BMCR 2022.04.38

Ancient medicine, behind and beyond Hippocrates: essays in honour of Elizabeth Craik

, , Ancient medicine, behind and beyond Hippocrates: essays in honour of Elizabeth Craik. Technai, 11. Pisa; Roma: Fabrizio Serra, 2020. Pp. 216. ISBN 9788833152882. €125,00.

[Authors and titles are listed at the end of the review]

Elizabeth Craik’s writings in the domain of Hippocratic medicine, culminating in her invaluable survey, The ‘Hippocratic’ Corpus: Content and Context (Routledge, 2015), are noted for their conscientious approach to a vast, involuted, multifaceted subject, and in particular for their informative attendance to questions of language and date. The volume under review collects ten papers presented at a conference in her honour at St Andrews and succeeds in conveying something of the spirit of Craik’s work into a broad array of topics pertaining to the Corpus, its internal (in)consistencies, and its place in the wider context of ancient Greek medicine. No formal arrangement of the papers is in evidence; the impression one gets is of a glancing view of contemporary Hippocratic scholarship, wherein minor treatises, textual affinities, and subtleties of context are framed as equally productive ingresses into the Hippocratic Corpus (hereafter HC) and related scholarship. The rough division offered by the editors themselves (p.18) into papers concerned with individual treatises within the HC and those which interrogate some aspect of their broader context applies but is frequently too indistinct to be instructive. I will discuss the papers in the order they occur.

The opening paper by Jacques Jouanna—the only non-English inclusion—presents the author’s recent edition of the Law as an example of the fruits one might glean from an inclusive assessment of all the witnesses to a given manuscript tradition. Particular attention is afforded to the Arabic and Medieval Latin traditions from which Jouanna uncovers, among subtler novelties, an entire sentence, with implications for the dating and socio-philosophical context of this “petit joyau” (p.37). Jouanna’s prefatory salute to multilingualism in Hippocratic studies, welcome in its own regard, is variously attested by the content of his paper. Continuing the focus on short, deontological texts, Amneris Roselli, drawing inspiration from Craik’s exposition of the shorter Hippocratic works, applies her focus to On the Physician. She maintains, contra J. E. Pétrequin (1847, 1877) and in consonance with twentieth-century scholarship, that the treatise as extant is a unity, striking in its focus and internal coherence, and not a fragment of greater surgical manual. Roselli highlights the linguistic patterns (esp. as pertain to τέχνη) that identify the treatise as “a clear and organic project” (p.44), and draws attention to the parallels between On the Physician, On Fractures, and On Joints with respect, in particular, to “the nexus of correct behaviour and competence” (p.44) common to the surgical texts.

Having touched on the theme of genre classification in the HC, the collection moves to that of authorship. Franco Giorgianni offers a lucid history of the research on the so-called Hippocratic “author C,” the long-recognised anonymous authority behind On Generation/On the Nature of the Child and Diseases IV, which also functions as a primer on the main criteria for assigning Hippocratic texts to an “author,” and the troublesome nature of that concept in the ancient world. With the historical-critical context in place, Giorgianni seeks to advance the conversation. In a short exhibition of investigative avenues yet to be fully pursued, he offers a statistically-guided, wide-ranging lexicographical analysis of two of C’s preferred terms, and a suggestive (though duly cautious) comparison of passages from Diseases IV with the Anonymus Londinensis testimony on Aegimius of Elis, which unearths several theoretical and terminological affinities.

The influence of ancient medical writing on the philosophical and literary tradition is noted at the outset of Pilar Pérez Cañizares’ treatment of the aphoristic content of On Affections. Her two-part paper begins with an overview of the aphoristic genre in the HC—a group of texts too frequently eclipsed by the treatise that gave the genre its name—then proceeds to the generalising property of aphorisms in the unique context of On Affections, the only treatise in the collection intended for a non-specialist audience. The question of dating Hippocratic texts is then taken up by Robin Lane Fox and Andrew Meadows. Lane Fox revisits some supporting arguments pertaining to his ca. 470 BC dating of Epidemics 1 and 3, presented in greater detail in his recent The Invention of Medicine (Penguin, 2020), then proceeds to an illuminating exploration of the use of Aeginetan weight-standards in a subset of Hippocratic treatises (On Disease II, On the Nature of Woman, On Superfetation) as an opportunity for determining the date and location of their composition. Meadows identifies the standards in question with coin-standards, resolving stark inconsistencies between the weights of the medicaments prescribed in the texts and the proposed manner of their ingestion, and takes their use as indications of a Cnidian origin and fifth-century date.

