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Preface

The Codex 2, kept in the Archives of the Benedictine Abbey of SS. Trinità of Cava dei Tirreni (Salerno, Italy), is one of the earliest copies of the Etymologies. It was compiled at the “Scriptorium” of Montecassino, along with the grammar miscellaneous contained in the Paris lat. 7530, between 777 and 778 [1]; this timeline is suggested by the calendar marking the “depositio” of the abbot Potone of Montecassino, who became abbot of the Abbey SS. Trinità of Cava dei Tirreni from 779 to 796.

The complete manuscript of Isidore’s Etymologies consists of 20 books, concerning the entire body of knowledge of that era. It was extremely popular, as over a thousand copies of it have been preserved. Many complete and partial editions of the Etymologies have been released over the centuries. One of the latest editions was published by UTET under the supervision of Velastro Canale and printed in 2004 [2]; it is a translation of the very ancient Isidori hispalensi episcopi Etymologiarum sive Originum Libri XX printed by W.M. Lindsay in Oxford in 1911 [3].

There are no signs that Lindsay consulted the Codex 2; Lindsay referred to an edition with the books arranged in a different order; indeed, the De Medicina is reported in Book VI instead of Book IV [4]. The Codex 2 was written in Latin with black ink and Beneventano – Cassinese font style, and features miniatures.

This work deals with the book VI of the “De Medicina” in the Codex 2, and its 13 chapters (f. 183-198). We are translating the parts about medicine in general, and semiological methodology; we are listing only the medical terms and their etymology, and those dealing with nephrology.

We comment on the different parts, and evaluate them in the light of contemporary knowledge.

The treatise Etymologies was compiled in the years between 624 and 636; its author was Isidore of Seville, a most prominent figure of the Catholic Visigoth culture, one of the highest cultural achievers in medieval times, who succeeded to his brother Leander as bishop of Seville in 602. He compiled an encyclopedia collecting an outstanding body of knowledge, with the aim of broadening the cultural status of his time, while preserving the Greco-Roman cultural heritage, and spreading it through an erudite means: the “etymological” research of things.

Severiano of Cartagena, father of Isidore, was from one of the most prominent Hispanic-Roman families of the early VII century. He was exiled to Seville by the Arian ruling class in 555, because of his alleged ties to the byzantine invaders. Isidore, the youngest of four children, was born in Seville between 556 and 571. He prematurely became an orphan, and was left to the care of his three brothers. Leander, who became bishop in 578, personally took care of his education. Isidore’s studies began with the arts concerning the words (also known as trivium), consisting of grammar, rhetoric and dialectic; later he studied the arts concerning numbers (quadrivium): arithmetic, geometry, music and astronomy. Isidore most likely studied the books from the Bishops Library in Seville, that was put together by his brother Leander for the most part, and consisted of holy texts and works of Christian authors, as well as scientific and technical books along those of pagan authors, that were used for educational purposes.

Isidore gathered information from diverse sources: Augustine, Virgil, Gregorius Magnus, Solinus, Servius, Pliny the Elder, Lactantius, Lucan, Girolamus, Varro. Celius Aurelianus is the main source for Isidore’s “De Medicina”; he lived in the V century A.D. Isidore also got information from Asclepiades, who lived in the I century A.D. Isidore often reports entire paragraphs from their works in his manuscript, without citing them.

 

Methods

Chapter I – About Medicine

Medicine is the discipline that preserves or restores health in the body: it deals with diseases and wounds. It is performed by those men we properly call doctors, and is also about food, drink, clothing and garments.

Chapter II – About its Name

It is thought that the term “medicine” derives from “modus”, meaning “the right measure”; its effects are gradual and not immediate. Moderation has positive effects on nature. Excesses are dangerous.

Chapter III – About its Inventors

The Greek considered Apollo as the inventor of medicine. His son Asclepius successfully broadened medical knowledge, but after he got struck by lightening and died, the study of medicine was forbidden. Medicine was a hidden practice for about 500 years until Hippocrates, born in Cos as a descendant of Asclepius, brought it back to light, during the kingdom of the Persian king Artaxerxes.

Chapter IV – The Three Medical Schools

We can distinguish three medical schools: the first one, founded by Apollo, was called the “methodical”. It studied and contemplated magical remedies and formulas. The second one was founded by Aesculapius, and was called “empirical”, thus experimental, as it was based on experimental data only. The third one was founded by Hippocrates and was named “logical”, in the sense of rational. Indeed, Hippocrates used reason to investigate the cause of a disease, while considering the age of the patient, the environmental conditions, and the type of ailment he was dealing with.

