Unit 6 - The Translations Movement in the Medieval Europe: From Gondishapur to Toledo
Universidad Complutense de Madrid (ES)
Middle Age represents in medical history a silent and foundational work to prepare the conditions to build a scientific medicine. This universal enterprise starts in Mesopotamia, follows with Egyptian medicine, became a complete project in Greek colonies of Cos, Knidos and Croton and passes to the modern age through the collective effort of the medical schools of Alexandria, Gundishapur, Baghdad and Salerno. If medicine is essentially a clinical discipline in all these schools, what the Middle Age shows is that the possibility of a modern medicine depends on the multidisciplinary project to build a universal science. For that reason, the role of the Toledo School of Translators, Chartres Cathedral, and the numerous monasteries ad cathedral schools is equally important to contribute to the progress of medical history.
Medical schools are essential to contribute to what Lain Entralgo define technical medicine for their power of synthesis theoretical and practical. The Alexandrian School is essential for the synthesis between Greek and Egyptian medicine, the Gundishapur School provide a synthesis among Mesopotamian, Indian and Greek medicine, in the House of Wisdom in Baghdad all these traditions are aligned and systematised in the Arabic medicine.
The Middle Age represents for medical history the translation of all the ancient traditions to the modern Age. This enterprise is possible through the support of the Universities who contribute to the universalization of culture providing a standard method: the Scholasticism. In this unit we will explore the methodological continuity between the School of Alexandria, the School of Gundishapur and the School of Toledo in order to highlight the connection between clinical knowledge and humanities and their role to assure the modernisation of medicine. Modern medicine and its contemporary model of evidence-based medicine are part of the universal enterprise to build science and the collective effort to consolidate medical professionalism.
For several reasons, the Middle Age represents a crucial moment for medical history even though is not characterized by disruptive innovators as in the classical and modern medicine. The universities and Scholasticism provide for the first time a standard medical education, scientific knowledge contribute to develop a new scope for clinical research, the role of the hospitals improve the quality of professionals and healthcare. Medical profession as other domain of European western civilisation starts a slow and unperceived walk toward the secularization and independence from the great monotheistic religions. For all these reasons the contribution of the great medical schools is essential for the synthesis and the integration of the different medical traditions and the progress of clinical practice.
The Unit is organised around the role of three different moments of the Middle Age medicine represented by the Alexandrian Medical School, the Gundishapur School and Translators School of Toledo in order to describe the commonalities that help to understand the essential contributions of this part of medical history. Commonalities are represented through different aspects along the Unit, the synthesis between the different medical traditions from Mesopotamia to the advent of scientific medicine, the Scholasticism methodology and its roots in the medical education, the role of library, translations and humanities to build the project of a universal and scientific medicine.
The Alexandrian Medical School has a philosophical framework at the basis of its activity (Garofalo, Galen’s Legacy in Alexandrian text written in Greek, Latin and Arabic, in Brill’s companion to the reception of Galen, Koninklijke, Leiden 2019) and this represented an essential aspect of the differences of Alexandrian physicians in term of methodology. The development of synopsis and compilation introduced in the medical education several components to design a specific curriculum for medical students and obtain a quality standard in the teaching activities. The synoptic work has been driven by the hermeneia (interpretation) of the studied object and consented a critical and systematic exposition of Hippocratic works. In term of clinical research, the most significant contribution of Alexandrian School is the practice of autopsies (view by one-self) and the vivisections. These practices are connected to the influence of sceptical philosophy of Pyrrhus and the innovative spirit of the School to verify anatomical and physiological knowledge (Lain, 1979).
The in term of methods Galen represent the most effective legacy of the Alexandria School and will exert a big influence on Byzantine medicine for a side and Arabic medicine for other side. These aspects are explored in the Unit 1 about the European medicine of Middle Age and in this Unit in the description of the connection between Alexandria and Gundishapur. Greek science at the end of the Hellenistic period survived in Syria, in Edessa and Nisibis, an area of influence of Byzantine Empire, and in Persia, in Gundishapur.
The unit show how medical and scientific knowledge are transferred from the Greek environment to the Arabic culture and how this transfer is essential to recovery Greek culture in the Western Latin Europe. In the Gundishapur School, Greek medicine is updated by the influence of Galen’s works and the Indian and Mesopotamian medicine. Translations at Gundishapur involves Hippocratic and Galenic works to the Syriac became the reference for the work of the Arabic translators of the House of Wisdom in Baghdad.
The conversion of the Alexandrian and Gundishapur traditions into the Arabic medicine is not only in terms of medical knowledge but is methodological and lays the groundwork for the Scholasticism. Arabic medicine elaborates synopsis, compilation and elenchus in the encyclopaedia and a monograph, which became the core work of Rhazes, the most important clinician among the Arabs doctors. Alexandria, Gundishapur and Baghdad are the three milestones of Western medical history to convert medicine in an academic discipline in the Universities of the Middle Age.
Another relevant aspect of the Unit is to highlight the role of the Gundishapur School in the development of a second key aspect of the medical history of the Middle Age: the birth of hospital and all the benefits and the contribution of this innovation to the clinical practice. The hospital impact on the organisation of clinical work in term of quality is undeniable, the hierarchy of healthcare professionals, the specificity of competences and the systematization of place and time care important aspects of the quality of care improvement.
The organization of medical practice implies a systematic record of the activities and the development of medical records to drive clinicians decision-making. This new knowledge available consent to orient medical education in two different areas, theoretical work through the study of texts and books contained in the great library available to medical student, and the clinical work in the hospital. With the library the need to increase the volumes available to the student and the reading practices provoke an increment of the translations in the school and the synthesis of the different medical traditions. The hospital represents a further methodological revolution in medical education and offer for the first time the opportunity to define a standard in medical education.
Medical students after a standard education program receive a license and are habilitated to practice medicine. The Gundishapur medical education model is exported into the hospital in Baghdad and became the standard for the golden age of Arabic medicine. The progress of medical education of the Middle Age is spread through the Arabic hospitals and the great libraries built around the most important cities of the Islamic Empire. Translations from Baghdad are exported progressively in the Western through Spain and South of Italy. This process is supported by the birth of the Cathedral Schools in some European countries as alternative to the monasteries and the incipient secularization of knowledge, which increase the interest in science in the Medieval Europe.
The interaction between the medical School of Salerno and the Translators School of Toledo represents the main source for the new European medicine. This work is possible through the involvement of some Cathedral Schools, the most important in Chartres, France, which are possible the integration of philologists and philosophers in the enterprise. The translation movement in Toledo starts as a spontaneous process produced by the new interest for science and the availability of manuscripts and translators coming from the South of Spain and from the Normand court in Sicily. With the Toledo translators work the updating of medical knowledge is in its great majority complete to be applied in the Universities and to prepare the humanistic revolution of Renaissance and the integration of science in medicine.