This is an ambitious but ultimately unsatisfactory attempt to recover domestic medical practice in the period from Plautus to Pliny. Recent scholarship has concentrated on ‘popular medicine’, but this book tries to go beyond that to look at underlying attitudes to health as deducible from both the written and non-written record. This is a challenging task, as is made clear in the theoretical introduction setting out a range of possible approaches, not least when every word in the title is hard to define and the written record is meagre. The problem of generalisation is here acute, and while one can admire some of the observations in each of the five chapters, many of the overall conclusions seemed forced. The evidence of archaeology and palaeopathology is adduced in what are the best sections of the book and could well have been extended. But to focus on Rome, Ostia, Pompeii and Herculaneum, as is admitted, is a poor basis for generalising about Central Italy as a whole. We never reach as far as Perugia, with the possible continuation of Etruscan healing, or across the Apennines, while the information from Pompeii and Herculaneum comes with warnings that these places are likely to be untypical. The impact of Hellenisation also needed more discussion, since the increasing availability of Greek healers (of all types) will have had an impact on wider ideas about health and healthfulness.

The second chapter deals first with ideas on health and lifestyle, largely drawn from the elder Cato, Cicero, Celsus and Seneca. We are told about porticoes and pleasure gardens as well as more traditional ideas on individual balance and how to achieve it. Recent work on the organisation of Roman society helps to modify some older dichotomies between elites and non-elites and suggests a widespread acceptance of ideas found in authors such as Celsus. The much-debated question of the extent to which he put some of his Greek theories into practice could have been pursued further either here or in the last chapter. D. then provides a detailed discussion of Roman houses and gardens, arguing for the importance of such spaces as a contribution to both mental and physical health, although the relevance of the private gardens of the elite to the inhabitants of the insulae of Rome and Ostia is questionable. The extent to which Vitruvian ideas were put into practice needs more careful assessment, and sceptics may wonder whether health was ever a prime consideration in designing a house or garden, still less in city planning. Domestic medicine may well have depended largely on herbal simples from the garden, but more complex medicines are likely to have been made by specialists outside the home. But the medical recipes found in books depend increasingly on non-local materials, certainly in the imperial period, and there is ample evidence from the four centres mainly studied of imports from the East. D. argues for the importance of the household gods, occasionally invoked in illness, as well as noting some evidence for the cult of Asclepius in private houses, where she has been anticipated by G.H. Renberg, MAAR (2006–7), 87–172, and in his 2017 volumes on incubation cults.

A substantial chapter discusses the possible organisation of healing in a Roman household, from the pater familias through the bailiff and his wife to slaves who were taught medicine or had somehow acquired expertise. It is difficult to say whether the rule in Digest 38.1.27 that a hypochondriac or play-loving master could not make constant use of the operae of his freed slave doctors or pantomimi for himself relates to a real situation or is a learned joke; he was, of course, allowed to hire out his freedman's services to friends and those willing to pay. We are rightly cautioned about putting too much weight on the existence of large numbers of medical attendants in the house of Livia or other members of the imperial family, but more should have been said about valetudinaria. The short final chapter discusses the ways of transmitting medical knowledge; through writing, talking with others or simply experience. Many healers, and any literate household, had one or two books, but Celsus’ De medicina, one section in a large and expensive encyclopaedia of Artes, stands at the opposite extreme from scribbled notes on domestic remedies, and the type of literature available needs more discussion. But to conclude that anyone in the household who was literate, and many who were not, could provide more than a very basic minimum of treatment seems an exaggeration.

The weakness of this book – the relative lack of written information – is compounded by an unwritten assumption; that in this period and region domestic medicine was an entirely Latin thing. Hence, the almost total absence of reference to Greek texts, despite their relevance. Too much trust is placed in the opposition of Cato and Pliny to Greek medicine, which from at least the 220s bce was being welcomed and adopted first by the elite who had experienced Greek culture and then by others. By the end of the Republic Rome could be thought of as a Greek city, attracting immigrants and visitors from around the Eastern Mediterranean. Soranus of Ephesus, for example, deplored the Roman custom of making very young children walk on marble floors, thus causing various distortions. Galen is a mine of information about healing practices in Rome and Italy, while fragments of the treatise by Rufus of Ephesus entitled The Layman, probably identical with one written for ‘those who have no doctor’, continue the tradition visible in Celsus and include both simple and compound recipes. Scribonius Largus also has some domestic remedies in his Recipes, and there are plenty from what appear to be Italian sources to be found in Galen's drug books. Links with the Greeks in Southern Italy and Sicily could also have been explored further, by looking at a site like Velia/Elea, frequented by many of Rome's elite. Texts in the (as yet untranslated) Geoponici Graeci add to our understanding of agricultural beliefs and practices, not just in Greece and Asia Minor, and could be usefully studied by historians of gardening.

As a survey of evidence in Latin, this book has its merits, particularly in its use of archaeological material, although its analysis of the literary sources is not as detailed as J.-M. André’s 2006 La médecine à Rome (which also neglects the Greek sources). But it is doubtful whether one can go much beyond the classification of medical healers suggested by W.V. Harris in the introduction to his edited volume, Popular Medicine in Graeco-Roman Antiquity (2016), briefly noted on p. 19, until we have more palaeopathological and regional studies. Health is such an elastic concept that almost everyone can be thought to have an interest in it, however it is defined. Some have even suggested that economics also played a part in health care, when a supposed decline in the number of slaves acquired by conquest in the Late Republic encouraged owners to take greater responsibility for those they had already purchased and to turn to slave-breeding to ensure replacements.

The individual chapters are useful in themselves, even if the argument seems unduly forced at times, but the book as a whole does not cohere. Given the very high cost of the volume, two or three articles in prominent journals would have better served to make D.’s conclusions more accessible, as well as tightening up the argument.