Asklepiosmedizin: Medizinischer Alltag in der römischen Kaiserzeit (review)

This wide-ranging monograph defines the medicine being practiced in the temples of Asklepios/Asculapius during the High Roman Empire as indicative of the everyday experiences of medical interventions throughout the Mediterranean basin. Florian Steger characterizes the medicine of these Asklepieia as a combination of mythic and cultic ritual together with a knowledge of developments in contemporary medicine that altered the patient's diet and lifestyle in order to restore health. The writings of sophisticated and academic physicians—first in the Greek world with the Hippocratic Corpus, and subsequently in the Roman world with the writings of Celsus, Galen, and others—provide scant access to the sociocultural ambience of patients, paying little attention to how Romans described their sicknesses, or how they responded to medicaments. Steger has no interest in retrospective diagnoses in modern biomedical terms, but rather aims at recontextualizing patients' episodes of sickness and recovery within the ancient milieu from which they came. Hence, his emphasis is on accounts from those who approached Asklepios, examining both the mental and physical reactions of the sick to their maladies and the medical procedures that the god prescribed for them in dream-encounters. In a brief introductory chapter Steger surveys previous scholarship, underscoring recent attention to the hiatus between the early development of the healing cult of Asklepios in the fifth to early third centuries BC, when it spread outward from Epidauros to most Mediterranean lands, including Rome and the Tiber island (293 BC), and its subsequent development from the age of Augustus to the end of antiquity. He advances beyond the material on Asklepios collected more than sixty years ago by the Edelsteins by embracing new evidence for the cult from coins, inscriptions, and archeological digs. In the second chapter he describes the pluralities that characterized the "medical marketplace" of the Roman world: choices abounded, although it was only Roman soldiers, and sometimes slaves, who profited from the establishment of fixed places (valetudinaria) in which medical care was available. Many of the individuals named are familiar ones in the history of Roman medicine, from Archagathos (the first Greek to immigrate to Rome in 219 BC) to Oreibasios (who served as doctor to the emperor Julian).

The third chapter amply fulfills Steger's commitment to revisit Asklepios. Comparison among the temple-complexes demonstrates not only concern for a salubrious location, but also for plentiful sources of water for ritual purification, as well as a setting in which patients prayed, made offerings, and otherwise prepared themselves for incubation at the sacral center. Among the many interesting points raised, Steger calls for further investigation of the often-repeated division of competence that assigned hopeless cases to Asklepios (p. 104), and observes that among the votive body-parts from Asklepieia, outwardly visible organs markedly outnumber depictions of inner organs (p. 129). This third chapter concludes with an innovative investigation of patients' self-reflective expression of illness and recovery through Asklepios. At Epidauros the god instructed M. Julius Apellas to employ techniques for warming his body, such as those also recorded by Pliny the Elder and Galen: he should eat cheese, bread, celery, and lettuce; he should bathe, run, exercise with a swing, go barefoot; he should pour wine over his body, and massage it with sand.

The fourth chapter follows the transformations that took place in the medical cultures of the ancient Mediterranean over the millennia, as practices migrated from Babylonia and Egypt to Greece, Rome, and, after the end of antiquity, to the Arab world—only to travel west once more, as Constantinus Africanus and others translated Arabic into Latin. In the fifth and final chapter Steger argues that macrohistorical phenomena are better explicated through microhistorical examples: the Asklepieia of the High Roman Empire well exemplify the plurality inherent in the medical systems of the Mediterranean world.