Histoire de la médecine

SOMMAIRE
- Tefaw ancêtres des scies chirurgicales : A propos d’une représentation égyptienne (Richard-Alain Jean)
- Pulvérisateur Vaast et pulvérisateur Armand Vaast (Bernard Petitdant)
- Charles Louis SIR-HENRY : nouveaux poinçons (Philippe Mereau)
Histoire de la santé :
- Le savon Pears : marketing sur support monétique au XIXe siècle (Jean-Pierre Martin)
- Le docteur Ernest Gauckler (1876-1924) et son illustre famille (Jacques Poirier)
- De l’utilisation de l’art pictural en odontologie médico-légale (Xavier Riaud)

SOMMAIRE N° 50 –MAI 2016 - (ISSN 2257-7459)
NUMERO SPECIAL
« LA MEDECINE DANS L’ANTIQUITE »
. Editorial : 5 ans !
. Une brève histoire de la médecine antique illustrée par
la philatélie (Jean-François Hutin)
. L’Égypte comme modèle de la science médicale dans le monde antique : Mythe ou réalité ? Enquête dans la littérature latine. (Joëlle Jouanna-Bouchet)
. Pour une introduction à la médecine égyptienne (Ri- chard-Alain Jean)
. Essai (raisonné) sur les guérisons dans les temples d’Esculape (Louis-Jean-Dupré)
. Cheiron le Centaure, inventeur de la chirurgie (André J. Fabre)
. Les cachets d’oculistes ou cachets à collyres (Jacques Voinot)
. La bourse à clystère (Jean-Pierre Martin)
. Le Cyasthique de Dioclès (Bernard Baldivia)
. Une cucurbite romaine (Henri Kugener)
. Aux sources de l’anesthésie : la mandragore magique. Approche historique et bibliophilique (Jacques Hotton)
. La phytothérapie bucco-dentaire selon Celse et Scribo- nius Largus, deux médecins de l’Antiquité (Joëlle Jouan- na-Bouchet, Xavier Riaud)
. Un Saint-Côme méconnu en Gironde (Charles Tama- relle)
En musardant sur la Toile (Bernard Petitdant) Courrier des lecteurs / nouveautés en librairie

The first volume of Viaggiatori “Curatele” series seeks to recreate some
scientific dialogues, namely meetings, exchanges and acquisition of theoretical and practical scientific knowledge, thus linking the cultural, historical and geographical context of America, Asia, Europe and Mediterranean Sea between the 16th and the 20th century.
More specifically, the main objective is to consider the role of travellers as
passeurs, as “intermediaries” for building and allowing the circulation of
knowhow and the practical and theoretical knowledge from one continent to another.

Dans sa thèse de médecine, soutenue en 1943, Georges Canguilhem a développé une critique de la conception scientifique et quantitative de la maladie, faisant valoir l’irréductible normativité des catégories du normal et du pathologique. Cette critique de l’objectivisme médical est étroitement liée chez Canguilhem avec une réflexion sur la normativité de la vie. Depuis 1943, le contexte de discussion a bien changé. En philosophie de la médecine, les débats ont été en grande partie structurés par l’alternative entre les conceptions naturaliste et normativiste de la santé et de la maladie, la normativité étant alors envisagée dans son aspect social et culturel, non au sens « biologique » de Canguilhem. Simultanément, la philosophie de la biologie et la philosophie de la médecine n’ont cessé de s’éloigner l’une de l’autre, une tendance lourde aujourd’hui remise en question par certains auteurs. Le style de recherche a aussi changé : l’approche « historico-épistémologique» chère à Canguilhem a perdu de son évidence, au profit d’un divorce croissant entre les travaux proprement historiques, et des études philosophiques de caractère analytique. Le contexte scientifique a aussi considérablement changé. Pour ne citer que quelques exemples, la notion épidémiologique de facteur de risque a discrédité l’idée d’une démarcation claire entre phénomènes normaux et phénomènes pathologiques ; la génétique médicale, l’immunologie, la médecine des troubles mentaux ont par ailleurs bouleversé l’explication, la nosologie et la prise en charge des pathologies. Enfin, la médicalisation croissante des sociétés contemporaines se traduit par une pathologisation d’innombrables problèmes dont la solution était traditionnellement sociale plutôt que médicale. Ce livre a pour ambition d’évaluer dans quelle mesure les catégories du normal et du pathologique ont connu une mutation et si elles sont toujours d’actualité.

