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Comparative Analysis Of The Dietetics Topic In Ancient Greece And Ancient Rome

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Dietetics are the study of food, food intake and food preparation. Dietetics has always been part of the culture of a society regardless in ancient or modern era. This leaves no exception for ancient Greek and Roman dietetics culture. Diet patterns and habits are shaped by attitudes a certain society hold – diet patterns and food handling methods were shaped by the socioeconomic factors in the two cultures. Approaches to food and drink, in return, are assimilated into a culture as an integrated component – this is potentially the reason for some ancient dietetics practice to still be use nowadays as it might have evolved and have formed the way we eat in the modern Western society. Due to historical and political reasons, ancient Greeks and Romans shared a great amount of similarity in their diets. The resemblance of food consumed between these two ancient societies informed modern readers about their common dietary structures: cereal (such as wheat and barley) was the main staple food, followed by large amount of fresh vegetables and fruits. Meat wasn’t uncommon but was not always readily available either.

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Other than dietary structures, more importantly, ancient Greeks and Romans held some common beliefs in utilising diet or dietotherapy as a mean to combat illnesses. However, there were views expressed by the conservative Romans, led by Cato the Elder, on employing diets as therapeutic treatments for the patients that diverged from the rest of the population. This marked the major difference in attitudes on the relationship between dietetics and medicine existing between Greeks and (some) Romans. Nevertheless, both ancient Greeks and ancient Romans recognise the significance of personalisation of dietetics approach in catering to an individual, a certain group and even a certain society. These topics are going to be addressed in this essay below.

Dietary patterns and food preservation practice in both ancient Greece and ancient Rome were shaped by socioeconomic influences. Diets amongst the rich and poor were different in ancient Greece and Rome. In fact, this pattern still exists in our diet culture in modern days. Diets in ancient Greece was influenced by the level of wealth of individuals as difference in wealth stratified “personal opportunities and preferences” amongst groups in the society. Aristophanes, a comic playwright in ancient Athens, described the situation and commented on the different lifestyles lived by “hardworking olive pickers” and “a sybarite”. The latter was said to be “living in the midst of hare and creamy puddings”. From his words, it is learned that food available to and consumed by the rich differed to a great extent to that of the poor. This dietary difference between the rich and poor was also seen in ancient Rome. As mentioned in the book Food as Therapy, the author Cacciafoco provided a detailed account of food eaten by the poor in daily life. The poor relied on puls, porridges made from cereals, since the porridges were “such simple and economic dishes for survival”. Occasionally there would be vegetables and meat but only “if (they were) available”. Whereas for the wealthy population in ancient Rome, each meal was extravagantly divided into “three courses”. The first course was known as gustatio/promulsis, or more commonly known to the modern population as the appetiser. Ingredients for the appetiser ranged from “eggs, fish, shellfish and raw vegetables”. The main course, or prima mensa, was often made from “cooked meat and vegetables”. Desserts were called secunda mensa, which mainly consisted of “sweet pastries or fruits”. Comparing the three meals course structure of the rich with the diet of the poor, who could barely afford to consume anything other than cereal as staple food, a vast difference in their dietary patterns was observed. In fact, in ancient Rome, not only the dietary patterns differed between the wealth and the poor, eating habits of the rich also distinguished themselves from the lower class. The wealthy was said to “reclined on couches at dinner parties” while eating or “ate outside in gardens, with the weather permitted”. On one side, judging from the examples, socioeconomic factors of the population in these two societies had major impact on people’s approaches to dietetics.

