Practical Knowledge and Medical Practice in Ancient Mediterranean Cultures

International conference organised by project A03 ‘The Transfer of Medical Episteme in the “Encyclopaedic” Compilations of Late Antiquity’ (Heads: Markham J. Geller, Philip J. van der Eijk), 2–3 November 2015

23.12.2015

Reduction of a dislocated mandible. Illustration in a 10th-century MS of Apollonius of Citium's Commentary on the Hippocratic On Joints, Biblioteca Medicea ‒ Laurenziana, Florence. Wellcome Library, London (cropped)

Reduction of a dislocated mandible. Illustration in a 10th-century MS of Apollonius of Citium's Commentary on the Hippocratic On Joints, Biblioteca Medicea ‒ Laurenziana, Florence. Wellcome Library, London (cropped)

Conference report by Christine F. Salazar

Like most other academic disciplines, the history of medicine, too, has been subject to successive waves of altering intellectual fashions. In its early stages, in the nineteenth and early twentieth centuries, when it was mainly the domain of retired (or, in some cases, still practising) doctors, research centred mainly on practical aspects, mostly based on the authors’ own medical concepts. This was often an investigation into how medicine had developed to reach its current pinnacle (How did the Greeks treat X? How successful were the Ancients in curing X?). In the second half, and especially the last third, of the twentieth century, this approach came to be seen as excessively positivist, and the focus of scholars’ interest shifted to more theoretical topics, such as philosophical doctrines underlying medical theories, sociological facets of ancient medicine, or the language of medical writing – more or less to the exclusion of medical practice. While medical theories, their relationship to schools of philosophy, etc., are important, one should not lose sight of the fact that ancient medicine was more than just an intellectual endeavour. It was also, or perhaps predominantly, a system of practical skills that were performed every day, and often by practitioners who had very little book learning, if any.

Of course, this daily routine of medical treatment is harder to reconstruct from what little written and archaeological evidence we have than grand theories, but we considered this a fruitful topic for this year’s conference, and so invited participants to look at practical medical knowledge and the way in which this knowledge was gained and transferred in various medical traditions. (Even within our own project, A03, this approach promises results, since we can recognise some procedures familiar from Greek medicine in the Talmudic texts, whereas the accompanying theoretic framework is not necessarily detectable.)

The conference was held in three different venues: the lectures on Monday, 2 November, were given at the HU main building (Unter den Linden), the first keynote lecture on Monday evening at the Berlin-Brandenburgische Akademie der Wissenschaften (Gendarmenmarkt), and the papers on the second day at TOPOI-Haus (Hittorfstraße), where the Jewish Studies side of A03, under Markham J. Geller, also held a conference-related workshop on Wednesday, 4 November.

After an opening address by Philip J. van der Eijk, the conference began with Karl-Heinz Leven’s contribution about plagues in antiquity. Given the frequency and demographic impact of plagues, it is surprising that there is so little information about them in medical writings, and the historian has to turn to other genres (histories, hagiography) to supplement it. It is also striking that, despite their general inability to help plague victims, physicians nevertheless administered treatment individually. (In the hagiographical texts their helplessness is contrasted with the effectiveness of the assistance given by the saints.)

Matteo Martelli examined different textual traditions in which the ‘prophet Esdras’ is credited with the invention of specific formulas for medicines and alchemical compounds. The ancient, late antique and Byzantine traditions (Archigenes, Aetius of Amida, Paul of Aegina and Theophanes Chrysobalantes) preserve several versions of a supposedly powerful antidote attributed to him, while a Syriac alchemical collection contains an entire book under his name. Based on these sources (most of them not available in modern editions), the speaker discussed the historical and cultural background that could have led to the attribution of medical recipes to a Jewish scribe and priest.

