transforming medicine into a non-hereditary profession

In his thirteenth-century History of Physicians, Ibn Abi Usaibia describes Hippocrates as transforming medicine into a non-hereditary profession.  According to Ibn Abi Usaibia’s history, Asclepius, the first physician, taught medical knowledge orally only to members of his family. That professional structure was not sufficient to preserve medical knowledge.  Hippocrates thus changed the transmission of medical knowledge:

Hippocrates, on seeing that medicine was on the verge of extinction, that its mark was being erased from the descendants of Asclepius (among whom he himself was included), sought to revive it by disclosing it to and propagating it among strangers and also by setting it down in books in order to establish it and make it widely known. [1]

The Hippocratic Oath supported a non-hereditary medical profession. A person who recited the Hippocratic Oath declared:

I swear by Apollo Physician and Asclepius and Health {Hygieia} and Panacea and all the gods and goddesses, making them witnesses, that I will make complete this oath and this written covenant according to my ability and discernment .. {I swear to} make an imparting of the set of rules and lecture and all the rest of instruction to my sons and those of my teacher, and to those pupils who have been indentured and who have taken an oath according to the medical law, but to no one else. … [2]

Most of the Hippocratic Oath addresses proper practice of medicine.  Yet the oath itself, and a minor proviso within it, opened the medical profession to persons other than physicians’ sons. In ancient regulations, as well as in modern ones, important changes are often buried in the details.

Ibn Abi Usaibia recognized the relationship between the Hippocratic Oath and the opening of the medical profession.  He listed under Hippocrates’ books:

“The Covenant,” also known as “The Book of Oaths.”  Hippocrates wrote this for his pupils and also for those they would treat, in order that they might be guided by it and not offend against the stipulation he therein imposed on them and in order to dispel by his statements the odium he incurred for transferring this art from hereditary transmission to free dissemination. [3]

Incumbents typically don’t favor entry into their field.  The Hippocratic Oath provided alternative regulation of entry in a way that was both open to more persons and that promoted proper professional practice.

The Hippocratic Oath probably didn’t govern access to medical books.  Writing is not necessarily associated with an open-access regime for knowledge.  Means other than the Hippocratic oath could have restricted access to medical books.  However, according to Ibn Abi Usaibia, Hippocrates wrote medical books to make medical knowledge widely known. As a cosmopolitan physician, scholar, and writer in the thirteenth-century Islamic world, Ibn Abi Usaibia apparently regarded the preservation and dissemination of medical knowledge as an activity that did not just concern medical practitioners.  Throughout his History of Physicians, Ibn Abi Usaibia celebrates the development and dissemination of knowledge.  He understood that activity as an open, heroic human profession in which everyone should have an interest.

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Notes:

[1]  HP p. 27.  Roger Pearse discovered this translation in the U.S. National Library of Medicine.  He is doing painstaking work to create a digital version. Ibn Abi Usaibia’s work shows a vibrant intellectual culture spanning Europe, North Africa, and southwest Asia and encompassing knowledge from ancient Egypt, classical Greece, Rome, Judaism, Christianity, and Islam.  The U.S. government commissioned Kopf’s translation, which subsequently and sadly attracted no attention.  Advancing study and public discussion of Ibn Abi Usaibia’s work surely is an important contribution to the public interest.

[2] From Howard Herrell’s “literal translation” of the Hippocratic Oath from an early Greek manuscript.  Ibn Abi Usaibia preserves a version of the Hippocratic Oath edited to lessen its association with polytheism.  Ibn Abi Usaibia’s version of the Hippocratic Oath begins:

I swear by God, the master of life and death, the giver of health and the creator of healing and every cure, and I swear by Asclepius and by all those close to God, both men and women, making them all my witnesses, that I will keep this oath and pledge…

HP p. 49.  The Testament of Hippocrates, which Ibn Abi Usaibia includes, HP p. 51-2, restricts students of medicine to persons of “free birth, good nature, young age, medium stature, and well-proportioned limbs,” as well as describing other character requirements.  The Testament of Hippocrates probably dates to no earlier than the first century.  It does exist in ancient Greek and Latin manuscripts.  See Temkin (1991) p. 142, ft. 84.

[3] HP p. 65.

References:

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.

