Historical Perspectives
Galenism and Early Christianity
Dmitry Balalykin, MD, PhD, I.M. Sechenov First Moscow State Medical University
The triumph of Galen’s theoretical and applied system was an important event in the history of science. It was the foundation for the developments in medicine during the III - XVI centuries. We not an interesting fact - the views of the pagan physician and philosopher became dominant within the framework of Christian civilization.
In our view, this may be explained by a commonality between the natural philosophical views of Galen and the Fathers of the early Church. Historians of the early Christian Church primarily focus on purely theological questions, or the position of Christians in the Roman Empire at that time. By the III century, Christians had begun to reconcile their relation with the main natural philosophical trends of the Hellenic tradition.
In “Preparatio Evangelica” written by Eusebius Kessarisky, we discovered and translated into Russian several fragments written by the Bishop of Alexandria, St. Dionysius the Great, in the treatise "De natura". It follows from there that the main opponents of Galen and of Christians in the area of natural philosophy were atomists and their perception of the human body as a set of randomly moving atoms. In the text of St. Dionysius we find criticism of atomism, very close to the text of Galen’s work "De usu partium". The Christian Bishop and Galen contra-pose atomism with teleological views about the human body, being the creation of God (the Demiurges). In this case, the anatomical and physiological processes are determined by the laws of the efficient operation rooted in by the Creator. Perfect evidential knowledge of these processes determined by the empirical knowledge is available for a man. The manner of thinking and direction of Galen’s thoughts were undoubtedly attractive to Christian authors. Moreover, in his treatise "De natura", we found a direct criticism from St. Dionysius concerning the main opponents of Galen – “methodologists”, physicians defending the position of atomism.
Another important issue concerns Galen’s agnosticism, which has existed in the historiography for some time. We have translated and analyzed his work "The dependence of the properties of the soul on the temperaments of the body" and found that Galen considers the reasonable, highest part of the soul to be a special "incorporeal" substance; at the moment of death, it is thought to separate from the body. He does not speak directly about the immortality of the soul - as far as we know, Galen never directly supported this assertion of Plato. However, we find it impossible to unequivocally claim that he did not think so. Galen intentionally states that he cannot examine this point using the methods available to him. Herewith, Galen’s description of the rational part of the soul completely corresponds to the Christian point of view. This fact completely eliminates the thesis of "Galen’s agnosticism".
“A Division of Labor but a Unity of Spirit”: Spiritual Dimensions of Illness and Healing in the Context of the (De)medicalization of Childbirth from the Ancient Greco-Roman World to Today
Katherine van Schaik, MD-PhD(c), Harvard University
“A division of labor but a unity of spirit”: Rabbi Heschel’s quote, which begins the description of the conference theme, describes the ways in which the separation of religion from medicine, and vice versa, demonstrates a gross misunderstanding of the act of healing. Many aspects of this separation concern the sick and those who care for them: this paper will discuss the implications of such an idea for those who are not, in fact, sick, but whose conditions have become progressively medicalized over the last two millennia: pregnant women and their newborn infants.
A natural process that affects the entire world’s population (we are all born, and nearly half of us will give birth) has become a reason for hospital admission, with the patients’ typical chief complaints being labor and birth. While sound justification exists for hospital admission in some cases (it has certainly saved the lives of many), it must be recognized that there is, indeed, a “division of labor” as a process imbued with cultural, familial, and religious significance often becomes deconstructed in the modern hospital. This paper will first consider how the ‘spiritual’ and ‘medical’ dimensions childbirth were considered by the earliest physicians in the Greco-Roman tradition (Hippocrates, Soranus, Galen, and their counterparts). It will be argued that these early physicians contributed to the development of the millennia-long western tradition of the medicalization of childbirth and its disassociation from the spiritual and cultural dimensions which their ‘patients’, the laboring mothers, and their families valued. Their ideas about medical care and childbirth continue to affect our lives today. Problems wrought by the medicalization of childbirth are especially obvious today in Indigenous communities in Western Australia, as expectant mothers are often removed from their communities to give birth in urban hospitals, away from their families and without the ability to practice the cultural traditions associated with childbirth. In the United States, recent attempts to restore “unity of spirit” to the birthing process have led to dramatic changes in hospitals and birthing centers, including options for midwife-mediated birth and for variations on home-birthing plans and practices. Childbirth is one of few events in human life and history that can show – across time and culture – the complex and enduring issues and conflicts surrounding definitions of disease and health and the role of spirituality in medical processes.
