CS 2902A: Ancient Medicine - Sources & Problems

Sources

• Only a fraction is extant

• Complication: structure of Greek society affected literacy rates

• Passage of time

• Experiential medicine & oral traditions

• Biases of scribes: copying & recopying

• Highly specialized works often lost

Types of Sources

• Written texts: Treatises, Letters, Inscriptions, Poetry, Papyri

• Art (vase) paintings, Statues, reliefs, etc

• Physical evidence

• Artifacts & tools

• Archaeological sites & buildings

• Human remains

Factors influencing the transmission of sources

• Natural disasters, fires, warfare etc.

• Monasteries picking what is transcribed; empirical works lost

• Latin medical texts from before 350 AD lost (Exception: Pliny’s Natural History & Celsus’ On Medicine; amateur writers)

• Greek East: scarcity of medical and science books copied from 650 AD

• Book roll to codex 850 AD: changes in Greek handwriting made earlier manuscripts less accessible

Saving Grace of Medical Works

• Galenism: Galen’s view on authenticity of Hippocrates & valuable treatises

• Printing press 1499 (Venice): Greek medical works (e.g. Aldine Dioscorides and works of Galen) printed

• Books printed from 1499-1540 survived

• Papyri finds & new translations of previously lost manuscripts (Syriac, Hebrew, Arabic)

What does that mean for us?

• Generalizations

• Use of other sources to supplement the picture: legal, historical, poetic, plays, inscriptions, papyri, material remains

• View of the patient & social context of medicine

• Texts assume a level of knowledge

Problems

• Isolationist view vs. Cultural view of Hippocrates as “founder/ father of medicine” centers histories of the discipline around him

• Ignore Near Eastern & Mediterranean practices & interplay between medicine and theology

• Modern scholars lacking skillset: linguistic, historical, archaeological

• Limited interest

• Rational medicine vs. Magic, superstition, religion

A Note on Language

• “Rational” vs. “magic/ supernatural”

• Problematic binary

• Scholars’ desire to classify the study of ancient medicine as “rational” and “magical/ supernatural” approaches existed side by side (even worked hand-in-hand)

• Both valid approaches

• ”primitive”

• Derogatory

• Awareness of the problematic nature of these terms

More problems

• Focus on elements that led to modern techniques/ theories

• Reduction & causation ideologies

• Causation: seek single entity causing disease (e.g. germ, gene)

• Reduction: separate pathogen from patient (problem: bacteria/ virus not patient)

• Clinical practice of medicine relies on these ideologies & affected study of history of medicine

Even more problems

• Key historical figures: those correctly identifying a cause & reducing it to get targeted approaches

• Problem: ignores patients

• Reduction/ causation: medicine = natural world

• Investigation through scientific method; no room for the supernatural

New approaches

• Anthropological approach: relationship between disease, patient, and healer

• CULTURE

• Don’t: narrow, natural-world point of view

• Do: wider, integrated perspective on human interaction & culture

• Look at rational thought behind medical practices reconciling natural world and cosmology

Health

• Reliance on cultural norms (compare modern medical definitions of “the norm”)

• Health = fitting into a statistic

• Generalization: Absence of disease

• Anthropological definition: health = balance between people, nature, supernatural

Health (continued)

• Health = fitting into culturally defined categories

• 2 spheres:

  • Personal

  • Communal

• Mix of personal & communal depends on culture

Disease

• Also culturally defined

• Generalization: disease = deviation from the norm

• Goal: restoration of health

• Disruption to communal sphere needs to be fixed

• Restoration into society & re-establishment of community cohesion

• May need new category: “disabled” (problematic)

Healers

• Medical pluralism: lots of healers to choose from

• Consultation depends on a variety of factors (economics, location, perception of disease, etc.)

• More than one healer can be consulted

Ancient Health Care Practitioners

• Physicians

• Gk.: iatros/ iatroi

• Lat.: medicus/ medici

• Root cutters ("sorcerers")

• Gk. rhizotomos

• Drug traders/ sellers/ makers (i.e. pharmacists)

• Obstetricians

• Gk.: maia

• Lat.: obstetrix (female physicians/ “midwives”)

Ancient Health Care Practitioners (continued)

• Massage therapists

• Gymnastic trainers

• Bone setters

• Surgeons

• Lithotomists (surgeons removing bladder stones)

• Ritual/ shamanic healers

• Temple priests/ religious officials

• Deities/ spirits/ supernatural beings → Medical pluralism

Diseases

• Textual evidence: Coughs, diarrhea, conjunctivitis

• Physical deformities* (note the asterisk in the source)

• Bad teeth* (asterisk)

• Reproductive health (esp. childbirth)

• Combat wounds* (asterisk)

• Archaeological evidence

• Bad teeth

• Anemia

• Degenerative joint diseases (incl. arthritis)

• Physical deformities

• Combat wounds

• Identifying ancient patterns of disease: Malnutrition, Epidemics

📖 Chapter 1: Approaching the History of Medicine (pp. 1–15)

Why Study Ancient Medicine?

• Modern medical curricula emphasize biology and anatomy, but history enriches training by showing:

  • Origins of oaths, diagnostic methods, medical charts, and bedside manner.