Temkin, Owsei. 1991. Hippocrates in a world of pagans and Christians. Baltimore: Johns Hopkins University Press.

wartime mobile communication

In World War I, a truck carrying this Model 5 linotype followed U.S. General John Pershing through battlefield action in France.  It printed maps, charts, reports, and orders.  It was part of the 29’th Engineers mobile printing battalion.  The battalion consisted of nine printers and one pressman.  I’d guess that a general’s communications technical staff is much larger today.

Henry Mayhew described human mating market failure

Writing in London about 1856, Henry Mayhew observed:

The majority of the habitual female criminals are connected with some low brute of a man who is either a prize-fighter, or cab-driver, or private soldier, or pickpocket, or coiner, or costermonger, or, indeed, some such character. And for this lazy and ruffian fellow, there is no indignity nor cruelty they will not suffer, no atrocity that they are not ready to commit, and no infamy that they will hesitate to perform, in order that he may continue to live half-luxuriously with them in their shame. A virtuous woman’s love is never of the same intensely passionate and self-denying character as marks the affection of her most abject sister.  …

We once troubled our head with endeavouring to discover what qualities in man partake of the admirable in the eyes of such women as these. Do they love the half brutes with whom they cohabit, and from whose hands they bear blow after blow without a murmur, giving indeed only kisses in return; and for whose gross comforts they are daily ready to pollute both their body and soul?—do they love these fellows, we asked ourselves, for any personal beauty they fancy them to possess; or what strange quality is it that makes them prize them beyond any other being in the world?

We soon, however, discovered that they care little about the looks of their paramours, for not only are the majority of such men coarse and satyr-like in feature, but these women, generally speaking, have even a latent contempt for the class of public performers who are wont to trick their persons out to the best possible advantage. Again, it is not honour, nor dignity of character, nor chivalry of nature, nor energy of disposition, nor generosity of temperament that they think the highest attributes of man; for the fellows with whom they cohabit are mean and base to the last degree, selfish as swine, idle as lazzaroni, and ruffianly even as savages in their treatment of females.

In a word, it is power and courage that make up the admirable with woman in her shame; and hence the great proportion of what are termed “fancy men” {prostitutes’ lovers} are either, as we have said, prize-fighters, or private soldiers, or cab-drivers, or thieves, or coiners, or indeed fellows who are distinguished either for their strength, or “pluck,” or their adventurous form of life.[*]

Mayhew, a son of a wealthy London solicitor, was a writer. He was one of the founders in 1841 of the popular magazine Punch.  Mayhew’s friend Douglas Jerrold was a successful, well-connected London author and a contributor to Punch.  In 1844, Mayhew, then 31 years old, married Douglas Jerrold’s 19-year-old daughter, Jane. They were a match made within the norms of the elite Victorian mating market.

Shortly after Henry Mayhew and Jane Jerrold married, Henry suffered acute financial troubles and had to declare bankruptcy.  Upset with Henry’s apparent financial mismanagement, his father disinherited him. Henry and Jane had their first child, a girl, about this time.  They subsequently had another child, a son named Athol.  Henry Mayhew never regained financial security.  Henry and Jane’s marriage failed and they separated sometime after 1850.

Mayhew’s description of female criminals’ lovers seems to be painted with envy.  Mayhew did pioneering social research.  He wrote important articles on London’s poor and outcasts.  Mayhew’s work displayed intellectual power and personal courage far beyond that of most upper-middle-class English gentlemen of his time.  Yet Mayhew apparently perceived himself to be lacking the mating-market attractiveness of other, much less publicly valued men.

The mating market is fundamental to human evolution and human civilization. The human mating market has worked well enough thus far to generate relatively high human population, material wealth, and personal freedom.  Yet sufficiently bad incentives in the human mating market surely could destroy civilization.

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[*] Mayhew, Henry (1856), The Great World of London (London: David Bogue) pp. 466-7.

early history of the codex

The shift from scroll to codex in the Roman Empire seems to have been more a matter of perceptions of fashion and authority than of economic and technological advantages.  About 85 GC, the Latin poet Martial boasted that his epigrams were available in a convenient parchment codex:

You who long for my little books to be with you everywhere and want to have companions for a long journey, buy these ones which parchment confines within small pages: give your scroll-cases to the great authors – one hand can hold me.[1]

Despite the advantages Martial described, codices amount to less than 20% of surviving literary and scientific books from his and the next two centuries.[2]  The great authors existed on scrolls.  The prestige they gave to scrolls seems to have outweighed the advantages of codices for centuries after codices were produced and promoted.[3]

An authoritative forerunner of the codex was Roman legal documents written on wooden tabulae.  Codex is a Latin term that meant “block of wood.”  Roman legal documents written on wooden tabulae made written contracts and themselves served as artifacts of those contracts.  These codices were “prestigious documents, carefully preserved by their rightful possessors and familiar by sight to others any place that Roman citizens or those granted Roman legal privileges lived.”[4] Unlike Homer’s epics, Roman legal documents did not offer a memorable story along with moral instruction.  Roman legal documents depended on Roman administrative machinery and ultimately, the rule of the Roman emperor.  They had legal authority, but not literary prestige.

