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Post-Byzantine Medical Manuscripts: New Insights into the Greek

Medical Tradition, its Intellectual and Practical Interconnections,


and our Understanding of Greek Culture

Christos Papadopoulos

Journal of Modern Greek Studies, Volume 27, Number 1, May


2009, pp. 107-130 (Article)

Published by The Johns Hopkins University Press


DOI: 10.1353/mgs.0.0044

For additional information about this article


http://muse.jhu.edu/journals/mgs/summary/v027/27.1.papadopoulos.html

Access Provided by Princeton University at 02/20/11 1:30AM GMT


Post-Byzantine Medical Manuscripts:
New Insights into the Greek Medical
Tradition, its Intellectual and
Practical Interconnections, and our
Understanding of Greek Culture
Christos Papadopoulos

Abstract

Greek medical texts of the seventeenth and eighteenth centuries known as


ιατροσόφια form a significant corpus of manuscripts employed as vernacular
manuals of medical instructions. In modern times, their image has been generally
unfavorable and their systematic study relatively ignored. A re-examination of
diverse manuscripts offers fresh insights into contemporary notions on medicine,
aspects of assimilation of Hellenic, Byzantine and Western medical customs,
the language of disease, the interplay between learned and magico-religious
medicine, and broader cultural notions and interactions between Orthodoxy,
science, and tradition. As a result, our appreciation of Greek therapeutics,
and place in the wider European medical practice are all enhanced and, from
the point of view of a social history of medicine, new light is shed on cultural
aspects of contemporary Greek Orthodox society.

Introduction
The so-called ιατροσόφια .  .  . a diluted and darkened decoction of the
ancient teaching, mixed with all kinds of superstitious ingredients, sympa-
thetic (therapeutic) means, and exorcism formulas. (Karl Krumbacher, as
cited in Touwaide 2007:154)

In general, post-Byzantine medical manuscripts known as ιατροσόφια


have not been portrayed in a very favorable light by modern scholars.
Typically, in the nineteenth century, the renowned Byzantinist Karl Krum-
bacher judged them with particular severity. Perhaps, their vernacular,
all-embracing features presented a particularly discordant quality to the
great philologist’s classical sensibilities. Krumbacher’s canonical views

Journal of Modern Greek Studies 27 (2009) 107–130 © 2009 by The Johns Hopkins University Press

107
108 Christos Papadopoulos

have carried through to the twenty-first century. Modern commentaries


include that in the medical dictionary of Greek folklore—“badly writ-
ten, difficult to read, grammatically incorrect, badly syntaxed” (Regatos
2005:138), and the dictionary of Modern Greek language—“ιατροσόφια
do not cure diseases” (Babiniotis 2002:415) and are characteristic of the
modern image of the genre.1
Did the Greek world of the seventeenth and eighteenth centuries
share modern opinions on ιατροσόφια? Were they idiosyncratic collections
of traditional therapeutic theories and practices recorded at random
or were they conscious efforts to document existing beliefs and new
knowledge in a dynamic therapeutic environment for the assistance
of ordinary Orthodox men and women? Every society holds medical
beliefs—belief systems that attribute sickness to natural or supernatural
causes, ideas on life and death, the causes of pain, the healthy life, and
therapeutic knowledge transmitted from generation to generation. At
the close of the eighteenth century, for the French traveller and physi-
cian François C. H. L. Pouqueville, maintaining a healthy existence was
especially demanding for the Greek population “for the entire slavery
of the nation changes its physical constitution” (1806:74). How far can
a detailed inspection of anonymous iatrosophic manuscripts illuminate
our understanding of Greek healing practices during the period of
Tourkokratia (Ottoman rule) and what, if anything, do they reveal about
the contemporary Orthodox community and culture?
The generally passive attitude of scholars toward the manuscripts
is mirrored by the relative lack of a systematic study of texts written in
the 200-year period prior to the Greek war of Independence. Significant
recent academic research in the field is limited to the influential work
of Giannis Karas in cataloguing the manuscripts(1994), Agamemnon
Tselikas and the work of the Historical and Palaeographic Archive of the
Cultural Foundation of the National Bank of Greece (MIET) (1995), the
collections of the Folklore Research Centre of the Academy of Athens,
Alain Touwaide’s contribution on Byzantine and earlier periods (2007),
Despina Kostoula on Agapios Landos (1983), and the doctoral thesis of
Aglaia Bibi-Papaspyropoulou on traditional medicine in the Pelopon-
nese (1985).
A new examination of the content of Post-Byzantine iatrosophic
texts “from below” and from the fresh approach of the social history of
medicine offers new insights into the world of Orthodox Greek society
in the seventeenth and eighteenth centuries. It further yields perspec-
tives on the texts themselves, ones that differ considerably from those
of Krumbacher.
Post-Byzantine Medical Manuscripts 109

