It is not the act of a friend, but of a crafty cheat, to enhance one’s reputation by profiting from other people’s mistakes, making oneself look good to bystanders, behaving like those surgeons who perform operations in the theaters as a way of drumming up custom (Plutarch, How to Tell a Flatterer from a Friend 71a).
The history of fraudulent doctor’s note excuses is at least 2350 years old. In 346 BC, the Athenian politician Aeschines wanted to avoid going on an embassy to Philip of Macedon: He simply had to stay where he was. So, what was he to do? He got himself excused by claiming to be ill. His brother went to the Council with Execestus the doctor, and swore an oath that Aeschines was ill (Demosthenes, On the False Legation 124).
Charmis of Marseilles suddenly took Rome by storm. He condemned earlier doctors and hot baths as well, actually managing to persuade people to take cold baths even during wintry weather. He immersed sick people in tubs, and we used to see old men of consular rank showing off as they grew stiff with cold. Seneca vouches for this. There is no doubt that all such doctors were trading with our lives in their pursuit of fame through some gimmick (Pliny, Natural History 29.10).
A sensible person does not call on those doctors who can speak with greatest polish about the medical art, but rather on those with the greatest practical experience in it (Lucian, Hippias 1).
So-called “talk-doctoring” [logiatry] has nothing at all to do with helping the sick; diseases are cured by medicines, surgery, and diet, not by words (Philo, De congressu eruditionis gratia 53).
Some doctors know how to treat just about every illness, disease, or weakness, but cannot give you a true or reasonable explanation of how they do it, and then there are doctors of the other sort, clever talkers, tip-top at explaining the symptoms, causes, and treatments that make up the science of medicine, but, when it comes to the actual treatment of sick patients, they are absolutely useless, incapable of contributing in the slightest way to finding a cure (Philo, Quod deterius potiori insidiari soleat 43).
Mithridates VI of Pontus was an amateur physician. Some of his courtiers volunteered for surgery and cautery at his hands. This was flattery in action, not just in words, for he regarded their confidence in him as testimony to his skill (Plutarch, How to Distinguish a Flatterer from a Friend 14).
Menecrates was a doctor from Syracuse, who specialized in epilepsy. He took no fee for treating patients, but he required them to agree to be his slaves. He used to call himself Zeus, and gave the name of a particular deity to those whom he cured, calling one of them Hermes, another Apollo (Suda s.v. Menecrates).
A sick person is lying wracked with disease. A mighty mass of medical men meet up, though we are not gripped by pity for the dying man nor by our shared humanity. No, it is like an Olympic contest, with one doctor declaiming, another arguing, another constructing a diagnosis, another demolishing it, and all in pursuit of empty glory. While the doctors wrangle among themselves and – Oh, the shame of it! – the patient deteriorates, does not Nature herself seem to speak like this? “Oh the foolishly ungrateful race of mortals! A sick man is being killed, he’s not just dying – and yet I am accused of weakness? Dreadful diseases exist, but I have given cures. Poisons lurk in plants, but they produce more remedies. Away with this wrangling and confusion, this empty passion for chattering. Those are not the cures I have provided to ensure health. No, I have provided the mighty powers to be found in seeds, in crops, in herbs, and everything I have brought forth for mankind’s benefit” (Theodorus Priscian, Euporiston 1.2).
It frequently happened to me in my travels that, when either I myself or one of my attendants fell ill, I had dealings with doctors who were fraudulent in a variety of ways; some of them sold very ordinary medicines at highly inflated prices, and others were driven by greed to take on cases that they had no idea how to cure (Gargilius Martialis, Appendix to Medicina Plinii Preface).
It is important to devote time to personal examination of each medicine, so as to distinguish those that are effective from those that are useless. For drug sellers are so crafty at tampering with medicines that they can fool even people with great experience in such matters (Galen, On Antidotes 14.7K)
An old woman with eye trouble called in a doctor. He came and put ointment on her eyes. While she had her eyes closed, he systematically removed every piece of furniture from her house. When it was all gone and he had cured her, he asked her for the agreed fee. She refused to pay it, so he took her to court. She said that she had indeed promised to pay him if he restored her eyesight, but that her vision was worse after the treatment than it had been before it, “for I used to be able to see all the furniture in my house, but now I can’t see any of it at all” (Aesop, Fables 57).
