12 May

Although  Hippocrates is the  dominant figure  in modern  accounts  of Greek  medicine,  in  antiquity   the  good  doctor  shared  the  stage  with the  healer  who  began  his career  as the  ‘‘blameless physician’’ in the Ilaid. It was during the age of Hippocrates, not the age of Homer,  that Asclepius was elevated to the status of a god. This was a time of extraor- dinary  tension  between  intellectual  freedom  and  intolerance.  Impiety and ‘‘godlessness’’ were crimes that could be punished by death or ban- ishment.  Excessive interest  in the nature  of the universe could even be regarded  as a sign of madness, as in the case of Democritus  of Abdera, the  founder  of  atomic  theory.  When  Democritus   began  a  series  of dissections as a means of understanding structure  and function  in ani- mals,  his neighbors  interpreted these  anatomies  as signs of madness, outside the acceptable range of scholarly eccentricity. According to tra- dition, Hippocrates was called upon to cure the philosopher,  but having spoken  at  length  with  Democritus,   the  physician  told  the  people  of Abdera  that  they were more  likely to  be mad  than  Democritus,  who was both  rational  and wise.

As demonstrated in the history of other  civilizations, what is now called modern  scientific medicine has not  totally  displaced  traditional, folk, or religious approaches to healing. Thus, it should not be surpris- ing that Hippocratic medicine did not totally displace religious medicine in  the  ancient  world.  For  chronic,  episodic,  and  unpredictable  con- ditions, such as arthritis, gout, migraine headache,  epilepsy, impotence, infertility, and malaria, when patients felt that the physician was ineffec- tive, magicians and priests could always offer hope and even the illusion of cure during  the  intervals  between  attacks.  Some historians  believe that  the increase in magical and  superstitious medicine during  the age of Hippocrates may have been due, in part,  to the growing burden  of malaria.   Still,  despite  the  differences  between  Hippocratic  medicine and religious medicine, Asclepius and Hippocrates shared certain basic assumptions   about  the  best  approach to  healing.  ‘‘First  the  word,’’ Asclepius taught,  ‘‘then the herb, lastly the knife.’’ Over the course of several centuries,  the cult of Asclepius spread throughout  the  Greek  world,  established  itself  in  Rome,   and  only gradually  gave ground  to Christianity as arbiter  of the meaning of dis- ease and healing. Legendary  accounts  of the life and times of Asclepius agree that he was the son of Apollo, but there were disagreements about the place and manner  of his birth.  His mother  was either a nymph or a woman named Coronis who was killed by Apollo’s sister Artemis. With poor Coronis on her funeral pyre, Apollo decided to bring his son to the home  of  Chiron   the  centaur,   who  had  tutored   many  great  heroes. According  to Homer,  Chiron  taught  Achilles and  Asclepius the secret of  drugs  that  relieve pain  and  stop  bleeding.  Thanks  to  his mentor, Asclepius mastered  the use of the knife and  learned  the secret virtues of herbs. When in addition to curing the sick, Asclepius took to restoring the dead to life, Pluto, god of the underworld, complained to Zeus. Afraid that  mortals  would  ignore  the  gods  if they  felt  that  human  healers could  save  them,  Zeus  struck  down  the  son  of  Apollo.  Eventually, Asclepius  became  the  god  of  medicine  and  was worshipped  in mag- nificent temples, served by priests who called themselves Asclepiads (descendants  of Asclepius).

Asclepian temples were built at Cos, Cnidus, Epidaurus, and other sites blessed with springs of pure water and magnificent views. In temple illustrations,  the god  was often  portrayed with  his daughters,  Hygeia and Panacea,  and Telesphorus,  the god of convalescence. Like Lourdes and  other  modern  healing  shrines,  the  temples  of  Asclepius  became places for hopeful pilgrimages and miraculous  cures. Information about temple  medicine  has  come  from  studies  of  archaeological   remains, votive tablets that record the stories of satisfied patients,  models depict- ing the  organs  healed  at  the  temple,  and  references  to  temple  magic in  literary  sources.  But  even  in  ancient  Greece  there  were  skeptics who ridiculed  the testimonies  as deliberate  forgeries or the ravings  of hypochondriacs and  insisted  that  there  would  have  been  many  more tablets  if those who were not cured had made declarations.

