Doctor Patient Compliance in Ancient Times, Celsus on dietary regulation

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One of the crucial issues in healing is the issue of control, self- or

otherwise. The teachers of all traditions of medicine have had to try to

strengthen their patients' abilities to choose what is best, with varying

degrees of success. The following passage shows Celsus acutely aware of the

importance of diet, but having to recognize limitations in what he may

prescribe. Celsus writes,

 

Neque ulla res magis adiuvat laborantem quam tempestiva abstinentia.

Interperantes homines apud nos ipsi cibi *modum sibi constituunt nec magis cibi*

tempora curantibus dantur: rursus alii tempora medicis pro dono remittunt, sibi

ipsis modum vindicant. LIberaliter agere se credunt, qui cetera illorum

arbitrio relinquant, in genere cibi liberi sunt: quasi quaeratur quid medico

liceat, non quid aegro salutare sit, cui vehementer nocet, quotiens in eius,

quod adsumitur, vel tempore vel modo vel genere peccatur.

 

To a sufferer nothing is more advantageous than a timely abstinence. Among

us intemperate men with regard to their food themselves determine the amount,

and do not even leave the times to the doctors; again others relinquish the

times as a gift to their doctors, but keep for themselves the amount. (A third

kind) believe themselves generous when they give up to their doctor's judgement

all else, but insist on choosing the kind of food. -- As if the question was

all about allowance to the doctor, not about what benefits the sick, who do

themselves great harm, whenever they err in the time, the amount, and the kind

of food taken. (De Medicina, Book II, 16, 2)

 

This whole discussion has to be understood within the context of the

Hippocratic teaching that food is medicine, medicine food. Abstinence from what

does harm is the essence of medical advice, but in every culture people overcome

desire with varying degrees of success. Necessity for change and inability to

do so -- perhaps this is the birth of hospitals.

 

When Celsus goes on to give three classifications for food, the strongest,

middle, and weakest kinds of foods, the echoes of the Shen Nung Ben Cao are

unmistakable -- but in the Pharmacopeia itself, divisions are made according to

therapeutic effects, as in the Tang and Song collections in China.

 

Carl Ploss