Transcript: 364. Guido Giglioni on Renaissance Medicine

An interview with Guido Giglioni, who speaks to us about the sources and philosophical implications of medical works of the Renaissance.

Note: this transcription was produced by automatic voice recognition software. It has been corrected by hand, but may still contain errors. We are very grateful to Tim Wittenborg for his production of the automated transcripts and for the efforts of a team of volunteer listeners who corrected the texts.

Peter Adamson: I guess the first thing to ask is what the Renaissance philosophers were reading when they did medicine or what Renaissance doctors were reading. How does their reading material differ from what was available in the medieval period and how does Renaissance medicine in general differ from medieval medicine?

Guido Giglioni: It's a very important question, the one related to the sources of medical knowledge in the Renaissance. The most important sources of information were, of course, books and texts. The difference with the Middle Ages is that, first of all, Renaissance medical practitioners had access to many more books, many more sources. Of course, the great majority of medieval texts, translations from antiquity, were still read, but we need to consider a new wave of books that were translated, for instance, directly from Greek sources. Here is the important element created by the humanists, who were scholars interested in recovering the knowledge of antiquity with a much more sophisticated philological approach to reading and editing and translating texts. So whereas in the Middle Ages, the main activity of translation and reception of ancient medical sources happened through the mediation of the Arabic sources, who already, especially in the 9th century, had translated a great amount of medical texts from Greek antiquity - especially Galen, who was considered the most important medical author - in the Renaissance, scholars and medical scholars, because often physicians were trained as humanists in the university, they could have access to texts in Greek, original texts in Greek, through the mediation of Byzantine culture and through the arrival of Greek refugees and emigres coming from Constantinople after the fall of Constantinople.

Peter Adamson: So is the expansion of sources more to do with having better access to these really important authors like Hippocrates and Galen, or Avicenna, I guess would be another example from the Islamic world?

Guido Giglioni: Yes, it was a better, more precise, accurate reading of texts. But I would also say it was maybe a different approach from how the medieval doctors and learned scholars read texts of antiquity, I would say in a different way. Here we need to consider a particular aspect of medieval, let's say, knowledge and science: the so-called scholastic approach to knowledge - which was very logical, very systematic, and not necessarily very attentive to the cultural or historical element in the reception of knowledge. So the new element in the rediscovery of classical texts of antiquity was a more historical, cultural assessment of those texts. For instance, an important source of information for doctors were herbal remedies, botany, and many texts - for instance, Dioscorides, who wrote in the first century AD an important collection of materia medica, that is of remedies and drugs based on botany - was translated and read through many accretions developed by the Arabic reading, who introduced information about botany and herbal remedies that belonged to their culture. So there was an effort by humanist doctors to assess what was the original, what was culturally added when previous scholars were reading the same texts.

Peter Adamson: So that actually sounds a lot like the whole process of absorption and reflection on philosophical works in the Renaissance as well. There's a movement into humanist appropriation of philosophy away from the scholastic philosophy, although scholastic philosophy continues alongside it. And to some extent, of course, it's the same people who are doing it. So you have humanists who are interested in philosophy and medicine. And for me, that raises the question of what they thought was the relationship between philosophy and medicine. Did they even think that medicine was part of philosophy the way that they thought of physics, for example, as part of philosophy?

Guido Giglioni: It is a very complex question. In a way, the two disciplines, medicine and philosophy, were connected from the very beginning. Aristotle himself says at a certain point, in the Parva Naturalia book collection of small treatises about nature, that there is a very close relationship between the doctor, the physician, and the natural philosophers, because the doctor dealing with notions of health and disease inevitably has to have a proper training in the fundamental principles of physics and natural philosophy. And Galen - who can be considered as important as Aristotle for the transmission of learning from antiquity through the Middle Ages, up to the early modern period - Galen himself saw his work as the work of a philosopher. He wrote a treatise exactly dealing with this, saying that the best physician is also a philosopher.

Peter Adamson: I wonder whether that goes the other way around, though. You could say, 'well, a doctor needs to have philosophical training because he needs to know about the four elements, say, to understand heat and cold in the body.' But is the reverse also true? Does a good philosopher have to be a doctor?

Guido Giglioni: I would say yes. In this case, I would refer to Plato, who often referred to Hippocrates, this kind of almost mythical figure who represented a community of physicians between the late fifth and early fourth century before Christ. Plato looked at Hippocrates as a model of doing research, investigations - not just about nature, but about human nature and human nature in a cultural and social context. I would say that in the Timaeus especially, you can see how important it was for Plato to consider the medical aspects of political and philosophical organization when he talks about the diseases of the soul and the diseases of the body, and how they were very connected and how they were an important condition for a future of political prosperity.

Peter Adamson: Yeah, and of course, that's why Galen commented on the Timaeus as well.

Guido Giglioni: Exactly. And Galen himself, I think, especially in his work on the possible reconciliation between Hippocrates and Plato - which by the way is one of those works that is rediscovered in the Renaissance that was almost ignored before, not very considered. This text becomes very important. And the text where Galen talks about the relationship between the body and the soul and where he says openly that the best philosophical approach is a combination of Hippocrates and Plato.

