Interviewing Jane Lightfoot
On Ancient Medicine
Professor Jane Lightfoot is a pre-eminent classical scholar, and teaches Greek Literature at Oxford University. You can find a list of her publications here. In the first interview of Labours of Love, we’ll be asking her about her passion for ancient medicine and hear her thoughts on all things Classics, from her distaste for Ovid to the ancient figures she’d invite to dinner. Enjoy!
LB: Your track record is very impressive: after studying Classics as an undergraduate at St John’s College, you were awarded a Prize Fellowship at All Soul’s College, and have since become a Professor of Greek Literature at New College. You write that you enjoy “finding underexplored texts and patiently uncovering them like an archaeologist excavating a new site.” You’ve written, for example, about the love-stories of Parthenius, which survive in one manuscript, the astrological poetry ascribed to Manetho, none of whose original texts survive, and even translated Hellenistic poetry never before accessible in English. But what sparked your passion for classical literature, and how has it developed over 35+ years at Oxford University?
JL: Actually I didn’t intend to do Classics at all. I wanted to study medicine and become a palaeopathologist (as a matter of fact I still do).1 But I turned out to be very good at Greek and ended up applying to Oxford for that. The makings of me were the Prize Fellowship at All Souls which gave me an initial seven years when I could simply learn how to be a scholar. I had a terrific text to work on — Lucian’s De Dea Syria — which required me to turn myself into a part-time epigraphist and numismatist as well as a palaeographer and literary critic studying dialect, style, genre, literary imitation (it was that, in fact, that put me on to Aretaeus, who is part of the same literary currents in the second century AD). What’s good about the stuff I work on is the mixture of high literary quality and technically demanding material: the latter is crucial. You absolutely can’t get away with fluff. It’s a good field for a scientist manqué. As for how it’s developed, once you’ve got into it you get a sense of the field and what needs to be done — what can be added to the sum total of human knowledge — and what is pointless, boring, cudgelled to death, and unnecessary. See question 5, below.
LB: When we spoke you told me about your recent research into ancient medicine, especially the Greek physician Aretaeus. What’s so interesting about his eight treatises on diseases, and why does he deserve as much attention as more renowned medical writers, such as Hippocrates or Galen?
JL: Just because he is very, very good. The Hippocratic Corpus is a rag-bag of stuff. Aretaeus is writing some half-millennium later, when they simply knew a lot more, knew more anatomy; and, unlike Galen, he isn’t having any of this nonsense about humours. As for Galen, (i) Galen isn’t terribly interested in disease itself, so that Aretaeus complements what we largely miss in his more famous (?) contemporary except for the odd specialist treatise (like On the Affected Parts). Come to think of it, (ii) Galen isn’t interested in anything so much as himself, whereas Aretaeus is deeply reticent and modest. (iii) Aretaeus is a brilliant writer, who revives Hippocrates’ dialect — Ionic — but interlaces it with many Homerisms as well as expressions from tragedy and other poetry in order to make his already-compelling subject matter an intellectual and literary treat to read. No-one could accuse Galen of being a gifted writer. Actually there has been a long tradition of medical writers who were also literary men. Aretaeus, in my view, is the most gifted from all antiquity. He leaves Galen for dust.
LB: Which extract from Aretaeus’ treatises fascinates you most, and why?
JL: If you want him at his best, you could take an extract from his description of leprosy, which he calls elephantiasis. It illustrates his best qualities: minute observation of symptoms (superb clinical skills) combined with empathy (emotive writing) but also deep literary sophistication: it isn’t necessarily obvious from a translated excerpt, but he writes this, his final chapter, in such a way as to make it a summation of his general theory of disease (caused by a chilling of the native heat) and so as to link it with other chapters, so that leprosy has something of all of them. He wants his diseases to be rock-stars. Epilepsy was antiquity’s no. 1 rockstar disease, but Aretaeus turns leprosy into the paradigm case for his entire nosology.
