The Magic in Medicine and the Medicine in Magic

Brief History of Medicine

Ancient medicine had its origins thousands of years ago, before recorded history, when primitive humans faced a hostile world for survival. The ancient hunters and gatherers lived in fear of nature and of being fodder for wild beasts at the cave entrance. Early humans created ghosts and spirits to explain the world around them and the diseases and injuries that were responsible for their maladies. Ancient humans would attribute those maladies, including diseases, to supernatural forces that had to be forced or bribed away.

Next came those individuals who convinced the masses that they had power over the mysterious spirits that caused disease. These men of power, believed to be able to remove the deadly spirits, were referred to as medicine men. These early “doctors” practiced white magic by claiming to cast out the evil spirits from members of their clan and also often were believed to be able to bring sickness down on enemies or rival clans.

Hundreds of years later, as humans became more civilized, tribes became organized into larger groups. The medicine man now was referred to as a priest, who performed ceremonies and rites, and maintained customs. Being elevated to this elite position required initiation and special training.

These ancient healers believed that supernatural forces caused disease and that a special priest or medicine man was required to rid those afflicted of these unseen yet potentially lethal forces. These healers made use of what we call today psychotherapy, dealing with the patient’s mind. These healers had the ability—or their patients thought they did—to frighten away the evil spirits that cause disease. This goal often was accomplished by dancing, shouting, and shaking noisemakers in front of the patient. Often, just as in today’s modern medicine, healing the mind does actually improve the health of the patient. Patients whose problems were more mental than physical often were cured by these incantations and laying on of hands. In the mind of the patient and the clan or community, therefore, it was the medicine man who cured the disease by using the unique treatment that was handed down from one medicine man to another. Perhaps this was the beginning of early medical education.

Plants and Animals

For thousands of years, humans searched for drugs in nature, purporting that plants had healing properties. Ancient medical practices identified drugs in barks, seeds, fruit bodies, and other parts of plants. Even modern medicine has acknowledged that certain plants and animals can have pharmaceutical properties.1

Paracelsus (1493-1541), a Swiss physician and alchemist, believed that certain substances could be used for healing. According to this belief, God marked the healing substances with signs that indicated their application for certain diseases. For example, because the appearance of hazelwort is reminiscent of the liver, it must be beneficial for liver diseases, and St. John’s wort (Hypericum perforatum L.) would be beneficial for treatment of wounds and stings, because the leaves of the plant appear as if they have been stung.2

Since time immemorial, animals have been used for healing purposes. Hundreds of medicines are derived from animal fat, excretions, bones, teeth, feathers, hair, horns, buffalos, elephant, camel, donkeys, goats, and sheep.3

Medical Amulets

Almost every ancient civilization used minerals and gemstones in healing. Minerals, gems, and crystals were used to release mental, physical, and spiritual blockages in order to achieve emotional and spiritual balance.

The Romans wore healing stones as talismans, amulets, and adornments to enhance health. The Ancient Egyptians also used healing crystals extensively. Their kings and queens were adorned from head to toe in lapis lazuli. In China, green jade has long been valued as a lucky charm and attractor of prosperity. Ancient Greece and India also reference many of the gemstones and their meanings in their practices. From large geodes to the smallest stones, these gemstone, and their meanings have a balancing, positive effect on your body and mind.

Egyptian Medicine

Ancient Egypt had priests who also served as physicians. These physicians were of an elite class because they were able to read and write. They would start as scribes and then be promoted to priest or physician. These ancient physicians probably had an advantage over the Greek physicians, because they were able to examine the anatomy of the body when they embalmed the pharaohs and wealthy members of society who could afford a ritual burial after death.

The ancient Egyptians also were fastidious about hand-washing as a part of their religious rituals, a procedure that might have been copied from the Hebrews who were living in exile in Egypt. The ancient Egyptians probably did not understood the concept of germs and bacteria, but because they valued cleanliness, hand-washing, again perhaps learned from the Hebrews, was part of their daily ritual. The mortality rate following medical procedures in ancient Egypt was probably less than that of any European hospital up until the 20th century, when personal cleanliness and the sterilization of instruments became common practice.

The ancient Egyptian physicians also used magical spells and recipes for reversing aging. They mixed herbs, plants, and parts of animals into creams to apply topically to remove wrinkles. This is often considered the origin of pharmacology. For a crying child, a potion with opium—what we would call an “active ingredient”—was prescribed.

Ancient Egyptian doctors were instructed to conduct three discussions with patients they were asked to treat: (1) this is an illness I can treat; (2) this is an illness which I will contend as the patient may not survive; and (3) this is an illness I will not treat because the patient is certain to succumb to the injury or disease. These early physicians were concerned about their reputation long before online reputation management was in vogue.