Asclepius at Epidaurus: Religious Space and the Experience of Healing in Ancient Greece
James Zainaldin, PhD(c), Harvard University
“Temple medicine” describes the practice in antiquity of visitation to a temple in hopes of receiving a miraculous cure for an illness. The most famous of such temples in the Mediterranean world was that to Asklepios, Greek god of healing, in Epidauros (southeastern Greece). Inscribed stone pillars have preserved a record of the miraculous healings reported to have occurred there from the 4th century BCE onwards. In this paper, I examine these records with an eye to the following questions: How do people think about the physical temple space and the religious experience associated with being within its boundaries? What principles (if any) govern the miraculous healing experiences there? How far is it possible to see parallels between the perceptions of patients in the ancient world regarding the power of healing spaces, and the perceptions of patients in the modern world who come to hospitals in hopes of being healed there? I argue that certain patterns among the miracle healings suggest an important role in temple medicine for patient expectation and beliefs about miraculous possibility within the boundaries of the temple space.
The cures at Epidauros fall into two primary categories by frequency of appearance: those reporting healing through dreams and those through contact with animals. The former comprises the largest share of surviving inscriptions, a fact that can be explained by the great importance in temple medicine of the ritual known as incubatio (Lat.), a “lying-in” the temple precinct in order to receive a dream that would heal or instruct the suppliant. Both categories describe routine events that gain miraculous restorative powers owing to their occurrence in the temple grounds. This commonality suggests that patient belief about the nature of the temple space allowed everyday events (e.g., an encounter with a snake) occurring there to adopt special, medically charged significance. The contents of the miraculous dreams show further how the healing experience was conceptualized. Two ways the dream contents are structured include 1) crude “surgical procedures” (for example, healing by decapitation) and 2) bartering of the reciprocal do ut des type (Lat. “I give so that you may give”) ubiquitous in Greek religion. Each of these patterns supports the stronger thesis that patient expectations regarding the temple space not only enabled otherwise impossible events but also structured the experience of these healings.
Although it is not possible to conclude from the Epidaurian inscriptions alone that expectation influenced patient outcomes, it is reasonable to treat the records as a kind of case study of how patient expectation can structure the experience of healing and medical care. The finding that patient (religious) expectation about a place’s possibilities can directly and indirectly influence the experience of healing itself has great relevance in the context of contemporary caregiving (e.g., the hospital) and finds support in recent scholarship on patient beliefs about modern medicine that emphasize the importance of place and physical location in health-seeking behavior and in the healing process.
From Portent to Pathology: How Medicine has Reshaped the Monstrous Body
Devan Stahl, MDiv, PhD(c), Saint Louis University
Before humans were considered part of the evolutionary chain of being, before heritability and genetics were clearly understood, and before science wrenched itself away from theological and philosophical speculation, monsters roamed the earth. The word monster, which is derived from the Latin monstrum—meaning “portent”—was once used to describe a host of aberrant biological occurrences, and until the 19th century, it was the preferred term for extraordinary or marvelous human bodies that seemed to disrupt the natural order. Unlike the feared (and mostly fictional) “monsters” of today, in past centuries “monsters” were commonly understood in the Christian world as portents or prodigies—beings whose very existence were an occasion for marvel, dread, or prophetic insight. Theological understandings of God’s intentions for creation helped to shape the therapeutic response to extraordinary bodies; it was potentially blasphemous to try to repair or fix the body of a monster intentionally created by God. As scientific inquiry began to eclipse theological mystery in the 17th century, however, the monstrous body moved from portent to pathology. No longer believing the world was sacred or enchanted, scientists in the 19th century tamed and rationalized monstrosity, making the extraordinary body one of charity and technological manipulation. Through their books of teratology and advances in genetics, embryology, anatomy, and reconstructive surgery, scientists helped moved the monstrous body from wonder to error. Whereas the monsters were once revered, the “disabled” body is now considered vulnerable and even pitiable.