Contexts and Practices

The geographic spread and considerable number of iatrosophic texts


that have been identified to date suggest they were widespread sources
of medical knowledge in the Greek communities under Ottoman and
Venetian rule. Research carried out by the Neo-Hellenic Research Cen-
tre and the Historical and Palaeographic Archive (MIET) point to their
existence in most of the Ottoman provinces in Europe, the coast of
Asia Minor, the Aegean, the Ionian Islands, Crete, and Cyprus. Despite
the frequent and devastating impact of wars, earthquakes, and politi-
cal change in the region, a considerable number of manuscripts have
survived in the Balkan and Eastern Mediterranean region. According
to Karas, over 250 known post-Byzantine iatrosophic manuscripts have
been located in monasteries, libraries, and private collections (1994,
Vol. 3:160–320). Some, however, are near copies so Tselikas places their
actual number around 150 (1995:61).
Most of the manuscripts were written by a variety of individuals
in an effort to provide practical therapeutic guidance to a community
frequently deprived of easy access to academic physicians and lacking
the financial means for professional medical treatment. The copyists
were interested laymen, professional healers, or clerics with access to
existing manuscripts and occasional social contact with practitioners of
the healing arts (Karas 1994:176, 236, 243). Altogether, clerical input
features strongly throughout the iatrosophic corpus.
For the scribes and users of the text, the information embodied
treasured “medical wisdom,” an ιατροσόφιον. Each text was presented in
self-contained chapters for use as a practical instruction manual in matters
of medical theory and healing practice. Reflecting their beliefs on the
text’s indisputable provenance and great significance, manuscripts were
frequently referred as Διαθήκη (Testament), Ιατρική Βíβλος (Medical Bible)
or Ερμηνíαι (Interpretations) (Karas 1994:174, 259, 193). A significant
number of the works provide a statement of provenance, and at once an
authority device, that acknowledges their quality as compilations of the
medical wisdom of physicians and authors of great repute:
Διαθήκη των τριών ιατρών Γαλήνον, Ιπποκράτους και
Διοσκορίδους, των σοφών περί της των ανθρώπων κατασκευής . . . .
Πάσι τοις θέλουσιν ευ διάγειν περί της αυτού υγείας

Testament of the three doctors, Galen, Hippocrates and


Dioscorides, wise on the construction of the human (body) . . .
For the health of all those who wish to live well. (StK, fol. 2)
110 Christos Papadopoulos

ιατροσόφιον εκλελεγμένον υπο πολλών ιατρικών βιβλίων


Ιπποκράτους και Γαληνού και Μελετίου μοναχού και
άλλων δοκιμωτάτων και σοφών ιατρών

ιατροσόφιον selected from many medical books of


Hippocrates, Galen, Meletius the monk, and other most
worthy and wise doctors. (AA, Mar fol. 37)

Besides the great classical personalities, other authorities mentioned


include Paul of Aegina, Alexander of Tralles, Paul of Nikaea, Meletius,
Gerasimos of Crete and, importantly, Italian sources such as Mateoli and
Castor (Durante). Frequent misspellings of the authors’ names by the
scribe, regular use of the vernacular language and grammar, incorpora-
tion of Christian religious beliefs, and promotion of magico-religious
healing practices have cast doubts as to the authenticity of provenance
from classical and Byzantine sources, even for parts of the text. Clearly,
however, for most of the scribes, those seeking medical instruction, and
others within the Greek community, the texts were, for the most part,
credible and their famous authors held in singular esteem: «Των εξοχο-
τάτων και σωφωτάτων Ιπποκράτου και γαληνού των φηλοσόφων και ιατρών
της ικουμένης» (“The most excellent and wise Hippocrates and Galen the
philosophers and physicians of the world”) reads the ιατροσόφιον in the
Library of the Romanian Academy in Bucharest (Karas 1994:208).
Indeed the Orthodox community was familiar with basic aspects of
Hippocratic medical principles. Many of the texts give detailed explana-
tions of the humoral theory and Figure 1 is typical of the genre. The
explanation of human creation based on the four elements—air, fire,
earth, and water—and the primary qualities—hot, dry, cold, and wet—
together with the account of the four humors follow the centuries-old
schema of associations with the four ages of man—childhood, youth,
adulthood, and old age. Occasionally, iatrosophic texts were accompanied
by illustrations representing important aspects of the ideas considered in
the text. Next to the commentary on creation, the scribe has introduced
the reader to an image of exceptional refinement and creativity to facili-
tate the understanding of the relationships integral to the Hippocratic
medical system. The diagram is typical of the tetradic type and helps
communicate the humoral concept of natural philosophy. It is based
upon the notion of the συζυγές, the state of being separate yet analogous
and corresponding to others within an inter-connected entity.
In a pleasingly symmetrical form, four intertwined female figures
represent the four humors and link the four elements with the four
primary qualities, the four winds, four periods of the day, and four
tastes. Stretching of the arms and embracing each other in a circular
Post-Byzantine Medical Manuscripts 111

Figure 1. Human Creation and the Four Humours, Monastery of Iviron.

and harmonious fashion, they blend the macrocosm of the world; that
is, the elements and seasons, with the microcosm of the individual
composed by the four humors in the form of four females intertwined,
separate in their form and color, yet fully interconnected. The choice
of the female figure to represent each humor is typical of medieval
representations of personified abstract qualities such as the cardinal
virtues, vices, nature, and fortune. The facial features depict a female
form in a rather expressionless manner and, although nude, there are
scant further signs of female anatomy. It is a distinctive work, possibly
following an older original as this pattern of corresponding figures is
not unusual (Sears 1986:25–31). Nevertheless, the work reveals a realistic
appreciation of the inter-connective characteristics of humoral theory
and a competent understanding of the scientific reasoning underpin-
ning the ancient text.
As the inclusion of the Italian authors Mateoli and Castor (Durante)
shows, the texts were not mere interpretations of ancient wisdom. Thera-
peutic advice was added into an ιατροσόφιον as new medical knowledge
became available from a wide variety of sources. One manuscript claims
112 Christos Papadopoulos

