Medicine - Physic and Physicians As Depicted in Plato Part 2
( Originally Published 1905 )
So much for the general conception of the structure and functions of the body, in order and disorder, as conceived by Plato. Were nothing more to be gleaned, the thoughts on these questions of one of the greatest minds of what was intellectually the most brilliant period of the race, would be of interest, but scattered throughout his writings are innumerably little obiter dicta, which indicate a profound knowledge of that side of human nature which turns upper-most when the machinery is out of gear. There are, in addition, many charming analogies drawn from medicine, and many acute suggestions, some of which have a modern flavour. The noble pilot and the wise physician who, as Nestor remarks, "is worth many another man," furnish some of the most striking illustrations of the Dialogues.
One of the most admirable definitions of the Art of Medicine I selected as a rubric with which to grace my text-book, "And I said of medicine, that this is an Art which considers the constitution of the patient, and has principles of action and reasons in each case." Or, again, the comprehensive view taken in the statement, "There is one science of medicine which is concerned with the inspection of health equally in all times, present, past and future."
Plato gives a delicious account of the origin of the modern medicine, as contrasted with the art of the guild of Asclepius.
Well, I said, and to require the help of medicine, not when a wound has to be cured, or on occasion of an epidemic, but just because by indolence and a habit of life such as we have been describing, men fill themselves with waters and winds, as if their bodies were a marsh, compelling the ingenious sons of Asclepius to find more names for diseases, such as flatulence and catarrh; is not this, too, a disgrace?
Yes, he said, they do certainly give very strange and new-fangled names to diseases.
Yes, I said, and I do not believe there were any such diseases in the days of Asclepius; and this I infer from the circumstance that the hero Eurypylus, after he has been wounded in Homer, drinks a posset of Pramnian wine well besprinkled with barley-meal and grated cheese, which are certainly inflammatory, and yet the sons of Asclepius who were at the Trojan war do not blame the damsel who gives him the drink, or rebuke Patroclus, who is treating his case.
Well, he said, that was surely an extraordinary drink to be given to a person in his condition.
Not so extraordinary, I replied, if you bear in mind that in former days, as is commonly said, before the time of Herodicus, the guild of Asclepius did not practise our present system of medicine, which may be said to educate diseases. But Herodicus, being a trainer, and himself of a sickly constitution, by a combination of training and doctoring found out a way of torturing first and chiefly himself, and secondly the rest of the world.
How was that? he said.
By the invention of lingering death; for he had a mortal disease which he perpetually tended, and as recovery was out of the question, he passed his entire life as a valetudinarian; he could do nothing but attend upon himself, and he was in constant torment whenever he departed in anything from his usual regimen, and so dying hard, by the help of science he struggled on to old age.
A rare reward of his skill!
He goes on to say that Asclepius did not instruct his descendants in valetudinarian arts because he knew that in well-ordered states individuals with occupations had no time to be ill. If a carpenter falls sick, he asks the doctor for a "rough and ready cure—an emetic, or a purge, or a cautery, or the knife—these are his remedies." Should any one prescribe for him a course of dietetics and tell him to swathe and swaddle his head, and all that sort of thing, he says, "he sees no good in a life spent in nursing his disease to the neglect of his customary employment; and therefore bidding good-bye to this sort of physician, he resumes his ordinary habits, and either gets well and lives and does his business, or, if his constitution fails, he dies and has no more trouble."
He is more in earnest in another place (Gorgias) in an account of the relations of the arts of medicine and gymnastics: "The soul and the body being two, have two arts corresponding to them: there is the art of politics attending on the soul; and another art attending on the body, of which I know no specific name, but which may be described as having two divisions, one of them gymnastic, and the other medicine. And in politics there is a legislative part, which answers to gymnastic, as justice does to medicine; and the two parts run into one another, justice having to do with the same subject as legislation, and medicine with the same subject as gymnastic, but with a difference.
Cookery simulates the disguise of medicine, and pretends to know what food is the best for the body; and if the physician and the cook had to enter into a competition in which children were the judges, or men who had no more sense than children, as to which of them best understands the goodness or badness of food, the physician would be starved to death."'
And later in the same dialogue Socrates claims to be the only true politician of his time who speaks, not with any view of pleasing, but for the good of the State, and is unwilling to practise the graces of rhetoric—and so would make a bad figure in a court of justice. He says: "I shall be tried just as a physician would be tried in a court of little boys at the indictment of the cook. What would he reply under such circumstances, if some one were to accuse him, saying, `O my boys, many evil things has this man done to you; he is the death of you, especially of the younger ones among you, cutting and burning and starving and suffocating you, until you know not what to do; he gives you the bitterest potions, and compels you to hunger and fast? How unlike the variety of meats and sweets on which I feasted for you.' What do you suppose that the physician would be able to reply when he found himself in such a predicament? If he told the truth he could only say: `All these evil things, my boys I did for your health,' and then would there not just be a clamour among a jury like that? How they would cry out!"
