De tuenda sanitate praecepta

Plutarch had more than a casual interest in medicine, for, besides this essay on keeping well, his other works abound in references to the behaviour of the sick and their treatment, and the medical practices of his day. Long before the time of Plutarch the art of medicine, always empirical, had been put on a solid foundation, and the acute observations of Hippocrates and his school had been set down in writing; and this body of Hippocratic medical writings, along with others, was in circulation, and had undoubtedly been read by Plutarch.

That medicine has made very great advances since Plutarch’s time is, of course, self-evident; aseptic, antiseptic, and sterilize are now household words, and the germ theory of disease has, in recent times, shed light on much which before was dark. But Plutarch is not dealing with the technical side of medicine; he is only giving some common-sense advice on rational living, and much that he has to say in regard to rest, exercise, and diet is in accord with the best medical practice of the present day. In fact, it is doubtful if any physician would take exception to anything that Plutarch advises (his advice is meant for men whose work is done with their heads rather than their hands), and one might name men in public life to-day, well on in years, who have followed many of his suggestions, unwittingly, no doubt, but to their own advantage.

The essay seems, at the first glance, to be put in the form of a dialogue, but it is about as much of a dialogue as Quiller-Couch’s Foe-Farrell. The dialogue form is merely a literary subterfuge to present an essay in a slightly more attractive form, and the third person of the dialogue, only occasionally recalled to the reader by the parsimonious interjection of he said, may be presumed to be Plutarch, the author. The two speakers in the brief dialogue at the beginning of the essay are Moschion, a physician, whom Plutarch introduces also into the Symposiacs (Moralia, 658 a), and Zeuxippus, a friend of Plutarch’s, who is introduced also as a speaking character in two other essays of Plutarch’s (Moralia, 748 e and 1086 c), besides being mentioned several times in other essays.

That the essay was written some time after a.d. 81 is clear from the reference to the death of the Roman Emperor Titus (123 d).

The title of the essay is included in Lamprias’ list of Plutarch’s works, and Stobaeus, in his Florilegium, has several quotations from it, sometimes with a slightly different reading, but none of these readings changes the meaning of the passage at all, and rarely is one to be preferred to the reading found in the mss. of Plutarch (see Vol. I. Introd. p. xxi).

Indeed, the text of this essay has suffered more at the hands of modern editors than from the ancient copyists, for a glance at the foot-notes in Bernardakis’s edition will show that the gratuitous and unnecessary changes introduced into the text by modern editors outnumber their corrections of the minor errors in spelling, and the like, made by the ancient copyists.

MOSCHION. So, Zeuxippus, yesterday you drove away Glaucus, the physician, when he wished to join in your philosophical discussions.

ZEUXIPPUS. No, my dear Moschion, I did not drive him away, nor did he wish to join in philosophical discussion, but I avoided him and feared giving an opening to a man fond of contention. In medicine the man is, as Homer [*](Homer, Il. xi. 514.) puts it, Worth many others together, but he is not kindly disposed towards philosophy, and there is always a certain harshness and ill-nature inherent in his remarks. And just then he was coming at us full tilt, crying out, even before he came near us, that it was no small or suitable task, amounting in fact to a confusion of all bounds, which had been boldly assumed by us in discussing a healthful manner of living. For he asserted that the subjects of philosophy and medicine are as far remote from each other as are the boundaries of any Mysians and Phrygians [*](Proverbial; cf. Nauck, Trag. Graec. Frag., Adespota, No. 560.); and thereupon, as he had at the tip of his tongue some statements of ours, which, though not very carefully formulated, are certainly not without utility, he proceeded to tear them to pieces.

MOSCHION. Well, in this and in other matters,

ZEUXIPPUS. That is because you, Moschion, have a natural gift for philosophy, and you feel incensed at the philosopher who does not take an interest in medicine, and you are indignant that such a man should imagine it more becoming for him, in the eyes of mankind, to profess some knowledge of geometry, logical discussion, and music, than to desire to seek out and know

All that of evil and good may have chanced to betide in the dwelling [*](Homer, Od. iv, 392.)

MOSCHION. Well, Zeuxippus, let us say no more about Glaucus, who is so self-important that he wants to be a law unto himself, needing no help from philosophy; but do you tell us in detail the whole discussion; or, if you prefer, just those statements [*](Homer, Od. iv. 392.)

