Anonymi Medici: de morbis acutis et chroniis

404 Pages·1996·11.485 MB·English

by  Ivan Garofalo, Ivan Garofalo

ANONYMI MEDICI
DE MORBIS ACUTIS
ET CHRONIIS
Edited with Commentary by
I van Garofalo
Translated into English by
Brian Fuchs
EJ.BRILL
LEIDEN • NEW YORK • KOLN
1997
Che paper in this book meets the guidelines for permanence and durability of the
Committee on Production Guidelines for Book Longevity of the Council on Library
Resources.
ISSN 0925-1421
ISBN 90 04 10227 2
© Copyright 1997 by EJ. Brill, Leiden, The Nether/,ands
All rights reserved. No part of this publication may be reproduced, trans/,ated, stored in
a retrieval .rystem, or transmitted in any form or by any means, el.ectronic,
mechanical, photocopying, recording or otherwise, without prior written
permission ftom the publisher.
Authorization to photocopy items for internal or personal
use is granted by E.J. Brill provul.ed that
the appropria.te fees are paid direct!), to The Copyright
Cl.earance Center, 222 Rosewood Drive, Suite 910
Danvers MA 01923, USA.
Fees are subject to change.
PRINTED IN THE NETHERLANDS
CONTENTS
Introduction . ................................................................... ........... ..... vii
Editorial practice .......................... ....................... ........................... xxvii
Acknowledgments .......................................................................... xxix
Siglorum explicatio .................... ........................ ............. .. ............. xxx
ANONYMI MEDICI
De morbis acutis et chroniis, Greek text and
English translation in front............................................................. 2
Bibliography . . . ........... ................. .. . . . ..................................... .......... 263
Indices ...... ............ ............ .. ... ..................................... .. . ................. 267
Index nominum propriorum .................... ................ .................. 269
Index graecus .... .......... ..... . ........................ ............... .................. 271
Index auctorum et locorum .................... ................ ................ .... 343
Index of drugs and foods ...... .. ...... .... .. ................ ............. .......... 355

INTRODUCTION
The work on acute and chronic diseases, by an anonymous physician of
the imperial age
Anonymus Parisinus1 (AP) Darembergii2 sive Fuchsii,3 is the still name-
less4 author of the only work beside Aretaeus' ,5 preserved in Greek, on
acute and chronic diseases.6
The distinction between the two kinds of disease is of course a very
ancient one. We have the Hippocratic work on the regimen in acute dis-
eases and the therapeutical treatises of the Corpus Hippocraticum (CH)
7
describing many acute diseases.8 After "Hippocrates" other works enti-
tled On Acute diseases are mentioned.9 Chronic diseases, however, were
not dealt as opposed to acute ones. A distinction between internal and
external diseases goes back to the CH and was followed later on. 10 Diodes 11
and Praxagoras 12 entitle their works On diseases, their causes and treat-
ment.
1 The name Parisinus is due to the fact that the sole complete manuscript is the
Parisinus suppl. graec.636, a codex brought to Paris by the M. Mynas (s. below).
2 Daremberg was the first who understood the independence and the originality
of this work, Mysas saw in it Galen's Euporista. See Garofalo Prolegomena.
3 R. Fuchs was the first editor of parts of AP (s. below).
4 For tentative identifications see below.
5 Ed. Hude, see bibliography.
6 In Latin we have the adaptation of Soranus' by Caelius Aurelianus.
7 Of course we are considering the subject, not the title, which is not ancient.
8 Of the sixteen dealt with by AP (phrenitis, lethargy, epilepsy, apoplexy, cephalea,
angina, tetanus, pleuritis, peripneumonia, syncope, bulimia, hydrophobia, cholera,
ileus, colic, satyriasis) all, except bulimia, hydrophobia and satyriasis are described
in the CH.
9 Asclepiades: CA Ac. I §6, II §6 etc. De celeribus. For Asclepiades see Vallance
1990 and 1993.
10 Cf. De interioribus. Heraclides of Tarentum CA Ac. I §166 (Curationes de
intemis passionibus), Apollonius Glaucus, CA Chr. IV§ 113 (De interioribus).
11 Fragments collected by Wellmann. A new collection is being prepared by P.
van der Eijk.
