Medicine - Physic and Physicians As Depicted in Plato Part 3
( Originally Published 1905 )
From the writings of Plato we may gather many details about the status of physicians in his time. It is very evident that the profession was far advanced and had been progressively developing for a long period before Hippocrates, whom we erroneously, yet with a certain propriety, call the Father of Medicine. The little by-play between Socrates and Euthydemus suggests an advanced condition of medical literature: "Of course, you who have so many books are going in for being a doctor," says Socrates, and then he adds, "there are so many books on medicine, you know." As Dyer remarks, whatever the quality of these books may have been, their number must have been great to give point to this chaff.
It may be clearly gathered from the writings of Plato that two sorts of physicians (apart altogether from quacks and the Esculapian guild) existed in Athens, the private practitioner, and the State-physician. The latter, though the smaller numerically, representing apparently the most distinguished class. From a reference in one of the dialogues (Gorgias) they evidently were elected by public assembly,—" when the assembly meets to elect a physician." The office was apparently yearly, for in the States-man is the remark, "when the year of office has expired, the pilot or physician has to come before a court of review" to answer any charges that may be made against him. In the same dialogue occurs the remark, "and if anyone who is in a private station has the art to advise one of the public physicians, must he not be called a physician ? "2 Apparently a physician must have been in practice for some time and attained great eminence before he was deemed worthy of the post of State-physician. "If you and I were physicians, and were advising one another that we were competent to practise as state-physicians, should I not ask you, and would you not ask me, Well, but how about Socrates himself, has he good health? And was any one else ever known to be cured by him whether slave or freeman?"
A reference to the two sorts of doctors is also found in the Republic: "Now you know that when patients do not require medicine, but have only to be put under a regimen, the inferior sort of practitioner is deemed to be good enough; but when medicine has to be given, then the doctor should be more of a may."
The office of State-physician was in existence fully two generations before this time, for Democedes held this post at Athens in the second half of the sixth century at a salary of £406, and, very much as a modern professor might be, he was seduced away by the offer of a great increase in salary by Polycrates, the tyrant of Samos. It is evident, too, from the Laws, that the doctors had assistants, often among the slaves.
For of doctors, as I may remind you, some have a gentler, others a ruder method of cure; and as children ask the doctor to be gentle with them, so we will ask the legislator to cure our disorders with the gentlest remedies. What I mean to say is, that besides doctors there are doctors' servants, who are also styled doctors.
Cle. Very true.
Eth. And whether they are slaves or freemen makes no difference; they acquire their knowledge of medicine by obeying and observing their masters; empirically and not according to the natural way of learning, as the manner of freemen is, who have learned scientifically themselves the art which they impart scientifically to their pupils. You are aware that there are these two classes of doctors?
Cle. To be sure.
Eth. And did you ever observe that there are two classes of patients in states, slaves and freemen; and the slave doctors run about and cure the slaves, or wait for them in the dispensaries—practitioners of this sort never talk to their patients individually, or let them talk about their own individual complaints? The slave-doctor prescribes what mere experience suggests, as if he had exact knowledge; and when he has given his orders, like a tyrant, he rushes off with equal assurance to some other servant who is ill; and so he relieves the master of the house of the care of his invalid slaves. But the other doctor, who is a freeman, attends and practises upon freemen; and he carries his inquiries far back, and goes into the nature of the disorder; he enters into discourse with the patient and with his friends, and is at once getting information from the sick man, and also instructing him as far as he is able, and he will not prescribe for him until he has first convinced him; at last, when he has brought the patient more and more under his persuasive influences and set him on the road to health, he attempts to effect a cure. Now which is the better way of proceeding in a physician and in a trainer? Is he the better who accomplishes his ends in a double way, or he who works in one way, and that the ruder and inferior?
This idea of first convincing a patient by argument is also mentioned in the Gorgias, and would appear indeed to have furnished occupation for some of the numerous sophists of that period. Gorgias, lauding the virtues of rhetoric and claiming that she holds under her sway all the inferior arts, says: "Let me offer you a striking example of this. On several occasions I have been with my brother Herodicus, or some other physician, to see one of his patients, who would not allow the physician to give him medicine or apply the knife or hot iron to him; and I have persuaded him to do for me what he would not do for the physician just by the use of rhetoric. And I say that if a rhetorician and a physician were to go to any city, and had there to argue in the Ecclesia or any other assembly as to which of them should be elected state-physician, the physician would have no chance; but he who could speak would be chosen if he wished." In another place (Laws) Plato satirizes this custom: "For of this you may be very sure, that if one of those empirical physicians, who practise medicine without science, were to come upon the gentleman physician talking to his gentleman patient, and using the language almost of philosophy—beginning at the beginning of the disease, and discoursing about the whole nature of the body, he would burst into a hearty laugh—he would say what most of those who are called doctors always have at their tongue's end: foolish fellow, he would say, you are not healing the sick man, but you are educating him; and he does not want to be made a doctor, but to get well."
