La chirurgie dans l'Égypte Gréco-Romaine d'après les papyrus littéraires grecs (review)

Marie-Hélène Marganne. La chirurgie dans l'Égypte Gréco-Romaine d'après les papyrus littéraires grecs. Studies in Ancient Medicine, vol. 17. Leiden: Brill, 1998. xxx + 192 pp. Ill. $81.00; Nlg. 138.00.

Marie-Hélène Marganne is well known for her interest in medical papyri. In this volume she summarizes and examines the information about Greco-Roman surgery that is preserved on papyrus fragments recovered in Egypt. The book is taken up in the main with seven fragmentary texts dating from the first to the third century c.e. Of these, five derive from rolls (volumina), one from a codex, and one is written on the back of a personal memorandum. Two were recovered in the Fayum, while the rest are of uncertain provenance. Also supplied is a catalog of eleven other fragments (first to seventh century c.e.) with a brief summary of the contents of each (pp. 148-54). Marganne has herself worked with much of this material in the past.

The major fragments include: (1) directions for plastic surgery to repair a facial lesion (coloboma); (2) some views of Archibius on surgical education; (3) four ways of reducing a dislocated jaw; (4) details on bone surgery, and surgical intervention for fistula; (5) a portion of a surgical dictionary cast in question-and-answer format; (6) a fragment of book 5 of the treatise On Surgery by the renowned Heliodorus, dealing with the causes and treatment of damage to the anal sphincter resulting in involuntary discharge of feces; and (7) a description of three ways of reducing a dislocated shoulder.

Following a brief but detailed introduction to Greco-Roman surgery, its practice in Egypt, and Greek medical and surgical papyri, Marganne presents the texts. Her treatment of these fragmentary documents is comprehensive and thorough. Along with a description and edition of each, she provides a bibliography, critical and grammatical notes, a translation into French, a full commentary with ample citation of relevant classical sources (Hippocrates, Celsus, Oribasius, Aetius, Paul of Aegina), and, when appropriate, illustrations. At the end of the volume there are an extensive general bibliography and two indices, one of proper names, the other of subjects treated.

Each of the fragments provides some item or feature of interest. Fragment (2), in linking Archibius to the Empiricists, sheds a bit of light on this shadowy figure. Fragment (4) adds to what we know of the use of trephine and chisel in surgery; here Marganne provides in her commentary a list of Greco-Roman surgical instruments recovered in Egypt. Especially noteworthy is fragment (6), because it constitutes the sole witness to the final sentences of book four of Heliodorus's lost treatise On Surgery, as well as the sole direct witness to the work itself; included in Marganne's comments is a useful summary of all five books of the treatise as gleaned from extracts of it made by Oribasius. The most extensive fragment is (3), where we have ninety-seven lines of running text in good condition. Among other things it sheds light, along with fragment (7), on the so-called instrumentalists (organikoi), practitioners who attempted the reduction of dislocations and fractures with an array of mechanical gadgets. Fragment (7) also provides treatments for a dislocated shoulder that are otherwise unattested to, some involving resection of the bone in cases complicated by fracture. As these last two texts are not always easy to understand, Marganne illustrates them with a series of helpful drawings (some from Littré), along with illustrations taken from the famous Florentine manuscript containing the commentary on Hippocrates' On Joints by Apollonius of Citium.

The benefits to be derived from the close study of these papyrus fragments are well summarized in the concluding chapter, where Marganne justifiably stresses the value of these early witnesses for correcting...