SAINT APOLLONIA: BETWEEN PAGANISM AND CHRISTIANITY IN MEDICINE

Abstract

The history of medicine and dentistry shows that dental medicine is entitled to take upon itself, as representative elements of the field, symbols or spiritual protectors, religious (either Christian or pagan) archetypes from different historical periods. These paved the way for the elaboration of a long-lasting set of professional and ethical criteria that ennoble today the dental profession. This present study analyzes some of the symbols of historical- religious nature, stressing their cultural impact and the manner in which such symbols are interpreted in various scientific, medical, theological, artistic contexts and, last but not least, in the general social perception. The professional ethical domain of dentistry makes use of numerous symbols with religious connotation, the more so that this branch of medicine and the various religions have numerous elements in common. Either stylistically, or appearing as products of folk culture, the main symbolistic or legendary references specific to dental culture are the legend of Cadmus and the canonization of Saint Apollonia, the champion of dentists and of those suffering from toothache.

Headnote

Abstract

The history of medicine and dentistry shows that dental medicine is entitled to take upon itself, as representative elements of the field, symbols or spiritual protectors, religious (either Christian or pagan) archetypes from different historical periods. These paved the way for the elaboration of a long-lasting set of prof essional and ethical criteria that ennoble today the dental profession. The present study analyzes some of the symbols of historical-religious nature, stressing their cultural impact and the manner in which such symbols are interpreted in various scientific, medical, theological, artistic contexts and, last but not least, in the general social perception. The professional ethical domain of dentistry makes use of numerous symbols with religious connotation, the more so that this branch of medicine and the various religions have numerous elements in common. Either stylistically, or appearing as products of folk culture, the main symbolistic or legendary references specific to dental culture are the legend of Cadmus and the canonization of Saint Apollonia, the champion of dentists and of those suffering from toothache. Such symbols give to the representatives of this profession a feeling of belonging to a noble medical domain; they also decode and facilitate communication with patients, therefore being outflanked by the idea that awareness on the existence of such religious symbols and on their practical cohesion is especially helpful.

Keywords: symbol, dentistry, Saint Apollon in

1. INTRODUCTION

Along the historical evolution of various civilizations, science has been gradually accepted as a legitimate, part and parcel component of each culture. If, initially, science was only coexisting with abstract cultural entities - such as spirituality or magic - in time it came to be grasped as an autonomous cultural domain, substantiated by its own system of laws, axiomes or theories, viewed as scientific principles and, consequently, separated from and independent on the spiritual sphere. The same holds true for the medical science. Nevertheless, a global view on the history of medicine - generally, and of dentistry, especially - will reveal some common historiographic lines of medicine versus spirituality. This common evolution is especially traceable today in cultural areas in which spirituality, esoteric doctrines and science are equally accepted and highly valued, the more so that all these spheres of human knowledge have a common objective, namely to search for and disclose the essential existentialistic truth [1]. Paradoxically, in our days, such a unitar}' finality in the domain of medicine gives credit to a phenomenon defined in the literature of the field as over-romanticism, by virtue of which patients need and require more and more substantial spiritual, psychological and personal support - actually, a basic concept in Chinese medicine, having survived and still active for more than 4,000 years, in full agreement with and strict observation of the religious concepts [1, 2]. Unlike the Western medical world, recognized as taking distance, for quite long periods of time, from religion and spirituality, different other cultures (such as Ayurveda or Buddhism) have always and necessarily developed the religious principle of the inseparable body-soul communion, an idea ultimately recognized by World Health Organization [3].

Dentistry itself is characterized by a history deeply interconnected with multiple religious, Christian as well as pagan (polyteistic) beliefs. Highly actual contemporary topics evidenced - as early as the Antiquity - deep connections between dentistry and religion - for example, certain aspects of dental aesthetics were viewed as stigmats of a certain religious affiliation, sometimes proof of divine veneration, requiring even dento-facial mutilations [4]. Later on, mediaeval historiography provided important evidence on the fact that dentists were hierarchically subordinated to the authority of a church representative (archbishop) [5]; there results from here that, along the modern and contemporary history, dental profession is entitled to take upon itself, as representative symbols or spiritual protectors, religious (either Christian or pagan) archetypes from different historical periods, which paved the way for the elaboration of a long-lasting set of professional and ethical criteria [6]. This explains the establishment of a symbolistic system with ancient origins, having accompanied the interweaved evolution of religion and dentistry. In our times, all these symbols appear as cultural landmarks not only for the representatives of dental profession but also for all patients and for the society, at general level.