The historical-cultural context of progress in ancient medicine is treated in Vivian Nutton’s exploration of the practical and intellectual challenges inherent in compiling the Constitutions in Epidemics 1 and 3. Nutton foregrounds the unusual achievement of the Constitutions by contrasting the world of its construction, the tightly circumscribed, dynastic, largely oral-dependent tradition of the fifth century BC, with the altogether more literary milieu of Galen of Pergamon, “Hippocrates’ greatest admirer” (p.114). His appraisal of the organisational accomplishment of the Constitutions leads him, via the emerging (though short-lived) concern for communal diseases in medical texts (cf. Airs, Waters, Places), into the mystery of medical lack of interest in epidemic/endemic diseases after the fourth century BC. Nutton points to the absence of civic infrastructure in the ancient world and the challenge of aggregating community case-histories, regarding which the Constitutions proves an educative outlier, as relevant considerations on the path to a solution. His suggestions—visited in more depth in his “Epidemic Diseases in a Humoral Environment: from Aris, Waters and Places to the Renaissance” (Holism in Ancient Medicine and Its Reception, p.357–76, Brill, 2021) – are pertinent, but the explicandum, in my estimation, merits broader treatment, accounting for medicine’s theoretical-cum-professional maturation through the Hellenistic period and beyond. In general, the relationship between Hellenistic/early Roman and Hippocratic (i.e., fifth/fourth century) medicine is the closest thing this volume has to a neglected topic.[1] This is itself reflective of broad trends in ancient medical scholarship which, somewhat forgivably, tend to focus where the sources are most plentiful. The absence cannot be said to undermine the editors’ stated aims.

Laurence Totelin reflects on the precept that the ancient doctor should “cause pain to no-one” in her welcome exposition of the funerary stele of Phanostrate (mid-fourth century BC), the earliest known monument commemorating a female physician. Totelin considers Phanostrate, Μαῖα καὶ ἰατρὸς, in the context of the professionalisation of women’s medicine in the fourth century, then compares the phrase οὐθενὶ λυπηρά (she caused pain to no-one) in the funerary epigram to related passages in the HC (On Winds 1, Epidemics 1.2.5, the Oath), the Iliad, and Euripides’ Hippolytus. The question of τέχνη-appropriate practices arises where the Oath’s prohibition on abortive pessaries meets an inscription that locates a “midwife and doctor” in a similar tradition. Though the information is limited, Totelin makes a persuasive case against a consensus that understands ἰατρός as Phanostrate’s more prestigious title and proposes instead that we read μαῖα and ἰατρός as in this case referring to mutually beneficial but importantly distinct disciplines. The growth of medical subdisciplines into nigh-independent τέχναι in the fourth and third centuries BC remains, among ancient medical historians, underexplored territory; Totelin’s paper is a welcome reminder of the role played by women’s medicine in the formalisation of specific and enduring kinds of expertise. She concludes by noting a second inscription which mentions one Phanostrate, this time a verse dedication of a statue to Asclepius in Athens, which, in a manner further resonant of Hippocratic practices, subordinates her talent to that of the god.

Recalling the historical-cultural gulf between ancient medicine’s most plentiful literary corpuses (raised by Nutton above), Maria Börno and Sean Coughlin consider the question of Hippocratic authority as perceived through Galen’s highly literary lens. The focus is on Galen’s recourse to κακοζηλία—bad style/affectation as expressed through word-selection—in his Hippocratic commentaries as an ad hoc criterion for determining the Hippocratic provenance of a given claim. Over the course of seven case-studies, the authors investigate “style” and its absence as a sign of Hippocratic authenticity, the merit of a given emendation to a text, and the credibility of variant readings of Hippocrates in Galen’s exegetical writing. Through their efforts, the reader is acquainted both with Galen’s literary-cum-linguistic erudition and with the Hippocrates of his design, exemplary physician and communicator almost without flaw.