Did the physicians of the Middle Ages have a vision of man radically different from those of philosophers and theologians ? This study attempts to respond to this question through an examination of one of the central concepts of medieval medicine : the complexion or temperament of the body. Emerging in Antiquity and filtered across a series of Arabic sources, this notion was deployed by physicians to define the human body in its specificity, notably in relation to other animal species. It also, however, defined the human in its individuality since each body possesses a singular complexion. The hypothesis explored in this paper is the following : to define man by his complexion rather than his substantial form, to consider him in bodily terms rather than in terms of the soul, reveals the presence of a new anthropological discourse in the Middle Ages. This perspective is, of course, not radically opposed to the philosophical and theological theories of that time. However, it opens the way to new interpretations of the diversity that exists at the heart of the human in evading all essentialist hermeneutics. The idea of complexion appears in numerous medieval texts, including those well beyond the field of medicine. Yet, between the 13th and 15th centuries, it circulates with a particular intensity amongst Italian medical circles, notably in the universities of Bologna and Padua. In this context, an initial mode of interrogation emerges in theoretical medical texts : how to define the nature of complexion with the philosophical tools of the period, largely influenced as they were by various forms of Aristotelianism ? The physicians examined in this article all have backgrounds in philosophy and went on to study at the Faculty of arts, explaining, in part, their utilization of philosophical concepts in the elaboration of the ontology of complexion. Two thinkers, Taddeo Alderotti and Pietro d’Abano, are of particular interest here insofar as they establish in an definitive manner the general framework of questions, which continue to be invoked by their successors.
The general problematic of complexion can be summarized as follows : Galen appears to affirm in certain texts that the soul can be reduced to the complexion of the body, that it is thus material, and hence also mortal ; however, since such an idea is generally unacceptable from a Christian perspective, it was necessary to rethink the notion of complexion so as to not confound it with the soul while simultaneously preserving its fundamental characteristics. Following Aristotle, philosophers and theologians tended largely to identify the soul to substantial form, which organizes matter and gives life to it, while remaining ontologically distinct from it. Taddeo Alderotti and Pietro d’Abano demonstrate how complexion is not identical to the soul, but is rather a property present in each man and which is not a mere accident. For them, complexion was a “substantial quality”, a property which distinguishes man as such and which all men possess. The discourse of the physicians thus has the same extension as the philosophical discourse on the soul insofar as every being who has a soul also has a human complexion and vice versa.
A second line of questioning then immediately emerges : can one still speak of the specific form of man, if the real object of medical anthropology is located in the quasi‑infinite particularity of individual beings and the complexion of their bodies ? Once again, Taddeo Alderotti and Pietro d’Abano will fix the theoretical framework for the next generations. The specific form is one, from a metaphysical perspective, since it is possible to think of man as a unity, independently of his particularities. However this
form, which is nothing but the soul, is variously received in matter depending on the degree of perfection of the complexion of the body which is the result of the process of embryo generation. According to this medical theory, the human soul does not exist as
such in the body unless it has been prepared by its complexion to receive it. Following from this, complexion comes first and will determine the degree of participation in human functions defined by the nature of the human soul. All men do not therefore accede to the same degree of humanity. Moreover, complexion, even after the arrival of the soul, is in no way fixed : it changes incessantly in each individual in accordance with the variable factors of age, climate, diet, and care. Thenceforth, the physician can hope to raise complexion to its greatest point of equilibrium and thus, beyond simple medical care, give back to the body its highest degree of humanity. Hence, it is not surprising that the majority of Italian physicians of the late Middle Ages asked the question of both the definition and attainability of perfect complexion (that which would bring the individual to the highest degree of humanity). The physicians called this complexion equalis ad justiciam (equal according to justice), that is to say the most adapted to its object. Yet, such equilibrium is not mathematical, but depends on each context and each individual. On this point, the Italian physicians, in particular Gentile da Foligno (d. 1348) and Ugo Benzi (d. 1439), draw on the enumeration of the modalities of equilibrium evoked by Avicenna in the first book of his Canon. The art of the physician allows him to determine certain limits to humanity and also the latitude proper to each group that constitutes such humanity : for instance, the ideal complexion for someone inhabiting the southern regions of the world is not the same as someone inhabiting the northern regions of Europe – it is the task of the medical doctor as practitioner to determine what lifestyle, what diet and what medicine was needed to attain such relatively ideal complexion. The ambition of the Italian physicians of the 14th and 15th centuries thus appears to surpass the simple medical project of healing and assuring good health : they aspire to change or improve man. With this objective in mind, it was necessary for them to determine the complexion of a given individual, a determination made through the analysis of various exterior phenomena ranging from physiognomy to astrology. Complexion, given to one at birth, was also referred to as “innate complexion”, but the physicians never considered it as fixed or immutable in any manner : on the contrary, they remained convinced that the art of medicine could be used to change complexion. In this sense, their vision of man, far from being essentialist, was fundamentally optimistic : every man, while determined by nature, could hope to be improved – from a biological perspective, such as the prolonging of his life beyond its natural term, but also from a moral perspective, as Pietro Torrigiano affirmed at the beginning of the 14th century. With the aid of this extremely nuanced notion of complexion, the Italian physicians of the late Middle Ages developed a strikingly original anthropology, one which was compatible with those of the philosophers and theologians, but also one which allowed for a more flexible point of view on human beings, more attentive to the singularity of individuals. Hence, they were capable of explaining simultaneously the unity of humanity and the infinite multiplicity of its manifestations and the possibility of its variation.