It's been a few weeks now since I finished Goldacre's book, and I still think about it quite frequently. I had it in mind quite a bit while I was reading Perrottet's Route 66 A.D and while listening to Garland on the topic of science and medicine.
From both sources, it struck me how our term "quack" really doesn't apply to the ancient world. Medicine for the ancients was a mix of the rational and the irrational, and they were very comfortable with that. They were terribly superstitious people, and our modern notion of there being "real" doctors and "quack" doctors simply does not apply. A doctor could, at once, use a rational technique but then recommend an offering to the gods or some other remedy that, to us at least, would seem like quackery. The great Galen himself practised medicine in this manner.
This is brought very much to the fore in Route 66 A.D when Perrottet discusses the Empire famous orator Aristides, who, by all accounts, was a perennial hypochondriac. He spent much of his life attempting to cure his sickness(es), with little success. He would follow the instructions of Asclepius from his dreams and often journey to famous health spas all over the Empire.
These resorts, such as the famous one at Pergamum - home of Galen, would promote both rational medicine and non-rational, side by side, for both could help. It seems to me now that to consider some of them quacks, one needs to apply modern standard and that seems unfair.
Another thing that occurred to me was that medicine was a service industry - those who did it provided a service for a fee, and so it seems reasonable to me that some of these people were surely offering bogus medical advice in an attempt to swindle the genuinely sick.
Given the Greek's penchant for service industries during the Empire, and the tradition of the Greeks being learned, they constituted most of the doctors, especially the famous ones. As in many aspects of the Greek/Roman relationship the latter distrusted the former and considered them somehow dishonest. Cato the Elder, not especially a fan of the Greeks, was worried they were killing their patients, and recommends that a sick Roman stick to the wonder cure that is cabbage and avoids sneaky Greek doctors.
All in all, then, quackery is not an especially useful term when applied to the ancient world. What we would consider quackery was practised side by side with more "rational " medicine and the ancients would use both if they helped. That said, it goes without saying that there were some doctors who were peddling wonder cures for big bucks, and in that respect the ancient world certainly would have had it's fair share of dubious doctors selling wonderful potions, much like many "nutritionists" today.
You would think that we, today, would be able to discern much more clearly real medicine from money-spinning wonder cures, but I suppose, like the ancients, many folks will believe almost anything that a "doctor" tells them in the hope that it may help. Sadly many people, it seems, are happy following the Aristides model of following dubious medical advice with great gusto, despite the fact that it doesn't really help.
Finally, something which Garland mentions which brings this all into perspective is that the overwhelming amount of people in the ancient world would have no access whatsoever to medicine, rational or quackery, and so the question hanging over whether ancient quacks were swindling people is a bit of a misnomer - for to be sold a fake medicine one must first have access to a "doctor", which most people simply did not have.
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