GALENIC MEDICINE

Galenic medicine (also called humoralism or Galenism) derives its name from the Greek physician and philosopher Galen (129–c.216c.e..). Galen's prolific writings were rooted in the Hippocratic corpus as well as the philosophical doctrines of Plato, Aristotle, and the Stoics. Medicine was identified with Galenism for 1,300 years, and was institutionalized in the European universities of the eleventh century after Arabic translations of Galen's writings were retranslated into Latin. Though Galenism was eclipsed in Europe by the rise of modern medicine, it still survives as Unani (Greek) medicine in some parts of India and Pakistan.

The foundation of modern medicine rests on the divorce of medicine from philosophy, two disciplines wedded in Galenism. Both philosophy and medicine were practical arts that sought to answer the Socratic question: How should a person live the good life? (Hadot 2002). The good life demanded a striving toward excellence (arête), in the gymnasium no less than in the symposium. In medicine, health was the excellence expressed by the proper blending of the humors (krasis). In philosophy, virtue required knowing what was moderate or intermediate between excess and deficiency. As such, bodily health was analogous to moral virtue and the physician like the philosopher was a guide to living according to the mean (mesotes)(Tracy 1969).

The Galenic physician could only assist nature (physis) to restore the proper balance in the patient because it was inherently good. Nature thus constituted both the source and the limit of the physician's art. In order to gain insight into the workings of nature, the Galenic physician incorporated the three parts of philosophy (natural philosophy, logic, and ethics) into diagnosis, prognosis, and therapy. How deeply the physician was steeped in the study of philosophy also distinguished true medicine from quackery (Galen 1997).

The study of natural philosophy allowed the physician insight into both human nature and the nature of the universe. The Galenic body was fluid because it was composed of humors—blood, black bile, yellow bile, and phlegm—which were formed by the same elements that constituted the cosmos (fire, water, air, and earth). Disease resulted from the imbalance (dyskrasia) of the humors or the predominance of one or another quality (hot, cold, wet and dry) Humors and their qualities linked humankind to the macrocosm and established a correspondence or proportion between them.

Logic was necessary to make sound judgments about conditions of illness and health. The good physician was urged to train and sharpen the senses, which included not only the five external senses but also the common sense (koine aesthesis) through which the givens of the senses were synthesized and delivered to the intellect (Nutton 1993). Hence both reason and sense experience were essential for the discovery and confirmation of the true nature of things. Logic also led to the search for causes within a teleological cosmology that demanded the inference of the invisible from the visible; the hidden causes from the manifest signs.

Ethics was the domain of human action and conduct. In Galenism, the patient, the physician, and their mutual relation were subjected to an elaborate askesis aimed at cultivating certain dispositions and habits (hexis) to restore the balance of body and soul (Edelstein 1967). Galenic therapeutics throughout the Middle Ages placed a strong emphasis on dieta, the art and craft of moral and somatic virtues. Health required the good ordering of the naturals (elements, humors, parts of the body, and faculties) and the regulation of the non-naturals (rest, motion, food and drink, evacuation, passions, and errors of the soul). The virtuous character of the physician hastened the healing powers of nature by forging a relationship of trust and friendship (Entralgo 1967).

The union of philosophy and medicine in Galenism was founded on the norms of a teleological nature. The medical art was practiced within the bounds of the natural order that tended toward health and virtue as the right proportion of the humors and the passions. The replacement of Galenism with scientific medicine occurred in the seventeenth century when nature lost its telos and was construed as an inert mechanism to be manipulated at will. In Galenism, the foundation in teleological nature made the medical art inherently ethical. By contrast, medical ethics in the twenty-first century is the mere application of established rules to a professional field.

SAMAR FARAGE

SEE ALSO Acupuncture;Complementary and Alternative Medicine;Health and Disease.

BIBLIOGRAPHY

Edelstein, Ludwig. (1967). "The Ethics of the Greek Physician." In Ancient Medicine: Collected Papers of Ludwig Edelstein, ed. Lilian Temkin and Oswei Temkin. Baltimore, MD: Johns Hopkins University Press.

Entralgo, Lain P. (1967). Doctor and Patient. New York: McGraw Hill. Explores the ethics of the doctor-patient relationship from ancient Greece to the present.

Galen. (1997). "The Best Doctor is Also a Philosopher." In Galen: Selected Works, trans. Peter N. Singer. New York: Oxford University Press. Galen's text that discusses the nature of the relation between philosophy and medicine.

Hadot, Pierre. (2002). What is Ancient Philosophy?, trans. Michael Chase. Cambridge, MA: Harvard University Press. Excellent investigation of ancient philosophy as a way of life and the changes brought about by Christianity and the Middle Ages.

Nutton, Vivian. (1993). "Galen at the Bedside: Methods of a Medical Detective." In Medicine and the Five Senses, ed. Roy Porter and William F. Bynum. New York: Cambridge University Press. Nutton shows the intimate relation between experience and reason in Galenic medicine.

Tracy, Theodore. (1969). Physiological Theory and the Doctrine of the Mean in Plato and Aristotle. Chicago: Loyola University Press. Exploration of the Greek founding of moral virtues and physical excellences in the notion of the mean.