AVICENNA xiii. The influence of Avicenna on medical studies in the West

From the early fourteenth to the mid-sixteenth century Avicenna held a high place in Western European medical studies.

 

AVICENNA

xiii. The Influence of Avicenna on Medical Studies in the West

From the early fourteenth to the mid-sixteenth century Avicenna held a high place in Western European medical studies, ranking together with Hippocrates and Galen as an acknowledged authority. His works had a formative influence on the scholastic medicine of the later Middle Ages, and at some places continued to be used for teaching up to the eighteenth century.

Although Avicenna was more of a philosopher and natural scientist than a physician, the Europeans saw him primarily as the princeps medicorum (prince of physicians), in contrast with the Muslims who revered him as the æayḵ-al-raʾīs (chief master, i.e., of all the sciences). It is not yet possible, however, to assess his impact on the rise of scientific medicine in the West because systematic studies of the various fields are still, on the whole, lacking. A catalogue of the manuscripts of Latin versions of Avicenna’s writings on medicine is still a desideratum, and there is no critical bibliography of the printed editions which came out in the fifteenth, sixteenth, and seventeenth centuries.

Three medical works by Avicenna were available in Latin versions in the later Middle Ages: al-Qānūn fi’l-ṭebb, a five-book medical encyclopedia translated as Canon medicinae and provided with a glossary by Gerard of Cremona (d. 1187) at Toledo in the second half of the twelfth century; al-Adwīa al-qalbīya, a treatise on psychiatry translated as De viribus cordis (On the powers of the heart) by Arnald of Villanova (d. 1311) at Barcelona in 1306; al-Orjūza fi’l-ṭebb, a medical manual in verse rendered into Latin prose under the title Cantica by Arnald’s nephew Armengaud Blasius (d. 1312) at Montpellier in 1294, together with Ebn Roæd’s commentary thereon. The last two translations were wrongly attributed to Gerard in certain early printed editions.

The Canon translation was one of the fruits of the endeavors of the twelfth-century Toledan school of translators to open up the whole range of Arabic learning. They took particular interest in philosophical and theoretical writings. This phase in the Western reception of Greco-Arabic medicine had been preceded in southern Italy about a century earlier by one of greater concern with practical matters. Starting from Salerno, early scholastic medicine with a scientific approach based on Arabic material had spread into the medical schools and the new universities of France and Italy (Baader, “Reformdenken,” pp. 268f.), preparing the ground for acceptance of the Canon. This work met the needs of the new scholastic medicine in three respects: (1) with its immense wealth of information, it provided Western physicians with a synopsis of virtually all the knowledge amassed in the preceding 1500 years and stimulated them to work further on their own; (2) with its systematic incorporation of every subject, down to the smallest detail, in a well-ordered theoretical framework, it greatly facilitated the adoption of its contents for teaching and at the same time satisfied the scholastic liking for a logical classification of subject matter; (3) last but not least, Avicenna linked the medicine of Galen to the natural philosophy and theory of science of Aristotle, who from the thirteenth century onward dominated intellectual life in Europe. Avicenna’s Aristotelian views on basic questions of biology (e.g., the central organ of the body, the roles of the sexes in reproduction) provided starting points for discussions, typical of the scholastic medicine of the time, about the discrepancies between philosophers and physicians, i.e., between Aristotle and Galen, and thereby prompted new efforts to solve old problems.

The Canon came into use among medical scholars during the thirteenth century (mainly the second half) and in university courses during the fourteenth century, when commentaries providing the groundwork for interpretation by professors (magistri) first became available. Key roles in this field appear to have been played by pupils of Taddeo Alderotti (d. 1295) at Bologna, particularly by Dino del Garbo (d. 1327) who for the first time systematically elucidated large parts of the Canon (Siraisi, pp. 96f., 105-09). As to the first introduction of the Canon into academic curricula, direct evidence is lacking for the Italian universities. The earliest testimony is a syllabus for mastership candidates at the university of Montpellier included in a papal bull of 1309. The Canon is recommended in this document as one of a number of optional textbooks. By 1340, however, it had been firmly established in the various course programs. Arabic science was long to maintain a strong position at Montpellier, where lectures on Avicenna’s works often went far beyond what was required by the syllabus; as late as 1545 he still clearly ranked above the ancient Greek authorities (Germain, La médecine, pp. 9-12). At Paris the Canon is first mentioned as lecture material in 1330, and it also appears in the library catalogue of the medical faculty made in 1395 (Seidler, Die Heilkunde, pp. 49f.). Following the example of Paris, German universities founded in the fourteenth and fifteenth centuries also admitted the Canon to their programs of study.

Academically trained physicians in the later Middle Ages undoubtedly were familiar with the entire Canon. Lectures, however, were concentrated on certain parts of the work, with slight local variations in choice and range. The compulsory teaching matter always included the part on physiology in the first fen (transcription of the Arabic fann) of book 1, which expounds the general principles of medicine, and the theory of fevers (Canon 4.1), sometimes together with the theory of crises (4.2). Often the three remaining fens of book 1—on etiology and symptomatology, dietetics and general therapy—were also prescribed. Book 3, on the specifics of pathology and therapy, was by reason of its vast range less often used as lecture material, and then only in excerpts, but it was a favorite source for examination questions. In some universities book 2 on materia medica was read together with other pharmaceutical treatises of Arabic origin. For surgical training, in so far as this took place on the academic level, Avicenna’s surgery (Canon 4.3-5) was among the standard textbooks.

