Section of the History of Medicine

Lucian and Medicine.

By J. D. ROLLESTON, M.D.

PART I.

THERE is no single representative of belletristic as distinct fromscientific literature in the ancient world who throws so much light oncontemporary medicine as does Lucian of Samosata. Although somuch relating to medicine and its practitioners may be gleaned fromhis writings, no monograph on the subject, to my knowledge, is extant.I have, therefore, thought it worth while to collect the passages ofmedical interest in Lucian as I recently did in the case of the GreekAnthology.' Some events in his life are recorded in his writings,especially in " Somnium," " Nigrinus," " Bis Accusatus," " Piscator,""Alexander," "Hermotimus " and " Apologia pro mercede conductis,"and internal evidence shows the period at which some of these workswere written.

He was born at Samosata, near Antioch, about 120 A.D. After avery brief and unhappy experience as a sculptor's apprentice to hisuncle he left Samosata to study rhetoric in Ionia. For some yearshe seems to have practised with success as an advocate at Antioch,but later his occupation consisted in composing speeches for othersto deliver-of which " Hippias " or " The Bath," " Abdicatus " or "TheDisinherited Son," and "De Dipsadibus," an essay on poisonousserpents, to mention only those of medical interest, are examples-and in giving lectures on rhetoric in various towns of Asia Minor,Greece, Italy, and Gaul.

In the course of his travels he visited the impostor and false prophetAlexander in Paphlagonia, and narrowly escaped assassination as theresult of trying to expose his trickery. He spent some time in Rome,which he first visited to consult an oculist, for, like Horace, he sufferedfrom some eye trouble of uncertain nature. His intimate knowledge ofsocial life in Rome is well shown in "'De mercede conductis," whichcontains several passages of medical interest. At the age of 40, havingprobably acquired by then a sufficient competence, he abandoned rhetoric,but before devoting himself entirely to moral and religious satire, for

' Proceedings, 1913-14, vii (Sect. Hist. Med.), pp. 3-13, and 30-56.

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which he is best known, he passed through a transition period to whichbelong the "De Saltatione," a dialogue on pantomime, "Anacharsis,"Toxaris, and probably the " Calumniae non temere credendum," a treatiseon slander, which all contain passages of medical interest. The best-known writings of the subsequent period which concern us are " TheDialogues of the Dead," " The Dialogues of the Gods," " The Dialoguesof Courtesans," " Philopseudes," and " Alexander."

Towards the close of his life, "when he had already one foot inCharon's boat " ("Apol. pro merc. cond."), he moved from Athens, wherehe had been living hitherto, to occupy an important administrative postin Egypt. His death, which has by some been attributed to gout, onwhich he has written two burlesques, took place about 200 A.D., whenhe was aged 80, thus affording another example of longevity of which hehad already recorded so many in the " Macrobii." The story related bySuidas, that his death was due to the bite of a mad dog as a punishmentfor his attacks on Christianity, is generally discredited.

The same difficulty attends the medical study of Lucian as inthe case of the Greek Anthology. Many of the writings attributedto him are of doubtful.authenticity and their date is therefore uncertain;among these are the burlesques "Tragodopodagra" and "Okypus,"as well as " Macrobii," "Abdicatus," and "Alexander." The factremains, however, that whether they are genuine or not, thesewritings contain, as I shall attempt to show, much that deserves theattention of the medical reader.

The same plan will be followed in the present paper as in my studyof the Greek Anthology. The allusions to medical men, either asindividuals -or as a class, will first be considered, and notice will thenbe taken of the other medical allusions. In the preparation of thispaper I am most indebted to the admirable introduction to the studyof Lucian by M. Croiset, and to the French translation of Belin deBallu, edited by Louis Humbert. I have also consulted the Englishtranslations of H. W. and F. G. Fowler and of A. M. Harmon. Theedition from which the quotations are made is the Greek text publishedby Teubner in 1847.

