Bryn Mawr Classical Review 2006.07.14
Philip J. van der Eijk (ed.), Hippocrates in Context. Papers read at the XIth International Hippocrates Colloquium. University of Newcastle upon Tyne, 27 - 31 August 2002. Studies in Ancient Medicine 31. Leiden: Brill, 2005. Pp. xvi, 528; ills. 4. ISBN 90-04-14430-7. €149.00.
Reviewed by Marietta Horster, University of Rostock, Germany (firstname.lastname@example.org)
Word count: 2486 words
[Authors and titles are listed at the end of the review.]
The first international Hippocrates Conference ('Colloque International Hippocratique') took place in Strasbourg in 1972. Nine conferences followed in France, Italy, Germany, Spain, and in the French speaking parts of Switzerland and Canada. Of the forty-four presentations at Newcastle in 2002 twenty-eight are published in the volume at hand.1 The different modern languages of the papers and the authors' intellectual background (mainly philology, history, philosophy) reflect the broad interest in studies on the history of medicine and ancient medical texts.
Medical treatises were written in particular times and places, written by individuals who had contacts to other scholars -- philosophers, medical authors, literates, practitioners etc. The authors were familiar with several texts, were influenced by ideas; they interacted with practitioners and had an impact on others with their writings. The texts do not only provide information on medical practice and theory of Greek and Roman times but they are treasures of information on social, intellectual and cultural history. As the title "Hippocrates in Context" indicates the focus of the volume is to contextualise medical authors, texts and ideas.
There are five sections discussing various topics on: 1. The epistemological context of Hippocratic medicine, 2. The social context of Hippocratic medicine, 3. 'Hippocratic' and 'non-Hippocratic' medicine, 4. The Hippocratic medical discourse in its linguistic and rhetorical context, 5. The impact and later reception of Hippocratic medicine.
In the following review not all of the twenty-eight papers will be presented and commented in equal length (as all papers have an abstract in English it is quite easy to get an impression of their content).
J. Jouanna, one of the best-known experts in the field of medical texts studies the notions of cause and crisis used by Hippocratic writers, Herodotus and Thucydides (3-27). Despite lots of similarities -- to be seen in the use of medical topics in the historians, the metaphorical use of medicine as a model of politics and the transfer of medical models to concepts of historical developments -- differences sometimes seem more apparent. In sharp contrast to D. Lateiner, G. Rechenauer2 and others, he convincingly concludes that we should not be sure of direct influence of Hippocratic writings on historians as some sources have been lost and because of the manifold differences in details and concepts.
Several papers focus on the intellectual context of 'De vetere medicina' (On ancient medicine): J. Barton considers the search for answering the philosophical challenge especially of the Empedoclean school of medicine and other presocratics in De vetere medicina, postulating that the medical explanations should follow the inductive method, that it should start from the idea of the perpetual evidence of phenomena and that phenomena are not precisely quantifiable (29-47). F. Dunn (49-67) compares the structure of arguments about teleology and the ideas of progress in chapters 1 and 3 of 'De vetere medicina' with Hesiod, Sophocles, Aeschylus, Democritus, and Antiphon. M. J. Schiefsky (69-85)3 discusses the theory of human nature in 'De vetere medicina': it should be based on knowledge of the effects of each thing (especially food and drink) on each individual and thus based on a "theory of what human beings are in relation to their regimen" (77). Such a theory is based on analogy. If such knowledge is attained and medicine mastered, such a theory and such knowledge "will enable the doctor to draw reliable conclusions about the formation and development of the human being" (83).
V. Boudon-Millot's interesting paper (87-99) on the notion of 'stochazesthai' in the Hippocratic corpus and Galen makes a strong point -- against H.G. Ingenkamp's4 arguments mainly based on 'De vetere medicina' -- that Hippocratic medicine cannot be called stochastic (= using the conjectural mode of knowledge) as opposed to Galen, who makes conjecture (stochasmos) "a conceptual tool in its own right along with reasoning and experience" (94). 'Stochazesthai' in the Hippocratic corpus is meant to be the search for "the right measure" as an "individual" measure. A first shift in the meaning of 'stochazesthai' to "the right mean" is to be seen in Aristotle, but still one should not speak of "a fully developed stochastic art" in his philosophy (96). The relevance and significance of signs (semeia) for prognosis is the focus in D. Fausti's paper (101-117).
