Incantations in the Medical Philosophy of Petrus de Abano (c. 1250-1316)

Matthew Klemm

Johns Hopkins University

            In what follows, I will discuss an influential analysis of the use of incantations and magic in medical practice from Peter of Abano’s Conciliator.  In this text, Peter offers a thorough explanation of how incantations function in general and how certain incantations can heal patients by instilling them with “confidence” in health.  In describing his position, I will pay particular attention to the light it sheds on two broader aspects of Peter’s medical philosophy.  First, Peter’s explanation of incantations offers one of the most thorough descriptions by a physician of the symbiotic relationship between the soul and body.  Incantations, which affect the patient’s soul primarily and the body secondarily, provide Peter with an opportunity to explain a vast web of holistic interactions affecting health.  Next, I will briefly look at Peter’s analysis in the context of his ambition for the potential of medical science as a whole.  The case of magic offers insight into the vision he has for medical “science” to encompass topics that had not traditionally been considered within the domain of scholastic medicine.  I should note that the force of Peter’s arguments remains for the most part on an abstract level.  So although he begins by discussing incantations, he includes other types of magic in his discussion, including astrological images, magical inscriptions, and other occult phenomena to offer an analysis of the principles by which they all work.  For this reason, I will use the words “magic”, “spells” and “incantations” almost interchangeably in this essay.

Peter of Abano is familiar to many historians of science and medicine for the significant role he played at a time when medical faculties were increasing in importance at universities throughout Europe and the place of medicine in the hierarchy of knowledge was being re-evaluated.[i]  Like many of his contemporaries in scholastic medicine, he attempted to unite the study of medicine more securely to the principles of natural philosophy.[ii]  Peter’s most famous work, the Conciliator (completed ca. 1303) is a large and systematic work based on Peter’s teaching at the university of Paris in the last quarter of the thirteenth century.[iii]  The Conciliator follows the basic pattern of several comprehensive medical texts popular at the time: after a general introductory section consisting of ten questions (called “differentiae”), the remainder of the 210 differentiae is divided into roughly equal sections on the theory and practice of medicine.  As Peter suggests in the prologue to the entire work, he hopes to bring together many problems common to his medical and philosophical sources into a single medical model.[iv]  The holistic nature of his medical interests contributed to the Conciliator's continued popularity in both medicine and philosophy throughout the following centuries.[v] 

Among the Conciliator’s practical problems, the 156th differentia considers the question of whether an incantation pronounced by a physician can assist in restoring or maintaining the health of a patient.[vi]  This defense of spells in a medical context is unusual in that most university-trained physicians restricted themselves to problems of a more evidently physical nature.  Yet for Peter, the topic of magic as a medical question derives from observation and experience and thus warranted discussion.   Peter believed that experience demonstrated the validity of incantations and that the question is not whether or not they work, but how and why they work.  In this way, this topic is like most of the other questions among the “practical” problems, which fill the final section of the Conciliator.  Most of these problems are neither more nor less “practical” than the medical theory which precedes them.  Rather, they are practical because of their derivation from practice or empirical observation and the fact that they can not always be predicted through reason alone.[vii] 

Following the standard format of scholastic questions, Peter first presents the objections to the idea that spells can produce bodily cure.  These objections fall into two categories.  The first is the issue of how something seemingly immaterial, such as a spoken word used in a spell, is able to alter the material disposition of the body, a recurring problem in natural philosophy.[viii]  The second type of objection is that the most revered medical authorities, including Galen and Hippocrates, had criticized the use of incantations as superstitious (in contrast, of course, to their own scientific cures).[ix]  Because of the deep respect for these authorities, on his own part and on the part of his readers, this second objection was perhaps the more problematic for Peter.

