The Art Is Long: On the Sacred Disease and the Scientific Tradition (review)

The fifth-century BC medical text On the Sacred Disease is often used in positivist accounts of the origins of modern medicine. In this elegant and readable analysis, Julie Laskaris submits that the text demonstrates not the first stage of the triumph of scientific thought, but the enduring strength of other ways of healing dating back to the Bronze Age. In a tightly argued introduction, drawing in particular on the work of Karl Popper, she examines what we mean by "science" and suggests that this treatise is "scientific," not in terms of its methods and goals, but because it offers a critical challenge to earlier theories: it uses observation not to generate, but to test, theory. A chapter on medicine in Greece before the fifth century sets the context within which the author of On the Sacred Disease was writing, and uses archaeological evidence to explore knowledge of medicinal plants and the role of writing in transmitting medical knowledge. Drawing on Rosalind Thomas's work on orality and literacy, Laskaris discusses the role of specific cultural contexts in determining whether writing is used to fossilize knowledge, or to facilitate criticism and debate. Further chapters examine the history of scholarship on this text, noting its lack of impact on ancient medicine, and analyze it in terms of its rhetorical and sophistic features.

Laskaris defines her field as the opposition between "secular" medicine and "magico-religious healers." She resists the label "Hippocratic" because the adjectival form is not used before Galen and, in any case, the term obscures the wide variation between the texts of the corpus in theories and outlook. She rejects even more firmly that of "rational" medicine, a value judgment which she exposes as the product of an ethnic opposition between an irrational Eastern medicine based on spells and sacrifices, and a rational Western medicine using drugs and surgery. This model, equally reductive for both sides of the divide, leads us to ignore both the "rational" elements in Near Eastern medical systems and the "irrational" elements, such as coprotherapy, in Greek medicine. Laskaris also resists retrospective diagnosis, noting that the "sacred disease" appears to encompass a range of other conditions in addition to the epilepsy with which it is usually identified.

The polemic of the author of On the Sacred Disease against the magico-religious healers who claim to treat the condition shows that "the art is long"—in other words, that the long history of medicine in earlier Greece led to a high level of common ground between the two types of healer, and hence serious competition between them. It is Laskaris's central contention that the treatise, originally given as a speech, was intended to attract patients and, perhaps, students. Renaissance writers praised it not for its "rationality" but because it showed that "Hippocrates" had a proper respect for religion, and Laskaris shows that the writer does indeed present himself as both more pious and more knowledgeable than the magico-religious healers. He selects this disease for his attention precisely in order to take on his rivals and defeat them in an area in which they claim special expertise; he demonstrates that he understands the "divine" better than they do, and works to subsume their "supernatural" within his category of the "natural." In the process, he aims to show that medicine is a technê, meaning that its actions are based in theory, and its success is based on this rather than solely on chance.

Throughout, Laskaris offers pertinent comparisons with early modern thought and with anthropology, particular highlights being her investigation of "natural law" as a social construct, using Stuart Clark's work on demons, and her discussion of why contagion did not take off as a concept within humoral medicine...