Definitions and Authorities

Thomas nowhere stops to construct or defend a definition of medicine in the way that he does with physics, metaphysics, or theology. Still he several times quotes definitions of medicine on the way to some other point. Three times he gives the formula, "medicine is the science of the healthy and the sick"; in a fourth text, he says that medicine is by definition "about the healthy and the sick."11 The phrases might be taken as echoes of the short definition that Galen himself calls the "old account" of medicine.12 Something like it also figures in the works of Albert the Great from the time Thomas was with him in Cologne.13 Alternately, Thomas's formula might be taken as an abbreviation of the tripartite definition offered in Galen's Art of Medicine, which states that medicine concerns the healthy, the sick, and what is neither.14 This definition is widely echoed in the Latin tradition, both in medical texts and in compendia of the sciences.15 Of course, it might be simpler to suppose that Thomas's definition comes from Aristotle, who offers quite similar formulations as examples or analogies.16

Thomas spends more attention on the question, whether medicine is practical or theoretical. He poses it in his early exposition of Boethius's On the Trinity, when he is trying to defend the Aristotelian division of speculative science. The objection holds that while medicine is divided into

11 Respectively, Sent Phys. 8.2; Sent. Metaph. 5.17; Sent. Ethic. 6.9.

12 De sectis cap. 1, ed. Georg Helmreich in Claudii Galeni Pergameni Scripta minora, ed. Johann Marquardt et al. (Leipzig: Teuber, 1884-1893), 1:1.8-9.

13 Albert the Great, Super Dionysii epistulas 7, as in his Opera omnia ad fidem codicum manuscrip-torum edenda, ed. Institutum Albertus Magnus Coloniense (Munster: Aschendorff, 1951- ), 37/2:502. I will refer to this edition as "Cologne Opera omnia."

14 Ars Medica 1, in his Opera omnia, ed. Karl G. Kühn et al. (Leipzig, 1821-1833; rptd. Hildesheim: G. Olms, 1964), 1:307.

15 See, for example, Constantine the African, Pantegni 1.2, as in Constantini Africani . . . Opera conquisita undique magna studio . . . (Basel: Heinrich Petri, 1536-1539), 2:2, and Gundissalinus, De divisione philosophiae, ed. Ludwig Baur, BGPhM 4/2-3 (Munster: Aschendorff, 1903), 83.14-15.

16 See, for example, Topics 6.4 (141a19-20), 6.5 (143a3-5); Nicomachean Ethics 1.1 (1094a7), 6.10 (1143a3). It might also come from Thomas's thinking that Aristotle's Parva naturalia included a treatise "De sanitate et aegritudine." See Sent. De sensu prol. and the notations in Opera omnia (Leonine) 45/2:4 for ll. 38-54.

theoretical and practical, the same might be true of any other knowledge ordered to skilled activity. Every skill, then, deserves to be counted as theoretical science. Thomas's reply depends on a citation to the opening of Avicenna's Canon ofMedicine, which explains the distinction between theoretical and practical medicine.17 Following Avicenna, Thomas holds that the distinction is only one between principles and their particular application. Practical medicine teaches that certain remedies are to be used, say, in treating certain tumors ("apostemes"): theoretical medicine teaches the kinds and numbers of vital powers or fevers. Both the distinction and the illustrations are from Avicenna, to whom Thomas explicitly refers when invoking them elsewhere.18 Can we assume he knew the whole of Avicenna's Canon directly? On the contrary, this single reference is precisely the kind learned from public disputation or as part of a tradition of commentary.

Other explicit citations to medical authorities are few in Thomas. Galen is cited several times for his views on the soul.19 The ultimate source here is Nemesius of Emesa, but the proximate source may be Albert.20 Perhaps it was neither. Galen's view on these matters was notorious. Thomas's contemporary and fellow Dominican Raymond Marti quotes Algazel as saying that Galen was the prince of those natural philosophers who held for the soul's mortality.21 Certainly Thomas refers to Galen elsewhere. He cites the Book on the Action of Simple Medicines in favor of the principle that all bodies are consumed by fire.22 A general allusion reports Galen as teaching that "abstinence is the best medicine."23 Both of these are again the sort of aphoristic locus easily learned at second hand. The only other medical authority named by Thomas is Constantine the African. Constantine is cited not for his systematic works or translations — which were enormously influential in the twelfth century at Salerno, at Chartres, and in England — but for the little treatise On Coitus. His authority is needed by Thomas only to

