astrologers and physicians in ancient intellectual competition

Astronomy and astrology originally developed as royal services for setting governing calendars and ensuring godly favor for a community.  Ancient writers considered astronomy and astrology to be largely coextensive areas of knowledge.[1]  In the Hellenistic world under the Roman Emperor Augustus, astrology rapidly gained value as astrologers offered personalized predictions based on natal star-signs and offered personalized advice on auspicious times for particular actions.[2]  Astrological knowledge became one type of expertise claimed among mass-market personal service providers.

Like an astronomer-astrologer, a physician offered personal prognoses and prescriptions.  The personal health of a ruler was of great concern to the ruler and to his subjects.  Fear of poisoning stimulated royal interest in medical antidotes.  Wealthy elites showed their status by seeking royal health care.  At the same time, sickness and ill health are a universal human concern.  Medical knowledge was another type of expertise among mass-market personal service providers.

Given the difficulty that consumers had in judging expertise and evaluating outcomes, expert disciplinary solidarity played a key role in preserving knowledge value among astrologers and physicians.  They typically divided medical services, with physicians prescribing the nature and treatment of illness, and astrologers prescribing the timing of treatment.  This market division, like most such agreements among potential competitors, was fragile.  A top-end consumer of medical services in Baghdad under al-Rashīd’s caliphate (786-809 GC) organized service provision to respond to potential inconsistencies in knowledge claims:

Yūsuf ibn Ibrahim, the astrologer known as Ibn al-Dāyah, reports that Umm-Ja`far, the daughter of Abū al-Fadl {al-Fadl ibn al-Rabī, al-Rashīd’s vizier}, had a hall in the castle of `Isā ibn `Alī, where she lived, in which she assembled only astrologers and physicians.  She would never complain about an illness to a physician without having all the men of the two above-mentioned professions come and wait in that hall until she entered. … She then described whatever she was suffering from, and the physicians held council among themselves until they reached a unanimous decision as to the nature of the illness and its treatment.  If there was a difference of opinion, the astrologers would intervene and defend the view that seemed right to them. The patient would then ask the astrologers to choose a suitable time for the treatment.  If they agreed unanimously, there was nothing more to be said, but if not, the physicians would examine the different views and pronounce the one that seemed the most logical to them.[3]

Personal concern for a patient’s welfare sometimes trumped professional solidarity:

Al-Jadid, the mother of al-Rashīd’s son, was suffering from colic. She sent for `Isā {the physician `Isā ibn Hakam of Damascus} and the two astrologers al-Abakh and al-Tabari, and then asked `Isā’s opinion concerning her treatment. `Isā reports: “I told her that the condition of her entrails was grave, and that if she did not counteract it immediately with an enema, her life was in danger. She turned to al-Abakh and al-Tabarī, saying: Choose the time for my treatment for me.’ Said al-Abakh: ‘Your illness is not of a kind whose treatment may be postponed to a time recommended by the astrologers. My advice is that you start treatment without any astrological preliminaries; `Isā ibn Hakam agrees with me in this.’ She turned again to me, and I confirmed al-Abakh’s pronouncement. Al-Tabari, asked for his opinion, said: ‘Tonight the moon is with Saturn, tomorrow it will be with Jupiter. I advise you to postpone treatment until the conjunction of the moon with Jupiter.’ Al-Abakh protested: ‘I fear that by the time the moon is with Jupiter the illness will have reached a stage where there is no more call for treatment.’ Al-Jadid died before the moon reached Jupiter. When it did, al-Abakh said to Muhammad’s mother {al-Tabari’s mother}: ‘This is the time chosen by al-Tabari for the treatment. Now where is the patient?’ This remark made her still angrier, and she bore a grudge against him right up to her death.”[4]

The illustrious Bakhtīshū` family of physicians acquired expertise in both medicine and astrology.  Yūhannā ibn Bakhtīshū` wrote a book on what a physician ought to know of astrology.[5]  Bakhtīshū ibn Jibrā’īl ibn Bakhthīshū` used astrology to time his prescriptions:

Bakhtīshū` used to prescribe enema when the moon was in conjunction with a comet and thereby cured colic on the spot. He used to prescribe the drinking of a medicine when the moon was facing Venus and thus cured the patient the same day. [6]