Responding to these objections, Peter’s strategy is to compare magic to other, more universally accepted, phenomena which involve similar immaterial interactions and which are also “occult” in the sense that their mechanisms are not immediately obvious to our senses.  These include mundane sympathetic reactions – such as feeling tired when we see someone yawning or having to urinate when we see someone urinating (a favorite example of Peter’s).  They also include less perceptible (yet equally accepted) effects such as the power of the celestial bodies to alter our dispositions, the power of faith to cause a patient’s recovery, and even the power of a priest to cause the transubstantiation of the Eucharist.  All of these invisible forces function in essentially the same manner according to Peter, namely by first being absorbed by the soul and then affecting the body (with the notable exception of the transubstantiation of bread into Christ’s body, since presumably bread has no soul).[x]  

To explain the process through which the physician may use a spell to affect the patient’s soul, Peter judges the power of faith or confidence to provide the most apt comparison among the examples above.  He refers the reader to an earlier discussion in the Conciliator of the creation of ‘confidence in health’ in the soul of the patient and its subsequent psychosomatic effects.[xi]  The usefulness of establishing confidence in the patient through rhetorical strategies is something that was universally accepted by Peter’s authorities and his contemporary readers alike.  Thus, uniting the analysis of spells to this topic had the advantage of addressing the objections of Galen and Hippocrates.  In fact, the consideration of confidence as a psychosomatic cure derived from the opening remarks of the Hippocratic Prognostics, one of the most basic textbooks in the 13th-century medical curriculum, which circulated with a commentary by Galen.[xii]  The topic of the Prognostics is ostensibly the foreknowledge of the future course of illnesses based on the interpretation of natural signs.  However, the Hippocratic author and Galen’s commentary bluntly describe the value of future knowledge not so much in terms of its intrinsic utility, but as a rhetorical tool to convince the patient of the physician’s profound knowledge of the natural world and thereby build his trust.[xiii] 

Peter argues that if one uses the tools of natural philosophy to examine the physical process by which confidence is created in the soul, one finds that incantations function in much the same way.[xiv]  In an incantation, as in the case of rhetoric, the external force of the words alone is rarely sufficient to produce the desired effect of confidence in a patient.  The efficacy of a spell depends on the recipient, the enchanter, and the spell itself.  A skeptical patient will be neither persuaded nor enchanted, regardless of the rhetoric or the spell (with the exception of a particularly powerful enchanter wielding a particularly powerful spell).[xv]  Rather, an incantation can usually only act on someone who is “desirous, as hopeful as possible, and predisposed in every way that the action [of the spell] occur in the prepared matter.”[xvi]  The enchanter himself should be “astute, believable, influential, and of a strong mind.”[xvii]  Normally, the spell will inform the senses or imagination and then affect the body. 

To explain the action of incantations in the soul, Peter draws on the faculty psychology of the Arabic philosopher Avicenna and on the notion of "intentional existence" as it had developed in Paris in the second half of the thirteenth century.[xviii]  According this psychology, the soul is composed of various powers, or faculties, each responsible for certain activities.  These faculties are arranged hierarchically from the vegetative – such as eating or sleeping, to the powers of sensation and perception, to the intellectual powers of memory, will and reason.[xix]  The imaginative faculty, which is particularly important for the action of magic, forms a bridge between sense perception and the intellect.  The lower the level of the soul, the more it interacts with the matter of the body.  According to Peter, confidence in health is ordinarily formed in the soul when the sense faculties receive “intentional species” from several sense experiences, such as the image or words of an especially famous physician, or particular sensations of bodily health, which produce the feeling of confidence.[xx]  These “intentional species” or simply “intentions” are entities that are neither wholly material nor wholly immaterial.  Their existence was posited by philosophers to explain the diffusion of a vast network of forces and information, including the transmission of visual images from an object to an eye in sense perception, or other, more occult forces perceived by other parts of the soul.  These intentions are almost entirely immaterial, yet have enough mass that as they are received, they are able to physically “impress” the senses, however subtly, and transmit their information to an apt recipient.  In the case of confidence, after a patient has received enough “healthy” intentions, whatever their source, the intentions continue to exist in the patient’s soul, where they are transformed as they move through the different parts of the soul until they become a permanent concept of health in the patient’s intellect.[xxi] 