18 De ver. 2.8 corpus and, without the reference, 3.3 arg. 2.

20 Nemesius of Emesa, Premnon physikon 2. For Albert's role, see the passages considered below.

21 Raymond Marti, Pugio fidei 1.2.7, ed. Joseph de Voisin (Leipzig: haered. Friderici Lanckisi, 1687), p. 94.

22 Scriptum Sent. ad 1, 4.44.3 ad 3. The bit of Galen occurs together with a quotation from the pseudo-Aristotelian Liber de proprietatibus elementorum: "no animal can live in fire." For a similar appearance of the question of the salamander, see Albert, Sent. 2.15 C ad aliud . . ., as in his Opera omnia, ed. Auguste Borgnet (Paris: Vives, 1890—1899), 27:278.1 will refer to this edition as "Borgnet Opera omnia'.'

explain the teleology of sexual pleasure.24 Since the citation refers to the very beginning of Constantine's work, and since the phrase is once again of the sort that circulates in sayings-collections and public debates, it is hard to argue from it for any prolonged reading on Thomas's part.

The question of authorities is more complicated in Thomas's epistolary extract On the Motion of Heart. The editors of the critical edition think that Thomas's tract is something of a reply to Alfred of Sareshel.25 Alfred's own On the Motion, written before 1217, had a fairly wide circulation in the thirteenth century.26 It is cited by Albert the Great, for example, in his Questions on Animals.27 Since Thomas wrote his little treatise after 1260 and perhaps as late as 1273 (if one follows Mandonnet),28 he could have garnered some knowledge of Alfred's position from any number of sources. Moreover, his explicit point is to justify and perhaps clarify the Aristotelian model for the heart. There are 12 explicit citations to Aristotle and four to unnamed interlocutors. Perhaps the latter prove a direct use of Alfred or, indeed, of the medical sources Alfred outlines in order to reject. The unattributed views claim that cardiac motion derives from an extrinsic universal cause, that it comes from heat, and that man is a microcosm, a "lesser world."29 Certain "physicians" are further credited with distinguishing vital from animal operations.30 Of course, Man as Microcosm is a well worn image and needs no specific source. The Leonine editors do find a specific echo of Alfred in the claim that cardiac motion comes from heat. Yet the doctrine also figures in Constantine the African and even in Cistercian anthropology.31 The distinction between animal and vital forces is indeed a medical doctrine, found in Constantine and Johannitius, for example.32 Of course, it also enters into such tracts as the Cistercian On Spirit and Soul, which Thomas cites elsewhere.33 The claim for a universal extrinsic causality is common enough in

24 Scriptum Sent.; compare Summa theol. Suppl. 65.3. There is a textual difficulty here, since Busa reads only "as Augustine says." Elsewhere in the Scriptum on the Sentences, the opinion is attributed just to the medici; see Scriptum Sent. ad 6.

25 See the editorial remarks in Leonine Opera omnia, 43:96.

27 Quaestiones de animalibus 3.5 (Cologne Opera omnia, 12:126—127).

28 See the summary in Leonine Opera omnia, 43:95—96.

29 De motu (Leonine Opera omnia ll. 24—27, 151—152; 43—45; and 59, respectively).

31 Constantine, Pantegni theor. 4.19 (Basel [1539] 92): William of St Thierry, De natura corporis et animae 1 (Migne PL 180:700D).

32 Compare Constantine, Pantegni theor. 4.1 (Basel [1539] 79); Johannitius, Isagoge 9. For the Galenic context, see Owsei Temkin, "On Galen's Pneumatology," Gesnerus 8 (1951) 180—189.

33 De spiritu et anima 20—22 (Migne PL 40:794—795); compare Scriptum Sent. sol. 2 ad 1, where Thomas comments on its reputed composition by "a certain Cistercian."

the philosophical tradition and appears elsewhere in biological discussions — for example, with regard to the origin of the human soul. An editor's impulse to provide an exact source once again leads us astray.

I conclude that neither explicit nor implicit authorities demonstrate that Thomas had any extensive acquaintance with medical authors. If this is a trial for his editors, it is a boon for ambitious readers who want to project missing sciences onto him. Had Thomas referred in detail to a large library of medieval medical authorities, it would be more difficult for later readers to project their versions of medicine onto him. The very generality of Thomas's references to medicine provide a relatively blank slate onto which other conceptions of the disciplinary power of medicine can be written. Moreover, and crucially, later readers who wanted to manufacture a Thomist medicine did not go even so far as I have already gone in noticing the details of medieval medicine that do appear. They were content — they were required — to snatch up a few "principles" of the utmost generality so that they would not be distracted by even the few details that the texts offer. Take this as a parable for the construction of Thomistic sciences. The gaps in Thomas's interest or erudition are the points at which his authority can be most easily appropriated for later disciplinary struggles.

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