Bryn Mawr Classical Review 2005.10.33
Françoise Gaide, Frédérique Biville, Manus medica. Actions et gestes de l'officiant dans les texts médicaux latins. Questions de thérapeutique et de lexique. Actes du Colloque tenu à l'Université Lumière-Lyons II, les 18 et 19 septembre 2001. Aix-en-Provence: Publications de l'Université de Provence, 2003. Pp. 272. ISBN 2-85399-549-6. €24.00 (pb).
Reviewed by John Scarborough, School of Pharmacy & Department of Classics, University of Wisconsin (firstname.lastname@example.org)
Word count: 2708 words
As is the case with many subspecialties in classical studies, new research in ancient medicine frequently appears in published versions of papers delivered at regional, national, and international conferences. This habit owes its persistent recurrence to the nature of the subspecialties themselves: although all marshal techniques of classical philology, each also superimposes details of a particular aspect of expertise (e.g. economics, military technology, astronomy), and we who study ancient medicine will suggest technical aspects of what 'medicine' means in a particular era, locale, or in a living cultural context. If, as several of the papers in this collection do so well, an analysis is given of pharmacy among the Romans, it must control botany and mineralogy, and occasionally drugs manufactured from animals; a text in Greek or Latin that suggests "physiology" also indicates certain specifics of a philosophic or popular argument that might underpin what a physician pronounces as a "cause" or a "cure" or a therapy for a "disease" defined by that culture, not our own. When a student contemplates ancient botany and a derivative pharmacy, it is necessary to 'translate' carefully ancient drug lore into some facets of modern pharmaceutics. This does not mean that we need to express Scribonius Largus' complex recipes in terms of molecular chemistry, but it does mean that we do as folk medical practitioners do: express drug actions in terms of generalized observations on what a drug does in or on a patient (engenders sweat, urine, promotes the appetite, alleviates pain, suppresses the menstruals, etc.); once we have determined the broad results of administration of a simple or compound medicament, we then again 'translate' into known principles in rough proportions.1 For example, if celery seeds are an ingredient among several in a prescription for a compound to treat quinsy,2 we would note that celery seed oil is rich in selinine, sequiterpenes, and d-limonene, a modern description 'explaining' chemical action. Scribonius Largus would know the 'action' of the drug as a menstrual regulator, a stimulant tonic (the oil from crushed seeds), and as an analgesic in a poultice. Control of the Latin is essential, but so also is the command of a more scientific modern manner of description. Ancient medical studies are, at their best, judicious combinations of ancient with modern, with the scholar carefully separating the ancient from the modern. Manus Medica addresses how words "work" and why medical vocabulary almost always reflects a specialized, technical activity, generally demarked from common speech and literature. The good prefatory essay, "La main salutaire" by Frédérique Biville (pp. 9-23) sets the stage for the collection with short essays "La relation au divin," "Un terme générique," "La manus medica (Verg., Aen. 12, 402)," "Les gestes de contact," "Les gestes de pénétration et d'extraction," and "La préparation des remèdes: Les ingrédients [and] Le mélange."
It is always a pleasure to acknowledge excellent contributions from widely published and accomplished scholars, as well as newcomers in ancient medicine, and Manus Medica contains seventeen essays that occasionally give entirely fresh insights. The French, les gestes médicaux, is deliberately employed throughout in its dual and sliding sense of "medical actions or deeds," and "gestures and movements," suggestive of the particular activities of physicians as they went about their business in Roman times. Sometimes words in themselves become far more significant in a medical milieu than they might be in ordinary circumstances, quite similar to our own common use of such twin nuances in non-medical speech and writing (e.g. we say "germ" when we mean "bacterium," but "bacterium" when we wish to designate a causative agent for a particular disease). The Romans were equally adept at shadings, and several of the articles in Manus Medica indicate why this is important.