ZEUXIPPUS. Well, our companion [*](Plutarch himself presumably.) asserted that he had heard somebody say that keeping the hands always warm, and never allowing them to get cold, is in no small measure conducive to health, and, conversely, the chilling of the extremities, by concentrating the warmth in the interior of the body, creates, as it were, a habit or a predisposition towards feverishness; and for a man to divert the substances in his body toward the surface, and to conduct and distribute them, along with the warmth, to all parts of his body, is healthful. [*](Cf.Moralia, 635 C.) If therefore we happen to be doing something with our hands and using them, the motion itself brings the warmth to these parts, and keeps it there; but when not engaged in such activities we must by no means allow the cold to find lodgement in our extremities.

ZEUXIPPUS. This, then, was one of the things ridiculed. The second, I think, concerned the food which you people serve to the sick. For he urged that we should partake of it and taste it from time to time, and get ourselves used to it in time of health, and not abhor and detest such a regimen, like little children, but gradually make it familiar and congenial to our appetites, so that in sickness we may not be disaffected over our fare as if it were so much medicine, and may not show impatience at receiving something simple, unappetising, and savourless. [*](Cf. Moralia, 661 B.) For this reason, too, omitting the bath now and then before going to a meal is not a thing to be avoided, nor drinking only water when wine is at hand, nor drinking anything lukewarm in the summer-time when there is snow on the table; and while dismissing

ZEUXIPPUS. Well has it been said, Choose the life that is best, and constant habit will make it pleasant, [*](A precept of Pythagoras according to Plutarch, Moralia, 466 F, and other writers who quote it; cf. also Moralia, 602 B.) and, in particular, it is profitable for a man, experimenting with each several department of life and especially with those which have to do with the practices which affect the body, to inculcate a fixed habit during periods of soundest health, so thus to make these things agreeable, familiar, and congenial to his nature, [*](Cf. Plato, Laws, p. 797 E.) bearing in mind how some men feel and act in times of sickness, being angry and fretful when hot water and gruel, or plain bread, is served to them, calling these things abominable and unpleasant, and abominable and hard-hearted also those who would force such things upon them. A bath has proved to be the death of many men who at the outset had not much the matter with them, save only that they could not and would not bear to taste food unless they had first had their bath; of whom Titus the Emperor [*](There are varying accounts regarding the manner of Titus’s death, poisoning or drowning being also alleged.) was one, as those who attended him in his illness affirm.

ZEUXIPPUS. Something, moreover, was said to this effect, that, while the less expensive things are always more healthful for the body, we ought especially to guard against excess in eating and drinking, and against

ZEUXIPPUS. If, however, such imperative occasions suddenly confront us when we are overloaded and in no condition for taking part — if, for instance, we receive an invitation from a high official, or guests appear, so

’Twere better, friend, to gain your hatred now Than be soft-hearted and lament anon.

ZEUXIPPUS. These are the teachings which Glaucus in derision quoted aggressively to us as pedantic. The rest he was not eager to hear, nor we to tell him. But I beg that you will examine each of the several statements.

ZEUXIPPUS. First there is Socrates,[*](Xenophon, Memorabilia, i. 3. 6; cf. Plutarch, Moralia 513 C, 521 E, and 661 F.) who, in urging us to be on our guard against such things to eat as persuade us to eat when we are not hungry, and such things to drink as persuade us to drink when we are not thirsty, did not absolutely forbid the use of these things; but he was instructing us to use them only if we needed them, and to make the pleasure in them serve our necessity, just as our statesmen do who turn to military uses their funds for amusements.[*](Perhaps a reference to Demosthenes, lix. 4, which says that in time of war all surplus funds are to be devoted to the army.) For that which is pleasant, in so far as it is a nutritive element, is congenial to our nature, and it is by remaining still hungry that we ought to get enjoyment from the necessary or the pleasant foods; but we should not stir up in ourselves a second and separate set of appetites after we have appeased the usual ones. And here is another consideration. Just as Socrates [*](Xenophon, Symposium, ii. 17-20; again referred to infra, 130 E and Moralia, 711 E.) found dancing a not unpleasant exercise, so the man for whom pastry and sweets serve as a meal and as food suffers less injury. But when a man has satisfied the moderate demands of his nature, and has had his fill, he ought to exercise the very greatest vigilance against helping himself to such things. And in such matters, while we should be on guard against love of pleasure and gluttony, yet we should be no less on guard against vulgarity and love of notoriety. For these latter often help to persuade people to eat

