Module 4: Medical Practice: Who did what to Whom?

Objectives:

  1. Students will demonstrate a knowledge of how different aspects of medical practice in antiquity affected both patient and healer (doctor, midwife).
  2. Students will become aware of another culture’s medical system through its practices.
  3. Students will discuss important medical terms found in these readings, such as gynecology, pharmakos, etc.

Case Studies and Diagnosis

Epidemics 1 (This reading is 18 pages.  The old Loeb edition gives a good introduction to this work.  When reading this text, it may be useful to raise the questions, “How was this text used?”, “How is this different from the authorial voice in The Sacred Disease?”, and “Why don’t the doctors intervene in the case studies?”  In paragraph 5 of the “Second Constitution” (page 5-6) there is a brief description of the duty of the physician.  At the end of this text there are 14 case studies. These give a specific picture of the physician’s practice in the 5th century.)

Mirko Dražen Grmek, “The Hippocratic Conception of Disease: An Exemplary Clinical Report” from his book Diseases in the Ancient Greek World. (This Chapter is 20 pages long without the endnotes.  Grmek begins the article with a discussion of the case of Philiscus in Epidemics 1.  He discusses the problems with translating and how he addresses them.  This is useful for students to understand.  These texts were written in a foreign language and translation is interpretation.  Grmek goes on to outline how we can know the date and place of Philiscus’ disease.  In the next section, the history of the term kausos is given, as this has been the assumed diagnosis of Philiscus.  In “Hippocratic Prognosis and its Relationship to Diagnosis,” Grmek asserts that “Hippocratic prognosis is partly diagnosis in disguise” (293).  The last two sections are pretty technical and give in depth descriptions of blackwater fever and a history of the diagnoses of Philiscus.  For this module the first half of the chapter is most useful, but the second half is interesting in its own right.)

Prognostics 1 (This text is 15 pages long.  The author begins by touting the benefits of prognosis.  Primarily, knowing when to treat someone and when someone is beyond treatment will protect a doctor’s reputation.  If you wanted to sample this text, you could focus on a few symptoms.  Fever is one that is addressed in Epidemics 1 and here as well (paragraphs 20-25).)

Instruments

Lawrence J. Bliquez, The Tools of Asclepius (Chapters 1-2) (Chapter 1 is 20 pages and very readable.  If you wanted to shorten the reading you could leave out the section titled, “Earlier Work on the Instruments.”  You may want to summarize for students the section “Emphasis on Nomenclature,” as the Greek is not translated or transliterated for them and there is quite a bit of it.  The section “Surgeons: Training and Practice” is particularly relevant for this module and cites a great deal of material evidence.  In “Design and Manufacture of Tools” we can see how these instruments were made; some more common instruments were made and sold, others were commissioned.  The section “Materials, Characteristics, and Qualities of Tools and Paraphernalia” reminds us that some tools would not have survived through the ages and that the quality of one’s tools would be a reflection of their status.  The final section in this chapter, “How Successful were the Surgeries,” takes into account the immense risk of ancient surgery and the faith one had to put in their surgeon.  Chapter 2 is 27 pages long, but can be divided among students or groups into the following sections: Cupping Vessels, Cutting and Puncturing Instruments, Cauteries, Probes, Bone and Tooth Instruments, Forceps and Retractors, Gynecological Tools, Tubes, and Speculum.  Each student/group could give a 5 minute presentation on their instrument.)

Assignment: Look at some examples of ancient medical tools and find the modern equivalent.

Women as Patients and Practitioners

“Writings of Practicing Physicians” in Lefkowitz and Fant, Women’s Life in Greece and Rome, 4th ed., pp. 306-331.  This is a selection is 25 pages. In keeping with the topic of this module, I would recommend 427 (13 ff.) (description of an abortion), 434 (women as patients), 439 (Galen treats a lovesick woman), 441 (Inflammation of the womb/the womb has a mind of its own), 442 (especially “Contraception” and “Abortion”), 443 (Soranus’ instructions to the midwife), 452 (grave stele of a woman who died in childbirth), 453 (Clitoridectomy), 463-9 (Epitaphs of women practitioners), 470 (Soranus’ description of a midwife), 471-6 (more evidence of women practitioners), 477 (hiring a wet nurse), and 478-9 (contracts for wet nurses).  Some of these selections are shorter than others.  Much of what I have left out of my recommendations contains descriptions of women’s anatomy, which may be helpful, but does not directly relate to the topic of women as patients and practitioners.

Assignment: Find a contract for a wet nurse from another country (e.g. China) and compare with the contracts in Lefkowitz and Fant.  What are the primary concerns?  How much are they paid?  Are the regulations more or less strict?

Lesley Dean-Jones, Ancient concepts of the Hippocratic (Ch. 1, anatomical parts) This is a very long chapter, 68 pages.  This chapter focuses on the anatomy and physiology of women, which is not the focus of this module.  However, this is useful background information that we could summarize for our students.  This is broken up into clear sections, so it could be divided and dispersed.

Galen On Prognosis Chapter 6. This is a very short reading, only 2 pages. This is excerpt is 439 in Lefkowitz and Fant, where Galen treats a woman suffering from lovesickness.

Hanson, Ann, “Continuity and Change: Three Case Studies in Hippocratic Gynecological Therapy and Theory” in Sarah B. Pomeroy, ed. Women’s history and ancient history, 73-110. (This is 24 pages without the endnotes.  With the endnotes it is 39 pages.  I would not recommend this for undergraduates as her arguments are complex and, at times, difficult to follow.  In this chapter, Hanson reveals the dialogue between the folk tradition and the Hippocratic Corpus as it pertains to gynecology.  The first case study is of a uterine infusion.  This case shows a connection to home remedies and the author’s desire to distance himself from them.  The second case study is of the use of odor therapies.  The autonomy of the uterus described in Hippocratic writings show that their theories were originally based on folk therapies.  The third case study is of a difficult birth, where misconceptions about uterine contractions during labor align with folk medical theory.)

Hanson, Ann. “The Medical Writers’ Woman” in Halperin, Winkler, and Zeitlin, edd. Before Sexuality: The Construction of Erotic Experience in the Ancient World, 309-337. (This chapter is 25 pages long.  If you wanted to shorten it, you could leave out the section “Recent Interests in the Gynecologies of Greco-Roman Antiquity,” though I would suggest reading the last paragraph of this section which outlines her intentions for this chapter.  This would be a good introduction into ideas of female anatomy in the ancient world.  Hanson also ties in the social implications of these physiological concepts and the issue of male access to knowledge about women’s bodies.)

Lloyd, G. Science, Folklore, and Ideology, 62-94. (This selection from the Introduction is 32 pages.  Lloyd addresses works outside of the Gynecologies that do or do not mention differences between men and women (62-8).  He also has a useful section on the relationship between women and their doctors (69-79).  This may be a sufficient excerpt for our purposes.  He, then, looks at reproductive theories that give women equal weight and their rejection of the norm, women as inferior (86-94).  This would be a nice supplement to Hanson’s “The Medical Writers’ Woman,” however, I do not think that it is necessary for undergraduates.  Perhaps it is best used as a resource for the instructor.)