Early concepts of nutrition, digestion, diseases of the gastrointestinal tract and their treatment: from Hippocrates and Galen to Maimonides

For over a thousand years, Hippocrates and Galen have been the Alpha and Omega of medical knowledge. Despite the importance of their contributions to clinical and theoretical medicine, they lacked a true understanding of anatomy and physiology. Hippocrates is commonly associated with proposing the doctrine of «tissue fluids», or humoral pathology, and his book, «On the Nature of Man», promotes this point of view. Galen became inherited the knowledge of Hippocrates. Ultimately, he was recognized as one of the most influential physicians of all time. The number of his works was enormous: he wrote more than a hundred books, which were widely distributed. One of Galen’s main commandments was the rule of harmony: all body systems are balanced; disease is a result of an imbalance. As one might expect, some of his ideas, however, were erroneous. Aristotle considered the pancreas, due to its location in the abdominal cavity, as an organ which only task was to protect the adjacent vessels. In an era when unknown diseases wreaked havoc, the concept of known causes of diseases led to the fascination with the study of food poisons and their antidotes. This was common among aristocracy who felt particularly vulnerable to this kind of threats. According to legend, one of the most famous connoisseurs of poisons was Mithridates VI. Pedanius Dioscorides was a Greek who served in the Roman army during the reign of the emperor Nero. The wandering nature of life led him to study a large number of diseases and medicines. The catalogue of his medicinal herbs and plants became the basis for the study and understanding of the medicinal properties of plants. Liver was considered the source of divine prophecy in many ancient cultures. The anatomy of liver was well known in ancient Babylon: a huge number of clay tablets and objects were left, which testify to the importance of «hepatoscopy» in the Middle East as a form of prediction. Those who used the insides of animals for divination (e.g., haruspices — divine interpreters of the future, using the liver as a prediction tool), could be considered the first official anatomists, since the understanding of the future depended on accurate knowledge and interpretation of certain liver components. After the victory of the Assyrian king Sargon over the forces of Urartu and Zikirti in 718 BC, Sargon wanted to appease the gods by sacrificing animals; in doing so, he studied their livers for predictions. Although the concept of pancreas is rooted in ancient times, as evidenced by the comments of haruspices and priests, knowledge of the organ functions eluded humanity until the works by Danish physiologists Francis Sylvius and Regnier de Graaf. Prior to their studies of pancreatic secretion and the elucidation of the role of pancreas in digestion, described by van Helmont and Albrecht von Haller, most researchers focused on the anatomical description of the organ. If the ancient Assyrians and Mesopotamians did not believe that liver predicts the future, but believed that it was pancreas that did it, then pancreatology may have earlier origins. Maimonides, a Jewish scholar and humanist, was also influential in other fields: he condemned astrology and its attempts to calculate the time of the Messiah’s coming. In the field of medicine, he paid attention to prevention, and was interested in the treatment of diseases of the gastrointestinal tract. By the beginning of our era, ideas about digestion, diseases of the digestive tract and their treatment remained very vague. There was a long and difficult way ahead in this area.

LOUIS DE CASENEUVE’S ΔΩΔΕΚΆΚΡΟΥΝΟΣ HIEROGLYPHICORUM ET MEDICORUM EMBLEMATUM: EMBLEMS AS A LANGUAGE OF THE 17TH CENTURY MEDICINE