While some questioned astrological knowledge, Bakhtīshū` apparently sincerely believed in such knowledge:

At the end of his service, Bakhtīshū` said to {Caliph} al-Muhtadī: “O Emir of the Faithful, I have never fallen ill or taken a medicine for forty years now, but the astrologers have decided that I will die this year. I am not grieved at dying, but at having to leave you.” Al-Muhtadī talked to him kindly and said: “The astrologers are rarely right.”[7]

In early-twelfth-century Baghdad, Ibn al-`Ainzarbī “applied himself to medicine and the philosophical sciences and became proficient in them, especially in astrology.”  He became “one of the most outstanding masters of the medical art.”  Al-`Ainzarbī’s knowledge of astrology helped him through a difficult period early in his career after he had moved from Baghdad to Cairo:

An envoy from Baghdad who had been acquainted with Ibn al- `Ainzarbī in that city and knew him as a person of wide learning, came to Egypt.  While walking along a street in Cairo, he suddenly saw Ibn al-`Ainzarbī sitting there practicing fortune-telling for a living.  He recognized him and greeted him, wondering why a man of such great learning, a first-rate expert in medicine, should be in such a sorry condition.  He kept the incident in mind and, on meeting the Vizier, mentioned Ibn al-`Ainzarbī in the course of the conversation, pointing out his great knowledge and experience in medicine, etc.  He remarked that the people were unaware of his worth and that a person of his caliber should not be disregarded. The Vizier eagerly desired to meet ibn al-`Ainzarbī. He sent for him and, on listening to him, was much impressed and was convinced of his talents and eminence in science.  He spoke about him to the Caliph, who awarded him such a stipend as befitted a man like him.  Presents from court dignitaries now reached him continually.[8]

In this account, practicing fortune-telling is not disreputable.  Practicing fortune-telling in the street for a living is a sorry status relative to practicing medicine and fortune-telling under the patronage of the caliph’s court.

Astrology was highly valued in the intellectually vibrant ancient Islamic world.  Nafi ibn al-Harith, a prominent Arab physician-scholar who died in 670, prescribed the time for bloodletting in terms of the phase of the moon.[9]  The Bakhtīshū family of physicians, who served Abbasid caliphs for three centuries, claimed and applied astrological knowledge.  Prominent “Islamic Golden Age” physicians and scholars claiming astrological knowledge include the “father of Arab philosophy” al-Kindī, court astrologer, and European source for Aristotle’s theories of nature Abū Ma`shar al-Balkhī, court intellectual Ahmad ibn al-Tayyib al-Sarakhsī, the prolific and influential polymath al-Rāzī, al-Rāzī’s teacher and encyclopedist Abu al-Hasan Ali ibn Sahl Rabban al-Tabari,  the influential physician and medical author Ibn Butlān, and many others.[10]  In word count frequencies in Ibn Abi Usaibia’s History of Physicians, astrology on its own ranks in the middle of the educational subjects of the quadrivium.  If astrology and astronomy are considered together, study and interpretation of the stars was a leading subject, significantly behind only philosophy.

Astrology is a difficult subject for post-Enlightenment scholars.  The ancient Islamic world was much more intellectually open, productive, and vibrant than pre-Enlightenment Europe.  An intellectually open, productive, and vibrant world is associated with contemporary rationality.  Not surprisingly, a prominent contemporary scholar of Islamic/Arabic medicine declared that “by and large, astrological considerations play only a small part in Arabic medicine.”[11]  Another knowledgeable scholar has attracted less attention with this statement:

In the course of research on Arabic Medicine, I became aware of the significant role Astrology played at the thriving age {Islamic Golden Age} of this art.  Astrology lived by no means an obscure life in Islam.  On the contrary, it attracted many intellectual minds also among Arab physicians, despite heavy attacks from its opponents.[12]

The historical evidence seems to me to favor decisively the significance of astrology in the ancient Islamic world.  Given the intellectual vibrancy of the ancient Islamic world, and of our own, could there be an equivalent of astrology in leading intellectual thought today?

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Data: subject frequencies in Ibn Abi Usaibia’s History of Physicians (HP) (Excel version)

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[1] Barton (1994) p. 32.  Claudius Ptolemy (90-168 GC), a Roman citizen of Egypt, wrote both the Almagest, a leading treatise on astronomy, and Tetrabiblos, a large and influential work on astrology.

