January 2012 – Page 3

Galen dominates Greeks in Ibn Abi Usaibia's History of Physicians

In the thirteenth century GC, Damascus-based physician Ibn Abi Usaibia wrote a book on “classes of physicians.” It consisted of “essential information” concerning the lives and writings of physicians, as well as “some savants and philosophers who studied and practiced medicine,” from the origin of medicine to Ibn Abi Usaibia’s present.[*] While by modern convention Ibn Abi Usaibia’s book is called History of Physicians, that book in its time seems to have been understood to help constitute the present profession of physicians. History of Physicians is a trans-historical record of medical profession membership and status.

Galen of Pergamon dominates among Greek figures in History of Physicians. References to Galen measure 0.55 on an authority index in which references to Allāh / God measure one. The three next most frequently referenced Greek figures are Hippocrates, Aristotle, and Plato. They have authority indices of 0.26, 0.22, and 0.10, respectively. Galen himself emphasized the authority of Hippocrates. Hence the relatively frequent references to Hippocrates are partly an effect of Galen’s authority. Aristotle, who wrote extensively on anatomy, taxonomy, and philosophy, is a much bigger figure than Galen in modern Western classical studies. But references to Aristotle in History of Physicians are less than half as frequent as references to Galen. Other Greek physicians who achieved prominence in their days, such Plistonicus, Heraclides, Pedanius Dioscorides, Rufus of Ephesus, and Oribasius, are very infrequently mentioned.

History of Physicians emphasizes written work. It nearly uniformly lists the written works of each physician. History of Physicians has relatively little information about specific medical treatments, techniques, and medicines. Symbolic competition with high social influence tends to produce highly concentrated popularity distributions (blockbusters / celebrities). The dominance of Galen among Greek figures suggests that competition for attention to written work within active social networks was a primary driver of physicians’ reputations.

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Statistics and source:

Here are token frequency distributions for Ibn Abi Usaibai’s History of Physicians (Excel version). Those token distributions could not have been compiled without Roger Pearse‘s enormous labors to produce a machine-readable transcription of the English translation below.

HP: Ibn Abi Usaybi’ah, Ahmad ibn al-Qasim. English translation of History of Physicians (4 v.) Translated by Lothar Kopf. 1971. Located in: Modern Manuscripts Collection, History of Medicine Division, National Library of Medicine, Bethesda, MD; MS C 294. Online transcription.

Note:

[*] In the book’s preface, Ibn Abi Usaibia calls it “`Uyunu al-Anba fi Tabaquat al- Atibba.” Kopf translates this as “Essential Information Concerning the Classes of Physicians.” Regarding the term translated as “Essential Information,” Kopf notes, ‘Most scholars have wrongly translated this as “Sources of Information.”‘ See HP p. 3 and footnote 15 to HP Chapters 1-5. At HP p. 942, the title of the book is translated as “Important Information Concerning the Classes of Physicians.” Other thirteenth-century physicians refer to the book as Ibn Abi Usaibia’s book concerning the classes of physicians. See HP pp. 730, 763, 899. The book’s chapter titles echo the term “classes of physicians,” emphasizing its thematic importance.

Wednesday's flowers

reasoning against harsh punishment

An anger-driven justice system doesn’t necessarily generate harsh punishment. In ancient, democratic Athens, anger made a citizen’s case for public action against a wrongdoer. Yet anger-driven justice seems not to have supported harsh punishment. Executions in democratic Athens were limited to means that did not draw blood; specifically, drinking hemlock and being crucified by being bound, not nailed, to a board. Athenian themselves considered their city to have mild, even too mild, punishments.[1] Anger was not a recognized impediment to a just public order.

Scholarly development set reason against emotion. The relation between reason and emotion became a key issue among teachers (philosophers) competing vigorously for students. Among most philosophers, the favored position was that reason should control emotion. That’s the idea underlying Plato’s famous image of reason as a charioteer controlling conflicting emotions.

