CHAPTER VII.
SICKNESS AND PHYSICIANS, DEATH AND BURIAL.
The Great Plague—Homer’s References to Physicians—Asklepiadae—The Oath of Hippocrates—General Practitioners and Specialists—Plutus of Aristophanes—Customs connected with Death, Burial, and Burning—Tombs and their Ornaments.
Greek mythology tells us that in the golden age mankind lived without trouble or sorrows, equally unacquainted with vice and with cruel disease; but when fatal curiosity opened the disastrous box of Pandora, along with a thousand other troubles which pursue mankind, there came forth also the countless diseases which attack men by day and night. The myth thus expresses in simple language that, with the advance of civilisation and the disappearance of the ancient simple mode of life in accordance with nature, the number of diseases also increased. But the greater the number of these attacks on the health and life of mankind, the more eagerly do men seek to avoid them, though, at first, in a purely empirical manner, and, therefore, the beginnings of the healing art are as ancient as human civilisation itself. The oldest literary monument of Greek life, the Homeric Epic, makes little mention of disease, with the exception of the great plague, which devastated the camp of the Greeks before Troy. The reason of this, however, lies in the nature of the poet’s subject, and we must not on that account infer that illness was little known. Even in Homer mention is made of physicians, and though the Homeric doctors were chiefly concerned with healing the wounds inflicted in war, still they possessed some surgical skill in cutting arrows out of wounds, putting on bandages, etc., and were also acquainted with the healing qualities of certain herbs, which they used not only for external treatment of injuries, but also apparently for internal use, in reducing fever, etc. Knowledge of this kind always appears very early, even among nations of slight civilisation, and is handed down from generation to generation. But the healing art was not confined to heroes or demigods, such as Aesculapius and Podalirius, who were afterwards regarded as ancestors of the physicians’ profession, and who traced their origin and their knowledge alike to the gods. There were also, even at that time, professional physicians, and certainly it cannot have been left to chance to determine that some persons possessing surgical and medical knowledge should be with every army.
It is no longer possible to trace in detail the development of the medical profession after the times of Homer. In the historical period we find the healing art developed in two special directions; first, as practised by an actual medical profession; secondly, as a kind of religious mystery in the hands of priests; besides these, quackery was known in antiquity, as in all times.
The professional physicians, who, even in later times, regarded their art as divine, and handed down by their ancestor Aesculapius (on which account they also called themselves Asklepiadae), were probably a development from the priestly physicians. It is very likely that in the first centuries after Homer, the practice of the medical art was still directly connected with the worship of Aesculapius, and that the separation which we find in the historic period, where some remained as medical assistants to the priests in the sanctuaries, and others practised independently on their own account, only gradually made way. It cannot be a mere chance that the places where the most celebrated medical schools of antiquity existed, Cos and Cnidus, were also regarded as the chief seats of the worship of Aesculapius. The professional physicians, who practised their art independently, and were not connected with the sanctuaries, naturally received a fee, and though this brought them into somewhat bad repute, with which every art that conduced to making money was regarded, yet their occupation stood in much higher general estimation than any of the trades, and it was a serious reproach if they, as sometimes happened, insisted on receiving their payment beforehand, and in case of inability to pay, refused to give any treatment at all. Their knowledge was not acquired at colleges or hospitals, like that of our modern physicians, but, as a rule, they became assistants or apprentices to old experienced physicians, whom they accompanied on their visits, and by whom they were instructed in diagnosis and therapeutics, as well as in the preparation of medicines. There were sellers of drugs, who kept the most important remedies, but there were no apothecaries in our modern sense, and physicians always prepared their own medicines. There does not appear to have been any examination necessary in early times before practising the medical profession, or any direct control or supervision of the doctors, but in later times physicians seem to have held together in a sort of guild, and, perhaps, even solemnly dismissed their apprentices at the end of their period of instruction before their assembled colleagues. This is suggested by the oath of Hippocrates, which has been preserved to us, in which the young disciple of Aesculapius promises to keep only the welfare of his patient before him, to keep silence, to give no one poison, even at his own request, etc. Probably this oath was only used in the school of Hippocrates and his followers.
