Vivian Nutton, Ancient medicine, Sciences of Antiquity, London and New York, Routledge, 2004, pp. xiv, 486, illus., £65 (hardback 0-415-08611-6).

Vivian Nutton has written a magisterial history of a 1400-year span of Greek and Roman medicine from the earliest textual evidence of the Homeric poems (eighth century BCE) through the Later Roman Empire (seventh century CE). The work's greatest strength is its dazzlingly thorough treatment of medical textual sources, prosopography, and doxography, the result of the author's considering medical theories and practices primarily as the contributions of individuals. The final words of the Conclusion sum up the work as attempting to “give an appropriate weight to the three elements involved in any medical practice, the healer, the patient and the illness. The legacy of Antiquity is still with us” (p. 316). One may reasonably argue that the weight given to individuals is undue, and that since some ideas and practices similar to the Greeks' and Romans' are found in numerous other cultures, they are simply the sort of thing humans are likely to think and do, and so do not depend on individual achievement or failure. The virtue, however, of the individual focus is that we get a vivid sense of the struggle for survival that was and is at the heart of medicine—a sense that is missing from studies with different perspectives and aims. Moreover, Nutton's approach maintains the tension between early science and ancient medicine still extant in their respective modern fields: medicine may be based on theoretical or scientific principles, but its success—measured in human lives—depends on the skill of individual doctors in applying those broad principles to individual, unique cases. Nutton does not, however, entirely abandon an anthropological approach. He consciously avoids imposing anachronistic categories on ancient concepts and practices. No ink is wasted, for example, in discussing whether one form of healing is more rational by modern standards than another, nor in imposing on ancient texts modern definitions of “disease” (the useful distinction between “disease” and “illness” is not observed, however) or modern disease identifications (Chapter 2 surveys the scholarship in archaeology and palaeopathology pertaining to disease identification from physical remains, but that is another matter). Instead, picking up the gauntlet from Henry Sigerist, Nutton seeks to understand healing as it occurred within the many social contexts found in the broad geographical and chronological range under consideration. Thus, while the Hippocratic Corpus (Chapters 4–6), the Alexandrians (Chapter 9), and Galen (Chapters 15–16) get their just and expected due, a full array of other theorists and practitioners are also taken into account, including philosophers, herbalists, drug-sellers, midwives, trainers, astrologers, religious healers, and magicians. Not all are given equal weight, granted (the scantiness of our sources sometimes precludes thorough treatment), but none is treated dismissively. Of particular note is the inclusion of topics usually short-shrifted except in specialized studies: Hellenistic medicine (Chapter 10), pharmacology (passim, but especially Chapter 12), Methodism (Chapter 13), alternatives to humoral medicine (Chapter 14), medicine in Late Antiquity and the impact of Christianity (Chapters 18–19). One must note, however, certain absences. Ancient medicine treats only Greek and Roman medicine, with the medical traditions of other cultures given little or no mention. This would not be a subject for criticism—authors must draw lines somewhere—were it not that the book's title—perhaps the publisher's choice?—indicates a broader scope (a scope that would require multiple volumes and multiple authors). Ancient medicine will be of great value to historians of Greek and Roman medicine, as well as to some historians of religion and philosophy. Though dense with factual information, it is a highly readable book, and the author's enthusiasm for his subject is just as evident as is his erudition. This is particularly true of the chapters on Galen, on whom the author is a leading authority. Vivian Nutton has done the worlds of classical scholarship and medical history a true service in providing this detailed and comprehensive account of Greek and Roman medicine.