Disease, Prolonged Treatments, and Death

Plato, Republic 3. 406d

“I said, ‘A carpenter who gets sick considers it right to take a medicine from a doctor to puke up the sickness or to cleanse his bowels or to escape the disease through fire or incision. But if anyone advises a treatment of long duration to him—wrapping his head with bandages and the steps that follow that—he immediately says he does not have the time to be sick and that there’s no profit in living like this, that if he pays too much attention to sickness he neglects that work before him.

After that, he says farewell to that kind of a doctor and returns to his normal life, returning to health while focusing on his own work. But if his body isn’t strong enough to recover, then he’s free from all his problems because he’s dead.”

Τέκτων μέν, ἦν δ’ ἐγώ, κάμνων ἀξιοῖ παρὰ τοῦ ἰατροῦ φάρμακον πιὼν ἐξεμέσαι τὸ νόσημα, ἢ κάτω καθαρθεὶς ἢ καύσει ἢ τομῇ χρησάμενος ἀπηλλάχθαι· ἐὰν δέ τις αὐτῷ μακρὰν δίαιταν προστάττῃ, πιλίδιά τε περὶ τὴν κεφαλὴν περιτιθεὶς καὶ τὰ τούτοις ἑπόμενα, ταχὺ εἶπεν ὅτι οὐ σχολὴ | κάμνειν οὐδὲ λυσιτελεῖ οὕτω ζῆν, νοσήματι τὸν νοῦν προσέχοντα, τῆς δὲ προκειμένης ἐργασίας ἀμελοῦντα. καὶ μετὰ ταῦτα χαίρειν εἰπὼν τῷ τοιούτῳ ἰατρῷ, εἰς τὴν εἰωθυῖαν δίαιταν ἐμβάς, ὑγιὴς γενόμενος ζῇ τὰ ἑαυτοῦ πράττων· ἐὰν δὲ μὴ ἱκανὸν ᾖ τὸ σῶμα ὑπενεγκεῖν, τελευτήσας πραγμάτων ἀπηλλάγη.

Copper engraving of Doctor Schnabel [i.e Dr. Beak], a plague doctor in seventeenth-century Rome ( Paul Fürst, Der Doctor Schnabel von Rom)

Disease, Prolonged Treatments, and Death

Plato, Republic 3. 406d

“I said, ‘A carpenter who gets sick considers it right to take a medicine from a doctor to puke up the sickness or to cleanse his bowels or to escape the disease through fire or incision. But if anyone advises a treatment of long duration to him—wrapping his head with bandages and the steps that follow that—he immediately says he does not have the time to be sick and that there’s no profit in living like this, that if he pays too much attention to sickness he neglects that work before him.

After that, he says farewell to that kind of a doctor and returns to his normal life, returning to health while focusing on his own work. But if his body isn’t strong enough to recover, then he’s free from all his problems because he’s dead.”

Τέκτων μέν, ἦν δ’ ἐγώ, κάμνων ἀξιοῖ παρὰ τοῦ ἰατροῦ φάρμακον πιὼν ἐξεμέσαι τὸ νόσημα, ἢ κάτω καθαρθεὶς ἢ καύσει ἢ τομῇ χρησάμενος ἀπηλλάχθαι· ἐὰν δέ τις αὐτῷ μακρὰν δίαιταν προστάττῃ, πιλίδιά τε περὶ τὴν κεφαλὴν περιτιθεὶς καὶ τὰ τούτοις ἑπόμενα, ταχὺ εἶπεν ὅτι οὐ σχολὴ | κάμνειν οὐδὲ λυσιτελεῖ οὕτω ζῆν, νοσήματι τὸν νοῦν προσέχοντα, τῆς δὲ προκειμένης ἐργασίας ἀμελοῦντα. καὶ μετὰ ταῦτα χαίρειν εἰπὼν τῷ τοιούτῳ ἰατρῷ, εἰς τὴν εἰωθυῖαν δίαιταν ἐμβάς, ὑγιὴς γενόμενος ζῇ τὰ ἑαυτοῦ πράττων· ἐὰν δὲ μὴ ἱκανὸν ᾖ τὸ σῶμα ὑπενεγκεῖν, τελευτήσας πραγμάτων ἀπηλλάγη.

