It should come as no surprise that the classics are put to medical uses in the modern world.

After all, pre-medical students learn Latin after the tradition of Vesalius, the kal-KAY-neul tendon is more familiar to us as the Achilles, and doctors in many countries take a Hippocratic Oath in one form or another. Even where that oath has been judged obsolete, it is still used as a starting point or a touchstone in discussions about what a medical code of ethics should look like today. However, the classics are also put to work in more subtle ways. For example, patients and their advocates use retrospective diagnoses of classical figures as part of the creation of positive illness identities; medical researchers may comb the classics for evidence to assist them in the construction and legitimation of new disease categories; and proponents of alternative therapies derived from ancient eastern systems of healing use classical medical concepts to link those earlier systems to modern western medicine. This paper is a preliminary exploration of some of the many ways in which doctors and laypeople use and abuse the classics and other ancient sources in pursuit of medical power. First, let us consider retrospective diagnoses. Retrospective diagnosis is a term for a reading of recorded past experiences through a modern medical lens. Through this lens, any figure in recorded history can be viewed as a patient or as a configuration of symptoms that are recognized by modern medicine. Political, cultural, spiritual, and other contextual influences on that persons behavior and experience are overlooked. Laypeople often make rather transparently self-interested uses of this medical lens, as we can see in examples of Biblical figures diagnosed retrospectively. This is Michelangelos Conversion of St. Paul, which the creator of the website caffeineandmigraine.com has recaptioned: Paul suffers a migraine on the road to Damascus around 37 a.d. The elements of Pauls visionary experience are parsed and reconfigured as migraine. The same event has been identified elsewhere as a seizure. From the website fibromyalgia-information-relief.com, we learn that the sufferings of Job can be attributed to fibromyalgia. A contested disease is thus given historical heft, and we can view the choice of Job, an icon of suffering, as a corrective to the way in which people with fibromyalgia are often suspected of malingering or fabricating their symptoms. A somewhat more sophisticated example is in the placement of Julius Caesar on published lists of famous people with epilepsy. People suffering from epilepsya poorly understood, underfunded, and stigmatized condition--add a powerful image to their repertoire by 1

in a sense recruiting Caesar as a representative, even a sort of forebear or epilepsy ancestor. As classicists, you may know that Caesars diagnosis is problematic, and we wont be resolving the controversy today. Our purpose is to call attention to the layers of difficulty involved in diagnosing the kind of complicated conditionslike epilepsy, migraine, or fibromyalgia--for which sufferers are most likely to look to the past to establish a lineage of suffering. Taking epilepsy as our example, consider first how difficult it is for a medical specialist to diagnose a living patient. There are many different conditions that mimic epilepsy, including syncope, low blood sugar, pseudoseizures, some forms of stroke, abnormal blood flow in the brain, and migraine. Even the idea of a single condition called epilepsy is suspect; some specialists refer to the epilepsies to suggest the range of causes, manifestations, and treatments of this supposedly unitary condition. Diagnosing a patient with one of the epilepsies is certainly no guarantee of a cure, leading us to ask what it actually means to say that a patient has epilepsy, especially in the case of the 20 to 40% of sufferers for whom this diagnosis is meaningless in terms of improvement in their condition. If we dont even know quite what epilepsy is in the here and now, how can we transport this label to other peoples and other times? Second, consider what cross-cultural diagnosticians have to tell us about how much more difficult it is to diagnose a patient from a different lifeworld, who experiences, interprets, and reports symptoms differently from those patients with whom a doctor was trained to interact. Finally, then, how much more suspect must be the medical diagnoses we make retrospectively, about figures whose experiences are recorded secondhand, years after the fact, with no physical lesions or firsthand accounts to assist us? The three authors on whose writings Caesars diagnosis is basedSuetonius, Plutarch, and Appianuswrote over 100 years after Caesars time. Furthermore, according to historian Owsei Temkin, even where the word ep-ee-lahm-BAH-nayn is used, its worth noting that this term did refer to being seized by any number of different illnesses before it came to designate seizure disorders exclusively. Leaving the scholarly debate over the labeling of Caesars sufferings aside, we can see that for laypeople, the classics are a trove of universally well-known or iconic figures who can be recruited to lend positive value to a modern illness condition. This ranges from strategically taking a side in the debate over Julius Caesars possible epileptic condition, to cavalierly diagnosing an iconic figure with a disease to enhance the image of that disease and its sufferers. Implications may range from the (in my opinion) rather benign and even empowering use of 2