The principle of continuity, of uniformity, so striking in ancient physics was transferred to the body, which, like the world, was conceived as a whole. Several striking passages illustrative of this are to be found. Thus to the question of Socrates, "Do you think that you can know the nature of the soul intelligently without knowing the nature of the whole?" Phaedrus replies, "Hippocrates, the Ascie-piad, says that the nature even of the body can only be understood as a whole."' The importance of treating the whole and not the part is insisted upon. In the case of a patient who comes to them with bad eyes the saying is "that they cannot cure his eyes by themselves, but that if his eyes are to be cured his head must be treated" : and then again they say "that to think of curing the head alone and not the rest of the body also is the height of folly."
Charmides had been complaining of a headache, and Critias had asked Socrates to make believe that he could cure him of it. He said that he had a charm, which he had learnt, when serving with the army, of one of the physicians of the Thracian king, Zamolxis. This physician had told Socrates that the cure of the part should not be attempted without treatment of the whole, and also that no attempt should be made to cure the body without the soul, "and, therefore, if the head and body are to be well you must begin by curing the soul; that is the first thing. . . . And he who taught me the cure and the charm added a special direction, `Let no one,' he said, `persuade you to cure the head until he has first given you his soul to be cured. For this,' he said, `is the great error of our day in the treatment of the human body, that physicians separate the soul from the body.' "The charms to which he referred were fair words by which temperance was implanted in the soul.
Though a contemporary, Hippocrates is only once again referred to in the Dialogues—where the young Hippocrates, son of Apollodorus, who has come to Protagoras, "that almighty wise man," as Socrates terms him in another place, to learn the science and knowledge of human life, is asked by Socrates, "If you were going to Hippocrates of Cos, the Aselepiad, and were about to give him your money, and some one had said to you, `You are paying money to your namesake, Hippocrates, 0 Hippocrates; tell me, what is he that you give him money?' how would you have answered ?" "I should say," he replied, "that I gave money to him as a physician." "And what will he make of you?" "A physician,' he said—a paragraph which would indicate that Hippocrates was in the habit of taking pupils and teaching them the art of medicine; and in the Euthydemus, with reference to the education of physicians, Socrates says, "that he would send such to those who profess the art, and to those who demand payment for teaching the art, and profess to teach it to any one who will come and learn."
We get a glimpse of the method of diagnosis, derived doubtless from personal observation, possibly of the great Hippocrates himself, whose critical knowledge of pulmonary complaints we daily recognize in the use of his name in association with the clubbed fingers of phthisis, and with the succussion splash of pneumo-thorax. "Suppose some one, who is inquiring into the health or some other bodily quality of another: he looks at his face and at the tips of his fingers, and then he says, `Uncover your chest and back to me that I may have a better view.' " And then Socrates says to Protagoras, " Uncover your mind to me; reveal your opinion, etc."
One of the most celebrated medical passages is that in which Socrates professes the art of a midwife practising on the souls of men when they are in labour, and diagnosing their condition, whether pregnant with the truth or with some "darling folly." The entire section, though long, must be quoted. Socrates is in one of his "little difficulties" and wishes to know of the young Theaetetus, who has been presented to him as a paragon of learning, and whose progress in the path of knowledge has been sure and smooth—"flowing on silently like a river of oil"—what is knowledge? Theaetetus is soon entangled and cannot shake off a feeling of anxiety.
Theaet. I can assure you, Socrates, that I have tried very often, when the report of questions asked by you was brought to me; but I can neither persuade myself that I have any answer to give, nor hear of any one who answers as you would have him; and I cannot shake off a feeling of anxiety.
Soc. These are the pangs of labour, my dear Theaetetus; you have something within you which you are bringing to the birth.
Theaet. I do not know, Socrates; I only say what I feel.
Soc. And did you never hear, simpleton, that I am the son of a midwife, brave and burly, whose name was Phaenarete?
The ext. Yes, I have.
Soc. And that I myself practise midwifery?
Theaet. No, never.
Soc. Let me tell you that I do though, my friend; but you must not reveal the secret, as the world in general have not found me out; and therefore they only say of me, that I am the strangest of mortals, and drive men to their wits' end. Did you ever hear that too?
Soc. Shall I tell you the reason?
Theaet. By all means.
Soc. Bear in mind the whole business of the midwives, and then you will see my meaning better. No woman, as you are probably aware, who is still able to conceive and bear, attends other women, but only those who are past bearing.
Theaet. Yes, I know.
Soc. The reason of this is said to be that Artemis—the goddess of childbirth—is not a mother, and she honours those who are like herself; but she could not allow the barren to be midwives, because human nature cannot know the mystery of an art without experience; and therefore she assigned this office to those who are too old to bear.