12 Ed. Steckerl.
Vlll INTRODUCTION
Prior to Themison13 (1st c. BC), according to Caelius Aurelianus,14
physicians did not treat specifically chronic diseases. In Celsus'15 times
(under Tiberius) the specificity of chronic diseases was recognized, but
theoretical difficulties arose in ranking diseases among either group, and
Celsus himself does not adopt the classification.
In the methodist school, 16 which was developing in Rome in this pe-
riod, the treatment of chronic diseases became very sophisticated, with
Thessalus, 17 in the Neronian age, and other anonymous methodists. 18 It
reached its perfection with Soranus. 19
The other "Roman" school, the pneumatists, 20 were also active in de-
veloping special treatments for chronic diseases. Aretaeus' treatise On
Acute and Chronic Diseases is not to be dated with certainty. 21 Archigenes22
(fl. under Trajan) wrote on the causes' signs ('t&v o~icov Kcxt xpovicov
1tcx0oyvcoµovtKa)23 and on the therapy (0epcx1teunKcx 't&v o~icov Kcxt
xpovicov 1tcx0&v) of acute and chronic diseases, of which many chapters
13 On Themison v. Diller, RE Themison, Pigeau p.566 ff.
14 See CA Preface to Chronic Diseases I §3 scribentium igitur medicinam nullus
ante Themisonem tardarum passionum curationes principaliter ordinavit. The rea-
son is both theoretical and sociological. Caelius stresses the medical difficulties of
healing a chronic disease. But it was also an economical question. The treatment of
chronic disease requires a class of relatively rich patients, such as the urban bour-
geoisie of the Roman Empire.
15 Celsus ed. Marx, 3.1.1. For difficulty concerning this classification v. Celsus
ib.
16 For the philological problems concerning the origin of methodism see Edelstein,
RE Suppl. VI, Methodiker, and Pigeau.
17 On Thessalus see Diller RE and Pigeau.
18 CA Chr. I §3. For methodist medicine see Mayer-Steineg.
19 On Soranus see Hanson-Green, ANRW, also for the vexata quaestio concern-
ing the degree and quality of Caelius' originality. For the text of Caelius Aurelianus
(CA) ed. Bendz and Drabkin.
20 Wellmann's Pneumatische Schute is still fundamental. For recent literature
Kudlien Pneumatische Aerzte.
21 On the chronology of Aretaeus see S.M. Oberhelmann, ANRW 37.2 also for
bibliography. His dependence from Archigenes, affirmed by Wellmann Pneumat.
Schute, is now rejected.
22 The fragments of Archigenes are chiefly preserved in Galen and Aetius. A mod-
ern collection does not exist. Most are in Wellmann's Pneumat. Schute. The partial
edition by Calabro is not completely reliable. A great improvement on the text will
be made by the critical edition of Aetius' IX-XVI prepared by Garzya and his equipe.
23 Gal. De tocis ajfectis 8.203: a quotation from the causes of vertigo (skotomaticon
pathos).
INTRODUCTION ix
are extracted by Aetius24• Galen relies largely on him.25 A work of this
title is not attested for Rufus, although in his fragments chronic diseases
are present, and the Ephesian wrote three monographs on chronic dis-
eases, on The diseases of kidneys and the bladder, on Gout, on Jaundice.
Only the first is preserved in Greek.26
The division ac./chr. is not followed by Oribasius, Alexander of Tralles,
Aetius, Paulus of Aegina, Paulus of Nicea.27
AP
Both acute and chronic diseases are ranged a capite ad calcem, according
to the common disposition in Greek medical works 28 and follow a precise
physiopathology, which is often different from the principles followed by
Aretaeus and Caelius Aurelianus and others. 29 In particular, for acute dis-
eases: head (phrenitis, lethargy, epilepsy, apoplexy, cephalea), neck (an-
gina, tetanus), chest (pleuritis, peripneumonia, syncope), esophagus30 (hy-
drophobia), peritoneum (cholera), intestines (ileus, colic), sexual organs
(satyriasis).
In the chronic diseases: head (vertigo, madness, melancholy, fanati-
cism, various forms of paralysis)31; chest (blood-spitting, phthisis,
empyems, atrophy,32 asthma); abdominal cavity (liver inflammation, jaun-
dice, liver cirrhosis, spleen inflammation, spleen cirrhosis, kidney inflam-
mation, bladder haemorrhage, ulceration and paralysis); intestinal diseases
(lientery, dysenteric rheumatism, dysentery) then general diseases
(cachexia, dropsy), anus (tenesmus) and penis (gonorrhoea), joints (sci-
24 Orib. 8.1-2 on hellebore.
25 Galen himself did not write a manual, but treated the subject of aetiology, se-
meiology and therapeutics in a general way. In practical details he prefers to com-
ment on other authors' works, such as Arc hi genes' IlEpt trov icatcx toitov <papµa.icrov,
drugs according to the (affected) places, in his De comp. med. sec. genera and De
comp. med. sec. locos. The loci paralleli are given at the beginning of the commen-
tary to each chapter.