to incorporate the application of ideas and methods of a hospital thus


making the manual «. . . έτι δε και εκ του ξενώνος περί φλεβοτομίας άριστον»
(“especially suitable for the practice of blood-letting”) (Karas 1994:177).
Occasionally, the copyist added ρετζέτα (Italian ricetta, medical prescrip-
tion) obtained from “most excellent” professional medical practitioners
and Manuscript I.16 in the University Library of Jas*i, Romania, includes
the systematic collection of prescriptions during the period 1736 to 1784
from six named doctors (Karas 1994:296). The physicians mentioned
within the iatrosophic corpus, most probably include the renowned
Emmanuel Timonis (1669–1720) from Chios, possessor of medical
degrees from Padua and Oxford, Fellow of the Royal Society, and family
physician to the British Ambassador Edward and Lady Mary Montagu.2
Importantly, in their evident acknowledgment of the importance of
physicians, the manuscripts reveal the community’s deference to profes-
sional medical opinion, a subject of special relevance in a society without
medical schools, few doctors, and a near total absence of printed medical
books in the Greek language.
The first modern medical college in the Greek world, Collegio
Medico in Corfu, was not established until 1802. While it did not teach
medicine, it was empowered to approve the licensing of medical practi-
tioners following apprenticeship with an established doctor or surgeon
for a number of years (Hennen 1830:203). Outside large towns, access
to a doctor was especially limited, even for those able to pay for the
service. Typically, the population of the island of Zante (Zakynthos),
which through its Venetian connections was generally better served by
the medical professions than those under Ottoman rule, had no physi-
cians or surgeons “located in the countryside” (Mercati 2002:78).
Meanwhile, the first scientific medical book in the Greek language
was printed in 1724 followed much later by a further 13 works published
in the period 1745 to 1799 (Karaberopoulos 2003:33). At a time when
books were especially expensive and medical publications for general pub-
lic use a rare event, this marks a decisive point in the value apportioned
by the Greek community to the knowledge and experience contained
within a ιατροσόφιον and those individuals engaged in healing practice
professionally or through free advice for their fellow citizens.
Iatrosophic aspects of provenance and authority acquire particular
significance when the manuscripts are viewed in the context of their
religious association and relationship. Notwithstanding their links with
named, ancient and pagan authors, in most of the texts we detect the
insertion and synthesis of Orthodox Christian philosophy into what, after
all, were accounts of pre-Christian therapeutics:
Post-Byzantine Medical Manuscripts 113

. . . περι πως εγίνη ο κόσμος παρά Θεού και πως εγίνη και
ο άνθρωπος και ότι από τέσσερα στοιχεία τον έκαμεν ο Θεός
. . . και διά τι λέγεται ο άνθρωπος άνθρωπος και ο Αδάμ διά τι
ωνομάσθη Αδάμ. Των θείων διδασκάλων, κεφάλαιον α΄

. . . on how the world was created by God and how man was
created and that he was created from four elements by
God; and why man is called man and Adam named Adam.
Chapter a’ of the divine fathers. (AA, Mar, fol. 17)

Ο δε μέγας Αθανάσιος λέγει . . . ούτω και ο άνδρας με την


γυναίκα συνουσιάζεται ευθύς δημιουργία Θεού γίνεται
βρέφος με σώμα και ψυχήν

The Great Athanasius says . . . as a man has intercourse


with a woman, instantly by God’s creation an infant is
formed with a body and soul. (MTS, fol. 92)

Εις δόξαν Χριστού αμήν

For the glory of Christ amen. (Kef 9, fol. 5a)

This is not particularly surprising as healing was central in Christian


philosophy and the Orthodox Church occupied a pivotal place in both
the secular and spiritual affairs of the Greek community from the Balkans
and South East Europe, to Asia Minor, and most of the islands and shores
of the Eastern Mediterranean sea. Since classical times, the connection
of Greek religious faith and medicine had been a close one. Asclepius,
popular God of healing, acted directly or through a physician. Because
of his healing and charitable nature, his qualities of Σωτήρ (Savior) and
Φιλάνθρωπος (Philanthropist) were subsequently adopted in reference
to Christ. Thus in Christian dogma, the power of healing continued the
link of the divine with the secular.
In post-Byzantine times, the Orthodox Church had always played a
principal part in the daily affairs of the congregation, albeit submitting
to the higher secular authority of the Sultan or the Venetian Senate. The
daily challenges of Ottoman and Venetian rule, however, engendered
an even stronger relationship between Orthodox clerics and their flock,
thereby reinforcing their bonds and Church influence over the lives of
the Orthodox community. Naturally, Church authority encompassed
intellectual as well as practical aspects of medicine as, for example, its
role in copying and augmenting the secular ideas of the iatrosophic texts
with those of Orthodox Christian doctrine and its philosophical position
on the causes of sickness. In the texts above, we detect the introduc-
tion of Christian systems of belief into allegedly Hippocratic teachings,
114 Christos Papadopoulos

the introduction and blending of ideas from Genesis with elements of


humoral theory, the thoughts of St. Athanasius the Great (AD 293–373),
and the use of the healing manual for the glory of Christ’s church. In
this process, classical theory was assimilated with the religious beliefs of
the congregation, thus making any separation between the two impos-
sible for the lay person. Significantly, as the iatrosophic manual served
the Orthodox community at large, religious aspects were offered in a
vernacular rendering that frequently represented a demotic expression
of Church beliefs rather than the sophisticated discourse of its author-
ized doctrine.
As a result, the texts emerge as part of a whole corpus of a vernacu-
lar philosophy of healing that does not differentiate between the pagan
and the Christian. In mutual intellectual support, Hippocrates and Galen
stand shoulder to shoulder with the people’s Christ and His saints, both
defining and reflecting the accepted wisdom of contemporary Greek
society: assimilation of classical precepts and Church beliefs combined
with unquestioning loyalty to the Orthodox Church and its local repre-
sentatives. The influence of Orthodox Christian philosophy and Orthodox
clericalism are felt throughout the texts. Frequently, Meletius “the monk”
and other Christian personalities feature prominently and the scribe’s
style reflects that acquired in a Christian religious environment.3
The religious influence on the character of iatrosophic texts
increased further with the inclusion of demotic Church philosophy
on the causes of illness and the combination of Christian prayers with
healing incantations:
Περί των παιδίων οπού γίνονται λωβά η αλλέως
νοσεμένα, από (ποίο) πράγμα γίνονται. Του προφήτου
Μωυσέως και Ιωάννου Πατριάρχου του Νηστευτού