In the vibrant intellectual circumstances of the ancient Islamic world, a leading physician counseled an emir to administer punishment based on reason, not anger. According to a history that the physician’s son wrote, the Emir said to the physician:

I want you to take care of my physical well-being and of something even more important to me, namely my morals, for I have faith in your intelligence, learning, piety and devotion. I am greatly distressed by the fact that anger often drives me to actions such as flogging and executions, which I regret when my wrath has subsided. I therefore request you to watch me, and if you detect any defect in my behavior, do not hesitate to tell me so and advise me how to rid myself of it. [2]

The physician reportedly replied:

I have heard the Emir’s order and shall obey it. The Emir will at once hear some general rules from me as to how to deal with the failings he is concerned about, while details will follow as the occasion arises. Remember, O Emir, that you occupy a position in which no man can gain the upper hand of you, that you are free to do whatever you please at any time you choose. … Bear in mind, therefore, that anger intoxicates a man much more powerfully than wine. A man drunk with wine is apt to do what he will neither understand nor even remember when he is sober again and will regret and be ashamed of when reminded of it, and the same applies, only more so, to a man drunk with anger. So, whenever you feel anger rising in you, then, before its effect becomes too heady and you are no longer master of yourself, make it a rule to defer punishment to the following day, since you may be sure that what you were about to do can be done just as well on the morrow. … If you behave in this way, the fit of anger will pass during the night. It will subside of itself and you will sober up. … When recovering from your intoxication, reflect upon the matter which aroused your anger.

The physician encouraged the Emir to reason:

Think about God:”just as you would like God to forgive you, so other people hope for your clemency and forgiveness. … Great credit will accrue to you by being merciful. Remember the word of Allāh, the Most High: Let them pardon and overlook; do ye not like that Allāh should forgive you; Allāh is forgiving, compassionate {Qur’ān, XXIV, 22}”
Recognize that deterrence will continue to exist: “Neither the evildoer nor anyone else will think that you were too weak to mete out punishment or that you lacked power to do so.”
Think about proportionality: “mete out punishment commensurate with the crime, and no more otherwise you will be a wrongdoer and your prestige will suffer.”
Reason about your interests: “justice {is} much more profitable to the ruler than tyranny, as it leads to happiness in this world and the next.”

Such reasons have been continually discussed among scholars right through to present-day criminologists.

If emotions are recognized as an integral component of reasoned decision-making, then the Emir’s problem points to a different treatment. What events caused the Emir to get so angry that he would have persons flogged and executed? What could be done so that the Emir wouldn’t get so angry in response to those events? Discussion and particular training experiences could well be effective treatment.

Unfortunately, actual human decision-making is difficult matter for scholarly writing. Compared to abstract reasoning, actual human decision-making is much more contingent on persons and circumstances. Abstract reasoning, presented within actual or fictive history, can be much more easily marketed across an expert’s clients.

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Notes:

[1] On anger in relation to prosecution and punishment in democratic Athens, see Allen (2000) pp. 50-9, 148-51. The Athenian form of crucifixion was called apotympanismos. Archaeological evidence indicates that apotympanismos involved strap bindings around the neck, wrists, and ankles. It obviously was not a mild form of punishment. Other forms of punishment were fines, loss of political rights, and banishment. Citizens were not subject to corporal punishment, and imprisonment was rare. Given the limited evidence available, a good measure of the harshness of Athenian punishment doesn’t exist. Yet much more physically brutal punishments have been common across the world and throughout history. The Athenians apparently were proud of their mildness in punishment. See Hall (1996) pp. 73-4.

