Capturing Medical Tradition:

Caelius Aurelianus’
On Acute Diseases
Anna Dysert

The translations of Caelius Aurelianus serve as an important histori-

cal link in the transmission of Greek medical practice and thought through-
out the later Roman Empire and Middle Ages. Notably, Caelius’ Latin
translation Celerum vel Acutarum Passionum,1 “On Swift or Acute Dis-
eases,” from the work of Soranus of Ephesus, codifies many Methodist
tenets and treatments for transmittance to the Latin-speaking West. As
such, the historical text figures prominently into the tradition of medical de-
velopment from the perspective of modern scholarship, particularly in con-
sidering the transferal of Greek medical learning. In addition to this, the
text self-consciously engages in the medical conversations of its time.
Caelius’ consideration and refutation of other therapies and philosophies of
disease provide clues as to how the Methodists defined themselves and their
practice in light of contemporary sectarianism in medicine.
Soranus of Ephesus, among the most famous physicians of the
Methodist sect, practiced medicine during the time of Trajan and Hadrian,
according to the Byzantine Suda.2 Tradition holds that he was educated in
Alexandria, which, as Vivian Nutton notes, would have been appropriate for
162 HIRUNDO 2007

a young man from Asia Minor and would indeed have accounted for his
anatomical knowledge.3 Soranus of Ephesus was arguably the third leading
Methodist after Themison of Laodicea and Thessalus of Tralles. Themison
first posited the theory of κοιυóτητες, “general states,” or “communities”
based on the principals of his Asclepiades, who taught that the body was
composed of atoms moving through pores.4 According to Themison, the
diseased body is one where this movement is too tense and restricted (what
Caelius translates as strictura), too relaxed and fluid (solutio), or some com-
bination of both (complexio).
Thessalus succeeded Themison, practicing medicine in Rome under
Nero. He is credited with developing the system of restorative and metasyn-
cretic treatments used according to intervals of time.5 Soranus followed
Thessalus, although his system was less radical than that of Thessalus.
Methodism itself rose as a reaction to the competing sects of Dogmatism
and Epiricism in medicine, but Soranus’ writings indicate broad historical,
philosophical, and medical interests, plus a great familiarity with other
schools of medical thought. While Soranus in On Acute Diseases does em-
phasize aspects of practice and theory that are specifically Methodist, for ex-
ample, the sharp distinction between acute and chronic disease, the relative
unimportance of anatomy, and a holistic view of disease, he is not averse to
entertaining other theories and explaining them.
What little scholars know about the circumstances of Caelius Aure-
lianus’ life comes largely from the information he divulges in his writing.
Indeed, scholars do not even know his correct dates, but situate him in the
fifth century AD based on linguistic and stylistic comparison with Cassius
Anna Dysert Capturing Medical Tradition: Caelius Aurelianus and On Acute Diseases 163

Felix,6 a mid-fifth century Latin translator of Greek medical texts.7 Caelius

Aurelianus calls himself methodici Siccensis, “methodist of Sicca,” a
Roman colony in Numidia. Beyond this, however, no details of his life are
known.
Caelius has left four extant texts, two of which are the translations
On Acute Diseases and On Chronic Diseases from works of the same name
by Soranus of Ephesus. His third extant work is fragments of a Latin trans-
lation of Soranus’ Gynaecia and fourth is his own original treatise entitled
Medicinales responsiones.8
The question of translation practices complicates any analysis of On
Acute Diseases. Indeed, Caelius’ name seems often to overshadow that of
Soranus in scholarship of the text—an odd phenomenon considering that we
ourselves would never claim to be reading a translator when what we are in
fact reading is the author’s translated text.9 Caelius himself frequently re-
minds us that he is merely the translator and Soranus, the author. An exam-
ple of this attestation occurs as Caelius ends the section Quomodo Curandi
sunt Cardiaci, “the way to care for cardiac disease,” by writing, haec est se-
cundum Soranum cardiacorum methodica curatio (“this ends Soranus’
treatment of cardiac disease according to the Methodists.)”10
Yet the relationship of translator to text is more complicated and less
transparent than Caelius claims. Examination of the textual history does
lead us to believe that Caelius is, as he states, truly just humbly seeking to
translate Soranus’ work into Latin.11 However subtle manipulations of tone
and presentation of information cause him to sound more distinctly author-
ial. This too, though, must be reconciled with an Antique view of transla-
164 HIRUNDO 2007

tion and textual transmission very different from modern standards.

