Cito tuto jucunde, a phrase that can be translated as “Quickly, safely, and pleasantly,” was the motto of one of the fathers of medicine—a Greek who refuted the Hippocratic doctrine of the four humors in favor of a proto-microbial theory based on Democritus’ atomic theory. He was a man who recommended not confining the mentally ill but instead treating them with massages, exercise, and diet. He was a pioneer in the use of music therapy, and the Platonic philosopher Antiochus of Ascalon described him as “unsurpassed in the art of medicine and also well-versed in philosophy.” We are talking about Asclepiades of Bithynia.

He was born around 120 BCE in Cius, a city founded in the 7th century BCE by Milesian colonists, which in 202 BCE was renamed Prusias Thalassa (Prusias Maritima) because it was located on the Bithynian coast of the Propontis, the present-day Sea of Marmara. In other words, it was in what is now northeastern Turkey—at the time, a deeply Hellenized region that was already beginning to fall under Rome’s influence. It would come under Roman rule in 74 BCE when King Nicomedes IV bequeathed it upon his death, turning it into another province of the Republic. This event triggered the Third Mithridatic War, as Mithridates VI sought to claim it for himself.

In fact, Asclepiades was invited by Mithridates to join his court, but he chose instead to settle in Rome. He traveled extensively in his youth: after studying in his homeland, he went to Athens to learn Epicurean philosophy “about the construction of the world.” It was probably in that city that he had the opportunity to become well acquainted with the work of Hippocrates, who was regarded in antiquity as the father of medicine and the ultimate authority on the subject, having surpassed the practice of incubatio (leaving the patient in the temple of the god Asclepius to be healed). Asclepiades, suspected to be the son of a iatros (physician)—as it was customary to inherit one’s father’s profession, though no further details are known—was about to break with Hippocratic doctrine.

Physician Asclepiades microbes rome greece
Bust of Asclepiades. Credit: Wellcome Images / Wikimedia Commons

Hippocrates had revolutionized medicine by opting for the healing tradition of Cos over that of Cnidus. Whereas Cnidus focused on diagnosis, Cos emphasized treatment based on observation. This approach offered a higher probability of success, as diagnoses were extremely difficult and only effective for common illnesses in an era when knowledge of internal anatomy was limited—dissection of human cadavers was forbidden except in Alexandria. The therapeutic approach of Cos, and thus that of Hippocrates, was passive, based on fostering the healing power of nature.

It was Hippocrates who formulated the theory of the four humors, which held that diseases result from an imbalance in the pepsis (proportion) of bodily fluids—blood, black bile, yellow bile, and phlegm. When a dyscrasia (bad mixture, imbalance) occurs, a person falls ill and remains so until equilibrium is restored through therapy. Otherwise, the condition worsens, increasing the risk of a crisis that could be fatal. According to Hippocrates, these crises usually occurred on so-called critical days, at fixed intervals after the onset of the illness.

Asclepiades rejected much of this theory, particularly the idea of critical days, as he believed that illnesses did not have a predetermined or fixed resolution. Consequently, he downplayed the importance Hippocratic medicine placed on anatomy and the phenomenological observation of disease, considering it a waste of time and instead focusing on treatments. In contrast to Hippocrates, he proposed a theory derived from atomism, or corpuscular theory, as formulated by the philosopher Democritus of Abdera, who conceived of a universe composed of atoms and void.

Hippocrates
Bust of Hippocrates in the Pushkin Museum. Credit: shakko / Wikimedia Commons

In this view, diseases were caused by molecules—invisible particles that, through inharmonious and irregular motion, acted upon the pores of the skin, either clogging them due to accumulation (resulting in acute illnesses) or relaxing them due to insufficiency (causing chronic diseases). An interruption in bodily fluids and pneuma (an ambiguous term that could be translated as either breath or spirit, referring in any case to how air circulates through the body and mediates between the heart and brain) would cause mild illnesses. In fact, he classified diseases into three types: strict state, lax state, and mixed state.

