Herodotus 3.130, breast tumor & narratology

[Paul Derouda]

ἐν χρόνῳ δὲ ὀλίγῳ μετὰ ταῦτα τάδε ἄλλα συνήνεικε γενέσθαι. Ἀτόσσῃ τῇ Κύρου μὲν θυγατρὶ Δαρείου δὲ γυναικὶ ἐπὶ τοῦ μαστοῦ ἔφυ φῦμα, μετὰ δὲ ἐκραγὲν ἐνέμετο πρόσω. ὅσον μὲν δὴ χρόνον ἦν ἔλασσον, ἣ δὲ κρύπτουσα καὶ αἰσχυνομένη ἔφραζε οὐδενί: ἐπείτε δὲ ἐν κακῷ ἦν, μετεπέμψατο τὸν Δημοκήδεα καί οἱ ἐπέδεξε. ὁ δὲ φὰς ὑγιέα ποιήσειν ἐξορκοῖ μιν ἦ μέν οἱ ἀντυπουργήσειν ἐκείνην τοῦτο τὸ ἂν αὐτῆς δεηθῇ: δεήσεσθαι δὲ οὐδενὸς τῶν ὅσα ἐς αἰσχύνην ἐστὶ φέροντα.

Atossa, Darius' wife, develops a lump in her breast, which first was small and then bursted and spread. Once her condition had badly deteriorated, she called the physician Democedes, who naturally promised to cure her (which he did), under certain conditions.

Now Asheri's commentary note's that φῦμα is "an inflammatory or apostemic tumor, but certainly benign; breast cancer should be excluded. Others have suggested acute superficial mastitis with suppuration and cellulite." I've never heard "apostemic tumor" before, but apparently it means an abscess. Now I think Asheri is misguided here. Without looking any references, I assume that the reason why Asheri excludes breast cancer is simply that Democedes was able to cure her – that would have been impossible in the case of an advanced breast cancer (a breast cancer that ulcerates is already quite advanced). But here, as in many other places in Herodotus, I think you should look into this from a narratological point of view.

Now breast cancer is a quite common disease, lifetime incidence in women is about 10 % nowadays; besides, unlike a tumor in an internal organ, a breast tumor at an advanced stage is easy enough to appreciate from the surface. The natural course of the disease before modern treatment was often quite horrible, as beside painful metastases, many patients developed ulcers in their breast which in most extensive cases destroyed the entire breast and excavated the thoracic wall. Without looking for the evidence myself, I've been told that even before generalized access to doctors, average people (or at least average older women, I suppose) used to know that this disease existed and that it was bad, even if they didn't call it with a modern name. In Herodotus' time likewise many people probably knew enough about this disease to appreciate that an ulcerating lump in the breast typically meant a slow and painful death, except of course when it was something else than a cancer, like an abscess, in which case the patient usually got better – but for the average 5th century BC person, it was just a case of someone dying and someone getting better. What mattered for Herodotus is that his physician Democedes is the archetypal skilled doctor who, if anyone, is able to cure even the ugliest and deadliest affliction. It's just a story, you can't just say that since she was cured, she couldn't have had breast cancer. And how was Herodotus supposed to know so precisely the nature of Atossa's illness? Did he have access to her medical files?

[mwh]

I agree. But nothing is "just a story."

[Hylander]

Thanks for a physician's perspective on this. It reminds me of modern attempts to identify Thucydides' plague, or looking to more recent history, the causes of Mozart's death ("miliary fever" according to his doctor) or the sources of Beethoven's deafness (venereal disease, according to his 19th century biographer Thayer). Schubert and Schumann have also been branded with the stigma of syphilis by modern diagnosticians. Around the mid-19th century, medical diagnoses seem to have fallen into line with today's classifications of diseases.

[jeidsath]

I would argue that the the only thing about this story that is based in reality are the symptoms. They don't strike me as fantastical. I think that Herodotus must have lifted the symptoms from a real account. I imagine that it was breast cancer that Herodotus saw or heard of (perhaps from a physician's description), and the outcome to the actual case was not as rosy as it is here in the fiction.

An abscess would make sense as something that someone could recover from (it's what I thought of first), except for the description here of what happens after it bursts.

Another famous account of a fictional person with clinically real symptoms is the death of Shakespeare's John Falstaff.

[mwh]

Hasn’t syphilis been diagnosed as such since the early 16th century, when it was given that lovely name in a pastoral poem by Girolamo Fracastoro, one of my heroes.

The narratological factors that apply to Atossa’s lump surely don’t apply in quite the same way to the Athenian plague.

[jeidsath]

The earliest accounts of syphilis date from 1494-5 in Naples. It seems that Columbus' men brought it back on the first boat home. The genetic evidence is almost conclusive (there's a closely related disease endemic to Central America somewhere).

One of the very few diseases to come back in that direction. With its greater population density, the Old World had many more diseases to share with the lightly populated Americas.

[Paul Derouda]

I actually looked up one the references given by Asheri (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1034507/). Just as I thought – the argumentation would be quite sound if only we could be sure that what Herodotus is telling about Atossa's condition is the truth, the whole truth and nothing but the truth. But how could he have known details of the queen's medical history, for one? No, the father of history is making things up, either part of the story or all of it. He didn't know the difference between an ulcerative cancer and an abscess, even less their epidemiology (Atossa was probably less than thirty, which made breast cancer less likely, goes the argument), he just wanted to suggest a serious illness his expert physician was able to cure.