Peter Adamson: So let me ask you a philosophical question about medicine, which I think is still really pressing for us today when we think about medicine, which is what the purpose of medical treatment is, or maybe a different way of putting it would be what health is. Because we might think that the goal of a doctor's treatment of the patient is just to make sure the patient doesn't die, or make sure the patient doesn't suffer from some kind of pain or suffering. But is it really right from the Renaissance doctor's point of view to say, for example, that the goal of medicine is to just prolong life? Or is it actually to somehow instill in the patient's body, and maybe even the body and soul, some kind of more complex idea of flourishing? I mean, are they really going for the idea of a flourishing human being or are they just trying to make you not sick?

Guido Giglioni: No, you're right. With a view of health, this was more complex that a purely medical understanding of health or even using a sort of contemporary word, "medicalizing" view. For many reasons, intellectual and cultural and social, health was much more than just having a long life, healthy life, but included also components coming from ethics about happy life - civic commitments. For instance, it was very common for an individual living during the 15th, 16th century to consider his life or her life as something involved in society or in activity. There was this emphasis on the so-called primacies of contemplative life over purely theoretical life, which was instead a value that was much more considered in the past, during the Middle Ages or even before in antiquity. So I would say that in many discussions about health, one of the recurrent points was whether it's better to have a long life or a meaningful, intense, happy life, but maybe shorter. This is particularly evident in such authors as I would say, for instance, Francis Bacon, who was also not just a philosopher, but very interested in medicine, who contributed actually to medical knowledge. But also a politician, a political person, or a doctor who was also a philosopher during his time, like Girolamo Cardano, who lived in the first part of the 16th century and was not just a professor of medicine in Padua or in Bologna later, or just a practicing physician but an author of philosophical treatises. And he often insisted that we shouldn't consider the length of life as the basic criterion to judge about the healthiness of one existence, but also involvement with the reality and other aspects of one's life.

Peter Adamson: One thing that Galen talks about a lot in his medical works is that the medical treatment you give someone also has to be tailored very carefully to the patient in question. And I wonder whether the Renaissance philosopher doctors, like Cardano, for example, who you just mentioned, whether they picked that up. And in particular, I think an interesting case here is what they say about women. You actually said just a minute ago that they think about the patient's "his or her" role in political life. Were you just being polite or do they actually talk about women?

Guido Giglioni: No, actually not. And going back to the point about the relationship between philosophy and medicine and whether there was a specific philosophy that was medical. And this is another case in which we would say 'actually, the physicians were different from the philosophers.' We need to look at this also not purely intellectual sense, but also in institutional sense. You have to imagine people that were trained as philosophers going for a particular profession in life that could be sometimes medicine, or people that were instead more focused on the medical training of their studies. And so much so that there was this division of the path of the physicians and the path of the philosopher. And of course, one of the authoritative sources of information for the philosophers was Aristotle, and on the other side for the physicians was Galen. It's very interesting to see from the early Middle Ages on until the 17th, even 18th century, how doctors had their particular view of the world shaped by this genuinely medical philosophy and how philosophers, less and less maybe involved with Aristotle, but they also had their particular worldview. 
About women, this is evident. It was very difficult to get rid, I think, for philosophers or doctors, a certain tacit misogynist view of women. Because of Aristotle's philosophy, the use of certain images, especially the relationship between form, which is male, and the matter, which is usually attributed to the women, and also in natural philosophy, was translated in such a way that the active principle was of a male origin. In the theory of conception, for instance, in the Aristotelian view, the active principle comes from the male seed. And so on. The form is actually emitted in the organism through the male. And the intellect in a way is, it's supposed to be the full blossoming of this form. In the medical camp, that was different, because Galen is very clear that both the male and the female seeds and principle of reproduction contribute in equal terms in the production of the new organism. And in some cases, in some developments of the medical tradition, you will even see the womb as a very important organ, as a very important principle of generation. Some extreme cases can be, for instance, Paracelsus, as very important medical author of the Renaissance, for whom actually the parts of the female body, principle of generations, are in a way more important than the male counterpart. From the point of view of therapy, I would say that doctors were open to the observation and the cure of female patients as much as male patients. We have famous important books of gynecology from antiquity. We have a specific field, which is actually the medicine for women, that became very important during the Renaissance, especially in the vernacular, when some of those treatises were either translated or written directly in vernacular.

Peter Adamson: When they did treat women or men for that matter, so when they treat their patients, what kinds of things are they looking at? Do they administer drugs a lot? Do they do surgery? What are the standard tools with which a Renaissance doctor would actually treat you? I guess that probably everyone has in their head an image of leeches now.

Guido Giglioni: Yes, or phlebotomy.

Peter Adamson: Yeah, phlebotomy, which is where they actually cut little cuts in your skin and bleed you out. Presumably, they offered more than that. Let's hope.