For Asclepiades, the key role of a physician was to provide the patient with the appropriate treatment, striving to be empathetic and kind rather than dismissive—a rarity at the time, despite the fact that physicians were considered demioergós (public servants). Hence the motto: Cito tuto jucunde.

His methodical medicine began by prescribing improvements in diet, moderating wine intake (not prohibiting it increased his popularity), ensuring that food portions were appropriate, and resorting, in cases of excess, to the application of enemas and/or bloodletting to cleanse the body. He also relied on exercise, massages, and baths. He preferred all these methods over pharmaceuticals, which he considered useless on their own, although the influence he received from Pythagoreanism did open him up to the use of herbal medicine.

Physician Asclepiades microbes rome greece
A Greek physician, illustration by Warja Honegger-Lavater. Credit: Public domain / Wikimedia Commons

Another method he frequently used was music therapy, which he applied to two types of patients: first, those who had been poisoned by a snake bite or scorpion sting; second, those suffering from mental disorders. Contrary to the usual practice, he did not isolate them from others and, along with the usual diet and massages, he applied soft music (for those who were overly excited) or loud music (for those who were depressed; in the latter case, using the so-called Phrygian mode, that is, harmonia or tonos in a descending scale).

Asclepiades believed that the affected part of the body would dance to the rhythm of the notes, restoring balance and expelling pain. However, he ruled out the use of the flute, considering its sound too loud and counterproductive.

Galen and Aretaeus, two other illustrious Greek physicians who were somewhat later and Romanized, tell us that another innovation of their Bithynian predecessor was the performance of a tracheotomy in a case of asphyxia, which earned him great prestige. However, Galen also criticized him, as Asclepiades believed that the kidneys had no physiological function, whereas Galen wrote in his De Naturalibus Facultatibus that they played a homeostatic role. Pliny the Elder also expressed some doubts about his excessive reliance on herbs, which he associated with “magical deceptions.”

roman physician
A Roman physician in a painting by John William Waterhouse (1877). Credit: Public Domain / Wikimedia Commons

As we mentioned earlier, after training in Cius and Athens, Asclepiades followed the example of many colleagues and settled in Rome, though not before stopping at the Cycladic island of Paros to study under Cleopato, a renowned pharmacologist. Once in the city of the Tiber, and after an initial period devoted to rhetoric, he eventually turned to medicine—not only treating patients but also teaching. For this, he earned both the nickname Philosophicus and Pharmacion, as well as the praise of Antiochus of Ascalon (the last philosopher of the Third School, who attempted an eclectic synthesis of Aristotle’s and Plato’s positions and was Cicero’s teacher), which we referenced at the beginning.

One of his distinguished students was Themison of Laodicea, the first to use leeches for bloodletting, founder of the Methodic school—which would have great influence for a long time—and author of several medical works, of which only the titles and some fragments remain, as is the case with his master’s writings: Libri Periodici; Epistolae; Celeres Passiones; Tardae Passiones; Liber Salutaria; and De Plantagine.

What Themison could not do was emulate Asclepiades in a legendary feat recorded by Pliny in his Naturalis Historia: so confident was he in his science that he bet against the goddess Fortuna that he would stop being a physician if he ever fell ill; he won, as he died at a very old age after falling down a staircase, today being considered the first to develop something akin to a germ theory, even anticipating Marcus Terentius Varro.

This article was first published on our Spanish Edition on February 26, 2025: Asclepíades de Bitinia, el médico griego que fue el primero que creyó en la existencia de «microbios»

SOURCES

Christa Yapijaki, Hippocrates of Kos, the Father of Clinical Medicine, and Asclepiades of Bithynia, the Father of Molecular Medicine

J. T. Vallance, The lost theory of Asclepiades of Bithynia

John Scarborough, Pharmacy and drug lore in Antiquity. Greece, Rome, Byzantium

Wikipedia, Asclepíades de Bitinia

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