In the second section on the social context of hippocratic medicine J. Wilkins starts with a discussion of the reception and use of 'Regimen II' in Galen. Galen's commentary expands the list of food and plants as well as the case studies, thus adapting the text to readers in the Roman empire -- readers who are likely to be readers of a certain education and wealth, at least not peasants. The author of 'Regimen II', in contrast, did not write for an exclusive audience but distinguishes in his discussion and recommendations between different labours. A somewhat irritating and (to the reviewer's mind) inappropriate question about the relation of reason versus faith, about "rational" Hippocratic medicine and the irrational (?) healing cults, is treated by M. E. Gorrini (135-156); her paper as well as the following of H.-H. Chang about the wealth of the northern Greek cities (157-171) are two of the few disappointing papers in the otherwise very stimulating and sometimes provocative volume.
A thoughtful argument about the astonishing alteration between the Greek- and the Roman-speaking of and the use of therapies employing animal excrements and human milk is given by J. Laskaris (174-189). Based inter alia on H. von Staden's paper on the Greek idea of women's pollution and cathartic treatment and L. Bonfante's findings of images of human and divine nursing mothers in Etruria, Italy and Sicily, which differ from Greek traditions,5 Laskaris concludes that misunderstandings, different conceptions of gender (the Romans not associating women with pollution in the same degree as the Greeks) and the influence of Egyptian medicine (with its use of animal-excretion in magic healing rites) resulted in a specific Roman attitude towards excrement and human milk therapy.
Theories and arguments on authorship of the Hippocratic pseudepigrapha are always difficult to prove. E. Craig and E. D. Nelson address such questions. Craig's paper (197-207) discusses the affiliation of the 'Peri Opsios' treatise and the different theories about a common authorship with 'Affections', 'Places in Man' and 'Glands'; however, not all of her arguments are convincing. More complex is Nelson's theory (209-236) that the 'Ambassadorial Oration of Thessalus' and the 'Speech from the Altar' are excerpts of (or the latter at least based on) Macareus' lost 'History of Cos' written in the third century BC. He has strong points concerning the Calydonian-Man-episode connected to the Aetolian League's domination of Delphi and the dramatic setting of Thessalus' speech, which seems not to have been composed as an independent text.
The third section deals with the impact and interdependence of Hippocratic and non-Hippocratic medicine. A. Thivel (239-249) distinguishes three stages about breathing from Homer to the late fourth century BC, of which the boundaries cannot be defined sharply: an "archaic" (air is strange to the body), an "Empedoclean" (air and blood are sources of life and circulate in the body), and an "Aristotelian" (lungs as organs of respiration; air cools) theory. Only the last theory is mainly absent in the Hippocratic Corpus. F. Le Blay (251-269) has a theory about a unique character of analogy (having two directions) in the relation of microcosmos and macrocosmos in Hippocratic thought; although analogies between macro and micro as well as between micro and macro are undisputable, the singularity and relevance in Hippocratic writings is not demonstrated in this paper. Reticance on the subject of humoural medicine in the writings of Plato and Aristotle is P. Demont's subject (271-286). His careful analysis of philosophical scepticism towards humoural medicine and its subjectivist relativism of the physicians' creations of humoural realities is instructive and convincing. E. García Novo (287-294) seems to discuss on Plato and Hippocratic medicine mainly to make a statement against methods of modern diagnosis which, according to her, is reduced to machines and instruction books. D. Manetti (295-313) convincingly identifies three doctors and medical authors named Herodicus (whereas in Aristotle and Soranus the name Herodicus is corrupted): 1) one of Cnidus and founder of dietetics, 2) one of Selymbria, mentioned in Plato's dialogues, 3) probably the brother of Gorgias of Lentinoi. D. Nickel (315-323) reasons against F. Steckerl6 that Praxagoras was not influenced by Hippocratic thinking as far as mental diseases are concerned (epilepsy in fragm. 70, ecstasy = pathos in fragm. 71). Theophrastus' interest in some of the Hippocratic writings and his knowledge of the Regimen treatises is discussed by A. Debru (325-342): direct influence and borrowings cannot be detected, although Theophrastus' epistemological interests and other "structural features of certain Hippocratic treatises may have attracted Theophrastus" (341). T. Stover (345-361) examines the protreptic essay 'Prorrhetic II'. Obviously, this treatise was written to win over masses of pupils, promising them that by following him they will compete successfully with other physicians and will be admired by their patients. Protreptic and epideictic features of another Hippocratic treatise 'Internal Affections' are underlined by P. Péréz Cañizares (363-370), who analyzes the frequency the use of adverbs and of the third person imperative. M. Martínez' (371-384) paper is a plea for an extensive linguistic study of antonymic pairs ('enantiosis', pairing of opposites, polaric thinking) in the Hippocratic Corpus. He presents one such study looking at 'eu'- and 'dus'- compounds, of which many are attested in the Corpus exclusively.