Of the fourteen medical men mentioned by Lucian-viz., Agathocles(Cataplus, 6), Alexander (De morte Peregrini, 44), Antigonus(Philopseudes, 6, 21, 25, 26), Antiphilus (Toxaris, 27-34), Archibius(Gallus, 10), Callimorphus (Quom. hist. sit. conscr., 16); Ctesias(Vera hist., i, 3; ii, 31), Dionicus (Convivium, 1, 3, 20, 47),Hippocrates (Hermotimus, 1 ; Vera hist., ii, 7), Nicander (De

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dipsad., 9), Paetus (Alexander, 60), Sopolis (Lexiphanes, 18-22),Soter (Okypus, lines 78 et seq.), and Toxaris (Scytha, passim).Hippocrates and Nicander are the best known ; Callimorphus andCtesias, though physicians, were better known as historians; Antigonus,Archibius, and Sopolis are spoken of by other writers, though theiridentity with Lucian's doctors cannot be determined; while the namesof the other seven do not appear in any work which I have consulted.

Most of them seem to have been honourable if obscure practitioners,but one at least was a "shady" character. This was "Poetus, a physicianby profession and a grey-haired old man, who did what was neitherfitting for a physician or for one of his grey hairs," by seeking to bethe successor of the impostor Alexander (Alexander, 60). Of the tworeferences to Hippocrates one is a quotation of his well-knownaphorism, "Art is long and time is fleeting," which Lucian says iseven more true of philosophy than of medicine, while the other relatesto the Telamonian Ajax, who is handed over to Hippocrates to be curedof his madness before he is admitted to the assembly of heroes in theIsles of the Blessed.

Some of Lucian's doctors seem to have been special friends oftheir patients, such as Dionicus, Archibius, and Antigonus, as theyattended their banquets and took part in the conversation. Theirfreedom of speech towards their patients shows that their conditionhad considerably improved since the time when they were merelyslaves in the Roman household. Thus the doctor Alexander, attendingthe philosopher Peregrinus who was suffering from fever and callingfor water, refused to give it him, but told him that if he was so anxiousto die death would come to him of its own accord, and that he hadno need to sacrifice himself on a funeral pyre (De morte Peregrini, 44).Similarly outspoken language is used by Sopolis, who administers anemetic and purgative to Lexiphanes, and by Soter, who attends thegouty Okypus.

There are other doctors whose names are not given, such as theoculist whom Lucian consulted at Rome, the speaker in Abdicatus,and the medical attendant on the King of Assyria, whose diagnosticacumen in detecting the symptoms of love in a young man who feignedillness is amusingly told in the essay on the Syrian Goddess (De DeaSyria, 17-18).

I alluded in my last paper to the epigram variously attributed toLucian, Lucilius, and Agathias, of the doctor who sent his son to a tutorbut took him away again when he had only learnt the first three lines

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of the "Iliad," saying that this lesson would be learnt at home, as hehimself sent many souls to Hades and for that had no need of a tutor(Anth. Pal., xi, 401).

Apart from references to individual doctors, numerous passages, bothlaudatory and satirical, relating to the medical profession are to be foundin our author. Some of the most interesting passages occur in the" Abdicatus " or " Disinherited Son." This is a rhetorical piece whichappears in mnost editions of Lucian's works, though attributed by someto Libanius, a rhetorician of the fourth century, A.D., supposed to havebeen delivered by a medical man who had been disinherited by his fatherfor refusing to undertake the treatment of his stepmother's disease, asto the nature of which we are left in doubt. The speaker relates howto enable himself to cure his father's illness, which seems to have beensome kind of insanity, he had travelled abroad and after association withthe most illustrious physicians in various countries had with much labourand zeal mastered the art of medicine. On hiA return he took his father'streatment in hand. "I did not," said he, " undertake to cure him atonce, for that is not our custom, nor does our art advise us to do so, butfirst of all we are taught to see if the disease is curable or incurable andtranscending the limits of our art. Then, if it is susceptible of cure, weundertake it and exert all our endeavours to save the patient; but if wesee that the disease has got the upper hand we do not attempt to treatit, in conformity with the old rule of the forefathers of medicine, whosay that one should not take patients in hand who have been conqueredby the disease" (Abdicatus, 4).

Further quotations from the same piece testify to the high estima-tion in which the medical profession was held in the second century A.D." The nobler and more useful for life it is, the freer it should be. Itsliberty is one of its noblest privileges. It should be subjected to noviolence or commands, but it is a -holy thing, invented by the gods andpractised by learned men. It is not under the yoke of the laws, it isinaccessible to fear, not subject to the punishment of tribunals, thethreats of a father or the anger of a private person. . . . One mustpersuade the doctor, not command him; he should be induced, notintimidated, but should of his own free will undertake the conduct ofa case. Our art is freed from paternal authority. It enjoys immunitiesof every kind. Wherever there are physicians cities .bestow honours andthe front rank upon them and grant them privileges and exceptions"(ibid., 23).