Статья посвящена почти неизвестному в исследовательской литературе барочному эмблематическому трактату «Δωδεκάκρουνος. Двенадцатиструйный источник иероглифических и медицинских эмблем» (1626) французского медика Луи де Казнёва (?–1645), принадлежащему к дискурсивной формации гуманистической медицины – области ученой культуры раннего Нового времени, возникшей в первой половине XVI столетия и продолжавшей существовать, постепенно маргинализируясь, по крайней мере до начала эпохи Просвещения. Трактат де Казнёва охватывает все значимые разделы и сюжеты современной автору медицины: первая из эмблем выступает символическим изображением самого трактата, следующие четыре представляют темпераменты, три посвящены разного рода патологиям (одна – гуморальной патологии, еще одна представляет собой своего рода «патологическую энциклопедию», третья – умственным расстройствам и дурным страстям), одна – терапии и еще одна – прославлению врача и врачебного искусства. «Двенадцатиструйный источник», как кажется, является единственным в своем роде идеографическим словарем медицины начала XVII столетия – других сочинений, которые были бы сходны с ним по жанру, нам обнаружить не удалось. Мы анализируем это сочинение на фоне масштабных трансформаций в ученой культуре XVI–XVII веков: расцвета и упадка «эмблематического мышления», появления новаторских форм экфрасиса и менипповой сатиры, рождения медицины, основанной на практиках наблюдения. Сочинение де Казнёва рассматривается как специфический гибрид нескольких жанров ученой литературы раннего Нового времени: эмблематического трактата, экфрасиса, медицинского учебника, ученой мениппеи. Демонстрируется, как де Казнёв, создавая в своем трактате резервуар визуальных топосов гуманистической медицины, использует для этого синтез разных форм воплощения и трансформации смысла (в раннее Новое время существовал специальный термин для обозначения модификации смысла невербальными средствами: restrictio). Это были такие формы, как создание виртуальных анаморфических ландшафтов, вольная комбинация почерпнутых у античных авторов мифологических архетипов, использование métaphores mutuelles. Предметом специального внимания стало проблематическое сопряжение в трактате разных эпистемологических программ: перипатетизма, вульгаризованного платонизма и герметизма. Кроме того, виртуальные ландшафты, которые открываются перед читателем в эмблемах и эпиграммах де Казнёва, рассматриваются в контексте ранненововременного феномена «философских садов» – «садов знания», как раз в начале XVII века стремительно эволюционирующих от барочной эстетики удивления, meraviglia, к этосу наблюдения, классификации и эксперимента. В приложении к статье приводится поэтический перевод эпиграмм ко всем тринадцати эмблемам трактата. The article deals with one of the most magnificent samples of the early 17th century emblematic literature – Δωδεκάκρουνος Hieroglyphicorum et Medicorum Emblematum (1626) by the French physician Louis de Caseneuve (Lat. Ludovicus Casanova). This text may be considered as the only extant full-scale emblematic treatise in the field of medicine; therefore, its study enables its reader to take a closer look at the early modern medical imaginotheca. The composition of this text aims at encompassing all the traditional branches of medical knowledge: the first emblem symbolically represents the Δωδεκάκρουνος itself; in the following four, the author represents the temperaments, combining their traditional iconographic attributes very freely; other three are dedicated to different pathologies (humoral pathology caused by the excess of black bile, melancholicus aeger; then follows a kind of a “pathological encyclopedia”, a list of the diseases of all the organs of the body; the third one deals with the mental illnesses and evil passions); the penultimate one to the therapy, and the last one to the glorification of physicians and medical science. Δωδεκάκρουνος may be viewed as belonging to the discursive formation of medical humanism – one of the extinct dialects of the early modern learned culture that emerged in the first half of the 16th century in the texts of such authors as Niccolo Leoniceno, Fortunato Liceti, Jean Frenel, and Jakob Schegk. About a century after de Caseneuve’s treatise was published, medical humanism definitely came to an end together with emblematic, humanist dialectics, sacred physics, Ciceronianism, iatrochemistry, Jesuit “middle knowledge”, moral logic, et al. A special focus has been made on the mixture of genres of the learned culture carried out in the treatise: Δωδεκάκρουνος is simultaneously an emblematic treatise, an ekphrasis, a medical manual, and, last but not least, a specific learned “Menippean satire”. The polyvalence of the text, visible in this fusion of genres, is corroborated by a broad use of illusionistic verbal and visual effect – anamorhosis. The anamorphic effect, a conscious ambivalence of signification, may be found not only in the emblems and epigrams, but in the “serious” scientific parts of the text as well. This ambivalence manifests itself in a certain epistemological tension which may be detected throughout the text: the “episteme of similarity”, heavily present all over the treatise, especially in its “humoral” section, coexists with the resolute Aristotelian philosophical credo and the gesture of recognition towards the Hermetic medicine.

