ASKLEPIOS
Studies on Ancient Medicine
Acta Classica Supplementum II
Classical Association of South Africa
This publication has been made possible by a generous grant from
the University of the Free State.
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ascribed to the Classical Association of South Africa or the Editor.
ISSN 0065-1141
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ASI<LEPIOS
Studies on Ancient Medicine
Edited by Louise Cilliers
ACTA CLASSICA SUPPLEMENTUM II
CLASSICAL ASSOCIATION OF SOUTH AFRICA
Bloemfontein
2008
EDITORIAL BOARD OF ACTA CLASSICA
Editor
Prof. Louise Cilliers, University of the Free State
Chairperson of the Classical Association
Dr. J.C. Zietsman, University of Stellenbosch
Editorial Secretary
D r J .F.G. Cilliers, University of the Free State
Treasurer
Dr P.R. Bosman, University of South Africa
Additional Members
Prof. W.J. Henderson, University of Johannesburg
Prof. J .L. Hilton, University of KwaZulu-Natal
EDITORIAL ADVISORY BOARD
Prof. D avid Konstan, Brown University, USA
Prof. Lorna Hardwick, The Open University, UK
Prof. Stephen Harrison, University of Oxford, UK
Prof. Manfred Horstmanshoff, University ofLeiden, The Netherlands
Dr Daniel Ogden, University of Exeter, UK
Prof. John Scarborough, University of Wisconsin, USA
Prof. Betine van Zyl Srnit, University of Nottingham, UK
PATRON
Justice D.H. van Zyl
HONORARY PRESIDENTS
Prof. J.E. Atkinson
Prof. P]. Conraclie .
Prof. W.J. Henderson :
Prof. D .M. Kriel
Prof. D.B. Sadclington
Dr. G. van N. Viljoen
CONTENTS
INTRODUCTION
VERONIQUE BOUDON-MILLOT, The Library of a Greek
Scholar in the Roman Empire: New Testimony from
Galen's Recently Discovered Peri A!upias
FLORENCE BOURBON, Necessity and Timeliness in
Hippocratic Gynaecological Treatises
NADINE BRAND, The S anus Homo in the De Medicitza of Celsus
LoUISE CILLIERS, Roman North Africa in the 4th Century AD:
its Role in the Preservation and Transmission of Medical
I<nowledge
ELIZABETH CRAIK, Myelos: Matters of Life and Death
KLAUS-DIETRICH FISCHER, The Acharistum in a Manuscript
from the Library of Nicholas of Cues
JACQUESJOUANNA, <<L'autre Hippocrate»: un traite anonyme
inedit Sur !es quatre humeurs par questions et reponses (Vat.
gr. 293, XIVe s., fol. 223r-225v)
BRIGITTE MAIRE, A Comparative Reading of Soranos and
Mustio: an Example of €pwTmr6Kpwts
SUSAN P. MATTERN, Galen's Ideal Patient
FRAN~OIS P. RETIEF, Marcus Aurelius: Was he an Opium
Addict?
JOHN SCARBOROUGH, Attalus III of Pergamon: Research
Toxicologist
CONTRIBUTORS
1
7
19
29
49
64
74
86
103
116
131
138
157
PREVIOUS SUPPLEMENTS
I
J.E. Atkinson,
A Commentary on Q. Curtius Rufus) Historiae
Alexandri Magni Books 5 to 7,2. Adolf Hakkert Publisher,
Amsterdam 1994.
INTRODUCTION
This publication had its origin in the July 2007 conference of the Classical
Association of South Africa, whose delegates included a significant number
of international scholars specializing in Ancient Medicine. Most of their
papers, reworked as articles, are included in this book, as are articles by three
scholars who could not be present but kindly sent their contributions (Proff.
Craik and Fischer and Ms Brand). All the articles were reviewed by two
referees.
There was no set theme for the conference sessions on Ancient
Medicine, with the result that the articles in this book - emanating from
scholars in France, Scodand, Germany, Switzerland, the United States and
South Africa- may at first sight seem disparate, yet they do in fact form a
unity, linked by a golden thread. Three of them (by Boudon-Millot, Fischer,
and Jouanna) deal with manuscripts: incorrecdy identified texts are still being
discovered in early manuscripts, while incorrecdy translated texts require
reinterpretation. Gynaecology is the theme of two articles (by Maire and
Bourbon), while two more (by Retief and Scarborough) dea1 with pharmacological aspects. Doctors' views of and advice to patients are discussed in
two further articles (by Brand and Mattern), while the correct interpretation
of a medical term is dealt with by Craik. Finally, the preservation and
transmission of Late Antique medical texts (many of them from North
Africa) is discussed by Cilliers.
Fresh ground is broken whenever a new manuscript is discovered, and
we are privileged to be the first to publish an article on the content of a
treatise by none other than Galen, discovered by V eronique BoudonMillot under an erroneous title in a pre·viously unknown manuscript found
in the V1adates monastery in Thessaloniki. The llEpL ciA.urr(as had been
regarded as entirely lost, in Greek as well as in Latin and Arabic - it was
known only through a reference to the title in Galen's De Ubris Propriis.
Written after a great flre in Rome had destroyed his workshop and library,
which contained many of the books he had authored as well as his medical
instruments and medicines (in particular a few branches of the precious
aromatic, cinnamon), it gives us an important insight into the Pergamene
physician's activities as scholar, physician, surgeon and philosopher.
Scholars who have worked on manuscripts, even those dealing with
matters as mundane as medical recipes, know that their dedication is
occasionally - very rarely! rewarded with an unexpected revelation. In his
article Klaus-Dietrich Fischer traces the history of one of the finest and
2
INTRODUCTION
oldest manuscripts in the Harleian collection at the British Library in
London (Harley 5792) and proceeds to discuss the meaning of the word
acharistum (the title of the recipe), its contents and its administration.
Acharistum appears to be the name of some kind of antidote to various
ailments, but closer study produces a surprising result!
Many of the treatises in manuscripts transmitted to us are anonymous
and have therefore been attributed over the centuries to the great figures of
the past with whose known works they reveal certain correspondences. This
was the case with a hitherto unpublished, anonymous treatise on Greek
medicine in which the theory of the four humours (blood, phlegm, yellow
bile and black bile) is presented in question-and-answer form. This document, discussed by Jacques Jouanna, is one of a series of medical treatises
from Late Antiquity, when the theory of the four humours had reached a
of systematization unknown in Galen's day. These teachings are
generally attributed to Hippocrates, but this Hippocrates - a product of the
Byzantine imagination was not the Hippocrates who was rediscovered in
the course of the Renaissance, and he is therefore called 'the other Hippocrates'. Although this systematic theory of the four humours was cut off
from its roots - the founding treatise on the Nature of Man
it was
disseminated in the Western Roman Empire, notably by the pseudo-letter of
Vindicianus to Pentadius.
Another treatise in question-and-answer form is the subject of an article
by Brigitte Maire. Extracts containing descriptions of the anatomy and
physiology of the uterus, from the 5th/6th century author Mustio's Gynaecia
and Soranus' IlEpt yuvmKdwv 1Taewv, are compared with specific reference
to the methods of composition used by Mustio in his translation/ adaptation
of Soranus' work. The ancient medical practitioners were fascinated by the
uterus, but since the female reproductive organs were poorly understood,
mysterious and difficult of access, they remained perplexed by them. The
discussion of these two authors' presentations also leads to a general consideration of the status of anatomy in ancient medical discourse.
Elizabeth Craik explores the use of the Greek term myelos (usually
translated as 'marrow' but with a wider semantic range) as it was understood
by different authors from Homer to the Hippocratic writers and beyond.
She finds a broad diachronic, synchronic and generic consistency in the
usage of the word which transcends the boundaries between literary genres
(epic, lyric, and tragedy) and between medical treatises (on anatomy,
physiology, and pathology). The significance of nryelos in gynaecological
therapy is also discussed. Problems with the interpretation of the word often
INTRODUCTION
3
arise because it is difficult for us, as modern readers, to divest ourselves of
modern medical knowledge and to resist the temptation to measure ancient
works against this understanding.
Ignorance about gynaecological physiology, function, and pathology on
the part of both doctors and women themselves would have been the cause
of many a death in antiquity. Florence Bourbon recalls how the ignorance
of Deianeira in Sophocles' Women of Trachis leads to the tragic death of her
husband, Heracles, despite her having asked the (inexperienced) young girls
of the chorus for advice. In real life women were usually too embarrassed to
ask for advice and doctors often failed to provide timely treatment, which
meant that the disease would pursue its inexorable course. The authors of
the Hippocratic gynaecological treatises differ from those of the other
treatises in that they seem to have had a profoundly humane vision of their
patients and not to have regarded them as mere clinical 'case studies'. They
discuss certain types of ailment, mention detailed treatments, and give the
impression of acutely observing the course of the disease, winning the
woman's trust, asking the right questions, and listening attentively to the
patient's answers - all of which should have enabled them to intervene at the
right time.
Galen's surviving works contain several hundred 'case studies' of his
patients. In her article Susan Mattern discusses the type of patient that
Galen considered most typical, defined on the basis of age, temperament,
constitution and lifestyle. This was an urban youth between 25 and 40, a
member of the leisured class who exercised in the gymnasium, of moderately
hot and dry temperament, of a masculine disposition (relatively hairy, lean
and hard), rich in the humour of yellow bile, and susceptible to the emotions
of anger and anxiety. The extreme of this type of temperament is the athlete.
Mattern's analysis also reveals that age constituted a fundamental distinction
among male (but not female) patients, and that peasants comprised a
marginal, medically distinct category, characterized by exceptional firmness
of body and by emotion, particularly stress.
Although Aulus Cornelius Celsus was probably not a medical practitioner, the De Medicina, in which he adapted Hellenistic medical theory to the
practical Roman approach in the 1st century AD, is one of the best examples
of a Latin work on medicine. In her article Nadine Brand discusses Celsus'
views on health preservation and the conditions that might affect the sanus
homo, which form the focus of Book 1. The most important points which
Celsus discusses are appropriate exercise, a simple diet, fresh air and sunlight,
rest and bathing (but not too often). Things to be avoided are cold, heat,
4
INTRODUCTION
overindulgence, exertion, and excessive passion, as well as vomiting and
purging merely to lose weight and become slimmer. In short, a balanced
lifestyle should keep the body healthy.
Another way of maintaining one's health was to take antidotes or
medication. Galen tells us that his most famous patient, the philosopheremperor Marcus Aurelius, was dependent on theriac, a universal antidote
which included among its ingredients an extract of the opium poppy. The
antidote was prepared by Galen himself, mainly to treat the emperor's
insomnia. In recent times it has been suggested by scholars that Marcus'
humane nature and remarkable tolerance towards offenders (even his
wayward wife, Faustina) may have been partially due to his life-long ingestion
of theriac. However, an investigation by Fran~ois Retief shows that Marcus'
clinical profile was not really compatible with the diagnosis of an opium
addict (which leads to progressive moral deterioration, among other things).
Retief's quantitative analysis of the daily dose of theriac ingested, based on
recipes dating back to the 2nd century, also demonstrates that the theriac
taken by the emperor did not contain enough opium to cause addiction.
Antidotes to poisons were in existence long before Galen's time: in this
regard, John Scarborough discusses the contribution of Attalus III
Philometor of Pergamum (regnat 138-133 BC), who was famous not only for
bequeathing his kingdom to the Senate and the People of Rome, but also for
his 'weird hobby' - his interest in pharmacology, especially the toxicology of
certain plants, animals and mineral substances. It is recorded that the king
grew herbs in his own garden, both beneficial ones (fittingly called 'Attalids'
in his honour) and harmful ones (which the historians tell us were tested on
convicted criminals); Plutarch tabulates Attalus' poisonous animals (e.g. the
sea-hare) and plants (henbane, hellebore, hemlock, aconite and thornapple).
Scarborough suggests that Nicander of Colophon lfl. 130 BC) was probably
the 'court poet' at Pergamum and that the species and their antidotes, as
determined by the royal botanist and toxicologist, were recorded by him in
his well-known works Theriaca and Alexipharmaca.
Many of the texts discussed above would not have been transmitted to
posterity had it not been for a confluence of events usually viewed as a
catastrophe. The 5th and 6th centuries were turbulent rimes in North Africa.
The Vandal conquest and the Byzantine re-conquest scarcely a century later,
followed by the invasion of the Islamic armies, sent successive waves of
refugees to Europe. Louise Cilliers suggests that many of the scholars who
fled during these political and religious upheavals would have taken \vith
them works by North African authors, such as Helvius Vindicianus, Thea-
INTRODUCTION
5
dorus Priscianus, Cassius Felix and Caelius Aurelianus, who had produced a
great number of medical writings during the 3rd and 4th centuries. This was
an era characterized by the compilation of existing knowledge rather than by
original research. Cilliers points out that these authors - beginning with
Vindicianus - seem to have realized the urgent need to ensure the survival of
the knowledge of the Greeks of old, something which could only be
achieved by passing it on in a language- Latin- which would be understood
by the masses. Paradoxically, it was due to the very insecurity of the times
that such Latin translations/ adaptations were taken to Europe and preserved
for posterity.·
The editor would like to thank the authors for their contributions and
their co-operation in producing this publication. Although medical historians
are not a homogeneous group, there is a wonderful spirit of understanding,
support and enthusiasm among them, which accounts in part for the strong
current interest in Ancient Medicine as a global and local field of research.
Finally, I should like to express my appreciation to Bill and Ann Henderson
for their meticulous care in formatting, typesetting and correcting the fmal
text for publication.
The Editor
THE LIBRARY OF A GREEK SCHOLAR IN THE ROMAN
EMPIRE: NEW TESTIMONY FROM Gi\.LEN'S RECENTLY
DISCOVERED PERI ALUPL1S
V eronique Boudon-1'Aillot
CNRS, Sorbonne University
Galen was a prolific '.VTiter, but of the five hundred treatises written by this
physician of Pergamum in the 2nd century AD, only about a hundred have
been transmitted to us in Greek. Some of the other manuscripts are only
available in Arabic, Latin, or even Hebrew, while yet others are completely
lost. For example, De Indo/entia (IlEpl aXurr(as), about which we only know
from a reference to the title in De Libris Propriis, has so far been considered
completely lost both in Greek and in Arabic:l
'My opinion on the issues of moral philosophy have been made clear in
the following works: on 'The diagnosis of the affections and errors of
each individual', in two books; on 'Moral character', four books;
'Against Favorinus' attack on Socrates'; one book on 'The avoidance of
pain' (rrEpt aA.vTI[as i'v).z
However, a new manuscript of Galen's works, Vlatadon 14, which was
recently discovered in the V1atades monastery in Thessaloniki, has allowed
me to identify I1Epl al-.urr(as under the corrupted title of I1Epl aAuyLa(as,
which is repeated at the end of the treatise in the formula TEXos ral-.rwoD
rrEpl al-.oyw(as .3 Despite this erroneous variation (d.A.uyLa(as I al-.oyw(as),
1 The only remaining parts of the text come from quotations by Arabic and Hebrew
writers; see A.S. Balkin, 'Classical and Arabic material in Ibn Aknin's Hygiene tif the
S out, Proceedings tif the A111erican Acctdenry tif]e~tish Research 14 (1944) 60-65, 110-15 and
M. Zonta, 'Un interprete ebreo della filosofia d.\ Galena. Gli scritti filosofici di
Galena nell'opera di Shem Tob ibn Flaquera', Eura.riatica 39 (1995) 113-23.
2 Galen, Sur ses propres lilJreJ c. 15.1, ed. V. Boudon-Millot, CUF (Paris 2007) 169.17
L Miiller, Se1ipta Minora 2.121.11; Kuhn, 19.45. See also J. Ilberg, 'Ober die
Schriftstellerei des }Qaudios Galenos', RhM 52 (1897) 611-12 on TIEpl aA.vrr[as.
Concerning V/atadon 14, seeS. Eustratiades, KardAoyoS" rill/ El/ rtf f.LOI/i} BAan!uw
(maOVS' Mol/aarifpt) aTTOf(ELf.lEI/{t)l/ /({1)8/K&I/L (Thessaloniki 1918) 57, who unfortunately forgot to mention TIEpl. ahrr[as among the works by Galen contained in
Vlatadon 14. Thls catalogue was also published under the title 'KaTaA.oyos Twv EV
8
BOUDON-MILLOT
there is no doubt that this is indeed Galen's IlEpl aA.urr(as, as will be
demonstrated in the course of this article. I would also add that I have
edited this text with a French translation in Miscellanea in honour of ].
Jouanna (2007).4
About the Vlatadon 14 codex, I will refer to my previous articles and
indicate here that it is a 281-folio 5 manuscript, measuring 305 x 220 mm, 6
dating from the 15th century and probably coming from Constantinople.
Written by a number of copyists, it contains about thirty Galenic or
pseudo-Galenic treatises.? Apart from IlEpl aA.urr(as which can be found in
folios 10v to 14v, Vlatadon, most notably, contains De Ordine Librorum
Suorum, De Libris Propriis and De Propriis Placitis, for which it is the only
Tfj llOVfj BA.aTEUlV o:ITOKEL llEVUlV KUl8LICUlV' in Fpljyopl05" 0 naA.a;uis- 2 (1918) 97-107'
224-37, 274-83, 326-30, 386-404, 437-43, 473-75, 503-07, 708-17; 3 (1919) 29-45,
74-91, 137-50. Both catalogues are mentioned in M. Richard, REpertoire des
bibliotheques et des catalogues de manuse1its grecs, 3rd edition revised and corrected by J .M. Olivier (Turnhout 1995) 782. However, Vlatadon, despite being described by
Eustratiades, couldn't appear in Diels' catalogue (H. Diels, 'Die Handschriften der
antiken Arzte. I. Teil: Hippokrates unci Galenos', Abhandl. Kiinigl. Preuss. Akad.
Wissenschaften, Berlin 1905, a monumental task completed two years later as 'Erster
Nachtrag', Abhandl. Kiinigl. Preuss. Akad. Wissenschaften, Berlin 1907). This probably
explains why Vlatadon escaped the notice of all later editors of Galen's works.
4 See V. Boudon-Millot, 'Un traite perdu de Galien miraculeusement retrouve, le Sur
l'inutilite de se chagriner. texte grec et traduction fran<;aise', in V. Boudon-Millot, A.
Guardasole & C. Magdelaine (edd.), La science medicale antique. Nouveaux regards.
Etudes reunies en l'honneur de J. Jouanna (Paris 2007) 72-123.
5 And not 276 as indicated by Eustratiades (note 3) 57, because, as Pietrobelli
explains in our joint article, Boudon-Millot & A. Pietrobelli, 'De l'arabe au grec: un
nouveau temoin du texte de Galien (le manuscript Vlatadon 14)', CRAI fasc. 2
(avril-juin 2005) 502 n. 11, two folios are numbered 233 and two others 258, to
which one has to add the three folios at the begi~g of the manuscript, which
have not been taken into account in the foliation.
6 Once again, the dimensions given by Eustratiade,s (note 3) 57, namely 30 x 32 em,
differ from those indicated on the microfilm (305 x 220 mm).
7 Twenty-seven complete treatises, to be precise. Eustratiades' list mentions twentythree treatises (which amount to twenty-one when the three books of 'On crises',
counted separately, are combined), to which one must add 'On the avoidance of
pain' (IIEpl ciA.urr(as- f. 10v), not identified by Eustratiades, as well as De Cattsa
Affectionum (IIEpl aLTLUS" f. 15r), De Paro:xysmorum Temporibus (IIEpl TUJV EV ToLS"
rrapoEvallOLS" KaLpwv f. 44v), De Totius Morbi Temporibus (IIEpl Twv Tov oA.ov
voa~llaToS" Kmpwv f. 53v), 'On the order of my own books' (f. 65v), also forgotten
by Eustratiades and De Dignotione in Somniis (f. 100v).
BOUDON-MILLOT
9
remaining manuscript that preserves the entire Greek text. It is therefore an
important witness for the history of Galenic texts.
Uterary genre
The treadse I1Ept aAuTI(as belongs to the consolation genre. Galen explains
we can resist the ills that plague us ;;vithout giving in to sorrow. The
most famous examples of this genre are Plutarch's Consolation to Apollonios,
the Consolations penned
Cicero, Ovid or Seneca, as well as Boethius' 6th
century Consolation ofPhilosopf?J. 8 However, Galen's treatise departs from the
tradidonal theme of consolation in a number of ways: first and foremost in
that it is not addressed to someone in sorrow, but rather to a correspondent
who was surprised never to have seen Galen
sad; secondly, because
the author of the consoladon is the stricken person himself; finally because
the subject is not the death of someone close, but rather the loss of material
as
goods. The themes developed by Galen clearly show Stoic
can be seen in a reference to the main representatives of the philosophy of
the Porch (Zeno, Chrysippus and Musonius), and in identifiable parallels
with Epictetus' Handbook.9 Finally, I1Ept aAuTI(as also belongs to the
epistolary genre, since it presents itself as a letter to a recipient who
probably stayed in Pergamum. The opening of I1EpL aAuTI[as is also
reminiscent of one of Plutarch's treatises, De Tranquilitate Animi (ITEpL
Eu8ujltas), in which the philosopher from Chaeronea addresses his
correspondent Paccius who had asked the author to enlighten him on that
subject, in the same way. Both treatises, Galen's and Plutarch's, also bear
8
Concerning literary genres in Antiquity, see T.G. Rosenrneyer, 'Ancient Literary
Genres: A Mirage?' in A. Laird (ed.), O:iford Readings in Ancient Literary Oiticism
(Oxford 2006) 421-39. On consolation as a literary genre, see E. Boyer, Les
consolationJ chez fes Crees et les Romains (J\Jontauban 1887); J. Cornelissen, Over
Consofatie-Iiteratum: Mededeelingen van bet Nederlandsch Historisch Instituut te
Rome rs-Gravenhage 1926); R. Kassel, 'Untersuchungen zur griechischen und
romischen Konsolarionsliteratur', Zetemata, Monographien zur klassischen
Altertumwissenschaft 18 (J\Junich 1963); and D. Scourfield, Consoling Heliodorus: A
Commentary on JeronJe, Letter 60 (Oxford 1993), which presents in its introduction a
useful general overview of the topoi used in consolation writings.
9 See in particular 73 where the name of Musonius Rufus Epictetus' teacher is
quoted by Galen. Regarding Musonius, see
Disco11rses 1.1.27;
9.29;
3.6.10; 23.29.
10
BOUDON-MlLLOT
strong similarities in that they quote the same anecdotes involving Zeno
and Aristippus.lO
Composition date of the treatise
The composition of I1Epl aA.vTI(as was motivated by a very specific event:
the loss by Galen of a good part of his books and possessions during the
great fire that had just devastated the Palatine Hill. And this event is easily
datable. It is the fire that started in Rome just before Commodus was killed
on 31 December 192. Galen, therefore, wrote I1Epl aAvTI(as right after that
event, which is to say, at the beginning of the year 193.
The great fire in Rome in 192
This great fire (~ J.lEYclAT] 1TVpKma, as Galen used to say, to differentiate it
from other lesser fires) which happened during Commodus' reign, must not
be mistaken for other fires that occurred under Marcus Aurelius. The
damage caused by the previous
had nothing to do with the destruction
brought about by the 192 fire, this time during Galen's second stay in
Rome.
Indeed, we have at least two testimonies
Greek historians of the 3rd
century: that of the historian Cassius Dio (who died in AD 235), and that of
Herodian. These narratives should be compared to Galen's account.
Cassius Dio gives us valuable information concerning the origin of the fire
and its progression in Rome:
'Aside from that, the following signs preceded Commodus' death: eagles
came roaming around the Capitol \\'irl1 shrieks iliat boded noiliing
peaceful; an owl was heard iliere; a fire, which started in a house during
ilie night and reached the Temple of Peace, burned down ilie
warehouse for Egyptian and Arabic traders; ~fter which, continuing to
rise, it reached ilie Palatine where it caused much damage, so iliat ilie
archives of ilie state were all but destroyed. This particular circumstance
showed iliat ilie scourge would not be linllted to Rome, and that it
would spread to the whole universe. The fire could not be stopped by
human hands, even though a great many civilians and soldiers set out to
bring water, and even iliough Commodus himself hastily returned from
10 Regarding Zeno, compare Plutarch, Concerning Eutl!)lmia 467d and Galen, IIEpl
dA.V1r(as 48; regarding Aristippus, compare Plutarch, ibid. 469c-d and Galen, ibid. 42.
BOUDON-I'vllLLOT
11
his house in the suburb; it only stopped when it had burned down all
the bodies it had attached itself to, having nothing left to fuel it.' 11
A passage in Galen's treatise (18) in which the physician of Pergamum
retraces the progression of the fire directly echoes Cassius Dio's
recollection:
'But presently the books on Palatine Hill perished on the same day as
mine, the fire having not only attacked the damaged warehouses along
Via Sacra, but also, before that, those located near the Temple of Peace,
and those further along the road, on the Palatine and the villa we call
Tiberiana where there was a library with many books of all sorts.'
Similarly, Herodian mentions this event which probably left a strong
impression on Galen's contemporaries since it turned, in the space of a
single night, yesterday's rich people into today's paupers:
'The fire started in the Temple of Peace ... It was one of the most
beautiful and luxurious buildings in Rome; it was adorned and enriched
by the offerings of gold and silver that our ancestor's piety had
consecrated. This location being very secure, all sorts of people used it
to stock their most prized possessions: thus, in one night, the fire ruined
many families, and almost everyone had to lament personal losses, as
well as the public disaster. The flames, after reducing the proud building
to ashes, continued onwards and burned down other temples ...
Consequently, it was thought that this accident was anytlling but natural:
people said that the gods, who had started the fire, were the only ones
capable of stopping it; others added that the desttuction of the Temple
of Peace was the infallible sign of a war menacing the empire: this
prophecy was only too accurate, as we will see later on.'12
11 Cassius Dio 72.24 (Boissevain, Berlin 1901, 3, 305): TTUp TE VVKTWP apfJE:v
OLiclQS TtvOS KQL ES TO ELpT]VQLOV EllTTEaOV TGS QTTOfl~KQS TWV TE AL YUTTTlWV KQL
TWV , Apa~(wv ¢opTlWV ETTEVElllQTO, ES TE TO naMnov llETEWpwSE:v E~fjAfJE Kal
TTOAAa. m1vu m!Tou IWTEKaUaEV, W<JTE Kal Ta 'YPU!lllUTa TQ
apxfj TTpOG~KOVTQ
oA( you BEi:v TT<lVTa <Pflapfjvm.
12 Herodian, 1.14.2-6: m'iv To Tfjs EtpJ1vTJs TE!lEvos KUTE<j>AE.xSTJ, llE'YL<JTov Kat
KaAAwTov yEvollEvov Twv E:v Tfj TTOAEt E'pywv· TTAouuLwTaTov BE: ~v mivTwv kpwv,
Bta au<j>aAEWV dvaen!la<JL KEKO<J!lT]!lEVOV xpuaou TE Kal cipyvpou, EICUCJTOS BE. a
ELXEV EKELCJE EflJ]aaup((ETO, aAAG To TTDp EKElVJ]S VUKTOS TTOAAovs EK TTAoua(wv
TTEVT]TQS ETTOLT]CJEV' OfJEv wAo<j>upovTO KOLVfj !lEV mivTES TQ BT]!lOCJLa, EKaCJTOS BE
Ta [5w ahoiJ.
12
BOUDON-MlLLOT
Once again, Herodian's narration directly echoes Galen's, when the latter
depicts in IIEpl a:\urr(as the unexpected and brutal remains of some
inhabitants of Rome (7), such as that of the grammarian Philippides; when
he underlines the burglar-proof reputation of the warehouses on Via Sacra
(8); or when he draws a parallel between the common devastation and his
personal loss (1 0).
IIEpL a:\urr(as is not the
treatise in which Galen deals with the
fire of 192. He makes a passing reference to it in at least three other
texts: On tlt)' OJ1!1l books, (already mentioned), On compound drugs according to
gender and On antidotes. In On 11!)' rmm books, copied after IIEpL a:\urr(as (since
this book is quoted among the works on moral philosophy), Galen
mentions the great ftre twice: flrst, when he
the loss of many works
written during his second stay in Rome (rro:\:\a yvjl.va(wv Ejl.avTov Ell
rro:\:\o'ls rrpo~A~jl.aow taTptKo'ls TE Kat <Pt:\oa6<Pots, <ilv Ta rr:\E'laTa
8tE<P8apTJ KaT T~v 1-lEYciXT]v rrupKmciv,
To Tfjs Etp~vT]s TEjl.Evos
ajl.a KaL rro:\Ao'is a:\:\ots EKaU8TJ) and secondly, when he alludes to the
a
u
conferences and meetings that used to take place in the Temple of Peace
before it was burned down (KaTa haaTT]V ~jl.Epav ds To Tfjs Etp~VTJS
a<PtKVOUjl.EVOl, KCLTQ 0 Tl Kal rrpo TOU Kau8fjvm TTU(JlJ! ~v E8os
a8pot(Ea8m TOLS TCtS AOYLKUS
jl.ETHXELPL(Ojl.EVOLS). 13
In On compound drugs according to gender, Galen explains to his readers how
he had to rewrite a new version of this essay after the two first copies were
destroyed in the 192 flre:
'I had already
two years previously, 14 a book of which I had
published tl1e first two copies, but I had left
-w-iili ilie oiliers, in
my deposit on ilie Via Sacra (E:yKaTaAEt<PSE.vTwv 8€: E:v TD KaTa T~v
lEpav 68bv ccrro8~KTI), when ilie Temple of Peace and ilie great libraries
of mount Palatine were completely devastated by the fire (~v[Ka TO
Etp~v11s TEilEvos 5Xov E:Kaue'l Kal KaTa To IIaXanov at !lE')'aAaL
~t~Xto8~Km).
During ilie catastrophe, many auiliors' works were
when it comes to my own, all those iliat were in the
warehouse I mentioned, were destroyed (TTIVLKauTa yap
TE
TTOAAWV cirrwA.ovTO ~l~A(a Kal TWV EflWV Q(Ja KaTa T~V arro8~KTIV
EKELVTJV EKELTO), and none of my Roman friends could guarantee that
13
Galen, On "!Y o1vn books, 3.7 Boudon-Millot (note 2) 143.1-4; Milller (note 2) 2.
99.23; KUhn (note 2) 19.19, and 3.14 = Boudon-Millot (note 2) 144.15-19; Milller
(note 2) 2.101.12; KUhn (note 2) 19.21.
14 Galen probably means here that he had a reviewed and corrected copy of the
book for publication, but that it had not yet been made public, oilierwise ilie rest of
this text would make little sense.
13
BOUDON-MILLOT
they had copies of the first two books. Since my friends were
encouraging me to write the same treatise anew, it seemed necessary to
mention the previously published works, so that should someone
venture upon one of these copies, that person wouldn't ask why I had
covered the same themes twice.'15
Finally, in On antidotes, which was written under Septimius Severns, Galen
regrets the loss of one particularly precious aromatic, cinnamon (also
mentioned in I1Epl ciA.uTI(as 6). He had indeed 'left a few branches in the
warehouse where he kept his most prized possessions. And when it was
destroyed by the fire which also burned down the Temple of Peace, all he
had acquired of the five existing varieties of cinnamon perished' (aTIE8Ej1TJV
u
6A.Iya Tiaptl E.11auTQ KA.wvw, KaTtl T~v aTio8J1KTJV, E.v
mivm 11ou Ttl
TL j1aAcpEaTaTa KTJlj1aTa TIEpLd XETO · KaTaKau8EL<JT]S' 8€ ain~s, emoTE
Kat TO TllS' ELpJlVTJS' TEj1EVOS' EKUU9T], Kal TWV aA.Awv m€VTE 8wcpopwv TOU
KLVVUj1Wj10U TIUV Q(JQ]J EKEKTJlj1TJV U1TWAET0).16
But of course, I1Epl UAUTILUS' is the book in which Galen
us the
most details on this fire, some of which are entirely new. Galen thus
confirms the existence of depositories and warehouses (aTio9~Km) near the
Via Sacra (2). Those depositories, contrary to what Moreau thought,17 are
quite distinct from Galen's personal residence in Rome, whose exact
location we cannot identify in the current state of our knowledge. They
were safe places where one could deposit valuables, apparently at interest
(9), and they were considered fireproof because
were made of stone,
not wood, except for the doors (8: Ttl TLj1UAcpE<JTaTa TWV KTTJ!l<hwv E.v
alJTaLS' cl1TETL8EVTO, eappELV
aUTaLS' <Ecpa<Jav> oui TO ll~TE ~UAOV
aunxs
11~ KaTa TUS' 9up(8as), and also because they were far
from any particular house and heavily guarded (ll~TE nva ')'EL TVLa<JLv
on
LOLWTLK"flS' OLKEf.as, ETL TE
15
cppoupEL<J9m <JTpanwnKij cppoupc;i).
On compound dmgs according to gender 1.1 (Kuhn 13.362).
Galen, On antidotes 1.13 (I<iihn 14.66).
17 P. Moraux, Galien de Pergame. Souvenirs d'un medecin (Paris 1985) 24, is thus a bit
rash in identifying this warehouse as Galen's personal residence when he writes 'In
Rome . . . Galen took lodgings not far from the Forum of Vespasian, near the
Temple of Peace. This is where his library was; this is where he kept the original
manuscripts, published or unpublished, of his own works. Finally, this is where he
deposited his rich collection of "simple medicines" ... Unfortunately, a few years
before Galen's death, all these treasures were lost to the flames.'
16
14
BOUDON-MILLOT
Analysis and content of the treatise
I will now flnally deal with the contents of IIEpL aA.un[ac; and the very
concrete information Galen gives us about his life in Rome. In IIEpL
aA.un[ac; Galen is answering one of his friends who had asked him how he
managed never to give in to sorrow, even after the loss of his most valuable
possessions. However, the name of the person for whom Galen's treaty was
intended, is not mentioned in IIEpL aA.un[ac;. The physician of Pergamum
only tells us he is one of his former fellow disciples, who received the same
education as he (57) and whose temperance Galen praises (79). This person
had lived in Rome, just like Galen (1), and is now back in his home country.
Aside from the considerations and advice stemming from moral
philosophy, IIEpL aA.un[ac; is packed with details concerning the doctor's
everyday life. Galen thus tells us that he gave particular attention to the
making of his instruments, carefully crafting wax prototypes himself before
he gave them to the blacksmiths to forge (4-5):
'<And you said> you were surprised, not that I had felt no sorrow
when the fire destroyed part of the silver, gold, silvetware and numerous
IOU s that were kept there, but rather that I also did not regret it when it
burnt the great number of books I had written, as well as a wide
selection of varied medicines, both simple and compound, and
instruments of all kinds: (5) tools well adapted to medicine, that I said I
had lost, but was trying to ftnd, and tools that I had discovered, for
which I had made wax models that I gave blacksmiths to forge, so that I
cannot get new ones without much time and effort.'
Galen also describes the exceptional collection of medicines he owned (31):
'I had decided to possess the recipes for really astonishing remedies,
recipes no one else had in the Roman world, which happened partly by
chance, and without me having personally colletted them beforehand.'
Afterwards, Galen explains how he inherited the collection of remedies that
a rich citizen of Pergamum had acquired. He also tells us how, when he
arrived in Rome for his flrst stay, he met one of his former fellow disciples
Teuthras, whose collection was passed on to Galen after the former's death
during a plague outbreak.
Galen tells us that he used to have a house in Rome, and a country
house in Campania where he spent the summer. In Rome, he used to
BOUDON-MlLLOT
15
deposit his most precious belongings in one of the warehouses located
alongside the Via Sacra, which, as I have said, were thought to be
indestructible. Likewise, he used to leave a copy of his works both in this
warehouse and in his house in Campania. And had the fire happened just a
bit later, he would have had the time to go to Campania to deposit the
books he was currently writing (21-23):
(21) 'Indeed, all my works that were meant for publication were at that
rime copied down twice, except for those that were meant to stay in
Rome, because my friends in Pergamum had asked me to send d1em all
the works I had composed so d1at they could deposit them in a public
library, like others had done for many of my books in other cities, and
because I also wanted to keep a copy of everything. (22) Therefore,
there were copies of all of my productions in Campania, except for
those d1at were meant to stay in Rome, as I said. (23) But the fire started
around ilie end of winter, ' 8 while I was planning to bring to Campania
bod1 those of my books iliat I wanted to keep there and d1ose that were
supposed to be sent to Asia in the summer, to profit from the Etesian
\vinds. 19 Fate trapped us by robbing us of so many books, particularly
the one on vocabulary I had compiled from all the ancient comedy.'
Likewise, Galen gives us precious details concerning his personal library.
He had copied by hand a number of works by ancient authors (6) and
written a great many synopses of various medical and philosophical works
(30). He informs us that he composed two treatises that were up to now
unknown to us: Agaimt Epimrus (68) and On tich people infatuated 121ith monry
(84). Among the main authors quoted in the text, most notable are Homer
and Plato (13), Theophrastus, abundantly mentioned (15-17), Eudemus
(probably the anatomist and contemporary of Herophilus), Chrysippus (15),
Aristotle (17), Didymus (24-27), Hippocrates (25-26), but also the lesserknown names of Cleitos and Phanias (15), Philistion and Ariston (26) and,
more generally, the ancient grammarians, orators, doctors and philosophers
(13), the comic authors and Attic prose writers (28):
The fire broke out just before the assassination of Commodus on 31 December
192, which does not correspond, to be precise, with the end of vlinter.
19 Etesian winds are winds that blow on the Aegean Sea and across the Bosphorus
during the warm months, from May till September, i.e. during the best navigating
season.
18
16
BOUDON-MILLOT
(14) 'Aside from those very important and numerous books, I lost on
the same day all the books that I had written down after correction to
serve as perfect models, exempt from obscurities and copying mistakes,
so as to claim for myself an edition based on what I had further
discovered, after having worked on the written form to reach exactitude,
so that there was nothing in excess and nothing missing, not even a
simple or double paragraphe, 20 or an ill-placed coronis between books,2 1
not to mention commas and periods, 22 which as you know have so
much in1portance in complex books that whoever pays attention to
them has no need for a commentator. (15) Such were the books by
Theophrastus, Aristotle, Eudemus,23 Cleitos24 and Phanias,25 as well as
most of those written by Chrysippus and all the ancient physicians.'
20
All the punctuation marks mentioned by Galen in tlus extract have t!Us in
common that they indicate pauses and articulations in the discourse. On the
question of punctuation (in papyri), see G. Cavallo, Ubri Scritum Scribi ad Ercolano.
Primo Suppl. a CEre 13 (Naples 1983) 24. The simple paragraphe (usually expressed
by a simple horizontal dash) is the most commonplace and least constricting sign; it
indicates the end of a development or paragraph; see Aristot. Rhet. 3.8.1409a21. The
double pamgraphe (or duple) presents 'different aspects that could have corresponded
to different degrees in strengili, if not to specific values (for instance, to delinut a
quotation inside of a longer period)', according to D. Delattre, La Villa des Papyrus et
les rOttleaux d'Herculanum. La bibliotheqt~e de PhilodeNJe. Editions de l'Universite de Liege,
Cahiers du CEDOPAL no. 4 (2006) 60.
21 The coronis is a punctuation mark in the shape of a curve, which is chiefly used to
mark the end of a book, as Cavallo reminds us (note 20) 24 n. 19. It is the strongest
of all punctuation marks, and therefore remains relatively rare.
22 The word crn 'Yil~ belongs to the geometrical vocabulary and refers to the period
mark. Used as punctuation, it is used as an end period; see Killin (note 2) 3.815.9.
The unocrn Yll~ indicates a lesser punctuation and corresponds to the comma;
Dion. 'Thrax, Ars Gramlll. 1.1.8.1.
23 Galen mentions more than one Eudemus; see the different Eudemus' listed by H.
von Staden, Herophilus (Cambridge 1989) 62-63. Apart from Galen's contemporary,
the Peripatetic philosopher Eudemus of Pergamum, the two most serious
contenders are the Eudemus, mentioned by Galen in his Method of healing, 6.6 (Kuhn
10.454) as the inventor of blistering, and particularly Eudemus the anatomist,
frequently mentioned by ancient writers, and by Galen himself (see On my own books
3.32
Boudon-Millot [note 2] 152.18; Miiller [note 2]2.108.14; Kuhn [note 2]
21.30) at the same time as Herophilus, whose master and initiator he is reputed to
have been.
24 One Cleitos is mentioned by Diog. Laert. 7.191, as being the dedicatee of a
treatise by Chrysippus. /\ Cleitos is also mentioned by Lucian, DMort. 13.6. In the
summary Osaybia has given of tl1is part (see Uyun al-anba, ed. Miiller & Le Caire,
=
BOUDON-.MILLOT
17
Galen also took special pleasure in interspersing his text with quotations
from Euripides (52, 56 and 77) and anecdotes taken from the lives of
Aristippus (39-46), Socrates and Diogenes (45), as well as Zeno (48) and
Musonius (73).
llEpL d.A.un(as has also preserved a great number of names, those of the
collectors Aristarchus, Callinos and Atticus, whom Lucian had already
mentioned, and that of Pedukos (or Pedukinos), thus far unknown (13).
Galen also mentioned some of his contemporaries, that of his fellow citizen
of Pergamum and disciple Teuthras, already mentioned, whom Galen met
again in Rome and to whom he owed a good deal of his vast collection of
remedies (34-45), and that of the grammarian Philippides, who, as far as I
know, has not been mentioned elsewhere (7):
'And <you were saying> that you also heard that Philippides,26 the
grammarian, died after losing his books in the
overcome by despair
and sorrow, and that so and so went around tov,m dressed in black for a
long time, emaciated and ashen-faced, as though in mourning.' 27
Finally, he doesn't shy away from more personal memories when he alludes
to the difficult years during Commodus' reign (54), or to the intellectual and
spiritual legacy of his father, grandfather and great-grandfather (58-59):
(58) 'For I had a father thanks to whom, each time I remember him, I
can feel my soul improv-ing. Indeed, no man has honoured justice and
temperance as exactly as my father, and thanks to these same virtues, he
naturally kept this disposition, without the need for philosophical
speeches. (59) Nor had he neglected philosophers during his youtl1 with
his father, my grandfather, having been trained since childhood both in
1882, vol. 1, 84.31-85.2), they are mentioned alongside Aristotle, Anaxagoras, and
Andromachus (whose mention incidentally seems rather surprising), whose names
never appear in conjunction in the whole treatise.
25 Concerning Phainias or Phanias (both spellings can be found), a Peripatetic
philosopher from Ephesus, see Diog. Laen. 2.65; 5.37; 6.8.
26 I have found no trace of a grammarian by the name of Philippides, if that is his
name- our manuscript has a lacuna here.
27 Herodian 1.14.5 alludes to these people who, in tl1e space of one night, had lost
everything and, from rich as they were, became poor (aAA.a TO 1TUp EKELVT]S' vuKTOS'
1TOAAOUS' EK TIAOUITLWV 1TEVT]TUS' E1T0l T]CJEV).
18
BOUDON-MILLOT
virtue and in architecture, fields in which this attitude 28 also held the
first place for that man. 29 And my father said his father had had a life
just like his own, but also like the life his own father and grandfather
had had, according to him, the former being an architect and the latter a
geometer.'30
Incidentally, we note that Galen gives us interesting information concerning
his forebears' activity up to the third generation. We already knew his father
was an architect; we now know that his grandfather was one, too, and that
his great-grandfather was a geometer.
To conclude, IIEpl aA.mr(as
us an important testimony for our
knowledge of the intellectual circles of 2nd century Rome. It also reveals
precious details concerning the Physician of Pergamum's intellectual
training, his lifestyle and philosophical convictions.
AuTo here obviously refers to TOUTO to describe this philosophical attitude made
of justice and temperance.
29 I.e. his father's father.
30 Galen also refers to his father, grandfather and great-grandfather in On nry mvn
books 14.4 = Boudon-Millot (note 2) 164.25-165, 2; Miiller (note 2) 2.116; Kiihn
(note 2) 21.40:
T~V TWV Iluppwvdwv chrop(av E::VE1TETTTWKELV
Kal auTOS, EL
ll~ Kal TU KaTa 'YEW!lETp[av apLI:l!lT]TLK~V TE K((L AO'YWTLK~V KaTELXOV, EV
E1TL
28
av
TT AE'icrTov U1TO n!JnaTpL nmlkUOjJ.EVOS E~ apxf\s TTpOEAT]AU8ELV OTTO TTCJ.'TTTTOU TE Kal
TTpomiTTnou 8ta8E6EyjJ.EVcp T~V 8Ewp(av. But Galen also adds a few entirely new
details concerning the respective occupation of each one of them.
NECESSITY Ai\TD TIMELINESS IN HIPPOCRATIC
GYNAECOLOGICAL TREATISES
Florence Bourbon
Universite Paris IV-Sorbonne, IUFM de l'academie de Paris
In the Hippocratic Collection, the gynaecological treatises are similar to Diseases
II because of their stylistic characteristics and medical quality. The authors
unlike those of Epidemics did not strive to establish individual index cards
for each patient with a name, date and place;1 instead they chose to show
certain types of ailments, leaving little room for the doctor's personal
testimony. They drew up clinical charts, came up with detailed treatments
and conscientiously made a list of all pharmaceutical formulas which could
prove beneficial. This acute sense of observation was backed up by doctors
who listened attentively to their patients; consequently, these doctors had a
profoundly humane approach to their patients.
Hippocrates, Diseases of Women 1, c. 62
In the collective writings constituting the gynaecological treatises, a
distinctive voice underlines this characteristic in chapter 62 from Diseases of
Womm (Book I, c. 62, 112.23-114.7 Grensemann = 8.126.4-19 L):
1 All these ailments
more often to those women who have not
borne a child, but
also frequently happen to women who have.
These diseases are dangerous, as has been said, and generally they appear
as acute, serious and difficult to understand because of the fact that the
women share in the diseases. 2 Sometimes they do not know why they
are sick until they become acquainted (E!l1TEtpot) with diseases from
menstruation and when they are older (yEpatTEpat). Then both necessity
and time (~ TE avayKll Kal 6 xp6vos) teach them the cause of the
diseases. Sometimes, when women are unaware of what they are
suffering from, the disease has become incurable before the doctor has
learned correctly from the patient what she is
from. 3 For tl1ey
are also ashamed to tell, even if they know. They find it shameful
because of their inexperience (imo aTIELPLllS) and ignorance. At the same
time, doctors also make mistakes by not learning precisely the cause of
1
In the gynaecological
there are only two individual forms: Diseases
lV'ometi c. 40 and Barret! Wometl c. 232.
of
20
BOURBON
the disease, but treating it as though it is a masculine disease. I have
already seen many women die from this type of suffering. 4 It is essential
to immediately and precisely enquire into the cause. For the healing of
diseases of women differs greatly from the healing of diseases of men
(translation K. Whiteley). 2
If this excerpt seems to you like a complete discovery, you were probably
surprised by the tone in this piece of technical literature exposing the tragic
plight of sick women. The ailments they suffer from go far beyond those of
ordinary mortals, and can become incurable and deadly; above all, the
likelihood of being cured is reduced to nothing by the accumulation of
aggravating circumstances, such as the patients' ignorance, the shame they
feel and the doctors' incompetence. When women have overcome the first
obstacle, they usually fall victim to the other two. Hence women suffer in
solitude; they are the victims of their own ignorance3 and of the ignorance of
others, and the qualified doctor who intervenes too late can do nothing but
watch them die.