Chapter V – Of Acute Diseases

By definition, Oxea is an acute disease that can result in a quick death, such as pleuritis and franticness: “oxys” comes from a Greek root meaning acute and fast. The term “fever” derives from “fervore”, meaning abundant heat. The expression cardiac disease comes from the word “cor”, meaning heart: we talk about cardiac disease when the heart undergoes fear or pain. The Greeks called the heart “cardia”. Synanchis (angina) comes from the act of holding one’s breath and the subsequent choking feeling; “synanchein” means “to hold” in ancient Greek. “Apoplexy” is a sudden blood leak that can result in death from asphyxiation. The name apoplexy is given to a rapidly developing failure due to a sudden lethal blow; apoplexy is the Greek word for blow.

The Latin term “spasmo” indicates a sudden contraction of the limbs or of the nerves that comes with a violent pain; this affection originates from the heart, the source of our vigor. The causes of a spasm can be the “repletio”, meaning filling up, in the sense of excessive food intake, or the “inanitio”, which means “emptying”, in the sense of lack of food.

The “telum”, which means dart, comes as an intense pain in one’s side. Doctors named the disease as such because it caused a pain similar to that of a sword going through a body. The “Ileos” is a pain in the intestine, and it comes from the term “ilium”, derived from the Greek word eilyein, which means “to coil”; it indicates that the intestine is in a coil because of the pain. The plague is a form of “contagium”, an epidemic infection that affects only one person at first, but spreads rapidly to many other people. It originates from tainted air that penetrates the guts and settles. It is also called “pestilential”, a sort of “pastulentia” because it “depascit”, it spreads like a fire. The term “contagium” comes from the word “contingere”, which means “to touch”; indeed, it spreads to whoever touches it. Another name for the plague is “lues”, coming from “labes” and “luctus”, meaning respectively “ruin” and “mourning”; it manifests itself in such an acute way that perishes hopes of future life, and causes a sudden weakness that leads to death.

Chapters VI and VII – Of Chronic Diseases

By definition, a chronic disease is one prolonged in time, like podagral or tuberculosis; indeed, the Greek word for time is “chronos”. “Cephalea” (headache) has its name derived from its cause, being a pathology of the head.; the Greeks called the head “cephale”. “Scophonia” derives its name from clinical signs of the disease: the eyes get suddenly covered by darkness, and this sign comes along with vertigo and dizziness. One talks of vertigo when arteries and veins in a man’s head produce air in excess, as a consequence of “scialorrea”, determining a rotation on the eyeballs; thus, vertigo means “revolving”. The “types” are cold fevers, and take this name from a type of grass that grows in the water. In Latin, this pathology is named “form” or “status”; it comes with significant increases and decreases in body temperature in given “statutas”, meaning time intervals.

“Reuma” is a Greek word corresponding to the Latin words meaning “eruption” or “flow”. “Catarrh” is a continuous rheumatic flux coming from the nostrils; when it gets to the throat, it is called “branchos”, meaning hoarseness; when it reaches the chest and the lungs, it is called “ptysis”, spit. When a secretion goes from the head to the nostril bones, causing irritation and sneezing, it is defined “coryza”. The choking feeling induced by cold humors is called “brancos”; the throat is also called “brancos” in Greek. “Sospirium”, also called asthma, is so defined to describe the difficulty in breathing in air. “Peripneumonia” derives from the lungs; it is a pathology marked by the swelling of the lungs, and traces of blood in the saliva. “Haemoptois” (emoftoe) is the bleeding from the mouth; indeed, “aima” is the Greek word for blood. Tuberculosis (tisis) is a swelling with ulceration of the lung, very frequent among the youth; its name is derived from the Greek word “phthitis” which means wearing out of the entire body. “Apostema” is the Greek word indicating the storage of different humors. “Empiesis” (empyema) is an internal apostema and means “pressure”; it can be found in the side or in the stomach; it comes with pain, fever, coughing and abundant mucus. The hepatic disease comes from the Greek “epan”, meaning liver. “Hydropisis” takes its name from the watery humor of the skin, and comes from the Greek word “hydor”, water. It manifests itself with turgid liquid under the skin and fetid breath (possibly uremic). The word “nephritis” indicates a weakening of the kidneys, called “nephroi” in Greek. “Cachessia” comes from the Greek “cachexia”, serious suffering. It indicates a temperamental patient, a wrong cure or a disease that takes a long time to heal. “Atrophy” is a Greek term, and indicates the gradual shrinking of the body because of insufficient nourishment and latent causes. “Sarcia” (sarcina) means obesity, and derives from the Greek term “sarx”, that means “meat”, in the sense of excessive growth of meat. “Calcolo” (stone), a stone found in the bladder, (from “calx” – calcium), derives from phlegmatic humors. “Stranguria” (strangury) is so called because of a narrowing of the urinary ducts, that makes urination difficult. “Diarrhea” derives from the Greek “diarroia”, and is characterized by a continuous flow of feces to the intestine, unlike dysentery, where the “dis” and the “entera” parts of the intestine are separated because of ulcers. The word “colica” (colic) derives from “colon”, the Greek word for intestine.

