Medicine and Philosophy M 735

between God and the world. All nature finds fulfillment in Maximus der Bekenner (1961b) Die Mystagogie. In: von Balthasar HU
Kosmische Liturgie. Das Weltbild Maximus des Bekenners. Zweite
God, where the Logos brings unity out of diversity
völlig veränderte Auflage. Johannes, Einsiedeln, pp 409–481
through movements of contraction and expansion. Italian
Maximus lived in a highly intellectual milieu, which Massimo il Confessore (1979) Umanità e divinità di Cristo (trans, intro,
may be characterized as ‘‘scholastic.’’ However, Maximus and notes: Ceresa-Gastaldo A). Collana di testi patristici, no, 19.
was neither rationalistic nor systematic; rather, he offers Rome
Massimo il Confessore (1980) Il Dio-uomo. Duenceto pensieri sulla
a mystical vision of the world as relating to the person of
cognoscenza di Dio e sull’ incarnazione di Cristo (trans, intro, and
Jesus Christ. Maximus’ opaque spiritual theology points notes: Ceresa-Gastaldo A). Già e non ancora, no. 66. Milan
towards the mystery of the Incarnation. Maximus contin-
ually pushed the boundaries of articulation outward into Secondary Sources
the darkness of mystery (Balthasar 2003). Monographs
Balthasar H (2003) Cosmic liturgy: the universe according to Maximus
the Confessor (trans: Daley BE). Ignatius Press, San Francisco
See also: ▶ Philosophical Theology, Byzantine ▶ Philoso-
Gatti ML (1987) Massimo il Confessore. Saggio di bibliografica generale
phy, Byzantine ▶ Trinitarian Logic ragionata e contribute per una riconstruzione scientifica del suo
pensiero metafisico e religioso. Vita e pensiero, Milan
Bibliography Larchet JC (1996) La divinisation de l’homme selon Saint Maxime le
Confesseur. Éditions du Cerf, Paris
Primary Sources Louth A (1996) Maximus the Confessor. Routledge, New York
Maximus the Confessor (1865) Complete works in Greek are located in Sherwood P (1955) The earlier Ambigua of St. Maximus the Confessor
Patrologia Graeca, vols 90–91. J.P. Migne, Paris and his refutation of Origenism. Herder, Rome
Critical Editions of Maximus the Confessor Thunberg L (1995) Microcosm and mediator: the theological anthropol-
Corpus Christianorum, Series Graeca ogy of Maximus the Confessor. Open Court, Chicago
(1990) Maximi Confessoris Quaestiones ad Thalassium II, Quaestiones Collections
LVI–LXV, una cum latina interpretatione Ioannis Scotae Eriugenae Heinzer F, Schönborn C (eds) (1982) Maximus Confessor: Actes du
iuxta posita. Leuven University Press/Brepols,Turnhout (CCSG 22) Symposium sur Maxime le Confesseur. Editions Universitaires Fri-
Declerck José H (ed) (1990) Maximi Confessoris Quaestiones et Dubia. bourg Suisse, Saint-Paul Fribourg, Suisse
Leuven University Press/Brepols,Turnhout (CCSG 10) M
Laga Carl, Steel Carlos (eds) (1980) Quaestiones ad Thalassium I–IV.
Maximi Confessoris Questiones ad Thalassium I, Quaestiones I–LV,
unam cum latina interpretatione Ioannis Scotae Eriugenae iuxta
posita. Leuven University Press/Brepols,Turnhout (CCSG 7)
van Deun Peter (ed) (1991) Maximi Confessoris Opuscula exegetica duo.