26 Ed. Sideras. On Gout is in Latin translation (ed. M~rland); of the third we have
several fragments in the Arabic tradition: see Sideras and Ullmann inANRW II 37.2.
27 All are arranged a capite without distinction ac./chr.
28 Since the hippocratic De morbis and De int.
29 Details in the commentary.
30 See the aetiology, p.84.
31 Except bladder (see below).
32 Atrophy is placed in CA Chr. III vii after liver diseases and jaundice.
X INTRODUCTION
atica, arthritis, gout), and, last, a new disease, elephantiasis, as in Aretaeus. 33
Against both Aretaeus and Caelius Aurelianus, AP ranges cephalea
and colic among the acute diseases. Against Aretaeus, but in agreement
with Caelius, he classes madness and blood-spitting among the chronic
diseases.34
The author does treat the external diseases, such as those of the skin,
eyes, ears, nose, like Aretaeus but unlike CA the internal ones: stomach
diseases, koiliakon35 pathos and pneumatosis. Among the forms of pa-
ralysis, those of the penis and rectum are not dealt with.
Each chapter is divided into cause, signs, treatment, with chapter ti-
tles;36 this division is not preserved in other medical works37 except that
of Alexander of Tralles. 38
Specific to AP is also the fact that the aetiology is generally not the
author's aetiology,39 but a list of opinions from four medical authorities,
Hippocrates, Diodes, Praxagoras, Erasistratus.40
The capacity of AP for mastering the subject has been recognized by
Daremberg and Wellmann.41 The high quality of his treatments is con-
33 Aretaeus CD 2.13. In CA it is between dropsy and phtiriasis. In Themison
elephantiasis was not in the book on Chronic Diseases, but in the second book of
letters to Asilius Dimas (CA, Chr. IV § 4).
34 Aretaeus ranges in the two groups respectively the acute and chronic types of
some diseases, such as epilepsy, kidney diseases etc. As to AP and CA in the treat-
ment of acute diseases a degeneration into chronicity is sometimes taken into ac-
count, and in chronic diseases an acute phase is generally considered.
35 But he treats rheumatism under dysentery (ch. XLII), which is probably the
same disease with other name: see commentary. p.215ss. and Garofalo, Relazioni.
On the cause of this absence of stomach diseases see below.
36 The titles are missing in the Latin translation of chapter XLII and sometimes in
ms. V; perhaps they are not original.
37 On the distinction between signs and treatment see ex. gr. Demetrius of Apamea
CA Ac. I §4 (De passionibus), III § 178 (in libro signorum). Celsus does not treat
causes: he gives signs and then treatment. In Aretaeus causes and signs are dealt
together in the four books on signs and causes, the treatment is dealt in other four
books on treatment. In Soranus-Caelius the matter is arranged as in AP, cause, signs,
therapy, but cause and signs are not separated by chapter titles.
38 Ed. Puschmann.
39 The author expounds his own aetiology in chapters XII, XV, XVI, XVII, XXVI,
XXVII, XXVIII, XXIX, XLII, XXXI, XXXIV, XXXV, XXXVI, XXXVIII, XXXVIII,
XXXIX, XL, XLII, XLIV, XLVII.
40 A study by P. van der Eijk will appear soon.
41 See Wellmann, "Herodot".
INTRODUCTION xi
firmed by the several extracts made by Oribasius, Paulus of Aegina,
Aetius.42 For certain diseases (such as angina, or haemoptysis) AP's thera-
peutics are among the best we have in medical literature.
The author 43
Fuchs's identification of AP with Asclepiades' disciple Themison was cor-
rectly rejected by Wellmann.44 But Wellmann was wrongly convinced that
the author of our work is the pneumatic-eclectic Herodotus.45 Similarities
in doctrine, lexicon, style are unduly emphasized by the German philo-
logist when he compares AP with the extended extracts of Herodotus,
preserved in Oribasius, Paulus Aegineta and Aetius.
