van der Eijk: rational medicine

The notion of ‘rational’ medicine has long been taken for granted, as it was felt that it was undeniable that there was such a thing as Greek rational medicine, which was perceived to lie in the examples of Hippocratic rationalism and empiricism as referred to above — aspects in which Greek medicine was perceived to be different from Egyptian or Babylonian medicine. As I have already indicated, this notion of rational medicine, together with the presuppositions underlying it, has come under attack more recently and is sometimes dismissed as an old-fashioned relic from a positivist way of thinking that is regarded as something that has long been superseded. Nevertheless one needs to be careful here and not   give way too easily to relativism or deny to Greek medicine any distinctive character compared to what preceded it. The crucial question here, though, is how one defines ‘rationality’. As far as medicine is concerned, it seems that the discussion would be clarified if an important distinction were made between two uses of the word ‘rational’. First, there is the use of ‘rational’ as opposed to ‘irrational’ or ‘supernatural’, by which the characteristic element of Greek medicine is seen to lie in the absence of any appeal to gods or divine or supernatural powers. I have already discussed this above, when we saw that the view that Greek medicine was free from such appeals is too simplistic. In particular, one could ask what is so ‘rational’ about the claim made by the author of On the Sacred Disease that all diseases are divine and all are human (see ch. 1). Is this rational by his standards, or by ours? Or what is ‘rational’ about the assumption of the existence of four humours in the body, which the writer of On the Nature of Man simply posits, or about the role of the number seven in medicine, which the author of On Fleshes takes as a given? Examples like these could easily be multiplied. Yet a different use of the word ‘rational’ is in the sense in which ancient medical writers themselves used it, where ‘rational’ stands for ‘rationalist’, ‘theoretical’ (logikos, rationalis) as opposed to empirical/practical, thus denoting the speculative, theoretical nature of Greek medical thought and its close relation with natural philosophy, epistemology, etc. On this view, one can safely say — and comparisons with other ancient medical traditions have confirmed — that Greek medicine, with its emphasis on explanation, its search for causes, its desire for logical systematisation, its endeavour to provide an epistemic foundation for prognosis and treatment, and especially its argumentative nature and urge to give account (logos  , ratio) of its ideas and practices in debate, does show a distinctive character. (p. 9)