Helen Rhee. <i>Illness, Pain, and Health Care in Early Christianity</i>

Helen Rhee considers how early Christians “understood, adopted, appropriated, and reframed Greco-Roman medicine and healthcare from the second century CE to the fifth century CE” (p. 1). Rhee aims to demonstrate that there is a “critical link” between the many forms of Greco-Roman medicine and health care and the “formation of Christian identity” in the early centuries of the church. The reformulation of medicine and health care in the church shaped how Christians defined themselves. Fundamental to the author’s thesis is that most of the literary evidence regarding illness and healthcare come from the perspective of the elites in the culture, and writings show the perspectives of physicians, not patients. Understanding the iterations of Greco-Roman medicine is critical for understanding how the early Christians engaged with these ideas and practices. The book is confined to Hippocratic and Galenic medicine as representing the Greco-Roman medical tradition, which is what the church fathers engaged with.After the introduction, there are five chapters, followed by a conclusion. In the introduction, Rhee describes her approach and offers definitions of disease and illness by medical anthropologists, the constraints of the study, and the connection between Greco-Roman medicine and early Christian medicine and health care. The introduction lastly provides a brief overview of the following chapters.Chapter 1, “Health, Disease, and Illness in Greco-Roman Culture,” examines ideas of health, disease, and illness in Greco-Roman literature, medicine, and philosophy. Not only did the early Christians interact with these ideas and understandings, but they “set the stage” for subsequent ideas and understandings of health, disease, and illness up through the Renaissance at least. The chapter also shows how the idea of illness as having a “personal and psychosocial meaning-making experience” was shaped by Greco-Roman contexts (p. 13). Greeks in the third century BC and long after viewed health as the “highest good.” Greek medicine understood health as the proper blending of bodily humors, for example, sweet, bitter, acidic, etc. Poor health occurred when one of the humors exerted dominance over the others. Plato and those who followed him, as well as Galen, saw health as the proper mixture of earth, fire, water, and air.There is a brief section on women’s health. Their health was seen as primarily related to menstruation and the ability to become pregnant. The idea of health for women is a precarious one and implies medical intervention” (p. 36). Women were seen as having a greater risk of illness due to their “natural instability and imperfection” (p. 36). While many saw the Antoine Plague as a divine punishment, Galen did not. From this, Rhee talks about illness as a cultural construct. Starting with the Homeric poems to inscriptions in the temple of Asclepios at Epidaurus, “there had been a link between human action, divine punishment, and illness” (p. 64). During many plagues, the Greeks and Romans turned to religious rituals as “both their causes and solutions” and sought religious significance for them. Ancient Israelite cultural and early Christian communities had similar views.“Health, Disease, and Illness in the Bible and Early Christianity,” chapter 2, considers health, disease, and illness in the Hebrew and Christian Bibles. It also looks at how the early Christians living in the Greco-Roman world developed their own theories on these topics. Early Christians adopted and modified the philosophical and medical views in Greco-Roman writings and practices. The biblical notion of health is that God is the creator of physical health and spiritual, mental, emotional, relational, and socio-political well-being” (p. 78). Shalom is the condition of perfection and wholeness that creation after the Fall longs to return to. The emphasis on Sabbath rest for humans, animals, and the land in the Hebrew Bible reflect a concern with health. Leviticus offers many restrictions and practices related to health. The story of Jesus’s healing miracles in the gospels indicate that Jesus shared these values of health and wholeness.References to disease and illness far outnumber mentions of health in the Hebrew and Christian Bibles, including the Apocrypha. In the Hebrew Bible, disease and illness are God’s actions. Second Temple literature continues and develops ideas about health, sickness, and healing. For example, fallen angels cause illness in 1 Enoch. The Christian Bible continues this demon–illness connection, although the majority of healing stories in the gospels do not involve exorcisms. The gospels present Jesus as the ultimate physician. Early church fathers agreed that the body was “specifically attuned for reason” and designed for a useful purpose. Any changes to this would result in illness. Early Christian leaders incorporated the naturalism of Galen and Hippocrates into their own understanding of humans as created by God into their own ideas of health. The chapter concludes by describing early Christian views of disease. Christian Hellenistic Jewish writers saw most illnesses and diseases as having natural causes. God also caused ailments, either as punishment or pedagogy. In some cases, demons caused health