No manuscript copies of On Acute Diseases or On Chronic Diseases
are extant and critical analysis of these Caelian texts must rest upon the ear-
liest printed editions of the sixteenth century. On Chronic Diseases was first
published in 1529 by Johannes Sichart for Heinrich Petri in Basle and On
Acute Diseases was first published four years later by Winter von Arnder-
nach for Simon de Colinis in Paris. The manuscript or manuscripts these
printed editions are based upon disappeared shortly later.12 Scholars are able
to compare these editions with the fragments of Soranus’ extant Gynaecia
and fragments of Caelius’ Latin translation of the work, along with Caelius’
extant Medicinales responsiones, as well as other Latin translations of Greek
medical texts to ascertain that Caelius most likely rendered Soranus’ original
faithfully.13 However, it is impossible to know what sort of omissions he
may have made. Other scholars tend to agree that Caelius’ translation is a
redaction and they allow for “certain degree of independent thought.”14 Vi-
vian Nutton writes that “Caelius was avowedly drawing on a large work of
the same name by Soranus [On Acute and Chronic Diseases], for he cites
him frequently and in a manner that shows that he was consulting him in the
Greek original.”15 This paper does not seek to engage in the controversy re-
garding how closely Caelius Aurelianus followed Soranus’ work in the
Celerum Passionum. Instead, as Caelius considered himself the translator,
so shall we consider him. Though we do not know all the specific editorial
decisions that Caelius made, we do see Caelius the translator manipulating
the text with authorial intent in the way he presents Soranus and his views.
Caelius Aurelianus chooses to insert references to Soranus at very
Anna Dysert Capturing Medical Tradition: Caelius Aurelianus and On Acute Diseases 165

curious and telling times throughout the text. The text itself includes fre-
quent debates regarding the causes of diseases and particularly, proper ther-
apies. At these times, Caelius is most likely to assert Soranus’ authority in a
way that changes him from being the author of the text to being one of
“characters” in the medical argument. In the reply Ad Asclepiadem et
Themisonem et Herclidem Tarentum, Caelius rejects Themison’s method of
treating lethargy patients by forcing liquids on them by claiming that So-
ranus would have said that this potion is harmful.16 Caelius’ displaces So-
ranus as author of the text at this moment by bringing Soranus into his own
text and setting him within the debate. In instances such as this, Caelius ac-
tually takes authorial predominance away from Soranus instead construct-
ing an authorial persona for himself. While we do not know how authorial
Caelius truly was in editing or adapting Soranus’ work, this example com-
plicates Caelius’ claim to being merely Soranus’ translator.
These sorts of frequent medical debates are common throughout the
text, reflecting not only Soranus’ distinct historical and philosophical inter-
ests, but also the inclinations of his readership. As I.E. Drabkin writes, “So-
ranus’ broad philosophical and historical interests…serve to distinguish his
treatises on acute and chronic diseases from mere handbooks of medical
practice.”17 Soranus clearly had a historical interest in medical tradition and
its implications for contemporary medicine. As mentioned previously, he
describes the ideas and treatments of other physicians and medical tradi-
tions, occasionally even tracing the history of a disease back to its refer-
ences in Homer.18
From this, we may surmise that his readership was a coterie of
166 HIRUNDO 2007

learned doctors and intellectuals. It is highly likely that even doctors of dif-
ferent sects would have read Caelius’ translation; we know for certain, at
least, that Galen was familiar with Soranus’ work (likely in its original
Greek) because he praised Soranus even though he could not stand
Methodists in general.19 In his article on Caelius Aurelianus’ contemporary
Cassius Felix, G. Sabbah contrasts the readerships of the two writers. The
Latin translations prepared by Cassius Felix would have been destined

non pas à un public cultivé… comme celui de Celse, voire celui

de Caelius, mais à un public de professionnels, de practiciens,
le contenu et la méthode d’un cours professoral.20