Caesar as a sort of epilepsy hero, to the somewhat more insidious tendency to seek symbolic support from the past for the construction and legitimation of disease categories such as fibromyalgia. Whether harmful or helpful in a specific instance, trawling through the past with a net of modern medical definitions and understandings to see what can be caught does carry the risk of reinforcing the way we do medicine today and occluding alternative theories of health and illness. Historian Charles Rosenberg has shown that the idea of discrete disease categories unique conditions existing outside of their manifestations in particular bodies in particular contextsis a fairly recent development in medicine, dating to the 1800s. Retrospectively applying the label of epilepsy to Julius Caesar, Hercules, Socrates, Pythagoras, and Alexander the Great not only gives a symbolic weight to our understanding of epilepsy, but supports the very notion of discrete disease categories by taking the universal applicability of these categories across times and places as a given. Other understandings of health and diseasesuch as notions of balanced and unbalanced systems, as in humoral theories, ayurveda, or Chinese medicine are pushed further into the background each time modern, Western, discrete disease categories are applied across times and cultures in an unreflective way. Unreflective use of the modern medical lens is also made by medical professionals, as we can see in this example: Five thousand years ago, Mesopotamian physicians viewed headache as a disease entity rather than a symptom and attributed it to an evil spirit named Tiu. A clinical description from that time noted: Headache roams the desert, blowing like the wind. Flashing like lightning it is loosed above and below. It cuts off like a reed him who fears not his god. . . . This man it has struck, and like one sick of heart, he staggers; Like one bereft of reason, he is broken. Treating this text, which could be understood as a poem, an incantation, treating it as a clinical description begs the comparison to a modern doctors office notes. This contrast highlights the strangeness of the text and places it in the undifferentiated realm of the primitive, which exists only in contrast to the technological and scientific sophistication of the present. Consider that contrast alongside this phrase from the articles introduction: Headache, an ancient and much studied complaint, has a rich historical literature that illustrates the evolution of our knowledge from the magical to the molecular level. Viewing the past through a present3

day medical lens and situating that past in an evolutionary chain of knowledge helps the author establish the state of headache medicine today as the pinnacle of a narrative of progress, of the triumph of science over magic. This is particularly interesting when we consider that chronic headache remains a baffling condition for which no adequate treatment exists. When the evidence for sciences conquest of nature isnt available in the present, we turn to the past. As a side note, we might also suppose that this author gains a certain air of erudition from the way in which he calls upon ancient sources. While he denigrates earlier times as states of lesser knowledge than our own, by discussing them he extends the sphere of his mastery back through timehe is not only a master of disease and healing in the present, but of the magic and mystery of the past. Simply citing a classical source in a medical journal article is an act that stamps a technical piece with a mark of broader erudition and situates the medical researcher as the inheritor of a long tradition, whose work proceeds as much through artistry as through technical skill. Taking a medical look at the past CAN be done well, as when historian Stanley W. Jackson sought and found a core cluster of symptoms akin to modern depression that recur in reports from Hippocratic times to the present. What makes Jacksons work so valuable is that he neither primitivized the past nor failed to problematize the present. He did not assume that he would find historical progress toward full understanding of depression, as predefined in presentday terms. Rather, he looked in historical accounts of states of sadness or dejection for a possible common core of suffering, and finding such a core, chronicled the changes that have occurred in the recognition, construction, and treatment of that core of symptoms. Depression researchers Allan Horwitz and Jerome Wakefield, relying on the work of Jackson and other historians, investigated the ways in which this core of depressive or melancholic symptoms has been interpreted over time. They found that in ancient times, scholars such as Hippocrates and Aristotle treated melancholic disorder (different from depression but consisting of the same common core) as distinct from normal melancholy in that it was beyond due measure or without a cause in the events of the sufferers life. This distinction between disordered sadness (or sadness without cause) and normal sadness appeared throughout the Roman period as well; indeed, in every subsequent era except for our own. This finding is one of the bases of Horwitz and Wakefields argument that modern diagnoses of depression are often misrecognitions of the normal sadness of living. In the classics, these scholars found an alternative to a modern 4