Medicine and Philosophy
Leuven University Press/Brepols, Turnhout (CCSG 23)
Other Series JOEL CHANDELIER
Ceresa-Gastaldo A (ed) (1963) Capituli sulla carità, editi criticamente con Université de Paris 8
introduzione, versione e note (Verba Seniorum, N.S. 3). Rome, (CSC) Paris
Select Translations
English
France
Berthold George C (trans and notes) (1985) Maximus Confessor: select
writings. SPCK, London
Dom Julian Stead (trans with commentary) (1982) The church, the Abstract
liturgy and the soul of man: the mystagogia of St. Maximus Confes- The question of the connection between philosophy and
sor. St. Bede’s, Still River
Saint Maximus the Confessor (1955) The ascetic life. The four centuries
medicine raised in Antiquity remains a serious bone of
on charity (trans and annot: Sherwood P). Longmans, Green, Lon- contention in the Middle Ages. The problem, which stems
don (ACW) from the acceptance of the Galenic synthesis as the foun-
French dation of medicine in late Antiquity, is the discrepancy
Maxime le Confesseur (1943) Centuries sur la charité. Introduction et between the concrete, empirical foundations of medieval
traduction de Joseph Pegon, Paris-Editions de Labeille. Éditions du
Cerf, Lyon
medical practice and the cosmological model that is sup-
Saint Maxime le Confesseur (1992) Questions à Thalassios (intro: Larchet posed to integrate it. While the first authors are circum-
J-C et trans and notes: Ponsoye E). Les Éditions de l’Ancre, Sursenes spect, the eminent Arabic doctors and philosophers
Saint Maxime le Confesseur (1994) Ambigua (intro: Larchet J-C, preface, Avicenna and Averroes propose solutions, one through
trans: Ponsoye E, comments: Staniloae D). Les Éditions, Paris- a strictly instrumental view of medicine, the other through
Suresnes
German
a drastic limitation of its field of experience. Translated
Maximus der Bekenner (1961a) All-eins in Christus. Auswahl, into Latin in the twelfth and thirteenth centuries, these
Uebertragung, Einleitung von Endre von Ivánka. Johannes, Einsiedeln developments lead scholastic doctors to construct a more
736 M Medicine and Philosophy

autonomous medical discipline that distinguishes itself sixth and the seventh century. In this school is born
more neatly from natural philosophy and delineates its a figure destined to remain in the Arab and Byzantine
own goals and methods. Thus, at the birth of the Renais- world, the iatrosophist, a doctor-philosopher capable of
sance, medicine loses its ambition of being a ‘‘second providing care as well as mastering grammar and dialectic.
philosophy’’ but secures greater independence. The thought of Galen is linked by the Alexandrians more
strictly, and often more inaccurately, to the great philo-
From the time of Hippocrates, the proper relation between sophical systems of Antiquity. To justify their reasoning,
medicine and philosophy has been the subject of great the iatrosophists rely on the statements of Aristotle, who
debate. In simple terms, the central problem is whether insists in his On Sense and Sensible Objects on the necessary
medicine must appeal to philosophical principles to deter- link existing between the philosophy of nature and med-
mine the model of human nature that grounds the condi- icine: ‘‘Most natural philosophers, and those physicians
tions of its practice, or whether it must be wholly who take a scientific interest in their art, have this in
autonomous and draw its knowledge solely from its exper- common: the former end by studying medicine, and
imental resources. In the first case, philosophy provides the latter base their medical theories on the principles of
information on the elements that constitute human beings natural science’’ (On Sense and Sensible Objects, I, 436a19–
and thus situates them in a cosmology; in the second, 436b2). The Alexandrians go even further, attributing to
doctors settle for perceptible information gathered empir- Aristotle many definitions that depict medicine as
ically. In the Hippocratic corpus, we find two opposite a ‘‘philosophy of the body’’ or the ‘‘sister of philosophy.’’