The works of Cassius Felix have more of a practical application than do the
works of Caelius Aurelianus, intended instead for a “cultivated” readership.
Indeed, Celerum Passionum does contain methods of therapy, but the au-
thor’s interest is largely concentrated in discussing the ideas behind and his-
tory of the practical treatments.
The consistent format which the author uses to describe each disease
also reflects the interest in historicism. The text discusses the acute diseases
a capite ad calcem using an entry format that begins with the etymology of
the word, followed by the definition of the diseases, its symptoms, the
method of discerning the particular disease from other ones similar in ap-
pearance, the disease’s treatment according to the Methodist, and finally a
discussion and refutation of the disease’s treatment according to other physi-
cians.21 Caelius’ description of hydrophobia (or rabies) nicely illustrates all
Anna Dysert Capturing Medical Tradition: Caelius Aurelianus and On Acute Diseases 167

the entry components.

First, Caelius relates the origins of the word hydrophobia, nam
Graeci timorem phobon vocant, aquam hydor appellant, “for the Greeks
call ‘fear’ ‘phobon,’ and call ‘water,’ ‘hydor.’”22 He continues to outline dif-
ferent names which the disease has been called, hygrophobia, phobodipsos,
cynolyssos. Next he gives the antecedens causa as the bite of a mad dog,
although he admits that other animals may transfer the diseases, and also
that the diseases may arise spontaneously when the body is in an extreme
state of strictura as a result of poison.23 Here, Caelius begins to subtly in-
troduce the cause of the disease according to the Methodists.
In his next section, he lists an irrational fear of water as the symp-
tom of hydrophobia and mentions other physical ailments which will ac-
company the disease, including anxiety, irascibility, and heaviness in the
esophagus, among others. His account is not only clinical as he punctuates
his description of the symptoms with a variety of anecdotes, for example,
the baby with hydrophobia who was terrified by its mother’s milk.24 The
great care and attention he pays to this section of the entry indicates the
great importance of symptoms to the Methodist system of medicine. J.
Pigeaud notes that “dans cette description des symptômes, toute l’attention
que le médecin prête au malade… l’essentiel pour le médecin méthodiste,
comme le dit Caelius lui-même, devrait être la maladie.”25 For the
Methodists, defining the disease is second to understanding its array of
symptoms. Following this, he details the physiological causes of hydropho-
bia: inflammation and lack of moisture which cause a state of stricture in
the sufferer.26
168 HIRUNDO 2007

In the section on distinguishing hydrophobia from similar diseases,

the author supplies a distinction based on anatomy—a contrast to his usual
feeling of disdain towards physicians who are overly concerned with
anatomy. He writes that mania and phrenitis, the diseases most closely re-
sembling hydrophobia, are different in that they affect the head principally
while hydrophobia affects the esophagus.27
In the next section on which part of the body is affected by hy-
drophobia, Caelius has a much more customarily Methodist statement to
make. He describes various other physicians’ theories about what part of the
body hydrophobia actually diseases, but concludes by saying that the disease
affects the entire body.28 This is a traditionally Methodist idea that Caelius
sets up against other sects’ views many times, as we shall see.
Lastly, in his section on therapeutics, Caelius posits his treatment ac-
cording to the Methodist system, and then details treatments from other
medical traditions. In comparisons such as these (which Caelius makes for
all of the diseases he discusses), we may observe how the Methodists define
their medical practice against the other medical sects and we may determine
what is uniquely Methodist about many of the practices he describes.
The Methodist therapies Caelius describes involve attempting to
loosen the state of stricture by having the patient’s body massaged, covered
with a gentle heat (warmed olive oil prepared without the patient’s being
able to see it), and above all attempting to get the patient to drink voluntar-
ily.29 The Methodist theory of stricture and relaxation is demonstrated in a
contrast Caelius make with another method of treatment from Artorius. Ac-
cording to him, doctors should force their patients to drink by putting them
Anna Dysert Capturing Medical Tradition: Caelius Aurelianus and On Acute Diseases 169