Numerous other passages in Lucian illustrate the prestige enjoyed

Section of the History of Medicine

by the medical profession. In three places (Quomodo hist. sit. conscr., 7;De Dipsad., 5; Philopseudes, 10) we find the term iarpciv 7ra'3e? or'Ao/cX,7rtOv waZSE3s to signify regular practitioners as distinct from thelay public or charlatans. Thus, in De Dipsadibus, 5, we read that theLa'pc..w 7raF&q explained the unquenchable thirst caused by the bite ofthe serpents on the theory that the naturally thick venom, on beingdiluted with water, becomes more active and rapidly diffused throughoutthe systam. In the same piece Lucian says: "I have not wished toshow myself a rival of Nicander or prove that I have carefully,studiedLibyan serpents. Such praise would be more suited for medical menwho are obliged to know these things" (ibid., 7).

Elsewhere we read that the sage Demonax reprobated vices butpardoned offenders, and urged that philosophers should imitatephysicians who cure disease without being angry with the patient(Demonax, 7).

It is noteworthy that, though several references are made to oculistsabd eye salves, they are not of a satirical character as in Martial or theGreek Anthology. Mention has already been made of the oculist whomLucian visited at Rome. In " Lexiphanes " one of the speakers says:"My sight is weakened, I am constantly blinking, and my eyes arewatering and want a salve. I need a disciple of Asklepius, some oculistto make up a remedy to take away the redness from my eyes, cleartheir bleariness, and stop their running" (Lexiphanes, 4).

The philosopher Peregrinus, some days before his suicide, appliedan eye salve which was so strong that it made his eyes water. The useof an eye salve at such a time seems to Lucian as absurd as if a manabout to be crucified were to have a wound on his finger dressed (Demorte Peregrini, 45).

The dangers to which doctors were exposed in the exercise of theirprofession are alluded to in more than one passage. Thus in Cataplus, 6,we read of the physician Agathocles accompanying to Hades hisnumerous patients who had died of fever. In the Convivium, 20, andAbdicatus, 16, the risks associated with attendance on the insane aredescribed, and in Calumn. non tem. cred., 13, the medical man is givenas an example of a victim of slander. "Slanders as a rule turnagainst their object the disadvantages he may possess and attribute tohim crimes which appear probable. Thus a doctor is accused of beinga poisoner, just as a rich man may be of seeking to be a tyrant."

It is not iinprobable that Lucian, like Cicero and Horace, hadfriends amongst the medical profession in Rome or elsewhere. Such

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a supposition may explain the frequent allusions to medical subjects aswell as his use of medical metaphors such as the following:

Gnathon the parasite, after being struck by Timon, asks for moneyto staunch his wounds: "Gold," said he, "is a wonderful haemostatic(Timon, 46). In the Quomodo hist. sit. conscr., 7, we read that " Historycan no more tolerate a lie, even the smallest, than the trachea, as themedical faculty call it, caV allow the entry of fluid." In the Apolog. promerc. conduct., 2, one of the speakers, in submitting to cross-examination,says: " It is my place now to keep silence and submit to be cauterised,if necessary, and for you to apply the remedies and have ready the knifeand the cautery."

The incisive language of a philosopher is described in similar terms:"The discourse of Nigrinus did not make a slight or superficial impres-sion upon me, but the wound was deep and fatal and his well-directedwords, so to speak, cut right into my soul" (Nigrinus, 35).

With the exception of the epigram of doubtful authenticity alreadymentioned, the satirical allusions to doctors in Ltucian do not, as in theGreek Anthology, make any reference to thievish or murderous practi-tioners. Boastfulness, incompetence, and quackery are rather the viceswhich are stigmatised. In several passages the ostentatious and ignorantpractitioner is contrasted with one of real skill and experience. Thusin Hippias, 1, we read that " A sensible man, when he is ill, does not sendfor the doctor who is -best able to discourse about his art, but for onewho has been longest in practice." In the piece entitled "AdversusIndoctum," 29, an uneducated man owning a large library is comparedto " ignorant doctors who buy ivory medicine boxes, silver cuppingglasses, and knives with gold handles, but when these instruments areneeded do not know how to use them. It is then that a really experiencedpractitioner comes forward with a sharp though rusty knife and at oncerelieves the patient."

