- Marquis Berrey
Methodists were a self-identified medical sect of the 1st century bce, Imperial period, and late antiquity who shared a common method of observation and causal inference about the practice of medicine. Methodists took their name from the “method” (Gk. methodos), an observable path or evidence-based medicine which the physician undertook to gain secure therapeutic knowledge. The path was supposed to reveal the general similarity between patients’ ostensibly differing conditions. Three similarities, or “commonalities,” as they were called, were possible: fluid, constricted, or a mixture of the two. Opponents pilloried Methodists for the loose logic of their methodological revolution and socially disruptive claims to teach medicine within six months. Primarily a Roman phenomenon, the popularity of Methodism seems to have been due to a ready supply of practitioners and its focus on certain, fast therapy. Methodists wrote chiefly on internal medicine, surgery, and medical history.
- Science, Technology, and Medicine
Methodists (Gk. methodikoi, Lat. methodici), a self-identified medical sect or school (hairesis) of the 1st century bce, Imperial period, and late antiquity, shared a common method of observation and causal inference about the practice of medicine. One of the three chief sects under the Roman Empire, Methodism was a distinctly Roman phenomenon, whereas their opponents—the Rationalists and Empiricists—practiced in both the Hellenistic and Imperial periods. Methodists took their name from the “method” (methodos), an observable path of evidence-based medicine which the physician undertook in order to gain secure therapeutic knowledge (Celsus 1.pr.57). The path was intended to reveal the general similarity between patients’ ostensibly differing conditions. Three similarities, or “commonalities” (koinotēteis), were possible: fluid or lax (Gk. rhoōdes, L. laxus), constricted (Gk. stegnon, L. strictus), or a mixture of the two (Gk. epipeplegmenon, L. mixtus). Methodists wrote chiefly on internal medicine, surgery, and medical history.
The lengthy success of the sect preserves the names of eighteen Methodists from antiquity, dating from the middle of the 1st century bce to c. 500 ce. Apart from Soranus of Ephesus and Caelius Aurelianus, the two Methodists some of whose works survive, all other evidence are fragments and testimonia. While associating particular Methodists with specific innovations or doctrines is beyond the purview of extant evidence in most cases, a general outline of the sect’s history is possible. The sect’s doctrines were first established by Themison of Laodicea-in-Syria, a student of Asclepiades of Bithynia, who adapted Asclepiades’ teachings to a new system. Thessalus of Tralles is said to have completed Methodism (Ps.-Galen Intr. 4.3, 14.684K); Galen, who preserves most testimonia about Methodism, took Thessalus as his paradigmatic Methodist opponent. Soranus’s later treatment of Methodism was influential, although his methodological treatises have been lost. Since testimonia about Methodist methodology are sometimes contradictory, it remains unclear whether this is due to an internal philosophical incoherence of Methodism, the historical development of the sect’s principles, or the bias of sources.
The medical doxographies of Celsus, Ps.-Galen, and Galen treat Methodists as the third medical sect and an upstart at that. Methodists’ opponents pilloried them for loose logic, reductionism, and the claim to teach medicine within six months (Gal. Sect.Int. 6, 1.83K). Far from building a bridge between the other two sects, Methodism constituted a methodological revolution in ancient medicine. Medicine was no more than therapy for Methodists (Celsus 1.pr.64). Methodists practiced allopathic healing but rejected the remainder of Hippocratic tradition: Hippocrates had unnecessarily complicated medicine with a focus on detailed observation, causation, and patient individuality. Methodists classified nosologies into three classes of commonalities that posited a pole of flux and a pole of constriction, followed by an intermediate mixed status of these. Methodists did not speak of traditional disease entities but rather “affections” (pathē), a nosological variant of the commonalities that was not lesion-specific to any parts of the body. To provide secure therapy for affections, some Methodists distinguished them by multiple domains of therapy and specific lesions (Ps.-Galen Intr. 3.6–7, 14.680–682K). Yet proliferating affections risked undermining the general similarity between patients’ differing conditions. Methodists did not describe the natural activities of the body in the terms, well known to ancient medicine, of fluids or humors, but rather maintained that the body was a mechanism of corpuscules (onkoi) and tubes (poroi). Illness resulted from a blockage of the pores creating a certain affection, which indicated the allopathic therapy to be used (Ps.-Galen Intr. 8.2, 14.691K). Methodists treated their patients with an initial regulated time period of three days (diatritos), best understood as forced fasting and observation with a light dietetic treatment occurring on the third day. The allopathic treatment corresponded to the commonality. Astringent treatments for a fluid commonality and relaxing ones for a constricted commonality were gentle food and lifestyle applications rather than heroic therapeutic measures. An initial period of limited therapy gave Methodists the flexibility to undertake a more drastic dietetic treatment, using purgatives and cupping, that aimed to change the local make-up of the body’s pores, called metasyncrisis (Caelius Aurelianus TP 1.24–31). Chronic diseases, whose general characteristics Themison was the first to recognize, demanded metasyncritic therapy (Caelius Aurelianus TP 1.pr.3). A therapeutic step beyond drastic local dietetic treatment was the possibility of lesion-specific surgical interventions, an arena where Methodists were prominent. Thus Methodism was able to embrace a therapeutic account of internal medicine and surgery with a flexibility of treatment.