Of the personal qualifications of the physician not much is said; but in the Republic (III. 408) there is an original, and to us not very agreeable, idea: "Now the most skilful physicians are those who, from their youth upwards, have combined with a knowledge of their art, the greatest experience of disease; they had better not be in robust health, and should have had all manner of diseases in their own person. For the body, as I conceive, is not the instrument with which they cure the body; in that case we could not allow them ever to be or to have been sickly; but they cure the body with the mind, and the mind which has become and is sick can cure nothing."
Some idea of the estimate which Plato put on the physician may be gathered from the mystical account in the Phaedrus of the nature of the soul and of life in the upper world. We are but animated failures—the residua of the souls above, which have attained a vision of truth, but have fallen "hence beneath the double load of forgetfulness and vice." There are nine grades of human existence into which these souls may pass, from that of a philosopher or artist to that of a tyrant. The physician or lover of gymnastic toils comes in the fourth class.
But if Plato assigns the physician a place in the middle tier in his mystery, he welcomes him socially into the most select and aristocratic circle of Athens. In that most festive of all festal occasions, at the house of Agathon; described in the Symposium, Eryximachus, a physician and the son of one, is a chief speaker, and in his praise of love says, "from medicine I will begin that I may do honour to my art." We find him, too, on the side of temperance and sobriety: "The weak heads like myself, Aristodemus, Phaedrus, and others who never can drink, are fortunate in finding that the stronger ones are not in a drinking mood. (I do not include Socrates, who is able either to drink or to abstain, and will not mind, whichever we do.) Well, as none of the company seem disposed to drink much, I may be forgiven for saying, as a physician, that drinking deep is a bad practice, which I never follow, if I can help, and, certainly do not recommend to another, least of all to any one who still feels the effect of yesterday's carouse." The prescriptions for hiccough, given by Eryximachus, give verisimilitude to the dialogue. When the turn of Aristophanes came he had eaten too much and had the hiccough, and he said to Eryximachus, "You ought either to stop my hiccough or speak in my turn." Eryximachus recommended him to hold his breath, or if that failed to gargle with a little water, and if the hiccough still continued, to tickle his nose with something and sneeze, adding, "if you sneeze once or twice even the most violent hiccough is sure to god."
Upon the medical symptoms narrated in that memorable scene, unparalleled in literature, after Socrates had drunk the poison in prison, it is unnecessary to dwell; but I may refer to one aspect as indicating the reverence felt for the representative of the great Healer. Denied his wish (by the warning of the jailor, who says that there is only sufficient poison) to offer a libation to a god, Socrates' dying words were, "Crito, we owe a cock to .Esculapius," "The meaning of this solemnly smiling farewell of Socrates would seem to be," according to Dyer, "that to Esculapius, a god who always is prescribing potions and whose power is manifest in their effects, was due that most welcome and sovereign remedy which cured all the pains and ended all the woes of Socrates—the hemlock, which cured him of life which is death, and gave him the glorious realities of hereafter. For this great boon of awakening into real life Socrates owed Esculapius a thankoffering. This offering of a cock to Esculapius was plainly intended for him as the awakener of the dead to life everlasting."
And permit me to conclude this already too long account with the eulogium of Professor Jowett—words worthy of the master, worthy of his great interpreter to this generation:
"More than two thousand two hundred years have passed away since he returned to the place of Apollo and the Muses.
Yet the echo of his words continues to be heard among men, because of all philosophers he has the most melodious voice. He is the inspired prophet or teacher who can never die, the only one in whom the outward form adequately represents the fair soul within; in whom the thoughts of all who went before him are reflected and of all who come after him are partly anticipated. Other teachers of philosophy are dried up and withered—after a few centuries they have become dust; but he is fresh and blooming, and is always begetting new ideas in the minds of men. They are one-sided and abstract; but he has many sides of wisdom. Nor is he always consistent with himself, because he is always moving onward, and knows that there are many more things in philosophy than can be expressed in words, and that truth is greater than consistency. He who approaches him in the most reverent spirit shall reap most of the fruits of his wisdom; he who reads him by the light of ancient commentators will have the least understanding of him.
"We may see him with the eye of the mind in the groves of the Academy, or on the banks of the Ilissus, or in the streets of Athens, alone or walking with Socrates, full of these thoughts which have since become the common possession of mankind. Or we may compare him to a statue hid away in some temple of Zeus or Apollo, no longer existing on earth, a statue which has a look as of the God himself. Or we may once more imagine him following in another state of being the great company of heaven which he beheld of old in a vision (Phaedrus, 248). So, `partly trifling but with a degree of seriousness' (Symposium, 197, E), we linger around the memory of a world which has passed away
(Phaedrus, 250, C)."