Section five focuses on the reception of Hippocratic medicine. Quite striking is the existence of Greek medical papyri in the village of Tebtunis in the possession of local priests. A. E. Hanson (387-402) explains this phenomenon with the theory that citizens of the metropolis of Antinoopolis possessed land in Tebtunis and imported medical texts and the interest in such treatises to that village. She compares the number and quality of the texts to other medical texts found in Egypt, using the results of van Minnen and Andorlini.7 But why would the rich metropolites have an interest to 'educate' the Egyptian priests? Would they trust a medication of these priests only because the priests had read some relevant texts (mainly prescriptions and recipes; a list of twelve texts in Greek and three in Demotic script found in Tebtunis is given p. 391-393)? The conclusion of this fine and carefully argued paper, that in this manner rich patients influenced "the health care available to them and their families when resident in the village", however, does not convince the reviewer. The following four papers -- M. Pardon (403-411) on the originality of Celsus' 'De Medicina' in relation to the Hippocratic Corpus; A. Roselli (413-432) on Aretaeus' use of the writings of the Hippocratic Corpus; I.-S. Yeo (433-443) on Galen's use of 'Epidemics VI'; and I. Garafalo on Galen's commentary on Hippocrates' De humoribus (445-456) -- do not add very much to the understanding of mechanisms of the reception of Hippocratic writings. A. Guardasole (457-463) undertakes to elucidate the complicated tradition (Oribasius) and reception of the Hippocratic 'On Haemorrhoids' (a Byzantine anthology about aetiology and therapy of haemorrhoids etc. is integrated in 14th century-manuscripts of Galen).
The volume ends with Th. Rütten's paper (465-491) which draws a lively picture of the French and Italian humanist's intellectual and social environment, of their networking but also of envy and jealousy, and of the French struggle for acceptance by their Italian colleagues. In 1508 the first (known) printed version of the 'Hippocratic Oath' was published in France by F. Tissard in a little textbook with several Greek and Hebrew texts. The 1508 'Oath' text is in Greek with a Latin translation between the Greek lines (4 illustrations, p. 482-485). It is likely that Tissard has brought the text and the translation with the other Greek and Hebrew texts of the printed opusculum from Italy. His exact source is unknown, the Latin text does not correspond to any other edited texts known.
Most of the papers of this carefully edited volume are worth reading. The volume is easy to use with its abstracts, a general index and an index of passages cited. 'Hippocrates in Context' is an excellent demonstration of the vivid discussions of established experts as well as young colleagues in the field of and around medical texts, medical history, reception studies and Greek and Roman intellectual and social history.
SECTION ONE: The epistemological context of Hippocratic medicine.
