In this volume, Louise Cilliers takes an unusual approach to ancient medicine by narrowing down the focus to one particular geographical area in late antiquity. There are good reasons for choosing North Africa, which in the late Roman Empire was the most prosperous province and – especially the city of Carthage – a hub of cultural activity. (The Church Father Augustine, for one, was from North Africa.) During the fourth and fifth centuries it was home to a surprising number of well-known medical authors, namely, Vindicianus, Theodorus Priscianus, Cassius Felix, Caelius Aurelianus and Muscio. They all translated Greek medical texts into Latin or at least contributed to keeping alive the knowledge contained therein, at a time when ever fewer people were able to understand Greek.

The book opens with a potted history of North Africa, its culture shaped by successive waves of foreign invaders, followed by an overview of what Cilliers calls health facilities – aqueducts, baths, sewers and hospitals, not all of them actually in North Africa. (Pace Cilliers, there is some evidence for a valetudinarium at Lambaesis, in the form of an inscription, cil 2438, mentioning trainee medical orderlies, discentes capsariorum.) It is intriguing to read that these buildings appear to have been the only traces of Roman influence left after the area ceased to be a province of the Empire in the fifth century.

After introducing Greek, Roman and Christian views on the causes of diseases, Cilliers gives a bird’s-eye view of the variety of medical practitioners and medical training in Roman North Africa (under the slightly misleading heading ‘The knowledge and competence of physicians in the late Roman Empire’). The role of Alexandria as a medical centre is well known, but Carthage, the capital of Africa Proconsularis, in the fourth and fifth centuries became another. Importantly, Greek was still taught there and in other towns of the region at a time when the language was losing importance in the West.

The chapters about the five medical authors, really the core section about medicine in Roman North Africa, provide biographical information where possible and useful summaries of the main works. Although there tends to be little of the former available in the case of medical writers, for Vindicianus there are both references in Augustine and an inscription dedicated by him to the emperor. He was archiater (chief physician) at the emperor’s court at Treviri and later proconsul of his native province. Cilliers also investigates Vindicianus’ sources, suggesting that Galen was not the great authority in the West that he was in the Greek East. Nevertheless, the claim that his theories became known via Oribasius and Paul of Aegina, “who translated some of his works into Latin, but this was many centuries after Vindicianus” (p. 127, n. 56) is wrong on two counts: both authors wrote exclusively in Greek, and Oribasius was more or less a contemporary of Vindicianus. There are brief résumés of letters by Vindicianus; one to the emperor, which had been the introduction to a lost pharmacological work, his letter to his nephew Pentadius about the four humours, and a résumé is given also of the Gynaecia.

Very little is known about Theodorus Priscianus, the author of several works including another Gynaecia (dedicated to a midwife), apart from his own statement that he was a pupil of Vindicianus. Little is known too about Caelius Aurelianus, except that he was from Sicca Veneria and in his medical views was a Methodist. All we know about Mustio is that he produced a Q&A version of Soranus’ gynaecological work in Latin.

The chapter on Augustine focuses on his (fairly conventional) knowledge of medical matters and references to illness and cure in his writings, often in the context of miraculous healings. Given that the North African medical writers are not so well known, even among classicists, this and the following chapter about ‘Greco-Roman and Christian views of healing’ (not specific to the region), as well as the summing-up in the final chapter could perhaps have been compressed to make room for a more detailed treatment of the extant works. Classicists in particular will miss quotes in the original language.

The book could also have done with more careful fact-checking. To give some more examples, the year 641 is not (p. 23) “a few generations after the death of Muhammad” (d. 632), figures 4.3 and 9.1 are votive reliefs, so the “doctor” is Asclepius (hence the difference in size compared to the other figures depicted). To interpret the descriptions of patients’ addresses in some case histories of the Hippocratic Epidemics (e.g., “lay sick by the Sacred Way/the Thracian Gate”) as indications that these were homeless people lying in the street (p. 209) is unusual to say the least. It is a pity that these errors have crept in to a book that, in other ways, makes a very good comprehensive introduction to the study and practice of medicine in this particular corner of the Roman Empire.