Roman North Africa: Environment, Society and Medical Contribution by L. Cilliers (review)

This is the first book-length work in English to take late-antique Roman North African medical authors as its focus, but it represents a rising interest in the social context and popularization of learned medicine in Late Antiquity. The extraction and clear presentation of information about and from late-antique medical works is welcome indeed.

In this book, Cilliers accomplishes three central tasks: she synthesizes the limited knowledge we have about late-antique medical writers in Roman North Africa, she situates these writers against the backdrop of ancient and late-antique medicine, Roman North Africa, and the rise of Christianity, and she makes the fairly obscure medical texts of Late Antiquity accessible to a wider audience of scholars and students. Following a series of introductory chapters, Cilliers offers individual discussions of key late-antique medical authors closely associated with North Africa: Vindicianus (mid-/late fourth century ce), Theodorus Priscianus (late-fourth and early-fifth centuries ce), Caelius Aurelianus (fourth or fifth century ce), Cassius Felix (fifth century ce), and Muscio (fifth or sixth century ce). The information available for each of these authors is sparse, and Cilliers is careful not to speculate further than is justified by the existing evidence. The final third of the book moves on to consider the role of Christianity in the preservation and transformation of learned medicine in late-antique Roman North Africa, focusing especially upon the fourth-/fifth-century bishop Augustine of Hippo.

The first chapter, 'History, environment, population and cultural life' (pp. 15–56), is the longest in the book. It offers a cultural history of North Africa from Punic settlement in c. 800 bce to Islamic settlement in the seventh century ce. Cilliers organizes this survey around key themes: important cities; olive and wheat production, as well as red-slip pottery; people groups (Berbers, Ethiopians, Phoenicians, Greeks, Vandals); languages; and intellectual life. This chapter is an impressively deft account of a broad range of scholarship on North African cultural history in Antiquity. It is marred in parts by its presentation from a Romanocentric perspective, as reflected in the absence of 'Romans' from the list of people groups accounted for. The Romans are not the object of study, but the lens. This results in some infelicities that seem out of step with Cilliers' own agenda. While Cilliers does point out to the reader that 'a negative view of the Berbers' has, in recent decades, been 'repudiated as Eurocentric' (p. 43), this very perspective manifests itself in the text through valorization of Roman imperialism, as on p. 23:

'The revival under Byzantine rule … had the benefit that the high level of civilisation of the previous centuries was maintained, with the result that the Arabs' inheritance was not that left by the Vandals and Berbers, but that of cultured people who could still read and write and remembered what the Romans had taught them.'

Chapters Two through Four provide background information on ancient medicine in its social context. Chapter Two, 'Health facilities in the cities of Roman North Africa' (pp. 57–78), offers a useful guide to aqueducts in the Roman Empire in general, and in Roman North in particular, to the public baths, and to sewers; it also includes a discussion of hospitals, including military hospitals. Chapter Three, 'Greek, Roman and Christian views on the causes of infectious epidemic diseases' (pp. 79–96), offers a brief account of the development of learned medicine and rationalistic explanations of disease, a discussion of ancient views on contagion, and a brief account of epidemics known from literary sources. As Cilliers emphasizes, bacteriology is a modern discovery, and the closest that ancient sources come to theorizing contagion is in theories of pollution or transmission through airbourne 'seeds'. Chapter Four, 'The knowledge and competence of physicians in the late Roman Empire' (pp. 97–116), gives an account of state regulation of the medical profession (drawing on information from late-antique legal digests) and surveys what...