This presentation will examine how a return to theologies of monstrosity might help Christians reimagine care of the “disabled” body in contemporary medicine. The church once knew how to honor and minister to monsters, but today, people with extraordinary bodies are either tamed through medicine’s “biopsychosocial-spiritual” disciplinary power or eradicated. I will contend that western science’s dismissal of theological considerations has helped to shape this medical response to the “deformed” and “disabled” body. Not only has contemporary medicine separated the care of the soul from the care of the body, by evacuating divine intentionality from the medical consciousness, medicine is compelled to imagine physical and mental abnormality as “defects” to be cured. As an alternative, I will propose that a rearticulation of the Christian understanding of the doctrine of creation may help to reveal the goodness and meaningfulness of extraordinary bodies as well as how they might best be cared for. The first step toward discerning how best to care for persons with disabilities might be the recognition that not all instances of bodily diversity represent defects to be overcome through medical technologies.
Touring Clinics and Medical Philanthropy: Missionaries in Colonial South India
Sam Nesamony, PhD, Jawaharlal Nehru University
Medical education and hospitals were considered as significant missionary strategies during the colonial era. Medical missions with dual objective – evangelistic and humanitarian goals was envisioned, deliberated and even visualized as one of the most indefatigable and zealous missionary endeavors in colonial India. Missionaries with a motto ‘heal the sick’ offered rudimentary health in their dispensaries and hospitals, which was clearly perceived by the depressed class masses as a responsive reaction to their genuine need, while missionaries on the other hand understood that the ‘medical mission-cum-salvation’ included the health of the body and the enlightenment of the mind. This paper argues that medical missionaries made themselves to be seen by the colonial state as their ‘valuable’ and ‘beneficent’ allies than as ‘contested’, ‘alien’ and ‘powerful rivals’, leaving an unconstrained partnership with the colonial state and native kingdoms in the sphere of medicine and health system. The historic and crucial role in the making of an eminent public health system in colonial South India reached the pinnacle of missionary involvement in emancipation and humanitarianism through charity and philanthropy. The missionary way of launching ‘touring clinics’ in the countryside through bandi’s (bullock carts with a hanging lantern), which is consecrated into ‘medical modernity,’ left behind an ineffaceable and stirring imprint, coupled with a legacy through their work in such ‘secular’ fields as medicine, nursing, health care and so on, leaving a fascinating chapter in the history of India’s health care.
Dmitry Balalykin, MD, PhD, I.M. Sechenov First Moscow State Medical University
The triumph of Galen’s theoretical and applied system was an important event in the history of science. It was the foundation for the developments in medicine during the III - XVI centuries. We not an interesting fact - the views of the pagan physician and philosopher became dominant within the framework of Christian civilization.
In our view, this may be explained by a commonality between the natural philosophical views of Galen and the Fathers of the early Church. Historians of the early Christian Church primarily focus on purely theological questions, or the position of Christians in the Roman Empire at that time. By the III century, Christians had begun to reconcile their relation with the main natural philosophical trends of the Hellenic tradition.
In “Preparatio Evangelica” written by Eusebius Kessarisky, we discovered and translated into Russian several fragments written by the Bishop of Alexandria, St. Dionysius the Great, in the treatise "De natura". It follows from there that the main opponents of Galen and of Christians in the area of natural philosophy were atomists and their perception of the human body as a set of randomly moving atoms. In the text of St. Dionysius we find criticism of atomism, very close to the text of Galen’s work "De usu partium". The Christian Bishop and Galen contra-pose atomism with teleological views about the human body, being the creation of God (the Demiurges). In this case, the anatomical and physiological processes are determined by the laws of the efficient operation rooted in by the Creator. Perfect evidential knowledge of these processes determined by the empirical knowledge is available for a man. The manner of thinking and direction of Galen’s thoughts were undoubtedly attractive to Christian authors. Moreover, in his treatise "De natura", we found a direct criticism from St. Dionysius concerning the main opponents of Galen – “methodologists”, physicians defending the position of atomism.
Another important issue concerns Galen’s agnosticism, which has existed in the historiography for some time. We have translated and analyzed his work "The dependence of the properties of the soul on the temperaments of the body" and found that Galen considers the reasonable, highest part of the soul to be a special "incorporeal" substance; at the moment of death, it is thought to separate from the body. He does not speak directly about the immortality of the soul - as far as we know, Galen never directly supported this assertion of Plato. However, we find it impossible to unequivocally claim that he did not think so. Galen intentionally states that he cannot examine this point using the methods available to him. Herewith, Galen’s description of the rational part of the soul completely corresponds to the Christian point of view. This fact completely eliminates the thesis of "Galen’s agnosticism".
