In Plato’s “Republic” (Book III., Chapter 15) mention is made of a certain Herodicus (of Selymbria; about 450 B. C.) who effected many cures by a method of treatment which combined athletic exercises with dieting. He gained considerable celebrity in this way, and is undoubtedly entitled to the credit of having been the first to call serious attention to the value of this plan of treating certain maladies. But, unfortunately, he made use of it in not a few instances where it proved harmful rather than beneficial to the patient, and thus brought discredit upon the method.
Already previous to the time at which the changes mentioned above took place, there had occurred still other changes in the character and practice of medicine. The business of cutting for stone in the bladder, for example, had been left entirely in the hands of men who made a specialty of this branch of medicine—men who might truthfully be called medical artisans. Then there was another class of men who devoted their energies to collecting medicinal roots and plants. They were a necessity to physicians, and constituted the first representatives of the modern apothecary. Still another change in the status of the Greek physicians had been slowly developing throughout this pre-Hippocratic period, a change which tended more and more to make them men of self-reliance and of considerable importance in their respective communities, and which indicated very clearly that they were steadily growing in skill and breadth of knowledge. As evidence of the correctness of this statement it is sufficient to mention the fact that Greek physicians had established so good a reputation that they were frequently called to see important cases at a great distance—in Egypt, in Persia, etc. But before further consideration is given to this subject of the development of the Greek physician during the period immediately preceding the appearance of the Hippocratic writings, it seems advisable to say a few words concerning the facilities for medical instruction which were available at that time.
Medical Instruction in Connection with the Asclepieia.— It does not appear clearly in any of the published descriptions of these ancient Greek sanatoria just what were the relations between the priests and the men who utilized all this rich clinical material—records of all sorts of diseases, and the means (other than religious) employed in treating them, pictures or plastic reproductions of the visible pathological lesions, etc.—for the purpose of instructing the younger men who contemplated engaging in the practice of medicine. The modern teachers of the art know very well how difficult is the task of combining in a satisfactory manner these two things—the safeguarding of the patient’s interests and the utilization of their maladies as object lessons for men who are preparing to cure or relieve the bodily ills of those who may at some future moment need their professional services. To them, therefore, it would be a matter of very great interest to learn how this difficult problem had been solved nearly twenty-five hundred years ago. But, unfortunately, no satisfactory data upon which a trustworthy account might be founded are obtainable, and we are obliged to fall back upon such aid as our imagination may furnish. From Puschmann’s work on medical teaching in ancient times the following statement relating to the subject has been taken:—
The priests in the Aesculapian temples were not, as is generally assumed, physicians in the ordinary sense. They may have acquired some knowledge of the art, and they may even in some instances have been regularly trained physicians, but the important fact remains that they wished it to be understood that the treatment carried out in the temple was in accordance with revelations made to them by the god Aesculapius, and not the mere fruit of human knowledge. Consequently the intervention of regular physicians in the temple management of the sick must have appeared to them quite superfluous. For this reason, therefore, it is not likely that there existed, on the part of either the temple priests or the physicians, any feeling of animosity or opposition. It is more likely that the contrary was the case, for the evidence shows that the physicians—the Asclepiadae—paid most humble reverence to the sacred relics of Aesculapius, and placed the most implicit confidence in the opinions which he was supposed to give in desperate cases.
FIG. 8. PARALYSIS OF THE LEFT FACIAL NERVE.
(Courtesy of Prof. Dr. Meyer-Steineg, Jenaer medizinisch-historische Beiträge, Heft 2, 1912.)
While Puschmann does not say to what period in the history of these temples his statement applies, it is safe to assume that he had in mind only the earlier stages. When the systematic teachings of medical pupils began, those physicians who gave the instruction—viz., the Asclepiadae who were not at the same time priests—took up their abode somewhere in the neighborhood of the temple. Thus, medical schools were formed at different places, those of Rhodes, Crotone, Cyrene, Cos and Cnidus attaining the greatest celebrity. The pupil paid a fee for his instruction, and when his training was believed to be completed he was admitted into the association or brotherhood of the Asclepiadae upon taking the following oath, which for ages past has been known as “The Hippocratic Oath,” but which is now believed to have been formulated long before the time of Hippocrates:—
THE HIPPOCRATIC OATH
I swear by Apollo the Physician and Aesculapius, and Hygieia and Panacea and all the gods and all the goddesses—and I make them my judges—that this mine oath and this my written engagement I will fulfil as far as power and discernment shall be mine.