As in Mycenaean times, both religious and secular medical practice continued to operate side by side. Physicians frequently contributed to the Asclepieian temples, and columns of the temples were sometimes inscribed with the names of honored physicians.
Although the temples and cult of Asclepios eventually became the principal focus of religious medicine, a long and mythological heritage had preceded. The ancient gods of the earth and underworld, with animal agents such as snakes and moles, were often healing forces, and Asclepios may have been the later personification of some of these older gods.
The legendary Melampos (c. 1500 B.C.) gained fame as a healer when he cured the mad women of Argos, among whom were daughters of the king of Tiryns, a citadel like Mycenae. His method of first stimulating the women to even further wild behavior is said to have foreshadowed the Dionysian mysteries involving orgiastic rites. He then employed the drug black hellebore, which has a number of actions depending on how much is given—narcotic, diuretic, cathartic.
Amphiaraos was one of the most famous descendant divinities of Melampos. He may have originated as a local subterranean demon known in Thebes, Athens, and especially in Oropos where he apparently became a sort of competitor to Asclepios. Tromphonios was another supernatural physician from the underworld, whose ministrations were sought in caves and whose healing powers were conveyed through snakes, which go back to early times as symbols of regeneration and therefore of cure.
More in the orbit of Olympian gods was Orpheos, whose music and poetry had power over the soul, and who once may have lived as a mortal in Thrace about 1300 B.C. A religious sect developed around him involving a belief in reincarnation and asceticism (celibacy, vegetarianism, exercises). The philosophic medical center of Pythagoras (fl. c. 530 B.C.) was intimately connected with Orphic mysticism.
Of course, almost every god in the Greek pantheon, as well as many demigods and heroes, seems to have had some association with illness and health. Hera, Zeus's wife and goddess of the home, was a protector of women in childbirth. Athena, the goddess of wisdom, also had temples dedicated to her as a healer and was sometimes referred to as a patroness of the eyes.
Chiron was a half brother of Zeus, sharing the same father, the Titan Cronos, from whom the Olympian Zeus wrested power over the universe. Half human, half horse, he had a special place as a patron of healing. There were legends as late as the Middle Ages of his having imparted secrets of medicinal plants to Apuleius, the compiler of a famous herbal. His knowledge of the healing properties of herbs was said to have been conveyed to him by Artemis. Pindar's poetic stories indicate that Chiron, in addition to performing magic cures by incantations, also administered drugs, soothing applications, and surgery, from which we may infer their use in the author's own time (518-438 B.C.). Chiron was indeed the godhead of medical teachers, for his pupils were said to include Melampos, Achilles, and Asclepios. However, it was Apollo who became identified as the principal divinity controlling illness. The legend that Asclepios was Apollo's son may have helped him to eventual predominance as god of healing.
The Iliad speaks of Asclepios as a warrior-king contributing ships and men to the Trojan war. It was his two sons Machaon and Podalirios who were knowledgeable in the healing arts. Nevertheless, by the time of Hesiod (700 B.C.?), about two centuries after Homer, Asclepios was considered the principal god of healing. Hesiod's version of Asclepios's birth and elevation has remained the best known, although it is not clear whether he created or simply reported it.
The story is that Coronis, a mortal woman, either voluntarily or unwillingly, succumbed to the sun-god Apollo, but while pregnant with the god's child she married Ischys, to whom in some versions she had been betrothed. Apollo killed Ischys while his sister Artemis slew Coronis, but before her body was burned on the funeral pyre Apollo snatched the babe Asclepios, bringing him to the mountain retreat of Chiron, the centaur, who raised the child and taught him all there was to know about the healing arts, especially in regard to plants and medicines. When the boy grew to manhood he had become so skillful that he even brought a dead man back to life. Zeus, the chief Olympian god, fearing that the afterworld would be depopulated if Asclepios continued to resurrect people, struck down the healer with a thunderbolt. Asclepios was then brought into the heavens as a deity.
