Diagnosis Matters: Reading the Body in the Ancient World

Diagnosis sits at the intersection of science, culture, and the body. It was the centrepiece of ancient medicine, but it also lay at point where scientific knowledge was brought to bear on the individual, their body, and their understanding of illness and disease. This project lays bare the architecture of a cultural discourse which shaped the lives of sick individuals throughout the Roman Empire. Broadly defined as the recognition of the body's physical and psychological condition or the illnesses a patient experiences, diagnosis was practiced in all ancient medical sects, and many health-care contexts. Despite its importance, however, there is no major scholarly study dedicated to this aspect of ancient culture. This fellowship will address that critical gap in classical scholarship by providing a cultural history of diagnosis in medicine during the Roman Empire.

The research combines four related areas of investigation. I start by probing how ancient doctors understood the concept of diagnosis. I question how Roman doctors from different medical sects drew on (and supplemented) philosophical and scientific thinking from the Hellenistic and Classical periods. I also investigate how Roman doctors adopted ideas from contemporary thinkers and practitioners in order to show how theories of diagnosis were, during this period, characterised by cross-fertilization between different sects and medical contexts. Additionally, I probe how diagnosis was seen in relation to other forms of recognition: I ask how doctors understood, defined, and justified their activity, and how they understood their practices of diagnosis, in relation to other discourses of knowledge in this period. Secondly, I scrutinise the way diagnosis was represented as a practical activity. I investigate the case-histories and accounts of diagnosis contained in a range of Imperial doctors (e.g. Galen, Rufus of Ephesus, Achigenes, Soranus of Ephesus). I investigate what methods are used to evaluate the patient, how those methods relate to explicit theoretical or methodological statements by doctors, how different diseases (gout) and symptoms (pulse or pain) are incorporated into effective diagnoses, and what acts of evaluation are brought to bear on the patient's body in the process of diagnostic recognition and explanation. I also interrogate how social context and personal relationships inflect diagnosis: I continually draw out how interpersonal interaction, social connections and relationships, interpersonal issues such as emotion and the psychological impact of disease underpin ancient diagnostic practices. How do these factors influence and how are they managed within, the clinical encounter? Finally, I locate this medical discourse within Roman culture, more broadly. I probe how diagnosis was discussed or represented in other cultural contexts, such as Lucian and Fronto (who both wrote extensively about gout) and the Greco-Roman novels. I examine how these texts represent diagnostic activity and disease explanation, particularly in cases where similar diseases or conditions are represented by literary figures. I also ask, at this level, how these writers construct the authority and importance of medical recognition. I probe, then, the way scientific and literary cultures intersect, and the extent to which medical views of diagnosis are reflected in other cultural contexts.

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