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                         Dreams in Ancient Medicine

  Dreams in the Ancient World  Dreams in Ancient Medicine Further Reading

    I. Dreams in the Ancient World

Along with many people before and since, most Greeks and Romans believed
that dreams could give information about past, present, and even future
events. Dreams, however, are manifestly not records or transcriptions of
these events. Dreams demand interpretation.

Even when interpreted, some dreams will prove to be false; first of all,
therefore, the interpreter must decide how to distinguish true dreams from
false, as Penelope does at Odyssey xix.560 ff. She suggests that dreams can
be distinguished according to the path by which they reach us; true dreams
pass into our consciousness through a gate of burnished horn, while
deceptive dreams enter our world through a gate of ivory. The need to
distinguish true dreams from false leads naturally to consideration of the
causes and mechanisms of dreaming.

Dreams could be caused by external factors like a god, a ghost, or a daemon,
or by internal factors like the dreamer's own soul, recollection of waking
activities, or physiological state. Plato recognized that dreams were one of
the ways by which the gods conveyed their intentions to mankind (Apology
33c); at the same time, he allows that natural causes, including
disturbances in the body's internal motions, can give rise to dreams
(Timaeus 45e).

Around these fundamental polarities of true vs. false and divine vs.
natural, ancient philosophers, writers, and theorists of all kinds organized
their thought about dreams. For most people, the most important function of
dreams was to predict the future, and the first step in interpreting dreams
was to recognize which dreams were both god-sent and true. Aristotle's
agnostic attitude toward the possibility of prophesy through dreams (On
Dreams 462b12-17) marks an exception to this general rule, as does the
Epicurean dogma that "Dreams have no divine nature nor any prophetic force
but originate from the impact of images" on the senses (Epicurus, Vatican
Sayings 24).

    II. Dreams in Ancient Medicine

Medical writers also took an interest in the distinction between divine and
natural dreams; for the most part, however, they were interested in the
dreams that were both natural and true, from which a physician could gain
information about bodily states and processes that were hidden from direct
observation. The earliest extant Greek treatise on dreams happens to be a
medical work: the fourth book of the Hippocratic treatise On Regimen, from
the end of the fifth or beginning of the fourth century. The author of this
treatise stakes out for himself the territory left by the diviners'

     Whatever dreams are divine and foretell evil or good to
     communities or to private persons have interpreters who are in
     possession of an art concerning such matters. But whatever
     physical symptoms the soul foretells--surfeit, depletion, excess
     of what is natural, change to what is unaccustomed--these things,
     too, have intepreters, and sometimes they chance to get it right,
     but at other times they miss the mark. (Regimen 4.87)

The author of On Regimen 4 claims to offer a true account of the dreams that
foretell physiological events. This account of such natural dreams combines
explanation of their causes with suggested interpretations of their meaning.

In its concern with causes, however, On Regimen 4 is anomalous in the
literature of ancient medicine. Most medical writers and schools, with the
prominent exception of Galen, did not concern themselves with the aetiology
or mechanism of dreams. Instead, they used dreams as a diagnostic and
prognostic tool without committing themselves to any explanation of how or
why dreams reflected physiological reality. It was enough to accept that a
patient's dreams might be part of the ensemble of information that the
physician brought to bear in his attempt to construct an account of the
patient's condition, and an appropriate therapy for it.

Modern scholars, following Galen's lead, often speak of three or more
medical sects or schools in Roman medicine: dogmatists, empiricists, and
Methodists. Some speak also of an eclectic school, whose chief
representative is Galen himself. Only the Methodists, however, could claim
to be a genuinely self-defined sect, with a founder and distinct medical
theory. "Dogmatist" and "empiricist," like "liberal" and "conservative" in
American politics, refer to tendencies of thought, not clearly defined
doctrines, and in practice the therapies of dogmatist and empiricist
physicians probably resembled each other more than they differed. In
evaluating dreams, however, these two schools at least stood apart from the

According to Galen (On the Natural Faculties I.12), the Methodists rejected
dreams and other forms of divination as indicators for diagnosis or therapy.
Empiricist physicians, who rejected theory of all kind and based their
practice on experience, accepted the possibility that dreams, like any other
experience, might point to useful therapeutic practices. No indication seems
to have survived of the dogmatists' attitude toward medical dreams, but
there is no reason to believe that they denied their utility.

Divine dreams are another matter. Those that came from Asclepius or other
healing gods play an especially prominent role in Greco-Roman medicine.
These dreams, which the sick eagerly solicited at shrines like those at
Pergamum or Ephesus, had by their very nature a claim to be regarded as both
god-sent and true, and thus distinct from the natural dreams that were the
province of physicians. For the ordinary patient, messages from a healing
god were one among many available sources of medical knowledge. The Sacred
Tales or Hieroi Logoi of the rhetorician Aelius Aristides (2nd century A.D.)
present an extreme example of one highly educated patient's faith in healing
dreams and in Asclepius as something like a personal savior; more typical,
perhaps, are the cures recorded in a series of inscriptions from the
sanctuary of Asclepius at Epidauros.

These inscriptions were set up on a series of tablets or stelae in the
sanctuary; six of them were seen by Pausanias in the second century A.D
(Descriptio Graeciae II.27,3 = Edelstein and Edelstein T384, p. 195). The
tablets describe miraculous cures performed by Asclepius. Not all the cures
involve sleep; in one, for example, a voiceless boy is cured immediately
after performing the preliminary sacrifices to Asclepius; in another, a
growth on a boy's neck is healed when one of the temple dogs licks it. These
are exceptions, however, and the vast majority of cures recorded on the
stelae come after the ailing suppliants have slept in the sanctuary in hopes
of a cure. This practice is called "incubation."

Some of the Epidauros suppliants see a "vision" (opsis), others a
"vision-in-sleep" (enhypnion)-the word used by Galen in On Diagnosis from
Dreams. Still others appear to have a direct encounter with the god, like
that of a certain Euhippus, who had lived for six years with the point of a
spear embedded in his jaw.

     As he was sleeping in the Temple the god extracted the spearhead
     and gave it to him into his hands. When day came Euhippus departed
     cured, and he held the spearhead in his hands. (Inscriptiones
     Graecae IV 2, 1 = Edelstein & Edelstein T423, p. 232).

In a few cases, the patient is cured after sleeping in the shrine, but no
mention is made of a dream or vision.

Finally, it is important to avoid the temptation to construct a tidy scheme
in which divine dreams are the province of faith healers and natural dreams
a tool of rational physicians. The dichotomy between divine and natural
dreams does not correspond exactly to the distinction between rational
medicine and divine healing, and in fact that distinction was far from
absolute in Greco-Roman medicine. Galen, to give only one example, records
with apparent agreement the case of a wealthy man who came to the shrine of
Asclepius at Pergamum and was cured there by a dream from Asclepius
(Subfiguratio Empirica 10,78 Deichgräber = Edelstein & Edelstein T436, p.
250) and acknowledges his own cure at the hands of the god (De Libris
Propriis 2 = Edelstein & Edelstein T458, p. 263).

Lee T. Pearcy