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Inventing Diagnosis: Theophilus’ De urinis in the Classroom

Abstract

This paper shows how the two earliest Latin expositions of Theophilus’ De urinis understood diagnosis in different ways. The «Chartres» commentator sees urine as a sign of physiological process and something which is derived from a disease state. By contrast, the Digby commentator is more concerned with how uroscopy functions at the bedside as a tool that enables us to infer disease states from urine. Though they understand the role of diagnosis differently, both commentaries reflect the new intellectual context of twelfth century medicine, where physical signs cease to be mere prognostic omens, and become tools for attaining knowledge of processes otherwise inaccessible to the senses.

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Inventing Diagnosis: Theophilus’ De urinis in the Classroom

Author: Wallis, Faith
Publisher: Universidad de Granada
Year: 2000
Source: https://digibug.ugr.es/bitstream/10481/78538/1/86628-Text%20de%20l%27article-111902-1-10-20080424.pdf
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
In en ing Diagnosis: Theophilus’ De u inis
in he Class oom (*)
FAITH WALLIS (**)
SUMMARY
1.—U oscopy and medie al medicine. 2.—Wes e n u ine doc ine be o e Theophilus.
3.—Theophilus and his De u inis. 4.—The ex o Theophilus in he Wes . 5.—The
«Cha es» and «Digby» commen a ies. 6.—Theophilus in he class oom. 6.1.—The
scien ia and doc ina o u ine: he accessus. 6.2.—Physiological con ex : he p oduc ion o
u ine. 6.3.—The s a e o heal h: na u al u ine. 6.4.—F om semio ics o diagnosis: hin,
whi e u ine. 6.5.—Theo e ical e- aming o semio ics: he ch oma ic scale o u ines.
7.—Compa ison wi h he Digby commen a y. 8.—In en ing diagnosis.
ABSTRACT
This pape shows how he wo ea lies La in exposi ions o Theophilus’ De u inis
unde s ood diagnosis in di e en ways. The «Cha es» commen a o sees u ine as a
sign o physiological p ocess and some hing which is de i ed om a disease s a e. By
con as , he Digby commen a o is mo e conce ned wi h how u oscopy unc ions a he
bedside as a ool ha enables us o in e disease s a es om u ine. Though hey
unde s and he ole o diagnosis di e en ly, bo h commen a ies e lec he new in ellec ual
(*) The schola s who a ended he King’s College con e ence we e ex emely gene ous
wi h hei commen s and sugges ions on he e sion o his pape p esen ed
he e. I wish o acknowledge in pa icula he help o Joan Cadden, Danielle
Jacqua , and Michael McVaugh. The esea ch on which his pape is based was
unded by a g an om Associa ed Medical Se ices/Hannah Ins i u e o he His o y
o Medicine. In he ansc ip ions o medie al manusc ip s ep oduced below, he
ollowing con en ions a e used: (/deno es an in e linea addi ion, (( // a ma gi-
nal addi ion, <> ma e ial supplied by mysel , [] ma e ial dele ed by mysel .
(**) Associa e P o esso . Depa men o His o y and Depa men o Social S udies,
McGill Uni e si y. McIn y e Medical Sciences Building. 3655 D ummond S ee .
Mon eal, Quebec. Canada H3G 1Y6.
32 FAITH WALLIS
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
con ex o wel h cen u y medicine, whe e physical signs cease o be me e p ognos ic
omens, and become ools o a aining knowledge o p ocesses o he wise inaccessible o
he senses.
BIBLID [0211-9536(2000) 20; 31-73]
Fecha de acep ación: 15 de junio de 1998
The wel h cen u y’s new collec i e and cu icula s yle o medical
ins uc ion, i s ia schola is, e-de ined medicine as a scien ia, ha is, a
uniquely ce ain ype o knowledge de i ed om p inciples and
demons a ed by eason. I also iden i ied i wi h physica, he b anch o
philosophy conce ned wi h he na u al wo ld. As a scien ia and a b anch
o philosophy, medicine was also doc ina, he kind o knowledge which
could be con eyed by o mal ins uc ion, based on ex s (1). In he
wo ds o Cons an ine he A ican’s Pan egni, i became medicina li e alis (2).
(1) See PESENTI, Tiziana. A i e medicina: la o mazione del cu iculum medico. In:
Luciano Ga gan; O onzo Limone (eds.), Luoghi e me odi di insegnamen o nell’I alia
medioe ale (secoli XII-XIV), Gala ina, Congedo edi o e, 1989, pp. 155-177; BYLEBYL,
Je ome J. The Medical Meaning o Physica. [In: Michael R. McVaugh; Nancy G.
Si aisi (eds.), Renaissance Medical Lea ning: E olu ion o a T adi ion] Osi is, 1990,
2nd se ies, 6, 16-41; JORDAN, Ma k D. The Cons uc ion o a Philosophical
Medicine: Exegesis and A gumen in Sale ni an Teaching on he Soul. [In: ibid.]
Osi is, 1990, 2nd se ies, 6, 42-61, esp. pp. 60-61; O’BOYLE, Co nelius. Medicine,
God, and A is o le in he Ea ly Uni e si ies: P e a o y P aye s in La e Medie al
Medical Commen a ies. Bulle in o he His o y o Medicine, 1992, 66, 185-209; SIRAISI,
Nancy G. Taddeo Alde o i and his Pupils: Two Gene a ions o I alian Medical Lea ning,
P ince on, NJ, P ince on Uni e si y P ess, 1981, chps 4-5; OTTOSSON, Pe -
Gunna . Scholas ic Medicine and Philosophy: A S udy o Commen a ies on Galen’s Tegni
(ca. 1300-1450), Napoli, Bibliopolis, 1984; AUSÉCACHE, Mi eille. Gilles de Co beil
ou le médecin pédagogique au ou nan des XIIe e XIIIe siècles. Ea ly Science
and Medicine, 1998, 3, 191-192.
(2) CONSTANTINE. Pan egni, edi ed by Ma co T. Mala o and Umbe o de Ma ini,
Roma, Is i u o di s o ia della medicine dell’Uni e si à di Roma, 1961, p ae a io,
p. 39. Elsewhe e in his pape , I shall ci e om he edi ion o he Pan egni
published in Basel by Hein ich Pe i in 1539, and which Ma k Jo dan has iden i ied
as he mo e eliable o he wo Renaissance edi ions: JORDAN, Ma k. The Fo une
o Cons an ine’s Pan egni. In: Cha les Bu ne ; Danielle Jacqua (eds.), Cons an ine
he A ican and ‘Al„ ibn al-‘Abb†as al-Mag†us„: The «Pan egni» and Rela ed Tex s,
Leiden, B ill, 1994, pp. 286-290. Howe e , his edi ion does no con ain he
33
In en ing Diagnosis: Theophilus’ De u inis in he Class oom
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
The componen s o he A icella seem o ha e been chosen o illus a e
hese no el claims. The Isagoge o Johanni ius, he Apho isms and P ognos ics
o Hippoc a es, and e en ually a e he mid- wel h cen u y, he A s
medicine o Tegni o Galen u nished a once a classical pedig ee and a
comple e heo e ical amewo k o a medical science (3). These a e
ex s abou wha doc o s hink and know, no abou wha doc o s a e
supposed o do. Bu he A icella also con ained wo o he less ob iously
heo e ical ex s, bo h o Byzan ine p o enance: he pulse ea ise by
Phila e us, and he handbook o u oscopy by Theophilus P o ospa ha ios.
As manuals o diagnos ics, bo h ex s ha e a dis inc ly p ac ical sa ou :
hey a e abou he hings ha doc o s do, no abou wha hey hink.
Indeed, hey may ha e been chosen o inclusion in he A icella p ecisely
o coun e balance he collec ion’s s ongly heo e ical o ien a ion. I is
wo h ema king ha he Isagoge o iginally con ained ma e ial on pulse
and u ine which was excised in Cons an ine’s ansla ion (4).
p e ace. Since i also does no con ain he P ac ica Pan egni, his sec ion o he
wo k, as well as he Via icum, is ci ed om he Lyon edi ion o 1515, p in ed by
Ba holémi T o .
(3) On he o igins and de elopmen o he A icella, see KRISTELLER, Paul Oska .
Nuo e on i pe la medicine sale ni ana del secolo XII. Rassengna s o ica sale ni ana,
1957, 18, 61-75; Ba holomaeus, Musandinus and Mau us o Sale no and o he
Ea ly Commen a o s o he ‘A icella’, wi h a Ten a i e Lis o Tex s and Manusc ip s.
I alia medioe ale e umanis ica, 1976, 19, 57-87; and e isions and expansions o he
la e in his S udia sulla Scuola medica sale ni ana, Napoli, Is i u o i aliano pe gli
s udi iloso ici, 1986, pp. 97-151. On he A icella and medical heo y, see JORDAN,
Ma k D. Medicine as Science in he Ea ly Commen a ies on ‘Johanni ius’. T adi io,
1987, 43, 121-145, and JORDAN, no e 1, pp. 42-61. On he ole o he A icella in
p o iding a his o ical pedig ee o medicine, see CRISCIANI, Chia a. His o y,
No el y and P og ess in Scholas ic Medicine», [In: Michael R. McVaugh; Nancy
G. Si aisi (eds), Renaissance Medical Lea ning: E olu ion o a T adi ion]. Osi is, 1990,
2nd se ies, 6, 118-139, and KIBRE, Pea l; SIRAISI, Nancy G. Ma heolus o Pe ugia’s
Commen a y on he P e ace o he Apho isms o Hippoc a es. Bulle in o he His o y
o Medicine, 1975, 49, 405-428.
(4) JACQUART, Danielle. P incipales é apes dans la ansmission des ex es de médecine
(XIe-XIVe siècle). In: Jacqueline Hamesse; Ma a Fa o i (eds.), Rencon es de
cul u es dans la philosophie médié ale: aduc ions e aduc eu s de l’An iqui é a di e
au XIVe siècle. Ac es du colloque in e na ional de Cassino 15-17 juin 1989, Lou ain-la-
Neu e/Cassino, Uni e si é ca holique de Lou ain/Uni e si à degli s udi di Cassino,
1990, p. 257.
34 FAITH WALLIS
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
The pu pose o his pape is o examine he o unes o one o
hese p ac ical ex s, Theophilus’ De u inis, in he academic medical
milieu o he wel h h cen u y. The commen a ies on his ex e eal
much abou how e en u oscopy could be cons ued as a scien ia, a
doc ina, and a pa o medical physica. They also h ow ligh on he
genesis o a new «philosophical» concep o diagnosis.
