Abstract
It is common for persons in different disciplines to learn from one another. Though one may not have the necessary skills and resources for conducting proper scholarly inquiries in another’s discipline, one may yet uncover material of great interest there.1 So it is when the philosopher of medicine makes use of historical studies. It is always a hazardous matter when a philosopher transgresses disciplinary boundaries in this fashion. The hazard is doubled if he seeks to draw analogies between ancient and contemporary developments, given the radically different social and intellectual contexts in which these developments unfolded. Nonetheless, in a volume largely devoted to contemporary visions of the medical body — Cartesian, phenomenological, sociopolitical, and the like — I think there is some value to reflecting on the ancient roots of Western medicine, and noting that themes of currently hot debate have themselves had a long history. In the conflicts of the ancient schools we see questions raised which still are with us — the importance of generality and classification within medicine versus attention to the individuality of the patient; the bodily interior as the locus and cause of disease versus disease as arising in the interaction of self and world; the doctor’s experience as determinative of the medical encounter versus that of the patient, etc. I have tried neither to write an in-depth historical treatise, nor to develop fully the philosophical ramifications of these ancient debates. The former is beyond the scope of my training, the latter, beyond the scope of this work. Nevertheless, I hope what I here present will be suggestive to readers of this volume, and place some of its other articles in a broader context of cultural history. Given this limited aim, I am hopeful that my brief introduction to ancient medicine and its diverse views of the body will not unleash too harsh a critique from those more expert than I in the subtle, though always enchanting, entanglements of historical matters.2
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Notes
A central concern of mine for many years, as it has been within phenomenology and existential thought [11].
I should note that the following reflections were spurred primarily by only several medical historians’ works, especially L. Edelstein [4], G. Majno [6], L. J. Rather [9], O. Temkin [10]. This, quite obviously, hardly scratches the many surfaces of even ancient medical thought. Others consulted include the rather controversial three-volume study by H. I. Coulter [3] — whose works, quite problematic philosophically as well as historically, I found interesting primarily because of his many translations of ancient medical writings (Coulter’s own quite patent bias toward homeopathy I regard as a curiosity that can be readily ignored while benefitting from other facets of his work).
Coulter argues that medical thought grows out of and is continually governed by this “therapeutic experience”. “Therapeutic theories in all their variety are attempts to make sense out of the healer’s experience with the patient” ([3], p. viii). He does not sufficiently appreciate, however, that this presents the healer with a complex “text” that needs interpretation. It should also be pointed out that Coulter’s usages, especially “empirical” and “rational” — whatever historians may think of them — are very problematic philosophically. It seems, indeed, a far more modern sense he has in mind than could possibly have been present in Hippocratic times.
The physician was enjoined to be the servant of the body’s own powers. “The physies are all untaught (Nutriment XXXIX). “The physies are the physicians of diseases” (Epidemics VI). “Even where the resources of art are applied, the Natura (physis) can do the most,” and “with the Natura in opposition, the art of medicine avails nothing” (Celsus, De Medicina II).
It thus seems to me that the Hippocratic Oath expresses more empiricist than dogmatic views.
Celsus notes that vivisection was conducted on criminals who were delivered over to the anatomists. His discussion of vivisection is shaped by apologetics and the accusation of cruelty. Later physicians, such as Theophrastus, while opposed to bloody sacrifices even of animals, reasoned that men must kill animals for food in order to survive. Similarly, Edelstein notes, “one is allowed to kill human beings and to punish criminals with death. It is only the unnecessary sacrifice, the unnecessary cruelty, that should be shunned. If then the killing of human beings, and in addition of criminals who have forfeited their lives and whose killing was regarded as permissible and proper, if the killing of such men was the necessary condition for saving other, innocent people, why should even the most humane scientist not decide to practice vivisection?” ([4], p. 285).
I use this term deliberately, evoking especially Ortega y Gasset’s usage [7].
As Edelstein also emphasizes, correctly it seems to me, this form of empiricism is unique to medicine, “its original contribution”. Indeed, he points out, “if the Greeks have a dislike for the individual and a preference for the typical, the counter-balance is provided by medicine, not by geography, history, or another science” ([4], p. 201 n. 18). Both dogmatism and Hellenistic empiricism, to the contrary, are strictly derivative from prevailing philosophies.
Thus, in De partibus animalium ([2], pp. 645-647) he states that when the soul is gone (at death), there is no longer a living creature, and although a corpse has the same shape and fashion as a living body, yet it is not a man.
As Edelstein points out, “the study of animals was supposed to provide a clue to the knowledge of human organs”, which presupposes “that in the last analysis man and animals are identical” ([4], p. 293). Where comparisons were still thought possible, moreover, these were understood to be mere similarities, no longer strict analogies ([4], p. 294).
It should be noted, however, that, for whatever reasons, Galen was not able to dissect human beings; this made it necessary for him to rely both on reports from earlier anatomists and, more especially, on animal dissections for his anatomical theory. In this respect, moreover, he reverted to the thesis that was rejected by those earlier anatomists: the comparability of animals and humans.
Edelstein’s argument that the Oath is Pythagorean — which may be disputed — is, while interesting, not germane to the point being made here. Rather, it has seemed to me, the notion that human beings do not act in ways that are always in their own best interests, and thus are of special interest to healers in this tradition, is an idea that harbors interesting implications, for the body, and more generally, for the nature of humanity. “ Although usually regarded as an empiricist, Scribonius’ argument here seems to me far closer to the skeptic’s position.
Bibliography
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Zaner, R.M. (1992). Parted Bodies, Departed Souls: The Body in Ancient Medicine and Anatomy. In: Leder, D. (eds) The Body in Medical Thought and Practice. Philosophy and Medicine, vol 43. Springer, Dordrecht. https://doi.org/10.1007/978-94-015-7924-7_7
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