ancient arguments about the origin of medicine

Public arguments that have a well-recognized form are more likely to attract interest and participation.  An early example of this communicative principle is ancient arguments about the origin of medicine.  Ancient arguments about the creation of the heavens and the earth set the pattern for ancient arguments about the origin of medicine.

In the beginning, proponents of creation from eternally existing elements squared off against proponents of creation from nothing.  Greeks from no later than the fifth-century BGC taught that externally existing elements composed the universe.[1]  Latter Hellenistic philosophers argued for a prime mover or first cause that caused all things to come into being.  The first reference to creation in both the Hebrew and Greek (Septuagint) text of Genesis 1:1 doesn’t clearly take sides in that dispute.[2]  Jewish and Christian biblical interpreters in the Hellenistic era generally favored God creating the universe from nothing (creatio ex nihilo).  By 200 GC, elaborate and vociferous arguments defended and attacked the two positions.

Since elites were keenly interested in medicine and accounts of origins provide authority, arguments about the origin of medicine naturally occurred.  Galen’s Commentary on the Hippocratic Oath reportedly described the structure of discourse:

The statements as to how the art of medicine came into being fall into two primary categories. Some claim that it has existed from eternity, others that it was created. Those who believe in the creation of bodies maintain that medicine was created, just as the bodies to which it is applied were, while those who believe in pre-existence hold that medicine has existed from eternity, from the beginning of time, it being one of the primeval phenomena that have always existed.[3]

That is an entirely plausible Galenic description.  Even if not actually from Galen, that description surely describes ancient discourse from before the tenth century, and most probably from before the sixth century.[4]

Galen was much more interested in actual medical practice and immediate scholarly prestige than he was in abstract arguments about the origin of the universe or of medicine.  In Galen’s Commentary on the Hippocratic Oath, Galen reportedly declared:

As for myself, I maintain that it would be most proper and most plausible to say that God, the Blessed and Exalted, created the art of medicine and revealed it to man, because it is unthinkable that the human mind should have been able to conceive so sublime a science. Only God, the Blessed and Exalted, is the Creator Who is truly capable of this.  For we do not find that medicine is inferior to philosophy, which is generally believed to have taken its origin from God, the Blessed and Exalted, Who revealed it to mankind.[5]

Galen plausibly would refer to the art of medicine as “so sublime a science,” and even more so, make the agonistic, perhaps sarcastic remark, “we do not find that medicine is inferior to philosophy, which is generally believed to have taken its origin from God.” That later declaration might be the (rhetorical) motivation for Galen claiming that god created and revealed medicine to man.

Galen’s Commentary on the Hippocratic Oath, if actually by Galen, clearly includes interpolations.  The text, preserved only in Arabic in the ancient Islamic world, presents Galen as praising God in the Islamic style.  Tensions in such praise are evident in another related passage from the same text:

The great majority of people bear witness that it was God, the Blessed and Exalted, who through dreams and visions inspired them with medical knowledge which rescued them from severe diseases. We find, for example, countless people who were healed by God, the Blessed and Exalted — some with the aid of Serapis, others with the aid of Asclepius. In the cities of Epidaurus, Cos and Pergamum, the last being my native town, in short, in all the temples of the Greeks and of other nations there are cases of serious diseases cured through dreams and visions.[6]

Jews and Christians, like Muslims, believe in one God, the Blessed and Exalted.  Serapis and Asclepius were some of the many gods honored in the temples of the Greeks.  Galen respected and used Greek temples and gods, and he elsewhere ridiculed Jewish and Christian beliefs.  Praise of “God, the Blessed and Exalted” in a Galenic text surely is an Islamic interpolation.  On the other hand, reporting empirical observations is characteristic of Galen.  Galen also embraced dreams in medical practice.[7]  These aspects of the text are consistent with Galen’s writings.  Overall, the text has the form argumentum ad populum: the great majority of persons bear witness that medical knowledge comes from God.  That’s consistent with Galen’s rhetorical sophistication.