"Les gestes médicaux chez poètes satryques latins: lecture sémiotique" by Daniel Vallat (pp. 255-270) rather nicely exploits some famous passages in Martial, and some not-so-well-known verses in the Palatine Anthology, to indicate how medical words can become exaggerations that satirize pomposity among professionals, not merely physicians; set side-by-side with well-chosen lines from Cornelius Celsus and Pliny the Elder, the non-medical quip becomes a medical thorn, intended to wound, metaphorically, to draw blood. Cartoons in the New Yorker accomplish the same, but far more crudely than with what Martial provides. Vallat's "Les gestes" is a splendid example of how philology can indeed elucidate medicine, and, in this instance, in a non-medical context.
Vocabulary and surgery, instruments and how they are described (what they 'look like') are fused in a fine study by Valérie Gitton-Ripoll, "La chirurgie des chevaux dans L'Antiquité: étude lexicale des termes latins désignant le personnel soignant, les gestes chirurgicaux, les instruments spécialisés" (pp. 207-228); here are the often-ignored -- and important -- Latin tracts on veterinary medicine, and, even though Gitton-Ripoll reaches the limited conclusion that cautery and bloodletting are generally the 'operations' described, she notes along the way that the horses tended by a Pelagonius were essential in the new Roman army after Constantine. "La chirurgie" points the way to a study of veterinary medicine in the Roman army, and there are far more procedures described in the remnants of the veterinary works of Apsyrtus and others (in Greek).3
David Langslow presents "The Doctor, his Actions, and the Terminology" (pp. 25-35) and focuses on the involved linguistics, as does his book on the topic,4 but here there are some added notes on uses in Scribonius Largus, Theodorus Priscianus, and others. Significantly, Langslow blends the recent insights of van der Eijk,5 Riddle,6 and von Staden7 to reinforce how medical language in ancient and modern times is dominated by nouns. Eponyms were and are common in descriptions surgical procedures, but the actions themselves are timeless as they are employed repeatedly ("nominalized" so Langslow). Minor figures (Antonius Musa, Zoilus, Andron, and Polyarchus) are "exceptions that prove the rule."
Careful explication of technical particulars characterize the essays on drug lore, and each contributes much in the way of leads into the sources, as well as how Romans perceived their drugs and why they named them as they did. "Fabriquer un médicament composé, solide et compact, dur et sec: formulaire et réalités" by Danielle Gourevitch (pp. 49-68) guides the reader into the thicket of technicalities (and does so with admirable clarity) that envelop and transfuse catapotium / cataputium / cataputia; collyrium / collurium, concharium / concarium, coptarium, globus / globulus, litharium, magdalium, pastillus, pilula, sphragis / sphargis / sfragis / sparagis, trigonus and trochiscus / trociscus, and how each was made. Gourevitch's listing is a useful supplement to some entries in the Oxford Latin Dictionary, and citations emerge from Cornelius Celsus ('nettement plus sensible'), Scribonius Largus ('véritable pharmacologue'), Marcellus Empiricus, Caelius Aurelianus, and Cassius Felix. She acknowledges the role of the papyrological texts but notes that archaeological finds (thus far) have proven to be refractory. In passing, Gourevitch suggests the wealth of details on pharmacy in the Compositiones of Scribonius Largus and implies that any modern translation must include a precise and intricate commentary. Muriel Pardon's, "In medicinis uenena. Celse et la défense de la médecine pharmaceutique" (pp. 103-116) is a welcome corrective to the all-too-numerous modern opinions that state Greek and Roman pharmacy had little use and that, if it did, it was usually opaque and foggy in its theory. Pardon demonstrates that Celsus' clarity on pharmaceuticals is not forced and that translations and/or transliterations of Greek labels into a Latin form can be confirmed occasionally by similar matters in the Natural History of Pliny the Elder. Pardon shows through Celsus, De medicina, VI, 6. 1 e-m, that the theory of Hellenistic pharmaceuticals was anything but vague and was founded on clearly empirical observations verified over time.