answers: Ancient Medicine or Nature of Man states that the The echo of these Alexandrine’s conceptions is found in
doctor does not need to rely on the principles of natural the encyclopedist Isidore of Seville (d. in 636). In his
philosophy to establish its art, while for the treatise Regi- Etymologiae (IV, XIII 5), he asserts that medicine deals
men (I.10), human beings are said to be ‘‘a copy of the with the whole human body, and therefore is rightly called
whole.’’ Galen’s answer, in the second century CE, sets the a ‘‘second philosophy,’’ in the image of the first, which
context for subsequent medieval discussions. Indeed, he pertains to the soul. Though the Latin medicine of the
asserts in his That the Best Physician is Also a Philosopher time is in full intellectual decline, this mention reveals the
that ‘‘if, then, philosophy is necessary to doctors with influence of conceptions developed by the last heirs of
regard both to preliminary learning and to subsequent ancient philosophical teachings. However, integrating the
training, clearly all true doctors must be philosophers.’’ two domains of knowledge in a single system is not with-
Galen insists, moreover, on the necessity, for the practi- out important difficulties. On many points, Galen and
tioner, of mastering the three parts of philosophy defined Aristotle are in clear opposition. The most famous exam-
by the Stoics, namely, logic, physics, and ethics: the first to ple of these conflicts involves the organic origin of the
understand the science of demonstration, the second to functions of the soul. For Aristotle, the heart is their
have an understanding of nature in general, and finally the unique seat; but Galen, thanks to vivisections, notices
third to instill a contempt for wealth and the love of work. that brain or nerve lesions can cause paralysis, and logi-
However, the links that Galen highlights between medi- cally places the seat of sensation in the brain. Thus, Galen
cine and philosophy do not lead him to adopt a precise favors a return to the platonic conception of the tripartite
cosmology: on the contrary, he borrows as much from soul, whose functions are placed in the heart, the brain,
Plato as from Aristotle, for instance for the division of and the liver. Another famous case is the role attributed to
matter in four elements, and does not hesitate to contra- the woman in generation: for Aristotle, she has the passive
dict these authors on many important points. The result is role of providing matter, while Galen credits her also, as he
a balanced synthesis, however fragile, between the most does the man, with the active role of giving the embryo’s
important ancient philosophers. form. Embarrassed by these contradictions, Alexandrian
thinkers prefer to sidestep these problems or to approach
Alexandrine Teaching and the Ancient them indirectly. Thus, on the question of the existence of
Heritage a neutral state between health and sickness, stated by
This heritage is adopted and systematized by the authors Galen at the beginning of Medical Art and contradicted
of late Antiquity, and in particular by those active around by Aristotle who affirms in the Categories that these
the school of Alexandria, chief center for the teaching of two terms are an example of contraries that admit no
traditional ancient Greek philosophy. One of the charac- intermediate, Agnellus of Ravenna (sixth century) avoids
teristics of this school is that medicine and philosophy are citing explicitly Aristotle but answers objections from
frequently, if not systematically, associated during the anonymous critics – plainly Aristotelian – by relying on
 Medicine and Philosophy M 737

other passages from the Stagirite. Stephanus of Athens, solution to the problem, in order to provide a general
iatrosophist from the sixth century, is equally cautious in principle to mediate conflicts between the two disciplines.
his commentary on Hippocrates’ Prognostics when he The first to propose a solution of this kind is the philos-
addresses the question of the origin of sensation: enumer- opher al-Fārābı̄ (872–950). His comments come down to
ating the reasons that lead some to place it in the brain, an attack against the philosophical pretensions of the
and those that lead others to place it in the heart, he doctors, especially Galen’s. For al-Fārābı̄, Aristotle, who
concludes his presentation of opposing arguments by draws on logical reasoning, prevails against Galen and his
a simple sentence: ‘‘The question remains unresolved up empirical observations. This clear choice for Aristotelian-
until now, whether the governing principle is situated ism leads al-Fārābı̄ to place medicine among the practical
in the brain or heart.’’ In this way, the authors of late arts, with agriculture or cooking, and to divide it in seven
Antiquity had provided a framework to the relation parts, of which the first three (knowledge of the organs,
between philosophy and medicine, but without answering health, and diseases) are totally or partially common to
the essential problems the relation raises. natural philosophy and medicine, while the next four
By conquering the principal intellectual centers of Late (symptomatology, nutrition and medication, hygiene
Antiquity, like Alexandria, the Arabs integrated a large and dietetics, and therapeutics) are part only of the
part of Greek science, in particular through translations second.