ZEUXIPPUS. It is a great marvel if we get off unscathed, when we concede to the body only as much of pleasures as Nature in her need finds a place for, but still more so when we battle with it vigorously to thwart its appetites, and keep putting them off, and finally consent to some negotiation with such as will not be denied, or, as Plato [*](The quotation does not appear in Plato, but Plutarch is probably summing up from memory an account of a contest with the passions such as may be found, for example, in the Phaedrus, pp. 254 ff.) says, yield when the body bites and strains. But when the case is reversed,

If one must needs do wrong,

To do it for a kingdom’s sake.

Do not, by always making our fare more ample than lentils, Throw us all into discord.

These knavish dainties and these complex foods,

ZEUXIPPUS. At some other time, then, it may be that we shall have to speak against pleasures, and show what an intrinsic beauty and dignity belongs to continence; but the present discourse is on the side of many pleasures and great. For diseases do not take from us and spoil for us so many of our enterprises or hopes or travels or pastimes as they do of our pleasures. Hence contempt for health is least profitable for those who make pleasure their chief aim. For infirmities allow many persons to be philosophers, or actually even generals or kings, but the pleasures and enjoyments of the body in some cases do not come to life at all in time of disease, and those that come to life yield but a brief part of what they properly should, and even that is not pure, but contaminated with much that is foreign, and marked, as it were, by the beatings of surge and storm. For it is not true that In well-gorged bodies Love resides,[*](The sentiment is probably taken from Euripides; cf. Nauck, Trag. Graec. Frag., Euripides, No. 895, and Plutarch, Moralia, 917 B.) but rather in serenity and calmness of the flesh does

ZEUXIPPUS. As Demades used to say that the Athenians, who were for making war in season and out of season, never voted for peace save when wearing black, so we never give a thought to a plain and restrained way of living except when using enemas and poultices. But when we find ourselves in this plight we try hard to stifle the thought of our wrongdoings, setting ourselves against their remembrance, and, as is the way of most people who object to this or that air or this or that locality as insalubrious when they say that they dread travelling, we exclude our intemperance and self-indulgence from the cause of our illness. Nay, we should recall how Lysimachus [*](202 B.C.; cf. also Moralia, 183 E and 555 D. Lysimachus was one of the successors of Alexander the Great.) among the Getae was constrained by thirst to surrender himself and the army with him as prisoners of war, and afterwards as he drank cold water exclaimed, My God, for what a brief pleasure have I thrown

ZEUXIPPUS. I am not unaware that men contract fevers

ZEUXIPPUS. We ought to take special precautions in the case of premonitory symptoms and sensations. For what Hesiod has said [*](Works and Days, 104, quoted more fully supra, 105 E.) of the illnesses that go hither and thither assailing mankind is not true of all, that

Silent they go, since the wisdom of Zeus has deprived them of voices,

ZEUXIPPUS. Moreover, it is well that those who because of pleasures fail in self-control, and give way to their desires or are carried away by them, should be instructed and reminded that pleasures derive most of their satisfaction from the body;

ZEUXIPPUS. and as the Spartans give to the cook vinegar and salt only,

ZEUXIPPUS. The very exact mode of living, exact to a hair’s breadth, to use the popular expression,[*](See the note on 86 A in Vol. I.) puts the body in a timorous and precarious state, and abridges the self-respect of the soul itself, so that it comes to look askance at every activity, and to no less

Before the storm, as though along the strand The North wind blew.[*](Diels, Fragmente der Vorsokratiker, ii. p. 88.)