Doctrinal convergences
In the therapy of phrenitis (I.3.7, p.6.25 ss. of this edition)46 AP prescribes
somniferous drugs, in words similar to those used by Herodotus in the
case of insomnia (Orib.Syn. 6.32), but Oribasius has one more ingredient:
melilotus; against kataphora (coma, attacks of lethargy) Herodotus
(Orib.Syn. 6.33) prescribes washing the face with sponges in lukewarm
water and vinegar, binding the extremities, odoratories, cuppings on neck
and spine, while AP has no face sponging and does not apply cuppings as
does Herodotus for remissions of the disease, ev 'tcx'i; a.vfoecn, but if the
µri
disease does not remit, evOtOOv'tO; 'tou 1ta0ou;.
Herodotus recommends blown bladders for tympanites dropsy, like
AP (45.3.30), but this is an ancient and common measure, found in
Asclepiades, Celsus, Archigenes and Caelius Aurelianus (as Wellmann
remarks). Use ofHicesius' plasters on both sides, front and back, in dropsy
(AP 45. 3.41) is also found in Herodotus (ap. Gal. 13.788), but in Caelius
Aurelianus as well. The use of a willow plaster is frequent in AP and in
Herodotus (ap. Gal. 13.801) but also CA.
42 See below, indirect tradition.
43 Fuchs in Puschmann-Neuburger-Pagel p.328 ff. and in his edition of AP Acute,
1903.
44 Wellmann "Herodot". Beside many aspects of doctrine, the decisive argument
against this identification is the fact that AP mentions (p.204.1 252.26 of the present
edition) Mnaseas' plaster. Mnaseas is posterior to Thessalus (ps. Gal. Introd.
14.684),who belongs to the Neronian era. See Deichgriiber Mnaseas in RE.
45 Wellmann presents other, non-conclusive, arguments in Hermes 48, 141-143.
The identification is accepted by Diels, Handschriften, and Gossen RE s. v. Herodotos.
Kudlien in Kleiner Pauly is sceptical.
46 See the commentary, p.3, for the text.
XU INTRODUCTION
Physiotherapeutical prescriptions for anasarca dropsy (XLV 3.4) -
gestatio in a litter, sedan, hand-cart, or boat - are similar to ones given
by Herodotus ap. Orib. 6.23, but also to ones given by CA and Celsus.
Exclusive to AP and Herodotus is that in winter AP advises heating
sand for anasarka hydropics ( 45.3.19) as does Herod. ap. Orib.10.8.17.
Doctrinal divergences
A) In his work on evacuant remedies (KEvouµevcx) Herodotus describes
the preparation and administration of hellebore for madness (mania): E7tl
OE 'tffiV µmvoµivrov lCCXl µ11oevt 'tpomp All'l'Oµevrov CXU't0V lCCXl 1tpo<; 7t0.0'CXV
'tpoq,riv u1e61e'trov exetv ft ota 'tou'tou Mcrti; &.picr't11 · JCcxt yap Ei µri
OtcxlC0'l'EtE 'tEAEID<; 'tTJV V0O'OV eµEirocrE µEV'tOt, O)O''tE 7tOAA<X1Ct<; lCCXl
~ou1..oµivot<; EK oeu'tepou ooOf\vm. The use of hellebore for mania is a
commonplace throughout Greek and Latin literature, not just medical
writers. Yet for mania AP (18.3.4) does not prescribe hellebore but the
less drastic hiera.
B) The cure using sand baths (cxµµoxrocricx) of Herodotus (Orib. 10.8)
shows similarities with AP, but also divergences: AP does not recommend
this cure either for asthma or for sciatica.
C) Exposure to the sun (ft1..irocrt<;) is prescribed by Herodotus (Orib.
10.9) and AP. But the aim of this treatment in Herodotus, the fomentation
of the voluntary neura (motor nerves), differs from that in AP, who em-
ploys it against cachexia and elephantiasis.
Language
There is only a single and incomplete, literal coincidence between AP
and the extracts from Herodotus: the passage on kataphora quoted above.
On the linguistic level we find, along with similarities attributable to the
common lexical stock in trade of Greek technical writers of the imperial
period, strong differences, which I cannot examine here.47 I will confine
myself to an examination of the examples cited by Wellmann to support
his identification of AP with Herodotus. Some of them tum out, on closer
inspection, to be mare's nests, and others are too weak to prove much of
anything.
47 A special study is to appear soon.