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THE AUDIENCE OF GREEK MEDICAL LITERATURE - (P.) Bouras-Vallianatos, (S.) Xenophontos (edd.) Greek Medical Literature and its Readers. From Hippocrates to Islam and Byzantium. Pp. xii + 239, ills. London and New York: Routledge, 2018. Cased, £115, US$144.95. ISBN: 978-1-4724-8791-9.

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(P.) Bouras-Vallianatos, (S.) Xenophontos (edd.) Greek Medical Literature and its Readers. From Hippocrates to Islam and Byzantium. Pp. xii + 239, ills. London and New York: Routledge, 2018. Cased, £115, US$144.95. ISBN: 978-1-4724-8791-9.

Published online by Cambridge University Press:  01 July 2019

George Kazantzidis*
Affiliation:
University of Patras
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Abstract

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Copyright
Copyright © The Classical Association 2019 

The volume explores the intended readership of a variety of medical texts, spanning from Greek antiquity to the Islamic and Byzantine worlds, and examines how the reception of a medical treatise across a diverse audience of physicians, students and (educated) laymen conditions the very generation of ‘scientific’ discourse. The term ‘scientific’ requires some qualification in this context; for it would be a mistake to think of ancient medical literature as building on some kind of self-enclosed, technical idiom that was only accessible to a select audience of specialised physicians. The evidence that we have yields a radically different picture according to which medical discourse in the pre-modern world takes its shape and form by investing on its discursive openness, sliding across varying modes of operation and levels of difficulty with a view to a readership that in part consists of people with no knowledge of medicine whatsoever. Some of the Hippocratic treatises were delivered orally in front of mixed audiences; apart from instructing and laying out complicated principles about the human body, health and disease, they were also meant to impress – in which case we should start thinking of their ‘literary’ qualities and whether, for example, a theory about the wind penetrating the body and regulating it from within as a dunastês sounded more like a neat piece of fiction rather than as ‘pure science’. At the same time, we have plenty of evidence to suggest that physicians did not claim an exclusive hold on medical lore. Some of them insist in fact that issues of (maintaining) health and (avoiding) disease can be summed up in a few basic principles which even laymen can easily grasp and follow: science, in this case, is not meant to pose any restrictive barriers between medical authority and the passive body of the patient subjecting himself to external enquiry, examination and treatment. On the contrary, it invests on the comforting thought that attentive readers can become their own selves’ personal doctors, as it were. The present volume does a good job in showing how, while claiming its status as an individual technê, ancient medicine remains sensitive to its sharedness and openness across a stratified audience whose members have different skills, needs and expectations.

Part 1, ‘The Classical World’, consists of three chapters. In Chapter 1 S. Kouloumentas revisits the incipit of Alcmaeon's On Nature, one of the few surviving prefaces of early Greek prose. The text is syntactically obscure but, after reviewing several interpretations advanced in the past, Kouloumentas proposes a convincing reading according to which Alcmaeon addresses his treatise simultaneously to two different kinds of audience: on the one hand, a narrow and specialised audience of Pythagoreans (with whom Alcmaeon could be critically exchanging ideas in a friendly or antagonistic environment) and, on the other hand, an open and less specialised audience. Alcmaeon's pronounced interest in medical matters – among which we find the earliest known aetiology of disease based on the interaction between bodily constituents – is thus framed by a discourse that is ‘technical’ in the sense that it responds to a close group of fellow philosophers, but also oriented towards a wider audience since it constitutes part of a general set of principles regarding (human) nature. In Chapter 2 L. Totelin asks a very intriguing question: since medical idiom features so prominently in ancient comedy, why not also look for inherently comic elements in medical texts? In that case, we should not view Aristophanes as simply extracting material from ‘serious’ Hippocratic sources and then re-contextualising them in a comic frame, but as responding essentially to a comic vein already implicit in medical literature. Totelin's case study is the Hippocratic On Winds (a treatise that must have been orally delivered), whose emphasis on ‘air’ makes it read ‘like a neat, if somewhat over-complicated, treatise on belching and farting’ (p. 31). The hypothesis is attractive, and it could have been further corroborated if Totelin had taken into account comparative evidence from other treatises, especially the Hippocratic On Hemorrhoids. The idea that ancient medical texts could raise a laugh is immensely appealing, and it helps us disentangle ourselves from the fixation that this was ‘serious’ literature intended only for a restricted audience of grave-looking, pensive physicians. That said, there are treatises in the Hippocratic Corpus that seem to have been primarily intended for medical professionals. In Chapter 3 C. Thumiger discusses the patient histories recorded in the Epidemics as one such case. Although some of these reports give the impression of lists comprising random symptoms, Thumiger cogently argues that they are in fact carefully crafted narratives, built in such a way as to facilitate memorisation by operating physicians and medical students. To our sensitivity, the Epidemics read as some kind of literary micro-stories, surveying in a condensed form the life of a patient before s/he dies or survives. But, according to Thumiger, this was not their authors’ original intention: the recorded case histories do not make ‘any explicit appeal to win over lay audiences’; the ‘non-theoretical, observation-based and data-centred’ pace of the narrative reveals a didactics at work appealing to a readership that is ‘firmly delimited as professional and medical’ (p. 58).

