A Holistic Model of Healthcare: Lessons from Asclepius to Modern America
Just as it is important to look toward the future for innovation and possibility, it is equally important to look back on the most influential minds of the past and reflect on their lessons for improving our quality of life and making the world a brighter, more compassionate place. Although, in terms of technology, modern American healthcare services are comparatively advanced to those provided by the temples of Asclepius in Ancient Greece, many of today’s healthcare facilities have been found to overlook providing their patients with the holistic care that was crucial to the services of the Asclepieia and their physicians. It is time to implement a healthcare model that not only adopts from the medical philosophy of Asclepius and his followers, including Hippocrates, but also improves upon it so that more American hospitals can effectively eliminate their patients’ physical illnesses while restoring their overall mental and emotional wellbeing.
Throughout the Greek World, the highly mythological figure of Asclepius was revered as the son of the healing god Apollo and a god of medicine himself, as well as “a great doctor for every disease” (Mironidou-Tzouveleki 167). There were over five hundred temples dedicated to Asclepius spread over the Greek world (singular Asclepion and plural Asclepieia) with the most famous being in Trikala, Epidaurus, Athens and Kos. Each was operated by priest-therapists who treated a variety of illnesses including psychological conditions, skin and lung diseases, and gynecological as well as ophthalmic conditions. Priest-therapists placed a heavy emphasis on promoting the patients’ overall physical and psychological wellbeing through therapeutic treatments that, combined with surgical procedures and medicine prescriptions, both alleviated patients of their negative physical symptoms and restored the spiritual connection between the natural and social environment,
the body, the mind and the soul (Kleisiaris). According to the philosophy of Asclepius, and later the physician Hippocrates, the three main parts of treatment include, in addition to surgeries, the promotion of mental and physical health as well as art therapy. Upon arriving at the Asclepion, patients were taken to their own private “quiet rooms” in a hotel-like building called the “kataklintyrio” (Mironidou-Tzouveleki 168). The patients were personally attended to by the priest-therapists everyday, and received purifying baths as well as messages. They were encouraged to visit the theatre and exercise in the stadium, the most famous being the theatre and stadium of Epidaurus which were located close to the Asclepion of Epidaurus. Music and theatre were thought to have a powerful effect on the body and the soul when performed to the patient. The combined sounds of instruments like flutes and harps were thought to cure physical illnesses like gout and the ancient tragedies were thought to allow patients to release their emotions in a process known as catharsis (Kleisiaris). Patients were also encouraged to entertain themselves with poetry, reading, and going on walks around the clinic.
Due to the importance placed on the patients’ environment, the temples of Asclepius were typically located away from large cities and surrounded by natural beauty (Mironidou-Tzouveleki 167). The Asclepieia were well known for their treatment of “enkoimesis” or sleep therapy (Askitopoulou). Patients would be taken to a private section of the temple which, according to the ancient geographer Pausanias, was the place where “supplicants of the god sleep” (Pausanias 393). This place was called the “Enkoimeterion” and here patients would make sacrifices of rams to the god Asclepius before being induced to sleep through the use of drugs like opium. In their dreams, they were thought to be visited by the god Asclepius who would instruct them on the proper method of treatment for their illness or even cure them himself. These spiritual and physical treatments were found to have
actually had a positive impact on patients as they, combined with the specialized calming environment, helped relax the patient and lower their anxiety before undergoing surgery (Askitopoulou). And they appear to have been effective at successfully treating the patient because the most famous temples, such as the one on Epidaurus and Kos, remained in operation for centuries, from the fifth century B.C. to the fourth century A.D. During this time thousands of people, including the famous comedian Theopombos, were believed to have travelled on pilgrimages to stay at these temples when their illnesses were not responding to any other treatments (Askitopoulou). According to Pausanias, there were even slabs in the entrance of the Asclepion of Epidaurus that attest to the large number of people healed at the Asclepion and “On them are inscribed the names of both the men and the women who have been healed by Asclepius, the disease also from which each suffered, and the means of cure” (Pausanias 393).
When looking at the American healthcare system in comparison, it is clear that healthcare facilities can benefit from a revised model that takes into account the personalized mental and physical care that is emphasized in the philosophy of Asclepius and Hippocrates. By combining the treatment of symptoms with holistic therapeutic treatments, we may be able to improve our own healthcare services and provide patients with a higher quality of care. The American Hospital Association came out with a survey in 2017 that found there to be little incorporation of behavioural health services in the treatment of many hospital patients, with only 17% of hospitals incorporating these services in extended care and only 38% incorporating it into primary care (“It’s Time for Holistic Patient Care”). In addition to this, studies have found that many improvements to the patients’ physical environment that greatly improve the patients’ overall comfort and recovery time
also reflect the therapeutic treatments that play such prominent roles in the philosophy of Asclepius and Hippocrates. For patients with winter depression who had a view of natural scenery and access to daylight from their hospital rooms, they were found to have had shorter hospital stays as well as fewer medications and complications than patients who had a view of brick walls or stayed in dimly lit rooms. Furthermore, when assessing the comfort of patients in their environments, the study found that the noise level can have a negative impact on the patients’ recovery and stress by disrupting their sleep cycles. They concluded that the incorporation of sound-absorbing ceilings would solve the issue (Huisman).
The healing and calming effect that natural environments can have on the mental and physical wellbeing of the patients was one of the core principles of the Asclepion and an integral aspect of the temples’ personalized design and treatments. For instance, the temples’ location in areas surrounded with natural scenery and the promotion of travelling around the clinic as well as the inclusion of private “quiet rooms” for patients to relax in before their procedures. Hippocrates specifically addressed the significance of these environmental factors -- sight, sound, smell, design of the room, and the effect of seasons -- on his patients’ physical and psychological wellbeing. He explains how “The season and the kind of illness will make a difference” and elaborates that “Some patients are put into breezy spots, others into covered places or underground.” Hippocrates informs his students to “Consider also noises and smells” (Hippocrates 297).
That being said, several modern American healthcare facilities have adapted from the examples provided by the temples of Asclepius and Hippocrates. Similar to how one of the major areas of treatment for Hippocrates and Asclepius was the incorporation of art therapy to improve both the patients’ mental and physical health, the University of Florida has also
launched an initiative to expose more hospital patients to different forms of art. This initiative aims to lower anxiety and improve the effectiveness of treatments among patients. There is a focus on the physical environment with the use of specialized healthcare architects who will construct “therapeutic” or “healing” gardens. Not only this but there is a focus on increased music, poetry and art therapies with the increase of music and theatre performances for patients and bedside interactive song and play-writing to help lower stress (National Organization for Arts in Health).
Overall, as the American healthcare system continues to evolve to better reflect the needs and overall wellbeing of the patients, it is crucial that we heed the lessons provided to us by the healthcare services of the Greek World, namely those of Asclepius and Hippocrates. While striving to treat the patient’s physical condition, we must also keep in mind the fundamental principles of these physicians’ medical philosophy which emphasizes the significance of the natural environment as well as the holistic care of both the body and mind. Modern healthcare facilities have already begun adapting their design and treatments from these pivotal figures of Ancient Greece and we must continue to both adopt and improve on the wisdom they have left behind to provide patients with the utmost quality of care for their whole being.
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