Ancient medicine has got a good deal of traction with the scholarly community in the last decades, as it continues to offer a wonderfully challenging field of study with an extraordinary range and volume of source material. The Invention of Medicine, longlisted for the 2021 Runciman Award, is a most welcome contribution to this ever-growing field by one of today’s most eminent voices in ancient history. In his latest book, Robin Lane Fox, probably best known for his work on Alexander the Great and Augustine, offers a refreshing and at points ground-breaking revision of the beginnings of ancient Greek medicine.
The title of the book is somewhat provocative, since medicine, unlike philosophy, was not of course an invention of the Greeks, as it had long been practiced in other and older societies, especially in Egypt, India, and Babylon.[1] But the ‘invention of medicine’ does have a specifically Greek connotation, since Hippocratic doctors in the fifth century BCE developed a consciousness of having established a new method and looked on medicine as a craft they had invented. In tracing this history, Lane Fox knowingly and gratefully builds on the work of eminent predecessors (especially “the big battalions who study ancient medicine”, p. xxiv), but he also offers new critical readings and at times boldly imaginative interpretations of the available source materials, of which he makes a particularly rich selection (including literary texts, inscriptions, coinage, stone reliefs, amphorae, medical equipment, bio-archaeology, DNA analysis, etc.).
The argument follows a tripartite structure. The first part (‘Heroes to Hippocrates’) comes as a chronological-thematic prelude covering the timespan from the early physicians who treated Homer’s heroes up to the time of Hippocrates and the Hippocratic Corpus. We read about the musings on health and the body in early Greek poets and philosophical thinkers alike (Homer, Hesiod, Solon, Sappho, Pindar; Anaximander, Pythagoras, Alcmaeon), and follow individual, mostly wandering, doctors and ‘school’ practitioners as they lived their lives and carried out their profession (including such murky names as Aineios, Sombrotidas, Onesilas, Democedes, and also the Asclepiads at the medical centres of Cos and Cnidos, including Hippocrates himself). This is followed by a careful disentangling of (the very few) facts and (many) fictions relating to the figure of Hippocrates and a crash-course on what came to be transmitted as the Hippocratic Corpus, with a critical evaluation of its scattered claims towards having developed a new craft and a distinctive method.This synthetic overview is not meant to be substantially innovative as it mostly revisits some well-known debates in the field (for instance, Hermann Frölich’s notorious theory that Homer must have been a military doctor) yet it does in an engaging way set the scene and tune for the rest of the book. At its back is the structuring opposition between divine and natural conceptions of health and illness, in a build up to the ‘magnificent’ Hippocratic move away from explanations involving divine intervention, in itself a well-known poetical—and thus, by definition, artificial—way of thinking.[2]
The second part (‘The Doctor’s Island’) is by far the most valuable in the book because it has radically new things to say about both Hippocratic medicine and the Hippocratic Corpus. Lane Fox is here on top of his ancient historical game. Zooming in on the vast collection of case histories collected in the Epidemics, he makes an impressive case for a new date of books 1 and 3, originally united as one. The work is traditionally dated to ca. 410, but Lane Fox argues for a slightly earlier date in the later 470s, early 460s (ca. 471-467 BCE).[3] Much of the argument is based on a new chronology of the magistrates named in a series of inscribed lists found in the city of Thasos, where most of the case histories of Epidemics1 and 3 are situated. This new date—which I leave to the experts to assess—is important, since, if it stands, the “text becomes much the earliest datable example of a medical text for practitioners and students […]. It even becomes the first Greek prose text which survives in full […]. Even more striking, if written c. 470 BC, its terse style, its implicit reasoning and its author’s emphasis overturn simple linear views about the progression of Greek thinkers and authors from an ‘archaic’ to a ‘classical’ age, traditionally located from c. 450 BC onwards. There is nothing ‘archaic’ about this author” (p. 150, cf. p. 165). Epidemics 1 and 3 may well be by Hippocrates himself, as Lane Fox believes; at any rate, the two books were already considered authentic in antiquity. But issues of authorship aside, what Lane Fox probably shows best is that (p. 87): “The ‘Hippocratic Corpus’ remains a fascinating labyrinth, far the most valuable evidence for Greek medicine, and has not been exhausted by scholars even after 150 years of study.”
