post-byzantine greek medical mss

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

Christos Papadopoulos

Journal of Modern Greek Studies, Volume 27, Number 1, May2009, pp. 107-130 (Article)

Published by The Johns Hopkins University PressDOI: 10.1353/mgs.0.0044

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

107

Post-Byzantine Medical Manuscripts: New Insights into the Greek Medical

Tradition, its Intellectual and Practical Interconnections, and our

Understanding of Greek CultureChristos 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

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.

109Post-Byzantine Medical Manuscripts

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 καιΔιοσκορίδους, των σοφών περί της των ανθρώπων κατασκευής . . . . Πάσι τοις θέλουσιν ευ διάγειν περί της αυτού υγείας

Testament of the three doctors, Galen, Hippocrates andDioscorides, wise on the construction of the human (body) . . . For the health of all those who wish to live well. (StK, fol. 2)


ιατροσόφιον εκλελεγμένον υπο πολλών ιατρικών βιβλίωνΙπποκράτους και Γαληνού και Μελετίου μοναχού καιάλλων δοκιμωτάτων και σοφών ιατρών

ιατροσόφιον selected from many medical books ofHippocrates, Galen, Meletius the monk, and other mostworthy 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


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

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


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:


. . . περι πως εγίνη ο κόσμος παρά Θεού και πως εγίνη καιο 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 wascreated and that he was created from four elements byGod; 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 τηνγυναίκα συνουσιάζεται ευθύς δημιουργία Θεού γίνεταιβρέφος 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,


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 αλλέωςνοσεμένα, από (ποίο) πράγμα γίνονται. Του προφήτουΜωυσέως 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 κορυφήνκλίνας και έσωσας τον πιστόν σου λαόν, παύσον και τονκεφαλόπονον 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)


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


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 δετάρταρι 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 waterone 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


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 ροδακίωντην 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


Ointment for the μαλαφράντζα. Flower-oil . . . [plus other ingredients] . . . mercury . . . make them allinto 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


Figure 2. Fumigation. Wellcome Library.


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 sunrules . . . with a good winter, good crops . . . and the child tobe born in such a year, on a Sunday, grows to become big.If on a Monday . . . many bad winds, a dry summer and deathamong the children. (Kontomichis 1988:217)

Figure 3. Notes on Fumigation, Monastery of Olympiotissa.


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,


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 spotsΕις τσάκισμα χειρών — For hand-bone fracture Εις όποιον πτύει αίμα — For blood spittingΜατζούνι διά σβραχνάδα — Prescription for hoarsenessΕις τά χελώνια — For scrofulaΕις κιτρινάδα — For jaundice (literally yellowing). (Karas

1994:186–190)


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

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


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 κάτωθενπεντάλφα και εξάλφα

For parotitis (mumps), write the followingpentagram and hexagram. (AA, Mar fol. 132)


Όταν δεν κοιμάται το παιδί εύρε οφιδίου ένδυμα καικάψε το να γένη στάκτη. Έπειτα ανακάτωσε την με παλαιόκρασί και βάλε το εις το βλέφαρον του και του έρχεται ύπνος.

When a child cannot sleep, find (discarded) snake skinand 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.


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.


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


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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