The Ancient Doctor

REPUTATION AND STATUS

Everything was in such a confused state that a soldier who had been enrolled in the Senate from the ranks of the centurions took it into his head to aspire to become emperor, as also did the son of a mere doctor (Cassius Dio, History of Rome 79 frg. 7).

In practically every case, whether it involves a disease or a wound, people blame the doctor for any further suffering that arises as the consequence of the suffering that the patient is already undergoing. They do not understand the constraints that make it inevitable. Suppose a doctor visits someone suffering from a fever or a wound, and treats him: if there is no immediate improvement in his condition, if indeed by the next day it has deteriorated, people blame the doctor. But if there is an improvement, they do not praise the doctor as much as they blame him for deterioration, for they think the patient was going to improve anyway (Hippocrates, Diseases 1.8).

When anyone criticizes me, I balance this against the praise I hear from other people, for wanting to gain the approval of everyone is like wanting to own the wealth of all the world (Galen, The Affections and Errors of the Soul 44).

I have continued practising as a doctor right into my old age, but to this day I have never committed a blunder, either in treatment or in prognosis, though I have seen many other doctors with the highest reputations doing so (Galen, On the Affected Parts 8.146K).

Pay attention to me now, more closely than you would if you were being inducted into the Mysteries of Eleusis or Samothrace or into some other such sacred rites, and were completely intent on what the initiating priests were doing and saying. You should regard the rites I am carrying out now as in no way inferior to those mysteries, and no less capable of revealing the wisdom, the forethought, and the power of the creator of living things. You should bear in mind especially that I was the first to discover these rites that I am now performing. No previous anatomist had any knowledge of these nerves or of the facts that I explained earlier about the construction of the larynx. That is why earlier practitioners made so very many mistakes in explaining how the various parts of the body work and why they did not discuss even a tenth part of their functions. So, even if you have never done so before, turn your mind now to holier things, showing yourself worthy to hear what is about to be said, and follow me as I explain the wondrous mysteries of nature (Galen, The Function of the Parts of the Body 3.576K).

There was once a great famine in Rome, and it was difficult to find a way to relieve the situation. So Augustus expelled all the slaves in the slave-market from the city, and also the troupes of gladiators, and all the foreigners; exceptions were made only for doctors and teachers, and a small number of slaves from each household (Suetonius, Life of Augustus 42).

 

FUNERARY INSCRIPTIONS

In honor of Trophimus, our doctor, we, the wild beast hunters, who had confidence in him … set up this bronze statue of him near the gate through which the animals enter the arena. By the vote of the Council (Corpus of Greek Inscriptions 1106).

If there were a way for a doctor to escape death, old Philon, who knew every remedy, would not have gone down under the ground. He reached extreme old age without being carried off by any illness. So it may be said that he had a very enviable life, a good man who enjoyed a prosperous and healthy old age (Griechische Versinschriften 1699, part of a third-century BC epitaph from Athens).

Noble Apollonides, excellent young man and skilled doctor, your parents buried you with sorrow and lamentation. Your companions groan loudly for you, for you were a flower among your peers but you died when you were just eighteen years old. This altar, a last gift, was set up by Menander, your friend who was a brother to you (Griechische Versinschriften 1543).

To the Gods underground: The earth hides the best doctor in the world, Dionysius, who despised gold, but was himself all golden (Notizie degli scavi di antichità [1941] 193, a second-century AD Greek epitaph from Rome, with the lines written in the shape of an altar).

This is the sarcophagus of Marcus Aurelius Ptolemaius, also known as Aristotle, of Sidyma, chief doctor and exempt from public services, and also of Demetria, daughter of Demetrius, his wife and niece. We shall be buried here. If they should so wish, our very sweet children, Demetrius and Hippocrates, will have permission – they, and they alone – to be buried here. But no one else will have permission. If anyone dares to bury anyone else here, he will be liable for tomb violation, and will have to pay fifteen hundred denarii to the people of Sidyma (Tituli Asiae Minoris 2.224).

 

THE IDEAL DOCTOR

A doctor should have a ready wit, for both those who are well and those who are sick find dourness off-putting. He should be careful to keep himself well covered up, and should stick to the essentials when talking to laymen, for gossiping might well lead to criticism of the treatment he gives. He should perform all his duties without fuss or ostentation. He should think about everything in advance, so that everything is ready to hand when needed; otherwise, there will be unpleasant difficulty at the crucial time (Hippocrates, Decorum 7).

Doctors are not content for their patients’ health to be won at the cost of suffering and anxiety. Not being sick is not enough: I want people to be vigorous, cheerful, and lively. If all you can say about someone is that he is not actually in bad health, he is practically no better off than an invalid (Tacitus, On Orators 23).

An expert doctor is not one who simply cures, but rather one who understands the basis for the cure (Alexander of Aphrodisias, Commentaries on Aristotle’s Topica 561).

Here is an experiment I once tried. I stretched a patient out on his back, and placed an empty bag under him, below the hump in his back, and then blew air into the bag through a bronze pipe. But it did not work. Whenever I managed to get the patient well stretched out, the bag would deflate, and it was not possible to force air in. And in any case the bag tended to slip sideways, defeating any attempt to force the patient’s hump and the curvature of the inflated bag to come together in the same place. Whenever I did not stretch the patient out so much, and the bag was full of air and nicely curved, the patient’s whole back would bend, not just the part that needed to do so. I have recorded this experiment advisedly, for good lessons can be learned even from experiments that turn out to be failures, provided they make clear why it was that they failed (Hippocrates, On Joints 47).

I think the famous doctor Hippocrates behaved very commendably when he acknowledged some mistakes he had made, so as to prevent other people from repeating them later on (Quintilian, Education of the Orator 3.6.64).

If my physician does no more than feel my pulse and class me among those whom he sees in his daily rounds, pointing out what I ought to do or to avoid without any personal interest, then I owe him no more than his fee.  Suppose that my physician has spent more consideration upon my case than was professionally necessary; that it was for me, not for his own credit, that he feared: that he was not satisfied with pointing out remedies, but himself applied them, that he sat by my bedside among my anxious friends, and came to see me at the crises of my disorder; that no service was too troublesome or too disgusting for him to perform; that he did not hear my groans unmoved; that among the numbers who called for him I was his favourite case; and that he gave the others only so much time as his care of my health permitted him: I should feel obliged to such a man not as to a physician, but as to a friend (Seneca, On Benefits 6.16).