1. UROSCOPY AND MEDIEVAL MEDICINE
Few medical p ac ices a e mo e dis inc i ely wes e n and medie al
han u oscopy (5). Pulse-diagnosis acqui ed a ully elabo a ed heo e ical
jus i ica ion in An iqui y, bu ancien u oscopy was a ai ly ma ginal
p ognos ic skill, wi h li le in he way o a cohe en physiological a ionale,
excep in cases o u ina y ac illness (6). The de elopmen o his
(5) Despi e his, he his o iog aphy o Wes e n u oscopy is e y meag e. Fo a s imula ing
hypo hesis on i s ise and appa en decline in academic medicine, see McVAUGH,
Michael R. Bedside Manne s in he Middle Ages. Bulle in o he His o y o Medicine,
1997, 71, 201-223. La e An ique and Byzan ine u oscopy has been s udied in
DIMITRIADIS, Kons an in. Byzan inische U oskopie, Bonn disse a ion, 1971, and
in he b ie su ey by DIAMANDOPOULOS, A hanasios A. U oscopy in Byzan ium.
Ame ican Jou nal o Neph ology, 1977, 17, 222-227. A aluable his o y o ea ly
medie al u oscopy in he La in Wes has been ske ched in KEIL, Gundol . De
Ku ze Ha n ak a des B eslaue ‘Codex Sale ni anus’ und seine Sippe, Bonn disse a ion,
1969, and in KEIL, Gundol . Die u ognos ische P axis in o - und ühsale ni anische
Zei , F eibu g-im-B eisgau Habili a ionssch i , 1970. The la e , un o una ely,
has no ye been published; I am g a e ul o D Keil o p o iding me wi h a
pho ocopy o he ypesc ip . See also KEIL, Gundol . Die mi elal e liche Übe se zung
om Ha n ak a des ‘Ba holomäus’. Sudho s A chi , 1963, 47, 417-455. Sale ni an
u oscopy has been su eyed by OLDONI, Massimo. U oscopy in he Sale no
School o Medicine. Ame ican Jou nal o Neph ology, 1994, 14, 483-487, and by
RIHA, O un; FISCHER, Wil ud. Ha ndiagnos ik bei Isaak Judaeus, Gilles de
Co beil und O ol on Beie land. Beobach ung zu Bea bei ungs echnik. Sudho s
A chi , 1988, 72, 212-224. The classical wo k, VIEILLARD, Camille C. L’u ologie e
les médecins u ologues dans la médecine ancienne. Gilles de Co beil: sa ie, ses oeu es,
son poèmes des u ines, Pa is, Lib ai ie scien i ique e li é ai e, 1903, emains
use ul.
(6) This ela i ely na ow de ini ion o he scope o u oscopy is exempli ied by
HIPPOCRATES. P ognos ics, 12, edi ed by W. H. S. Jones, Camb idge, Mass,
Ha a d Uni e si y P ess, 1923, pp. 24-28; by HIPPOCRATES. Coacae p aeno a iones,
35
In en ing Diagnosis: Theophilus’ De u inis in he Class oom
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
echnique and i s a ionale was essen ially he achie emen o la e An iqui y
and he Middle Ages. The a ionale was g ounded in he h ee-s age
model o diges ion expounded mos ully by Galen. Each s age p oduces
a co esponding was e p oduc : om he i s diges ion in he s omach
come he aeces; om he second diges ion in he li e , ed bile, black
bile, and u ine; and om he hi d diges ion in he membe s, a a ie y
o esidues, including he sedimen s in u ine, spu um, swea , hai ,
ea wax and so o h (7). The p emiss is ha examining hese supe lui ies
a e hey eme ge on he ou side o he body will e eal some hing
abou he unseen diges i e p ocess wi hin. U ine, howe e , is he easies
o hese esidues o ob ain in a quan i y su icien o pe mi examina ion,
and he easies o di e en ia e and classi y (8).
2. WESTERN URINE DOCTRINE BEFORE THEOPHILUS
Di e en ia ing and classi ying u ines was one o he majo p ojec s
o la e An ique medicine. An emb yonic sys em can be de ec ed in
7.34.564 sq. In: É. Li é (ed.), Oeu es complè es d’Hippoc a e, ol. V, Pa is, J.-B.
Bailliè e, 1846, p. 712 sq.; and by HIPPOCRATES. Apho isms, 4.68 sq. This poin
is made by ANGELETTI, Luciana Ri a; CAVARRA, Be enice. C i ical and His o ical
App oaches o Theophilus’ De u inis. U ine as Blood’s Pe cola ion and U oscopy
in he Middle Ages. Ame ican Jou nal o Neph ology, 1994, 14, 283, and by WITTERN,
Rena e. Diagnos ics in Classical G eek Medicine. In: Yosio Kawaki a (ed.), His o y
o Diagnos ics. P oceedings o he 9 h In e na ional Symposium on he Compa a i e
His o y o Medicine, Tokyo, Di ision o Medical His o y, The Taniguchi Founda ion,
1984, p. 78. On he weak concep o diagnosis in Hippoc a ic medicine, see
PAGEL, Wal e . P ognosis and diagnosis: A Compa ison o Ancien and Mode n
Medicine. Jou nal o he Wa bu g and Cou auld Ins i u es, 1938-39, 2, 382-398. To be
su e, he i s book o he Epidemics akes a somewha b oade iew o he use ulness
o u ine inspec ion, and uses analy ical ca ego ies which la e became sys ema ized
in u oscopy, namely ex u e, colou and sedimen . Howe e , Epidemics I was no
a ailable in La in in he Middle Ages; mo eo e , Galen’s commen a y on he
Epidemics su i es only in La in, and only o book six, which sugges s ha i had
li le in luence in he G eek and A ab wo ld in which u oscopy was de eloped.
(7) KEIL, no e 5, p. 16.
(8) On la e medie al schema a o analysis o swea , spu um, aeces, skin-e up ions,
as well as haema oscopy (a diagnosi ic echnique closely modelled on u oscopy),
see KEIL, no e 5, pp. 17-18.

36 FAITH WALLIS
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
Caelius Au elianus’ Ta dae passiones and Celsus’ De medicina. A e aeus
u nishes he i s eco ded explana ion o how he kidneys sepa a e
u ine om blood in De causis e signis acu o um mo bo um (9). Bu u oscopy
as a diagnos ic echnique eally de eloped in he Byzan ine Eas , beginning
wi h O ibasius and Ae ius o Amida. I is in e es ing ha u oscopy
pa icula ly appealed o medical w i e s wi h s ong philosophical in e es s,
such as S ephen o A hens (10) and Magnus o Emesa (11). Theophilus
was he lega ee o his adi ion.
Li le o his eached he Wes be o e he ea ly Sale ni an pe iod.
The e a e e y ew La in u oscopy ex s w i en be o e 1100, and e en
ewe eco ds o he use o u oscopy in a clinical con ex . Desc ip ions
o clinical p ac ice in he ea ly Middle Ages men ion diagnosis om
pulse and occasionally haema oscopy (12), bu a ely u oscopy (13).
(9) CAELIUS AURELIANUS. Ta dae passiones 5.3.55-57, edi ed by Ge ha d Bendz,
Co pus medico um la ino um 6.1, Be lin, Akademie Ve lag, 1993, p. 886; CELSUS.
De medicina, 2.4.8-9, 2.5.11-13, 2.7.11-13, edi ed by F. Se a, Sc ip o um omano um
quae ex an omnia 164-166, Pisa, Gia dini, 1976, pp. 88-89, 91-92, 95-96; ARETAEUS.
De causis e signis acu o um mo bo um 2.9, edi ed by Ka l Hude, Co pus medico um
g aeco um 2, Be lin, Akademie Ve lag, 1958, pp. 30-31.
(10) On he ca ee and in luence o S ephen o A hens, see BISCHOFF, Be nha d;
LAPIDGE, Michael. Biblical Commen a ies om he Can e bu y School o Theodo e and
Had ian, Camb idge S udies in Anglo-Saxon England 11, Camb idge, Camb idge
Uni e si y P ess, 1995, p. 49 sq. S ephen composed a numbe o wo ks on scien i ic
and medical subjec s, including a commen a y on he Apho isms o Hippoc a es,
edi ed by Leende G. Wes e ink, Co pus medico um g aeco um 11.1, 3, Be lin,
Akademie Ve lag, 1985-1992, ano he on he P ognos ics, edi ed by John M. Du y,
Co pus medico um g aeco um 11.1, 2, Be lin, Akademie Ve lag, 1983, and a
u ine ea ise edi ed in BUSSEMAKER, C. T ai é d’E ienne su les u ines, publié
pou le p emiè e ois d’ap ès un manusc i de la Biblio hèque oyale. Re ue de
philologie, de li é a u e e d’his oi e anciennes, 1845, 1, 415-438, 543-560. On his
ea ise, see ANGELETTI, Luciana Ri a; CAVARRA, Be enice. The Pe i ou on
T ea ise o S ephanus o A hens: Byzan ine U oscopy o he 6 h-7 h cen u ies AD.
Ame ican Jou nal o Neph ology, 1997, 17, 228-232, and DIMITRIADIS, no e 5, pp.
33-36.
(11) See BUSSEMAKER, U. Ca s. Übe Magnus on Emesis und dessen Buch om
Ha ne. Janus, 1847, 2, 273-297; DIMITRIADIS, no e 5, pp. 29-32.
(12) Fo example, in he Casus sanc i Galli, Ekkeha d IV o S Gall ells how he g ea
monas ic physician No ke p edic ed, on he basis o he smell o he blood
emi ed by a pa ien ’s bleeding nose, ha he pa ien would all ill wi h smallpox:
37
In en ing Diagnosis: Theophilus’ De u inis in he Class oom
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
The mos common p e-Sale ni an u oscopy ex is Pseudo-Galen’s
De u inis (14). The Pseudo-Galen is a usion o wo ex s: he u ine
ea ise p ope , and i s a iable addenda, he mos popula o which was
a «Ca alogue o U ine Rules», possibly composed in he se en h cen u y
in wes e n Eu ope. The co e ex p o ides a heo e ical basis o u oscopy.
I comp ises an apology o he use ulness o he echnique, a spa se
physiological accoun o u ine o ma ion, a discussion o he echnical
equisi es o u ine inspec ion, and inally, a ca alogue o u ines o
a ious colou s and ex u es, in no pa icula o de , oge he wi h hei
pa hological signi icances. Howe e , he e is no a emp o explain he
logic behind u ine’s semio ic ole (15). The « ules» a e bald o mulae,
almos all o which a e p ognos ica o y, and almos exclusi ely o acu e
diseases and e e s (16). Wha is mos in e es ing pe haps abou Pseudo-
Galen is ha he inspec ion o u ine does no always, o e en usually,
u nish a diagnosis. Diagnosis is he p oduc o a whole a ay o symp oms
and signs; he eal alue o u oscopy is p ognosis (17).
HAEFLE, Hans F. (ed.). Ekkeha d IV. S . Galle Klos e geschich e, Ausgewähl e Quellen
zu deu schen Geschich e des Mi elal e s 10, Da ms ad , Wissenscha liche
Buchgesellscha , 1980, p. 240.