Guido Giglioni: Well, probably the best remedy, the best therapy was still based on a particular manipulation of diet and food. In a way, some of the drugs, which were mainly of herbal origin, until Paracelsus and the kind of chemical revolution that Paracelsus introduced in the field of medicine. Before Paracelsus, I would say the remedies were mostly of an herbal nature. So first of all, diet was the most efficient approach, I would say. And then there was other forms of keeping people healthy through a particular lifestyle, physical exercise, how to organize one's life according to the rhythm of sleep and waking. An important element was how to control one's emotion. This particular aspect, control of passions and not to be overwhelmed - especially by the most dangerous passions from the point of view of health: anger, fear, and sadness, was a very important part of early modern and Renaissance medicine with a very long tradition.

Peter Adamson: It sounds almost like the Renaissance doctor is a kind of life coach, which makes me wonder whether part of the service they're offering could even go so far as trying to make you more virtuous. Because we talked before about how they might be not just trying to prolong your life, but trying to make you more flourishing or even more capable of political engagement. And now you're saying, well, they're going to help your emotions be brought into check or made more appropriate. So would they go so far as to say something that Gallen actually sometimes implied: if you want to be a virtuous person, then come talk to me and I'll tell you what to eat. It'll actually make you a better person. Would they go that far?

Guido Giglioni: Yes. There is an aspect of the rediscovery of Gallenism in the Renaissance that is exactly related to this. There was far more very radical Gallenism in the Renaissance. I'll mention just one treatise by a Spanish doctor, Huarte de San Juan, who wrote his book in which he wanted to show that mental dispositions, professions, abilities depended on the temperament - that is the constitutions, the physical constitutions of one's body. And of course, he referred to Galen. Galen, we should remember, also wrote three or four treatises in which he wanted to show that, following his ideas on medicine, you could become happier and to become more virtuous. So going back to the point about Renaissance doctors who were, let's say, meddling also with psychotherapy - to use modern terms - that was almost natural, given, again, the specific tradition of medicine, but also the complexity of the new cultural panorama in the Renaissance. There were authors who were doctors, but also now they could read not just Aristotle, but Plato, who had been translated and commented upon by, for instance, Marsilio Ficino, who actually would suggest that the most important component in one's health was related to the mind. And so much so that I would say it wasn't just the use of the old proverb "mens sana in corpore sano," which means a sound mind in a sound body, but for someone like Ficino, it was the opposite, really, that the most important thing was the sound mind.

Peter Adamson: But on the other hand, some of what you were saying about the doctors, and again - this is true of Galen himself - presupposes a very close relationship between what's going on in the soul and what's going on in the body. The idea apparently being, 'well, if you eat the right things, then your ethical dispositions will change.' But we assume usually that the ethical dispositions are in the soul, in the body. So can we actually extract from this medical literature some kind of position on what we might think of as a question in philosophy of mind, so how the soul relates to the body? Or are they resolutely unwilling to get into this area because it's too philosophical, so to speak?

Guido Giglioni: No, I think it was probably more common to do that kind of exercise at the time than now. For us now, it seems that it's kind of difficult to have a psychosomatic approach to our health. Of course, there are many attempts, there are books, but we feel that relationship between the body and the mind is difficult, complicated - something that needs to be argued over and over again. I think there was in the past, let's say before Descartes probably, let's say until the 16th century - there was an assumption that the body and the mind, however different, however belonging to maybe different realms of reality, the completely intellectual and the natural one - there was the idea that there was a certain porosity between the two worlds and the shift from one to the other was much easier. So for instance, going back to a fervent Platonist like Marsilio Ficino in 15th century Florence, he wrote three books actually on how to live properly in order to be actually a good scholar and maybe to be open to receive celestial influences from heaven. But the book is mainly about what to eat, what kind of drugs, if you're sick, what kind of wine, because those elements were supposed to be connected to the, let's say, the life of the whole universe and there couldn't be any disharmony between the body and the mind, and the mind needed a healthy body in order to perform properly.

Peter Adamson: That's really interesting because I think people have this idea in their heads - and actually even I have this idea in my head - that Platonism is really a philosophy where you have this radical contrast between immaterial souls and material bodies, and then we tend to think of Aristotelianism as a philosophy that brings the soul much closer to the body. It's the form of the body. Maybe it's nothing other than the dispositions or the capacities of the body. But what you just said makes it sound like the Platonists of the Renaissance also have this very holistic picture in which the immaterial soul - because they still think it's immaterial of course, but it's going to be integrated into this kind of organic unity, which is the physical cosmos as a whole.

Guido Giglioni: Yes, I agree. The mind and the soul, they find themselves for more or less circumstantial reasons trapped within a body, and the best thing to do is to try to make the body a place where the mind can still perform as clearly as possible. Of course, at the end we know that there will be death, and the mind will be freed from the constraints of the body. But Platonists in the Renaissance and maybe even later - I think in the 17th century, there are still Platonists also in England, Cambridge Platonists - the important thing is to reach a point where the death is good, where you actually move to the other level of awareness and understanding. That is, when you die in a proper way.

Peter Adamson: It strikes me that a lot of what you said makes it sound like the Renaissance doctors were already doing a lot of what people wish doctors would do more today: paying attention to the whole patient and the patient's life, taking women seriously, just as seriously as men, thinking about the patient's emotional state as part of their medical condition and everything. That's really interesting. 


Add new comment

The content of this field is kept private and will not be shown publicly.