"[...] ἀτὰρ οὐδὲ ἴσχει τέκμαρ οὐδὲν ἡ ἀρχὴ τῆς νούσου μέγα: οὐδέ τι ξενοπρεπὲς κακὸν τὸν ἄνθρωπον ἐπιφοιτῇ : οὐδὲ ἐπὶ τοῖσι ἐπιπολῆς τοῦ σκήνεος φαντάζεται, ὡς ἰδεῖν τε εὐθὺς καὶ ἀρχομένῳ ἀρῆξαι. ἀλλὰ τοῖσι σπλάγχνοισι ἐμφωλεῦσαν ὅκως ἀΐδηλον πῦρ, ἤδη τύφεται, καὶ τῶν εἴσω κρατῆσαν αὖθίς κοτε ἐπιπολαίως ἐξάπτεται, τὰ πολλὰ μὲν ὅκως ἀπὸ σκοπιῆς τοῦ προσώπου ἀρχόμενον τηλεφαν ὲς πῦρ κακόν. μετεξετέροισι δὲ ἀπὸ τοῦ ἄκρου ἀγκῶνος, γούνατος, κονδύλων χειρῶν τε καὶ ποδῶν. τῇδε καὶ ἀνέλπιστοι οἱ ἄνθρωποι, ὅτι περ ὁ ἰητρὸς οὐ πρὸς τὰς ἀρχὰς τὰς ἀσθενεστάτας τοῦ πάθεος τῇ τέχνῃ χρέεται, ῥαθυμίῃ καὶ ἀγνοίῃ τῶν καμνόντων τῆς ξυμφορῆς."
"But the commencement of the disease gives no great indication of it; neither does it appear as if any unusual ailment had come upon the man; nor does it display itself upon the surface of the body, so that it might be immediately seen, and remedies applied at the commencement; but lurking among the bowels, like a concealed fire it smolders there, and having prevailed over the internal parts, it afterwards blazes forth on the surface, for the most part beginning, like a bad signal-fire, on the face, as it were its watch-tower; but in certain cases from the joint of the elbow, the knee, and knuckles of the hands and feet. In this way the patient's condition is hopeless, because the physician, from inattention and ignorance of the patient's ailment, does not apply his art to the commencement when the disease is very feeble."
- Of Chronic Diseases, Book II, trans. Adams (1856)LB: What do we, living through ground-breaking developments in science and medicine, have to learn from the thoughts of such ancient writers?
JL: An interesting question. What do they teach them in medical school? (If I’d stuck to my original plan I’d have found out.) Do they just get stuck into cell mutations and pathogens and immunotherapy? Or is there time for reflection about what a disease actually is? Or for the philosophy of causation? Aretaeus is extremely good value on both. Although he couldn’t know about genetics, he is excellent on the complexity and multiplicity of interlocking causal factors; he comes from a tradition which thought long and hard about what is meant by “origin” and “cause”. As for disease, modern theorists essentially pit two different conceptions of disease against one another: the “realist” — diseases really are “out there” — vs the idea that they are only ever embodied and every sufferer has their own experience. Aretaeus has interesting ways of mediating between those two positions. His inventories imply a “realist” approach, but he is very alive to individual suffering and writes with intense empathy. (“One of the most ill-starred meetings in modern medicine is that between a frail, defenceless old man nearing the end of his life, and an agile young intern at the beginning of his career.”2 Not in Aretaeus’ world, though. This encounter wouldn’t happen.) His trademark combination of brilliant clinical observations — don’t take my word for it, many historians of medicine have considered them still unmatched — and sensitive as well as literarily sophisticated writing shows us that scientists don’t have to be siloed. I also think there are much-needed lessons on the reception of knowledge and on humility. He shows us how the Hippocratic Corpus was never a fixed thing; he is crucial evidence for how it was interpreted half a millennium after the texts were written; he himself was almost lost — his work came down to us by the slenderest of threads, because a single manuscript survived the fall of Byzantium; and the reception of his own work shows how ideas fall in and out of fashion, and even good ones are not guaranteed to survive.3 It’s by no means a story of incremental and uni-directional progress. Talking of which, I was almost forgetting those ground-breaking developments in medicine and science. There’s one point at which Aretaeus reminds us that “men do not have a womb.” Those super-progressive young BMA activists could learn a thing or two from that.