Chapter VIII – Of the Diseases Visible on the Surface of the Body

“Alopecia” is hair loss affecting blonde hair, the color of copper. The name derives from the fact it affects hair like that of a fox, called “alopex” in Greek. “Parotitis” (earache) is a swelling and hardening due to an accumulation of humor in the ear area, usually due to fever or other causes; ears are called “ota” in Greek. “Erysipelas” was called “holy fire” by the Romans; indeed, when it occurs, the skin turns the color of a red flame, sign of a burning fever. “Itch” is so called because it causes a burning feeling. “Itterizia” comes from a Greek root, from the name of a yellowish animal. The Romans called it the “bow disease”, because it sometimes manifests itself with the colors of the rainbow. Varro calls it “aurea” because it resembles the color of gold. This disease is also called the “regal disease” because it is best cured with good wine and high quality food. “Cancer” is a wound, as doctors say, that cannot be cured by any medicine; it takes the name from a marine animal. The limbs where cancer originates are amputated to prolong life, but death eventually occurs. The “pimple” is a pointy swelling, and derives its name from “fervet”, meaning inflammated.

The “ulcus”, a sore, takes its name from “olet”, “bad smelling”; “Vulnus” is a wound caused by a weapon, also called “vis”. “Pustola” (zit) is a swelling on the surface of the skin, caused by a concentration of humors. The “papula” is a small rash, surrounded by reddened skin, as a “pupula”, meaning pupil. The scar covers up a wound and it takes the same color as the surrounding skin; it is so called because it conceals the wounds.

Chapter IX – Of Remedies and Medicines

A medical cure should not be denied. Indeed, Isaiah sent a medicine to the ailing Ezekiel, and Paul the apostle told Timothy that a small amount of wine has beneficial effects. Diseases can be cured in three ways: with “pharmacology”, which the Romans called medicine; surgery, called “manual operation” by the Romans “cheir” is the Greek name for “hand”; diet, which the Romans call “rule”, meant as a way of life. Dieting is applied through rules and lifestyles. Pharmacology cures with medicines. Surgery cures diseases that cannot be cured with drugs, and is performed by cutting with metallic tools. In ancient times medicine was applied only through herbs and their juices; other medicines and metallic tools came later. Medical cure is performed through “opposites” or “similar”; for example, one can cure heat with cold, and humid with dry, as a boasting man can only be cured with humility. An example of similarity can be given by applying a round bandage to a wound with the same shape. The “antidote” is an opposite and it derives from a Greek word meaning, “given to you backwards”. Medicines take different names according to their effects:

The “hiera” (hieros) means divine vigor. The “arteriace” is about arteries, and the trachea, and can be used for pain and swelling of the throat. The Greek word “catartica” corresponds to the Latin one “purgante”, meaning cleansing. Other medicines take their name from the place where they get introduced into the body; the “catapotia”, from the Latin verb “potantur” (to drink) are taken orally. The “elettuario” is so called because it has to be sipped slowly. The “trocisco” (pill) takes the name from its round shape; the wheel is called “trochos” in Greek. “Collirium” (eye drops) is a Latin word meaning washing the eyes from waste. We talk of “epitema” when a treatment overlaps with a previous one. “Cataplasma” means “to spread” and is derived from Greek. “Pessario” takes its name from its meaning: to put at the bottom, inside the body. A certain Chiro invented medicine for animals. Later on, he was depicted as half-man and half-horse. He operated with his hands, as he was a surgeon.

