Tuesday, November 19, 2013

2013.11.33

Steven M. Oberhelman (ed.), Dreams, Healing, and Medicine in Greece: From Antiquity to the Present. Farnham; Burlington, VT: Ashgate, 2013. Pp. xiv, 341. ISBN 9781409424239. $119.95.

Reviewed by Chiara Thumiger, Humboldt-Universität zu Berlin (chiara.thumiger@hu-berlin.de)

Version at BMCR home site

The topic of dreams has received much and diverse attention in recent scholarship. Oberhelman presents this project as a diachronic survey of dreams in relation to medical doctrines and healing practices in Greece, over a time span that goes from the ancient world to modern culture and contemporary trends. Most of the material in the book is, however, focused on ancient and Byzantine times, venturing into contemporary dreaming experiences only in two of the contributions. This is partly due to the chosen focus on Greece: discussions of dreaming in contemporary psychiatry, for example, or healing dreams in other modern and contemporary non-Western, or non-urban cultures, could have otherwise fittingly expanded the section on the modern world.

The volume opens with an Introduction by the editor, Steven M. Oberhelman, an essay in its own right, which sets the methodological frame. At its centre there is the increasingly important notion of 'medical pluralism', as Oberhelman insightfully illustrates: the interweaving of different levels of social, professional and cultural figures and situations within the medical culture of a given context, complicated by continuous exchanges and overlapping between levels. The variety of topics and sources in the following chapters reflect such looser meaning of 'medical', if we compare it with contemporary Western professionalism. Layeredness of medical culture is cast here as the demonstrandum, with the aid of thinkers such as Kleinman or Gentilcore. As the discussion correctly shows, it is rather its opposite, a monolithic pyramidal view of medical professionalism, that needs to be proved. Pluralism, by contrast, is the normal state of things, not just in ancient societies, but, arguably, if at different degrees, also in our own.

The body of the book is divided into three chronologically arranged sections: 1) 'Antiquity', 2) 'Byzantium' and 3) 'The post- Byzantine period to the current day'. As the editor points out, however, the diachronic organisation is complicated by the deep continuities across periods, as well as internal stratifications of what he summarises as formal, popular and religious medicine across times and practices (this last term, 'formal', a label that occurrs more times in this section of the book, does not appear as the best choice for what I take it to be meaning here – secular, scientific in intentions, with an interest in theory).

The section on Antiquity opens with medical sources. M. Hulskamp ('The value of dream diagnosis in the medical praxis of the Hippocratics and Galen') offers a competent and exhaustive discussion of the role of dreams as element of diagnosis and prognosis in the Hippocratic texts, not only in the better known Regimen 4 but also in a variety of other less well known passages. Hulskamp includes a discussion of medical dreams in Galen's surviving works, in dialogue with and in contrast to the Hippocratic predecessors. This chapter is a precious resource both for the ancient material it surveys and for its wide engagement with scholarship, and it contributes also a relevant conclusion, that 'the status of dream diagnosis was much less prevalent than has hitherto been suggested'.

The section continues moving from theory to the practice of 'Dream healing in Asclepieia in the Mediterranean' by Louise Cilliers and François Pieter Retief. The topic is obviously central to the volume and the chapter serves well, in its first part, to illustrate incubation, healing dreams, practical aspects of temple healing and the interrelation of professional and sacerdotal medicine in these contexts. We are somehow missing the sense of a chronological development from the early sources to the time of Aelius Aristides, as the authors picture a rather monolithic experience. Some engagement with the vast theoretical literature questioning an opposition of 'religious healing' to 'rational medicine' would have also been expected, especially in the light of the editor's careful introduction. In the second part of the chapter the data about incubation is scrutinised in ways that are not always convincing: in particular, reflections are offered on physiological and psychological aspects of dreaming, with medical explanations of the ancient experiences. The risk implicit in measuring cultural facts by the standards of 'modern science' is a devaluing perspective that runs counter to the spirit of the volume; an anthropological outlook would have served as a better corollary to the material presented. Nonetheless this chapter is useful and informative about practical aspects of temple healing.

