Alexander of Tralles was an ancient physician who wrote in the late sixth century, combining his wide-ranging practical knowledge with earlier medical theories. He is noted for his main work, the Therapeutics, which follows the well-established medical tradition of writing a capite ad calcem (from head to toe) and has details on diagnosis and treatment of diseases divided into twelve books.
Background
Alexander of Tralles was born circa 525 in Tralles, Lydia (now Turkey), and was the son of Stephanus, a physician. He had four brothers: Anthemius, a famous mechanician, who was involved in rebuilding Hagia Sophia; Metrodorus, a grammarian; Olympius, a jurist; and Dioscorus, another physician.
Career
As we know by his own dedicatory preface, Alexander was the protégé of the father of a certain Cosmas; to this Cosmas he dedicated his work, which he says that he wrote, at the behest of Cosmas, at an advanced age, when he was no longer able to practice medicine. It is unlikely, however, that this Cosmas was the famous geographer Cosmas Indicopleustes, as his modern biographer Theodor Puschmann hypothesizes. The historian Agathias, a contemporary of Alexander, indicates that Alexander’s life was beset with hardships. Agathias also records that Alexander practiced in Rome for some time, while Alexander’s own writings mention his travels in Gaul and Spain.
The writings of Alexander that have survived have been subjected to a thorough and critical examination by Puschmann, whose findings may well be accepted. According to him, the dedicatory preface to the works as a whole and the book Concerning Fever were written during Alexander’s last years; the other eleven books are either hastily sketched or more elaborate notes for a handbook on internal medicine, in accordance with a plan set forth at the beginning of the work. A letter about intestinal worms, directed to an unknown Theodorus, is extant, and Puschmann has collected a few additional fragments; all of Alexander’s other writings are apparently lost. The entirely of Alexander’s work is known to have been available in Greek in numerous codices and in equally numerous Latin translations; his work was also much read and translated by the Arabs.
Puschmann is perhaps biased in favor of his subject. One must remember that Alexander’s importance lies within the framework of Byzantine medicine–a rather sterile, literary tradition. Alexander is praised for his self–reliance; this independence should, however, be more precisely formulated as deriving from the consideration that Alexander did not simply edit a medical anthology composed of other people’s texts, as did Oribasius or Aetios of Amida, but wrote a work of his own. He was not the only Byzantine author to do so, however–compare especially the work of Johannes Actuarios.
Alexander indeed had an extensive practice, made many original observations, and knew the value of empiricism; but this may also be said of other Byzantine physicians (again, especially Johannes Actuarios). While Alexander sometimes dared to criticize even Galen, Johannes Actuarios, too, had a self-confident sense of the value of his own work as compared to the work of his predecessors, as is especially apparent in his book About the Urine. Alexander’s style is justly praised for its comprehensibility and clarity; not all other Byzantine physicians wrote pompously, however, Moreover, Alexander–like all other Byzantine physicians, and like all those of late antiquity–was uncritical of a great deal of the older medical literature that he cited, and was by no means entirely free from superstition. Finally, very few remnants of Byzantine medical texts and practice are available to us to provide a measure by which Alexander may be objectively evaluated. In summary, one may state that Alexander was, as a representative of Byzantine medicine, rather refreshing, not uninteresting, and not, perhaps, altogether unimportant.
Religion
In exorcising gout he says, "I adjure thee by the great name Ἰαὼ Σαβαὼθ" (Iao Sabaoth), and a little further on, "I adjure thee with the holy names Ἰαὼ, Σαβαὼθ, Ἀδοναὶ, Ἐλωί" (Iao, Sabaoth, Adonai, Eloi), from which he would appear to have been either a Jew or a Christian, and, from his frequent prescription of pork, it is most probable that he was a Christian.
Views
Although Alexander of Tralles had scant knowledge of anatomy and physiology, he was a careful observer of clinical situations. Perhaps the most curious art of his practice appears to be his belief in charms and amulets.
Quotations:
Here is an example of how Alexander chooses to give his advice on a certain purgative by introducing a real scene from his professional career:
"I beheld [ἐθεασάμην] one of those readers falling down; then, he said, whenever it was about to happen, he felt an aura of cold rising from the tarsus up to the brain. And so I purged him by giving him pills with which to remove the phlegm and the black humour (…) and I [ἡμῶν, lit. ‘we’] have practised in this way, the young man became healthy. The medicament, which I applied in his case to help this treatment was the herb called pepperwort; for although there are other herbs producing the same effect, none is as well suited as that herb."
However, Alexander has a personal view, providing us with the following sequence of observations:
"I purged well by using the hiera and I also gave three grammata of Armenian stone and I helped (the patients). However, I have not found [εὗρον] any other (treatment) so effective in patients with chronic epilepsy, as this purgative (white hellebore) and I know [οἶδα] many who, having been given up by other doctors, were cured by using only this purgative (white hellebore)."
Membership
German scholar Johann Albert Fabricius considered Alexander to have belonged to the sect of the Methodici, but in the opinion of Freind this is not proved sufficiently by the existing text.