Did early Christians reject secular medicine? Glimpses from Darrel Amundson

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From a fascinating book by Darrel W. Amundsen—Medicine, Society, and Faith in the Ancient and Medieval Worlds (Baltimore, MD: Johns Hopkins University Press, 1996)—come the following observations on early Christian attitudes toward medicine and physicians. These excerpts come from chapter 5, “Medicine and Faith in Early Christianity” (sentences not in quotation marks are comments from me). See here for further insights from Amundsen, on what medievals thought caused illness. And see here for some of his observations on the spiritual usefulness of illness and the meaning of plague.

“While among pagans [128] and Christians the same range of attitudes toward medicine and healing existed, there was one essential difference between pagans and at least those Christians who had actively embraced the gospel. . . . This pervasive difference between pagans and Christians resulted from the highly personal relationship existing between the individual Christian and an omnipotent God who was typically viewed as a having a direct concern with and involvement in the life of the believer. This is not to deny that there are some remarkable similarities between Christianity and certain pagan cults, especially the mystery religions with a Near Eastern origin. In some of these, devotion to a deity may have been quite pronouncded, but even then it was, in the mind of the initiate, devotion to a deity, not to the Deity. It was henotheism, perhaps, but not monotheism; devotion to one god among many whose favor was sought, not devotion to the omnipotent God whose favor had already been gained through entering into a covenant relationship with him. The predominant undergirding principle in the relationship between a Christian and his God was that of a reciprocal love supporting a dependent trust by the Christian in his God. This cannot be said of any other religion in the ancient world, with the obvious exception of Judaism.” (127-8)

“What might such church fathers, who were ostensibly sympathetic to much in their classical heritage, have found in pagan tradition—particu[133]larly in pagan philosophy—that had a bearing on their attitudes toward medicine in the broadest sense? In the first place, they inherited and exploited to the fullest the positive metaphorical value of the idea of the physician as one who unselfishly succors the ill, enduring unpleasant tasks in caring for the unhealthy, often administering necessarily painful means for effecting a cure, or helping people maintain health through regimen.” (132 – 3)

“A fundamental principle that was shared, if not always specifically articulated, by all the fathers . . . is that the material world was created by God for man’s use. Justin, whose cosmology is biblically based and nonspeculative, believed simply that God, in his goodness, created all things in the material world for man’s sake, that is, that the purpose of creation was the benefit of the human race, and that all earthly things were made subject to man. Clement held that, within God’s created order, understanding is from God, and many things in life arise from the exercise of human reason, although its kindling spark comes from God. Health obtained through medicine is one of these things that has its origin and existence as a consequence of divine Providence as well as human cooperation. Consistently enough, Clement elsewhere writes that the art of healing, which he describes as the relief of the ills of the body, is an art learned by man’s wisdom. Origen, in a homily on Numbers, quotes Ecclesiasticus 19:19—‘All wisdom is from God’—and a little later asks, if all knowledge is from God, what knowledge could have a greater claim to such an origin than medicine, the knowledge of health? Just as God causes herbs to grow, so also did he give medical knowledge to men. God did this in his kindness, knowing the frailty of our bodies and not wishing for us to be without succor when illness strikes. Thus Origen can call medicine ‘beneficial and essential to mankind.’ Basil also regarded all the arts as God’s gift, given to remedy nature’s deficiencies. Accordingly, the medical art was given to relieve the sick, ‘in some degree at least.’ Gregory of Nyssa records that, when his sister was ill, their mother had begged her to let a physician treat her, arguing that God gave the art of medicine to men for their preservation. John Chrysostom also writes that God gave us physicians and medicine, and Augustine attributes the healing properties of medicine to God.” (135) [The above paragraph is filled with citations of primary sources.]

