Graeco-Roman case histories and their influence on medieval Islamic clinical accounts

Social History of Medicine

Volumn 12, Issue 1, 1999, Pages 19-43

  Millán, Cristina Álvarez ^a  

^a UNIVERSITY COLLEGE LONDON   (United Kingdom)

Author keywords

Ab bakr Muhammad ibn Zakar y ' al R z (Rhazes); Case histories; Epidemics; Galen; Hippocratic Corpus; Medieval Islamic medicine; Rufus of Ephesos

Indexed keywords

EID: 9944234670     PISSN: 0951631X     EISSN: None     Source Type: Journal    
DOI: 10.1093/shm/12.1.19     Document Type: Article

References (118)

1. For a general description, see P. Lain Entralgo, La historic clínica. Historia del relato patográfico (Madrid, 1950).
2. Epidemics I and III are two halves of the same work, while books II, IV, and VI are closely related to each other, and Epidemics V and VII constitute a third block. A classic study on the characteristics and dating of each group of the Epidemics is K. Deichgräber, Die Epidemien und das Corpus Hippocraticum (Berlin and New York, 1933, repr. 1971). For other approaches to the study of the Epidemics, see Lain Entralgo, La historia clínica, pp. 17-47; V. Langholf, Medical Theories in Hippocrates: Early Texts and the 'Epidemics' (Berlin and New York, 1990); W. D. Smith, 'Generic Form in Epidemics I to VII', in G. Baader and R. Winau (eds.), Die Hippokratischen Epidemien. Theory-Praxis-Tradition (Stuttgart, 1989. Sudhoffs Archiv; Heft 27), pp. 144-58; and chapter 3 in H. King, Hippocrates' Woman: Reading the Female Body in Ancient Greece (London, 1998).
3. Epidemics I and III are two halves of the same work, while books II, IV, and VI are closely related to each other, and Epidemics V and VII constitute a third block. A classic study on the characteristics and dating of each group of the Epidemics is K. Deichgräber, Die Epidemien und das Corpus Hippocraticum (Berlin and New York, 1933, repr. 1971). For other approaches to the study of the Epidemics, see Lain Entralgo, La historia clínica, pp. 17-47; V. Langholf, Medical Theories in Hippocrates: Early Texts and the 'Epidemics' (Berlin and New York, 1990); W. D. Smith, 'Generic Form in Epidemics I to VII', in G. Baader and R. Winau (eds.), Die Hippokratischen Epidemien. Theory-Praxis-Tradition (Stuttgart, 1989. Sudhoffs Archiv; Heft 27), pp. 144-58; and chapter 3 in H. King, Hippocrates' Woman: Reading the Female Body in Ancient Greece (London, 1998).
4. Epidemics I and III are two halves of the same work, while books II, IV, and VI are closely related to each other, and Epidemics V and VII constitute a third block. A classic study on the characteristics and dating of each group of the Epidemics is K. Deichgräber, Die Epidemien und das Corpus Hippocraticum (Berlin and New York, 1933, repr. 1971). For other approaches to the study of the Epidemics, see Lain Entralgo, La historia clínica, pp. 17-47; V. Langholf, Medical Theories in Hippocrates: Early Texts and the 'Epidemics' (Berlin and New York, 1990); W. D. Smith, 'Generic Form in Epidemics I to VII', in G. Baader and R. Winau (eds.), Die Hippokratischen Epidemien. Theory-Praxis-Tradition (Stuttgart, 1989. Sudhoffs Archiv; Heft 27), pp. 144-58; and chapter 3 in H. King, Hippocrates' Woman: Reading the Female Body in Ancient Greece (London, 1998).
5. Epidemics I and III are two halves of the same work, while books II, IV, and VI are closely related to each other, and Epidemics V and VII constitute a third block. A classic study on the characteristics and dating of each group of the Epidemics is K. Deichgräber, Die Epidemien und das Corpus Hippocraticum (Berlin and New York, 1933, repr. 1971). For other approaches to the study of the Epidemics, see Lain Entralgo, La historia clínica, pp. 17-47; V. Langholf, Medical Theories in Hippocrates: Early Texts and the 'Epidemics' (Berlin and New York, 1990); W. D. Smith, 'Generic Form in Epidemics I to VII', in G. Baader and R. Winau (eds.), Die Hippokratischen Epidemien. Theory-Praxis-Tradition (Stuttgart, 1989. Sudhoffs Archiv; Heft 27), pp. 144-58; and chapter 3 in H. King, Hippocrates' Woman: Reading the Female Body in Ancient Greece (London, 1998).
6. Epidemics I and III are two halves of the same work, while books II, IV, and VI are closely related to each other, and Epidemics V and VII constitute a third block. A classic study on the characteristics and dating of each group of the Epidemics is K. Deichgräber, Die Epidemien und das Corpus Hippocraticum (Berlin and New York, 1933, repr. 1971). For other approaches to the study of the Epidemics, see Lain Entralgo, La historia clínica, pp. 17-47; V. Langholf, Medical Theories in Hippocrates: Early Texts and the 'Epidemics' (Berlin and New York, 1990); W. D. Smith, 'Generic Form in Epidemics I to VII', in G. Baader and R. Winau (eds.), Die Hippokratischen Epidemien. Theory-Praxis-Tradition (Stuttgart, 1989. Sudhoffs Archiv; Heft 27), pp. 144-58; and chapter 3 in H. King, Hippocrates' Woman: Reading the Female Body in Ancient Greece (London, 1998).
7. The textual tradition of the Epidemics will not be taken into consideration here, since these works were transmitted and read by later scholars in the shape we now have them. W. D. Smith, Hippocrates. Volume VII: Epidemics 2, 4-7 (1994; Loeb Classical Library), p. 1; W. D. Smith, The Hippocratic Tradition (Ithaca, 1979), pp. 38 and 201. Likewise, it is beyond the scope of this work to analyse in full detail the case histories of the Epidemics. Therefore, I shall only point out the most relevant features related to this paper.
8. The textual tradition of the Epidemics will not be taken into consideration here, since these works were transmitted and read by later scholars in the shape we now have them. W. D. Smith, Hippocrates. Volume VII: Epidemics 2, 4-7 (1994; Loeb Classical Library), p. 1; W. D. Smith, The Hippocratic Tradition (Ithaca, 1979), pp. 38 and 201. Likewise, it is beyond the scope of this work to analyse in full detail the case histories of the Epidemics. Therefore, I shall only point out the most relevant features related to this paper.
