Studies in Ancient Medicine

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No abstract text is available yet for this article.

This chapter looks from an early modernist's perspective at some of the major questions and methodological issues that writing the history of patients in the ancient world shares with similar work on Patientengeschichte in medieval and early modern Europe. It addresses, in particular, the problem of finding adequate sources that give access to the patients' experience of illness and medicine and highlights the potential as well as the limitations of using physicians' case histories for that purpose. It discusses the doctor-patient relationship as it emerges from these sources, and the impact of the patient's point of view on learned medical theory and practice...

In the modern world, we are experiencing an epidemiological shift represented by the increasing prevalence of chronic diseases relative to that of acute diseases: more people are living longer, with more diseases, than ever before in human history. How are we to understand and to respond to this change? A study of provision of cancer treatment in Western Australia, especially among Indigenous populations, can illuminate ways in which healthcare providers and societies might better understand the treatment of chronic disease: healthcare providers should take care to appreciate patient perspectives and beliefs about disease aetiology and treatment...

Aelius Aristides, one of the most renowned orators of the so-called second sophistic, has often been thought of as the paradigmatic patient who surrendered his physical and psychological health to Asclepius, and spent a large part of his life in the temple of the god at Pergamum blindly following divine orders on diet and regimen. This study looks at the Hieroi Logoi as an illness narrative and argues against such a simplistic view and in favour of a more complex picture: Aristides is a far cry far from the submissive patient, who idly resided in the Pergamene Asclepieion relying exclusively on the therapeutic powers of the god and his human helpers...

The majority of surviving ancient medical literature was written by medical practitioners and produced for the purpose of ensuring the effective diagnosis and treatment of their patients, suggesting an audience of medical professionals ranging from instructors to students. This has led historians to concentrate on the professional medical practitioner and their theories, methods and practices, rather than on lay medical practitioners, or even patients themselves. This chapter seeks to redress this imbalance, and examine the ancient literary and documentary evidence for lay medical theories, methods and practices in the Roman Republic and Empire in an attempt to reconstruct the experiences of lay medical practitioners and their patients...

Ideally in Galen's model of preventive medicine, the patient does not become a patient at all but remains a healthy person able to maintain his or her health without need of either medicines or other therapies. This chapter is divided into four sections, Galen's ideal patient; less than ideal patients; patients in old age; and patients whose nature is inclined to a bad mixture of humours, and so in need of medication. In all four categories, even those where medical recommendations such as blood-letting are recommended, Galen offers an option based on hygieine, or the art of maintaining good health...

This paper provides the first analysis of case histories in the Byzantine period as they feature in the On Urines of John Zacharias Aktouarios (ca. 1275-ca. 1330). This group of clinical accounts is of special importance in that they have no counterpart in the Greek-speaking world since Galen. This study aims to illustrate various factors determining the patient's response to the physician's advice through close examination of John's clinical narratives. The first part deals with the terminology that John uses to indicate the patient's gender, age, social status, and clinical condition...

Images of physicians, patients, and medical instruments were placed on Graeco-Roman funerary monuments, altars and fresco paintings. These representations are examined here to determine whether there existed a standard convention by which physicians were depicted in order that the lay and possibly illiterate viewers could identify what the scene represented. Greek physicians were frequently shown with cupping vessels, midwives were seen with birthing stools, while Roman physicians were often shown with various surgical implements...

This paper examines the effects of the emergence of pulse measurement as an essential diagnosis and prognosis method used on Graeco-Roman patients. It argues that the introduction of this diagnostic tool brought about changes to the encounter between patients and their doctors and may have also increased intimacy and patients' forthcomingness during these encounters. The paper demonstrates that the popularity and conspicuity of the practical and theoretical engagement with the pulse afforded many opportunities for the transmission of professional knowledge from doctors to patients...

The brief collection of deontological guidelines entitled Praecepta is one of the most important literary evidence regarding the fee of the ancient physician. This chapter focuses on three passages from the Praecepta, which offer us a wealth of information on this topic. Some technical terms used in the text, such as the term μiσθápiov, show clearly that the author intends both to provide guidelines for the ideal bedside manners and to defend the repute of the physicians from the widespread charge of greed...

