By J.C. McKeown (Guest Contributor)
A doctor, like a savior god, should be on equal terms with slaves, with the poor, with the rich, with kings, and he should help everyone like a brother. For we are all brothers. He should not hate anyone, nor harbor spite in his mind, nor foster self-importance.[1]
Asclepius with his sacred snake, looking up at him like a faithful dog.
Leaving aside the possible difficulty in avoiding self-importance while acting like a god, does this noble view of the medical profession really reflect the attitudes and convictions of doctors in ancient Greece? Even in our own enlightened times, the quality of medical treatment provided often depends on the patient’s ability to pay and outrageous price hikes for essential drugs are still legal, so it is perhaps not overly surprising to find that similar market forces affected medicine in antiquity.
Vested interests, we are told, reared their head right from the start. Asclepius, the god of medicine himself, was deified in recognition of his medical skill,[2] but only after he been killed by the god of the Underworld for reducing the supply of dead people.[3] There was a hostile tradition that Hippocrates, revered as the founder of Western medicine, stooped to handicapping potential competition by burning a temple which stored medical case-studies.[4]
Cutting out the competition was inevitably important, given that there was no central authority regulating the profession and endorsing a doctor’s credentials:
To have himself recognized as a qualified practitioner, a doctor does not need to give an actual demonstration of his skill, even though medicine is such an eminently practical discipline – all he has to do is claim to have received his training in Alexandria[5]
Charlatans thrived in such an unmonitored environment. How else might one account for the low expectations aspired to one of the leading physicians of the early Hellenistic period?:
Ideally, a doctor should be outstanding in his medical expertise, and also a person of excellent character. If one of these qualities is missing, it is better that he should be a good man with no learning rather than a thoroughgoing expert, but unscrupulous and immoral. The decency that accompanies good character seems to compensate for lack of knowledge, whereas moral flaws may taint and corrupt medical skill, however great.[6]
The loudest and brashest of all such quacks, if we may believe his opponents, was undoubtedly Thessalus of Tralles, who flourished in the mid-first century AD:
During the rule of Nero, Thessalus rose to fame in the medical profession, sweeping aside all received medical wisdom and denouncing all doctors from every epoch with a sort of frenzy. You can get a clear idea of his sense of judgment and his attitude just by looking at his tomb on the Appian Way, where the inscription refers to him by the Greek term iatronikes (“The Conqueror of Doctors”). No actor or charioteer went out in public accompanied by a larger throng.[7]
One last financial consideration may perhaps give some comfort to today’s young medical practitioners, heavily burdened by debts accumulated through long years of study. The Hippocratic Oath required students “to share their livelihood with their teachers and give them a tithe of what they possess, should they be in need”. This provision does not appear in modern versions of the oath.
J.C. McKeown is professor of Classics at the University of Wisconsin-Madison. He is the author of A Cabinet of Roman Curiosities (2010) and A Cabinet of Greek Curiosities (2013), also published by Oxford University Press
[1] Supplementum Epigraphicum Graecum 28 (1978) 225, part of a damaged inscription from the Sarapion monument in the temple of Asclepius on the Athenian acropolis.
[2] Celsus On Medicine Preface 2.
[3] Diodorus Siculus The Library 4.71.
[4] Soranus Life of Hippocrates 4.
[5] Ammianus Marcellinus History of Rome 22.16.
[6] Erasistratus frg. 31.
[7] Pliny Natural History 29.9.