Copper engraving of Doctor Schnabel [i.e Dr. Beak], a plague doctor in seventeenth-century Rome ( Paul Fürst, Der Doctor Schnabel von Rom)

Doctors, Don’t Gossip!

Hippocrates, On Decorum 7

“Everything that’s been said already is true: a doctor needs to have a certain appropriate manner, since austerity is offensive to the healthy and sick alike. Doctors should also watch themselves carefully and avoid revealing too much that is personal and gossiping with regular people, saying only what is needed.

Realize that gossip invites criticism of treatment. Doctors should do nothing that seems too fussy or showy. Figure out everything you need to do or use beforehand for each situation. If you don’t, something will always be missing when it is needed.”

VII. Ὄντων οὖν τοιούτων τῶν προειρημένων ἁπάντων, χρὴ τὸν ἰητρὸν ἔχειν τινὰ εὐτραπελίην παρακειμένην· τὸ γὰρ αὐστηρὸν δυσπρόσιτον καὶ τοῖσιν ὑγιαίνουσι καὶ τοῖσι νοσέουσιν. τηρεῖν δὲ χρὴ ἑωυτὸν ὅτι μάλιστα, μὴ πολλὰ φαίνοντα τῶν τοῦ σώματος μερέων, μηδὲ πολλὰ λεσχηνευόμενον τοῖσιν ἰδιώτῃσιν, ἀλλὰ τἀναγκαῖα· †νομίζει γὰρ τοῦτο βίη εἶναι ἐς πρόσκλησιν θεραπηίης.†2 ποιεῖν δὲ κάρτα μηδὲν περιέργως αὐτῶν, μηδὲ 10μετὰ φαντασίης· ἐσκέφθω δὲ ταῦτα πάντα, ὅκως ᾖ σοι προκατηρτισμένα ἐς τὴν εὐπορίην, ὡς δέοι· εἰ δὲ μή, ἐπὶ τοῦ χρέους ἀπορεῖν αἰεὶ δεῖ.

File:Illustration of medieval Arab doctor treating a patient by cauterizing a wound.jpeg
Illustration of medieval doctor treating a patient by cauterizing a wound. http://images.google.com/hosted/life/7629a77e9a19b656.html

Disease, Prolonged Treatments, and Death

Plato, Republic 3. 406d

“I said, ‘A carpenter who gets sick considers it right to take a medicine from a doctor to puke up the sickness or to cleanse his bowels or to escape the disease through fire or incision. But if anyone advises a treatment of long duration to him—wrapping his head with bandages and the steps that follow that—he immediately says he does not have the time to be sick and that there’s no profit in living like this, that if he pays too much attention to sickness he neglects that work before him.

After that, he says farewell to that kind of a doctor and returns to his normal life, returning to health while focusing on his own work. But if his body isn’t strong enough to recover, then he’s free from all his problems because he’s dead.”

Τέκτων μέν, ἦν δ’ ἐγώ, κάμνων ἀξιοῖ παρὰ τοῦ ἰατροῦ φάρμακον πιὼν ἐξεμέσαι τὸ νόσημα, ἢ κάτω καθαρθεὶς ἢ καύσει ἢ τομῇ χρησάμενος ἀπηλλάχθαι· ἐὰν δέ τις αὐτῷ μακρὰν δίαιταν προστάττῃ, πιλίδιά τε περὶ τὴν κεφαλὴν περιτιθεὶς καὶ τὰ τούτοις ἑπόμενα, ταχὺ εἶπεν ὅτι οὐ σχολὴ | κάμνειν οὐδὲ λυσιτελεῖ οὕτω ζῆν, νοσήματι τὸν νοῦν προσέχοντα, τῆς δὲ προκειμένης ἐργασίας ἀμελοῦντα. καὶ μετὰ ταῦτα χαίρειν εἰπὼν τῷ τοιούτῳ ἰατρῷ, εἰς τὴν εἰωθυῖαν δίαιταν ἐμβάς, ὑγιὴς γενόμενος ζῇ τὰ ἑαυτοῦ πράττων· ἐὰν δὲ μὴ ἱκανὸν ᾖ τὸ σῶμα ὑπενεγκεῖν, τελευτήσας πραγμάτων ἀπηλλάγη.