carried out in the eighth and ninth centuries. Hence, it is Still, this solution does not resolve the problem
not surprising that we find, in the first medical texts completely, since it has no answer to an essential question:
written in the language of the Qurʾān, the same categories how must the doctor act in a controversial case? Must he,
and the same problems, than those that had preoccupied despite their incorrect theoretical origin, apply against his
the iatrosophists. Thus, Yuh: anna ibn Masawayh (l. 777– better judgment all the treatment methods that Galen
857), in the eighth aphorism of his Medical Axioms, heartily recommends? Faced with this difficulty, Avicenna
declares that ‘‘when Galen and Aristotle agree upon some- (980–1037) goes further than al-Fārābı̄ and proposes an
thing, it is true; when they are in disagreement, it is original solution, developed in particular in the Canon of
exceedingly difficult for the mind to determine the truth Medicine. Avicenna gives first a definition of medicine that M
of the matter.’’ Al-Majūsı̄ (d. at the end of the tenth reduces neatly his ambition, since for him medicine is
century) represents the synthesis of these Alexandrine concerned with the human body solely qua healthy or
teachings revisited by the Arabic authors. In his al-Kitāb sick, and not, as does natural philosophy, in itself. From
al-Malakı̄ (Royal Book), he takes up again the distinction this model follows logically another way of looking at the
between theory and practice, by specifying that the first is relation between the two subjects. Avicenna explains often
a science, that is, a true knowledge necessary for action. that ‘‘the physician does not need to proceed following
This science divides, in turn, into things that are natural, a demonstrative argument that will lead him from this
those that are nonnatural and those that are against disagreement to the truth, nor qua physician will he see the
nature. Though al-Majūsı̄ does not point it out, he is path to this, nor does this impede him in his investigations
certain that this scientific part of medicine must tackle and actions.’’ Avicenna’s position is simple: the doctor
the problems posed by the correspondence between the must not take an interest in the causes of phenomena
two disciplines. For the rest, when he treats certain ques- and search for the principles of natural mechanisms,
tions concerning the connection between medicine and since this search is within the purview of the philosopher
philosophy, he prefers to suspend judgment: thus, when alone; he must be content to take an interest in the rem-
he wonders if the soul that we find in the brain is the soul edies that he uses against illness without wondering about
itself or if it is merely its instrument, since the soul is not their first causes: only the immediate causes are for him
a body, he prefers not to argue the point stating that it relevant, and if they seem to contradict the claims of
‘‘belongs to philosophy more than to medical art.’’ natural philosophy, he is not authorized to search for
a reconciliation that only the philosopher is able to
The Systems of Arabic Authors achieve. However, Avicenna takes care to specify that the
doctor’s actions, that is, his concrete activities as
The Instrumentalism of Avicenna a therapist, must not be changed according to debates
However, from the tenth century, conflicts between Arabic that arise in another discipline.
philosophers and doctors intensify, and this attitude of This attitude is called ‘‘instrumentalism’’ (McVaugh),
avoidance seems no longer tenable. Certain scholars, often because it regards medical theories as adequate instru-
philosophers, devote themselves to finding a general ments for predicting and evaluating phenomena, but
738 M Medicine and Philosophy

ill-suited for attaining truth. Instrumentalism, in the work but only try to do what is possible to help nature take its
of Avicenna, goes hand in hand with a model of the doctor course. In this way, Averroes reinforces the importance of
that confine him to the restoration of health without the prognostic art and of the pure practical art of the
exploring the true nature of things, and merely studying doctor, and limits drastically its theoretical pretensions.