Chapter X – About Medical Books

The “Aphorism” is a brief scientific conversation that exactly conveys the sense of reality (Figure 1). The “prognostic” is a prevision of how a disease will evolve.

“Oportet enim medicum et praeterita agnoscere, et praesentia scire, et future praevidere”.

(It is necessary that the doctor knows the past of his patient, understands the present, and foresees the future).

“Dinamidia” are the books that describe the medicine that originated from plants. The word comes from the Greek “dynamis”, meaning “strength” of the plants and the properties of the herbs.

The “Botanicum Herbarium” is the text that lists all the medicinal herbs.

Chapter XIII – About the Beginning of Medicine

One could ask why Medicine is not included in the liberal arts. The answer is that, while other arts apply to a specific subject, Medicine covers all of them. A doctor should know Grammar as he should understand and explain what he reads. He should also be familiar with Rhetoric as he needs to correctly define the pathology he is dealing with. He should also know Dialectic to understand the rational causes of a pathology, so that he can find the best way to investigate and cure it. Same for Arithmetic, so that he can time the occurrences of a disease and its symptoms. Also Geometry will help the doctor in studying the characteristics of a place, so that he can give advice about precautions. The doctor will also have to know Music, which can help the patient; indeed, many diseases can be cured by music. Moreover, the doctor will have to know Astronomy, as it will help him tracking the movement of the planets and the changing of the seasons. In fact, the changes happening to planets’ position and seasons can affect the human body. Because of these things we have said, Medicine can be considered a second Philosophy. Indeed, both disciplines are about the human being as a whole. Philosophy cures the souls, Medicine cures the bodies.

 

Comments

The study of the Etymologies by Isidore has a clear Alexandrine background. When the Alexandria Library, the largest and the one with the greatest number of books in the world, was destroyed in 641 A.D., it was a real catastrophe. 1000 years of human history and cultural heritage applying to all the different fields almost got lost. Having copies of the texts kept in that library helped in containing the damage, keeping records of the achievements and progress of human knowledge on parchments, and not on stones, as it happened for previous civilizations.

The Medicine analyzed in this study has a clear Hippocratic nature. It refers to books by Celius Aurelianus, who lived in the V century A.D. and Asclepiades, who lived in the I century A.D. [6, 7].

It expresses the correct semiological procedure applied by the doctor: know the past, understand the present, foresee the course of the disease, apply the right therapy. Many definitions of some pathologies back up the cardiocentric theory inspired by Hippocrates and Aristotle (the heart is the source of our strength and feelings) [5].

A disease cannot be cured without an appropriate diet and a change in lifestyle, if the latter had a role in the onset of the disease. This concept is in line with a modern approach to Medicine. It took us years to realize that we have to live while being aware that we are a component of the world surrounding us; we cannot claim we dominate nature, but we need to respect it and accept all the gifts it can provide.

One notes that a pathology’s name often derives from one of its signs, the most evident one. Sometimes the name clearly derives from animal or agricultural backgrounds.

Ethical exhortations are also present: “Excessive pride can only be cured by humility”.

 

Conclusions

This great Encyclopedia obviously did not claim it could teach every single subject, but it was arranged in such a way that each knowledgeable man, regardless of his job, could understand basic notions about different fields, so that he could better understand the world as a whole.

Even today, in the era of modern technologies, the Etymologies by Isidore provides a valid and sound method to deal with the globalized world.

 

Bibliography

1. Orofino G. I codici decorati dell’Archivio di Montecassino. Vol I, pag 19; Istituto Poligrafico e Zecca dello Stato. Roma 1994.
2. Isidoro di Siviglia. Etimologie o Origini, Volume I e II, a cura di Angelo Velastro Canale. Utet libreria. Torino 2004.
3. Isidori Hispalensis episcopi Etymologiarum sive Originum Libri XX, ed. M.Lindsay, 2 vol, Oxford Clarendon Press, 1911.
4. Mattei-Cerasoli L. Etymologiarum libri XX. Incipit liber VI f.183-198; Badia di Cava, 2007.
5. Manuli P, Vegetti M. Cuore, sangue e cervello, Biologia e antropologia nel pensiero antico. Episteme editrice, Milano, 1977.
6. Coronelli V. Biblioteca Universale sacro-profana. Tomo IV. Cosmografo della Serenissima Repubblica,in Venezia, MCCIII.
7. Renzi S. Storia della Medicina in Italia. Tomo terzo. Tipografia Filiatre-Sebezio; Napoli, 1845.