Lee T. Pearcy's piece 'Writing the medical dream in the Hippocratic Corpus and at Epidaurus' brings together the topics of the first two chapters by looking at dreams as 'battlefield' for the assertion of medicine's privileged authority against other healing practices. The account of the competitive nature of the medical profession from its beginnings and the discussion of the iamata offer rich material for comparison. The case for an engagement of passages from Epid. 5 and 7 with Asclepian case histories remains far from made, there are some difficult statements about Hippocratic questions of authorship, and the parallels between Epidemics cases and the epigraphies are not always convincing; the point however about the self-definition of medicine and the appropriation of the prognostic dream is a relevant and pertinent one.

Janet Downey's 'Dream hermeneutics in Aelius Aristides' Hieroi Logoi' discusses this most famous patient (and autobiographer) of antiquity, in whose experience of illness dreams played a key role. Downey's approach is neatly defined and all the more helpful for that: to look at the dream accounts as literary pieces, in their stylistic features and idiomatic choices, in order to reconstruct why did this particular dreamer choose to report his experience in this particular way. Especially enlightening is the analysis of the features of uncertainty, tentativeness and conjecture that characterize the recounting of dreams and mark Aelius Aristides' own style, as well as the highlighting of his personalisation of the experience of dreaming in relation to his own individual life, the construction of a 'personal narrative' and a view of therapy as 'theatrical, or rhetorical performance'.

In Christine Walde's chapter, 'Illness and its metaphors in Artemidorus' Oneirocritica: a negative list', the author packs in much information about this text and the images of health and disease that feed into its representation of dream experiences. The reading is at times dense, and the chapter lacks structure (some intricacies of the English also did not help); on the other hand, it offers a detailed presentation of a unique text. I welcomed the topic of metaphor an imagery, although the introduction of the concept of 'metaphor' in relation to disease, and the evocation of Sonntag's famous essay could have been developed further and with greater theoretical precision concerning usage of 'symbol', 'metaphor', 'analogy' and the like.

The second section is on Byzantium and the Byzantine age. First Ildikó Csepregi's 'Who is behind incubation stories? The hagiographers of Byzantine dream-healing miracle' offers a subtle analysis of the creation process behind hagiographic stories and the interactions of authorship, audience, and conventions of the genre in the composition of these texts. Csepregi chooses to focus on the hagiographer as narrator-persona and textual creation, an interesting angle away from the usual key actors, patient and healer. This was one of my favourite chapters. In 'Healing dreams in early Byzantine miracle collections' Stavroula Constantinou notices the importance of illness as a theme in Byzantine literary texts 'that focus on the ill and suffering body' (189). To analyse the role of dreams in healing miracle stories was a promising objective, and interesting information is offered; however, I found this chapter thin by comparison with the others, both for the limited number of examples given and for the quickness of the analysis.