This selection was of course influenced by the wealth of commentaries on the Canon, which in the absence of a systematic inventory (a first attempt by Eckleben has left many gaps) can not yet be adequately surveyed. The most numerous are exegeses of Canon 1.1 and 4.1. No Latin commentary on the entire work is known to exist. The most comprehensive commentary, produced by Jacques Despars (d. 1458) after more than twenty years’ work and printed in toto at Lyons in 1497-98, deals only with Canon 1.3 and 4 (Jacquart, Un médecin, pp. 109-12). Outstanding among the numerous exponents who wrote in the heyday of Canon-exegesis in the fourteenth and fifteenth centuries were certain professors of the then pre-eminent north Italian universities, whose commentaries were widely used as textbooks and quite frequently printed after the introduction of printing in the mid-fifteenth century. In addition to Dino del Garbo (see above), Gentile of Foligno (d. 1348), Ugo Benzi of Siena (d. 1439), and Jacopo of Forli (d. 1414) dealt with several parts of the Canon; others, like Giovanni Matteo Ferrari of Grado (d. 1472) and Giovanni Arcolani (d.1458), commented only upon individual sections. Leonardo of Bertapaglia wrote a commentary on the surgical chapters in 1424 (Thorndike, Science and Thought, pp. 60-65). As Jacquart (Le regard, pp. 43-76) has shown in the case of Despars, the exegetic writings were often amplified with personal observations and experiences of their authors. These hitherto neglected sources are therefore likely to provide interesting evidence of the ways in which the Canon stimulated new developments in Western medicine. It was a main source for many medical manuals and monographs and it was sometimes also taken as a model of form; for example, the collection of medical counsels by Ferrari of Grado (Venice, 1514 and several times reedited) is arranged according to the method of Avicenna.

The Canon was one of the medical books most frequently printed in the fifteenth and sixteenth centuries. Incunabula from before 1500 were for the most part printed in Italy; they comprise eleven complete editions (among which the five-volume Venice edition of 1490-95 is supplemented with commentaries by various authors) and two partial editions. The earliest printed edition (1472) consists only of Canon 3, the Bologna edition (1482) only of Canon 4.1, 3-5. A Hebrew version was printed at Naples in 1491-92. Up to 1608, fourteen more complete editions of the Latin version were printed, including three with commentaries, as well as an epitome by Michael Capella (Flores Avicennae, Lyons, 1508, 1514) and an alphabetically arranged adaptation by Gabriel of Tarrega (Bordeaux, 1520, 1524). To these must be added excerpts published in compilations, particularly collected doctrines of the three principal authorities, Avicenna, Galen, and Hippocrates, and the lemmata in the numerous commentaries. The original Arabic text was printed at Rome at 1593, but like all products of the Medici press was intended primarily for export to the East.

Most of the printed editions of the Canon included two other works of Avicenna which played a minor role in university teaching. These were De viribus cordis (initially in the Paduan edition of 1476, but also printed separately at Lyons in 1527 with a commentary by Jaime López of Calatayud) and the Cantica (initially in the Venetian edition of 1482-83). The Cantica and Ebn Roæd’s (Averroes’) commentary on them were printed together at Venice, 1483, and in Ebn Roæd’s Opera at Venice, 1484, and were included with the other principal texts from the Canon in some printings of the textbook Articella (e.g., Venice, 1509; Lyons, 1519, 1534).

From the end of the fifteenth century onward, efforts were made to remedy the linguistic deficiencies of the medieval version of the Canon, e.g., its clumsy word-for-word renderings and many transliterated borrowings of Arabic terms. Andrea Alpago (d. 1522), who had acquired a deep understanding of both the language and the subject during his thirty years of service as physician to the Venetian embassy at Damascus, supplied emendations derived from Arabic manuscripts to the Latin versions of the Canon, the Cantica, and De viribus cordis (which he more accurately entitled De medicamentis cordialibus), and compiled a new glossary, mainly of Arabic names of drugs. His corrections were published posthumously in 1527 by his nephew Paolo in the first edition of the Canon from the Giunta press at Venice (d’Alverny, “Avicenne,” pp. 184-89). The tater Giuntine editions of the 1544, 1555 (reprinted at Basel in 1556), 1562, 1582, 1595, and 1608 were based on Alpago’s revised text, from 1555 onward augmented by marginal notes—taken from Alpago’s manuscript—by Benedetto Rinio, which show parallel readings in ancient Greek and Arabic works (d’Alverny, pp. 196f.). To facilitate reference, an index by Giulio Palamede was also printed (Venice, 1557, 1584).

