However, from the tenth century, conflicts between Arabic philosophers and doctors intensify, and this attitude of avoidance seems no longer tenable. Certain scholars, often philosophers, devote themselves to finding a general solution to the problem, in order to provide a general principle to mediate conflicts between the two disciplines. The first to propose a solution of this kind is the philosopher al-FarabI (872-950). His comments come down to an attack against the philosophical pretensions of the doctors, especially Galen’s. For al-FarabI, Aristotle, who draws on logical reasoning, prevails against Galen and his empirical observations. This clear choice for Aristotelian-ism leads al-FarabI to place medicine among the practical arts, with agriculture or cooking, and to divide it in seven parts, of which the first three (knowledge of the organs, health, and diseases) are totally or partially common to natural philosophy and medicine, while the next four (symptomatology, nutrition and medication, hygiene and dietetics, and therapeutics) are part only of the second.
Still, this solution does not resolve the problem completely, since it has no answer to an essential question: how must the doctor act in a controversial case? Must he, despite their incorrect theoretical origin, apply against his better judgment all the treatment methods that Galen heartily recommends? Faced with this difficulty, Avicenna (980-1037) goes further than al-FarabI and proposes an original solution, developed in particular in the Canon of Medicine. Avicenna gives first a definition ofmedicine that reduces neatly his ambition, since for him medicine is concerned with the human body solely qua healthy or sick, and not, as does natural philosophy, in itself. From this model follows logically another way of looking at the relation between the two subjects. Avicenna explains often that ‘‘the physician does not need to proceed following a demonstrative argument that will lead him from this disagreement to the truth, nor qua physician will he see the path to this, nor does this impede him in his investigations and actions.’’ Avicenna’s position is simple: the doctor must not take an interest in the causes of phenomena and search for the principles of natural mechanisms, since this search is within the purview of the philosopher alone; he must be content to take an interest in the remedies that he uses against illness without wondering about their first causes: only the immediate causes are for him relevant, and if they seem to contradict the claims of natural philosophy, he is not authorized to search for a reconciliation that only the philosopher is able to achieve. However, Avicenna takes care to specify that the doctor’s actions, that is, his concrete activities as a therapist, must not be changed according to debates that arise in another discipline.
This attitude is called “instrumentalism” (McVaugh), because it regards medical theories as adequate instruments for predicting and evaluating phenomena, but Ill-suited for attaining truth. Instrumentalism, in the work of Avicenna, goes hand in hand with a model of the doctor that confine him to the restoration of health without exploring the true nature of things, and merely studying sensible and manifest entities on which he can act. It is interesting to note that this position does not forbid doctors from being philosophers as well, like Avicenna was himself, because the important element is the expression ‘‘as a doctor’’: in reality, a doctor can, as philosopher, ask himself questions concerning the true nature of things; but he must then refrain from basing himself on medical empirical observation and, thus, to conduct himself as a doctor. We see that Avicenna establishes a neat distinction between philosophy and medicine, each having its proper objectives and methods. Such a conclusion might seem to subordinate medicine to natural philosophy; in reality, we must instead insist on the great autonomy conferred on a medical discipline that, while on a more restricted domain, can henceforth develop with fewer restrictions.
World History