By the time of Pindar, the unfairness of the gods in the plot had become unacceptable, and so alterations were made in the legend to fit the changed notions of morality. Coronis was turned into an adulteress who deceived both Apollo and her husband, thus deserving her treatment. Asclepios's punishment was made acceptable by having him perform the resuscitation for a fee rather than a noble purpose. This revision also showed that every physician, even Asclepios, should be punished for hubris, the sin of aspiring to what belongs to the gods; that nature must not be thwarted; that physicians are mercenaries—perhaps an indication of common attitudes of the time.
Asclepios had a large family, most of whom had health and medical functions. His wife Epione soothed pain, and his daughter Hygeia was the deity of health who came to represent prevention of disease. Panacea, another daughter, represented treatment. The boy Telesphoros who normally accompanied him stood for convalescence.
The healing temples of Asclepios originated about the sixth century B.C., apparently in Thessaly—either in Tricca (according to both the Iliad and Hesiod) or in Epidauros (on the basis of archaeological evidence). By the fourth century B.C. temples were in many places on the mainland, including the Argolid, Mantinea, Gortys, Cyllene, Corinth, Aegina (just off the coast), Athens (following a plague in 410 B.C.), and Piraeus. Asclepios was not recognized on the island of Cos, the birthplace of Hippocrates, until the fourth century B.C.—first as a sort of healing partner with Apollo. This was after Hippocrates had died, so there could have been no connection with local medical practice on Cos during his lifetime. After the temple to Asclepios was established, it flourished for centuries, indeed outlasting the Hippocratic teaching group on the island.
Two of the most famous temples to Asclepios (established in the fourth century B.C.), second only to that of Epidauros, were in Pergamon on the coast of Asia Minor and on the nearby island of Rhodes. Delos and Lebera also established temples soon after. There was a rapid spread of the cult throughout the Greek world—east to Ephesos and beyond, south to Crete and Africa, west to Taras (Tarentum) and Syracuse. In Egypt, the divinity of Asclepios became mingled with that of the deified Imhotep, as Asclepios-Imhoutes. After the death of Alexander in 323 B.C., the strong support by the ruling Ptolemies for the god Serapis as the healing divinity seems to have been followed by another merger with Asclepios. Apparently the legend was so persuasive, and Asclepios so satisfied the need for a personal, compassionate divinity, that he inherited, replaced, or merged with the power and influence of each local healing god, wherever the Asclepieian rites were introduced.
The first temple to Asclepios in Rome was erected in 295 B.C. According to the story, a request was brought to the temple in Epidauros for help in stopping the plague then raging in Rome. The Epidaurian snake came out of the temple precincts, boarded the waiting ship, sailed to the island in the Tiber, and there disembarked. A temple was built on the spot, and the epidemic ended.
Each Asclepieian temple was a conglomeration of buildings and areas, depending in size and opulence on its wealth and influence. The dominant structure was usually the main temple, in which a statue of the god was given a prominent place. The Epidaurian statue is said to have been huge and awe-inspiring with its gold and ivory decorations. Statues of various members of the family of Asclepios were often to be seen either in the temple or within its compounds. Somewhere in the precincts, on the entrance gates or before the portals, were tablets describing earlier miraculous cures and votive offerings which expressed gratitude for successful results. A round building, the tholos, contained water for purification, sometimes in a pool or bubbling from a sacred spring. Here, too, paintings and decorations were frequent.
The most important structure to the ailing suppliant was the incubation site, the abaton, where the actual cure took place in the worshiper's dreams. All the preparations and anticipations were prelude to what happened within the abaton, where the patient went to sleep until he was visited by the god.
The large temple compounds like that at Epidauros might have included a theater, stadium, and gymnasium, serving to entertain, soothe, and otherwise affect people's spirits. Often inns and temporary housing were also necessary, though usually situated outside the boundaries of the complex. The Asclepieian temples were extremely popular among both rich and poor. Rather than forerunners of hospitals, they seem to have been in modern terms a mixture of religious shrine and health spa.
The ceremony itself, begun after sundown, was surrounded by well-developed rituals which, together with the impressiveness of the buildings, the diversions outside, and the influence of many successful case histories, put the visitor into a mental state receptive to the healing ministrations of the priests and staff.