Pain might be a powerful diagnostic tool, but it is at the same time an intensely private and subjective experience that represents a formidable problem in the communication between physician and patient. Galen addresses (principally in De locis affectis) the problem of constructing a consistent and univocal terminology for different pain sensations, rejecting the system proposed earlier by Archigenes on the grounds that he relies on metaphorical descriptors which indiscriminately incorporate terms belonging to information generated by all the senses, fails to conform to patient testimony, and refers to ambiguous concepts...

Compassion is considered an important quality for a successful physician today, but did ancient physicians display and value this emotion? How did they feel when faced with the pain and suffering of their patients? How did their patients' emotions affect their own? Many ancient physicians are not well-known for expressions of compassion in their writings; however, this seems to change in the second century AD. One medical writer who exemplifies this change is Soranus of Ephesus (c. 98-138 AD). In his Gynecology, there are a number of passages where compassion is addressed or expressed (such as the chapters on the qualities of the best midwife, the symptom of pica, childbirth, and superstition)...

Despite advocating perpetual virginity and viewing childbirth as inherently injurious to female health, Soranus' attitude towards the infant in Book 2 of the Gynaecia is remarkably positive. In fact, it is only towards the infant that Soranus displays such consistently positive attitude. This compassionate approach is evident both in the content and the language employed, which is characterised by a striking occurrence of diminutives. His preference here for authorities such as Thracians and Scythians rather than illustrious ones, along with his 'language of the nursery', points to an oral, rather than literary, tradition...

This paper analyses gender as an aspect of the role of touch in the relationship between doctors and patients, as represented in the Hippocratic Corpus. Touch is an essential aspect of the ancient doctor's art, but one potentially fraught with concerns over gender: while seeing, hearing, and smelling are also central to the medical encounter, touching is the act that places the greatest demands on the privacy and bodily integrity of the patient. This paper shows--perhaps counterintuitively--that, despite the multiple assertions of gender differences put forward by the authors of the Hippocratic Corpus, these authors make little distinction between touching male and female patients...

This paper focuses on the mental patients in Arabo-Islamic Middle Ages. Patients suffering from mental illnesses generated a lot of interest for Arabo-Islamic physicians. The first objective of this study is to identify who were the mentally infirm and to compare the Arab physicians' typologies of mental patients to that of their Greek predecessors. The second part of this paper shifts the focus from theoretical descriptions to case histories and biographical sources, in order to understand how the physicians treated their mental patients, and to find out what was the social impact of this medical approach...

Galen describes a syndrome he associates with an emotion called lypē, with specific symptoms and a course that may lead to humoral imbalance, disease, and death. Lypē is an emotion that encompasses distress at a loss, as the death of a close friend or the destruction of one's books by fire; but Galen also associates it with chronic worry about a future threat, and a physiology between the emotions of worry and fear (that is, 'anxiety'). Lypē can cause a progressive syndrome characterised by insomnia, fever, pallor, and weight loss that can kill patients or degenerate into psychotic illness...

Hippocratic authors frequently utilise silence, babbling, lisping and otherverbal signs to diagnose a variety of physical illnesses and predict theircourse. This chapter examines these 'voice pathologies' and evaluatestheir impact on the dialogue between patients and Hippocratic physicians. In short, Hippocratic authors treat patients' voices in two dissonant ways. On the one hand, physicians promote some form of discourse,implicitly relying on patients to report internal sensations resulting fromillnesses...

Instead of being self-evident depictions of sickness, ancient medical texts were narratives created from certain points of view and for intended purposes. As a guide for the physician travelling to an unfamiliar community of people, the treatise Airs, Waters, Places anticipated "communal" conditions resulting from seasonal changes, while admitting the possibility of "personal" sickness due to individual lifestyles. Even with its geographical situatedness, Epidemics 1 continued to prioritise population narratives, subsuming sickness within the experiences of the anonymous majority whenever possible...

This chapter looks at the patient cases of the Epidemics as testimonies to the interaction between the physician and the patient. My corpus of reference is the patient cases in fifth- and early fourth-century medical texts, mostly the more elaborated examples offered by Epidemics 1 and 3. A patient case collects information from various sources: the patient's observable behavior and state; his or her account of her disease, its history and the patient's lifestyle; the contribution given by relatives and friends; and, of course, the physician with his judgment, his agenda, his terminology and didactic aims...