Although Dan Levene was detained in the UK by dense fog at Heathrow, he was able to give his paper – including the PowerPoint presentation – via Skype. At first sight, the topic appeared to be outside both the geographical and the chronological ranges of the conference, but the speaker, who has done much of his research on late antique Aramaic incantations, argued that although the Ethiopian healers belong to a different tradition, they offer a unique opportunity to study a variety of healing styles (including incantations) within a living context, and therefore to draw comparisons with Near Eastern magico-medical traditions.

The focus of the first keynote lecture, by Ralph Jackson, a Senior Curator at the British Museum, was the material evidence for late antique medical practice, especially in the form of surgical instruments. Both finds in burials and those in a settlement context are important for our understanding of surgical practice, the former often for their completeness and the better state of preservation, and the latter for providing an idea about the settings in which they were actually used. The lecture contained a wealth of visual material from some key finds, including the Casa del Chirurgo at Rimini.

The second day opened with a welcome address on behalf of SFB 980 by Gyburg Uhlmann, then Strahil V. Panayotov gave a fascinating insight into a topic unknown to most participants, Mesopotamian surgery. Based on cuneiform material, mainly from the first millennium BCE, as well as some archaeological finds, he described surgical interventions – incisions, scarification, the setting of bones, bloodletting, etc. – to various parts of the body. It had been claimed by scholars until recently that there was no surgery in Mesopotamian medicine, but the texts presented here suggest that this was not the case.

In the second keynote lecture, Nils P. Heeßel also addressed the topic of actual medical practice, this time in Babylonian medicine. Disease aetiology, theories of healing and the manufacture of medicines in Ancient Babylonia have all been amply discussed, but it is far from clear how a medical examination would have been conducted. This paper attempted to work this out based on diagnostic texts, incantations and letters.

Ronit Yoeli-Tlalim, too, was unfortunately unable to come because of flight cancellations at Heathrow (and in her case a Skype connection could not be established), but the topic of her planned contribution, bloodletting, was also discussed by Lennart Lehmhaus, who expanded his paper at short notice to fill the session. He discussed various aspects of venesection as mentioned in the Rabbinic and Talmudic sources. It had been practised in the Egyptian and Greco-Roman traditions, both for therapeutic and for preventive purposes. Interestingly, there is much evidence for it to be found in the Eastern, or Babylonian, Talmud, while the Western, or Palestinian, Talmud shows much less familiarity with this technique. Questions addressed were who did the bloodletting, under what circumstances, what were the attitudes of the rabbis towards it, etc.

Shulamit Shinnar discussed techniques prescribed in Talmudic literature for examining vaginally secreted tissue, so as to determine whether it is menstrual mucosal tissue, vaginal discharge caused by illness, or parturient tissues relating to birth or miscarriage. Some of these prescriptions are extremely detailed, for example instructing the woman to cut open the tissue. Although the paper was focused on some Tannaitic and Palestinian Amoraic rabbinic texts, the techniques were also contextualised within the context of Greco-Roman medical traditions.

The issues investigated by Stefanie M. Rudolf related to medicine as described by the 12th-century lexicographer Bar Bahlul. Although Syrian doctors had been famous for their (presumably Galenic) medical knowledge in the early Islamic period, being employed as court physicians, Bar Bahlul never mentions Galenic medicine, and seems to have a concept of medicine more closely related to folk medicine. This raises questions about the nature of Syrian medicine in general.

After some concluding remarks by Markham J. Geller, the final keynote lecture, by Paul U. Unschuld, pleaded for a more precise use of the term ‘medicine’ as a designation of a scientific pursuit. The presentation took Chinese medicine as its point of departure, highlighting some of the aspects that make it different. The speaker argued against the widespread association of traditional Chinese medicine with the ideas of harmony and balance, stressing rather the rhetoric of struggle and conquest visible in the canonical medical texts.

The conference was organised by Christine F. Salazar, Lennart Lehmhaus and Franziska Desch, within Markham J. Geller’s and Philip J. van der Eijk’s project ‘The transfer of Medical Episteme in the Encyclopaedic Compilations of Late Antiquity’ (A03).