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The Problem with the Four Humors Theory

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The Problem with the Four Humors Theory WOMEN’S NATURE (PHUSIS) AND DISEASES AS OBJECTS OF OBSERVATION IN THE HIPPOCRATIC GYNECOLOGICAL WRITINGS: AN EPISTEMOLOGICAL STUDY A THESIS SUBMITTED TO THE GRADUAL SCHOOL OF SOCIAL SCIENCES OF THE MIDDLE EAST TECHNICAL UNIVERSITY BY GÖKÇESU AKŞİT IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY IN THE DEPARTMENT OF PHILOSOPHY JANUARY 2013 ii Approval of the Graduate School of Social Sciences _______________________________ Prof. Dr. Meliha ALTUNIŞIK Director I certify that this thesis satisfies all the requirements as a thesis for the degree of Doctor of Philosophy. _________________________________ Prof. Dr. Ahmet İNAM Head of Department This is to certify that we have read this thesis and that in our opinion it is fully adequate, in scope and quality, as a thesis for the degree of Doctor of Philosophy. ________________________________ Assoc. Prof. Dr. Samet BAĞÇE Supervisor Examining Commitee Members Prof. Dr. Ahmet İNAM (METU, PHIL.) _________________________________ Pfor. Dr. Halil Ş. TURAN (METU, PHIL.) _________________________________ Assoc. Prof. Samet BAĞÇE (METU, PHIL.) _________________________________ Assoc. Prof. Billur TEKKÖK (METU, PHIL.) _________________________________ Assoc. Prof. Tansu AÇIK (METU, PHIL.) _________________________________ I hereby declare that all information in this document has been obtained and presented in accordance with academic rules and ethical conduct. I also declare that, as required by these rules and conduct, I have fully cited and referenced all material and results that are not original to this work Name, Last name: Gökçesu AKŞİT Signature: iii ABSTRACT WOMEN’S NATURE ( PHUSIS) AND DISEASES AS OBJECTS OF OBSERVATION IN THE HIPPOCRATIC GYNECOLOGICAL TEXTS: AN EPISTEMOLOGICAL STUDY Akşit, Gökçesu Ph.D., Department of Philosophy Supervisor: Assoc. Prof. Dr. Samet Bağçe January 2013, 208 pages This study concentrates on the disease and treatment cases of women in the Hippocratic texts, to identify and describe the Hippocratic medical style as one that, through its mode of practice, represents a significant departure in making the human body observable. As an antidote to a bias in the literature that has always made the male more visible, we chose to view Hippocrates’s novel way of making the woman visible since, producing a new entity for observation, this style of practice led to the emergence of a new profession of medicine, gynecology. In this way, the “white armed” women of ancient times were brought into the realm of the visible. Examination of the case histories in the corpus revealed that the observational style was used in light of two principles, that of nature as an active force, generally for healing, and water as a function and humor; both the nature and water concepts uniting the analytical and the metaphorical in a holistic way. The nature inspiration enables an ecological view of Hippocratic practice in such a way that later categories described by Kuhn as incommensurable are seen to function in interrelation. The theoretical trajectory therefore, involves a short survey which starts with Popper and follows through Kuhn, Lakatos, Feyerabend, and finally Crombie, with the latter’s concept of “styles of thinking” which accounts for how habits of thought inform specific practices like Hippocratic gynecology. Key Words: styles of thinking, women studies, Hippocratic Corpus, phusis, theory of four humors. iv ÖZ HİPOKRATİK JİNEKOLOJİK METİNLERDE GÖZLEM NESNELERİ OLARAK KADINLARIN DOĞASI (FÜSİS) VE HASTALIKLARI: EPİSTEMOLOJİK BİR ÇALIŞMA Akşit, Gökçesu Ph.D., Felsefe Bölümü Danışman: Doç. Dr. Samet Bağçe Ocak 2013, 208 sayfa Bu çalışmada, Hipokratik tıp pratiğinin insan bedenini nasıl görünür kıldığını anlatmak ve anlamak için Hipokratik metinlerdeki kadın hasta geçmişleri ve bunların ele alınış biçimleri incelenmiştir. Genelde erkeklerin daha görünür olduğu eskiçağ yazının aksine, Hipokrates’in kadınları da görünür kılan metodu, gözlem, yeni bir gözlem nesnesi yaratarak, jinekolojiyi doğurmuştur. Böylece antikitenin “beyaz- kollu” kadını artık görünürün alanına getirilmiş olur. Bu hikayelerde, gözleme dayalı Hipokratik iş yapma biçiminin temelde iki kaynak ışığında çalıştığı söylenebilir: her ikisi de, analitik ve analojik olanı bütünleştiren şekilde, genelde sağaltmaya doğru aktif bir güç olan doğa, ve bedeni oluşturan dört temel sıvıdan (suyuk) biri olan su. Doğa’nın Hipokratik pratikte bu kullanılış biçimi ekolojik bir bakış açısıyla Kuhn’un “karşılaştırılamazlık” kategorisine karşı, bir arada iş yapma biçimlerini mümkün kılar. Çalışmada kısaca bilimsel (d)evrimlerin yapısı incelenmeye Popper ile başlanmış, Kuhn, Lakatos, Feyerabend, ve son olarak Crombie ile devam