Asclepiades of Bithynia

Bust of Asclepiades

Asclepiades (Greek: Ἀσκληπιάδης; c. 124 or 129 – 40 BC), sometimes called Asclepiades of Bithynia or Asclepiades of Prusa, was a Greek physician born at Prusa in Bithynia in Asia Minor and flourished at Rome, where he established Greek medicine near the end of the 2nd century BC. He attempted to build a new theory of disease, based on the flow of atoms through pores in the body. His treatments sought to restore harmony through the use of diet, exercise, and bathing.

Life

Asclepiades was born in Prusias in Bithynia. He travelled much when young, and seems at first to have settled at Rome as a rhetorician.^[1] In that profession he did not succeed, but he acquired great reputation as a physician. His pupils were very numerous, and his most distinguished pupil, Themison of Laodicea, founded the Methodic school. It is not known when he died, except that it was at an advanced age. It was said that he laid a wager with Fortune, that he would forfeit his character as a physician if he should ever suffer from any disease himself. Pliny the Elder, who tells the anecdote,^[2] adds that he won his wager, for he reached a great age and died at last from an accident. Nothing remains of his writings but a few fragments.

Family lineage of Asclepiades is not well known. It is assumed that his father was a doctor due to ancient physicians coming from medical families.^[3] He received the names Philosophicus due to his knowledge of philosophy and Pharmacion for his knowledge of medicinal herbs.^[4] Antiochus of Ascalon said about Asclepiades, "second to none in the art of medicine and acquainted with philosophy too."^[5]

Medicine

Asclepiades began by vilifying the principles and practices of his predecessors, and by asserting that he had discovered a more effective method of treating diseases than had been before known to the world. He decried the efforts of those who sought to investigate the structure of the body, or to watch the phenomena of disease, and he is said to have directed his attacks particularly against the writings of Hippocrates.

Discarding the humoral doctrine of Hippocrates, he attempted to build a new theory of disease, and founded his medical practice on a modification of the atomic or corpuscular theory, according to which disease results from an irregular or inharmonious motion of the corpuscles of the body. His ideas were likely partly derived from the atomic theories of Democritus and Epicurus. All morbid action was reduced to the obstruction of pores and irregular distribution of atoms. Asclepiades arranged diseases into two great classes of Acute and Chronic.^[6] Acute diseases were caused essentially by a constriction of the pores, or an obstruction of them by an excess of atoms; the Chronic were caused by a relaxation of the pores or a deficiency of atoms. Asclepiades thought that other mild disease were caused by a disruption in bodily fluids and pneuma. He separated illnesses into three separate categories: status strictus (too tightly held), status laxus (too loosely held), and status mixtus (a little of each). He also believes that there are no critical days of diseases, meaning that illnesses do not end at a definite time.

His remedies were, therefore, directed to the restoration of harmony. He trusted much to changes of diet, massages, bathing and exercise, though he also employed emetics and bleeding. A part of the great popularity which he enjoyed depended upon his prescribing the liberal use of wine to his patients,^[7] and upon his attending to their every need, and indulging their inclinations. He would treat all his patients fairly and not discriminate based upon gender or mental illness. He believed treating his patients kindly and amicably was a staple to being a good physician. Cito tuto jucunde meaning to treat his patients "swiftly, safely, and sweetly" was a motto that he followed.^[8] Many physicians during his era had a tendency to be uncaring and have a lack of sympathy towards their patients.

Drug theory

Digestion was a primary factor in Asclepiades' drug theory. Particles of food are seen as a main cause of indigestion. If the particles of food were small, digestion would follow its normal course. However, if the particles were too big, indigestion would occur. If an illness were to occur, he believed that drugs were not the solution. His prescribed treatment was food and wine (given in appropriate amounts) superseded by an enema. This procedure would remove the cause of illness. Asclepiades believed that the use of drugs for cleansing was of no use - "all the substances were produced by the drugs themselves".^[9]

Music therapy

Asclepiades used music therapy to treat mentally ill patients in order to maintain "psychogenic equilibrium". While Asclepiades was not the first to use music therapy, he used it to treat mental illness along with other ailments including viper bites, scorpion stings, etcs. Gentle music was recommended to those in a flippant state, while those in a somber state were encouraged with music using the Phrygian mode. He did not recommend the use of a flute in any treatments because it was considered to be too energetic and would not be have a calming effect on patients. He believed that the part of the body that was affected would dance to the music and expel the pain from the body.^[10]

The medical writers Galen and Aretaeus, both of whom lived in the 2nd century, credit Asclepiades with being the first individual to perform an elective (non-emergency) tracheotomy.^[11][12]

Asclepiades advocated humane treatment of mental disorders, and had insane persons freed from confinement and treated them with natural therapy, such as diet and massages. His teachings are surprisingly modern, therefore Asclepiades is considered to be a pioneer physician in psychotherapy, physical therapy and molecular medicine.^[12]

Notes

1. Pliny, Hist. Nat. xxvi. 7
2. Pliny, Hist. Nat. vii. 37
3. Polito, Roberto. "On the Life of Asclepiades of Bithynia". The Journal of Hellensitic Studies Vol. 119 (1999), pp 48-66
4. Yapijakis, C. (2009). Hippocrates of Kos, the Father of Clinical Medicine, and Asclepiades of Bithynia, the Father of Molecular Medicine. in vivo, 23(4), 507-514.
5. John Scarborough Pharmacy in History Vol. 17, No. 2 (1975), pp 43-57
6. Caelius Aurelianus, De Morb. Chron. iii. 8. p. 469
7. Pliny, Hist. Nat. vii. 37, xxiii. 22
8. Jack Edward McCallum "Military Medicine: From Ancient Times to the 21st century" pp. 26-27
9. Reference 3
10. Ana Marta Gonzalez. The Emotions and Cultural Analysis p. 1982
11. Gumpert CG (1794). "Cap. VIII: de morborum cognitione et curatione secundum Asclepiadis doctrinam". In Christianus Gottlieb Gumpert. Asclepiadis Bithyniae Fragmenta (in Latin). Vinariae: Sumptibus novi bibliopolii vulgo Industrie-Comptoir dicti. pp. 133–184. Retrieved 8 August 2010.
12. Christos Yapijakis (1 July 2009). "Hippocrates of Kos, the Father of Clinical Medicine, and Asclepiades of Bithynia, the Father of Molecular Medicine" (PDF). In Vivo. 23 (4): 507–514. PMID 19567383. Retrieved 8 August 2010.

Further reading

• Cumston, Charles Greene (1926). An Introduction to the History of Medicine From the Time of the Pharaohs to the End of the Nineteenth Century. New York: Alfred A. Knopf.
• Green, Robert M., ed. (1955). Asclepiades, His Life and Writings: A Translation of Cocchi's Life of Asclepiades Gumpert's Fragments of Asclepiades. New Haven, CT: Elizabeth Licht.
• Rawson, Elizabeth (1982). "The Life and Death of Asclepiades of Bithynia". Classical Quarterly. 32 (2): 358–370. doi:10.1017/S0009838800026549. PMID 11619646.
• Vallance, J.T. (1990). The Lost Theory of Asclepiades of Bithynia. Oxford: Clarendon Press.
•  This article incorporates text from a publication now in the public domain: Chisholm, Hugh, ed. (1911). "Asclepiades (physician)". Encyclopædia Britannica (11th ed.). Cambridge University Press.
•  This article incorporates text from a publication now in the public domain: Smith, William, ed. (1870). "^{article name needed}". Dictionary of Greek and Roman Biography and Mythology.