to preserve, if only mummified, the spirit of Classical Antiquity and the same happened to the literature on the Olympic Games. In the West, knight races preserved, in a latent form, the competitive spirit of the Games. Strangely, actual creation often took place in completely un-gym-like places, such as monks’ caves and hermitages. Many words of the ancient Greek language developed a completely different meaning during the Christian era, most well known examples of which being “angel”, “martyr” and “evangelion” (=Gospel). In the same way the words “athlema“ (struggle) and athlete, training and trainee (ascetes) do not refer to physical performance any more, but to the feats of the soul of hermit monks. As St. Paul wrote: “The struggle now is not against the flesh and the blood, but against the powers, the governors, the war – lords of the darkness of this century, the cunnings between the heavenly bodies.

After searching the vast majority of the surviving texts of the Byzantine period we conclude that these words refer to physical effort in 20% and spiritual effort in 80% of all cases. (Illustration 18)
	The athletes inspiring the crowds with their bravery are the martyrs. This bravery is even more pronounced when Saint George, or Saint Demetrius, or the Saints Theodor, on horse-back are shown killing the dragon, heroes of a post-idololatric age. The new training places had nothing in common with the gymnasiums of Antiquity. They were “the deserts and the caves and the holes of the earth” near a saint’s burial site usually, reminiscent of the worship of the burial and underworld spirits of the pro-Archaic Olympiads. The body should appear as neglected as possible. As the famous monk-author of the 8th century, Theodorus Stoudites, wrote: “our way of life is not really this, to eat a lot, to drink a lot, to jump around and to throw stones”.
We might wonder about the connection of all this with Medicine and Health. The connection is two-fold. On one level, health was guaranteed by miracle therapies taking place in monasteries. On a second, spiritual exercise guaranteed a much-ignored today aspect of health. We may all repeat mechanically the Alma Mata definition of health as “the sum of physical, mental and social health”, but in reality we shun everything that may guarantee our mental health, if this is founded on a kind of spirituality that is not in accord with the politically correct view of globalisation culture on spirituality. The Byzantine revulsion towards the body and the worship of the soul often led to unhealthy excesses, but the current worship of the body and revulsion towards all moral barriers happens every day, with at least equally disastrous results.

In the following centuries there were of course no Olympics. The need for heroic confrontations and their political exploitation were satisfied via knight duels of feudal origin. Later, in the writings of John Locke (1623 – 1704) and Jean Jacques Rousseau (1712 – 1778) exercising the body is the medium, not only for the promotion of health but for mental development as well. Monarchy started to lose its glamour and democratic ideals, especially those of revolutionary France, sought for an answer to the glorified like ancient athletes and demi-gods kings. Thus Olympia was proposed as the place where the fertile juices of Democracy would run freely. Also as a place for an indirect attack to Christianity, as

under the influence of the Enlightenment and the French Revolution, a neo – paganistic movement was emerging. The idea was established amongst the representatives of the Enlightenment and was represented in a rare illustration for the book “The New Anaharsis”, translated by Rigas Velestinlis. Rigas, an active advocate for medical studies, believed that their second bloom in Greece, as with the Olympics, would permit the renaissance of the country. The following extract from his translation of the work “Olympias” by Abba Matastasio where he inserts the word Freedom, which is lacking from the original, is characteristic of the mythological extension of Olympia’s landscape in the subconscious of the revolutionary circles.
O, beautiful dearest woods, O, my happiest and dear Freedom Armies are not needed here Nor do castles with big walls Freedom is complete Secure and safe Nothing tempts the heart towards covetousness O, beautiful dearest woods O, my happiest and dear Freedom.
Rigas notes that in his village in Thessalia some of the Olympic sports still survive because “The Olympic Games were celebrated by our ancestors”. The relationship between the games taking place in many towns and villages of Greece and the Greek communities of Asia Minor for the celebration of an honoured saint has been noted by many Greek and foreign researchers. In Gastouni, the ancestral village of the author of this article, in South Western Greece, athletic contestations between the youths of the area took place in the beginning of the 19th century in honour of famous warlords. For Hellenes and Philellenes alike, similar games in their poor and humble present were considered as inheritors of the bright civilisation of Antiquity. , , In the same frame of mind, the folk medicine therapies the oppressed Greeks of the same period used to treat their illnesses had the false claim that of being genuine recipes of Hippocrates, Galen etc.
After the ousting of the Bourbons and the establishment of the French Revolution, in an eruption of easy antimonarchism, the first contemporary Olympic Games take place in August 1793, in Paris. Only the ambassadors of republican countries are invited, as the presence of royalty would contaminate the democratic nature of the games. The ambassador of Ottoman Empire was invited though as the West’s agenda made it shut its eyes to a totalitarian regime and accept it as one of the democratic countries. History is often repeated as a farce
As Frederic Goethe wrote, the revival of ancient institutions in modern eras may please or surprise, but it will never resurrect the world in which they were born. In the same line of thought, after the establishment of the Greek Kingdom, the national benefactor and millionaire, Evangellos Zappas, sponsors the first modern Olympic Games on Greek land in 1859 in Athens. The second were also hosted in Athens in 1870, attracting 30.000 spectators, while the third took place in the same city in 1875. The responsibility of the events belonged to the “Committee for the Olympics”. A similar committee, called “ Olympic Society” was founded by the British medical doctor W.P. Brooks during the 1850’s in England and worked in close collaboration with the Greek one. Both societies were approached by the French Baron de Coubertin who visualised the ressurection of the Olympics on an international basis. (Illustration 19)