edilip, sonuncunun ‘düşünme biçimleri’ kavramının, pratiğe odaklanması ile, Hipokratik jinekolojik metodu anlamakta kullanıldığı vurgulanmıştır. Anahtar Kelimeler: düşünme biçimleri, kadın çalışmaları, Hipokratik Metinler, füsis, dört suyuk teorisi. v ACKNOWLEDGEMENTS In the period of this study many people helped me, both in academic and other circles. First I want to thank my family besides all who where always there when needed, especially my parents Bahattin and Belma Akşit, my sister Elif Ekin Akşit and her family, and my cousins Pınar Tankut and Aydın Tankut who are no less than a sister and a brother. My dear thesis advisor Assoc. Prof. Samet Bağçe also carried me much in the long journey of this study. Besides the jury members, I specially want to thank Assoc. Prof. Billur Tekkök for being always available with answers to all manner of questions. Prof. Dr. Halil Ş. Turan is my first advisor who encouraged me to begin my doctoral studies in the field of the history of science and supported me in many ways. Prof. Dr. Ahmet İnam played a key role in inspiring me to do philosophy. I want to thank Assoc. Prof. Tansu Açık for trying my enthusiasmos in the vast literature of ancient Greek studies seriously. Thus all my friends, deserves special thanks for the care they give to me, although sometimes it was cursing, it was always curing at the end. vi TABLE OF CONTENTS PLAGIARISM……………………………………………………………...………..iii ABSTRACT……………………………………………………………...…………..iv ÖZ………………………………………………………………………...…………..v ACKNOWLEDGEMENTS……………………………………………..……….…..vi TABLE OF CONTENTS…………………………………………….……………..vii LIST OF FIGURES……………………………………………………………..…...ix CHAPTER 1. INTRODUCTION………………………………………………….….…..……..1 2. HISTORICAL AND THEORETHICAL BACKGROUND…………..………..10 2.1. Approaches to History and Philosophy of Science…………………………10 2.2. Medical Histories of Ancient Greece………………….……………...……16 2.2.1. Hippocrates, Pre- Hippocratic Temple Medicine and the Pre-Socratics...........................................................................................19 2.2.2. The Pre-Hippocratic Period: The Histories of Herodotus……….......24 2.2.3. The Post-Hippocratic Period……….…….………………………….29 2.2.3.1. Dogmatics, Eöpirics and the Methodists………………….....31 2.2.3.2. The Roman Tradition: Celsus, Dioscorides, Areteaus, Rufus, Soranus and the Pneumatics……………………………...34 2.2.3.3. Galen of Pergamum………………………………………….36 2.3. Medical Theories of Ancient Greece……………………………………….37 2.4. Conclusion…………..………………………………………………….…..43 3. DISEASES OF WOMEN IN HIPPOCRATIC CORPUS……………………….48 3.1. Women in the Ancient Greek Medicine…………………………...……….48 3.2. Women in the Hippocratic Corpus…………………………………………49 3.2.1. The Gynecological Writings…………………………………..…….52 3.2.1.1.1. On Generation, On the Nature of the Child and Diseases IV……………..………………………………53 vii 3.2.1.1.2. On Generation………………………….……………….54 3.2.1.1.3. On the Nature of the Child………...……………..…..58 3.2.1.1.4. Diseases IV, On the Nature of Man and the Problem with the Black Bile…….……………………….…60 3.2.1.2. On the Seven Months Child, On the Eight Months Child revisited and Superfetation, On the Diseases of Virgins, On the Excision of the Fetus and the related parts of Coan Prenotions…………………………………………………71 3.2.1.3. The Core Hippocratic Gynecological Writings………......….77 3.2.1.3.1. On the Diseases of Women………………………..…78 3.2.1.3.2. On the Nature of Women………………………….....94 3.2.2. The Non-gynecological Hippocratic Writings...…………………...100 3.2.2.1. The Hippocratic Genuine Writings…..…………………….100 3.2.2.2. Other Hippocratic Writings….……………………………..127 3.2.2.2.1. Epidemics II,IV-VII…………………………….…..127 3.2.2.2.2. Other Hippocratic Writings (On the Nature of Bones and the Non-gynecological parts Of Coan Prenotions)………………………………………….139 3.2.3. Conclusion…………………………………………………….……140 4. THE WOMEN PHUSIS IN HIPPOCRATIC OBSERVATIONS AND ARETE: BASIC CONCEPTS IN HIPPOCRATIC GYNECOLOGY……..….145 4.1.Phusis…………………………………………………………………...….147 4.2. Hydor………………………………………………………………….…...151 4.3. Oiko-logy…………..……………………………………………………...157 4.4. Observation…….………………………………………………………….160 5. CONCLUSION………………………………………………………...…...168 REFERENCES………………………………………………..………………...…176 APPENDICES 1. TURKISH SUMMARY….………………………………………..……….189 2. CURRICULUM VITAE…………………………………………..…….....206 viii LIST OF FIGURES FIGURES FIGURE 1. ANCIENT GREEK AND ROMAN CHRONOLOGY OF POLITICAL, PHILOSOPHICAL AND MEDICAL THINKERS AND EVENTS………………………………….……………………....18 FIGURE 2. THE PROPERTIES OF THE FOUR HUMOURS AND THEIR CORRESPONDING ELEMENTS…………………...……….41 FIGURE 3. NATURE’S ROLE IN HIPPOCRATIC PRACTICE………….………76 ix CHAPTER 1 INTRODUCTION This study concentrates on the disease and treatment cases of women in the Hippocratic writings, describing the Hippocratic medical style as one that, through its mode of practice, represents a significant departure in making
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