Plato, The Republic, on medical obsessions

Plato seems to have understood all there is to understand 2400 years ago.  (tr. Reeve 2005, sec. 405a-408b)


S
OCRATES: And as intemperance and disease breed in a city, aren’t many law courts and surgeries opened? And don’t the legal and medical professions give themselves airs when even free men in large numbers take them very seriously?

GLAUCON: How could it be otherwise?

SOCRATES: Could you find better evidence that a city’s education is in a bad and shameful state than when eminent doctors and lawyers are needed, not only by inferior people and handicraftsmen, but by those who claim to have been brought up in the manner of free men? Indeed, don’t you think it is shameful and strong evidence of lack of education to be forced to make use of a corrective imposed by others, as if they were one’s masters and judges, because one lacks such qualities oneself?

GLAUCON: That is the most shameful thing of all.

SOCRATES: Do you really think so? Isn’t it even more shameful not just to spend a good part of one’s life in court defending oneself and prosecuting someone else, but to be so vulgar that one is persuaded to take pride in this and regard oneself as amazingly clever at doing injustice, and as so accomplished at every trick and turn that one can wiggle through any loophole, and avoid punishment—and to do all that for the sake of little worthless things, and because one is ignorant of how much better and finer it is to arrange one’s own life so that one won’t need to find a judge who is asleep?

GLAUCON: Yes, that is even more shameful.

SOCRATES: What about needing the craft of medicine for something besides wounds or some seasonal illnesses? What about needing it because idleness and the regimen we described has filled one full of gasses and phlegm, like a stagnant swamp, so that sophisticated Asclepiad doctors are forced to come up with names like “flatulence” and “catarrh” to describe one’s diseases? Don’t you think that is shameful?

GLAUCON: Yes, it is; and those truly are strange new names for diseases.

SOCRATES: And of a sort that I do not imagine even existed in the time of Asclepius himself. My evidence for this is that his sons at Troy did not criticize the woman who treated the wounded Eurypylus with Pramneian wine that had lots of barley meal and grated cheese sprinkled on it, even though such treatment is now thought to cause inflammation. Moreover, they did not criticize Patroclus, who prescribed the treatment.

GLAUCON: Yet, surely it was a strange drink for someone in that condition.

SOCRATES: Not if you recall that the sort of modern medicine that coddles the disease was not used by the Asclepiads before the time of Herodicus. Herodicus was a physical trainer who became ill and, through a combination of physical training and medicine, tormented first and foremost himself, and then lots of other people as well.

GLAUCON: How did he do that?

SOCRATES: By making his death a lengthy process. You see, although he was always tending his illness, he was not able to cure it, since it was terminal. And so he spent his life under medical treatment, with no free time for anything else whatsoever. He suffered torments if he departed even a little from his accustomed regimen; but, thanks to his wisdom, he struggled against death and reached old age.

GLAUCON: A fine reward for his craft that was!

SOCRATES: And appropriate for someone who did not know that it was not because of ignorance or inexperience of this kind of medicine that Asclepius failed to teach it to his sons, but because he knew that everyone in a well-regulated city has his own work to do, and that no one has the time to be ill and under treatment all his life. We see how ridiculous this would be in the case of craftsmen, but we do not see it in the case of those who are supposedly happy—the rich.

GLAUCON: What do you mean?

SOCRATES: When a carpenter is ill, he expects to get a drug from his doctor that will make him throw up what is making him sick or evacuate it through his bowels; or to get rid of his disease through surgery or cautery. If anyone prescribes a lengthy regimen for him and tells him that he should rest with his head bandaged and so on, he quickly replies that he has no time to be ill, and that it is not profitable for him to live like that, always minding his illness and neglecting the work at hand. After that, he says goodbye to his doctor, resumes his usual regimen, lives doing his own job, and recovers his health; alternatively, if his body cannot withstand the illness, he dies and escapes his troubles.

GLAUCON: That does seem to be the correct way for someone like that to use the craft of medicine.

SOCRATES: Isn’t that because he had a job to do, and that if he could not do it, it would not profit him to go on living?

GLAUCON: Clearly.

SOCRATES: But a rich person, it is said, has no job assigned to him of the sort that would make his life not worth living if he had to keep away from it.

GLAUCON: So it is said, at least.

SOCRATES: What, have you not heard the saying of Phocylides that once one has the means of life, one must practice virtue?

GLAUCON: And even earlier, in my view.

SOCRATES: Let’s not quarrel with him about that. But let’s try to find out for ourselves whether this virtue is something a rich person must practice, and if his life is not worth living if he does not practice it; or whether nursing  an illness, while an obstacle to putting your mind to carpentry and other crafts, is no obstacle whatever to taking Phocylides’ advice.

GLAUCON: But, by Zeus, it is: excessive care of the body that goes beyond simple physical training is pretty much the biggest obstacle of all. For it’s a nuisance in household management, in military service, and even in sedentary political office.

SOCRATES: And most important of all, surely, is that it makes any sort of learning, thought, or private meditation difficult, by forever causing imaginary headaches or dizziness and accusing philosophy of causing them. Hence, wherever this sort of virtue is practiced and submitted to philosophical scrutiny, excessive care of the body hinders it. For it is constantly making you imagine that you are ill and never lets you stop agonizing about your body.

GLAUCON: Yes, probably so.

SOCRATES: Then won’t we say that Asclepius knew this, too, and that he invented the craft of medicine for people whose bodies are healthy in nature and habit, but have some specific disease in them? That is the type of person and condition for which he invented it. He rid them of their disease by means of drugs or surgery, and then prescribed their normal regimen, so that affairs of politics would not be harmed. However, he did not attempt to prescribe regimens for those whose bodies were riddled with disease, so that by drawing off a little here and pouring in a little there, he could make their life a prolonged misery and enable them to produce offspring in all probability like themselves. He did not think that he should treat someone who could not live a normal life, since such a person would profit neither himself nor his city.

GLAUCON: Asclepius was a true man of politics, in your view.

SOCRATES: Clearly so. And it was because he was like that, don’t you see, that his sons, too, turned out to be good men in the war at Troy, and practiced the craft of medicine as I say they did. Don’t you remember that they “sucked out the blood and applied gentle drugs” to the wound Pandarus inflicted on Menelaus? But they no more prescribed what he should eat or drink after that than they did for Eurypylus? That was because they assumed that their drugs were sufficient to cure men who were healthy and living an orderly life before being wounded, even if they happened to drink wine mixed with barley and cheese right afterward. But they thought that the lives of naturally sick and intemperate people were profitable neither to themselves nor to anyone else, that the craft of medicine shouldn’t be practiced on them, and that they should not be given treatment, not even if they were richer than Midas.

 



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