in sacks or vessels filled with cold water. According to Methodist thought,

however, this is not only ineffectual but dangerous as the patient becoming
cold would make the body even tighter, more restricted, and liable to have
seizures. 30 Caelius criticizes doctors who provide treatments such as evacu-
ation, venesection, cupping, and other treatments the Methodists would con-
sider metasyncretic, or designed to disrupt the disease and shock the body
into health, because again, these measurements do not procure relaxation in
the body, which is the ultimate cure for hydrophobia’s state of stricture.
Thus does the particular style and focus of the disease entries in Celerum
Passionum reflect some of the concerns and theories of Methodist practice,
with its large concentration on analysis of symptoms and in the telling refu-
tations of other physicians’ treatments.
Elsewhere in the text, Caelius Aurelianus describes other preoccupa-
tions that are particularly Methodist, such as in the example of the impor-
tance of symptoms. One peculiarity of Methodism that Caelius relates is
the interest in anatomy, but the ultimate rejection that diseases lie in parts
rather than in the body as a whole. Although there may be debates regard-
ing specific terminology of the Methodist philosophy (Nutton gives the ex-
ample of ‘fluid,’ writing, “did it refer to the fluid state of the whole body or
of a part?”),31 Caelius remarks in the text that Soranus considered the whole
body to be affected by disease, rather than just a part. In the section regard-
ing the part affected in attacks of phrenitis, the author writes, nos autem sive
locorum sive vicinitatis eorum cause generalem curationem non mutamus.
Non est enim sub eodem genere iacens locorum necessaria differentia.32
This quote disparages leaders of other sects who, as Caelius claims, need to
170 HIRUNDO 2007

discover which part is affected by the disease in order to apply their treat-
ments. The superior method practiced by Methodists does not require an al-
teration of treatment because of a more holistic view of the body and
disease. For the Methodists, the “commonality of symptoms” 33 dictates the
treatment, not the nature of the individual part. On the other hand, the inter-
pretation of symptoms operates within this framework of the body as atoms
and pores liable to too much opening or closing, if the reliance on symptoms
does not approach the Empiricist sort of conception.
The definition of disease is less important for the Methodists, ac-
cording to Soranus, precisely because the symptoms of disease are the basis
of treatment. At the very beginning of the section on defining pneumonia,
Caelius warns that diffinire Methodici iuxta Sorani iudicium declinant,
“Methodists, in the manner of Soranus, turn away from judgement [defini-
tion].”34 Categorization is not of the utmost concern for Methodists because
again, treatment is not based upon it.
As one of the only extant documents on Methodism, Caelius Aure-
lianus’ On Acute Diseases is crucial for reconstructing the transmission of
Greek medicine learning to the Latin West. It provides modern scholars
with a great deal of information on earlier doctor’s theories and treatments
preserved in the refutation of methods apart from the ones advocated by So-
ranus. In this way, the text has a unique internal and external historicity.
The contemporary medical debates that Caelius records from Soranus also
illuminate Methodist thought and application, including such particularities
as the opinion and usage of anatomy, the importance of the symptom, and
the resistance to defining and categorizing disease, through the way it de-
Anna Dysert Capturing Medical Tradition: Caelius Aurelianus and On Acute Diseases 171

fines itself against others.

