Rhetoric and Medicine in Early Modern Europe

Nancy S. Struever, Stephen Pender

• Publisher: Routledge
• Year: 2016
• eBook ISBN:
  9781317063278
• Topic: Medicina
• Subtopic: Critica letteraria

Through close analysis of texts, cultural and civic communities, and intellectual history, the papers in this collection, for the first time, propose a dynamic relationship between rhetoric and medicine as discourses and disciplines of cure in early modern Europe. Although the range of theoretical approaches and methodologies represented here is diverse, the essays collectively explore the theories and practices, innovations and interventions, that underwrite the shared concerns of medicine, moral philosophy, and rhetoric: care and consolation, reading, policy, and rectitude, signinference, selfhood, and autonomy-all developed and refined at the intersection of areas of inquiry usually thought distinct. From Italy to England, from the sixteenth through to the mid-eighteenth century, early modern moral philosophers and essayists, rhetoricians and physicians investigated the passions and persuasion, vulnerability and volubility, theoretical intervention and practical therapy in the dramas, narratives, and disciplines of public and private cure. The essays are relevant to a wide range of readers, including cultural, literary, and intellectual historians, historians of medicine and philosophy, and scholars of rhetoric.

Chapter 1
Between Medicine and Rhetoric

Stephen Pender

To physician, idéologue, and reformer Pierre-Jean-Georges Cabanis, writing in 1788, medicine was the “basis of the only good rational philosophy.”1 Medicine, Cabanis argues, comprehends the “organic states” (états organiques) and “physical sensibilities” (sensibilités physiques) essential to intellection and emotion, action and reaction. That the intellect and the passions hold sway over the body is “an incontestable general fact” (un fait gééral incontestable); so too do physical processes condition moral operations.2 Cabanis’ “physiological monism,” his assertion that “the moral is only the physical considered under certain more particular points of view,” is central to his and others’ efforts to establish a secure, material foundation for moral philosophy in the late eighteenth and early nineteenth centuries.3 To Cabanis, moral philosophy cannot rest solely or comfortably on its theological substrata; instead, it should be investigated under the lissom rubric ‘physiology,’ envisioned as a “science of man” encompassing ethics, politics, and healing. Thus armed, physicians might form a ‘new priesthood,’ its liturgy medical, moral, and social reform.4

If medicine was to be the “basis” of a new, rational philosophy, its theory and practice required substantial renovation. In Du degré de certitude de la médicine (1798), Cabanis moors this reformation to the recovery of Hellenistic medical thought. Consonant with late eighteenth-century neoclassicism, Cabanis insists that medicine’s ancient legacy offered its inheritors a substantial repertoire of theories and practices as well as “all the means necessary to lead to their attainment.” Attempting to rescue medicine from “an uncharted sea” (une mer inconnue) of uncertainty, combing ancient texts for resources that might assist his project, Cabanis proposes precise, detailed clinical observation as the engine of reform in contemporary nosology, medical epistemology, and therapeutics.5 “The true knowledge of our art,” Cabanis argues in Du degré, “is constituted of a more or less correct assemblage of sensations derived from clinical observations.”6 ‘Sensations’ are the physician’s perceived or recalled impressions, “traces dans les organes de la pensée,” raw material assembled for judgement.7 For Cabanis, the solution to medical uncertainty hinges on the putative relationship between careful clinical observation, its extension by analogy (what ancient physicians called “transition to the similar”), and induction.8 Cabanis sifts these sensations with tools drawn from the history of rhetoric:

Noting with care all the circumstances capable of seducing, agitating, or convincing in discourse, in images, or in the form of reasoning, the ancient rhetors [les anciens rhéteurs] were soon convinced that these beauties, or rather the means by which they are produced, are far from being as numerous as at first sight they would seem to be; and that by uniting under the same title all those that resemble each other, they are all reducible to a very limited number of heads, or of common results.… The preceding remarks are equally applicable to those objects which the study of diseases presents to our minds. Each new case is at first believed to present new facts – but these, however, are only new combinations or shades of the same circumstances.

While physicians must continue to pursue the particular “spirit” [génie] of an illness and inquire into the effects of specific remedies, by focussing on “common results” and by drawing on the methods of ancient rhetors, this “méthode symptomatique” simplifies the observation, history, and treatment of disease.9 Cabanis’ enthusiasm for this symptomatic method is tempered by his recognition that diseases “are various, and susceptible of infinite complication,” that medical semiotics “or the art of recognising different states of the animal economy, by their characteristic signs, is without doubt the most difficult, as well as the most important branch of medicine.” Faced with misprision, in practice physicians must content themselves with “certitudes practiques,” practical certainties, which are nevertheless sufficient to ensure “conservation et … bien-être.”10

Nor does Cabanis’ engagement with its history exhaust his attention to rhetoric; elsewhere, investigating the relationships between medicine, “belles-lettres et arts,” he concluded that “the cultivation of letters and of fine arts can be moored to the more severe work of the art of healing.” As Ludmilla Jordanova observes in relation to Cabanis’ Coup d’œuil sur les révolutions et la réforme de la médicine (1804), it “should not be thought that literature and art were peripheral to medicine – quite the contrary, they constituted its very core, provided its languages, and were its basic tools of thought.” While Cabanis nowhere suggests that physicians declaim in grand style, even his attentiveness to Hippocrates was in part stylistic.11 Cabanis’ recourse to les anciens rhéteurs also sharpens the focus on individual skill; he urges discretion and sagacity, recommending the study of art for refining the physician’s tact.12 As we shall see, these strictures draw on residual notions of what might be called ‘medical prudence.’

