ABSTRACT
To devote a chapter to the history of medicine in the Hellenistic Greek world, apart from anatomy and the coming of Greek medicine to Rome, might be thought unduly quixotic. Few original treatises survive, a situation characteristic of Greek literature of this period in general. The very success of Hellenistic scholars in commending as models the writings of earlier Greek historians, poets and orators militated against their own survival. What followed the Golden Age came to be seen as degenerate, lacking in originality or serious purpose, produced by ivory-towered pedants, akin to twittering birds in a cage and about as useful.1 In philosophy, the later triumphs of Aristotelianism and (neo-)Platonism left little space for their opponents, the Epicureans and Stoics.2 In medicine, Galenism emphasised the link with Hippocrates at the expense of other theoretical developments in the Hellenistic world, and, since what later writers thought the most significant results of the work of Hellenistic pharmacologists and surgeons could be easily incorporated into more up-to-date treatises, there was little reason to preserve the original books themselves. The literary remains of Hellenistic medicine have thus to be reconstructed almost entirely from the fragments preserved by others, with the constant dangers of deformation and misunderstanding. The traditional skills of the philologist, the precise decipherment and interpretation of an ancient text, must be exercised on material that rarely allows certainty. Yet from a different perspective this historical enterprise takes on a less gloomy aspect. Although many details are inevitably gone beyond recovery, new trends, new developments and new opportunities can be discerned, without which the history of later Graeco-Roman medicine cannot properly be understood. New types of evidence begin to appear in abundance, notably the Egyptian papyri and the inscriptions set up in cities around the Greek world, especially in Asia Minor. If for the fifth and fourth centuries we are largely dependent for our information on medical treatises, speeches, histories and plays, the balance shifts in the Hellenistic period towards the non-literary evidence. No one city dominates; even Alexandrian medicine takes on a different appearance when viewed from a town several hundreds of miles up
the Nile valley. Nor is there a block of contemporary material, such as the Hippocratic Corpus, on which attention can be easily focused. The resulting pattern is both more varied and more impressionistic.3 If the fourth century BC was the time when dietetics developed as an almost independent part of medicine, the Hellenistic period saw the rise of pharmacology to a similar status. Alexander’s conquests and the growth of Alexandria to be the major entrepôt for the import and export of rare substances from Africa and India saw a massive increase in the range of herbs and spices becoming available.4 Aristotle’s pupil and successor Theophrastus (c.371-287), as well as displaying a wide interest in many aspects of biology, also wrote extensively on plants, including medicinal ones, combining information he obtained from rootcutters with his own observations and experiments.5 His listings of plants are more extensive than those in the Hippocratic Corpus, and the number of new substances recorded in medical and botanical texts continued to increase for several centuries more. This interest in new drugs was accompanied by a more sophisticated understanding of their workings. Diocles has been credited with introducing the important notion that drugs worked through their properties, or potentialities in the sense of the word used by Aristotle.6 In a poison, for instance, the transmitted venom, although relatively small, had the potentiality to bring about enormous changes within the body of the host. Erasistratus developed this notion further when discussing antidotes either in a separate tract called On Causes or, more likely, in a large work dealing with the properties of poisons.7 The exact effect of the bite of a poisonous snake, the cenchrines, he discovered by performing an autopsy.8 But it was the followers of Herophilus, more than the Erasistrateans, who most developed medical botany.9 Although none of their works survives in full, both Andreas of Carystus (d. 217 BC, who was one of the personal doctors to Ptolemy IV of Egypt) and Mantias (fl. 120-100) were regarded as significant authorities, and their portraits were included among those of the great pharmacologists in the opening pages of the Vienna manuscript of Dioscorides, of c.AD 512. Andreas was praised by Dioscorides in his preface as one of the two most accurate writers on medicinal roots and plants – the second being Crateuas – although others were less convinced of his personal experience.10 Mantias’ expertise lay in the production of compound remedies, although he was not the first to make such preparations.11 Another pharmacologist, Apollodorus (fl. 280 BC), was regarded by later writers as the author of the first specific study of poisons. He is likely to have been among the sources on which the poet Nicander of Colophon, about 100 years later, drew for his own two works on pharmacology, his Theriac and his Antidotes.12 Written in a highly ornate and mannered style, these two poems describe both animal venoms and poisonous plants. Antidotes shows a remarkably detailed knowledge of the specific action of plant toxins, but those from animals are less clearly differentiated or understood.13
