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The Liber Medicinalis of Quintus Serenus, a late didactic poem of 1107 lines in the Plinian medical tradition, has received little attention despite recent interest in ancient didactic poetry. I propose that the central problem for Quintus is not so much the familiar contrast of technical content and poetic form, but rather one of competing modes of structuring a text: the Liber Medicinalis is torn between the pragmatic drive to divide and compartmentalise medical knowledge for convenient reference and the aesthetic demands of composing unified hexameter epos. After raising expectations in the proemial invocation of Apollo and Asclepius, Quintus’ poetic text is atomised into sixty-four discrete sections, each of between five and thirty-six lines, separated by capitula which appear to be an authentic. How does medical knowledge retain its utility in verse? And how can the hexameter poem retain its unity and integrity while formally organised like a handbook?

I compare the Liber with extant fragments of Greek medical poetry (Nicander, Andromachus the Elder, Philo of Tarsus, and the Carmen De Herbis), arguing that Quintus’ construction of and engagement with his addressee, together with his choice to organise the text by ailment rather than materia medica, conveys a relatively strong interest in the practicality of knowledge. I offer a preliminary answer for Quintus’ choice of poetic form by attending to the careful production of mnemonic qualities in his verses.

On the other hand, the Liber’s fragmentation into discrete sections raises the question whether it should perhaps be regarded as an anthology of shorter compositions. While recognising some attractions of this interpretation, I ultimately reject it in light of a survey of metaphors, images and intertextual allusions that firmly locate the Liber in the tradition of Roman epic. However this raises the further, and deeper, problem of unity. How far does Quintus succeed in delivering a worthy successor to that tradition? And to what extent is the Liber as a whole more than the sum of its parts? I examine two aspects of Quintus’ solution to this structural problem by turn.

First I present the results of a systematic study of transitional lines at the start and end of each of the Liber’s subsections, illustrating Quintus’ use of techniques such as prolepsis, surprise and false closure. I conclude that these transitions are significant for the medical work’s narrative development, and hence we should not reduce the text to its parts. Second, I argue that Quintus’ deployment of the capite ad calcem ordering for the majority of the Liber implicates his work in poetic and rhetorical traditions of regarding a text as a body. The Liber is unified because it is a body. Furthermore I suggest that this realisation helps us understand Quintus’ notable preoccupation with the materiality of texts, both his own Liber qua papyrus (line 10) and other repositories of knowledge (e.g. Lucretius in line 606, Livy in line 721).