“A Division of Labor but a Unity of Spirit”: Spiritual Dimensions of Illness and Healing in the Context of the (De)medicalization of Childbirth from the Ancient Greco-Roman World to Today
Katherine van Schaik, MD-PhD(c), Harvard University
“A division of labor but a unity of spirit”: Rabbi Heschel’s quote, which begins the description of the conference theme, describes the ways in which the separation of religion from medicine, and vice versa, demonstrates a gross misunderstanding of the act of healing. Many aspects of this separation concern the sick and those who care for them: this paper will discuss the implications of such an idea for those who are not, in fact, sick, but whose conditions have become progressively medicalized over the last two millennia: pregnant women and their newborn infants.
A natural process that affects the entire world’s population (we are all born, and nearly half of us will give birth) has become a reason for hospital admission, with the patients’ typical chief complaints being labor and birth. While sound justification exists for hospital admission in some cases (it has certainly saved the lives of many), it must be recognized that there is, indeed, a “division of labor” as a process imbued with cultural, familial, and religious significance often becomes deconstructed in the modern hospital. This paper will first consider how the ‘spiritual’ and ‘medical’ dimensions childbirth were considered by the earliest physicians in the Greco-Roman tradition (Hippocrates, Soranus, Galen, and their counterparts). It will be argued that these early physicians contributed to the development of the millennia-long western tradition of the medicalization of childbirth and its disassociation from the spiritual and cultural dimensions which their ‘patients’, the laboring mothers, and their families valued. Their ideas about medical care and childbirth continue to affect our lives today. Problems wrought by the medicalization of childbirth are especially obvious today in Indigenous communities in Western Australia, as expectant mothers are often removed from their communities to give birth in urban hospitals, away from their families and without the ability to practice the cultural traditions associated with childbirth. In the United States, recent attempts to restore “unity of spirit” to the birthing process have led to dramatic changes in hospitals and birthing centers, including options for midwife-mediated birth and for variations on home-birthing plans and practices. Childbirth is one of few events in human life and history that can show – across time and culture – the complex and enduring issues and conflicts surrounding definitions of disease and health and the role of spirituality in medical processes.
Asclepius at Epidaurus: Religious Space and the Experience of Healing in Ancient Greece
James Zainaldin, PhD(c), Harvard University
“Temple medicine” describes the practice in antiquity of visitation to a temple in hopes of receiving a miraculous cure for an illness. The most famous of such temples in the Mediterranean world was that to Asklepios, Greek god of healing, in Epidauros (southeastern Greece). Inscribed stone pillars have preserved a record of the miraculous healings reported to have occurred there from the 4th century BCE onwards. In this paper, I examine these records with an eye to the following questions: How do people think about the physical temple space and the religious experience associated with being within its boundaries? What principles (if any) govern the miraculous healing experiences there? How far is it possible to see parallels between the perceptions of patients in the ancient world regarding the power of healing spaces, and the perceptions of patients in the modern world who come to hospitals in hopes of being healed there? I argue that certain patterns among the miracle healings suggest an important role in temple medicine for patient expectation and beliefs about miraculous possibility within the boundaries of the temple space.
The cures at Epidauros fall into two primary categories by frequency of appearance: those reporting healing through dreams and those through contact with animals. The former comprises the largest share of surviving inscriptions, a fact that can be explained by the great importance in temple medicine of the ritual known as incubatio (Lat.), a “lying-in” the temple precinct in order to receive a dream that would heal or instruct the suppliant. Both categories describe routine events that gain miraculous restorative powers owing to their occurrence in the temple grounds. This commonality suggests that patient belief about the nature of the temple space allowed everyday events (e.g., an encounter with a snake) occurring there to adopt special, medically charged significance. The contents of the miraculous dreams show further how the healing experience was conceptualized. Two ways the dream contents are structured include 1) crude “surgical procedures” (for example, healing by decapitation) and 2) bartering of the reciprocal do ut des type (Lat. “I give so that you may give”) ubiquitous in Greek religion. Each of these patterns supports the stronger thesis that patient expectations regarding the temple space not only enabled otherwise impossible events but also structured the experience of these healings.