Part 2 moves to the ‘Imperial World’. In Chapter 4 Xenophontos discusses Galen's Exhortation to the Study of Medicine and suggests that the work (whose second part is missing) was intended for beginners in philosophy, who were then expected to continue as medical students. One of the chapter's fresh insights concerns the number of parallels adduced by Xenophontos between Galen's and Plutarch's moralising discourse; Galen, so it is argued, appears to have been directly influenced by Plutarch, thus providing us with a nice example of how philosophy, medicine and popular ethics can work with each other in a didactic context. M. Meeusen in Chapter 5 discusses the preface to Medical Puzzles and Natural Problems by ps.-Alexander of Aphrodisias. The work operates on a ‘question and answer’ format (pointing back to the ps.-Aristotelian Problemata physica) and ‘is firmly rooted in a medical school setting’ (pp. 94–5). Unlike ps.-Aristotle who often provides more than one explanation for each problem that is being raised, ps.-Alexander is mostly interested in providing straightforward answers by assuming an authoritative tone that imposes a clear hierarchy between author and reader. As the preface makes clear, not all problems are worth exploring: some of them are too obvious, while others are so obscure that they admit no solution. Therefore, it is proposed that one should deal with problems of an ‘intermediate nature’, which are open to plausible – yet, by no means, conclusive – explanations. As Meeusen argues, ps.-Alexander does not aim to offer an exhaustive corpus of medical puzzles. What is at stake ‘is intellectual not practical training’; the audience is expected to read the collection ‘with an eye of extracting useful aetiological principles that can be reused in the discussion of comparable problems’ (p. 102). This idea of an ‘active reading’ shows that the reader plays an intrinsic role in complementing the text with a virtually endless list of problems, in raising and solving them as instructed.

Part 3 deals with the ‘Islamic World’. In Chapter 6 U. Vagelpohl offers an extremely informative discussion of Ḥunayn ibn Isḥāq's translations of Galen. Rather than stick to a word-by-word translation, Ḥunayn (a) ‘amplifies’ the Galenic text, by expanding it in cases where its content is believed to be ambiguous, (b) ‘annotates’ it with translation notes whose length varies from a couple of lines to several manuscript pages and (c) provides epitomes of entire Galenic treatises in order to make their content more easily available. Although some of these techniques betray a possible engagement with a ‘wider audience’ (p. 124), Ḥunayn's work is mainly targeting practising physicians and medical students. The ‘user-friendly’ Galen, as Vagelpohl puts it in the title of his chapter, undergoes significant adaptations from one language to the other, but still with an eye to a more or less specialised audience. In Chapter 7 E. Wakelnig examines the Arabic reception of Galen's De usu partium. By surveying evidence that spans from the ninth to the early twelfth centuries, Wakelnig shows how in its Arabic adaptation the Galenic treatise is not only read for its medical insights but mainly for its ‘argument from design’. In the Arabic version, Galen's emphasis on a providential, personified Nature is suppressed, and the God emerges as ‘the sole principle of creation’ (p. 142). Ultimately, this suggests an ‘enlarged’ audience, which extends beyond physicians and includes also theologians and philosophers who find the treatise's teleological premise appealing.

Part 4, ‘The Byzantine World’, consists of two chapters. In Chapter 8 E. Gielen offers a comparative reading of two Byzantine texts on human anatomy, the Constitution of Man by Meletios and the Epitome on the Nature of Man by Leo the Physician. Just like in the Arab world Galen's De usu partium reads as a theological treatise, so does Meletios combine his presentation of Galenic material on various body parts with quotations from the Church Fathers (emphasis is once again placed on teleology and the notion of providence). Leo's epitome, as Gielen argues, draws from Meletios’ treatise, but proceeds to eliminate references to patristic literature, thus re-adapting it (often by means of erotapocritic formulas) to the needs of a more professional audience. In Chapter 9 Bouras-Vallianatos focuses on the circulation and textual transmission of Galen's Therapeutics to Glaucon in Byzantium. Bouras-Vallianatos surveys evidence from Byzantine commentaries on the Galenic treatise (intended to elucidate the text as well as ‘instruct future generations of physicians’, p. 193) and medical handbooks with reader-friendly information for practising physicians. Therapeutics to Glaucon, as is shown, ‘constituted a constant source of inspiration for’ the authors of these manuals (p. 194). This is by no means an accident since Galen himself seems to have conceived of this particular work with a wider, well-educated readership in mind.

The editors of the volume rightly point out that, while much work has been done in recent years on ancient medicine, the issue of ‘how medical authors attempted to appeal to particular groups of students’ (p. 1) remains relatively understudied. Admittedly, the volume deals with a novel – and thorny – subject, and for that it should be praised. A more comprehensive introduction, laying out the methodological difficulties involved in this project and seeking assistance from reception theory (H.R. Jauss is mentioned once cursorily, at p. 180), would certainly have helped to better flesh out the volume's scope and high aspirations.