Prior abstinence from specific foods and wine or even fasting could be required, and a clean white robe was to be worn after ritual bathing. A gift or sacrifice to the god Asclepios followed, which might be food, an animal, or some other evidence of obeisance. In later times, a rooster came to be particularly common as a donation to Asclepios; its special significance may have derived from Zoroastrianism, where the crowing of a cock was believed to drive off evil spirits and prevent illness.
The suppliant was now ready for the vital part of the ceremony: incubation. He or she would lie on a pallet, usually of skins, and await a visit by the god. There appears to be little evidence that drugs induced the somnolence or half-awake state in which worshipers found themselves. During the night, the priest, dressed as Asclepios, accompanied by his daughters, servants, assistants, and snake or dog, would make his "rounds" (in the semidark), moving from sleeper to sleeper, administering the cure or giving advice. Usually the impressive retinue carried medicines, bandages, and other accoutrements of physicians in the world outside the temple. The patient was treated by the god, by his assistants, or by an accompanying snake or dog which might lick the affected part. To treat a woman's sterility, a snake was placed on her abdomen, and in one situation, a woman dreamed that a large snake had intercourse with her. Other animals also participated in the curing process, including a sacred goose which would bite a boil. The divinity used a variety of treatments: laying on of hands, applying a medication, performing a surgical operation, or giving instructions or advice.
By morning the visitor expected to be cured. Sometimes it took longer, and the person might have to remain in the precincts or nearby for days. In any case, before departing from the temple, the cured person was expected to leave a sign of his gratitude—a modest token if poor, a sumptuous gift if rich.
A great many different techniques were used by the god, but most often they were clearly based on the usual practices of the secular doctors and the folklore of the day. Sometimes the precise actions in regular surgical operations were employed, with blood dripping on the floor and assistants holding the patient while the god-physician operated. Even conservative, nonoperative surgery was practiced, in one instance countering the advice of a person's physician for surgical drainage of an abscess on the chest. He was told the pus would later break out by itself, thus draining the chest.
Not all methods used were copies of the rational procedures of physicians. Some were magical and fantastic. Also a vicarious kind of treatment was occasionally reported, whereby one person could sometimes stand in for another, going through the incubation so that the other might be cured. Even cure at a distance was supposed to have occurred.
Many types of illness were treated, but the vast majority were of a kind that might be psychically based. Blindness, muteness, and lameness were sometimes cured by what may be characterized as miracle methods, such as bathing in a sacred spring, or by surprise techniques, such as snatching away a boy's crutches in hopes he would instantly chase the thief before remembering he was lame. A particularly ironic cure of blindness was effected on Phalysios by sending him a special tablet at which he was to look. When he looked his sight was restored, but he was shocked to read an order for him to give an exorbitant gift to the temple. Barrenness, impotence, headache, and skin diseases also made up a large part of the list of symptoms reputed to have been cured.
Clearly the most important ingredient in the effectiveness of the temple cure was faith. The suppliant's belief in the efficacy of the god was aided by accounts of cures on tablets and probably by oral descriptions given by temple assistants. Also a feeling of relaxation was engendered by music and comfortable surroundings. The religious and spiritual atmosphere was inspiring, and the appearance and ministrations of the priest acting as Asclepios, with his accompanying retinue, were doubtless impressive.
It is not astonishing that the healing cult of Asclepios was so popular and lasted for so many centuries when one considers that secular physicians had few specific or effective remedies for the organic diseases of the time. Furthermore, since it was considered prudent and moral to refuse to treat the hopeless (to do otherwise was criticized as fraud), the patients had no other pathways open except to charlatans or the temples. Since there must have been instances in which illnesses deemed incurable by physicians were actually psychically based, word of a dramatic success in the temple would surely be spread widely and give hope to numerous sufferers.
It is difficult to know how much of the temple healing was believed by the priests themselves, how much was deliberate deception. In any case, the temples continued to be a haven of hope to the sick even as some physicians were elsewhere using the rational, nonreligious means that were available to them.