Galen and the Rhetoric of Healing (review)

The twin impulses of the historian, to archive and to narrate, are often in tension. The archivist wants to collect and preserve, indiscriminately and exhaustively, the artefacts of history. The narrator, by contrast, seeks to tell a story by emphasizing certain of those artefacts at the expense of others, judging, at least implicitly, which of them are significant and which are not. Susan Mattern’s latest book, Galen and the Rhetoric of Healing, showcases the work of a historian both alive to the demands of these impulses and talented enough to meet them. That is not to say that both demands should always be met.

The subject of Mattern’s study, as it happens, is neither Galen’s rhetoric proper nor his views on healing per se but rather the “clinical narratives” or “case histories” that survive in his writings. She has done us the great service of combing Galen’s corpus for these, cataloging and studying them along the way. Here is where Mattern’s archival impulses are most potent, for example, in the book’s two appendices, the first of which lists the standard editions of each of Galen’s works, while the second comprises a table containing an entry for each case history in Galen (358 total). Each entry records the textual reference, the name or unique description of the patient, the medical problem at issue, and a summary of Galen’s involvement with space for additional comments in the case of especially remarkable or interesting histories. This is typical of the diligence and discipline Mattern exercises in her treatment of the subject, evident also in the dense thicket of footnotes that cite a bibliography of truly admirable scope and depth. The main body of her text is divided into six chapters that organize and present the case histories according to their basic narrative elements of setting and character. The second (“Place and Time”) and fourth (“The Patient”) of these are particularly “archival.” Here Mattern is most careful to make connections and offer analyses without prejudice as to their broader significance (scientific, social, cultural, or otherwise). Indeed, she is willing in places to risk the coherence of her exposition for the sake of impartiality, as she sometimes recognizes, for example, when she introduces a discussion of the categories Galen uses to describe his patients: “The division is not especially logical nor can it be made entirely consistent, but it captures certain complexities in Galen’s way of thinking, which I have tried to sum up in the conclusion to this chapter” (99).

Nevertheless, it is when Mattern uses Galen’s stories to tell a story that her book is most engaging. This is true especially of the third and fifth chapters (entitled, respectively, “The Contest: Rivals, Spectators, and Judges” and “Physician and Patient”), which analyze Galen’s portrayal of the relational dynamics between himself and the other “characters” in his clinical narratives. The third chapter makes a convincing case that, whatever other purposes they may serve, the clinical narratives are for Galen a record of his public struggles with and victories over his medical (and sometimes philosophical) competitors. The agonistic atmosphere of the Second Sophistic, during which time orators and other intellectuals routinely gave public demonstrations of their talents for the sake of fame and fortune, transformed a sick person from a mere patient into an opportunity—an opportunity both for Galen to succeed and for rival physicians to fail. The fifth chapter suggests that the reputation Galen acquired through these displays of healing had social implications. In a thoroughly Thucydidean moment, Mattern describes how, when a person fell ill, the exigencies of sickness and survival could dissolve the usual social conventions and invert political hierarchies. So Galen tells us that he gives orders like a general, regardless of whether his patient is a pais or a politician (146). At the same time, he reports consorting with slaves and others of marginal status...