Ancient Egypt often had annual epidemics. When the cause of an epidemic—such as bubonic plague— was unknown, the ancient doctors treated their patients magically using spells and incantations to remove the demons that were believed to be responsible for the illness.

The Egyptians even had a magical spell to make an old man a youth. They created a cream from plants and herbs, which is perhaps the beginning of pharmacology. They believed that if herbs and plants were mixed in the proper proportions, health could be restored.

Egyptian physicians prescribed cannabis for treatment of patients with cancer, possibly the earliest mention of the drug. The Berlin Medical Papyrus, written between 1570-1069 BCE, deals with contraception and fertility, and includes the earliest known pregnancy tests.

The ancient Egyptians also performed surgery. Circumcision was performed as a religious ritual on boys between the ages of 10 and 14, marking the transition from adolescence to manhood. It was done by a doctor who also served as a temple priest, but in spite of their precautions this procedure still sometimes resulted in infection. Because the nature and source of the infection were unknown to them, it was considered the result of supernatural influence and dealt with through magic spells; this most likely resulted in the deaths of many young men.

Greek and Roman Medicine

Greek medicine was codified, systematized, and put into its classical form by Hippocrates, who is best remembered for the theory of the four humors: black bile; yellow bile; phlegm; and blood. (Hippocrates also is credited with the creation of the Hippocratic Oath, which is still recited today by every Western physician upon graduation from medical school.) The concept of the four humors was combined with the four qualities of heat, cold, wet, and dry, which were used in all treatments and would remain influential for the next 1500 years. The belief was that an imbalance in bodily fluids was the cause of many health problems and that appropriate treatment could correct the imbalance. This balance could be regained in various ways, including inducing vomiting, or bleeding a patient by applying leeches to the skin, neither of which was very successful.

Asclepius is a god associated with medicine in ancient Greek religion and mythology. He is the son of Apollo, who was considered the god of healing and diseases. The “rod of Asclepius,” a snake-entwined staff, remains a symbol of medicine today.

In 33 BCE, an important medical school that served to transmit Greek medicine to the Romans after they conquered Egypt was established in Alexandria. The early Romans did not like to rely on doctors; rather, their prescription for a healthy life was a simple diet of good, wholesome food; personal cleanliness and hygiene; and plenty of exercise. The Romans also were great devotees of the bath. Although these Roman “discoveries” may not fall into the field of pure medicine, poor hygiene was a constant source of disease, so any improvement in public health would have a major impact on society. The brightest star in the Roman medical establishment was Galen, considered the greatest physician of the Roman Empire. Galen’s teachings allowed doctors to make precise diagnoses and to prescribe specific remedies to restore the body’s balance. Galenic physiology was a powerful influence in medicine for the next 1400 years.4

Middle Ages and Renaissance

The three great medical leaders of the Renaissance were Paracelsus, Vesalius, and Pare. During this time, Latin was abandoned as the language of medical texts, and they started being written in the vernacular of the country where each medical scholar lived. Renaissance physicians abandoned the herbal medicines of Galen and substituted strong minerals, such as mercury, lead, sulfur, iron, and arsenic. Care had to be taken when prescribing these minerals, because, unlike the Galenical medicines, which were safe but often ineffective, the minerals could be beneficial but were potentially harmful.

Ambroise Paré introduced many surgical practices, some of which are still in use today, such as hernia repair. His surgical contributions lasted for over 200 years until John Hunter made surgery a science.

In 1616, William Harvey discovered how blood circulation in the body worked. Harvey first used mathematical measurements to report on the flow of blood and the process and function of the lungs in respiration. Also in the 1600s, the microscope was introduced and opened new medical fields. In the late 1700s, Edward Jenner discovered the process of vaccination against smallpox.

Nineteenth Century and Modern Medicine

In the mid-1800s, general anesthesia was developed, making longer surgical procedures possible. During the same period, Florence Nightingale established the nursing profession.

The History of Magic

The origins of medicine and magic are entwined, much like the snakes on the caduceus, the staff of Hermes, which is closely associated with the rod of Asclepius.

In Greek mythology, Hermes, the messenger god, enjoyed fame for his ability to fly anywhere at the speed of thought. It also was believed that he escorted all who died to the edge of the River Styx, where recently departed “shades” would await Charon, the grim boatman, to ferry them across the river to the far shore of the underworld. Among his many attributes, Hermes also was the god of magic, and his magical staff had the power to confer life upon anyone he touched with it. Accordingly, the caduceus remains a symbol often associated with medicine and various medical practices.

The legacy of Hermes extends beyond Greek mythology and appears in early Egyptian writings, notably The Emerald Tablets of Thoth. This ancient text is regarded as the original source for Hermetic philosophy and alchemy. Hermes, known to the Egyptians as Thoth, was believed to be the author of the tablets.