On how children that are born leprous or


otherwise afflicted; how this happens (based
on the teachings) of the prophet Moses and
Patriarch John the Faster. (AA, Mar: fol. 22)

Τους ήλους υπομείνας Χριστέ και την άχραντον κορυφήν


κλίνας και έσωσας τον πιστόν σου λαόν, παύσον και τον
κεφαλόπονον του δούλου σου . . .

Christ who endured nails, (who) bowed the immaculate


head and saved your faithful people, relieve the
headache of your servant . . . (MTS: fol. 99)
Post-Byzantine Medical Manuscripts 115

The prevailing Greek social and cultural setting prompted clerical


opinions on matters relating to sexual behavior and disease that high-
light further the closeness and complexity of the relationship between
Orthodox religion and contemporary medical ideas and practices. In
the ιατροσόφιον the writer introduces a vernacular version of religious
instruction where sexual union during menses is judged against God’s
word, sinful, and, above all, potentially harmful to the infant. In so doing
the author mirrors the general thrust of official position as provided in
Orthodox Church canon law based on the letter of Saint Dionysios of
Alexandria (Orthodox Church 1998:547–548).
The offer of “petitional” prayers was a Christian ritual frequently
employed in the service of the Orthodox believer. Church teaching on
the subject of Divine Providence accepted that God might on His own
wish to intervene in earthly affairs to the benefit of the pious: “Let my
prayer be set forth before thee as incense” (Psalms 141.2). Ευχολόγιον,
the Orthodox priest’s prayer book, sanctions prayers encompassing
almost every aspect in the life of the community from health to harvest,
home to the field, in life and death. Typically, it recommends prayers
for “every disease,” for “the ill and unable to sleep,” and “those in the
agony of death” (Orthodox Church 1803:160, 316, 233).
An important consequence of the fusion of classical medical phi-
losophy and Orthodox religious precepts and practice within the iatro-
sophic corpus was the strengthening of the bonds between the official
church and its faithful, be they recorders, practitioners, or recipients of
iatrosophic medicine; Christ guiding the healing arts for the benefit of
His people. In turn, by contributing to the text, unofficially or not, the
Church bestowed its blessing, thereby enhancing the authority of the
texts and their professed efficacy in the eyes of its congregation. Such a
profound level of Orthodox religious presence gave iatrosophic texts a
relevance and immediacy beyond those of tenuous classical linkage or
quack medicine.
The dynamic character of iatrosophic texts is especially evident in
the copyist’s readiness to embrace Western academic medicine derived
from established European medical practice. Over the centuries, in
accordance with Hippocratic precepts, purging had been a standard
procedure of learned medicine throughout Europe. The practice con-
tinued well into the nineteenth century when pharmaceutical chemistry
changed long-established therapeutic regimes. The physician applied
purging in order to evacuate the patient’s system to help recover the
balance of nature or pave the way for further medication. “Those who
are in good bodily condition are hard to purge,” and “purge at the start
of an illness if you think fit” are just two of the Hippocratic aphorisms on
116 Christos Papadopoulos

the subject (Lloyd 1983:211). In the following iatrosophic prescription


for a purgative, we detect the kind of materia medica used at the time by
the wider academic medical community:
Διά να κάμης καθαρτικόν ονομαζόμενον ποτζιόνε πολετίβα μαγγιστράλε
(Most efficacious palliative potion).
Βάλε σιναμεκκή καλά παστρεμένη δράμη 1, κρημέρ δε
τάρταρι καλά τριμμένο δράμι 1 και δύο πρέζες γλυκάνισον,
νερόν φλιντζάνια δύο και βράσε το ολίγον.

In order to make the purgative named ποτζιόνε


πολετίβα μαγγιστράλε, place in two cups of water
one dram of σιναμεκκή cleaned thoroughly, one
dram of well ground tartar, and two pinches of
aniseed and boil them for a while. (MTA, fol. 2)

Σιναμεκκή refers to the plant Cassia (Cinnamomum aromaticum) and


tartar to the chemical compound potassium antimony tartrate, both
common purgatives available in the eastern Mediterranean. Cassia and
κρημέρ δε ταρταρι (Cremo di tartaro) feature in the 1753 catalogue of
officially approved medicines for sale in the pharmacies of Zante at the
time ruled by Venice, a primary supplier of materia medica throughout
the region, both through approved pharmacies and authorized import
houses located within the Ottoman empire (Emmanouil 1936:11–12).
Moreover, the recording of precise measures in the prescription suggests
that this medical recipe was intended for the serious purpose of healing
rather than general interest.
The preparation for purgative was not a rare event in the assimila-
tion of classical and Western medicine in the Greek iatrosophic corpus.
The prescribed treatments for θέρμη (malaria) and μαλαφράντζα (the
French disease; i.e., syphilis) are two of several other examples of Western
remedies embraced to relieve the symptoms of ailments prevalent in the
contemporary Greek community. The geography and trading activities
of the Mediterranean world offered favorable conditions for the spread
of these diseases.
The accounts of Western travellers to the region in the eighteenth
century suggest malaria was endemic in a substantial part of the country
(Schizas 2005:19–25). Prior to the extensive drainage programmes of the
twentieth century, Greece had been a marshy country both near the coast
line and in the interior. The medical profession had already made the
connection between the disease and swampy environments, but it would
be very late in the nineteenth century when science would finally point
to the role of the anopheles mosquito and the malarial parasite rather
Post-Byzantine Medical Manuscripts 117