I must admit that Pardon's essay was my favorite among the seventeen, but the qualities of similar, sharp and clear explication on drugs and their effects are featured in "Étude des gestes thérapeutiques dans les Compositiones de Scribonius Largus: quand les nécessités de l'acte médical créent le mot" (pp. 117-130) by Joëlle Jouanna-Bouchet, Valérie Bonet's "Les applications dans la pharmacopée végétale de Pline l'Ancien" (pp. 131-147), and Brigette Marie's "Actions thérapeutiques ou gestes littéraires: le lexique des Medicinae de Gargilius Martialis" (pp. 147-160). Jouanna-Bouchet begins her narrative with Herophilus, the touchstone of Hellenistic medicine, then proceeds to show how Scribonius Largus' pharmaceuticals in all of their complexity do mirror the particulars of popular magic, but become carefully compounded according to the principles of a practical botany (vide esp. pp. 120-121); peeping through the technical details of how the analgesic called acopum is prepared (Scribonius Largus, Ch. 271 [translated into French in n. 18, pp. 128-129]), is the revelation that Livia trusted this pain-killer, as did Antonia, the mother of Claudius.8 The Compositiones has a number of these 'personally recommended' compounds, and not only could one compose a good study of the drugs in Claudius' royal medicine chest, but one also could set out some pharmaceuticals sanctioned for gladiators and soldiers (mineral-based medicaments are prominent, and these have a very long 'shelf-life'). Bonet's rapid survey of the enormous collection of pharmaceutical data in Pliny's often-compressed collection is deliciously suggestive of what can be done with Pliny's drug lore: as she demonstrates with a few well-chosen passages, Pliny might be careless in combining one source with another or several others, but he is quite precise in listing the use of the many botanicals and animal products. Bonet shows how the Latin verbs, prefixes, and suffixes describing pharmaceuticals lend clarity to an otherwise jumbled text, and ancient readers came to appreciate the loose classifications typical of the Natural History. Linked to Pliny in many respects is the domestic botany-based medical handbook by Gargilius Martialis, an author generally ignored by both classicists and ancient medical historians. Now that we have Marie's fine new text, translation, and commentary of Gargilius Martialis,9 we no longer can omit the Garden Medicines from the study of Roman pharmacy. Among the Roman texts, Garden Medicines ranks next to Dioscorides' Materia Medica, in expounding how drugs are easily derived from the personal plots enjoyed by many urban dwellers (and country folk, to be sure) in antiquity. Gargilius Martialis is the direct classical ancestor of the monastic garden, and Marie indicates exactly why this is so: garden plants are the most accessible sources of ready-made botanicals, and if one raises them the ingredients of such pharmaceuticals will always be fresh, or stored for short periods. If a garden supplied drugs, there was no need to purchase the unknowable products of the wandering rootcutters.
Very commonly, Roman pharmacologists prepared ingredients in compound remedies by charring them, or reducing them to ash, with the apparent belief that simples gave their best results in this form. Once again, a careful consideration of cultural and religious contexts aids our comprehension of why Romans assumed a potency that was stronger than if the substance were simply powdered, or mixed with wine or another medium for administration to a patient. Patricia Gaillard-Seux, "La crémation des remèdes dans les texts médicaux latins" (pp. 69-86) provides a pioneering article that examines the phenomenon, and she sifts (the pun is irresistible) the evidence in Pliny the Elder, Quintus Serenus (Sammonicus), Pseudo-Apuleius, and Marcellus Empiricus, to indicate the frequency of such preparations (she could also have cited numerous examples in the Materia Medica of Dioscorides). It becomes apparent that the physical qualities of ash are much more readily mingled with other ingredients that are ground into a powder, and similarly when ash is added to other ingredients in a compound that have been shredded, peeled, or macerated. Gaillard-Seux concludes that the overriding reason for such common use in pharmaceuticals is the equally-common practice of cremation among the Romans. While pertinent to discussion of the question of ash as a pharmaceutical form of ingredient, the technologies of smelting also are important, an aspect repeatedly emphasized by Dioscorides, especially in Book V of the Materia Medica. At the end of her essay, Gaillard-Seux recognizes how mining technologies and the smelting of ores also give contexts to pharmaceutical practices, so that what is here in "La crémation" is a very excellent summary of texts and very well-chosen suggestions for further research on this (again) ignored facet of Roman medicine and pharmacology. Later, one can hope that chemical analyses will be included (e.g. How does "burnt bone" change in its chemical properties? Or does "charring" shellfish bring out pharmaceutical properties?), and Gaillard-Seux has, in effect, opened up a new aspect of Roman pharmacy.