Sophocles, Women of Trachis
When one reads this excerpt, the image of Deianeira weeping on her
marriage-bed may spring to mind. Deianeira, whose fate is intrinsically linked
to her condition as a woman; Deianeira, whose ignorance has disastrous
consequences; Deianeira, whose feeling that things are beyond repair sends
her down a spiral of despair while it outrages the doctor one does not treat
a woman the way one treats a man, and even if it's too late for some women,
there is still time to help others.
When Deianeira, in Sophocles' tragedy Women of Trachis, realizes the
deadly effect of the philtre with which she coated Heracles' tunic in order to
revive his love, she finds refuge inside the palace, racked by despair. The
nurse relates the moments preceding her suicide:
And when she had ceased from that, suddenly I saw her burst into the
marriage chamber of Heracles, and shadowed as to my eye so that it
2
The Greek text is from the Grensemann 1982 edition, but the breakdown of the
text into paragraphs is mine. The English version was kindly given to me by Kathy
Whiteley to whom I address my warmest thanks.
3 On the women's medical knowledge in the Hippocratic Collection, see Dean-Jones
1995:41-59 and King 1998:135-38.
BOURBON
21
would be secret; and I saw the woman casting blankets on the bed of
Heracles. When she had finished that, she leapt up and took her place in
the middle of the bed (€v jlEO'OLcrLv EUVUTT}p(ov;). Hot streams of tears
burst from her eyes, and she said, '0 my bridal bed, farewell now for
ever, since you will never
receive me to lie upon this couch
(EuvTjTpwv) (Tracb. 912-22). 4
In the staging of the messenger's address Sophocles emphasizes the solitude
of the heroine: Deianeira enters Heracles' room all alone, makes the
marriage-bed,s takes her place on it and seems to be joined to it. She knows
that nobody \Vill join her there and that she has no one to talk to: her words
are addressed to the marriage-bed, symbolizing her love and her status as a
married woman, as suggested by the word-pair EuvaTTJp(mc; /EuvTjTpwv.
Like all tragic heroines, she may
accused of uPPL<> (hubris); she wanted
to free Heracles from his new lust for lole and therefore carried on
regardless of Cypris' divine will. Yet she is first and foremost a woman,
victim of her own ignorance;6 she trusted an ill-intentioned centaur who
recommended a remedy even worse than the evil itself. By sending the
poisonous tunic to Heracles, Deianeira does something irreparable. Even if
he were to survive, her husband would feel nothing but hatred for her. It is
too late to save Deianeira and she commits suicide. The nurse overhears her
last moans while the doctor is powerless during the last moments of a patient
who was not treated in time.
Yet, Deianeira had broken the silence and asked for help. Before she
sends the deadly tunic, she dares to confide in the coryphaeus (Trach. 58493):
DE. But in the hope that I may somehow overcome this girl with spells
and charms, the deed has been contrived ... unless you think that
what I'm doing is foolish! If so, I shall abandon it (EL 8E: jl.Tj,
TIETIUUUOjlaL ).
CH. \Vhy, if one can have any faith in the performance (Ev TOtS
8pWjlEVOLc;), we thinl~ you have not been ill-advised.
4
Translation Uoyd-Jones 1994:213-17; Easterling 1982:189.
Easterling 1982:189 points out that the preparation of Heracles' bed echoes the
one performed by Hyllos for his father in lines 901-02.
6 Lichas also tries to keep Deianeira in a state of ignorance
hiding !ole's identity
from her. Added to the lies of Nessos and Lichas are !ole's silence and the chorus'
lack of experience.
5
22
BOURBON
DE. My faith extends so far, that I can believe it, but I never put it to
CH.
the test (TIELPQ.).
Well, you must know when you take action, since even if you think
you have one, you have no way of testing it unless you try it
(1TELPWilEVTJ).
From the point of view of the plot, the evasive answers given by the
coryphaeus, underlined by the repetition of the verb ooKELV,' leave the
heroine entirely accountable for her actions. Her situation, surprisingly,
reminds us of the plight of sick women: the individuals Deianeira confides in
despite her shame, have hardly more information than she has since the
chorus is composed of ignorant young girls. Fate is in marching order
(EPXOJlEVa JlOLpa, 850), leading Deianeira to an inexorable death.
Must ignorance lead sick women to such a tragic ending? Can the doctor
check the course of events?
Necessity and time
In the Hippocratic gynaecological treatises, doctors acknowledge the
unavoidable aspect of certain bodily reactions and of certain pathological
developments (see in particular DWI.8.10.9; 64.14; 78.14). The beginning of
chapter 133 in Diseases of Women II (15.12-17 Countouris 1985 8.280.12-17
L) gives us a perfect example:
=
\Vhen the womb rises against the hip, if it is not S\"llifdy restored to its
proper position, it eventually dries out: there necessarily (d.vci)'KTJ)
follows a curvature of the orifice and, because it has moved upward and
because of the curvature, the orifice shuts. Thus curved and shut, it
becomes hard, tense and cripple.
The physician describes a series of reactions (a<;:tually running down a whole
page in the Littre edition) and the sickness is comparable to a process, which,
if not checked, takes a disastrous turn (with, down the line, an incurable
ailment and the patient's death). The term avayKTj is to be taken in the sense
7 Easterling 1982 notices that the verb oOKEtv means 'to seem' and 'bethought' in
lines 586 and 589, and 'to think' in line 582. She refers to Jebb 1892, who suggests
that TO oOKEtv means 'e"-'Pecting to succeed', and Kamerbeek 1970, 'seeming likely to
succeed'.
BOURBON
23
of a logical sequences rather than that of a fatality one could not fight
against. In chapter 62, the second paragraph explains what befalls women
whose experience (EflTIELpOL) and
(yEpaLTEpm) teach us about gynaecological diseases; the use of cLVcl)'KT] (necessity) underlines the fact that women
face the facts and understand on their own the logic of their body if only life
leaves them time to do so, that is to say, if they do not suffer from serious
ailments. The pair cLVcl)'KT]/XpOVOS (necessity/time) work as an informant, a
part the doctor could have played had he been called upon. Yet if women
suffer from a serious ailment when they are still young and inexperienced,
time is on the side of the disease which can become deadly.
Time, xp6vos, as a worsening factor, is confirmed in the accounts given
of these ailments
in particular DTV" 1.8.30.4 L and DTV" II.8.266.4 L) and
may lead to death (DTF?" II.8.282.22). However, such a death mostly appears
as a possibility in gynaecology, as shown in the prognosis, by the recurrent
use of the adjective Elavan}8T]S ('which t!IC!JI cause death').
Altering the course of events
When time is against the patient, the doctor tries to step in before the disease
becomes incurable. The feeling of urgency is conveyed by such expressions
as ws TUXUJTa, 'as fast as possible', rrplv av, 'before' and EL 11~, 'unless', for
example in the prognosis presented in chapter 6 in Nature if Women (8.17-19
Bourbon 7.320.4-5 L):
Often, because of the suppuration, the sick women are cured using
shredded linen, and they die from the flow, unless you carry out cautery
or make an incision.9
The recommended solutions are extreme remedies,10 which must be applied
as quickly as possible to avoid the patient's death. The situation is similar in
chapter 38 in Diseases ifTV"omen I (132.6-19 Grerisemann 8.94.16-20 L):
8 The term ava:yKT] can even be used to provide, in hindsight, an explanation in an
aetiology (BW 8.432.4-5 L).
9 The tragic aspect of the prognosis is intensified by a chiasmus in the Greek text:
the complications (EKrrufaKOVTaL, 'they produce pus'), followed by an ineffective
treatment (expressed by two participial clauses Ell!lOTOL '}'LVO!lEVm ~eat pEOJl.EVat)
may lead to a fatal ending (arro8vl]u~eoumv,
die').
10 Cauterization is suggested prior to an incision (or bleeding) because ftre is
supposed to stop the flux (see Jouanna 1999: part 2, c. 3).
24
BOURBON
Yet sometimes nothing comes out, which is, contrarily, a sign of death,
unless the vein is prompdy incised or the stomach softened; in d1at case
it is better to turn to enemas; if the woman vomits easily, she must be
made to vomit; it is exceUent to urinate and sweat. For aU these means,
the timely moment (Kmp6s) arises when needs be.
The sentence closing the chapter establishes a direct link between the
doctor's intervention and the notion of Katp6s. \X'hen the doctor wants to
check the development of the disease, he must watch out for the right time,
Katp6s, which appears like a rift in the course of time, a rift the doctor must
step into knowing it will happen only once. According to the author of
DiJeaJeJ I chapter 5 there is even a Katp6s for each disease. If the doctor
intervenes at the right time, the critical time, 11 he may alter the course of
events and help the patient escape death. Which is precisely what the
coryphaeus did not do when there was still time to stop Deianeira
(remember here the TIETiaucrojlat pronounced by Deianeira when she asks
the chorus).
The time of intervention in the course of the treatment must be
considered carefully. The doctor must choose the right time for a meal (DW
II.8.298.8 L) or for a milk diet (Dff7II.8.246.3 L) or wait for the right time to
move on to the next stage (DW II.8.258.21 L). Chapter 133 in Diseases of
l:Pomen (8.294.5-9 L) is revealing in this regard:
If applying only once seems sufficient to create an insufflation of the
womb, you may stop; but if there is still need, apply like before.
Consequently, when the time is right (omv ooKElJ oOL Kmp6s dvm),
make a preparation for a vapour-bath, witl1 aromatics.
,
The doctor patiently waits for the desired effect brought about by the
pessaries to be complete in order to administer an effective fumigation. It is,
however, not specified how to obtain the pessaries' effect, hence the text
lacks information. Did the Katp6s depend solely on oral tradition? Could it
be taught at all? The choice of the right moment probably depends on
11
The term Katp6s can bear the notion of space; see Trede 1992:38-44. When it
bears a notion of time, it underlines the breaking point or the meeting point (ibid. p.
46). In this case it could underline a change in the course of events. The kairos can
have various and multiple definitions, whether it deals with therapeutics (the object
of our present study) or aetiology and semiology: see e.g. 11iiX.A.ov Tou Katpou or
Kmpou (NW" 7.342.6; DW !.8.14.18, 8.32.9, 8.64.7 and 8.66.2). On the meanings of
kairos in the Hippocratic Collection, see Trede 1992:147-88.
BOURBON
25
general knowledge, on individual professional experience and on the taking
into account of specific circumstances. We now have a better understanding
of the beginning of Hippocrates' aphorisms: 'life is short, art is long,
opportunity is fleeting, experience is perilous and decision difficult.' One
must bear in mind here the dialogue between the chorus and Deianeira, and
the fluctuation between decision (80KELV, 'to seem', 'to think') and
experience (rrEI.pq./TIELpO!-LEVTJ).
Mapping out the course of events
Yet, in Hippocratic therapeutics in general and in gynaecological therapeutics
in particular, Kmp6s does not only constitute a chance one must take. The
authors of the gynaecological treatises also use this term to refer to a notion
of duration, as shown in chapter 241 from Barren Women (8.454.11-16 L):
In this particular case, medicines facilitating a downward evacuation
must be administered at intervals while the entire body and the womb
may benefit from a vapour-bath mixing vinegar and sea water with
incandescent stones thrown in. Cy'Press powder may be added to the
preparation, together \vith crushed bay leaves and po!Jcnetmml mqjtls
leaves. The session may last for as long as deemed appropriate (rrupt fjv
OE OKOLOV av OOKElJ Katpos Elvm xp6vov).
In this account, the vapour-bath session is the second step in the treatment.
The composition of the pharmaceutical liquid is detailed and followed by an
indication of its approximate duration. The practitioner must assess the
duration of time in the treatment accorcling to its effect, in the exact same
way he had to choose the right moment to administer the second treatment
in chapter 133 in Diseases if Women. Furthermore, the mention of Kmp6s may
sometime conclude a recipe at the heart of a list of remedies:
Expulsive pessary:
salt, rat excrements, wild cucumber, and a
of half-cooked honey to pour on top: take a drachma of resin,
it to the honey, the cucumber and the rat excrements: crush
everything until you obtain pellets, apply them against the womb for as
long as deemed appropriate (E'ws av OOKElJ Katpos Elvm) (DW L78,
8.188.8-13 L).
The indication of duration in the nosology account is comparable to what we
would nowadays call 'directions for use'. In most cases, there is no link
between Kmp6s and time, and i<aLp6s is only concerned with the choice of
26
BOURBON
ingredients (DWII.8.254.18 L; Supeif. 8.504.4 L) and their order (BW 8.422.2
L = Supeif. 8.498.6 L). The timing refers as much to the pharmaceutical
content as it does to time management.
Moreover, the dosage and the duration of time are sometimes intimately
linked:
Wash with hot water and clean the privy parts and ulcerations using a
sponge or limp wool dipped in hot water, then, dip the sponge or the
wool in pure wine and use it similarly; apply the ointment using this
medicine, as many times as deemed appropriate (OKOCHIKLS" QV 8oK{!]
KULpos- Elvm) (DWI.64, 8.132.11-15 L).
Administering the medicine with increased frequency leads to an increase in
the quantity of medicine prescribed. Conversely, the doctor can space out
the treatments:
When the ulceration decreases, when the pains ease off and have longer
intermissions, administer medicine in order to evacuate downward rather
than upward, placing intervals as long as deemed appropriate (8wA.EL m~v
xpovov OKOCJOV av 8oKE1J KULPOS" Elvm). Also use temperate vapourbaths and elevate the patient if deemed appropriate (~v 8oKE1J hcicrTOTE
Kmpos- Elvm). Thus the patient may be cured. This disease is rather
temperate and may cause death. Only a few come through (DW 1.64,
8.134.2-6 L).
The intervals between two evacuations must be adjusted according to the
intensity of the pain, turning Kmp6s- into the equivalent of a 'happy medium'.
Moreover, the doctor, who constantly examines the patient, continues to
look for the most favourable moment for the treatment,JZ even if the risk of
death is high. Whether Kmp6s- expresses a notion of time or an estimation of
duration and frequency, it seems to overcome in the end a potentially
harmful xp6vos-.
·
When the doctors are not in a hurry, they seem capable of controlling its
course. The author of chapter 62 contemplated all scenarios linked to a fatal
outcome; likewise the practitioners are able to contemplate therapeutic
alternatives increasing the chance of recovery. They can anticipate failures,
12
The temperate vapour-bath session depends also on the doctor's assessment
(Kmp6s-) in DWI, Lime VIII, 19-20. In Nature of Women (35.6 Bourbon= 8.378.10
L) a vapour-bath session may only be administered after the timely duration
following a purge.
BOURBON
27
suggest new attempts 13 and even encourage events, as suggested in chapter
35 in Nature of Women. After the description of a long treatment, the chapter
then ends:
She should sleep with her husband as often as possible while the
circumstances are favourable (ws JlUALGTa Twv KULpwv rrap6vTwv). If
she keeps the semen and if there is a pregnancy, she evacuates, by the
same means, the impurities in the fundus. It is the main road to recovery
(NW 52.7-11, Bourbon= 7.378.17-20 L).
By creating favourable circumstances right from the beginning (Kmpwv), it
appears possible to control the course of events in which a phenomenon
leading to recovery will come up in a near-natural way.
Consequently time, when it is controlled, can become an ally for the
doctor treating women. Yet the conclusion of chapter 62 in Diseases o[Womm
underlines that this control may not be disassociated either from specific
knowledge or from a professional approach based mainly on a set of medical
questions. Admittedly the patient is often ignorant, but she carries with her
the information with which to identify her ailment and cure herself. It is up
to the doctor to win her trust, to learn to listen, and to ask the right
questions which will enable him to seize the opportunity to save her. Thus,
the doctor who does not fight against the empire of silence may not become
the ruler of time.
Bibliography
Bourbon, F. 2004. Hippocrate. Nature de Ia femme: iJclition critique, traduction et
cotmnentaire, These de doctorat nouveau regime. Paris. (Publication in
preparation).
Countouris, N. 1985. Hippokratische Gynakologie. Die gynakologischen Texte des
Autors B, nach den psettdohippokratischen Schiiften de Mulieribus I tmd II.
Dissertation. Hamburg.
Dean-Jones, L. 1995. 'Atttopsia, historia and what women know: the authority
of women in Hippocratic gynaecology'. In D. Bates (ed.), Kn01vledge and the
Scho!arfy };Iedical Traditions, 41-59. Cambridge.
Easterling, P.E. 1982. Sophocles. The Trachiniae. Cambridge.
13
See e.g. .1\JW cc. 8 and 13.
28
BOURBON
Grensemann, H. 1982. Hippokratische Gynakologie. Die gynakologischen Texte des
Autors C, nach den pseudohippokratischen S chriften De Mulieribus I, II und De
sterilibus. Wiesbaden.
Jebb, R.C. 1892. Sophocles. The Plqys and Fragments, Vol. 5: The Trachiniae.
Cambridge.
Jouanna,J. 1999. Hippocrates. Baltimore & London.
Kamerbeek, J.C. 1970. The Plqys o/ Sophocles: Commentaries, Vol. 2: The
Trachiniae. Leiden.
King, H. 1998. Hippocrates' Woman. REading the Female Bocfy in Ancient Greece.
London.
Lloyd-Jones, H. 1994. Sophocles. The Women rifTrachis. Cambridge, Mass.
Trede, M. 1992. Kairos. L'd-propos et /'occasion (Le motet Ia notion d'Homere d Ia fin
du IVe siecle avant ].-C.). Paris.
THE SANUS HOMO IN THE DE MEDICINA OF CELSUS*
Nadine Brand
University of Stellenbosch
Celsus' significance in the study of medicine
The position and significance of Aulus Cornelius Celsus (c. 25 BC-50 AD) in
the study of medicine in antiquity have been controversial. The views range
from regarding him as a mere compiler or translator of a Hellenistic medical
handbook (Wellman and Marx respectively) 1 to a physician who practised
medicine.z Neither of these extreme views is accepted today.3 Celsus reveals
a thorough acquaintance with, and understanding of, Greek medicine, but
expresses a definite Roman approach. Unfortunately nothing is known about
Celsus other than what can be deduced from the contents of his remaining
• This article is based on my MA thesis (University of Stellenbosch, 2007). The
translations from the De Medicina, Book 1 used in this article were taken from the
thesis and are my own; the text and _translations of passages for the ProoemimJJ and
other books of the De Medicina are d1ose of Spencer (1935). The text of Marx (1915),
based on manuscripts V, F, P and J, was used by scholars as definitive for many
decades and was used by Spencer (1935). In 1982 Phillippe Mudry produced a
French translation and commentary of the Prooemium, using an improved text since
he added manuscript T that had been described by Granados (1973) and Capitane
(1974). In his introduction to the French translation and commentary of the
complete work Serbat (199 5) comments that he had also researched the five
manuscripts and has provided a more exact and workable text than Marx. The text
of the De Medicina, Books 1 and 2 used in my reasearch is based on that of Serbat
and Mudry.
1 M. Wellmann, A. Cornelius Celsus, eine Queflenuntersuchung (Berlin 1913; quoted in
Spencer 1935a:ix), argues that Celsus merely copied from a certain Cassius; however,
he later changed his mind. Marx 1915:lxxxiv-xciv believed that Celsus copied from a
Greek source that he actually identified as T . Aufidius Siculus. Celsus himself does
not refer to this Greek source and, since he names his main sources in the Prooemium,
Marx's argument is unconvincing.
2 Spencer 1935a:xi-xiii summarises some of the passages from the De Medicina as
arguments for regarding Celsus as a learned and experienced medical practitioner.
3 Cf. i.a. Nutton 2004, Langslow 2000, Serbat 1995,Jocelyn 1985, and Mudry 1982.
..-.~.
..
-··
30
BRAND
work and from references to him by a few contemporaries whose works
have survived.
When scientific Greek and Latin texts were recovered during the
Renaissance, Celsus' text was one of the first medical texts to be put into
print and the pe Re Medicina, as it was known then, became a popular work.
When the De Medicina was printed in Florence in 1478, Celsus was referred
to as Cicero mediconmfl because of his elegant style. Scarborough (1969:60)
supports this worthy title with the comment that he is a superbly educated
Roman aristocrat with a keen mind and elsewhere refers to him as 'one of
the leading intellects of his time' (Scarborough 197 5:25). Daube (197 4:42)
expresses the view tl1at he is 'reminiscent of Leonardo da Vinci' and Spencer
(1935:x) remarks that 'the writer [Celsus] did for science what Cicero did for
philosophy.' Marx (1915:xciv) comments that the best example of a Latin
work on medicine is that of Celsus and that much information can be
gleaned about the history of Tiberius' age while researching the De Medicina.
Celsus as author
Celsus wrote treatises on diverse subjects of which the eight books of the De
Medicina are the only works extant today. According to Celsus himself
(Prooem. 1; De Med 5.28.16 C) and his contemporaries (Columella, RNst.
1.1.14; Pliny, NH 14.33), his books on agriculture were written before those
on medicine. The other subjects, rhetoric, philosophy and the military, are
not as well documented, although from the manuscripts we may deduce that
all these treatises were indeed written by him and formed part of a collection.
Serbat (1995:xiv) suggests the following possible arrangement:
Artes de agricttltttra
de medicina
de rhetorica
de philosophia
de re militari
1 to 5
6 to 13
14 to 20
21 to 26
27 to (unknown)
The five subjects compiled under one title, Aries, represent a unity with a
definite connection in the content. If the lost works were of the same high
standard as the De Medicina, the work as a whole would have been a useful
4 Although d1ere are many subsequent references to this epiiliet in articles and
commentaries on Celsus, its exact origin has not been ascertained.
...
· .. ·
BRAND
31
guide for the homo Romamts. The books on agriculture contain advice on food
production and warding off hunger and cold; the books on medicine advice
for health preservation and warding off disease; the books on oratory and
philosophy deal with human interaction and communication. Should the
latter fail, the books on military aspects contain advice on self-defence and
subjugating the enemy.
Quintilian (c. 35-95 AD) acknowledges in 10.1.124 that Celsus was a very
gifted writer:
scripsit non pamm Jmt!ta Co melitiS Celstts1 SextiosseCII!tts1
11011
sine mitt! ac nitore.
Cornelius Celsus, a follower of the Sextii, wrote a good deal, and with
elegance and polish (trans. Russell2001).
However, in his conclusion of the l11stitutio Oratoria (12.11.24), Quintilian
refers to Celsus as a vir mediocri i11genio. The translation and interpretation of
these words have been debated by many scholars. The usual understanding
of the phrase 'a man of very ordinary ability' is often challenged;
Scarborough (1969: 196), for instance, suggests the interpretation 'not
ordinary' rather than the meaning 'average'. Daube (1974:42) prefers the
translation 'a man of versatile capacity' or 'comprehensive mind'. Highet
(1975:57) does not agree with him and suggests that the word 11011 has been
omitted and it should read vir 11on mediocri ingenio. Serb at (199 5:xiii) argues that
Quintilian's words should not be interpreted as being derogatory and should
be viewed iri perspective.
I think that the phrase Cornelius Celsus vir mediocri ingenio should be read in
context. This qualifying phrase for Celsus appears where Quintilian pays
tribute to teachers, devoted to varied studies in contrast to specialisation,
who were role models in his time. He names Homer, Hippias of Elis, Plato
and Aristotle of old, and Cato, V arro and Cicero as examples of his own
countrymen. He ends the passage:
Ouid plura? cum etiam Come/ius CelstiS1 mediom· vir ingenio1 11011 soltmt de his
omnibus conscripserit artibus1 sed amp/ius rei militaris et msticae et medicinae
praecepta reliqueri" digm1s vel ipso proposito1 ut emJJ scisse omnia ilia credamus.
Need I say more? Even Cornelius Celsus, a man of vety ordinary ability,
not only wrote about all these arts [rhetoric and philosophy], but also left
books of instruction on tactics, agriculture, and medicine: his plan alone
justifies us in believing that he knew all these things! (trans. Rudd 2001).
· . . ;f·. , ..
32
BRAND
Although a man of moderate ability, Celsus was also worthy of the credit due
to a polymath because of his obvious interest in various subjects with which
he was well acquainted.
The value of Celsus' works lies in the fact that he compiled information
and scholarship on various subjects in many volumes, and imparted this
learning to his readers in a clear and concise style and in well-ordered subdivided units. Celsus' works are written in Latin for a Roman audience; yet
he acknowledges the strong Greek influence on his chosen subject matter.
The De Medicina
Celsus divides the De Medicina into three parts: the first deals with health
preservation and how the healthy should conduct themselves; the second,
the nature of diseases; and the third, the treatment of diseases. Treatment of
diseases is subdivided into three: diet, medication and surgery. Although
Book 1 is the focus of the sanus homo and health preservation, this theme is
carried on throughout the other books of the De Medicina, which deal with
the diagnosis and prognosis of diseases, general therapeutics, pharmacology
and surgery.
Celsus was an exceptional teacher who quoted a wide range of Greek
practitioners and specialists, and researched them accurately. He openly
acknowledges these sources with due respect for their expertise and accomplishments, naming celebrated philosophers of the 5th century BC such as
Pythagoras, Empedocles and Democritus who became expert in medicine
because the science of healing was considered part of philosophy. According
to Celsus it was Hippocrates who first distinguished between medicine and
philosophy and he adds that Hippocrates was et arte et facundia insignis
('notable both for professional skill and for eloquence'; Prooem. 8). Here
medicine is referred to as a professional skill' (ars) for the fust time, and
Celsus' high regard for Hippocrates is evident. 5
Celsus also mentions authorities in Rome for whom he has a high regard,
e.g. Meges,6 Asclepiades and his pupils, Thernison, Aufidius and Nicon,
5 Jocelyn 1985:311 points out that facundia was attributed to speakers and writers
whose eloquence was natural rather than acquired.
6 De !vied. 7. Prooem. 3.
BRAND
33
Cassius7 and Euelpides.s Celsus' recogrunon of the importance of his
predecessors' achievements and contributions lends him credibility and so
strengthens the authority of his work. He rearranges and develops their
views and practices, yet holds strong opinions of his own and often
challenges their advice and remedies.
Greek medical terminology
When Celsus does not employ Greek terms, he uses innovative Latin phrases
to translate and replace acknowledged Greek medical terms. Langslow
(1994:300-01) sets out reasons that could have motivated Celsus to do this;
firstly, the stylistic standards reportedly set for Latin by influential contemporaries; and secondly, the practical advantage that Latin equivalents would
have had over unfamiliar Greek terms. As to the first motivation, according
to Suetonius (Tib. 70.1), the emperor Tiberius (42 BC-37 AD) modelled his
Latin oratorical style on that of Valerius Messalla Corvinus,9 whom he
studied in his youth. As far as being bilingual, Tiberius spoke Greek fluently,
yet preferred to use Latin, especially on official occasions such as in the
Senate. Secondly, Tiberius also insisted that foreign terminology be
substituted by Latin and if a Latin word could not be found, it was to be
paraphrased in Latin. Marx (1915:xcvi) reasons that since Celsus wrote
during the reign of Tiberius, he would certainly have complied with the
example set. Langslow (1994:301) points out that Latin phrasal equivalents to
Greek medical terms would have been an added advantage to the probable
(Roman) readers of the De Medicina.
Langslow further believes that Celsus himself is tl1e originator of these
descriptive medical words and phrases, since they occur only in Celsus in
7
Cassius ingeniosissimHs saeCtf!i nostri medicus ('Cassius, the most ingenious practitioner of
our generation'; Prooem. 69).
s Euelpides atttem, qt~i aetate nostra maximus ocu!aritts medicus ('Euelpides, the most
famous oculist of our time'; 6.6.8 A).
9 A celebrated orator referred to by Cicero, Att. 15.17 .2; 16.16.A.5 and Horace, A.P.
370: 'An average jurist and lawyer comes nowhere near the rhetorical power of
brilliant Messalla' (trans. Rudd 2005). Quintilian (Inst. 10.1.113) regards Messalla as
being elegant (nitidtts) and lucid (candidus) and states he gives proof of the nobleness
of his birth in his diction (in diem do).
34
BRAND
extant Latin.10 This innovative creativity of Celsus may be a sign of the early
stages in the development of a new descriptive medical terminology.
Quintilian (Ins!. 10.1.124) refers to Celsus' style as: non sine cttlttt ac nitore,
whereas the word elegantia is often used by post-classical authors to describe
Celsus' style. 11 According to Jocelyn (1985:310), 'Eiegantia was a term of
rhetorical criticism but nothing made it inappropriate to the description of
kinds of writing other than oratory. It had to do with the avoidance of
vulgarity, artificiality and obscurity, vices feared by the ancient stylist in many
contexts.' It is clear that the De Medicina, apart from being a scientific manual
with practical value, can also be read with great enjoyment as a literary text.
The sanus homo
Celsus' concept of the samts homo in the De Medicina is comprehensive. He
treats the notion of santts homo systematically, discussing any possible
condition that might have an effect on a healthy body. There should be a
balance in lifestyle and habits in order to keep the body healthy and if it
becomes weak or diseased it should be restored to health. He draws a clear
distinction between the santts homo, whom he defines as qui et bene valet et suae
spontis est ('one who is strong and in control of himself; 1.1.1) and the homo
imbecilltts, one who has a delicate constitution. This condition is self-inflicted
because the homo imbecilltts usually lives in a large town, 12 and is attracted to
and involved in literary pursuits.B A person with a weak constitution should
take every precaution possible to restore his body to a state of health, and
Quintilian (Inst. 9.2) quotes many examples of parts of speech where Celsus
supplies Latin terms for the Greek.
11 E.g. Antonio Beccadelli described his ftrst reading of the De Medicina of Celsus in a
letter to his teacher, Guarino of Verona, in ApriL 1426: .. . ne ipsum quidem latinae
eloqttentiae principem Ciceronem in hoc genere materiae ornatius !ttculentitts atque elegantius
disserere potuisse (' ... not even the celebrated authority on Latin eloquence, Cicero,
could have discussed this type of subject matter more splendidly, more brilliantly
and more elegantly'). Guarino held a similar view: ... opus elegans summa Jacundia copia
dulcedine ornatissin1um (' ... excellent elegant work of the greatest eloquence, riches and
charm'). Barthlomaeus Pontius who edited the fust printed edition in 1478 stated
that Celsus was ... SCiiptor gravissimtls atque eloquentissimus (' ... a most dignified and wellspoken writer'). Marx 1915:xix: elegantia venustas conspicua est and Spencer 1935:x: 'the
language is strong, lucid and elegant.'
12 quo innumero magna pars ttrbanorttJJJ ('among whom a great many are town dwellers').
13 omnesque paene cupidi litteramm stmt (1.2.1).
10
BRAND
35
Celsus offers the precepts and advice for achieving this in Book 1 of the De
Medicina.
In Prooemittm 70 Celsus passes on to the reader what the sanus homo should
heed - advice given by experienced contemporaries and experts (auctores)
such as Cassius. To preserve his health the sanus homo should avoid cold,
heat, overindulgence, exertion and excessive passion (libido), especially when
in unhealthy localities and during high-risk seasons. In these places and
during these seasons he should rest often and neither upset the stomach with
emetics nor the bowels with purging.
The principle that each individual has his own strengths and weaknesses
runs through the entire work up to Book 7. In 2.10.2-5, for instance, where
he discusses bloodletting, Celsus states:
Interest enim, non quae aetas sit ... sed quae vires sint. ... non quicquid autem
intentionem animi et pmdentiam exigit protimts faciendm;; est, cum praeciptta in hoc
ars sit, quae non annos numeret, sed vires aestimet. ... Interest etiam inter va/e11S corptts
et obesum, inter temte et injirmtml.
For it matters not what is the age, but what may be the patient's strength.
Not d1at we should be in a hurry to do anything that demands anxious
attention and care; for in that very point lies the art of medicine, which
does not count years, but calculates d1e strengd1 of d1e patient.... There is
a difference between a strong and an obese body, between a thin and an
infirm one (trans. Spencer 1935).
Celsus emphasizes the importance of preventing illness, but in the case of
illness states that treatment lies in restoring the disturbed balance by exercise,
diet, baths and medication. Medication (medicamentum) pertains to disease,
which is not the focus of this article, yet folklore remedies, since they can
prevent serious illness, 14 are appropriate in the context of the smuts homo, and
are briefly discussed.
Folklore
Celsus separates the remedies and cures used by country folk from those
prescribed by medical practitioners. There are many examples in the De
Medicina of these natural remedies that are practical, inexpensive and easily
14 Cf. De Med. 3.2.6: per haec enim saepe instai1S gravis morbus disctttitur ('For often in this
way a severe disease is dispersed while it is pending').
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obtainable. The following few examples illustrate their unusual and varied
qualities: herba trixago, germander (4.13.3), 15 anguem edit, eating a snake (5.28.7
B), eating a nestling swallow (4.7.5), mashed liver of a fox in the treatment of
the distressful disease asthma (4.8.4), the inhalation of steam from an
infusion of catmint and boiling water. In 5.28.18 B, after the discussion of
elaborate treatments for papules and pustules, Celsus simply states:
sed levis papula etiam, si ieitma saliva cotidie defricatm; sanescit.
But in fact a slight papule heals if it is rubbed daily with spittle before
eating.
These examples of Celsus' down-to-earth view of folklore remedies confirm
that the De Medicina was also intended for the pateifamilias of a household
who would have appreciated appropriate practical advice, therapies and cures
that were easily obtainable in the country. It substantiates the observation
that the concept of the sanus homo, the theme in Book 1, is of such
importance to Celsus that the remedies of physicians are trivialized by the
unsophisticated and harmless folklore remedies, which he suggests as an
alternative. Unnecessary intervention and medication can cause more harm
than benefit, especially to a healthy and robust body. For the sanus homo: nihil
magis quam ambulatio lenta paene usque ad lassitttdinem ('there is nothing better
than a walk until almost fatigued'; 4.8.4).
Exercise
According to Celsus the most important consideration in the lifestyle of the
sanus homo is exercise, prima autem eius curatio exercitatio est ('its most important
care is exercise'; 1.2.5), which strengthens the body and keeps it youthful.
Inactivity weakens the body and causes it to age prematurely. This view is in
accordance with the view Hippocrates state~ in Regimen 2.60: 'Inaction
moistens and weakens the body ... but labour dries and strengthens the
body.' Cicero had also come to this conclusion:
15
Pliny, NH 24.80 also describes trixago (germander, chamaedrys, 'ground oak' or
'the Trojan plant'), records its uses as cure for chronic coughs and stomach disorders
and adds its application to many other ailments.
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37
sequit11r iflud: ipse meliot· fio, primmJJ valetudine, qttaJ/1 intet7Jiissis exercitationibus
allliseram; deinde ipsa ilia, si qua j11it in me, jac11ftas orationis, nisi me ad has
exercitationes rettulisseJII, examisset (FaJJJ. 9.18). 16
Next, I benefit directly, first in health, which I lost when I gave up my
exercises; and then my oratorical faculty, if I had any, would have dried up
had I not gone back to these exercises.
Celsus stresses self-control and warns that the athlete's excessive training,
when interrupted, causes weakness in the body. Exercise should take place
before meals and each person should acquaint himself with his strengths and
weaknesses to decide how much exercise his body needs. He suggests
suitable types of exercise, namely reading aloud, drilling in armour, ball
games and walking, and explains the latter in more detail: the terrain should
not be level to enable the body to move in a variety of ways, and it is
healthier in the open air and in sunshine or natural shade caused by plants
rather than under the roof of an arcade (palaestra). Walking is especially
beneficial if someone has been inactive, since his body must become
accustomed to activity gradually; he should start by walking about slowly.
Exercise should preferably be followed either by anointing (unctio) or a
bath, depending on the body's constitution, and a short rest. After exercise
the person must perspire and feel tiredness (lassitudo), yet not suffer
exhaustion (citra jatigatione; 1.2. 7) . True to the well-structured, comprehensive
design of his work, Celsus specifies the different degrees of fatigue. He gives
instructions on what action to take when someone is totally exhausted
(nimium alicui fatigato): bathing and gentle rubbing with oil to which salt and
wine have been added, resting and taking diluted liquids, but definitely not
cold drinks which are very harmful. When someone suffers chronic fatigue
(assidua fatigatio), he advises' drinking water alternated with wine and
preferably not bathing (raro balneo) . Change of activity relieves a general
feeling of weariness or lethargy (lassitudinem) ; on the other hand, that which is
contrary to routine may also cause tiredness (/assai). In this case routine tasks
refresh and the daily resting place (cotidiamtm cubile) provides the best comfort
for the resulting fatigue lfatigato). Celsus gives special advice for relieving
tiredness on a journey (ambulando fatigatur ... in itinere). Frequent rubbing
during the journey is important and when the destination has been reached, a
16
Cicero writes to Paetus while he is relaxing at Tusculum in 46 BC.
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short rest followed by anointing and bathing the upper part of the body with
warm water.
Celsus recommends reading aloud for those suffering from pains in the
colon, stomach aches and slow digestion (1.8.3). The calming effect of
reading rhythmically would promote relaxation and digestion, as well as
relieve abdominal pains. Celsus advises that someone who is frequently
troubled by an upset stomach (1.6.1) should vary the types of exercise,
especially exercising the upper part of the body with ball games, and walking
on an empty stomach.
Diet and digestion
According to Celsus, when scholars began to distinguish between the Art of
Medicine and the study of philosophy1 7 they divided cures into three
categories, the first being diet (victus, 18 Graeci nominarunt ~WL TT]TLK~v), the
second, medication (medicamenta, Graeci nominarunt <I>ap11aKEUTLK~v) and the
third, surgery (mantts, Graeci no11tinarunt XELpoupy[av). Here Celsus cites the
Greek with the Latin; before Celsus the terms used existed only in Greek.
Supporters of the diet cure also endeavoured to study nature because they
considered that the Art of Medicine would be weak and incomplete without
this knowledge. In Prooem. 19 Celsus records tl1e natural functions of the
body, which are breathing, digestion of food and drink, the functioning of
the blood-vessels and sleep; of these digestion is the most important. If
something should go wrong with any of these natural functions, disease is
sure to follow and therefore, according to some authorities, knowledge of
their functioning would be helpful in finding a cure. However, Celsus' own
view is more pragmatic and sensible. He emphasizes the importance of
avoiding disease by managing one's health, and continues (Prooem. 38):
intersit, quid morbm11 faciat, sed quid tollat,· neqtle ad rem pertineat, quomodo, sed
qmd optime digeratur ... Neque quaermdmJJ esse quomodo spiremus, sed quid gravem
et tardm11 spi1itum expediat ... Haec autem cognosci expnimentis. ... itaqtte ingenitml
etjaetmdiam vincere, morbos autem 11011 e!oquentia sed remediis curari.
11011
17
Hippocrates was said to be the first to have made this distinction, followed by
Diodes of Carystus, Praxagoras, Chrysippus, Herophilus and Erasistratus (Prooem. 8).
18 Spencer 1935:2 comments that victus, like the 8(aL Ta ('regimen') of Hippocrates,
includes not only regulation of diet, but rubbing, rocking and rules for exercise.
_. . ,,_;,-'
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39
It does not matter what produces the disease but what relieves it; nor does
it matter how digestion takes place, but what is best digested ... We had no
need to inquire in what way we breathe, but what relieves laboured
breadling. ... All dus was to be learnt through experiences; and so
cleverness and fluency may get the best of it; it is not, however, by
eloquence, but by remedies that diseases are treated.
In 1.1.2 Celsus explains what is meant by the balanced lifestyle, which he
believes the santts bomo should follow, with special reference to diet. He is not
prescriptive, yet emphasizes variety in the kind, the quantity and frequency of
food taken. His only stipulation is 'provided one digests it'. In 1.2.2 he
emphasizes the importance of digestion by warning that a person who has
not digested his food should not work, nor exercise, nor attend to business,
but rest completely. Even if he has digested partially he is still to rest and
sleep; this is in accordance with Hippocrates who states:
those who suffer from distention of the hypochondrium showing that the
food remains undigested, should take more sleep (Reg. Sal11t. 7).
Throughout the De Medicina the strong influence of Hippocrates is apparent
and many of Celsus' precepts are taken from the Hippocratic C01ptts. Serbat
(199 5:25) emphasizes Celsus' stylistic originality: 'Celsus rearranges Hippocrates' ideas in an original way and uses a personal tone.' Pardon (2005:401)
thinks that Celsus clarifies and completes the prescriptions of Hippocrates.
By comparing two similar passages (Hippocrates' Pron·betic 2.18 and Celsus'
De Medicina 60601a-d) she concludes: 'Celsus' nosography is different from
that of the Hippocratic Corptts. The two passages illustrate both the obvious
kinship and unbridgeable gap between Celsus' work and the Hippocratic
texts.'
In 2.19 .1 Celsus lists the foods that have good juices (boni suet), digestible
foods, and bad juices (mali suez), indigestible fo'ods; for instance, everything
that is over-sweetened is bad for the digestion (1.2.9 and 2.25), with the
additional disadvantage that more is usually consumed because of its pleasant
taste. This leads to overindulgence (intemperantia), even overeating (nimia
satietas), which in itself is very harmful and should be avoided at all costs.
Like Hippocrates, who states in Apb. 2.4: 'Neither a surfeit of food nor of
fasting is good, nor anything else which exceeds the measure of nature',
Celsus advises that excessive eating after fasting is not healthy. He states that
overindulgence is safer in drinking than in eating (1.2.8), a recommendation
40
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also given by Hippocrates: 'it is better to be full of drink than full of food.'
(Aph. 2.11).
An indication that the body is healthy because of optimal digestion is the
. colour of the urine early in the morning. A tawny colour is proof that food
has been digested well, yet, if it is clear it indicates that digestion is still taking
place. 19 According to Celsus (1.7) digestion is promoted by reading aloud,
exercise such as walking, a warm bath and warm food and drinks. Those
who digest slowly become bloated and should make a special effort to follow
Celsus' advice.
In 2.19-33 Celsus considers general benefits that not only sustain the sick
but also preserve health. These communes are the effects of different foods on
the bodily functions,
pe1tinetque ad rem omnitltJJ proprietates nosse, primw;; ttl sani sciant (2.18.1 ).
and an acquaintance with the properties of all is of importance, in the flrst
place that those in health may know how to make use of them.
They include digestible, indigestible, bland and acrid foods, those that cause
phlegm to become thicker (e.g. raw eggs, milk and glutinous substances) or
thinner (e.g. salted and acrid products) or produce flatulence (e.g. leguminous, fatty and sweet food, garlic, onion and cabbage); on the other hand,
fennel and anise in particular relieve flatulence. There are foods that are
suited or unsuited to the stomach, yet these do not necessarily fall in the
groups that are digestible or indigestible. Apart from the effects different
foods have on bodily functions, their nutritional value should also be
considered. Celsus informs his reader that the nutritional value of food
depends on soil type, climate and habitat, for instance grain grown in hilly
districts 20 is more nutritious than d1e grain of the plains; fish found among
rocks are less nutritious than those in sand, which in turn are less nourishing
than those in mud (2.18.9).
'
19 Cf. Pliny, NH 28.68: Attgttria valett1dinis ex ea tradttnttll; si mane candida, dein rufa sit, illo
modo concoqttere, hoc concoxisse signiftcatttr ('Urine gives us symptoms of general health: if
in the morning it is clear, becoming tawny later, the former means that coction is still
going on, the latter that it is complete'; trans. Jones 1963).
zo Spencer 1935:196 states that the spring wheat grown in southern Italy is rich in
gluten and used for making pasta.
·... ··
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Water and bathing
The sanus homo should follow a routine of appropriate exercise, a simple diet,
fresh air and sunlight (saepius in agro; 1.1.1 ), and rest:
haec firmis servanda sunt, cavmdumque ne in secunda vafetudine adversae praesidia
COIW/JJJallf/1
(1.1.4).
<The healthy> must heed these precautions and take care not to use up
in good health their defences against ill-health.
To these Celsus adds the use of water, usually in conjunction with dietary
regulation. Book 1 contains sixteen recommendations for preventive medicinal bathing which was gaining popularity. Celsus testifies to Asclepiades'
promotion of bathing: antiqtti timidius eo <balineo> tttebantur, Asclepiades
audacius ('The ancients used it <the bath> more timidly, Asclepiades more
boldly'). Celsus recognizes the advantages of water and recommends the use
of hot water as well as cold springs (1.1.2).
The use of cold springs for bathing became fashionable at this time.
According to Suetonius (Aug. 81),21 Augustus suffered from several acute
diseases during his lifetime. In 23 BC when he had a severe bout of abscesses
of the liver, his physician, Antonius Musa, advised him to bathe in cold
springs when hot fomentations, the usual remedy, brought him no relief. He
was cured and was so appreciative that he had a statue of Musa erected
beside that of Aesculapius (Aug. 59). He even exempted all physicians from
taxes (Aug. 42).
In a letter to V ala (Ep. 1.15), Horace mentions that he was given the same
advice by Antonius Musa. He complains that he can no longer make his
usual journeys to Cumae and Baiae and that those towns, with their famed
sulphur springs, are falling into disrepute. Now that he bathes in cold water,
even in winter time, he has to change his well-known resting places to the
springs of Clusium and chilly Gabii. He also asks V ala which districts
produce healthy, beneficial food and water ('Do they drink from tanks that
collect the rain or from wells of water that never fail?'; trans. Rudd 2005), so
that he may return home 'as fat as a tme Phaeacian'. 22 He enquires about the
21
This incident is also recorded by Pliny, NH 25.38.
Phaeacian: 'a man in good shape', after the fabled carefree and indolent
inhabitants of the isle of Scheria (Corcyra). Cf. Hom. Od. 6 and 8.248-49.
22
~
.·. . .
·: .
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climate at Velia and Salernum where there are cold springs, later also referred
to by Pliny the Elder in NH 31.5.
Pliny discusses the healing powers of water, especially that of Cutilia of the
Sabines - very cold and very healthful for the stomach, the sinews, and the
body as a whole. Celsus himself recommends Cutilia in 4.12. 7 when he refers
to jrigidis medicatisque fontibus, quales Cutiliarum S ttmbruinammque ('cold
medicinal springs such as Cutilia and Simbruvium') as an excellent cure for
an ailment of the stomach if food is not digested, and the body wastes away
because of malnutrition.