Among the professional physicians there was a further distinction between those who practised privately and those who had official positions. The former either gave their advice at home or else visited their patients. Slight invalids, who were able to go out, generally visited the physician in his consulting hours, and there they received not only advice but sometimes also direct treatment, since other apartments for bathing, operating, etc., were connected with the consulting room, and the physician also prepared and dispensed his medicines here. Even those who were very ill, as, for instance, the wounded Lamachus in the “Acharnians” of Aristophanes, were carried straight to the doctor when the case was pressing. Of course a very celebrated physician could not himself treat all his patients, and he therefore employed assistants in his consulting room, who also accompanied him when he paid visits abroad, in order to profit by the master’s experience at the sick bed; and it may not have been very pleasant for the patients when the doctor thus arrived in company of a not inconsiderable troop of students. It was still more unpleasant, however, if want of means compelled them to resort to inferior assistants, who sometimes were even slaves. These slave doctors were not only summoned to the slave population, but they also treated free people, chiefly those who were too poor to pay a high fee. Of these it was said that they differed from the better physicians, who were careful and who studied and watched their patients, in paying very hasty visits, scarcely taking time to inquire after the nature of the illness, and hurrying on after giving any directions that might occur to them. Sometimes a citizen had one of his slaves taught the healing art by some physician, supposing he showed any ability for this profession, and by this means he had someone in the house who, in case of need, could supply help at once. The position of the Greek slaves, especially in Attica, was a comparatively free one, and therefore we must not be surprised that they were willing to entrust the welfare of their body to a slave, seeing that they even left much of the moral training of their children to him. Complaints were often made, too, about free physicians, not on account of their hastiness and carelessness, but rather because of their boastful and haughty bearing; thus, for instance, Menecrates, a physician of Syracuse, was accused of always dressing in the most elaborate fashion, and wishing to be called Zeus. Others were rude or inconsiderate to their patients, like that doctor who answered a patient, when he expressed fear of death, with the words of Homer:—“Patroclus, too, is dead, and he was a better man than thou.” Others gave annoyance by carelessness in their dress and noisy manner, loud talk, etc. Hippocrates insisted that a physician should aim at a certain amount of elegance in dress and care in regard to his person, though he adds characteristically that any doctor is at liberty to do otherwise supposing his patients prefer it.
The position of the public physicians, who were chosen and paid by a community, and therefore bound to receive no fees for their treatment, was a different one, though it is not clear whether they treated all the citizens or only the poor ones. These public physicians sometimes received very high salaries. Thus the physician Democedes, as public doctor at Aegina, received a salary of one talent (about £326); thereupon he was summoned to Athens with a salary of a hundred minae (£393), and in the following year the tyrant Polycrates, of Samos, invited him, probably to fill the post of public physician, not as his own private doctor, and gave him a salary of two talents (probably Attic talents, therefore £471). On the other hand we sometimes hear of rich physicians treating the poor free of charge.
Specialists do not seem to have been common in ancient Greece, the same doctors treated external and internal complaints, and also men and women. It seems, however, from the oath of Hippocrates that there were specialists who undertook the operation of cutting for stone. Oculists were unknown till a later period, when the medical practice generally developed in various ways, and in particular the influence of gymnastics, and the dietetics connected therewith had a very important influence on medical methods.
