BMCR 2007.12.03

Soigner et Servir. Histoire sociale et culturelle de la médecine grecque à l’époque hellénistique

, Soigner et servir : histoire sociale et culturelle de la médecine grecque à l'époque hellénistique. Culture et cité ; 2. Paris: De Boccard, 2005. 338 pages ; 24 cm.. ISBN 9782701801858. €33.00 (pb).

In this interesting study Natacha Massar investigates the services that doctors performed for Greek city-states of the Aegean and for monarchs whose kingdoms abut the Aegean’s littoral during the Hellenistic period.1 She relies on inscriptions that commemorate particular physicians,2 as well as literary sources that remember Hellenistic doctors, both anecdotes about them and quotations from their medical writings, embedded in later writers, for very few treatises by Hellenistic medical writers survive intact. As Massar makes clear from the outset, her intention is to draw detailed portraits of famous iatroi, leaving aside ordinary practitioners.3 Hers is a social and cultural history of those who belong to the rarified strata of the profession, and she traces in detail the images these distinguished figures imprint on subsequent generations. The techne iatrike) serves her as an important lens through which to view specialization within the broader concept of paideia and cultural priorities. Particularly important is her elucidation of the diplomatic roles played by doctors and the ways in which their movements enhance cooperation among communities. Massar’s volume falls into two parts, a first that considers the variety of actions physicians carry out, when attached to a polis or a monarch, and a second part that looks at the manner in which medical writings from the Hellenistic period partake in the intellectual and literary expansions that characterize the period. She finds that the medical treatise increasingly intersperses theory and therapy; new also is the philological attention devoted to precursor texts being collected in the recently founded libraries, as well as the development of new medical genres, such as the commentary and glossary. Pharmacology and specialized dietetics rise to new prominence. The little stories Massar tells about famous medical men, drawn from many sources, make the volume highly enjoyable to read, but difficult to summarize; fortunately for the reader, every section ends with her interpretation of the anecdotes just narrated.

Part One consists of a brief overview, followed by three chapters that probe the following topics: engagement of a physician (pp. 31-63); activities undertaken by a physician that bring him recognition (pp. 65-122); mobility of a physician and circulation of medical information (pp. 123-67). The career of Demokedes of Kroton underscores the fact that poleis (Aigina, Athens) and monarchs (Polykrates, Darios) early on find it attractive to acquire the services of a skilled practitioner, with Herodotos the one to preserve his story (3.125-38). In the Hellenistic world, it is the decrees in honor of a demosios iatros that inform most fully; some are set up in the city where he served, others are transmitted back to his native city upon completion of his sojourn, and all express fulsome thanks for services he rendered. From the point of view of a candidate to the post, an essential ingredient is the demonstration of medical competence: testimonials from satisfied patients and public lectures ( akroaseis), medical confrontations and diagnoses ( apodeixeis) figure large, as does the fact that a candidate has learned medicine from a famous teacher.4 We know more about the actions of a city-state in choosing and recruiting a public physician than how a monarch recruits and introduces an archiatros into his court, although the source of one’s training (an Asklepiade from Kos) and renown of one’s teacher again seem important factors. Massar suggests that being known to the king’s philoi likewise proves crucial, since loyalty is highly valued in court circles. In any case, the city-state that invites makes the terms of the appointment explicit through a contract approved by the Assembly and/or magistrates, specifying salary and duration of service. Commemorative decrees also stress the moral qualities the city itself values: zeal, benevolence, gentlemanly demeanor, and euergetism ( spoude, eunoia, kalokagathia), as well as willingness to care for one and all, including non-citizen visitors, even without recompense. Anticipation of wars and sieges impel some cities to engage a physician, while chance devastations brought by epidemics and earthquakes afford him an opportunity to perform heroic services. Monarchs expect doctors at the court to accompany them to war and, when at home, to participate along with other courtiers in deliberations. Massar takes particular pains to set forth the evidence that doctors serve as ambassadors to oracles and festivals and that their circulation among the elite in other poleis and at monarchs’ courts enhances networking for the physicians themselves and fosters diplomatic exchanges among the communities. On the island of Cos sending out medical men to royal courts, cities, and leagues develops into a deliberate and useful policy that continues into Roman times. Massar subtly re-examines evidence which connects Erasistratos of Keos with the Seleucid monarchy in the middle decades of the third century BC, prioritizing associations of his father Kleombrotos and his teachers Chrysippos and Metrodoros with the court of Antiochos I over the romantic episode of Antiochos and his stepmother Stratonike that carries an implied date in the reign of Seleukos I Nikator (ca. 294/93, pp. 105-12). She also tackles Celsus’ claim in his Prooemium to the De medicina that both Erasistratos and Herophilos practice vivisection on humans, rather than dissection of human bodies supplemented by vivisection on animals, stressing that Celsus is rehearsing polemics from Empiric doctors current at Rome in his own day (pp. 248-53).

