Patients and Healers in the High Roman Empire by Ido Israelowich (review)

This book promises a more holistic and encompassing study of health care in the Roman Empire than has hitherto been provided in the scholarly literature. Rather than privileging the practitioners’ perspective, and the practitioners of more learned literate medicine at that, Israelowich claims to give equal attention to the patients, to their beliefs, expectations, and actions: indeed “all actors involved in health care” will be given full consideration (p. 9). This is a laudable project, but, unfortunately, poorly executed here.

The problems emerge on the contents pages. The chapter topics themselves give pause for thought, as they do not seem to match the project. Chapters titled “The Identity of Physicians during the High Roman Empire,” “Patients’ Understanding of Health and Illness,” “The Domus and Reproduction,” “Health Care in the Roman Army,” and “Medical Tourism during the High Roman Empire” do not indicate engagement with all aspects of healing and health in the Roman world. Moreover, the identity of these “patients” turns out to be even more restricted, and rather differently constructed, than might be expected. There is no attempt here to use the surviving letters from the Roman Empire, for example, as evidence for interactions of patients with their physicians, from the perspective of the former. There is almost no attempt to use a wider range of Roman, nonmedical writings to explore the way people thought about, and were active around, their bodies and health, disease and healing, more broadly: to delineate and discuss a general category of “users” of health care services construed as inclusively as possible, and certainly including self-help, from the full array of material available. Rather, the focus is on what physicians say about their patients, or, to be more precise, what one physician says in one text about those too stupid to want to be his patients, rather misleadingly interpreted, taken together with a particular set of evidence about the recipients of divine cure. This is both literary, and epigraphic, and presented from the point of view of those cured, though unfortunately most of the inscriptions come from classical Greece, around half a millennium before the period this book claims to cover; but the key question is actually whether this is a group that can, in any sense, stand for either “patients” or the users of health care services more generally.

The same mismatch occurs in all the chapters. The only mothers who feature under the heading of “Mothers’ Experiences” are classical Greek beneficiaries of divine assistance in having children, “Health Care in the Roman Army” is about its providers, and it turns out the “medical tourists” in the final chapter are essentially the same people who appeared as “patients” earlier. Moreover, the pattern of misleading interpretation, and reliance on evidence from other periods, is also repeated, with some egregious errors thrown in, and much relevant recent bibliography is ignored (in both the field of Roman medicine and medical history more broadly). A single case illustrates several of these flaws. Johannes (or John) is not the name of a Roman jurist (as stated on p. 79), but the imperial official—the famous praetorian prefect John the Cappadocian—to whom Emperor Justinian addressed various clarifications and revisions of inheritance law in 531 CE, long after the empire ceased to be “high” (a rather old-fashioned designation anyway). This comes as part of a discussion about Roman midwives that makes no reference to the key articles on the subject by Christian Laes (2010 and 2011), for instance, nor to the slew of recent publications on Roman motherhood. Even the cover illustration is mislabeled; this relief does not come from “the tomb of an unknown Roman midwife” (as claimed on the back cover). A lengthy inscription (A. Helttula, Le iscrizioni sepolcrali latine nell’ Isola sacra [Rome 2007], no. 133; also included in the standard online databases, and much discussed in many contexts) announces that the monument was erected by Scribonia Attice for...