On the other side, some dietetic practices in ancient times shared by both ancient Greece3 and Rome2 population contributed to the evolution and formation of food we consume today. Take food preservation as an example – Fish was a universally enjoyed across the two ancient cultures, despite it being more abundance and available in Greece than in Rome. Fish oil was once the major source of vitamin A and D for ancient Greeks while despite “its close proximity to the sea” Rome didn’t have a “ready supply”. Food preservation was difficult in ancient times for perishable seafood. However, seen from its popularity in ancient Greece and its scarcity in ancient Rome, fish ought to be preserved for the population’s taste. Therefore, in ancient Rome, if these sea products were not “shipped live to their destination”, they were preserved through a series of repetitive “salting, pickling, smoking and drying processes”. Milk was also had a similar issue thus was often made into cheese through “pickling in brine or vinegar or salting or smoking”. Likewise, in ancient Greece, fish preservation was also achieved by “salting and pickling” according to Craik in Diet, diaeta, and dietetics. Food treated through methods mentioned above not only enabled a long-term preservation in ancient times but also brought excellent flavours to the dining tables. As a result, many dietetics practice in these two ancient cultures contribute to the formation of our modern diet in many Western countries nowadays – ancient Rome diets were said to have formed “the basis of some Italian favourites” while ancient Greek diets were described to have reflected “the Mediterranean triad”.

Connection between dietetics, health was recognised and the integration of dietetics into treatment for illness was commonly observed in ancient Rome and ancient Greece. Various literature sources have shown the inseparable relationship between dietetics and medicine in ancient Greece. The most significant literature collection reflecting this connection is the Hippocratic Corpus. The Greek word for diet (diaita) appeared rather late in the Greek language but was mentioned more than 200 times in the Hippocratic Corpus, showing an important role diet regimes played in the process of healing patients’ illness and restoring health in ancient Greek culture. The close relationship between diet and health in ancient Greek was potential a result of physicians’ strong belief in the ideology of four elements and four humours. It was believed in ancient Greek medicine that the cosmos was made from fire, water, earth and air associated with four qualities of warm, damp, dry and cold. To achieve the balance of four humours, exist within human bodies, namely, blood, phlegm, yellow bile and black bile, physicians should utilise food taken from nature with different qualities associated with the four elements to restore the equilibrium between the four humours. Diet was valued so much in ancient Greek medicine that food used to be prescribed as therapeutic means to treat diseases of patients and eventually the that led to the concept of dietotherapy.

Similarly, in ancient Roman culture, the same ideology about the four elements, four qualities and four humours applied thanks to Galen of Pergamon, who was an admirer of Hippocrates himself. Galen contributed to the spread of Greek medical practice to ancient Rome particularly the theory on balance or disturbance the four humours through a therapeutic diet or a faulty diet respectively. Diet was recognised by many physicians, not just Galen, as the first line treatment for illnesses in ancient Rome. According to Scribonius Largus, a court physician to Emperor Claudius, “stages of medical care follows: first came diet, then drugs and finally either cautery or surgery”. This reveals the central position diet stood in the treatment regimens employed by ancient Roman physicians influenced by medical theory from ancient Greece. Other than the belief in the four elements and four humours, there are a few other reasons that motivated these ancient Greek and Roman physicians to utilise diet as their first line treatment other than surgery. These reasons include general public’s fear for invasive procedures and as well as their desire to gain control of their health through practice of therapeutic diet. The most interesting reason, however, had to do with a correlation between performing surgeries and low social status of the physicians – in ancient Rome especially, surgeries were considered dirty labour work thus were often performed by apprentices. Therefore, in order to maintain a prestige reputation, physicians, including Galen, would often start treating their patients with diets in order to avoid complications which require surgeries later. Sounding very counterintuitive today, it explains the reason for physicians’ in ancient times to favour dietetics compared to other treatments, which is another common theme in ancient Rome and ancient Greece.

However, conservative Romans, including Cato the Elder, considered diet or the broader concept of diaita as part of self-care rather than treatments prescribed by doctors. Cato had a conservative political view opposing Hellenisation and this was seen also from his view towards diet and health in ancient Rome. Interestingly, he not only disliked the influence of ancient Greece, but he had a general disapproval for doctors as he considered doctors “generally less trustworthy”. His attitude was reflected by his words, “when that race (Greeks) gives us its literature it will corrupt all things, and even more if it sends hither its physicians”. This attitude in fact was not only held by Cato but many other conservative Romans. Because of his rejection to the Greece and to doctors, Cato promoted traditional practice and was said to be “consciously harking back to traditions that had largely disappear”. He favoured traditional dietetics regimens since they were “based on a natural way of living”. He also believed more in the notion of “self-help” which had “kept him and his family in good health” with the dietetic regimen he practiced on himself and his family. Ancient Greek and Roman doctors recognised the importance of individualising dietetics as a therapeutic treatment to their patient by not only assessing the people but considering the broader context of the environments. As discussed previously, dietetics or dietotherapy in ancient Greek and Roman cultures by doctors to promote or restore health.