After having dealt with the Epidemics’ historical aspects, the third and final part turns to their medical merits, delving into the physician-author’s underlying mindset (‘The Doctor’s Mind’). A number of crucial concepts pass under review, for instance, that of the ‘critical day’ (potentially the author’s own invention, as Galen believed), the processes leading up to it, and its role in medical prognosis. In spite of general skepticism among historians of ancient medicine, Lane Fox keeps an open mind towards retrospective diagnoses, because “if correct,” they can “validate the author’s claims to practice accurate observation” (p. 237). Among other diseases (e.g., an outbreak of the mumps) the ‘three great killers’—TB, malaria, and typhoid—may have been present on Thasos. Whether the doctor-author and his helpers managed to avoid illness themselves is unknown, but without a doubt they “were selflessly courageous, under-appreciated heroes of the early fifth century BC, acting without an awareness of infection by contagion but well aware of the constant risk of death” (p. 251). By its aim to record signs and assist prognosis in future, Epidemics 1 and 3 was potentially the first practical text in the invention of medical science. As the final sections of the book vividly demonstrate, their relation to ancient Greek drama, philosophy, and historiography suggest a changing/changed attitude to health and illness. Not surprisingly, later Greek, Islamic, and Western European medicine is highly indebted to that change.
In his attempt to disentangle and revise the ‘invention of medicine’ as a highly complex and multifaceted phenomenon in early medical history Robin Lane Fox succeeds brilliantly in constructing a narrative that is, at the same time, innovative and introductive, informative and entertaining, thoroughly historical yet with the occasional contemporary twist. Writing in an accessible style, aimed at both a general and informed readership and abounding in donnish wit,[4] Lane Fox takes his reader on a scholarly joyride not easy to find in a field otherwise dreaded for its inherent technicality (by which I do not say there is none in the book, and by which I also leave unmentioned its sharp price). The Invention of Medicine is a sample of mature research and scholarship, if at times slightly eccentric, yet ever true to the solipsism of that English gardener: “Fashion is for those who have no style, so I ignore it. I go my own way. I’m aware what’s going on, and I go on learning.”[5] Ancient historians and archaeologists will especially want to take a fresh look at the Thasian list of magistrates and our author’s dissident take on it, while the ‘big battalions who study ancient medicine’ should critically consider the new Hippocratic beginnings proposed by this, indeed, much too ‘humble foot follower’.
Notes
[1] Lane Fox even wonders, p. 48: “Was ‘Greek’ medicine until c. 500 BC basically Near Eastern medicine, but less detailed and without kings, usually, to fund it?”
[2] Acknowledged p. 20: “Historians of Greek thought tend to present rational medicine as emerging after a time, attested in Homer, when an illness was ascribed to random divine intervention and when healers did not think in terms of natural effects inside the body […]. However, what Homeric poetry presents is stylized and selective. In real life, contemporaries sometimes ascribed a sickness to pollution, miasma, that invisible agent which Homer never mentioned. He said nothing about everyday sickness, either, the small change of Greek winters and unwashed food. These commonplace conditions were outside the range of heroic epic, but nonetheless they occurred in Homer’s own world […].”
[3] Three endnotes further corroborate this new dating. See also his recent contribution to Elizabeth Craik’s Festschrift, co-authored with Andrew Meadows: “Dates and measures: history and some Hippocratic texts”, in Ancient Medicine, Behind and Beyond Hippocrates: Essays in Honour of Elizabeth Craik, eds. Vivian Nutton and Laurence Totelin (Technai: An International Journal for Ancient Science and Technology, 11, 2020), pp. 95-112.
[4] A few beautifully appalling examples should suffice, drawn from a range of five pages: Apollo is a “predatory god” lusting for Iapix, the inglorious healer from the Aeneid, who “received his [healing] gifts from a harassing god in return for sex”; so quite accurately, “[s]ex assisted the young man’s career” (p. 22). In the Iliad, to give another example, Hephaestus’ limping famously strikes the gods as comic; indeed “Homer’s Olympians would find our paralympics hilarious” (p. 25). In the context of bodily deformities, we read that “Greek nobles and the beautiful boys whom they courted stood out in sharpened contrast against many of the physiques around them”, “[j]ust as slim modern Americans stand out in a rising tide of obesity” (p. 26).
[5] “Robin Lane Fox: five tips from a lifetime of gardening”, Financial Times, September 6 2020, at 5’16”.