Generally speaking, I'm rather skeptical of identifications of this sort. How many theories are there about Mozart's death? But of course it depends. I believe the physical remains of Beethoven, for instance, still exist (or at least have studied rather extensively at some stage), which I suppose is a good starting point for more credible interpretations.

[seneca2008]

Generally speaking, I'm rather skeptical of identifications of this sort. How many theories are there about Mozart's death? But of course it depends. I believe the physical remains of Beethoven, for instance, still exist (or at least have studied rather extensively at some stage), which I suppose is a good starting point for more credible interpretations.

However sceptical one is of the possibility of a diagnosis one is still left with the question why authors continue to put them forward. The answer reveals nothing about their subjects but everything about the authors themselves. So to in Herodotus. Which is why I agree with what you wrote with the exception of "its just a story". History is the arrangement of stories and their selection, juxtaposition and omissions, reveal as much, and sometimes more, about the creators than their subjects.

[Timothée]

But how could he have known details of the queen's medical history, for one? No, the father of history is making things up, either part of the story or all of it.

I cannot take a stand on this particular instance, but only remind ourselves of the fact (which may well have been touched [or indeed dwelt] upon in the other Herodotean thread) that Herodotus did have some access on Persian archives and he had Persian sources available. They might possibly have an entry on this. But I should really read Wiesehöfer's book carefully and ponder upon his reconstructions and usage of sources. Herodot und das persische Weltreich (Harrassowitz 2011) may also have useful articles.

[Hylander]

I believe the physical remains of Beethoven, for instance, still exist (or at least have studied rather extensively at some stage), which I suppose is a good starting point for more credible interpretations.

Off-topic, but leaded drinking glasses.

Anyone who's interested should read Jan Swafford's superb recent biography:

http://www.amazon.com/gp/product/061805 ... 1_1&sr=8-1

Disclosure: Jan is a personal friend. But his Beethoven biography really is superb.

I probably shouldn't have posted this, knowing the severe penalties Paul imposes on spammers and their entire families.

Democedes looks like a "speaking" name, but maybe this sort of name ran in families of physicians. One thing that occurs to me about the passage in Herodotus: is this an advertisement for Greek medicine? Around 400, Artaxerxes had a Greek physician, Ctesias, who wrote his own version of the conflict between Artaxerxes and Cyrus, among other things.

https://en.wikipedia.org/wiki/Ctesias

[Paul Derouda]

I probably shouldn't have posted this, knowing the severe penalties Paul imposes on spammers and their entire families.

Fear thou not. I have a penchant for blind poets and deaf composers.

[Bart]

I once saw a modern day Atossa, an elderly woman from a Viennese suburb (I did part of my study there). Like her she kept her affliction, an ulcerating breast tumour invading and excavating the thoracic wall, hidden from her family out of shame and fear, until she could bear the pain no longer and came to the emergency department. It was my very first day as a medical intern and she was the very first patient I was ordered to examine. I have seen quite some shocking things since then, but her I will never forget. And as Paul says, this must have been quite a common occurence in the days, not so long ago, that nothing could be done for women suffering from this disease.

[Bart]

I didn't mean to kill this thread with my somber recollections. Sorry.

Hylander, thanks for the link to the Beethoven biography: you may tell your friend you've sold his book for him

[Paul Derouda]

Bart, I don't think you killed the thread. I've heard many stories similar to your poor lady, and reading the passage about Atossa brought them to my mind. I'm glad you seem to agree with my analysis. On a less somber note, my only diagnosis of breast cancer (a young woman barely 30) had, to my knowledge, a much happier outcome (not that I had anything to with that). Luckily such cases as you told about are so rare nowadays that I have personally never seen one.

As for Democedes: I know little about ancient Greek medicine, but at least he's not Ionian but rather from Croton, an Italian colony (they're not Ionian, right?). So maybe he's from a different tradition than Hippocrates et al.?

[Paul Derouda]

It's been 5 years since I started this thread, but thought to mention I found an article on the subject which I found interesting. "From rags to riches: Democedes of Croton and the credibility of Herodotus". Those who have access to Jstor can get it from here https://www.jstor.org/stable/43655705?seq=1.

I was happy to know that Davies draws similars conclusions as I did. But the article ranges much wider, arguing that the whole Democedes episode is full of folk tale elements. In the final appendix of the article, Davies even writes that he is skeptical about the historicity of queen Atossa.

[Bart]

A very old thread indeed. I don’t have access to the article unfortunetaly. But I do want to steer this thread off topic again to point out that Jan Swafford -Hylander’s friend and writer of an excellent Beethoven biography mentioned above- has written an even better one of Mozart. It was one of the books of the year according to the Economist: https://www.economist.com/books-and-art ... -of-mozart

Okay, that’s all; back on topic again.

[Paul Derouda]

Ah, thanks for the reminder - but think I’ll start with the Beethoven book. As I said a few years ago, I have penchant for blind poets and deaf composers! (I especially like Beethoven’s later works.)