(13) KEIL, no e 5, p. 22, no e 18. See also WALLIS, Fai h. Signs and Senses: Diagnosis
by Pulse and U ine in AD 1000. Social His o y o Medicine, 2000, 13, 265-278.
(14) KEIL, no e 5, pp. 22 and 25. P obably composed in he i h o six h cen u y, his
ex was ansla ed om G eek in o La in in he ea ly medie al pe iod. I was i s
edi ed by LEISINGER, He mann. Die la einischen Ha nsch i pseudo-Galens, Bei äge
zu Geschich e de Medizin 2, Zü ich and Leipzig, O ell Füssli, 1925, and again
by Gundol Keil.
(15) KEIL, no e 5, p. 25.
(16) E.g. «In quo de o ina [sic] alba au mul a in acu is eb is soli udine [sic] eiusdem
eg i udinis u u am nuncia »: KEIL, no e 5, p. 62.
(17) Fo example, Pseudo-Galen says: «Hi quidem colo es u inae [i.e. ed and awny]
equen e a nobis uisi sun secundum diue si a em eg e udinis.... Debe enim
cau e equi i u um cum dolo e an sine dolo e si , an ue o hus ionem in ue e o
aci uel si calida es dum ege i ipsa u ina ac si uelu i uiscidi a is iace , id es
quidam s ip icum si . I a diuisas e iam quam maxime e diligen e in ende e
nebulas quasdam quas g eci ni ias appellan , quia diue si a em suam e in cunc an e
demons a . Sed cum cau e aspexe is, ibi eppe ies mala uel bone u u ae discusionis
signa, id es i ae e mo is»: KEIL, no e 5, pp. 57-58.
38 FAITH WALLIS
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
3. THEOPHILUS AND HIS DE URINIS
When wes e n s uden s o medicine encoun e ed Theophilus’ De
u inis in he ele en h cen u y, hey ecognized a subjec wi h which hey
we e al eady somewha amilia . Howe e , Theophilus’ ea men o his
opic ep esen ed a wholly unp eceden ed o de o sophis ica ion.
Theophilus’ li e and ca ee a e e y di icul o ace. We do no
e en know exac ly when he li ed, hough he se en h cen u y seems
highly likely. He was a ollowe o S ephen o A hens (who lou ished in
he second hal o he six h and he beginning o he se en h cen u ies),
and like S ephen, a p oli ic medical scholias and w i e (18). His De
u inis summa izes and schema izes he en i e La e An ique/Byzan ine
adi ion o u oscopy. Though mode n commen a o s end o ega d
his u oscopic adi ion as e idence o Byzan ine empi icism (19),
Theophilus, like S ephen be o e him, seems no o ha e been a clinician.
His i le p o ospa ha ios indica es ha he was an o icial in he cou
bu eauc acy, bu he is also iden i ied in he G eek manusc ip s as a
monk and a philosophe . He s ands, hen, in he adi ion o he
ia osophis ae, o physician-philosophe s.
Theophilus’ alen lay in syn hesis and schema iza ion. He analyzed
u ine unde h ee aspec s: i was a liquid subs ance, which migh be
« hick» o « hin»; i came in a ange o colou s om whi e o black; and
i con ained sedimen s which a ied as o hei posi ion in he u ine
(18) He w o e scholia on he Apho isms o Hippoc a es, ea ises on pulse, u ine and
exc emen s, as well as a compendium o Hippoc a ic-Galenic he apeu ics and a
gene al wo k on ana omy and physiology in 5 books: see KRUMBACHER, Ka l.
Geschich e de byzan inischen Li e a u , Handbuch de klassischen Al e umswissenscha
9.1, 2nd edi ion, München, Beck, 1897, p. 614; BISCHOFF; LAPIDGE, no e 10,
p. 55. On he De u inis see ANGELETTI; CAVARRA, no e 6. The G eek ex has
been edi ed by IDELER, Julius L. Physici e medici G aeci mino es, Be lin, 1841,
ep in ed Ams e dam, Adol M. Hakke , 1963, pp. 261-283. The La in ex was
edi ed om he mid-ele en h-cen u y manusc ip Einsiedeln, S i sbiblio hek, MS
32 (1060) by KEIL, no e 5, pp. 97-135: his codex, oge he wi h Auxe e, Biblio hèque
municipale, MS 240, is he oldes wi ness o he ex .
(19) ANGELETTI; CAVARRA, no e 6, p. 285.
39
In en ing Diagnosis: Theophilus’ De u inis in he Class oom
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
lask, hei colou and hei shape. Theophilus wo ked ou he pe mu a ions
and combina ions o hese h ee in an o de ly manne , and linked hem
o he no ion o c asis, he quali a i e complexion o he body in heal h
and illness. Unde lying he en i e ea ise is he concep ha illness is
diso de o c asis, and ha his diso de lea es an imp in on he u ine.
Hea and cold con ol he ange o colou s in he u ine, while mois u e
and d yness de e mine i s ex u e. The e o e, he isible aspec o he
u ine is a di ec image o he complexional s a e o he body. Theophilus,
signi ican ly, is in e es ed in he u ine o heal hy people, as well as o
he sick.
Pe haps he mos signi ican di e ence be ween Pseudo-Galen and
Theophilus is ha Theophilus p esen s u oscopy as a ool o diagnosis,
ha is, as a means o de ec and iden i y a disease s a e, as dis inc om
p edic ing he ou come o a disease s a e, which is p ognosis. Theophilus
sha ed he p e-mode n concep ion o disease as an e en a he han an
en i y, a mo bid change in he body d i en by changes in he ela ionship
o he elemen al quali ies o ho and cold, we and d y. The e o e,
diagnosis was essen ially applied humo al physiology and humo al ae iology.
4. THE TEXT OF THEOPHILUS IN THE WEST
The da e o he La in e sion o Theophilus and he iden i y o he
ansla o con inue o be a ma e o deba e. I is no e en ce ain
whe he he ansla ion p e- o pos -da es he wo k o Cons an ine he
A ican. I s companion ex , Phila e us on pulses, was ce ainly a ailable
in Sale no in Cons an ine’s ime, o Al anus o Sale no (d. 1085) used
i in his own De pulsibus (20). Bu doub s pe sis abou Theophilus,
pe haps because Cons an ine he A ican, in he p ologue o his ansla ion
o Isaac Judaeus’ ea ise on u ines, says ha he could ind no eliable,
au ho i a i e wo k on he subjec in La in, and so elec ed o ansla e an
(20) CREUTZ, Rudol . De ühsale ni ane Al anus und sein bislang unbekann e
‘Libe de pulsibus’. Sudho s A chi , 1937, 29, 57-83; BLOCH, He be . Mon e
Cassino in he Middle Ages, 3 ols, Camb idge, Mass, Ha a d Uni e si y P ess,
1986, ol. 1, p. 98.
46 FAITH WALLIS
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
The ex o he Digby commen a y on Theophilus also bea s some
s iking simila i ies o Ba holomaeus, bu i s esemblance o he Cha es
commen a y is close . In ac , he Cha es and Digby commen a ies a e
much close o each o he han ei he is o Ba holomaeus, hough
en i e sec ions o all h ee ex s ma ch almos e ba im (35). They also
sha e many s uc u al ea u es; o example, hey aise he same quaes iones.
Bu he e a e signi ican di e ences as well. Whe e Cha es p e e s o
use he ex o Theophilus as a sp ing-boa d o mo e independen
commen a y, Digby s icks much mo e closely o he lemma a. The
esemblances among he h ee a e especially e iden on he «glossing»
le el, i.e. when dealing wi h he speci ics o Theophilus’ ex . On he
«commen a y» le el, i.e. when jumping o om he ex o dila e on a
poin , he h ee commen a ies a e mo e independen , and in some
cases, widely di e gen . This sugges s ha a common body o glosses on
Theophilus lies behind all h ee ex s, and ha i was on he basis o
hese ounda ional glosses ha each au ho buil up his own commen a y.
My hypo hesis ha he Cha es and Digby commen a ies a e ela ed
o, bu no de i ed one om he o he , di e ges om he conclusions
d awn by Ma k Jo dan om his ex ensi e wo k on he Cha es and
Digby Johanni ius commen a ies. In he case o he Johanni ius commen a y,
Jo dan a gues ha Cha es is a « eaching summa y» o Digby, because
Digby con ains e e y hing ound in Cha es, bu no ice e sa, and
because Cha es seems o be a simpli ied, pa ed-down endi ion o
Digby (36). Tha his is a om being ue o he Theophilus commen a y
will be made e iden in wha ollows. Which o us is co ec mus be le
o he judgemen o o he schola s; bu i is no impossible ha we a e
bo h igh , in which case we a e aced wi h he p ospec ha no all he
commen a ies g ouped in he Cha es and Digby collec ions a e by he
same au ho , o om he same milieu. E iden ly, he way o wa d is o
compa e he con en s o he di e en commen a ies wi hin each g oup,
(35) The Mau us commen a y is he odd man ou . Mau us does no seem o be using
he same ex o Theophilus as he o he h ee, and he « ounda ional glosses»
which I posi unde lay he Cha es, Digby and Ba holomaeus glosses (see
below) a e absen in Mau us.
(36) JORDAN, no e 1, pp. 43, 45-53; see also JORDAN, no e 3.

47
In en ing Diagnosis: Theophilus’ De u inis in he Class oom
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
as well as be ween g oups—a ask which clea ly anks high on he agenda
o u u e A icella esea ch.
The « ounda ional glosses» which I posi unde ly he Cha es,
Digby and Ba holomaeus glosses all make use o Cons an ine he A ican’s
co pus o medical w i ings, pa icula ly his ansla ion o Isaac Judaeus,
he Pan egni, and in he case o he Cha es and Digby commen a ies
a leas , p obably also he Via icum (37). Abo e all, he h ee commen a ies
bea he unmis akable signs o he new collec i e and cu icula medical
eaching: a s ong in e es in heo y, especially in ae iology and humo-
al physiology; a ma ked as e o schema iza ion, and o pungen and
apho is ic summa ies; an in e es in quaes iones aised by he ex ; and a
conce n, albei aci , o ela e Theophilus o he o he elemen s o he
A icella, especially Johanni ius.