In the " Demosthenis encomium," 22, one of the interlocutors in thedialogue is compared to a doctor who had not understood what was thematter with the patipnt and was treating him for the wrong disease.

In the essay on " How to Write History " two physicians incurLucian's satire, not for their medical but for their literary misdeeds.The first of these was Callimorphus, " whose fault was that he gave hisbook a more high sounding title than this mode of composition required-viz., " The Parthian History of Callimorphus, physician of the sixthlegion of pike-bearers." He started with a very frigid preface, in whichhe declared that it was proper for a physician to write history, as

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Asklepius was son of Apollo, and Apollo was leader of the Muses andmaster of all the sciences " (Quomodo hist. sit. conscr., 16). Elsewherein the same treatise (ibid., 39) Lucian attacks Ctesias, the author of aPersian history, and attributes his unveracity to his being physician toArtaxerxes and to a desire to obtain a substantial reward for his fulsomepanegyric.

The prevalence of charlatanism is illustrated in several passages.In the two Syrians from Damascus (Tragodopodagra, 265 et seq.) wehave examples of itinerant quacks, though dignified by'the name ofphysicians, who under the pressure of poverty and hunger have broughtwith them a secret remedy for gout bequeathed them by their fatheron his death-bed, with the strict injunction never to reveal itscomposition.

In the " Apologia pro mercede conductis," 7, a man whose claimsare unwarranted is compared to a quack, who while boasting of aremedy for a cough is suddenly interrupted by a violent paroxysmhimself.

The palm in quackery, however, is to be given to the impostor andfalse prophet Alexander, to whose adventurous career Lucian hasdevoted one of the most entertaining of his descriptive pieces.Alexander was born in Paphlagonia, a region notorious for its simple-tons, and was brought up by a man who was professedly a physicianbut was probably a poisoner, a friend of Apollonius of Tyana.Possessed of all the physical advantages a* charlatan couJd desire, alofty stature, a handsome face and commanding appearance, a piercingeye and a pleasant and sonorous voice, Alexander found his fellow-countrymen an easy prey. With a dancing master as his accomplice,he buried two brazen tablets in a disused temple of Apollo with theinscription that Asklepius, accompanied by his father, Apollo, wascoming and would take up his abode at Abonoteichos. The tabletswere soon discovered and'by clever juggling with some tame snakeshe convinced the populace- that a new Asklepilus had appeared. Hegave himself the name of Glycon, simulated divine inspiration by wildgestures and filling his mouth with foam obtained by munching soap-wort, and for the modest sum of 1 drachma and 2 obols (about tenpence)made oracular responses to all who consulted him about their health orother matters of importance. His fame rapidly spread to the adjacentprovinces of Bithynia and Galacia, and finally over the whole. Ronmanempire, and his annual income reached the respectable figure of 70,000drachmas (about £2,880), by which he was able to defray the expenses

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of a large staff of assistants, spies, clerks and interpreters. Messengerswere sent to every country to announce that he cured all diseases andeven raised the dead. His early training had given him some know-ledge of medicine, but the remedy on which he set most store was anostrum composed of goat's fat which he seems to have used as apanacea. As might be expecteli, his prognosis was not always correct,but he safeguarded himself by producing oracles after the events.Thus, when patients died whose recovery he had pronounced certain,he produced another oracle couched as follows: " Seek not a cure foryour dire disease. Your fate is certain and it is impossible to escapeit." He did not even hesitate to fortell a visitation of a pestilence andpromised to avert it. Unfortunately for him the houses on which hehad had inscribed the promise, " Phoebus of the unshorn locks will keepthe pestilence far from you," were precisely those which were strickenwith the plague. Attempts to expose his trickery were met by theretort that his opponents were Epicureans or Christians, both highlyunpopular sects. Lucian himself only escaped assassination by the soft-heartedness of the sailor whom Alexander had ordered to drown him.The impostor's end was a fitting one. Though he had prophesied thathe would live one hundred and fifty years and be killed by lightning,he died at the age of 70, " eaten of worms," like Herod, and of " putri-faction of the foot extending to the groin" (probably senile gangrene).It was not till his last illness that it was discovered that he wasbald, for the severe pain in his head compelled him to remove hisfalse hair. %