LB: In our A-level Latin course, we have to study the poems of the Augustan writer Ovid. You mentioned that you weren’t a fan of his. Could you explain why?
JL: Oh dear, because there is too much of it and it is all the same and it is like squeezing toothpaste out of a tube and it’s smooth and facile and more and more of it just keeps coming out. Also because there’s no point to it: Callimachus had already done the genuinely clever and interesting stuff (see next question). I don’t hate him as much as I hate the Aeneid, though.
LB: Finally, if you could have dinner with any three historical figures, who would you choose, what would you eat, and what would you talk about?
JL: This is a great question. Is it the one dinner or three separate dinners? If I have three separate encounters, then here goes.
a. Scenario number one. I am not really into dining and have terrible food recognition and appreciation. But if it has to be a dinner setting, then the first figure would be an ancient doctor, let’s say Aretaeus (definitely not Galen, who would just talk about himself). I would let him choose the menu and let him talk me through what he thought was happening to the food as we ate it and as our bodies processed it. I would want to probe him on how he thought we put on weight — what mechanism he thought explained that — and how he would treat it. In antiquity they thought that food was eventually turned into blood and distributed over the body in the venous system; given that they knew about the contractions of the heart and the pulse and that veins and arteries carry blood (indeed different kinds of blood) I have never quite understood why the penny didn’t drop about the circulation of the blood until Harvey, and I would ask some leading questions about that.
b. Scenario number two. I would bring the Alexandrian poet Callimachus together with James Joyce. Callimachus WAS antiquity’s James Joyce, and I would bring them head to head. There was a lot of dining in the Museum; on the other hand Callimachus tells us he didn’t enjoy overloaded banquets, so I would let Joyce choose the menu (something light — a gorgonzola cheese sandwich and glass of burgundy, maybe).4 My favourite section of Ulysses is the Oxen of the Sun, which consists of literary parodies of everything beginning with Fescennine verses through to late nineteenth century street slang with dazzling parodies of literary illuminati along the way.5 But if you ask me, Callimachus’ great poem, the Aitia, was already doing something like that — a collection, not exactly of parodies, but of take-offs of the styles and mannerisms of any and every classical genre, Greek literature having by then become a treasure-house of styles to be appreciated and ripped off and creatively combined and transformed. I wouldn’t say much. I would just sit back and let them talk. Then again the whole thing would probably turn out to be a disaster — like the famous occasion when Joyce met Proust and they basically ignored each other.6
c. Scenario number three. This is my answer to the question (of which yours is a more interesting variant) “Which one figure from antiquity would you like to meet?” The answer is Pontius Pilate. This doesn’t involve dinner at all (it takes place on a fast day, after all). Why Pilate? Just because you have to know. What did he really make of that infuriating and baffling Jewish rabbi on that inauspicious and cold spring morning? And also whether he ever found out the answer to his own question (John 18:38), which is simultaneously the best ever soundbite and the most important question there is — What is truth?
Palaeopathology is “the study of ancient diseases and injuries in organisms through the examination of fossils, mummified tissue, skeletal remains, and analysis of coprolites.”
Bert Keizer (Dutch physician), writing about his father’s death in 2001.
JL: “The editio princeps was in Latin in 1552; the Greek was first published in 1554; it’s not entirely clear how many, or which, manuscripts the first editors were using. My reconstruction of the chain of transmission is that a single MS survives the fall of Byzantium and is probably brought to Crete and thence Italy, maybe as a result of the efforts at manuscript preservation by Cardinal Bessarion.”
James Joyce’s Ulysses (1922), page 164:
— Have you a cheese sandwich?
— Yes, sir.
Like a few olives too if they had them. Italian I prefer. Good glass of burgundy; take away that. Lubricate. A nice salad, cool as a cucumber, Tom Kernan can dress. Puts gusto into it. Pure olive oil. Milly served me that cutlet with a sprig of parsley. Take one Spanish onion. God made food, the devil the cooks. Devilled crab.
— Wife well?
— Quite well, thanks... A cheese sandwich, then. Gorgonzola, have you?
— Yes, sir.