When discussing his daily routine and exercise, Seneca reveals that he used
to be a devotee of cold baths when he was younger,23 but now in old age a
cold plunge means 'just short of warm', and he uses his own pool which has
had the chill taken off by the sun.
Celsus mentions many advantages of cold water, e.g. bathing one's face in
cold water upon waking in the morning (1.2.4), ending the bath ritual with
cold water (1.4.2), cold water being healthy and cooling in the summer
season (1.3.36), for someone with a weak head to douche his head daily with
cold water from a strong flowing pipe (1.4.3), and for those who suffer
chronic eye inflammations to treat the face and eyes with lots of cold water
(1.5.1). Likewise a cold-water infusion is beneficial to treat the stomach and
joints and to combat indigestion (1.9.6). Conversely Celsus points out the
dangers of cold water, especially if used unexpectedly by people
unaccustomed to it, for it causes pains in the sides and provokes tumours in
the neck (1.9.6) .
Hot water could, according to Celsus, also be beneficial for the sanus homo
and useful in the treatment of certain weaknesses of the body. He
recommends that a warm bath be taken after exercise and before the main
meal; however, bathing after a meal was sometimes thought to promote
digestion (1.8.3).
In 1.4.2 Celsus describes the order in which the different stages of a bath
should be taken: first, sweat for a little while ill the tepid room (tepidarium)
without undressing; then be anointed (unguz); next, proceed to the thermal
chamber (caldarium), and after a course of sweating (sudavit) not to go down
into the hot tub (solium), but to pour some hot water over the head, then
tepid, and lastly cold water. Finally, the person should be rubbed and dried
Sen. Ep. 83: ' ... regularly paying my respects to the Canal on the flrst of January
and jumping into the Maiden Pool in just the same way as I read, wrote and spoke
some sentence or other every New Year' (trans. Campbell 1969).
23
.:
•• . •
i
t'
•• • · : · · ' ;-_.
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43
and then anointed again. It is clear that he does not believe this ritual should
be followed daily since he states at the beginning of Book 1: pmdest etiam
interdum balneo ... ttfi (1.1.2: 'It is certainly advantageous to enjoy a bath at
times'), and, concerning a bath after exercise, he adds in 1.2.7: exercitationem
recte sequitur modo ttncfio, vel in sole vel ad igmm; modo balmttm ('The proper
sequel to exercise is sometimes oiling, either in the sun or in front of a fire;
sometimes bathing'). This view is upheld by other authors, e.g. Columella
where he recommends providing bathing facilities for the household:
nam eas quoque rejert esse, in quibus familia, sed tamm .ft1iis,
corpons rob01i convenitji-equens ustts earttJJJ (Rttst. 1.6.20).
lavetm~·
neque mim
for it is important also that there be such places in which the household
may bathe - but only on holidays; for the frequent use of baths is not
conducive to physical vigour (trans. Ash 1948).
Suetonius (At~. 82) has the same view, stating that Augustus 'made good his
weakness by great care, especially by moderation in bathing' (trans. Rolfe
1998). Seneca (Ep. 108) tells Lucilius that he has avoided hot baths his entire
life, believing that 'it is effeminate and pointless to stew one's body and
exhaust it with continual sweating.' In Ep. 86 he criticizes people for
spending money on extravagant bathing facilities and indulging in excessive
bathing rituals for recreation. He commends previous generations for using
tl1e bath only to clean themselves after hard work and states tl1at it was not
their custom to have a bath every day; only hands, feet and legs were washed.
Bathing was undertaken weeldy for health and cleanliness.
The Younger Pliny's extravagant bathing facilities at his houses, on the
other hand, are not an indication of moderation. He enthusiastically
describes them in his letters, e.g. Ep. 2.17.11-12:
inde balinei cella ji-igidaria spatiosa et effi!Sa, Cllitts in contrariis parietibtts duo
baptisteria velut eiecta simtantm~ abtmde capacia si mare in proximo cogites. Adiacet
tmctorium, f?ypocauston, adiacet propnigeon balinei, mox duae cellae magis elegantes
quam sumptuosae; cohaeret calida piscina miriftca, ex q11a natantes mare aspiciunt.
Then comes the cooling-room of the bath, which is large and spacious
and has two curved baths built out of opposite walls; these are quite large
enough if you consider that the sea is so near. Next come the oiling-room,
the furnace-room, and the antechamber to the bath, and then two restrooms, beautifully decorated in a simple style, leading to the heated
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swimming-bath which is much admired and from which swimmers can
see the sea (ttans. Radice 1963).
When the sanus homo suffers from sunburn he needs the bath immediately to
enable him to pour oil over his head and body. The tub should be well
heated (bene ca/idum) and lots of hot water poured over the head followed by
a cold douche (1.3.10). In 1.3.16 there is a further use for hot water where
Celsus advises those who are stout to control their weight in order to remain
healthy. Bathing in hot salty water as well as bathing on an empty stomach
are ways to slim the body.
Vomiting and purging24
A hot bath, quite a pleasant way of slimming, may well control overweight,
but Celsus also suggests other, less healthy means of obtaining a slimmer
body, namely vomiting and purging (1.3.17): extenuat corpus ... vomitus, deiectio
('vomiting and purging slim the body'). He warns that this may be dangerous
if it becomes a daily habit and is the result of overindulgence. He also
cautions that vomiting must not be practised because of opulent living and
that no one who wants to keep well (the samts homo) and live to old age
should indulge in this daily. Asclepiades,zs one of Celsus' mentors whom he
often quotes, rejected this custom, and especially warned against purging
with dangerous substances. Asclepiades did, however, admit that if
something had been corrupted or was noxious it should certainly be
expelled. Hippocrates had already stated that vomiting, if spontaneous, was
beneficial to a patient since the body got rid of noxious matter that disturbed
the stomach (Aph. 1.2).
Since Celsus usually gives a balanced view about a subject, stating the
advantages and disadvantages, he feels that this practice should not be
condemned totally, but be examined more thoJ;oughly. He sets out his own
precepts and thoughts about vomiting and purging in eight paragraphs
The custom of unacceptable purging is often satirised, e.g. Juv. Sat. 6.432: the
hostess ... bibit et vomit while her guests wait for their dinner; and Cic. Phil. 2.104
where he criticises the conduct of Antony at Varro's house: at quam multos dies in ea
villa turpissime es perbacchatus ab hora tertia bibebatu1; ludebatttr, vomebatur ('Day after day,
at Varro's mansion, you continued your disgusting orgies. From seven in the
morning onwards, there was incessant drinking, gambling and vomiting'; trans.
Grant 1960:147).
25 Celsus refers to his book De Tttenda Sanitate in 1.3.17.
24
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45
(1.3.19-26) , commencing with the benefits, followed by instructions to
perform these procedures as harmlessly as possible.
Vomiting is also beneficial if the sanus homo practises it for the sake of
health - this Celsus knows from own experience. Those who become bilious
easily, suffer bitter eructation, salivate, suffer heartburn, and whose ears ring,
eyes water, and mouth has a bitter taste, are advised that vomiting will bring
relief.
Celsus gives clear instructions on how to induce vomiting, but at the same
time causing the least harm to the body, because emetics could be dangerous
and disturb the stomach. He suggests natural preparations, such as starting
with tepid water followed by a stronger mixture of tepid water with salt or
honey. If these preparations are not effective, other stronger mixtures are
wine with honey or hyssop and eating radish before taking the tepid water.
This is similar to Hippocrates' mixture:
The emetic should consist of a gill of ground hyssop in six pints of water;
this should be drunk after adding vinegar and salt to improve the taste.
(Reg. SaM. 5)
Vomiting may cause weakness of the stomach or trntation of the throat,
therefore the sanus homo should take care to eat small portions of suitable
foods for the next few meals. Celsus (1.3.24) insists that all food should be as
dry as possible, such as old bread and roasted meat, and that the drink
consist of three ladles of cold water or sour undiluted wine. Following
Hippocrates' precept,26 Celsus advises that vomiting twice a month should
be done on two consecutive days rather than every fortnight.
He is more emphatic about the dangers of purgatives. Laxatives and
clysters should always be gentle since they entail a risk especially when used
frequently. A natural laxative such as aloe should be taken, and vomiting is
also said to relieve constipation. Although, he admits that clysters are
sometimes beneficial, Celsus states that they were not used often in his day,
which he observes as a positive trend (2.11.2).
·
Celsus observes that vomiting is not always self-induced, e.g. sailing may
cause nausea followed by vomiting, which can be relieved by abstaining from
food. Secondly, if one should regurgitate undigested food, a drink of cold
26 Cf. Reg. Salut. 5: 'Those who are accustomed to induce vomiting twice a month
will find it better to do so on two consecutive days rather than every fortnight; as it
is, most people do the opposite.'
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water and self-control (se continere) bring relief (1.2.2). The advice he suggests
in these examples is simple, practical and safe.
Sleep and sana mens
Although sleep may be difficult, it is necessaty, mainly, because while
sleeping many are cured. Drugs to induce sleep should be used in
moderation or preferably not at all. Sleep may be assisted by d1e sound of
falling water, and rocking after a meal and at night, particularly with the
motion of a hammock (3.18.15). These suggestions are practical and pleasant
to put into practice. Celsus tries to avoid intervention that would upset or
threaten the troubled mind.
Depression (tristitia) should be treated by prolonged rubbing, cold water
poured over the head, the emersion of the body in water and oil, eating
moderately and brisk exercise even until fatigued. Positive d1oughts and
hope (bona spes) should be suggested as well as entertainment provided, such
as storytelling and games. A depressed person should also be gendy reproved
and told that his melancholy could be without cause; in fact, the vety things
that trouble him may often be a source of joy (3.18.18).
The general treatment, prescribed by Celsus, for dementia is the same as
the general precepts that he repeatedly presents to the smzus homo. Fundamentally, he supports a balanced lifestyle with healthy habits, most
importantly plenty of exercise, prolonged rubbing - even twice a day, a
healthy diet (i.e. neither fatty meat nor wine, but light food) and ftnally, a
change of scenery by travelling at least once a year. Even delirium (3.18.24)
because of fright, a rare type of insanity, should be treated like all other
mental afflictions by dietetic regimen (similique victtts gemre cttrandtmt est;.
Conclusion
Celsus' precepts and advice for the santts homo reveal an interest in human
nature and human behaviour in the maintenance of a health-giving lifestyle.
Celsus concludes Book 2, the book on general therapeutics, with the remark:
his autem omnibus, et simplicib!ls et permixtis, vmie medici ttftmtm~ til magis quid
quisq/lepers11aserit sibi appareat, quam quid evidenter comperetit (2.33.6).
But as regards all these medicam ents, whether used as simples or in
mixtures, their uses by medical men (medicz) vary, so that it is clear that
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47
each man follows his own ideas rather than what he has found to be true
by actual fact.
Celsus implies that the Art of Medicine might not be as scientific, effective
and successful as people wish to believe, an important reason for the sanus
bomo to keep his body healthy and avoid medical intervention. Although
Book 1 is the focus of the samts bomo and health preservation, this theme is
carried on throughout the other books of the De Medicina, which deal with
the diagnosis and prognosis of diseases, general therapeutics, pharmacology
and surgery.
Bibliography
Ash, H. B. (trans.). 1948. Columella, L ucius ]tmius Moderatus, On Agriculttwe.
Vol. 1. Books 1-4. LCL. London.
Campbell, R. (trans.). 1969. Seneca. Letters from a Stoic. London.
D aube, D. 1974. 'The mediocrity ofCelsus.' CJ70.1:41-42.
Grant, M. 1960. Cicero, Selected IV'orks. Penguin Classics. Harmondsworth.
Highet, G. 1975. 'The mediocrity of Celsus.' CJ 40.4:57.
Jocelyn, H.D. 1985. 'The new chapters of the Ninth Book of Celsus' Artes.'
In F. Cairns (ed.), Papers oftbe Livepool Latin Seminar, Vol. 5:299-336. Leeds.
Jones, W.H.S. (trans.) . 1963. Flit!)', Natural History. Vol. 8: Books 28-32. LCL.
Cambridge.
Langslow, D.R. 1994. 'Celsus and the making of a Latin medical
terminology.' In Guy Sabbah & Philippe Mudry (edd.), La Medecine de Celse:
Aspects bistoriques, scienti.fiques et litteraire, 297-318. Saint Etienne.
Langslow, D.R. 2000. Medical Latin in tbe Roman Empire. Oxford.
Marx, Fridericus. 1915. A. Cornelii Celsi quae sttpemmt. CML. Leipzig, repr.
Hildesheim 2002.
Mudry, P. (ed. trans. comm.). 1982. La Priface du de Medicina de Celse.
Lausanne.
Nutton, V. 2004. Ancient Medicine. London.
Pardon, M. 2005. 'Celsus and the Hippocratic C01pus. The originality of a
'plagiarist'.' In Philip J. Vander Eijk (ed.), Hippocrates in Contex t: Papers Read
at tbe 11 tb International Hippocrates Colloquium, 27-31 August 2002, 403-411.
Leiden.
Radice, B. (trans.) . 1963. Tbe Letters of tbe Younger Pliny. London.
Rolfe,J.C. (trans.). 1998. Suetonitts. Vol. I. Books 1-4. LCL. Cambridge Mass.
Rudd, N. (trans.). 2001. Horace, Satires and Episles. Persitts, Satires. London.
48
BRAND
Russell, D.A. (ed. trans.). 2001. Quintilian, The Orator's Education. Books 1-12.
LCL. Cambridge.
Scarborough, J. 1969. Roman Medicine. London.
Scarborough,]. 1976. 'Celsus on human vivisection at Ptolemaic Alexandria.'
Clio Medica 11 (1):25-38.
Serbat, G. 1995. Celse de la medecine Tome I 1-2 texte etabli, traduit et commentrf.
Paris.
Spencer, W.G. (ed. trans.). 1935. Celsus de Medicina. Vols. 1-3. LCL. London.
ROMAN NORTH AFRICA IN THE 4TH CENTURY AD: ITS
ROLE IN 'rHE PRESERVATION AND TRANSMISSION OF
MEDICAL KNOWLEDGE
Louise Cilliers
University of the Free State
North Africa and in particular refounded Carthage experienced a flowering
of scientific and medical activity in the late Roman Empire. A great number
of medical texts produced in this period in the Roman Empire at large
originated in North Africa, which led the French scholar Guy Sabbah to
believe in the existence of an 'African School' of doctors and/ or medical
authors between c. 370 and 450 AD. 1 In this article the following aspects will
be discussed:
1. Circumstances which could possibly have been conducive to such a
density of Latin medical works in this period in North Africa;
2. The contribution of four outstanding medical authors in late 4th century
North Africa (viz. Vindicianus, Theodorus Priscianus, Cassius Felix and Caelius Aurelianus), and
3. Their role in the preservation of medical knowledge and its transmission
to Spain and France after the fall of Carthage to the Vandals in AD 439.
1. Circumstances conducive to the production of the great number of
medical texts
1.1 Peace and prosperity, rural and urban
Roman North Africa was a very prosperous region in the 4th and early 5th
centuries AD, so much so that the provin~e of Africa Proconsularis (=
modern Tunisia) with Carthage as its capital became an object of envy
among the other provinces. 2 One reason was that it was peaceful during the
G. Sabbah, 'Notes sur les auteurs medicaux africains de l'Anriquite tardive (IV-V
siecles)', Recherches et Tmvaux 54 (1998) 131-50.
2 Salvian had much to say about the wealth of Africa: 'Africa was so rich that thanks
to the opulence of her commerce she seemed to possess the treasure house of d1e
I
50
CILLIERS
3rd and 4th centuries when the rest of the Roman Empire was ravaged by
wars, plundering and epidemics with the concomitant economic repercussiOns.
North Africa's prosperity depended mainly on the export of agricultural
products. The climate of the region was stable and the harvests reliable, with
the result that it was one of Rome's principal suppliers of corn during the
Empire. 3 In drier regions which were not suitable for cereals, the olive was
cultivated. Although it takes 10 years for an olive tree to bear fruit, it requires
little labour for a good return. Olive oil was in great demand all over the
Empire - it was used for cooking, lighting, a rub-down at the baths, as soap
and perfume. The large quantities of oil exported annually to Italy and the
provinces were largely responsible for the country's wealth. 4
Freedom from war and foreign invasions also led to great advances in city
life, especially from the 2nd century AD onwards when Trajan showed a
great interest in North Africa. The cities flourished- by the end of the 2nd
century there were 600 cities (in comparison with 60 in Gaul). 5 Warmington
provides evidence indicating impressive building activity between the death
whole world' (De Gttbematione Dei 7.13-17, C.S.E.L. 8.173-81). Various other contemporary authors also referred to its wealth, e.g. Lactantius who stated that the
emperor Maximian was the privileged one in Diocletian's tetrarchy because the
region assigned to him was Italy and the rich provinces of Africa and Spain (De
Mortibtts Persecutomm 8, quoted by C. Lepelley, Les cites de !'Afrique &maine au BasEmpire, Tome 1 [Paris 1979] 29 n. 2). The 5th century African author Victor of Vita
stated that the Vandal king Genseric deliberately brought his people to Africa,
having travelled through Gaul, Spain and Morocco, because he had heard that it is
exceptionally wealthy, 'and they found a beautiful country which was flourishing in
all respects' (Historia Persecutionis Afn"cae Provinciae 1.1.3, C.S.E.L. 7.3). In the dark
days of the Vandal invasion, Quodvultdeus, the bishop of Carthage, lamented:
'Where are those great and most splendid cities?' (\Sermo II de tempore barbarico'
5.4, C.C.L. 60.476-77, quoted by C. Lepelley, 'The survival and fall of the Classical
City in late Roman Africa', in Aspects de !'Afrique &maine. Les cites, Ia vie mrale, le
Christianisme [Bare 2001] 87 n. 3).
3 Cf. S. Raven, &me in Africa (London 1969) 69.
4 The story is told that when the country was invaded by the Arabs, the general of
the victorious army was amazed at its wealth and asked the local inhabitants about
the reason; one citizen is reported to have picked up an olive and, laying it before the
general, told him that that little fruit was the cause of all their prosperity (A. Graham,
&man Africa. An Outline
York 1902]307 n. 1).
s Raven (note 3) 10.
of the
History
of the
&man Occupation
of N011h
Africa [New
51
CILLIERS
of Gordian III (244) and the Vandal conquest in 439. 6 Archaeological excavations have revealed that the beautiful mosaics found in villas depicting
agricultural scenes can be dated to the 3rd and 4th centuries.7 Contemporary
authors raved about the wealth and beauty of Carthage: the author of the
Expositio Totius Mundi mentioned its streets which were set out like a draughtboard or like the rows of trees in a plantation. 8 The French historian Claude
Lepelley states that Carthage was referred to as the 'African Rome'.9
I believe that the prosperity and peace in North Africa would have played
a role in the increased level of scholarly activity - there was time for specialised studies such as medical research which would not have been possible in
an unsettled environment characterised bywarfare; furthermore, peace made
travel possible so that precious medical scrolls and codices could be acquired
from Alexandria and elsewhere.
1.2 The educational !)!Stem in &man North Africa
Another factor which should be taken into account is the educational system
in Roman North Africa as it comes to the fore in passages in St Augustine's
writings. In two well-known passages in the Conjessiones (1.13.20 and 1.14.23)
he remarks that though he was taught Greek at Thagaste, he was not very
good at it. What emerges here is the significant fact that while a knowledge
of Greek was becoming rare in the West (even in cultured circles),lO it was
still taught in a primary school in a small provincial town in North Africa; we
also know tl1at Greek was taught at what was the equivalent of a 'university'
at Carthage (see below). This bilingual upbringing of the youth equipped
6
B.H. Warmington, The North Africa Provinces from Dioc!etian to the Vandal Conquest
(Westport, Conn. 1954) 32-33.
7 Raven (note 3) 21.
s Cf. note 2 above.
9 Lepelley (note 2) 34.
10 M. Green, The Transmission of Ancient Theories of Female Prysiology and Disease through
the Ear!J Middle Ages (Diss. Princeton University 1985) 130 remarks that at the
beginning of the 3rd century 'Roman society (or at least its higher levels) was essentially a bilingual one: Latin was the language of law and the forum, Greek the
language of science, philosophy and medicine', but by the late 4th century 'a
functional knowledge of Greek in the West even among the most educated Roman
citizens was becoming rare ... ' The gradual shift of the political and cultural centre
of the Empire from Rome to Constantinople after Diocletian's division of the
Empire could possibly be one of the causes.
,.
52
CILLIERS
scholars for the reading and the translation of Greek medical works into
Latin.
After Thagaste St Augustine went to Madauros, a centre of Roman culture.
Thereafter he became a rhetor at Carthage, at that stage regarded as second
only to Rome as a centre of Latin studies.tl Salvian, the 5th century minister
of the Christian church at Marseilles, refers with admiration to the schools in
Carthage before the Vandal invasion - according to him they taught the
liberal arts, Greek and Latin literature and philosophy. 12 Like many of his
contemporaries, St Augustine then went overseas and obtained the post of
public rhetor at Milan and made contact with influential people in the palace
in the hope of quickly obtaining the governorship of a province, or a high
position in the palace. However, his career took a different course after his
conversion which led to a break in his earthly ambitions. It is interesting to
note that St Augustine, who had such an enormous influence on intellectual
life at the end of the Roman Empire in the West, spent very few years of his
life outside Africa, and apparently found Hippo Regius, where he eventually
settled as bishop, quite sufficient to maintain contact with Rome, Milan and
the East, and to stay informed of intellectual and theological developments.
1.3 Alexandria
The proximity of the medical school in Alexandria which underwent a
dazzling revival in the 4th century,B would also have had an influence on the
unusual intellectual and scientific activity in Carthage in the late 4th and early
5th centuries. Alexandria14 attracted numerous students from all over the
11
Cf. St Augustine in a letter to a wealthy Greek who had come there to study Latin
language and literature: Duae tantae ttrbes Latinartt!JJ ljtterarum artifices Roma et Carthago
(Ep. 118).
.
12 De Gttbernatione Dei 7 .16, referred to by Lepelley (note 2) 230.
13 Cf. Amm. Marc. 22.16.18: Medicinae atttem ... ita studia attgmtur in dies ttl, licet opus
ipsum redo/eat, pro onmi tamm experimento sufftciat medico ad commendandem artis auctoritatem,
Alexandriae (st) se dixerit emditum; referred to by Sabbah (note 1) 148. An anonymous
contemporary of Ammianus further stated: 'Asclepius wished to grant to Alexandria
skill in medicine, and he thought it right to furnish it with the finest doctors in the
whole world, and thus that city is agreed to be the foundation of health for all men';
referred to by V. Nutton, 'Ammianus and Alexandria', Clio Medica 7 (1972) 173.
14 Described by Sabbah (note 1) 148 as the 'lighthouse of medicine in the 4th
century.'
CILLIERS
53
world.15 That there was contact between the scholars (and physicians) of this
flourishing school and those of Carthage is attested by St Augustine's
description of an incident where the retired advocate Innocentius summoned
a physician from Alexandria after unsuccessful surgery in Carthage. 16
Furthermore, in the introductory chapter of his Gynaecia, Vindicianus refers
to 'experts of earlier times who practiced medicine in Alexandria.' Some of
the names are anatomists who belonged to a movement which originated in
Alexandria at the beginning of the 2nd centuty AD, of which well-known
medical authors like Marinus, Quintus and Numesianus were the main
exponents.n
1.4 An 'African school'?
It is against the background of this remarkable intellectual activity in North
Africa attested by St Augustine and Salvian that one must see Sabbah's
hypothesis18 of an 'African School' of doctors, translators and adaptors of
medical works, as an explanation of the density of medical writings 19 which
were produced in North Africa in the late 3rd and early 4th centuries.
Although there is no specific mention of a medical 'school' in any of the
contemporary or later authors, Sabbah believes that it is possible to postulate
the existence of such a 'school' (in the broad sense of the word), in the
flourishing city of Carthage in North Africa. He refers to the nature of the
medicalZO works in this period in support of his theory - Vindicianus'
Epistula ad Pentadium Nepotem and the Gynaecia, the De Medicina of Cassius
Felix and the Medicinales Responsiones of Caelius Aurelianus - all of them dry
15 Both Gregory of Nyssa (P.G. 46.961) and Eunapius (Vitae Sophistamm 530-38, ed.
Wright) attested to the fact that scholars flocked to. Alexandria.
16 De Civitate Dei 22.8.3.
17 D. Gourevitch, 'The paths of knowledge: medicine in the Roman world', in M.D.
Grmek (ed.), Western Medical Thot~ght from Antiquity to the Middle Ages, translated by A.
Shugaar (Cambridge, Mass., 1998) 120. This is confirmed by Vindicianus in the foreword of his Gynaecia; cf. L. Cilliers, 'Vindicianus' Gynaecia: text and translation of the
Codex Monacensis (Clm 4622)', The Journal ofMedieval Latin 15 (2005) 196.
18 Sabbah (note 1) 132.
19 Sabbah (note 1) 132 n. 5 refers to various other works of which the titles only are
known.
20 Sabbah (note 1) 148: 'actives, renommees, frequentees par des etudiants nombreux
'
54
CILLIERS
and dogmatic manuals which could well have been student handbooks,
based on Greek texts of previous centuries and written in Latin.
2. The contribution of some 4th/5th century North Mrican authors to
the preservation of medical knowledge
2. 1 Vindicianus
Among the North African authors, who made a contribution in the medical
field, the earliest was Helvius Vindicianus, a distinguished physician from
Carthage in the second half of the 4th centuty AD. He held important
government positions: possibly in 380/121 he was Proconsul of the province
of Africa Proconsularis 22 and he also held the high rank of comes arcbiatrorttllt
or Count of the Roman College of Physicians, newly established by the
emperor Valentinian I in 368. 23 Another indication of his high position is a
constitution of the emperors Valens, Gratian and Valentinian II 24 in 379,
addressed to Vindicianus, ordering him to guard the privileges of doctors. 25
A. Beschaouch, Mustitana. Recueil des nouvelles i11scriptions de lvlustis, cites Romaine de
Ttmisie. Tome 1 (Paris 1968) 133-35. The inscription on the slab in Musti, dedicated
by Vindicianus to the emperor Theodosius, does not permit any precision since he
reigned from 379 to 395; it does, however, establish a terminus post quem, namely 380.
The only textual indication of the chronology is in St Augustine's Confessions 4.3 (qui,
proconsule, mamt sua, coronam z!/am agnisticam imposuerat 11011 sano capite meo, sed non ut
medims) which confirms that the tnminus ante qmm was 383 when St Augustine left
Rome for Milan (Conf. 5.8; 12.22) .
22 Sabbah (note 1) 134 points out that this was not one of the honorary prefectures
given to intellectuals as e.g. to Libanius or the father of Ausonius. The status of
doctors had changed for the better, as is clear frorp the legislation of Constantine
and his sons (Cod. Tbeod. 13.3.1.2.3), confirmed by JUlian (Cod. Tbeod. 13.3.4) and later
by Valentinian and Valens (Cod. Tbeod. 13.3.8.9 and 10).
23 Cf. the heading of Vindicianus' letter to the emperor Valentinian in which he
styles himself as comes archiatromm. It was a prestigious College, the doctors being
selected with great care and placed in a hierarchy for advancement.
24 A synopsis of Vindicianus' exceptional career occurs on the stone slab found in
Musti, by Vindicianus, containing an inscription dedicated by him to the emperor
Theodosius: Propagat01i Romani imperii, domitori gentium barbamm, condit01i /eg11111, d(omino)
n(ostro) Theodosia pe1pet11o ac semper A [u]g(usto) He/vius Vindiciamts, v(i1) c(larissimus)
ampl(issimus)q(ue) pro[c](ostl~ p(rovinciae) A(fiicae) v(ice) s(acra) i(ttdicans) C/1111 C(aio) Feli(cio)
Torquatio, [v(iro)] c(/missimo), leg(ato) provinci[ae N]umidiae s11o, n[um]ini maiestatiq(ue) eius
21
CILLIERS
55
The high regard in which Vindicianus was held by contemporaries, and
also after his death, is confirmed by various testimonia. In c. 400 AD St
Augustine, one of his students, left the following testimonial of the mentor
of his youth: 'There was at that time a man of deep understanding, who had
an excellent reputation for his great skill as doctor ... .' 26 Another testimonial
is from his student Theodorus Priscianus who stated that Vindicianus' fame
after his death was even greater than during his lifetime.27 His fame had even
spread to Gaul, where Marcellus of Bordeaux (early 5th century) knew of
him and quotes some of his remedies.2B The exceptional personality of
Vindicianus led Sabbah29 to suggest that Vindicianus could, in the highly
intellectual milieu of Carthage, have been the founder of his proposed
'African medical school'; his dogmatic and confident tone in his letter to the
emperor Valentinian30 could well support Sabbah's suggestion.
Only three short works ofVindicianus have been transmitted, 31 namely
semper dicatus: 'To him who enlarged the boundaries of the Roman Empire, to the
conqueror of barbarian tribes, to the legislator, our lord Theodosius, for ever and
always Augustus, Helvius Vindicianus, vir clarissimus and proconsul of a very high
rank of the province of Africa, with the task of passing judgement as delegate of the
emperor, together with Caius Felicius Torquatus, vir clarissimus, his legate of the
province of Numidia, always devoted to his divine being and majesty (set this up)'.
The word amplissillii!S together with his judicial prerogatives (vice sacra i11dica11s)
indicate the very high rank ofVindicianus.
zs Cod. Theod. 13.3.12.14: De Medicis et Profissmibus. According to]. Korpela, 'Das
medizinalpersonal im antike Rom', Annales Academiae S cimtiart/IJJ Fennicae Dissettations
HmJtanarmll Utteramm 45 (1987) 140, the comes archiatmmm had in the 4th centuty the
highest position in the inner hierarchy of the privileged group. Cf. too V. Nutton,
From Democedes to Harvry. Studies in the H istory ofMedicine (London 1988) VIII.27.
26 Aug. Conf. 4.3 . Cf. too Ep. 138.3: ~Magnus ille nostror:t/111 medims Vindiciamts.
27
Physica 3.
28 Me d. 16.100 (Marcellus iiber Heilmittel, hrsg. M. Niedermann & E. Liechtenhan.
CML 5 [Berlin 1968] 292) .
29 Sabbah (note 1) 143-44.
30 Epistula ad Valentiniamtm par. 2 and 3.
31 A number of other works which have been ascribed to Vindicianus are not
directly related to the G)'IIClecia; they are tl1e so-called Epitome Altera, tl1e fragment in
tl1e Codex Parisinus 7027 referred to as the De Natura Gene1is Httmani, and the
treatise referred to as tl1e De Semine in tl1e Codex Bruxellensis 1348; cf. Cilliers (note
17) 154 n. 6. In his letter to Pentadius, Vindicianus also claims to have translated
some works of Hippocrates, a translation which is attested nowhere else.
56
CILLIERS
(i) Gynaecia,32 a short work on anatomy and embryology, probably lecture
notes for young doctors, or a vademecum for doctors when travelling, or a selfhelp in private houses; in short, a kind of 'Idiot's Guide' on medical matters;
(ii) a letter to his nephew Pentadius 33 which contains an exposition of the
theory of the four humours adapted to Roman circumstances;
(iii) a letter to the emperor Valentinian J34 which served as an introduction to
a now lost collection of medical recipes, disseminated by later authors.35 This
letter gives us the clearest glimpse of Vindicianus' style, his personality (his
confidence and disdain of his colleagues) and his medical views.
These three short works of Vindicianus were among the most widely
excerpted medical works throughout post-Classical times and the Middle
Ages. 36 The Gynaecia and the letter to Pentadius are both adaptations and
translations of earlier Greek works - in the Gynaecia which was clearly written
to be disseminated as widely as possible, Vindicianus expressly states that he
32
Ed. V. Rose, Tbeod01i Ptisciani Eup01iston L ibti III accedunt Vindiciani Ajii quae fenmtur
Reliquae (Leipzig 1894) 426-63. The title Gynaecia is incorrect; only two of the 13
manuscripts containing Vindicianus' text had this title and in both cases the text was
flanked by gynaecological treatises. This might have influenced a subsequent copyist
to give this misleading title to a nameless medical text. Cf. Cilliers (note 17) 154.
33 Rose (note 32) 484-92.
34 Cf. note 28: 46-53.
35 Cf. Theodorus Priscianus, Gynaecia c. 21 (ed. Rose [note 32] 238); Cassius Felix, De
Medicina c. 32, 42 and 69; Marcellus, Med. 16.1 00; and the Antidotmii of the Middle
Ages .
36 D . Langslow, Medical Latin in tbe &man Empire (Oxford 2000) 65. As proof one
can mention Isidore of Seville's Otigines 9.3.12 and 19.31.8 which contain a section of
the Gyn. c. 1. K.-D. Fischer, in P.L. Schmidt (ed.), Handbttcb der lateiniscben Literatur,
(Munich, forthcoming) Vol. 6, s.v. Vindicianus, also mentions an Epistola Ypocratis de
Anatomia (13th century), in which various fragment_s of Vindicianus are quoted by
Vincenz von Beauvais, and gives references to Vindicianus in tl1e 'Bamberger
Chirurgie' (ca. 12th century, Tract. de Cbimrg. 9 and 63). C. Ferckel, 'Ein deutscher
anatomischer Vindiciantext', Z!f:7G 7 (1914) 306, furthermore, states that Vindicianus' Gynaecia was often ascribed to Hippocrates or Galen during the Middle Ages,
and adds various references to Vindicianus in later authors; his description of the
embryo also occurs without mention of a source in Trotttla. De Mttliemm Passionibus
12 (end of 12th century). Various versions of a poem found in the Leiden University
Library had Vindicianus as author; it was, however, written by Marcellus of
Bordeaux, but indicates that Vindicianus' name was still so well-known in the 17th
and 18th centuries that it was often linked to poems of which the author was
unknown.
. . ,..·
CILLIERS
57
wrote it in Latin for those who do not understand Greek; even the average
practitioner could at that stage no longer understand Greek.
2.2 Tbeodorus P!iscianus
We know very little about Theodorus Priscianus apart from the fact that he
came from Cirta,37 an ancient town in Numidia, and was a student of
Vindicianus, whom he gready respected as indicated above. 38 Only one work
of Theodorus has been transmitted, namely the E ttporista (lit. those [sc.
medicaments] which are easy to procure). He states that he had written this
work as an old man (senex), which would be about 400 AD. This tripartite
work on Greek medicaments was written at the instigation of a colleague,
and is a compendium of popular and practical medical aids for diseases. It
was originally composed in Greek39 because Theodorus believed that he
would win fame by following the custom established by his predecessors,40
but he later translated it into an abbreviated Latin version himself following in the footsteps of his master, Vindicianus, who was the flrst of
this group of medical writers to break with tradition and write in Latin
(Greek was until then the language of science, philosophy and medicine, and
Latin the language of law) .41
Theodorus' work was practical rather than theoretical or speculative (a
characteristic of Roman medical thought). 42 In the late Classical period and
the Middle Ages he enjoyed a high reputation,43 and his works were known
and cited in the Greek-speaking East as well as in the Roman West.
37 In the heading of the Eup01ista text in the Parisinus manuscript 6114 he is
mentioned as a citizen of Cirta. Sabbah (note 1) 137-38 mentions other possible
indications of Theodorus' African origin: in ch. 13 there is a reference to stigmata
which mark the faces of black women, which seems to be an observation made on
the spot by a curious Roman doctor; in ch. 20 he uses a Punic word, showing that he
wrote for the Romans of North Africa who would have known the word.
38 Pf?ysica praef. Rose (note 32) 251.
39 Preface to Faenomenon of Eup01ista 1.1, Rose (note 32) 1-2.
40 Faen. 1, Rose (note 32) 1.
41 Cf. Green (note 10).
42 Green (note 10) 172: 'd1e emphasis is on practicality ... ' and 'the other side of this
emphasis on practicality was the concomitant lack of any strong theoretical bent in
early medieval medical literature ... '
43 Theodorus is cited by Alexander of Tralles in the 6th century - the latter's
diagnosis of epilepsy closely resembles that of Theodorus; in the Middle Ages the
~-.
r
.-!L.
•••
:·
l
:: •..r' ·r'
58
CILLIERS
2.3 Cassius Felix
Cassius Felix, the author of the De Medicina, was a well-known and respected
physician who practiced and probably also taught medicine in North Africa44
in the first half of the 5th centuty. The work is dedicated to the consuls
Artaburus and Calepius,45 which enables us to date it to the year 447. From
the heading of the text one can also deduce that Cassius Felix (also) came
from Cirta, 46 where he probably practiced before going to Carthage in later
life. He is connected with Carthage in a hagiographic text in which it is
recorded that a famous archiater from Carthage named Felix was summoned
to treat a young woman afflicted with facial paralysis after childbirth.47 He is
the only medical author of the period discussed who openly professed his
Christian faith.48
His works abound with Greek expressions as was common in works of his
time; in his Preface he explicitly states that his work provides us with a
summary of the knowledge taken over from the Greek authors of the
Dogmatic sect. 49 His citations of Greek texts furthermore show that he had
contact with physicians and medical teachers in Alexandria. so
Gynaecia was often read and transmitted independently; the second book was also
often excerpted.
44 Cassius Felix's African origin is attested by his use of Punic words, e.g. girba in
31.1 (= a mortar), and gelelam in 73.3 (= a coloquint, a fruit resembling a watermelon
and used as a purgative), and by his reference to Vindicianus (of whom three recipes
are quoted) namely in tl1e De Med. 32.4 (a remedy against toothache), 42.21 (against
vomiting) and 69 (against the sting of a scorpion).
45 According to the text of the De Medicina in tl1e Codex Parisinus Latinus 6114.
46 Corrected by Rose (note 32) from 'Cassii felicis artensis' to 'cirtensis', a plausible
suggestion, especially since there is a funerary inscription in Cirta (CIL 8.7566) of a
Q. Cassius Felix; M. Schanz, Geschichte der Riimischen Literatttr bis '{!1111 Gezet:rgebungsJverk
des Kaisar Justinian. Zweiter Teil (Munich, 1913) 284.
47 The De Miraculis Sancti Stephani Protomartyris (PL 41.833-54); it is recorded tl1at he
gave a pessimistic diagnosis.
48 Omnipotens Dei Nttttt (De Medicina praef.) Vindicianus in his letter to the emperor
Valentian and Theodorus Priscianus in the Preface to his Pbysica botl1 still adhered to
tl1e philosophical and medical concept of natura/pf?ysis.
49 De Med. praef.: ex graecis logicae sectae attctoribus.
50 Reference in]. Scarborough, 'Cassius Felix', in Paul T. Keyser & G. Irby-Massie
(edd.), Biographical Enryclopaedia if Ancient Natural Scientists (London & New York,
fortl1coming).
·.·, ....·
·:
·. .
'
CILLIERS
59
Cassius Felix's De Medicina was probably composed as a practical guide for
young doctors as was the custom in his day; the didactic form of the work
suggests that it was probably a course given by an archiater to his students.st
The work is oriented towards the therapeutic rather than to theory. The
relatively technical level of certain recommended courses of action, the
treatment indicated and the surgery described, seem to indicate that he was a
specialist.52 In contrast to the Euporiston of Theodorus Priscianus, which
claims to offer a simple medication to the non-specialist, enabling a lay
person to look after himself, Cassius Felix's work requires a reader who can
understand the abundance of Greek terms. Even if the knowledge of Greek
declined less quickly in Africa than in the rest of the Western Empire, only a
small group of intellectuals would still have understood it easily.
2.4 Caelius Attreliamts
Caelius Aurelianus flourished in the first half of the 5th century and came
from Sicca Veneria 53 in the province of Africa Proconsularis.54 It is possible
that he spent some time in Rome,55 but it cannot be proved. The incipit of
Thus A. Fraisse, Cassius Felix. De fa medecine (Paris 2002) xxviii.
This is also the view of Fraisse (note 51) viii, xviii and xxi.
53 His name occurs in the manuscripts as Caefius Attrefianus methodic11s Siccensis, and
also in an inscription (CJL 8.1289) in Africa Proconsularis. The incipit of d1e editio
p1inceps of Acute Diseases and Chronic Diseases and that of the Leyden manuscript
(Voss. Lat. Q no. 9: Geneciar11m Cefi Aure/iani Methodici Sicensis liberprimus incipif) also
connect Caelius wid1 Sicca; cf. Sabbah (note 1) 140-41 for references.
54 Warmington (note 6) 119, contra Schanz (note 469 285, who incorrecdy states that
Sicca V eneria is. in Numidia.
55 Caelius refers to Italian wines and to medicinal fountains in Italy, but Schanz (note
46) 286 states d1at he could have found that information in Soranus. A stronger
argument is a reference to a graectts fiber epistolarum, which Caelius dedicated to one
Praetextatus (referred to in the MC 2.1 .60); according to Sabbah (note 1) 142 it could
have been the City Prefect of Rome in 367-368, and Praetorian Prefect of Illyria,
Italy, and Africa in 384; he was consul designate at dut stage and died at d1e end of
384 (which would place Caelius in the late 4th centuty). He was, together with Nicomachus Flavius and the orator Symmachus, d1e principal exponent of the 'pagan reaction' at the end of d1e 4d1 century. Scarborough (note 50), however, believes that it
refers to Rufus Praetextatus Postumianus, consul in 448 (CIL 6.1761).
5!
52
60
CILLIERS
more than one manuscript reveals that he was an adherent of the Methodist
School of medicine. 56
He was one of the most important Latin medical writers of the period not as original researcher, but as translator of important Greek works. His
translation of Soranus' On Acute Diseases (in three books) and On Chronic
Diseases (in five books) is one of the most significant contributions in Latin
medical literature. Knowledge of the works of the ancient Greek authors was
in this way made available for Roman readers in their own language. The
work is also important since it followed the custom of some of the ancients
in presenting the text in the form of arguments with predecessors, encapsulating (and sometimes preserving intact) medical theories of authors whose
works have been lost.57 Caelius, too, was writing for readers who knew little
Greek.
There are a great number of resemblances between Caelius Aurelianus and
Cassius Felix. The problem is that we do not know whether Cassius used
Caelius, or the other way round, or whether both independently used a
common Greek source and a Greek-Latin, Latin-Greek medical glossary.
However, it seems more likely that Cassius would have used the richer and
more developed version of Caelius for his own abbreviated version (breviloquium).SB Then there are also the introductory lines of Cassius' work in
which he warns his son not to go and look for medical knowledge elsewhere
than in his own work,59 which could have been directed at Caelius, since
Cassius, as a Christian, did not want the works of the heathen Caelius to be
read.
3. Conclusion
The 5th and 6th centuries were turbulent times in North Africa. The Vandal
conquest and thereafter the reconquest of Africa by the Byzantines and the
in..vasion of the Islamic armies disrupted society ,and sent successive waves of
refugees to Europe. Yet it seems to have been precisely due to these unsettled circumstances that many manuscripts were preserved and transmitted,
56 On the Methodist School of Medicine, cf. I.E. Drabkin (ed. and transl.), Caelitls
Aureliam1s. On Acute Diseases and On Chronic Diseases (Chicago 1950) xvi.
57 Scarborough (note 50) mentions that Acute Diseases closes with 'replies' to Diodes,
Erasistratus, Asclepiades, Themison and Heracleides.
58 Sabbah (note 1) 143 and 167.
59 Unde admoneo, fili dttlcissime, ne quid j01te huic scripturae addendum velminuendum existimes,
Med. praef.
.: .·
.~.:: ;. :~ . :. ··•·. ··~
.
CILLIERS
61
since the scholars who fled during the political and religious upheavals would
have taken with them to the European continent the works of contemporary
North African authors. GO After the fall of Carthage in the 5th century and the
Muslim invasion in the 6th century, the focus of translation activity gradually
shifted from North Africa to the North Italian city ofRavenna.6t
Evidence that the works of North African authors were known in Italy,
can be traced back to the middle of the 6th century. At his foundation at
Vivarium in Southern Italy Cassiodorus, the senator-turned-monk, compiled
an introduction to the studies of the monks, called the Institutiones.62 It
consists of two books, one dealing with Christian learning in general for their
monastic life, the other being a compendium of such secular knowledge as
Cassiodorus thought necessary for his monks. Among these secular works
were a few essential medical texts - Gargilius Martialis, and some Latin
translations of Hippocrates, Galen, Dioscorides and possibly also Caelius
Aurelianus. 63 We also know that Theodorus Priscianus' Euporista was known
in Italy by the middle of the 5th century, since it was used as source for the
Latin version of Oribasius' encyclopaedia.64
Some North African Latin literature also entered Europe via Spain: in the
first decades of the 6th century, Isidore of Seville composed his Etymologiae,
an encyclopaedic work in 20 volumes dealing with the liberal arts, law,
medicine, religion, etc. As the title indicates, his intention was to trace words
and concepts back to their origin. He therefore he inserted bits and pieces of
numerous earlier works to illustrate his point, i.a. from Vindicianus,6s Cassius
60
Thus also Green (note 10) 209, who sees this as 'the principal reason why much
late antique African literature has survived at all'. On p. 139 Green points out that
Carthage was still an open harbour and a regular stopping point for ships, and there
still seems to have been an effective postage system - one need only think of St
Augustine who had a regular correspondence with friends in Italy and sent
manuscripts as far abroad as Jerusalem.
61 Green (note 10) 140-41.
62 R.A.B . Mynors (ed.), Cassiod01i Senatoris Institt/tiones (Oxford 1937, repr. 1963) ix.
63 C. 31 (Mynors [note 62] 78-79). V. Nutton, Ancient M edicine (London & New York
2004) 300, points out that Caelius Aurelius in Cassiodorus' text could refer to
Caelius Aurelianus' On Acute and Chronic Diseases, but due to the size of the work, it
may be a popular compendium ascribed to one Aurelius. It is also uncertain which
works of Hippocrates, Galen and Dioscorides were available at that stage for Cassiodorus to refer to.
64 Cf. Green (note 100) 209 and 242 n. 37.
65 There are six passages in the Etymologiae which show a resemblance to Vindicianus' Gynaecia; cf. Cilliers (note 17) 158 n . 12.
