between the rock and the cold, cold sea

Books 2009: 77

non-fiction


77. Soranus, Gynecology, trans. Owsei Temkin, Johns Hopkins, 1956.

Soranus was a Greek physician who worked in the Roman world shortly before Galen. Most of his work, when it survives, does so only as paraphrases and quotations by other authors.

The Gynaecologia deals with the diseases of women, the things according to nature and the things against nature. It's divided into "On the midwife" and "On the things with which the midwife is faced", and it's an interesting look into the mind of an ancient physician.

If you read it, be prepared to be horrified at the bleeding, and the cupping, and the purging, and the use of hellebore in the more extreme of the "metasyncretic" treatment. And the dismembering infants during labour if there's no other way to get them out.

On the other hand, considering his handicaps and his philosophy, what's almost more surprising is that at times Soranus actually makes sense. Which just goes to show, I guess.

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In other news, I remain miserable sick. Alien spores, wheezing, the works. It's very inconvenient.

Books 2009: 76

non-fiction


76. Guido Majno, M.D., The Healing Hand: Man and Wound in the Ancient World, Harvard, 1975.

This is a really interesting book. It deals with ancient medicine in Mesopotamia, Egypt, Greece, Alexandria, India, China and Rome.

It's not exhaustive, and Majno's offhand comments about the historical contexts make it obvious he's not primarily an ancient historian. However. As an introduction to ancient medicine, I can't imagine a better book. It talks both about the theories behind the medicine of the times, and about the techniques of that medicine.

Surgery. Operations to drain pus from the chest cavity. (Empyema: so much pus in the pleural cavity that a fistula appears between the ribs.) Infected bone. Theories of inflammation. Wound dressings, and how likely were you to be helped, rather than hurt, by an ancient physician? Removal of arrows. Sutures, and whether or not they were likely to suppurate and fall out.

And what happens if you get hit on the head? Majno writes:

"To the iatrós [the Greek surgeon], the preliminary probing is essential. If there is a fracture, he will not operate further; if there is no fracture, he will drill a hole in the skull; and if the is just a hedra [a dent], he will scrape it away. Here he runs into a diagnostic problem: how is he going to distinguish a thin crack from a normal joint between two bones?

"The answer... First he shaves the head. Then he enlarges the wound, lifts the scalp all around it, and packs the space with lint. Then he plugs the wound itself with a plaster made by boiling vinegar and barlley flour, and covers the whole with a bandage. That is all for the day. The next day he removes everything, smears the skull with something that looks like black shoe polish, and covers it again with oil, linen, and more barley plaster. The third day he scrapes the blackened skull with a sharp knife: experience has shown him that the black will come off everywhere except from cracks and dents. He goes on scraping until all the black is gone. To the Hippocratics this horrible procedure was very important."

And of osteomyelitis:

"Patches of bare bone, exposed by infection, were so common they had a special name, now forgotten: psíloma, 'a bareness'."

He quotes from Epidemics VII:

"Trepanation brought out of the bone itself a thin ichor, serous, yellowish, stinking, deadly. In such cases vomiting may also occur, and spasms towards the end, and sometimes loud cries, and sometimes paralysis...

"The child of Theodoros exposed himself to the sun on the ninth day. Fever came on the tenth day from a bareness of the bone which was, as one might say, nothing at all. During the fever the part became livid, the skin came off; many loud cries; on the twenty-second day the belly swelled up, especially toward the hypochondria; on the twenty-third he died...

"The child of Isagoras was wounded in the back of the head, the one was injured and became livid on the fifth day. He was healed, and the bone did not slough off...

"At Cardias, the son of Metrodoros, after a toothache, had gangrene of the jaw; terrible overgrowth of flesh on his gums; he gave a moderate amount of pus; the molar teeth and the jaw fell out."

Yep. Definitely an interesting book, with descriptions of the dressings - if you had a honey and resin dressing, or one with honey and copper verdigris, you might be okay: sheep's fat and dove's droppings, not so much. Majno also descibes experiments on the antibacterial properties of various of the treatments - honey, vinegar, wine: altogether useful.

Recommended, but not if you have a weak stomach.