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War and wealth are both useful for training doctors, the first providing dead bodies, the second the living who can pay for recovery. Robin Lane Fox begins The Invention of Medicine on the battlefield of Troy, where Homer’s “anatomical topography” has long been admired by modern students of the “brachial plexus lesion” (a numbed hand after a blow on the collar bone), the “greater sciatic notch” (pathway for a spear from buttock to front), and the type of throat wound that allows a dying hero a last word.
Lane Fox’s story ends in the lesser known medical training grounds of Thasos, a gold-mining island in the north Aegean sea which, some 500 years after the Trojan war, was home to wealthy patients who paid doctors to study closely their ailments, few from violence, more from excess of wine, sex and other enjoyments of money.
In this engaging history by the biographer of Alexander the Great, lightened with wry donnish wit, Thasos is more important than Troy. Lengthy study there of sick individuals, thoroughly noted in surgeries and at bedsides by writers of the so-called Hippocratic corpus, turned medicine from vivid description into science. The idea of an earlier “Doctor Homer”, an ancient with a black bag describing liver membranes, had obvious appeal to surgeons who sought poetry in their profession’s past.
The entire plot of the Iliad, the wrath of Achilles, comes from the hero’s reaction to the wounding of the Greek army doctor, Machaon. But epic poets were not concerned with natural cause. Gods did the causing and sometimes the curing too but they did not deal with the mundane.
One of the earliest big medical fees came in around 520BC to a fortunate Greek slave called Democedes from Darius, king of Persia. For healing a damaged foot he received fetters of gold: “forerunners of our golden handcuffs, they were a typically regal gift to an inferior”, Lane Fox explains.
Apollonides, a travelling healer in around 440BC, sought his rewards from a Persian princess in sex until his failure to cure the royal womb earned him two months of torture before a burial alive. Philosophers advanced learning at a lower risk and price: the name of Alcmaeon is attached to the reasoning, around 510BC, that sensation and understanding came from the brain, a potentially great advance had it not been reasoned against by Aristotle.
Lane Fox’s emphasis is less on philosophical wranglings or the fortune of chancers than on detailed observation, the path that takes him to the gold-rush island of Thasos and the controversy over who was the Hippocrates who got the credit for so many doctors’ work. Few dates here are certain but the timing is important: if the most impressive case studies date from around 470BC, not long after Homer’s poems were first set in writing, their author was a pioneer of the rational empiricism that made Greece famous; if they are later, then Hippocrates was merely one of a crowd.
This is itself a much-trodden battlefield. Scholars will argue over how persuasive is Lane Fox’s long argument for the earlier date, based on vocabulary, on the types of diseases (no war wounds) and on inscriptions and remains (“the most massive erect penis to survive in Greek sculpture”).
Other readers can enjoy a vivid ride through a part of Greece little visited in either body or mind. This includes the most detailed account in Greek history of daily weather, the linking of weather to disease, generalisations from samples of urine, blood and excreta, the 19-day course of a drunken fever, the 80-day trial of a woman dying delirious after childbirth, the simultaneous coincidence of a first period with a nosebleed. One of these doctors compares the learning of medicine from predecessors to the cultivation of “what grows in the ground”.
Lane Fox, also gardening correspondent of the Financial Times, notes with satisfaction that “whatever his date” the writer is the first person known to have compared medical teaching to gardening.