	Coubertin’s effort for the revival of the Olympic Games was based on the desire for the renaissance of the decadent – primarily French – youth of the industrial era, for an international understanding, and finally against Medicine. Coubertin believed, not entirely without foundation, that the medical status quo tries to “inform” society in such a way that even healthy, young men who exercise will feel the constant need for a doctor.
He advised athletes not to accept any restraints on their athletic vigour and to be cautious about accepting the advise of doctors, who they should view as mere guides and not despots of their athletic life. Thus the mutual lack of trust between doctors and those participating in sports events, expressed already by Hippocrates and Galen, was continued. The first official Olympic Games are held in Athens in 1896. (Illustration 20)
	The role of politics is again evident, as the members of the Royal Family (Illustration 21) are the sole supporters of the Games, whereas the Trikoupi government is opposed on financial grounds. In the end, everyone is affected by this dream of revival, expressed in parallel through art. Hybrid garments, buildings and ceremonies try to bridge a gap of centuries. (Illustration 22)

	All this is expressive of the desire of the progeny to form a link with their glorious past. The victory of a simple potter, Spyros Louis, at the Marathon, forms a link between the aristocratic facet of the Games popular culture. Medical services were provided for the athletes by a few enthousiastic military doctors from the upper classes of the Athenian society. Their leaders were Christos Rallis and Loucas Bellos (a gynaecologist!). The Marathon athletes were escorted by riding officers and horse-pulled coaches which were used as mobile pharmacies and ambulances. A far cry from the 2004 Athens Olympics where a whole hospital was purposefully built for the Games, an array of other affiliated hospitals are upgraded for Olympic use all over Greece, and several thousands of specialist doctors and paramedics stand in attendance. A side-product of the medical progress then was the publication of guides to healthy living and exercise in Greece as well as at the big urban centres of the Greek Diaspora. All appeared well and ready to support the reappearance of “beautiful and good” young men. World peace would reign supreme.
Since then, two World Wars and innumerable smaller ones have destroyed this dream of peace on a global scale. The Olympic Games themselves became a vehicle for political propaganda, with Hitler’s propaganda taking advantage of their organisation in Berlin in 1936, with their cancellation in 1940 and 1944 and their use as a medium for intense competition between the West and the Socialist Republics of the Soviet Union during the Cold War. The murder of two athletes from Israel marred the 1972 Games, whilst the discussions on whether a 2-billion population strong China should be allowed to participate at the, now global, Olympics continued for years. The USA collect the vast majority of medals, causing a feeling of revulsion in the rest of the world, reminiscent of Sparta, which, during the first 10 years of the Ancient Games won 46 out of 81 trophies. The world of 2004 in which the Athens’ Olympic Games take place has changed completely in the 109 years from their revival. Mass entertainment, consumerism, cultural life - or the lack of - characterise a continuously growing part of our planet. (Illustration 23)