This s ong esemblance jus i ies he ollowing me hod o his
pape . Because I wan o examine in some de ail he s a egies o
in e p e ing Theophilus—and in e p e ing u oscopy i sel —I shall
concen a e he e on he Cha es commen a y, and add a ew ema ks
o a compa a i e na u e on he Digby ex . I shall also con ine mysel o
i e sec ions o Theophilus’ ex which o e he iches lode o ma e ial
e lec ing he commen a o ’s sou ces, app oaches and ideas. These a e: (1)
he p ologue, including he commen a o ’s accessus, because i de ends
u oscopy’s claim o be conside ed a scien ia;(2) he accoun o how he
(37) Cha es and Digby ci e only Isaac Judaeus di ec ly, bu Ba holomaeus also
quo es di ec ly om he Pan egni. Howe e , he e is some ai ly solid e idence
ha Cha es and Digby used he Pan egni and he Via icum, which will be discussed
below. The Theophilus commen a ies show none o he in luence o Nemesius
which Ma k Jo dan ound o be so p ominen in he Cha es and Digby Johanni ius
commen a ies (no e 1, p. 49). Howe e , I am inclined o accep Jo dan’s conclusion
ha hese ea lies commen a ies a e Sale ni an p oduc s. An al e na i e hesis,
ha he A icella was assembled and i s ea lies commen a ies composed in no he n
F ance, has no ecei ed much suppo : see MORPURGO, Pie o. I commen i
sale ni ani all’A icella. In: Monkika Asz alos, John E. Mu doch; Ilkka Niiniluo o
(eds.), Knowledge and he Sciences in Medie al Philosophy. P oceedings o he Eigh h
In e na ional Cong ess o Medie al Philosophy, Helsinki, 24-29 Augus 1987, Helsinki,
Publica ions o Lu he -Ag icola Socie y, se ies B 19, 1990, ol. 2, pp. 97-105, and
MORPURGO, Pie o. Filoso ia della na u a nella Schola Sale ni ana del secolo XII,
Bologna, Coope a i a lib a ia uni e si a ia edi ice Bologna, 1990.
48 FAITH WALLIS
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
body makes u ine, because i es ablishes he connexion o u oscopy o
physiology and ana omy which jus i ied ha claim; (3) he discussion o
«na u al» u ine, because i e-w i es u oscopy in e ms o humou al
heo y; (4) he pa hological signi icance o u ine which is hin and
whi e, because i illus a es how he Cha es commen a o de ines diag-
nosis as a kind o expe imen al physiology, a he han (in Guldol
Keil’s ph ase) a o m o «medical di ina ion» (38); and inally (5) he
discussion o he spec um o colou s ound in u ine, because i ma ks,
I belie e, he ini ial s ages o e lec ion on he p oblem o he elemen s.
6. THEOPHILUS IN THE CLASSROOM
6.1.The scien ia and doc ina o u ine: he accessus
All o he wel h-cen u y commen a ies on Theophilus begin wi h
ha hoa y class oom echnique, he accessus. Howe e , each ames he
accessus somewha di e en ly. To pu he Cha es commen a y’s accessus
in o pe spec i e, I ha e d awn up a able compa ing i s accessus o hose
o he Digby commen a y, and he commen a ies o Ba holomaeus and
Mau us o Sale no. High hopes ha e been pinned on he accessus as a
clue o he o igin o hese commen a ies (39), bu in his case, he
accessus shows he complex in e connexion o hese ex s; i does no
es ablish any linea ela ionship (40).
The Cha es amily has been dis inguished om he Digby g oup
on he g ounds ha Cha es has a six-pa accessus, while Digby uses
se en ca ego ies (41). Howe e , his may be a dis inc ion wi hou a
(38) KEIL, no e 5, 14-15.
(39) Especially by MORPURGO, no e 37 (1987), pp. 100-102. Fo c i ique o his
app oach, see JORDAN, no e 1, pp. 47-48; c . JACQUART, Danielle. A is o elian
Though in Sale no. In: Pe e D onke (ed.), A His o y o Twel h Cen u y Wes e n
Philosophy, Camb idge, Camb idge Uni e si y P ess, 1988, p. 414, no e 29.
(40) The accessus scheme adop ed by all hese commen a ies is b oadly modelled on
ha used by Boe hius in his accessus o he Isagoge o Po phy y: see MINNIS,
Alas ai J. The Medie al Theo y o Au ho ship, London, Schola P ess, 1984, pp. 18-28.
(41) BURNETT, no e 28, pp. 129-130.
49
In en ing Diagnosis: Theophilus’ De u inis in he Class oom
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
di e ence. The Cha es commen a o explici ly says ha he will conside
six ca ego ies, bu in ac he adds a se en h, he i ulus. Digby does no
o mally decla e how many ca ego ies cons i u e i s accessus. Cha es’
emphasis on he numbe six may ha e been in luenced by he Pan egni,
which p esen s a six-ca ego y accessus (42). Howe e , nei he Cha es
no any o he o he commen a ies ollow he Pan egni’s o m o accessus:
in en ion, u ili y, i le, pa o doc ine o which i pe ains, name o
au ho , and di isions. I should be no ed ha Cha es and Digby sha e
he same e minology (excep o modus ac andi/ diuisio), bu he o de
o ca ego ies is no he same. Mau us and Digby, on he o he hand,
employ he iden ical ca ego ies, in he same o de , bu again wi h some
(42) CONSTANTINE. Pan egni, Theo ica 1.2, Basel, 1539, pp. 1-2. Haly Abbas s a s
wi h 8, which Cons an ine educes o 6: see JACQUART, Danielle. Le sens donné
pa Cons an in l’A icain à son oeu e: les chapi es in oduc i s en a abe e en
la in. In: Cha les Bu ne ; Danielle Jacqua (eds.), no e 2, p. 79. I should be
no ed ha he Cha es Theophilus commen a y uses he same accessus o ma as
he Cha es Johanni ius commen a y: JORDAN, no e 1, p. 46.
TABLA I
Compa ison o accessus in Cha es, Digby, Ba holomew and Mau us
Cha es Digby Ba holomaeus Mau us
London BL Royal 8.C.IV Bodleian, Digby 108 Main Tex : Winches e 24 Pa is, B.N. la . 18449
ol. 163 ol. 76 ol. 157 ol. 145 .
Va ian : E u Amplonian 4E
ol. 58
ma e ia ma e ia in en io ma e ia
modus ac andi in en io causa in en ionis in en io
( a ian : ope is)
in en io causa in en ionis u ili as in en ionis causa
u ili as u ili as ad quem pa em u ili as
philosophie spec e
cui pa i philosophie cui pa i philosophie quo gene e doc ine supposi io
suppona u suppona u u a u
causa di isio di isio o do ac andi
( i ulus) i ulus i ulus i ulus
50 FAITH WALLIS
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
small a ia ions o e minology. In pa icula , Mau us, like Cha es,
eschews diuisio in a ou o o do ac andi (Cha es: modus ac andi).
Ba olomaeus uses diuisio, bu commen s ha i is in ac inapp op ia e,
as Theophilus’ ea ise has no di isions, hough one can speak o an
o do (43). This may be why Mau us does no use he e m diuisio, and
ac ually subs i u es Ba holomaeus’ e m o do. Bu wha abou Cha es?
Did he Cha es commen a o ead Ba holomaeus, o ice e sa?
Ba holomaeus complains ha pedan s hink ha e e y book has o
ha e a diuisio because i says so in he Pan egni. I he Cha es commen a o
was awa e o he Pan egni, his would u nish some e idence o his
c i ical and independen a i ude. None heless, his angled web should
ale us o he pi alls o a emp ing o use accessus as a so o gene ic
ma ke o he a ilia ion o commen a ies.
The Cha es, Digby and Mau us accessus also include he ca ego y
ma e ia, which is some hing o an oddi y, in ha i usually belongs o he
ex insic o subjec accessus, no he accessus ci ca lib um. This s ikes me
as qui e delibe a e. The unglamou ous and echnical subjec o u oscopy
needed some explaining i i was o be accep ed as doc ina, some hing
ha dese ed o be augh om ex s, in schools. We shall see in a
momen how he Cha es commen a o handled his (44).
(43) «Que lib i diuisio. in ei ue i a e nulla es . quidam amen diuisionem assi<g>nan e
conan u . decep i ex quibusdam ue bis que in pan egni haben u . dici u enim
ibi VII [sic] esse inqui enda in p incipiis lib o um. In e que enume a u lib i
diuisio. Vnde in omnibus lib is diuisionem assigna e uolun . Nos au em concedimus
ubique inqui endum esse. sed non ubique assignandum. ubi scilice nulla es .
hec au em peni us nulla es qua e assignanda (non/ es . Sed loco diuisionis
po es inqui i o do. qui alis es ..». (E u , S adbiblio hek, MS Amploniana, Q
174 ol. 58 b).
(44) One migh add as well ha Mau us abb e ia es Cha es/Digby’s «cui pa i
philosophie suppona u » o he e se «supposi io» (Pa is, Biblio hèque na ionale,
MS la . 18499, ol. 145 b), bu Ba holomaeus pu s i e y di e en ly: «ad quem
pa em philosophie spec e » (E u , S adbiblio hek, MS Amploniana, Q 174, ol.
58 b). This ph ase is ound e ba im in Gundissalinus, De di isone philosophie
[MORPURGO, no e 37 (1987), p. 100], whose o mula o accessus ci ca lib um
also uses in en io, u ili as, i ulus and dis inc io lib i. Gundissalinus seems o ha e
done mos o his w i ing in he 1150s, i.e. abou he same ime as, o sligh ly
ea lie han Ba holomaeus, bu how he wo men came o sha e iden ical e minology
o he accessus is no clea .
51
In en ing Diagnosis: Theophilus’ De u inis in he Class oom
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
The Cha es commen a y on Theophilus begins by plunging di ec ly
in o he accessus. The subjec ma e o Theophilus’ book is u ine, i s
colou and i s sedimen . The manne in which Theophilus ea s he
subjec (says he commen a o ) is i s by de ining u ine, and hen
desc ibing i . Theophilus dis inguishes u ines acco ding o subs ance
( hin, hick, and in-be ween), and acco ding o hei colou s, showing
how one colou a ises om ano he (as we shall see, his is a pa icula ly
Cha ian ouch). Then he shows (os endi ) which kinds o subs ance
can be combined wi h which colou s. Finally, he de ines and dis inguishes
be ween di e en kinds o sedimen (hypos asis). The Cha es
commen a o ’s choice o e bs is elling, o de ini ion, desc ip ion,
dis inc ion, demons a ion a e he me hods o a scien ia, and hey ele a e
u oscopy o a highe , «doc inal» plane.
The Cha es commen a o also cha ac e izes Theophilus’ in en ion
in ma kedly philosophical e ms: i is o discuss he essence [essen ia]
and o ma ion o u ine, and o demons a e i s a ia ions (45). Mo eo e ,
he u ili y o he wo k is also concei ed in a heo e ical way: i p o ides
secu e knowledge abou heal h, sickness, and he neu al s a e (which
is a ain echo o Theophilus, hough p obably de i ed om Johanni ius),
and he causes o hese hings (which is no in Theophilus) (46). The
e m «cause» (causa) de ines u oscopy as an adjunc o ae iology.
(45) L ol. 163 a: «In en io ue o heophili es essen iam u inalis e usionis cum loco
gene a ionis ipsius e o ma ionis. os ende e. eiusdemque di e en ias in subs an ia.
colo e. e sedimine. cum suis signi ica ionibus. demons a e».