Jacques Jouanna, Cause and Crisis in Historians and medical writers of the classical period, 3-27
Jane Barton, Hippocratic Explanations, 29-47
Francis Dunn, On Ancient Medicine and its intellectual context, 49-67
Mark J. Schiefsky, On Ancient Medicine on the Nature of Human Beings, 69-85
Véronique Boudon-Millot, Art, Science and Conjecture, from Hippocrates to Plato and Aristotle, 87-99
Daniela Fausti, Modelli espositive relativi alla prognosi nel Corpus Hippocraticum (Prorrhetico 2, Malattie 1-3, Affezioni, Affezioni interne, Prognosi di Cos), 101-117
SECTION TWO: The social context of Hippocratic medicine
John Wilkins, The social and intellectual context of Regimen II, 121-133
Maria Elena Gorrini, The Hippocratic Impact on Healing Cults: The archaeological evidence in Attica, 135-156
Hui-hua Chang, The cities of the Hippocratic Doctors, 157 - 171
Julie Laskaris, Error, loss, and change in the generation of therapies, 174-189
Elizabeth Craik, The Hippocratic treatise Peri Opsios (De videndi acie, on the organ of sight), 191 - 207
Eric D. Nelson, Coan Promotions and the Authorship of the Presbeutikos, 209-236
SECTION THREE: 'Hippocratic' and 'Non-Hippocratic' medicine
Antoine Thivel, Air, Pneuma and Breathing from Homer to Hippocrates, 239-249
Frédéric Le Blay, Microcosm and Macrocosm: The dual direction of analogy in Hippocratic thought and the meteorological tradition, 251-269
Paul Demont, About Philosophy and Humoural Medicine, 271-286
Elsa García Novo, The way to wisdom in Plato's Phaedrus and in the Hippocratic Corpus, 287-294
Daniela Manetti, Medici contemporanei a Ippocrate: problemi di identificazione dei medici di nome Erodico, 295-313
Diethard Nickel, Hippokratisches bei Praxagoras von Kos? 315-323
Armelle Debru, Theophrastus' Biological Opuscula and the Hippocratic Corpus: A Critical Dialogue, 325-342
SECTION FOUR: The Hippocratic medical discourse in its linguistic and rhetorical context
Tim Stover, Form and Function in Prorrhetic 2, 345-361
Pilar Péréz Cañizares, Special features in Internal Affections: Comparison to other nosological treatises, 363-370
Marcos Martínez, On Enantiosis in the Corpus Hippocraticum: the eu- / dus- opposition, p. 371-384
SECTION FIVE: The impact and later reception of Hippocratic medicine
Ann Ellis Hanson, Greek medical papyri for the Fayum village of Tebtunis: Patient involvement in a local health-care system?, 387-402
Muriel Pardon, Celsus and the Hippocratic Corpus: The originality of a 'plagiarist', 403-411
Amneris Roselli, Areteo di Cappadocia lettore di Ippocrate, 413-432
In-Sok Yeo, Hippocrates in the Context of Galen: Galen's commentary on the classification of fevers in Epidemics VI, 433-443
Ivan Garafalo, Galen's Commentary on Hippocrates' De Humoribus, 445-456
Alessia Guardasole, Autour de la connaissance du traité hippocratique Des Hémorroides à l'époque byzantine, 457-463
Thomas Rütten, François Tissard and his 1508 edition of the Hippocratic Oath, 465-491.
1. A list of the papers given but not published in the conference acts are listed on p. XII note 1.
2. D. Lateiner, The empirical element in the methods of early Greek medical writers and Herodotus: A shared epistemological response, Antichthon 20, 1986, 1-20; G. Rechenauer, Thucydides und die hippokratische Medizin, Berlin 1991.
3. He has just published a translation and commentary of 'De Vetere Medicina': M. J. Schiefsky, Hippocrates On Ancient Medicine, (Studies in Ancient Medicine, vol. 28), Leiden 2005.
4. H.G. Ingenkamp, Das στοχάσασθαι des Arztes (VM, 9), in: F. Lasserre, P. Mudry (eds.), Formes des pensée dans la Collection hippocratique, Geneva 1983, 257-262.
5. H. von Staden, Women and Dirt, Helios 19, 1992, 7-30; L. Bonfante, Votive terracotta figures of mothers and children, in: J. Swadding (ed.), Italian Iron Age Artefacts in the British Museum, London 1985, 195-203; ead., Nursing mothers in classical art, in: A.O. Koloski-Ostrow, C.L. Lyons (eds.), Naked Truth -- Women, Sexuality, and Gender in Classical Art and Archaeology, London, New York 1997, 174-196.
6. F. Steckerl (ed.), The Fragments of Praxagoras of Cos and his School, Leiden 1958.
7. P. van Minnen, Boorish or Bookish? Literature in Egyptian villages in the Fayum in the Greco-Roman period, Journal of Juristic Papyrology 27, 1998, 99-184; I. Andorlini, Trattato di medicina su papiro, Florence 1995 (edition with commentary).