This book has covered the whole span of medicine in Greek and Roman Antiquity, from its earliest written records until the seventh century of the Christian era. It has taken a broad view of what medicine was and how it was practised, trying above all to set it within a context of other developments in ancient society. Such a project could be extended almost indefinitely in a whole series of volumes, but this study has chosen to emphasise three aspects of ancient medicine that provide complementary reasons why one should take an interest in the medical world of so distant a past: its place in the development of Western medicine in general; its continuing influence on modern preconceptions about health and healing; and the diversity of ancient medical practice. The theories of Antiquity formed the very foundation of Western medicine for centuries, even if they were eventually rejected. On this interpretation of the importance of ancient medicine the crucial moment comes very early in the story, as a result of the interaction of medical practice with the new philosophical ideas of the sixth and fifth centuries BC. To the novel form of medicine that developed then were added a more subtle understanding of dietetics in the fifth and fourth century and of human anatomy in the third, with its repercussions for surgery. As a result of wars and conquest the medicine of the Greek-speaking world of the Aegean was successfully transplanted to the Hellenistic world of Egypt and the Levant, and, with even more momentous consequences, to Rome and its Empire. Such medicine, compared with what is known, for example, of Egyptian or Babylonian medicine, can be characterised as progressive, even if authors like Galen saw all progress as ultimately finite and largely achieved by their own day.1 Galen is an ambiguous figure: prodigiously learned and a remarkably talented observer and anatomist, he left a legacy that variously inspired, daunted and constricted his successors. After him, mediaeval learned physicians, writing in Greek, Syriac, Arabic, Latin or Hebrew, strove to synthesise what they knew of ancient medicine and to harmonise its contradictions, confident from their own experience that it provided an effective way of understanding health and disease and of curing patients. Many mediaeval institutions, such as hospitals, civic physicians and collegiate associations, can also be traced back to an origin in Late Antiquity,

if not earlier. When, in the medical Renaissance of the fifteenth and early sixteenth centuries, the writings of the ancient Greeks were rediscovered by humanist scholars and read again in their original Greek in Western Europe for the first time for a thousand years, the belief was widespread that, through this return to the very springs of medicine, the accretions of later error and uncertainty could be purged away. But after this high point in the early 1540s, the influence of Greek and Roman writings within modern medicine began to diminish. Doctors and surgeons set out to emancipate themselves from the perceived tyranny of the ancients by appeals to their own experience and to more modern theories. Galen’s authority was challenged and overthrown, first in anatomy, then in physiology and finally in therapeutics. The more protean Hippocrates survived, but it was as the author of observations and of the Oath, not as the giver of clinical precepts, a medical Moses, that he continued to be honoured.2 The conviction, still strong in the 1820s, that the ancient authors contained much valuable information on diagnosis and therapy was severely shaken by new developments in chemistry and physiology.3 By 1860 ancient medicine was something that could be left definitively in the hands of philologists and antiquarians. Those who wished to derive practical benefit for the present from the theories and practices of the Classical past were viewed as cranks or worse.4 The obituary of Alexander Kavvadias, the son of the excavator of Epidaurus and a distinguished endocrinologist who in the 1920s and 1930s championed a neo-Hippocratic holism, refers slightingly to his wealthy foreign patients and his association with Colonel De Basil’s Ballet Russe.5 Galenism, as Yunani (Greek) medicine, may still endure today as a living learned tradition in the Muslim world and be investigated with the help of the latest technology and scientific experimentation, but Western biomedical science has no longer any need of its ancient past.6 Nonetheless, even if it does not contribute directly to the latest scientific developments, ancient medicine has framed our Western medical tradition and continues to do so in many different ways.7 Patients in darkest Finchley have been shown to assimilate the latest discoveries of modern medicine best if these can be placed within a context of ideas of individual balance and the environment that derive directly from the Greeks. A similar study, also in London, has revealed a continued belief in the six non-naturals as the prime determinants of health, although the technical term itself was never used.8 Patients, of course, can be dismissed as more traditional in their outlook than their doctors, and easily lured away from hi-tech therapies by the siren song of holistic medicine. But, more recently, many doctors too have come to appreciate anew some of Galen’s methodologies in studying foodstuffs, anatomy and the sick patient.9 In the 1990s a best-selling and academically respectable study of child psychology argued strongly that Galen’s theory of the four temperaments and his somatic model of interaction between mind and body offered a better way of understanding psychological development than Freudianism and its successor theories.10