(46) L ol. 163 a: «V ili as ue o es i ma cogni io sani a is. eg i udinis. e neu ali a is.
cum causis eo um». C . Theophilus: «Nam ypoc as de u inis exponens. e aliud
alibi in ac a ibus suis spa sim angens. e gene a. e species. e di e en ias
ea um. e ex eis cogni iones e p ecogni iones. u u is pa ium disposi ionibus
p e e na u am e in sanis co po ibus. e in acu is eg i udinibus minus haben em
doc inam elinqui ». (KEIL, no e 5, p. 97). Johanni ius: Theo e ical medicine is
di ided in o h ee pa s «i<d es > in con empla ionem e um na u alium e non
na u alium e ea um, quae sun con a na u am, ex quibus sani a is, aeg i udinis
e neu ali a is scien ia p ocedi ..». [MAURACH, G ego (ed.). Isagoge ad Techne
Galieni. Sudho s A chi , 1978, 62, p. 151]. Fo p oblems connec ed wi h his
admi edly wo king edi ion, see JORDAN, no e 3, pp. 124-125, no e 16, and
FISCHER, Klaus-Die e . Ve besse ung zu Isagoge des Johannicius. Sudho s A chi ,
1983, 67, 223-234.

52 FAITH WALLIS
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
Signi ican ly, he commen a o does no men ion ha inspec ion o
u ine migh se e p ognos ica ion, o indeed, any clinical pu pose
wha soe e . No su p isingly, he pa o philosophy o which his book
pe ains is physica. The commen a o is a he empha ic ha u oscopy
is an exclusi ely heo e ical science in which «con empla ion alone
ope a es» (47). The unnamed sou ce o his schema is Johanni ius, who
di ides medicine in o heo y and p ac ice, and de ines heo y as
«con empla io na u alium» (48). The cause o Theophilus’ wo k is he
p olixi y and lack o o de in he wo ks o Hippoc a es, Galen, and
Magnus: in sho , i was composed in he in e es s o doc ina.
Theophilus says ha u ine e eals «obscu e hings» (obscu as es).
The commen a o in e p e s hese «obscu e hings» no as he unce ain
ou comes o disease, o e en as he diseases hemsel es, bu a he as
he in e nal o gans (especially he li e ) and he diges i e i ue which
makes blood. He adds ha because he ollowe s o Galen, Magnus and
he o he s did no know u ines, hey consequen ly did no know he
in e nal o gans (49). In sho , o he Cha es commen a o , u oscopy
is p ima ily in e es ing as a key o ana omy and physiology (50).
(47) L: ol. 163 a: «physice supponi u an um pe ((h//eo icam. In hac enim
scien ia sola con empla io ope a u ». C . pa allel passage in Digby (no e 97).
(48) See no e 46 abo e; howe e , i should be no ed ha Mau ach did no use he wo
ea lies manusc ip s o he Isagoge, namely Pa is, Biblio hèque na ionale, MS
nou . acq. la . 1628 and Mon e Cassino, MS 225 (bo h s. XI, in Bene en an
sc ip ), and which bo h ead «in con empla ionem na u alium ex quibus sani a is..».:
see NEWTON, F ancis. Cons an ine he A ican and Mon e Cassino: New Elemen s
and he Tex o he Isagoge. In: Cha les Bu ne ; Danielle Jacqua (eds.), no e 2,
p. 33, no e 56 and igs. 1 (p. 43) and 2 (p. 4).
(49) L ol. 163 b: «Obscu as es id es in e icaces ope a iones. e obscu os in ellec us id
es inexplicabiles e alsos sun . Vel haben obscu as es id es epa . e alia
in e io a que pa iun u sun eis obscu a. De obscu is ue o haben obscu os
in ellec us. Nam u ina um e ce e a. Ve o quia non haben cogni ionem u ine.
non haben cogni ionem in e io em pa ium. quia si habe en cogni ionem u ine.
e habe en cogni ionem illa um pa ium».
(50) I is no ewo hy ha a his poin he E u e sion depa s om he London
e sion o dila e on he abili y o u ine o e eal c asis: «Obscu as id es g aues uel
maledicans. e es que paciun u . u capu . pulmo. s omacus. e in ellec us id es
quomodo deben in elligi pacien es pa es uel passu e. e quid pacian u . e
53
In en ing Diagnosis: Theophilus’ De u inis in he Class oom
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
6.2.Physiological con ex : he p oduc ion o u ine
A e de ining u ine as « he il a e o he blood» (colamen um sanguinis),
Theophilus’ ea ise p o ides a b ie ana omical accoun o how i is
p oduced. When ood is u ned in o blood in he li e , he ligh e ed
bile ises o he op, and is aken up by he gall bladde h ough i s duc
posi ioned nea he li e . The spleen bea s o he ea hy ma e , he
d egs o he blood so o speak, by i s duc . A wa e y supe lui y is le
wi h he blood, so ha i can pass h ough he b anches o he chilic
ein, and hence o he kidneys. The e i is u ned in o u ine, and
ansmi ed o he bladde . I blood is clea and pu e, i s supe lui y will
be likewise. Bu i o some eason he ope a i e i ue o he blood is
impeded om ca ying ou i s wo k, he u ine will appea hin and
whi e, o hick and whi e. These u ines a e he p oduc o impe ec
and c ude diges ion, whe eas o he s a e he supe lui y o an o e hea ed
and adus blood.
The Cha es commen a o inds his accoun inadequa e, and p oceeds
o supplemen i wi h an imp o ed ana omical and physiological back-
g ound, culled ex a lib um (51). This accoun s esses ha he p oduc ion
o u ine has an ana omical se ing as well as a physiological con ex ,
which is exac ly wha was announced in his accessus. Fo his ma e ial, he
commen a o u ns o he opening chap e o Isaac Judaeus’ ea ise on
quomodo. e unde. e ex quo empo e. Vnde subdici . Nam u ina um ap a id es
cong ua secundum empus e passionem aci nos cognosce e. non appa en es
locos. sicu epa in i mum. e splenem. e enes. e quomodo disposi i sun loci id es
quomodo diue so modo posi i sun in sani a e uel in eg i udine uel neu o. E
hoc exponi quod sequi u . E secundum qualem c asim id es habi udinem uel
empe anciam. Ea enim con i macio es p edic o um loco um. Tempe ancia dico
au secundum calidum e humidum. uel secundum ce e a. que dis empe anciam
na u e uel de imen a paciun u . Ex a na u am id es in hiis que sun non
na u ales. P e e na u am id es nondum in i ma i sed eg o a e pa a i. e secundum
qualem c as[s]im e ideo addi . Eius enim que sanguinem ope a u . hoc addi u
os enda cuius p o essionis si locus ubi nasci u id es epa e a quo disce ni u
id es in senibus». ( ol. 1 a)
(51) L ol. 163 b: «P emisso p ologo agi de u ina pe di ini ionem. Sed p iusquam
ponamus illam di ini ionem quedam sun no anda ex a lib um u melius pa ean
illa que sun in lib o».
54 FAITH WALLIS
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
u ines, as well as an as ye uniden i ied ana omical sou ce wi h a s ongly
eleological bias, edolen o he Second Sale ni an Demons a ion (52).
A e being diges ed, he ood passes in o he duodenum, so called
because i is wel e inge s in leng h. I hen goes o he jejunum, which is
so called because i akes no hing o i sel . F om he jejunum, he li e
a ac s he liquid pa o i sel h ough he mesen e ic eins, which a e like
leeches (a a he dis u bing analogy, no ound in Isaac). This phase o
he p ocess gi es he commen a o a chance o dig ess on he phenomenon
o a ac ion in gene al. All a ac ion, he says, is caused ei he by hea
(like oil in a lamp) o by an ins umen (as ai is mo ed in he a e ies,
o wa e in canals, o i on by a magne ), an analogy d awn om he
discussion o diges i e ac ion in Pan egni Theo ica 4.2 (53).
The Cha es commen a o ’s ana omical excu sus in ac exceeds
conside ably he equi emen s o any accoun o he p oduc ion o
u ine, especially in i s leng hy and ci cums an ial desc ip ion o he
a ious b anches o he po al ein and hei unc ions. A e dila ing
on hese, and on he oles o he s omach, gall bladde and spleen, he
e u ns o he heme o he o ma ion o u ine. I is in he po al ein,
(52) Jo dan has a gued ha he Digby commen a o and he au ho o he Second
Sale ni an Demons a ion a e one and he same pe son on he basis o a s ong
esemblance be ween hei espec i e dicussions o ision: JORDAN, no e 1, pp.
48-49. Howe e , i should be no ed ha while he au ho o he Second Sale ni an
Demons a ion claims o ha e composed commen a ies on Johanni ius, he Apho isms,
and Phila e us, he e is no men ion o Theophilus. Mo eo e , Digby’s discussion
o he bladde (London, B i ish Lib a y, MS Royal 8.C.IV ol. 179 a) men ions
he wo holes h ough which u ine en e s, and he e idence p o ided by animal
dissec ion (compa e o Cha es ex ci ed in no e 55 below). This passage is no
ound in he Second Sale ni an Demons a ion: see ed. in RENZI, Sal a o e de.
Collec io sale ni ana, Napoli, Tipog a ia del Filia e-Sebezio, 1853, ol. 2, p. 398.
Finally, bo h Cha es and Digby used ana omical e ms no ound in he Second
Sale ni an Demons a ion, e.g. uena chilis.
(53) Basel, 1539, p. 82. C . LAWN, B ian (ed.). The P ose Sale ni an Ques ions, Auc o es
B i annici medii ae i 5, London, Ox o d Uni e si y P ess o he B i ish Academy,
1979, B 47 (p. 23), whe e he analogies o he canal and he wick a e used in he
con ex o a discussion o magne ic a ac ion. Lawn poin s ou , howe e , ha
U so o Calab ia used he same ma e ial in his commen a y on Hippoc a es’
Apho isms. This dig ession on a ac ion is no ound in he Digby commen a y.
55
In en ing Diagnosis: Theophilus’ De u inis in he Class oom
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
he says, ha he ood i s ecei es he sub le ex u e and ed colou o
blood. The colou is ac ually impa ed o he blood by he ed li e
i sel (54). This is a a he in e es ing idea, no only because Theophilus
nowhe e explains why blood should be ed, bu because he Cha es
commen a o is obsessed wi h he issue o how hings in gene al, and
u ine in pa icula , ac ually change colou . He e he seems o sugges
(al hough i is no explici ) ha physical con ac wi h he ed li e dyes
o blood ed. Mo e on his subjec will ollow la e .
A e he body membe s ha e ex ac ed he nu imen om he
blood, he emaining wa e y liquo descends by wo b anches o he
ena chilis in o he kidneys. The u ine hus o med in he kidneys
descends o he bladde . The e a e wo openings in he bladde : a small
one on op by which i is illed, and a la ge one below by which i is
emp ied. Animal dissec ion howe e does no show he smalle opening.