Doctors are in the habit of making up many compounds, but when you come to buy these pricey concoctions, you will be disappointed and pour out vast sums of money for no good purpose. Why not learn how to guarantee your health with inexpensive remedies? (Quintus Serenus Sammonicus, Book of Medicine 27.517)
After Hippocrates, there was no limit to the profits to be made from medicine. One of his pupils, Prodicus of Selymbria, invented the ointment cure, thereby discovering a source of income for anointers and medical menials (Pliny, Natural History 29.4). [The elder Pliny may have a low opinion of such people, but his nephew and adopted son, the younger Pliny, thought highly enough of his own ointment-doctor to obtain citizenship of Rome and Alexandria for him by special dispensation from the Emperor Trajan (Letters 10.5, 6, 7, and 10).]
In AD 93-94, Vespasian’s son Domitian had to issue a rescript designed to check abuses of these privileges (Sources of Roman Law before Justinian 427):
The Emperor Caesar Domitian, holding tribunician power for the thirteenth time, hailed as commander of the army twenty-two times, censor in perpetuity, Father of the Fatherland, to Aulus Licinius Mucianus and Gavius Priscus:
I have decided that very strict measures must be taken to check the greed of physicians and teachers. Their skills should be passed on to selected freeborn young men, but are being sold quite scandalously to many domestic slaves who are trained and then sent out, not for the benefit of mankind, but as a scheme to make money. Therefore, anyone who makes money from training slaves in these professions is to be deprived of the privileges granted by my deified father, just as if he were exercising his art in a foreign community.
With diseases of the hypochondrium, it can happen that the rich receive less effective treatment than the poor. Because of their delicate lifestyle, the rich not infrequently miss out, for they not only forego bloodletting but also receive excessively fussy attention from their doctors, who do something to the patient’s body every day. So then, for a start, because of their soft living, most rich people cannot bear bloodletting, even though they are more susceptible than are poor people to plethoric conditions, seeing that they stuff themselves with food more and lead a more idle life. And because the most important treatment has been left aside, the doctors in attendance on them think that they can make up the deficiency through the other remedies that they apply. But their patients, equating a rest cure with neglect, and mere busying oneself with attentiveness, compel their doctors to apply some treatment to their hypochondrium every day – and, of course, the doctors are quite willing to do this, so as to seem always to be actively engaged, for they hope thereby to get a bigger fee (Galen, The Therapeutic Method 10.783K).
Laymen surpass their usual standards of ignorance when it comes to the proper treatment of acute diseases, for it is particularly in their handling of such diseases that people who are not doctors get a reputation for being doctors. It is easy to learn the names of the medicines that are normally given to patients suffering from acute diseases; if barley-water is specified, or such and such a wine, or honey-water, the man in the street thinks that doctors, the good ones and the bad ones alike, prescribe all these things. But this is not true: doctors differ widely in the way they treat acute diseases (Hippocrates, Regimen in Acute Diseases 2).
The cobbler who became a doctor. An incompetent cobbler, ruined and impoverished, went to a place where he was not known, and began to practise medicine. He sold an antidote to poison under a false name, and gained a reputation thanks to his crafty eloquence. The king of the city was prostrated by a serious disease; to test the cobbler’s skill, he asked for a cup, and poured water into it, but pretended that he was mixing poison and the antidote together. He then commanded the cobbler to drink the whole mixture for an agreed payment. In dread of death the cobbler confessed that he owed his reputation as a doctor, not to any knowledge of the art, but rather to the witlessness of the masses. The king called a public meeting and commented: “How insane do you suppose it is, to put your lives without hesitation in the hands of a person whom no one trusted to fit his feet with a pair of shoes?” I would say that this fable is really about those whose stupidity allows unscrupulous people to make money (Phaedrus, Fables 1.14).