9. On the avoidance of using women's names in the Epidemics, see David Schaps, 'The Woman Least Mentioned: Etiquette and Women's Names', Classical Quarterly, 27 (1977), 323-30.
10. W. H. S.Jones, Hippocrates. Volume I (1923, repr. 1985. Loeb Classical Library), III. case 3, p. 223, III c. 3, p. 263, III. c. 13, p. 279, III. c. 10, p. 275, III. c. 16, p. 285. On the links between reckless behaviour and disease, see G. E. R. Lloyd, The Revolutions of Wisdom. Studies in the Claims and Practice of Ancient Greek Science (Berkeley, 1987), pp. 17-18.
11. W. H. S.Jones, Hippocrates. Volume I (1923, repr. 1985. Loeb Classical Library), III. case 3, p. 223, III c. 3, p. 263, III. c. 13, p. 279, III. c. 10, p. 275, III. c. 16, p. 285. On the links between reckless behaviour and disease, see G. E. R. Lloyd, The Revolutions of Wisdom. Studies in the Claims and Practice of Ancient Greek Science (Berkeley, 1987), pp. 17-18.
12. Although in three instances the narrative in the first person is found (I. c. 4, p. 195; III. c. 8, p. 271; III. c. 13, p. 281), the physician acts as a spectator.
13. V. Nutton, 'Healers in the Medical Market-Place: Towards a Social History of Graeco-Roman Medicine', in A. Wear (ed.), Medicine in Society (Cambridge, 1992), p. 21.
14. Langholf, Medical Theories in Hippocrates, pp. 102-9.
15. On the implicit principles of Hippocratic disease definition and classification, see Lain Entralgo, Let historia clínica, pp. 36-40; P. Potter, 'Some Principles of Hippocratic Nosology', in P. Potter, G. Maloney, and J. Desautels (eds.), La Maladie et les Maladies dans la Collection Hippocratique (Québec, 1990), pp. 237-53.
16. On the implicit principles of Hippocratic disease definition and classification, see Lain Entralgo, Let historia clínica, pp. 36-40; P. Potter, 'Some Principles of Hippocratic Nosology', in P. Potter, G. Maloney, and J. Desautels (eds.), La Maladie et les Maladies dans la Collection Hippocratique (Québec, 1990), pp. 237-53.
17. Laín Entralgo, La historia clínica, pp. 5, 48.
18. See Epidemics VI.3.12 and Epidemics VI.8.26. Smith, Epidemics 2, 4-7, pp. 239-40 and 287.
19. See Epidemics VI.3.12 and Epidemics VI.8.26. Smith, Epidemics 2, 4-7, pp. 239-40 and 287.
20. See Epidemics VI.3.12 and Epidemics VI.8.26. Smith, Epidemics 2, 4-7, pp. 239-40 and 287.
21. While Epidemics II and VI seem especially concerned with the instruction in diagnosis and prognosis - and, as Smith notes, with the understanding of the body ('Generic Form in Epidemics', p. 151)- Epidemics IV leans towards pathology (either in relation to particular weather conditions or not) from the point of view of real cases rather than in the form of a theoretical discussion. Epidemics VI is particularly related to lecture topics and mnemonic statements regarding well-observed disease phenomena.
22. In Epidemics IV, which contains a larger number of case histories than Epidemics II and VI, descriptions of other patients are often reported within a single case history as presenting slight variants (IV: 2, 23, 25, 29, 31, 41, 55; VI.3.5). As for the opposite, one patient (or more) is brought into the general observation in order to reinforce the theoretical learning - 'as in the case of, 'like so-and-so' - (II.3.18; IV: 34, 40, 45, 48, 50, 56; VI.3.5, VI.3.14, VI.6.9, VI.6.10, VI.6.13, VI.7.2, VI.7.10, VI.8.10, VI.8.18, VI.8.32).
23. Epidemics II.2.3, II.2.18; IV: 6, 13, 15, 17, 21, 25, 26, 35, 41, 52, 53, 55, 56; VI.2.15, VI.3.2, VI.3.9, VI.8.20, VI.8.3, VI.8.32.
24. Epidemics IV.11. In Epidemics VI.3.18, the writer states openly that a colleague killed patients due to a wrong treatment, but again, the point is made about the appropriateness of a certain therapy to a given condition. See also, IV.58, VI.2.15, and VI.8.32.
25. Epidemics VI.8.24. In addition, the fact that the reader (or listener) is addressed a number of times (II.1.8, II.2.1b, II.3.14, 11,4.5, II.5.24; IV.20b; VI.1.5, VI.2.1, VI.2.6, VI.2.7, VI.2.14, VI.5.15, VI.6.5, VI.6.6, VI.7.4), and the form in which the writer addressed his audience, support Langholf's theory regarding its being a teacher's lecture notes (Medical Theories in Hippocrates, pp. 141-9).
26. See W. D. Smith, 'Implicit Fever Theory in Epidemics 5 and 7', in W. F. Bynum and V. Nutton (eds.), Theories of Fever from Antiquity to the Enlightenment (London, 1981), pp. 1-18.
27. Samples of these features in Epidemics V are cases number 7, 15, 18, 19, 26, 29, 30, 31, 34, 76.
28. This feature is particularly evident in Epidemics V.26. The author fails to identify the patient's bilious complexion and admits so in the terms 'one did not notice it'. The mistake apparently leads him to choose the wrong treatment. Then he recognizes in an impersonal manner that the nature of the condition was far more serious than supposed (this is, perhaps, a literary way of saving that the patient is going to die), and finally, he states that, whatever care was given, there was no cure. The narrative in the first person occurs on just one occasion (V.27).
29. A number of cases relate to the disease called opisthotonos, a sort of tetanus that draws the patient backwards into a bow shape (Smith, Epidemics 2, 4-7, p. 189). Epidemics V.81 and V.82 refer to two curious phobias, and V.86 to a young drunk man who died when a snake went into his mouth while he was asleep.