sensible and manifest entities on which he can act. It is It is tempting to compare Averroes’ position on medicine
interesting to note that this position does not forbid to the one he adopts in his commentary on De caelo
doctors from being philosophers as well, like Avicenna concerning Ptolemy’s theories; in fact, he does not hesitate
was himself, because the important element is the expres- to reject them despite their usefulness, as they seem to
sion ‘‘as a doctor’’: in reality, a doctor can, as philosopher, him not to comply with the Aristotelian philosophy that
ask himself questions concerning the true nature of things; predicts uniquely circular movements for stars, when
but he must then refrain from basing himself on medical the Ptolemaic system, to save appearances, introduces
empirical observation and, thus, to conduct himself as a complex system of epicycles and eccentrics. In astron-
a doctor. We see that Avicenna establishes a neat distinc- omy as in medicine, Averroes’ object is to make all knowl-
tion between philosophy and medicine, each having its edge coherent with Aristotelian philosophy, which is the
proper objectives and methods. Such a conclusion might only one to be authorized to research and expound truth.
seem to subordinate medicine to natural philosophy; in
reality, we must instead insist on the great autonomy The Salernitan Masters and the Physica
conferred on a medical discipline that, while on a more The texts of Avicenna and Averroes are not known in the
restricted domain, can henceforth develop with fewer West before the thirteenth century. However, the Latin
restrictions. scholars have access, before this date, to some of the
thoughts of Greek and Arabic authors, notably due to
Averroes and the Subordination of Medicine to the translations of Constantine the African in the eleventh
Philosophy century. These translations, mostly of medical texts, push
Averroes (1126–1198) pushes even further the distinction Latin doctors of the following century to take a closer look
between medicine and natural philosophy. In his Colliget, at philosophy, especially since the texts then available
one of his rare medical works, he defines the discipline make medicine a part of natural philosophy. For the rest,
thus: ‘‘Medicine is an effective art, based on true principles it is the thought of the twelfth century on the whole that
and concerned with preserving man’s health and abating aims to replace the study of the human body, and so its
disease, as far as possible’’ (Colliget, I, 1). Comparing diseases, in a global analysis of Creation. This tendency,
medicine with navigation or military affairs, he states which develops at a moment where most of the Aristote-
explicitly that the ‘‘true principles’’ on which it must be lian corpus is still unknown, is most prevalent among the
established are those of natural philosophy. The two doctors of Salerno. The texts studied in this great center of
domains of knowledge are thus completely separate and teaching are of Greek or Arabic origin: for example, The
placed in a clear and restrictive hierarchical relationship, Isagoge by Johannitius, the Aphorisms, Prognostics et Reg-
since the doctor must, according to Averroes, deduce from imen of Acute Diseases by Hippocrates, the Medical Art by
the principles expounded by the philosopher the practical Galen, or the Pantegni by Constantin, adapted from the
applications that he carries out. Where Avicenna affirms al-Kitāb al-Malakı̄ by al-Majūsı̄.
clearly the autonomy of medicine as a science, Averroes, In their commentaries on The Isagoge, the Salernitan
who returns partially to al-Fārābı̄’s solution by radicaliz- masters strive to situate medicine in the general organiza-
ing it, makes medicine into a simple practical application tion of knowledge, while it belongs neither to the trivium
of philosophical theories. nor to the quadrivium. Contra Hughes of Saint-Victor,
So, as a faithful Aristotelian, Averroes attacks Galen who around 1120 makes medicine a purely mechanical
repeatedly, not hesitating to renounce established treat- art, the Salernitan authors divide all knowledge into
ments for their theoretical incompatibility with natural three branches, logic, ethics, and physics, and place
philosophy, all the while trying to justify certain biological medicine in the latter, with physics and meteorology.
claims of the Stagirite. If we consider Avicenna’s an instru- Medicine is then considered a full-fledged science,
mentalist position, we can rightly call Averroes’ own divided itself into theory and practice on the Arabic
a realist position insofar as it insists on the coherence model.
between philosophical theories and their concrete medical In this way appears in the West the idea that medicine
applications; the definition of the Colliget emphasizes the includes a theoretical part, which is grounded in natural
fact that medicine cannot even aim for complete recovery philosophy. The definition of medicine given by
 Medicine and Philosophy M 739

Bartholomew of Salerno (twelfth century) is in this regard does not permit the pursuit of the intellectual tradition
emblematic: established in the city. Of course, the Salernitan’s works are
not completely forgotten and continue to be studied, but
" The science of medicine deals with the actions and pas-
the reception of the great philosophical systems provokes
sions of the elements in mixed bodies. Although it has
important reconsiderations in the West. Many debates on
been invented for the human body, it considers every
the relation between medicine and philosophy then repeat
thing that can change it, as the nature of animals, herbs,
the terms of the question that Arabic authors had already
trees, spices, metals, stones, because all of them can
tried to resolve; but the new conditions of the practice of
change the human body.