Magnus of Nisibis was considered more gifted as a speaker than as a doctor. The old writers say that, when Archidamus was asked whether he was stronger than Pericles, he replied: “Whenever I throw him down, he still wins, by declaring that he has not actually been thrown down.” In just the same way, Magnus used to demonstrate to patients who had been cured by other doctors that they were in fact still sick. And whenever people who had been restored to health and strength tried to express their gratitude to those who had treated them, he still got the better of the doctors when it came to talking and asking questions (Eunapius, Lives of the Philosophers 498).
Early doctors did not need to inquire how we breathe or what makes our blood vessels move, but it was important to find relief for labored and difficult breathing and to determine the meaning of each type of movement of the blood vessels. These things were discovered through practical experience. In every problem of this sort, one can make a case for either side, and hence clever glibness often wins the argument. But diseases are cured by remedies, not by eloquence. A man who is tongue-tied but knows through experience how to observe what is important will make a rather better doctor than someone who refines his tongue but has no actual experience (Celsus, Proem 39).
Rest assured that if a doctor who practices medicine on the basis of experience rather than reasoning should ever come across a free doctor in discussion with a free patient, using language that is almost philosophical, engaging with the disease at its very origin and explaining the nature of the whole body, he would burst out laughing loudly straightaway, and he’d say what most of those who are called doctors are always so quick to say: “You fool, you aren’t treating your patient, you’re practically giving him an education, as if he needs to be made a doctor, and not just healthy” (Plato, Laws 857d).
Some people distinguish between doctors and examine their skill by criteria remote from and irrelevant to the practice of medicine. Wealthy physicians, they believe, are better than poor and needy physicians, and those who are accepted by many great and rich citizens are better than those who are not. … Most of the rich are accustomed to flattery from those who visit them frequently: they listen and act with one purpose, to seek pleasure. Wicked men who take up medicine are aware of this, and by coaxing the rich seek – among other things – to deceive them and to extort money. Should a rich man fall ill, those practitioners, aware of the desire of their client for pleasure, would not administer the treatment most conducive to good health, but, instead, they would prescribe a most desirable and pleasurable regimen. In any case, they would be unable correctly to administer the most appropriate treatment, should they wish to do so. This is because it has never been their intention to apply the art of medicine properly. Their only aim is to gain money, power, and position (Galen, On Recognizing the Best Physician 1.6)
It is so painful for people to disclose their misfortunes that many prefer to die rather than to reveal anything about their hidden ailments to a doctor. Just imagine Herophilus, or Erasistratus, or Asclepius himself, when he was a mortal, going from house to house with his drugs and his instruments, enquiring whether anyone had an anal fistula, or if any woman had uterine cancer. Curiosity on their part would, of course, be life-saving. … But, when it comes to busybodies who enquire into these very same ailments and others that are even worse, not intending to cure them but merely to publicize them, such people are quite properly detested. It is rather like the way we complain and grumble about customs officials, not when they pick out things which are being imported openly, but when they rummage around in people’s baggage looking for things that have been concealed (Plutarch, On Curiosity 518d).
All the ancient writers on the subject made some contribution, whether great or small, to our understanding of medicines, and they did so without resorting to witchcraft and trickery such as Andreas later displayed. … You should stay away from Andreas and all the other such charlatans, and especially from Pamphilus, for he has never seen, even in his dreams, the plants whose characteristics he attempts to describe. Such people are like heralds who advertise the distinguishing characteristics of a runaway slave whom they themselves have never seen. They get the details from those who do know him and announce them as a sort of chant, but they themselves would be incapable of recognizing them, even if the slave happened to be standing right beside them (Galen, De simplicium medicamentorum temperamentis ac facultatibus libri xi 11.795K).
This doctor claims to have set Asclepius’ broken leg, and Apollo’s broken arm (Plautus, The Menaechmus Brothers 885).