30. Epidemics VII: 1, 2, 5, 11, 13, 23, 25, 26, 39, 43, 46, 59, 83, 84, 120.
31. What is described in Epidemics I and III as 'irrational behavior' and 'delirium', in Epidemics VII appears, for example, as 'he spoke more aggressively and greeted people more warmly than the occasion warranted' (VII. 10), or 'She would reach out with her hand from time to time towards the plaster wall . . . She would put her hands on her chest and sometimes throw off the cover' (VII. 11). While the writer enjoys himself with the description of seemingly irrelevant details, in contrast, he is unsure of the day on which a given symptom was noticed (VII: 26, 42, 43), he does not recall what side of the body was affected (VII.24) nor on what day the patient passed away (VII.28). Moreover, the reference to specific days is usually preceded by expressions such as 'towards', 'about', and 'perhaps'.
32. On the application of the prognostic aphorisms in the case histories of Epidemics, see V. Langholf, 'Generalisationen und Aphorismen in den Epidemienbüchern', in G. Baader and R. Winau (eds.), Die Hippokratischen Epidemien. Theory-Praxis-Tradition (Stuttgart, 1989), pp. 131-43; and Langholf, Medical Theories in Hippocrates, pp. 222-31.
33. On the application of the prognostic aphorisms in the case histories of Epidemics, see V. Langholf, 'Generalisationen und Aphorismen in den Epidemienbüchern', in G. Baader and R. Winau (eds.), Die Hippokratischen Epidemien. Theory-Praxis-Tradition (Stuttgart, 1989), pp. 131-43; and Langholf, Medical Theories in Hippocrates, pp. 222-31.
34. E.g., VII.5: 'as he was approaching the end', VII.11: 'until the final days', VII.41: 'as she was dying', VII.52: 'the end was near', etc.... This form of announcing the patient's death might also be linked to a certain reluctance to state openly that the patient actually died.
35. Epidemics VII: 11, 24, 26, 28, 42. The presence of the physician who initially recorded the observations occurs only on two occasions at the end of the book (VII: 80, 111).
36. See A. Sideras, 'Rufus von Ephesos und sein Werk im Rahmen der antiken Medizin', in W. Haase and H. Temporini (eds.), Aufstieg und Niedergang der römischen Welt, hereafter A.N.R. W. (Berlin and New York, 1994), Teil II, Band 37.2, pp. 1077-253; A. Abou-Aly, 'The Medical Writings of Rufus of Ephesus' (unpublished, Ph.D. dissertation, University College London, 1992); M. Ullmann, Die Medizin im Islam (Leiden and Köln, 1970), pp. 71-6; F. Sezgin, Geschichte des arabischen Schrifttums, hereafter C.A.S. (Leiden, 1970), III, pp. 64-8.
37. See A. Sideras, 'Rufus von Ephesos und sein Werk im Rahmen der antiken Medizin', in W. Haase and H. Temporini (eds.), Aufstieg und Niedergang der römischen Welt, hereafter A.N.R. W. (Berlin and New York, 1994), Teil II, Band 37.2, pp. 1077-253; A. Abou-Aly, 'The Medical Writings of Rufus of Ephesus' (unpublished, Ph.D. dissertation, University College London, 1992); M. Ullmann, Die Medizin im Islam (Leiden and Köln, 1970), pp. 71-6; F. Sezgin, Geschichte des arabischen Schrifttums, hereafter C.A.S. (Leiden, 1970), III, pp. 64-8.
38. See A. Sideras, 'Rufus von Ephesos und sein Werk im Rahmen der antiken Medizin', in W. Haase and H. Temporini (eds.), Aufstieg und Niedergang der römischen Welt, hereafter A.N.R. W. (Berlin and New York, 1994), Teil II, Band 37.2, pp. 1077-253; A. Abou-Aly, 'The Medical Writings of Rufus of Ephesus' (unpublished, Ph.D. dissertation, University College London, 1992); M. Ullmann, Die Medizin im Islam (Leiden and Köln, 1970), pp. 71-6; F. Sezgin, Geschichte des arabischen Schrifttums, hereafter C.A.S. (Leiden, 1970), III, pp. 64-8.
39. See A. Sideras, 'Rufus von Ephesos und sein Werk im Rahmen der antiken Medizin', in W. Haase and H. Temporini (eds.), Aufstieg und Niedergang der römischen Welt, hereafter A.N.R. W. (Berlin and New York, 1994), Teil II, Band 37.2, pp. 1077-253; A. Abou-Aly, 'The Medical Writings of Rufus of Ephesus' (unpublished, Ph.D. dissertation, University College London, 1992); M. Ullmann, Die Medizin im Islam (Leiden and Köln, 1970), pp. 71-6; F. Sezgin, Geschichte des arabischen Schrifttums, hereafter C.A.S. (Leiden, 1970), III, pp. 64-8.
40. These accounts appear attributed to 'Rufus and other ancient and modern [physicians]' in a manuscript preserved at Oxford, Bodleian Library, MS. Hunt. 461, fols. 38b-50a. The authorship of these clinical histories is still unclear, but for the sake of clarity, I shall refer to this group of accounts as 'Rufus's case histories', since there is general agreement that they were known in the form we have them as a unit of Greek origin. The text has been studied, edited and translated into German by Prof. M. Ullmann, who attributes the whole of the collection to Rufus (Rufus of Ephesos Krankenjournale, edition, translation and study by M. Ullmann (Wiesbaden, 1978)). Against Ullmann's philological and historical assumptions, Abou-Aly argues that only the first five cases can be attributed to him; however, her refutation (Medical Writings of Rufus, pp. 211-17) is no more convincing than Ullmann's efforts to establish Rufus' authorship (see below notes 31 and 32). See also Fridolf Kudlien, 'A New Testimony for Erasistratus?', Clio Medica, 15 (1980), 137-42.
41. These accounts appear attributed to 'Rufus and other ancient and modern [physicians]' in a manuscript preserved at Oxford, Bodleian Library, MS. Hunt. 461, fols. 38b-50a. The authorship of these clinical histories is still unclear, but for the sake of clarity, I shall refer to this group of accounts as 'Rufus's case histories', since there is general agreement that they were known in the form we have them as a unit of Greek origin. The text has been studied, edited and translated into German by Prof. M. Ullmann, who attributes the whole of the collection to Rufus (Rufus of Ephesos Krankenjournale, edition, translation and study by M. Ullmann (Wiesbaden, 1978)). Against Ullmann's philological and historical assumptions, Abou-Aly argues that only the first five cases can be attributed to him; however, her refutation (Medical Writings of Rufus, pp. 211-17) is no more convincing than Ullmann's efforts to establish Rufus' authorship (see below notes 31 and 32). See also Fridolf Kudlien, 'A New Testimony for Erasistratus?', Clio Medica, 15 (1980), 137-42.
