From Diogenes Laertius, Book 10 (The Biography of Epicurus), we read something that may lead us again to revisit the matter of the apparent chronic ill health of Epicurus, and how the great philosopher confronted and dealt with serious bodily health issues.
Here is the excerpt by Diogenes Laertius: “Timocrates, the brother of Metrodorus, in his treatise entitled the Merry Guests, and this Timocrates had been a disciple in his school, though he afterwards abandoned it; and he says that he (Epicurus) used to vomit twice a day in consequence of his intemperance; and that he himself had great difficulty in escaping from this nocturnal philosophy, and that mystic kind of association.”
We imagine Epicurus staying up late hours at night, forgetting all the pains of his chronic ill health, and sitting pleasantly at a table discussing with his friends the nature of all things, as they wrote their books and worked to clean up the foolish messes that had been written by other philosophers. So, for this reason, Epicurus should be accused as intemperate by the enemies of pleasure, and of life itself?
But insults are not something that astonish us as Epicureans, since they happen even up to the present day. That is why the following is first in the list of Epicurus’s admonitions to the wise man, as recorded by Diogenes Laertius:
Injuries are done among men either because of hatred, envy, or contempt, all which the wise man overcomes by reason.
As for the ill health of Epicurus, the insults recorded by Diogenes Laertius came from a man who was described as trifling and silly - Timocrates. Of course insult was exaggerated, however, there is a Greek idiom that says : “There is no smoke without fire.” Timocrates may have indeed seen Epicurus vomit when he had a breakout of his chronic illness, because, nausea and vomiting are one of the main symptoms of nephrolithiasis.
It might be, and as Norman DeWitt suggests in his book “Epicurus and His Philosophy” (page 244), that the fourth of the principal doctrines was added on the due to observation and experience arising from Epicurus’ own chronic nephrolithiasis. Although I do not totally agree with DeWitt’s thought, doctrine four does seem to fit a description of a chronic or a sharp pain, as suffered by Epicurus, and as ridiculed by Epicurus’ enemies. Nevertheless, DeWitt should have reminded his readers also about the admonition by Epicurus to the wise man that even when put to torture, the wise man would still be eudaemonic/happy, which means, in the words of Friedrich Nietzsche, that whatever does not kill me, makes me stronger!
Moreover, when we read Epicurus’s biography, we see that Epicurus’s illness was mentioned by Hermarchus, with its precise name. Much progress had been made in medicine in the Hellenistic and Roman periods, but afterwards, the Abrahamic religions brought about the medieval Dark Ages, in which knowledge was suppressed, books were burned, and medicine regressed to the point where cures consisted of leeches drinking human blood. Paraphrasing Lucretius DRN Book I, 101: Yes, indeed to such heights of foolishness has religious and political obsession, and idealism in general, been able to drive men. It should not amaze us, but cause us to reflect in pity, that mankind has lost so many centuries of discoveries in science and medicine, along with the Epicurean perspective on the Universe and Nature.
As Diogenes Laertius mentions, “He (Epicurus) died of renal calculi (kidney stones), as Hermarchus mentions in his letters, after having been ill a fortnight; and at the end of the fortnight, Hermippus says that he went into a brazen bath, properly tempered with warm water, and asked for a cup of pure wine and drank it; and having recommended his friends to remember his doctrines, he expired.
And when he was at the point of death, he wrote the following letter to Idomeneus:
"I have written this letter to you on a happy day to me, which is also the last day of my life. For strangury has attacked me, and also dysentery, so violent that nothing can be added to the violence of my pains. But the cheerfulness of my mind, which arises from there collection of all our philosophical discussions, counterbalances all these afflictions. And I beg you to take care of the children of Metrodorus, in a manner worthy of the devotion shown by the youth to me, and to philosophy.”
One of our Epicurean friends who is a doctor, Elayne Coulter, has written the following remarkable thoughts:
“I am grateful to Epicurus for his letter on his deathbed. It's very personally meaningful for me. He gave us evidence that his philosophy held up as a happy way of living even during pain. I have seen people with other beliefs who were terrified when approaching death, despite their lifetimes of faith, and that always seemed to me a tragic thing. They had no comfort when they needed it most.
I do not believe suffering/pain is good or necessary, but it happens to all of us at times. Epicurus gave us a philosophy which helps us in good times and hard times alike. It will not fall through-- it is reliable. Pain cannot always be removed, but pleasure can be found anyway, especially having practiced finding it.
We might not believe that, minus testimony from Epicurus and others based on direct experience.