To return to the case of magic, Peter notes that incantations often accomplish this same task in a more immediate manner, transmitting unusually subtle and powerful intentions directly to the imagination of the patient and skipping the lower levels of the soul.[xxii]  In fact, he adds that spells can be more effective if the patient is asleep (but presumably prepared for the ordeal), because the imagination is especially active at this time, while the soul’s other powers are resting.[xxiii]  To a modern reader, the fact that a spell can take effect in sleep might seem like a crucial difference between a spell and a physician’s rhetorical ability.  But according to Peter, this should be understood not as a difference in kind between rhetoric and magic, but as a difference in the degree of their power and in the power of the physician as a minister of nature.  Just as a novice physician may have difficulty creating confidence in his patients while another, more distinguished, physician does it effortlessly, some especially renowned physicians, who possess “elevated souls” and who are able to harness natural (especially celestial) powers, will simply be able to implant the concept of health directly into the patient’s imagination.[xxiv]  From the imagination, the intention of confidence may either travel to the lower levels of the soul (in the manner described below) or form an abstract concept in the intellect.

It remains for Peter to explain how the concept of health existing in the higher levels of the soul is able to cause real change in the body.  As a concept in the intellect, it is still almost wholly abstracted from the material world.  As Peter notes, “the [intentional] species of confidence in health, especially if it is in the intellect and very far from material health, does not bring health on its own.”[xxv]  Rather, once such an abstract concept is formed (or simply implanted by magic) it must use intermediate means to be productive of real health.  The advantage of intentions in the intellect is that they are stable, but they are only capable of interacting with other abstractions, so that the intellect can only contemplate healing the abstract “man”, not a particular man (another favorite example of Peter’s).  However, a concept in the intellect is an active principle, which may then inform the lower levels of the soul and body with its purposes.  In order to return to the level of particularity where all real healing occurs, the abstract intention of confidence reverses its path and instructs the soul’s lower levels.  Once confidence returns to the imagination, Peter compares it to innate heat in the healing process, in that there is a great range of potential in the illnesses it can cure: “Either the illness will be cold and the heat will cure it by contrarity, or the illness will be hot and the heat will destroy it by forcing it to evaporate.”[xxvi]  Whatever type of illness the patient has, the imagination will move other parts of the soul to heat the body in the proper way and induce healing.

Throughout Peter’s analysis of magic, the abstract and conceptual world of the intellect is viewed as working in a close and positive relationship with the body’s material health.  For Peter, the interactions between the multiple levels of the soul and the body are so extensive that the notion of “health” must include balanced mental capacities as well as corporeal health.  This is an important point for Peter’s general conception of health and for his understanding of man’s natural potential (i.e. human potential in this life as opposed to the afterlife).  In Peter’s time there had been intense debate at the university at Paris and elsewhere about what constituted man’s “natural perfection” and how it could be achieved.[xxvii]  The most common opinions among philosophers and theologians are a variation on the idea that the highest activity available to man – namely the activity of the intellect – could be perfected only through the abandonment of the body and its senses to pure metaphysical or theological speculation.  Even much medical opinion held that the powers required for thought are in inevitable opposition to bodily health.[xxviii]  Peter’s symbiotic understanding of body and soul in the intellectual context in which he wrote, can be taken as a criticism of this metaphysical strain of thought of his colleagues.[xxix]

To conclude, Peter's discussion of incantations helps to reveal the ambitions of his medical philosophy.  By taking all levels of the soul into account in his notion of health, Peter has greatly expanded the range of possible medical topics.  Using the quasi-material notion of “intentional existence” to explain the forces at work in magic, Peter supplies occult activity with a “scientific” explanation and brings this subject into the realm of medicine.  For Peter, incantations are one of many tools to be used by physicians to produce health.  His discussion of the communication of the body and soul and its further development throughout Peter’s work helped to establish a holistic understanding of medicine as a genuine competitor to the traditional dominance of more metaphysical philosophies around 1300.