Month: April 2012

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.

the scope of ancient competition in medical knowledge

Ancient competition in medical knowledge had wide geographic scope.  Asaph’s Book of Medicines, a Hebrew text from the tenth century or earlier, describes southern Europe, northern Africa, Mesopotamia, and southwest Asia as comprising a common space for pursuit of medical knowledge:

The sages of India, Macedonia and the Nestorians excelled all the remaining peoples in the study of the medical books.  The sages of India toured the land to find medicinal trees and incense trees; the sages of Aram found various medicinal herbs and seeds.  They translated all the medical books into Aramaic.  The sages of Macedonia were the first to practice medicine in the land; the sages of Egypt began to find connections in the stars to foretell the future according the the signs of the zodiac and the celestial bodies; they learned the books of the Chaldean Wisdom translated by Kanghar son of Ur son of Kesed, and they performed all the crafts of the astrologers.  Their wisdom was the greatest until the rise of the Aesculapius (one of the sages of Macedonia) and forty astrologers who had studied the translated books.[1]

In mid-tenth-century southern Italy, the ambitious Jewish scholar Shabbetai bar Abraham, called Donnolo the doctor, sought “to understand the science of medicine and the science of the planets and constellations”:

my heart bade me to explore the science of the Greeks, the Arabs, the Babylonians and the Indians.  I did not rest until I had copied out books by Greek and Macedonian scholars in their original language and with their explanations; I also made copies from books by Babylonian and Indian scholars.[2]

Under the Abbasid caliphs in the eighth and ninth centuries, scholars in Baghdad gathered and translated into Arabic medical knowledge from ancient Greek, Syrian, Persian, and Indian sources.  Geographic distance and language differences did not prevent the emergence of a large communicative space before modern communication technologies.

A large communicative space coexisted with distinctive cultural interests.  Asaph’s Book of Medicines sought to incorporate Greek medical knowledge, including medical astrology, within distinctive Jewish culture. Shabbetai Donnolo worked on the same scholarly task.  He noted:

a few {Jewish scholars} said that indeed there was nothing to be learnt from books by Jews on the constellations.  This science, they said, was to be found among the nations, and their books were not written in accordance with the ideas in books by Jews.[3]

Shabbetai Donnolo justified his cosmopolitan studies thus:

After careful study I found that, in everything regarding the science of the planets and constellations, these books were the same as those by Jewish scholars: the opinions of all were correct and identical.  Then I saw from the books by Jewish scholars that this whole science derived from the Baraita of R. Samuel the Exegete.  And the books by non-Jewish scholars also agree with this Baraita.  It is just that Samuel made his book very difficult to understand.[4]

The literature of who invented what first (we did) is voluminous and spans all cultures and times.  Scholars have long had to dance to make broad learning acceptable within the narrow interests of their particular circumstances.  Vast changes in communication technology have not changed human social nature.

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Notes:

[1] Trans. Muntner & Rosner (1971) p. 2.  Nestorians (early Christians), Aram, and Aramaic all characterize an area about present-day Syria.  This description makes clear the close connection between medicine and astrology in the ancient world.

[2] Trans. Sharf (1976) p. 10.

[3] Id. p. 9.

[4] Id. p. 10.

References:

Muntner, Sussman, and Fred Rosner, trans. & ed. 1971.  The Book of Medicine of Asaph the Physician: Commentary (vol. 1) and translated text (vol. 2).  Document 06-501-N-L, Prepared under the Special Foreign Currency Program of the U.S. National Library of Medicine and U.S. National Institutes of Health, Public Heath Service, U.S. Department of Health, Education, and Welfare, Located in: Modern Manuscripts Collection, History of Medicine Division, National Library of Medicine, Bethesda, MD; MS C 294.

Sharf, Andrew. 1976. The universe of Shabbetai Donnolo. New York: Ktav Pub. House.

think outside the screen

For televisions fixed in living rooms, what’s outside of the box adds nothing.  Out-of-home media makes media context more significant.

Consider Doug Aitken’s SONG 1, now showing on the Hirshhorn Museum in Washington, DC.  Much of its art is in its relation to what’s off-screen.

Out-of-home video should play well within its particular physical circumstances.  More mobile apps should encourage users to look up.

smart disclosure progressing

Smart disclosure can bring to data the people-centric orientation that smart growth has to urban planning.  Data is an increasingly valuable economic resource.  Collecting, sharing, combining, and analyzing massive amounts of data can produce highly relevant, actionable information for individuals.  Data now drive a wide variety of services, including personalized health care, personalized education and entertainment recommendations, personally relevant information search, and personally relevant advertising. Smart disclosure promotes a data ecology that serves the public interest, fosters economic growth, and incorporates beneficial competition among private enterprises.

One flagship of smart disclosure is the U.S. Security and Exchange Commission’s movement to machine-readable financial disclosures.  To facilitate data processing, data-texts have to be well-structured and tagged with standardized, meaningful tags.  Since  2004, the Security and Exchange Commission (SEC) has been developing the application of eXensible Business Reporting Language (XBRL) to SEC financial disclosures.  The SEC calls XBRL-formated financial reports interactive data reporting.  An SEC order issued in April, 2009, requires interactive data reporting for all companies’ financial statements covering a fiscal period ending on or after June 15, 2011.  While the SEC’s current financial-filing access system (EDGAR) shows little signs of interactive data, other enterprises are stepping in to make powerful data tools.[1]  Calcbench, for example, makes SEC financial data computable.  By enabling instant data querying, company comparisons, and industry aggregations, Calcbench unlocks tremendous value from SEC data.

A principle of smart disclosure is that individuals should have access to their personal data in a machine-readable, computable form.  The U.S. Department of Veteran Affairs gives veterans access to their health records via a blue button.  Energy companies across the U.S. are giving consumers access to their energy-use data via a green button.  These buttons allow individuals to get third-party health-care and energy-use analysis.  Truaxis and Validas have similarly built mobile-phone bill economizing services that analyze phone users’ calling data to offer money-saving recommendations.

Thinking about smart disclosure in retailing compared to billing could be helpful.  To aid consumers with phone bills, Truaxis and Validas collect data on phone companies’ calling plans.  They collect that data largely through phone companies’ retail service offerings, rather than through their bills.  Retail offerings, however, often do not completely describe relevant prices, terms, and conditions. For example, banks advertising consumer accounts typically reveal nothing about their overdaft terms and charges, even though overdraft fees account for 74% of all of banks’ service-charge income from deposit accounts.[2]  On the other hand, consumer-service bills often don’t detail charges and may be largely incomprehensible.  Getting a good disclosure data structure could help to produce a good industry structure for the underlying service provision.

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Notes:

[1] In August, 2009, the SEC announced plans to replace the EDGAR system with the Interactive Data Electronic Applications (IDEA) system. That system apparently has not thus far been realized.

[2] See 2008 FDIC Study of Bank Overdraft Programs, Executive Summary, point 11, p. III.