The Methodist relation to their sectarian opponents is more complex than a direct rejection of theory and experience. While breaking with the Rationalists and Empiricists, Methodists borrowed philosophical language from them. Like the Empiricists, they directed their attention to observable conditions (phainomena); like the Rationalists, they marked causal relationships (endeixis). The Methodists thought the relationship between observable conditions and the commonalities was causal, although the Hippocratic tradition thought commonalities a theoretical construct (Celsus 1.pr.62–63). Causal relationships at once apparent between existent entities did not need the time and semiotics of the Rationalist’s inference from the patient’s bodily signs (Ps.-Galen Intr. 3.5, 14.680K). Anatomy and physiology too was useless, unless a Methodist might learn it for learning’s sake (Sor. Gyn. 1.3); but Methodist success in surgery suggests that many did. The Methodists went further than the Empiricist principle of history in reviewing the reported opinions and doctrines of their predecessors. Caelius Aurelianus’s abridged and paraphrased translation of Soranus’s On Acute and Chronic Diseases is a lengthy historical review of previous physicians’ theoretical accounts and treatments of particular diseases, such as madness, rabies, or toothache. If Caelius’s historical reviews are more broadly representative of Soranus’s later Methodism (cf. Sor. Gyn. 3.2–4), at least later Methodists provided a comprehensiveness of historical review and corresponding systematic criticism of past physicians, including Methodists, to present the best understanding of medicine according to current Methodism. As for other sectarian predecessors, Methodists extensively criticized Asclepiades for his confusion of causes but adapted his mechanical model of the body, its health, and disease.
Methodism was practiced both as an elite and non-elite medicine in Rome. The ancient Hippocratic tradition compared Methodist medical practice in hospitals to veterinary medicine, whose patients did not communicate with their healers and lacked individuality (Celsus 1.pr.65). Yet Methodism was not confined to lower classes and slaves whose individuality disappeared in hospital treatment. Thessalus wrote an open letter to Nero, and several Methodists tended the Roman imperial family (Gal. MM 1.2, 10.7–8K, cf. Plin. HN 29.9; Gal. Praen. 12.7, 14.663K). The apparent social success and popularity of Methodism in Rome seems due to its supply of practitioners and its focus on certain, fast therapy that adapted to local conditions. A student could learn the basics of Methodism and begin practice within six months, an education that proved socially disruptive to the previous model of the ancient Hippocratic tradition with its lengthy medical apprenticeships. Methodists could readily supply physicians to satisfy the demographic demands of the teeming Roman metropolis. Further, Methodists believed, against the Rationalists and Empiricists, that all parts of medicine were capable of certainty (Ps.-Galen Intr. 5.1, 14.684K). The method grasping commonalities provided an immediate causal relationship that was certain. The certainty and speed of Methodist medicine contrasted with the lengthy necessary observations and conjectural therapeutics of the Hippocratic tradition.
Methodism initially survived the rising tide of Galenism in late antiquity, as Caelius Aurelianus’s reference to his own students shows (CP 1.pr.1). While later commentaries on Galen’s On Sects for Beginners, a standard teaching text in the medical schools, continued to list Methodists as one of the three medical sects, it remains unclear when Methodism died out as a live option for medical practice (John of Alexandria Commentaria In Librum De Sectis Galeni).
- Caelius Aurelianus. CP and TP. Latin text and German translation in Bendz, Gerhard. Caelii Aureliani Celerum Passionum Libri III; Tardum Passionum Libri V. 2 vols. Corpus Medicorum Latinorum 6.1. Berlin: In Aedibus Academiae Scientarum, 1990–1993. English translation in Drabkin, I. E. Caelius Aurelianus On Acute Diseases and Chronic Diseases. Chicago: University of Chicago Press, 1950.
