There are few surviving manuscripts or fragments of late antique medical books. One that recently caught my attention was an early seventh-century fragment described as containing the Pseudo-Hippocratic Letter to Maecenas (now Munich, BSB, clm 29688). It is described in Codices Latini Antiquiores as being written in an unremarkable uncial coming ‘most likely from Italy’, although it was used for a long time as a fly-leaf for a book in St Emmeram’s in Regensburg.

In many ways the fragment is not very exciting and mostly deals with the health benefits of vomiting. The Letter of Maecenas certainly does discuss this too. But an attentive reader might notice that the words – and indeed the exact advice on what to do – are different.[1] ‘Is it a different text?’ you may ask.

As it happens the text of the fragment does have a perfect match in another related text: the Doctrine of Hippocrates (Dogma Hippocratis). (As ever this comes with the Covid lockdown apology: I am sure that someone else has made this identification but I cannot find it in the works I have available, which reaffirm the old identification).

In practice, the Doctrine of Hippocrates is a paraphrased version of the popular Pseudo-Hippocratic Letter to Antiochus. Beccaria listed it as a fourth variant of that text in his standard 1956 reference book on early medieval medical manuscripts, while the Thesaurus linguae Latina lists it as ‘version β’ (‘scarcely after s. vi’). (I omitted it from an earlier discussion of the letter tradition on here, by the way, because I was not aware of any early manuscripts at the time). There is an edition of the whole text by Rudolf Laux from 1930 as part VIII of an Ars medicinae, an early medieval primer for medical students.[2] Laux’s edition, based primarily on an eleventh-century manuscript, is notoriously a little chaotic, especially with regards to which supporting manuscripts he used.[3] I don’t think our fragment, however, has entered any conversation about it, which is a shame, because it would be comfortably the earliest.

I should add that the fragment was not necessarily originally part of the Ars medicinae as we find it later. As Cloudy Fischer has observed, there are other similar collections which used very early material in wide circulation but which only came together later on. Our fragment is associated with another fragment which contains Pseudo-Apuleius’s Herbarius, so it might just have been an addition to that, much as the Pseudo-Hippocratic Letter to Maecenas often was.

Does reidentifying the text ‘matter’? Does anyone really care? Everyone will have an opinion. I still remain stung by an old peer review, for an article on a different subject, that suggested I delete my discussions of manuscripts ‘because they are only of interest to the author.’ I should instead concern myself with ‘identity theory’, although that wasn’t what the article was about. Well, I remain unrepentant. I do think getting our actual evidence nailed down and understood properly is at worst an essential foundation for anything else interesting we might want to say. But, okay, getting the balance right to satisfy readers is also hard.

For me, what is interesting about the reidentification, is that it adds to the complexity of our knowledge of the period. Late antique and early medieval medicine is supposed to be very limited indeed. And in many ways it is. But that makes every data point crucial. We would often begin an assessment of late antique Italian medical knowledge by pointing to the texts Cassiodorus recommended in his Institutions as primers for monks or else by pointing to the texts claimed for the medical school in Ravenna. Strikingly, although we have at least a dozen pre-Carolingian Italian medical manuscripts, none of these contain the texts mentioned by Cassiodorus nor those from Ravenna. Mostly, to be honest, they contain bits of Pseudo-Apuleius. That is still valuable to know, however, because it shows different contours of medical knowledge compared to what we would get from our standard reference points. In that context, to find that a text isn’t the common-as-muck Letter to Maecenas but the much rarer Doctrine of Hippocrates expands and deepens that picture. Every little detail helps.

[1] The standard edition is part of Marcelli De medicamentis liber, ed. E. Liechtenhan (Berlin, 1968), with the relevant section at 28/30 (online here).

[2] R. Laux, ‘Ars medicinae. Ein frühmittelalterliches Kompendium der Medizin’, Kyklos 3 (1930), 418-32.

[3] J. Jouanna, ‘Hippocrate et la Collection Hippocratique dans l’Ars medicinae’, Revue d’histoire des texts 23 (1993), 95-111; K.-D. Fischer, ‘The Isagoge of Pseudo-Soranus: An Analysis of the Contents of a Medieval Introduction to the Art of Medicine’, Medizinhistoriches Journal 35.1 (2000), 3-30 at 17; B. Löfstedt, ‘Notizen zur Ars medicinae’, Acta Classica 46 (2003), 119-121.