than “the air” as the cause of the disease in humans. Until that time,
mirroring professional medicine, iatrosophic remedies offered:
Διά την καθημερινήν θέρμην, Κίνα και ροδακίων
την ψύχαν κοπάνισον κάμε χάπια.

For everyday malaria, grind kina together with


the flesh of peaches and make into pills. (Elia 18, fol. 128)

Διά να κόψης την θέρμην. Πάρε κίνα πρώτη . . . Ψήσε τα


είδη αφ’ ου τα κοπανίσης καλώς και τα ρίπτεις εις
250 δράμια κρασί καλόν . . . Έπειτα δίδεις εις τον
πάσχοντα από θέρμην μίαν δόσιν το πρωί, μίαν το
γεύμα και άλλην το εσπέρας . . .

To stop malaria. Take kina first . . . (plus other ingredients)


Grind them well, bake and mix in 250 drams of good wine . . . .
Then give to the malaria sufferer one dose in the morning,
one with lunch, and another in the evening. (MTS, fol. 159)

Introduced into Europe from Peru around 1630, kina (cinchona


bark) was arguably the first effective specific drug to help malaria sufferers.
In these two examples kina is used, in pill or draught form, to reduce the
fever and offer relief to the afflicted. Similar to other important medicines,
Cortex Peruviani was available in the eastern Mediterranean and included
in the official drug catalogue of Venice (Emmanouil 1936:13).
As with malaria, syphilis was regularly encountered in most of
Europe. Notably, the common name for the disease in iatrosophic texts
is μαλαφράντζα a Greek version of the Italian for the “French disease.”
This widespread term was derived from the popularization of the Latin
poem “Syphilis sive morbus Galicus” by the physician Fracastoro. It appears
the Italian doctor was influenced by the virulence of the disease among
French troops in the war between Spain and France in 1494. He pub-
lished his account of the disease in 1530 and, to give particular intensity
to his ideas, in poetic form. One of many, the following remedy for the
“French disease” is offered in an iatrosophic manuscript and bears close
resemblance to Acqua luminosa, a preparation offered in official Vene-
tian drugstores in the middle of the eighteenth century (Emmanouil
1936:20):
Αλοιφή της μαλαφράντζας. Ανθόλαδον [plus
other ingredients] Διάργυρον . . . αυτά όλα
κάμε τα αλοιφήν και άλειφε το κορμί όλον ζεστόν
118 Christos Papadopoulos

Ointment for the μαλαφράντζα. Flower-oil . . .


[plus other ingredients] . . . mercury . . . make them all
into an ointment and rub on the body warm. (MTS, fol. 144)

Mercury was the basis of different remedies to treat the symptoms


of the disease. It was administered in a number of ways including skin
application and fumigation, the latter a hygiene process familiar to most
of the Greek community. In cases of fumigation treatment for the “French
disease,” Western patients were occasionally placed in a closed-box appa-
ratus under which a fire caused the mercury to vaporize and reach the
skin (Figure 2). Iatrosophic texts also include such fumigation process in
their range of remedies for the disease. In manuscript 55, in the library
of the Monastery of Olympiotissa, we observe the copyist’s attempt to
provide an illustration of the fumigation process that closely resembles
that of the Western European model (Figure 3). Such a connection may
seem irrelevant as access to mercury or other drugs might have been
difficult in the regions under Ottoman rule. Evidently, however, there
was substantial contact between Europe and the east through officially
sanctioned trading arrangements, large-scale seasonal migrant labor, and
some trade in pharmaceutical products (Mercati 2002:53, 88, 105).
In the context of this study, it is especially significant that iatrosophic
texts included contemporary therapeutic options employed by Western
academic medicine. Clearly, access to European knowledge, trade con-
tacts, medical literature, or personal instruction by physicians educated in
Europe contributed to the assimilation of Western medical theory and its
application in popular medicine. The practice points not only to an on-
going exchange of ideas between the learned community, lay or clerical,
and the wider society, but to the significance of these texts in the daily
lives of the Greek community. Evidently, most iatrosophic texts were of
importance to the local community. The note in ιατροσόφιον 151 (4271)
in the monastery of Iviron on Mt. Athos reads: “offered by me, Savas the
monk, to the hospital for the cure of those afflicted” (Karas 1994:215).
The case of Manolis Fourlanos (d. ca 1818), a cleric from the village of
Vourlikas in the island of Santa Mavra (Lefkas), helps to illustrate the
point further. Fourlanos offered religious, natural, and magico-religious
healing to his congregation. His personal records of therapeutic rem-
edies were found in the Church register among the records of births,
baptisms, and deaths and copied by Pantazis Kontomichis in his account
of popular healing practices in the island (Kontomichis 1988:61). In
addition to the liturgical therapeutic armory provided to him by the
official Church, papa-Fourlanos’s notes contain preparations based on
herbal ingredients, eight apotropaic incantations and two Προλήψεις from
Post-Byzantine Medical Manuscripts 119

Figure 2. Fumigation. Wellcome Library.


