“...Hippocrates, walking along the seashore, saw some bird...” and in short accord invented the enema!(1) Bartholomaeus’ rapid account describes how, after witnessing the bird “drawing seawater by the beak”, Hippocrates watched as it “poured [the seawater] into its anus” (hauriens...aquam marinam rostro per anum infudit), thereby extracting compacted excrement.(2) Hippocrates was inspired, and the aperient enema was born.
The bones of the story were old. Herodotus noted that enemas were frequently employed in Egypt(3), and Pliny elaborated on their Egyptian nature, reporting that enemas had been discovered through the observation of Egypt’s most emblematic bird, the ibis(4). Where exactly Pliny got his information is unclear,(5) but the link between the ibis and the enema was frequently repeated, the story of its discovery retold by Cicero, Plutarch, Diodorus Siculus, and Aelian. Galen cited the ibis’ enema as just one example of animals restoring a healthful balance, common enough that he could reference it in passing (item Aegyptiam avem clysterem imitantem).(6) Meanwhile, the Pseudo-Gallenic author of Introductio sive medicus, used the location of the discovery as evidence of the inferiority of Egyptian medicine, derisively contrasting its empirical nature with the Greek medical art, which found its culmination in Hippocrates.(7)
A thousand years later, however, Bartholomaeus severed the connection with Egypt, not only omitting the geographical name, but also having the bird employ “saltwater” (aquam marinam);(8) previous iterations, including Isidore of Seville’s, had the bird drawing water from the freshwater Nile.(9) He also replaced Egypt’s most well-known bird with just “some bird” (quandam auem).
Furthermore, the enema-giving bird loses its place as sole star of the tale. In Pliny’s account, the ibis is the active participant in the encounter, the human discoverers anonymous and ill-defined. Similarly, in Plutarch, it is the ibis that “was the first to teach the use of medical aperients”; humans merely received the lesson.(10) In Bartholomaeus’ Practica, by contrast, there is an active human observer, who, even as the bird ignores his presence, not only recognises the value of what he is seeing, but insists on applying it (item uidens Ypocras idem fieri hominibus posse animaduertit. inde ergo sumpta occasione clisteria fieri iussit).(11) Moreover, this productive observer is Hippocrates, beacon of the Greek medical art, praised in Introductio sive medicus as the very antithesis of empirical Egyptian medicine. This not only awards the invention of the enema to the Greek tradition, it rehabilitates natural observation as a legitimate, fundamentally valuable aspect of the medical art. Little does it matter whether the incident is ever mentioned by Hippocrates himself...
1. Cambridge, Clare College 12, fol. 65r : "...Ypocras transiens iuxta litus maris uidit quandam auem..."
2. Cambridge, Clare College 12, fol. 65r.
3. Herodotus, The Persian Wars, Volume I: Books 1-2, trans. A. D. Godley. Loeb Classical Library 117. (Cambridge, MA: Harvard University Press, 1920), Book II.77, pp. 362-365.
(For an open-access translation, see: Herodotus, Herodotus: A New and Literal Version from the Text of Baehr, with a Geographical and General Index, trans. Henry Clay. (New York: Harper & Brothers, 1877), Book II. 77, p. 124.)
4. Pliny, Natural History, Volume III: Books 8-11, trans. H. Rackham. Loeb Classical Library 353. (Cambridge, MA: Harvard University Press, 1940), 8.41, pp. 70-71.
(For an open-access translation, see: Pliny the Elder, The Natural History, trans. John Bostock. (London: Taylor and Francis, 1855), 8.41.)
5. It has been suggested that Pliny misunderstood the Egyptian hieroglyph for the god Thoth—a particularly vitriolic statement of this assessment can be found in Chabas, F., Mélanges égyptologiques, vol. 1.(Chalon-sur-Sâone: Dejussiet, 1862), p. 66.
6. Galen and Karl Gottlob Kühn, Medicorum graecorum opera quae exstant, volumen XI (Leipzig: Officina Librarie Car. Cnoblochii, 1826), p. 168. = Galen De venaesectione adversus Erasistratum, VI.
7. Jouanna, Jacques. Greek Medicine from Hippocrates to Galen: Selected Papers, transl. Neil Allies, ed. Philip van der Eijk. (Leiden: Brill, 2012), p. 16; Hanson, A.E. “Papyri of medical content,” Yale Classical Studies 28 (New Haven: Yale University Press, 1985), pp. 25-26.
8. Cambridge, Clare College 12, fol. 65r.
9. Isidore of Seville, Isidori Hispalensis Episcopi Etymologiarum siue Originum libri XX, ed. W. M. Lindsay. (London: Oxford University Press, 1911), XII. VII. 33.
10. Plutarch Plutarch’s De Iside et Osiride, transl. J. G. Griffiths. (Cardiff: University of Wales Press, 1970), p. 237.
11. Cambridge, Clare College 12, fol. 65r.
12. Enemas continued to be popular for many centuries, and the ibis' association with them persisted, though sometimes other birds were substituted. This is a 15th-century example of an 'Egyptian stork' (chicogue...egiptienne), held by the BNF. For the clearer (edited) version used above, visit the University of Adelaide's free ebooks website.