[2] All the above quotes are from HP pp. 425-8. The physician’s name was Abū Sa`īd Sinan ibn Thābit ibn Qurra. His son’s name (the author of the text) was Abū al-Hasan Thābit ibn Sinān ibn Thābit ibn Qurrah. The general thrust of the advice follows that of Galen, On the passions and errors of the soul, trans. Harkins (1963) pp. 42-3. Seneca, Of Anger, Bk. 1, Ch. 1, described anger as brief insanity (brevis insania). Fady (1998) interprets Sinan ibn Thābit as describing a case of Galenic psychotherapy. However, the historical circumstances and the textual style suggest that the case is probably fictive. Sinan ibn Thābit (the father) served as physician to three successive caliphs: al-Muqtadir, al-Qāhir, and al-Rādī. The brutal behavior of rulers clearly was a important public issue in Sinan ibn Thābit’s time. Consider, for example, the behavior of the caliph al-Qāhir:

With an outward affectation of godliness, al-Qāhir went to every excess of cruelty and extortion. He even tortured the mother of al-Muqtadir and his sons and favorites, to squeeze from them the wealth built up throughout the late reign. Many fled from his grasp. Al-Qāhir had his nephew, who was to have followed him, walled up alive. Thus relieved from immediate threat, al-Qāhir broke out into such tyranny, even against friend and foe, as to make his rule unbearable.

In fear of al-Qāhir, Sinan ibn Thābit at one point fled from Baghdad to Khorāsān. HP p. 422. Al-Qāhir was subsequently disposed, imprisoned, and blinded. Under the next caliph, brutal punishments continued. For example, the wazir ordered a wealthy, elite public servant, Ibn Muqlah (father of Abū al-Husayn), to be harshly beaten. Thābit ibn Sinān recorded his first-person observations:

On entering his room I found him stretched out on a shabby mat with a dirty pillow under his head and wearing nothing but a pair of trousers. His whole body, from head to toe, was the color of eggplant, without a single clear spot.

Ibn Muqlah subsequently had his right hand cut off as further punishment. Then his tongue was cut out. He was left in prison and prevented from receiving care and help. Thābit ibn Sinān records:

I heard that he even had to draw his own water, pulling the rope with his left hand and holding it in his mouth. He continued in wretched misery until his death.

For the details of Ibn Muqlah’s punishment, see HP pp. 430-3. Thābit ibn Sinān also recorded a high official’s compassionate treatment of prisoners. That text seems much more stylized than Thābit ibn Sinān’s first-person observations of Ibn Muqlah’s punishment.

References:

Allen, Danielle S. 2000. The world of Prometheus: the politics of punishing in democratic Athens. Princeton, N.J.: Princeton University Press.

Hajal, Fady. 1998. “Galen’s ethical psychotherapy: Its influence on a medieval Near Eastern physician.” Journal of the History of Medicine and Allied Sciences. 38: 320-333.

Harkins, Paul W, trans. 1963. Galen: On the passions and errors of the soul. Ohio State University Press.

Hall, Margaretha Debrunner. 1996. “Even Dogs have Erinyes: Sanctions in Athenian Practice and Thinking.” Ch. 5 in Foxhall, Lin, and A. D. E. Lewis. 1996. Greek law in its political setting: justifications not justice. Oxford: Clarendon Press.

art empire: prolegomena to repressed sequels

In 1997, Douglas Gordon made a pirate recording of two hours of Andy Warhol’s Empire. Gordon, “a noted sculptor of cinematic time,” wasn’t persecuted and imprisoned for copyright infringement. Today, Gordon’s work, “Bootleg (Empire)” is on display in the Hirshhorn Museum’s exhibit Directions: Empire³. Pirating a copyrighted work has thus helped to develop further an art empire.

Vigorous public debate about strict new copyright enforcement measures hasn’t sufficiently appreciated alternatives to punishing persons for copyright infringement. The Hirshhorn has a guard stationed near Gordon’s “Bootleg (Empire).” The guard stops anyone who attempts to takes a photo of the television playing Gordon’s pirated video. If you want to maintain a totalitarian empire, guards are more effective than copyright.