Ancient priests also served as physicians, which connected Egyptian magic and medicine. Traditionally, the fundamental purpose of magic has been to create a change in the natural world through the control of supernatural forces, which are manipulated according to the will of a magician. It is easy to see how a physician’s will (intention) to effect a positive change in a patient’s health could be seen as corresponding to the role of a magician.

The history of magic may be divided into two great branches: ceremonial or ritual magic, and theatrical or stage magic.

Ritual Magic

Ceremonial magic, or ritual magic, is the kind of magic generally embraced by ancient peoples. It depends on incantations, rites, and practices intended to win the favor and influence of supernatural entities through the applied will of a magician. Due to limited understanding of natural laws, the perceived reality of magic, religion, and the earliest forms of science became intertwined, and the edges of one discipline often blurred into another. Nevertheless, an interest in ceremonial magic persists into contemporary life in the worlds of witchcraft, and ritual “magick” still is practiced by occult groups around the globe. In relatively modern times, figures such as Aleister Crowley (1875–1947) and Anton Szandor LaVey (1930–1997) emerged as prominent examples of ritual magic practitioners who captured considerable public interest during their lifetimes. It should be noted, however, that a general fear of the occult clouded the reputations of these figures, characterizing them as dark influences upon the world.

Stage Magic

Theatrical, or stage, magic is the kind of magic that most often comes to mind when people think of magic. It does not depend on supernatural entities or forces; it depends, rather, on the successful application of misdirection, sleight of hand, and various props that enable magicians to produce illusions of magical effects taking place before an audience, primarily for purposes of entertainment (and sometimes education). The publication in 1584 of The Discoverie of Witchcraft by Reginald Scot probably signals the beginning of theatrical magic and the decline of ceremonial magic in the public’s mind. Scot’s book exposed a number of well-known magical effects that had been viewed as demonstrations of genuine supernatural power. Scot’s exposé served, among other things, to counter the superstitious persecution of witches and street conjurers who otherwise meant no harm. To this day, magic on stage continues to fascinate the public, who have learned to grant magicians “the willing suspension of disbelief” in order to enjoy their magical performances. Throughout the 19th and 20th centuries, a number of performers enjoyed enormous theatrical success, notably Alexander Herrmann (1843-1896), Harry Kellar (1849-1922), Howard Thurston (1869-1936), and Harry Houdini (1874-1926). Among the most popular stage magicians working today are David Copperfield (b.1956), David Blaine (b. 1973) Lance Burton (b. 1960), and Jeff McBride (b. 1959).

In spite of the obvious differences between ceremonial magic and theatrical magic, there is still a common link: both types of magic are driven by the force of a magician’s will to accomplish the desired result. This, of course, distinguishes magic from coincidence and random occurrences in nature that may resist explanation.

What Can Contemporary Doctors Learn From Magicians?

Past

According to Haggard,5 mystery, magic, and medicine historically were one and the same. It is only in the past several hundred years that medicine became more scientific and separated from the realm of magic.

The ancient Egyptians combined medicine and magic several thousand years ago. Perhaps many of the ancient Egyptian medical practices were learned from the Hebrews, such as handwashing and circumcision. The ancient Hebrews made handwashing a ritual before and after toileting, several thousand years before the Viennese physician Semmelweis connected physician handwashing on maternity wards with the reduction of puerperal fever. Handwashing and daily hygiene also seem to have protected many Jews from contacting bubonic plague during the plague that ravaged Europe between 1546 and 1553. The death rate among Jews was only half that of Christians, quite possibly due to the sanitary and hygiene practices of Jewish law. Because the cause of the Black Death was unknown, some Christian religious fanatics in various communities in Europe circulated the rumor that the Jews had poisoned all the water wells of Europe so as to kill out all the Christians. These accusations led to many attacks against Jewish communities in Europe, resulting in the destruction of those communities.

Present

Today, physicians and magicians have very little in common, sharing only the desire to leave patients or audience in an improved condition. For example, the doctor strives to improve health or prevent further deterioration, whereas the magician’s goal is to raise the spectator’s spirits or instill a pleasurable sense of wonder and, at least for a moment, to suspend logic and believability. The magician wants the audience to believe that everything is possible and even physics and gravity can be changed, if only for a moment.6

Magicians use techniques to direct a spectator’s attention away from a particular area when the magician doesn’t want the spectator to see “the move” or the sleight that makes the trick effective. Magicians will spend many hours to hone their craft of misdirection.

I am not suggesting that doctors use deception or misdirection when treating a patient, but they do make use of subtle techniques when engaging a patient about a surgical procedure. For example, when a doctor is reviewing the benefits of a procedure, test, or surgery, he or she may look directly at the patient and speak in a confident manner. However, when the doctor is discussing the risks and complications of the procedure or test, the doctor may increase the tempo of the discussion, and move his gaze away from the patient. The doctor may not be aware that he or she is using the same subtle psychological technique that is used by magicians, but it has the same effect: it indicates that the important part of the discussion—that concerning the benefits of the procedure—has passed and that the current information is of secondary importance.6 Using this method, the doctor can direct or lead the patient to be certain he or she knows the advantages of the advice provided by the physician, and that the doctor disclosed all the negative and unlikely events that may occur.

