On Ancient Medicine (review)

The treatise On Ancient Medicineis probably the most heavily commented-on work in the Hippocratic Corpus. The studies that have been devoted to it include books or articles by Festugière, Miller, Diller, Wasserstein, Jouanna, Hankinson, and Cooper—just to mention some of the most important. Mark Schiefsky completed a Harvard Ph.D. dissertation on this treatise in 1999, which he has now turned into a substantial monograph. He uses Jouanna's text and disclaims any ambition to produce a full-dress critical edition—but he provides a full introduction, a clear translation, and an extensive commentary, the detail and depth of which surpass those of Festugière and Jouanna themselves. Two appendices deal with On Ancient Medicineand medical empiricism, and with the contrasts between On Ancient Medicineand Plato, Aristotle, and others on the imprecision of medicine. The resulting tome will surely stand as a scholarly reference work for many years to come.

On Ancient Medicinedeserves the scholarly attention lavished on it, because of all the works in the Hippocratic Corpus it is by far the most methodologically and epistemologically sophisticated. The cruces of interpretation it presents include especially (1) the sense of hupothesisand the nature of the method the treatise rejects, and (2) the degree of exactness the author allows for medicine. On (1) the chief question is whether the author objects to hupotheseisin general, or just in medicine, or just to the new-fangled hupotheseisspecifically introduced by his unnamed opponents ("hot, cold, dry, wet and anything else they want" [as the author puts it in Chapter 1]). Schiefsky opts for a version of the second view, interpreting hupothesisas a unifying or foundational principle, but not as an axiom. On Ancient Medicine, on this view, can accept the use of such in other fields, such as meteorology. When that point is made in On Ancient Medicinechapter 1, Schiefsky detects no irony, even though the continuation undermines the concession (if there is one) to meteorology by adding that "there is nothing by reference to which one would necessarily attain clear knowledge" (chapter 1).

On (2) On Ancient Medicineis again somewhat ambivalent, suggesting in chapter 9 that accuracy ( to akrekes) is rarely to be seen, but claiming nevertheless in chapter 12 that precision ( akribeia) has been achieved in many aspects of medicine. The most important point is that medicine is a genuine technenevertheless. The limitations of medical knowledge, on Schiefsky's reading, stem firstly from the variations between one patient and another, and secondly from the tools available to the doctor. The doctor has no other measure ( metron) besides the feeling of the body—which Schiefsky takes to be a matter of how the patient feels, not of how the doctor feels the patient. Against those who have interpreted On Ancient Medicineas being close to the position of Protagoras in Plato's Theaetetus, Schiefsky insists that the author is no relativist—but no more does he anticipate Plato's view on the contrast between an art/skill and a mere matter of experience ( empeiria).

There is nothing startlingly novel in the views that Schiefsky adopts on these (and indeed most other) issues. In general, he opts for a position at the conservative end of the spectrum of scholarly opinion. He maintains "with some confidence" (p. 64) that On Ancient Medicinewas written during the last quarter of the fifth century BCE—though his chief arguments for this, I would say, are quite inconclusive (for example, that the author's concern with discovery and his notion of continual progress are "characteristic" of the late fifth century; or arguments that relate On Ancient Medicineto other Hippocratic works that are themselves of quite indeterminate date). But Schiefsky can be congratulated on a thorough survey of the issues raised by this important work.