medicine, and especially its teaching in universities, are
Medicine has, thus, for most Salernitans, a universal reach, eventually going to modify radically this perspective.
which expresses itself in particular by the use of the term
physicus, which designates the doctor-philosopher at Scholastic Teaching and the Synthesis of
Salerno. Greek and Arabic Contributions
But the relation between medicine and philosophy
goes even further than this connection established The Search for an Agreement
between medicine and natural philosophy. Indeed, the For Latin authors, the problem was always the same:
Salernitan and the authors of the twelfth century, such as harmonize Aristotle’s physiological and biological infor-
William of Conches, could not know the zoological works mation with Galen’s, all the while according, as much as
of Aristotle, which had not yet been translated; so they possible, the philosophical systems of the two scholars.
strive, from available texts such as the Physics, On Gener- However, the question presents itself in a new light, since
ation and Corruption but also from the commentary of at the same time were translated the Arabic interpreta-
Plato’s Timeus by Calcidius, to reconstitute a natural phi- tions, notably those of Avicenna (Canon, translated in the
losophy coherent with medical data, in a process that twelfth century by Gerard of Cremona), of ‘Alı̄ ibn Ridwān
reverses the trend that had until then dominated. This (commentary of Tegni translated by Gerard of Cremona)
trend ends with doctor Urso of Salerno, who dies around and of Averroes (Colliget translated in 1285 by Bonacosa in M
1200. The latter strives to connect, in one systematic theory, Padua). The assimilation of all these works in the first half
the contributions of medicine and natural philosophy. His of the thirteenth century leads to a period of important
thought develops around the question of the elements: Urso debates between 1270 and 1320, a period that has been
tries to show how elements shaped by the Creator from prime called the ‘‘times of controversies’’ (Jacquart and Micheau
matter combine to form the ‘‘elementata’’ in bodies. These 1990). The two most debated questions are the primacy of
‘‘elementata,’’ which can transform under the effect of the the heart as a first principle of the body, and the existence
interactions between the essential and accidental qualities of a feminine seed. Contrary to what is often claimed,
of the elements that compose them, are at the base of all these debates are not limited to a simple controversy
natural phenomena, in the human body (through the with the ‘‘doctors’’ on one side and the ‘‘philosophers’’
intermediaries of complexions) as in the sublunary on the other. The double quality of many authors, notably
world in general. Through his detailed study of the theory in Italy, prevents us from a too cut-and-dried opposition
of elements, Urso aims to provide a single explanation for between the followers of the two disciplines. Thus, Pietro
natural phenomena that come under medicine or philos- Torrigiano, medical doctor active in Paris in the first
ophy; his goal is to be an inventor, that is, a founder like decades of the fourteenth century, defends the Aristotelian
Hippocrates was for medicine, to whom the qualifier was position that makes the movements of the heart a simple
traditionally attributed, and to found a new discipline physical process, while the majority of doctors of the
synthesizing contributions of doctors and philosophers. thirteenth and fourteenth centuries go along with
This discipline constitutes, for Urso, the Physica, whose Aristotle’s denial of the existence of a female seed. How-
ambition largely exceeds medicine in the strict sense, since ever, beyond the diversity of views, it is possible to find
its investigations spread to all things in nature. a certain number of constants, particularly in some centers
However, this ambitious project has no immediate of teaching. In Italy, the problem is more acute because
sequels in the West for two main reasons: first, the arrival medicine and philosophy are often taught in the same
of new translations, notably of Aristotle, Avicenna, and faculty, and by the same person, as in the case of Iacopo
Galen, modify clearly from the beginning of the thirteenth da Forlı̀ (d. 1404) who teaches natural philosophy from
century the idea of the relation between medicine and 1384 to 1386, moral philosophy and medicine in 1392–
philosophy; second, the decline of the Salerno school 1393 and 1395–1396, and finally logical and natural
740 M Medicine and Philosophy

