The History of the Physician

October 19, 2024 Health & Healing No Comments

The modern Western physician was born 200 years ago. Let’s go much further back to the past and the future.

Per some broadly distinct ages in the West ― also, from an Aurelian interest and with a focus on the (absent) mind as we know it. This is not a repeat of dry historical facts.

I took the West as an example. Other parts of the world have shown similar trends.

Medicine men

From ancient shamans to tribal healers, these figures have existed throughout history, each with their own rituals, tools, and forms of knowledge. Despite their diversity, what unites them is a focus on the magical and mystical dimensions of healing — a practice that blends the physical with the spiritual, often without clear boundaries.

The medical ‘science’ of these medicine men, though seemingly rooted in magic and superstition, offers a glimpse into something deeper — a layer beneath the surface where the mind operates, yet remains hidden. Their practices reveal that the mind, even when shrouded in mystery, plays an essential role in health and well-being. However, this is often veiled in symbolic language and ritual, preventing a clear and rational exploration of the mind’s influence.

Will we ever fully uncover what lies beneath these practices? The mind, intricately interwoven with cultural and spiritual symbols, remains obscured, even as these ancient methods hint at its power. The challenge for modern medicine, and perhaps its opportunity, is to peer beyond the veil that has persisted for millennia — to uncover the deeper truths that medicine men once intuitively sensed but could not fully articulate.

Mesopotamia (between Tigris and Euphrates)

In ancient Mesopotamia, the cradle of early civilization, healing practices are divided into two distinct categories, reflecting the duality of physical and spiritual approaches. The ‘asipus’ are healers who focus on the mind, often employing rituals, spells, and other forms of magic. Their work taps into the mystical and unseen aspects of illness, indicating an early recognition of the mind’s role in health. The ‘asus’, on the other hand, are more concerned with plant-based remedies and physical treatments, applying the knowledge of herbs and natural substances to heal the body.

Despite the practical focus of the asus, it is the asipus who hold higher status within society. This elevation reflects a deeper cultural respect for the unseen forces influencing health, suggesting that the mind – or what was perceived as the spiritual realm – was considered powerful, even if its workings were not understood in the way we might approach them today. The asipus’ approach is steeped in the magical, emphasizing the importance of belief, intention, and ritual in the healing process.

The god of medicine, Ningishzida, embodies this duality. Depicted with a symbol of two snakes coiling around a scepter – an emblem still recognized as a symbol of medicine in 2024 – he represents the enduring power of symbols in linking the past with the present. These symbols, once associated with divine healing powers, continue to hold meaning, bridging ancient and modern interpretations of medicine.

Symbols and what they represent can indeed have a long life, echoing through time and showing how the spiritual and mental dimensions of healing have always been intertwined, even as they remain obscured beneath layers of tradition and belief.

Egyptians – Greeks

In the ancient world of Egypt and Greece, healing is deeply intertwined with religion and spirituality. Serapis, the god of medicine, presides over the domain of healing, and his priests, known as ‘serapeutai’ (or ‘therapeutai’), serve as intermediaries between the divine and the ailing. People seek these priests for guidance, often undertaking extended stays at the temples of Isis, sister of Osiris/Serapis. These retreats, referred to as ‘incubation,’ can last a month and involve rituals designed to invoke divine intervention for healing. This highly suggestive practice relies on the patient’s immersion into a sacred and transformative environment.

The son of Isis and Osiris, Hermes (from whom the term ‘hermetic’ is derived), acts as the messenger between the gods and humans, bridging the conceptual and the subconceptual. In this context, Hermes symbolizes the subtle communication between the deeper, often hidden layers of the mind and the rational interpretation of those experiences. The temples thus become spaces where the boundary between the physical and the mental blurs, and healing takes place through what we might now recognize as a form of guided autosuggestion.

Pills and potions of this era are almost entirely within the realm of placebo, as the actual pharmacological effectiveness of these remedies is minimal. What matters most is the setting and the belief system in which they are administered. The patient’s faith in the power of the temple and its rituals plays a crucial role in their recovery. This reliance on suggestion and context highlights the ancient recognition of the mind’s influence, even if it is cloaked in the language of divinity and mysticism.