Copper engraving of Doctor Schnabel [i.e Dr. Beak], a plague doctor in seventeenth-century Rome ( Paul Fürst, Der Doctor Schnabel von Rom)

Healing the Spirit: Sayings on Doctors and Philosophy

The following anecdotes are taken from the Gnomologium Vaticanum

 

37 “When people were asking [Aristippos] why he spent time with wretched men he said “Because doctors also minister to the sick.”

῾Ο αὐτὸς εἰπόντος τινὸς αὐτῷ, διὰ τί τοῖς μοχθηροῖς πλησιάζει, εἶπεν· „ὅτι καὶ ἰατροὶ τοῖς νοσοῦσιν.”

 

412 “Nikokles used to say that doctors are lucky because the sun shines on their successes while the earth hides their mistakes.”

῾Ο αὐτὸς τοὺς ἰατροὺς εὐτυχεῖς ἔλεγεν, ὅτι τὰς μὲν ἐπιτυχίας αὐτῶν ὁ ἥλιος ὁρᾷ, τὰς δὲ ἀποτυχίας ἡ γῆ καλύπτει.

 

289 “Erasistratos [the doctor] used to say that medicine was philosophy’s sister: one treats maladies of the spirit, the other treats those of the body.”

῾Ο αὐτὸς τὴν ἰατρικὴν τῆς φιλοσοφίας ἔφησεν ἀδελφὴν εἶναι· τὴν μὲν γὰρ τὰ ψυχικά, τὴν δὲ τὰ σωματικὰ θεραπεύειν ἀῤῥωστήματα.

 

226 “After [Demosthenes] saw that a bad wrestler was acting as a doctor he said “Now you’ve found a way you can throw everybody down!”

῾Ο αὐτὸς ἰδὼν κακὸν παλαιστὴν ἰατρεύοντα „νῦν” εἶπεν „εὕρηκας μέθοδον, δι’ ἧς πολλοὺς καταβαλεῖς”.

Image result for Ancient Greek doctor vase

Hippocratic Precept: Don’t Blackmail Sick People for Money

Corpus Hippocratica, Precepts 4.10

“The way you address a patient requires some kind of a theory too. For, if you begin talking about payment, then something else occurs in every situation. You will leave the sick person with the kind of impression that you will abandon him and leave if there is no agreement and that you don’t care and you will not apply any relief in the present.

Therefore, you should not make an issue about payment. For we believe that this kind of thought is harmful when someone is sick, and even more so if the sickness is intense. For the swiftness of a sickness which does not provide ample time for changing your mind urges the one who practices medicine well not to seek profit but to think more of reputation. It is, therefore, better to rebuke patients who have been saved rather than to blackmail those who are facing ruin.”

παραινέσιος δ’ ἂν καὶ τοῦτ’ ἐπιδεηθείη τῆς θεωρίης· εἰ γὰρ ἄρξαιο περὶ μισθαρίων· ξυμβάλλει γάρ τι καὶ τῷ ξύμπαντι· τῷ μὲν ἀλγέοντι τοιαύτην διανόησιν ἐμποιήσεις τὴν, ὅτι [οὐκ] ἀπολιπὼν αὐτὸν πορεύσῃ μὴ ξυνθέμενος, καὶ ὅτι ἀμελήσεις, καὶ οὐχ ὑποθήσῃ τινὰ τῷ παρεόντι. ἐπιμελεῖσθαι οὖν οὐ δεῖ περὶ στάσιος μισθοῦ· ἄχρηστον γὰρ ἡγεύμεθα ἐνθύμησιν ὀχλεομένου τὴν τοιαύτην, πουλὺ δὲ μᾶλλον, ἢν ὀξὺ νόσημά τι· νούσου γὰρ ταχυτὴς καιρὸν μὴ διδοῦσα ἐς ἀναστροφὴν οὐκ ἐποτρύνει τὸν καλῶς ἰητρεύοντα ζητεῖν τὸ λυσιτελές, ἔχεσθαι δὲ δόξης μᾶλλον· κρέσσον οὖν σωζομένοισιν ὀνειδίζειν ἢ ὀλεθρίως ἔχοντας προμύσσειν.