The present study will analyze some of the symbols of historical-religious nature, stress being laid on their cultural impact and manner in which such symbols are interpreted in various scientific, medical, theological, artistic contexts and, last but not least, in the general social perception. Structurally, the study opens with the definition of certain concepts of professionalism in dentistry, continues with an analyitical presentation of some religious prorotypes with symbolic value in stomatology, the last part being devoted to a series of operational, religious and spiritual concepts active in dental practice. Methodologically, the investigation proposes a heterogeneous, multidisciplinary bibliographical and critical reference system, including equally biomedical sciences, theology and arts. In the end of the study, several conclusive aspects are discussed, for evidencing the need of a better and more subtle understanding and interpretation, with shades of difference, from the part of the academic medical community, as well as of the society, in general, of the symbols embodying the ethical principles of a century-old biomedical profession.

2. PROFESSION AND PROFESSIONALISM IN DENTAL CARE

A correct definition of some cultural aspects with symbolic value, characterizing biomedical sciences, first requires elaboration of precise coordinates for defining the concepts of profession and professionalism, with special reference to dentistry. In the opinion of the authors, this is especially important, as the various symbolic values of different cultural elements are based on ethical and philosophical principles specific to a certain profession and to a certain professional(ism) background.

Accordingly, the notion of profession defines a vocation requiring knowledge on some department of learning or science, or a body of persons engaged in an occupation or calling; as a result, the notion of professionalism involves professional spirit, character or method [7]. Therefore, the definition of the here discussed concepts brings together the existence (i) of some scientific knowledge or theories, (ii) of a body of persons (iii) and of some - ethical, philosophical - principles on which exercising of the respective profession is based.

Secondly, by the practical activity it develops, profession involves, on one side, a certain contact with the beneficiary for whom it is performed, dependent on the power relation it assumes (of subordination type, similar to a fiduciary relation) [8], assimilated to a promise whose visible effect is modification of the moral and intellectual attributes [9]. One may therefore observe how, between the professional body and the population benefiting from its work, an exchange of professional principles of ethical nature occurs, the professional symbols being thus transformed into operational concepts available to the whole society. However, professional ethics represents a branch of the much more vast domain of professional philosophy, studying the resources of justice and professional equity according to Plato's model. Since ancient times (XIIIth century, T. Aquinas in Summa theologica), the idea of righteousness has been viewed by philosophers as preexistent to religion, so that the deduction may be made that it is exactly religion the one that may transform the fundamental ethical values into generally accessible symbols, part of them having exclusively and specifically professional roots.

The professional ethical domain of dentistry makes use of numerous symbols with religious connotation, the more so that, as evidenced in the introduction paragraph, this branch of medicine and the various religions have numerous common elements. In this respect, one should not forget that, in Great Britain, for example, the Anglican Archepiscopate of Canterbury has been the institution which, along the history, provided the licences of dental practice, a situation which, even if now - legally - has fallen into disuse, formally it is still valid [5,10]. Usually, for getting a licence, the dentist had to obtain professional recommendations from the clergy representatives, after which it was the Church, once again, the institution in charge of registering the quota of patients, which actually represents the first official data bases recorded in the field of dentistry [5].

All these considerations evidence the common points between stomatological practice and the various church authorities along the history. Apparently, such relations are merely and basically of admistrative nature, the more so that, generally, the history of medicine used to situate the doctor and the clergyman on antagonistic positions, as to their beliefs and ontological principles, which implanted the myth of the skceptical physician, interested exclusively in science; nevertheless, at least principiallv, medical ethics is based on numerous norms with religious character, the roots of which are to be found in the permanent contact with human suffering [11]. The doctor is entirely devoted to his mission, learning professionalism during his soothing actions on the sufferers, helping them with all his mights, practising of his profession being expected to observe, at least symbolically, the virtues of Christian charity.