philosophy in 1398–1399. The Conciliator of Pietro as a university discipline at the end of the thirteenth
d’Abano, written between 1303 and 1310, must be consid- century, as well as the progressively more important
ered an attempt to bring solutions to these debates that place granted to the doctor in society, permits authors to
then stimulate the medical community. The acuity of cast a critical eye on accepted definitions, and in particular
these questions, as institutional as intellectual, doubtlessly on the distinction between theory and practice. Wonder-
explain in part the success obtained in Italy by the Canon, ing about the legitimacy of this distinction, Gentile da
which becomes over the course of the fourteenth century Foligno maintains that medicine can be divided in this
the almost unique source of all medical teaching: it was the way, but the theoretical part then coincides with a part of
only one to give a solution allowing to conserve the ben- natural philosophy, since medicine is ‘‘a science made up
efits of Galenism and the great principles of philosophy. It of numerous other sciences’’ (comm. Canon, I.1.1.1.).
is therefore not surprising that the Averroist doctor and For him, medicine is composed of a theoretical part,
philosopher Antonio da Parma proposes, in the first years which corresponds to natural philosophy, and a practical
of the fourteenth century, a solution to the problem based part of its own; contra Avicenna, he abandons the exis-
on Avicennian instrumentalism, by distinguishing, in tence of a distinct and specific medical theory. The conse-
accordance with Aristotle, two types of arguments: the quence of such a presentation is evident: the medical
first one, the dialectic argumentation, is the philosophers’, theory no longer constitutes a proper part of medicine,
and is true and necessary; the second one is the rhetorical and while the doctor must know it, he must not learn it as
argumentation, which is ‘‘much less probably’’ (comm. a science that forms an integral part of his discipline.
Canon, I.1.6.2.): it is the doctors’. The influence of Averroes on the relation between phi-
In the following generation, Gentile da Foligno (d. 1348) losophy and medicine appears to be even more evident in
deepens this distinction by trying to show, for each of the Paris and Montpellier, probably because the two disciplines
controversial questions, that the contradiction between the are more distinct in these particular universities. During the
discourse of philosophers and doctors does not prevent trial of the empiricist Jean de Domprémi (1423–1427), the
the latter from acting to maintain health. He concludes that masters of the faculty of Medicine in Paris declare ‘‘ubi
the physicians can content themselves with the assumptions desinit phisicus incipit medicus’’ (‘‘where the philosopher
of their discipline, even if they appear false. We must note, ends, the doctor begins’’), while in the preceding century
however, that Avicennian instrumentalism does not lead Évrard de Conty uses a similar formula in his Livre des
these authors to abandon the debates between Galen and eschez amoureux moralisés: ‘‘ou philosophie fine, medicine
Aristotle. On the contrary, the distinction between the doctor commence.’’ Jacques Despars, in the first half of the fifteenth
acting ‘‘as a doctor’’ and the doctor reflecting ‘‘as a philoso- century, comes to a synthesis between the Avicennian instru-
pher’’ allows them to engage these questions without confus- mentalism and the Averroist definition slightly different
ing the two disciplines, and without substantially modifying from those of contemporary Italian authors: he tends to
the modes of treatments left by the Galenic tradition: the insist on the practical character of medicine, to distinguish
theoretical questions still remain, in the first half of the it from theoretical questions that must come under natural
fourteenth century, an essential part of medical education. philosophy, and thus must not influence recommended
modes of treatments. For Despars, as claims Arnaud de
The Influence of Averroes and the Decline of Villeneuve in Montpellier at the beginning of the fourteenth
Philosophy in Medicine century, the doctor is foremost a sensibilis artifex, whose
The introduction of Averroes’ Colliget in the West has explanations are hypothetical constructions founded on
a determining role in the subsequent evolution. While sensible experience, necessary for practice but only approx-
the position of the Andalusian doctor and philosopher imating truth without ever corresponding to it perfectly.