Among  the ruins of the temple at Epidaurus is a shrine dedicated to Hygeia,  who may have been the original  Greek  goddess  of health. Like  the  Chinese  sages who  would  not  treat  the  sick, Hygeia  taught people to achieve health  and  longevity by proper  behavior.  Her  inde- pendent cult was eventually subsumed by that of Asclepius and her sta- tus was reduced from independent  practitioner to physician’s assistant. Asclepius also enjoyed the help of holy dogs and sacred snakes. In con- trast to the Mesopotamian hero Gilgamesh, who lost the herb of healing to a snake, Asclepius received the precious herb from a sacred serpent. Thus, Asclepius was often portrayed with a snake coiled about  his staff. The  caduceus,  the  sign of the  modern  physician,  which contains  two snakes intertwined  on a winged staff, seems to suggest increased snake- power,  but  it  is actually  closer  to  the  magic  wand  of  Mercury,  the messenger of the gods and the patron of thieves and merchants.

The Asclepiads boasted  that  all who entered the temple sanctuary were cured.  Presumably,  they  achieved  a  perfect  record  by  carefully selecting their patients.  Temporary remissions and spontaneous recov- ery  from  psychosomatic   complaints  and  self-limited  diseases  provide all medical  systems with  a large  measure  of success. Nevertheless,  in Plato’s  Republic Socrates  says that  Asclepius did not  attempt  to  cure bodies  thoroughly wrecked  by  disease.  Even  the  healing  god  would not  lengthen  lives that  were plainly  not  worth  saving, or  allow weak fathers  to beget even weaker sons.

The  most  important part  of  temple  medicine  was  called  ‘‘incu-bation,’’  or  temple  sleep. Incubation was part  of the ancient  practice of seeking divine dreams  of guidance as the culmination  of a series of preliminary   rites  which  might  include  fasting,   prolonged   isolation, self-mutilation, and  hallucinogenic  potions.  Sleeping on  animal  skins in front  of an image of Asclepius was a rather  mild form of this nearly universal ritual.  Some patients  reported  instantaneous cures after being touched  by the god, or licked by the sacred snakes and holy dogs that guarded  the temple. Fortunate patients  reported  that  Asclepius himself came to  them  during  therapeutic dreams.  Sometimes  the  god  recom- mended   simple  remedies,  such  as  vegetables  for  constipation, but Asclepius might also direct the patient  to smear his eyes with blood  or swim in icy rivers. For  some conditions,  cure or  improvement  might indeed result from the combination of rest, fresh air, good diet, hope, and suggestion encountered  at the temples of Asclepius. Religious rituals and the release of tension and anxiety occasioned by following the com- mands  of the god might  have cured  many  psychosomatic  complaints, and comforted  many patients,  even if a specific cure was impossible.

Women  were not  allowed to give birth  within the grounds  of the temple, but Asclepius accepted various gynecological and obstetric hallenges, especially infertility. Many barren  women reported  that  they became pregnant  after visiting the temples. However,  as demonstrated by the testimonial  of Ithmonice,  who asked the god if she could become pregnant  with a daughter,  supplicants  had to be very careful in framing their requests. Hinting  at the complications  that might occur, Asclepius asked  Ithmonice  whether  she wanted  anything  else, but  she could  not imagine wanting  more. After carrying  the child in her womb for three years,   Ithmonice   sought   another    favor   from   the   god.   Asclepius reminded  Ithmonice  that  she had  only requested  conception  and  had not mentioned  delivery, but the god graciously granted her new request. As soon as Ithmonice  left the sacred precincts her daughter  was born.

According  to the testimonies, grateful patients  praised the god for curing headaches, paralysis, general debility, and blindness. A man who claimed to have swallowed leeches and a woman who thought she had a worm in her belly testified to being opened up by the god, who removed the infestation  and stitched up the incision. Even relatively minor prob- lems might receive the god’s attention. One man came to the temple for help because his neighbors  made  fun of his bald  head.  During  temple sleep, the god  anointed  his head  with  a drug  that  caused  the growth of thick black hair.

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