Galen’s Commentary on the Hippocratic Oath treats arguments about the origin of medicine rhetorically.  It describes these arguments explicitly in parallel with arguments about the universe.  It stakes its position as a status claim in rivalry with philosophy.  It supports that position with popular belief.  Galen was keenly interested in true knowledge about biological reality.  At the same time, he was thoroughly engaged in the sophistic rivalries of his time.  The origin of medicine had little relevance for the pursuit of true medical knowledge.  Arguments about the origin of medicine primarily concerned rhetorical interests.  Galen’s Commentary on the Hippocratic Oath is plausibly attributed to Galen.  It shows the closely intertwined history of rhetoric and reason.

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Notes:

[1] See, e.g. Parmenides and Empedocles.

[2] The Hebrew root used in Genesis 1:1 for create (bara’) encompasses the meanings create, shape, and transform.  The same is true for the Greek root (poen, as in poet and poetry) from the Septuagint.  The relevant Latin term in the Vulgate (creavit) has meaning more closely confined to “create, beget, give origin to.”  Helpful tools: Blue Letter Bible, Biola University’s Unbound Bible (Septuagint, with accents, roots and parsings), and Perseus’ Word Study Tool.

[3] HP p. 5.  Rosenthal (1959) B.1.b. p. 55 has a similar translation.  The text appears in Ishaq ibn Hunayn‘s ninth-century Ta’rikh al-atibba.  Hunayn ibn Ishaq’s Risalah testifies to the existence of a Commentary on the Hippocratic Oath that Galen wrote.   Id. pp. 54-5.  I use above the title Galen’s Commentary on the Hippocratic Oath for the text so attributed in HP.

[4] Rosenthal (1959) judges the text to be from between the second and sixth centuries.  Since it appears in Ishaq ibn Hunayn’s work, the text is surely from before the tenth century.  Id. p. 55, n. 2, states,“The statement that medicine always existed, even before the creation of man, is remarkable and to my knowledge not attested elsewhere in classical literature.” Lack of other specific attestations may reflect selective survival of documents under Christian and Muslim copyists.

[5] HP p. 7.  Rosenthal (1959) p. 59 presents a translation of this text without the references to God and without the context of rivalry with philosophy.  HP p. 9 quotes Ibn al-Maṭrān (d. 1191) as writing: “Galen, in his commentary on the Covenant {Hippocratic Oath} maintains that this art {medicine} is revelational and inspirational.”  Rosenthal (1959), p. 81, judges that Ibn al-Maṭrān had independent access to Galen’s Commentary on the Hippocratic Oath.  Galen’s apparent position of the origin of medicine did not parallel his position on creation: “on the problem of world generation he {Galen} takes no sides.”  See Chiaradonna (2009) p. 247.

[6] HP p. 17. Rosenthal (1959) p. 60 (fragment B.1.c.) has a nearly identical text, but without the (Islamic) epithet “Blessed and Exalted” that repeatedly follows God’s name in the above text.  Id. n. 27 claims:

This summary and vague statement hardly goes back to the original {Galenic} Commentary; it might at best be an echo of Hunayn’s notes.

I think that the above text in substance probably did go back to Galen’s Commentary.

[7] According to Galen, he received medical instructions from Asclepius in a dream, and those instructions saved his life. Oberhelman (1983) p. 37 observes:

Dreams are fully incorporated into Galen’s medical science and play an active role in his treatment of illnesses. They also proved to be of crucial importance for him personally throughout his life and career.

References:

Chiaradonna, Riccardo. 2009. “Galen and Middle Platonism.” Ch. 11 in Gill, C., Wilkins, J. and Whitmarsh, T. (eds), Galen and the World of Knowledge.  Cambridge University 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.

Oberhelman, Steven M. 1983. “Galen, On Diagnosis from Dreams.”  Journal of the History of Medicine and Allied Sciences. 38 (1): 36-47.

Rosenthal, Franz. 1956. “An ancient commentary on the Hippocratic Oath.”  Bulletin of the History of Medicine. 30(1): 52-87.

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