Theca. I dare say.
Soc. And I dare say, too, or rather I am absolutely certain, that the midwives know better than others who is pregnant and who is not? Theaet. Very true.
Soc. And by the use of potions and incantations they are able to arouse the pangs and to soothe them at will; they can make those bear who have a difficulty in bearing, and if they think fit, they can smother the embryo in the womb.
Theaet. They can.
Soc. Did you ever remark that they are also most cunning match-makers, and have a thorough knowledge of what unions are likely to produce a brave brood?
Theaet. No, never.
Soc. Then let me tell you that this is their greatest pride, more than cutting the umbilical cord. And if you reflect, you will see that the same art which cultivates and gathers in the fruits of the earth, will be most likely to know in what soils the several plants or seeds should be deposited.
Theaet. Yes, the same art.
Soc. And do you suppose that with women the case is otherwise? Theaet. I should think not.
Soc. Certainly not; but midwives are respectable women and have a character to lose, and they avoid this department of their profession, because they are afraid of being called procuresses, which is a name given to those who join together man and woman in an unlawful and unscientific way; and yet the true midwife is also the true and only matchmaker.
Soc. Such are the midwives, whose task is a very important one, but not so important as mine; for women do not bring into the world at one time real children, and at another time counterfeits which are with difficulty distinguished from them; if they did, then the discernment of the true and false birth would be the crowning achievement of the art of midwifery—you would think so?
Theaet. Indeed I should.
Soc. Well, my art of midwifery is in most respects like theirs; but differs in that I attend men and not women, and I look after their souls when they are in labour, and not after their bodies; and the triumph of my art is in thoroughly examining whether the thought which the mind of the young man is bringing to the birth, is a false idol or a noble and true birth. And like the midwives, I am barren, and the reproach which is often made against me, that I ask questions of others and have not the wit to answer them myself, is very just; the reason is, that the god compels me to be a midwife, but forbids me to bring forth. And therefore I am not myself at all wise, nor have I anything to show which is the invention or birth of my own soul, but those who converse with me profit. Some of them appear dull enough at first, but afterwards, as our acquaintance ripens, if the god is gracious to them, they all make astonishing progress; and this in the opinion of others as well as their own. It is quite clear that they had never learned anything from me; the many fine discoveries to which they cling are of their own making. But to me and the god they owe their delivery. And the proof of my words is, that many of them in their ignorance, either in their self-conceit despising me, or falling under the influence of others, have gone away too soon; and have not only lost the children of whom I had previously delivered them by an ill bringing up, but have stifled whatever else they had in them by evil communications, being fonder of lies and shams than of the truth; and they have at last ended by seeing themselves, as others see them, to be great fools. Aristeides, the son of Lysimachus, is one of them, and there are many others. The truants often return to me, and beg that I would consort with them again—they are ready to go to me on their knees—and then, if my familiar allows, which is not always the case, I receive them and they begin to grow again. Dire are the pangs which my art is able to arouse and to allay in those who consort with me, just like the pangs of women in childbirth; night and day they are full of perplexity and travail which is even worse than that of the women. So much for them. And there are others, Theaetetus, who come to me apparently having nothing in them; and as I know that they have no need of my art, I coax them into marrying some one, and by the grace of God I can generally tell who is likely to do them good. Many of them I have given away to Prodicus, and many to other inspired sages. I tell you this long story, friend Theaetetus, because I suspect, as indeed you seem to think yourself, that you are in labour—great with some conception. Come then to me, who am a midwife's son and myself a midwife, and try to answer the questions which I will ask you. And if I abstract and expose your first-born, because I discover upon inspection that the conception which you have formed is a vain shadow, do not quarrel with me on that account, as the manner of women is when their first children are taken from them. For I have actually known some who were ready to bite me when I deprived them of a darling folly; they did not perceive that I acted from good will, not knowing that no god is the enemy of man—that was not within the range of their ideas; neither am I their enemy in all this, but it would be wrong in me to admit falsehood, or to stifle the truth. Once more, then, Theaetetus, I repeat my old question, "What is knowledge?" and do not say that you cannot tell; but quit yourself like a man, and by the help of God you will be able to tell.,
Socrates proceeds to determine whether the intellectual babe brought forth by Theaetetus is a wind-egg or a real and genuine birth. "This then is the child, however he may turn out, which you and I have with difficulty brought into the world, and now that he is born we must run round the hearth with him and see whether he is worth rearing or only a wind-egg and a sham. Is he to be reared in any case and not exposed? or will you bear to see him rejected and not get into a passion if I take away your first-born?" The conclusion is "that you have brought forth wind, and that the offspring of your brain are not worth bringing up." And the dialogue ends as it began with a reference to the midwife: "The office of a midwife I, like my mother, have received from God; she delivered women, and I deliver men; but they must be young and noble and fair."