Image result for medieval manuscript doctor seeing patient

Diagnose Thyself: Why Be a Doctor?

Galen, On the Opinions of Hippocrates and Plato 9.5.5-7

“For some  practice the art of medicine for the money, and some do it for exemption from taxes. But some pursue medicine because of their love for humanity [philanthrôpia] just as there are those who do it for the fame or honor medicine attracts. Therefore doctors are named by the fact that they are all craftsmen of health in common, inasmuch as they perform their craft for different reasons—one will be called a lover of humanity [philanthrôpos], another titled a lover of honor [philotimos], while another is considered a lover of reputation [philodoxos] and another is a money maker.

The aim of a doctor for doctors, then, is not fame or wealth, as Mênodotos the Empiricist wrote. This is a goal for Mênodotus but not for Diocles or Hippocrates or Empedocles nor even a few others of those ancient doctors—however so many ministered to people because of their love of humanity [philanthrôpia]. Left bare among these kind of examples—and they are abundant in Hippocrates and Plato—the particular features and the common traits of each craft may be examined.”

τινὲς μὲν γὰρ ἕνεκα χρηματισμοῦ τὴν ἰατρικὴν τέχνην ἐργάζονται, τινὲς δὲ διὰ τὴν ἐκ τῶν νόμων αὐτοῖς διδομένην ἀλειτουργησίαν, ἔνιοι δὲ διὰ φιλανθρωπίαν, ὥσπερ ἄλλοι διὰ τὴν ἐπὶ ταύτῃ δόξαν ἢ τιμήν.  ὀνομασθήσονται τοιγαροῦν ᾗ μὲν ὑγιείας εἰσὶ δημιουργοὶ κοινῇ πάντες ἰατροί, καθόσον δὲ τὰς πράξεις ἐπὶ διαφόροις ποιοῦνται σκοποῖς, ὁ μέν τις φιλάνθρωπος, ὁ δὲ φιλότιμος, ὁ δὲ φιλόδοξος, ὁ δὲ χρηματιστής.

οὔκουν τοῖς ἰατροῖς τὸ τέλος ἐστὶν ὡς ἰατροῖς ἔνδοξον ἢ πόριμον, ὡς Μηνόδοτος <ὁ> ἐμπειρικὸς ἔγραψεν, ἀλλὰ Μηνοδότῳ μὲν τοῦτο, Διοκλεῖ δ’ οὐ τοῦτο, καθάπερ οὐδὲ ῾Ιπποκράτει καὶ ᾿Εμπεδοκλεῖ οὐδ’ ἄλλοις τῶν παλαιῶν οὐκ ὀλίγοις ὅσοι διὰ φιλανθρωπίαν ἐθεράπευον τοὺς ἀνθρώπους. γυμνασάμενος οὖν ἐν τοῖς τοιούτοις τις παραδείγμασι, πάμπολλα δ’ ἐστὶ παρ’ ῾Ιπποκράτει καὶ Πλάτωνι, ῥᾳδίως κατόψεται τά τε ἴδια τέχνης ἑκάστης καὶ τὰ κοινά.

 

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From medievalists.net

What Physicians Want: Fleet Footed is Gout!

