From Homer onwards, Egypt loomed large in the ancient Greek imagination as a land of healing (in the Odyssey, for example, Helen numbs the sorrow aroused by memories of Odysseus by means of cunning drugs given to her by a woman from Egypt, where the earth holds a great store of medicaments and ‘every man is a physician’ [4.219–32]). Some four centuries later, after the death of Alexander, Greek medicine arrived in an unprecedented way on Egyptian shores with the rise of the Ptolemies, bringing with them a wave of Greek settlers and a Hellenising agenda.

These ancient clues of cross-cultural interaction have meant that historians of Greek and Egyptian medicine have always had an eye on the other tradition. But in the absence of much direct evidence for this interaction, they have had to rely largely on speculation about the extent and the nature of the traffic. In such a climate, shaky assumptions about the defining qualities of Greek or Egyptian medicine have long tended to creep in. The focus, moreover, has been on the learned medical texts of each tradition at the expense of other kinds of evidence and a more variegated picture of healing practices within Ptolemaic Egypt.

Philippa Lang’s Medicine and Society in Ptolemaic Egypt cannot avoid the speculative vein entirely. But in its sober and thorough survey of the available evidence, it offers the best attempt to date to grasp the richly diverse world of health and disease in Ptolemaic Egypt. It sheds light, too, on the broader question of the relationship between Greek and Egyptian medicine.

Lang is guided throughout the study by the seemingly unassuming statement with which she begins her first chapter: ‘Illness is a sociocultural concept’. (p. 1) Such an orientation, however, is part of what marks the originality of her study in its field. Lang is alive to the intersection of medicine with other social domains, the fluid relationships between different models of healing in the everyday tug-and-pull of what Vivian Nutton has called the ‘medical marketplace’, the mobile place of the gods in an individual’s attempts to make sense of disease, and the easy circulation of remedies originating in different traditions.Footnote ¹ Indeed, the emphasis on flexibility in practice is a running theme in the book. It leads Lang to privilege a model of exchange between Egyptian and Greek models in the Ptolemaic period that is governed by the contingencies of individual experiences of illness and the various hybrid identities produced at the intersections of ethnic and cultural communities.

Such flexibility does not eliminate the categories of Greek medicine and Egyptian medicine. But it does enable Lang to consider the boundaries of these categories in a way that is suspicious of many tenacious assumptions about the two traditions. Perhaps most predictably, she adopts a sceptical attitude towards the old divide between ‘rational’ Greek medicine and ‘irrational’ Egyptian medicine by eroding those terms: Greek medicine is more open to the gods and ‘magical’ practices than advocates of its alleged rationality acknowledge; magic and religion are not irrational if the explanations they offer fit with the evidence as well as talk of phlegm or bile. These are by now familiar arguments in the study of ancient medicine, and Lang’s analysis here feels a bit dated. More provocative is her dismissal of any significant Egyptian influence on pre-Hellenistic disease theory in Greece, based on a reconsideration of alleged parallels. She also offers a useful deconstruction of the differences between Egyptian healing sanctuaries and the cult of Asclepius in Greece, the best-known form of temple medicine. In those contexts where the two traditions were explicitly conflated, as in the Hellenising identification of the Egyptian god Imhotep with Asclepius, she takes a judicious approach, emphasising the persistence of Egyptian practices and symbolic structures as well as the ways in which existing Egyptian temples and cult sites adapted to Greek clients and incorporated Greek textual material into their archives.

Against this backdrop, the world of elite Alexandrian medicine, the subject of the last chapter and the traditional centre of ‘Ptolemaic medicine’, is sharply defined in Lang’s account by its exceptionalism. If the majority of practitioners and clients in Ptolemaic Egypt adopted what Lang calls an ‘inclusive’ approach to healing and disease – a willingness to try whatever might work – the Hellenised elite who populated the ‘intellectual hothouse’ at Alexandria exemplified an ‘exclusive’ approach, intolerant of non-naturalising explanatory models and invested in the cultural authority of Greek medicine. Of course, the most striking innovations of Alexandrian medicine – the brief flirtation with systematic human dissection, vivisection, and the proliferation of compound drugs – are undoubtedly products of its uniquely hybrid milieu. Lang’s emphasis, however, is on the insular self-consciousness of elite Greek physicians. What we find here is, as Lang writes in her closing sentence, ‘Greek cultural exclusivity at its most extreme: the attempt to define knowledge and its canon through an excluding framework of heuristics, demonstration and textual control’ (p. 266).

That sentence shows that Lang is not short on definitive pronouncements about medicine in Ptolemaic Egypt. When she does hesitate to make them, it is because she is unwilling to go beyond what the evidence warrants and rightly averse to totalising generalisation when dealing with social domains that are by definition pluralistic and dynamic. Yet what the book lacks is a strong articulation of its methodology and overarching aims: the two-page preface serves as its introduction and there is no conclusion. It would have been helpful to see Lang more actively position her work and summarise her conclusions, especially since many readers will lack expertise in one of the medical traditions under consideration and the book has such a wealth of data. Nevertheless, Medicine and Society in Ptolemaic Egypt will no doubt be an invaluable point of reference for scholars interested in both Ptolemaic Egypt and the interaction between two of antiquity’s most robust and influential medical traditions.