42. Cases showing this feature are I, II, V, VI, VII, VIU, IX, X, XI, XIV, XVI, XVIII, XX, XXI.
43. The narrative in the first person is used in all the accounts, except the fourth, which is not related to one of his patients. The authorial 'we' only appears in cases number VII, VIII, IX, XV and XVI. The writer introduces some of the cases by claiming ' I have seen a person ...' (I, XXI) or 'I know a person' (II, III), and expressions like 'I was called in' (VI, VIII, XI, XII, XVI, XVIII), or similar (X, XIV, XVII), are increasingly found.
44. As for the three patients who died, apart from case number XX, interestingly, the first one (case n. III) dies while being treated by another physician, the second one (case n. XII) had a bad crisis, and the third one (case n. XIX) was suffering from angina, considered a fatal disease.
45. Ullmann suggests that Rufus had a notebook in which he would have written his experiences in order to participate in the annual medical competition held in Ephesos, and believes that the Arabic translation is only a fragment of the original work (Rufus of Ephesos, Krankenjaurnale, p. 24). Abou-Aly, however, argues that these annual contests in Ephesos are not documented before the second century ( Medical Writings of Rufus, pp. 214-15).
46. Ullmann suggests that Rufus had a notebook in which he would have written his experiences in order to participate in the annual medical competition held in Ephesos, and believes that the Arabic translation is only a fragment of the original work (Rufus of Ephesos, Krankenjaurnale, p. 24). Abou-Aly, however, argues that these annual contests in Ephesos are not documented before the second century ( Medical Writings of Rufus, pp. 214-15).
47. Whether these clinical accounts were written by Rufus or not is still far from being resolved. Given the number of occasions on which Islamic copyists omitted or misinterpreted the information concerning the authorship of the text they were reproducing, the heading which precedes these accounts might well be unreliable. Moreover, the features I have described do not just appear in the first five cases which Abou-Aly attributes to Rufus, nor only in the rest of the clinical cases but, on the contrary, most of them occur evenly distributed throughout. Unfortunately no further ancient case histories beyond those discussed in this paper seem to have survived, and therefore we cannot demonstrate how clinical histories by other authors would differ. However, it would be reasonable to think that twenty-one accounts by Rufus and 'other ancient and modern' physicians would have shown different styles or formal elements. Yet the three general features I have mentioned seem unlikely to be the result of any reelaboration by a later compiler, or indeed to be the stylistic product of the Arabic translator's editorial work.
48. Galen, On the Affected Parts, translation from the Greek text with explanatory notes by R. E. Siegel (Basel, 1976), pp. 38-9.
49. Galen, On Prognosis, edition, translation and commentary by V. Nutton (Berlin, 1979). Corpus Medicorum Craecorum (hereafter C.M.G. V8 1).
50. Galen, On Prognosis, edition, translation and commentary by V. Nutton (Berlin, 1979). Corpus Medicorum Craecorum (hereafter C.M.G. V8 1).
51. V. Nutton, 'Galen and Medical Autobiography', in V. Nutton (ed.), From Democedes to Harvey: Studies in the History of Medicine (London, 1988), p. 52.
52. Galen, On Prognosis, pp. 53-7; Ullmann, Die Medizin im Islam, p. 44; Sezgin, G.A.S. III, pp. 114-15. The Arabic translation for this tide was Kitab̄ Nawādir taqdimāt al-ma 'rifah.
53. Galen, On Prognosis, pp. 53-7; Ullmann, Die Medizin im Islam, p. 44; Sezgin, G.A.S. III, pp. 114-15. The Arabic translation for this tide was Kitab̄ Nawādir taqdimāt al-ma 'rifah.
54. Galen, On Prognosis, pp. 53-7; Ullmann, Die Medizin im Islam, p. 44; Sezgin, G.A.S. III, pp. 114-15. The Arabic translation for this tide was Kitab̄ Nawādir taqdimāt al-ma 'rifah.
55. Galen's On the Affected Parts was known in Arabic under the title Kitāb al-A 'dā' al-ālimah. The Latin translation was known as De locis affectis. Ullmann, Die Medizin im Islam, p. 41-2; Sezgin, G.A.S III, 90-1.
56. Galen's On the Affected Parts was known in Arabic under the title Kitāb al-A 'dā' al-ālimah. The Latin translation was known as De locis affectis. Ullmann, Die Medizin im Islam, p. 41-2; Sezgin, G.A.S III, 90-1.
57. The Arabic version of On the Method of Healing appears under the title Kitāb Hilat al-bur' and Kitāb al-Sinā'at al-kabirah (in the Latin tradition as Methodus Medendi or Ars Magna. Ullmann, Die Medizin im Islam, p. 45; Sezgin, G.A.S. III, 96-8. See V. Nutton, 'Style and Context in "The Method of Healing"', in F. Kudlien and R. J. Durling (eds.), Galen's Method of Healing (Leiden, 1991), pp. 1-25.
58. The Arabic version of On the Method of Healing appears under the title Kitāb Hilat al-bur' and Kitāb al-Sinā'at al-kabirah (in the Latin tradition as Methodus Medendi or Ars Magna. Ullmann, Die Medizin im Islam, p. 45; Sezgin, G.A.S. III, 96-8. See V. Nutton, 'Style and Context in "The Method of Healing"', in F. Kudlien and R. J. Durling (eds.), Galen's Method of Healing (Leiden, 1991), pp. 1-25.
59. The Arabic version of On the Method of Healing appears under the title Kitāb Hilat al-bur' and Kitāb al-Sinā'at al-kabirah (in the Latin tradition as Methodus Medendi or Ars Magna. Ullmann, Die Medizin im Islam, p. 45; Sezgin, G.A.S. III, 96-8. See V. Nutton, 'Style and Context in "The Method of Healing"', in F. Kudlien and R. J. Durling (eds.), Galen's Method of Healing (Leiden, 1991), pp. 1-25.
60. L. Garcia Ballester, 'Elementos para la construcción de las historias clínicas en Galeno', Dynamis 15 (1995), 41-6. In addition, Galen could have taken this feature from the Hippocratic case histories, which he knew and imitated in some of his accounts. See L. Garcia Ballester, 'Galen as a Clinician: His Methods of Diagnosis', in W. Haase and H. Temporini (eds.), A.N.R. W. Teil H, Vol. 37.2, p. 1646 ff. See also Galen, In Hippocratis Epidemiarum libros I et II, C.M.G V.10.1; - In Hippocratis Epidemiarum librum III, C.M.G., V.10.2.1; - In Hippocratis Epidemiarum librum VI, C.M.G., V.10.2.2.