Alpago’s was to be the only textual revision of the entire Canon. Andrea Grazioli brought out a new version of only book 1 (Venice, 1580) based on an unfinished translation by Girolamo Ramnusio (d. 1486), Alpago’s predecessor at Damascus (d’Alverny, pp. 182-84). Another translation by Miguel Jerónimo Ledesma (Valencia, 1546) went no further than Canon 1.1. Jacob Mantino’s translations of Canon 1.4 (five editions between 1530 and 1555) and Canon 3.1.1.29 (on headache; Bruges, 1538) and the translation of excerpts from Canon 3.1-2 by Jean Cinqarbres (Paris, 1570, 1572) are not from the original Arabic but from the Hebrew version, while Jean Bruyerin’s new rendering of the book on heart drugs (Lyons, 1559) was from the Arabic.

Western Europe also has to thank Andrea Alpago for his translation of two other medical treatises by Avicenna, De removendis nocumentis quae accidunt in regimine sanitatis (On harmful things in the regulation of health which have to be prevented—Dafʿ al-mażārr al-kollīya ʿan al-abdān al-ensānīya) and De syrupo acetoso (On oxymel—sekanjabīn), as well as the only Latin versions of two Arabic commentaries on the Canon, those of Qoṭb-al-dīn Šīrāzī on books 2, 3, and part of book 4, and of Ebn al-Nafīs on book 5 (pharmacopeia), in which, incidentally, there is no mention of Ebn al-Nafīs’s discovery of pulmonary circulation. These four texts were published by Paolo Alpago at Venice in 1547; the first two were also appended to several later editions of the Canon.

But even the availability of these new texts and the improved versions of previously known works could not arrest the growing rejection of Avicenna’s authority in the universities. In the context of humanist efforts to reform medicine, criticism of the Canon spread and gained strength in the course of the sixteenth century. The most spectacular onslaught was the public burning of the Canon by Paracelsus in the Midsummer-Day bonfire at Basel in 1527—though a gesture admittedly motivated by his rejection of all written authorities, and by no means typical of the age. In general the humanist critics of Arabic medicine, who made Avicenna their prime target, strove for a revival of ancient Greek and Roman medicine. Scholars such as Niccolò Leoniceno, Giovanni Manardi, Symphorien Champier, Janus Cornarius, and Leonhart Fuchs, who were intent on demolishing the medieval system, dismissed its textbooks of Arabic origin as verbal and factual misrepresentations of ancient teachings and replaced them by newly recovered Greek and Latin medical writings. Their criticism of detail focused mainly on Avicenna’s prescriptions, where the indications and dosages differed from the ancient traditions. On the other hand, Avicenna’s innovations were praised as practical advances by his defenders, such as Sébastien Monteux, Bernhard Unger, and Lorenz Fries.

Although the scholastic features of academic medicine were not finally discarded until the eighteenth century, in the choice of subjects for study it was the humanistic tendency that prevailed. In the second half of the sixteenth century, the Canon gradually fell out of the syllabus at most European universities, though it was still taught by individual professors, e.g., by Werner Rolfinck at Jena in 1670. It remained obligatory well into the eighteenth century at the Spanish universities of Valladolid and Salamanca (Gonzalez, p. 20) and likewise at Padua, where Giovanni Battista Morgagni, the founder of morbid anatomy, still lectured on its first book in 1712-15-just as Santorio Santorio, one of the pioneers of experimental medicine, had done a century before him (Pazzini, “Manoscritti,” pp. 179-82). It would appear, however, that these teachers used the set text mainly as background for the presentation of more recent knowledge; for example, Santorio in his commentary (Venice, 1625, 1626) describes instruments which he himself had invented (clinical thermometer, pulse meter).

Work on the preparation of more accurate Latin versions continued in the seventeenth century. Preoccupation with Arabic on the part of physicians seeking better comprehension of the Canon even contributed to the advance of Arabic philology at that time (Fuck, pp. 57-59). In 1624 Zacharias Rosenbach attempted to introduce an Arabic language course for medical students at the Herborn academy (Grün, pp. 64f.). In 1609 Peter Kirsten, a physician of Breslau, brought out an Arabic-Latin edition of the materia medica (Canon 2). Vopiscus Fortunatus Plemp, who lectured on Avicenna at the university of Louvain, could not fulfill his plan to retranslate the whole of the Canon but published new translations of books 1 and 2 and part of book 4 in 1658. At Paris in 1659 a translation by Pierre Vattier of 16 chapters from Canon 3.3-4 on mental diseases (one of the highlights of the work on account of its penetrating differentiations) appeared under the title De morbis mentis. Georg Hieronymus Welsch in his Exercitatio de vene medinensi (Augsburg, 1674), an overexpanded commentary on Avicenna’s short discussion of the Medina worm (Canon 4.3.8.4), quotes passages in the original Arabic accompanied by his own translations. Finally Avicenna’s didactic poem al-Orjuīza was retranslated into Latin by the Netherlander Anton Deusing under the title Canticum (Groningen, 1645). These philological as well as medical contributions already mark the transition to a purely historical interest in the Canon.

 

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(U. Weisser)

Originally Published: December 15, 1987

Last Updated: August 18, 2011

This article is available in print.
Vol. III, Fasc. 1, pp. 107-110