ZEUXIPPUS. For it is absurd to give careful heed to the croaking of ravens, the clucking of hens, and swine m their wild excitement over bedding,b as Democritusc put it, making signs of winds and rains out of these, and at the same time not to forestall nor take precaution against the stirrings, the ups and downs, and the premonitory symptoms in the body, and not to hold these to be signs of a storm that is going to take place in one’s self, and is just about to break. Wherefore not merely in the matter of food and exercise do we need to keep watch of our body, to see whether, contrary to its habits, it takes to these reluctantly and without zest, or at another time is thirsty and hungry in an unnatural way, but also, in the matter of sleep, to beware of lack of

ZEUXIPPUS. It is very profitable when visiting sick friends to inquire of them the causes of their illness, not by talking pedantically and officiously about stoppages, irruptions, and trite generalities, and incidentally displaying some acquaintance with medical terminology and literature, but by listening in no perfunctory way to these homely and common details of overeating, exposure to the sun, fatigue, sleeplessness, and especially the manner of living which the man was following when he fell sick of the fever. Then, like Plato, who, on his way home, was accustomed to say on the subject of others’ faults, Am not I too possibly like them? [*](Cf.Moralia, 40 D, 88 E, and 463 E.) a man ought to correct in himself the faults he observes in his neighbours, and be watchful and mindful not to become involved in

ZEUXIPPUS. Let us now take up each topic anew once more; and in the first place, on the subject of exercises suitable for scholars, we beg to remark that one might follow the example of the man who, by saying that he had nothing to write for people dwelling by the sea on the subject of ships, showed clearly that they were in use; and so in the same way one

ZEUXIPPUS. After reading or discussion, before going to walk, one should make use of rubbing with oil in a warm room to render the flesh supple, extending the massage so far as practicable to the inward parts, and gently equalizing the vital spirit and diffusing it into the extremities. Let the limits of the amount of this rubbing be what is agreeable to the senses and not discomforting. For the man who thus composes the inward disquiet and tension in his vital spirit manages the superfluous in his body without discomfort, and if unfavourable weather or some engagement prevent his going to walk, it does not matter, for Nature has received her proper due. Wherefore neither travelling nor stopping at an inn ought to be made an excuse for silence, nor even if everybody there deride one. For where it is not disgraceful to eat it is certainly not disgraceful to take exercise; nay, it is more disgraceful to feel timid and embarrassed before sailors, muleteers, and innkeepers, who do not deride the man who plays ball and goes through the movements of sparring alone, but the man who speaks, even though in his exercises he instruct, question, learn, and use his memory. Socrates said [*](Xenophon, Symposium, 2. 18. ) that for a man’s movements in dancing a room that would accommodate seven persons at dinner was large enough to take exercise in, but for a man who takes his exercise through singing or speaking every place affords him adequate room for this exercise both when standing up and when lying down. But we must observe this one caution — not to strain our voices too hard

ZEUXIPPUS. To take a cold bath after exercising is ostentatious and juvenile rather than healthful. For the power of resistance to external influences and the hardiness which it seems to create in the body really produces a more evil effect on the inward parts by stopping up the pores, causing the fluids to collect together, and condensing the exudations which are always wanting to be released and dispersed. Besides, those who insist upon taking cold baths have to make a further change into that exact and strictly ordered way of living which we are trying to avoid, and they have to be always taking heed not to transgress this, since every shortcoming is at once bitterly brought to book. On the other hand, warm baths have much to offer by way of excuse. For they do not detract so much from vigour and strength as

ZEUXIPPUS. Coming now to the subject of food, if there be anything helpful in my earlier suggestions as to how we may beguile and pacify our appetites, we must give some further advice regarding what comes next; but if it be difficult to manage a belly that has been set free, as it were from bondage, and to wrangle with it when it has no ears to hear, as Cato [*](The same remark is found in Moralia, 198 D, 996 D, and Life of M. Cato, chap. viii. (p. 340 A).) used to say, we must contrive by means of the character of our food to make the quantity less burdensome; and of the solid and very nourishing foods, things, for example, like meat and cheese, dried figs and boiled eggs, one may partake if he helps himself cautiously (for it is hard work to decline all the time), but should stick to the thin and light things, such as most of the garden stuff, birds, and such fish as have not much fat. For it is possible by partaking of these things both to gratify the appetites and not oppress the body. Especially to be feared are indigestions

ZEUXIPPUS. Of the liquids milk ought not to be used as a beverage but as a food possessing solid and nourishing power. With regard to wine we ought to talk as does Euripides [*](From an unknown play: cf. Nauck, Trag. Graec. Frag., Euripides, No. 967. The sentiment is a favourite one with Euripides; cf., for example, Iphigeneia at Aulis, 543-557; Medea 627-634; Helena, 1105.) with regard to Love:

May est thou be mine, but moderate be, I pray, yet ne’er abandon me.