61. L. Garcia Ballester, 'Elementos para la construcción de las historias clínicas en Galeno', Dynamis 15 (1995), 41-6. In addition, Galen could have taken this feature from the Hippocratic case histories, which he knew and imitated in some of his accounts. See L. Garcia Ballester, 'Galen as a Clinician: His Methods of Diagnosis', in W. Haase and H. Temporini (eds.), A.N.R. W. Teil H, Vol. 37.2, p. 1646 ff. See also Galen, In Hippocratis Epidemiarum libros I et II, C.M.G V.10.1; - In Hippocratis Epidemiarum librum III, C.M.G., V.10.2.1; - In Hippocratis Epidemiarum librum VI, C.M.G., V.10.2.2.
62. L. Garcia Ballester, 'Elementos para la construcción de las historias clínicas en Galeno', Dynamis 15 (1995), 41-6. In addition, Galen could have taken this feature from the Hippocratic case histories, which he knew and imitated in some of his accounts. See L. Garcia Ballester, 'Galen as a Clinician: His Methods of Diagnosis', in W. Haase and H. Temporini (eds.), A.N.R. W. Teil H, Vol. 37.2, p. 1646 ff. See also Galen, In Hippocratis Epidemiarum libros I et II, C.M.G V.10.1; - In Hippocratis Epidemiarum librum III, C.M.G., V.10.2.1; - In Hippocratis Epidemiarum librum VI, C.M.G., V.10.2.2.
63. Nutton, 'Style and Context in "The Method of Healing"', p. 12.
64. On Galen's self-construction of authority and its relationship with the rhetorical theories and practices of his time, see H. Von Staden, 'Anatomy as Rhetoric: Galen on Dissection and Persuasion', Journal of the History of Mediane and Allied Sciences, 50 (1995), 47-66.
65. Galen, On the Method of Healing. Books land III translated with an introduction and commentary by R. J. Hankinson (Oxford, 1991), p. xxxiv and p. 3.
66. V. Nutton, 'Beyond the Hippocratic Oath', in A. Wear, J. Geyer-Kordesh and R. French (eds.), Doctors and Ethics: The Earlier Historical Setting of Professional Ethics (Amsterdam, 1993), pp. 10-37.
67. Interestingly, in his commentary to the Epidemics, Galen discarded the books which actually consisted of case histories (books IV, V, and VII), under the excuse that they were not written by Hippocrates himself. Arabic translation of Galen's commentary by Hunayn b. Ishāq, Escorial, MS. 805, fol. Iv (paginated as a Western manuscript).
68. Nutton, 'Style and Context in "The Method of Healing"', p. 12.
69. See Ullmann, Die Medizin im Islam, pp. 128-36; M. Ullmann, Die Natur- und Ceheimwissenschaften im Islam (Leiden and Köln, 1972), pp. 210-13 and 383; Sezgin, G.A.S. III, pp. 274-94 and IV, 275-82. Encyclopaedia of Islam (Leiden, 1952-), VIII, pp. 474-7, s.v. Al-Rāzā, Abu Bakr [L. E. Goodman]; S. Pines, 'Al-Rāzi', in C. C. Gillispie (ed.), Dictionary of Scientific Biography (New York, 1970-80), XI, pp. 323-6. Two updated syntheses on al-Rāzi's life and writings are those by L. Richter-Bernburg, 'Abū Bakr Muhammad Al-Rāzi (Rhazes) Medical Works', Medicina nei Secoli, 6 (1994), 377-92, and R. Kuhne Brabant, 'Al-Rāzi', in Storia della scienza, Instituto della Enciclopedia Italiana, Vol. II, Sez. B: Arabic Science, Part 7: Scientific Portraits (forthcoming).
70. See Ullmann, Die Medizin im Islam, pp. 128-36; M. Ullmann, Die Natur- und Ceheimwissenschaften im Islam (Leiden and Köln, 1972), pp. 210-13 and 383; Sezgin, G.A.S. III, pp. 274-94 and IV, 275-82. Encyclopaedia of Islam (Leiden, 1952-), VIII, pp. 474-7, s.v. Al-Rāzā, Abu Bakr [L. E. Goodman]; S. Pines, 'Al-Rāzi', in C. C. Gillispie (ed.), Dictionary of Scientific Biography (New York, 1970-80), XI, pp. 323-6. Two updated syntheses on al-Rāzi's life and writings are those by L. Richter-Bernburg, 'Abū Bakr Muhammad Al-Rāzi (Rhazes) Medical Works', Medicina nei Secoli, 6 (1994), 377-92, and R. Kuhne Brabant, 'Al-Rāzi', in Storia della scienza, Instituto della Enciclopedia Italiana, Vol. II, Sez. B: Arabic Science, Part 7: Scientific Portraits (forthcoming).
71. See Ullmann, Die Medizin im Islam, pp. 128-36; M. Ullmann, Die Natur- und Ceheimwissenschaften im Islam (Leiden and Köln, 1972), pp. 210-13 and 383; Sezgin, G.A.S. III, pp. 274-94 and IV, 275-82. Encyclopaedia of Islam (Leiden, 1952-), VIII, pp. 474-7, s.v. Al-Rāzā, Abu Bakr [L. E. Goodman]; S. Pines, 'Al-Rāzi', in C. C. Gillispie (ed.), Dictionary of Scientific Biography (New York, 1970-80), XI, pp. 323-6. Two updated syntheses on al-Rāzi's life and writings are those by L. Richter-Bernburg, 'Abū Bakr Muhammad Al-Rāzi (Rhazes) Medical Works', Medicina nei Secoli, 6 (1994), 377-92, and R. Kuhne Brabant, 'Al-Rāzi', in Storia della scienza, Instituto della Enciclopedia Italiana, Vol. II, Sez. B: Arabic Science, Part 7: Scientific Portraits (forthcoming).