Representing the gloomy side of ancient medical studies is Guy Sabbah, "Les gestes du chirurgien dans le De medicina de Celse, VII, 17-24" (pp. 89-102). Here is an instance in which I disagree with the arguments of a widely respected scholar, even while I honor his precision in analysis, formulation of a hypothesis, and solid conclusion about Celsus' surgery in particular, and Roman surgery in general. What Sabbah sees as a great ethical ambiguity, reflected in the many words applied by Celsus in his descriptions of abdominal surgeries, I would interpret as Celsus' very positive notions about the results of successful operations (and there were many successes: too often modern physicians assume such surgeries were undergone without anesthetics, a point of misinformation, as documented by our texts).10 Sometimes we modern medical professionals forget how often in past centuries surgeons were denigrated by "proper physicians," since they deigned to "work with their hands" as did tinsmiths, shoemakers, and the like. Roman culture was indeed rife with an almost rigidly-applied class-structure, but Celsus' obviously personal experience as a military surgeon (another hotly debated topic among ancient medical historians) suggests surgical techniques that did effect cures and that sometimes employment of mandrake, datura, henbane, opium latex, and other narcotics made the task easier for both surgeon and patient.11 Thus I think Sabbah's quotation of the famous passage from Jerome's Letters, 40. 112 on the cruelty of surgeons and surgery is not representative of Roman surgery as a whole, but of those less-than-skilled practitioners who were to be avoided. As is usual in his scholarship, Sabbah documents carefully, and this essay is well worth anyone's time to ascertain why ancient medical studies is such a lively part of Classics, and also why we seem to enjoy the best of the traditional camaraderie even while disagreeing pointedly with one another. Such is the nature of the "best science" in any era.
Manus Medica has five more essays of equal merit (as one used to say, "there's not a clinker in the bunch"), which I will list by title, so that colleagues can look these up if interested in particular topics: Anne Fraisse, "Place et statut des pratiques magiques dans les texts médicaux tardifs. Le cas de Cassius Felix et de Théodore Priscien" (pp. 161-172 [a fundamental article on medical magic by the talented editor of the Budé Cassius Felix]);13 Michèle Meilhac-Léonelli, "La tienture des cheveux, un geste médicale? À propos de Théodore Priscien Eup.1,5-6 (éd. V. Rose)" (pp. 173-182 [does a horse's coloration become important in veterinary medicine? Another facet of that important, if understudied, aspect of Roman expertise about animals]); Nicoletta Palmieri, "Practicon diuiditur in duo: mesures prophylactiques et mesures thérapeutiques chez Agnellus de Ravenne" (pp. 183-206 [the teaching of medicine at Ravenna, another newly-opened facet that puts paid the opinions of the "backward" Latin West]); Isabelle Boehm, "Toucher du doigt: le vocabulaire du toucher dans les textes médicaux grecs et latins" (pp. 229-240 [palpation is essential in diagnostics, as both ancient and modern doctors would agree]); and Pascal Luccioni's very fine "Gr.τράκτον, lat. tractum, ou comment rouler une pâte" (pp. 241-254 [the pharmacist explains how one can roll up a pasty drug, that is a drug that will become a plaster or poultice, a very common manner of drug-application well into the 20th century; this is probably the best of the technical essays in the collection]).
As a whole, the articles in Manus Medica signal new directions and emphases in scholarship on the Latin texts of Roman medicine and pharmacy, and do so with skill, depth of perception, and splendid suggestions (explicit and implicit) for further research. It is unusual that all contributions in an assembly of published versions of papers delivered at a regional conference are of such high quality. Commenting upon them has been an equally rare pleasure.
1. Or as expressed in phytochemical terms, "the efficacy of valerian depends upon an interplay between constituent groups [of monoterpene alkaloids] rather than on individual substances." Max Wichtl, "Valerianae radix/Valerian root," in Max Wichtl, ed., Herbal Drugs and Phytopharmaceuticals, 3rd ed., trans. from the 4th German ed. (Stuttgart: Medpharm, 2004), pp. 630-634 at p. 631 col. 3.
