The Latin West

In the West, meanwhile, the picture was in some ways very different. Although the Aphorisms circulated widely, few of the works of classical

medicine survived, especially after knowledge of Greek declined during the fifth and sixth centuries. Although in northern Italy some Byzantine commentaries and encyclopedias were adapted into Latin during the sixth century—among them, the work of Oribasius—most "new" medical texts were short works based on Soranus.^[233] The late fourth- or early fifth-century^[234] Latin version of Soranus by Caelius Aurelianus survived into the Middle Ages, while the fifth- or sixth-century version by Muscio circulated more widely. Muscio plays down Soranus's attack on the idea that the womb moves around the body, going so far as to add to Soranus's introduction to the condition a new phrase claiming that the womb rises up toward the chest.^[235] Thus the versions of Soranus that circulated in the West included womb movement from an early date.

Several of the texts produced in the West originated in Africa, among them the works of Caelius Aurelianus and Muscio. Predating these is the late fourth century Euporiston of Theodorus Priscianus, a pupil of Vindicianus, whose own Gynaecia was a text on parts of the body and their development in the womb. Originally written in Greek, the Euporiston was translated by Theodorus Priscianus himself into Latin.^[236] This version contains a section entitled De praefocatione matricis , which follows the constriction/relaxation approach of Soranus, omits womb movement, but includes scent therapy. In A.D . 447 another African writer, Cassius Felix, took a different approach, publishing an encyclopedia allegedly based on Greek medical writers of the logical, or dogmatic, sect, but in fact owing much to Soranus as translated by Caelius Aurelianus; this contains a very Hippocratic description of hysterical suffocation, incorporating womb movement as well as scent therapy.^[237]

Other Latin texts of this period survive and are probably more representative than the African works of medicine in the West after the fall of Rome. A dialogue allegedly between Soranus and a midwife, apparently designed as a midwives' catechism, is preserved in a ninth-century manuscript but may date to the sixth century; this is the Liber ad Soteris .^[238] Another short text from this period is the Gynaecia by pseudo-Cleopatra.^[239] It mentions a condition called suppressiones vulvae , the main symptom of which is difficulty in speaking and which thus may be identified with hysterike pnix ; however, womb movement is not mentioned, nor is scent therapy advised.

The ancient Hippocratic theories were not, however, entirely lost to the West. Between the fifth and seventh centuries A.D . many Hippocratic texts were translated into Latin at Ravenna, among them Aphorisms and Diseases of Women (1.1, 1.7-38, and extracts from 2).^[240] Several texts on womb movement and suffocation are included in such translations.^[241]

Also translated was Galen's On the Method of Healing, to Glaucon , with its reference to scent therapy for a moving womb; the Ravenna commentator considers that, by using scent therapy, Galen is apparently endorsing the wandering womb theory.^[242]

It is, however, as misleading to regard the work of the scholars of Ravenna only as translation as to dismiss the Byzantine writers as mere compilers. It is important to understand the purposes for which they used these texts, since these in turn influenced the translation. These purposes fall under two headings: practice and instruction. Hippocratic medicine was seen above all as being of immediate relevance for medical practice; the Ravenna texts are thus not academic editions, but manuals. As a result the more theoretical or speculative Hippocratic texts were neglected, while those selected for translation were adapted according to the different moral and historical context within which they were now to be used.^[243] The second, closely related aspect instruction led to the recasting of some texts in new formats in which extracts were set out in question-and-answer form, as dialogues like the Liber ad Soteris , as calendars, as visual representations, or as letters. The letter format, direct and personal, was very popular, an example being the Epistula ad Maecenatem , the Letter to Maecenas . Also known as the De natura generis humani , this comprises extracts from the Hippocratic Diseases of Women (1) and from Vindicianus. The Epistula ad Maecenatem is found in the ninth-century manuscripts Paris BN Lat. 7027 and Paris BN Lat. 11219, and in these manuscripts it includes two passages of Diseases of Women used in the hysteria tradition: 1.7, on movement of the womb to the liver, and 1.32, on movement of the womb in a pregnant woman.^[244] The late eighth century/early ninth century manuscript Leningrad Lat. F.v.VI.3 is a handbook including Latin translations of sections from Diseases of Women , one of which is our 2. 127, a further description of the movement of the womb to the liver. In the recipes given for cures, substitutions are made in the pharmacopoeia according to what was available in the period.^[245]