72. See Ullmann, Die Medizin im Islam, pp. 128-36; M. Ullmann, Die Natur- und Ceheimwissenschaften im Islam (Leiden and Köln, 1972), pp. 210-13 and 383; Sezgin, G.A.S. III, pp. 274-94 and IV, 275-82. Encyclopaedia of Islam (Leiden, 1952-), VIII, pp. 474-7, s.v. Al-Rāzā, Abu Bakr [L. E. Goodman]; S. Pines, 'Al-Rāzi', in C. C. Gillispie (ed.), Dictionary of Scientific Biography (New York, 1970-80), XI, pp. 323-6. Two updated syntheses on al-Rāzi's life and writings are those by L. Richter-Bernburg, 'Abū Bakr Muhammad Al-Rāzi (Rhazes) Medical Works', Medicina nei Secoli, 6 (1994), 377-92, and R. Kuhne Brabant, 'Al-Rāzi', in Storia della scienza, Instituto della Enciclopedia Italiana, Vol. II, Sez. B: Arabic Science, Part 7: Scientific Portraits (forthcoming).
73. See Ullmann, Die Medizin im Islam, pp. 128-36; M. Ullmann, Die Natur- und Ceheimwissenschaften im Islam (Leiden and Köln, 1972), pp. 210-13 and 383; Sezgin, G.A.S. III, pp. 274-94 and IV, 275-82. Encyclopaedia of Islam (Leiden, 1952-), VIII, pp. 474-7, s.v. Al-Rāzā, Abu Bakr [L. E. Goodman]; S. Pines, 'Al-Rāzi', in C. C. Gillispie (ed.), Dictionary of Scientific Biography (New York, 1970-80), XI, pp. 323-6. Two updated syntheses on al-Rāzi's life and writings are those by L. Richter-Bernburg, 'Abū Bakr Muhammad Al-Rāzi (Rhazes) Medical Works', Medicina nei Secoli, 6 (1994), 377-92, and R. Kuhne Brabant, 'Al-Rāzi', in Storia della scienza, Instituto della Enciclopedia Italiana, Vol. II, Sez. B: Arabic Science, Part 7: Scientific Portraits (forthcoming).
74. See Ullmann, Die Medizin im Islam, pp. 128-36; M. Ullmann, Die Natur- und Ceheimwissenschaften im Islam (Leiden and Köln, 1972), pp. 210-13 and 383; Sezgin, G.A.S. III, pp. 274-94 and IV, 275-82. Encyclopaedia of Islam (Leiden, 1952-), VIII, pp. 474-7, s.v. Al-Rāzā, Abu Bakr [L. E. Goodman]; S. Pines, 'Al-Rāzi', in C. C. Gillispie (ed.), Dictionary of Scientific Biography (New York, 1970-80), XI, pp. 323-6. Two updated syntheses on al-Rāzi's life and writings are those by L. Richter-Bernburg, 'Abū Bakr Muhammad Al-Rāzi (Rhazes) Medical Works', Medicina nei Secoli, 6 (1994), 377-92, and R. Kuhne Brabant, 'Al-Rāzi', in Storia della scienza, Instituto della Enciclopedia Italiana, Vol. II, Sez. B: Arabic Science, Part 7: Scientific Portraits (forthcoming).
75. See Ullmann, Die Medizin im Islam, pp. 128-36; M. Ullmann, Die Natur- und Ceheimwissenschaften im Islam (Leiden and Köln, 1972), pp. 210-13 and 383; Sezgin, G.A.S. III, pp. 274-94 and IV, 275-82. Encyclopaedia of Islam (Leiden, 1952-), VIII, pp. 474-7, s.v. Al-Rāzā, Abu Bakr [L. E. Goodman]; S. Pines, 'Al-Rāzi', in C. C. Gillispie (ed.), Dictionary of Scientific Biography (New York, 1970-80), XI, pp. 323-6. Two updated syntheses on al-Rāzi's life and writings are those by L. Richter-Bernburg, 'Abū Bakr Muhammad Al-Rāzi (Rhazes) Medical Works', Medicina nei Secoli, 6 (1994), 377-92, and R. Kuhne Brabant, 'Al-Rāzi', in Storia della scienza, Instituto della Enciclopedia Italiana, Vol. II, Sez. B: Arabic Science, Part 7: Scientific Portraits (forthcoming).
76. Among al-Rāzī's Islamic biographers, M. b. Ishāq Ibn al-Nadim, Kitāb al-Fihrist, ed. G. Flügel (Leipzig, 1871-72), I, pp. 299-302; Sulaymān b. Hassān Ibn Juljul, Tabaqāt al-atibbā' wa-l-hukamā', ed. F. Sayyid (Bayrūt, 1985), pp. 77-80; Abū Rayhān M.b.M. al-Birūnī, Risāla fi fihrist kutub Muhammad ihn Zakarīyā' al-Rāzī ed. by P. Kraus as Epître de Bērūnī contenant le répertoire des ouvrages de Muhammad ibn Zakarīyā al-Rāzi (Paris, 1936), pp. 1-11; 'Ali ibn Yūsufal-Qirti, Ta'rīkh al-hukamā', ed. J. Lippert (Leipzig, 1903), pp. 271-6; Ibn Abī Usaybi'a, 'Uyūn al-atibā', fi tabaqāt al-atibbā', ed. A. Müller (Kairo and Königsberg, 1882-84), I, pp. 309-21.
77. This work was one of his most successful texts in the Latin tradition, translated by Gerard of Cremona (d. 1187) in Toledo under the title Liber ad Almansoris. The ninth chapter, or Liber nonus ad Almansorem, devoted to therapy according to local diseases from head to toe, gained a particularly widespread circulation in separate printed editions, being the subject of several commentaries by university scholars and Renaissance anatomists like Vesalius. D. Jacquart and F. Micheau, La médicine arabe et l'occident médieval (Paris, 1990), pp. 191-2; N. Siraisi, Medieval & Renaissance Medicine (Chicago, 1990), p. 131.
78. On the contents and main features of this work, see my forthcoming article, 'Al-Rāzī·Kitāb al-Tajārib: Everyday Medical Practice in Tenth-Century Islamic Medicine'.
79. Istanbul, Topkapi Sarai, Ahmet III, MS. 1975, fol. 10a.
80. Ibid., fol. 3b.
81. Ibid., fol. 42a.
82. Ibid., fol. 32a.
83. Ibid., fol. 50a-50b.
84. Ibid., fol. 45a.
85. Ibid., fol. 6b.
86. Ibid., fol. 122a.
87. Ibid., fol. 36a.
88. Ibid., fol. 108a.
89. Ibid., fol. 109a.
90. Since Galen's commentary on the Epidemics only dealt with books I, II, III, and VI, al-Rz̄zī could hardly have had access to books IV and V, nor to book VII (see above, note 44).
