§7. Galen’s Shadow-
After Galen, the medical sects disappear. By the fourth century he was an authority in Alexandria, which was again the center of ancient medicine, a position it maintained beyond the Arab conquest of 642.
In the last years, Alexandrian physicians developed a new approach to teaching medicine, which would also be followed under Islam. There is now only one medical science, based on the parts of classical philosophy that Galen accepted. Doctors are expected to have studied logic, astronomy, and human anatomy and physiology. The medical curriculum also closely followed that of philosophy, grammar, and rhetoric, both in pedagogical organization and substantially in the texts studied. Medicine is now a philosophical subject and it was impossible to teach medicine scientifically without some knowledge of philosophy, where Neoplatonic ideas and terminology predominated. It was at this time and in this milieu that Galen's approach was systematized and alternatives eliminated, creating a medical orthodoxy that lasted down to the sixteenth century.65In the eleventh century the Alexandrian-Islamic synthesis of Galen enters Europe in the teaching at Salerno. This Galen is not all of Galen, and it is Galen through the lens of a whole medical philosophy derived from generations of Arab commentary, culminating in Ibn Sina’s Qanun (Canon), the principal medical authority in Europe until the Renaissance, when Galen became fully accessible again. The medical school at Salerno was the earliest center for the circulation of medical ideas in Europe, and its first center for professional training. These first medical professors established the idea that medicine is a subject of academic study taught by teachers knowledgeable in classical authors. By the fourteenth century, Galen’s works had been recovered and newly translated into Latin. The summit of this “new Galen” was the medical school of Padua, where Galileo, a professor of mathematics there for twenty-eight years, encountered their methods and terminology.66
The philosophical tradition from Aristotle denies that an art (techne) can have its own logical method and be the equal of a science (episteme). For Galen, however, medical techne is precisely such an art, and its disciplined, methodical use of qualified experience is an independent source of natural philosophical explanation, alongside the intellection of universal principles, an idea forcefully restated in the medical teaching at Padua.
For Aristotle in Posterior Analytics, and for classical philosophy generally, science is not a matter of discovering new things. A scientific theory makes explicit what one had in a way always known. There is little interest in methods of inquiry, since, as Aristotle explained, “Almost everything has been found out.” The contrast with Hippocratics could not be more vivid. One of these authors writes, “To discover something that was unknown before and, once discovered, makes things better than if it had not been discovered, is the ambition and work of intelligence, as it is to bring to fruition something that was half completed.” That is not a thought to be read in Plato or Aristotle, but it is a theme in the materialistic empiricism Plato despised in Democritus.67According to scholars, Ibn Sina’s Qanun did not use a term translatable as ars or techne (art), medical knowledge being rendered as scientia in the standard translation. In the Renaissance, medicine began to be recognized as a different sort of scientia than the one Aristotle canonized (§14), with a different method and value than Aristotelian episteme. Additional new medical translations gave sixteenth-century authors confidence in being able to go beyond ancient medicine. The recovery of Galen’s Anatomical Procedures was the starting point for Versalius’s anatomical research. Galen’s Hippocratic ideas about analyzing experience and reconstituting it in experimentally confirmed terms were the beginning of the method of analysis and synthesis. This new Galen was an alternative to Aristotle, an alternative authority and tradition in medicine as well as natural philosophy, and friendly to the use of experience as an instrument of knowledge.68