Full of interest and clear in scope and objective is the next piece, 'Hospital dreams in Byzantium', by Timothy S. Miller. This chapter gives us insights about the hospital context and the interaction between religious and official medicine in the Byzantine xenônes through the accounts of dreams sick men had while staying at the hospital or in its dependencies. Miller argues that dreams are an important source of information about these institutions, although underexplored and even if their reliability needs the backing of external information. He looks at five dream narratives of different provenience from various Miracles collections, showing how they offer a perspective complementary to the Byzantine medical texts, from which hospitals are almost absent, by placing a more vivid picture of patient experience alongside the iatrosophic more professional evidence. Jovan Bilbija, in 'The stuff of dreams: substances and dreams in Greek and Latin literature', gives a learned survey of substances regarded as capable of interfering with dreaming activities in the ancient world. The topic is relevant and the listing thorough; I was left wanting to hear more, alongside the catalogues of categories and substances, on possible interpretations of these pharmacological beliefs. Barbara Zipser's chapter on 'Magic, infidelity, and secret annotations in a Cypriot manuscript of the early 14th century (Wellcome MSL 14)' is a competent discussion of a fourteenth-century manuscript containing dietary and medical instructions to which elements of magic were added during its use through the centuries. Notable among these is a magical practice to drive a woman to confess infidelity getting her to talk 'in her sleep'; other than this aspect, however, there is no interest in dreams in the piece whatsoever nor an effort to engage with the theme of the book, so that this interesting chapter does not really belong to the collection. Part 3 is devoted to 'The post-byzantine period to the present day'. The reader has much to learn from Oberhelman's own contribution on 'Dreams, dreambooks, and post-Byzantine practical healing manuals (iatrosophia)', which offers an overview of material both ample in the time span covered and number of references considered, and microscopic in its analysis. The chapter focuses then on one particular text, an eighteenth century codex of a fifteenth century text by one Blasius of Athens on dream interpretation and its debts to Hippocratic and Galenic medicine, as well as reflecting folk beliefs.

The last two chapters move into the afterlife of the ancient association between dreaming and healing. The first, by Charles Stewart, 'Fields in dreams: anxiety, experience, and the limits of social constructionism in modern Greek dream narratives' opens with some important methodological points and moves to examine Greek contemporary experiences of anxiety dreams related to illness, suffering and healing. Stewart analyses the oneiric imagery of plains and fields, the religious and biblical background of these images, and their possible (explicit and less explicit) association with the afterlife. I enjoyed the conclusions in this chapter as an especially useful methodological exercise, with their illustration of different competing, or parallel approaches to dreams and culture. The last piece, 'Dream healing for a new age' by Jill Dubisch takes us into contemporary Western spiritualist trends, describing the unfamiliar (to this reviewer at least) existence of New Age practices of spiritual tourism in Greece, which include re-enacting of versions of the ancient myths and rituals as well as a form of incubation experience. I found the topic an original and potentially thought-provoking conclusion to the volume, although I would have very much liked some stronger anthropological consideration to be built on the reporting of the trip in its various phases. I also found the piece surprisingly neutral about or even supportive of the claim of an (a-temporally conceived) 'quintessentially Greek' nature of the ancient myths and practices, seen to preserve, somehow, a kind of intrinsic power through the centuries. I would have found it interesting to read some exploration of the therapeutic power of relating to the semiotics of cultures that are familiar but distant for the healing of psychiatric disorders (e.g., PTSD in war veterans), as well as to reflect on a comparison between Tick's work and the well known relationship between the development of psychoanalysis and the contemplation of ancient cultures, from as early as Freud and Jung.

On the whole, this volume does successfully what a collection of essays should do – offer a comprehensive coverage of the topic, with different sources, media and perspectives. Of the three items in the title, dream, healing and medicine, the third results perhaps overshadowed by the first two, in the sense that popular beliefs tend to dominate; this is to be expected, and ultimately there is only one chapter speaking from the standpoint of 'official' ancient Greek medical sources. Also, the choice of specifying the Greekness of the story may attract objection. Unless one is inclined to imagine a transcendent Greece of loose geographical borders surviving through the centuries, the chapters on the modern experiences, with all their interest, have to do with two Greeces - that of contemporary Greek with (degrees of) Christians faith and that of American New Age sympathisers - that have little but the name to share with the world of Hippocrates, Galen or Greek temple medicine for that matter.

The tone and cogency of chapters in the volume, as well as their exhaustiveness, may vary, but the resulting final picture keeps its unity – for example, the pieces in the Byzantine section give their best if read as segments of a whole. Very different readers will benefit in different ways from this collection; surely it represents a valuable reference for scholars interested in ancient religious beliefs and practices and their points of contact with medical ideas and popular medicine, and not least an enjoyable and stimulating read.

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