3. SYMBOLS AND LEGENDS OF THE DENTAL CULTURE

Along the history of (general, as well as dental) medicine, folk culture attributed to the doctor, to his professional activity or to the malady, in general, a series of symbols and legends bearing a strong religious connotation, of either Christian, antique, pagan or polytheistic nature. To begin with, it is to be considered that a definition of the terms symbol and legend should be provided. Consequently, a symbol expresses a thing conventionally regarded as typifying, representing, or recalling something, especially an idea or quality, while the notion of legend (myth) includes a sum of popular beliefs, traditional stories popularly regarded as historical but unauthenticated [12].

By the deep persistence of the existentialistic connotations they reveal, both legends and, generally, symbols, are somehow related with the concepts of continuity, identity, tradition or collectivity, thus defining values with a special spiritual significance. When these values belong to a professional (written or custom) ethical code, such symbols and legends come to characterize a professional culture. Acting either stylistically, according to the principle of metonymy, or appearing as products of folk culture, the main symbolistic or legendary references specific to dental culture are: the legend of Cadmus, canonization of Saint Apollonia, the champion of dentists and protector of dental patients, or the elephant fangs characteristic to the Sanskrite and Hindoo medical cultures [6].

As an archetype, the legend of Cadmus springs from the myth of Aesculapius, the son of Apollo, whose name was given to the city of Apollonia, the place where Cesar died during a pest which Therein, presenting himself as a healing snake, thus giving rise to the well-known international Aesculapian symbol of the struggle against diseases; the same emblem of a serpent-dragon appears, too, in the legend of Cadmus [13], the brother of Europe raped by Zeus, who, during his wanderings in search of the lost sister, arrives at the Oracle of Delphi, where he is asked to build up a town on the territory of a terrifying dragon with monstruous fangs. Cadmus kills the dragon with his sword and thrusts his fangs into the earth, thus establishing the antic city of Theba, the cradle of valliant warriors [14]. The fangs of the Boeotian Dragon, defeated by the sword of Cadmus, appear nowadays as a metonymic symbol of pagan mithological origin, simbolizing dentistry - especially in the AngloSaxon world (Figure 1) [6].

Much better known in the universal stomatological culture is the symbol of Saint Apollonia, canonized as the patron of dentists and champion of people suffering from dental diseases. Like Saint Lucia, protector of ophtalmological patients, Saint Sebastian - defender against pestilential maladies, Saint Remy - protector against fever, Saint Gall - fighter against tumours, Saint Valentine - known as having cured epilepsy, or Saint Margaret, champion of pregnant women, Saint Apollonia, by the horrible, historically acknowledged martyrdrom she suffered, is now unanimoulsy recognized as the religious symbol of dentistry [15, 16].

The historical-religious stories on the life of Saint Apollonia date around 249 A.D., when the great persecutions of Christians were in course in Alexandria; among the sacrified ones was Apollonia who, after a period spent in prison, was tortured, her teeth being torn out and her jaws fractured, the martyrdrom ending with her burning at the stake, as final punishment for her having not given up Christian faith; in the year 300 A.D., she was canonized, and since then she has been considered as the protector againts dental ache, her cult including icons, pictures, sculptures, poems and tellings [17]. In his Ecclesiastic History, the Greek poet Eusebius tells us the following story about Saint Apollonia: "They then seized the very marvellous virgin, an old lady, Apollonis, and they beat her jaws knocking out all her teeth, and heaping up a pyre in front of the city, they threatened to burn her alive if she should not join them in speaking declarations of infamy. But she begged off a little, and on being released eagerly leaped into the fire and was consumed" [18].