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ancient public gestures of compassion for the sick and prisoners

Early in the tenth century, brutality and fear were common in Baghdad. That city was then the capital of the Abbasid caliph and probably the largest city in the world. When Caliph al-Muktafi died in 908, his thirteen-year-old son became the caliph, taking the name al-Muqtadir.[1] Political turmoil and intrigue was intense across al-Muqtadir’s caliphate. Across al-Muqtadir’s 25-year reign, the leading governing position of wazir changed person fourteen times.[2]

External threats contributed to a civic climate of paranoia. The Fatimid al-Mahdi attacked Abbasid Egypt from his base in Ifriqiya, an area along the coasts of present day Algeria, Tunisia, and Libya. The Carmathians, Muslim rebels based in Bahrain, pillaged Basra in 924, threatened Baghdad in 927, and sacked Mecca in 930. The Carmathians killed Hajj pilgrims and took the revered Black Stone away from Mecca. The Black Stone was returned to Mecca only in 952, after the Abbasids paid a huge ransom.[3]

Within this unstable and fearful political climate, the celebrated Persian mystic Mansur al-Hallaj was imprisoned for eleven years and then executed. The execution occurred in Baghdad in 922 after a long and contentious public trial. Alī ibn `Isā, a leading government official, allowed the execution of al-Hallaj to proceed. Alī ibn `Isā apparently took this course of action to avoid angering the wazir Hāmid ibn al-`Abbās. Alī ibn `Isā served as wazir himself several times during al-Muqtadir’s caliphate.[4] Alī ibn `Isā thus undoubtedly was a shrewd political operator enmeshed in high politics. The execution of al-Hallaj most probably was politically expedient.

Particular acts of public compassion had value even within this political climate. Al-Muqtadir’s physician’s son, who himself was also a high-ranking physician, wrote a “Book of History” that describes Alī ibn `Isā’s actions.[5] According to that book, Alī ibn `Isā directed the caliph’s physician (the author’s father) to arrange for physicians to go to an area lacking medical services and care for residents there. Alī ibn `Isā directed that once the needs of Muslims had been met, the physicians should also treat Jews, as well as other non-Muslims, in other areas that lacked medical services. Alī ibn `Isā also intervened to ensure that revenue from a religious endowment was not diverted from supporting a hospital. He ordered the endowment administrator:

Do everything to pay out what is due, and see that the physically and mentally sick inmates are kept warm with blankets, clothing and fuel, supplied with food and given constant treatment and care.

Another of Alī ibn `Isā official missives to the caliph’s physician concerned prisoners:

I have been pondering on the situation of those in prison and on the fact that owing to their number and uncomfortable accommodation, they will inevitably become affected with disease. They cannot look after themselves and consult doctors about their condition. It is fitting therefore, that you assign special physicians to them who should visit them every day, carrying drugs and medicines. The should make the rounds of all the prisons in order to attend the sick inmates and cure their diseases. An order should also be issued that those who are in need of muzawwarāt should be given it.[6]

The author of the “Book of History” was deeply involved in high Abbasid politics. That book plausibly was a literary means for buttressing the reputation of the author’s father (the caliph’s physician), Alī ibn `Isā, and other politicians that the author favored. Across millennia and across many different political circumstances, care for those sick and in prison has been a sign of personal merit.

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Notes:

[1] The boy’s name was originally Ja’far b. al-Mu’tadid. Al-Muqtadir means “mighty by the help of the Lord.”

[2] Sourdel (1977) p. 135. Wikipedia says thirteen times. Some persons had multiple turns in the office of wazir.

[3] Sourdel (1977) p. 136.

[4] Sourdel (1977) pp. 135-37, HP p. 422. Alī ibn `Isā’s full name was Abū al-Hasan Alī ibn `Isā ibn al-Jarrāh.

[5] HP pp. 422, 429, 433. The physician’s name was Abū Sa`īd Sinan ibn Thābit ibn Qurra. His son’s name was Abū al-Hasan Thābit ibn Sinān ibn Thābit ibn Qurrah.

[6] Previous two quotes are from HP pp. 422-6.

References:

Sourdel, Dominique. 1977. “The ‘Abbasid caliphate.” Ch. 4 in Holt, Peter Malcolm, Ann K. S. Lambton, and Bernard Lewis, eds. The Cambridge history of Islam. Vol. 1A, The central Islamic lands from pre-Islamic times to the First World War. Cambridge: Cambridge University Press.