  • Shifts in ethics and confidentiality (ancient focus on protecting family reputation vs. modern focus on patient privacy).

• Studying history challenges assumptions of progress:

  • Ancient remedies (e.g., foxglove for heart disease, wormwood for malaria, galantamine for dementia) still resonate today.

  • Physicians’ “soft skills”—tone, touch, confidence—were recognized as part of effective treatment.

Six Core Reasons to Study Ancient Medicine

1. Continuities:

   • Hippocratic Oath as precursor to modern codes of ethics.

   • Ancient diagnostic charts influence today’s patient records.

2. Changes:

   • Confidentiality motivations have shifted.

   • Ancient medicine embedded in household reputation, modern focus on individual rights.

3. Complicating “Progress”:

   • Medicine isn’t a straight line of improvement.

   • Ancient insights anticipated later discoveries.

4. Broadening Perspectives:

   • Healing involved doctors, family, religious rituals, and magic.

   • Physicians faced financial survival pressures, misdiagnoses, and patient resistance.

5. Context Matters:

   • Reproduction heavily studied due to unstable demographics.

   • Gendered theories (e.g., “wandering womb”) reveal cultural assumptions.

   • Encourages questioning modern medical language (e.g., military metaphors in immunology).

6. Empathy and Sensitivity:

   • Engaging with past worldviews builds tolerance for difference.

   • Improves patient–doctor relations and is tested in MMIs (Multiple Mini-Interviews) in medical schools today.

How Historians Study Ancient Medicine

• Texts: medical treatises, case histories, recipes, oaths.

• Material culture: surgical tools, votive offerings, hospitals.

• Bioarchaeology: bones and teeth → diet, malnutrition, trauma.

• Paleogenetics/parasitology: DNA and parasites → ancient microbiomes.

• Evidence reveals:

  • Health disparities (urban vs. rural, rich vs. poor).

  • Common interventions (trepanation, bone setting).

  • Environmental factors (lead poisoning, mosquito-borne disease).

Scope of the Book

• Covers Greek and Roman medicine (500 BCE–600 CE).

• Balances:

  • Professional medicine with religious and magical healing.

  • Elite texts with archaeological evidence.

• Limitations:

  • Surviving sources skewed toward literate, urban, male elites.

  • Many works lost (e.g., Temple of Peace fire in Rome).

Translation and Terminology

• Modern translations used; older ones often outdated or censored.

• Avoid retrospective diagnosis (e.g., ancient “cholera” ≠ modern cholera).

• Preserve “strangeness” of ancient texts to highlight worldview differences.

• Translations aim for clarity, consistency, and contextual explanation.

✅ Takeaway (pp. 1–15)

• Ancient medicine provides continuity and contrast with modern practice.

• Historical study emphasizes cultural context, ethics, and empathy.

• Sources are multidisciplinary, combining texts, artifacts, and scientific methods.

• The field teaches us that medicine is never just technical—it is human, social, and deeply contextual.

Hippocratic Corpus, On The Nature Of Human Selection

The author of the nature of human selection rejected that human beings consisted of a single substance (humor) and instead offered that the human body was made up of four humors. Any illness that a host had was due to an imbalance of the humors and the treatment should follow the opposite of what the humor represented (too dry = put them in a wet area)

1. Healing as Balance through Opposites

• Illness is seen as an imbalance in the body or lifestyle.

• The rule is: treat with the opposite of what caused the problem.

  • If sickness comes from excess (fullness) → treat with depletion (fasting, purging, bloodletting).

  • If sickness comes from depletion → treat with nourishment and strengthening.

  • If sickness arises from too much exercise → prescribe rest.

  • If from inactivity → prescribe exercise.

• The physician’s job is to “counter” what is excessive or deficient in constitution, season, or age.

👉 Message: Health is restored by re-balancing, undoing what has gone too far in one direction.

2. Two Causes of Sickness

The author distinguishes between individual causes (regimen) and collective causes (air/pneuma):

• Regimen (diet, lifestyle, habits):

  • When illnesses vary among individuals, the cause is personal lifestyle.

  • Treatment = adjust diet, activity, habits according to age, constitution, and season.

• Air (pneuma):

  • When many people of all types (young/old, male/female, active/inactive, rich/poor) are struck by the same sickness at the same time, the cause cannot be regimen.

  • Instead, the cause must be the air (pneuma) – polluted or corrupted atmosphere.

  • This is an early recognition of epidemic disease: a shared environmental cause rather than individual behavior.

👉 Message: Physicians must look at the pattern of disease (who is sick and how many) to correctly identify the cause.

3. Treatment Principles

• For individual sicknesses:

  • Adjust regimen gradually (food, drink, exercise).

  • Avoid drastic changes, which could harm the body.

• For epidemics (air-borne sicknesses):

  • Do not radically change regimen (since that is not the cause).

  • Instead:

    • Eat and drink less → keep the body thin and weak to reduce the need for deep breathing.

    • Seek purer air → move away from infected regions.

    • Inhale less → minimize intake of corrupted air.

👉 Message: For epidemics, survival depends on avoiding bad air and making the body less dependent on breathing it deeply.