Even if, in the historical medical literature, the legends and myths on Saint Apollonia usually have a high versatility and historiographical variability (if considering the existence of a series of historical sources supporting them, alongwith a considerably higher number of folklore variants of the main legend), in our days, parts of her body remainings are worshipped in numerous Christian churches from both Europe and North America, such as Santa Maria Basifica, San Basilio Basilica of Rome or the Church of Saint Anne de Beaupre, in Quelle [19]. Part of Saint Apollonia's teeth are now preserved in various European cities, such as Naples, Antwerpen, Brussels, Milan, Liege, Köln or Rah (Figure 2) [19, 20].

Saint Apollonia is celebrated on February 9, a day in which, in numerous cathedrals and Christian churches, religious feasts are organized; however, the most famous and oldest celebration of Saint Apollonia (initiated as early as the IXth century) is the procession of her relics in the Belgian town of Tournai, each first Sunday of September [20,21]. One of the symbols bearing a special Christian spiritual message is the Prayer to Saint Apollonia: "O, Glorious Apollonia, patron saint of dentistry and refuge to all those suffering from diseases of the teeth, I consecrate myself to thee, beseeching thee to number me among thy clients. Assist me by your intercession with God in my daily work and intercede with Him to obtain for me a happy death. Pray that my heart like thine may be inflamed with the love of Jesus and Mary, through Christ our Lord. Amen. O My God, bring me safe through temptation and strenghten me as thou didst our own patron Apollonia, through Christ our Lord. Amen" [16].

A hermeneutical analysis of the text of the prayer would go beyond the scope of the present investigation, yet no one should deny the significant contribution brought - due to its historical and theological connotations - by the legend of Saint Apollonia to the domain of arts. The iconography of the saint is especially present in painting, one of the most famous works being that of the Spanish painter Francisco Zurbarán (1598-1664) (Figure 3). A brilliant representative of the golden age of Spanish painting, Francisco Zurbarán, contemporary of Velázquez, Ribera or Murillo, all obviously and openly influenced by El Greco, is reputed for his propensity for religious painting, with ascetic connotations, his preference for the monachal monk orders, his characters being consumed by belief, introspection, introversion, pasivity and divine contemplation [17].

Among the other painters known for having portrayed Saint Apollonia, mention should be made of Ercole de Roberti, Albrecht Dürer, Peter Paul Rubens or Jean Fouquet, the latter one famous for having painted the martyrdrom of Saint Apollonia (Figure 4) [16, 22, 23].

Important portrayals of Saint Apollonia may be also found in philately (Figure 5) [24], and especially in the Christian iconography. In this respect, special mention should be made of the iconographie treasures of St. Chaterine Academic Cathedral of Zagreb, and of St. Catherine Church of Vodnjan, Croatia. According to literature data [25], St. Catherine Academic Cathedral of Zagreb holds a chapel and an altar dedicated to Saint Apollonia, adorned with paintings and sculptures created - in the first case - in the years 1674-1675, while the latter location shelters icons of the saint painted in the XIVth century (Figures 6 and 7).

Numerous representations of Saint Apollonia may be admired in several churches of Great Britain [26]. Evocations of the dental ache she suffered, explaining her champion myth and still of interest in our times in the folk culture, are due to the movie industry - e.g., the screenings Little Shop of Horrors, Marathon Man or The Dentist [27].

All these considerations show the special place occupied by Saint Apollonia in the artistic domain, particularly in visual arts. A possible explanation of such preference is related to the myths on her life, her martyr dr om, to the special interest manifested by researchers in the history of medicine and, generally, of art, and equally to the fact that she is universally acknowledged as the patron of a medical profession with a peculiar social and scientific visibility. Along the history - as actually demonstrated by the already cited bibliographical references -, intense researches have been devoted to various historical, theological or artistic aspects in the fife of Saint Apollonia, which brought a valuable and rich scientific contribution to the history of dentistry.

A systematic review of the iconographie traits and of the artistic values of the works depicting Saint Apollonia - no matter how challenging would it be - is beyond the scope of the present study. According to the authors, especially important to outline is the fact that - as a professional body - dentistry is characterized by extremely rich symbolic connotations, perceptible by both their spiritual and artistic aspects, and by full recognoscibility in the popular culture. The martyrdom of Saint Apollonia inspired both the artistic and the scientific world, while the loftiness of her Christian virtues remains an example for the dental professional ethics.