Why? Because i is cons ic ed by he cold, like he po es and he
openings o ne es (55).
Now a las , he commen a o eels ha he s age has been adequa ely
se , and he can ac ually u n o Theophilus’ wo ds. Bu hose e y
opening wo ds— ha u ine is he il a e o he blood—immedia ely
p o oke a quaes io. Is i a il a e o blood alone, o o blood and he
o he humou s? The inspi a ion o his quaes io is Isaac Judaeus, who
says ha u ine is he il a e o all he humou s (56). The commen a o
p o ides wo solu ions. Fi s , ed bile and black bile, being by na u e
d y, canno low. The e o e u ine can only be he il a e o blood and
(54) L ol. 163 a: «In hac au em po a sublimi as cibo um p imum ecipi modum e
colo em sanguinis. quia cum ab epa e ibi decoqui u . in suum colo em conue i ».
(55) L ol. 163 a-b: «Sun au em in uesica duo o amina. unum supe ius e pa uum
quo imple u uesica. al e um in e ius. e magis qua euacua u . Pa uum amen
animali occiso non appa e . Claudi u enim pe es ic ionem igo is sicu po i.
e o amina ne uo um». As men ioned abo e (no e 52), his in o ma ion is no
om he Second Sale ni an Demons a ion, o any o he he o he ex s iden i ied
and ansla ed by CORNER, Geo ge W. Ana omical Tex s o he Ea lie Middle Ages,
Washing on DC, Ca negie Ins i u e, 1927, no does i de i e om Pan egni Theo ica
3.33. The Digby commen a y men ions wo small openings h ough which he
bladde is illed, bu no he opening by which i is emp ied.
(56) FONTANA, no e 21, p. 144.
62 FAITH WALLIS
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
e e s i signi ies «a diminu ion o he humou ». I is also a sign o
obs uc ion [emph axis], o example in cases o neph i is, incipien
qua an e e , and d opsy. When people expe iencing pain in he neck,
head and shoulde s pass hin whi e u ine, i he alds dizziness and
ain ing [lipo omia](74).
The Cha es commen a o ’s main objec i e in his sec ion is o
explain why wha Theophilus says is ue—why such condi ions mus o
necessi y lead o hin, whi e u ine (which is some hing ha Theophilus
does no explain)—and o couch ha explana ion in e ms o a ully
humo al ae iology. To begin wi h, why does Theophilus say ha hin,
whi e u ine «p ecedes all he o he s?» The Cha es mas e ’s explana ion
akes syllogis ic o m, o which he is qui e sel -conscious. The colou
whi e signi ies indiges ion, and all he o he colou s diges ion. Bu
indiges ion is p io o diges ion, o ha which is undiges ed can be
diges ed and decoc ed; bu ha which is decoc ed canno e u n o a
aw s a e. The e o e he colou whi e is p io o he o he colou s. O
else i is p io because i akes on all he o he colou s, while he o he s
do no ake on whi eness ( his will be he s a ing poin o his analysis
o he colou s o u ine in he nex sec ion) (75). Thin subs ance p ece-
des he o he subs ances because hinness signi ies indiges ion and
hickness adus ion. Wha is undiges ed p ecedes wha is diges ed o
bu n . The e o e, hin subs ance p ecedes mode a e and hick subs ance.
The London e sion o he commen a y obse es ha he wo syllogisms
a e analogous (76).
(74) KEIL, no e 5, pp. 100-102.
(75) The sou ce o his obse a ion is Isaac Judaeus: FONTANA, no e 21, p. 185.
(76) L ol. 164 b: «Albus colo p ecedi alios colo es hoc modo. Albus colo signi ica
indiges ionem. omnes ue o alii diges ionem. Indiges io ue o p io es diges ione.
Nam illud quod es indiges um. po es dige i e decoqui. Illud au em quod es
decoc um. non eue i u ad c udi a em. E go albus colo p io es aliis colo ibus.
Vel ideo p io es quia suscipi omnes alios colo es. alii ue o non suscipiun
albedinem. Tenuis subs an ia p ecedi alias subs an ias. quia enui as signi ica
indiges ionem pinguedo adus ionem. P ius es quod indiges um es quam quod
[in] diges um uel [MS: in] combus um. Tenuis e go subs an ia p io es medioc i
e pingui. Locus a ce e o in u oque sillogismo».

63
In en ing Diagnosis: Theophilus’ De u inis in he Class oom
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
(77) L ol. 164 b-165 a: «V ina alis mul a in quan i a e. similis id es con inua in
empo e signi ica diabe en id es ansi um u ine equen em; i enim aliquando
in enibus nimia dis empe an ia calo is p ope nimium calo em. uel aliam causam.
Quoniam ue o calo is es a ahe e enes quasi si iculosi sempe sibi a ahun
aquosi a em ab epa e. a ac am lice indiges am. epa a s omacho. s omachus ab
ex e io ibus. Vbi quia non es locus decoc ionis. conuenien e ansi ad uesicam.
Vnde i enuis luxus u ine». The sou ce o his explana ion has no been aced:
i is e y di e en om ha pu o wa d by Isaac Judaeus (FONTANA, no e 21,
p. 161) bu ma ches on a numbe o poin s Pan egni Theo ica 6.34, and e en
mo e so Via icum 5.19, Lyons, 1515, ol. 163 b.
(78) L ol. 165 a: «V ina e ce e a. Alba e enuis e mul a in eb ibus amphime is id es
co idianis. signi ica eb em illam de ice e p op e huiusmodi humo es qui euacua u .
Cum enim co idiana habea ie i ex legma e. si legma habunde in emissione
u ine eg i udo necessa io euacua u ».
The Cha es commen a o also ans o ms Theophilus’ bald equa ions
o hin, whi e u ine wi h ce ain diseases in o elabo a e pa hog aphies,
o which u ine p o ides he demons a i e semio ic clue. Fo example,
he ills in he logical s eps in Theophilus’ desc ip ion o diabe es.
Because i is he p ope y o hea o a ac , he o e hea ed kidneys, as
i pa ched wi h hi s , a e always a ac ing o hemsel es wa e y subs ance
om he li e , e en hough wha hey a ac is undiges ed. Because
decoc ion canno ake place in he kidneys, he mois u e eadily passes
o he bladde , whence i exi s as a lux o hin u ine (77). This is a
good illus a ion o he Cha es commen a o ’s s a egy. Theophilus’
diagnosis is some hing o a «black box»: hin, whi e, abundan u ine
signi ies diabe es, a diso de o excess hea , which a ac s mois u e.
Wha he commen a y does, is explain why he esul ing u ine will hen
be no only abundan (as one migh na u ally an icipa e) bu also hin
and whi e: he mois u e unna u ally d awn o om he li e is undiges ed,
and he kidneys canno diges i .
An e en be e example is u nished by he commen a o ’s analysis
o Theophilus’ s a emen ha whi e, hin and abundan u ine in cases
o epheme al e e signi ies ha he e e is aba ing because he humou s
a e being e acua ed. Why should his aba emen p oduce whi e, hin
u ine? The commen a o answe s ha epheme al e e comes om
co up phlegm. I phlegm abounds in he u ine, hen i s ands o
eason ha he sickness is being e acua ed (78). Theophilus does no
64 FAITH WALLIS
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
(79) I should be no ed ha Johanni ius dis inguishes «epheme al» and «co idian»
e e s: epheme al e e s a e sea ed «in animo», while e e s a ising om co up ed
humou s a e «pu id». O hese, co idian e e is caused by mo bid phlegm:
MAURACH, no e 46, p. 160. Bu i will be no ed ha he commen a o equa es
amphime is wi h co idianis: so does Cons an ine in Via icum 7.6, Lyons, 1519, ol.
168 b, and in Pan egni P ac ica 3.32, Lyons, 1519, ol. 90 b, bu no in Theo ica
8.4. Since he P ac ica o he Pan egni was assembled o e some ime, and no
manusc ip ea lie han 1200 su i es, i seems mos likely ha he commen a o
was using he Via icum.
say ha epheme al e e s a e caused by co up phlegm; he commen a o
d ew his in o ma ion om Cons an ine (79).
6.5.Theo e ical e- aming o semio ics: he ch oma ic scale o u ines
Ano he o Theophilus’ inno a ions was o p esen he colou s o
u ine in he o m a ch oma ic spec um om ligh o da k, s a ing
om whi e and i s shades («milky whi e», «ligh g ey» [glaucus], camel-
hai g ey [ca apos]) and unning h ough yellow (pale yellow [subpallida],
«somewha awny» [sub u us], awny [ u us], eddish [sub ubeus]), ed
[ ubeus] and i s a ian s ( lame- ed [ypico he on/ipe i he on], blood- ed
[e icon], wine- ed [inopos], blue-g ey kianon [=cyanon], «dusky» [ uscus]),
g een [cla on o clo on] and cha coal-g ey [pelicinon/peli hinon], o black.
The no ion o a anging he colou s in such a spec um is no ound in
Isaac, who deals wi h he colou s o u ine in appa en ly andom o de :
whi e, black, g een, g ey, yellow, ed, pu ple and pink.
The Cha es commen a o is clea ly imp essed by Theophilus’
spec um. He is pa icula ly aken by he idea ha each colou is made
om he colou ha p ecedes i , beginning wi h whi e, which is he i s
amongs colou s. I seems o sugges o him he no ion ha he humou s
which unde lie and de e mine u ine a e no en i ies, bu a he poin s
on a spec um. The commen a o says ha i chole ic ma e is added
o whi e, he esul is a colou which is whi e-ish [subalbidus]. I mo e o
his same chole ic ma e is added, wha e en ua es is pale yellow
[subpallidus]. I you add s ill mo e chole ic ma e , i becomes somewha
awny [sub u us]. Then i mo e is added, i becomes awny, and so o h.
The image he e o a pain e beginning wi h whi e pigmen , and p og essi ely
65
In en ing Diagnosis: Theophilus’ De u inis in he Class oom
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
(80) L ol. 165 b-165 a: «No a in is o ac a u IIIIo gene a colo um cons i ui. albi.
scilice . ubicundi. ui idis. e nig i. e la i udines eo um id es species. quomodo
unaquaque ex alia p oc ee u ascendendo ab albo. qui es p imus usque ad alios
colo es. Es igi u e ce e a. IIII sun p incipales colo es. albus. ubicundus.
ui idis. nige . Quo um unusquisque habe plu es species. e unus ex alio habe
ie i. Ve bi g a ia. Si albedini adda u cole icus colo subalbidus inde es p incipali e .
amen ab albedine e ici u . u decoc io semic ude ca nis posi e supe ca bones.
que p imum incipi pallesce e. Subpallidus es albus. cui si plus pa um adhuc
cole e adda u . e ici u pallidus. Si adhuc plus. i sub u us id es subci inus.
qui assimila u au o uenien e de cel ica egione. unde u pu us au us sole
ueni e. deinde si plus adda u . u us e ici u id es ci inus sicu o izon au um
uel eu izon. Eu izon bona adix in e p e a u pe quam bonum au um accipimus.