62
CILLIERS
Felix and Caelius- Aurelianus. 66 Isidore's Erym ologiae was one of the main
routes by which classical learning was transmitted to the Middle Ages. From
Spain copies of medical manuscripts spread to the abbeys and monasteries of
France (Poitiers, Orleans, Vendome, Chartre, Fleury-sur-Loire). Even as far
north as the Anglo-Saxon area traces of medical literature were found:
Vindicianus' letter to his nephew Pentadius is quoted by the Venerable
Bede. 67
But what was the role played by the four authors discussed above in this
process of preservation and transmission? Coming from the still partly
bilingual province of North Africa in the 4th century AD, they knew Greek at
a stage when the knowledge of Greek began to become the exception in
other parts of the West;68 they could thus read and translate the works of the
Greek medical authors of old. The era in which they lived was characterised
by a rich medical culture based on an extensive knowledge of the long
foregoing Graeco-Roman medical tradition. The emphasis at tlus time was
on compiling existing knowledge rather than on original research and
systematic anatomical investigation,69 thus most of the works of this period
were translations, adaptations or compilations of earlier medical texts, made
Cf. Sabbah (note 1) 149 n. 81 for Cassius Felix and Caelius Aurelianus as sources
for Isidore.
67 Sabbah (note 1) 149 and n. 83.
68 Green (note 10) 130 remarks that at the beginning of the 3rd century 'Roman
society (or at least its higher levels) was essentially a bilingual one: Latin was the
language of law and the forum, Greek the language of science, philosophy and
medicine', but by the late 4th century 'a functional knowledge of Greek in the West
even among the most educated Roman citizens was becoming rare .. . ' She ascribes
this to the gradual shift of the political and cultural centre of the Empire from Rome
to Constantinople after Diocletian's division of d1e Empire.
69 Cf. G. Marasco, 'Litterature et realite dans l'oeuvre de Vindician', in Actes du VIe
coffoque international sur fes texts medicaux latins (Nantes 1998) 166: '!'erudition avait
efface presque entierement !'interet pour la recherche.' V. Nutton, 'From Galen to
Alexander; aspects of medicine and medical practice in late antiquity', Dtimbarton
Oaks Papers 38 (1984) 1-14, refers to authors of the 4th and 5th centuries as 'the
summarizers, the encyclopaedists - who have been studied not for d1emselves but
for d1e earlier sources that they happen to encapsulate. Oribasius, Aetius, Alexander,
Paul are the medical refridgerators of antiquity.' However, Sabbah (note 1) 149
pleads d1at one should not fail to recognise d1e originality of the work of translation
and adaptation to d1e Roman mentality, and in the Latin language which did not
have its own medical vocabulary yet, and the scholarly systematisation in which
originality played a greater role d1an evaluated.
66
CILLIERS
63
with the express purpose of preserving this knowledge and making it
accessible for self-help among the laity.7° Apart from Cassius Felix, who
seems to have written for a specialist target group, Vindicianus, Theodorus
Priscianus and Caelius Aurelianus wrote their works for students and for
dissemination among the laity. Vindicianus' works were the first of these
Latin translations/adaptations of the old Greek masters and according to
Langslow heralded 'the beginning of what may be seen as a "golden age" of
ancient Latin medical compendia.'71
Vindicianus clearly realised the urgent need to ensure the survival of this
knowledge, which could only be done by passing it on in a language - Latin
- which would be understood by the masses.7 2 Theodorus Priscianus, and
somewhat later Cassius Felix and Caelius Aurelianus followed his example,
thus ensuring the preservation of the knowledge of important Greek texts.
Circumstances made it possible that their texts were taken to Europe and
thus preserved for posterity.
70
Langslow (note 41) 63.
Langslow (note 41) 63; for an explanation of this 'new medical landscape' cf.
Nutton (note 63) 293.
72 In the foreword to his Gynaecia he explicitly states that he is writing the treatise in
Latin for those who could no longer understand Greek; cf. his Gynaecia, Codices
Sangallensis 751 and Laurentianus 73.1; cf. V. Rose (ed.), Vindiciani Afri Expositionis
Membrorum Quae Reliqua Sunt (Leipzig 1894) 428. Manuscript P 4883: Hanc epistolam
disponere ex libris Graecis in latimmJ sermonem . .. , and L 73.1: placuit propter quondam huius
modi ser111one ignorantiae in latinitatem inte1pretare ...
7!
...
MYELOS: MATTERS OF LIFE AND DEATH
Elizabeth Craik
University of St Andrews and University ofNewcasde upon Tyne
Myelos and myxa interconnected in etymology and pathology
Ancient medical theories on the maintenance and disruption of health were
predicated on beliefs about good or bad, benign or noxious, nourishing or
destructive, fluids present or predominant in the body. The main good fluid
is blood in the phlebes, but nryelos is important also. The supposed course of a
channel from the brain -pure, nurturing and life giving in health, but subject
to adulteration in disease - is explicitly described or tacitly postulated in
many Hippocratic texts. The contents of this channel are commonly equated
or associated with llUEAOS", frequently qualified by the adjective vwna'Los, lit.
'of the back', and equated with vital cerebral, spinal and seminal fluids. Fluids
centred on or collecting in the head might be adulterated by excess or
deficiency in quantity or by fluctuation in quality, especially temperature; the
resultant flux of noxious matter caused disease at various points in the body.
Two types of flux were invoked: shallow flux, from the scalp above the skull
(commonly supposed to be phlegmatic) and deep flux, from the brain. The
former was common and treatment was routine, while the latter was more
serious and intractable.! It is here argued that such theories are deeply embedded in Greek thought, rather than arising with the development of
Hippocratic medicine.
While llUEAOS" (Ionic 11uaA.6s) is a 'good' and pure body fluid the related
term 11u~a is almost always 'bad' and noxious, commonly associated with pus
and putrefaction. LSJ s.v. 11u8os, 'damp': 'clamminess', 'decay' compare a
Lettish verb mudet 'become mouldy' and an Old English substantive smut,
which in turn, according to OED, is allied with Middle High German Smuz
'fat', 'grease'. There is a range of cognate terms:' llU~W8l]s , llU~OTIOLOS", 1.LU8Civ,
llu8a(vELv, (8La)l.lu8aA.Eos, 11u8wv, I.LU8T]<JLS" . This range of words for noxious moisture is found in medical and non-medical texts alike: the verb
11u8Civ is the mot jttste for the purulent oozing of ulcerated flesh (U/c. 10
[6.408 L.], VC 15 [3.242 L.]; cf. 11v8wv Poll. 4.191 and I.LU8T]<JLS", Gal. 14.770),
1
See Craik, forthcoming.
CRAHC
65
while the verbs OLaj.lUOaLVELV and j.1U8dv are used in tragic texts of incipient
decay in a corpse (A. fr. 112; S. Ant. 406; cf. Hsch. gloss j.1U8ai:vw · a~rrw).
The term j.lU~a is most commonly applied to nasal discharge or mucus,
sometimes loosely 'phlegm' (e.g. Morb. 2.19 (7 .34 L.], A .if. 2 [6.210 L.]; cf.
Pollux s.v. TO pEUj.la Tfjs pw6s), but it and such derivatives as j.lU~WOT]S",
j.lU~OTTOLOS" are applied also to other peccant matter, including anal discharge
coming from the bowels (A.ff. 26 [6.238 L.], Epid. 7.45 [5.412 L.], Prorrh. 2.23
[9.54 L.], vaginal discharge coming from the womb (Nat. Mttl. 17 [7.336 L.]
etc., or, similarly, stuff in the womb preventing the embryo from lodging
there, and so precipitating miscarriage (Aph. 5.45 [4.548 L.]; cf. Diokles fr.
22). Thus, essentially similar peccant matter is thought to manifest itself at
different bodily orifices.
In Places in Man, 1-1u~a is specifically said to occur naturally in the joints:
when this is pure the joints are lubricated and all is well, but pain and discomfort arise when irypaaLT], 'moisture', i.e. impure moisture, flows into the
joint from the flesh after an injury, for this new impure moisture is not a
lubricant (Loc. Hom. 7 [5.290 L.]. LSJ tr. 'synovial fluid', but this anachronistic
term imputes too much knowledge to the author. (In translation and commentary I followed LSJ, but this needs some refinement. 2) The situation
envisaged in the affected joints is exactly analogous to that postulated in the
affected eye (Loc. Hom. 13 [5.298, 300, 302 L.]): the moisture which flows
from the brain to the lower body is usually pure and nourishing though uncommonly and seriously it can be adulterated, while moisture which flows
from the scalp to the lower body is prone to be adulterated, impure and
causing disease. In Articulations, j.lU~a may be a feature of normal people with
loose joints or a pathological abnormality (Artie. 8 [4.98 L.]); similarly in
Aphorisms, it is stated tl1at j.lU~aL supervene in cases of recurrent dislocation
of the hip (Aph. 6.59 [4.578 L.]). Just as phlegm in the body may be harmless,
occurring naturally, and just as pus commonly bad may sometimes be good,
11!)1Xa in the body, specifically the joints, may be a natural and harmless,
though always potentially harmful, presence. Here, the word is at its closest
to JJryelos to which we now return.
Two types of myelos
Some of the complexities inherent in tl1e term j.lUEAOS" are recognised in LSJ,
where s.v. 1 'brain' is offered as an alternative to 'marrow' and also, for 1-l·
2
Craik 1998.
r.-·. ·.......'
.
.·..
66
CRAIK
pax( TTJS', ~- vwna'Los-, 'spinal cord'; s.v. 2 XTJVOS' ~- is translated 'fat'; s.v. 3
instances are listed of 'marrow' as good food; s.v. 4 'marrow' in metaphorical
usage is covered. Despite this, 'marrow' seems to have become an automatic
modern translation and, in any case, the alternatives offered by LSJ are not
quite correct. More properly, it might be said that the term is applied (1) to
bone marrow and (2) to the contents of a channel believed to course from
brain to spine to genitals (in men) or to womb and potentially thence to
vagina (in women) and to the lower limbs especially the joints (in both
sexes). For our purposes, the most important point about 2 is that a distinction between spinal fluid and spinal cord is unknown to ancient authors,
both being perceived as the 'marrow' of the vertebrae. This is unsurprising:
spinal fluid would flow away unseen on section, while the creamy white
spinal cord, identical in appearance to brain tissue, would be seen if the
vertebrae were cracked. 3
Spinal myelos in Hippocratic authors, Plato and Aristotle
The author of On Flesh correctly states that
o ~uEA.os- o KaAEO~EVOS'
VWTLQLOS' Ka8~KEL cmo TOU EYKE<jJaA.ou, 'the myelos called that of the back
descends from the brain': the continuity between cerebral and spinal fluid, or
CSF, is recognised (Carn. 4 [8.588 L.]). And he correctly observes that, being
different from the nryelos in other bones it ought not to have the same name.
In addition, he correctly notes ~ouvos- yap ~~vLyyas- EXEL, 'spinal 17ryelos
alone has meninges', showing awareness of the meninges enclosing the
spinal cord. 4 The author of Articulations too knows the meninges, described
as 'coverings': he promises to expound in another work the extent and
3 See Blacks Medical Dictionary, s.v. marrow, ' ... yellow marrow, which contains a
large amount of fat, is found within the shaft of long limb bones .. .' (also 'red
marrow, which has a highly cellular structure, occupies a space within the ribs,
sternum, vertebral bodies, and the ends of the long bones', but this does not concern
us here); s.v. cerebrospinal fluid, 'the fluid within the ventricles of the brain, bathing
its surface and that of the spinal cord ... normally a clear colourless fluid'; s.v. spinal
cord, 'the lower portion of the central nervous system which is situated within the
spinal column ... the spinal cord is considerably shorter than the spinal column ...
from the base of the skull to the lumbar region ... a cylinder, about the thickness of
the little finge~; .. .'
4 See Blacks Medical Dictionary, s.v. meninges 'the membranes surrounding the
brain and spinal cord'; cf. Whiten 2006:30, fig. 3.3.2, dissection of the spinal cord
and its meninges.
. .....
CRAne
67
nature of vascular interconnections, and to explain with regard to the notiaios
OLCJ"LV EAUTpWTaL EAUTpOL<JLV KaL o8Ev WPilllllEVOL<JL, 'with what coverings it
is covered, and from where these come'; he explains that the vertebrae are
linked 8EOWfl llUCW8EL KaL VEUpw8EL, 'by a slippery and sinewy bond' (Artie.
45 [4.190 L.]). As in Places in Man, a connection between myxa and nryelos is
implicit.
It is possible that we hav.e, embedded in On Bones, a fragment of the work
promised by the author of Articulations. The title On Bones is misleading; the
work is actually (apart from the initial section) about vessels and part of it
was known to Galen as 'Appendix to Mochlicon' (Galen 19.128 K.); Mochlicon
of course paraphrases Fractures and A1ticttlations. A detailed anatomical
account of the route taken by a vessel described as ~ apxa(Tl cpA.b\J, 'the
archaic vessel' or 'the primal vessel' occupies a large portiq,_n of On Bones.
(The mistranslation 'main' and the emendation to naxd11, 'thick' are alike to
be rejected.) It encircles the head, is closely entwined with the spine, courses
to the womb or is rooted in the genitals, then goes on to hips, knees and feet
(Oss. 11-18 [9.182 sqq. L.]). In this, the spine acts as centre of fluid collection
and distribution. This vessel is envisaged as entwined with the myelos by
means of little vessels passing through the vertebrae (Oss. 14 [9.186 L.]); it
collects contents from the ?l!Jelos, becoming filled with sperm (Oss. 15 [9 .190
L.]); it is also the vessel which nurtures the nryelos (Oss. 16 [9.190 L.]). Its
contents are ELALKpLVECJTaTov, 'purest' of all fluids in the body (Oss. 15 [9.188
L.]); this corresponds to the synonymous Ka8apwTaTov, applied to cerebral
fluid in Places in Man (Loc. Hom. 2 [6.278 L.]); cf. 13 [6.300 L.]). 5
In Generation, sperm is the i.axup6TaTov Kal. m6TaTov, 'strongest and
richest' of all bodily moisture; derived from brain and nryelos it flows from
brain to sacrum to genitals (Gmit. 1-2 [7.470 L.]). To these accounts, explicitly postulating an alliance between CFS and semen, can be added several
passages where similar views are implicit: an encephala-myelogenic theory of
seminal fluid underlies the belief that infertility would result if an incision
were to be made behind the ears (Aer. 22 [2.76 L.]), Genit. 2 [7.472 L.]), Loc.
Hom. 3 [6.282 L.]). Such an incision was a recognised treatment for kedmata,
disease of the hip joint, caused by a flux of peccant matter by the same route
(Epid. 6.5.15 [5.320 L.]). In women, this flux of peccant matter might affect
the same joints as in men; but in addition it might attack the genitalia and, as
5
On d1e course of this vessel, see Harris 1973:62-73; also Duminil 1998. See also
Craik, forthcoming, on similarities with ilie DU channel of Chinese medicine.
. :~
68
CRAIK
in men, have an effect on fertility.6 Menstrual blood which, instead of
flowing 'pure' from womb and 'hollow vessels', brings KOAAWOES O[l.OU T<fl
a'L[laTL, 'viscous stuff with the blood', EK TWV ap8pwv KQK T~S oa¢uos Kal.
tax(ou, 'from the "joints", and from sacrum and hip' corresponds to the
adulterated contents of the channel carrying myelos (Mttl. 2.114 [8.246 L.]). In
this passage ap8pov, 'joint' probably refers to the female genitals: the word is
so used in Herodotos (3.87, 4.2, of mares) and Aristotle (HA 504b23, of
dolphins) as well as elsewhere in the Hippocratic Corpus (Sten'l. 230 [8.442
L.], Cam. 19 [8.610 L.]).
In Internal Affections, two types of phthisis are associated with abnormal
functioning of the nryelos (Int. 12,13 [7.192, 198 L.]); similarly in Diseases 2
VWTLas ¢8(aLs has its origins in the myelos (Morb. 2.5, 51 [7.12, 78 L.]); the
oma8Ev ¢8(ULs of Places in Man is similar (Loc. Hom. 23 [6.314 L.], cf. 10
[6.294 L.]). In Koan Prognoses it is asserted that a KaTCippous vwna'ios, 'flux in
the [myelos of the] back' does not occur before puberty and that it does not
occur in older men (Coac. 5.502 [5.700 L.]); this is in accord with Diseases 2
and Internal Affections, the disease affecting young, sexually active, or overactive, men.
Plato in the late dialogue Timaetts presents a remarkably similar view of the
anatomical and physiological importance of nryelos to that seen in the
Hippocratic works Generation, On Flesh and On Bones. Myelosis cardinal in the
formation of the human body (73b); brain, spinaltJryelos and sperm are linked
(73a-74b); nryelos passes from the head through the neck and then along the
spine, to become sperm in men or to reach the womb in women (91a). At
the same time, Plato's account is imbued with a mystical significance related
to his tripartite view of the soul: cerebral fluid is associated with the rational
part and spinal fluid with the irrational part of the soul. (The third 'spirited'
part is located at the kardia.) Plato's standing in antiquity as a medical theorist
is confirmed by the concise summary of the dialogue contained in the
papyrus known as Anonymus Londinensis (Anon. Land. XV). Plato's
account of myelos is not confined to anatomy and physiology, but extends to
pathology: disease of the myelosis serious and often fatal (84d); one cause of
such disease is an excess of sperm (86). Here too there are close Hippocratic
analogues, noted above.
Aristotle regards myelos as 'a kind of blood', to be dissociated from
spermatic fluid and as essentially fatty in character (PA 651b); like the author
6 See Lonie 1981:119-22; Lloyd 1983:66; Dean-Jones 1994:149-53 for ancient views
on the contribution of female sperm in reproduction.
CRAIK
69
of On Flesb, he distinguishes spinal tl!Jelos from regular bone marrow (PA
652a). He recognises a continuum between brain and spine, but regards them
paradoxically as opposites (brain cold and dry; spinal myelos hot and fatty). A
more brief account elsewhere suggests an analogy between the two
important bodily irypa, 'fluids', blood carried in the vessels and fl!)'elos carried
in the bones (HA 521 b). Aristotle regarded the soul as the locus of the
appetitive faculty (Arist. de anim. 433b13-18).
Myelos in gynaecological therapy
The use of animal nryelos in gynaecological pessaries, poultices and douches
presents different questions. In medical theory, the prevalence of abstract
speculation militates against precise translation in modern terms: in particular, as noted above, a distinction between spinal fluid and spinal cord is
often unclear. In medical practice, a doctor recommending the application of
nryelos must have a particular substance in mind. A range of animal fats (such
as butter and beeswax as well as aA.EL<j>a or <JTEap, fat from miscellaneous
animals) and vegetable oils (such as almond-oil, oil of roses) was used in
various combinations, usually to act as emollients and in particular to soften
the cervical orifice in fertility treatments. Among these, myelos has a
prominent place, and deer 11ryelos is especially favoured. Some examples (not
an exhaustive list) are: goose, deer or ox myelos (Mul. 1.74 [8.156 L.]); deer
flryelos (Mul. 1.90 [8.218 L.]); deer 11ryelos and fat (Nat. Mul. 32 [7.366 L.]; deer
11ryelos (Mul. 2.158 [8.336 L.); deer and goose fat (Mttl. 2.171 [8.352 L.]); deer
tl!Jelos or fat from sheep or goat (Mttl. 2.205 [8.394 L.]); deer 11ryelos with goose
fat (Steril. 221 [8.425 L.]); deer myelos for preference, failing which goose fat
(Steril. 230 [8.442 L.]). Surely the ingredient derived from geese, which are
notoriously fatty, is simply 'fat', loosely designated myelos - and LSJ s.v. 2
renders '(goose) fat' - but the substance derived from deer, venison being a
famously dry meat, is surely bone-marrow; similarly in the case of nryelos from
sheep, goats and cattle. Cooked marrow is solid and can readily be scooped
from the bones. It could easily be combined with other ingredients and
formed into balls, in the manner prescribed in one passage.
The reason for these applications is in part mechanical use of cures by
opposites or sirnilars: soft and fatty substances, whether externally applied or
internally ingested - and both brain and marrow were regarded as highly
nutritious foodstuffs (Viet. 2.49 [6.552 L.]) - would make the body soft and
fatty; or in this case would lubricate the cervix, and make the womb more
receptive to impregnation. But the supposed association of 11ryelos with semen
70
CRAIK
and with female generative fluid is surely implicit. In On Generation, the
mixing of male and female sperm is illustrated by the analogy of mixing
KT]p6v, 'wax' with cnEap, 'fat' (Genit. 6 [7.478 L.]). A further reason, rooted in
sympathetic magic, may underlie the preference for deer myelos: Artemis, the
goddess associated with women, especially in childbirth (Vi~g. 1 [8.468 L.]),
was associated also with deer, and stags were important sacrificial victims in
her cult.7
Myelos and aion
Erotian A 70 glosses mwv· 6 vwna'Los llUEAOS", gJ.vmg two Hippocratic
citations and one Pindaric citation in support. This usage is recognised in
LSJ, where A I 'life' and II 'long space of time' are given, followed by B
'spinal marrow' (perhaps regarded as seat of life). Erotian says he draws his
second citation Tov al.wva vo<J~<Jas ns E~8o11a'Los cmE8avEv from Wounds
and Missiles, a work now lost; but it is suspiciously close to a sentence in
Epidemics 7, 6 Tov al.wva cp8LV~<Jas E~8o11a'Los chrE8avEv (Epid. 7.122 [5.468
L.]) . This brief case history comes very close to the end of the work, situated
in a rather inconsequential sequence of statements on miscellaneous sexual
ailments. The patient's wasting disease of the aion is evidently a version of
the 'back phthisis' of the JJryelo.r, noted in Internal Affections and other treatises,
discussed above. Erotian's first Hippocratic citation EGcpaKEALG8T] Tov al.wva
cannot be traced in the corpus as we have it. However, as the account in
Diseases 2 states that JJryelos trouble begins with GcpaKEAWilOS" EYKEcpaA.ou, the
same condition in the brain (Morb. 2.5 [7.12 L.]) and as similarly in Airs,
lf1"ate1:r and Places this brain condition is said to lead to some cases of phthisis
(Ae1: 10 [2.50 L.]) it is evident that a nexus of diseases, perceived to be
related and all centred on the JJryelos is discussed. The author of Articttlations
promises a long treatise TrEpL GcpaKEAWilWV TWV GUllrravTwv C)(JTEWV (Artie.
33 [4.154 L.]). Perhaps such a work, known to Erotian, is the source of his
citation.
7
See Farnell1896, vol. 2:431-33 on wild animals, especially stags, regarded as sacred
to Artemis; Parke 1977:125 on the month Elaphebolion at Athens; King 1998:esp.
180 on Artemis as midwife.
CRAne
71
Poetic texts
Erotian, giving examples of usage in exegesis of his glosses, frequently cites
poetic texts alongside medical works. The Pindaric passage cited describes
how Herakles wields his club, TEA.os 8E: aELpas rrpos an~apas amipa~E
TTAEupas , alwv OE Ol, oaTEWV Epa(a8T], 'finally raising it, he tore into [his
adversary's] strong side, and the aion was ctushed from his bones' (Pind. fr.
111, Schroeder). In the Homen·c Hymn to Hermes, the god acquires a tortoiseshell by impaling the creature through the aion: alwv' E~ETOpT]aEV opEaKtflOLO
XEAWVTJS and 8L 'alwvas TETOp~aas (h. Mere. 42, 119). Homer regarded
wounds causing loss of aion or myelos (both terms being used) as mortal: EK 8'
alwv rrE:<j>aTm, KaTa 8E: xpoa mivTa aaTT~l] , 'the aion was struck out and rot
spread overall in the flesh' (II. 19.27) and ~uEA.os UlJTE a<j>ov8vA.(wv EKTTaA.8',
'nryelos leapt from the vertebrae' (II. 20.481-83). Hippocratic writers too
viewed damage to the ?lryelos- like damage to such other vital organs as brain
and liver- as fatal (Morb. 1.3 (6.144 L.] ; Coac. 4.499 (5.698 L.]).
A passage sung by tl1e old men of the choms in the parodos of Aeschylus'
Agamemnon has puzzled commentators: aTE yap VEapos ~uEA.os aTE:pvwv
EVTOS avaaawv I laoTTpEa~US (Ag. 76), 'as the ll!Je!Os of the young, ruling in
the breast, is like that of the aged.' Hermann's emendation, avqaawv,
'leaping' or 'coursing' for avaauwv, 'tuling' is commonly adopted. The point
is simple enough, clarified in context by the balancing laxuv luorrmoa,
'strength like that of children' immediately preceding: the very young and the
very old are both physically weak; but the expression in terms of bone
marrow, which neither 'tules' nor 'leaps', has seemed obscure.8 If we suppose
that Aeschylus is using the term 1l!Jelos to signify not bone marrow, but a
fluid associated with virility and vigour, the passage makes perfect sense. The
verb avqauELv is used in Hippocratic works of vessels coursing through the
body (Oss. 10=Epid. 2.4.1 (9.178 L.=5.122 L.]). It is ironic, in view of
Hermann's insistence 'verbum awaELV saepius obscttraftttn librariortttn imperitia'
(Fraenkel, comm., ad loc.), that the word is missing from the standard Hippocratic concordance.
The tortuous route of the vessel associated with JJryelos in On Bones includes
the lungs; cf. aTE:pvov, 'breast' in Aeschylus and 'side' in Pindar (above).
8
See for instance Denniston and Page, comm., Oxford, 1957, noting that 'There
seems to be no useful parallel' and citing Dover's rather desperate suggestion that
'Aeschylus may have believed that d1e marrow was pumped through the bones like
sap, and that this process accompanied growth.' The rendering 'sap', found both in
Campbell's translation of 1893 and in Collard's of 2002 is, however, a good one.
:: •-""''
72
CRAIK
Sophocles situates passionate love in the tJ;ux~ in one fragment and in
another explicitly in the tJ;ux~ rrA.Eu116vwv, 'the psyche in the lungs' (frr. 684,
941). Although the process of respiration was not understood, the importance of the lung to life was fully recognised; thus, a link is made with the
vessel believed to carry the essence of life. Indeed aion, synonymous with
1l!Jelos, can be synonymous also with p.ryche, as in the Homeric hendiadys
tJ;ux~ TE Kal. atwv (II. 16.453) and in Euripides' aTTETTVEU<JEV atwva (Eur. fr.
801). 9
The counsel of the Nurse to Phaidra, victim of a hopeless Aphroditeinduced passion in Euripides' Hippo!Jtos, that it is safer if affections do not
penetrate 'to the innermost myelos of the being' surely has a sexual slant (Eur.
Hipp. 225, TTPOS' aKpov llUEAOV tJ;uxfjs-). A reference in Sophron to a disease
'indurated' in the tJryelos is perhaps comparable (Sophron, fr. 33, v6aov ELS'
TClV llUEAOV <JKLpw8fjvm). Theokritos' description of Syracuse as the 'nryelos of
Sicily' is ambivalent: it clearly intends to suggest the richness of the city, and
its central importance in the island and might depend on either sense of
Jl!)lelos (Theoc. 28.18, v6.aw TpLvaKp(as- llUEA.6v).lO
Diachronic, synchronic and generic consistency
There is remarkable general consistency, despite much superficial difference
in emphasis, in the ways in which myelos is understood and described by
different authors with different concerns. This consistency extends in time
from Homer to the Hippocratic writers and beyond; it transcends boundaries between literary genres (epic, lyric, tragedy) and between medical
treatises (on anatomy, physiology, pathology); it can be seen in philosophical
and historical writing. Evidently, much of the medical theory first documented in the late 5th or early 4th century had long been popularly familiar:
the casual allusiveness in Agamemnon, produced 458 BC, is a telling instance.
It is significant too that the passage has been f=Onsistently misunderstood. It
is difficult for us, as modern readers, to divest ourselves of modern medical
knowledge and to resist the temptation to measure ancient works against it.
Understood on their own terms, the Hippocratic writers, though often
'wrong', are seldom silly. The case of Jl!)lelos is paradigmatic. Many of these
ideas were slow to die. Vesalius remained agnostic on the question of a
9
See Chadwick 1996:311-20, with summary table at 320, first sense 'animating
principle, life-force.'
10 See Gow, comm .. , Cambridge, 1965 ' ... the kernel or quintessence of a thing ...
but the use lacks precise analogies.'
CRAIK
73
connection between cerebral and seminal fluid. And it was not until 1660
and 1664 that Schneider robustly argued that there was no route from head
to lower body such as that postulated for myelos and indeed for other fluids.
This was in the treatise De Catarrhis, 'On downward flux' - not, of course,
'on catarrhs' - here is another term ubiquitous in ancient medical theory but
very commonly mistranslated and misunderstood.
Bibliography
Chadwick, J. 1996. Lexicographica Graeca. Oxford.
Craik, E.M. 1998. Hippocrates. Places in Man. Oxford.
Craik, E.M. (forthcoming). 'Hippocratic bodily 'channels' and oriental
parallels.' Medical History 2009 (new version of 'Aspects of Hippocratic
vascular anatomy.' For R. Arnott & L. Dean-Jones (edd.), Proceedings of the
First European Meeting of the S ociery for Ancient Medicine, advertised but never
published).
Dean-Jones, L. 1994. Women's Bodies in Classical Greek Science. Oxford.
Duminil, M.-P. 1998. Hippocrate t. 8. Paris.
Farnell, L.R. 1896. The Cults of the Greek States. Vol. 2. Oxford.
Harris, C.R.S. 1973. The Hearl and the Vascular System in Ancient Greek Medicine.
Oxford.
King, H. 1998. Hippocrates' Woman. London.
Lloyd, G.E.R. 1983. Science, Folklore and Ideology. Cambridge.
Lonie, I.M. 1981. The Hippocratic Treatises 'On Generation' etc. Berlin & New
York.
Parke, H.W. 1977. Festivals of the Athenians. London.
Schneider, V. 1660, 1664. de Catarrhis. Wittenberg.
Vesalius. 1543. de humani corporisJabrica. Basle.
Whiten, S. 2006. Flesh and Bones ofAnatonry. Edinburgh.
THE ACHARISTUM IN A MANUSCRIPT FROM THE LIBRARY
OF NICHOLAS OF CUES*
Klaus-Dietrich Fischer
Johannes Gutenberg-Universitat, Mainz
Collecting mediaeval manuscripts is not what one might call a cardinal sin,
unless the collector himself happens to be a cardinal. The cardinal in
question would have been one of my closer neighbours, had I lived in the
early 15th century. Born in 1401, Nicolaus Cusanus would also have been a
close neighbour of Hildegard of Bingen, had she been born three hundred
years later. The Cusanus part in Nicholas' name tells us where he came from,
the village of Cues (now part of Bernkastel-Kues) on the Moselle river,
praised by Ausonius in the 4th century in a Latin poem.
Nicholas spent his life between the Rhine valley and Italy, studying flrst
theology in Heidelberg then law in Padua, and flnally in Cologne. From 1432
onwards he was one of the representatives of the Archbishop of Trier at the
council of Basle, and some believe that it was there that he acquired the
manuscript I am going to discuss. 1 Unlike most of Nicholas Cusanus'
collection of medieval manuscripts, which can still be encountered housed in
the old hospital at Kues that he founded and where his heart was buried
after his death (the body itself remained in Italy in Rome's San Pietro in
Vincoli), it did not remain there, but travelled further afleld ending up in the
British Library in London.
Our manuscript, at present Harley 5792, was written in Italy in the 8th
century. It was perhaps the oldest manuscript in Nicholas' collection and
must certainly be considered one of the flnest. This makes it, not
surprisingly, the oldest MS with medical content in the Harley collection.
Some eighty years ago it was studied by a young Swiss doctor, Henry E.
.
:..:: :·
.
• The work was undertaken in connection with ·ilie cataloguing of the medical
manuscripts in the Harleian collection by Dr Laura Nuvoloni, working with a grant
provided by The Wellcome Trust. Her descriptions can now be found online on the
British Library website. An earlier version of the article was given as a paper in
Raleigh, North Carolina, in March 2007. The Latin text and a commentary as well as
additional bibliography will be published (in German) in a Festsch1ijt for Michael
McVaugh.
1 Cf. Sabbadini 1914:16-26, especially 26.
· : ·
...
FISCHER
75
Sigerist (1891-1957), who, much like Nicholas before him, travelled widely. 2
Sigerist's interest in medieval medicine, evidenced here for the first time, was
instigated by that of his mentor and predecessor on the Leipzig University's
Chair of the History of Medicine, Karl Sudhoff (1853-1938). (This chair, the
first to be dedicated to the history of medicine in Germany, had been
established in 1905 with an endowment left by the widow of Theodor
Puschmann (1844-1899),3 who had gained his habilitation in medical history
at Leipzig in 1878 with his edition of Alexander of Tralles, 4 and from 1879
was professor of medical history in Vienna.) Sigerist had, while still in
Zurich, contacted Sudhoff as the leading medical historian of the time, and
Sudhoff had directed the budding medical historian towards the study of
early medieval recipe collections, because they must be seen as a prelude to
the Antidotaritlln Nicolai. The Antidotarium Nicolai was elaborated in Salerno in
the second quarter of the 12th century and soon became the canonical
pharmacopoea that was to dominate pharmaceutical practice until the mid16th century, leaving traces even in 19th-century European pharmacopoeas.5
The fruit of Sigerist's researches into recipes in early medieval MSS was a
book entitled S tudien tmd Texte zur jriibmittelalterlicben Rezeptliteratttr, and this
was presented, in 1921, as his habilitation thesis at the University of Zurich,
Switzerland. In it Sigerist published six distinct collections of recipes,
preserved in MSS in libraries both on the continent of Europe and in the
British Isles, ranging from the Harley MS, the earliest, to the famous
Canterbury class book, written partly in the mid-11th century and partly
somewhat later around 1100 (University Library, Cambridge, England, Gg.
5.35). Two years later, in 1923, Sigerist's habilitation thesis appeared in print
as vol. 13 of Studien zur Gescbicbte der Medi;dn, herausgegeben von der
Puschmann-Stiftung an der Universitat Leipzig, Redakteur: Karl Sudhoff. 6
This was Sigerist's first book, followed a few years later by his edition of
the herbal of Pseudo-Apuleius and other treatises 7 transmitted in conjunc2
Fee & Brown 1997.
Cf. Locher, Puschmann & Theodor 2004:13-14.
4 Not replaced to this very day.
s See Goltz 197 6.
6 It was reprinted in Vaduz, Liechtenstein, in 1977.
7 Antonii Musae de herba ttettonica fiber; Psettdoapttfei herbmitts; Anolrymi de taxone fiber; S exti
P!aciti fiber medicinae ex animalibtts etc. ecliderunt Ernestus Howald et Heruicus E.
Sigerist, Lipsiae et Berolini 1927 (Corpus MedicormJJ l.L!tinomm eclitum consilio et
auctoritate Instituti Puschmanniani Lipsiensis. IV). It was the last volume in the
series that was published before the end of the Second World War; then, the Berlin
3
76
FISCHER
cion with it; Sigerist's co-author was the Swiss classicist Ernst Howald (18871967), professor of Classics at Zurich from 1918 until1952. Sigerist's plan of
a comprehensive survey of medieval medical manuscripts in Swiss libraries
was never even begun in earnest, let alone finished, but Sigerist retained his
interest in medieval medicine even after he had taken up a second professorship in the United States, travelling to libraries in France during the summer
months in order to catalogue MSS; and the very last work from his pen,
published posthumously, happened to address again the medical literature of
the early Middle Ages.s
So much for biographical detail. Now back to Harley 5792 and the one
page of medical interest in it which Sigerist did not publish. It is quite literally
a single page, because Sigerist's edition, mentioned earlier, starts on the very
verso of Jol. 273, which (one must admit to be fair) begins with a fresh
heading. I would venture to suggest that it had been the heading on top of
fol. 273r that misled Sigerist, and many others with him, by suggesting that
the text that follows and which we will study, formed part of a work called
Dynamidia.
A further digression on recipe collections, or: what are Dynamidia and
Antidotaria?
'Dynamidia' is an entry that one would search for in vain in the Lexikon des
Mittelalters. Thus a few words on recipe collections in general and the
meaning of cfynamidia in particular will not be amiss.
There is an abundance of works or texts called cfynamidia, not just the
multiple explicits that Loren C. Macl<:inney alluded to in the title of one of
Academy, where the Co1pus Medicorum Graecorttm had been established in the early
years of the 20th century, took over the editorship of the Latin series as well. But it
took almost twenty yea,.rs from the end of the war for the first volumes to appear,
second editions (this time with German translations) of E. Liechtenhan's Anthimus
(Corpus Medicor11111 Latinonm1 VIII 1) and M. Niedermann's Marce!!tts (CML V), to be
followed in 1964 by the ftrst 'new' text, Alf Onnerfors' Plinii Semndi Iunioris qui
fenmtttr De Medicina lib1i tres (CML III; it lacks a German translation) and in 1990 and
1993 by the two volumes of Gerhard Bendz's edition of the two larger works by
Caelius Aurelianus (CML VI 1). It will be noted that there was not one German
scholar among the editors of these texts.
8 The Latin medical literature of the Early Middle Ages.' ]oumal if the History if
Medicine and Allied Sciences 13 (1958) 127-46 (being the James Bryce Memorial Lecture
delivered at Somerville College, Oxford, on 1 June 1950).
FISCHER
77
his studies. 9 Especially two among these works are more frequently referred
to as Dynamidia; one of these is ascribed to Hippocrates, and the other (as
one might well have guessed) to Galen. Any experienced medievalist would
suspect that these names were invented by unknown and unnamed
redactors, or compilers if you wish. Thus, we have the pseudo-Hippocratic
Dynamidia on the one hand and the pseudo-Galenic Dynamidia on the other.
Both works seem to have been sufficiently popular and are well attested in
medieval MSS, and both still 'await the attentions of an editor in the true sense
of the word. One version of the pseudo-Hippocratic Dynamidia, or rather
portions of it, was printed by Johannes Schott in StraBburg in 1533, this time
under the title of Oribasii Medici De Simplicibus LibriQuinque. It is just one item
among a number of medieval and late-antique medical texts in the huge tome
in question that also comprises the PI:!Jsica S. Hildegardis, the Theodori PI:!Jsici
Dieta and Esculapius' book on chronic diseases. The rapid development of
the art of medicine in the 16th and 17th centuries must be blamed for the
fact that three hundred years were to pass before a part of the Dynamidia was
printed once more, and then for the benefit of philology and not of
medicine, by the second cardinal in our story, Angelo Mai. A generation after
him, in 1870 to be precise, Valentin Rose published further parts of the
Dynamidia from MSS in St Gall and Berlin; and after that, to this very day, no
more editions of this text or parts of it have appeared.
Let us now turn our attention to the pseudo-Galenic Dynamidia for a
moment. This text did not even get an entry in the Bibliographie des Textes
Medicaux Latins (Saint-Etienne 1986), an oversight which is partly my
responsibility. My ignorance can, perhaps, be excused, because the pseudoGalenic Dynamidia was last printed in volume 10 of Rene Chartier's edition
of the works of Hippocrates and Galen, with the imprint of Paris, 1679. The
pseudo-Galenic Dynamidia comprises two books, of which the first is fragmentary, filling just one large folio page in Chartier's edition, whereas Book 2
runs to 33 pages (vol. 10.670-702), and these are large folio pages with two
columns. This pseudo-Galenic Dynamidia is a hodgepodge of recipes and of
excerpts of complete or incomplete shorter works on medicine from Late
Antiquity, somewhat resembling, in this respect, the pseudo-Soranic Isagoge. I
am not aware of any- and I stress any- secondary literature on the pseudoGalenic Dynamidia.
Some confusion may have been caused by the fact that cfynamidia are
mentioned in both medical and veterinary works and that this was taken as a
9
MacK.inney 1952:195-205.
·- .
78
FISCHER
reference to the Dynamidia, meaning a specific work with that title. If so,
scholars were mistaken in their identification. Dynamidia are mentioned in the
writings of Esculapius, in the Mulomedicina Chironis and likewise in the
pseudo-Galenic Liber Tertius; from there, the reference to cfynamidia passed to
the Passionarius Galieni, also known as Gariopontus (the alleged author or
compiler). I would argue that in all these instances, cfynamidia refers to a
collection of recipes included as an annex to the work in question. Whereas
the main body of the medicai work was devoted to a discussion of the
symptoms and signs and to the therapy of a particular disease, excluding full
references to recipes, that appendix contained a collection of recipes mentioned earlier on just by their name. A modern parallel can be found in the
4th edition of the Merck Veterinary Manual, Part 7: Prescriptions.
The unambiguous instances of this practice in antiquity are Celsus' work
on medicine, parts of Books 5 and 6 and, once more, veterinary texts, the
Mufomedicina Chironis, Vegetius' Digesta Artis Mufomedicinalis and the Hippiatrica
Berolinensia. Further evidence comes from Oribasius' Synopsis, where Book 3
is formed by a series of 220 recipes, and from Paul of Aegina, Book 7,
chapters 4-24.10
While we know that the pseudo-Galenic Liber Tertius in its present form is
incomplete and that its recipe section could be missing for that very reason,
Esculapius' account of chronic diseases based on Soranus seems to be more
or less completely preserved. In this case, I deem it possible that the section
on recipes was either never translated into Latin, or that it was lost during a
very early stage in the transmission.
Nevertheless, it remains true that collections of recipes were also transmitted as independent works in their own right albeit under different titles,
not usually, as far as we know, called Dynamidia. Scribonius Largus, the
doctor who had accompanied the Roman emperor Claudius on his British
campaign in 43 CE, called his manual Compositioms, 'recipes'; Marcellus at the
beginning of the 5th century chose the title De Medicamentis, 'On remedies';
the compilation in tl1ree books from Pliny's Natural Hist01]' bears the generic
title De Medicina; and the poetic work with a similar ancestry, composed by
an otherwise unknown Quintus Serenus, is likewise a Liber Medicinafis.
Occasionally, the Greeks seem to have used more fanciful titles, like
Nmthex, 'Medicine box', but apart from Galen's two very comprehensive
collections, Medicines Arranged f?y Kinds and Medicines According to Parts rif the
Bocfy, only Dioscorides' (or Pseudo-Dioscorides') Peri euporistqn, 'Easily pro-
IO
I have not personally counted the number of recipes.
FISCHER
..· .
•
79
cured remedies' has come down to us. 11
All the works I have mentioned so far listed medicaments made up from
a combination of various ingredients, .ryntheta or, with their Latin name,
composita, 'compound drugs'. We must not overlook another kind of recipe
book that was perhaps of greater practical importance for the majority of
people unable to afford or procure many of the exotic drugs, namely, books
listing recipes based on single ingredients ('simples' or simplicia), usually
plants, but sometimes parts of animals. The foremost representative of this
kind of recipe book is the collection of treatises associated with the herbal of
Pseudo-Apuleius (see note 6), and, if I am not mistaken, the Greeks had
nothing to match it. (The status of a herbal on papyrus from which a
splendid illustration has been preserved is not clear.)
I have introduced this distinction between books giving compound drugs
and those listing remedies based on simples, whether they be vegetable or
animal, because rfynamidia is indeed attested as a title of recipe books in Late
Antiquity or the early Middle Ages. Our witness is Isidore of Seville - not a
cardinal, because cardinals of the church in the latter sense had not been
invented, but at least a bishop, and a saint. In his Etymologies Isidore has a
brief section on medical books with an entry on tfynamidia: Dinamidia, pr;testas
herbamm, id est uis et possibilitas. Nam in herbarttm cura uis ipsa 8Vva~us dicitur; tmde
et dinamidia nuncupatur, ubi eorum medicinae scribtmfttr ('Dynamidia, the might of
the herbs, that is the power and potency, because in herbal cures, this power
itself is called tfynamis'). Therefore, tfynamidia is the name of a book where the
medicines derived from herbs are listed. Isidore's definition may apply to
both kinds of recipe books, that is, those listing simple and compound drugs.
We might have expected to flnd in Isidore another name that
medievalists are familiar with, antidotarium, literally 'a collection of antidotes'.
The original meaning of antidote still current today is 'sometl-llng given to
counteract a poison, either administered by a personal enemy or from the
bite of a poisonous snake or spider', also called theriac. Thus, antidotes are
very potent drugs and they usually derive their power from an impressive list
of ingredients, sometimes as many as one hundred (one version of the
Mith1idaticum). Not surprisingly, antidotes achieved great popularity (at least
in pharmaceutical literature), with lists of indications even exceeding in
length those of ingredients. But none of the texts edited by Sigerist is, as a
matter of fact, called 'Antidotarium' in his manuscript sources. Rather, tl1e
11 A recent addition is Daria Crismani, E/io Promoto Afessandrtno, Manuale della salute,
Alessandria 2002 (Hellenica. 9).
.
\
..
80
FISCHER
earliest evidence for antidotarium, 'recipe book' comes from the heading of a
large collection of recipes preserved in a MS from the abbey of Montecassino
(225), dated the second half of the 11th century, just when Constantine the
African was active there.
Reading the Harley recipe step by step
Having explored the meanings of cfynamidia and antidotarium, we return to folio
273r of our Harley MS.12 The introduction that precedes the single recipe that
follows, before the new heading on fol. 273r and the text edited by Sigerist,
indicates that it must have started out as the beginning of a collection of
recipes, even if it breaks off after the first one, our acbaristttm: corifectionis
diuersa antidotis epitemarum ue/ unittersarum medicamimnn ('sundry compositions,
antidotes, epithems and universal remedies'). The imperfect grammar of the
quotation makes it impossible to understand, or translate, these lines with the
necessary rigour. The authors named are the top class of ancient physicians,
Hippocrates, Galen and Soranus. Soranus is a name we may not have
expected to flnd. This doctor from the late 1st and early 2nd century, and the
leading exponent of Methodism, was respected even by Galen who in
general cannot be called a friend of methodist doctors and doctrine; and the
fact that Soranus flgures side by side with Hippocrates and Galen shows us
that his renown in Late Antiquity and the Early Middle Ages must have been
considerable. Like Hippocrates and Galen, he had works attributed to him
that were anonymous compilations, e.g. the Quaestiones medicina/es, an exposition of medicine in question-and-answer form for beginners, or a treatise
on pulses.
What is the meaning of acharistum?
..
_~..·
The recipe on fol. 273r has a name, acbaristum. Antique compound drugs in
fact quite often do have a name. This may be a combination of a generic
designation, like 'a poultice', 'an eyesalve', followed for instance by the name
of the inventor. Other names of drugs refer to their composition, like tetrapbarmakon, 'with four ingredients', or di' oon, 'with eggs'. Not infrequent are
qualiflcations that emphasize the efflcacy of a drug, and as we will discover,
it is in this category that the Harley acbaristttm belongs. Our recipe comes
with an additional story: a famous doctor (whose name is -distorted beyond
12
An English translation can be found in the Appendix.
FISCHER
81
recognition) handed it over on his deathbed, as a special gift.