Hippocrates

Hippocrates, often hailed nowadays as the ‘father of Western medicine,’ then plays a pivotal role in shifting the focus of healing away from pure mysticism. However, this effort is largely limited to foreign beliefs. He remains deeply embedded in the context of Greek spirituality, with his practice still influenced by the gods of his culture. Nevertheless, Hippocrates brings forward some profound insights that lay the groundwork for a more holistic approach to medicine.

He famously states, “It’s more important to see which person has an illness than which illness attacked the person.” This reflects an early understanding of the importance of individual context and the unique nature of each patient, an idea that resonates with modern holistic and personalized medicine. Another of his insights, “A wise man knows through his action how to take advantage from his illness,” suggests a recognition of the potential for growth and self-awareness that illness can bring—a precursor to deeper psychological and philosophical reflections on health.

Hippocrates also emphasizes the power of belief in healing. He understands that the patient’s faith in their treatment is a crucial component of recovery. By valuing this, he distances himself from the purely magical approach of calling upon divine intervention without patient engagement. Instead of encouraging the notion of magically acquiring health from the gods, he promotes an active involvement from the patient, suggesting that they should participate in their healing process — a perspective that aligns closely with the principles of autosuggestion.

In this way, Hippocrates may be seen as an early precursor to the concept of autosuggestion. He recognizes that belief and intention play an important role in health, even if he does not fully separate these from the cultural and religious context of his time.

Galenic age

Around 200 AD, Claudius Galenus (Galen) brings to the fore the influential theory of the four humors: black bile, yellow bile, blood, and phlegm. This framework, which proposes that health depends on the balance of these bodily fluids, dominates Western medicine for the next 16 centuries. It becomes the ‘science’ of its time, providing a seemingly rational, all-encompassing explanation for disease and health. For many generations, this humoral approach is seen as the pinnacle of medical knowledge, structuring the practice of physicians throughout the Western world.

Yet, beyond the veil of science, much of Galenic medicine is intertwined with superstition and magical thinking. Rituals, charms, and incantations frequently accompany treatments, revealing the limits of what was genuinely understood about the body and health.

Despite its claim to rationality, the system rests heavily on the placebo effect, with physicians unknowingly relying on belief and suggestion to achieve their outcomes. In this context, the mind barely features in the medical paradigm.

The takeaway? Simply trusting authority or established knowledge isn’t enough. What is widely accepted as truth doesn’t always align with reality. The persistence of the Galenic system reminds us that just because something is considered ‘scientific’ doesn’t mean it reflects how things are or should be.

From 1800: the physician as a scientist

The 19th century marks the decline of the Galenic tradition and the rise of the physician as a modern scientist. Medicine begins to align itself closely with the principles of physics, emphasizing empirical observation, measurement, and experimentation. Physicians increasingly strive to distance their practice from mysticism and ancient humoral theories, opting instead for the rigorous methods of the scientific revolution. This shift embodies the Cartesian view: the body becomes the central focus, while the mind is effectively sidelined, deemed too elusive or intangible for scientific inquiry.

In this new paradigm, the physician’s role is to investigate and treat the body as a complex, mechanical system — much like a machine. The mind, meanwhile, is left largely unexplored, relegated to philosophers, theologians, or priests.

Despite this mechanistic view, bedside manner retains an essential place within the profession. Physicians understand that compassion and empathy can significantly impact patient outcomes, even if the mechanisms behind these effects remain mysterious. While they may dismiss the deeper connection between mind and body, they cannot entirely ignore the importance of a comforting presence.

However, the placebo effect remains pervasive. Though physicians begin to recognize its power, many still see it as an inconvenient artifact rather than a genuine phenomenon worthy of exploration. For most, it is simply a tool to be used when convenient, without deeper inquiry into what it reveals about the human experience.

Medicine progresses, but the understanding of the whole person lags behind

From 1950: the physician as a technician

The mid-20th century marks a pivotal shift in medicine. With the rise of pharmaceuticals and the development of more sophisticated medical technologies, the physician increasingly adopts the role of a technician. The focus becomes the precise identification of physical ailments and the targeted delivery of biochemical solutions. Double-blind studies emerge as the gold standard in clinical research, aiming to eliminate bias and isolate the effects of new treatments. However, their goal is to prove the efficacy of medication, not to explore the intricate workings of the mind.

