California 2023 (p/b) 446pp £34 (ISBN 9780520299726)
The authors identify many good reasons why we should study the history of medicine. Modern values and ethics are rooted in past practices; ancients devised non-invasive ways of diagnosing illnesses and reading signs and symptoms from outside the body which are as important now as they were then; so too is the practice of taking careful clinical notes; and ancients had much to say about the importance of the ‘bedside manner’.
Again, we can learn from the way in which medical practices have changed over the millennia. The Hippocratic oath, for example, is important for its demand for confidentiality in relation to the patient’s treatment and the life of the household. Further, some ancient practices—e.g. examining stool samples—have been adopted in the light of modern understanding. Equally, studying ancient practices can re-focus minds on modern ones, e.g. the ancients emphasised the vital human element in doctor-patient relations. Our socio-cultural milieu too is very different from that of the ancients, but the prejudices, practices and priorities that we see in the past can alert us to the impact of our own. Finally, historical records reveal a multitude of different ways in which doctors talked about, observed and responded to their patients. Contact with such a variety of ancient practices and diversity of patients makes us more aware of the importance of dealing with such problems in our own world.
This sourcebook provides a huge range of resources, from letters and paintings to medicinal recipes and physical remains, relating not to the intricate, technical details of the various different schools of ancient medicine (though different approaches are discussed) but to the work of their most important practitioners (including those dealing in magical and religious healing) and how the development of evidence-based medicine (that is, what the ancient took to be evidence: it is the principle that counts) informed the health and healthcare of the patients.
So we read e.g. of the experience of the sick, the criticisms of their treatment and the effect of their physical surroundings on their health, as well as the results of research into health and diet revealed by e.g. isotopic analysis of bones. But the main emphasis is on the humanistic side of medicine: ‘the experiences, practices, decisions, challenges, and complications listed by healthcare professionals and by sick and suffering people’.
The authors are also careful not to confuse the ancient with the modern. For example, the Greek nosos and Latin morbus, usually translated as ‘disease’, often refer to e.g. illness, sickness, ailments, and injuries, while ‘disease’ in modern terminology refers to specific long-term conditions, a category which ancient medicine did not recognize: so the two terms are left untranslated.
After a general chronological overview of Greek and Roman medicine and a discussion of living conditions in the ancient Mediterranean—the scope and clarity of this overview are exemplary—the chapters cover how the ancients imagined the relationship between human health and the cosmos; the emergence of professional definitions of health and illness; the doctors’ diagnostic protocols; case notes and case histories; common complaints; common treatments; the training and status of doctors; the perspectives of the sick and suffering; ethical principles and professional conduct; the stages of life; and the various healing sites across the Mediterranean.
Each of these chapters is introduced by an instructive overview of the topic, followed by well-chosen extracts from an impressive range of original sources relevant to the subject in hand. For example, the chapter on ‘Common Complaints’ contains passages from Hippocrates on diseases of women, and Metrodora on the conditions of the womb; on digestive and intestinal ailments from Caelius Aurelianus’ Chronic Conditions, wounds and fractures from Celsus’ On Medicine, Nikander on bites and stings, Galen and Paul of Aegina on eye conditions, Celsus on fevers, Hippocrates (On the Sacred Illness i.e. epilepsy) on mental and emotional afflictions (‘People must know that our pleasures, joys, laughter, and jokes, arise only from inside the brain, and that the brain is also the source of griefs, sorrows, anxieties, and weeping), and Thucydides and Procopius on epidemics.
One could quote endlessly from the range of well-translated sources on display. I have always enjoyed Cato’s assertion that cabbage is the ultimate panacea, eaten cooked, or if raw, dressed with vinegar, and recommended for consumption if you wish to get drunk at a party. Boiled up and consumed it will purge the body, and it acts as a cure for various sicknesses, colic, painful urination, wounds, sores, dislocations, joint injuries, and insomnia and senility (fried in hot fat with a little salt). The urine of cabbage eaters is also effective for dealing with eye disease, head and neck pain, and certain female problems, as is wild cabbage for purging the body and curing nasal polyps and blocked ears. This is surely gold-dust for Gwyneth Paltrow. On the other hand, perhaps the most important piece of ancient medical advice is this: ensure you question your doctor to make certain (s)he knows what (s)he is talking about.
The volume is well illustrated, has a glossary of topics and relevant ancient authors, suggested further reading and a full index. It is an admirably imaginative, clear, wide-ranging, informative and stimulating introduction to ancient medicine.