91. See E. Savage-Smith, 'The Working Files of Rhazes: Are the Jāmi' and the Hāwi Identical?' (forthcoming).
92. The printed Arabic text consists of 23 volumes. M. b. Z. al-Rāzi, Kitāb al-Hāwi fi l-tibb (Hyderabad, 1955-68).
93. Jacquart and Micheau, La médicine arabe, pp. 207-8; E. Savage-Smith, 'Europe and Islam', in I. Loudon (ed.), Western Medicine: An Illustrated History (Oxford, 1997), p. 45.
94. Jacquart and Micheau, La médicine arabe, pp. 207-8; E. Savage-Smith, 'Europe and Islam', in I. Loudon (ed.), Western Medicine: An Illustrated History (Oxford, 1997), p. 45.
95. Al-Rāzī, Hāwī II, 190.5.
96. An illustrative example is al-Rāzi's version of Galen's case history (see above, note 33) in Hāwī vol. I, p. 5.15-19. The Arabic translation of this account by Hunayn b. Ishāq follows Galen's text closely (London, Wellcome Library, Arabic MS. 14a, fols. 22b.3-19-3a.1-15). It must also be stressed that al-Rāzī collected about a third of Galen's On the Method of Healing in the Hāwī, and that in this large portion of quotations, al-Rāzī omitted Galen's arguments against his colleagues. U. Weisser, 'Zur Rezeption der Methodus medendi im Continens des Rhazes', in F. Kudlien and R. J. Durling (eds.), Galen's Method of Healing (Leiden, 1991), pp. 132-3. A listing of al-Rāzī's quotations from Galen's work is in U. Weisser, 'Die Zitate aus Galens De methodo medendi im Hawi des Razi', in G. Endress and R. Kruk (eds.), The Ancient Tradition in Christian and Islamic Hellenism: Studies on the Transmission of Greek Philosophy and Sciences (Leiden, 1997), pp. 279-318.
97. An illustrative example is al-Rāzi's version of Galen's case history (see above, note 33) in Hāwī vol. I, p. 5.15-19. The Arabic translation of this account by Hunayn b. Ishāq follows Galen's text closely (London, Wellcome Library, Arabic MS. 14a, fols. 22b.3-19-3a.1-15). It must also be stressed that al-Rāzī collected about a third of Galen's On the Method of Healing in the Hāwī, and that in this large portion of quotations, al-Rāzī omitted Galen's arguments against his colleagues. U. Weisser, 'Zur Rezeption der Methodus medendi im Continens des Rhazes', in F. Kudlien and R. J. Durling (eds.), Galen's Method of Healing (Leiden, 1991), pp. 132-3. A listing of al-Rāzī's quotations from Galen's work is in U. Weisser, 'Die Zitate aus Galens De methodo medendi im Hawi des Razi', in G. Endress and R. Kruk (eds.), The Ancient Tradition in Christian and Islamic Hellenism: Studies on the Transmission of Greek Philosophy and Sciences (Leiden, 1997), pp. 279-318.
98. An illustrative example is al-Rāzi's version of Galen's case history (see above, note 33) in Hāwī vol. I, p. 5.15-19. The Arabic translation of this account by Hunayn b. Ishāq follows Galen's text closely (London, Wellcome Library, Arabic MS. 14a, fols. 22b.3-19-3a.1-15). It must also be stressed that al-Rāzī collected about a third of Galen's On the Method of Healing in the Hāwī, and that in this large portion of quotations, al-Rāzī omitted Galen's arguments against his colleagues. U. Weisser, 'Zur Rezeption der Methodus medendi im Continens des Rhazes', in F. Kudlien and R. J. Durling (eds.), Galen's Method of Healing (Leiden, 1991), pp. 132-3. A listing of al-Rāzī's quotations from Galen's work is in U. Weisser, 'Die Zitate aus Galens De methodo medendi im Hawi des Razi', in G. Endress and R. Kruk (eds.), The Ancient Tradition in Christian and Islamic Hellenism: Studies on the Transmission of Greek Philosophy and Sciences (Leiden, 1997), pp. 279-318.
99. Oxford, Bodleian Library, MS. Marsh 156. E. G. Brown, Arabian Medicine (London, 1920), pp. 48-53.
100. M. Meyerhof, 'Thirty-Three Medical Observations by Rhazes', Isis, 23 (1935), 321-56, reprinted in M. Meyerhof, Studies in Medieval Arabic Medicine: Theory and Practice, ed. by P. Johnston (London, 1984).
101. M. Meyerhof, 'Thirty-Three Medical Observations by Rhazes', Isis, 23 (1935), 321-56, reprinted in M. Meyerhof, Studies in Medieval Arabic Medicine: Theory and Practice, ed. by P. Johnston (London, 1984).
102. O. Temkin, ' A Medieval Translation of Rhazes' Clinical Observations', Bulletin of the History of Medicine, 12 (1942), 102-17.
103. Al-Rāzī, Hāwī XVI (1963), pp. 189-208. The text is based in another two copies, Escorial Arabic MS. 817, fob. 88-90 and Arabic MS. 855, fols. 165-70 (although MS. 856 has been quoted in the title page by mistake).
104. Rufus of Ephesos, Krankenjoumale, pp. 81-5 (case n. VIII) and pp. 107-9 (case n. XVII). In the same manner, although similar case histories might be found in Galen's works, al-Rāzi's account number XVI - in which the patient's death follows the intervention of another doctor - recalls case number XX by Rufus ( Krankenjoumale, pp. 113-15).
105. Rufus of Ephesos, Krankenjoumale, pp. 81-5 (case n. VIII) and pp. 107-9 (case n. XVII). In the same manner, although similar case histories might be found in Galen's works, al-Rāzi's account number XVI - in which the patient's death follows the intervention of another doctor - recalls case number XX by Rufus ( Krankenjoumale, pp. 113-15).
106. The Arabic version of Galen's On Prognosis, the Kitāb fi Nawādir taqdimāt al-ma 'rifah is cited at least twenty-two times within the Hāwī. Galen, On Prognosis, pp. 54-5.
