I.’s concise book provides a multifaceted overview of the ‘shared belief system’ (p. 5) that I. argues characterised the entire ‘medical market place’ (p. 3) of the High Roman Empire. I. articulates his central argument regarding the relationship between patients and healers in Chapter 1, ‘The Identity of Physicians during the High Roman Empire’: in the ‘“medical market place” … authority was in the hands of the health care providers but power remained in the hands of the sick, insofar as they chose which of the available treatment options to follow’ (p. 31). Patient choice and questions of authority and power are treated in detail throughout the book. In Chapter 1, I. first sketches the activities of medical practitioners in the Hellenistic world, arguing that the political and social structures of the Hellenistic world created official roles for physicians and opportunities for the exchange and standardisation of Greek ideas of health and disease. Subsequent Roman adaptation of many aspects of Greek administrative and social organisation, as well as the need for physicians to look after soldiers in the Roman army, contributed to the development of physicians' professional authority. In the absence of an official system of licensure, however, physicians ultimately relied on the testimony of their patients as evidence of their skill and integrity. Chapter 2, ‘Patients’ Understanding of Health and Illness’, uses inscriptions and literary sources to argue that, ‘from the patients’ point of view, all the practitioners were operating within the same health care system’ and that ‘one professional language was shared by both physicians and priests’ (pp. 51–2). When the patients' perspective is taken into account, I. concludes, we find that ‘patients did not see any difference between physicians and other types of health care provider in terms of techne or discipline’ (p. 61). Chapters 3–5, ‘The Domus and Reproduction’, ‘Health Care in the Roman Army’ and ‘Medical Tourism during the High Roman Empire’, present case studies that examine various ‘arena[s] of the medical market place’ (pp. 73, 84, 86, 115, 124) of ‘the Greco-Roman health care system’ (pp. 71, 111, 112, 121, 132) and of the ‘Roman health care system’ (pp. 94, 106). These chapters focus on locations and situations in which physicians would have had the opportunity to share their medical knowledge with patients and in which patients would have sought health care from physicians and other health care providers (including midwives and priests).

I.’s goal is important and challenging: studies of interactions between patients and physicians (in both ancient and modern settings) often emphasise the diversity and personal nature of these exchanges, shifting discourse away from the construction of a general framework that might be used to contextualise such relationships. As I. demonstrates, a more general framework can be useful in accounting for phenomena that manifest themselves across the expanse of the Roman Empire. I. draws his evidence from admirably diverse sources, including papyri and inscriptions, and it does in many instances support his assertions regarding the use and mutual understanding of a general medical vocabulary among lay people and health care providers of all sorts living in the time of the High Roman Empire. In this reviewer's opinion, I.’s discussion of the imperially-sponsored provision of health care in the Roman army, and its role in dissemination and standardisation of medical knowledge, is the part of the book that most strongly makes the case for the necessity and utility of I.’s generalising approach.

I.’s theoretical assumptions, which so deeply inform the language and approach of his book, deserve further consideration. In the introduction, I. sets out the approaches that have informed his views of the interaction between patients and physicians (Kleinman), the development and maintenance of health care systems (Kleinman and Kuhn), and the relationship among knowledge, power and authority (Barton). This theoretical orientation to the modern scholarship of medical anthropology and epistemology is useful, though the section on theoretical approaches would have been enhanced by direct engagement with and discussion of the ‘market place’ model that undergirds the central tenets of I.’s argument. As it is, the idea seems insufficiently explicated in proportion to the amount of work it performs later in the book: I. uses the language ‘the medical market place’ and its ‘arenas’ to characterise and to justify his claims about how and why medical knowledge became generalised and standardised in the High Roman Empire, though he only devotes a few sentences and one endnote (n. 4) in the introduction to presenting his use and application of this term. Among other sources in this endnote, he cites the 2002 book Reinventing the Bazaar: a Natural History of Markets, written by the late Stanford School of Business professor John McMillan for the lay public. The arguments of McMillan's book are serviceable for I.’s model of an ancient medical market place, but McMillan's definition of ‘markets’ also includes engagement with issues of customer awareness of options, power distribution among market participants, costs borne by the creators of new ideas, market regulation and other aspects of ‘markets’. I. does not always seem to address as explicitly as he might the full implications of applying the language and conceptual framework of a ‘market’ to explain the exchange of medical theory and practice in the High Roman Empire. (Such expansion on the theoretical underpinnings of the ‘medical market place’ might also have clarified confusion regarding the use of the terms ‘customer’ and ‘consumer’ in the conclusion of Chapter 3 [p. 86].) Nevertheless, I.’s application of the notion of the market place to questions of patient choice and physician authority provides a thought-provoking model for understanding this relationship in its broader social context.

In addition, a more comprehensive index would have been beneficial for a text that speaks with equal facility and interest to both advanced scholars and beginner students: many of the key terms and concepts that I. employs for his arguments (‘medical market place’, ‘surgery’, ‘licensing’) are not found in the index, which is mostly limited to people and places. Inclusion of topical terms would have been helpful, especially for a book that deals so extensively with ideas and concepts.

Concerns about definition of terms and the index aside, I.’s book is an important contribution to the literature on the history of medicine for two major reasons. First, it endeavours to present patient perspectives, a difficult task when primary source material associated with this topic is so limited. Second, in a field in which both histories that focus on unifying similarities and histories that focus on distinct differences are informative and necessary, I.’s book provides a useful contribution to the exploration of these unifying aspects of health-related theories, beliefs and practices in the High Roman Empire.