Another important aspect of dietotherapy shared across the two cultures was the recognition of the importance of personalisation of the dietetic treatment for their patients. Personalised treatment is a goal practitioners aim for in today’s medical practice but surprisingly, it had already been addressed even back in ancient times. In ancient Greece, according to the author of a medical treatise De vitus ratione in morbis acutis, it was recommended that physicians first assess the specific conditions the individual patients were in, including their “metabole” (change), their “physis” (nature of patients) and their “hexis” (habit). It was recommended that the diet prescribed to the patients shouldn’t cause them to deviate to far form their normal eating habits. Mentioned by Jouanna in Dietetics in Hippocratic Medicine: Definition, Main Problems, Discussion, ancient Greek medical practice indicated that “the dietary provision of patients” should include “no addition or subtraction made that clashes with their habits”. Even with health individuals who were not suffering from illness, “it is better to preserve an unhealthy diet than bring about a rapid change to a better one”. This means that doctors in ancient Greece were encouraged to follow the same eating habits of patients when prescribing an ideal dietary treatment that tailored to these individual patients. Moreover, in many ancient Greek medical literature, a holistic approach advised doctors to consider not only the eating habits of patients, but also their surrounding environments such as seasons (as qualities of certain food in diets should counteract the qualities of a particular season to maintain a balance of the four humours), local conditions as well as the health and physical nature of patients (whether patients were in good health or in sickness). This approach integrated factors influencing the lifestyles of and temperaments of patients. This multi-dimensional approach was in fact reflected from the hidden meaning behind the Greek word diet (diaita) – the word diaita in ancient Greek medical literature has a broader meaning than the concept we understand today about diet or dietetics. The word diaita correlates more with the mode of life of patients as a whole rather than simply focusing on the food and drink aspect of diet. It takes into account exercise, bathing and sexual relationship as well as other aspects of patients’ life. Likewise, in ancient Rome, doctors were aware of the danger of blindly applying universal dietary regimens to patients without careful consideration of individual and environmental factors. Lucretius, an ancient Roman poet and philosopher, recognised that “every health measure and dietetic regime should be adapted for the individual” as “what was correct for one could be poison for another”. This common ground of knowledge about individualisation of diets to the population was shared across the two cultures, again, was possibly attributed to the heavy influence ancient Greek dietary culture had on ancient Rome. However, issues arose when attempts were made to adapt the “elitist Greek diaita” to the Roman population who were “subjected to the demands of ‘negotium’ and the requirement of ‘vita activa’”. Despite seeming like a conflict in cultural cross-over, the concern ancient Romans had about the compatibility of ancient Greek diaita to their daily life in fact revealed their attitude promoting “suitableness” and “uniqueness” of diets, which was similar to that of the ancient Greeks.

In conclusion, by comparing and contrasting between the attitudes and approaches to the topic of dietetics in ancient Greece and ancient Rome, it was understood that there was some major similarity between the dietary structures, dietary patterns, and dietary habits between the two societies. Historical and political causes were possibly the major contributors to their resemblance. Both ancient Greece and ancient Rome had a plant-based diet based on cereal as staple food accompanied by fresh vegetables and fruits and occasionally with some meat. This type of diet reflects some characteristics of the Mediterranean diet and the Italian cuisine respectively. Exploration of dietetic practice in ancient Greece and ancient Rome revealed some common beliefs on the relationship diets played in maintaining health as either targeting medical treatments or self-help methods to promote or restore balance of the “four humours”. Both ancient Greeks and ancient Romans acknowledged the significance of taking the holistic approach in assessing individual nature as well as considering seasonal, geographical factors when discussing dietetics.

18 May 2020

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