Confirmiation of the edifying story of one whom Froude has aptlycalled a " Cagliostro of the second century" is provided by the coinsminted by Alexander, of which Lucian speaks, being still extant.They bear on one side the image of Glycon and on the other Alexanderhimself, wearing the crown of Asklepius and holding the sword ofPerseus from whom he claimed to be descended on his mother's side.

The success of Aleglander's impostures is comprehensible when werealise that superstition, especially in therapeutics, was particularly rifeat that time. That credulity was not confined to ignorant folk such asthe Paphlagonians, but was prevalent also among the cultured classes,is admirably illustrated in the "Philopseudes." In this dialogue oneTychiades, whom we may regard as the mouthpiece of Lucian, relateshow he paid a visit to his friend Eucrates, whom he found sufferingfrom what was apparently an attack of gout, and surrounded by hisfriends, including the doctor Antigonus. All were discussing the disease

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Section of the History of Medicine

and suggesting a remedy. " If," said Cleodemus, " you lift from theground with the left hand the tooth of a weasel killed in the way I toldyou and tie it up in a freshly flayed lion's skin and bind it round theleg, the pain stops at once." "Not in a lion's skin," said Dinomachus,"but in the skin of a hind that has not been covered. This is muchmore comprehensible, for the hind is swift and its chief power rests inits feet. The lion, it is true, is strong, its right foreleg and the hairs ofits mane have great effect if one can use them with the appropriateincantation, but they have no power to cure the feet." Tychiades thenexclaims: " Do you believe that pains can be stopped by charms andamulets when the disease is internal ? " They laughed at this, andshowed that they condemned his ignorance of what was so obvious,such as no sensible person would contradict. The doctor Antigonus,however, seemed very pleased by the question, for he had long sincegiven up treating Eucrates with the help of his art by ordering himto abstain from wine, to eat vegetables, and to refrain from over-exertion. Cleodemus then remarked with a smile: " What, Tychiades,do you doubt that such things are of help in disease ? " " I do indeed,"replied Tychiades, " I should be a great simpleton (literally, " my nostrilswould be bunged up with mucus ") if I believed that remedies appliedexternally and having no connexion with the internal causes of diseasecould be effective by virtue of certain words or enchantments. Suchthings could never happen, even if sixteen hinds were tied up in theskin of the Neinean lion. Personally, I have often seen a lion limpingwith pain, although covered with its whole skin." " You are verysilly," said Dinomachus, " in having neglected to learn these kindsof remedies and their mode of application in disease. You do notappear to admit what is most obvious, such as the driving away ofperiodic fevers, the charming of snakes, the cure of inguinal tumoursand other things which old women do." Dinomachus then accusesTychisdes of atheism, but Tychiades refutes the charge with thesewords: " I reverence- the gods and see their cures and the good theydo to sufferers by drugs and the art of medicine. Asklepius and hissons cured their patients by mixing soothing balms and not by applyinglions or hinds."

Further miraculous cures are told by the others present, and thedoctor Antigonus relates the following story: "I have," said he, "abronze statue of Hippocrates, about a cubit high, which wheneverthe lamp is extinguished runs noisily up and down the house, upsettingthe nmedicine boxes, mixing the drugs together, and opening the doors,

rF -Gb

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especially if we delay the sacrifice which we offer him every year."Subsequently Antigonus relates how he attended a man who came tolife again twenty days after he had been buried-probably a sneer, asde Ballu suggests, at the resurrection of the Pamphylian ER whosestory is told in the tenth book of Plato's Republic (614B et seq.).

The Pythagorean philosopher Arignotus then appears, and afterjoining the chorus of indignant protest against the incredulity ofTychiades relates a story even more fantastic than those which hadgone before. Finally Tychiades makes an excuse for leaving thecompany: "After what I had heard," said he, "I felt my stomachblown out like one who had drunk sweet wine, and I needed an emetic.I would gladly have paid a large sum for a medicine to make me forgetall I had heard."

(To be continued.)