Early Christians early and uniformly used the codex for high-value copies of scripture.  Christian New or Old Testament scripture from the early centuries of Christianity does not exist in a new (non-recycled / recto side) roll form.  Yet in the first three centuries after the birth of Jesus, pieces from more than fifty Christian New or Old Testament codices have survived in Egypt, including fragments of an estimated 130-page codex of the Gospel of John probably from early in the second century.[5]  Christians didn’t invent the codex.  Christians, however, apparently used exclusively the codex for recording their scripture.

Roman codices, meaning legal documents written on wooden tabulae, plausibly were the prototypes for Christian  papyrus codices.  The Jewish Revolt against Rome, 115-117 GC, resulted in carnage in Alexandria, a leading center of closely intertwined Jewish and Christian life.  Perhaps political fallout from the Jewish Revolt prompted Christians to differentiate themselves from Jews and signal affiliation with Rome through the use of the codex for Christian scripture.[6]  But another possibility is more in keeping with the upside-down Christian vision.  Christians rejected the elite status competition centered on Greek literature.  With codices, Christians set themselves apart from that type of literature and life.  Moreover, while Christians did not seek the violent overthrow of the Roman Empire, they envisioned a higher kingdom and a greater savior than the Roman emperor:

the name that is above every name, so that at the name of Jesus every knee should bend, in heaven and on earth and under the earth, and every tongue should confess that Jesus Christ is Lord, to the glory of God the Father.[7]

Christians putting such scripture into a papyrus codex may have been a silent, but successful, revolt against Roman authority.

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Notes:

[1] From Nick’s translation of Martial’s epigram, I.2.  A codex book consists of uniformly shaped rectangular writing material bound in an order along one edge.  Writing is typically present on both sides of the writing material, usually the writing is parallel to the shorter dimension of the (rectangular) material, and typically the codex book has a cover.

[2] Kraft (2008), p. 37.  The share of codices are for Greek literature.  The number of surviving Latin books (text artifacts) from the first three centuries is relatively small.

[3] As a text storage technology, the codex has important advantages over the scroll.  Because the rolling of a scroll is not easily reversed, a scroll typically has writing on only one side of the writing material.  Hence for the same text, a book requires only roughly half as much writing material as does a scroll.  In addition, the scroll is a sequential access technology.  Just as for a magnetic tape, you have to scroll through to access a point in the middle.  The codex, in contrasts is a random-access technology like a disk drive.  You can access the text from any book page by seeking to open the book at that page. The main technological disadvantage of the codex relative to the scroll is that the codex requires slightly more skill to produce (the skills to cut uniform writing material and to make a binding and a cover).

[4] Meyer (2008) p. 311.  For her path-breaking work on Roman legal documents, see Meyer (2004).

[5] Bagnall (2009) pp. 72-79.  The Gospel of John instance is P52 = P.Ryl.3.457.

[6] Meyer (2008) pp. 325-8.

[7] Philippians 2:9-11 (RSV translation).  This text is replete with imperial terms enlarged in application to Jesus.  Matthew 22:15-21, with reference to a Roman coin, undermines the divine pretensions of the Roman emperor.

References:

Bagnall, Roger S. 2009. Early Christian books in Egypt. Princeton, N.J.: Princeton University Press.

Kraft, Robert A. 2008.  The Gestation of the Codex, stage one adaptation of Colin H. Roberts and T. C. Skeat, The Birth of the Codex London: Oxford University Press, 1983.

Meyer, Elizabeth A. 2004. Legitimacy and law in the Roman world: tabulae in Roman belief and practice. Cambridge, UK: Cambridge University Press.

Meyer, Elizabeth A. 2007. “Roman Tabulae, Egyptian Christians, and the Adoption of the Codex”. Chiron. 37: 295-347.