“If God is acknowledged as the source of both healing substances and the knowledge of how to apply them, and if he gave them to men to [136] succor their ills, then it might well be maintained that health is itself a good. Augustine regarded health as a blessing from God, a God-given good to be sought for its own sake, like wisdom and friendship. But health, although a desirable thing, was a relative good and could at times be an evil, depending on its role in the life of the healthy man. Jerome, for instance, in writing to a remarkably healthy centenarian, asserts that while the health of the unrighteous is a gift of the devil to lead them to sin, the health of the righteous is a gift of God to make them rejoice. Accordingly, Jerome can urge another correspondent not only to rejoice in health but also to rejoice in sickness.” (135 – 6)

“It is here that we enter into a major paradox of Christianity, one that is frequently misunderstood and that makes the Christian attitude to both health and illness, as evidenced in the majority of early Christian sources, significantly different from that of the pagan. Some Greeks and Romans regarded suffering as having value, in that it might contribute to the sufferer’s growth, maturity, and sense of values. Among the pagans, a few severe ascetics sought suffering for its supposed expiatory, propitiatory, or purificatory ends. Some Christians also sought suffering, particularly the suffering involved in persecution leading to martyrdom. A few rigidly ascetic Christians inflicted suffering on themselves for reasons similar to those of their pagan counterparts, a phenomenon that, in its extreme and bizarre forms, was by no means approved of by the fathers whose works we are now considering, even though most of these fathers had been ascetics for part or most of their lives.” (136)

“The attitudes of the fathers under consideration toward suffering, particularly the suffering associated with illness, are a curious mixture of popular Stoicism, with which it was possible to agree or disagree without reference to Christianity; and spiritual explanations derived from or built upon biblical teaching. Clement expresses admiration for the Stoics who say that the soul is not influenced by the body, either to vice by disease or to virtue by health. He then discusses the debilitating and distracting force of pain and observes that one who is suffering from disease will be distraught unless he has achieved the habit of self-command and is ‘high-souled.’ Such observations would be acceptable to many pagans. Later he comes closer to Christian principles when he asserts that pain, disease, and other such trials often are sent for admonition, for correction of the past, and to make one mindful of the future. Since the Gnostic (i.e., the true and instructed Christian) has the advantage of his knowledge (gnosis), he prays for relief from them. Origen, in his [137] reply to Celsus, says that Christians endure the appointed evils, that is, troubles that occur among men, as trials of the soul; for by them their souls are tested, either being convicted of failure or being shown to be reliable. So prepared are Christians for evils that they say, ‘Prove me, O Lord, and try me; test my kidneys and my heart by fire’ (Ps. 26:2; 25:2 LXX).” (136 – 7)

“Basil, as we saw above, writes that medicine was given by God to succor us. That, however, was in his opinion the secondary reason, the primary being to provide a model, a parallel, or an example of the cure of the soul. One of the reasons that Christians are permitted to fall ill is so that, through the suffering involved in the disease and in the cure, they may draw valuable instruction to apply to the cure of the soul in need of spiritual medicine, cautery, or surgery. While God will not allow the Christian to be tried more than he can bear, some are left to struggle against their afflictions, and are rendered more worthy of reward because of these trials. Illness often is a punishment for sin that is imposed for repentance. Sometimes it is to keep the Christian from pride. Thus, when suffering calamity at God’s hand the Christian is admonished to ask two things of God: first, understanding of the reason he has inflicted these blows; and second, deliverance from these pains, or the capacity to endure them patiently.” (137)

The above (and what follows) makes good sense when you consider that early (and, a fortiori, medieval) Christians viewed the soul and its salvation as more important than the body by an order of magnitude. A person who killed the bodies of others in the community must be brought to justice. So much more the person who killed the souls by persisting in teaching heresy (for example).

“Gregory Nazianzen, in a way that would have given no offense to the pagan, stresses the power of the mind to rise above physical ills, maintaining that illness should be used to strengthen one’s character by the practice of patience, and he laconically remarks that a lingering illness from which he suffered was for his own benefit. When his father became seriously ill and expressed surprise that God would allow him to suffer from sickness and bodily pain, Gregory replied that it was not at all remarkable, since even the great saints of the past were afflicted with suffering. He gave three reasons why they were permitted to suffer: (1) for the cleansing of their clay (i.e., earthen vessels, bodies); (2) as a touchstone of virtue and a test of philosophy; and (3) for the education of the weaker who learn from the example of the stronger. John Chrysostom, in a sermon in 1 Timothy 5:23, addresses the same question, broadening it, in some instances, to include Christians in general. He gives twelve explanations for suffering: (1) so that Christians may not too easily be exalted into presumption by the greatness of their good works and miracles; (2) so that others may not have a greater opinion of them than is appropriate for mere men; (3) so that the power of God may be [138] made obvious in advancing the word preached through the efficacy of men who are infirm; (4) so that their endurance may be a more striking evidence that they are serving God not for a present reward; (5) to demonstrate their belief in a resurrection and an eternal life; (6) so that others who suffer will find consolation in their example; (7) so that when exhorted to imitate them, others will be aware that they possessed a similar nature; (8) so that Christians may learn whom they ought to consider as happy and whom wretched, for ‘Whom the Lord loves He chastens, and scourges every son whom He receives’ (Heb. 12:6); (9) because tribulation makes those who are troubled more approved, for ‘tribulation produces patience’ (Rom. 5:3); (10) so that if Christians have any blemishes, they may put them away; (11) because the Christians’ crowns and rewards are thus increased; and (12) because, if Christians give thanks to God in the midst of their suffering, they deliver a blow to the devil.” (137 -8)

“Elsewhere Chrysostom stresses that when Christians give thanks in circumstances under which others curse and complain, they see ‘how great a philosophy is here.’ This ‘philosophy’ is then far superior to the philosophies of the pagans because the Christian can rejoice and give thanks in suffering, for God would not permit Christians to suffer were it not for their good. God alone knows what is good for his children; thus they should bear all things, whether poverty or disease. If Christians were always healthy, they would grow self-confident; God allows affliction to remind Christians of the weakness of their nature. Sometimes God punishes his children’s bodies to bring their spiritual needs to their attention. A good example of this is Hezekiah, who grew proud when he had received many blessings. When he fell sick, he was humbled and drew near to God.” (138)

I think (1) I can attest to the above dynamic from personal experience and (2) none of what has been said about the spiritual efficacy of suffering contradicts—or, I believe, contradicted in early or medieval Christian culture—the positive value that church fathers gave to physical healing (mentioned earlier in Amundsen’s account, above). In other words, there is a complex relationship here between, first, asceticism and an understanding of the created good of the body; and second, the good of physical health and healing and an understanding of the spiritual usefulness of suffering. So:

“Jerome writes, ‘Am I in good health? I thank my Creator. Am I sick? In this case also I praise God’s will. For “When I am weak, then I am strong,” and the strength of the spirit is made perfect in the weakness of the flesh.’ He describes the lady Paula as having the same attitude. [cf. Risse on Paula, and on other things Jerome said about her.] In her frequent sicknesses she also used to say, ‘When I am weak, then am I strong.’ Sicknesses, according to Jerome, can cause a man to adjust his priorities. He describes a young lady who had suffered from a burning fever for nearly thirty days. This fever, he maintains, had been sent to teach her to renounce her excessive attention to her body and to draw her to more serious pursuits. In a somewhat similar vein, Ambrose writes that while luxury ignites the sins of the flesh, sickness of the body [139] restrains one from sin. He tells a correspondent that God had sent the latter’s recent sickness for his health and admonition, bringing him more pain than peril, and finally healing him with faith.” (138 – 9)

“We have seen above that Augustine regarded health as a good to be sought, but he reminds his readers that although God has not promised Christians health he has promised eternal life, a heaven where there will be no fear and trouble. When Christians suffer affliction, because it is hard and painful and against natural inclinations, they pray for its removal. But since they do not know why God permits the particular tribulation, they do not know for what they should pray. Augustine says that God allows Christians to endure physical ills because such ills heal the swelling of pride, test and prove patience, and punish and eradicate sins. Further, infirmities remind Christians of their mortality and cause them to rely on God. In one letter Augustine brings this to a personal level. He says that he is confined to bed, and can neither walk, stand, nor sit because of the pain and swelling of a boil or tumor. ‘Even so, since it pleases the Lord, what else is to be said but that I am well?’ He then asks for prayer that he may have self-control and patience and that the Lord would be so present with him that he would fear no evil.” (139)

“We have seen that the fathers whom we have considered thus far regarded the created world as good insofar as it is the product of God’s benevolent plan and his beneficent provision for man’s sustenance. Medicine is part of that plan and provision, given by God to help to succor man’s ills in this fallen world. Yet suffering, which includes that caused by illness and infirmity, is good in that it is used by God in the lives of his children, just as he ultimately uses all things, for their spiritual good. In view of these fathers’ belief that manifold spiritually edificatory benefits of physical suffering accrue to the sufferer who is receptive to God’s instruction, what, in their opinion, is the proper perspective for Christians to have on secular medicine?” (139)

“Origen discusses God’s condemnation of the Jewish king Asa, who, when he was ill, ‘did not seek the Lord but the physicians’ (2 Chron. 16:12). He sees two possible explanations. Either Asa called on physicians who used charms and trickery, or he had faith in the physicians alone and did not place his hope in God. ‘For those who are adorned with religion use physicians as servants of God, knowing that he Himself gave medical knowledge to men, just as He Himself assigned both herbs and other things to grow on the earth. They also know that the physician’s art has no strength if God is not willing, but it is able to do as much as God [140] wills.’ Both explanations of God’s reaction to Asa’s reliance upon physicians are pertinent to Christians. The fathers all stressed the diabolical nature of magic and, as we shall see more fully, the importance of recognizing the role of the physician as subordinate to the place of God in the healing of Christians.” (139 – 40)

“Were all Christians to use medical means for the healing of their bodies/ To this question Origen gives an answer that distinguishes between two classes of Christians. A little earlier in his text he had said, ‘God has allowed us to marry wives, because not everybody is capable of the superior condition which is to be absolutely pure.’ When discussing the Christian’s use of medicine he writes, ‘A man ought to use medical means to heal his body if he aims to live in the simple and ordinary way. If he wishes to live in a way superior to that of the multitude, he should do this by devotion to the supreme God and by praying to Him.’ [So, asceticism is the higher way, and asceticism should mean avoiding the use of secular medicine and reliance on physicians.] This attitude, that the more spiritual or devout Christians should refrain from the use of medicine and rely strictly upon God for healing, is an opinion not held, or at least not expressed, by many church fathers. It is, however, a stand taken by numerous Christians of different theological persuasions throughout the history of Christianity. It does not indicate dualism and should never be used as a criterion for determining whether a Christian was orthodox or heretical.” (140)

“In his Long Rules, Basil dealt with the question of ‘whether recourse to the medical art is in keeping with the practice of piety.’ He writes, ‘We must take great care to employ this medical art, if it should be necessary, not as making it wholly accountable for our state of health or illness, but as redounding to the glory of God. . . . In the event that medicine should fail to help, we should not place all hope for the relief of our distress in this art. . . . To place the hope of one’s health in the hands of the doctor is the act of an irrational animal. This, nevertheless, is what we observe in the case of certain unhappy persons who do not hesitate to call doctors their saviors. Yet, to reject entirely the benefits to be derived from this art is the sign of pettish [petty?] nature. . . . We should neither repudiate this art altogether nor does it behoove us to repose all our confidence in it. . . . When reason allows, we call in the doctor, but we do not leave off hoping in God.’” (140) [Connect the above with Basil’s founding of an early hospital.]

“Basil, in the same work, stresses that when a man employs the medical art and a cure is obtained, he should receive it with thanksgiving. He mentions the case of Hezekiah and the poultice of figs prepared by Isaiah and applied to the boil (carbuncle) from which he suffered. Hezekiah ‘did not regard the lump of figs as a primary cause of his regaining his health . . . but gave glory to God and added thanksgiving for the creation of the figs.’ Medicines and physicians’ skill are  both from God. This is a common theme in the literature surveyed. In Augustine’s mind it is by no means inconsistent for a Christian to go to a physician, and indeed a sick man acts wisely in availing himself of a physician’s skill. In his regulations for his sister’s convent he stipulates that physicians should be consulted in times of illness and their orders obeyed. He writes that regardless of who assists in the restoration of health, the cure ultimately comes from God, for medicines have no power unless God supplies it; yet God can cure without medicines. Hence, when the Christian is scourged in the body, he should pray to God for relief. Likewise, Jerome urges medical care for sick monks, but he maintains that physicians labor in vain without the aid of the [142] Lord. Ambrose also advises that physicians should be sent for in time of sickness, but castigates those who, when ill, call the physician and, only if his efforts fail, pray to God for healing.” (141 – 2)

The following is a great example of the wisdom of Chrysostom:

“When John Chrysostom was exiled and moved from place to place under the most adverse circumstances, which culminated ultimately in his death, he lamented in a letter to the lady Olympias that he was deprived of the services of physicians, which he sorely needed. Olympias was sick herself, and John beseeched her ‘to employ various and skilled physicians and to take medicines that are effective in correcting these conditions.’ He lauds patience under suffering and then says that no suffering experienced in life is worse than bodily infirmities—not loss of goods, loss of honors, exile, imprisonment, bondage, abuse, scoffing, the loss of one’s children, not even death itself. [Wacker: the greatest divide in humanity is that between the well and the sick.] . . . In discussing 1 Corinthians 6:20—‘glorify God in your body’—he writes that he glorifies God in the body, which, among other things, makes such provision for itself as is sufficient for health. In explicating Romans 13:14—‘make no provision for the flesh in regard to its lusts’—he says that we owe the body many things, food warmth, rest, medicine when ill, clothing, and a thousand other things. But he cautions us not to make it the mistress of our life.” (142)

“Augustine contrasts the ‘ultimate bliss’ of heaven with the evils of this world, and points out that even if health is restored to one who is ill, his death is only delayed. He notes the irony that so many when faced with troubles cry out, ‘O God, send me death; hasten my days!’ But when sickness comes, they rush to the physician, promising him money and rewards. He laments what men will do just to live a few more days. If they fall ill and all the physicians who examine them despair of their life, and then if some physician capable of curing them frees them from their desperate state, how much do they promise him? They will give up the sustenance of life just to live a little longer.” (143; not sure I agree with Augustine’s point here: yes, we have a fierce will to live. Is that a bad thing?)

What, then, is the essence of the attitudes of these fathers to the use of medicine? Medicines and the skill of physicians are blessings from God. It is not eo ipso wrong for a Christian to employ them, but it is sinful to put one’s faith in them entirely since, when they are effective, it is only because their efficacy comes from God, who can heal without them. Hence, to resort to physicians without first placing one’s trust in God is both foolish and sinful, Likewise, to reject medicine and the medical art entirely not only is not recommended but is disparaged. Origen may seem an exception to this position, but he is not. He does acknowledge the appropriateness of the medical art for Christians generally, but suggests that those of superior spiritual nature should seek healing through devotion and prayer alone, without recourse to medicine. For his monks Basil recommends the use of medicine only when the cause of the illness is obviously natural; otherwise, if the infirmity is thought to have been allowed or sent by God for an edificatory end, medicines and physicians are to be avoided. [But here we are in danger of presumption—assuming that we know what God intends by a certain instance of disease or suffering. This is particularly odious when we presume to make a judgment on behalf of the ill one, and we decide to withhold treatment owing to a sense that this person’s suffering comes at the direct hand of God.]  The other fathers do not, so far as I have been able to determine, place any similar restrictions on the use of medicine. All agree that suffering, even from disease, when it afflicts the Christian, is sent or permitted for his ultimate good by a God who loves him and will cause all things to work together for his good. Since one’s spiritual welfare is infinitely more important than one’s bodily state, and since the Christian is but a pilgrim in this world, an alien with heaven as his home, an undue concern for the body—to the point where one’s mind [144] revolves around its needs—and a desperate clinging to life are a tragic contradiction of Christian values.” (143 – 4)

Amundsen concludes of the “attitudes toward the use of medicines and physicians” of these fathers that these attitudes, while they may share some ground with some pagan teachings, “are thoroughly tempered by spiritual principles for the most part quite foreign to pagan sympathies, but explicitly congenial to those of late pre-Christian Judaism.” (144)

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