problems.Chapter 3 considers “Pain in Greco-Roman Culture and Early Christianity.” Rhee considers the developing theology and its integration with Greco-Roman views on pain. While pain may be caused by illness, it is treated separately. The author considers how Greco-Roman medicine saw pain as the result of a physiological process along with its affective and social implications. Greco-Roman and early Christian ideas about pain are divided into those caused by illness and those caused by violence. According to the Hippocratic corpus, pain is a part of the human condition. Another view was that pain was caused by the unbalanced quality and strength of humors, for example, black or yellow bile. Galen saw pain as beneficial in warning and protecting individuals. After examining medical texts, Rhee discusses pain in Greco-Roman literature and philosophy. After describing Stoic views of pain, Rhee asserts that for Roman Stoics, pain should be turned into something useful. Stoics viewed pain as neither good nor evil. Pain is indifferentia but virtue and glory require it.Turning to “Christ’s passion narratives and Imitatio Christi,” Rhee describes the way the broken body of Jesus, hanging on a tree in excruciating agony, was “central to the Christian narratives and theology” (p. 155). In Jesus’s suffering and death, he modeled martyrdom according to the will of God. The first theologians and apologists sought to express Jesus’s incarnation, passion, and resurrection “in the light of contemporary philosophical language and concepts” in order to present the Christian faith as a true philosophy, equal or better than those the contemporary culture offered (p. 159).The chapter then considers early Christian pain narratives in relation to narratives of Jesus’s pain. Through public suffering, endurance, and courage, early martyrs nullified and reversed the intended effects of torture. For example, being tortured did not break the will of these martyrs and cause them to recant. The martyrdom accounts of Blandina, Felicitas, Perpetua, and Polycarp are seen as uniting in suffering with Christ. At the same time, some martyr narratives separate torture and pain, and martyrs testified that during their suffering, they felt no pain. Christ suffered in them. Some, like Sanctus, face suffering with “unflinching self-mastery like a Stoic, and a model of Roman masculinity” (p. 175). The early Christian appropriated “concepts, language, and forms of communication” from the surrounding culture.“Health Care in the Greco-Roman World” is the subject of chapter 4. Rhee states that, “Since illness is, by and large, a sociocultural phenomenon, so is health care,” and included people’s beliefs about sickness (p. 193). Health care in this chapter will consider many approaches considered efficacious and meaningful by patients and healers. The author focuses first on religious healing and temple medicine, in which the gods were seen as both causing and healing. Asclepius was seen as the primary god who gave healing. At the same time, the dreams of those in asclepeia corresponded often to treatments in rational medicine. Healings by the gods and holy men were a core part of the Greco-Roman “medical market.” In rational medicine, the goal was to achieve cure without doing harm to the patient. In the Hippocratic Corpus, physicians are advised to change the state of the body, such as moist to dry. Galen stressed the importance of both change and allopathy. Evacuation was a key method of temple and rational medicine. People also made use of exorcists, astrologers, and magic amulets.Chapter 5 considers “Health Care in Early Christianity.” Rhee divides this into two periods. In the second and third centuries, Christians engaged with Greek medicine, made the care of the sick one of their primary ministries, and sought religious healing. In the fourth and fifth centuries, Christians established hospitals and monastic infirmaries with limited medical care and practiced health care through both religious and rational medicine. While Christian health care followed Greco-Roman health care, Christian distinctives influenced Greco-Roman health care. Early apologists saw medicine as a divine gift. Christians distinguished themselves by caring for plague victims, even though it caused many of them to die. The use of relics, seeking healing from “holy men,” and Christian amulets were also common. Christian hospitals developed and were primarily for the poor and strangers. These had admission rituals and religious expectations. Bishops were also responsible to be healers of the soul. This chapter is followed by a brief conclusion.Rhee’s work is thoroughly researched and well-documented. She shows the way in which early Christians took over religious and rational medicine from the larger Greco-Roman world and how Christians adopted and adapted it. The church developed its own illness, pain, and healthcare narratives. Those who want detail will find it here. Rhee notes at points issues beyond the scope of the book, but provides numerous bibliographic entries that would make helpful starting points for further research. This work is highly recommended for those interested in Greco-Roman background and church history of the early centuries. It provides portraits of areas not normally covered in treatments of these topics.