Deinde si plus i sub ubeum p incipan e quidem ubo e similis guico id es
c oco o olano. deinde ubeum sicu c ocus ue us o ien alis. deinde epi econ
[ ec e: ype i he on] i id es sub ubicundum ac um ad aquoso sanguine. quasi
splendo id es ubo . si supe ueni e . quod e iam uoca u inicon id es dac ilicon.
quasi sun dac ili. deinde ue o si eu i on id es ubicundus sicu ipse sanguis sine
dolo id es adus ione. Deinde i inopos cum aliquid ing edi is iungi u ubicundi a i.
u uinum nig um id es nig edo aliquan ulum commisce u ubo i. au i u
uinum p o undius in nig e udinem. Si plus nig edinis ei adda u . i pu pu eus
sicu colo e epa is. Deinde si plus nig edinis adda u . i kianon colo e u ga us».
(81) «Si ue o in ec ionem ecipia aliquam ellis alba u ina secundum p imam quidem
a ionem subpallida i . u decoc io semic udis ca nis. Si ue o pe mane empo e
aliquo decoc io. in ec ionem maio em aciens pe ici pallidum colo em». (KEIL,
no e 5, p. 102).
(82) JACQUART, no e 39, p. 419.
adding mo e and mo e ed (80). The commen a o seems o ha e picked
up on an idea enuncia ed by Theophilus himsel , who says ha i whi e
u ine ecei es an in ec io o ed bile, i becomes subpallida. I i hen
ecei es in ec ionem maio em, i becomes pallida (81). The wo d in ec io
was des ined o become an impo an one o la e Sale ni an commen a o s
on he Isagoge such as Ba holomaeus and Mau us, o whom i came o
deno e he p ocess by which one elemen , coming in o physical con ac
wi h ano he , exchanges quali ies wi h i . Danielle Jacqua has documen ed
he use o in ec io in his con ex . She a gues ha in ec io ep esen ed an
expe imen in sol ing he p oblem o how he elemen s, quali ies and
humou s a e al e ed and combined—a p oblem posed by he Isagoge o
Johanni ius. This p oblem e en ually inci ed he Sale ni ans o explo e
he po en ial o A is o elian na u al philosophy (82). I would en u e o
66 FAITH WALLIS
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
(83) Isaac enuncia es a somewha simila idea (FONTANA, no e 21, pp. 170-171)
whe e he desc ibes colou s as compounds o o he colou s (e.g. pu ple is a
combina ion o black and ed), and he Cha es commen a o has ce ainly ead
Isaac, because he uses Isaac’s e ms o some o he colou s, e.g. ubicundus and
li idus. Bu Isaac does no o ganize his colou s as a spec um.
(84) Digby commen a y, L ol. 179 b: «Si que a u quomodo (e go/ alio um humo um
in ensio ((ali e in ec io//. pe u inam cognosci u . cum eo um non si supe lui as?
R<espondeo>. in en ione ((uel in ec ione// illo um hic sanguis ua ia u . quia
aliquando ua ia u . qui aliquando cole icus. aliquando legma icus. aliquando
melancolicus e ici u . quam sanguinis in ec ionem. uel al e na ionem pe u inam.
que ipsius es supe lui as cognosci opo e ».
(85) A ol. 2 a: «I em uidendum es de empo e. e p imum secundum e a es. Adolescen ia
enim bene colo a am debe habe e u inam. Na u alis enim calo in illis pe uale .
guess ha Ba holomaeus chose his wo d (and Mau us i s synonym
con agio) because i was used by Theophilus o designa e he g adual
ans o ma ion o whi e u ine by ed bile (83). They simply gene alized
he speci ic meaning gi en o i in De u inis. Indeed, in he copy o he
Digby commen a y p ese ed in Royal 8.C.IV, in ec io is used o desc ibe
he al e a ion o blood by he p esence o o he humou s, which will be
isible in he u ine (84). Pe haps i was his b oade issue which mo i a ed
he Cha es commen a o ’s ma ked in e es in how hings change colou .
Finally, he Cha es commen a o e u ns o Theophilus’ s a emen
ha ime is an impo an ac o in judging u ines. Time, he concludes,
mus ac ually a ec he colou and subs ance o he u ine, no jus he
sedimen . The e o e mo e is in ol ed ha jus he ime o collec ion.
The Cha es commen a o concludes ha he age o he pa ien mus
also be a ac o . He e again he u ns o Isaac Judaeus, o bo ow he
i s o Isaac’s chap e s on he e ec o he «non-na u als» on he
quali y o u ine. Adolescen s should ha e a well-colou ed u ine, o
na u al hea p e ails in hem, bu because hey ea all he ime, and oo
much, hei u ine appea s u bid and no well-cooked. In young men
he u ine is hin and awny because o an abundance o chole , and in
ma u e men, i is hin and whi e, because ma u e men a e melancholic.
He e he commen a o depa s om Isaac, who says ha he u ine o
ma u e men is ci ine. Ins ead, he picks up Johanni ius’ schema linking
he humou s o he s ages o he li e cycle. In ac he commen a o uses
Johanni ius’ and no Isaac’s e ms o he ages o man (85). Acco ding
67
In en ing Diagnosis: Theophilus’ De u inis in he Class oom
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
sed p op e assiduam e equen em comes ionem. u bida e non bene coc a
appa e . I em e si na u alis calo magis in e a e illa p eualea . in endi u amen
non in quali a e. que colo a bene. sed in quan i a e. In iuuenibus ue o enuis
u ina. e u a es p op e habundanciam cole icam. In quibus magis in endi u
na u alis calo in quali a e quam in quan i a e. Non enim c escun . quod es
opus quan i a is. In senibus enim enuis e alba es . Senes enim melancolici sun .
In senio au em u ba a e mala p op e habundanciam igidi a is e humidi a is
e p op e des uc ionem na u alis calo is». Johanni ius and Cha es call he
i s age adolescen ia (MAURACH, no e 46, p. 155); Isaac, pue i ia (FONTANA,
no e 21, p. 163).
(86) MAURACH, no e 46, p. 155.
(87) A ol. 2 a: «In empo ibus au em simili e conside andum es . In ue e namque
debe esse sanguinea. ibi enim sanguis exc esci . In es a e ue o cole ica. In
au umpno melancolica. in hyeme legma a. Si ue o in hyeme si sanguinea. uel
in ue e legma ica signi ica habundanciam uel sanguinis uel leuma is sicu e in
aliis». C . MAURACH, no e 46, p. 155.
(88) See no e 76 and compa e o Digby (London, B i ish Lib a y, MS Royal 8.C.IV,
ol. 180 b): «Albus enim colo alios colo es p ecedi hoc modo. Albus enim
o he Isagoge, melancholy is associa ed wi h he ma u e yea s (86).
Melancholy is cold and d y, so melancholic u ine is whi e and hin. The
Cha es commen a o goes on o link he colou s o u ines o he
seasons when he co esponding humou domina es. This is no ound
in Isaac, bu may be a de elopmen o Johanni ius’ schema linking
elemen al quali ies, ages o li e, and seasons (87).
7. COMPARISON WITH THE DIGBY COMMENTARY
The Cha es commen a y opens a window on o a school whe e
medicine is s udied om an agg essi ely heo e ical s andpoin . The
Digby commen a y, howe e , e eals a a he di e en wo ld.
On he whole, he Digby commen a y is no as igh ly o ganized and
c isply a gued as Cha es, and is a he mo e epe i ious. Though e e y
bi as commi ed as Cha es o es ablishing u oscopy on a igo ously
humo al basis, Digby lacks Cha es’ single-minded d i e o logic and
scien i ic cohe ence. Fo example, he syllogism h ough which Cha es
p o es why hin, whi e u ine should be conside ed i s is mo e loosely
p esen ed in Digby (88). Whe eas in e e y disease discussed unde he

68 FAITH WALLIS
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
signi ica indiges ionem. Alii ue o diges ionem uel adus ionem. Indiges io ue o
p io es diges ione. Illud enim quod indiges um es . po es dige i. Quod ue o
diges um es ad c udi a em nequi educi. Vel ideo p io . quia omnes colo es
suscepi . Alii ue o non suscepiun albedinem. Si quis dica . Nonne uidimus
ubo e e ci ini a e aliisque colo ibus de subi o co po e abla is.’ co pus emane e
album? Ad quem dicimus impossibile es albedinem succede e. nisi p ius colo es
illi emouean u . quod non es i a de albedine. I e um enuis subs an ia alia
p ecedi . P ius enim enui as es ibi dum nondum es ac a ebullicio qua inspissa u ».
(89) Digby, ol. 181 a: «Talis ueniens in eb ibus amphime inis id es co idianis. e mul a.
signi ica eb is solu ionem. e de icie e p obos humo es qui euacua u ». C . no e 78.
(90) Digby, ol. 179 b-180 a: «Quomodo si colligenda no andum si . Colliga u in
uase ui eo. albo. e cla o. e o undo in undo. ad uesice simili udinem uel
modum/. e ope ia u ne igido ae e co umpa u . sed in na u ali pe du e
colo e. sicu exi a co po e. neque de uase in uas mu e u . ne o e mu ando ae
igidus subine e . neque de loco in locum po e u . quia ex depo a ione u bida
e ici u . uel ing ossa u . e in ue i a e cognoscenda decipi u . Ro undum uas ad
modum uesice ideo opo e esse. u pa ua loci [illeg.] ac a uidea u . e sicu in
uesica iacui . sic in uase ((ui eo// epona u . cla um ideo.’ u quid in e ius si
sub ili e uidea u . Quan a colliga u .’ o a scilice quia melius o a quam pa s.
Ac ionem co po is os endi . e i e um quia quan i as ipsius op ime es conside anda.
I em quia aliquando sedimen cum u ina eg ediens in p incipio mi c/[nec] ionis
u i a dicam eg edi u . Aliquando in ine. Quecumque e go pa s u ine abicia u .’
o asse sedimen cum ipsa di undi u . Quod si in calice appa e e .’ in uen is
iudicium ce i ica e . Si mul o iens colligi u .’ diue sis in uasis epona u . u pe
se uniuscuiusque p op ie as appa ea . Quo empo e si conside anda. Opo e u
cum a uesica exie i . an equam ab ae e co umpa u .’ inspicia u . Quomodo
uidea u in loco scilice lucido solis splendo e opposi o. Vas in dex a enea u .