Now, how should we translate acharistum? If we consult the standard
Greek-English dictionary of Liddell-Scott-Jones, all we learn is that the name
was applied to an antidote - correct, but that had been our starting-point and that it was also used of an eyesalve. The Oxford Latin Dictionary agrees:
acharistum is an eyesalve, quoting Celsus. There are indeed a number of
kol!Jria or ophthalmic prepaptions bearing that name, a name which is of
course related to Greek charis, meaning 'grace' or 'thanks'; if preceded by a
negative preflx its meaning would be something like 'graceless', 'ungracious'.
The American papyrologist Louise C. Y outie came up with the translation
'thankless', explaining: 'any salve applied to the eyes would have been
uncomfortable and unappreciated, no matter how beneficial.' Is there
anybody who would not agree?
The problem of the meaning of achmisttiJll is indeed a case of oversight.
The correct interpretation can be found in Marcellus (De Niedicammtis 20.92):
'When administering this remedy, take whatever fee you can get, because
many patients who were cured [by it] in no time at all did prove ungrateful,
which is why this antidote is called acharisttmJ, which means 'no thanks'. Jean
de Garris Oohannes Gorraeus) quotes this passage from Marcellus in the
relevant entry in his Deftnitiones Medicae of 1564, as do, at the beginning of the
19th century, the editors of the revised edition of Stephanus' Thesattrtts
Linguae Graecae:
Achmistris, Antidottts sic dicta propter celerem quam fert opem. Qui mim cito
mratm; ingrattiJJJ se exhibet erga medimm, adeoque se minus peticulose laborasse ob
repentinam salutem existimat.
'an antidote, called thus because it brings speedy relief. Because who is
cured quickly, shows ingratitude towards the physician, judging he was
less seriously ill on account of his quick recovety.'
It is exhilarating to see that one of the most common medical dictionaries in
early modern times, that by Bartholomew Castelli, sides with the patient
rather than with the doctor, when it explains:
Achmist11m, 'AxapwTov, dicitur confectio contra catarrhos ... ita vocata, quod sit
gratis & sine mtmere danda, cttjtts descriptio ex tat in Antidotario Nicolai ...
'a compound for catarrh, called thus because it has to be administered
gratis and without fee, whose composition is given in the AntidotmitmJ
82
FISCHER
Nicolai ... '
This error was caused by the fact that the compiler of the Antidotarittm
Nicolai, while translating acharisttlllJ correctly as sine mttnere, did not elaborate
any further.
• .• I
~·
. '.
~~.
The indications
Having dealt with the first two paragraphs of the recipe, we now turn to the
next section, which gives the indications or conditions the drug was supposed to cure. It emerges that this acharist111n is not for catarrh (as the entry in
Castelli stated), underlining the fact that acharistttm is really a general term,
not the name of a particular remedy with a fixed composition. The Latin text
in the Harley MS is here so badly disfigured that we are grateful for the help
that Marcellus (Marcell. Med. 20.92) provides yet again, and for the parallel
versions in two MSS roughly one hundred years younger than our Harley MS,
Par. lat. 11218 and Bamb. Med. 1. Bamb. Med. 1 is also known by now as
Lorscber Arzneibttcb, named after an important monastery in the Rhine valley
near Worms of Nibelungen fame, where it was written, or rather copied, in
the first quarter of the 9th century.13
'It is appropriate for those who
(1) do not digest their food and keep repeating in an unpleasant way,
(2) for stomach-ache,
(3) for pain in the side,
(4) for sciatica,
(5) for troubles of bladder and kidneys and
(6) for spasms in one's insides,
(7) for patients spitting blood and
(8) coughs,
(9) for consumption and
(1 0) asthma,
(11) dysentery and
(12) sprue, that is flux from the bowel,
(13) for a sick liver and
(14) for twisting of the bowel;
! 3 Edition and translation by Ulrich Stoll, Das LrscherArzneibuch'. Ein medizinisches
Kompenclium des 8. Jahrhunderts (Codex Bambergensis Medicinalis 1. Text, Obersetzung, Fachglossar, Stuttgart 1992 (Sudhoffs Archiv. Beiheft 28).
FISCHER
(15)
(16)
(17)
(18)
(19)
(20)
• • •• .. • j
83
for conditions of the womb in women and
for snakebite and
the bite of venemous spiders and
to get rid of all poisons and
all that is around the chest and
that is vomited.'
The composition (section 6)" is comparatively simple - there are just twelve
ingredients - and I feel that this may point to the recipe being rather old. It is
also remarkable for the fact that the identification of the ingredients, for
once, poses no particular problem. Difficulties of supply are alluded to when
it is stated that if cinnamon cannot be had, twice the amount of cassia (wild
cinnamon) should be used, or if honey from Attica is not at hand, the very
best honey that has had its froth removed should be employed.
It is not all that often that we are given particulars of the preparation of
the compound; such knowledge is as a rule tacitly assumed. Directions for
storage, however, are given more frequently, as is the case here: the preparation should be stored in a container either made of glass or of stagnum /
stannum (an alloy of silver and lead).
Lastly, administration. The standard amount, or at least a standard
amount, was a piece the size of an (Egyptian) bean or a hazelnut, washed
down with some liquid. Ancient recipes usually recommend wine for afebrile
patients and hot or tepid water for those that are feverish. Our recipe
specifies a liquid that I did not recall from any other prescription I had read.
Its name is potio apullodie or apolodii, and I may be forgiven if I took the
second word for a distorted form of some personal name, 'the draught of
Apullodius'. In a rather serendipitous way, I found the solution, because the
draught is also mentioned in one of Sigerist's recipes. It turns out to be a
drink made from an infusion of bran, liquidissimttm potionis gentts, as it is called
by Paulus Diaconus in his epitome of Festus.
There is another rare and even curious request in the administration of
this acharistttm. The potion should contain twelve drops of vinegar, and this
vinegar should drip from the pinkie (whether of the right or the left hand, we
are not told). This smacks of superstition, but we must admit that this reservation is just based on our modern conception of how to prepare drugs.
Since phytotherapy has once more become very fashionable, I wonder if
there may be someone among my readers quite keen on experimenting with
this 'ungrateful' recipe. But if it does not have the desired effect, it might be
an idea to try the other pinkie next time.
84
FISCHER
Appendix
1. Here beginneth the Dynamidia of Hippocrates, Galen and
Soranus, where they reflected upon the human life and body, and
medicinal preparations which they personally used and knew and
passed on to others, sunqry preparations, epithems and all kinds
of medicines. 2. Thus they invented the preparation of this
antidote called acharistum, left to you by the famous doctor tbrotot
on his deathbed. 3. It is appropriate for those who do not digest
their food and keep repeating in an unpleasant way, for stomachache, for pain in the side, for sciatica, for troubles of bladder and
kidneys and for spasms in one's insides, 4. for patients spitting
blood and coughs, for consumption and asthma, dysentety and
sprue, that is flux from the bowel, for a sick liver and for twisting
of the bowel; 5. for conditions of the womb in women and for
snakebite and the bite of venemous spiders and to get rid of all
poisons and all that is around the chest and that is vomited.
6. Its preparation is as follows: cinnamon, 1 dram; if there is no
cinnamon, bark of wild cinnamon, 2 drams; Troglodytic myrrh, 3
drams; saffron, 4 drams; common pepper, 1 oz.; long pepper, 4
drams; castoreum, 1 oz.; costmary, 1 oz.; galbanum, 1 oz.; opium
from Thebes [in Egypt], 1 oz.; best quality storax, 1 oz.; spikenard,
1 oz.; honey from Attica, 1 oz. (if it cannot be had, the best quality
carefully cleared of its froth). 7. Boil the honey in the galbanum
on a slow fire, not a strong fire; boil the honey down further.
Grind it with care for a very long time in a mortar and combine all
drugs in a small (glass) container or a container made from
stagnum. 8. When you wish to administer it, give the size of a bean
or a hazelnut as a potion, and three days before a woman gives
birth, administer it with 12 drops of vinegar running down from
your pinkie, making sure to administer it in a potion made from
an infusion of bran. Feverish patients should take it in hot water
with the amounts of vinegar and honey specified above; patients
with no fever take it in wine as specified above.
FISCHER
85
Bibliography
Fee, Elizabeth & Brown, Theodore M. (edd.), 1997. Making Medical H istory.
The Life and Times of Henry E. Sigerist. Baltimore & London: The Johns
Hopkins University Press.
Goltz, Dietlinde. 197 6. Mittelalterliche Pharma=(je und Mediifn, dargestellt an
Geschichte und Inhalt des Antidotarium Nicolai. Mit einem Nachdruck der
Druckfassung von 1471, Stuttgart (VerOffentlichungen der Internationalen Gesellschaft fur Geschichte der Pharmazie e. V. Neue Folge. 44).
Locher, Wolfgang G., Puschmann, Ferdinand & Gustav, Theodor. 2004.
Neue deutsche Biographie Vol. 21. Berlin: Duncker & Hum blot.
MacKinney, Loren C. 1952. 'Multiple explicits of medieval Dynamidia.' Osiris
10:195-205.
Sabbadini, Rernigio. 1914. Le scoperte dei codici, Vol. 1, 16-26. Firenze: Sansoni.
<<L'AUTRE HIPPOCRATE»: UN TRAITE ANONYME INEDIT
SUR IES QUATRE HUMEURS PAR QUESTIONS ET
REPONSES (Vat. g1: 293, XIVe s., fol. 223r-225v)
Jacques J ouanna
Professeur emerite Paris-Sorbonne
a
Dans le cadre d'une recherche sur la posterite de la theorie des quatre
humeurs du traite hippocratique de la Nature de l'homme j'ai edite plusieurs
inedits de la periode tardo-antique posterieure a Galien (lie s. apres J.-c.) ou
la theorie des quatre humeurs (sang, bile jaune, bile noire, phlegme), et
eventuellement des quatre temperaments correspondants, est parvenue a un
stade de sytematisation qu'elle n'avait pas encore atteinte a l'epoque du
medecin de Pergame.t
Ces inedits ne peuvent pas etre dates avec precision; cependant ils se
situent en gros entre la seconde renaissance de la medecine a Alexandrie
(VIe-VIle siecles) et la medecine byzantine a Constantinople avant le XIVeXVe siecles. La plupart d'entre eux sont attribues a Hippocrate, qualifie
parfois de maitre de Galien, et plus rarement a Galien lui-meme. lis
reprennent une theorie humorale dont les fondements sont deja dans le traite
1
Je citerai ces inedits sur la theorie des quatre humeurs dans l'ordre de leur
elaboration (et pas necessairement de leur publication):
1. «Un traite inedit attribue a Hippocrate, Sur Ia formation de l'homme: editio princeps»,
dans V. Boudon, A. Garzya, J. Jouanna & A. Roselli (edd.), Ecdotica e riceifone dei Testi
Medici Greci. Atti del V Convegno Intemaifonale, Napoli, 1-2 ottobre 2004 (Napoli,
D'Auria, 2006) 273-319.
2. «Un traite pseudo-hippocratique inedit sur les quatre humeurs (Sttr le pouls et sttr le
temperament h11main)», dans A. Kolde, A. Lukinovich & A.-L. Rey (edd.), Kopv¢af(v
dvop!. Melanges offints ci Andre Hurst (Geneve, Droz, 2005) 449-61. Voir aussi
l'utilisation d'une nouvelle version de ce traite (= version B) dans J. Jouanna, <<La
theorie des quatre humeurs et des quatre temperaments dans la tradition latine
(Vindicien, Pseudo-Soranos) et une source grecque retrouvee», REG 118 (2005) 13867.
3. «Un pseudo-Galien inedit: Le Pronostic sur l'homme. Contribution a l'histoire de la
theorie quaternaire dans la medecine grecque tardive: l'insertion des quatre vents»,
dans S. David & E. Geny (edd.), Troika, Parcours antiques. lvielanges MicheliVoronoff,
Vol. 1 (Besan<;:on, Presses Univ. De Franche-Comte, 2007) 303-22. A ces inedits
s'ajoute une partie inedite du Pseudo-Jean Damascene Quid est homo? partiellement
edite dans la PG de Migne; voir inji-a, n. 5.
_.:,._:.-· •r'
JOUANNA
87
de la Nature de l'homme, c'est-a-dire dans un traite du Ve siecle avant J.-C.
appartenant a l'Hippocrate redecouvert a la Renaissance. Cependant, bien
que ces traites byzantins se reclament d'Hippocrate, ils ne font jamais
reference au traite fondateur. La theorie des quatre humeurs se trouve done
coupee de ses racines et fonctionne de fa<;on autonome. 2
Ces traites contribuent a dresser l'image de ce que j'appelle volontiers
«l'autre Hippocrate», pour le distinguer de l'Hippocrate redecouvert a la
Renaissance. Cet autre Hippocrate, fruit de l'imaginaire byzantin, a eu, en
revanche, une grande influence sur la medecine et la pensee medievales.3
*
A cette theorie
tardive des quatre humeurs attribuee a l'Hippocrate byzantin
appartient l'inedit que je presente ici, bien qu'il soit Anonyme et ne comporte
pas de titre.
La decouverte de cet inedit decoule directement des derniers prolongements demon etude sur la lettre du Pseudo-Jean Damascene, Quid est homo?,
un temoin, comme je l'ai montre ailleurs, de cette theorie des quatre humeurs
dont la diffusion sans precedent caracterise la litterature medicale grecque
tardive. 4 C'est, en effet, dans le manuscrit grec ou j'ai retrouve la fin
(tronquee) du Pseudo-Jean Damascene ornise dans la Patristique de Migne, a
savoir le Vaticanus g1~ 293 du XIVe siecle, que se trouve immediatement
2 Sur l'histoire de la theorie des quatre humeurs depuis le traite hippocratique de la
Nature de J'bomme, en passant par Galien, jusqu'a la medecine tardive, voir]. Jouanna,
«La posterite du traite hippocratique de la Nature de J'bomme: la theorie des quatre
humeurs», dans C.W. Miiller, Ch. Brockmann & C.W. Brunschon (edd.), A'ife und
ibre Inte1preten. Mediifniscbe Facbtexte der Antike afs Forscbmzgsgegenstand der kfassiscben
Pbilologie. Facbk01iferenz if' Ebrett von Dietbard Nickel (14. bis 15. Mai 2004) (Miinchen
& Leipzig, K.G. Saur, 2006) 117-41 (avec la bibliographie).
3 Pour l'expression «l'autre Hippocrate», voir par exemple J. Jouanna, <<Alle radici
della melancolia: Ippocrate, Aristotele e l'altro Ippocrate», dans A. Garzya, A.V.
Nazzaro & F. Tessitore (edd.), I Venerdi delle Accademie Napoletane, nell'amzo accademico
2005-2006 (fettura tenuta i/19 maggio 2006) (Napoli, Giannini, 2006) 43-72.
4 Voir J. Jouanna, <<Le Pseudo-Jean Damascene Quid est homo?», Troisieme
colloque d'etudes patristiques, le 9-9-2004, publie dans V. Boudon-Millot & B.
Pouderon (edd.), Les Peres de l'igfise face d fa science medicafe' de leur temps (Paris,
Beauchesne, 2005) 1-27.
88
JOUANNA
apres, aux fol. 223r-225v, ce traite sur les quatre humeurs par questions et
reponses .5
Ce n'est certes pas le plus important des inedits sur les quatre humeurs
que je viens de publier. Le plus important du point de vue historique est le
traite sur le pouls et le temperament humain, parce qu'il se trouve etre le modele
grec retrouve de la Lettre latine dite de Vindicien a son petit-fils Pentadius,
laquelle a ete l'un des relais les plus connus de la theorie des quatre humeurs
et des quatre temperaments dans la periode medievale. 6 Mais c'est jusqu'a
present le seul traite connu sur les quatre humeurs qui se presente sous la
forme de questions et de reponses. Bien que le traite ne possede ni titre ni
attribution dans le manuscrit, probablement parce qu'il est lacunaire en son
debut, je crois pouvoir dire qu'il appartient a la sphere de <<l'autre
Hippocrate». Les trois verbes de declaration que j'ai imprimes en gras dans le
texte ont tres vraisemblablement pour sujet sous-entendu Hippocrate.7
En voici le texte et la traduction:
1.
2.
3.
:_ :.:· .
Ka<l.> Tt 8La<j>EpouaLV aAA.~A.wv oL TEaaapEs oDToL xufl.ot;
llLa<j>EpOUGLV XPOLq, 8UVa[l.EL, GUGTaGEL KUllTOLOTTJTL.
I1oTaTI6v EGTL T6 xpoLq TO <j>A.Ey[l.a;
AEuKov ml. xpoLq Kal. ¢uaEL.
IloTaTI6v EGTL TlJ xpoLq TO aL[l.a;
'Epu8p6v EGTL.
I1oTaTI6v Ean TlJ xpoLq ~ ~ave~ xoA.~;
• oxpa Ean.
IloTUlT~ EGTLV ~ [l.EAULVU xoA.~ TlJ xpoLq;
MEA.mva Ka8u¢fls (?)
IloTam1 8E Eanv a1m1 TlJ avaTaaEL;
To al[l.a lTaxu·
5 La partie ineclite du Pseudo-] ean Damascene Quid est homo? tiree du Vat. gr. 293 a
ete publiee dans]. Jouanna, «La theorie des quatre humeurs ... » (2005 cite n. 1) 15657.
6 Pour l'eclition du traite Sur fe poufs et fe temperament humain, voir «Un traite pseudo- ·
hippocratique ineclit ...», (2005, cite n. 1). Pour ce traite modele de la Lettre attribuee a
Vinclicien, voir]. Jouanna «La theorie des quatre humeurs ... » (2005, cite n. 1) 15764; et pour !'importance historique de ce traite dans le passage de la theorie des
quatre humeurs de l'Orient a !'Occident, voir]. Jouanna, «Hippocrates as Galen's
teacheD>, a paraitre dans les Actes du 12e Coffoquitlm HippocratiCIIIJJ de Leyde (24-26
aout 2005).
7 Cette hypothese trouvera une confirmation dans le rapprochement fait ci-dessous,
p. 88, avec le traite pseudo-galenique, Les caractbistiques propres d Hippocrate.
. ·\
'
89
JOUANNA
4.
5.
6.
7.
TO <jlA.Ey(la CJU(lJlETpws- 1Tax{r
A.E1TT~ oE ~ ~ave~ xoA.~,
KaL TiaXELa ~ JlEA.awa.
IloTam:i ELCJL Tfj ouvci(lEL;
To JlEV al 11 a uypov Kat eEw6v,
TO OE <jlA.Ey(la uypov KaL t)Juxp6v·
~ ~ave~ xoA.~ eEpJl~ Kat ~TJpci,
~ 6E JlEA.mva bJPa KaL t)Juxpci.
IloTa1Tci ELCJL Tfj YEUCJEL;
To al 11 a yA.uKu·
TO <jlA.Ey(la aA.(lup6v·
mKpa ~ ~ave~.
KaL o~ELa ~ JlEAaLVa.
IloLOS' XUJlWV 1TAEOVa(EL ~ALKLc;t;
"AAA.os- KaTa UAAT]V (scripsi: aAA.ov cod.) ~ALKLav eE1TE (?) KUL
1TATJeuvEL (scripsi: 1TATJefjvm cod.) aL(laTL (secluserim).
MciA.wTa (lEV ovv T~v JlELpaK[wv TO aLJla ·
Twv vEavLCJKwv ~ ~ave~ xoA.~·
T<{l U1TEp~~4l ~ JlEA.mva,
TOLS' OE yEpouCJL TO <jlA.Ey(la.
I16CJm ow<jlopal. Twv KpaCJEwv;
Twv ~ALKLwv TECJCJapES', JlELpadwv, vEaVLCJKwv, TiapTJ~WvTwv,
KaL yEpovTwv· KUL Tas- TOuTwv KpaCJELS' 6w¢6po<u>scmo6[6wCJL.
Kat TO (lEV JlElpclKLOV uypov ELVaL KaL eEp(lOV ci>TJO'L"
eEpJl~v KaL ~TJpav Elvm T~v KpuCJLV Tou vwvLCJKou·
~TJpav 5E KaL t)Juxpav Tou TiapYJ~wvTos- (scripsi: Tiap[Kovn cod.)"
t)Juxpav OE KaL uypav TOU yEpOVTOS'
ilL a TL, TECJCJcipwv Twv xu11wv ovTwv, CYTJ1TOJlEvwv TovTwv,
TpELS' clVcl1TTOVTaL 1TUpETOL;
.tlL6n To aLJla KaTa <jluCJLv ECJTLv yA.uKu Tfj yEuCJEL, KaL Tpo¢~
Tou CJW(laTOS'. TouTo 1TAEovci(ov 1TOLEL T~v KaAOUJlEVTJV
1TAT]ewpav· CJa1TEV OE ou KaTaJlEVEL aL(la· (lETa~clAAETaL yap
Ei.s- Tivov ~ ELS' xoA.~v, wCJTE Kat oLa aTIOCJTTJJlciTwv t)JwpE'Lv.
'H JlEvToL JlEA.mva xoA.~ t)Juxpa KaL ~TJpa uTicipxEL· To oE ~TJpov
OUCJaAAOLWTOV KaL OUCJ(lETcl~ATJTOV YLVETaL CJO<jlL(ETaL OE
eEp(laLVO(lEVT] ELS' ~ave~v xoA.~v.
ot JlEVTOL AOL1TOL XUJlOL 1T AEOvci( OVTES' VOCJ~ (laTa 1TOLOUCJL v'
JlclALCJTa OE 1TEpL TO OEPJla, olov KapKLVOUS'. aA.<jlous-' AEUKUS''
U1TaVTas- OE 1TUpETOUS'
II6eEv 1TVEOUCJLV ot TECJCJapES' XUJlOL;
To al11a oLa pwos- 1TVEEL
~ ~ave~ xoA.~ OLQ TWV WTWV
~ JlEA.awa 6La Twv 6¢eaA.(lwv
TO OE <jlA.Ey(la OLa Tou CJTOJlaTOS'.
0
8.
0
0
9.
.:f.
90
JOUANNA
10. TlS" 6 Twv TECJCJapwv CJToLxdwv CJ<j>uyJ16S";
Tou atJlaTOS' 6 CJ<j>uyJloS" JlEYaS" KUl TTapayoJlEVOS'
(TTapay6JlEVOS' cod.: TTUKVOS' Kal yEJlWV Ps. Hipp. De Pulsu et
temperamento humano Ps. Gal. De Pulsibtts ad Antonium), KUL
Ka6uypOS'' CJUJlTTTWJla 8E a{JToiJ· KE<j>aAfjS' 0BVVT] CJ<j>o8pOTUTT],
KUL OAOU TOU O'WJlaTOS' rrupWCJLS''
TfjS' ~av6fjS" xoA.fjS' 6 CJ<j>UYJlOS' AETTTOS' Kal ~TJPOS'' TTL TTTWV'
CJuJlrrTw 11 a 8E a{JTov yaCJTPOS' CJTEvwCJLS" Kal CJTp6<J>oS" rrEpl T~v
KOLALav ·
TfjS' JlEAaLVTJS' xoA.fjS" 6 CJ<j>uyJlOS' rrA.E'Lov (rrA.E'Lov cod.: TTAEWS' Ps.
Hipp. De Pulsu et temperamento httmano), AETTTOTEPOS' Kal
TT~Kvo:EpOS'' O'UJlTTTWJlU 8E UlJTOU yovaTWV ~apOS', TTOVOL TTEpL
TUS' tj>UaS'·
KUL TOU <j>A.EyJlaTOS' 8E 6 CJ<j>uyJlOS' JlEyaS", Kal rrapayOJlEVOS'
(rrapayoJlEVOS' cod. Ps. Hipp. De Pulsu et temperamento humano:
CJrrapayJlw8ES' Ps. Gal. De Pulsibus ad Antonium), LCJOS' ( LCJOS'
cod.: uyp6S" Ps. Hipp. De Pulsu et temperamento humano Ps. Gal. De
Pulsibus ad Antonium), LCJOCJTa6JlOS'' CJUJlTTTWJla 8E a{JToiJ·
rrA.Eupwv rr6voL Kal CJTEVWCJLS' TTEpl TO CJTfj6oS" Ka6' EKUCJTT]V
~JlEpav.
11. Tl ECJTL XUJlOS'; Kal 8L<1 TL xuiJ.6S'; Kal rr66Ev TO rrapaxpfjCJ6m
a11a; II66Ev 8LUyLVwCJKOiJ.EV Tov Ka6apCJEWS' 8E6JlEvov xu116v;
'AlTO TOU EL80US' TOU VOO'~JlaTOS'' cmo TWV CJVVOVTWV
O'UJlTTTWJlUTWV Kal cmo TWV CJUCJTOLXWV,
II66EV YLVETUL 6 JlEA.ayxoA.LKOS' XUJlWV;
MEA.ayxoA.LKOS' XUiJ.OS' YLVETUL ~ TfjS' ~av6fj S" xoA.fjS'
urrEporrTOuiJ.EVT]S' Oege urrEpOTTTWiJ.EVTJS') Ka6' ~v Kal JlEA.mva
xoA.~ 6voJla(ETm ~
Kal EK Tou Tpuyw8ouS" atJlaToS"
UTTEpOlTTOUJlEVOU Oege UlTEpOTTTWJlEVOU), u<j> ' ou Kal KupLWS'
YLVETUL.
12. ELS' TTOCJU 8LULpELTUL 6 EVLauTOS';
tlL1JPTJTUL (scripsi: 8L ~PTJKUL cod.) 8E Kal 6 EVLauTOS' (scripsi: Tov
EVLUuTov cod.) ELS' wpaS" il· E'ap, kal 6EpOS', <j>6LV6rrwpov Kal
XELiJ.wva. Kal TovTwv 8E TaS" KpaCJELS' 8LUHaTTELv.
Ilomrr~ ECJTLv ~ haCJTTJS' wpaS" TfjS" KpaCJEWS' EvaAA.ay~;
To iJ.EV E'ap uyp6v TE Kal 6EPiJ.OV Elva( cj)T)CJI.,
TO 8E 6EpOS' 6EpJlOV KUL ~T]p6v,
TO <j>6LV6rrwpov ~T]p6v TE Kal tJ>uxp6v,
TOV 8E XELJlWVU tJ>uxpov Kal uyp6v.
Ka6aTTEp ovv EV TaLS' rrpoELPTJJlEVULS' TECJCJapCJL (scripsi:
TECJCJapES' cod.) ~ALKLULS' iJ.UAAOV KUL ~TTOV aA.A.ov KaT' UAAT]V
~ALKLav XUJlOV Ecj)T)CJE TTAT]6UVECJ6UL, OlJTWS' KaTa T~V avT~V
a.KoA.ou6(av Kal ETTL TWV wpwv anov KaT' UAAT]V wpav EV TOLS'
JOUANNA
91
CYW[WCYLV aveELV TE JCal 8uvacrTEUELV XV[l.OV" TTOTE TTAT)euvETaL
TO al.[La, JCal TTOTE ~ Eave~ xoA.~. TTOTE 8E: ~ [lEAaLVa KQL TO
<J>A.E-wa ·
T0 [LEV Eapt [lUAAOV To al.[la TTAT)euvEL,
T0 8E: eEpEl ~ Eave~ xoA.~ .
T0 cpetvorrwprp ~ flEAaLVa (scripsi: T~v flEAmvav cod.),
Kal T0 XELflb:lVt To <j>AEY[la.
1.
2.
3.
4.
5.
6.
Et en quai ces quatre humeurs different-elles les unes des autres?
Elles different par la couleur, la propriete, la consistance et la
qualite.
Comment le phlegme est-il par la couleur?
Il est blanc par sa couleur naturelle.
Comment le sang est-il par la couleur?
Il est rouge.
Comment labile jaune est-elle par la couleur?
Elle est acre.
Comment labile noire est-elle par la couleur?
Elle est noire.
Comment sont-elles par la consistance?
Le sang est epais.
Le phlegme est passablement epais.
Tenue est la bile jaune,
et epaisse la bile noire.
Comment sont-elles par la propriete?
Le sang est humide et chaud.
Le phlegme humide et froid.
La bile jaune chaude et seche.
La bile noire seche et froide.
Comment sont-elles par le gout?
Le sang est doux.
Le phlegme est sale.
Amere est la bile jaune,
et aigre la bile noire.
Laquelle des humeurs predomine suivant l'age?
C'est tant6t l'une, tant6t l'autre qui est abondante suivant chaque
age.
Dans l'age de l'enfance, c'est surtout le sang.
Dans l'age de la jeunesse, labile jaune.
Chez celui qui a depasse la jeunesse, la bile noire.
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JOUANNA
Et chez les vieillards, le phlegme.
Combien y a-t-il de differences de temperaments?
Il y a quatre ages: celui des enfants, celui des jeunes, celui de
ceux qui ont depasse la jeunesse, celui des vieillards. Et il (sc.
Hippocrate) etablit des differences entre leurs temperaments.
L'enfant est hurnide et chaud, ace qu'il (sc. Hippocrate) dit;
chaud et sec est le temperament du jeune;
sec et froid le temperament de qui a depasse la jeunesse;
froid et hurnide le temperament du vieillard.
8. Pourquoi, alors qu'il y a quatre humeurs, il y a seulement trois
fievres qui s'allument lorsque ces humeurs se putrefient?
Parce que le sang est par nature doux au gout et est la nourriture
du corps. Ce sang, quand il predomine, provoque ce que l'on
appelle la plethore. Mais une fois qu'il est putrefie, il ne demeure
pas du sang, car il se transforme en pus ou en bile, si bien que se
produisent aussi des demangeaisons causees par des abces.
La bile noire est froide et seche. Or le sec est difficile a modifier
et a transformer. Mais elle se change subrepticement, quand elle
s'echauffe en bile jaune.
Les autres humeurs, quand elles predominent, causent des
maladies, surtout a la peau, par exemple les «cancers», les dartres
farineuses, les <depres» blanches, ainsi que toutes les fievres.
9. D'ou proviennent les quatre humeurs quand elles s'exhalent?
Le sang s'exhale par le nez;
la bile jaune par les oreilles;
la bile noire par les yeux,
et le phlegme par la bouche.
10. Quel est le pouls des quatre elements?
Le pouls du sang est grand, prolonge et hurnide. Le sympt6me
qu'il annonce: mal de tete tres fort et inflammation du corps tout
en tier.
Le pouls de la bile jaune est faible et sec, tombant. Le sympt6me
qu'il annonce: retrecissement de l'estomac et colique dans le
ventre.
Le pouls de la bile · noire est plus grand, plus leger et plus
frequent. Le sympt6me qu'il annonce: lourdeur des genoux et
douleurs dans la region des lombes.
7.
JOUANNA
93
Et le pouls du phlegme est grand, prolonge, egal, et equilibre. Le
sympt6me qu'il annonce: douleurs des £lanes et retrecissement
dans la poitrine chaque jour.
11. Qu'est-ce qu'une humeur? Et pourquoi une humeur? Et d'ou vient
en meme temps un mauvais usage? Comment determinons-nous
qu'une humeur a besoin d'evacuation?
En considerant la forme de la maladie, les sympt6mes qui
l'accompagnent et les phenomenes du meme ordre.
D'ou vient l'humeur melancolique?
L'humeur melancolique provient ou bien .de la bile jaune
excessivement r6tie, d'apres laquelle elle est appelee bile noire,
ou bien du depot de sang excessivement r6ti, en vertu de quoi
elle est proprement l'humeur melancolique.
12. En combien de parties se divise l'annee?
L'annee se divise de meme en quatre saisons: le printemps,
l'ete, l'automne et l'hiver. Et les temperaments de ces
saisons changent.
Quel est le changement de temperament relatif a chaque saison?
Le printemps est humide et chaud, a ce qu'il (sc. Hippocrate) a
dit;
l'ete chaud et sec,
l'automne, sec et froid,
l'hiver froid et humide.
De meme que dans les quatre ages susdits telle humeur dans tel
age est plus ou moins abondante, a ce qu'il (sc. Hippocrate) a dit,
de meme, selon la meme consecution aussi pour les saisons telle
humeur dans telle saison s'epanouit et domine dans les corps;
tant6t ce qui est abondant c'est le sang, tant6t, la bile jaune,
tant6t labile noire et (tant6t) le phlegme.
Au printemps, c'est le sang qui estdavantage abondant,
en ete la bile jaune,
en automne la bile noire
et en hiver le phlegme.
Le traite, tel qu'il est transmis, n'est peut-etre pas complet en son debut.
Il n'a pas de titre et la premiere phrase conservee fait reference par son
demonstratif otJTOL aux quatre humeurs dont les noms ont ete
vraisemblablement enonces au moins dans une phrase precedente. La
structure du traite est assez claire. J'ai divise le texte en douze chapitres et je
_.: ,,)--' <
94
JOUANNA
-
l'ai dispose de telle fa<;:on que chacune des quatre humeurs apparrusse
clairement.
Les cinq premiers chapitres forment un tout. lis definissent les quatre
humeurs par quatre points de vue qui les differencient. Ces quatre points de
vue sont enumeres dans la reponse a la premiere question: la couleur, la
propriete, la consistance et la qualite (c. 1). Les quatre chapitres suivants (c.
2-5) envisagent chacun de ces quatre points de vue successivement (c. 2: la
couleur; c. 3: la consistance; c. 4: la propriete; c. 5: la qualite perceptible par le
gout).
Les deux chapitres suivants (c. 6 et c. 7) traitent de la variation des
humeurs et des temperaments selon les ages.
Le chapitre 8 se presente sous la forme d'un veritable probleme, c'est-adire d'une question qui comporte un expose paradoxa!. n n'y a que trois
fievres, bien qu'il y ait quatre humeurs.
Le chapitre 9 enonce les differentes parties de la tete par ou s'exhalent les
quatre humeurs.
Le chapitre 10 traite de la sphygmologie des quatre humeurs.
Le chapitre 11 ne forme pas une unite. ll comporte une accumulation de
cinq questions dont les trois premieres sont sans reponse. Les deux
dernieres, accompagnees d'une reponse, ne presentent pas de rapport entre
elles: l'une concerne le diagnostic de la plethore d'une humeur, l'autre
l'origine de l'humeur melancolique.
Avec le chapitre 12, on revient a un aspect bien connu de la theorie des
quatre humeurs, la variation des humeurs suivant les saisons de l'annee.
Pour situer ce nouveau traite dans l'histoire de !'evolution de la theorie
des quatre humeurs, je procederai a trois rapprochements principaux, l'un
avec le Pseudo-Galien, Sur les humeurs, l'autre avec un Pseudo-Galien oublie,
intitule Caracteristiques propres d Hippocrate, l'autre avec le Pseudo-Hippocrate,
Sur le pouls et le temperament humain.
Le lien entre !'Anonyme et les deux Pseudo~Galien peut d'abord se faire
par l'intermediaire d'une caracteristique du v6cabulaire pour designer les
gens du troisieme age chez qui predomine la bile noire et dont le
temperament est sec et froid. La doctrine selon laquelle la bile noire
predomine a cet age-la remonte jusqu'au traite fondateur, la Nature de l'homme.
Mais le vocabulai.re employe dans !'Anonyme pour designer cet age-la n'est
pas hippocratique. L'un des termes employes est rrapT)~wv , -WVTOS',
litteralement «celui qui a depasse la jeunesse». Or, ce terme est absent du
Copus hippocratique. En revanche, il est employe par Galien ou par des traites
JOUANNA
95
attribues a Galien. Deux traites pseudo-galeniques comportant la theorie des
quatre humeurs peuvent etre rapproches a cet egard de notre Anonyme.
D'une part le traite bien connu Stir les humeurs recueilli dans le corpus
galenique de KUhn. On y trouve, en effet, la meme expression rrapT)~wv,
-WVTOS' dans un meme contexte. n est dit dans le traite Surles humeurs, comme
dans !'Anonyme, que l'age de celui qui a depasse la jeunesse est sec et
hurnide. On comparera !'Anonyme c. 7 ce T)pav 8E KUL t);vxpav [sc. Kpacnv]
ToD rrapT)~WvTos-) et le traite des Humeurs (ed. KUhn 19, 489, 11 sq.): ~
rrapT)~Wcra [sc. ~ALKLa] eT)pcl Kal. t);vxpa. Le rapprochement est d'autant plus
etroit entre !'Anonyme et ce Pseudo-Galien qu'ils emploient aussi pour
designer ce troisieme age dans le meme contexte un autre terme encore plus
rare. C'est l'adjectif imEpT)~OS' dont le sens est analogue: «celui qui a depasse
la jeunesse». L'adjectif est employe dans le traite Sur les humeurs dans
!'expression Tcjl imEp~~Cfl ~ ~EA.mva «chez celui qui a depasse la jeunesse,
c'est labile noire qui predomine». Jusqu'a present cet adjectif etait considere
comme un hapax. Or voila que !'Anonyme au c. 6 presente exactement la
meme expression: Tcjl l!TIEp~~Cfl ~ ~EAULva! Cet inedit a done l'avantage de
fournir une seconde attestation du mot. Faut-il pour autant postuler un
rapport direct entre les deux traites? Si ce rapport existe, il ne peut
s'expliquer que par une influence du Pseudo-Galien sur !'Anonyme, parce
que le traite Sur les humettrs est plus complet. Cependant l'accord entre les
deux traites se fait sur un aspect de la theorie des quatre humeurs qui est un
acquis depuis sa fondation jusqu'a ses developpements les plus recents. Les
deux traites peuvent done etre independants. Tout juste peut-on emettre
!'hypothese qu'ils sont voisins par la date, vraisemblablement tardive.
Le second Pseudo-Galien, que l'on peut rapprocher de !'Anonyme par
l'intermediaire de l'emploi du participe rrapT)~wv, -WVTOS' dans un contexte
analogue sur la variation des quatre humeurs selon les quatre ages, est oublie
de !'erudition moderne, parce qu'il n'a pas . ete recueilli dans le Corptts
galenique de Kiihn.B Et pourtant, comme il s:;agit d'un traite conserve par
Stobee dans son Anthologie, on a !'assurance qu'il ne peut pas etre posterieur
au Ve siecle apres J.-C. Ce traite, attribue a Galien, est intitule Les caractiristiques propres a Hippocrate (f'aAT)VOU xapaKTT)pLa(ovTa ELS'' ITITIOKpcXTTJV).
V oici comment ce traite, cense etre ecrit par Galien qui expose les theories
8 Pourtant, Chartier l'avait publie dans son tome 2, p. 72 sq., sous le titre Galeni Notae
in Hippocratem. Sur ce Pseudo-Galien, voir J. Jouanna, «'Un Galien oublie: Caracteristiques propres d Hippocrate (Stobee, Anthologie 4.37.14), avec une nouvelle edition», a
paraitre dans les Actes du VIe Colloque international sur l'ecdotique des textes
medicaux grecs (Paris 10-12 avril2008) .
96
JOUANNA
d'Hippocrate, en vient a faire un expose sur les quatre humeurs. Il rapporte
des le debut que la nature de l'homme, selon Hippocrate, se compose de
trois elements: le solide, le liquide et le vent, et il mentionne les ouvrages
qu'Hippocrate a consacres a chacun de ces elements: pour le solide, ce sont
les Fractures et les Articulations et d'autres traites semblables; pour le vent, un
seul traite intitule Les Vents; et pour le liquide deux traites, le traite des
Humeurs et le traite de la Nature de l'homme, sans compter des developpements
dissemines ailleurs. Immediatement apres avoir enonce ces deux traites, il
expose la theorie des quatre humeurs. Ce n'est evidemment pas dans le traite
hippocratique des Humeurs qu'elle se trouve, mais dans le traite de la Nature de
l'homme. V oici 1' expose sur les humeurs:
"Eun BE: TQUTa QLI-W KQL cpAE'YilO, xoA.~ BL TT~, ~ave~ KQL llEAQLVQ. ELVQL
BE: TO !lEV OLilO T~V cpU<JLV uypov KQL BEPilOV KQL T~V xp6av Epu8p6v,
T~V BE: TIOLOTT]TQ yA.uKl1· TO BE: cpAE'YilO lj!uxpov KQL uypov KQL AEUKOV
KQL llUAAOV UA11Up6v· T~V BE: ~ave~v xoA.~v BEPil~V TE KQL ~T]pav KQL
wxpav KQL TILKpav, T~V BE: ETEpav t)luxpav KQL blPaV KQL llEAQLVQV KQL
<j>UKWBT]. apE<JKEl BE: aimjl KQL TOS' ~ALKLQS' BLULpELV ELS' B' Kal TQS' wpas
TOU ETOUS' OllOLWS'. TIAEOVU(ELV BE: TWV ELPTJilEVWV XUilWV EKQ<JTOV EV Ti]
~AlKLq. Kal Ttl wpq. Ttl otKELq. hauTou. Kal Ev 11E:v Ttl Twv TiaLBwv
~ALKL<;t TIAEOVU(ELV TO OL!lO, KQL Ti] wpq. TOU eapos· EV BE: Ti] TWV
UKilO(OVTWV T~V ~ave~v xoA.~v. KQL wpq. 8Epous· EV BE: Ti] TWV
TIUpT]~WVTWV T~V llEAQLVQV, KQL cp8LVOTIWPl!J' EV BE: Ti] TWV yEpOVTWV TO
<PA.Ey 11 a, Kal XEL 11 wvos· EOLKEVQL yap Tas Twv xu11wv cJluuELS' Ta'Ls Twv
wpwv. TO youv eap 8Ep110V TE KQL uyp6v' WS' TO aL!iO . KQL TO 8Ep0S'
8Ep116v TE Kal ~T]p6v · To BE: llETOTiwpov lj!uxp6v TE Kal ~T]p6v · 6 BE:
XELilWV lj!uxpos KQL uyp6s, avaA.6yws TOLS' XUilOLS'' KQTU TQlJTU BE: KQL
T~V ~llEpav BLOLpEL, KQL T(jl apL81l(jl KQL Ti] <j>U<JEL , WS' EV llLKp(.i Ti]
avaA.oy[q..
Ces humeurs sont le sang, le phlegme, la double bile, jaune et noire. Le
sang est par nature humide et chaud, par sa couleur rouge, et par sa
qualite doux. Le phlegme est froid, humide, blanc et plutot sale. La bile
jaune est chaude et seche, ocre, et amere; l'autre bile est froide et seche,
noire, et ayant le gout des algues. 9 Selon son avis (sc. l'avis
d'Hippocrate), les ages se divisent en quatre, et les saisons de l'annee
egalement. Chacune des humeurs dites predomine dans l'age et dans la
saison qui lui sont propres. Dans l'age de l'enfance, c'est le sang qui
predomine ainsi que dans la saison du printemps; dans l'age de ceux qui
sont dans la plenitude, c'est labile jaune ainsi que dans la saison de l'ete;
9
Le terme cpuKWBT] est assez exceptionnel. Je ne connais pas d'autre emploi analogue
pour qualifier une humeur semblable a des algues par le gout. Cet emploi n'est pas
recense dans les dictionnaires usuels. Ce traite de Galien est vraiment oublie.
/ • .Y ·r'
JOUANNA
97
dans l'age de ceux qui ont depasse la jeunesse, c'est la bile noire, ainsi
que dans l'automne; et dans l'age de la vieillesse, c'est le phlegme, ainsi
que pendant l'hiver. Car la nature des humeurs ressemble a la nature des
saisons. Effectivement, le printemps est chaud et humide, comme le
sang; l'ete est chaud et sec, l'automne froid et sec, l'hiver froid et
humide, de maniere analogue aux humeurs. Selon le meme principe, il
divise (sc. Hippocrate) aussi la journee et par le nombre et par la nature,
en tant qu'etant dans une correspondance a petite echelle (avec la
saison).
- . ,.
lei encore c'est dans le contexte de la variation des humeurs selon les ages
que le terme TWV '!WPT)~WVTWV designant les hommes du troisieme age est
employe. C'est l'age ou domine la bile noire et ou l'homme est froid et sec
(comparer Anonyme T<jl imEp~~l!l ~ llEA.awa ... ~T)pav 8E: Kal. t);uxpav Tou
rrapT)~WVTOS et Ps.-Gal. Caracteristiques EV 8E: Tfj Twv rrapT)~WVTWV T~v
llEA.mvav). Plus generalement, !'Anonyme presente d'autres analogies avec ce
developpement du Pseudo-Galien, aussi bien dans la definition des humeurs
selon leur propriete, leur couleur et leur qualite que dans la variation des
humeurs selon les saisons, et pas seulement selon les ages. Par exemple,
concernant la definition des humeurs, dans les deux traites, le sang est, par sa
propriete chaud et humide, par sa couleur rouge et par sa qualite doux, tandis
que le phlegme, envisage suivant les memes points de vue est froid et
humide, blanc, et sale. n n'est toutefois pas question de la consistance des
humeurs dans le Pseudo-Galien, mains compledt cet egard que 1'Anonyme.
Dans le developpement sur la relation entre les saisons et les humeurs, la
definition des saisons dans les deux traites est tres proche (Anonyme c. 12:
To !lEV Eap uyp6v TE Kal. 8Ep!10V Elva[ ci»TJUL, TO OE 8Epos 8Ep!10V Kal.
~T]p6v, TO <j>8w6rrwpov ~T)p6v TE ml. t);uxp6v, Tov 8E: XEL!lwva tJ;uxpov Kal.
uyp6v; Ps.-Gal. Caracteristiqttes TO youv Eap 8EPilOV TE KaL uyp6v, ws TO
al11a· Kal. TO 8Epos 8Ew6v TE Kal. ~T)p6v· TO 8E: llETorrwpov t);uxp6v TE Kal.
~T)p6v· 0 OE XELilWV t);uxpos KaL uyp6s, avaA.6yws TOtS XU!lOLS). A vrai dire,
on peut objecter qu'il n'y a rien de tres etonnant dans ces correspondances,
car la propriete des humeurs, leur variation selon les saisons et partiellement
selon les ages font partie du fonds commun de la theorie des quatre humeurs
des le traite de la Nature de l'bomme.1o C'est vrai. Toutefois, l'une des
10
Le Pseudo-Galien comprend toutefois dans la fin de la citation une indication sur
la variation des humeurs suivant la journee qui ne se trouve pas dans l'Anonyme.
Bien que cette mention soit allusive, il faut comprendre qu'il y a quatre parties dans
la journee comme dans l'annee qui correspondent a la predominance des quatre
humeurs, sang, bile jaune, bile noire, phlegme. Comme ce traite est anterieur au Ve
.·
. ,_.;,-'
98
JOUANNA
particularites du Pseudo-Galien conserve par Stobee me semble eclairer
l'Anonyme. Les doctrines d'Hippocrate y sont rapportees de telle fa<;:on
qu'Hippocrate n'est jamais nomme, mais apparait comme sujet sous-entendu
de verbes a la troisieme personne du singulier. Dans le passage cite il n'y en a
qu'un exemple, mais il est clair. C'est ala fln de la citation: 8LaLpEL «il divise».