treatment philosophy that may be causing more harm than good. Like Jackson, their work required them to suspend faith in modern medicine, and to treat the observations and interpretations of the ancients seriously at the same time as they sought evidence of persistent phenomena in the descriptions they read. What keeps their work from falling into the category of retrospective diagnosis is the way in which they refuse to privilege the modern-day definition of depression as the standard by which earlier conditions should be judged. Rather, they understood the current definition of depression as one construction among many alternative interpretations of the same common core of symptoms or experiences. However, we more often approach history with the modern definition of a disease as a real entity to be dug out of the murk of the past. One striking example appears in the work of sociologist Elizabeth Armstrong. Armstrong found that fetal alcohol syndrome, a condition first appearing in medical literature in the 1970s, was not so much discovered as it was constructed by a group of moral crusaders interested in linking alcohol consumption to birth defects. These crusaders had several obstacles to overcome, such as the lack of concrete cases that could be labeled FAS, commonsense skepticism based on the fact that birth defects had not yet been traced to alcohol consumption over the 1000s of years in which pregnant women had been drinking, and the likely minor importance of a condition that had not yet been noticed. Lacking concrete, modern-day evidence, researchers interested in constructing fetal alcohol syndrome as a legitimate medical condition turned to historical sources of evidence. Armstrong found abundant references in the medical literature on FAS to Vulcans lameness, attributing it to fetal alcohol syndrome rather than to an injury, for example, as well as repeated misinterpretations of the ancient Greek, Roman, and Carthaginian belief that intoxication at the time of conception led to birth defects. According to Armstrong, looking to the past allowed researchers to add cases to their body of evidence, to suggest that FAS had in fact been observed over the course of history, and to declare that it was high time for dealing with this overlooked condition. Furthermore, Armstrong found that classical authors were used to infuse the description of FAS with a morally judgmental tone, as when Aristotle is quoted: Foolish, drunken, and harebrained women most often bring forth children like unto themselves, morose and languid. This is, of course, not something that can be spoken in the researchers own voice in a medical journal, but Aristotle makes an unimpeachable mouthpiece for this sort of condemnation. In our study of classical

references in medical journals, we plan to apply and elaborate on these 4 points of Armstrongs theory of the use of the classics to construct and legitimate medical conditions. Armstrong sums up this use of the classics as the rhetoric of rediscovery, that is, positioning ones argument as a rediscovery of a forgotten truth rather than relying on current data and logical argument alone. We see this sort of move being made elsewhere as well. For example, a study of wine as a digestive aid referred to the ancient Greek custom of drinking wine with meals, supposedly to improve digestion. When we consider that the ancient Greek and Roman repertoires of health-promoting agents included gladiator blood, camels hair, and hippopotamus testicles, it seems strange to celebrate this particular concurrence of opinion. Either the classical treatises on healing are a treasure trove of viable treatments, and we should be conducting double-blind studies of the healing properties of gladiator parts, or else we need to ask what is gained by making such a reference to an ancient practice. Again, an air of erudition for the authors is achieved, as well as a construction of a sort of genealogy extending from the ancient Greeks to the modern western medical system. On the topic of the genealogy of medicine as nonclassicists often understand it, it is worth noting what is passed over in the supposedly unbroken line of descent that begins in Hippocratic times and confines the story of medical progress within the boundaries of the west. The Arabic translations of Greek medical writings, original works, and chronicles of earlier works are passed over in this story, as are the precursors of Hippocratic medicine. While I am not qualified to comment on those precursors, its interesting to note that Deepak Chopra, as part of his project to bring ayurvedic medicine into the mainstream, positions ayurveda as the root of Greek medicine. Other proponents of ayurveda find the basis of the four Greek humors in the doshas, and make claims such as this, from the Durham Center for Ayurveda: Greek medicine received its boost to greatness when Alexander the Great campaigned through Asia, bringing Ayurvedic doctors back home to Greece to share their knowledge. Regardless of the veracity of such claims, their makers realize that one way into the medical mainstream is to gain a foothold in its historical narrative. That is, ancient Greek medicine is the gateway to legitimacy for the eastern practice of ayurveda. This strategy of legitimation warrants further research. Toward medical ends, the classics have been at one extreme plundered for raw data to be analyzed according to present-day categories, and at the other, treated as a canon whose self6

evident value transmits itself to its users. Speaking for medical sociologists and other nonclassicists, one thing that we need from classical scholarship is a careful, contextualizing eye to the medical practices and health-related experiences of the past. Great power can be derived from uninformed uses of the classics, so great care must be exercised in their interpretation.