[2] Barton (1994) pp. 40-54.  Emperor Augustus was prominently recognized as being born under the sign of Capricorn.

[3] HP pp. 249-50.  The study of astrology in relation to medicine is sometimes called iatromathematics, a term that seems designed to give such study respectability.  Ibn Abi Usaibia wrote, in addition to History of Physicians, another book entitled, The Successful Astronomers.  HP p. 507.

[4] HP p. 229.  Other astrologers that al-Jadid regularly employed included “al-Hasan ibn Muhammad al-Tamimi from Tūs, known as al-Abahh; `Ūmar ibn al-Farkhān al-Tabarī and the Jew Shw’ayb.”  “Shw’ayb” probably represents the family name Schaub / Schwab.

[5] HP p. 389.  Sections of that book have been preserved in Ḥanūn ibn Yūḥannā Ibn al-Ṣalt’s book, Astrological Medicine.  See Klein-Franke (1984) pp. 100-109.  Al-Salt was a colleague of Hunayn’s son, Ishaq (Ishaq ibn Hunayn).

[6] HP p. 276.

[7] HP p. 266-7.

[8] HP pp. 721-722. The previous information and short quote on al- `Ainzarbī are from id.

[9] In a fictitious dialogue with Persian King Khosrau I, Nafi ibn al-Harith declared:

{Cupping} should be done when the moon is on the wane, on a fine day with no clouds and when the patient has a good disposition, when his blood flows calmly because of joy experienced and anxiety kept at bay.

HP p. 210. This astrological knowledge endured for centuries.  Ibn Butlān, a prominent physician and author in the eleventh-century Islamic world, observed:

The astrologers perform phlebotomy only when the moon is waning, so that the patient is in the condition appropriate for the purpose of bloodletting.

Klein-Franke (1984) p. 70, from the appendix to Ibn Butlān’s Physician’s Party.

[10] Ullmann (1978), p. 112, notes that al-Rāzī’s large medical encyclopedia al-Hawi includes “a short section on the influence of the stars on the crises of illnesses.”  Ibn Abi Usaibia records a astrological saying of al-Rāzī:

The movements of the planets lengthwise and widthwise determine the changes of natures and humors.

HP p. 542. Klein-Franke (1984), pp. 124-135, provides an English translation of astrological excerpts from Abū Ma`shar’s Kitab al-Mudhal al-Kabir.  Here’s some of Ibn Butlān’s analysis:

Since the Sirius star appeared in the year 445/1053 in the sign of the Gemini, which is the ascendant of Egypt, the plague in Fustāt was caused by the Nile’s failure to rise. So Ptolemy’s prediction {Claudius Ptolemy, probably from his Tetrabiblos} — Woe to the people of Egypt when one of the meteors causing melting establishes itself in the Gemini — came true. And when Saturn entered the sign of the Scorpion, the devastation of Iraq, Mosul and al-Jazirah became complete, habitations in Bakr, Rabī ‘ah, Mudar, Fāris, Kirmān, the Maghrib, Yemen, Fustāt and Syria became deserted, the position of the kings of the earth became precarious and wars, death and plagues abounded. Ptolemy’s statement that if Saturn and Mars came into conjunction in the sign of the Scorpion the world would be wrecked had thus come true.

HP pp. 465-6.

[11] Ullmann (1978) p. 114. Isaacs (1990) p. 363 echoes that evaluation.

[12] Klein-Franke (1984) preface.


Barton, Tamsyn. 1994. Power and knowledge: astrology, physiognomics, and medicine under the Roman Empire. Ann Arbor: University of Michigan Press.

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.

Isaacs, Haskell D. 1990. “Arabic Medical Literature.” In Young, M. J. L., J. D. Latham, and R. B. Serjeant. 1990.  Religion, learning, and science in the ʻAbbasid period. Cambridge: Cambridge University Press.

Klein-Franke, Felix, Ḥanūn ibn Yūḥannā Ibn al-Ṣalt, and Abū Maʻshar. 1984. Iatromathematics in Islam: a study on Yuhanna Ibn aṣ-Ṣalt’s book on Astrological medicine. Hildesheim: G. Olms.

Ullmann, Manfred. 1978. Islamic medicine. Edinburgh: Edinburgh University Press.

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