In sinis aque manu e<c> us mouea u . u cla i as. uel u bulen ia ipsius uidea u .
e leui e mo us pos ea equiesce e pe mi a u . u leui a em ypos asis e ueloci a em
ub ic o hin, whi e u ine, Cha es is conce ned o demons a e exac ly
why ha diso de would p oduce ha kind o u ine, Digby seems less
compulsi e: o example, Digby’s discussion o epheme al e e in ela ion
o hin whi e u ine does no men ion ha epheme al e e is caused by
phlegm, an omission which om Cha es’ ae iological pe spec i e a he
ob ia es he en i e poin (89). Bu abo e all, he Digby commen a o (as
indeed Ba holomaeus and Mau us) is much mo e in e es ed in clinical
ma e s han he Cha es mas e is. When he Digby commen a o uses
Isaac Judaeus, he ends o ollow him mo e closely han Cha es does.
Whe e Cha es edi s ou Isaac’s ins uc ions o how o inspec u ine in
he lask, Digby includes hem, almos e ba im (90). Cha es men ions
69
In en ing Diagnosis: Theophilus’ De u inis in he Class oom
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
mo ionis uideas. Si necesse si ad candelam uide i.’ simili e ia . Quo iens uidea .’
ibus uicibus (scilice / e in e missiue quiesca . V ina enim pos quam exii .’
mu a u in uase mul is modis. Aliquando enim mingi u enuis.’ e manea
enuis. Aliquando mingi u enuis.’ e ((pos ea i // spissa. Aliquando mingi u
spissa.’ e mane sic. Aliquando spissa eg edi u .’ e pos ea eddi u enuis. Quod
u scia u .’ e uidenda es scilice s a im pos quam exii . e paulo pos . e i e
pos ea e cio. e cum in e uallo. Si in ig<i>de u .’ non debe ecal<i> ie i; quia
aliquando u bida e alba ex pig icia calo is na u alis ad complemen um sui exi .
e pos ea [calo e ex e io i apposi o.’ subs an ia cla esci . e sump o: excised?]
calo e ex inseco.’ a calo e na u ali mu a u . e cum in se p ius indiges a esse .’
diges a uide u . e sic cum medici necessa io alli u ». C . FONTANA, no e 21,
pp. 152-153.
(91) Cha es (L ol. 164 b): «Plana quoque id es con inua. e ad modum pinee debe
esse. cum ex calo e in e ia decoc ione omnium memb o um decoqua u . unde
exiens modum pinee. in o ma debe e ine e. Quam o mam si habue i pe ec am
empe an iam calo is in co po e sine aliqua uen osi a e signi ica pe ec a». (The
sec ion in which his passage would be ound is missing in E u ). Digby (Royal
8.C.IV ol. 180 b): «Subs an ia ue o plana id es con inua; u si acu a supe ius
g ossa in e ius. ad modum pinee que o ma es ignis in quo no a u quod calo
p euale in diges ione na u ali. e inde o mam accipi ignis». Whe e his no ion
ha u ine sedimen should look like a pine cone comes om is no known. Isaac
does no say his. Howe e , he does say ha good hypos asis should se le o he
bo om o he lask in he o m a heap, wide a he bo om and na owing o a
poin a he op, like a lame. A ew lines la e , he adds ha he hea is shaped
like a pine cone, because i is he sea o he na u al hea (FONTANA, no e 21,
p. 205). Digby has e iden ly g asped Isaac’s main poin , which is o link he hea
o diges ion o he shape assumed by he sedimen .
(92) Digby commen a y, L ol. 181 b: «V ina e iam alis. mul a in quan i a e. e similis
id es con inua. in empo e signi ica diabe en id es id es [sic] ansi um equen em.
i aliquando in enibus nimia calo is dis empe an ia p op e nimium labo em.
uel aliam causam. Quoniam ue o calo is es a ahe e. enes quasi si iculosi
ha good sedimen should se le on he bo om o he lask in he o m
o a pine cone, bu he explana ion is e y ellip ical. The Digby commen a o
is much clea e and mo e de ailed abou wha his pine cone shape
means (91). In sho , one ge s he imp ession ha he is ce ainly mo e
in e es ed, and possibly mo e expe ienced, in he ac ual p ac ice o
u oscopy. E en when Digby mi o s Cha es qui e closely, li le de ails
e eal he o me ’s mo e clinical o ien a ion. Fo example, Digby’s
discussion o diabe es is almos iden ical o he one in Cha es, bu
Digby adds ha diabe ic pa ien s expe ience unquenchable hi s (92).
70 FAITH WALLIS
DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
sempe a ahun sibi aquosi a em ab epa e a ac am. lice indiges am. epa a
s omacho. s omachus ab ex e io ibus ubi quia diges ionis uel decoc ionis// non
es locus conueniens. e enes in e en ione sun debiles.’ s a im ansi ad
uesicam e exi . Vnde i con inuus luxus u ine e si is inde iciens. cum enes
sa u a i non possun . humidi a em a ac am e ine e nequeun es». C . no e 77.
(93) Cha es (L ol. 164 a): «Que i u au em qua e illas solas na u ales dica . ubi
ypos asis alba appa e . cum sepissime in u ina obus o um nulla uidea u ypos asis.
E dicimus quia obus i non sun pe ec e empe a i sed in calo e in ensi. Qui
calo e iam ecem sanguinis <que> in e cia decoc ione debe esse ypos asis
consumi . ideoque u ina eo um non iudica u na u alis». Digby ( ol. 180 a):
«Que i u qua e illas solas na u ales dica . ubi es ypos asis alba. e ce e a. Cum
sepissime in u ina obus o um e sano um nulla uide u [co . o uide[ ]a u ]
ypos asis. e dicimus quia hoc con ingi ex calo is o i udine. Tan us es in eis
calo qui supe lui a em e cie diges ionis omnino consumi . uel pe sudo em
expelli . e hoc nullum malum. si sedimen in u ina eo um non appa ea ». Digby
also picked his up om Isaac, who wice men ions Galen’s dic um ha he u ine
o hea hly people o en does no ha e sedimen : see FONTANA, no e 21, pp. 149
and 207. No ice ha Cha es e e s o hese people as obus i and Digby as obus i
and sani. Isaac calls hem sani.
(94) Digby ol. 182 a: «[U ine which is pallida] signi ica p incipium diges ionis e
igidi a is dominium. sed amen cole am admisce i ex qua commix ione aliquan ulum
colo a u . Si plus cole a i enda u u calo igidi a i equipollea . iun medioc es
colo es. Ru us e sub u us. Si plus deinde in enda u cole a u calo p eualea .’ iun
ubeus e sub ubeus. Deinde si plus adhuc.’ e sub ubicundus e ubicundus. Deinde
inopon. cum aliquid nig edinis iungi u cum ubicundi a e. Si plus nig edinis adda u .’
i pu pu eus sicu colo epa is. Si adhuc plus.’ kianon. cuius coniunc ionis egula
alis es . Si albo colo e supe uenia splendo id es ubo e pos ea aduenia plu imum
Whe e Cha es condemns he sedimen - ee u ine o a hle es as «unna u al»
Digby akes a mo e neu al and p agma ic app oach: hese people a e
ob iously heal hy, so in his case, u ine wi hou sedimen mus be
na u al (93). Like Isaac, bu unlike Cha es, Digby is in e es ed in he
e ec o all he «non-na u als» on he s a e o u ine; Cha es is only
in e es ed in he seasons, because unlike he o he non-na u als, he
seasons ha e quali ies which link hem o he humou s. The con e se is
ha Digby is somewha less in e es ed in issues which could be classi ied
as na u al philosophy han is Cha es: Digby, o example, is no cu ious
abou why blood is ed. The commen a o iews he ch oma ic spec um
o u ine as a scale unning om indiges ion h ough o o e diges ion,
om excess cold o excess hea , no as an illus a ion o how colou s
eme ge one om he o he (94).
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DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 2000, 20, 31-73.
nig edinis.’ ia kianon. Deinde i uscus ex albo e nig o equali e coniunc is.
Deinde i ui idis pe adus ionem cole e. Deinde pe i on ((uel peli hmon// id
es liuidus colo qui p o undio es usco. scilice nig edinem. e i ex albedine
e nig edine. p incipali e amen nig edine. i enim hic colo si nimia igidi a is
domine u sanguini. qui da liuidi a em. sicu possumus uide e in labiis qui
p op e igus liuescun . quibus si magnum igus accesse i .’ e iciun u nig a.
Sic e u ina. i (e / [enim: expunged] nig a (ex/ nimia adus ione». C . no e 80.
(95) Digby commen a y, L ol. 177 a: «Sicu in humano co po e non simplici e sed
mul i o mi e i opposi io [co . in ma g. ope a io]. i a omnis ope a ionis non
una sed mul a signa appa en . Quo um quedam signa in eges ionibus. quedam
in pulsibus. quedam in u inis. Ce e o umque signo um subiec is cons i u a sun .
I em sicu aliquando sani a i. aliquando eg i udini. aliquando neu ali a i subiaci .’
sicu eius al e i a is ((uel al e a ionis// diue sas signi ica iones eppe iun u ».
(96) Digby commen a y, L ol. 177 a: «Me i o igi u quisquis humani co po is s a us
[illeg.] uel conse uandos suscepe i diligens inues iga o insude u pe quasdam
supe lui a es a co po e eg edien es quicquid ((ali e quid// in e ius elabo e u .
sagaci coniec u a pe penda . Quo um heophilus non igna us. hunc libellum de
signi ica ionibus u inae ad communem omnium medico um u ili a em composui ».
(97) Digby commen a y, L ol. 177 a: «Physicae hunc libellum supponi nemo dubi a .
cum de e um con empla ionibus aga ».
(98) Digby commen a y, L ol. 177 a: «Ex his mani es is quan um ad illos ((qui//
haben . uel habue un . es obscu as. id es in e icaces ope a iones. e obscu os
in ellec us ((id es inexplicabiles sen en ias.// Vel haben obscu as es id es
passiones in e io um memb o um sun eis obscu ae. id es la en es. u epa is e
similium. e inde obscu os haben in ellec us».
Bu pe haps he mos s iking di e ence, in iew o he heme o
his pape , is he Digby commen a o ’s a i ude owa ds he ela ionship
o u ine and diagnosis. The commen a y opens wi h he obse a ion
ha he unc ions o he human body a e no simple, bu mul i o m,
and so he e is no one, bu many signs by which hey can be ead. In
sho , u ine inspec ion is only one o an a ay o diagnos ic s a egies;
a e y p ac ical pe spec i e (95). Digby goes on o iden i y he po en ial
eade as someone conce ned o es o e o conse e he heal h o he
human body, who should bes i himsel as a diligen in es iga o o ind
ou om hese supe lui ies wha is going on inside he pa ien (96).
Theophilus’ book is hus p ima ily use ul o doc o s, hough «no one
doub s» ha i belongs o physica, «because i deals wi h he con empla ion
o hings» (97). The «hidden hings», which he Cha es commen a o
sees as he inne o gans o he body, a e in e p e ed by Digby as he
diseases o he inne o gans [passiones in e io um memb o um](98). In