The Union of Substances

In this chapter, on Human Nature 2–5, Nemesius denies that the soul is a body, a harmony, a mixture, or a quality. His cosmopolitan anthropology rests on the conviction that the human soul is an incorporeal and immortal substance. Yet this creates two acute problems for the bishop. First, how is an incorporeal soul united to a body? And second, is it possible for an immortal soul to be united to a non-human body? In settling the first question, Nemesius draws on both Plato and Galen. ‘The body is an instrument of the soul’, he writes. This is a concept which underlies his physiology and psychology. In his handling of the second question, though, Nemesius uses Galen’s medical philosophy to refute Platonic theories of reincarnation. This is a far-reaching decision: it means that Nemesius’ idea of human nature, as such—as an idea—diverges from much of the Platonic tradition in late antiquity.

Philosophy within the contemporary practice of American medicine. Various forms of the relationship between both disciplines: Edmund D. Pellegrin's approach

The paper presented here illustrates the issue of philosophy within the contemporary practice of American medicine. Four forms of relationship between both disciplines will be discussed: philosophy and medicine, philosophy within medicine, medical philosophy, and philosophy of medicine. The aim of the paper is to illustrate the specificity of the proposed forms of relationship, i.e. the contrast between the autonomous approach of the both disciplines and the realistic philosophy of medicine promoted by Edmund D. Pellegrin, which closely links the issue of the nature and theory of medicine with the undertaking of philosophical reflection. The issue of the topicality of Edmund D. Pellegrin's philosophy of medicine in the context of the current challenges of American health care will also be discussed.

Health lag: medical philosophy reflects on COVID-19 pandemic

In this paper, we reflect on the COVID-19 pandemic based on medical philosophy. A critical examination of the Corona crisis uncovers that in order to understand and explain the unpreparedness of the health systems, we need a new conceptual framework. This helps us to look at this phenomenon in a new way, address new problems, and come up with creative solutions. Our proposal is that “health lag” is a concept that could help frame and explain this unpreparedness and unreadiness. The term “health lag” refers to the failure of health systems to keep up with clinical medicine. In other words, health issues in most situations fall behind clinical medicine, leading to social, cultural, and economic problems. In the first step to define health lag, we have to explain the distinction between clinical medicine and health and address the role of individual health, public health, and epidemic in this dichotomy. Thereafter, the reasons behind health lag will be analyzed in three levels: theoretical, practical, and institutional. In the third step, we will point out the most important consequences of health lag: the medicalization of health, the inconsistency of biopolitics, inadequate ethical frameworks, and public sphere vulnerabilities. Finally, we try to come up with a set of recommendations based on this philosophical-conceptual analysis.

Towards Culture-Oriented Medical Philosophy, Education, Research and Practice

Medicine is a sociotechnical system wherein culture manifests itself in all its aspects. Culture, however, is often intangible and is frequently neglected in formal healthcare education, research and practice. This sounding board article attempts to generate interest in making culture a serious component of healthcare systems at different levels, including its founding philosophical underpinnings, educational systems, research activities and clinical practice. It is recommended that a framework of culture-oriented medical philosophy, education, research and practice be implemented. Each component of this framework is briefly discussed in relation to healthcare. Culture should be reflected explicitly in healthcare through research activities, medical humanities, cultural competence, communication and ethics. Keywords: Medicine; Medical Education; Medical Philosophy; Biomedical Research; Communication; Bioethics; Culture; Policy Making.

**51** Chap 5.

From November 1797 to March 1798, scarlatina angiosa occurred in almost every town in the county of Cumberland, Maine. Barker reports on fifty cases treated, with the deaths of two children, one of whom was dissected. He comments on a change of medical philosophy in which “bile . . . [was considered] the mischievous cause” in 1784 but the cause was thought to be “septic acid” in 1797. He reviewed inflammatory fevers in 1799–1800 and measles in 1803–1804 in seaport towns, and scarlatina angiosa inland, with descriptions of patients aged eighteen months to thirty years. Barker referred to a “golden opportunity,” that is, an ideal time to see and treat patients for the best outcomes. He also wrote about hooping (whooping) cough in Maine from 1795–1806 and about quinsy or croup as he had found it earlier in Barnstable county, 1774–1780.