Humoral Pathology

This chapter talks about the role humoral pathology played in Jewish medicine. Humans were created from four elements: earth, wind, fire, and water. And the fact that someone, God forbid, falls ill is due to an imbalance of these elements. One becomes dominant over another and there is no peace between them. In both Jewish medicine and rabbinic literature, views on the elements, the humours, and the temperaments were concordant with the dominant conceptions across Europe and in the Middle East. Humoral theory in Jewish folk beliefs was a significant element of most popular publications cited in traditional health and medical manuals. However, with the rise of biomedicine, memory of the origins of many views and practices derived from humoral pathology faded. Nonetheless, like the temperaments, they remained a presence in colloquial phraseology. As humoral pathology filtered down into folk culture it began to interact with magic and religion, even offering grounds for speculation on the extrasensory world, angels, and so on.

Pi'uranga: Study of Cia-Cia's Nifas Period Treatment in the Bahari Village of Sampolawa District of South Buton Regency

This research aims to find out the types of diseases that arise when the mother nifas does not do pi'uranga and how to perform pi'uranga on the Cia-cia in the Bahari Village. The theory used to read the data is Hippocrates' Humoral Pathology theory of healthiness or pain occurring depending on the balance of "humour" (fluid) in the body. The study used ethnographic methods, data obtained through engaged observations, and in-depth interviews. The results showed that: (1) A disease that arises when the mother nifas does not do pi'urangawas known by the term puanaka, which consists of an old puanaka and a young puanaka. Symptoms of old puanaka include chills, difficulty standing, abdominal pain, and headaches, while young puanaka is characterized by loss of consciousness, cysts, and serious illnesses. (2) The way the implementation of pi'uranga in the Cia-cia in Bahari Village was done traditionally, through several stages; beginning with the mother nifas sorted by the shaman, the first bath after childbirth, the use of octopuses, the use of fireplaces, the use of folk remedies, to the sauna.

„The storm is up and all is on the hazard“ Shakespeares Tragödien und das Wetter

The article is dedicated to the role of weather in Shakespeare’s tragedies. It traces a dense network of instances of weather – stage weather, narrated weather events, weather imagery – throughout his plays, and attempts to reconstruct the weather’s structural implications for the genre of tragedy. The way early modern humoral pathology understood the weather’s influence on the humours of the human body – for which Shakespeare’s plays themselves give evidence – provides the background for reconstructing the function of the weather as a source of tragic force. Its turbulence not only infects the characters in the play and thereby drives the plot, but also transgresses the boundaries of the fictional world and affects spectators in the auditorium.

Eine Antwort auf die «Krise der Medizin»? Die Moderne Konstitutionslehre im Krisendiskurs 1925 bis 1933

Discussing the alleged «crisis of medicine» (ca. 1925–33) German physicians addressed the underlying mindset of medical theory and practice. Identifi ed as «scientifi c crisis», they called the scientifi c epistemology of medicine into question. Since 1911 modern constitutional medicine had offered concepts potentially useful to overcome this «crisis». Besides similar topics the two discussions shared prominent voices, presenting their ideas for better medicine in both discourses. However, this paper shows the minor role constitutional medicine actually played in the «crisis» discussion. It was rarely put forward as a solution to the supposed «crisis» and is conspicuously often discovered in discussions of historical background. Far more often, concepts designed to overcome constitutional medicine are invoked as a potential crisis solution, fi rst and foremost the so-called «constitutional therapy» fathered by Vienna gynaecologist Bernhard Aschner which evokes pre-modern humoral pathology.

Before Psychiatry

This chapter explores the three major conceptions of mental illness—supernatural, biological, and psychological—that developed among the ancient Greeks and that formed the major templates for madness that have continually resurfaced in Western thought through the present. During the long period between the fall of the Roman Empire and the European Renaissance and Reformation, physicians became subordinate to theologians and medical thought itself languished. Nevertheless, the Hippocratic psychiatric corpus remained virtually undisturbed. The chapter then considers views of madness that developed in the 16th century in the works of Robert Burton, Richard Napier, and William Shakespeare. Finally, it turns to how mental illness became increasingly likely to be viewed within medical, as opposed to spiritual or moral, frameworks over the course of the 17th and 18th centuries. Within medicine, the influence of humoral pathology, which had dominated medical thinking since ancient times, gradually waned as mechanistic notions grounded in nerves, fibers, and organs arose.