120 Christos Papadopoulos

Figure 3. Notes on Fumigation, Monastery of Olympiotissa.

a καλαντολόγιο, that is, astrological predictions for specific dates of the


year. To his flock he was indeed a healer of body and soul. According
to the cleric’s notes:
If the feast day of St. Basil falls on a Sunday, the sun
rules . . . with a good winter, good crops . . . and the child to
be born in such a year, on a Sunday, grows to become big.
If on a Monday . . . many bad winds, a dry summer and death
among the children. (Kontomichis 1988:217)
Post-Byzantine Medical Manuscripts 121

In relation to natural afflictions Papa-Fourlanos’s herbal preparations


treated:
— Headache
— Tummy swelling
— Scabies
— Snake-bite
— Excess wind
— Nosebleed
— Dandruff (‘bran speckles’ in the head)
— Pain of the spleen
— Carbuncles
— Excessive female bleeding
— Dog-bite
— Pain in eyes

The written quasi-religious incantations offered treatments for:


— ‘Every pain’
— Inflammation of the cornea
— Rheumatics
— Women in difficult labour
— Malaria (θέρμη)

The following incantation passage for malaria is typical of the genre:


St John, Honest Prodrome (forerunner) and Baptist
of Christ . . . assist God’s servant X, Archangels
Michael and Gabriel help from ague secondary, tertian,
quartan. στ, μ, λ, στ, μ, μ, τ, φ, θ, α, μ, . . . (Kontomichis 1988:216)

It is thought that the Greek letters in the incantation are the acro-
nym of secret words forming a mystical prayer known only to the priest
and similar to those frequently encountered in other iatrosophic manu-
scripts. Such incantations were in common usage and outside authorised
Church prayers. Notably, the Fourlanos remedies include instructions
for a potion to release a married couple from αμπόδεμα, which is sus-
pected maleficium (harm by supernatural means) to influence a marital
relationship (Kontomichis 1988:213). Evidently, eighteenth-century
clerical healing among the Orthodox community included a plurality of
practices engaged both in pastoral care and treatments for sickness. Its
offerings span supernatural cures and natural remedies. Importantly, the
demarcation of natural or supernatural therapies, officially approved or
irregular, was a subject scarcely occupying the congregation.
Regular social networks influence the manner in which perceptions
evolve. As the case of Papa Fourlanos shows, in the longue durée of Otto-
man, and to some extent Venetian, rule, it was natural that the centrality,
122 Christos Papadopoulos

proximity, educational influence, and authority of the Church shaped


many of the precepts embraced by Orthodox folk. In sanctioning selected
values, symbols, and rituals, it was a strong Church, its clerics, and vibrant
tradition that preserved Orthodox community sensitivities and defined
cultural ideologies about God, the saints, illness, the supernatural, and
the broader cultural outlook.
The preceding remarks invite the consideration of language also.
Although philological analysis falls outside the scope of this paper, a
number of observations can be made with regard to the language of the
iatrosophic texts and our primary concern with contemporary Greek
culture. Generally, the language of iatrosophic manuscripts displays the
scribes’ freedom to copy or add to their text without strict adherence
to grammar or a formal linguistic style. There are several spelling errors
including the name of Galen (Γαλυνού or Γαλήνον) and the mixing of
the language medium from the σεσαρκωμένον (archaic) to the φεγκαρίου
(vernacular), even within the same manuscript (Karas 1994:186, 194,
261). Frequently, as in Figure 3, the copyist adopts an informal writing
style with the focus on recording fresh knowledge rather than displaying
a scribe’s skill. A number of additional notes in the margins have been
recorded by the initial and subsequent writers, symptomatic of their
efforts to augment and develop the existing medical knowledge into a
practical therapeutic manual. For the most part, the scribe’s endeavor
seems to be focused upon the recording and later insertion of useful
popular therapies rather than faithful textual transmission for the learned
medical elite.
Transliteration has been used often to communicate Western dis-
eases or prescriptions in their original popular form rather than coin a
new Greek term as, for example, μαλαφράντζα, the Italian for the “French
disease.” The preference for easy-to-understand forms of language also
extends to the contemporary body of Greek popular healing terms. Typi-
cally, in the “dictionary” section of the seventeenth-century ιατροσόφιον
manuscript 217 from the Athonite monastery of Iviron , we observe the
writer’s wish to acquaint the reader with the names of medical plants as
understood by the general Greek population (Figure 4). Such partiality
towards the “vernacular” continues in several manuscripts with the names
of known diseases as the following examples demonstrate:
Εις κουκούδια κεφαλής — For head spots
Εις τσάκισμα χειρών — For hand-bone fracture
Εις όποιον πτύει αίμα — For blood spitting
Ματζούνι διά σβραχνάδα — Prescription for hoarseness
Εις τά χελώνια — For scrofula
Εις κιτρινάδα — For jaundice (literally yellowing). (Karas
1994:186–190)
Post-Byzantine Medical Manuscripts 123

Figure 4. Dictionary of popular plants, Monastery of Iviron.

