Galen and the Rhetoric of Healing (review)

Healing combines, among other things, medical, psychological, economical, and social aspects. It is the last that is the focus of Mattern's extraordinarily rich book on Galen's clinical experience. Despite the title, this is not a book on rhetoric, persuasion, or questions of how to represent medical arguments. Instead, "this book is about Galen's subjective experience and his subjective account of that experience" (conclusion, 159). If one prefers to stick with the arts of the trivium, (social) "grammar" would have provided a better analogy.

From a social historian's perspective, Mattern thoroughly analyzes Galen's accounts of healing, applying concepts like status, class, authority, occasion ("arena," market), social networks, etc. Mattern discusses these narratives from every conceivable angle, from realia-focused questions to more abstract ones, such as problems of time in narrative. A clear picture emerges of an upper-class Greek physician in imperial Rome, caught up as an actor in the network of traditions, patients, friends, and rivals. The result is a clearly presented and densely argued book that will be required reading for everybody interested in the Second Sophistic, imperial Rome, or Greek medical writing.

Galen's numerous works have largely defied the attention of both literary critics and (social) historians, because, except for a few specialists, it is almost impossible not to lose oneself in the jungle of his works. Not only the sheer bulk, but also Galen's frequent and unpredictable digressions make a newcomer's approach so difficult. Mattern's book changes the situation for social historians; it is one of the works everyone who works on Galen has been waiting for: her list of 358 case histories in Galen (appendix B) alone will prove an indispensable tool. After a concise and up-to-date discussion of Galen in his historical context (1–27 provide the best non-medical introduction to Galen, his writings, and the audience that I know of), Mattern turns to medical narrative. Meant as background to her research on clinical narratives, this part of the first chapter also contributes to literary readings of Greek medical writing (see especially 45 on the archetypal nature of medical case histories as stories). Many of Mattern's most compelling points are almost delivered as asides: e.g., she explains the fiercely competitive mood that pervades Galen's writings as influenced by high mortality in Rome (6), and his constant rhetoric of education as a status-conscious strategy that tries to get in touch with the sophistic concept of paideia (23–24).

In what one might label a "social reading," Mattern attempts to describe and understand Galen's clinical narrative as a whole. She collects and discusses all possible aspects of the healing encounter (place, time, social context of physician and patients, entourage, competitors, the arena, structure of the contest, audience, etc.) and its literary depiction. She provides a sophisticated discussion of the former that understands the medical realm as a subset of the agonistic mode that pervades the self-presentation of imperial social elites and makes many highly interesting points on matters as diverse as, e.g., the relation of town and country, the bedroom as a prime space for social encounters, or anger as part of social economy.

It is the latter, the clinical narrative as text, however, that provides the most significant step forward by understanding medical narrative as a means of exploring how reality, experience, and representation are related. Mattern's discussions of "medical time" (62–65), of conversion narrative (66–68, 95–97), of sickness as a social event, of the relation of physician and patient (ch. 5), of Polyclitus' Canon and Galen's idea of the well-balanced patient (104), of voices in case studies (119–20), of meaning in clinical narrative ("hung on a framework of taut wires," 136, almost a structuralist concept), of the struggle for power and authority underlying many of Galen's case histories ("obedience" 145–49), and of how diseases change roles and social...