Patients come to doctors to receive advice. The effective doctor imparts his or her opinion and advice and attempts to guide the patient toward the option that the doctor believes is best for the patient.

Both doctors and magicians must be very clear about their presentation to the patient or the audience. It has been noted that approximately 50% of the material that is given to a patient or family verballyis lost in just a few days.7 Likewise, a magic trick that is not clearly defined or presented well will be forgotten much sooner than the details of a medical discussion with a patient.

Healthcare has a similar challenge—the explanation of a disease, a treatment, or even the necessity of no treatment can have a powerful impact on the patient. It is no wonder today that more than 50% of patients don’t take their medication properly, and after one year 70% of patients will not refill their medications.8 This lack of compliance is partly the responsibility of the physician. For example, hypertension is usually a silent condition with no symptoms. It is difficult to get a patient to comply with medication when there are no symptoms. Even more difficult is getting the patient to lose weight or change lifestyle, again, with no symptoms of disease.

However, if the doctor is crystal clear about the condition and the outcome if the patient does not comply with the doctor’s recommendations, and then writes a prescription for a health club to increase the patient’s exercise, and also makes an appointment for the patient to see a nutritionist about weight loss, and then makes a follow-up appointment with a the goal that the patient lose five pounds in two weeks, there is a much greater chance of improvement in health style behaviors and compliance with medication.

Just like the magic show, where the memory of the effect persists long after the audience member leaves the show, the patient who receives a clear picture of the medical problem and a clear solution of what needs to take place is likely to have a better healthcare experience with his or her doctor.

Doctors and magicians need to be likable. It is true that having an MD after your name provides you with immediate credibility and status. Your patients are similar to an audience watching a magical performance—they (i.e., the audience and the patients) are rooting for you to succeed. Both “performers” are likeable. For the physician, likeability has even more advantages. If the doctor is likeable, the patient is more likely to retain more of the information conveyed by that doctor and may even be more compliant with their treatment. Physician likeability relaxes the patient and is likely to lead to more open discussions and enhance communication with the physician. One study showed that patients, including doctors as patients, prioritize bedside manner (likeability) over technical skills in choosing their doctor.9

One of us (NHB) often explains a procedure or a treatment multiple times each day, to many different patients. The message given to the last patient should be of the same level of communication and intensity as the first one at the beginning of the day. The same holds true for a magician, who performs the same effect over and over again and has to convince the audience that they are saying everything for the first time. In both situations, the audience and the patient should not be aware that the doctor/magician has given this “performance” on multiple occasions.

Bottom Line: Magic and medicine have been part of caring for patients since the beginning of recorded history. Although medicine is focused on maintaining the patient’s health and well-being, magic today is. In the final analysis, both magic and medicine can be seen to offer humanity a vital benefit—the gift of hope. Augmented by science and technology, modern medicine provides people with reliable evidence that chronic discomforts, disabilities, and diseases can be controlled or cured to a degree far beyond the expectations of the ancient world.

Correspondingly, contemporary magicians continue to provide demonstrations that allay the fears in our collective subconscious that supernatural forces cannot be controlled by the will of a skilled wizard. One of the most important ingredients of happiness in life is the ability to remain hopeful; and clearly, the “magic in medicine and the medicine in magic,” each in its own way, contribute to that end.

References

1.    Petrovska BP. Historical review of medicinal plants’ usage. Pharmacogn Rev. 2012;6(11): 1-5.

2.    Kelly K. History of Medicine. New York: Facts on File; 2009:29-50.

3.    Leena Gupta L, Silori CS, Nisha M, et al. Use of animals and animal products in traditional health care systems in District Kachchh, Gujarat. Indian Journal of Traditional Knowledge. 2003;2(1):346-356.

4.    Ergil KV. Unlocking the Mysteries of Health and Healing Through the Ages. Publications International Ltd; 1997

5.    Haggard H. Mystery, Magic, and Medicine. New York: Doubleday, Doran & Company; 1933.

6.    Sokol D. Medicine as performance: what can magicians teach doctors? J R Soc Med. 2008;101:443-446.

7.    Margolis RH. In one ear and out the other—what patients remember. Audiology Online. www.audiologyonline.com/articles/in-one-ear-and-out-1102.

8.    Zullig LL, Bosworth H. Engaging patients to optimize medication adherence. NEJM Catalyst. https://catalyst.nejm.org/optimize-patients-medication-adherence/.

9.   Klitzman R. When Doctors Become Patients. New York: Oxford University Press; 2007.