These physicians, although they at times made use of strange or “sympathetic” means of treatment, yet in general aimed at scientific methods, building on the knowledge handed down to them by their predecessors, and enriching it by their own experience and studies. On the other hand, the healing processes, to which the priests of the Aesculapian sanctuaries resorted, seem to have occupied a very doubtful position between empirical therapeutics and superstitious hocus-pocus. It had been a custom from ancient times for the priests of Aesculapius to practise the healing art. Their knowledge was supposed to be in part very ancient, handed down by the god himself, and in part divine revelation, which was continually renewed. Some of the sanctuaries of Aesculapius were renowned and visited beyond all others on account of their wonderful and successful cures, in particular Cos, Cnidus, Tricca, but especially Epidaurus, and afterwards also Pergamum. To these sanctuaries the invalids who sought healing went as pilgrims, just as people still go in Catholic countries to wonder-working shrines, and as in these we see countless memorials of successful cures, pictures and descriptions of diseases, wax or silver imitations of the part or limb that was healed, etc., so in ancient times thank-offerings were made to Aesculapius, sometimes in the shape of coin, sometimes also imitations of hands, legs, eyes, ears, and breasts, etc., in marble, silver, or gold, or else in simple wax or clay, together with the name of the person who found healing there. Some also dedicated tablets, on which was inscribed a detailed account of their illness and cure, and the priests set up large tablets in the domain of the temple, on which all manner of wonderful cures were described. The geographer Strabo tells us of such inscriptions, describing diseases, in the sanctuaries of Epidaurus, Cos, and Tricca. Pausanias saw in the temple domain at Epidaurus six large tablets of this kind. Very considerable fragments of two of these were found a few years ago, which give us a very interesting insight into the proceedings at the Aesculapian sanctuaries.
The healing methods of the priests of Aesculapius were especially distinguished from those of the professional physicians by the veil of secrecy and miracle which surrounded them, since they rightly understood that the love of wonders among the common people would always bring them success. The healing was effected by what was called “incubation”; the patient had to lie down at night in the sanctuary and sleep; in a dream the god appeared to him, and either suggested to him the remedy which would cure him, or else undertook, on the spot, to heal the sleeper, so that the patient, when he awoke, found himself restored to health, and went joyfully away! Aristophanes, in his “Plutus,” drastically depicts one of these cures in the temple. The blind god of riches comes to the temple of Aesculapius to seek for healing; after taking a bath in the sea, he is conducted to the sanctuary; he offers a sacrifice and then lies down to sleep, together with other patients, and one of the temple servants warns them to keep unbroken silence. The servant who accompanies Plutus, and who relates the proceedings, seems to be a somewhat free-thinking rogue. He cannot sleep, and as he observes that after the invalids have gone to sleep, the priests take away and pocket the offerings laid upon the altars, he also takes the opportunity to filch a pot of porridge from an old woman near him. After a time the god himself appears, accompanied by two goddesses of healing. He goes round, examines the individual patients, and, at last, comes also to Plutus; he feels his head, dries his eyelids with a linen cloth, and one of the goddesses puts a purple veil over his face. Suddenly two great snakes come from the interior of the temple, creep under the veil, and lick the eyelids of Plutus, who thus recovers the power of sight. Here the cure takes place during sleep, as also in the stories which are related on the inscriptions of Epidaurus, mentioned above. There, too, an account is given of the cure of a blind woman to whom Aesculapius appears in a dream, and restores her sight by dropping some healing lotion into her eyes, in return for the promise that she will dedicate a silver pig to Aesculapius (to whom pigs were often sacrificed), as a penalty for having come to the temple in a state of unbelief. Such cures of blindness are often mentioned in the inscriptions; sometimes the dog, which was also sacred to Aesculapius, takes the place of the god, as the snakes did in Aristophanes, and cures the eyes by licking them; in another case the snake of Aesculapius cures the wounded toes of a patient by licking. Many cases are even more wonderful. A man, who has completely lost one of his eyes, receives the lost eye again by means of healing lotion poured into his sockets by the god during sleep. A woman, who has a worm in her body, dreams that Aesculapius cuts it open for her, takes the worm out, and sews it up again. A man has moles on his forehead, which the god removes by laying a bandage over his brow, whereupon next moment it appears perfectly white and pure, while the moles are left on the bandage; another man has lost the use of the fingers of one hand, the god jumps on his hand and pulls his fingers straight again, whereupon he is once more able to use them, etc., etc. Indeed, Aesculapius not only cures sick people, but also lifeless objects. A slave has broken his master’s cup, and as he sits sadly looking at it, a passer-by laughingly says that even Aesculapius could not mend that. That suggests to him taking the fragments into the temple, and next morning, when he opens the case in which he has put them, behold, the cup is whole again!