4. PATTERNS OF RELIGIOSITY AND SPIRITUALITY IN DENTAL MEDICINE

A review of the either Christian or pagan symbols discussed in the preceding section demonstrates, beyond any doubt, the existence of certain patterns of religiosity and spirituality related to the dental profession. Religiosity is sensed as devotion and belief in a superhuman power entitled to obedience and worship [12], while the concept of spirituality refers to the belief pertaining to the incorporeal, to the soul [7]. In all cases, the religious aspects of the relation between the doctor and his patients are transmitting spiritual values characteristic to the profession of dentistry.

Quite visible is the fact that, in the modern epoch, medicine is becoming more and more secular; in our days, the interdependence between chinch and medicine is wholly different from that of the mediaeval or Renaissance models. Fortunately, this new situation does not exclude confessional affiliation, the deep faith of the physician who, like Doctor Juvenal Urbino from the famous Love in the Time of Cholera of GarciaMarquez, is capable of enriching the doctorpatient relation with subtle, not at all superannuated spiritual values. More than that, in an epoch in which new, still unknown or incompletely elucidated diseases are emerging, many patients need and require spiritual support for facing their health problems. The religious symbols of medicine facilitate this task, attenuating the skepticism which might sometimes alter the doctor-patient cooperation.

Equally important is the more and more frequently manifested tendency of the biomedical investigations of stressing the value of the associations between health condition or health behavior and religion or confessional behavior [28-31]. Religiosity has been recognized as a protecting element in various affections, such as dental caries or periodontites, as well as general chronic diseases [28, 29]. Either influencing wellbeing at psychological level, or representing a refuge and contemplation in certain stressing and vulnerable situations produced in the life of the patient, religiosity, spirituality and social support have a major impact upon the general and oral health condition of patients [28, 30].

Extremely interesting is to accept that the spiritual and cultural element is a key factor of the oral health condition in pediatric population [31]. The cultural values - the spiritual-religious ones included - influence the oral health status of children at both personal, and family and community level. Child's contact with the stomatologist may be favoured by some symbols known in the family, which helps the little patient to better understand certain medical aspects. In such cases, religion may play an important part, as children are accustomed from early childhood with the concept of God, angels, biblical stories, saints, etc.

5. CONCLUSIONS

Similarly with the other scientific biomedical branches, dentistry is extremely present in the general popular culture, due to its special impact upon people. The scientific terms of dental medicine, as well as its professional body, explain the complexity of dentistry, recognized by the historians of medicine since ancient times. That is why, the dental practitioner should learn how to become a professional, a position involving a complex and continuous effort, a full understanding of the specific ethical principles and a permanent availability for the challenges of the profession. According to dental ethics, practitioners should be especially sensible to the moral and spiritual aspects of dental practice, and also to their professional life. Deontological analysis and the principles of the doctor-patient relation represent vital aspects in the professional life of any dentist, expected to manifest the moral and legal responsibility permitting him to recognize and appreciate the spiritual values of his patients, and to adapt his medical work to their principles and standards.

Therefore, religiosity and spirituality are inherently related to the professional life and practice of dental medicine. Unlike other domains of activity, dentistry particularizes and puts into evidence its scientific and professional values by a multitude of extremely versatile - as to their social perception - symbols. On one hand, such symbols give to the representatives of this profession a feeling of belonging to a noble medical domain and, on the other, they decode and facilitate their communication with the patients - which brings us to the very scope of the present study, namely of outlining that awareness on the existence of such religious symbols and on their practical cohesion is especially helpful.

The paper, aiming at a systematic presentation of some of the elements with singular symbolic religious value, was elaborated on the basis of an ample bibliographic apparatus, bringing together research aspects of scientific, biomedical, as well as historical, artistic and theological nature. This approach enriched the information provided and improved analysis. Therefore, in the here presented case, symbolism occurs at the border between science and theology, its analysis highlighting once again singular ethical, social and historical-medical data.

References

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