Le sujet n'est autre qu'Hippocrate, ce qui est eclaire par le titre donne a
l'ensemble Caractbistiques propres d Hippocrate (I'UAT]VOU xapaKTT]pLCi(ovTa ELS"
'ITITIOKpUTTJV). Bien que l'Anonyme n'ait pas de titre conserve, il me parait
que la comparaison renforce l'hypothese que j'avais proposee, avant meme
de rapprocher le Pseudo-Galien, pour identifier le sujet sous-entendu des
verbes declaratifs dans l'Anonyme. On aurait done bien dans l'Anonyme un
traite qui expose les theories d'Hippocrate sur les humeurs, comme le
Pseudo-Galien conserve par Stobee.
Mais alors que le traite Pseudo-galenique relativement ancien met
explicitement en rapport la theorie des quatre humeurs avec le traite de la
Nature de l'homme, et que ces theories restent assez proches du traite
hippocratique, meme si elles sont systematisees, l'Anonyme n'a plus
conscience d'un lien avec le traite fondateur et expose des aspects de la
theorie plus recents qui n'ont plus rien a voir avec lui, tels que les lieux par
ou s'exhalent les humeurs (c. 9), et surtout le pouls relatif aux quatre
humeurs (c. 10), puisque le pouls est une decouverte de la medecine
hellenistique et puisque meme la forme systematique du pouls des quatre
humeurs est encore inconnue de Galien.
Or ces deux aspects recents de la theorie rapprochent l'Anonyme du
traite Pseudo-hippocratique, Sur le pouls et le temperament humain c. 6 et 9. li y a
d'abord un parallelisme tres etroit sur les differentes voies par ou les quatre
humeurs s'exhalent (Anonyme c. 9; traite Pseudo-hippocratique c. 6). Voici
le texte du traite Pseudo-hippocratique:
6. "Exou<n 8E: TOTTov 8L' oD (oD scripsi: div P) J~KaaTov a{m;jv TTVEL (A:
r·-__ ,.:~<:~7~-\~.-~:~:~·-...- -"'-:~ ~-:~:--~~~:~
I·-
• : . .-
::····
TTOLEL P)
-TO al11a 8u1 Twv /JLvwv,
-~/..;ave~ xoA.~ 8u1 Twv wnlV ,
- ~ 1-LEAaLVa xoA.~ 8u1 TWV 6<j>8aA!-LWV"
siecle apres ].-C., il faut y voir le temoignage le plus ancien qui soit conserve sur la
chronobiologie quotidienne des quatre humeurs, si l'on considere que la Lettre de
Vindicien a Pentadius n'est pas authentique. Ce temoignage doit etre ajoute a ceux
qui ont ete reunis dans J. Jouanna & K.-D. Fischer, «Chronobiologie dans la
medecine tardive. La variation quotidienne des quatre humeurs: Nouveaux
temoignages grecs et latins», Ga!enos 1 (2007) 175-86.
;'·
..
.-,
.: :.
JOUANNA
99
On ne peut pas souhaiter rapprochement plus etroit: le verbe employe pour
designer l'exhalaison est le meme, le verbe TTVEw; 11 les humeurs s'exhalent par
les memes voies et elles sont enumerees dans le meme ordre.1 2
On pourrait dire que la aussi un rapprochement serait possible avec
d'autres textes. De fait dans le texte grec le plus connu sur la theorie des
quatre humeurs a l'epoque tardive, a savoir !'Anonyme sur la Constitution de
/'Univers et de /'homme publie dans les Medici minores de Ideler, on trouve le
passage analogue que voici (Ideler I 304, 26-28): TO aLrw 8u1 pwos TTVEEL, ~
Eave~ xoA.~ aLa Twv <hwv rrvEEL, ~ [lEAmva aLa Twv 6¢8aA[lwv, mt To
¢AEy[la oLa ToD <JTO[lUTOS EKXEEL. Mais ce qui est caracteristique de la
relation entre 1'Anonyme du Vatican publie ici et le traite sur /e Pou/s et /e
temperament humain, c'est la presence conjointe de deux chapitres paralleles qui
ne se trouvent pas ailleurs dans la tradition grecque: outre les voies
d'exhalaison des quatre humeurs que l'on vient de voir, il y a aussi la
sphygmologie. V oici le texte sur la sphygmologie dans le traite pseudohippocratique:13
9. OL <J<j>Uy[lOL 8€: TWV 8' XU[lWV"
-ToD aL[lGTOS" u<j>uy[lOS" [lEy as-, rruKvos- Kal. YE[lWV Kal. Ka8uypos-·
<JU[llTTW[laTa 8€: auToD · KE<j>aA.aA.y(m, 68uvm u<j>o8p6TaTaL, Kal. oA.ou
TOV <JW[lGTOS" rrupw<JLS""
-TfiS" ~av8fis- xoA.fis- 0 <J<j>Uy[lOS" AE1TTOS"' ~TJPOS"' lTL lTTWV"
<JU[llTTW[laTa 8€: auTfjS" KEVW<JLS" Kal <JTp6<j>os- lTEpl T~JJ KOLALav ·
o
11
Le nouveau temoignage de l'Anonyme conflrme que dans le traite Sur le pouls et le
temperament humain la bonne let;:on lTVEL a ete conservee par le manuscrit A, alors que
la le<;:on lTOLEL de P est fautive.
12 Cette theorie du traite Pseudo-hippocratique a ete traduite du grec en latin dans la
Lettre de Vindicien a son petit-fils Pentadius. Voir]. Jouanna, «La theorie des quatre
humeurs ... » (2005, cite n. 1) 162.
13 Texte edite dans]. Jouanna, «Un traite pseudo-hippocratique inedit ... » (2005, cite
n. 1) 451. Je rappelle que c'est la version A et qu'il existe une version B de ce traite,
encore inedite, dans le Par. gr. 2494. Voir ]. Jouanna, «La theorie des quatre
humeurs ...» (cite n. 1) 161-64. En ce qui concerne la sphygmologie, la version B
presente d'assez grandes divergences par rapport ala version A. Toutefois, je n'ai pas
cru bon de publier ici la sphygmologie de cette version B, car elle n'eclaire pas la
version de l'Anonyme. Il apparait que cette version B est une reecriture a partir d'un
modele commun ancien plus bref que l'on peut assez facilement restituer par la
comparaison des trois versions presentees ici: d'une part l'Anonyme, d'autre part la
version A du traite sur le Pouls et le temperament humain et enfm la version du PseudoGalien, De Pulsibus ad Antonium.
..
~·
·> .
...
··:.
JOUANNA
100
-Tfjs 8E
IJ.EAOLVT]S xoA.fjs
6
a<PUYIJ.OS iTAEWS, AEiTTOTEpos KQL
~T]pOTEpos KOL apm6s· aUIJ.iTTWIJ.OTa 8E atnfjs yovaTwv ~apos, iTOVOL
iTEpl T~v l)Jvav·
-Tou 8f. <jJA.EyiJ.aTOS 6 a<jJuyf.lOS IJ.Eyas Kal <a>rrapayOIJ.EVOS (scripsi:
;rapayoiJ.EVOS P; an <a>;rapaTTOIJ.EVOS (? cf. a;rapay1J.W8T]s Ps. Gal.
De Pulsibus ad Antonium ed. KUhn 19, 641, 18), uyp6s. la6aT081J.OS'
aUIJ.iTTWIJ.aTa 8E mhoD · ;rovoL ;r\Eupwv, aTEvwaLs iTEpl To aTfj8os.
Les deux redactions, tres proches l'une de l'autre, remontent a un modele
commun. ll faut rappeler que la seule version publiee sur la sphygmologie
des quatre humeurs avant la publication du traite Sur le Pouls et le temperament
humain et du present Anonyme etait enfouie a la fm du Pseudo-Galien, De
Pulsibus ad Antonium, auquel elle a ete vraisemblablement rajoutee. 14 Ce texte
imprime ne prend son veritable sens que depuis la publication du traite sur le
Pouls et le temperament humain a laquelle s'ajoute maintenant !'Anonyme. Voici
cette version imprimee (I<:Uhn 19, 641, 9-642, 2):
a<jluy~J.ol Twv XVIJ.WV'
-TaD aLIJ.aTos Ka8uypos, IJ.Eyas, ;ruKvos Kal YEIJ.wv · Kal Ta IJ.EV
aUIJ.iTTWIJ.OTa ainoD KE<jJaA.fjs 68UvaL a<jJo8p6mTm KGL oA.ov TO aw11a
;rupw8Es.
-Tfjs ~av8fjs xoA.fjs 6 a<jluy11os A.mT6s, ~TJp6s, ;r[ iTTwv· aUIJ.iTTWIJ.aTa
8f. ainoD yaaTpos aTEvwaLs Kal aTp6<jJos iTEpl T~v KoLA.[av.
-Tfjs IJ.EAOLVT]S xoA.fjs 6 a<jJuyf.lOS AEiTTOTEpos Kal ~TJPOTEpos KQL
apm6s · aUIJ.iTTUlf.lOTQ 8E mhoD yovaTWV Mpos f(QL iTOVOL iTEpl T~V
tVVXTJV.
-TOU <jJAEYIJ.OTOS 6 a<!JUYIJ.OS IJ.EYOS KQL a;rapay1J.W8Es. uyp6s.
U8aTW8T]s. apmos KOL la6aTa81J.OS ' aUIJ.iTTWIJ.OTQ 8E TOUTOU iTAEUpWV
iTOVOL KQL uypa TU 8La yaaTpos <jJEpOIJ.EVa Ka8' EKaaTT]V ~IJ.Epav KTA.
OL
On dispose done desormais de trois versions paralleles en grec. 15 Leur
comparaison devrait aider a eliminer les fautes propres a chacune d'entre
elles.t6 Elle devrait aussi eclairer leurs relations: en particulier !'Anonyme ne
14
J'ai mentionne ce rapprochement des !'edition princeps du traite Sur le Pouls et le
temperament humain (citee n. 1) 459.
15 Voir aussi la traduction latine (simplifiee) dans la Lettre dite de Vindicien a son
petit-fils Pentadius (c. 9).
16 J'ai indique quelques variantes dans le texte de l'Anonyme, notamment a des
endroits ou le texte de !'Anonyme est problematique. Pour le texte du traite Sur le
pouls et le tel11jJerament humain, j'ai reproduit sans changement le texte que j'ai edite dans
l'edition princeps. Mais le nouveau temoignage de !'Anonyme confirme des fautes
dans le developpement sur la bile jaune et plus precisement dans les sympt6mes une
omission de yaaTp6s et une lectio facilior KEvwaLs que l'on pouvait deja deceler par
JOUANNA
101
peut pas deriver directement de la version du traite sur le Pouls et le
temperament humain, car il possede sur les sympt6mes relatifs au phlegme une
precision temporelle Ka8' EKUCJTT]V ~f!Epav absente de ce traite mais presente
dans la version du De Pulsibtts ad Antoniunt.
Il faudrait poursuivre la comparaison de l'Anonyme avec le traite Sur le
pouls et le temperament httJJtain. Je n'insisterai pas sur les concordances
comportant ce que j'ai appele le fonds commun, c'est-a-dire la definition des
humeurs (cf. Sur le pouls et le temperament humain c. 3) ou leur variation suivant
les saisons ou les ages (cf. Sur le pouls et le temperament humain c. 4 et 7).
L'Anonyme possede des elements en plus, tels que l'existence de trois
fievres, alors qu'il y a quatre humeurs (c. 8) 17 ou la question sur l'origine de la
bile noire (c. 12). 18 Mais il compte des elements en moins, tels que la
localisation des humeurs dans les parties du corps (Sur le pouls et le teJJJjJerament
humain c. 2) ou la variation des humeurs selon les heures de la journee et de la
nuit (Sur le pouls et le temperament humain c. 5). L'absence qui est surtout
notable, c'est la theorie des quatre temperaments exposee au c. 8 du traite Sur
le pouls et le temperament humain. L'inedit ne rentre done pas dans le groupe des
comparaison avec la version du Ps. Gal. De pulsibus ad Antonium ou on lit
yaaTpOS'
O"TEVWO"LS'.
17 Je ne connais pas actuellement d'equivalent au Probleme pose au c. 8 de
!'Anonyme sur !'existence de trois fievres alors qu'il y a quatre humeurs. Cette
position du Probleme est une preuve de !'ignorance totale du traite fondateur, le
traite de la Nature de l'homme comprenant quatre fievres (c. 15), causees il est vrai par
la bile Qaune ou noire) , et non par les autres humeurs.
18 La reponse sur l'origine de l'humeur melancolique issue du rotissement excessif
soit de la bile jaune soit du depot du sang provient vraisemblablement de Galien;
voir Galien, De Ia bile noire, c. 3, 5, ed. de Boer 75, 6-11. Voir aussi De symptomatum
causis libri III, c. 7, ed. KUhn 7, 245, 17-246, 6; De tumoribus praeter naturam I, c. 6, 720,
3; Synopsis librortttn St/Ort/Jll de pulsibus, c. 9, ed. Kiihn 9, 460, 9-12 (dans ce passage, la
bile noire est dite seche, alors que la bile jaune es.t dite non seulement seche, mais
aussi chaude; Galien ne qualifie done pas la bile noire de froide) . On retrouve le
rappel de ce processus surtout dans des Commentaires aux ecrits d'Hippocrate: In
Hippocratis Pron-heticum I commentaria III, I, c. 4, ed. KUhn 16, 512, 11-14 (production
de bile noire par rotissage excessif de bile jaune ou de sang epais dans les maladies
chaudes et seches, tels que les causus ou les phrenitis); ibid., c. 10, ed. KUhn 16, 534,
6-15; In Hippocratis librti!JJ 1/7 epidemiart/IJJ COJJJIJientarii 1/1, VI, c. 3, ed. KUhn 17b, 322,
1 sq.; In Hippocratis aphonsmos C01JIJJJentarii V7I, III, c. 22, ed. Ki.ihn 17b, 622, 4-6; ibid.,
VI, c. 53, ed. Ki.ihn 18a, 91, 6-16 (passage proche du De atra bile); In Hippocratis
prognosticum commentana III, III, c. 27, Ki.ihn 18b, 278, 4-11 (comparer aussi avec le De
atra bile) .
:... ~-~·.·.....
I
'.
'• •
102
JOUANNA
trrutes sur la theorie des quatre humeurs comportant la theorie des quatre
temperaments que j'ai rassembles ailleurs. 19 L'absence de cette theorie ne
permet pas de conclure que !'Anonyme est anterieur a ce groupe de traites.
La tres grande ressemblance entre !'Anonyme et le traite du PseudoHippocrate, Sur le pouls et le temperament humain pour des aspects de la theorie
qui appartiennent de toute evidence a la periode tardive, tels que le pauls des
quatre humeurs, situe !'Anonyme dans le meme milieu, c'est-a-dire dans cette
medecine byzantine qui a ete diffusee en Occident notamment par le relais
de la Lettre attribuee a Vindicien.
La presentation sous forme de question et de reponse adoptee par
!'Anonyme atteste que la theorie evoluee des quatre humeurs faisait partie
d'un enseignement vivant a l'epoque tardive, en reference a un Hippocrate
byzantin maitre de Galien, cet «autre Hippocrate», eloigne de l'Hippocrate de
Galien, et meme de l'Hippocrate pseudo-galenique du Ve siecle apr~s J.-C.
atteste par Stobee.
19 Voir ]. Jouanna & J.-P. Mahe, «Une anthologie medicale armeruenne et ses
paralleles grecs», Comptes Rendus de /'Academic des Inscriptions et Belles Lettres (CRAI),
avril-juin 2004, 549-98 et ]. Jouanna, <<La posterite du traite hippocratique de la
Nat11re de /'bonum... (cite n. 2).
A COMPARATNE READING OF SORANOS AND MUSTIO:
AN EXAMPLE OF E:punarr6Kpwv;-*
Brigitte Maire
University of Lausanne
The disappearance of Alexandrian medical literature and the highly
fragmentary nature of the ancient texts on gynaecology that have come
down to us do not provide a very promising framework for our study. I
must, indeed, de facto forego the idea of conducting a diachronic
investigation taking into consideration a large number of independent
descriptions of the anatomy and physiology of the female body, which
would demonstrate the gradual development of ideas, knowledge and
mental attitudes in this sphere. Even though the study of an extensive
corpus of writings is not possible, a reading of two texts that are central to
the history of gynaecology will none the less initiate a discussion and suggest
a few hypotheses, particularly regarding the manner of transmitting technical
information.
I propose to focus my study on a comparative reading of the Gynaecia of
Mustio 1 and of the IlEpL yuvmKELWV rra8wv of Soranos of Ephesus,2 and
more particularly, Questions 6 to 17 of Book I of the Gynaecia and chapters
6 to 16 of Book I of the IlEpL yuvmKELwv rra8wv. This choice is based on
the thematic unity of these extracts, which contain two descriptions of the
uterus offering anatomical and physiological observations that are
interesting in a number of respects. Although they are the work of authors
from different periods- 1st/2nd century in the case of Soranos and 5th/6th
century in that of Mustio - they cannot be studied from a strictly diachronic
viewpoint; for Mustio, as he himself says in the preface to his Gynaecia,
* My sincere thanks to Colin Burnell, who translated this text. This paper was given
as a talk at the SAM European Meeting on Anatomical Kn01vledge in the Ancient World
at the University of Birmingham on 16-19 June 2004.
1 I prefer this title to S orani Gynaeciorum vetus translatio Latina which is not transmitted
by any manuscript, but which is nevertheless adopted by Valentin Rose, the most
recent editor ofMustio (Teubner, Leipzig 1882).
2 For text, translation and commentary see Burguiere, Gourevitch & Malinas 19882000. For secondary literature see Hanson & Green 1994:968-1075.
MAIRE
104
-
translates and adapts into Latin Soranos' text, so that the similarities are to
be interpreted as being due to this specific method of composition, rather
than to the stagnation of anatomical knowledge. Conversely, the differences
are to be attributed to the dissimilar aims of the two authors and the means
they employ to achieve them, as they use a particular kind of erotematic3
and definitional catechism, rather than to any development of knowledge
regarding the anatomy and physiology of the uterus.
The aim of Soranos' and Mustio's treatises is primarily didactic. Both
resort to the genre of TO EpulTaTT6KpL<JLS', though they use it in their own
distinct way, and time. This pedagogical method and its characteristic style more synthetic and less elaborate in Mustio's work- consists of questions
and answers initiating the dialogue between a master and his student. This
stylistic device shapes the subject-matter, simplifying and to some extent
vulgarizing it. The syntax is simple, even paraphrastic, as in the famous
Hippocratic Aphorisms or the Aristotelian Problemata. It seeks to facilitate the
bearing of a complex technical subject by dividing it into simple units
accessible to a public which aspires to acquire anatomical and medical
knowledge, or to achieve a new professional status (midwives, or medicae
specializing in gynaecology). Their training and the memorizing of the
information are facilitated by this kind of textbook.
In order to go beyond a mere comparative description of the two texts
under scrutiny, I shall also examine the treatment of the subject-matter and
its transmission. This study complements others 4 on the same corpus with a
view to establishing a new critical edition of Mustio's Gynaecia.
This is why I have deliberately passed over Galen and Hippocrates, who
have hitherto attracted greater attention from philologists and historians of
medicine. 5 For the same reason, I will not deal with Caelius Aurelianus and
his Gynaecia. 6 Even though this treatise is similar to Mustio's Gynaecia insofar
3
The Annie philologique gives 19 references to this particular mode of composition.
One of them is relevant to my corpus, s.v. 'erotapokriseis' Doerrie & Doerries
1964:342-70, in particular 342-43. One can also profitably consult Ieraci Bio
1995:187-207.
4 Cf. Maire 2003:215-30; 2004a:317-23; 2004b:181-98; 2006:413-23.
5 For Galen, see e.g. Bonnet-Cadilhac 1988:267-91; Lachs 1903; Von Staden 1995:
47-66. For Hippocrates, see e.g. King 1998; Vazquez Bujan 1986; Grensemann
1982.
6 Drabkin & Drabkin 1951.
MAIRE
105
as 1t 1s also a translation/ adaptation of Soranos' work, it would require a
fuller discussion than the limits of this article allow.
From the macrostructural point of view the two treatises follow the same
expository layout, so that the passages dealing with the uterus appear at the
same point in both works, following a preface of varying length and after
some advice on how best to select the most suitable candidates as midwives.
In the sequence of the subjects discussed, therefore, the uterus comes third
- a favoured position that bears witness to the importance attached by both
Mustio and Soranos to the uterus. However, while the subject-matter and
the moment chosen to deal with it are identical, their treatment of the topic
differs.
Before discussing these differences, we have to consider their nature
through a parallel reading of Soranos and Mustio.
Both authors preface their anatomical and physiological discussion of the
uterus with some etymological remarks. While Soranos does not pay
particular attention to this aspect, beginning his chapter with a simple
etymological reminder,? Mustio devotes a special chapter to these remarks. 8
This way of dividing the subject-matter into various chapters is
characteristic of Mustio's method of composition: he uses a large number of
chapters, whereas Soranos chooses chapters with more general titles in
which he presents more varied subject-matter, usually expounded at greater
length and in more detail. This difference in the method of organizing the
material reflects a keener desire to systematize an area of knowledge on the
7
1.6.2-9: 'The uterus -metra- is also called I?Jsfera and delphys; metra because it is the
mother - meter- of all the infants produced by it, or because it enables those beings
that possess it to be mothers, or again, some say, because it determines the
measurement - metron - of time in menstruation and childbirth. It is also called
I?Jstira either because it manifests its activity later (I?Jstiron) or because it is located if not exactly, at least approximately - behind all the intestines. Lastly, it is called
delphys because it brings forth brothers and sisters (adelphoi).'
8 1.6: 'How many terms are used for the uterus? It is called by three principal
names: the first comes from the fact that women become mothers through
childbirth. It is also called hystira in Greek, i.e. coming last, either because it is
located hindmost among all the abdominal organs or because it is empty in virgins
up to the age of fourteen, or else because after the changes that come with age, it
reflects the effects of these changes in women through the medium of childbirth. In
Greek it is also called delpi?Js, because it makes all those who are born from the same
organ brothers.'
106
MAIRE
part of the Latin author than on that of the Ephesian, as well as a stronger
didactic concern and a different use of the erotematic genre.
However, although the two authors differ in their method of
composition, these etymological notes serve to introduce further remarks
that bear more directly on the anatomy and physiology of the uterus and
thus serve as an entry into the subject. While these etymological notes have,
to some extent, the function in both Mustio and Soranos to get the work
under way and impart a special orientation to the treatment to be applied to
the anatomy and physiology of the uterus, the Latin author gives a more
summarized version of the notes than does the Greek. This tendency to
conciseness is affirmed in the preface to the Gynaecia, and is given tangible
form here by the fact that Mustio cites only the three names (tribus nominibus
dicta es~ for the uterus (matrix,y stera, delfts) which he considers to be the most
widely used (princzpa!iter) . Each one is accompanied by only one etymological
explanation, or at the most two, as in the case of ystera, coordinated by aut.
Soranos too, cites three names for the uterus in the Greek tradition (fl~Tpa,
ucnEpa and 8EA.<j>us-), but does not indicate that there are other, less
common ones and that the terms he gives are a selection. Soranos, unlike
Mustio, does not hesitate to cite the various etymological explanations
attributed to a term (three for [l~Tpa and two for uaTEpa). The sequence of
these terminological explanations is not a random one, but indicates
Soranos' preference for an explanation based on language rather than on the
organ's location in the body.
Although there are three principal terms for the uterus, Mustio chooses
the Latin word matrix for the title of the chapter and reserves y stera and delfts,
the two terms of Greek origin, for the body of the chapter. The preference
given by Mustio to matrix permits him a stylistic effect, in the form of two
alliterations in -ix9 and in -icis or -is, 10 which punctuates the whole passage
devoted to the uterus. But Mustio's choice goes beyond a simple striving for
assonance and is part and parcel of his general plan in the Gynaecia, which is
to give the Latin speakers of Late Antiquity a treatise that will provide a
basis for a speciality - gynaecology - directly connected with his own
linguistic area. In this, the plan entirely parallels that of Soranos who
conducts it in the Greek sphere. Gynaecological terminology, like that of
medical terminology in general, is heavily indebted to the Greek language.
9
1.5: obstetrix , 1.6: tJJatrix which reappears in 1.8, 1.9 and 1.10.
1.8: muftis; 1. 9a: mrvis; 1.10: medicinalis; 1.12: matricis and mttliebris; 1.12a: 1mtliebtis;
1.13 matn"cis and digitis; 1.14: matricis.
10
MAIRE
107
This is why Mustio takes special care to accord preference to terms of Latin
origin such as matrix rather than to Greek terms, even if transliterated, such
as ystera and delfts, whose origin (graece) he moreover likes to recall and
emphasize.
Question 7 of the Gynaecia concerns the location of the uterus. Mustio
summarizes in an extremely condensed fashion the detailed information
given by his model: he simply says that the uterus is situated between the
two thighs, above the large intestine and below the bladder. 11 He thus omits
all the details given by Soranos concerning the bladder, whether these
concern the position of the bladder and the uterus relative to each other, or
the actual size of the uterus which, he tells us, varies according to whether
the person is a little girl, a young virgin, an older woman who has lost her
virginity or a woman who has borne a child (1.7.12-18). Neither does
Mustio take over the numerous detailed remarks made by Soranos about the
development of the uterus during pregnancy and after childbirth (1.7.181.8.42).
After concerning himself with the location of the uterus, Mustio leaves
aside for the moment a long passage of Soranos (1.9.43-1.10.72) and first
employs 1.11. 73-87 which he uses to draft Question 8 on the nature of the
uterus. He depicts it as fibrous (ne17Josa) , fleshy (contexta est pulpis), and
containing arteries and veins in great numbers (contexta est [... ] arteriis et venis
muftis) . To this end he uses only the beginning of paragraph 11 (1.11.73-75)
of Soranos' IlEpl. yuvaLKEL WV rra6wv and ignores a long passage in which the
Greek author provides numerous details about the origin and location of the
nerve fibres, arteries and veins, and considers these elements in relation to
the kidneys, another important organ of the urino-genital system (1. 11. 7 5-
87).
Questions 9 and 9a concern the two 'tunics' (i.e. membranes) that form
the uterus. These Questions result from tl;le reworking by Mustio of
1.13.105 to 1.16.148, of which nothing remains except the most essential
elements contained in Soranos' sentences used to introduce a new topic.1 2
The comparison, made by the Greek author between the body of the uterus
11 1.7:
intra duas cox as inttts, quod est sub se babens longaonem et vesicam desujm:
For Question 9: 1.13.106-09: 'The external tunic is rather fibrous, smooth, white
and sclerous, the internal tunic is rather fleshy, thick, delicate and reddish in colour.'
For Question 9a: 1.13.112-14: 'These two tunics are held to each other by thin
membranes and fibres.'
12
...
'•
108
MAIRE
formed by two tunics (membranes) intertwined like a papyrus,B is not taken
over by Mustio in his drafting of Question 9, although he could obviously
have used it for didactic purposes. In this Question Mustio retains only the
description of the texture of the two tunics, making a small change in the
sequence of the descriptive elements chosen by his model (1. 7 .12-18) for the
external tunic, and reversing them in the case of the internal tunic. The
details given by Soranos (1.14.117-20) concerning the specific behaviour of
each tunic of the uterus, according to whether the woman in question has or
has not already been pregnant, are ignored by Mustio.
The same treatment is accorded to the statement by Diodes (1.14.12026) that cotyledons 14 are present in the uterine cavity and enable the unborn
child to become familiar with nursing. This assertion is potentially
interesting and might on this account have been taken over by Mustio.
However, Soranos hastens to dispute it, basing his argument on dissection
which clearly reveals the incorrectness of the statement. 15 It thus seems
natural that Mustio, who is obliged to summarize his source to the utmost in
order to have the means of implementing the plan he announces in the
preface to the Gynaecia, should omit all elements that are presented in his
model as uncertain, false or controversial and that could therefore give rise
to confusion or error.
In 1.15.131-48, Soranos mentions the dispensable character of the
uterus, which can be removed without affecting life expectancy. He bases
his reasoning on Themison and on results of experiments performed in
Galatia on sows, which fatten more easily if their uterus is removed. But an
even more interesting observation is to come: Soranos states that the uterus
interacts with other organs or parts of the body such as the stomach, the
meninges and the breasts. This idea of interrelation among the organs, and
in particular between the uterus and the breasts, may seem very banal
nowadays, but it was far less so for the people of antiquity, who were unable
to base their thinking on laboratory analyses and were unaware of the
existence of the hormonal system. Nevertheless, Mustio does not retain any
of the elements which mention organs other than the uterus, thus following
13
1.13.105-06: 'The body of the uterus consists of two tunics whose internal
structures are situated opposite each other, somewhat like the fibres in a papyrus.'
14 On this topic cf. Maire 2007:207-22.
15 1.14.126-30: 'However, the existence of these 'cotyledons' is belied by dissection,
and the description given of them runs contrary to natural conditions, as has been
shown in the memorandum On Generation.'
JvlAIRE
109
the same method he used previously in omitting all references to the
bladder.
With Question 10, Mustio again follows the sequence of the elements
selected by Soranos. The Latin author takes over the first sentence of 1.9 16
as it is (without, however, retaining the zoological comparison), which
constitutes the sole subject-matter of Question 10: this concerns the shape
of the uterus, which is similar to that of a medical cupping-glass. 17
Question 11 resumes from 1.9.44-53 where Soranos enumerates the
various parts of the uterus (orifice, cervix and isthmus which form the stem;
lateral angles, sides, back, base, body, cavity and 'breast'). Here, for the first
time, the Latin text is very close to the Greek model. Mustio simply refers to
a drawing on which he cites some letters (A, B, C, D, E, F and G) which are
also inserted in the body of his text, serving as a caption. 18 This procedure
obviously has a didactic purpose, but it also enables Mustio to introduce
some variatio in his hitherto somewhat monotonous and dry manner of
expounding the subject.
Question 12 occupies the first sentence of 1.10. 19 Question 12a, in which
Mustio describes the vagina, the texture of which he compares to that of the
large intestine and the purpose of which he indicates, has no parallel in
Soranos. Mustio also establishes in this Question a terminological correspondence between the Greek pterigomata (TITEpuywjJ.aTa) and the Latin
p innacu/a, which denote the large labia.
Question 13 keeps to generalities concerning the distance between the
labia and the vaginal orifice and gives a verbatim translation of Soranos'
account (1.10.55-57).
Mustio continues his translation/ adaptation of his source, but again
reverses the order in which he takes over the material provided by Soranos.
He uses the excerpt from IIEpL yuvmKELWV Tia8wv in order to compose
Question 14 (1.10.67-72) which follows the excerpt he uses for Question 15
(1.10.59-61). Except for this inversion, Mus.tio proceeds in his accustomed
way and leaves out all the details and circumstances mentioned by Soranos,
16 1.9.43-44: 'The shape of the uterus is not twisted as in animals, but recalls that of
· a medical cupping-glass.'
17 1.10: p1incipaliter sicutformata est cucttrbita medicinalis.
18 1.11: quae singulae pmtes ut cognoscantur et facillime intellegi possint ei11s anguli, volui eam
inpingere et in singulis partibus eit1s singulas litteras adpomre.
19 1.10.53-54: 'The orifice of the uterus is located at the centre of the female
genitals.'
110
MAlRE
retaining only the main elements. Thus, for Question 15 he does not include
the circumstances - indicated by Soranos - which cause the cervix of the
uterus to become enlarged (sexual relations, menstruation, pregnancies), but
takes over only one element: the vaginal orifice in a state of rest is the same
size as the auditory canal. 20 Question 14 gives information about the size
and consistency of the vagina: in virgins it is soft and fleshy, whereas in
women who have given birth to a child it is wider and very hard. Mustio
reports the facts, while Soranos embellishes his description with
comparisons: he likens the texture of a virgin's vagina to the spongy texture
of the lung and the soft texture of the tongue, and compares the texture of
the vagina of a woman who has given birth to a child to that of the head of
an octopus, 21 and reports remarks by Herophilus when making a
comparison with the upper part of the trachea. This procedure enables
Soranos to introduce two types of comparison: the one anatomical, with an
organ or part of the body, and the other zoological, with an animal, thus
creating a variatio effect that is welcome in a somewhat repetitive account.
Moreover, his use once again of an authority in the person of Herophilos
provides Soranos with a kind of guarantee, but especially, as we shall see,
with an opportunity for embellishment. Mustio, for his part, refrains from
mentioning Herophilos for two reasons. First of all, he has to condense the
material provided by his model and must therefore make numerous
omissions. But, above all, he is an adherent of Methodism and, as such,
opposed to dissection. To the extent that Herophilos is the exponent of
dissection, the omission of his name is not surprising. Under these
circumstances, the refusal to mention Herophilos amounts to refusing to
use dissection, and provides an additional argument for believing that
Mustio treats the anatomy of the uterus in an idealized way. But why then
does Soranos, who is also a Methodist, mention Herophilos? 22 He is not
bound by the same demands for conciseness as Mustio and so it is much
easier for him to specify and explain his positio~ with regard to dissection.
He can thus use the reference to Herophilos in such a way that it serves as
an aesthetic embellishment rather than as a guarantee of adherence to a
specific doctrine or practice.
20 1.10.59-61 : 'This orifice varies in size, but in most women and in its natural state
its dimensions equal those of the extremity of the auditory canal.'
21 Dasen 2002:167-86.
221.10.71: 'To speak like Herophilos.'
111
MAIRE
In Question 16 on the ovaries, it appears that they are conceived by the
Latin author as women's testicles (testicu/i mu/iemm). For this purpose he uses
1.12.88-93 of IlEpL yuvmKE(wv rra8wv by Soranos. 23 Once again, however,
he omits numerous elements. Mustio first indicates the position of the
ovaries in relation to the uterus, then speaks of their round shape (rotundz)
which widens towards the base (in aliquantum ad bases suas latiores corpore) and
ends by saying that they are small and delicate (graciles). The comparison
made by Soranos with ganglions or glands, and also with testicles, is not
taken over.
Question 17 concerns the uterine (Fallopian) tubes. It derives from the
reworking of the second part of chapter 12 of Soranos' IlEpL yuvmKELWV
rra8wv (1.12.93-104). There are two uterine tubes; they are located at the
sides of the uterus and meet each other at the neck of the bladder. Each one
starts from one of the ovaries. Mustio stops there and refrains from
mentioning three contentious points:
1
1. According to the observations made on the uterine tubes and their
course, it appears that the female seed is discharged not into the uterus
but into the bladder. 24 Soranos tells us that he has stated his position on
this matter in a treatise he wrote on seed (IIEpL O"TTEplJ.UTOS'). This treatise
is now lost, but Soranos' formulation suggests that he must have
opposed this idea.
2. The idea that the ovaries are attached to the suspensor muscles is
likewise presented by Soranos in a way which makes it clear that he does
not share it.
3. A personal observation concerning the suspensor muscle: when a
woman was operated on for an intestinal hernia, the surgeon noted the
prolapse of an ovary due to the slackening of the blood vessels
surrounding it and of the muscles - including the suspensor muscle supporting it.
23 1.12.88-93:
'To the outside of the uterus, very close to the isthmus, are attached
the ovaries, one on each side; they are crumbly, like a ganglion, and covered by a
membrane peculiar to them; as to their shape, they are not oblong and slightly
concave like their counterparts in men, but rounded and widening out somewhat at
their base.'
24 Galen, De Semine 2.1.15-26 takes tl1e credit for correcting tlus n1istake which he
attributes to Herophilus.
112
MAIRE
The comparative reading of the passages dealing with the uterus in the
Gynaecia of Mustio and the llEpl yuvmKELWV rra8wv of Soranos have
highlighted various points concerning both the subject itself and the manner
of envisaging and treating it.
The differences noted derive essentially from a literary plan peculiar to
each of the authors: Soranos composed four relatively long books, while
Mustio's intention was to give a summarized translation/ adaptation of the
text of his model so as to make it accessible to an audience that he himself
identified, namely trainee midwives. The Latin author is therefore obliged to
make some radical choices to achieve this aim. A major contrast thus
becomes clear: Soranos gives a meticulous description of the uterus, in the
course of which he does not hesitate to mention details regarding the
bladder, the kidneys and the intestines. Mustio, on the other hand, restricts
himself to the uterus with two brief digressions on the ovaries and the
Fallopian tubes, which are justified by the role played by these two organs in
reproduction. However, this focus on a single organ would still be
insufficient and he would also have had to exclude some material relating
solely to the uterus.
One may therefore justifiably wonder whether there are not too many of
these omissions, to the point where the anatomical description becomes
unusable because it is too brief and incomplete. The answer to this question
really depends on the point of view adopted. If we look at the issue from a
positivist viewpoint, it must be admitted that the information given by
Mustio about the anatomy of the uterus does not enable us to obtain a
functional picture of that organ. In not presenting sufficient detailed
material Mustio would be contravening one of the main rules with regard to
the writing of a technical treatise, namely that of satisfying didactic
requirements. But it is possible to see here rather the expression of different
treatments of the same material in the composition of a technical treatise.
Mustio endeavours to convey a technical subject as concisely as possible
regarding content and clarity of exposition while Soranos develops and
discusses his material.
The fact that Mustio's composition is not linear is the first indication of a
personal way of handling this tension: this, in effect, is the method he chose
to appropriate Soranos' text and to give it a new contextualization. The text
of the model was thus taken over and reworked, summarized and simplified.
The anatomy was therefore handled by the two authors in accordance with
the method peculiar to each, and was merged into the background as a
subject in itself - more or less deliberately, depending on the author. It is
MAIRE
113
therefore no longer a matter of following a procedure aimed at verifying the
statements regarding the anatomy and physiology of the uterus, but of
examining the two authors' methods and purposes in describing the
anatomy and physiology of the uterus.
The specific method of composition adopted by Mustio for drafting his
Gynaecia suggests that this treatise was intended to be used as the written
basis for a course. Thus, only the guidelines and principal elements are given
in the treatise, while the details and additional information were to be given
orally. This procedure had at least two. advantages. First, it guaranteed that
teaching would still have to be given, since the manual did not in itself
suffice for acquiring gynaecological training. Secondly, it made it possible to
select candidates for such training, to control the quality of these new
specialists and to prepare the ground for what would today be called a
corporate body of specialists, who in this way endow themselves with a
certain degree of legitimacy.
Discussing the anatomy and physiology of the uterus, as Mustio and
Soranos do, is also part of a plan to rationalize discourse about the human
body. No literary genre is better suited for providing an appropriate
framework for the expression of this desire for rationalization than the
technical treatise. It is based primarily on a constant striving to structure the
subject-matter, which is less clearly apparent in Soranos than in Mustio, for
the Latin author condenses his composition to the extent of dividing the
material to be expounded into a large number of Questions, which are often
reduced to a single sentence, and of chapters that are often very brief.
Anatomy as dealt with in Mustio's Gynaecia and in the IlEpl. yvvmKELWV
TTa8wv of Soranos, just as in Greek statuary, tends towards idealization. The
level of appropriateness of a discourse on anatomy depends on the ability of
the speaker or writer to observe both medical and aesthetic conventions,
whether these pre-exist or are created for the occasion. This is why any
attempt to look for correspondences between .ancient anatomy and reality is
spurious. The anatomy of the uterus, as presented to us by Mustio and by
his model Soranos, reflects a determination to codify the human body and
to seek to systematize its representation.
Bibliography
Bonnet-Cadilhac, Ch. 1988. 'Connaissances de Galien sur l'anatomophysiologie de l'appareil genital feminin.' History and Philosophy if Life
Sciences 10:267-291.
114
MAIRE
Burguiere, P., Gourevitch, D. & Malinas, Y. (edd., trans.). 1988-2000. Soranos
dEphese, Maladies des femmes. 4 vols. Paris.
Dasen, V. 2002. 'Metammphoses de !'uterus d'Hippocrate a Ambroise Pare.'
Gesnertts 59:167-186.
Doerrie, H. & Doerries, H. 1964. fuallexikon for Antike und Christentum VI.
Stuttgart.
Drabkin, M.F. & Drabkin, I.E. (eds.). 1951. Caelius Aureliantts Gynaecia.
Fragments of a Latin Version of Soranus' Gynaecia from a Thirteenth Century
Manuscript. Supplements to the Bulletin of the History of Medicine 13.
Baltimore
Grensemann, H. (ed., trans.). 1982. Hippokratische Gynakologie. Die
!!Jndkologischen Texte des Atttors C nach den psettdohippokratischen 5 chriften De
muliebribus I, II und De sterilibus. Wiesbaden.
Hanson, A.E. & Green, M. 1994. 'Methodicorum princeps.' ANRLfl' 2.37.2:9681075.
Ieraci Bio, A.M.I. 1995. 'L' EPWTmr6KpLCJLS' nella letteratura medica.' In
Moreschini (ed.), Esegesi, parafrasi e compila'(jone in eta tardoantica, 187-207.
Naples.
I<ing, H. 1998. Hippocrates' Woman. fuading the Female Bocfy in Ancient Greece.
London & New York.
Lachs, J. 1903. Die Gynaekologie des Galen. Eine geschichtlich-!!Jnaekologische Studie.
Abh. zu Gesch. d. Med. 4. Breslau.
Maire, B. 2003. 'Le triangle methodique: Soranos, Caelius Aurelianus et
Mustio.' InN. Palmieri (ed.), Rationnel et irratiomzel dans la midecine ancienne et
midievale. Aspects historiqttes, scientifiques et cttltttrels, 215-230. Actes du
colloque, Universite de Saint-Etienne, 14 et 15 novembre 2002. Centre
Jean Palerne, Memoires 26. Saint-Etienne.
Maire, B. 2004a. 'Gynaecia Mttscionis. Reincarnation des Gunaikefa de Soranos
ou naissance d'un traite.' In V. Dasen (ed.), Naissance et petite etifance dans
l'Antiquiti, 317-323. Actes du colloque de Fribourg, 28 nov.-1er dec. 2001.
Orbis Biblicus et Orientalis 203. Fribourg & Gottingen.
Maire, B. 2004b. 'Cissa, rna chissa cos'e. Enquete sur un terme
gynecologique enigmatique.' In Ph. Mudry & 0. Thevenaz (edd.), Nova
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vulgaire - latin tardif, 7.413-423. Actes du 7e colloque international sur le
latin vulgaire et tardif, Seville, 2-6 septembre 2003, Universidad de Sevilla.
Coleccion Aetas 54. Seville.
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Maire, B. 2007. 'Conceptio, retentio et cotyledons ou quelques aspects de la vie
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savoirs et rites, 207-222. Gollion.
Rose, V. 1882. S orani Gynaeciorum vetus translatio Latina. Leipzig.
Vazquez Bujan, M.E.V. 1986. El De mulierum affectibus del Corpus
Hippocraticum. Estudio y edici6n cr!tica de Ia antigtta traducci6n latina.
Monografias de la Universidad de Santiago de Compostela 124. Santiago
de Compostela.
Von Staden, H. 1995. 'Anatomy as rhetoric: Galen on dissection and
persuasion.' Journal of History ofMedicine 50.1:47-66.
GALEN'S IDEAL PATIENT
Susan P. Mattern
University of Georgia
Who counts as normal? Even today, medicine posits a normative patient;
and only belatedly has it taken account of its tendency to generalize based on
the white male patient. In perhaps the best-known example, the public has
recently learned that the 'classic' symptoms of heart attack - crushing chest
pain - are typical of male but not female patients and that 43% of female
patients do not experience chest pain prior to, or during, a heart attack. 1
Galen treated all kinds of patients, including peasants he met by chance while
travelling, and people carried to his door in the city of Rome. He treated
women and children and he didn't charge fees. 2 But when he writes about his
patients, in the hundreds of stories from his practice that survive among his
works, he also has a normative patient in mind. For Galen the most important factors distinguishing patients were age, temperament and constitution,
and lifestyle. Sex was less important per se, but it was related in his mind to
temperament and lifestyle. Some lifestyles are so extreme in his view that
those who live them become practically another species, especially peasants
and athletes.
Galen often gives no information about the patient when he tells a story. It
is usually possible to determine the sex grammatically, and it is almost always
male, although Galen does tell about twenty-five stories about women. It is
also my impression that when the patient is a child Galen usually says so, and
he tells about twenty-five stories about children. 3 When Galen identifies a
1
See especially McSweeney, Cody, O'Sullivan eta/. 2003.
Peasants met travelling: Aliment. Fac. 1.7 (6.498-99K); Comp. Med. Lac. 6.2 (12.9596K); cf. Comp. Med. Gen. 3.2 (13.582-83K). Patient carried to door: Simp. Med. 10.2.9
(12.270-71K); cf. Hipp. Off 2.7 (18B.743-44K, 15 Lybns). Women and children: see
below. Fees: Meyerhof 1929:84. Boethus gives Galen a prize of 400 gold coins for
curing his wife in: Praecog. 8 (14.647K), but this was not a regular fee and Galen
otherwise does not discuss fees. On the independently wealthy physician who does
not take fees see Kudlien 1976, arguing that requesting payment was considered
dishonorable, but not receiving it.
3 Fifteen of the stories about women and twelve or thirteen of the stories about
children concern his own patients; the rest are about other doctors' patients, or
2
I.
'~
..
MATIERN
117
patient only as 'the person' (av8pwrros), or (using a substantive adjective or
participle) the sick person, the weak person, the affected person and so
forth, he means an adult man.
When Galen is more specific about a patient, the information he gives
most often is age. By this I don't mean age in years, although he does this
sometimes. But when Galen gives a patient's age in years it is usually a round
number or an estimate- 'a forty-year-old' or 'about 18 years old.' 4 We know
from other evidence that most people in antiquity did not know, or care,
exactly how old they were. 5 But Galen very often uses words for stages of
life, or ~ALKLa in Greek. Four age categories occur with some frequency. The
one that occurs most often is VEUVLO"KOS, usually translated as 'youth'. Galen
gives ages in years for four of his youths; they range from age 25 up to age
40. They are men in the prime of life. 6
Two male patients are called [J.ELpaKLOV, 'lad', which I translate as
'adolescent'. Galen gives ages for both; they are 'about 18 years old' as he
writesJ Galen also uses the word [J.ELpaKLOV of himself in stories he tells
about his early medical education in Pergamum. 8 Other passages also
associate the age of [J.ELpaKLa with education, for example Galen's treatise
'On matters of health' (IIEpl uyLELVWV, De Sanitate Tttenda). The second book
of this treatise describes the physical education, in the gymnasium, of a boy
between the ages of 14 and 21. The boy is called a rra'is, or child, at the
beginning of this book, and a [J.ELpaKLOV toward the end - the transition
occurs in between. 9 For Galen the age of [J.ELpaKLa is the late teens and early
twenties, and [J.ELpaKLa are students. Because only a small, urban aristocracy
Galen's relationship to the patient is unclear. For specific references see Appendix B
in Mattern 2008. Stories in which the patient's sex is ambiguous: Loc. Affect. 3.5
(8.147K), Meth. Med. 6.6 (10.453-54K). The grammar in the surviving text is
inconsistent in one case: Hipp. Aph. 2.41 (17B.540!<).
