BMCR 2024.06.25

Medicine, health, and healing in the ancient Mediterranean (500 BCE-600 CE): a sourcebook

, , , Medicine, health, and healing in the ancient Mediterranean (500 BCE-600 CE): a sourcebook. Oakland: University of California Press, 2023. Pp. 487. ISBN 9780520299702.

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Modern anthropological theory was reaffirming the connections between socio-economic status and health decades before the most recent global pandemic. Now, in a post-pandemic world, we are ever more cognizant of the outside factors affecting our health–our genes, our environment, our salary, or lack thereof. Health is an important metric in the study of communities and cultures, and the increasing nuance with which we study the health of our past is a testament to that. The authors of this source book have compiled a significant and helpful corpus of both texts and images for the study of ancient health. It will prove useful and informative for undergraduate courses focusing on ancient health, and could easily be incorporated into larger survey courses at the upper undergraduate and graduate level. Altogether this book accomplishes its goal of not only spanning the impressively wide time frame of 500 BCE to 600 CE, but also addressing its subject through various materials–literary writings are presented alongside artistic depictions, archaeological views, and recorded inscriptions. The authors are also keen to contextualize these materials in modern frameworks, noting the structural causes of ill health, the social and gender variations, and perspectives of not only medical professionals but their patients as well.

The first three chapters constitute the introductory materials, which in themselves are useful overviews of the material conditions of ancient life. The question posed in the first chapter “why study ancient health” and the echoing answer “because there is value in such understanding” is thoughtfully argued. I commend the authors on two specific points they include. First the recognition and inclusion of sources to “illuminate the fluid boundaries between medicine, philosophy, religion, and ‘magic’ in the ancient Mediterranean” (p. 8). Ancient health has never been the sole purview of one discipline or area, but pluralistic, and the breadth of sources included here certainly underscores this view. Second the authors also address the material and structural conditions that contribute to health challenges, like poverty, occupation, and geographic environment. As it has become abundantly clear through social and political economic studies of the last few decades and the most recent COVID-19 pandemic, economic status is a clear index of health outcomes–and the connections made to modern health serve to bolster the proposition that, yes, there is indeed value in understanding the history of health and medicine.

The chapters then proceed thematically, with an excellent balance between directly quoted primary sources and secondary-source analysis, and with an understandable reliance on the Hippocratic texts. Chapter four deals with the connection between human bodies and cosmos, especially noting the body as an environment–”a (micro)cosmos” p. 52. Chapter five moves to the field of medicine as a new profession, and the negotiation of ancient authors with their own skepticism–naturally again making use of the Hippocratic corpus. Chapter six reviews the cultural definitions of health in ancient contexts. Chapter seven delves deeper with the seminal On the Importance of Questioning a Sick Person from Rufus of Ephesus. Chapter eight offers “case studies” and continues the patient-focused clinical explorations, pulling from On Epidemics.

Chapter nine is a varied and significant chapter. It is split into eight different sections covering the “common complaints” we see in the ancient world: Women’s Illnesses; Digestive and Intestinal Ailments; Wounds and Fractures; Bites and Stings; Eye Conditions; Fevers; Mental and Emotional Afflictions; and Epidemics. The inclusion of “‘mental and emotional afflictions”  p. 192 in the list of common complaints is an excellent example of the authors’ wish to “illuminate the fluid boundaries between medicine, philosophy, religion, and ‘magic’” as so many of what we might call mental illnesses today were considered a symptom of other illnesses or having something to do with the divine–thus the ‘sacred illnesses.’ Indeed, there is resounding evidence that mental health is an integral part of physical health outcomes.

Chapter ten is split into five sections, detailing treatments provided for the previous chapter’s “common complaints,” including Regimen; Pharmacology and Drug Therapies; Surgery; Incubation and Dream Therapies; and Therapies of Touch, Word, and Sound.  Researchers and educators with a more material focus will enjoy the inclusion of the surgeon’s tool set (the one pictured is a 1st-2nd c CE set from Colophon) as well as the multiple inscriptions from the sanctuary to Asclepius at Epidaurus.

Chapter eleven moves to the training available to medical professionals, but this chapter also touches on their status in society. Medical practitioners were considered differently in Greece and Rome. Highly practiced individuals with good reputations could be wealthy, famous even, but the authors rightly mention the prevailing low status of foreign and enslaved medical practitioners in Rome. Also laudable is the authors’ attention to gender in this chapter, and how women were likely always involved with health care, whether they were noticed for it or not.

Chapter twelve changes perspective to that of the patient, and an emic view of those experiencing ill health, and their encounters with the medical world. Here I applaud the use of the Attic red-figure kylix depicting Patroclus being bandaged by Achilles in conversation with the Pompeiian fresco depicting Aeneas being tended to by the medic Iapyx. Although I note a missed opportunity to mention Venus, generally understood as helping the medic in this fresco, as an excellent example of medical professionals working alongside divine or magical influences.

Chapter thirteen addresses the ethics of medical professional conduct with the obligated Hippocratic Oath. Chapter fourteen is split into three sections on the life stages and their common struggles: Pregnancy and Obstetric Care; Childhood Ailments and Pediatric Care; and Geriatric Ailments and End of Life. Chapter fifteen is a wonderful addition from a more archaeological view of “healing spaces”, like the surgeon’s house in Pompeii, and military infirmaries, like the one at Novae in modern day Bulgaria. This adds another dimension to the already comprehensive corpus.

The end matter contains a short but informative timeline of the works and ancient authors mentioned, as well as a “Glossary of Subjects” which defines all the medical terms bolded throughout the text (a particularly useful inclusion as a teaching text). There is also a “Glossary of People” with brief but helpful overviews of the ancient sources, their time periods, geographical locations, as well as some manuscript tradition background. I found the index to be accurate and productive.