Aretaeus of Cappadocia

Aretaeus (Greek: Ἀρεταῖος) is one of the most celebrated of the ancient Greek physicians, of whose life, however, few particulars are known. He presumably was a native or at least a citizen of Cappadocia, a Roman province in Asia Minor, and most likely lived around first century CE. He is generally styled “the Cappadocian” (Καππάδοξ).

Aretaeus wrote in Ionic Greek a general treatise on diseases, which is still extant. The valuable book displays great accuracy in the detail of symptoms, and in seizing the diagnostic character of diseases. In his practice he followed for the most part the method of Hippocrates, but he paid less attention to what have been styled “the natural actions” of the system; and, contrary to the practice of the Father of Medicine, he did not hesitate to attempt to counteract them, when they appeared to him to be injurious.

Aretaeus offered clinical descriptions of a number of diseases among which he gave classic accounts of asthmaepilepsypneumoniatetanusuterus cancer and different kinds of insanity. He differentiated nervous diseases and mental disorders and described hysteriaheadachesmania and melancholia. He wrote the first known description of Celiac Disease, naming it disease of the abdomen, koiliakos.

The account which Aretaeus gives of his treatment of various diseases indicates a simple and sagacious system, and one of more energy than that of the professed Methodici. Thus he freely administered active purgatives; he did not object to narcotics; he was much less averse to bleeding; and upon the whole his Materia Medica was both ample and efficient.

It may be asserted generally that there are few of the ancient physicians, since the time of Hippocrates, who appears to have been less biased by attachment to any peculiar set of opinions, and whose account of the phenomena and treatment of disease has better stood the test of subsequent experience. Aretaeus is placed by some writers among the Pneumatici because he maintained the doctrines which are peculiar to this sect; other systematic writers, however, think that he is better entitled to be placed with the Eclectics.

After his death he was entirely forgotten until 1552, when two of his manuscripts, “On the Causes and Indications of Acute and Chronic Diseases” and “On the Treatment of Acute and Chronic Diseases”, both written in the Ionic Greek dialect, were discovered and published in a Latin translation in Venice in AD 1554. These works not only include model descriptions of pleurisy, diphtheriatetanus, pneumonia, asthma, and epilepsy but also show that he was the first to distinguish between spinal and cerebral paralyses. He gave diabetes its name (from the Greek word for “siphon,” indicative of the diabetic’s intense thirst and excessive emission of fluids) and rendered the earliest clear account of that disease now known.

Of diabetes he wrote:

“Diabetes is … not very frequent … being a melting down of the flesh and limbs into urine … for the patients never stop making water, but the flow is incessant, as if from the opening of aqueducts. It consists in the flesh and bones running together into the urine … the illness develop very slowly. The nature of the disease is chronic, and it takes a long period to form; but the patient does not live long once the disease is fully established; for the melting is rapid, the death speedy. Moreover life is disgusting and painful; thirst, unquenchable … and one cannot stop them either from drinking or making water”.

The origin of the name is explained as follows:

“The disease appears to me to have got the name of diabetes, as if from the Greek word διαβήτης (which signifies a siphon) because the fluid does not remain in the body, but uses the man’s body as a ladder (διαβάθρη) whereby to leave it”

Dr Marios Pedonomou MD, MSc, PhD
Laparoscopic and Bariatric Surgery