4 Galen gives ages for his patients in about 19 cases. Round numbers (40, 50 etc.):
Meth. Med. 7.8 (10.504K), 12.1 (10.814K), 12.7 (10.856K), 14.7 (10.9711<), 14.15
(10.9951<). 'About': Loc. Affect. 4.11 (8.2931<); Meth. Med. 5.12(10.366K), 8.2 (10.
537K'); Meth. Med. Glattc. 1.9 (11.28K). Between 50 and 60: Loc. Affect. 4.11 (8. 2931<).
s Parkin 2003:31-35.
6 Galen describes about 45 patients as vEavLcrKOL. For references see Appendix B in
Mattern 2008. Ages of vwv(mcoL: 25, Meth. Med. 10.3 (10.671-78K); 35, Meth. Med.
8.2 (10.535-421<); 40, Meth. Med. 12.7 (10.856-581<), 14.15 (10.995-961<).
7 [J.ELpaKw: Meth. Med. 5.12 (10.366-681<), Meth. Med. Glauc. 1.9 (11.26-291<).
8 E.g. Bon. MaL Sue. 1 (6.755-571<), Atra Bile 3 (5.1121<); Plen. 9 (7.5581<).
9 TTULS': 2.1 (6.811<); [J.ElpaKLOV: 2.12 (6.156, 157, 162, 1631<).
118
MAITERN
received secondary education in Galen's period, his idea of the Jl.ELpUKLOV is
class-specific.
Galen also calls many patients by the word rrrus or its diminutives rrm8[ov
and rrm8cipLOV. The word rra'Ls could mean 'slave' in antiquity, and some of
Galen's rra'L8ES" are clearly slaves because he also refers to their masters. 10
However, I have found no case in which Galen refers to a patient who is
obviously an adult as a rra'Ls. He calls enslaved adult patients av8pwrros or
one of his many words for 'patient', never rrrus. It is my impression that all
the patients Galen refers to as children are juvenile; some of them are
enslaved children. Galen does not distinguish between the word rra'Ls and its
diminutives, but uses rra'Ls, rrm8[ov and rrm8cipLov interchangeably. Sometimes he uses two of these terms for the same patient. 11 The ages he gives for
patients he calls children are 6, 13, 14, and 15, and two are obviously
infants. 12 Thus a person is a child until at least age 15, whereas Jl.ELpUKLa, as I
have mentioned, are in their late teens and early twenties.
Galen never mixes up the terms rra'Ls and its diminutives with Jl.ELpaKLOV
or vEaVLGKOS". That is, he never uses more than one of these of the same
patient. They are distinct age categories in his mind. In some passages he
mentions other stages of life, notably puberty (~~TJ), which he associates with
age 13 and the development of secondary sexual characteristics, following
Hippocrates;13 when he mentions this stage, Galen places it between
childhood and the 'age of Jl.ELpUKLa'. 14 But Galen's references to puberty
See Golden 1985. rra18ES" with masters: A nat. A dmin. 7. 13 (2.632K, 8EUITOTTJS");
and apparently Loc. Affect. 2.10 (8.132K) and Comp. Med. Gen. 3.8 (13.636K) .
11 Patients are both rra'Ls- and rrm8(ov in Comp. Med. Gen. 3.2 (13.605-07K); Simp.
Med. 6.3.10 (11.859-60K); Praecog. 7 (14.635-41K). The same patient (Maryllus the
mime-writer's slave) is rra'Ls- in Anat. Admin. 7.13 (2.632K) and rrm86.pLov in Plac.
Hipp. Plat. 1.1 (5.181K).
12 rrm86.pw : age 13 in San. Tuend. 5.3 (6.327K = 5.\0, 157 Koch); age 15 in Comp.
Med. Gen. 1.7 (13.403K). rrm8(a: clearly infants in San. Tuend. 1.8 (6.44-5K) and
Aliment. Fac. 3.14 (6.686K); ages 6 and 14 (two patients), Loc. Affect. 1.6 (8.64K); a
miscarried foetus in Ther. Pis. 11 (14.252K) . rra18Es : age 13, Loc. Affect. 3.11 (8.194K);
age 15, Comp. Med. Gen. 1.7 (13.402K).
13 See e.g. Hipp. Aph. 3.26 (17B.632K), 3.27 (17B.637K), 3.28 (17B.640K) .
14 San. Tuend. 5.1 (6.309K); Hipp. SaL Viet. 7 (15.187K); Hipp. 6 Epid. 3.27 (17B.77K);
Hipp. Aph. 3.29 (17B.641K). But cf. Hipp. Aph. 5.7 (17B.791K) , where puberty starts
at age 13 and lasts until age 25, subsuming the age of ~ELpaKLa; and conversely Hipp.
6 Epid. 4.27 (17B.212K), where children become ~ELpaKLa or rrap8EVOL at puberty.
On the concept of puberty in antiquity the main reference is still E yben 1972,
though he relies on some Galenic works that are now considered forgeries.
10
, .>-'
MATIERN
r
119
come almost exclusively from his commentaries on Hippocratic passages
about puberty. Puberty is a Hippocratic, not a Galenic concept.
The main stages of life that Galen recognized were childhood, adolescence
or the age of fl.ELpaKLa, youth or the prime of life, and fmally old age. Galen
has relatively little to say about old age, and hardly any of the patients he
describes are old. He refers to five patients as y€pwv or npE<J~us; one of
them is the philosopher Eudemus, age 62. Three patients are ages 50 to 60,
but he does not call them old.15
Galen uses terms for stage of life only for male patients. None of the
patients called na'is is female. llmo(ov and nmocipLov are neuter terms and
could theoretically refer to little girls but we don't know. MELpaKLov is a
neuter term, but it is never used of girls. The female equivalent of a
fl.ELpaKLov in Galen's view is nap8€vos, but he hardly ever uses this word and
none of his patients is called nap8€vos .16 Almost without exception he calls
his female patients yuv~ or its diminutive yuva(ov, and sometimes
av8pwnos, but vet-y rarely.n Galen does not seem to draw a distinction
between yuv~ and yuva(ov and he uses these terms interchangeably. He
applies them both to the same woman in one story. 18 The only female
patient whose age he records is 20 years old.19
Galen does not divide women into age categories as he does with men.
Rebecca Flemming (2000:288-358) has shown that Galen views women as a
kind of man rather than as a separate category of person, and his treatment
of age bears this out. It also reflects Greek civic organization in which VEOL
or VEUVL<JKOL were roughly the men of military age, and where different age
cohorts, including ephebes and the elderly, had their own leaders and
15 yEpwv: Loc. Affect. 1.6 (8.64K), Praecog. 3 (14.619K, Eudemus referring to himself).
Praecog. 6 (14.633K); Hipp. Viet. Acut. 3.36 (15.698-99K); one of the
npEa~UTT]S':
debaters in Praecog. 6 (14.633K). Eudemus' age: Praecog. 3 (14.614K). Patients aged 50
to 60: Loc. Affect. 4.11 (8.293K); Meth. Med. 12.1 (1P.814K), 14.7 (10.971K). Some
stories in San. Tuend. illustrating longevity also necessarily describe their subjects as
'old', but these narratives are a special category: Antiochus the physician in 5.4
(6.332-33K); Telephus the grammarian in 5.4 and 5.12 (6.333-34 and 379-SOK); and
the anonymous farmer in 5.7 (6.343, 345K).
16 The word napBEVOS' occurs 15 times in Galen's extant Greek works, but 5 of these
instances refer to Hippocratic patients and 5 are direct quotations from the Hippocratic Corpus or other authors. None of Galen's patients is called napBEVOS'.
17 avepwTTOS' of women, with the feminine article: Meth. Med. 10.5 (10.687K); Ven.
Sect. Eras. Rom. 1 (11.189K).
1s Feb1: Diff. 1.13 (7.328-29K).
19 Ven. Sect. Eras. Rom. 1 (11.187K.).
1•1
.
\'
'
'
_. .• ..r·
120
MAITERN
sometimes their own gymnasia. 20 Women were marginal to Greek civic life,
which typically organized them into two age cohorts, maidens (rrap8EVOL)
and married women;2 1 I cannot offer a good reason why Galen ignores the
virgin in his work. In Greek civic values, and in Galen's view of medicine,
vEaVLCJKOL or men in the prime of life are the most important group.
Galen's ideas about age relate closely to another set of ideas about
temperament and constitution. The temperaments or KpaCJELS' were literally
mixtures of the four qualities of hot, cold, wet, and dry. Constitution or ECLS'
referred to several qualities mostly derived from temperament, such as
hairiness, colouring and what we would now call body mass. In Galen's view
people had an individual and natural temperament. Temperament varied
with age throughout life. Children were hotter and wetter than adults, and
old men were cold and dry, so that one progressed from greater heat and
wetness to greater coldness and dryness throughout life. In Galen's scheme
no age is cold and wet, but women are cold and wet. (Again, women are a
type of man.)2 2
As I have mentioned, Galen argued that childhood was the hottest stage;
he also suggests in some passages that the perfect age was the age of E<!>TJPOL
or 11ELpaKw. 23 However, there are some complications to this, especially if
we examine the connection between temperament and masculinity. It is clear
that Galen considers the hot, dry temperament to be the most masculine
temperament; and he considers the prime of life, the age of VEUVLCJKOL, the
most masculine stage of life. When he describes llELpaKLa in his case
histories they are pale, soft and fatty - the llELPUKLOV is a balance between
male and female, and possibly an erotic ideal, but was not the ideal male.24
20
On civic age terminology in Greek, see Van Bremen 1996:145-50.
21 Ibid. 145-46.
'
22 Galen's main work on temperament is IlEpl KpacrEwv or De Temperamentis, 'On
mixtures' in three books (1.509-694K); on temperament and stage of life see especially Temp. 2.2 (1.577 -98K); on humoural theory in Galen see Siegel 1968, part 4; on
women see Flemming 2000:305-29.
23 Temp. 2.4 (1.618K), Hipp. Sal. V iet. 7 (15 .186-87). These passages represent two
rare occurrences of the word E<jlT]~OS' in Galen's work. Galen also invokes the
'Canon' of Polyclitus as the icon of the ideal, well-balanced human: Ars Medica 14
(1.342-43K); Temp. 1.9 (1.566-67K); Opt. Cmp. Const. 3 (1.744K), 4 (745K); Plac. Hipp.
Plat. 5.3 (5.449K).
24 Effeminate llELpaKLa: Meth. M ed. 6.2 (10.399K); Meth. Med. Glauc. 1.9 (11.28K).
''·
MATIERN
121
Galen often connects the idea of masculinity with the hot, dry, bilious
temperament. For example, consider a passage from I1EpL KpacrEwv ('On
mixtures', De Temperamentis):
A. It is necessary to consider the temperaments of the individuals by
reviewing each part separately, and not to conclude, if the chest is hairy,
that the whole body of this person is necessarily relatively hot and dry;
but the heat is gteatest in the heart, and thus he is high-spirited (or
irascible, 8u~uK6c;-) ... If the whole [sc. hot and dry] mixture of the body
is even throughout, for these people the whole chest will be very broad,
the veins broad, the arteries large, and with a large and very vigorous
pulse; and there will be much hair over the whole body, and the hair on
the head will be very fast-gtowing and black and curly in the first stage
of life, but with the passage of time baldness will follow. And for these
people the whole body will be tightly strung and well-articulated and
muscular, since they have an even mixture, and their skin will be
relatively hard and dark, and also hairy ... If all parts [of the body] are
relatively moist and cold, for these people the chest will be narrow and
hairless, and likewise the whole body will be bare of hair; and the skin
will be soft and white, and the hair reddish, especially in youth; and
when they gtow old they will not become bald; and they will be
cowardly, and cautious, and hesitant, and they will have small veins that
are difficult to see, and be inclined toward fat, and weak in the nerves
and muscles, and unarticulated in the limbs, and crooked in the legs
(Temp. 2.6, 1.625-26K).
Here the hot, dry temperament is hairy, hard, muscular, lean and bald in
maturity - qualities that distinguish men from women. Irascibility is also
characteristic of this temperament while the cold, wet mixture is cowardly
and cautious. The hot, dry temperament is especially typical of the stage of
'youth' - the prime of life. Although in theory Galen viewed 'youth' as cooler
than childhood and wetter than old age - since one gradually cooled and
dried out as one aged - nevertheless, like the Hippocratics, he tends to
associate 'youth' with the qualities of heat and dryness and their associated
humour, yellow bile. 2 5 Some of Galen's most memorable and fmely drawn
patients are hot, dry youths. As an example I cite passage B, the beginning of
a very dramatic story about a patient Galen revives from a coma. This hot,
dry patient is also lean and muscular- a very masculine patient:
25
Temp. 2.2 (1.583-84K); Hipp. Sal. Viet. 7 (15.186-87K); Hipp. Prog. 3.28 (18B.280K).
•
.~
.,_- '
· • .:.
• : -
,
' ',
I
122
MATTERN
B. The youth who was now seized with fever was twenty-five years old,
slender and muscular in body like a dog, and of a markedly dry and hot
temperament. He enjoyed gymnastic exercises and was otherwise an
anxious and industrious type (<jlpovnaT~S" TE Kal <jJLA.orrovos-). While
out of town, this man received some bad news, and was vexed; exerting
himself, he hurried to the city ... He went to the gymnasium intending
to bathe; when he had been oiled, he had a massage together with one
of the youths there. And when asked by [the other youth] to move a
little, a quarrel arose between them, the kind which gymnastic types
(YV!l.Va<JTLKOL) are often accustomed to fall into, and he exerted himself
more than usual; and he was already unusually dried out. As he was
leaving the gymnasium, he encountered some of his friends fighting; he
separated them, without realizing that he was again undertaking no
small additional exercise as he dragged them apart, and shoved some of
them, and seized others around the waist, and objected to some of
them that they were doing wrong, and became angry (Bull.OV!l.EVOS") on
behalf of the wronged, so that he returned home extremely dry, and
became aware of his own fatigue and that something was abnormal ...
(Meth. Med. 10.3, 10.671-72K).
The youth's character is a big part of the story. Galen describes him as
'anxious and industrious'. Galen tends to associate the verb <jlpovTL(ELv and
related words, which signify intense mental or intellectual activity, with youth
and the hot, dry temperament, and also with an emotion he calls Al!TTTJ, which
is translatable as 'grief' or 'anxiety'. Thus the patient of passage C- another
very dramatic story- is another hot and dry youth who is also <jlpovTWTLKOS:
C. The man himself was around thirty-five years old, dark in colouring
and of a slender and hairy constitution, and to those who touched him,
even when he was well, he clearly possessed a sharp heat; he had a lot
of yellow urine, and if he abstained somewhat from food it was sharp,
and his stomach was continually dry, and what passed through was
sparse, sharp and dry; his character was irascible and anxious (6Eueu116v
TE Kal <jlpovnanK6v), and he complained of little sleep and lying awake
(Meth. Med. 8.2, 10.537K).
The case of the epileptic Diodorus the Grammarian, whose story Galen tells
in three different places, illustrates the connection between 'thinking' words
and the emotion Galen calls Ali1TTJ:
D. A certain youth, a grammarian, was seized by the disorder of
epilepsy whenever he taught very vigorously, or worried (E:<jlp6vnaEv),
'
...
MATIERN
123
or went without food, or became angry (E8VJJ-W8T], Loc. Affect. 5.6,
8.340K).
E. He suffered from the symptom of convulsions when he went for a
long time without food, especially if he happened to be worried
(AvTIT]8ELS') or made angry (8uJJ-w8dS') in the meantime (San. Tuend. 6.14,
449K) .
Comparison of these two passages shows that Galen used words deriving
from AUnT] and those deriving from the verb <j>povTL(ELV interchangeably.
AUTTT] can be irrational anxiety, like fear of ghosts, or the fear that Atlas will
drop the world; it is grief at the death of a friend, or the feeling caused by a
guilty secret; but more significantly for this discussion, it is the emotion one
feels at the loss of property or of honour, or at the destruction of one's own
books by fire. Thus it is a failing typical of the cultural elite.z6 Thus the hot,
dry, masculine type is also an intensely thinking, worrying type; he may also
be an intellectual, like Diodorus or Eudemus, whom Galen twice cites as an
example of the bilious temperament.27 Galen does not perceive the
intellectual as effete; on the contrary, the intellectual is very masculine.
In all four passages B, C, D and E, anxiety is connected with anger, which
is also characteristic of the typical hot, dry temperament in passage A. In
passage B, the hot, dry youth becomes ill partly because he gets angry in a
series of fights at the gymnasium. In passage C, the patient is sharp-tempered
and anxious, o~u8vf!OS and <j>poVTLCJTLKOS. Diodorus the Grammarian
becomes sick when he fasts or becomes anxious or becomes angry, in both
versions of his story. Thus anger and anxiety together are typical of the hot,
dry, masculine temperament. Anger means indignation verging on violence.zs
Fear of ghosts: Hipp. 2 Epid. 207-08, Wenkebach & Pfaff. Atlas: Hipp. 1 Epid. 3.1
(17A.213-14K); Hipp. 6 Epid. 487, Wenkebach & ~faff. Death of a friend: Hipp. 6
Epid. 486-87, Wenkebach & Pfaff. Guilty secret: Praecog. 6 (14.631-32K and 633K);
cp. Praecog. 7 (14.640K). Loss of money or possessions: Anim. Affect. Dign. 8 (5.43451<.:), 10 (5.48-50K). Dishonour: Anim. Affect. Dign. 8 (5.43-44K). Destruction of
works: Hipp. 6 Epid. 486, Wenkebach & Pfaff; and Galen wrote TIEpL aA.vTILUS' about
his own reaction to the destruction of his books in what he thought was their
fireproof storage room near the Temple of Peace, see Boudon-Millot 2007. For
those passages transmitted only in Arabic I have interpreted tl1e word Kummer in
German translation as likely referring back to tl1e Greek AUTIT].
27 Temp. 2.6 (1.631K), Hipp. Viet. Act~t. 2.29 (15.565, 567K) .
28 On anger, honour, and competitive values in other Greek sources see Van Wees
1992: chap. 2 (Homeric anger); Cohen 1995: chap. 4 (litigation in Classical Athens);
26
'·.
·'
.
~
.
.
124
MATTERN
The youth of passage B gets upset when he is asked to move over on the
massage table. Again when he gets involved in a quarrel among his friends,
'he became angry on behalf of those wronged.' In this quarrel he drags,
shoves and seizes people although he does not actually hit anyone.
Like other philosophers of his era, Galen disapproved strongly of
violence. 29 But as a character flaw typical of the hot, dry, masculine temperament, anger that stops short of violence - I should say unorganized, nongymnastic violence, as I shall explain - seems almost ennobling. The picture
of Galen's ideal patient comes into sharper focus.
Finally, this ideal patient lives a 'gymnastic' lifestyle. Galen employs the
adjective yullvaaTLKOS' regularly; one could be a 'gymnastic type', as the
youth in passage B who visits what Galen calls a gymnasium. This is
probably one of the large bathing complexes in Rome like the baths of
Trajan which Galen also calls a gymnasium.30 Galen considers gymnastic
exercise part of a healthy lifestyle; his treatise On matters of health is largely
about gymnastic exercise. I make this point especially because there can be a
misconception that Galen disapproved of gymnastic exercises based on his
merciless criticism of athletes; perhaps Galen only approved of light
exercises and not wrestling or boxing, as one of his treatises (On the exercise
1vith the small bal~ suggests. 31 But this is not the case. On the exercise 1vith the
small ball is a polemical and probably humorous treatise that also describes
running, vocal exercise, jumping, and the discus as too risky compared to the
activity it extolls. It is true that Galen considers the athletic lifestyle a
perverse extreme; athletes are ugly, useless to the city and to their friends,
and lead a life of sexual abstinence, having unusually small or shrivelled
Fisher 1998 (violence and masculinity in Classical Athens); Harden & Purcell 2000:
chap. 11 (anger and 'Mediterranean' values); Konstari 2003 (anger in Aristotle).
29 The folly of violence against unworthy objects, especially slaves, is a common topos
in Greco-Roman philosophy, especially Stoicism. In Anim. Affect. Dign., which
thematically resembles other ethical-philosophical treatises like Seneca's De Ira,
Galen criticizes those who bite, hit, and assault slaves or inanimate objects in
frustration (sections 4, 8). On anger in Greco-Roman thought see recently Harris
2001, and the collection of articles by Braund & Most 2003.
30 Meth. Med. 10.15 (10.909-10K) with Schone 1917. Nero's baths were also called
the 'gymnasium of Nero' in Greek sources; see Richardson 1992, s.v. 'Gymnasium
Neronis.'
31 Pa17J. PiL 5 (5.909K) .
.
.
·.
,·
'
MATIERN
125
genitals. 32 What Galen really criticizes, though, is training in only one athletic
activity or only in athletics - Galen remarks in one treatise that the wellconditioned man competes in all athletic categories and also performs
manual labour.33 As for wrestling, most Greeks considered wrestling the
gymnastic exercise par excellence and Galen is no exception; thus, when he lists
gymnastic exercises, he puts wrestling first along with boxing and the
pancratium.34 Not only did he consider it a normal activity for men of his
class,35 but he also describes how he himself dislocated his collarbone while
wrestling at the age of 34. 36 The gymnastic patient's fight with his friends in
passage B also seems a little like a wrestling match.
Gymnastic exercise is linked to masculinity, where the athlete (as noted
above) represents a paradoxical extreme. Galen never recommends
gymnastic exercise for women; when he does prescribe exercise for pregnant
women, he means household chores.37 Thus 'ungymnastic' men are more
like women:
F. But since the female body is soft-fleshed, [it requires] the most gentle
[medicines] . Thus also those men (avopEs), who are white and softfleshed and bath-loving and ungymnastic, demand gentle medicines;
and no doubt also these are appropriate for children (rrm8(a, Meth. Med.
Gfattc. 2.11, 11.137K).
Gymnastics was a leisure activity. In On matters of health Galen makes it clear
that only the man of leisure can follow his prescription for the ideal lifestyle,
which includes gymnastics. He precribes modified versions of his regimen
32
Athletes ugly: San. Tttend. 5.3 (6.327K = 5.10, 157 Koch); Adh01t. Art. 12 (13132K). Useless: Bon. Hab. (4.753K, commenting on Plato's &public); Thras. Med.
Gymn. 45-46 (5.893-94K). Their unbalanced constitution: Adho11. Arl. 9-10 (1.2039K); Bon. Hab. (4.750-56K); Thras. Med. Gymn. (~.806-98K). Athletes and sex: San.
Tttend. 6.14 (6.446K); Simp. Med. 9.3.23 (12.2321<); Hipp. 3 Epid. 1.4 (17A.520-21K);
Loc. Ajfec. 6.5 (8.451K); Sem. 1.15 (4.571K). Discussion of Galen's views on atllietics:
Scarborough 1985; Konig 2005: chap. 6.
33 Thras. Med. Gymn. 33 (5.870K) and 46 (5.894K).
34 San. Tttend. 2.8 (6.133-34K).
35 Thus Syn. Puis. 9.451K: 'I encourage you to touch often while they are healthy
those close friends whom you think you are going to see as patients some day, at a
time in which their body has no unusual motion arising from walking or running or
bathing or anxiety or eating or drinking or 1vrestling or anger or fear .. .'
36 Hipp. Artie. 1.61 (18A.401-04K).
37 Cf. Flemming 2000:316. Domestic chores: Ustt Pari. 11.10 (3.885K) .
126
MATIERN
-
for those who are too busy, especially slaves. 38 Urban slaves could also do
gymnastic exercise, just not as much; Galen considers the difference in lifestyle between a typical urban gymnastic youth and that of his slave to be a
matter of degree:
F. One [patient] was a free man, a gymnastic type; the other was a slave
who was not ungymnastic himself- not, to be sure, very good in the
palaistra, but skilled in the daily exercises and labours that it is appropriate for slaves to perform (Meth. M ed. 9.4, 10.608K).39
Gymnastics was a leisure activity but one could also exercise by working, as
the urban slave in passage F. Rural labour such as digging, ploughing,
pruning vines, and reaping also counted as Epya, work. 40 Peasants work; they
do not do gymnastic exercise. In several passages Galen contrasts sailors,
hunters, fishermen, and especially peasants, (aypoLKOL) with children, women
and eunuchs as examples of extremes. Peasants are exceptionally hardbodied, as opposed to women and children who are especially soft-bodied.41
Some of Galen's stories about treating peasants remark on their hardbodiedness.42 Like the athlete, the peasant is an extreme; but an extreme of
the laborious lifestyle rather than the gymnastic one. Galen's stories about
peasants mostly illustrate the challenges of practising medicine away from
Rome and its resources; the picture he paints is one of isolation, deprivation,
and self-sufficiency; sickle-wounds, snakebites, indigestible food, and
untreated conditions.43 For Galen the city is the normal environment and the
38
San. Tuend. 5.1 (6.308K) and 6. 7 (6.412K) on Galen's own lifestyle. A modified
regimen (Galen uses the example of a domestic slave): San. Tuend. 6.5 (6.405K) .
39 Another slave is injured wrestling in Anat. Admin. 7.13 (2.632-33K).
40 On exercise and work see Thras. Med. Gymn. 9 (5.820K), 41 (5.885-86K); San.
Tuend. 1.12 (6.61-62K), 2.2 (6.86K), 2.8 (6.133-34K), 2.9 (6.140K), 2.10 (6.145-46K),
2.11 (6.154-55K), 3.2 (6.167-68K), 5.12 (6.376-77K); Sympt. Caus. 3.1 (7.212K); Hipp.
1 Epid. 3.1 (17A.210-11K); Hipp. 3 Epid. 1.4 (17A.520-21K).
41 Meth. Med. Glauc. 2.11 (11.137K); Simp. Med. 10.2.22 (12.298K); Comp. Med. Loc. 6.9
(12.1004K); Comp. Med. Gen. 7.11 (13.1009K).
42
Simp. Med. 10.2.22 (12.298-99K), 11.1.1 (12.323K); Comp. Med. Loc. 1.8 (12.466K);
Comp. Med. Gen. 3.2 (13.592K).
43 Diet: Aliment. Fac. 1. 7 (6.498-991<), 3.14 (6.686K); and see Galen's famous
description of the effects of famine on the peasant population, Bon. MaL Sue. 1
(6.749-52K). Snakebitten peasants: Loc. A.ffoct. 3.7 (8.166K), 3.11 (8.197-98K) . A
siclde-wound: Simp. Med. 6.4 (11.866K) . Other wounds: Comp. Med. Gen. 3.2 (13.58283K) and 3.6 (13.633K). Crushed, ulcerated and stubbed toes: Simp. Med. 10.2.15
MATTERN
127
countryside is a dangerous place that can make you sick. We know today that
the countryside was normal and the city was the hostile environment because
of infectious disease. 44 But Galen does not consider the countryside healthy
and he seems to view peasants almost as an alien species, comparing them in
one passage to donkeys in their constitution.45
Galen's normative or ideal patient is a male in the prime of life, what he
calls a youth, between the ages of about twenty-five and forty. He lives in the
city and is a member of the leisure class that exercises in the gymnasium. He
is hot and dry by nature and tends to be anxious and irascible. He is not a
woman, an athlete, or a peasant and probably not a slave although that
conclusion is more questionable. He is, I suggest, exceptionally Greek in
some of these qualities. He is in many ways like Galen himself.
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128
l'v1ATTERN
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MATIERN
129
Abbreviations
For the sake of simplicity, in my footnotes I cite texts by their volume and page
numbers in Karl Kuhn's 1821 edition of Galen's works; Kuhn is abbreviated as K
Here, I note standard modern critical editions, where these exist. Where the name of
the treatise is unaccompanied by references, the standard edition is still KUhn's.
Adh011. Art. = Adhortatio ad artes addiscendas. Edition, with French translation:
V eronique Boudon, Galien, Tome II: Exhortation d l'et11de de Ia medecim; Att medical.
L'Association Guillaume Bude, Paris 2000.
Aliment. Fac.
De alimentorum fam/tatibus. Edition: Konrad Koch et a/., Corpus
Medicomm Graecomm 5.4.2. Teubner, Leipzig 1923.
Anat. Admin. De anatomicis administrationibus (Greek and Arabic). Edition of books
surviving in Greek: Ivan Garofalo, Galemts: Anatomicamm administratiom1111 /ibri quae
sttpersunt novem, 2 vols . Brill, Naples 1986.
Edition of books surviving in Arabic, with German translation: Max Simon, Sieben
Bucher Anatomie des Galen. ].C. Hinrichs'sche Buchhandlung, Leipzig 1906.
Anim. Affect. Dign. = De animi cuiuslibet ajfectuum dignotione et curatione. Editions: Wilko
de Boer, Corpus Medicot7111J Graecorti1JJ 5.4.1.1. Teubner, Leipzig 1937.
Johann Marquardt, Iwan von Milller & Georg Helmreich (edd.), Claudii Galmi
Pergameni Scripta Minora, 3 vols. Teubner, Leipzig 1884-1893, repr. Amsterdam:
Hakkert 1967, vol. 1.
Ars Medica. Edition, with French translation: V eronique Boudon, Galien, Tome II:
Exhottation d /'etude de Ia medecine; Art medical. L'Association Guillaume Bude, Paris
2000.
Atra Bile = De atra bile. Edition: Wilko de Boer, C01pus Medicorum Graecorum, 5.4.1.1.
Teubner, Leipzig 1937.
Bon. Hab. = De bono habittt.
Bon. Mal. Sue. De bonis malisque sucis. Edition: Konrad Koch eta/., Corpus Medicortllll
Graecomm, 5.4.2. Teubner, Leipzig 1923.
Comp. Med. Gen. = De compositione medicamentonl!ll per genera.
Comp. Med. Loc. = De compositione medicamentorum secundum locos.
Febr. Diff. De febrium differentiis.
Hipp. Aph. = In Hippocratis aphonsmos commentarius.
Hipp. Attic. = In Hippocratis /ibrtiJJJ De mticulis commentmius.
Hipp. 1 Epid.
In Hippocratis Epidemiarum libt1tm ptimum commentmitts. Edition: Ernst
Wenkebach & Franz Pfaff, Cotptts Medicomm Graecortlm, 5.10.1. Teubner, Leipzig
1934.
Hipp. 2 Epid. = In Hippocratis EpidemiaruJJJ librttm semndttm commentmius (Arabic).
Edition, with German translation: Ernst Wenkebach & Franz Pfaff, C01pus
Medicomm Graecomm, 5.1 0.1. Teubner, Leipzig 1934.
Hipp. 3 Epid.
In Hippocratis Epidemiamm librmJJ tettium commentatitls. Edition: Ernst
Wenkebach, Corpus Medicorttm Graecomm, 5.10.2.1. Teubner, Leipzig 1936.
=
=
=
=
=
=
. . ...;,-·
130
MATIERN
Hipp. 6 Epid. = In Hippocratis Epidemiarttm libmm sextttm commentmitts. Edition, with
German translation of parts surviving in Arabic: Ernst Wenkebach & Franz Pfaff,
C01pus Medicorttm Graecomm, 5.10.2.2. 2nd ed. Akademie-Verlag, Berlin 1956.
Hipp. Off. = In Hippocratis librmJJ De officina medici commentmitts (Greek and Arabic).
Edition of Arabic text, with English translation: Malcolm Lyons, Copus Medicort/JJJ
Graecomm, SupplementtmJ 01ientale 1. Akademie-Verlag, Berlin 1963.
Hipp. Prog. = In Hippocratis Prognostica commentarius. Edition: Hermann Diels, Johannes
Mewaldt & Josef Heeg, Copus Medicorttm Graecorttm, 5.9.2. Teubner, Leipzig 1915.
Hipp. SaL Viet. =In Hippocratis vel Po/ybi De sa/ubn victtts ratione commentaritts.
Hipp. Viet. Acut. = In Hippocratis libmm De actttomm victu commmtanus. Edition: Georg
Helmreich, C01pus Medicomm Graecomm, 5.9.1. Teubner, Leipzig 1914.
Loc. A.lfect. = De locis ciffectis.
Meth. Med. = De methodo medendi.
Meth. Med. Glauc. = De methodo medendi ad Glattconem.
Opt. C01p. Cons!. = De optima cop01is nostri constitutione.
Pai7J. Pi/.
De parvae pilae exercitio. Edition: Johann Marquardt, Iwan von Miiller &
Georg Helmreich (edd.), Claudti Galmi Pergameni Scripta Minora, 3 vols. Teubner,
Leipzig 1884-1893, repr. Amsterdam: Hakkert 1967, vol. 1.
Plac. Hipp. Plat. = De placitis Hippocratis et Platonis. Edition, with English translation:
Phillip de Lacy, Copus Medicormr1 Graecomm, 5.4.1.2, 2 vols. 3rd edition. AkademieVerlag, Berlin 1984.
Praecog. = De praecognitione. Edition, with English translation: Vivian Nutton, Copus
Medicort/771 Graecomm, 5.8.1. Akademie-Verlag, Berlin 1979.
San. Tttend. = De sanitate tuenda. Edition: Konrad Koch et aL, Copus lvledicorum
G1·aecorttm, 5.4.2. Teubner, Leipzig 1923.
Sem. =De Semine. Edition, with English translation: Phillip de Lacy, Copus MedicomJJJ
Graecorttm, 5.3.1. Akademie-Verlag, Berlin 1992.
Simp. Med. = De simplicitllJJ medicamentormll temperamentis etfacu/tatibtts .
Sympt. Catts. = De !JmptomattJJJJ cattsis.
Syn. Puis. = Synopsis librorum de pulsibtts.
Temp. De temperamentis. Edition: Georg Helmreich, Ga/eni De temperamentis libri III.
Teubner, Leipzig 1904.
The1: Pis. De theriaca ad Pisonem.
Thras. Med. Gymn. = Ad Thra.[)'btiltm utrum medicinae sit an gymnasticae hygenie. Edition:
Johann Marquardt, Iwan von Miiller & Georg Helmreich (edd.), Claudii Galeni
Pergameni SCiipta Minora, 3 vols. Teubner, Leipzig 1884-1893, repr. Amsterdam:
Hakkert 1967, vol. 3.
Usu Pmt. = De usu pmtium. Edition: Georg Helmreich, Galeni De ttsu partium lib1i
XVII, 2 vols. Teubner, Leipzig 1907-1909, repr. Amsterdam: Hakkert 1968.
Vm. Sect. Eras. Rom. = De venae sectiom adversus Erasistrateos Romae degentes.
.,·. .. .
=
=
=
.
.·:·:_... .
MARCUS AURELIUS: WAS HE AN OPIUM ADDICT?*
Fran<;ois P. Retief
University of the Free State
Marcus Aurelius ruled the Roman Empire when it was at its peak (161-80).
He was the last of the 'Five Good Emperors', succeeding Nerva, Trajan,
Hadrian and Antoninus Pius. He was certainly the closest any Roman
emperor came to Plato's ideal that a good ruler should also be a philosopher
(Rep. 473d), and Dio Cassius (72.36.3) said that at his death the Roman
Empire deteriorated from an empire of gold to one of iron and rust. He was
a dedicated soldier and an able ruler, reasonable and considerate towards his
subjects. He tolerated his wayward wife, Faustina, and was merciful towards
enemies (Retief & Cilliers 2007:58). But Africa (1961:97-102) flrst suggested
that Marcus Aurelius' mellow and humane personality was not natural but
due to chronic opium addiction - the opium being ingested with his daily
dose of theriac. In this study the evidence for and against this allegation is
analysed.
Personal history
Marcus Aurelius was well educated in Latin, Greek, rhetoric, the arts and
science of the day, and he became and ardent supporter of the Stoic
philosophers. He was an enthusiastic and moderately able athlete, although
he disliked blood sports. Emperor Hadrian noticed the young man and
furthered his education. His successor, Antoninus Pius, took Marcus
Aurelius under his protection and at age 24 he married the emperor's
daughter, Faustina. At least 11 pregnancies resulted from his wedlock with
Faustina, although it was rumoured that she had numerous love affairs. Few
children survived childhood and the surviving eldest son, Commodus, was
possibly the son of a gladiator lover (Retie£ & Cilliers 2007:57-58). When
Antoninus Pius died in 161, Marcus Aurelius succeeded him at the age of 39
years.
* This article is a reworked version of an article which appeared in Tydskrif vir Geestes1Vetenskappe 47.1 (2007) 56-65.
132
RETIEF
He was a seri~us-minded person who lived according to the dictates of
Stoic philosophy. His Meditations, written at the war front, conveys his Stoic
convictions about life: his popularity with his subjects, his very human
handling of enemies, tolerance towards Faustina and persistent support of
his clearly incompetent son (and successor), Commodus, raised the question
of whether he was a good judge of mankind (Grant 1994:58). Except for a
brief triumphant return to Rome in 176, he spent the last 12 years of his life
on the Empire's north-eastern frontiers, successfully fighting the barbarian
invaders (the Quadi, Marcomanni and Jazuges nations). A brief rebellion in
the Eastern Empire under Avidius Cassius (175) was quickly suppressed, and
the emperor treated the culprits (who possibly included Faustina) with
leniency. She died shortly afterwards. Marcus died after a brief illness in 180,
almost certainly at Vindobona (present-day Vienna) (Retief & Cilliers
2007:58-59).
Medical history
Dio Cassius (72.29.3-4; 72.36.2) mentions that because of intense dedication
to his studies, young Marcus Aurelius was never physically strong. However,
he was quite adept at ball sports, took part in military exercises in full
armour, and on hunts could spear a boar from horseback. But we do know
that he suffered from ill-defined chest and abdominal problems from childhood; pain was often experienced. In letters to his tutor and life-long friend,
Cornelius Pronto, he mentions chest pain, respiratory infections and vague
asthenia. In his Meditations he refers to two episodes when he coughed up
blood (haemoptysis) and felt very dizzy. At the age of 22 he was ill with pain
in the chest and abdomen (Retief & Cilliers 2007:58-59).
By 172 the emperor's physical condition was clearly deteriorating with
progressive weakness and insomnia. He nevertheless continued his successful military career and was revered by his soldi.ers (Birley 1996:295). Life at
the frontier was hard, and Dio Cassius (72.6'.3-4) mentions that Marcus
Aurelius felt the cold intensely. He ate little (mainly at night) and at times he
was so tired at the end of the day that he went to bed without first
addressing the troops. But towards the late seventies, after a serious illness in
175 when he was generally expected to die, his condition improved (Birley
1996: 182). Thereafter he no longer donned his traditional armour and did
not partake in fighting. A later emperor, Julian, left a description of him at
this time: 'His appearance was untidy ... a long beard, with sober and simple
attire. Due to deficient nutrition his body had a shiny, almost translucent
RETIEF
133
appearance, like clear light. His appearance was very dignified, and the
impact of his learning was evident in the shiny eyes and lines on his
forehead. He rarely changed his facial expression - neither in happiness, nor
in sorrow' Oulian, Caesars 317c).
In March 180, when the Antonine epidemic (almost certainly smallpox)
which first appeared in the Roman Empire in 165/166, had not yet
expended itself after 15 years (Retief & Cilliers 2000:267-72), Marcus
Aurelius' flnal illness set in. Already exhausted, his condition deteriorated
progressively and on the 7th day he died in his sleep (Birley 1996:286-87) probably from smallpox, and not his previous life-long illness, which could
well have been chronic thoraco-abdominal tuberculosis (Retief & Cilliers
2007:62-64).
Doctors and theriac
Galen of Pergamon, prominent physician of the 2nd century, was Marcus
Aurelius' best known court physician. He came to Rome in 162, and
probably first attended to the imperial household in 166, when requested to
treat the sicldy Commodus. In 168 he briefly accompanied the emperor to
the war front at Aquileia, but then returned to Rome when he succeeded in
convincing Marcus Aurelius that the god Asclepius had ordered him in a
dream to combat the Antonine epidemic in the capital. The emperor
requested him to look after Commodus and proceeded to the north-eastern
frontier (Verdonk, Van Els & Van Dougen 1995:37-46). It is indeed
uncertain what his further contact with the emperor was. In his own writings
Galen gives the impression that he remained the prime imperial physician,
but there is no evidence that he ever visited the frontier, 1 000 km away from
Rome. During Marcus Aurelius' flnal illness Galen was in Sicily. The
emperor does not refer to him in his letters, his diary or in the Meditations
(Verdonk eta/. 1995: 42-43; Grant 1994:105). '
It is, however, a fact that Marcus Aurelius regularly took a daily dose of
the so-called universal antidote, theriac (Galen, On Antidotes 14.3-5K).
Originally prescribed by one Demetrius, Galen later took responsibility for it
(Watson 1966:87-88). The emperor took theriac in a dose equivalent in size
to one Egyptian bean (kuamos) with or without water or wine. An Egyptian
bean was almost certainly the fruit of the lotus plant (Nelumbrium speciosum),
not a true bean, but in size comparable to a broad bean. Evidence is that the
broad beans of antiquity were approximately the size of modern broad beans
(Dioscorides 2.128; Retief & Cilliers 2007:62-63).
_.:,,;' ·r'
134
RETIEF
Universal antidote was first prepared in Alexandrian times (3rd century
BC), and the name theriac (which caused much confusion) appeared later,
derived from a poem (Theriaca) by Nicander of Colophon (2nd century BC),
written for the king of Pergamon who was keenly interested in poisons. The
name derives from the Greek word tberion, a wild animal. Soon afterwards
Mithridates Eupator, lcing of Pontus, improved the compound drug - his
famous mithridatittm consisted of 41 ingredients, including viper flesh and the
juice of Papavemm somniferum, the opium poppy. A century later Nero's
physician, Andromachus, increased the ingredients to 55 items. Galen,
Marcus Aurelius' physician, had various recipes of theriac which now
contained more than 70 items. In his On Antidotes Galen gives a detailed list
of the ingredients and explains how the mixture was boiled in wine, the
residue separated and allowed to mature for at least 40 days - preferably for
12 years, for best results. There is no doubt that Marcus Aurelius ingested a
daily dose of opium with his theriac. The question is whether we have
evidence that the opium affected him significantly (Watson 1966:1-90;
Griffin 2004:317-25).
Discussion
Africa (1961:97-102) and others (Verdonk et al. 1995:37-46) make out a case
for opium addiction on the basis of Marcus Aurelius' strangely lenient treatment (for his time) of his fellow men, enemies, even his probably unfaithful
wife. The psychotropic effect of opium was first discovered by the Sumerians (Goodman & Gilman 1965:247), had been well documented by
Dioscorides in the 1st century (Scarborough 1995:4-23) and was probably
well known to physicians and educated persons of the 2nd century. Dio
Cassius (72.6.3-4) confirmed that the emperor seemed dependent ort his
theriac which he took like food, every day, and which allowed him to tolerate
the increasing chronic pain and exhaustion caused by his life-long mystery
illness. Galen stated specifically that taking theriac had become habitual with
Marcus Aurelius and that because of resultant drowsiness he was occasionally obliged to remove the poppy juice from the emperor's theriac. But
resultant sleeplessness usually forced him to replace it soon (On Antidotes
14.3-5K). Galen indeed created the impression that he was in constant
contact with Marcus Aurelius and regularly adapted the poppy juice to
accommodate the emperor's needs. However, for reasons mentioned above,
this was almost certainly untrue - Marcus Aurelius does not mention him in
his correspondence, diary or Meditations, and Galen did not visit the war front
RETIEF
135
where the emperor spent the final 12 years of his life. Dio Cassius and Galen
thus wrote that the emperor was dependent on theriac - presumably the
opium in the drug. But Scarborough (1995:18) and others have pointed out
that in a chronically ill person like Marcus Aurelius, drug dependence may be
largely psychological and not true drug dependence as happens in real
addiction.
Knowing the precise amount of opium in the emperor's daily dose of
theriac will obviously be of value in determining the likelihood of true drug
addiction. Galen's On Antidotes is very specific on the composition of theriac,
giving precise quantities of its more than 70 ingredients. From this it can be
calculated that 3,7% of the total weight consisted of poppy juice (Griffin
2004:318), and we know that approximately 25% of poppy juice represents
opium. The average adult needs 50-100 mg opium to elicit a psychotropic
effect (Goodman & Gilman 1965:250; Scarborough 1995:12-13). If one
accepts that an Egyptian 'bean' approximates the size of a modern broad
bean (Grmek 1991:212)- approximately 165 mg, as measured by the authors
(Retief & Cilliers 2007:63) -, the percentage opium present may be
converted into weight. Our determinators show that Marcus Aurelius
imbibed in the vicinity of 1,52 mg opium in his daily dose of theriac. Africa
(1961: 102 n. 102), who originally suggested that Marcus Aurelius might have
been an opium addict, also made calculations of theriac content and found a
comparable opium dose of 3,3 mg. However, he apparently did not find this
compromising his addiction thesis. One accepts that Galen had more than
one theriac recipe, and that calculations mentioned above could contain
significant errors, but it would indeed have required a prolonged daily
fiftyfold increase in opium dosage to convert the emperor into an addict.
Galen also prescribed another theriac preparation which was devoid of
poppy juice (On Antidotes 14.201K). A remark by Lucian (Adversus Indoctum
165) that Marcus Aurelius was occasionally under the influence of another
narcotic, mandragora, is almost certainly not to be taken seriously. Lucian
regularly referred to mandragora in his writings (Witke 1965:23-24).
I would thus conclude that Marcus Aurelius was not an opium addict. His
daily opium ingestion by way of theriac was only a fraction of that necessary
to cause addiction. True opium addiction would also have led to insistence
on a progressively larger dose of theriac, and all evidence shows that his dose
remained absolutely constant (Galen, On Antidotes 14.216K; Scarborough
199 5: 18) - the daily equivalent of one Egyptian bean, right through his life.
Chronic opium addiction, furtl1ermore, leads to progressive moral deterio-
136
RETIEF
ration (Eisendrath & Lichtmacher 1999:1033) of which Marcus Aurelius
showed no evidence.
Bibliography
Africa, T.W. 1961. 'The opium addiction of Marcus Aurelius.' Journal of the
History ofldeas, 97-102.
Birley, A. 1996. Marcus Aurelius. London: Eyre & Spottiswood.
Cary, E. 1927. Dio Cassius. Roman History. Loeb Classical Library Vol. 9.
Cambridge, Mass.: Harvard University Press.
Eisendrath, S.J. & Lichtmacher, J.E. 1999. 'Psychiatric disorders.' In L.M.