Part Two consists of two chapters — the first explores evidence that the prestige of medicine is increasing in the Hellenistic world and that author-physicians are themselves evolving into important figures in intellectual circles (chapter IV, pp. 170-201); the second looks to the medical genres that receive special emphasis and to whom medical writers are directing and dedicating what they compose (chapter V, pp. 203-73). It is again famous doctors and their illustrious pupils who accumulate vitae, remembrances, and apophthegms. The names of Erasistratos and the later Asklepiades of Prusias in Bithynia attach to numerous anecdotes: in old age Erasistratos has a wound in his foot which does not heal and after saying “Very well, then, I shall be mindful of the examples of my fatherland,” he drinks hemlock and dies. Asklepiades, perhaps most famous for recognizing that a man is still alive, even though he appears dead enough to be carried off to the funeral pyre; his own suicide in extreme old age is remembered as a jump off a ladder. Monarchs enhance the prestige and sometimes the financial well-being of the doctors who serve them, and in return author-physicians dedicate works to them and their courtiers. The multiplication of medical writings and the accumulation of these and other texts in libraries, especially that of the earlier Ptolemies in conjunction with the Mouseion, brings medical philology into being through lexica, commentaries, and close attention to texts. Erotian, the Neronian glossator of the Hippocratic Corpus, still consults that by Baccheios of Tanagra, a pupil of Herophilos and but one of the many physicians drawn to Alexandria during the third century BC. Alexander’s conquests provide Greeks increased access to exotic plants and animals, and kings and their doctors develop keen interests in medical botany and pharmacology. Plutarch reports that Attalus III Philometer cultivates with his own hand such plants as hellebore, hemlock, and aconite in the royal gardens, and several sources associate this same Attalus with Mithridates VI and Cleopatra VII in testing poisons and antidotes on condemned prisoners. Royal names attach to recipes and theriacs, while pharmacologists and doctors mention famous names of those to whom they have given medicaments. Socrates considers that a contest between a doctor and a pastry cook before a jury of children would result in total defeat for medicine; centuries later, however, Galen readily claims that some aspects of cosmetics ( kosmetika and cookery opsartytika are proper concerns of medicine and notes that doctors write in both genres about what is salubrious for the body and spirit.5 Largely lost are the Hellenistic writings that surely paved the way for the expansions of Greek medicine into other specialized fields and for a Galen to become in G.W. Bowersock’s felicitous phrase “a lion of society” at Rome. Massar’s volume closes with a review of her topics (pp. 275-91), a bibliography of ancient and modern sources (pp. 293-319), and a short index (pp. 327-330).

Notes

1. I apologize for the lateness of this review.

2. Of the 525 inscriptions gathered by E. Samama, Les médecins dans le monde grec. Sources épigraphiques sur la naissance du monde médical, Geneva 2003, only 20 percent (104) are Hellenistic in date, while the majority date to the first three centuries AD.

3. Medical professionals of the Greek and Roman worlds who do not achieve notoriety have been treated elsewhere: e.g. F. Kudlien, Der griechische Arzt im Zeitalter des Hellenismus. Seine Stellung in Staat und Gesellschaft, Mainz-Wiesbaden 1979; P. Lang, “Medical and Ethnic Identities,” in Reinventions. Essays on Hellenistic and Early Roman Science (= Apeiron 37, 2004) 107-31; V. Nutton, Ancient Medicine, London-New York 2004, 140-56; M. Hirt Raj, Médecins et malades de l’Égypte romaine, Leiden-Boston 2006.

4. E.g., decree of the deme of Halassarna, Cos, II BC: “Onasandros, son of Onesimos, having learned the art or medicine from Antipater, son of Dioskouridas, displayed irreproachable conduct toward all and spontaneously offered the services of his craft to those demesmen who had need of it during the time when his master was public physician among us…” (SEG 41, no. 680 = Samama no. 137).

5. Cf. Plato, Gorgias 521d-522a; Galen, Composition of Drugs according to Place 1.1, 12.403-404 Kühn, and Properties of Food Stuffs 2.52, 6.638-39 Kühn.