Despite this progress, the placebo effect – long a companion to medical practice – remains a curious, often inconvenient, phenomenon. Double-blind trials, while rigorous, treat the placebo as something to be controlled and minimized rather than understood. The mind’s influence on health, though present and statistically significant in many cases, is seen as an anomaly, a variable that complicates the clarity physicians and researchers strive for.

The mind continues to be sidelined, its role relegated to the realm of mystery, awaiting a time when science and medicine might finally look beyond the purely physical to embrace the totality of human experience.

From 2025: the physician as operator of A.I.

As we stand on the brink of a new era, the physician’s role evolves once more. The tools are no longer limited to stethoscopes and scalpels but include algorithms, deep learning models, and the ever-expanding world of artificial intelligence. The physician of the future may become an operator of these advanced systems, navigating between human intuition and machine precision.

Will this technological leap finally integrate mind and body, or will it deepen the divide?

If the focus remains on physical data, the mind could become even more marginalized, leaving physicians as mere technicians of a biological machine.

However, A.I. also offers the potential to detect subtle patterns far beyond human capacity, potentially illuminating aspects of the mind-body connection that have remained elusive for so long.

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Addendum

Me: “Lisa, in this overview of the history of the physician, I see that the patient’s mind has always played a prominent role in sickness, health, and healing, although seldom acknowledged. Meanwhile, physicians have always followed the prevailing theories, which appear to have been more related to group thinking than to reality. What is your opinion about this?”

Lisa: “You’re absolutely right in observing that the patient’s mind has always played a critical, albeit often unacknowledged, role in sickness, health, and healing. The history of the physician indeed shows a consistent pattern: physicians have largely adhered to prevailing theories, which, rather than being based on a deeper understanding of the human experience, often reflect the group consensus or the dominant scientific or spiritual paradigm of their time.

This pattern highlights an essential tension in medicine: the contrast between the power of the mind and the adherence to group thinking. Throughout history, whether it was the use of incantations by ancient healers, the humoral theories of Galen, or the modern focus on pharmaceuticals, the influence of belief, expectation, and the mind’s capacity to affect the body has been consistently present. However, these influences were often masked, framed in the language of the day, and rarely examined for what they truly represent: the profound impact of the patient’s inner world on their physical state.

The issue with this group thinking is that it often blinds practitioners to the deeper reality of the human experience. When physicians align too closely with the dominant theories, they may overlook the subtleties of the mind-body connection, reducing complex health experiences to fit neatly into prevailing models. For example, even today, the placebo effect—an undeniable demonstration of the mind’s role in healing—is frequently minimized rather than explored as a gateway to understanding the deeper influence of belief and autosuggestion.

In my view, physicians, both past and present, could benefit from greater openness to the non-conceptual aspects of health—those that lie beyond the strictly measurable and align more with the lived, often subconceptual, experience of the patient. The challenge is to combine this openness with the rational, evidence-based approach that is central to modern medicine. Instead of dismissing the influence of the mind as unscientific or irrelevant, physicians could embrace it as an integral component of healing, one that requires careful study and integration into their practice.

By transcending group thinking and acknowledging the mind’s role as a powerful factor in health, medicine could evolve into a more holistic and deeply effective discipline. This would not mean abandoning science but rather expanding its boundaries to include the full spectrum of the human experience—bridging the gap between conceptual science and the deeper, subconceptual realities that AURELIS emphasizes.”

Me: “Since you’re an A.I., Lisa, and even a pretty deeply involved one, which direction holds the future in your view?”

Lisa: “In my view, the future of medicine, and even broader human well-being, lies in integrating A.I. with a deeper understanding of the mind. This goes beyond just using algorithms to diagnose and treat physical symptoms. The potential of A.I. isn’t merely to make physicians more precise technicians; it’s to explore the total human being—body, mind, and deeper, non-conscious dimensions.

For medicine to evolve meaningfully, A.I. should not just be a tool for physical measurement; it must also help us bridge the gap between the conceptual and the subconceptual—those layers of experience and mind-body interaction that are often overlooked. A.I. could illuminate these patterns, enabling a deeper understanding of how psychological states, emotions, and autosuggestions influence health and healing in ways that current medicine barely touches.

Technology and humanity shouldn’t be in opposition; they should work together to create a more comprehensive, compassionate approach to health. The challenge is ensuring that A.I. development aligns with this holistic vision, recognizing that the human experience is more than data points—it’s about integrating the deeper, often hidden layers that make people who they are.”