BMCR 2021.10.24

Systems of classification in premodern medical cultures: sickness, health and local epistemologies

, Systems of classification in premodern medical cultures: sickness, health and local epistemologies. Medicine and the body in antiquity . Abingdon; New York: Routledge, 2020. Pp. 322. ISBN 9781138571129 $155.00.

Full text (Open Access)

This is an interesting and surely a valuable volume, but at the same time one that is exceptionally difficult to review. Partly this is a function of its broad geographic and temporal coverage, spanning a total of thirty-six centuries of historical material across three continents, from Egypt (three chapters) to Greece and Rome (three chapters), Mesopotamia (two chapters), Arabia (one chapter), Israel (one), China (one), and Tibet (one). At the same time, the volume attempts to bring together scholars working both in medical anthropology and in the history (and to a lesser extent the philosophy) of medicine. I have a very difficult time picturing any single scholar who could engage with this material meaningfully and consistently from its front cover through to its back. Nevertheless, I can see that quite a number of readers will find much of interest here, and the effort at reaching across the time and space is certainly a worthy one. As for disciplinary spread, the different scholarly approaches of history and anthropology don’t always transcend their various sandboxes in the volume, but it does seem a worthwhile attempt at opening a conversation. Certainly there is much to learn here for everyone.

It is common enough in reviews and referee reports of collected volumes to see comments on the ‘coherence’ of the set of papers. To be honest I have never fully understood this desideratum—as a reader of reviews and as a purchaser of collected volumes, my own concerns tend to be more limited: along the lines of “do I need a substantial enough portion of this volume for my own research or teaching?” From this utilitarian perspective I tend to see “coherence” as a kind of code for ‘are there more than a handful of scholars whose interests will benefit from more than just one or two papers in this volume?” I am sure that the answer to this question for Steinert’s volume will be yes, and a greater number of readers will find multiple chapters of interest—and indeed of stimulation to further research in areas that to which they may not have previously had much access. That is a very good thing.

But there is another aspect of “coherence” that is often commented upon, and on this front the volume will likely not meet the bar. For all that there are some excellent chapters in this book, they are of wildly different scope, and they sometimes miss opportunities for cross-fertilization. The papers here often have very different aims, ranging from very broad subject-area introductions, to methodological papers, to others narrowly focused on problems of interest to a very limited subfield. Some cover wide ground in summary over very few pages, others dig in to spend significantly more time on quite focused topics. Steinert herself, between the long introduction and her own chapter, has written roughly one-third of the book’s page count. If we include Elizabeth Hsu’s contribution (in part because we are told that Hsu consulted heavily in the writing of the introduction), the two authors are responsible for about 42% of the volume’s contents, excluding prefaces and indices. This is not in itself a bad thing—their work is great—but it is a noticeable weighting.

Another imbalance appears across disciplinary boundaries. The editor tells us that the volume was the outcome of a workshop held in 2016 in Berlin, bringing together scholars in medical anthropology and the history of medicine to discuss a wide range of Near-Eastern and Asian medical traditions. The three chapters on Greco-Roman medicine, Steinert tells us, were later additions. Although it is wonderful to see some of the great lights of Classical medicine represented, it is unfortunate that there is not more of them: the two chapters by Geoffrey Lloyd and Elizabeth Craik are each only nine pages long—enough to whet the appetite, but not enough to really satisfy. Peter Singer’s chapter on mental heath in Greco-Roman antiquity, which closes the volume, is sharp and insightful, but again the question of coherence with the volume as a whole arises. Like Steinert and Hsu earlier in the volume, Singer has an extended and fascinating discussion of conceptions, perceptions, and descriptions of disease/illness/sickness/dis-ease. All three chapters worry at length about the distinctions that might be elided by my use of slashes in the admittedly unwieldy “disease/illness/sickness/dis-ease.” But Singer’s discussion seems to operate in isolation from the Steinert-and-Hsu framing of the issues. Although Hsu and Steinert discuss and cross-site the same sources or each other, Singer does not discuss or cite any of that literature, nor do they discuss his. This is not to say that their separate discussions are not worth engaging—they certainly are—but that they do remain ineluctably separate.

Having said that, I think in this instance such a complaint might be misplaced. The reason for this is that things are changing very rapidly for the better in scholarly publishing. In addition to the usual overly expensive hardcover, this volume has simultaneously been published in an open access version. The pdf of the entire volume is available on the publisher’s website for free, and that changes the calculus considerably, or at least it does so for this reviewer. When there is no real cost-barrier for an interested or curious reader to overcome, I think that questions of coherence, scope, and tone begin to take a back seat to utility, and with respect to utility, this book will—or at any rate, should—be widely downloaded and read by anyone working on ancient medicine.

One clear hope for this volume is that by bringing together scholars from medical anthropology, the history of medicine, and the philosophy of medicine, even if the cross-disciplinary dialogue is just beginning, the questions opened up by the book as a whole will give us increasing opportunities to expand the conversation in ways that will make this material and these concerns more coherent going forward. Steinert and the authors of these individual chapters are to be heartily applauded for the effort.

Table of Contents

Ulrike Steinert, Introduction: sickness, cultural classifications and local epistemologies
Geoffrey E. R. Lloyd, Distinctive issues in the history of medicine in antiquity
Elisabeth Hsu, How to read a recipe? Working backwards from the prescription to the complaint
Rune Nyord, Experiencing the dead in ancient Egyptian healing texts
Susanne Radestock, Types of diagnoses in Papyrus Ebers and Smith
Juliane Unger, Ancient Egyptian prescriptions for the back and abdomen and their Mesopotamian and Mediterranean counterparts
Ulrike Steinert, Disease concepts and classifications in ancient Mesopotamian medicine
Elizabeth Craik, Classification of illnesses in the Hippocratic Corpus
Aaron Amit, The delicacy of the rabbinic asthenes: sickness, weakness, or self-indulgence?
Lucia Raggetti, The Paradise of Wisdom: streams of tradition in the first medical encyclopedia in Arabic
Katherina Sabernig, The Tree of Nosology in Tibetan medicine
M. Erica Couto-Ferreira, Disturbing disorders: reconsidering the problem of ‘mental diseases’ in ancient Mesopotamia
Peter N. Singer, Classification, explanation and experience: mental disorder in Graeco-Roman antiquity