Cabanis’ turn to rhetoric as a model for thinking through contingency and probability in medical experience exemplifies the form of loose, eclectic reasoning – seeking out common forms from variable, particular data; reasoning about causes from the probable evidence of effects; and turning to the trivium for assistance in doing so – that has characterised medical thought since early modernity.13 Gravely susceptible to error, medical reasoning relies on signs and examples, both gleaned from experience and both the subject of rhetorical inquiry; like rhetoric, medicine reaches plausible conclusions from probable premises.14 As Nancy Struever has argued, from the fourteenth century, particularly in the work of Pietro d’Abano, rhetorical figures were used to explain medical theory, and both rhetoric and medicine are pragmatic and interventionist: one devoted to the body, the other to the body politic. Struever has investigated this “rhetorical-medical mind set,” the intrication of therapy and cure, in d’Abano, Petrarch, Descartes, and others; and she has proposed a dual history of rhetoric and medicine in order to account for these habits of thought.15 Indeed, rhetoric is a “method for dealing with … domain[s] apparently beyond method” – ethics, politics, and medicine.16 In order to find viable means for inflecting normative medical theory with particulars and experience, ancient and early modern physicians settled on rhetorical and ethical tools – analogy, exemplarity, prudence. They enlisted a “rhetorised logic,” or that aspect of rhetoric in the Aristotelian tradition that involved interpreting signs, essaying probability, and establishing proofs;17 in Francis Bacon’s resonant phrase, the subject of rhetoric is “Imaginative or Insinuative Reason.”18 And since both rhetors and physicians must intervene, they must embrace certitudes practiques.

An examination of the antecedents of Cabanis’ ‘symptomatic’ method emphasises, if it does not solve, one of the central problems for the human sciences: how might general rules (about judgement, practice, intervention) be formed from the knowledge of particular cases? How might we attain ‘practical certainty’ in any inquiry devoted to the thinking, feeling human subject? How might a habit of thought, immured in one discipline, dwell productively in another? Early modern medicine is a fecund testing-ground for this inquiry; as Carlo Ginzburg notes in what is now a famous essay, the “future epistemological essence of the humane sciences was already being formulated in … discussions on the ‘uncertainty’ of medicine.”19

I focus on this moment in a very complex work – part of Cabanis’ broad and controversial programme of medical reformation based on “speculative physiology”20 – in order to isolate a constellation of ideas that has ancient roots and early modern branches, perhaps even contemporary foliation. In Du degré, Cabanis conjures the history of rhetoric as an entrepôt from which physicians might draw methods and models for reasoning about symptoms, for negotiating the relationship between the general (conceptions of illness) and the particular (individual cases). For physicians struggling with the variable, conflicting medical theories and a frangible, uncertain practice, rhetoric offers methods for reducing phenomena to their common forms, for placing these forms within emergent systems, and for practical intervention devoted to agitation, comfort, or cure.

Here, I explore some of the less obvious affinities between rhetoric and medicine – not solely to better understand Cabanis’ ruminations, but to suggest that rhetoric is a significant, and sorely neglected, aspect of medical thought from antiquity through to the early modern period. Both rhetoric and medicine are concerned with embodiment and with the passions, of course; since all accounts of perception and emotion must be ‘enmattered,’ as Aristotle insists, rarely was either treated in isolation from medical thought. This association between medicine and rhetoric is quite clear in both Cicero and Quintilian, for example, who enlist medicine in their inquiries into the passions.21 However, my purpose here is to suggest that rhetoric and medicine share forms of inference and reasoning as well as areas of inquiry and, in passing, to argue that these intersections should have more purchase in intellectual history.22 While early modern physicians for the most part reject persuasion, the affinities between medical thought and ‘rhetoricised logic’ are clear; sound conjecture ...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Contents
• List of Contributors
• Acknowledgements and Permissions
• Introduction: Reading Physicians
• 1 Between Medicine and Rhetoric
• 2 The Promotion of Bath Waters by Physicians in the Renaissance
• 3 The Anatomical Web: Literary Dissection from Castiglione to Cromwell
• 4 Medical Humanism, Rhetoric, and Anatomy at Padua, circa 1540
• 5 Political Pathology
• 6 Responses to Vulnerability: Medicine, Politics and the Body in Descartes and Spinoza
• 7 The Many Rhetorical Personae of an Early Modern Physician: Girolamo Cardano on Truth and Persuasion
• 8 You’ve Got to Have Soul: Understanding the Passions in Early Modern Culture
• 9 “The Babel Event”: Language, Rhetoric, and Burton's Infinite Symptom
• 10 Medicine’s Political Rhetoric: The Case of Bertini’s La medicina difesa
• Afterword: The Place of Medicine in a General Account of Early Modern Intellectual History
• Bibliography
• Index