Endnotes
1
I use the common abbreviation of the Latin title, Celerum Passionum, interchangeably
with the modern translation of the title On Acute Diseases.
2
Vivian Nutton, Ancient Medicine (New York, 2004) 195.
3
Nutton 195.
4
I.E. Drabkin, “Introduction” to On Acute Diseases and On Chronic Diseases, ed. and
trans. I.E. Drabkin (Chicago, 1950) xvii.
5
Drabkin (1950) vxiii.
6
G. Sabbah, “Noms et descriptions de maladies chez Cassius Felix,” in Maladie et
maladies dans les textes latins antiques et me-die-vaux, Actes du Ve Colloque international
‘Textes meWdicaux latins,‘ 295-312, ed. Carl Deroux (Bruxelles, 1998).
7
Drabkin (1950) xiv.
8
Ibid.
9
For the purposes of this paper, I will generally use “Caelius” and “the author” inter-
changeably while using “Soranus” at points when it seems appropriate to assume Caelius is
accurately reflecting Soranus’ text.
10
Cael. Aur. Acut. XXXVII: 217. All quotes from Celerum Passionum are taken from the
edition On Acute Diseases and On Chronic Diseases, ed. and trans. I.E. Drabkin (Chicago
1950). English translations in the text are my own.
11
Cael. Aur. Acut. X: 65: Soranus vero cuius haec sunt quae nostra mediocritas latinizanda
existimavit, “Soranus, whose very work is here translated into our Latin.”
12
Drabkin (1950) xiii.
13
I.E. Drabkin, “Notes on the Text of Caelius Aurelianus,” Transactions of the American
Philological Association, vol. 76 (1945) 299.
14
Nutton 195.
15
Nutton 195.
16
Cael. Aur. Acut. IX: 46, Soranus vero, qui normarum regulis methodum restituit, noxiam
esse inquit istius modi potionem, “Soranus who restituted Methodism by rules of standards,
172 HIRUNDO 2007

claims a potion of this measure to be poisonous.”

17
Drabkin (1950) xviii.
18
Cael. Aur. Acut. XV: 122. In discussing whether or not hydrophobia existed during for-
mer times, the author writes, passionis etenim causam prompte Homerus memoravit, “for
truly, Homer clearly recounted the cause of the disease.”
19
Nutton 195; Drabkin (1950) xviii.
20
Sabbah 303 (“not to a cultivated public… like that of Celsus, or even that of Caelius, but
to a public of professionals, of practitioners [as] the content and the method of a profes-
sional course.”
21
Drabkin (1950) xii.
22
Cael. Aur. Acut. IX: 98.
23
Cael. Aur. Acut. IX: 99.
2
Cael. Aur. Acut. X: 102.
2
J. Pigeaud, “La ‘phreWnitis’ dans l’oeuvre de Caelius AureWlien,” in Maladie et maladies
dans les textes latins antiques et me-die-vaux, Actes du Ve Colloque international ‘Textes
meWdicaux latins,’ 330-341, ed. Carl Deroux (Bruxelles 1998) 335. (“In this description of
the symptoms, all the attention that the doctor readies for the patient... the essence should
be, for the Methodist doctor, like Caelius himself says, the disease.”)
26
Cael. Aur. Acut. XI: 106.
27
Cael. Aur. Acut. XII. 107.
28
Cael. Aur. Acut. XIV: 117.
29
Cael. Aur. Acut. XVI: 126-133.
30
Cael. Aur. Acut. XVI: 133.
31
Nutton 192.
32
Cael. Aur. Acut. VIII: 53. “We [the Methodists], however, do not alter our general ther-
apy on the basis of these places or the regions about them. For in a given general type of
disease a difference in the parts affected is not an essential difference.” Trans. I.E. Drabkin.
33
Nutton 193.
34
Cael. Aur. Acut. I.XXVI: 142.
Anna Dysert Capturing Medical Tradition: Caelius Aurelianus and On Acute Diseases 173

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