Tierney, S. McHee & M.S. Papadakis (edd.), Current Medical Diagnosis and
Treatment. Stamford, Conn.: Appleton & Lange.
Goodman, L.S. & Gilman, A. 1965. Pharmacological Basis of Therapeutics. 3rd
Edition. New York: McMillan.
Grant, M. 1994. The Antonines. London: Routledge.
Griffin, J.P. 2004. 'Venetian treacle and the foundation of medicine regulation.' British Journal of Clinical Pharmacology 48.3:317-325.
Grmek, M.D. 1991. Diseases in the Ancient World. Transl. M. & L. Muiller.
Baltimore & London: Harvard University Press.
Haines, C.R. (transl.) 1916. Marcus Aurelius. Meditations. Loeb Classical Library
Vols. 1 & 2. Cambridge, Mass.: Harvard University Press.
Harmon, A.M. (transl.) 1905. Lucian. Loeb Classical Library Vol. 3.
Cambridge, Mass.: Harvard University Press.
Kuhn, C.G. (ed.) 1965. Galeni Opera Omnia. Vol. 14. 'On antidotes' eta/.
Hildesheim: Georg Ohns Verlagsbuchhandlung.
Osbaldeston, T.A. (transl.) 2000. Dioscmides. De Mate1ia Medica. A NeJV English
Translation. Johannesburg: Ibidis Press.
Retief, F.P. & Cilliers, L. 2000. 'Epidemics of the Roman Empire, 27 BC-476
AD.' South African Medical Journal90.3:267-272,
Retief, F.P. & Cilliers, L. 2007. 'Marcus Ailrelius se siektegeskiedenis en
dood: was hy 'n opium-verslaafde?' Tjdskrif vir GeestesJVetenskappe 47.1:56-65.
Scarborough, J. 1995. 'The opium poppy in Hellenistic & Roman medicine.'
In R. Porter & M. Teich (edd.), Drugs and Narcotics in History. Cambridge:
University Press.
Shorey, P. 1937. Plato. The Republic. Loeb Classical Library Vol. 1. Cambridge,
Mass.: Harvard University Press.
·~
.
...
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137
Verdonk, C.P. & Van Vels-van Dongen,J.A. 1995. 'Filosoofarts en filosoofkeizer.' InJ.J.E. Van Everdingen, F. Meulenberg, H.E. Fokke & A.]. Six
(edd.), Op bet l!Jjgeschreven. Amsterdam: Boom/Belvedere.
Watson, G. 1966. Tberiac and Mitbridatium. A Stur!J in Tberapeutics. London:
W ellcome Historical Medical Library Press.
Witke, E.C. 1965. 'Marcus Aurelius and mandragora.' CPb 60:23-24.
Wright, W.C. (transl.) 1913. Julian. Tbe Caesars et a/. Loeb Classical Library
Vol. 2. Cambridge, Mass.: Harvard University Press.
.
','
:
ATIALUS III OF PERGAMON: RESEARCH
TOXICOLOGIST
John Scarborough
University of Wisconsin
Honorary research Fellow, University of the Free State
Of snakes- and bugs- and sea hare's ink
Ofprisoners- and kings
And n;f?y the seasyield poets' songs
And JJJhether plants have stings*
..
. '
.
··.
Sea-hares and 19th century zoology: Darwin at St Jago
Aboard the Beagle on its voyage into the South Atlantic in 1832, en route to
tropical latitudes, the ever-observant Charles Darwin took advantage of an
extended shore leave at Porto Praya on St Jago in the Cape Verde Islands, to
make some of the earliest notes on this most famous of British scientific
ventures. Among the common animals he found in the shallows close to the
shore was a large 'slug' in great numbers, slowly flapping along the sea
bottom. 1 He writes that 'This slug, when disturbed, emits a very fine
purplish-red fluid, which stains the water for the space of a foot around.
Besides this means of defence, an acrid solution, which is spread over its
body, causes a sharp stinging sensation, similar to that produced by the
PI?Jsalia, or Portuguese man-of-war.'2
The former coleopterist does not acknowledge any particular debt to
contemporary authorities on marine life, but such 'sea-slugs' or 'sea-hares'
(opistl1obranch molluscs) had received careful description in 1761 by the
Dresden naturalist, J.B. Bohadsch, expanding on the brief account of
Grevinus in his 1571 Liber de Venenis. 3 Our own classification and description
of Opisthobranchiata, suborder Nudibranchiata (Mollusca: Gastropoda), owes much
* With apologies to Tweedledum and Tweedledee (and Lewis Carroll).
Keynes 1988:21-27, 34; Stanbury 1977:44-46; Burkhardt and Smith 1985:1,202.
Darwin 1839; rev. edd. 1860, 1894:ch. 1.
3 Thompson 1947:142-43.
1
2
:
~
.
':
SCARBOROUGH
139
to these earlier scholars, 4 and classically-trained naturalists of the 16th
through the 19th centuries were very familiar with Pliny the Elder's graphic
accounts of the Indian lepus marintts, a larger variety similar to the
Mediterranean kind, as well as his fearsome lines about the poisonous effects
of the Italian species, a description Pliny says he has borrowed from
'Licinius' Macer. 5 Likely, Darwin and his predecessors also knew other texts
in their wide reading among Greek and Latin authors who took up subjects
we might term 'natural history', but which often were simply topics of
specialized expertise and conversation. The sea-hare's toxic nature is
assumed by Plutarch's learned friends who mention, in their discussions
about fish associated with various cult-centres, that Artemis or Apollo are
sometimes named 'mullet-killers'. 6 This is a bit of misinformation, since not
only is the red mullet (trig/e) venerated by initiates into the Mysteries at
Eleusis, and honoured by Hera's priestess at Argos by excluding it from the
diet, but the mullet is also immune to the poisonous sea-hare, and therefore
a beneficial creature since ' ... it is particularly efficient in killing and eating
the sea-hare.'7 Apuleius of Madaura is intrigued by the sea-hare: not only
does he use the animal to describe his zoological researches, 8 he has certainly
dissected at least one specimen. 9 Athenaeus' dinner-talk, predictably, includes
the tradition of the mullet's hostility to the sea-hare, quoting from
Hegesander of Delphi that the trig/e is carried in the procession at the festival
of Artemis, since '... it is said that it relentlessly hunts sea-hares and
consumes them completely ([those creatures] are very poisonous), and
therefore since the trig/e acts for the benefit of mankind, this huntress-fish is
dedicated to the huntress-goddess.' 10 In the same decades of the early 3rd
4 Borradaile, Potts & Kerkut 1961:615-16 (ApbJSia).
s Pliny, NH 9.155 with 32.9.
6 Plut. Mor. Whether Land or Sea Animals are Cleverer [10]966a and [35]983e:
TpLyA.o~6A.os-. Thompson 1947:264-68: TPLYATJ = the red mullet, Mullus spp., likely
M. barbatus L.
·
7 Plut. Mor. [35]983f: TOll yap eaA.chnov A.ayw6v, OS' EGTLll civepwmp eavaaqws-,
KTELvouaLv al Tp(yA.m l!ciALUTa Kal KaTavaA.taKouaL 8La TaVTTJV ws- <jlLAciv9pwTia
Kal GWTJlPLa (<Jla TTJV a8ELQV EXOUGL.
8 Apul. De Mag. 33 = Helm 39 = trans. Hunink in Harrison, Hilton & Hunink
2001:58-59.
9 Ibid. 40 =Helm 47 = Hunink in Harrison, Hilton & Hunink 2001:64-65. Apuleius
is claiming 'medical expertise' at Apologia 40: quid enim tandem, si medicinae neque
instudiosus neque imperitus quaepiam remedia ex piscibus qttaero?
10 Athen. 7.325c; trans. somewhat altered from that of Gulick 1929:463. Hegesander
of Delphi (fl c. [?] 150 BC) wrote several anecdotal books about famous deeds,
140
SCARBOROUGH
century, 11 Aelian notes that the sea-hare is poisonous to those who eat it, and
has the look of a snail without a shell. 12 Pliny the Elder and his authority,
'Licinius' Macer, thus represent only a limited selection of sources that
focused on the sea-hare, an animal thought dangerous yet intriguing.
Pliny the Elder on sea-hares
At Natural History 9.155, Pliny writes:
Nor yet is there a lack of baleful poisons, as in the instance of the sea-hare
of the Indian Seas, poisonous simply through its touch, which instantly
causes vomiting and destruction of the stomach. In our own home waters,
it has the appearance of an amorphous lump, resembling a hare only in its
colour, but in India it has the size and the hairs like [the land-living hare],
but its hair is somewhat coarser; in that country, it is never taken alive. 13
And later:
No less marvelous also are the items that are given regarding the sea-hare.
It is poi~onous to some persons if it is given either in a drink or in [solid]
food; for others, the sea-hare is poisonous merely if they look upon it.
Indeed, if a pregnant woman simply looks at one of these (the female of
its kind), the woman is instantly nauseated and vomiting, indications that
the harmful effects have reached the stomach; and abortion of the foetus
results. A cure [or prevention] is a male [sea-hare], dried and salted for this
purpose, and [then] worn as a bracelet on an arm. In the ocean, however,
the sea-hare is not harmful, even if one touches it. The only other fish
that eats [the sea-hare] and does not die is the mullet, which becomes
more tender [from eating a sea-hare], but [the mullet] loses some of its
philosophers, statesmen, artists, writers, high-class call-girls, curious animals, and
remarkable events, typical of Hellenistic redactors ofmyths and tales connected with
particular locales; see Jacoby 1912. 46 fragments are extant: see Muller 1975:412-22.
11 Trapp 1996.
12 Aelian, NA 2.45.
13 Trans. J.S. Cf. De Saint-Denis 1955:87: Nee venena cessant dira, ut in Iepore, qut tn
Indico mmi etiam tactu pestilans vomitum dissolutionemque stomachi protinus creal, in nostro rjfa
infornis, colore tantum lepori similes, in Indis et magnitudine et pzlo, duriore tantum. Nee vivus ibi
capitur (Commentary, 142). Aelian (NA 16.19) seems to have taken Pliny (and his
source) and misunderstood the aspect of the sea-hare's 'fur' or 'hair,' since the sea
creature is like that which lives on dry land ' ... except for its hairs' ('rrA.~v TWV
TPLXWV).
.
·:·-
.... ,;.-· ·r'
SCARBOROUGH
141
flavour, and is therefore less highly desired [for consumption by humans].
People struck [or hit] by the sea-hare have the odour of the fish, [and] this
is the first evidence [or sign] that the poisoning is ascertained. Moreover,
death occurs in the same number of days that the sea-hare has been alive,
and thereby our aud1ority on the topic, Licinius Macer, says that this
poison has variable times for its action [or no definite predictable periods
when the poison will take effect]. Some say that in India the sea-hare is
never taken alive, and that [in India] a man is poisonous to a sea-hare, and
it perishes in the sea, merely touched by a human finger; and sinlllarly to
many anin1als [in India], the sea-hare is much larger than [our own kind]. 14
.
·· \.
.. ,
.
At first glance, one assumes that this diffuse account in Pliny the Elder's
Natural History is typical of his sandwiching one source on top of another,
especially true of his quotations, semi-quotations, synopses, abridgements,
summaries, and extracts culled from circulating Greek works on drugs and
folk-remedies, 15 perhaps melded with local Italian traditions of farm lore and
agricultural technologies. The citation, however, of 'Licinius' Macer, as an
authority on the poisonous sea-haret6 signals an important source of fairly
recent times - and a text that likely was in Latin - but 'Licinius' Macer is '.:.
a slip of memory, not a textual corruption.' 17
As is frequently the case in hurried scribbling, or dictating from his latest
find among books retailing arcana about strange animals and plants, tBPliny
has substituted one name for another, in. this instance 'Licinius' for
'Aemilius',t 9 and thereby a major source for some of the nasty characteristics
14 Pliny, NH 32.8-9 = De Saint-Derris 1966:25. The text bristles with difficulties as
indicated in the apparatus c1itims, so that my translation often approximates what the
Latin seems to say. Note the important variations in both text (generally replicated
from the earlier Teubner edition by Ian & Mayhoff) and translation in Jones
1963:468-71.
15 Scarborough 1986:60-63; Beagon 1992:233-37. ,
16 NH 32.9: cetero m01iuntur totidiem in diebus, quot vixerit lepus, incettique temp01is veneficittJJJ
id esse auctor est I.icinius Macer= De Saint-Derris 1966:25. The major textual difficulty
in these lines is the MSS variations, veneficium R, bem!ftcimll VE, and beficit/111 B (app. CJit.
9).
17 Courtney 1993:298 (fr. 15 [novum]); Pliny, NH 32.9; cf. Isidore 12.6.25: quibus saepe
pastus.
18 Stannard 1965; Beagon 1992:227-33.
19 Medieval scribes faithfully replicated both 'sources' as given by Pliny: 'Licinius'
Macer (NH 19, 21, 22, 28, 29, 30, 32); 'Aemilius' Macer (NH 9, 10, 11, 17). Latin
translations of Greek texts were sometimes available by the late 1st century BC, e.g.
the rendition of Mithridates VI's 'drug books' (likely set down by Crateuas) by
. , · _·
:~o ..F
142
·f'
SCARBOROUGH
of the sea-hare, is a Latin version of Nicander's Greek hexameter poems on
poisonous creatures and substances, the Theriaca and A/exipharmaca. Unlike
Nicander, with his patently didactic organizational mechanics, 20 Pliny sought
to record as much data as he could on a given topic, and frequently repeated
details previously culled from a separate source, 21 or from a circulating
synopsis of authorities who had extracted drug lore, or zoology, or medicine
into easily digested snippets.22 Such extracts, and the manner in which Pliny
uses them, are indicated by the 'table of contents' for Book 32 (Medicinae ex
Aqttati/ibtts, 'Drugs from aquatic animals'), with 32.8 (ed. 32.3) 23 listing simply
De Lepore lvlarino V, 'The sea-hare: five examples'. The two sets of names
listed at the end of the 'table of contents' for Book 32 (ex attctoribtts and
ex ternis ['Roman authorities' and 'Foreign sources1) also suggest how Pliny
sandwiched them all as he composed his account of the sea-hare: 24 Licinius
Macer, Trebius Niger, the Greek writings of Sextius Niger, the poet Ovid,
Cassius Hernina, Maecenas, Iacchus, and Sornatius are the Roman works; the
foreigners are King Juba, Andreas, Salpes, Apion, Pelops, Apelles,
Thrasyllus, and Nicander, all of whom wrote in Greek. Only Licinius (viz.
Aemilius) Macer is cited as a specific reference for a specific passage,
although he may well be underneath much more tl1an a sentence or two, but
the listing of Sextius Niger as a 'Roman' may suggest a period of residency in
Italy,zs a reasonable assumption given Sextius Niger's date (fl. c. 40 AD) and
his known expertise in slowly acting poisons, aphrodisiacs, and depilatories. 26
Significant on the list of names are Ovid and Nicander of Colophon, both
linked firmly to Aemilius Macer and the questions one has about how and
why the sea-hare should appear prominently in the pages of Pliny the Elder's
Natural H istory.
Lenaeus, a freedman of Pompeius Magnus, after 63 BC (NH 23; 24; 25). Scarborough 1996a; Nutton 2004:142; Cf. Max Wellmann 1893; Courtney 1993:292.
ZOBodson 1987:116.
21 Stannard 1987:99-102 ('collection rituals').
22 Bodson 1986:100-05.
23 Pliny, NH 1.50 XXXII continentur. Medicinae ex aquatilibtts. III. De Iepore mmino V =
ed. Jean Beaujeu 1950:144.
2 4 Ibid. 146.
25 Scarborough 2008 (forthcoming).
26 Wellmann 1889; Scarborough 1977a; Scarborough & Nutton 1982:206.
'....
··,
~.
SCARBOROUGH
143
Aemilius Macer and Nicander's Theriaca and Alexipharmaca
Sometime in the 20s BC, the young Ovid listened with apparent enchantment
to recitations by an elderly Aemilius Macer of adaptations of Nicander's
Alexipharmaca,27 and in company with the widely-known poetry of
Theocritus, and a number of other 'Alexandrian' poets and writers, 2B Macer's
Latinized Nicander became one of the portals through which Roman
scholars and physicians peered at Greek natural history, 29 especially
toxicology. 30 The less-than-skimpy fragment of Macer's Latin Alexipharmaca
shows that the poem was known to Ovid, Macer and Vergil,31 and Pliny does
get right that Macer had, indeed, written about the sea-hare, since Nicander's
Alexipharmaca (465-82), provides the even more detailed symptoms of the' ...
dire and fateful drink of the deadly sea-hare ... which stains the sea black
with its gall ... over the limbs of the poisoned spreads the dusky pallor of
jaundice, and piecemeal the flesh melts away and dwindles ... the surface of
the flesh swells and grows puffy about the ankles . .. the eyes are swollen ...
there follows a scantier flow of urine . . . sometimes red, at others more
bloody in colour. Then the sight of every fish is hateful to [the victim's] eyes
and in his disgust he loathes food from the sea.'3 2 Antidotes include - and
one presumes from the Greek text that the victim has quciffed the 'gall' of the
sea-hare - 'Phocian' hellebore, scammony, mallow, the resin of a cedar,
either Cretan or Aeginetan pomegranates, and strained grape-juice.33
Nicander's inclusion of the hellebore (the Greek does not specify either
'white' or 'black') will prove consequential in linking the Alexipharmaca with
Attalus III of Pergamon in his wide-ranging research on poisonous animals
and plants.
'· •·
; ' .. ~>-;:_, ..
.
27
Courtney 1993:292-93; Ovid and Macer: Ovid, T1istia 4.1 0.43; Quintilian 10.1.56.
Hollis 1973.
29 Hollis 1998.
30 Hollis 1992:283-85 (Vergil).
31 Courtney 1993:298-99; cf. Frr. 16 and 17 (remedies for snake bites, likely derived
from Nicander's Thniaca). Ocimt/111 ('basil' [Fr. 16]) appears in Dioscorides 2.141
(Wellmann 1.210-11) as a treatment for snake bite, but Nicander mentions WKLflOV
(basil [Ocimti!JJ basilic11m L.]) only as it resembles chameleon-thistle in its odour
(Aiexipharmaca 280). Cf. Scarborough 1977b:13 on possible 'field basil' used as an
antidote for snake bite at Thniaca 559 and 648, andA/exipharmaca 372.
32 Nicander, Alexipharmaca 465-82; the translation is by Gow & Scholfield 19 53:125,
127.
33 Ibid., 483-94.
28
..,
..
... ···.
144
SCARBOROUGH
Attalus III Philometor of Pergamon
In almost every account about the last years of the independent Hellenistic
kingdoms, one inevitably meets Attalus III of Pergamon, whose will
bequeathed his kingdom to the Senate and People of Rome at the time of his
death in 133 BC.34 Judgments of his character vary in our sources,3s from the
overtly adulatory to the totally negative, and many of the antipathetic and
averse opinions reflect his unusually open pursuit of knowledge about
pharmacology, especially the toxicology of certain plants, animals, and
mineral substances. Even general textbooks on Rome's expansion into the
Hellenistic eastern Mediterranean will mention Attalus' 'weird hobbies',
mentioning how the king raised poisonous plants for amusement, sometimes
sending them as presents to his friends. Such statements rest ultimately on a
famous few lines in the Epitome of tbe Philippic H istory of Pompeius Tragus by
Justin:
Then, with no regard for the administration of his kingdom, he began to
cultivate gardens, planting various herbs and mixing them together, the
poisonous with the harmless. He would then send assortments of these,
shot through with the sap of the poisonous ones, as special presents for
his friends. 36
The 'herbs' (poisonous) enumerated in Plutarch's nuanced narrative in the
Life of Demetrius, detail how Attalus III Philometor notoriously and efficiently
investigated aspects of medical botany, including the cultivation of carefully
chosen poisonous plants. The passage occurs in Demetrius where Plutarch
gives examples of royal hobbies, pastimes presumably illustrating the moral
characters of various Hellenistic rulers. 37 In contrast to other royals,
Demetrius Poliorcetes did not '. . . devote his cleverness to activities that
gave vain and idle pleasure or amusement, as did other monarchs who played
the aulas, or painted pictures, or did engravings in metalwork.'38 Aeropus of
34
35
36
Strabo 13.4.2
Hansen 1971:142-44; Virgilio 1993:19-23.
M. Iuniani Iustini Epitoma H iston"artmJ Pbilippicamm Pompei Trogi 36.4.3 (ed. Seel
1972:251). The translation is by Yardley 1994:231-32.
37 Duff 2004.
38 Plut. D em. 20.3 = Flaceliere & Chambry 1977:40; trans. by J.S.
.· . ·: ..
~-
. ··_.. ·.:·
-··. .
~
:
145
SCARBOROUGH
Macedonia enjoyed making small tables or arty versions of the stands for oillamps, and Attalus Philometor
. .. was in the habit of growing medicinal plants not only byosryam11s and
hellebore, but also hemlock, aconite, and thornapple, placing the seeds
himself and planting them in the royal gardens, becoming an expert in
their juices and fruits as well as the proper season for their harvesting. 39
Plutarch's five kinds are well-known narcotics and poisons, filling out the
abridgement of the same story in Justin-Trogus, who probably used a
common source, but omitted the specific names of the plants.40
Galen's testimony to 'one of his own' from Pergamon delineates Attalus'
reputation among kings who were astute pharmacologists among the
Hellenistic monarchs,41 and even allowing for a kind of 'patriotic
Ibid. trans. by J.S.
That is, four of the five are 'well-known', and receive identification in the standard
dictionaries, as well as in the numerous translations of Plutarch's Demetrius. The fifth
on the list, 8opuKvLov, here translated as 'thornapple', (not identified in the most
inclusive of Greek dictionaries), almost always is simply transliterated as doryknion in
current translations into English, German, and French. See Scarborough 2010
(forthcoming) . Andre 1985:90 offers three identifications, the second of which is
likely, Datura stramonium L., the thornapple. Thornapple is a major poison in
Nicander, Alexipbarmaca 376, and Dioscorides, 4.74 (Wellmann 2.233) groups it
among the narcotics, along with the opium poppy, mandrake, and 17 others of
similar pharmaceutical actions; cf. Scarborough 199 5.
4l Even when Galen couples Attalus III with Mithridates VI of Pontus (e.g. in
Antidotes 1.1 [Kiihn 14.2]), there is a clear separation of the 'research activities' of
Mithridates from the more precise inquiries by Attalus, and frequently Galen will
speak of Attalus as 'our own' as he does in Antidotes 1.1: 6 yap TOL ML9pLBUTTJS
OVTOS, waTTEp Kal 6 Ka9' ~1-lUS • ATTUAOS, or Compound Dmgs lry Kind 1.13 (Kiihn
13.416): Toiho To <J>ap 11 aKov ou Twv uno 11 ou npuhou avvTE9€vTwv EaT(v, a'-'-a ~811
39
40
npo no>.Awv Twv uno TOU ~aaLAEuaavTos ~ll-WV Twv I1Epya!-1TJVWV
'ATTaAou.
Oribasius, Synopsis for Eustathius 3.4 (Raeder 1926:62), replicates Galen's quotation of
the preceding recipe for this 'White Plaster of Attalus', highly recommended for the
healing and firm scarring of old, difficult-to-heal wounds, and even for healing of
bones exposed for a long time. Attalus' 'Saffron-imbued remedy for oedemas, pains
in the spleen, chest-pains, and jaundice' is recorded by Marcellus Empiricus, De
medicamentis 22.20 (Niedermann & Liechtenhan 1968:1.384), and its major ingredient
is ten denarii of saffron, making this multi-substance compound not only a bright
yellow (qui colorem luridum baben~, but also phenomenally expensive (monarchs also
favoured the included quantities of frankincense, myrrh, cinnamon, carefully
146
SCARBOROUGH
exaggeration' by Galen,42 there is a respect for Attalus' researches, set in
distinction from others, in the pharmacological doxographers who were
either careless or indulged in pharmaceutical fantasies or disgusting remedies,
e.g. Xenocrates of Aphrodisias (fl. c. 50-100 AD). 43 Importantly, Galen gives
one of his lengthy introductions to a compilation and discussion on humours
as they exist in animals,44 and therefore as they would be pertinent in
compounding pharmaceuticals with similar or oppositely-acting humours in
the treatment of various diseases (the wordiness is typical in Galen's writing).
Xenocrates is not merely incompetent, but he incorporates into his drug lore
the totally useless multi-ingredient compounds that include the various
dungs of animals and humans, and Galen does not grouch out of any sense
of prudishness, but since such 'medicine' includes the nefarious practices of
so-called physicians who advocate the drinking of menstrual fluids, or which
takes the advice of fellators and lesbians as if worthy of a physician's
attention and respect, let alone the presumed benefits to anyone's patients.
By contrast, Attalus conducted careful experiments, and anyone could
consult the writings by the king or his assistants, or those who recorded
substances, their effects and their antidotes. 45 Moreover, Galen emphasizes
distinguished from 'cassia', Indian spikenard, and costus, all to be pounded together
with honey and stored in an obviously-splendid drug-jar fashioned from silver (in
t/1111111 melle mixta colligtmtttr atqtte in pyxide argentea repommtttr), administered to the
patient in amounts of an 'Egyptian bean' (c. 4 gr.). Marcellus (fl. c. 400 AD) is linked
with the court of Theodosius, so the silver storage-vessel in Attalus' original
suggestions would have been equally suitable for the medicine chest of a Roman
emperor). Galen, Compound Drugs by Kind 1.14 (K.iihn 13.414-29), is an extended
critique of Heras' reformulation of Attalus' 'White-pepper plaster', followed by
equally-critical commentaries (ibid. 419-49) that condemn alterations to Attalus'
recipes by Andromachus, Asclepiades 'the Pharmacist', Heras, Xenocrates, and the
obscure Mnasaeus; therefore, on!J Attalus' actual recipes are to be called 'Attalids'
(ibid. 444 and 446), since ' ... an Attalid is compounded better ... ', in numerous
particulars (e.g. ibid. 428: Kal 8uvaLT' iiv KaTEpws aKEua(EGTaL TO <jlap11aKov, ou
11~v 6p8iiis 1-lOL 8oKE'i TO taov EllMA.A.Ew pvTLVTJS TE Kal KTJpoDPEA.T(wv yap ~
, ATTaALK~ auyKETaL, TOV KT]pOv Tf\S' PTJTLVT]S' A.allPavovaa 8llTAclULOV .
42 Fabricius 1972:111 with n. 19.
43 Kudlien 1983.
44 Galen, Blendings and Properties of Simples 10.1 (l<:::iihn 12.250-52).
4 5 Ibid. 250-51: ;rapa;r~aw 8f. T<!> SEVOKpaTEL Kal aAA.oL TLVES' Eypmj;av TIEpl (wwv,
E~ wv Kal auTOS 6 3EVOKpclTT]S E~Epya(j;aTO Ta iTAELUTa. iT08EV yap iiv T]UiTOpT]UE
ToaovTwv TE Kal TowvTwv ;rpayllaTwv auTos TIELpa8f\vm; 6 youv ~1-lETEpos
yEVO!lEVOS' TIOTE paaLA.Eus
"A TTaA.os EA.aTTova
<jJLAOTl!lOTaTa axwv iTEpl T~V TWV TOLOUTWV iTELpav.
<jla( VETaL
ypa<jlwv,
Ka( TOL
SCARBOROUGH
147
that Attalus tested the effectiveness of antidotes for poisons or poisonous
creatures on!J on criminals under the sentence of death,46 and such
experiments included testing antidotes against '... many different kinds of
spiders, scorpions, and snakes ... as well as the venom of the sea-hare.' 47
Nicander's Alexipharmaca also specifies symptoms and antidotes for the 'gall'
of the sea-hare, and it is significant that only Attalus is credited as testing
antidotes against this marine gastropod, an opisthobranch mollusc. And if
one recalls Plutarch's enumeration of Attalus' poisonous plants, Nicander's
'hellebore' is one of the five in Plutarch's catalogue, indicating that
Nicander's lines are, indeed, recording results of Attalus' experiments. 4B
Life and tinles: contexts and contacts
Attalus was born in 168 BC,49 and the chaotic political and military history of
the Pergamene kingdom in the reign of his uncle, Attalus II, is merely
suggested by the occasionally fragmentary inscriptions and the continual
interference by the Romans in the affairs of the so-called independent states
of Asia Minor. 50 An early teacher (whose name is unknown) and mentor to
the young Attalus hailed from Ephesus, 51 then under the rule of the Kings of
Pergamon thanks to the terms of the Treaty of Apamea (188 BC), which
effectively divided western Asia Minor between Pergamon and the Republic
of Rhodes, but left uncertain the status of Bithynia and other minor states.
Attalus' parentage is uncertain, although definitely within the 'royal line,'sz
and as a youth he occasionally travelled to Italy and Greece,s3 thereby
46
Ibid. 252: d 11-EV ovv ~aaLAELS OVTES EV av8pw1TOLS E1TL SavaT<p KGTGKEKPLILEVOLS
Also Antidotes 1.1 (I<iihn
ElTOL~aaVTO T~V 1TELpav mhwv, ov8EV E1Tap~av 8ELv6v.
14.2).
47 Antidotes 1.1 (I<iihn 14.2): nva ~LEV ovv GVTWV QVEUpEV [viz. Attalus] E1TL
<j>aA.ayy(wv t8(ws awo(OVTa, TLVa 8E E1TL OKOplTLWV, WOlTEp E1TL TWV ExL8vwv ana
... Ta 8E ETil A.aywou Tou SaA.aTT(ou ...
·
48 Nicander, Alexipharmaca 483-84 (Gow & Scholfield 1953:126): T{ii ~LEV <PwK~Eaaav
aALS 1TOOLV EAAE~6poLo EVEL~LELaS. The 'Phocian' hellebore is not significant, except
for its 'fit' into Nicander's hexameter; and neither Plutarch nor Nicander specify
'white' or 'black' hellebore, but likely the commonly-prescribed 'black' hellebore
(Hel/ebortts niger L.) is meant, given its well-known cathartic properties.
49 Allen 1983:194.
so Gruen 1984:1.184-91, 'The Continuities after Apamea'.
51 Allen 1983:120.
sz Ibid. 192.
53 Gruen 1984:1.195; 2.586 with nn. 67-69, and 608.
148
SCARBOROUGH
associating with the senatorial aristocracy in Rome. Likely Attalus whiled
away the years before 138 BC in pursuits that were considered inoffensive or
innocuous in the contexts of the continuous power struggles among the
minor dynasts in western Asia Minor, and there is just enough evidence to
suggest that Attalus became a young expert on the growing of grape-vines,
wine-production, and the cultivation of olive trees and the consequent
expertise in the manufacture of high-quality olive oils.s4 Columella says
Attalus' teacher in the skills of husbandry was the Sicilian, Epicharmus,ss and
Sicily in the 2nd century BC was famous for its olives, wines, and cereal
crops. It is, of course, unknown if Attalus spent time in Sicily, or if
Epicharmus was his mentor on agriculture as practised on the royal lands in
the Kingdom of Pergamon.
Quite apart from his famous (or infamous) research on poisons and their
antidotes was Attalus' invention of a number of beneficial drugs, sometimes
called 'Attalids' in his honour, formulas recorded in the pages of Cornelius
Celsus, Pliny the Elder, and Galen. Attalus' fascination with marine life and
medicaments made from fish is indicated by the short mention of 'tuna fat'
to treat 'scaly sores',S6 and Celsus' two recipes taken from Attalus' works,
'Attalus' plaster for wounds', and 'Attalus' eye-salve (col!Jtium)', suggest a high
level of pharmacological technology as well as a royal access to unusual
ingredients, including frankincense, beaver-castor, myrrh, 'Indian' lycium,
and the always-expensive saffronY One is uncertain if Celsus had before
him the actual books of Attalus, or if there were circulating 'handbooks' on
pharmaceuticals (likely in Greek) similar to those culled by Pliny the Elder,ss
but Galen's collection of recipes and commentaries on them emerge from
three or four circulating handbooks on drugs, incorporating hundreds of
authorities, including those put together by Andromachus the Elder, and his
Varro, RR 1.1.8. Columella 1.1.7-8.
.
Lundstrom 1915 (still considered the standard sttidy on the links between Attalus
and Epicharmus).
56 Pliny, NH 32.87: ... ad lepras cancri ... Attalus thynni adipe recenti.
57 Celsus, De Me d. 5.19.11: Est igitur ad vttlnera Attalium, quod habet: squamae aeris
P. '~-){VI; turis julginis P. *xv; Hammoniaci tandtundem; resinae terebinthinae liquidae P. *XXV,·
sebi tamini tantttndem; aceti heminas tres, olei sextmium. Celsus, De Med. 6.6.5B: Attalittm
quoque ad idem est, maxime ttbi multa pituita prrfluit: castorei P. *--; aloes P. *=; croci P. *I;
mtttTae P.II; Lyci P. *III; cadmiae curatae P. *VIII; stibis tantundem, acaciae sttci P. *XII. Quod
cum cummis quid hoc non habet, /iquidum in puxidicula servatttr.
58 Scarborough 1986:67 (e.g. Solon of Smyrna, whose compilation listed 'inventors'
and their drugs).
54
55
SCARBOROUGH
149
son, Andromachus the Younger (physicians in the time of Nero), an
Asclepiades 'The Pharmacist' (fl. c. 100 AD), and a fourth set down by
Criton, a personal physician to Trajan (98-117 AD). 59 Embedded in Galen's
Compound Drugs According to Place, 8.3,60 quoted from Asclepiades 'The
Pharmacist' is an 'Attalid' credited to the Herophilean physician, Mantias (fl.
c. 165-90 BC). 61 Mantias' tract carried the title of Dynameis, 'Properties' or
'Drug-remedies', in which appeared a prominent, multi-ingredient 'Attalid'
for upset stomachs and problems with vomiting and severe diarrhoea,
compounded from pharmaceutically active substances that included the
saffron crocus, spikenard, the seeds of the henbane, aloe-latex, tragacanth,
white pepper, acacia-gum, Pontic rhubarb, Syrian pomegranate, and rose oil,
to be mixed with heated dry wine, and then administered as pastilles. This is,
to be sure, a 'royal' remedy, since inclusion of the saffron crocus would make
it prohibitively expensive.6 2 Galen comments that this recipe was the first of
its kind, and very effective, and that Mantias was a skilled pharmaceutical
technologist, and suggests that by naming the compound an 'Attalid', he was
giving it the most appropriate label. Perhaps Mantias called his antidiarrhoeal and anti-emetic drug an Attalid in honour of the King of
Pergamon, given his reputation as a researcher on drugs, poisons, and
antidotes. Remotely it may be possible that Mantias became acquainted with
Attalus before he came to the throne in 138 BC, so that the older physician,
so expert in compounding drugs, had some role as a mentor to the royal
researcher.
Mantias could have been associated with Attalus at Pergamon, but
evidence is not firm for such a connection. What is clear, however, is that the
Hellenistic kings usually had court physicians,63 many of whom were experts
in toxicology, certainly the kind of knowledge required to serve these
monarchs, continually threatened with assassination by means of a royal
meal. And although we can be rightly sceptical that Nicander of Colophon
59
Fabricius 1972:185-89 (Andromachus the Younger), 190-92 (Criton), 192-98 and
246-53 (Asclepiades the 'Pharmacist'), and 201 (Andromachus the Elder).
Scarborough 1985.
6
Kuhn 13.162-64.
61 Von Staden 1989:515-18: 'Mantias', discussion and tabulation (no ed. or
translation) of 16 fragments.
62 100 000 flowers produce 1 kg.; Usher 197 4: 183; Van Wyk & Wink 2004: 116;
Czygan & Hiller 2004:159-62. 'Cheap' saffron markets for $250/oz.
63 Mastrocinque 1995 (royal physicians at the Seleucid court); Von Staden 1989:47277 (Andreas, physician to Ptolemy IV); among many.
°
150
SCARBOROUGH
-
had any medical talents (the Byzantine Suda says that is exactly what he was:
a physician who wrote poetry),64 the association between the composer of
the hexameters we have as the Theriaca and Alexipharmaca, and Attalus III of
Pergamon, are reasonably assured. Not only did Attalus do research on the
poisonous plants as listed by Plutarch's source (likely the same used by
Tragus, before his detailed history of Hellenistic times was abridged by
Justin), he apparently understood that several of the putative poisons were
also useful narcotics, e.g. the henbane (/?Yosryamos) which appears in both the
garden catalogue and in the Attalid recipe of Mantias. That Galen indicates
Attalus' testing of antidotes included those against poisonous animals shows
that the king expanded his interests and expertise beyond botanicals as
enumerated in the historical sources, and when one notes that Attalus alone
is credited for testing antidotes against the 'venom' of the sea-hare, this
becomes solid evidence that Nicander of Colophon was a court poet setting
down in easily-memorised hexameters the results of his royal patron's
research.
Nicander was a gifted glossator, so that his poems became texts in their
own right, in spite of his coinage of fresh words and violation of the norms
of Greek grammar. 65 His poetry was known by V ergil, who borrowed much
of the data on beekeeping from one of Nicander's lost poems on the subject,
and there are instances of quotations of poems on snake-legends, and a
Heteroettmena, 'Metamorphoses', was used by Antoninus Liberalis and Ovid.
Cicero expresses admiration for Nicander's Georgica, and the scholia mention
a hunting-poem, the Cynegetica, composed in elegiacs. All these subjects show
a keen interest in botany and zoology, as well as the kindred skills of
medicine. One of the epigrams in the Greek Anthology under the name of
Nicander is on the boredom of sexual relations with one's own wife. Of
course, Nicander is not the only poet in Hellenistic times to take up aspects
of nature or science as subjects of poetic compositions (Aratus' long poem
on astronomy and astrology comes to mind as another example, and several
of Theocritus' Icfylls are medically informed), but the close links between
Nicander and Attalus III are mirrored in the usually accurate depictions of
snakes, scorpions, spiders, insects, myriapods, and botanical poisons in both
the Theriaca and Alexipharmaca- even if the descriptions become obscured by
puns, double meanings, and fresh coinages as Nicander fashions terms to fit
64
Suda M, 194, and P, 142 =Adler 3 (1933) and 4 (1935) 324 and 16. The arguments
by Knoefel & Covi 1991 that Nicander 1vas a doctor, are not convincing.
65 What follows is a summary of details found in Scarborough 1996b, 1977b, 1979,
and Jacques 2002:xiii-ccvi.
SCARBOROUGH
151
the scansion necessary in his hexameters. Nicander borrowed much from
earlier authorities, especially a gifted toxicologist and natural historian of c.
250 BC named Apollodorus, but the subjects of his two poems reflect the
range of research at the court of the Attalids at Pergamon. Such research
could simply have been the rephrasing or culling of books in Greek extant
on the various topics (e.g. the famous zoological writings of Aristotle and the
long-influential treatises on botany by Theophrastus), but what both
Nicander and Galen reveal is that much of the research was performed on
living subjects. The king grew plants in his garden, harvested them,
compounded medicinals and . poisons, tested antidotes on living human
beings, and Nicander (and perhaps Mantias and others) either copied Attalus'
notes or recorded the king's recipes in poetry and prose.
And the sea-hare. This animal (today classed as one of the Apfysia)
continued to exercise the curiosity of Roman students of natural history, as
illustrated by Apuleius' Defence Against the Charges ofMagic.
'Now this little fish, which you call a sea-hare, I showed to a great number
of people who were present ... for this is a fish, as far as I know, that,
being without bones or other parts, has certain bones, twelve in number
in the stomach linked and united with one another appearing like the
knucklebones of a pig.'66
A modern authority notes that Apfysia spp. contain a toxin that is water and
acetone soluble, which produces muscular weakness and death in mice and
chicks, but frogs resist the poison.67 A malacologist in 1915 studied the
Mediterranean sea-hare (Apfysia depilans) and described three secretions: an
unpleasant-smelling clear fluid from the skin; a white, viscous liquid secreted
by what he called an 'opaline' gland; and a purple secretion also coming from
a gland.6B The opaline fluid had a bitter taste, produced irritation of the eyes
in rabbits and dogs, and caused muscular .paralysis when injected into
coelenterates, annelids, frogs, and other cold-blooded animals. 69 In 2005,
researchers reported that the 'major contribution to the purple in the ink
(with other pigments present) is phycoerythrobilin,'70 and a standard
66 Apuleius, Apol. 33 and 40 (Helm 1972:39 and 47). The trans. is by Hunink in
Harrison, Hilton & Hunink 2001:64-65.
67 Russell 1965:59.
68 Flury 1915 in Scheuer 1972:547-50.
69 Shier 1988:484.
70 Kicklighter, et af. 2005:549-54.
152
SCARBOROUGH
description of Apfysia vaccaria (a California species) indicates the gastropod is
apty named:71 'Its curled, earlike tentacles and herbivorous habits do remind
one of rabbits, and its soft rounded back (which conceals a thin shell) invites
gentle petting ... the animal will eject a slimy purple ink if roughly handled.
Sea-hares have a life expectancy of about a year, but grow extremely fast ...
the [California species] is the largest gastropod in the world, reaching over 75
em (about 30 inches) in length and weighing nearly 16 kg (about 35lbs.).'
Attalus and Nicander left accurate empirical descriptions, and given the
physiological chemistry of the ink - the ancient 'venom' - the emetic- and
diarrhoea-inducing properties produced effects easily interpreted as
'poisonous'. Attalus raised the hellebore that was an excellent purgative, a
pharmacological action exactly appropriate to alleviate the effects of sea-hare
'ink'. And Nicander says just this at Alexipharmaca 483.
.·
..
,'•'!
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CONTRIBUTORS
Veronique Boudon-Millot is Directrice de recherche au CNRS and
director of the French laboratory 'Medecine grecque' (Paris, La Sorbonne).
She is working on Greek medicine and in particular on Galen and Galenic
medicine. She has published on ancient medicine, philosophy and science.
She is the author of Galien. Protreptique. Art medical (Paris, CUF 2000) and
Galien, Sur l'ordre de ses propres livres. Sur ses propres livres. Que /'excellent midecin est
aussi philosophe (Paris, CUF 2007). She is co-editor of La science midicale antique.
Nouveaux regards (Paris, Beauchesne 2008).
..
Florence Bourbon is a lecturer at the University of Paris N-Sorbonne,
Institut Universitaire de Formation des Maitres. Her doctoral thesis is a
critical edition of Hippocrates' Nature rif Women with a French translation, an
introduction and a commentary, to be published soon in the Collection des
Universites de France.
Nadine Brand obtained an MAin Latin at the University of Stellenbosch,
and is a part-time lecturer at this university. Her research specialisation is
Ancient Greek and Roman medicine, with the focus on Celsus' de M edicina.
Louise Cilliers is Senior Professor and Head of Classical Languages at the
University of the Free State in Bloemfontein. She was Visiting Professor at
Leiden University in 2001 and Scaliger Fellow at the University of Leiden in
2002. She is the author and co-author of three books and numerous articles
in national and international journals, and is the editor of the national journal
Acta Classica. A member of the South African Academy of Arts and Science,
she has twice been honoured with its prizes for her research. Her main
interest is medical activities in North Africa during the Late Roman Empire.
Elizabeth Craik, formerly Professor of Classics at Kyoto University, Japan,
is now Honorary Professor at the University of St Andrews and Visiting
Professor at the University of Newcastle upon Tyne. Her publications on
Hippocratic medicine include the editions Places in Man (OUP, 1998) and Tlvo
Hippocratic Treatises: On Sight and On Anatomy (Brill, 2006). Current projects
include an edition of On Glands, and a general book on the 'Hippocratic'
Corpus.
' ·. · ·
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...
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.;. ~··
:.
158
CONTRIBUTORS
Klaus-Dietrich Fischer is a Fellow of the German National Scholarship
Foundation. He has been Professor of Medical History at Mainz University
since 1987. He was Visiting Professor at Freiburg, Switzerland, in 1988 and
again in 1991/1992, and also at the Hannah Foundation, University of
Western Ontario, Canada. In 2007 he was Visiting Fellow at All Souls
College. He is the founder and organiser of the annual Ancient Medicine
Workshop at Mainz which started in 1981. He specialises in research on the
transmission of medical and veterinary texts in Late Antiquity and the Early
Middle Ages.
Jacques Jouanna is Emeritus Professor at the University of Paris-Sorbonne,
Member of the Institut de France, specialist in ancient Greek medicine and
Greek tragedy. He is the author of two books on Hippocrates (Hippocrate.
Pour une archiologie de /'ecole de Cnide, Paris, Belles Lettres, 197 4, and Hippocrates,
Baltimore & London, 1999), and is the editor of several Hippocratic treatises
- one in the Corpus Medicorum Graecorum and eight in the Collection Bude, and is
the author of a book on Sophocles (Sophocle, Paris, Fayard, 2007).
Brigitte Maire teaches Latin at the University of Lausanne. She is Editor
and Research Director at the Institute of the History of Medicine
(Lausanne). She specialises in critical editions and has for many years done
research on ancient gynaecology, medical schools, and medical lexica. She
has contributed numerous articles to learned journals; her publications
include the critical edition of Gargilius Martialis, Remedes tires des legumes et des
fruits (Paris, Belles Lettres, CUP, 2002) and three lemmatised concordances
(Olms: Gargilius Martialis 2002, Caelius Aurelianus 2003, Cassius Felix
2003). She was co-editor with V. Boudon-Millot and V. Dasen of Femmes en
medecine (Paris, Bium, in the press). A critical edition of Mustio, Sorani
Gynaeciorum Vetus translatio Latina, is in preparation.
Susan Mattern is Associate Professor of History at the University of
Georgia. She is the author of Rome and the Enenry: Impenal Strategy in the
Princzpate (University of California, 1999).
Frans:ois Retief obtained his MB ChB from the University of Cape Town,
followed by a DPhil at Oxford (as Rhodes scholar), MD from the University
of Stellenbosch, and a FRCP from Edinburgh. He was Founding Dean of
Medicine at the University of the Free State, first fulltime Rector of Medical
University of Southern Africa, Director-General of the Department of
CONTRIBUTORS
159
Health and Population D evelopment, and subsequently Rector of the
University of the Free State. Since retirement he has involved himself in
research on medical history, in collaboration with the Department of
Classical Languages, University of the Free State.
John Scarborough is Professor, School of Pharmacy, and Departments of
History and Classics, University of Wisconsin-Madison. He is an Honorary
Research Fellow of the University of the Free State. His books include
&man Medicine (1969; 1976; 2nd ed. in prep.); Facets of Hellenic Life (1976);
Medical Terminologies: Classical Origins (1992; 2nd ed., 1998); [ed.] Symposium on
Byzantine Medicine (1984/1985), and Folklore and Folk Medicines (1987). A
monograph on Hellenistic toxicology is in progress: