Bryn Mawr Classical Review

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Bronwen Wickkiser's book, Asklepios, medicine, and the politics of healing in fifth-century Greece: between craft and cult, advances two main theses about the growing popularity of Asklepios worship in the classical Mediterranean. In the first half of her study, Wickkiser argues that increasing interest in the god's cult was a direct result of contemporary developments in medicine. In particular, she attributes this rise to a tendency among doctors expressed in certain Hippocratic writings to refuse to treat patients with either chronic or fatal conditions. At the same time, these works do not discourage suffering individuals from seeking divine help and healing. In the last three chapters, she argues that political factors played an important role in the introduction of the cult to the Athenian acropolis in 420 BCE. By emphasizing these political dimensions, Wickkiser challenges the scholarly position held by many of her predecessors that tends to dismiss politics as a contributing factor to the introduction of Asklepios cult to Athens and instead has tended to see the plague of 430 to 426 BCE as the main motivation behind the city's importation of the cult. In advancing this argument, Wickkiser makes her most important contribution to the study of ancient medicine and plots a course for a more general reconsideration of the growth and spread of the cult in other locations and times around the Mediterranean in antiquity. Although Wickkiser presents her two theses as partial answers to the question why interest in and patronage of the healing divinity increased in this period, one being a medical explanation, the other being a political one, she does not tie the two parts of her book together in a clear and convincing fashion, leaving her reader to wonder if it might not have been better to present these two arguments in separate works.

In her introductory chapter, Wickkiser highlights three anachronistic dichotomies that have been used to study Asklepios cult in the past, dichotomies which have led to the skewed and anachronistic understanding many scholars have developed about the cult's popularity. These are public versus private, church versus state, and rational versus irrational. It is the consistent application of one or more of these dichotomies that has contributed to scholarly blindness regarding the political dimensions of the spread of Asklepios worship. By abandoning these dichotomies as part of the conceptual framework for her investigation, Wickkiser is able to attend to a broader range of factors and to offer a more complex and nuanced explanation for the Athenian importation.

In order to make her argument that Asklepios gained popularity as a result of doctors' refusal to treat chronic and fatal conditions in the first half of her book, Wickkiser reviews the scholarship pertaining to both the increasing professionalization of medicine in fifth-century Greece and the nature of Asklepios worship and its spread in the same period. In Chapter One, "From Practice to Profession," the author gives an overview of the development of Greek medicine from the Bronze Age until the fifth century. The main development she is interested in is the emphasis in certain Hippocratic works that doctors recognize and work within the limits of their techne. They did not, however, disparage patients who sought healing from the gods for those conditions that went beyond the doctor's circumscribed set of skills. Before embarking on a discussion of Asklepios cult, Wickkiser summarizes what she sees as the Hippocratic position early in Chapter Two as follows:

The attitudes of the authors of early Hippocratic treatises towards matters of the divine and the gods can be summarized as follows: all illnesses are divine (theia) inasmuch as they have a nature (phusis) that can be identified and explained; the gods can play a role in maintaining health, and a person facing oncoming illness should therefore pray to the gods as part of their regimen to avert illness (Regimen 4); moreover, healing in sanctuaries is an option, one neither aggressively condoned nor in any way condemned (On the Sacred Disease). There is no evidence from medical treatises or from any other ancient source that doctors ever categorically opposed healing in a sanctuary.

In the rest of Chapter Two, "Searching for a Cure," and most of Chapter Three, "Asklepios and His Colleagues," Wickkiser reviews the rise of Asklepios worship, its main cultic expressions and the way in which the cult "worked" for its adherents, those seeking cures through incubation and votive offerings. In Chapter Three, she also discusses the close association between doctors and Asklepios, their patron deity, drawing in part on archaeological evidence which documents doctors' frequent involvement with the cult, their dedications and patronage. At the end of Chapter Three, Wickkiser once again restates her thesis that Asklepios' popularity was a direct result of physicians' unwillingness to treat chronic ailments. In this section, using the iamata from a number of different sites as well as literary evidence, the author argues that Asklepios specialized in chronic ailments. Her case would be more strongly made if she also demonstrated that the conditions she cites as examples of chronic illnesses were in fact those identified in Hippocratic treatises as ones which outstripped the technical skills of the professional physician.

I agree with Wickkiser that there is strong reason to believe that there are important connections between the development of professional medicine in this period and the rise of Asklepios worship. But I don't think this relationship can be explicated in terms of the simple causal relationship she proposes. It suggests that Asklepios cult expanded as a result of external factors and does not consider the agency of actors within the cult. I will return to this point in a moment. In his book Ancient Medicine (2004), Vivian Nutton offers a more complex picture. He argues that both the "Hippocratic corpus and the rise of Asklepios cult are part of the same phenomenon, the defining of an orthodoxy over against a magical alternative." ¹ In other words, healing was becoming increasingly professionalized in both contexts at the same time. Both Hippocratic doctors and the healing personnel associated with Asklepios were actively involved in marginalizing other kinds of healers whom Nutton refers to by the term "magical alternative," for instance, "traveling priests and exorcists," figures who offered healing outside the channels "that could be directed to the benefit of both the state and the individual patient."² Wickkiser does not engage with Nutton's thesis in her study, despite the fact his book was published in 2004. This is unfortunate, because his thesis offers one way in which to tie the two parts of her book together, namely the medical and the political.

The other difficulty I find I have with this section of Wickkiser's study is that she does not endeavor to get at the personnel behind the cult of Asklepios. She uses archaeological evidence effectively to demonstrate that doctors were intensely and actively involved in the cult. But by failing to consider who else may have been involved, she robs a whole class of ritual and healing experts of agency in the cult's growing popularity. In other words, the main characters of her first three chapters are doctors and the god Asklepios. But one wonders how these doctors fit into a more comprehensive social landscape of other cultic actors. Consideration of personnel beyond the clearly visible doctors might have also served to better link her two theses together in the case of Athens. If, as she convincingly argues, the importation of the cult from Epidauros was a political decision by Athenian leadership during the Peace of Nikias, then who were the cultic personnel that made this possible and what was their social location with reference to other civic elites?

In Chapter Four, "Documenting Asklepios' Arrival in Athens," Wickkiser challenges the dominant scholarly explanation for the importation of Asklepios to Athens, namely the plague that hit the city from 430-426 BCE. Through a careful reconsideration of the inscriptional evidence provided by the Telemachus monument, she argues that Telemachos, although responsible for moving the cult sanctuary, was not responsible for bringing the cult to Athens. Her analysis of the monument thus forces her to offer an alternative explanation, which she does in the remainder of the book. In both Chapters Five and Six she puts forth the claim that the importation of the cult can only be understood in terms of Athens' imperial ambitions in the context of the Peloponnesian Wars. Her approach to this argument is twofold. In Chapter Five, "Asklepios and the Topography of Athenian Cult," she situates the cult within the sacred topography of the Acropolis and the festival calendar of the city, demonstrating its close connections to two other cults with clear and powerful imperial resonances, namely, the cults of Dionysus Eleutheros and Eleusinian Demeter. Both of these cults served to project and celebrate Athenian empire. Like Asklepios, both cults were importations which reflected Athenian expansion (or attempts at expansion). They were also Panhellenic celebrations at which Athens could perform its imperial ambitions. For instance, it did so in part through the enactment of decrees such as the First Fruits Decree, requiring the entire empire to send representatives with offerings to Eleusinian Demeter. The alignment of Asklepios with these two other civic cults "suggests an elaborate orchestration capable of evoking particular associations" (89). Wickkiser writes, "Each of these links alone may not be significant, but the accumulation of evidence is striking. While factors such as health and the agricultural cycle help explain this orchestration, the ties to Athenian empire are impossible to ignore" (89). Wickkiser's reading of the political resonances of this cultic complex and the sacred landscape in which it was enacted is compelling and masterful.

This reading is further supported when coupled with her discussion of the strategic importance of Epidauros, the home of Asklepios, to the Athenian position in the Peloponnesian Wars in Chapter Six, "Asklepios and the Athenian Empire." Wickkiser sees the importation in 420 BCE as an attempt on the part of Athens to secure the good favor of Epidauros, a polis which was strategically crucial for Athens' relations with its Argive allies and its access to the Peloponnesus. By shifting focus away, somewhat, from Athens to Epidauros and the way it positioned itself over time in relation to such military powerhouses as Athens, Sparta and Thebes, Wickkiser's analysis affords a fresh look at Athens, one which puts its imperial ambitions into perspective. Here again, however, it would have enriched her discussion had she gone one step further to consider the role that cult personnel may have played in this negotiation of power. This is especially the case because her insightful and careful reading of the literary evidence would be well-suited to the application of a post-colonial lens in this respect.

In her conclusion, Wickkiser mentions that there are important parallels between the Athenian importation of Asklepios and the Roman one when considered from this political angle. She suggests that this may also be the case in places such as Kos and Pergamon. And she indicates in a footnote that she would like to pursue this line of research further in future. Having argued so effectively for her thesis in the Athenian case, one hopes she in fact does pursue this very promising line of research.

In conclusion, I offer a few words about the book's potential readership. The first half of this book will serve as a helpful introduction to Asklepios cult for advanced undergraduates and beginning graduate students studying the history of medicine and healing. It goes beyond any current study of Asklepios cult in its thorough consideration of the epigraphic, archaeological and literary evidence. The second half of the book makes an important contribution to scholarship on the Athenian cult, a contribution which may also serve to guide thinking about the importation of the cult in other locations. But it is difficult to determine the readership for the book as a whole. For those scholars interested in the political argument are likely to be familiar already with much of the research reviewed by Wickkiser in the first half.

1.   Vivian Nutton, Ancient Medicine (New York: Routledge, 2004) 114.
2.   Nutton, 114.