2. E.g. Scribonius Largus, Compositiones, 70 (ed. Sconocchia , p. 39).
3. The standard Greek texts of Apsyrtus, Hierocles, Hippocrates the Veterinarian, and others (possibly compiled in the reign of Constantine VII Porphyrogenitus [A.D. 913-959]) remains E. Oder and C. Hoppe, eds., Corpus hippiatricorum Graecorum, 2 vols. (Leipzig: Teubner, 1924-1927; rptd. Stuttgart: Teubner, 1971), cited as background by Gitton-Ripoll. A German translation of the surgical passages is useful: Ludwig Amann, trans. with commentary, Ausgewählte Kapitel über Chirurgie und Pferdezucht im Corpus Hippiatricorum Graecorum (Munich: Diss. Veterinary Medicine Ludwig-Maximilians-Universität, 1983).
4. D. R. Langslow, Medical Latin in the Roman Empire (Oxford and New York: Oxford University Press, 2000).
5. P. J. van der Eijk, "Towards a Rhetoric of Ancient Scientific Discourse: Some Formal Characteristics of Greek Medical and Philosophical Texts (Hippocratic Corpus, Aristotle)," in E. J. Bakker, ed., Grammar as Interpretation: Greek Literature in its Linguistic Contexts (Leiden: E. J. Brill, 1997 [Mnemosyne Supplement 171]), pp. 77-129.
6. John M. Riddle, Dioscorides on Pharmacy and Medicine (Austin: University of Texas Press, 1985), Ch. 3: "Drug Affinities" (pp. 94-131).
7. Heinrich von Staden, "Author and Authority: Celsus on the Construction of a Scientific Self," in Manuel Enrique Vázquez Buján, ed., Tradición e Innovación de la Medicina Latina de la Antigüedad y de la Alta Edad Media (Santiago de Compostela: Universidade de Santiago de Compostela, 1994), pp. 103-117, an essay in the published version of papers delivered at the 4th International Symposium on Latin Medical Texts, held at the University of Santiago de Compostela (1992) in the beautiful northwesternmost province of Spain.
8. Livia also suffered from inflamed tonsils, which sometimes led to choking fits (the 19th century "quinsy"); Scribonius Largus' complicated formula for a 'quinsy-remedy' adds that "the Augusta always had this compound at hand." Scribonius Largus, Compositiones, 70 (ed. Sconocchia, p. 39): hoc Augusta semper compositum habuit.
9. B. Marie, ed., trans., and comm., Gargilius Martialis. Les Remèdes tirés des légumes et des fruits (Paris: Les Belles Lettres, 2002 [Budé]), which completely supersedes the text ed. Valentin Rose, Plinii Secundi quae fertur una cum Gargilii Martialis (Leipzig: Teubner, 1875), pp. 129-212, and the nearly simultaneous publications of fresh editions in 1978, viz. Sebastian Condorelli, ed., Gargilii Martialis quae exstant (Rome: Bretschneider, 1978), and Innocenzo Mazzini, ed., Q. Gargilii Martialis De hortis (Bologna: Pàtron, 1978). The translation by Ruth Melicent Tapper as The Materia Medica of Gargilius Martialis (Madison: Diss. Classics University of Wisconsin, 1980) is based on Rose, lightly supplemented by Mazzini.
10. I detail these matters in my forthcoming "Roman and Byzantine Surgery for Hernia Repair," to be published in Robert Arnott and Leslie Dean-Jones, eds., Anatomical Knowledge in the Ancient World: Papers Presented at the Society for Ancient Medicine European Meeting 2004 (Birmingham: University of Birmingham School of Medicine); colleagues are welcome to request a pre-print, which I will send as an attachment.
11. Paraphrased from Piers D. Mitchell, Medicine in the Crusades (Cambridge and New York: Cambridge University Press, 2004), p. 202.
12. Sabbah, "Les gestes," p. 101 n. 78.
13. Anne Fraisse, ed., trans., comm., Cassius Felix De la médecine (Paris: Les Belles Lettres, 2002 [Budé]).