Although it is not possible to conclude from the Epidaurian inscriptions alone that expectation influenced patient outcomes, it is reasonable to treat the records as a kind of case study of how patient expectation can structure the experience of healing and medical care. The finding that patient (religious) expectation about a place’s possibilities can directly and indirectly influence the experience of healing itself has great relevance in the context of contemporary caregiving (e.g., the hospital) and finds support in recent scholarship on patient beliefs about modern medicine that emphasize the importance of place and physical location in health-seeking behavior and in the healing process.
From Portent to Pathology: How Medicine has Reshaped the Monstrous Body
Devan Stahl, MDiv, PhD(c), Saint Louis University
Before humans were considered part of the evolutionary chain of being, before heritability and genetics were clearly understood, and before science wrenched itself away from theological and philosophical speculation, monsters roamed the earth. The word monster, which is derived from the Latin monstrum—meaning “portent”—was once used to describe a host of aberrant biological occurrences, and until the 19th century, it was the preferred term for extraordinary or marvelous human bodies that seemed to disrupt the natural order. Unlike the feared (and mostly fictional) “monsters” of today, in past centuries “monsters” were commonly understood in the Christian world as portents or prodigies—beings whose very existence were an occasion for marvel, dread, or prophetic insight. Theological understandings of God’s intentions for creation helped to shape the therapeutic response to extraordinary bodies; it was potentially blasphemous to try to repair or fix the body of a monster intentionally created by God. As scientific inquiry began to eclipse theological mystery in the 17th century, however, the monstrous body moved from portent to pathology. No longer believing the world was sacred or enchanted, scientists in the 19th century tamed and rationalized monstrosity, making the extraordinary body one of charity and technological manipulation. Through their books of teratology and advances in genetics, embryology, anatomy, and reconstructive surgery, scientists helped moved the monstrous body from wonder to error. Whereas the monsters were once revered, the “disabled” body is now considered vulnerable and even pitiable.
This presentation will examine how a return to theologies of monstrosity might help Christians reimagine care of the “disabled” body in contemporary medicine. The church once knew how to honor and minister to monsters, but today, people with extraordinary bodies are either tamed through medicine’s “biopsychosocial-spiritual” disciplinary power or eradicated. I will contend that western science’s dismissal of theological considerations has helped to shape this medical response to the “deformed” and “disabled” body. Not only has contemporary medicine separated the care of the soul from the care of the body, by evacuating divine intentionality from the medical consciousness, medicine is compelled to imagine physical and mental abnormality as “defects” to be cured. As an alternative, I will propose that a rearticulation of the Christian understanding of the doctrine of creation may help to reveal the goodness and meaningfulness of extraordinary bodies as well as how they might best be cared for. The first step toward discerning how best to care for persons with disabilities might be the recognition that not all instances of bodily diversity represent defects to be overcome through medical technologies.
Touring Clinics and Medical Philanthropy: Missionaries in Colonial South India
Sam Nesamony, PhD, Jawaharlal Nehru University
Medical education and hospitals were considered as significant missionary strategies during the colonial era. Medical missions with dual objective – evangelistic and humanitarian goals was envisioned, deliberated and even visualized as one of the most indefatigable and zealous missionary endeavors in colonial India. Missionaries with a motto ‘heal the sick’ offered rudimentary health in their dispensaries and hospitals, which was clearly perceived by the depressed class masses as a responsive reaction to their genuine need, while missionaries on the other hand understood that the ‘medical mission-cum-salvation’ included the health of the body and the enlightenment of the mind. This paper argues that medical missionaries made themselves to be seen by the colonial state as their ‘valuable’ and ‘beneficent’ allies than as ‘contested’, ‘alien’ and ‘powerful rivals’, leaving an unconstrained partnership with the colonial state and native kingdoms in the sphere of medicine and health system. The historic and crucial role in the making of an eminent public health system in colonial South India reached the pinnacle of missionary involvement in emancipation and humanitarianism through charity and philanthropy. The missionary way of launching ‘touring clinics’ in the countryside through bandi’s (bullock carts with a hanging lantern), which is consecrated into ‘medical modernity,’ left behind an ineffaceable and stirring imprint, coupled with a legacy through their work in such ‘secular’ fields as medicine, nursing, health care and so on, leaving a fascinating chapter in the history of India’s health care.