Plutarch Moralia 501b

“Physicians by birth want two things—that person not be sick, and that someone who is sick should not be ignorant of being sick. This latter case is what happens in the afflictions of the mind. For when people are foolish, inappropriate, or unjust, they do not think they are doing wrong but some even imagine they are acting correctly. So, while no one ever calls a fever “healthy” or claims that consumption is “feeling fit” or that “gout” is being “fleet-footed”, or jaundice a “youthful blush”, many people call rage “manliness”, and lust “love” and envy “rivalry” and cowardice “circumspection”.

Even though people who are sick call doctors because they understand that they need them to address what is making them sick, those with mental ailments avoid philosophers since they believe that they are succeeding in the very acts in which they are going astray. Should we use this kind of logic, at least, we may say that poor vision is easier than madness and gout simpler than sickness in the brain. For a sick person feels it and calls for the doctor with cries….”

  1. Διὸ παῖδες ἰατρῶν βούλονται μὲν μὴ νοσεῖν τὸν ἄνθρωπον, νοσοῦντα δὲ μὴ ἀγνοεῖν ὅτι νοσεῖ· ὃ τοῖς ψυχικοῖς πάθεσι πᾶσι συμβέβηκεν. οὔτε γὰρ ἀφραίνοντες οὔτ᾿ ἀσελγαίνοντες οὔτ᾿ ἀδικοπραγοῦντες ἁμαρτάνειν δοκοῦσιν, ἀλλ᾿ ἔνιοι καὶ κατορθοῦν. πυρετὸν μὲν γὰρ οὐδεὶς ὑγίειαν ὠνόμασεν οὐδὲ φθίσιν εὐεξίαν οὐδὲ ποδάγραν ποδώκειαν οὐδ᾿ ὠχρίασιν ἐρύθημα, θυμὸν δὲ πολλοὶ καλοῦσιν ἀνδρείαν καὶ ἔρωτα φιλίαν καὶ φθόνον ἅμιλλαν καὶ δειλίαν ἀσφάλειαν. εἶθ᾿ οἱ μὲν καλοῦσι τοὺς ἰατρούς, αἰσθάνονται γὰρ ὧν δέονται πρὸς ἃ νοσοῦσιν· οἱ δὲ φεύγουσι τοὺς φιλοσόφους, οἴονται γὰρ ἐπιτυγχάνειν ἐν οἷς διαμαρτάνουσιν. ἐπεὶ τούτῳ γε τῷ λόγῳ χρώμενοι λέγομεν ὅτι κουφότερόν ἐστιν ὀφθαλμία μανίας καὶ ποδάγρα φρενίτιδος, ὁ μὲν γὰρ αἰσθάνεται καὶ καλεῖ τὸν ἰατρὸν κεκραγώς…
  2. Image result for medieval manuscript doctors
    Image Taken from here

Don’t Blackmail Sick People for Money, A Healthcare Plan

Corpus Hippocratica, Precepts 4.10

“The way you address a patient requires some kind of a theory too. For, if you begin talking about payment, then something else occurs in every situation. You will leave the sick person with the kind of impression that you will abandon him and leave if there is no agreement and that you don’t care and you will not apply any relief in the present.

Therefore, you should not make an issue about payment. For we believe that this kind of thought is harmful when someone is sick, and even more so if the sickness is intense. For the swiftness of a sickness which does not provide ample time for changing your mind urges the one who practices medicine well not to seek profit but to think more of reputation. It is, therefore, better to rebuke patients who have been saved rather than to blackmail those who are facing ruin.”