Introduction

The life of Anton Wilhelm Amo is summarized, with close attention to the archival documents that establish key moments in his biography. Next the history of Amo’s reception is considered, from the first summaries of his work in German periodicals during his lifetime, through his legacy in African nationalist thought in the twentieth century. Then the political and intellectual context at Halle is addressed, considering the likely influence on Amo’s work of Halle Pietism, of the local currents of medical philosophy as represented by Friedrich Hoffmann, and of legal thought as represented by Christian Thomasius. The legacy of major early modern philosophers, such as René Descartes and G. W. Leibniz, is also considered, in the aim of understanding how Amo himself might have understood them and how they might have shaped his work. Next a detailed analysis of the conventions of academic dissertations and disputations in early eighteenth-century Germany is provided, in order to better understand how these conventions give shape to Amo’s published works. Finally, ancient and modern debates on action and passion and on sensation are investigated, providing key context for the summary of the principal arguments of Amo’s two treatises, which are summarized in the final section of the introduction.

Emergence and Evidence: A Close Look at Bunge’s Philosophy of Medicine

In his book “Medical Philosophy: Conceptual issues in Medicine”, Mario Bunge provides a unique account of medical philosophy that is deeply rooted in a realist ontology he calls “systemism”. According to systemism, the world consists of systems and their parts, and systems possess emergent properties that their parts lack. Events within systems may form causes and effects that are constantly conjoined via particular mechanisms. Bunge supports the views of the evidence-based medicine movement that randomized controlled trials (RCTs) provide the best evidence to establish the truth of causal hypothesis; in fact, he argues that only RCTs have this ability. Here, we argue that Bunge neglects the important feature of patients being open systems which are in steady interaction with their environment. We show that accepting this feature leads to counter-intuitive consequences for his account of medical hypothesis testing. In particular, we point out that (i) the confirmation of hypotheses is inherently stochastic and affords a probabilistic account of both confirmation and evidence which we provide here; (ii) RCTs are neither necessary nor sufficient to establish the truth of a causal claim; (iii) testing of causal hypotheses requires taking into account background knowledge and the context within which an intervention is applied. We conclude that there is no “best” research methodology in medicine, but that different methodologies should coexist in a complementary fashion.

Fundamentals of the Islamic Medical Philosophy

The purpose of this paper is to advocate for a holistic medical philosophy that is capable of accommodating various models of medical explanations. Such a comprehensive and integrated approach of medical philosophy should be capable of addressing, the ethical, epistemological and metaphysical aspects of medical research and practice. The basic presupposition of the paper is that the Islamic principles on health promotion can play an important role in developing such a holistic medical philosophy. Adopting the analytic method, the paper investigates the three major frameworks of explanation that dominated the history of medical philosophy: (a) the humoral model that is based on balance of the humors; (b) the biocentric model which is based on causal explanation and defines disease in descriptive biological terms; and (c) the postmodern or meta-biocentric model that concerned mainly with the medical philosophy and aims at promoting the holistic approach. This paper, also, investigates the three basic forms of medical explanations which are determined by the above domains, i.e. the descriptive, the normative, and the integrated models. The paper traces the impact of explanation methods on good medical practices and explores the Islamic medical philosophy and its potential role in promoting the holistic approach. Along the way, the paper discusses the ideal relationship between physician and patient according to the Islamic perspective.

Out of Slavery

This chapter reaches back into slavery to underpin our understanding of African American childbirth culture and the specific cultural motifs that have persisted for generations. It describes a relational concept of health brought from Africa that clashed with the Western medical philosophy and the complexity of practice that emerged as a result. Enslaved midwives were granted authority to practice based on their spirituality and ancestry, both features of the relational vision of wellness, and became revered figures in the slave community and often in the white community too. Beyond establishing the centrality of the lay midwife’s role, this chapter shows how slave women resisted their owners’ attempts to usurp their bodies and how they adopted their own methods of controlling their fertility. This chapter sets the historical and cultural backdrop for the book.