The preference for such a demotic terminology of therapeutics


suggests iatrosophic texts were cultural products intended for the
understanding and use of the general public rather than the intellectual
elite. Importantly, while some parts of the texts can be attributed to a
common (probably sixteenth century) learned source, their linguistic
evolution points to the powerful influence of oral tradition in contem-
porary Greek culture.
In contrast to some Western European societies, this was not a
case of Galenic writers ignoring oral tradition in their effort to educate
124 Christos Papadopoulos

medical practitioners and the public; rather, it was the opposite, where
a strong healing tradition transmitted orally from generation to genera-
tion compensated for and contributed to the meager medical literature
of the time (Wear 2000:61). The abundance of iatrosophic prescriptions
using natural products as remedies, and written in the demotic language,
validates their oral provenance and close affiliation with the ordinary
Greek man and woman.
In the process of assimilation of therapeutic beliefs of all types
and from all sources for the community’s benefit, iatrosophic texts
embraced and transmitted miscellaneous remedies that included magical
and magico-religious practices. Widely held beliefs in the paranormal
had been a characteristic of Greek society since classical times, and
such notions continued well into the early modern period. Writing in
the seventeenth century, the Chiot theologian, physician, and scholar,
Leo Allatios, alludes to the widely held supernatural beliefs and heal-
ing practices of the Greek community (Hartnup 2004:252). Some were
acceptable while others were proscribed by the Orthodox Church. In
the iatrosophic corpus there is further evidence of the community’s
preoccupation with the “supernatural,” especially in matters relating to
health and disease. These customs are perhaps the most discomforting
aspect for scholars who sought the towering presence of Hippocratic
rationalism in the post-Byzantine Greek iatrosophic texts. Yet, the history
of later medicine in Europe is “first of all one of continuing pluralism”
(Lloyd 2003:235). In this context, the Greek community sought cures
from its considerable healing tradition within the framework of its own
experience and understanding. The iatrosophic corpus abounds with
examples of such remedies:
Εις μαγουλήθρες γράφουνται η κάτωθεν
πεντάλφα και εξάλφα

For parotitis (mumps), write the following


pentagram and hexagram. (AA, Mar fol. 132)
Post-Byzantine Medical Manuscripts 125

Όταν δεν κοιμάται το παιδί εύρε οφιδίου ένδυμα και


κάψε το να γένη στάκτη. Έπειτα ανακάτωσε την με παλαιό
κρασί και βάλε το εις το βλέφαρον του και του έρχεται ύπνος.

When a child cannot sleep, find (discarded) snake skin


and burn until it turns to ashes. Mix with old wine and
place it on (the child’s) eyelid. Sleep will come. (MTA, fol. 12)

As in most of the world, the use of phylacteries to avert personal


harm has been a characteristic of Greek culture throughout its recorded
history. Greek imagination and a belief in a potently spiritual environ-
ment “saw presages from a thousand incidents” wrote Pierre A. Guys, a
member of the Marseille Academy, to his friend Bourlat de Montredon
(1772:173). A firm belief in the vicissitudes of a hostile environment,
both natural and supernatural, and the power of certain objects to pro-
tect, gave rise to the popularity of phylacteries throughout pagan and
Christian times.
In the Mariopoulou manuscript we observe the long-held notion
of the apotropaic value of the pentagram and hexagram, in this instance
combined with the circle and Greek letters. The shapes are found together
and are thought to be connected to the seal of King Solomon (Wallis
Budge 1978:232–233). They are similar in style to the amulets found in
Hebraic sources and, in combination with the Hebrew names for God
and the Archangels, were thought to offer the recipient the favor and
protection of the Lord.
The letters of the Greek alphabet also play an important part in
the Mariopoulou inscriptions. The letters, Chi (Χ) and Sigma (Σ) refer
to the first and last letters of the Greek word for Christ, ΧΡΙΣΤΟΣ. The
connection of such a monogram with Christian protection spans many
centuries, beginning with Constantine the Great and the battle of the
Milvian Bridge in AD 312. On the eve of the battle, according to the
Emperor’s vision, a “cross-shaped trophy formed from light, and a text
attached to it which said, ‘By this you conquer’” (Eusebius 1999:80–81).
In that sign, the letter Χ intersected in the middle the letter, Rho (P),
thereby combining the first and second letters of the name “Christ.”
According to Eusebius, “this saving sign was always used by the Emperor
for protection against every opposing and hostile force” (1999:82). Since
then, similar symbols incorporating letters of Christ’s name have been
used throughout the Christian world for protection against harm. The
other letters in the manuscript’s pentagram and hexagram are significant
in that they illustrate popular belief in the power of letters when these
are associated with names of Christian holy persons or the initial letters
of the words forming the sacred invocation implicit in the amulet.
126 Christos Papadopoulos

In relation to the manuscript’s remedy for insomnia in children,


snakes have been linked with a host of religious beliefs and healing
practices. In classical times the staff of Asklepios, the healing god, was
entwined with a serpent, a symbol of rebirth and renewal. In this case,
the skin remnant embodies the creature’s healing associations including
the ease of entry into the worlds of light and darkness.

