University of Texas Health Science Center - IATRO Yearbook (Houston, TX)

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Let oh quart 4 ee ae Ag j eee i pius and his family depicted on votive tablet (c. 370-270 BC) Ascle — ee . Asclepius shown on a metope from the Temple of Asclepius at Epidaurus (c. 4th cent. BC). PM Be My SERMON hewn, SURES Bas-relief (c. 400-350 BC) depicting Asclepius and daughter Hygeia and symbolic snake curing patients during sleep. In fact, religious medicine has been present in the initial stages and throughout the course of every civilization. As there have always been individuals who would rather go to a priest than a physician for treatment of an illness, so too, have there been physicians from Antiquity to more modern times who relegated their incurable patients in need of miracles into the hands of the gods (Sigerist, p. 44). Greece, certainly, was no exception. Religious medicine was cited in the Homeric poems, and, in fact, it is in Homer’s Iliad, where one finds the origin of perhaps the most enduring of the ancient healing cults, the cult of Asclepius, one of the gods invoked in the ‘Hippocratic Oath.” In the liad (Book Il, line 731), Asclepius is mentioned as a minor chieftain and physician, who, with the help of his sons, Pol- daleirios and Machaon, treated the Greek wounded at Troy. Although the Greek gods had the ability to protect mortals against evil and to treat the sick, it was Apollo who became the god of medicine. Asclepius became important and eventually replaced Apollo as god of medicine when legend made him the son of Apollo. Hesiod’s Theogony, written around 700 BC, contains, perhaps, the first legend of Asclepius: In the Boebian lake, the lake of Phoebus, the beautiful maiden, Coronis, daughter of the Lapithian king, Phlegyas, was bathing her feet when Apollo (Phoebus) saw her and desired her. She became pregnant with the god’s child but her father had promised her to her cousin, Ischys. The day of the wedding came and all the preparations had been made, when the raven, a white bird until then, brought the evil news to Delphi, Apollo’s seat. The god, in his wrath, first punished the messenger of the evil tidings, who then on exhibited the black color of mourning and was feared as the herald of disaster. He then killed Ischys, shooting his darts at him, while his sister, Artemis (Diana), hit Coronis and her innocent compa- nions. But when the god saw the body of his beloved on the funeral pyre, he felt pity for the unborn child, removed him from the mother’s womb, and brought him to the cave of Chiron (demigod and Centaur) on Mount Pelion. There, Asclepius grew up, instructed by Chiron in the treatment of diseases with incantations, herbs, and the knife. He became a famous physician, sought by many from far and wide and became so self-assured that he even resuscitated the dead (Pin- dar later changed this to have Asclepius resuscitate a dead man for money), whereupon Zeus slew him with his thunderbolt (Gordon, p. 437). Hippocratic Oath 7

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RELIGIOUS MEDICINE AND THE ORIGIN OF THE HIPPOCRATIC OATH OATH | swear, by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and god- desses, making them my witnesses, that | will fulfill according to my ability and judgment this oath and this covenant: To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers of male lineage and to teach them this art — without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons of him who has instructed me and to pupils who have signed the covenant and have taken an oath according to the medical law, but to no one else. ! will apply dietetic measures for the benefit of the sick according to my ability and judgment; | will keep them from harm and injustice. ! will neither give a deadly drug to anybody if asked for it, nor will | make a suggestion to this ef- fect. Similarly, | will not give to a woman an abortive remedy. In purity and holiness | will guard my life and my art. ! will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work. Whatever houses | may visit, | will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves. What | may see or hear in the course of the treat- ment or even outside of the treatment in regard to My the life of men, on which no account one must lz spread abroad, | will keep to myself such things == 2 shameful to be spoken about. Statue of Asclepius found in Athens If | fulfill this oath and do not violate it, may it be Religion satisfies a perpetual desire to explain and granted to me to enjoy life and art, being honored give meaning to the unknown. It would, therefore, with fame among all men for all time to come; if | appear that religious medicine (ie., supplications to transgress it and swear falsely, may the opposite of | the gods for cures) developed as a natural outgrowth all this be my lot. of ancient religious dogma. (Edelstein, p. 6) 6 Hippocratic Oath

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Later myths are different and picture the miraculous birth of a god. One sees, by the fact that Zeus slew Asclepius for resuscitating a dead man, that, even in Antiquity, physicians were not to take their position for granted. It was not a god-given right for the physi- cian to interfere with the laws of nature by keeping people alive beyond their allotted time. The physi- cian, therefore, has great moral obligations (Sigerist, p. 53). Thus, in the beginning, Asclepius was a physician praised by Homer and eventually became the patron of physicians. Physicians were craftsmen, united and revered because they belonged to a guild founded in the assumption that physicians were descendants of Asclepius. He did not cure people but protected the physicians, who practiced, above all, a secular craft. Physicians of Antiquity travelled from town to town, and, soon, word spread about their patron hero, who, with time, became singularly identified with medicine and healing, ultimately renowned as the chief healer. Through the years, Asclepius, in fact, became less a patron to the physician and more the competitor. His deification occurred toward the end of the sixth century BC and the cult of Asclepius began immediately in Epidaurus and soon spread over all the Known world with Epidaurus, Cos (home of Hippocrates), and Pergamum (home of Galen) the Bx ait me chief centers of the cult. As the cult spread to Africa, Hippocrates, as envisioned by a 14th cent. Byz Asclepius became identified with the local deities =° % oly Bae (eg., Imhotep in Egypt), who were then worshipped together. Asclepius was pivotal in the struggle be- tween Christianity and paganism and his cult was the last to die, surviving well into the sixth century AD (Sigerist, pp. 56-61). It is clear, although once thought otherwise, that rational and religious medicine developed along parallel courses. Thus, mythology is not the origin of Greek medicine but, rather, one finds the roots of Greek medical science in the observations and thoughts of the early philosophers. In fact, for the true origins of the ‘Hippocratic Oath,’ one must look at the tenets of the school and cult of Pythagoras (Castiglioni, p. 126). The school of Pythagoras probably exerted the deepest influence on medicine. Pythagoras lived dur- ing the sixth century BC and he took part in the great religious movement that swept Greece during that time, making possible the development of the cult of Asclepius. People were no longer satisfied with the primitive Homeric gods and were seeking something more meaningful and representative of their lives. Although Pythagoras investigated nature and made obvious scientific contributions, his primary aim was religious. He sought the redemption of man from the +; cycle of reincarnations, attainable through the pompeian wall painting depicting Aeneas attended by a “Pythagorean way of life.’’ Since the cult of physician. Pythagoras was aristocratic in character, intellectual activities were most important. 8 Hippocratic Oath “a antine artist. a pg Sa