- Celsus. De Medicina 1. prohoemium. Latin text, French translation, and commentary in Mudry, Philippe. La Préface du De Medicina de Celse: text, traductione et commentaire. Lausanne: Institute de Suisse a Roma, 1982. English translation in Spencer, W.G. Celsus on Medicine: Volume 1: Books 1–4. Cambridge, MA: Harvard University Press, 1935.
- Galen. Sect.Int. Greek text in Helmreich, Georgius. Galeni Pergameni Scripta Minora, vol. 3. Lipsiae: Teubner, 1893. English translation in Frede, Michael, and Richard Walzer. Galen: Three Treatises on the Nature of Science. Indianapolis: Hackett, 1985.
- Ps.-Galen. Intr. Greek text, French translation, and commentary in Petit, Caroline. Galien: Tome III: Le Médecin. Introduction. Paris: Les Belles Lettres, 2009.
- Soranus. Gyn. Greek text, French translation, and commentary in P. Burgiurère, D. Gourevitch, and Y. Malinas. Maladies des femmes. 4 vols. Paris: Les Belles Lettres, 1988–2000. English translation in Temkin, Owsei. Soranus’ Gynecology. Baltimore: Johns Hopkins University Press, 1956.
- Fragments and testimonia in Greek and Latin collected and translated into English in Tecusan, Manuela. The Fragments of the Methodists. Methodism outside Soranus, vol. 1. Leiden, The Netherlands: Brill, 2004.
- Frede, Michael. “The Method of the so-called Methodical School of Medicine.” In Science and Speculation: Studies in Hellenistic Theory and Practice. Edited by J. Barnes et al. Cambridge, U.K.: Cambridge University Press, 1982. Reprinted in Frede, Michael. Essays in Ancient Philosophy. Minneapolis: University of Minnesota Press, 1987.
- Gourevitch, Danielle. “Le médecine practique: définition de la maladie, indication et traitement,” in Les écoles médicales à Rome. Actes du 2e colloque international sur les textes médicaux latins antiques, Lausanne 1986. Edited by P. Mudry and J. Pigeaud. Geneva: Libraire Droz, 1991.
- The Encyclopedia of Ancient Natural Scientists. Edited by P. Keyser and G. Irby-Massie. New York: Routledge, 2008. s.v. “Antipatros (Methodist), Apollonides of Cyprus, Auidianus, Caelius Aurelianus of Sicca, Dionysios (Methodist), Eudemos (Methodist), Iulianos (of Alexandria?), Meges of Sidon, Menemakhos of Aphrodisias, Mnaseas (Method), M. Modius Asiaticus, Olumpiakos of Miletus, Philon of Huampolis, Proklos the Methodist, Rheginos, Soranos of Ephesos, Themison of Laodikeia (Syria), Thessalos of Tralleis.”
- Leith, David. “The ‘Diatritus’ and Therapy in Greco-Roman Medicine.” CQ 58.2 (2008): 581–600.
- Mudry, Philippe. “Le regard souverain ou la médecine de l’évidence.” In Les cinq sens dans la médecine de l’époque impériale: sources et développements. Edited by I. Boehm and P. Luccioni. Lyon: De Boccard, 2003. Reprinted in Mudry, Philippe. Medicina Soror Philosophiae. Regards sur la littérature et les textes médicaux antiques (1975–2005). Réunis et édités par Brigitte Maire. Lausanne: Editions BHMS, 2006.
- Nutton, Vivian. “The Rise of Methodism.” In Ancient Medicine. 2d. ed. London: Routledge, 2012.
- Petit, Caroline. “What Does Pseudo-Galen Tell Us That Galen Does Not? Ancient Medical Schools in the Roman Empire.” In Philosophical Themes in Galen. Edited by P. Adamson, R. Hansberger, and J. Wilberding. Bulletin of the Institute of Classical Studies Supplement 114. Exeter, 2014.
- Pigeaud, Jackie. “Les fondements du méthodisme.” In Les écoles médicales à Rome. Actes du 2e colloque international sur les textes médicaux latins antiques, Lausanne 1986. Edited by P. Mudry and J. Pigeaud. Genève: Libraire Droz, 1991.
- van der Eijk, Philip, ed. “Antiquarianism and Criticism: Forms and Functions of Medical Doxography in Methodism.” In Ancient Histories of Medicine: Essays in Medical Doxography and Medical Historiography in Classical Antiquity. Leiden, The Netherlands: Brill, 1999.