The problems raised by the sources for ancient medicine represent an extreme version of those found in other fields of Greek and Roman history; to put it simply, how is our picture of the past formed by what happens to have survived, and does the nature of the evidence mean that we must close off some avenues of inquiry? There are two peaks in the quantity of evidence: the survival of the Hippocratic corpus, although the texts in it appear to date from a long time-period covering several centuries, and the still-expanding body of work by Galen, active in the second century and the beginning of the third century ad.
Between the survival of the works of Hippocrates and Galen, a less-well-documented peak occurred with the work of Herophilos (fl. c.280 bc) and Erasistra-tos (fl. 250 bc) in third-century bc Alexandria where, for a brief generation, human dissection was practiced. It is still not clear why this became possible, or why it stopped; suggestions for its introduction include changing Greek notions of the soul, a powerful monarchy which could permit anything it pleased, Greek presence in a culture in which the dead body had been treated very differently from funerary practices on mainland Greece, and the availability of an Egyptian subject population on whom to experiment (Flemming 2003). In the heady intellectual climate of Alexandria, Herophilos and Erasistratos not only opened bodies to explore parts such as the heart and the brain, but also used images taken from other fields of study, such as geometry, music (to explain the rhythm of the pulse), and mechanics (to explain how fluids were processed in the body). But their discoveries had surprisingly little lasting influence; while they made numerous anatomical observations, they were not able to understand physiology. Of the many treatises they are known to have written, none now survives in full.
It was, above all, their methods that later writers criticized. Some claimed that they had performed not merely dissection, but human vivisection; following Aristotle, animals and humans were seen as part of a single continuum, making it possible to extrapolate from animal dissection to the human body, and the roots of much early Greek knowledge of the body in sacrificial practice are clear. As animal vivisection was thought valid - Galen, in particular, seems to have performed this not only in private but also in public, to admiring audiences (Rocca 2003) - it is feasible that human vivisection would have been considered acceptable in Alexandria, particularly if its objects were non-Greek, low status or condemned criminals; Mithridates VI of Pontus (132-63 bc) was later alleged to have experimented on criminals in order to increase his (preventative) knowledge of poisons. Another reason why vivisection may have been carried out was that some critics of medical claims regarded knowledge gained from the dead body alone as irrelevant when it came to understanding how living bodies function.
The continued existence, or loss, of all these texts relates to their supposed authors and how subsequent historians have chosen to assess them. Already in the work of Seneca Hippocrates was seen as “the greatest physician and the founder of medicine” (Ep. 95.20), and by the Renaissance he had become the “Father of Medicine.” Works that could be attributed to Hippocrates were clearly highly valued. Only a few centuries after his death, he was attributed with a genealogy going back to the god of medicine, Asclepius, himself; he was seen as a culture-bringer, bringing medicine to humans just as Prometheus had brought fire and Triptolemos the gift of grain. The group of over 60 treatises that have come down to us as the Hippocratic corpus was put together in Alexandria, perhaps as early as the third century bc (W. Smith 1979: 204-46). But the historical Hippocrates remains a figure known to us only in two brief passages of Plato which may themselves be constructions for literary effect more than simple statements (Prt. 311b; Phdr. 270c-d). As for Galen, his wide-ranging synthesis of the ideas of some Hippocratic texts - in particular, On the Nature of Man, in which the theory of the four humors is described - with those of Aristotle and Plato quickly became the foundation of Western medicine.
Galen’s work was written in Greek but subsequently translated into many other languages including Arabic, Syriac, and Latin; where Greek originals are now lost, these texts can to some extent be reconstructed by working on surviving translations. While the Galenic corpus still continues to grow, the contents of the Hippocratic corpus are now being challenged afresh. For past generations, the “Hippocratic question” consisted of the attempt to identify a genuine work of the historical Hippocrates within the heterogeneous group of texts that goes under his name: today, most would accept that there is not a single one of those texts which can with certainty be attributed to Hippocrates. The date and context of the most famous one, the “Hippocratic Oath,” are still unclear, but there is in fact nothing to connect even this to Hippocrates. But some scholars are now going even further, questioning the value of the term “Hippocratic corpus” itself, with its inbuilt suggestions that the texts within the collection somehow represent the best of ancient Greek medicine, and that other medical texts dating from the same period must be inferior.
So what do we know of medicine outside the Hippocratic corpus and Galen? The Anonymus Londinensis papyrus, dating from the second century ad but discovered only at the end of the nineteenth century, is thought to have been written by a pupil of Aristotle. It names many early medical writers who would otherwise be unknown. Galen too identifies a large number of lost medical writers, from classical Greece up to the generation of his own teachers (W. Jones 1947). The work of some can be reconstructed, if only at a very basic level, from the fragments preserved by Galen himself and by the encyclopedic writers of late antiquity, such as the fourth-century compiler Oribasius and his successors Aetius of Amida and Paul of Aegina. However, here as in other fields of ancient history, the use of fragments is far from straightforward (Hanson 1996). It is not always easy to distinguish between a direct quotation and a summary and, just as quotations can be taken out of their original context, summaries may be skewed in order to present an inaccurate view of the writer being quoted. In the past few decades, very valuable collections of the fragments of some of the lost medical writers have been produced: for example, Diokles (van der Eijk 2000), Herophilos (von Staden 1989), Erasistratos (Garofalo 1988), and the Methodists, followers of one of the ancient medical “sects” (Tecusan 2004).
World History