The last two papers deliver on the volume’s promise to extend the ambit of inquiry beyond the HC; indeed, even a glancing view of Hippocratic scholarship would be incomplete without regard for the wider “medical marketplace” in which so-called Hippocratic practices competed for attention. Lorenzo Perelli looks at the other side of medicine in his investigation of the Hero-doctor via the so-called Thracian Rider, horseback healing hero, sometimes local deity, and subject of thousands of votive objects in the region of Thrace. Building an expansive case from a range of (archaeological, epigraphical, literary) evidence, Perelli links the Thracian Rider with the ἥρος ἰατρός attested in Attica, and the arrival of his and similar cults with the growing number of Thracians in Athens from the mid-fifth century BC. The final contribution, by Michiel Meeusen, approaches the link between Aristotelian natural philosophy and ancient medical theory via the Natural Problems (Pr.). Meeusen’s focus is on Pr. 37, Problems connected with the body as a whole, and in particular Pr. 37.3: “why do massages produce flesh?” His thesis is that Pr. 37, previously cast as a “mosaic” of materials elsewhere treated in the text, contains information sourced from outside Pr. which was subsequently excepted and inserted into the earlier books. Diocles of Carystus is suggested, convincingly enough, as the source of the chapters on massage (Pr. 37.3, 5, 6). But Meeusen’s principal concern is with the formulation and reformulation of the προβλήματα, the genre of philosophical writing uniquely concerned with the accumulation and organisation of particulars. Relations between προβλήματα., the HC, and medical literature more broadly are well-noted, but ultimately secondary to Meeusen’s exploration of the accumulation and redaction process by which Pr. was assembled. He notes that in the isolated case of Pr. 37.3 and its derivatives, fidelity to the source material comes at the expense of medical-scientific engagement; no effort is made to adapt the excerpts into their new contexts, suggesting, in the later stages of Pr.’s construction, a shift in emphasis away from engagement with the source materials and towards a more scholarly-philological approach, primarily aimed “at maximising thematic reach in the different sections of the Problems” (p.213).

In summary, the volume under review gathers a number of essays which, though particular in their foremost concerns, are sufficiently attentive to general themes in Hippocratic studies to be valuable to those with a broader academic interest in this and related subjects. Taken as a whole, the collection is a welcome overview of contemporary Hippocratic scholarship, largely successful in its ambition to demonstrate ‘how much can be gained by integrating the study of Greek medicine into a wider picture’ (p.20), and, given the ongoing work of several of its contributors, suggestive of further riches to come.

Authors and Titles

Vivian Nutton, Laurence Totelin, Introduction
1. Jacques Jouanna, L’ecdotique dans la Collection de Universités de France: une nouvelle edition de la Loi d’Hippocrate
2 Amneris Roselli, The Hippocratic treatise On the Physician: form and content
3. Franco Giorgianni, The hallmark of anonymity. Questions of authorship in the Hippocratic Corpus, specifically regarding the so-called ‘Author C’
4. Pilar Pérez Cañizares, The aphoristic sentences in the Hippocratic treatise On Affections
5. Robin Lane Fox, Andrew Meadows, Dates and measures: history and some Hippocratic texts
6. Vivian Nutton, The Epidemics: organising information on communal diseases
7. Laurence Totelin, Do no harm: Phanostrate’s midwifery practice
8. Maria Börno, Sean Coughlin, Galen on bad style (kakozēlia): Hippocratic exegesis in Galen and some predecessors
9. Lorenzo Perilli, Hippocrates’ competitors: the healing heroes and the Thracian Rider
10. Michiel Meeusen, «Why do massages produce flesh?». A case of textual reuse in the Aristotelian Natural Problems (37.3).


[1] References to Galen’s dispute with Athenaeus of Attalia and its influence on Galen’s reading of Hippocrates in Börno & Coughlin p.145–75 (summarised below) are the exception.