Greek Rational Medicine: Philosophy and Medicine from Alcmaeon to the Alexandrians (review)

In spite of its title, this book is not a depiction of early Greek medicine (techne iatrike = medical art) per se, but rather an attempt to inculcate in the reader the author’s positivist interpretation of this medicine’s development. The undergraduate U.K. students at whom Greek Rational Medicine is aimed are not, it would seem, intended to come away from the book with a direct, personal familiarity with the Hippocratic writings and the fragments of Herophilus and Erasistratus, upon which they can then freely build their own interpretations; rather, they are expected to gain a “proper recognition” of the “outstanding achievement” of the Greeks in “invent[ing] rational medicine” (p. viii).

After explaining that by “rational medicine” he means a medicine that regards the human body as consisting of the same material as the cosmos at large, that seeks its disease explanations in natural processes, and that excludes any arbitrary or supernatural element from its modes of thought, Longrigg expounds his fundamental thesis that Greek philosophy alone was responsible for the rise of rational medicine, and that Greek philosophy continued through the period under consideration to play an important role in shaping rational medicine’s development (pp. 1–5). The chapters that follow proceed chronologically from examples of “Pre-Rational and Irrational Medicine” in Mesopotamia, Egypt, and early Greece (pp. 6–25), to a discussion of the rise of natural philosophy in Ionia in the sixth century b.c. (pp. 26–46) and the special significance for medicine of such thinkers as Alcmaeon of Croton (pp. 47–81). Chapter 4 (pp. 82–103) contains a depiction of Hippocratic medicine derived mainly from interpretations of Ancient Medicine, Nature of Man, Nature of the Child, and Epidemics I and III, and the two subsequent chapters explore “Post-Hippocratic” medicine in Plato (mainly the Timaeus) (pp. 104–48) and the biological works of Aristotle (pp. 149–76). The book concludes with an account of “Early Alexandrian Medical Science” (pp. 177–219) and an appendix on “The Role of the Opposites in Pre-Aristotelian Physics” (pp. 220–26). Endnotes (pp. 227–59), bibliography (pp. 260–77), and two indices—one of ancient passages cited (pp. 278–86), and the other a general index (pp. 287–96)—close the volume.

This brief synopsis of Greek Rational Medicine alone suggests both the book’s undeniable erudition and its limitations. Arguments framed in the nineteenth-century positivist duality of science:religion (i.e., rational:irrational) follow one another in unbroken succession, dragging the reader to the inescapable conclusion that before the advent of Greek philosophy medicine was essentially irrational, magical, and religious; that through the influence of this philosophical movement subsequent Greek medicine became rational, natural, and scientific; and that this development represents an unqualified progress and advancement: “Without this background of Ionian Rationalism, Hippocratic medicine could never have been conceived. Virtually all that sets it apart and above earlier and contemporary medicine, whether Greek, Egyptian or Oriental [sic], has been derived from this philosophical background” (p. 2; emphasis added). Despite a suggested awareness of and ability to profit from more careful/sophisticated interpretational methods, the book’s simplistic positivist dualism is never differentiated, and never even justified; see, for example: “This emancipation of medicine from superstition (sc. by philosophy)” (p. 1).

But if we leave the question of the positivist straitjacket to the side for a moment, what can be said about Longrigg’s actual depiction of the genesis of Greek medicine? Three severe weaknesses of his performance immediately reveal themselves: unoriginality, a dependence upon an obsolete scholarly approach, and a negligent passivity vis-à-vis the secondary literature.

Lack of original interpretation, which Longrigg dismisses as “novelty” (p. viii), he himself concedes. This throws him back onto the interpretations contained in the more than two thousand years of Hippocratic scholarship reaching from Ptolemaic Alexandria down to the present—a scholarship highly influenced by sectarian medical disputes, and only in the...