Conclusion

Until relatively recently, the extensive iatrosophic corpus of post-Byzantine


medical manuscripts produced between1600 and 1800 has been of lim-
ited interest to scholars of Greek history. Those who did think and write
about them were mostly disparaging in their judgments. Considering
the subject anew, however, can help redraw perceptions of the ideas and
evolution of the therapeutic and other aspects of wider Greek culture.
A broad awareness of the great medical authors of Greek antiquity and
a firm belief in their intellectual authority and guiding principles on
issues relating to human health can be discerned in the transcriptions.
Taking into account the importance of medicine and popularity of the
texts among the wider Greek community, it is safe to say that few other
personalities from the classical era were of equal fame and status.
In the account of humoral theory, there are clear connections and
continuities with the classical heritage. Despite its intellectual complex-
ity, the theory was offered in a “blessedly simple, fully comprehensible
schema for the philosophically naïve” (Sears 1986:17). While this might
not have met with the approval of the literate elite, it offered to the
community a theoretical framework to embrace and guide much of their
healing practices. Significantly, it maintained an unbroken intellectual
and practical link with the Byzantine and classical past. Importantly, the
manuscripts also point to the influence and integration of academic
medical knowledge from Western European, mainly Italian, sources and
the readiness of the community to incorporate such a medical heritage
into their own. Thus, in the therapeutics of iatrosophic texts we see
reflections of the story of healing in Greek and wider European society,
however tenuous.
In examining philosophical and practical aspects of iatrosophic
medicine, we witness the central role of the Orthodox Church in its
philosophical and secular role, albeit with the borders between the
natural and supernatural, the sacred and the magic, and the Hellenistic
and the Judaeo-Christian indistinct and socially constructed. Iatrosophic
texts were brought together in a form that appealed to the needs, sen-
sitivities, and notions of a highly spiritualized Orthodox community.
Post-Byzantine Medical Manuscripts 127

Incantations for cure fused the Christian with the pagan and affirmed
Donald Nicol’s view of Greeks having “a sense of belonging to a theo-
cratic society” which, importantly, included non-Orthodox supernatural
forces (1979:130). Crucially, Greek Orthodoxy practiced a “vernacular”
religion. Most often, priests were chosen from local folk and probably
tutored in nearby monasteries rather higher schools of divinity studies.
They spoke in the local accent and needed to supplement their meager
incomes with teaching and agriculture. Indeed, in the demotic language
and healing character of the texts, we detect the closeness of the cleri-
cal community to the Orthodox flock and the multi-faceted aspects of
their pastoral care. In this context, the Church strengthened its authority
over the affairs of its parishioners as the principal source of knowledge
and expertise. The close connection of the Church to healing institu-
tions and prayers was widely acknowledged and readily received by the
Orthodox congregation.
In addition, iatrosophic texts illustrate how, at the popular level,
Orthodoxy accommodated science. Unlike the more energetic West-
ern medical deliberations in the matter of disease causation and cure,
­seventeenth- and eighteenth-century Greek Orthodoxy on the whole
lacked the philosophical motivation and local means for a wider debate
on the subject. For a thorough inquiry very few among the congregation
had access to medical schools, patristic works, and the opportunity to
compare Western treatises outside Orthodox Church circles. Moreover,
the prevailing socio-political climate of the Tourkokratia was not con-
ducive to intellectual debates in the matter. For the vast majority of the
highly spiritualized Greek Orthodox society, doctrinal transactions of
medical beliefs between the congregation and its clergy, psychological
aspects of belief and imagination, models and metaphors to comprehend
illness, and the struggle to protect one’s self from the threat of disease
took a special form and meaning.
What of Krumbacher’s “superstitious ingredients and exorcism
formulas?” In relation to iatrosophic texts and modern notions of the
“rational” and “scientific,” G. E. R. Lloyd’s seminal Magic, Reason and Expe-
rience, Studies in the Origins and Development of Greek Science (1979) should
be noted. Magical beliefs and the “irrational” have been part of Greek
life since antiquity and in the study of early modern Greek culture what
matters is that “magic” took place in a setting of pluralistic community
beliefs and customs regarding the supernatural.
With some exceptions, the study of post-Byzantine medical manu-
scripts has been ignored by the wider academic community. Yet, evaluated
from the “prism” of a broader, social history of medicine, the texts make
it possible to observe Greek Orthodox culture “from below” and gain
128 Christos Papadopoulos

insights into the almost personal meanings inherent in that community.


No Whig history here. Rather, what it felt like to be ill, to express pain,
and receive medication; to understand one’s body and its perceived
functions; and to appreciate the Greek Orthodox millet’s mind-set on
nature, the divine and the supernatural, and its sense of identity with
its classical, Christian, and European, heritage.4 This results in a new
addition to our understanding of the cultural and intellectual founda-
tions of modern Greek culture that is sensitive to the past and relevant
to modern issues.

wellcome trust, university college london

NOTES

Acknowledgements. My grateful appreciation to Professor Giannis Karas and Dr. Agamem-


non Tselikas for their guidance in this subject and to Dr. Tselikas for generously allowing
me to use illustrations from his unpublished paper on iatrosophic manuscripts delivered
at the Wellcome Trust Centre for the History of Medicine at UCL in May 2007.
Translation note. Unless otherwise stated, all translations from the Greek are those
of the author.
1
 Regatos (2005:138); «Κακογραμμένο, δυσανάγνωστο, ανορθόγραφο, κακοσυνταγμένο
χειρόγραφο, είναι η συνήθης εικόνα των ιατροσοφίων» (“Badly written, difficult to read, gram-
matically incorrect, badly syntaxed”). Babiniotis (2002:415); «Tα γιατροσóφια δεν θεραπεúουν
τις αρρώστιες» (“ιατροσόφια do not cure diseases”).
2
 In Karas (1994:277), palaeographic analysis places manuscript E.B.E. 2856 in the
eighteenth century, and the text gives the names of a number of contributing physicians
including that of Μανωλάκης Τιμώνης (Manolakis Timonis). My research shows no other
Greek doctor with a similar name qualified in a European university.
3
 For example in relation to Meletius, see Karas (1994:163, 167, 182, and to clerical
scribes pages 169 and 262).
4
 Millet (literally “nation”), a population group based on religious affiliation during
the period of Ottoman rule.

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