Background

During the twilight years of the late Roman Empire in the West, the province of Africa Proconsularis, with Carthage as its administrative capital and centre, experienced a flowering of scientific and, in particular, medical activity. North Africa had, up to the Vandal invasion in the early fifth century, escaped the disasters that struck the eastern and western empires in the third century. Great parts of the empire had been ravaged by internal civil wars, Persian and Germanic invaders defeated Roman armies and the country experienced a financial crisis that reduced the coinage to almost nothing. In fact, in the late fourth century, the re-founded Carthage was the largest city in the western empire after Rome, and the province was peaceful and prosperous.

The tranquil circumstances in North Africa during the late fourth and early fifth centuries could have been one of the reasons for the amazing number of medical texts coming from this small but vibrant province. The French scholar Guy Sabbah pointed out that in the period from c. 370 to c. 450 CE the greatest number of medical works produced in the Roman world at large were written by four medical writers – Helvius Vindicianus, Theodorus Priscianus, Caelius Aurelianus and Cassius Felix – all of whom lived in or near Carthage. One of the main reasons advanced in the course of his article is North Africa's good school system. The fifth-century-CE Gallic monk Salvian wrote with admiration about the schools in North Africa where Greek, Latin and philosophy were taught. Sabbah even suggested the existence of an ‘African School’ of physicians and medical writers, but that is perhaps taking it a step too far. Still, that there were highly intellectual circles in Carthage where medical matters such as the urgency of translating Greek works into Latin for ordinary doctors, and the provision of text books for aspiring medical practitioners of whatever level of expertise, were discussed, cannot be denied. In fact, the works by the aforementioned authors give the impression that they were didactic, lecture notes, as it were, written for students who study medicine. Vindicianus’ Gynecology is a prime example, as will be seen below; his letter to his nephew Pentadius likewise; Theodorus Priscianus’ Gynecology is written for midwives or people assisting with births (see Chapter 6), Cassius Felix's On medicine would also have been useful for students studying medicine (see Chapter 7).