παραινέσιος δ’ ἂν καὶ τοῦτ’ ἐπιδεηθείη τῆς θεωρίης· εἰ γὰρ ἄρξαιο περὶ μισθαρίων· ξυμβάλλει γάρ τι καὶ τῷ ξύμπαντι· τῷ μὲν ἀλγέοντι τοιαύτην διανόησιν ἐμποιήσεις τὴν, ὅτι [οὐκ] ἀπολιπὼν αὐτὸν πορεύσῃ μὴ ξυνθέμενος, καὶ ὅτι ἀμελήσεις, καὶ οὐχ ὑποθήσῃ τινὰ τῷ παρεόντι. ἐπιμελεῖσθαι οὖν οὐ δεῖ περὶ στάσιος μισθοῦ· ἄχρηστον γὰρ ἡγεύμεθα ἐνθύμησιν ὀχλεομένου τὴν τοιαύτην, πουλὺ δὲ μᾶλλον, ἢν ὀξὺ νόσημά τι· νούσου γὰρ ταχυτὴς καιρὸν μὴ διδοῦσα ἐς ἀναστροφὴν οὐκ ἐποτρύνει τὸν καλῶς ἰητρεύοντα ζητεῖν τὸ λυσιτελές, ἔχεσθαι δὲ δόξης μᾶλλον· κρέσσον οὖν σωζομένοισιν ὀνειδίζειν ἢ ὀλεθρίως ἔχοντας προμύσσειν.

Image result for medieval manuscript doctor seeing patient

Diagnose Thyself: Why Be a Doctor?

Galen, On the Opinions of Hippocrates and Plato 9.5.5-7

“For some men practice the art of medicine for the money, and some do it because of the exemption from taxes. But some pursue medicine because of their love for humanity [philanthrôpia] just as there are those who do it for the fame or honor medicine attracts. Therefore doctors are named by the fact that they are all craftsmen of health in common, inasmanuch as they perform their craft for different reasons—one will be called a lover of humanity [philanthrôpos], another titled a lover of honor [philotimos], while another is considered a lover of reputation [philodoxos] and another is a money maker.

The aim of a doctor for doctors, then, is not fame or wealth, as Mênodotos the Empiricist wrote. This is a goal for Mênodotus but not for Diocles or Hippocrates or Empedocles nor even a few others of those ancient doctors—however so many ministered to people because of their love of humanity [philanthrôpia]. Left bare among these kind of examples—and they are abundant in Hippocrates and Plato—the particular features and the common traits of each craft may be examined.”

τινὲς μὲν γὰρ ἕνεκα χρηματισμοῦ τὴν ἰατρικὴν τέχνην ἐργάζονται, τινὲς δὲ διὰ τὴν ἐκ τῶν νόμων αὐτοῖς διδομένην ἀλειτουργησίαν, ἔνιοι δὲ διὰ φιλανθρωπίαν, ὥσπερ ἄλλοι διὰ τὴν ἐπὶ ταύτῃ δόξαν ἢ τιμήν.  ὀνομασθήσονται τοιγαροῦν ᾗ μὲν ὑγιείας εἰσὶ δημιουργοὶ κοινῇ πάντες ἰατροί, καθόσον δὲ τὰς πράξεις ἐπὶ διαφόροις ποιοῦνται σκοποῖς, ὁ μέν τις φιλάνθρωπος, ὁ δὲ φιλότιμος, ὁ δὲ φιλόδοξος, ὁ δὲ χρηματιστής.

οὔκουν τοῖς ἰατροῖς τὸ τέλος ἐστὶν ὡς ἰατροῖς ἔνδοξον ἢ πόριμον, ὡς Μηνόδοτος <ὁ> ἐμπειρικὸς ἔγραψεν, ἀλλὰ Μηνοδότῳ μὲν τοῦτο, Διοκλεῖ δ’ οὐ τοῦτο, καθάπερ οὐδὲ ῾Ιπποκράτει καὶ ᾿Εμπεδοκλεῖ οὐδ’ ἄλλοις τῶν παλαιῶν οὐκ ὀλίγοις ὅσοι διὰ φιλανθρωπίαν ἐθεράπευον τοὺς ἀνθρώπους. γυμνασάμενος οὖν ἐν τοῖς τοιούτοις τις παραδείγμασι, πάμπολλα δ’ ἐστὶ παρ’ ῾Ιπποκράτει καὶ Πλάτωνι, ῥᾳδίως κατόψεται τά τε ἴδια τέχνης ἑκάστης καὶ τὰ κοινά.

 

Image result for medieval manuscript medical doctor
From medievalists.net