	New sports, more fit to the catwalk are added, as in the equivalent era in decadent Late Antiquity, when a winner of the Games showed off in a floral toga. The epitome of the difference between the 19th and the 21st century ideal about the Games, is the difference between Coubertin’s axiom that “The important is not to win but to participate” and today’s dictum “The first is everything, the second is nothing”
Medicine can but follow this general trend. Athletes are not motivated by their original aim to form a link with divinity, nor by the will to honour their country, not even as much for their own fame, as for money. LeRoy Burrell, the sprinter, left no doubts when he declared: “We do not participate at the games because we want to, or because we want to get into University. We are here to become rich”. In this environment, Medicine’s aim is to aid the acquisition of wealth at any cost. Primitive tricks, such as the oldest known incident of doping at athletic races i.e. the consumption of sugar dipped in ether to increase the stamina of the swimmers participating in the swimming contest between the canals of Amsterdam in 1865, do not suffice. Even in that era of limited doping we note the death of a British cyclist in 1866 due to pharmaceutical consumption. During the 20th century the revival of the Olympic Games and the development of professional sportsmanship, will be accompanied and marked by the spread of doping, meaning the use of pharmaceutical substances that is a result of the logicalisation of sport and its
incorporation in an industrial-consumerist society. A large number of experts (coaches, doctors, chemists etc) works on the athletes and aims to maximise their performance. The sports industry works methodically, scientifically, and, some times, inhumanly. Doping is placed within this context of organised and of specific aim exercise, as an action of disobedience, which does not conform to the rules of the athletic system, an action not tolerated by the athletic community and is severely punishable by law. An action yet that the same athletic system forces the athlete to perform, with the tempting commissions it offers, for which the athletes do not hesitate to risk their lives” . This is how we came to witness the distorted bodies of sportswomen from the Popular Republic of East Germany and the Communist countries in general from the abuse of androgens, and of many Western athletes from the use of stimulating substances for the improvement of performance. Even the celebrated Australian Olympic Team which opened the Sidney Olympics of 2000 was found guilty of doping and consequently several of its members were for bitten to participate in the Athens Olympics of 2004. (Illustration 24)
	This trend cannot come as surprise in societies where people feel free to take a pill to make love, another one for contraception, another one to look beautiful and be slim, another one to face their boss or meet their friends and finally, maybe another pill to undergo euthanasia.
Stimulants are not sufficient for contemporary medicine to fulfil its role as an aid to the dubious preparation for the Olympics. The supposedly innocent nutritional supplements, anabolics, b-blockers auto transfusion and erythropoeitin injections have given us the “pharmacogenic athlete”. And even this has not been enough to satisfy the voracious appetite of an international audience that has converted the Olympics, as Helen Lenskyji said, to the greatest Circus Maximus on the planet Earth. DNA manipulation will be able to give us embryos with perfectly formed and developed particular groups of muscles, that will become excellent athletes at particular sports. Gene cloning has already started. Either by introducing alien genes to an athlete’s body (difficult to trace), or by manipulating his/hers own genes (impossible to trace). Cloning will permit us to reproduce as many identical progeny as needed. Athletes will then be born having the correct body proportions for every contest. For example extreme height for basketball, large feet for swimming, high legs for running. In the same trend the members of the International Olympic Committee feel free to close their eyes to the overuse of boosting substances by athletes of the superpowers, the leading sportswear conglomerates dictate the mode of the Games and the politicians feel free to sign with fanfare the Olympic Truce and simultaneously to order homicides in vast scale, claiming that the Olympics are apolitical. (Illustration 25)

	After all these references to deviations from the classical ideals of athletes and doctors and their relationship, I shall try to answer the following question: Should we condemn as hypocritical the invocation of grand ideas by the organisers of the Olympic Games? Are the Olympic Oath and the Oath of Hippocrates nothing but fig leaves to cover the moral nakedness of all involved? The answer I suggest is: Probably not. Without the Games and without sports medicine, in whatever way they take place, our lives would be poorer. Apart from this utilitarian element though I will pause to evaluate morally what is being called hypocrisy. In a truly immoral world hypocrisy would not exist because there would be no need for it. We would all be immoral and feel no shame for it, since we would have lost our moral conscience completely. Under this light, the, to a certain extent hypocritical, invocation of ideals is nothing more or less than “a symbol of what we should believe, of what it would be absolutely essential that we believed in” as renown late Greek poet Konstantinos Kavafis, paraphrased, would have said.

This article started with the encouragement of Virtue to Hercules to exercise his body with pain and effort and not to resort to easy solutions as was suggesting by Vice. It will finish with the words of LaRosfouceau, the French philosopher of the 18th century who wrote: “Hypocrisy it’s the bow that Vice makes to Virtue”. Even in the New Testament we read that it is not necessary that we have a large amount of faith in all that is good. Even if we just had a seed of grain we could move mountains. Let us hope that the studies of the History of Medicine will aid us in retaining a small amount of faith, maybe at least one seed of grain in the ideals of Olympia and Medicine. (Illustration 26)

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[18] De Articulis, sect. 4, l. 1 (Περί Άρθρων)

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[39] Παυσανίου, Ελλάδος Περιήγησις, Αχαϊκά – Ηλιακά, Εκδοτική Αθηνών, Αθήνα, 1979, 262

[40] Abbot Vasilios of the Iviron Monastery on Mount Athos in the edition of Pindar’s Olympionikon (Winners of the Olympics).

[41] Kattapodis I., Barbarians or Bar-bar-oi, The Surgery, July-August 2002, p. 43 (in Greek)

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[62] Flavii Philostrati opera, Olms, (publ), Hildesheim, 1964, De gymnastica, 43.1

[67] Anonymous, University of Glasgow News Review, no 6, June 2004, cover page

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[90] Samara P., The revival of the Olympic Games in Greece, 1797 - 1859

[91] Didot F., Notes d’ un voyage fait dans le levant en 1816 et 1817, Paris, 1826.

[92] Μichael Biddis, The Athens Games of 1896, Baron Coubertin and the Cult of Health through Sport, Proceedings 1^st International Medical Olympiad, Cos, Marketos (edt), 1.15.

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[94] Lucian, Harvard University Press, Cambridge, Mass, 1913, Demon, 16.1

[95] Gutmann A., The Olympics. A History of the Modern Games, Urbana and Chicago, 2002, p.177.

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[97] . Bill Mallon, Drug use in sports. Athletics, 1990, IAAF.

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