107. Galen, On Prognosis, p. 56 and note 2.
108. R. Kuhne Brabant, 'El Sirr sinā'at al-tibb de Abū Bakr Muhammad b. Zakariyyā' Al-Rāzi', Al-Qantara 3 (1982), 347-414; idem. 'El Sirr sinā'at al-tibb de Abū Bakr Muhammad b. Zakariyyā' Al-Rāzî II. Traducción', Al-Qantara, 5 (1984), 235-92; idem. 'El Sirr sinā'at al-tibb de Abū Bakr Muhammad b. Zakariyyā' Al-Rāzi III. Estudio', Al-Qantara, 6 (1985), 369-95. From the 15th century onwards, this work was printed as part of al-Rāzi's Opera parva, under the title Aphorismi Rasis.
109. R. Kuhne Brabant, 'El Sirr sinā'at al-tibb de Abū Bakr Muhammad b. Zakariyyā' Al-Rāzi', Al-Qantara 3 (1982), 347-414; idem. 'El Sirr sinā'at al-tibb de Abū Bakr Muhammad b. Zakariyyā' Al-Rāzî II. Traducción', Al-Qantara, 5 (1984), 235-92; idem. 'El Sirr sinā'at al-tibb de Abū Bakr Muhammad b. Zakariyyā' Al-Rāzi III. Estudio', Al-Qantara, 6 (1985), 369-95. From the 15th century onwards, this work was printed as part of al-Rāzi's Opera parva, under the title Aphorismi Rasis.
110. R. Kuhne Brabant, 'El Sirr sinā'at al-tibb de Abū Bakr Muhammad b. Zakariyyā' Al-Rāzi', Al-Qantara 3 (1982), 347-414; idem. 'El Sirr sinā'at al-tibb de Abū Bakr Muhammad b. Zakariyyā' Al-Rāzî II. Traducción', Al-Qantara, 5 (1984), 235-92; idem. 'El Sirr sinā'at al-tibb de Abū Bakr Muhammad b. Zakariyyā' Al-Rāzi III. Estudio', Al-Qantara, 6 (1985), 369-95. From the 15th century onwards, this work was printed as part of al-Rāzi's Opera parva, under the title Aphorismi Rasis.
111. Kuhne Brabant, 'El Sin sinā'at al-tibb' (1982), p. 358; idem. 'El Sirr sinā'at al-tibb' Traducción.' (1984), pp. 236-7; §0.2, §0.3. Interestingly, Lynn Thomdike's English translation of this preface, based on the Latin edition of 1481, presents a completely opposite interpretation of al-Rāzi's Arabic text, as if the Latin translator had misinterpreted the source or altered it on purpose. It is also worth noting that Thorndike erroneously included this work in the chapter devoted to experiments and secrets, which he associated with magical or superstitious practices indiscriminately. L. Thorndike, A History of Magic and Experimental Sciences During the First Thirteen Centuries of Our Era (New York, 1947-58,8 Vols.), II, pp. 764-5.
112. Kuhne Brabant, 'El Sin sinā'at al-tibb' (1982), p. 358; idem. 'El Sirr sinā'at al-tibb' Traducción.' (1984), pp. 236-7; §0.2, §0.3. Interestingly, Lynn Thomdike's English translation of this preface, based on the Latin edition of 1481, presents a completely opposite interpretation of al-Rāzi's Arabic text, as if the Latin translator had misinterpreted the source or altered it on purpose. It is also worth noting that Thorndike erroneously included this work in the chapter devoted to experiments and secrets, which he associated with magical or superstitious practices indiscriminately. L. Thorndike, A History of Magic and Experimental Sciences During the First Thirteen Centuries of Our Era (New York, 1947-58,8 Vols.), II, pp. 764-5.
113. Kuhne Brabant, 'El Sin sinā'at al-tibb' (1982), p. 358; idem. 'El Sirr sinā'at al-tibb' Traducción.' (1984), pp. 236-7; §0.2, §0.3. Interestingly, Lynn Thomdike's English translation of this preface, based on the Latin edition of 1481, presents a completely opposite interpretation of al-Rāzi's Arabic text, as if the Latin translator had misinterpreted the source or altered it on purpose. It is also worth noting that Thorndike erroneously included this work in the chapter devoted to experiments and secrets, which he associated with magical or superstitious practices indiscriminately. L. Thorndike, A History of Magic and Experimental Sciences During the First Thirteen Centuries of Our Era (New York, 1947-58,8 Vols.), II, pp. 764-5.
114. Kuhne Brabant, 'El Sirr sinā'at al-tibb'(1982), p. 372, idem. 'El Sirr sinā'at al-tibb' Traducciōn' (1984), pp. 259-60; §3.01. Although this work might have a spurious origin, the cases seem to be written by al-Rāzi himself, and in fact two accounts also appear in al-Rāzi's Kitāb al-Murshid. Kuhne Brabant, 'El Sirr sinā'at al-tibb' Estudio' (1985), p. 389.
115. Kuhne Brabant, 'El Sirr sinā'at al-tibb'(1982), p. 372, idem. 'El Sirr sinā'at al-tibb' Traducciōn' (1984), pp. 259-60; §3.01. Although this work might have a spurious origin, the cases seem to be written by al-Rāzi himself, and in fact two accounts also appear in al-Rāzi's Kitāb al-Murshid. Kuhne Brabant, 'El Sirr sinā'at al-tibb' Estudio' (1985), p. 389.
116. Kuhne Brabant, 'El Sirr sinā'at al-tibb'(1982), p. 372, idem. 'El Sirr sinā'at al-tibb' Traducciōn' (1984), pp. 259-60; §3.01. Although this work might have a spurious origin, the cases seem to be written by al-Rāzi himself, and in fact two accounts also appear in al-Rāzi's Kitāb al-Murshid. Kuhne Brabant, 'El Sirr sinā'at al-tibb' Estudio' (1985), p. 389.
117. Meyerhof, 'Thirty-Three Clinical Observations', p. 326.
118. Regarding the development of the case history, as I mentioned at the beginning of this paper, it is possible to observe how clinical accounts evolve according to the progress of medical knowledge, and to trace the physicians' major concerns in each period. Among the three main groups discussed in this study, in the absence of a consolidated classification of disease phenomena, the Hippocratic case histories focus the attention on prognosis, while Galen's clinical accounts mainly emphasize local diagnosis - his most celebrated contribution to medicine - and al-Rāzi's clinical histories show an increasing concern with pharmacological therapy, a trend which would remain in later Islamic authors as well as in the Latin tradition through the Consilia.