In my life, I do not always remember to look for pleasure in the midst of pain, but as soon as I remember to look, it is easy to find. Like probably everyone here, I have had my human share of sorrow. In the past few years, there have been especially difficult circumstances for me and/or people I love-- deaths, incurable illnesses, financial ruin, violence and threats of violence, homelessness, betrayal, loneliness, and more. Peace and safety seemed nowhere to be found.
I have peace and safety again now, and I agree with Epicurus that this is necessary. And I can also report that even in the worst circumstances, there is always some kind of pleasure to find. Breathing, a sunset, a beautiful tree... and most especially memories of being with those I love. The practice of taking pleasure as a guide, even imperfectly done, is the best course at all times of life, right up until the last breath”.
Here is a modern description of the term “strangury” as used by Epicurus and as our epicurean friend Dr. Elayne Coulter indicates:
"The pain from kidney stones is generally intermittent and often severe, resolving when the stone passes—perhaps this gave Epicurus first-hand experience behind his words about severe pain being short in duration. Recurrent stones can cause chronic kidney disease which might have provided Epicurus the experience of a contrast between lower intensity, longer lasting pain and the intense pain of a stone, which has been compared by some to the pain of childbirth.
Acute kidney stones can cause obstruction but this is generally in one kidney at a time, and therefore the flow of urine is not usually decreased. Because Epicurus experienced strangury, the painful decreased flow of urine, we can consider some possibilities for how this might have happened. He could have had stones in both kidneys at once. It is possible that one kidney had already been rendered nonfunctional by prior stones, and thus when the other was obstructed, strangury resulted. Or perhaps he had, in addition to the stones, some other process causing bilateral obstruction, such as bladder or prostate cancer. Stones causing obstruction quite often lead to kidney infection, which can progress to sepsis and death. Because strangury is not just reduced flow of urine but painful flow, this suggests that Epicurus had infection as well as the stones".
That’s the reason why we realize, from the works by Metrodorus, how great was his concern for his very best friend’s illness, so he wrote three books addressed to Physicians; and one particularly on the Illness of Epicurus. All of these works have been lost. Why? Because I have the impression that Metrodorus, in his books addressed to physicians, did not agree with them and mostly with some of their idealistic ideas and myths that were spreading by Platonists and their “friends” Pythagoreans who were influenced by Hippocrates and his theory on “benevolent Nature”.
We also read the following from a remarkable work written by another Epicurean doctor, Christos Yapijakis:
“Asclepiades of Bithynia (124-40 BCE) was the first physician who established Greek medicine in Rome. Influenced by the Epicurean philosophy, he adhered to atomic theory, chance and evolution, and did not accept the theory by Hippocrates of a ‘benevolent Nature’. He suggested that the human body is composed of molecules and void spaces, and that diseases are caused by alteration of form or position of a patient's molecules. Asclepiades favored naturalistic therapeutic methods such as a healthy diet, massage and physical exercise. Above all, he introduced the friendly, sympathetic, pleasing and painless treatment of patients into medical practice, influenced by the teachings of Epicurus on pleasure and friendship. He was the first who made the highly important division of diseases into acute and chronic ones and to perform an elective non-emergency tracheotomy. As the founder of the Methodic School, Asclepiades was the first known physician who spoke about what is known today as molecular medicine”.
Diagnostic medical methods of our days.
- Blood testing.
- Urine testing.
- Imaging tests abdominal X-rays, dual energy computerized tomography (CT) ultrasound, a noninvasive test, and intravenous urography, (intravenous pyelogram) or obtaining CT images and (CT urogram).
- Analysis of passed stones.
These four treatments that can be used, in our days, to treat kidney stones:
- Shock wave lithotripsy
- Percutaneous nephrolithotomy or percutaneous nephrolithotripsy
- Open surgery
Here, and at this point, I would like to shout out loud:
How was he, the great philosopher Epicurus, able to foresee the evolution of the medical practices that in our days are used by Doctors for diagnosing this disease, and suggesting its cure? All this and much more he was able to envision based on methodology of his Canon of Truth – his methodology extended from the capabilities of our senses, from evaluating the possibilities in manifold ways, and grounded in the first principle of all nature arising from atoms to molecules to cells and beyond, giving rise to biochemistry, biogenetics, and so much more.
I have one more final thought on the topic of treatment that I am reminded of from the letter to Menoeceus: All of us should wish to live the life that is pleasant, not the life which is the longest.
So for that reason I would prescribe one more staple of the Epicurean philosophical “diet”:
We must not pretend to study philosophy, but study it in reality, for it is not the appearance of health that we need, but real health (ES 54).
Thank you for your attention, and I wish to all of you a truly healthy and pleasant life!
March 7th 2020
I dedicate this of my work to my epicurean friends and mentors in Epicurean Philosophy Cassius Amicus, George Kaplanis and Dr. Dimitris Altas.