can seem totally opposed to Avicennian instrumentalism, So, in most of the Latin world, Avicennian instrumen-
the Latin authors succeed in integrating it to a coherent talism is adopted to resolve difficulties connected to the
global vision. Averroes considers, as we have seen, that all relation between medicine and philosophy, since it permits
medicine is practical, and that theoretical aspects come the conservation of the advanced therapeutic ideas of the
under another discipline, superior to it, that is, natural first while it respects the truth expounded by the second;
philosophy. Such a presentation goes against the stated however, we must note that the precise interpretations vary
willingness of Latin authors of bestowing on their disci- from one place to another, in that they integrate more or
pline the status of a science, and, in Italy, against the less the restrictive definition of medicine given by Averroes
separation, in the medical curriculum, of theoretical and in his Colliget. It seems reasonable to relate, in this case,
practical medicine. However, the integration of medicine these differences to institutional conditions then prevalent
 Medicine and Philosophy M 741

in universities: strong connections between the disciplines Madrid; Latin translation: Venice, 1482; Catalan translation: Vásquez
de Benito M (2003). Trotta, Madrid
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Treatises on ‘‘Prophetic medicine’’ emerged in the ninth

Medicine in the Arab World century, flourished in the period of Sunni anti-Hellenistic
traditionalism, the thirteenth and fourteenth centuries,
HANS HINRICH BIESTERFELDT and are quite popular today, as can be seen from numer-
Seminar für Orientalistik ous modern printings. Their authors were religious
Bochum University scholars rather than physicians. One of the earliest speci-
Bochum mens of Prophetic medicine is the ninth-century Medicine
Germany of the Imams by al-Husayn b. Bist:ām b. Sābūr and his
˙
brother, writing in Iran, which collects medical advice of
the Prophet and of Shı̄ʿite religious authorities, magical
Abstract expedients, and prescriptions of compound drugs.
Medicine in the classical Islamic world was basically Another example is the contemporaneous Summary
shaped by three different traditions, sometimes on Medicine by the Andalusian Ibn Habı̄b (d. around
interacting with each other: pre-Islamic Bedouin folklore; ˙
853). From the heyday of this type of compilations, we
the so-called Prophetic medicine, the diagnosis and ther- have the works of the scholars of Hanbalı̄ jurisprudence,
apy of which was informed by the alleged practice of the ˙
Ibn al-Jawzı̄ (d. 1200), Ibn Qayyim al-Jawziyya (d. 1351),
Prophet Muh: ammad; and Hellenistic medicine. Prophetic and of al-Suyūt:ı̄ (d. 1505). The Medicine of the Prophet by
medicine must have enjoyed a considerable share in every- the Damascene historian and Shāfiʿite traditionist al-
day life, since a large number of compilations, all of them Dhahabı̄ (d. 1348) again compiles medical sayings from
by traditionists, jurists, historians, rather than physicians, religious authorities, but also from Greek medical authors
is extant in numerous manuscripts (and continues to be such as Hippocrates, Galen, and Dioscurides along with
reprinted until today). However, far more productive and Arabic authors in this tradition, for example, al-Rāzı̄ and
representative of medicine in Islam is the Hellenistic Avicenna. The peculiar fusion of this tradition and that of
tradition, as it was standardized mainly by Galen (d. al-t:ibb al-nabawı̄ (Prophetic medicine) is evident in
c. 216 CE), translated from Greek into Arabic and devel- a passage in the beginning of this work, which presupposes
oped from the ninth century onwards. Arabic medical the Galenic definition of health as the right balance (Greek
compendia which reflect this tradition in structure and eukrasia, Arabic i ʿtidāl) of the four humors and then goes
contents are Abū Bakr al-Rāzı̄’s Comprehensive Book on on to attribute the progressively perfect balance to, first,