The Byzantines of this time could boast of two great medical men, Aetius of Amida (about 502-575 A.D.) and Paul of Aegina (about 620-690). The works of Aetius were of value largely because they recorded the teachings of many of his eminent predecessors, but he was not entirely lacking in originality, and was perhaps the first physician to mention diphtheria, with an allusion to some observations of the paralysis of the palate which sometimes follows this disease.

Paul of Aegina, who came from the Alexandrian school about a century later, was one of those remarkable men whose ideas are centuries ahead of their time. This was particularly true of Paul in regard to surgery, and his attitude towards the supernatural in the causation and treatment of diseases. He was essentially a surgeon, being particularly familiar with military surgery, and some of his descriptions of complicated and difficult operations have been little improved upon even in modern times. In his books he describes such operations as the removal of foreign bodies from the nose, ear, and esophagus; and he recognizes foreign growths such as polypi in the air-passages, and gives the method of their removal. Such operations as tracheotomy, tonsellotomy, bronchotomy, staphylotomy, etc., were performed by him, and he even advocated and described puncture of the abdominal cavity, giving careful directions as to the location in which such punctures should be made. He advocated amputation of the breast for the cure of cancer, and described extirpation of the uterus. Just how successful this last operation may have been as performed by him does not appear; but he would hardly have recommended it if it had not been sometimes, at least, successful. That he mentions it at all, however, is significant, as this difficult operation is considered one of the great triumphs of modern surgery.

But Paul of Aegina is a striking exception to the rule among Byzantine surgeons, and as he was their greatest, so he was also their last important surgeon. The energies of all Byzantium were so expended in religious controversies that medicine, like the other sciences, was soon relegated to a place among the other superstitions, and the influence of the Byzantine school was presently replaced by that of the conquering Arabians.